Browsing by Author "Sherpa, Tshering Wangdi"
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Publication Clinical Profile and Endoscopic Management in Patients with Choledocholithiasis(Nepal Health Research Council, 2024) Lamsal, Manoj; Jha, Anurag; Kafle, Brindeswari; Hamal, Rabin; Sherpa, Tshering Wangdi; Kafle, Pradip Kumar; Bhattarai, Tulsi Ram; Bhusal, Mohan; Koirala, Dinesh; Pathak, RahulBackground: Common bile duct stones is a common medical problem that are usually seen in association with gallstone disease. Endoscopic management of Common bile duct stones involves doing Endoscopic retrograde cholangiography for bile duct clearance which is the primary therapeutic modality of choice. This prospective study was done to identify the clinical characteristics and outcome of patients presenting with Common bile duct stones undergoing Endoscopic retrograde cholangiography. Methods: A prospective observational study was conducted on all patients undergoing Endoscopic retrograde cholangiography in department of Gastroenterology, Tribhuvan University Teaching Hospital, for management of diagnosed or suspected choledocholithiasis from April 2023 to March 2024. Patient demographics, clinical characteristics, Endoscopic retrograde cholangiography findings and post procedure outcome data were collected and analysed. Results: A total of 110 patients (61.8% male and 38.2% female) were included in the final analysis. Successful clearance of Common bile duct was obtained in 76.4% patients with overall adverse events of 18% related to the procedure. Among patients undergoing the procedure, 16.4% couldn’t be managed with Endoscopic retrograde cholangiography and were referred for surgical management. Conclusions: Endoscopic management in form of Endoscopic retrograde cholangiography is a safe and effective method to manage patients with Common bile duct stones. Keywords: Common bile duct calculi; endoscopic sphincterotomy; ERCP.Publication Upper Gastrointestinal Bleeding among Patients Admitted in Department of Emergency in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Karki, Binod; Sherpa, Tshering Wangdi; Aryal, Egesh; Adhikari, Alisha; Regmi, Binit Upadhaya; Katwal, Srijana; Mandal, Sujit Kumar; Deo, Rajeeb Kumar; Dawadi, PravakarAbstract Introduction: Upper gastrointestinal bleeding is a common medical emergency with significant morbidity and mortality. Its causes can be classified under variceal bleeding or non-variceal bleeding. Peptic ulcer and variceal bleeding are common causes. Thus, this study aims to find the prevalence of upper gastrointestinal bleeding among patients attending the Department of Emergency in a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted on patients admitted to the Department of Emergency a tertiary care centre from September 2020 to August 2021 among 3375 patients. The ethical approval was obtained from the Institutional Review Committee of the hospital (Reference number: 328). Patients presenting with the clinical features of upper gastrointestinal bleeding in the form of hematemesis or melena were enrolled after written informed consent. Data entry was done in Statistical Packages for the Social Sciences version 20.0. for descriptive analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 3375 admissions in the Department of Emergency, 85 (2.52%) (1.99-3.05 at 95% Confidence Interval) patients presented with upper gastrointestinal bleeding. Conclusions: The prevalence of upper gastrointestinal bleeding is lower in comparison to other studies done in similar settings.