Giedrius Barauskas - Academia.edu (original) (raw)

Papers by Giedrius Barauskas

Research paper thumbnail of sj-pdf-1-ueg-10.1177_2050640620901973 - Supplemental material for Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis: A multicentre study of 1117 cases

Supplemental material, sj-pdf-1-ueg-10.1177_2050640620901973 for Multiple risk factors for diabet... more Supplemental material, sj-pdf-1-ueg-10.1177_2050640620901973 for Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis: A multicentre study of 1117 cases by Søren S Olesen, Jakob L Poulsen, Srdan Novovic, Camilla Nøjgaard, Evangelos Kalaitzakis, Nanna M Jensen, Trond Engjom, Erling Tjora, Anne Waage, Truls Hauge, Stephan L Haas, Miroslav Vujasinovic, Giedrius Barauskas, Aldis Pukitis, Imanta Ozola-Zālīte, Alexey Okhlobystin, Mikael Parhiala, Johanna Laukkarinen and Asbjørn M Drewes in United European Gastroenterology Journal

Research paper thumbnail of Application of one-stage surgical tactics treatment of acute cholecystitis in combination with choledocholithiasis

International journal of health sciences

Introduction: Concrements of the common bile duct (choledocholithiasis) occur from 8% to 20% in p... more Introduction: Concrements of the common bile duct (choledocholithiasis) occur from 8% to 20% in patients with acute cholecystitis. This pathology requires simultaneous correction of the pathology of the gallbladder and the common bile duct. Methods: We retrospectively analyzed the case histories of 135 patients who underwent endoscopic retrograde cholangio pancreatography, endoscopic papillosphincterotomy, choledocholithoextraction followed by laparoscopic cholecystectomy + CHEST + LCE) for acute cholecystitis in combination with choledocholithiasis in the period from January 2016 to March 2021. Patients who underwent simultaneous treatment (ERCP + EPST + CLE + LCE under one anesthesia) were assigned to the OS group (n = 63), patients who underwent two-stage treatment (ERCP + EPST + CLE and LCE on the 3-4th day during one hospitalization) were assigned to the TS group (n = 72). All endoscopic procedures in both groups were performed by the same endoscopist using the same technique. ...

Research paper thumbnail of DNA Methylation of HOXA11 Gene as Prognostic Molecular Marker in Human Gastric Adenocarcinoma

Diagnostics

Hypermethylation of tumor suppressor genes and hypomethylation of oncogenes might be identified a... more Hypermethylation of tumor suppressor genes and hypomethylation of oncogenes might be identified as possible biomarkers in gastric cancer (GC). We aimed to assess the DNA methylation status of selected genes in GC tissue samples and evaluate these genes’ prognostic importance on patient survival. Patients (99) diagnosed with GC and who underwent gastrectomy were included. We selected a group of genes (RAD51B, GFRA3, AKR7A3, HOXA11, TUSC3, FLI1, SEZ6L, GLDC, NDRG) which may be considered as potential tumor suppressor genes and oncogenes. Methylation of the HOXA11 gene promoter was significantly more frequent in GC tumor tissue (p = 0.006) than in healthy gastric mucosa. The probability of surviving longer (71.2 months (95% CI 57–85.3) vs. 44.3 months (95% CI 34.8–53.9)) was observed with unmethylated HOXA11 promoter in cancer tissues. Survival in patients with a methylation of HOXA11 promoter either in healthy gastric mucosa or gastric cancer tissue was twice as high as in patients wi...

Research paper thumbnail of Natrio chlorido tirpalo infiltracijos į negyvą kepenų audinį matematiniai ir eksperimentiniai tyrinėjimai

The aim of this study was to establish a mathematical model of the infiltration of sodium chlorid... more The aim of this study was to establish a mathematical model of the infiltration of sodium chloride solution into cadaveric liver tissue. METHODS: The time law of the flow of the infiltrated fluid at every node of the finite element model was obtained in terms of Darcy's velocity, pressure, and volumetric saturation fraction. The model equations interpret the liver tissue as a porous medium taking into account the hydraulic conductivity, capacity, and absorption mechanisms. Capability of the cadaveric liver tissue to absorb the fluid is taken into account by means of the nonlinear relationship of hydraulic capacity and absorption coefficients against the volumetric saturation fraction. To explain certain inadequacies between the computational model and experiment, the idealized models of empty blood vessels in the vicinity of the injection probe have been used. The model has been implemented in computational environment COMSOL Multiphysics. Experimental procedures were performed ...

