Publications by authors named "Vipul D Yagnik"

88 Publications

Comparison Between the Modified Parks and Garg Classifications of Cryptoglandular Anal Fistulas.

Dis Colon Rectum 2021 Jul 21. Epub 2021 Jul 21.

Professor of Surgery, SSR Medical College, Belle Rive, Mauritius Director and Consultant Surgeon, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, India.

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http://dx.doi.org/10.1097/DCR.0000000000002208DOI Listing
July 2021

Migration of biliary stent into the gallbladder: A surprising intraoperative finding.

J Minim Access Surg 2021 May 18. Epub 2021 May 18.

Department of Surgery, SSR Medical College, Belle Rive, Mauritius.

Post-endoscopic retrograde cholangiopancreatography stenting is a well-established treatment for benign as well as malignant biliary obstruction. The most frequently encountered complication is stent clogging. Stent migration (proximal or distal), on the other hand, is not very common. Proximal migration of a choledochal endoprosthesis into the gallbladder has not yet been reported in the literature.
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http://dx.doi.org/10.4103/jmas.JMAS_47_21DOI Listing
May 2021

Diagnosis of anorectal tuberculosis by polymerase chain reaction, GeneXpert and histopathology in 1336 samples in 776 anal fistula patients.

World J Gastrointest Surg 2021 Apr;13(4):355-365

Department of Statistics, Indian Council of Medical Research, New Delhi 110029, India.

Background: The association of tuberculosis (TB) with anal fistulas can make its treatment quite difficult. The main challenge is timely detection of TB in anal fistulas and its proper management. There is little data available on diagnosis and management of TB in anal fistulas.

Aim: To detect TB in fistula-in-ano patients were analyzed in different methods utilized.

Methods: A retrospective analysis of different methods, polymerase chain-reaction (PCR), GeneXpert and histopathology (HPE), utilized to detect tuberculosis in fistula-in-ano patients, treated between 2014-2020, was performed. The sampling was done for tissue (fistula tract lining) and pus (when available). The detection rate of various tests to detect TB and prevalence rate of TB in simple complex fistulae were studied.

Results: In 1336 samples (776 patients) tested, TB was detected in 133 samples (122 patients). TB was detected in 52/703 (7.4%) samples tested by PCR-tissue, in 77/331 (23.2%) samples tested by PCR-pus, 3/197 (1.5%) samples tested with HPE-tissue and 1/105 (0.9%) samples tested by GeneXpert. To detect TB, PCR-tissue was significantly better than HPE-tissue (52/703 3/197 respectively) ( = 0.0012, significant, Fisher's exact test) and PCR-pus was significantly better than PCR-tissue (77/331 52/703 respectively) ( < 0.00001, significant, Fisher's exact test). TB fistulas were more complex than non-tuberculous fistulas [78/113 (69%) 278/727 (44.3%) respectively] ( < 0.00001, significant, Fisher's exact test) but the overall healing rate was similar in tuberculous and non-tuberculous fistula groups [90/102 (88.2%) 518/556 (93.2%) respectively] ( = 0.10, not significant, Fisher's exact test).

Conclusion: This is the largest study of anorectal TB to be published. The detection of TB by polymerase chain-reaction was significantly higher than by histopathology and GeneXpert. Amongst polymerase chain-reaction, pus had a higher detection rate than tissue. TB fistulas were more complex than non-tuberculous fistulas but aggressive diagnosis and meticulous treatment led to comparable overall success rates in both groups.
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http://dx.doi.org/10.4240/wjgs.v13.i4.355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069068PMC
April 2021

Lessons learned from an audit of 1250 anal fistula patients operated at a single center: A retrospective review.

World J Gastrointest Surg 2021 Apr;13(4):340-354

Department of Statistics, Indian Council of Medical Research, New Delhi 110029, New Delhi, India.

Background: A complex anal fistula is a challenging disease to manage.

Aim: To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula center.

