Day 2 :
Burjeel Hospital, UAE
Keynote: Vomiting of surgical significance
Time : 09:00-09:40
M Amin El-Gohary has completed his MBBCh in 1972 and his Diploma in General Surgery in 1975 at Cairo University, Egypt. He became the Chief and Head of the Department of Pediatric Surgery of a large government hospital. He also held post as the Clinical Dean of Gulf Medical College, Ajman for 3 years. He is well known
in Abu Dhabi for his extensive interest and involvement in scientific activities. He was the President of the Pediatric Surgical Association of UAE. He is a Member of several associations in Pediatric surgery: Executive Member of the International Society of Intersex and Hypospadias Disorder (ISHID), British Association of Pediatric Surgery, Egyptian Association of Pediatric Surgeons, Asian Association of Pediatric Surgeons, and Pan African Association of Pediatric Surgery. He is also the founder and member of the Arab Association of Pediatric Surgeons.
Vomiting is common symptoms among neonates, infants and children and the majority are managed by pediatrician or pediatric gastroenterologist. However there are types of vomiting that should be referred and managed by pediatric surgeons.
These include the following:
1. Bilious vomiting however small or intermittent
2. Projectile vomiting
3. Frothy neonates
The cardinal signs and symptoms of bowel obstruction are: vomiting, abdominal distension , abdominal pain and constipation. Of which bilious vomiting is considered the most important sign. Any Baby who vomits bile should be considered as having an underling intestinal obstruction until proved otherwise Mal-rotation in particular carries a high mortality rate if associated with volvulus , despite its minimal symptoms in the form of intermittent bilious vomiting. The presentation highlights the different pathological condition associated with vomiting, and their clinical, radiological and surgical management.
Xinhua Hospital, China
Time : 09:40-10:20
Yingbin Liu has his expertise in improving the prognosis of hepato-biliary-pancreatic diseases. He is Vice President of Xinhua Hospital, Dean of Institute of Biliary Tract Disease Research, and Chief of General Surgery Department, Xinhua Hospital, Shanghai Jiaotong University.
Objective: To evaluate the feasibility and safety of total mesopancreas excision (TMpE) in the treatment of pancreatic head cancer.
Methods: The clinical and pathological data of 120 patients with pancreatic head cancer who had undergone TMpE in our center from May 2010 to January 2014 were retrospectively analyzed.
Results: The mean operative time was 275.0±50.2 min and the average intra-operative blood loss was 390.0±160.5 mL. Postoperative complications were reported in 45 patients, while no peri-operative death was noted. The specimen margins were measured in three dimensions, and 86 patients (71.6%) achieved R0 resection.
Conclusions: TMpE is safe and feasible for pancreatic head cancer and is particularly helpful to increase the R0 resection rate.
Southwest Hospital, Third Military Medical University, China
Time : 10:20-11:00
Yuming Wang has obtained his MD degree and is a Professor and Chief Physician at Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing. Currently, he serves as the Vice-President in Infectious Diseases Branch of Chinese Medical Doctor Association. His current research fields include severe hepatitis/liver failure, pathogenesis and treatment of viral hepatitis. He is the Chief Editor of 16 monographs, Associated Editor for 31 monographs and has published more than 400 papers, including Gastroenterology, Hepatology and CGH.
Chronic kidney disease (CKD) is defined as eGFR<60 mL/min-1.73m2 or a urinary albumin to creatinine ratio (ACR) >30mg/g is a global public health burden because of its increasing incidence and prevalence and progressive nature to end-stage renal disease (ESRD). The prevalence of adult CKD is over 10% and there are about 120 million adult CKD patients in China. Apart from major liver complications, clinical evidence suggests that chronic HBV infection exerts a negative impact on renal function, and can lead to glomerulonephritis, even in the absence of cirrhosis. In addition, nearly 15–30% of patients with chronic hepatitis B (CHB) have baseline renal dysfunction or comorbidities associated with CKD. Prevalence of CKD is likely to rise in patients with CHB because of increasing age, more advanced disease, comorbidities and nephrotoxic therapies. A CHB infection can cause renal dysfunction through immune complex mediated glomerular diseases, such as membranous nephropath and mesangiocapillary glomerulonephritis. In countries with endemic HBV infection, HBV-related glomerulopathies are an important cause of end-stage renal disease and renal replacement therapy. Currently, more and more attention is being paid to the safety issues for NUCs. Mitochondrial toxicity cannot explain the different adverse reactions, including nephrotoxicity, hyperlacticaemia, lactic acidosis, myopathy, peripheral neuritis, hepatic steatosis, etc. The currently approved oral antiviral agents are all primarily eliminated unchanged through the renal route. So, the core clinical issue is nephrotoxicity; other issues are either rare, related to a few special populations, or are easy to prevent. Consequently, current product labels recommend that in patients with renal insufficiency, dose reduction and/or increased dose intervals are recommended. Worsening of renal function during prolonged nucleotide therapy has primarily been reported with adefovir (ADV), but also with tenofovir (TDF). However, all current evidences indicate that among the NUCs, only telbivudine (LdT) therapy is associated with consistent increase in renal function (eGFR) across different CHB patient populations with decompensated and compensated disease. GLOBE study, a large scale clinical trial, has revealed that LdT significantly improved eGFR in CHB patients with compensated liver disease versus LAM/ETV. At the same time, most studies also revealed LdT can improve eGFR in patients with CHB versus ADV/TDF. But the mechanism of the beneficial effect of LdT therapy on renal function remains to be determined. These results may be important for clinicians to best assess the choice of antiviral therapy in those patients most vulnerable for renal dysfunction, including the elderly and those with baseline renal insufficiency, severe liver fibrosis, or decompensated liver disease. In summary, the number of patients with CHB with renal dysfunction is increasing. The key clinical safety issue for NUCs is nephrotoxicity. According to current evidence, patients with CHB receiving long-term NUC antiviral therapy should have renal function monitored. Renal function in patients with CHB improves steadily during long-term LdT monotherapy, while LdT+ADV/TDF combination therapy could improve eGFR as well. In addition, early prevention or protection of renal involvement is emphasized in clinical practice.