Research paper thumbnail of Ankstyvosios enterinės ir natūralios mitybos po pankreatoduodeninės rezekcijos efektyvumo palyginimas

The role of postoperative supplementary enteral nutrition after gastrointestinal surgery is contr... more The role of postoperative supplementary enteral nutrition after gastrointestinal surgery is controversial. Therefore, a randomized clinical trial with attempts to address the question of plenitude of routine application of postoperative enteral feeding on rate of postoperative complications following pancreatoduodenectomy was performed. Sixty patients undergoing pancreatoduodenectomy were blindly randomized into two groups: 30 patients in the first group received early enteral nutrition (EEN), while 30 patients in the second group were given early natural nutrition (ENN). The complications were evaluated according to definition criteria. All complications were further subdivided into infectious and noninfectious complications. Our data showed that patients in EEN group gained a larger amount of energy in kcal a day during the first five days after surgery in comparison to ENN group. There was a higher rate of postoperative complications in ENN group (53.3% vs 23.3%, P=0.03). This di...

Research paper thumbnail of Pirminio kepenų vėžio gydymo Kauno medicinos universiteto klinikose rezultatai

Though the results of treatment of primary liver cancer depend on many circumstances, the opportu... more Though the results of treatment of primary liver cancer depend on many circumstances, the opportunity to perform a curative liver resection remains the main point in prognosis on survival. The aim of the study was to examine our first experience in the treatment of liver cancer. From 1996 to 2001 we observed 54 patients with liver cancer: 46 hepatocellular and 6 cholangiocellular carcinomas, 1 malignant carcinoid, and 1 carcinosarcoma. In presence of liver cirrhosis (21 patients, 38.8%) hepatic function was evaluated using Child Pugh classification. Lesions were multiple in 28 cases and single in 26 cases. Ten patients (18.5%) were radically resected, 12 patients (22.2%) were managed by laparotomy and biopsy, 2 by percutaneous ethanol injections, 1 by trans-ileocolic portal vein embolization + hepatic artery embolization. There were 7 deaths (28%) and 18 complications (72%) after the surgical treatment. The survival results of patients who underwent resection were better (median 240...

Research paper thumbnail of Kasos morfologinių bei fiziologinių savybių įtaka kasos–plonžarnės jungties komplikacijoms po pankreatoduodeninių rezekcijų

Medicina-buenos Aires, 2003

Research paper thumbnail of Early identification of patients with severe acute pancreatitis

Research paper thumbnail of The significance of blood tests in differentiating the etiology of acute pancreatitis

Research paper thumbnail of Heatmap showing p values and significant Spearman correlation coefficient (ρ) between methylation levels of different CpGs in paired peripheral blood and ductal adenocarcinoma tissues (p values of >0.05 are in white, the shown ρ-values are corresponding to p values <0.05)

PLOS ONE, 2012

<p>Heatmap showing p values and significant Spearman correlation coefficient (ρ) between me... more <p>Heatmap showing p values and significant Spearman correlation coefficient (ρ) between methylation levels of different CpGs in paired peripheral blood and ductal adenocarcinoma tissues (p values of >0.05 are in white, the shown ρ-values are corresponding to p values <0.05).</p

Research paper thumbnail of Epigenetic Regulation of APAF-1 Through DNA Methylation in Pancreatic Cancer

Anticancer Research, 2020

Research paper thumbnail of Choices of Therapeutic Strategies for Colorectal Liver Metastases Among Expert Liver Surgeons

Research paper thumbnail of Long-term Survival of Patient with Ampulla of Vater Metastasis of Renal Cell Carcinoma