Methods: Anal fistulas operated on by a single surgeon over 14 years were analyzed. Preoperative magnetic resonance imaging was done in all patients. Four procedures were performed: fistulotomy; two novel sphincter-saving procedures, proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts (PERFACT) and transanal opening of intersphincteric space (TROPIS), and anal fistula plug. PERFACT was initiated before TROPIS. As per the institutional GFRI algorithm, fistulotomy was done in simple fistulas, and TROPIS was done in complex fistulas. Fistulas with associated abscesses were treated by definitive surgery. Incontinence was evaluated objectively by Vaizey incontinence scores.

Results: A total of 1351 anal fistula operations were performed in 1250 patients. The overall fistula healing rate was 19.4% in anal fistula plug ( = 56), 50.3% in PERFACT ( = 175), 86% in TROPIS ( = 408), and 98.6% in fistulotomy ( = 611) patients. Continence did not change significantly after surgery in any group. As per the new algorithm, 1019 patients were operated with either the fistulotomy or TROPIS procedure. The overall success rate was 93.5% in those patients. In a subgroup analysis, the overall healing rate in supralevator, horseshoe, and fistulas with an associated abscess was 82%, 85.8%, and 90.6%, respectively. The 90.6% healing rate in fistulas with an associated abscess was comparable to that of fistulas with no abscess (94.5%, = 0.057, not significant).

Conclusion: Fistulotomy had a high 98.6% healing rate in simple fistulas without deterioration of continence if the patient selection was done judiciously. The sphincter-sparing procedure, TROPIS, was safe, with a satisfactory 86% healing rate for complex fistulas. This is the largest anal fistula series to date.
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http://dx.doi.org/10.4240/wjgs.v13.i4.340DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069067PMC
April 2021

Laying Open and Curettage under Local Anesthesia to Treat Pilonidal Sinus: Long-Term Follow-Up in 111 Consecutively Operated Patients.

Clin Pract 2021 Apr 1;11(2):193-199. Epub 2021 Apr 1.

Nishtha Surgical Hospital and Research Centre, Patan 384265, Gujarat, India.

(1) Background: Several techniques for the treatment of pilonidal sinus disease (PSD) are in vogue, though none have emerged as the gold standard. Laying open (deroofing) and curettage under local anesthesia is one of the most straightforward procedures to treat PSD. In this study, the long-term follow-up in a large series was analyzed. (2) Methods: The laying open approach was performed for all types of consecutive PSD patients-simple, complicated, and abscess. The primary outcome parameter of the study was the healing rate. The secondary outcome parameters were operating time, hospital stay, time to resumption of normal work, and healing time. (3) Results: 111 (M/F-92/19, mean age-22.9 ± 5.7 years) consecutive patients were operated on and followed for 38 months (6-111 months). Of these, 24 had pilonidal abscesses, 87 had chronic pilonidal disease, while 22 had recurrent disease. Operating time and hospital stay were 24 ± 7 min and 66 ± 23 min, respectively. On average, patients could resume normal work in 3.6 ± 2.9 days and the healing time was 43.8 ± 7.4 days. Three patients were lost to follow-up. Complete resolution of the disease occurred in 104/108 (96.3%) patients, while 4 (3.7%) had a recurrence. One recurrence was due to a missed tract, while three recurrences presented after complete healing had occurred. Two patients with recurrence were operated on again with the same procedure, and both healed completely. Thus, the overall success rate of this procedure was 98.1% (106/108) with a recurrence rate after first surgery of 3.7% over a median follow-up of 38 months. (4) Conclusions: Pilonidal disease managed by laying open (deroofing) with curettage under local anesthesia is associated with a high cure rate. This procedure is effective in treating all kinds of pilonidal disease (simple, complicated, and abscess).
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http://dx.doi.org/10.3390/clinpract11020028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167585PMC
April 2021

Role of MRI to confirm healing in complex high cryptoglandular anal fistulas: long-term follow-up of 151 cases.

