Browsing by Author "Koirala, Nishnata"
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Publication Analysis of Outcomes of Surgery for Chronic Pancreatitis according to International Study Group for Pancreatic Surgery Reporting System(Institute of Medicine, 2025) Bista, Nimesh; Lakhey, Paleswan Joshi; Kandel, Bishnu Prasad; Pradhan, Sumita; Maharjan, Narendra; Sharma, Deepak; Koirala, Nishnata; Bhandari, Ramesh SinghABSTRACT Introduction: Due to lack of standard reporting system for chronic pancreatitis that could include all the aspect of the disease process. International Study Group for Pancreatic Surgery (ISGPS) formulated a framework for reporting the surgery for chronic pancreatitis. This framework incorporates our recent understanding, management and outcomes of chronic pancreatitis. We aimed to report surgery performed at our department for chronic pancreatitis with this standard reporting system. Methods: From January 2021 to December 2024, 32 patient who underwent surgery for chronic pancreatitis were enrolled in the study. Patients details of clinical baseline prior to surgery, morphology of diseased pancreas, type of surgery and post operative outcomes were evaluated and reported according to four domains of ISGPS. Results: A total of 32 patients underwent surgery. Alcohol was the etiology in six (18.75 %) and rest were identified as idiopathic. Diabetes was prevalent in 13 (40.6%) of patient with exocrine insufficiency in only one patient. All patient had parenchymal calcification. Ductal stone was present in 29 (90.6%) with stricture in 16 (50.0%) patients. Longitudinal pancreatojejunostomy with partial pancreatic head resection was the most common surgery performed in 27 (84.3%) patients. Postoperatively two patients had major complications. There was no 90 days re-operation and mortality. Conclusion:This reporting system is feasible to report surgery for chronic pancreatitis. However, large scale prospective study validation is required. Keywords: Chronic pancreatitis; ISGPS; reporting; surgeryPublication Short Term Outcomes after Elective Gastrointestinal Surgery in Octogenarians: A Retrospective Matched Cohort Study(Institute of Medicine, Tribhuvan University, 2025) Kandel, Bishnu Prasad; Koirala, Nishnata; Sharma, Deepak; Maharjan, Narendra; Maskey, Sumita Pradhan; Bhandari, Ramesh Singh; Lakhey, Paleswan JoshiAbstract: Introduction The incidence of gastrointestinal surgical conditions like malignancy increases with age. There is growing requirement of gastrointestinal surgery in elderly patients due to the aging of general population. Gastrointestinal surgery in octogenarian patients posses an unique challenges due to decreased functional status of organs and higher incidence of co-morbidities. Methods In this retrospective study we compared the co-morbidities and perioperative outcomes of octogenarian patients with case matched younger patients. There were 2115 patients who underwent gastrointestinal surgery from October 2021 to September 2024 out of which thirty four were octogenarian patients. Sixty eight younger patients who underwent similar surgical procedures were selected for comparison. Patients’ data were obtained from the medical records and the outcomes of surgery in two groups were compared. Results Octogenarian patients had more co-morbidities compared with younger patients. Occurrence of major postoperative complications (23.5% vs 8.8%; p value 0.04) and cardiac complications (20.6% vs 4.4%; p value 0.01) were higher in octogenarians. Postoperative hospital stay, intensive care unit stay, occurrence of overall complication and mean comprehensive complication index was similar in two groups. Conclusion Octogenarian had higher occurence of major complications after gastrointestinal surgery. Proper perioperative care is required for surgical management of octogenarian patients.