Prague Medical Report, 2018

Ampulla of Vater metastases from renal cell carcinoma are rare. The time between detection of the... more Ampulla of Vater metastases from renal cell carcinoma are rare. The time between detection of the primary tumour and its metastasis may extend to years. Management should be aggressive, since the prognosis of renal cell carcinoma is unpredictable and curative surgery of metastases may extend patient survival and even lead to definite cure. Herein we report a case of long-term survival after successful surgical treatment of a renal cell carcinoma metastasis to the ampulla of Vater. A 62-year-old man with a history of renal cell carcinoma in the left kidney underwent a successful left nephrectomy. Eight months later duodenoscopy showed a tumour at the site of papilla of Vater. Biopsy confirmed the diagnosis of carcinoma. Contrast enhanced computer tomography scan verified the periampullary mass, dilatation of the pancreatic and the common bile duct. No radiological signs of either local advancement or distant metastases were present. Pylorus-preserving pancreatoduodenectomy with lymph...

Research paper thumbnail of Meta-analysis of prophylactic parenteral antibiotic use in acute necrotizing pancreatitis

Medicina, 2007

Background. Acute pancreatitis is a potentially serious condition. It carries an overall mortalit... more Background. Acute pancreatitis is a potentially serious condition. It carries an overall mortality rate of 10–15%. Infectious complications account for approximately 80% of deaths from acute pancreatitis, and the question arises whether or not prophylactic antibiotics are useful in the prevention of these complications. Therefore, we performed an evidence-based analysis to assess the effect of available prophylactic antimicrobial treatment on the development of infected necrosis and sepsis, need for surgery, and mortality. Methods. A comprehensive PubMed search was performed evaluating the value of prophylactic administration of parenteral antibiotics in patients with acute necrotizing pancreatitis. Only articles published in English language between January 1990 and May 2006 were included. The search strategy initially generated 692 articles related to antibiotics in the treatment of acute pancreatitis. This number was reduced to 97 publications related to clinical trials on the sa...

Research paper thumbnail of Interventional and surgical management of abdominal compartment syndrome in severe acute pancreatitis

Medicina, 2010

Background and objective. Management of the abdominal compartment syndrome during severe acute pa... more Background and objective. Management of the abdominal compartment syndrome during severe acute pancreatitis by the open abdomen method is associated with considerable morbidity and resource utilization. Thus, the aim of this study was to evaluate the safety and efficacy of the ultrasound-guided percutaneous interventions and/or minimally invasive surgery in the treatment of abdominal compartment syndrome. Material and methods. Forty-four patients with severe acute pancreatitis were enrolled into a prospective study and treated according to the standard management protocol. Interventional and/ or surgical management of abdominal compartment syndrome was employed in 6 (13.6%) cases. In the context of this study, we assessed the feasibility and effectiveness of subcutaneous fasciotomy of the anterior m. rectus abdominis sheath, as well as the role of ultrasound-guided drainage of intra-abdominal and peripancreatic fluid collections in the management of abdominal compartment syndrome. R...

Research paper thumbnail of Radiofrequency ablation of liver tumors (II): clinical application and outcomes

Medicina, 2010

Radiofrequency ablation is one of the alternatives in the management of liver tumors, especially ... more Radiofrequency ablation is one of the alternatives in the management of liver tumors, especially in patients who are not candidates for surgery. The aim of this article is to review applicability of radiofrequency ablation achieving complete tumor destruction, utility of imaging techniques for patients’ follow-up, indications for local ablative procedures, procedureassociated morbidity and mortality, and long-term results in patients with different tumors. The success of local thermal ablation consists in creating adequate volumes of tissue destruction with adequate “clear margin,” depending on improved delivery of radiofrequency energy and modulated tissue biophysiology. Different volumes of coagulation necrosis are achieved applying different types of electrodes, pulsing energy sources, utilizing sophisticated ablation schemes. Some additional methods are used to increase the overall deposition of energy through alterations in tissue electrical conductivity, to improve heat retent...