Colorectal Dis 2021 Apr 26. Epub 2021 Apr 26.

SSR Medical College, Belle Rive,, Mauritius.

Aim: Complex fistula-in-ano can recur even after complete clinical healing has occurred. 'Radiological healing' of fistula on MRI correlates well with long-term healing rates but no study has yet objectively quantified this. The aim of this study was to assess the accuracy of anal fistula healing as documented on MRI and to correlate it with long-term healing as evidenced on long-term follow-up.

Methods: Patients with clinically healed anal fistulas who also had radiological healing checked by postoperative MRI were included in the study.

Results: Three hundred and twenty-five patients operated for high complex fistula-in-ano were followed up for 14-68 months (median 38 months). Postoperative MRI was done to assess radiological healing of the fistula in 151 patients, and they were included in the study. The mean age was 39.4 ± 10.5 years (116 men). Five patients were lost to follow-up. The fistulas did not heal radiologically (on MRI) in 20 patients and recurred in all these patients. The fistulas healed radiologically (on MRI) in 126 patients. On long-term follow-up, 124/126 patients remained healed while 2/126 had a recurrence. In the first patient, the fistula recurred 40 months after complete radiological healing. In the second patient, the fistula recurred 10 months after complete radiological healing but pus from the fistula tested positive for tuberculosis (by real-time polymerase chain reaction) and he was excluded from the analysis. Thus, there was only one (1/125) recurrence on long-term follow-up.

Conclusions: Radiological healing on MRI correlates well with long-term healing in complex fistula-in-ano.
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http://dx.doi.org/10.1111/codi.15695DOI Listing
April 2021

The Efficacy of Transanal Opening of Intersphincteric Space Procedure in High Complex Anal Fistulas on Long-term Follow-up.

Am Surg 2021 Apr 13:31348211011092. Epub 2021 Apr 13.

Department of General Surgery, 552925Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, India.

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http://dx.doi.org/10.1177/00031348211011092DOI Listing
April 2021

Re: Small bowel perforation from migrated biliary stent: why did it happen?

ANZ J Surg 2021 04;91(4):762-763

Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula, India.

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http://dx.doi.org/10.1111/ans.16520DOI Listing
April 2021

Re: Incarceration of a Meckel's diverticulum by jejunal diverticulosis: an atypical cause of small bowel obstruction.

ANZ J Surg 2021 04;91(4):761-762

Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula, India.

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http://dx.doi.org/10.1111/ans.16499DOI Listing
April 2021

Re: Irreducible inguinal hernia and acute appendicitis: a case of Amyand's hernia.

ANZ J Surg 2021 04;91(4):762

Garg Fistula Research Institute, Department of Colorectal Surgery, Panchkula, India.

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http://dx.doi.org/10.1111/ans.16493DOI Listing
April 2021

Modified Parks' Is Principally Similar to TROPIS Procedure for the Treatment of High Complex Anal Fistulas.

J Gastrointest Surg 2021 04 10;25(4):1080-1081. Epub 2021 Mar 10.

Department of General Surgery, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, India.

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http://dx.doi.org/10.1007/s11605-021-04970-xDOI Listing
April 2021

A Simple Protocol to Effectively Manage Anal Fistulas with No Obvious Internal Opening.

Clin Exp Gastroenterol 2021 2;14:33-44. Epub 2021 Feb 2.

Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, India.

Purpose: In some anal fistulas, the internal/primary opening cannot be located even after examination and assessment on MRI or transrectal ultrasound. The efficacy of a simple new protocol to manage such therapeutically challenging fistulas was tested.

Patients And Methods: All anal fistula patients operated consecutively over 7 years were included in the study. A simple two-step protocol was followed for fistulas in which the internal opening was not locatable after clinical examination and MRI assessment. First, the MRI was reassessed. The site where the fistula was closest to the internal sphincter was noted. It was assumed that the internal-opening was located at that position and the fistula was treated accordingly. Second, in horseshoe anal fistulas with no apparent internal opening, it was assumed that the internal opening was located in the midline. Low fistulas were treated by fistulotomy and high fistulas by a sphincter-sparing procedure. Incontinence was evaluated by objective incontinence scores (Vaizey scores).