Research paper thumbnail of Comparative diagnostic value of contrast-enhanced ultrasonography, computed tomography, and magnetic resonance imaging in diagnosis of hepatic hemangiomas

Medicina, 2010

Aim. To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous cont... more Aim. To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis of hepatic hemangiomas. Material and methods. The study enrolled 48 patients, aged between 20 and 79 years (35 [72.9%] women, 13 [27.1%] men; mean age, 53.5±12.855 years), who were examined and treated in the Departments of Gastroenterology, Surgery, and Oncology, Hospital of Kaunas University of Medicine, in the year 2007. All patients underwent intravenous contrast-enhanced US, intravenous contrast-enhanced CT, and MRI and were diagnosed with hepatic hemangioma according to the findings of these examinations. Results. The size of hemangiomas was ≤2.0 cm in 20 cases (41.7%) and >2.0 cm in 28 (58.3%). No association between hepatic hemangioma and patient’s age was found (χ2=0.547, df=2, P=0.761). Nearly one-third of hemangiomas were located in the segment IV of the left hepatic lobe. There we...

Research paper thumbnail of Percutaneous transhepatic biliary stenting: The first experience and results of the Hospital of Kaunas University of Medicine

Medicina, 2008

Malignant biliary obstruction may be caused by cholangiocarcinoma and other nonbiliary carcinomas... more Malignant biliary obstruction may be caused by cholangiocarcinoma and other nonbiliary carcinomas. At the time of diagnosis, 90% of patients with malignant obstructive jaundice may benefit from palliative treatment only. The objective of palliation is to relieve jaundice-related symptoms, prevent cholangitis, prolong survival, and improve quality of life. Percutaneous transhepatic biliary stenting is a well-established procedure used in patients with malignant obstruction of intra- and extrahepatic bile ducts. Twelve patients (9 women, 3 men; mean age, 68 years; range, 44–88 years) with inoperable malignant biliary obstruction were selected for percutaneous transhepatic biliary stenting with metallic stents in the period from January to December 2007. Technical and clinical success rate in this patient series was 83% and 80%, respectively. Minor and major complications occurred in 17% and 8% of cases, respectively, which is in the range reported by the others. This is our first expe...

Research paper thumbnail of Effects of Cyanidin-3-O-glucoside on Synthetic and Metabolic Activity of Ethanol Stimulated Human Pancreatic Stellate Cells

Phytotherapy Research, 2015

Activated pancreatic stellate cells (PSC) play a major role in the development of chronic pancrea... more Activated pancreatic stellate cells (PSC) play a major role in the development of chronic pancreatitis. Flavonoids (C-3-O-G) theoretically may have potential to suppress activated PSC. The aim of our study was to determine the ability of C-3-O-G to invert synthetic and metabolic activity of alcohol stimulated human pancreatic stellate cells (hPSC). In the present study we demonstrate that treatment with C-3-O-G decreased proliferation rate of ethanol activated hPSC by 51%. Synthesis of extracellular matrix proteins in activated hPSC was markedly inhibited, as shown by reduced levels of collagen I and fibronectin expression. The decrease of secretion of fibronectin by 33% and in collagen I-25% in ethanol activated and C-3-O-G treated hPSC was observed. Moreover, treatment of ethanol activated hPSC with C-3-O-G resulted in the decrease of oxygen consumption rate by 44% and reduced levels of ATP synthesis (i.e. energy production) by 41%. Hence, the effects of C-3-O-G on ethanol activated hPSC may provide new insights for the use of anthocyanins as anti-fibrogenic agents in treatment and/or prevention of pancreatic fibrosis. Copyright © 2015 John Wiley &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Sons, Ltd.

Research paper thumbnail of Apoptosis is activated in an early period after radiofrequency ablation of liver tissue

Hepato-gastroenterology

Hyperthermia induced apoptosis may lead to tumor cell death thus expanding the volume of non-viab... more Hyperthermia induced apoptosis may lead to tumor cell death thus expanding the volume of non-viable tissue and warrant a "safety margin" of at least 10mm to exclude the possibility of tumor recurrence. We carried out an experimental study to investigate the cellular injury produced by radiofrequency ablation in the area surrounding the ablated tissue and to describe early apoptotic processes in the transition zone following radiofrequency ablation procedure in a porcine liver model. Nine anesthetized pigs underwent laparotomy and local thermal ablation of the liver parenchyma. The ablated tissue and the surrounding parenchyma were investigated for apoptosis applying Western blot analysis and immunohistochemistry. The active (cleaved) caspase-3 17-kDa subunit was detected in the transition zone one hour after ablative procedure at a distance of 9-10 mm from the rim of the necrosis zone. In contrast analysis of tissues in necrosis zone and in surrounding normal liver parench...

Research paper thumbnail of sj-pdf-1-ueg-10.1177_2050640620901973 - Supplemental material for Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis: A multicentre study of 1117 cases

Supplemental material, sj-pdf-1-ueg-10.1177_2050640620901973 for Multiple risk factors for diabet... more Supplemental material, sj-pdf-1-ueg-10.1177_2050640620901973 for Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis: A multicentre study of 1117 cases by Søren S Olesen, Jakob L Poulsen, Srdan Novovic, Camilla Nøjgaard, Evangelos Kalaitzakis, Nanna M Jensen, Trond Engjom, Erling Tjora, Anne Waage, Truls Hauge, Stephan L Haas, Miroslav Vujasinovic, Giedrius Barauskas, Aldis Pukitis, Imanta Ozola-Zālīte, Alexey Okhlobystin, Mikael Parhiala, Johanna Laukkarinen and Asbjørn M Drewes in United European Gastroenterology Journal

Research paper thumbnail of Application of one-stage surgical tactics treatment of acute cholecystitis in combination with choledocholithiasis

International journal of health sciences

Introduction: Concrements of the common bile duct (choledocholithiasis) occur from 8% to 20% in p... more Introduction: Concrements of the common bile duct (choledocholithiasis) occur from 8% to 20% in patients with acute cholecystitis. This pathology requires simultaneous correction of the pathology of the gallbladder and the common bile duct. Methods: We retrospectively analyzed the case histories of 135 patients who underwent endoscopic retrograde cholangio pancreatography, endoscopic papillosphincterotomy, choledocholithoextraction followed by laparoscopic cholecystectomy + CHEST + LCE) for acute cholecystitis in combination with choledocholithiasis in the period from January 2016 to March 2021. Patients who underwent simultaneous treatment (ERCP + EPST + CLE + LCE under one anesthesia) were assigned to the OS group (n = 63), patients who underwent two-stage treatment (ERCP + EPST + CLE and LCE on the 3-4th day during one hospitalization) were assigned to the TS group (n = 72). All endoscopic procedures in both groups were performed by the same endoscopist using the same technique. ...

Research paper thumbnail of DNA Methylation of HOXA11 Gene as Prognostic Molecular Marker in Human Gastric Adenocarcinoma

Diagnostics

Hypermethylation of tumor suppressor genes and hypomethylation of oncogenes might be identified a... more Hypermethylation of tumor suppressor genes and hypomethylation of oncogenes might be identified as possible biomarkers in gastric cancer (GC). We aimed to assess the DNA methylation status of selected genes in GC tissue samples and evaluate these genes’ prognostic importance on patient survival. Patients (99) diagnosed with GC and who underwent gastrectomy were included. We selected a group of genes (RAD51B, GFRA3, AKR7A3, HOXA11, TUSC3, FLI1, SEZ6L, GLDC, NDRG) which may be considered as potential tumor suppressor genes and oncogenes. Methylation of the HOXA11 gene promoter was significantly more frequent in GC tumor tissue (p = 0.006) than in healthy gastric mucosa. The probability of surviving longer (71.2 months (95% CI 57–85.3) vs. 44.3 months (95% CI 34.8–53.9)) was observed with unmethylated HOXA11 promoter in cancer tissues. Survival in patients with a methylation of HOXA11 promoter either in healthy gastric mucosa or gastric cancer tissue was twice as high as in patients wi...

Research paper thumbnail of Natrio chlorido tirpalo infiltracijos į negyvą kepenų audinį matematiniai ir eksperimentiniai tyrinėjimai

The aim of this study was to establish a mathematical model of the infiltration of sodium chlorid... more The aim of this study was to establish a mathematical model of the infiltration of sodium chloride solution into cadaveric liver tissue. METHODS: The time law of the flow of the infiltrated fluid at every node of the finite element model was obtained in terms of Darcy's velocity, pressure, and volumetric saturation fraction. The model equations interpret the liver tissue as a porous medium taking into account the hydraulic conductivity, capacity, and absorption mechanisms. Capability of the cadaveric liver tissue to absorb the fluid is taken into account by means of the nonlinear relationship of hydraulic capacity and absorption coefficients against the volumetric saturation fraction. To explain certain inadequacies between the computational model and experiment, the idealized models of empty blood vessels in the vicinity of the injection probe have been used. The model has been implemented in computational environment COMSOL Multiphysics. Experimental procedures were performed ...