Results: A total of 757 patients were operated (median follow-up-33 months). Of these, 57 patients were excluded due to short or inadequate follow-up. In 154/700 (22%) patients, the internal opening could not be located while in 546/700 (78%), the internal opening was found. Both the groups were similar in all parameters. In the "internal-opening found" group, the fistula healed completely in 486/546 (89%) and in the 'internal-opening not found group', the fistula healed in 140/156 (90.9%) (p=1.01). The objective continence scores did not change significantly after surgery in both the groups.

Conclusion: This new protocol seems effective as a high cure rate could be achieved in 'internal-opening not found' fistulas which was comparable to fistula healing in the 'internal-opening found' group.
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http://dx.doi.org/10.2147/CEG.S291909DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866917PMC
February 2021

Gangrenous mesenteric Meckel's diverticulum: an uncommon cause of intestinal obstruction.

Authors:
Vipul D Yagnik

ANZ J Surg 2020 Dec 8. Epub 2020 Dec 8.

Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, India.

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http://dx.doi.org/10.1111/ans.16480DOI Listing
December 2020

Castleman disease of the greater omentum: a rare unicentric variant.

ANZ J Surg 2020 Dec 1. Epub 2020 Dec 1.

Department of Patholoy, Neuberg Supratech Laboratory, Mehsana, India.

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http://dx.doi.org/10.1111/ans.16457DOI Listing
December 2020

Mucinous cystadenomas of urachus: A case report and literature review.

Urol Ann 2020 Jul-Sep;12(3):291-294. Epub 2020 Jul 17.

Consultant Pathologist, Neberg Supratech Laboratory, Mehsana, Gujarat, India.

Urachal epithelial neoplasms are rare tumors that arise from the vestiges of the urachus. Mucinous cystadenomas are considered as a benign glandular tumors of the urachus. Cystadenomas are commonly found in the ovary, appendix, and pancreas. Mucinous cystadenomas of the urachus are extremely rare in the urachus, and only nine cases reported so far. We reported the 10th case of Mucinous cystadenomas of the urachus detected incidentally at the time of diagnostic laparoscopy for investigation of genitourinary tuberculosis.
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http://dx.doi.org/10.4103/UA.UA_118_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546063PMC
July 2020

Pure cutaneous paratesticular leiomyosarcoma of the scrotum: A rare case report.

Urol Ann 2020 Apr-Jun;12(2):199-202. Epub 2020 Apr 14.

Department of Pathophysiology, American University of Antigua College of Medicine, Coolidge, Antigua, Antigua and Barbuda.

Leiomyosarcoma (LMS) is a malignant mesenchymal neoplasm arising from the smooth muscle. Paratesticular LMSs are commonly located in the epididymis or spermatic cord. Pure scrotal cutaneous paratesticular LMS arising from the dartos muscle is very rare. Less than 40 cases have been reported in the literature to date. We report a case of pure scrotal cutaneous LMS in a 45-year-old patient.
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http://dx.doi.org/10.4103/UA.UA_156_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292421PMC
April 2020

ALK 1 Negative Inflammatory Myofibroblastic Tumor of the Ileum: A Rare Cause of Ileocecal Intussusception.

Authors:
Vipul D Yagnik

Surg J (N Y) 2020 Apr 19;6(2):e101-e104. Epub 2020 May 19.

Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, India.

An inflammatory myofibroblastic tumor is a rare tumor of mesenchymal background commonly found in the pulmonary system. It is rarely found as a primary tumor in the gastrointestinal tract. We report an unusual presentation of this rare lesion causing intussusception and intestinal obstruction in a 39-year-old male.
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http://dx.doi.org/10.1055/s-0040-1710531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237234PMC
April 2020

Re: Small bowel perforation from foreign body ingestion.