Research paper thumbnail of Ankstyvosios enterinės ir natūralios mitybos po pankreatoduodeninės rezekcijos efektyvumo palyginimas

The role of postoperative supplementary enteral nutrition after gastrointestinal surgery is contr... more The role of postoperative supplementary enteral nutrition after gastrointestinal surgery is controversial. Therefore, a randomized clinical trial with attempts to address the question of plenitude of routine application of postoperative enteral feeding on rate of postoperative complications following pancreatoduodenectomy was performed. Sixty patients undergoing pancreatoduodenectomy were blindly randomized into two groups: 30 patients in the first group received early enteral nutrition (EEN), while 30 patients in the second group were given early natural nutrition (ENN). The complications were evaluated according to definition criteria. All complications were further subdivided into infectious and noninfectious complications. Our data showed that patients in EEN group gained a larger amount of energy in kcal a day during the first five days after surgery in comparison to ENN group. There was a higher rate of postoperative complications in ENN group (53.3% vs 23.3%, P=0.03). This di...

Research paper thumbnail of Pirminio kepenų vėžio gydymo Kauno medicinos universiteto klinikose rezultatai

Though the results of treatment of primary liver cancer depend on many circumstances, the opportu... more Though the results of treatment of primary liver cancer depend on many circumstances, the opportunity to perform a curative liver resection remains the main point in prognosis on survival. The aim of the study was to examine our first experience in the treatment of liver cancer. From 1996 to 2001 we observed 54 patients with liver cancer: 46 hepatocellular and 6 cholangiocellular carcinomas, 1 malignant carcinoid, and 1 carcinosarcoma. In presence of liver cirrhosis (21 patients, 38.8%) hepatic function was evaluated using Child Pugh classification. Lesions were multiple in 28 cases and single in 26 cases. Ten patients (18.5%) were radically resected, 12 patients (22.2%) were managed by laparotomy and biopsy, 2 by percutaneous ethanol injections, 1 by trans-ileocolic portal vein embolization + hepatic artery embolization. There were 7 deaths (28%) and 18 complications (72%) after the surgical treatment. The survival results of patients who underwent resection were better (median 240...

Research paper thumbnail of Kasos morfologinių bei fiziologinių savybių įtaka kasos–plonžarnės jungties komplikacijoms po pankreatoduodeninių rezekcijų

Medicina-buenos Aires, 2003

Research paper thumbnail of Early identification of patients with severe acute pancreatitis

Research paper thumbnail of The significance of blood tests in differentiating the etiology of acute pancreatitis

Research paper thumbnail of Heatmap showing p values and significant Spearman correlation coefficient (ρ) between methylation levels of different CpGs in paired peripheral blood and ductal adenocarcinoma tissues (p values of >0.05 are in white, the shown ρ-values are corresponding to p values <0.05)

PLOS ONE, 2012

<p>Heatmap showing p values and significant Spearman correlation coefficient (ρ) between me... more <p>Heatmap showing p values and significant Spearman correlation coefficient (ρ) between methylation levels of different CpGs in paired peripheral blood and ductal adenocarcinoma tissues (p values of >0.05 are in white, the shown ρ-values are corresponding to p values <0.05).</p

Research paper thumbnail of Epigenetic Regulation of APAF-1 Through DNA Methylation in Pancreatic Cancer

Anticancer Research, 2020

Research paper thumbnail of Choices of Therapeutic Strategies for Colorectal Liver Metastases Among Expert Liver Surgeons

Research paper thumbnail of Long-term Survival of Patient with Ampulla of Vater Metastasis of Renal Cell Carcinoma

Prague Medical Report, 2018

Ampulla of Vater metastases from renal cell carcinoma are rare. The time between detection of the... more Ampulla of Vater metastases from renal cell carcinoma are rare. The time between detection of the primary tumour and its metastasis may extend to years. Management should be aggressive, since the prognosis of renal cell carcinoma is unpredictable and curative surgery of metastases may extend patient survival and even lead to definite cure. Herein we report a case of long-term survival after successful surgical treatment of a renal cell carcinoma metastasis to the ampulla of Vater. A 62-year-old man with a history of renal cell carcinoma in the left kidney underwent a successful left nephrectomy. Eight months later duodenoscopy showed a tumour at the site of papilla of Vater. Biopsy confirmed the diagnosis of carcinoma. Contrast enhanced computer tomography scan verified the periampullary mass, dilatation of the pancreatic and the common bile duct. No radiological signs of either local advancement or distant metastases were present. Pylorus-preserving pancreatoduodenectomy with lymph...

Research paper thumbnail of Meta-analysis of prophylactic parenteral antibiotic use in acute necrotizing pancreatitis

Medicina, 2007

Background. Acute pancreatitis is a potentially serious condition. It carries an overall mortalit... more Background. Acute pancreatitis is a potentially serious condition. It carries an overall mortality rate of 10–15%. Infectious complications account for approximately 80% of deaths from acute pancreatitis, and the question arises whether or not prophylactic antibiotics are useful in the prevention of these complications. Therefore, we performed an evidence-based analysis to assess the effect of available prophylactic antimicrobial treatment on the development of infected necrosis and sepsis, need for surgery, and mortality. Methods. A comprehensive PubMed search was performed evaluating the value of prophylactic administration of parenteral antibiotics in patients with acute necrotizing pancreatitis. Only articles published in English language between January 1990 and May 2006 were included. The search strategy initially generated 692 articles related to antibiotics in the treatment of acute pancreatitis. This number was reduced to 97 publications related to clinical trials on the sa...

Research paper thumbnail of Interventional and surgical management of abdominal compartment syndrome in severe acute pancreatitis

Medicina, 2010

Background and objective. Management of the abdominal compartment syndrome during severe acute pa... more Background and objective. Management of the abdominal compartment syndrome during severe acute pancreatitis by the open abdomen method is associated with considerable morbidity and resource utilization. Thus, the aim of this study was to evaluate the safety and efficacy of the ultrasound-guided percutaneous interventions and/or minimally invasive surgery in the treatment of abdominal compartment syndrome. Material and methods. Forty-four patients with severe acute pancreatitis were enrolled into a prospective study and treated according to the standard management protocol. Interventional and/ or surgical management of abdominal compartment syndrome was employed in 6 (13.6%) cases. In the context of this study, we assessed the feasibility and effectiveness of subcutaneous fasciotomy of the anterior m. rectus abdominis sheath, as well as the role of ultrasound-guided drainage of intra-abdominal and peripancreatic fluid collections in the management of abdominal compartment syndrome. R...

Research paper thumbnail of Radiofrequency ablation of liver tumors (II): clinical application and outcomes

Medicina, 2010

Radiofrequency ablation is one of the alternatives in the management of liver tumors, especially ... more Radiofrequency ablation is one of the alternatives in the management of liver tumors, especially in patients who are not candidates for surgery. The aim of this article is to review applicability of radiofrequency ablation achieving complete tumor destruction, utility of imaging techniques for patients’ follow-up, indications for local ablative procedures, procedureassociated morbidity and mortality, and long-term results in patients with different tumors. The success of local thermal ablation consists in creating adequate volumes of tissue destruction with adequate “clear margin,” depending on improved delivery of radiofrequency energy and modulated tissue biophysiology. Different volumes of coagulation necrosis are achieved applying different types of electrodes, pulsing energy sources, utilizing sophisticated ablation schemes. Some additional methods are used to increase the overall deposition of energy through alterations in tissue electrical conductivity, to improve heat retent...

Research paper thumbnail of Comparative diagnostic value of contrast-enhanced ultrasonography, computed tomography, and magnetic resonance imaging in diagnosis of hepatic hemangiomas

Medicina, 2010

Aim. To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous cont... more Aim. To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis of hepatic hemangiomas. Material and methods. The study enrolled 48 patients, aged between 20 and 79 years (35 [72.9%] women, 13 [27.1%] men; mean age, 53.5±12.855 years), who were examined and treated in the Departments of Gastroenterology, Surgery, and Oncology, Hospital of Kaunas University of Medicine, in the year 2007. All patients underwent intravenous contrast-enhanced US, intravenous contrast-enhanced CT, and MRI and were diagnosed with hepatic hemangioma according to the findings of these examinations. Results. The size of hemangiomas was ≤2.0 cm in 20 cases (41.7%) and >2.0 cm in 28 (58.3%). No association between hepatic hemangioma and patient’s age was found (χ2=0.547, df=2, P=0.761). Nearly one-third of hemangiomas were located in the segment IV of the left hepatic lobe. There we...

Research paper thumbnail of Percutaneous transhepatic biliary stenting: The first experience and results of the Hospital of Kaunas University of Medicine

Medicina, 2008

Malignant biliary obstruction may be caused by cholangiocarcinoma and other nonbiliary carcinomas... more Malignant biliary obstruction may be caused by cholangiocarcinoma and other nonbiliary carcinomas. At the time of diagnosis, 90% of patients with malignant obstructive jaundice may benefit from palliative treatment only. The objective of palliation is to relieve jaundice-related symptoms, prevent cholangitis, prolong survival, and improve quality of life. Percutaneous transhepatic biliary stenting is a well-established procedure used in patients with malignant obstruction of intra- and extrahepatic bile ducts. Twelve patients (9 women, 3 men; mean age, 68 years; range, 44–88 years) with inoperable malignant biliary obstruction were selected for percutaneous transhepatic biliary stenting with metallic stents in the period from January to December 2007. Technical and clinical success rate in this patient series was 83% and 80%, respectively. Minor and major complications occurred in 17% and 8% of cases, respectively, which is in the range reported by the others. This is our first expe...

Research paper thumbnail of Effects of Cyanidin-3-O-glucoside on Synthetic and Metabolic Activity of Ethanol Stimulated Human Pancreatic Stellate Cells

Phytotherapy Research, 2015

Activated pancreatic stellate cells (PSC) play a major role in the development of chronic pancrea... more Activated pancreatic stellate cells (PSC) play a major role in the development of chronic pancreatitis. Flavonoids (C-3-O-G) theoretically may have potential to suppress activated PSC. The aim of our study was to determine the ability of C-3-O-G to invert synthetic and metabolic activity of alcohol stimulated human pancreatic stellate cells (hPSC). In the present study we demonstrate that treatment with C-3-O-G decreased proliferation rate of ethanol activated hPSC by 51%. Synthesis of extracellular matrix proteins in activated hPSC was markedly inhibited, as shown by reduced levels of collagen I and fibronectin expression. The decrease of secretion of fibronectin by 33% and in collagen I-25% in ethanol activated and C-3-O-G treated hPSC was observed. Moreover, treatment of ethanol activated hPSC with C-3-O-G resulted in the decrease of oxygen consumption rate by 44% and reduced levels of ATP synthesis (i.e. energy production) by 41%. Hence, the effects of C-3-O-G on ethanol activated hPSC may provide new insights for the use of anthocyanins as anti-fibrogenic agents in treatment and/or prevention of pancreatic fibrosis. Copyright © 2015 John Wiley &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Sons, Ltd.

Research paper thumbnail of Apoptosis is activated in an early period after radiofrequency ablation of liver tissue

Hepato-gastroenterology

Hyperthermia induced apoptosis may lead to tumor cell death thus expanding the volume of non-viab... more Hyperthermia induced apoptosis may lead to tumor cell death thus expanding the volume of non-viable tissue and warrant a "safety margin" of at least 10mm to exclude the possibility of tumor recurrence. We carried out an experimental study to investigate the cellular injury produced by radiofrequency ablation in the area surrounding the ablated tissue and to describe early apoptotic processes in the transition zone following radiofrequency ablation procedure in a porcine liver model. Nine anesthetized pigs underwent laparotomy and local thermal ablation of the liver parenchyma. The ablated tissue and the surrounding parenchyma were investigated for apoptosis applying Western blot analysis and immunohistochemistry. The active (cleaved) caspase-3 17-kDa subunit was detected in the transition zone one hour after ablative procedure at a distance of 9-10 mm from the rim of the necrosis zone. In contrast analysis of tissues in necrosis zone and in surrounding normal liver parench...