ANZ J Surg 2020 05;90(5):938

Department of Pathology, Neuberg Supratech Laboratory, Mehsana, India.

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http://dx.doi.org/10.1111/ans.15588DOI Listing
May 2020

Re: Intussusception of colonic lipoma with ischaemic necrosis: a new colonoscopic finding.

Authors:
Vipul D Yagnik

ANZ J Surg 2020 05;90(5):938

Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, India.

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http://dx.doi.org/10.1111/ans.15618DOI Listing
May 2020

Gallbladder Hydatid Cyst: A Review on Clinical Features, Investigations and Current Management.

Clin Exp Gastroenterol 2020 2;13:87-97. Epub 2020 Apr 2.

Department of Surgical Gastroenterology, Gujarat Superspeciality Hospital, Baroda, Gujarat, India.

Background: Gallbladder hydatid cyst (GBHC) is highly uncommon with an incidence of 0.3-0.4% of all atypically located hydatid cysts. Our personal experience of one case of primary GBHC (PGBHC) managed laparoscopically motivated this systematic review. This study aimed to analyze the demographic characteristics, types [whether primary GBHC (PGBHC) or secondary GBHC (SGBHC)], clinical presentation, laboratory investigations, imaging studies, operative procedure, hospital stay, follow-up and recurrence.

Methods: A systematic review was performed using preferred reporting items for systematic reviews and meta-analyses guidelines.

Results: Twenty studies, including 22 cases plus one more case managed by us, were included in the review. For PGBHC, the mean age was 48.61 years while for SGBHC it was 47.9 years. PGBHC was more common in females (69.23%) while SGBHC was more common in males (55.55%). Overall, GBHC was more common in females (56.52%). The most common presentation overall was abdominal pain (100%) followed by nausea/vomiting (43.47%). The other common symptoms were nausea/vomiting (61.53%) and Murphy's sign (38.46%) in PGBHC, but jaundice (50%) and fever (30%) in SGBHC. In PGBHC, 50% patients had normal liver function while this was deranged in 66.66% patients with SGBHC. Serology was positive in 50% of PGBHC and 100% in SGBHC. Ultrasonography was positive in 50%, while CT-scan showed 70%. CT-scan was better at detection of SGBHC (100%). The most common operation was open cholecystectomy (78.26%) either isolated or combined. Isolated open cholecystectomy was commonly done in PGBHC (69.23%). Overall, only 56.52% of patients received albendazole, but no recurrence was reported. The average hospital stay was 7.25 days and follow-up ranged from 1 month to 10 years.

Conclusion: GBHC mostly affects females with abdominal pain being the most common symptom. Ultrasonography is expedient though CT-scan is more sensitive. Albendazole monotherapy has questionable value. Open cholecystectomy is the most common operation. However, laparoscopy is safe in experienced hands.
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http://dx.doi.org/10.2147/CEG.S243344DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135162PMC
April 2020

Response from Dr Yagnik and Dr Yagnik to Gangrenous giant Meckel's diverticulitis masquerading acute appendicitis: a surgical conundrum.

ANZ J Surg 2020 01;90(1-2):189-190

Department of Pathology, Neuberg Supratech Laboratory, Mehsana, India.

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http://dx.doi.org/10.1111/ans.15527DOI Listing
January 2020

Re: Torsion of low-grade appendiceal mucinous neoplasm.

ANZ J Surg 2019 12;89(12):1683-1684

Department of Pathology, Neuberg Supratech Laboratory, Mehsana, India.

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http://dx.doi.org/10.1111/ans.15572DOI Listing
December 2019

Ileoileocolic Intussusception Secondary to Isolated Ectopic Pancreatic Tissue: An Uncommon Case.

J Indian Assoc Pediatr Surg 2019 Oct-Dec;24(4):310-311

Department of Histopathology, Supratech Micropath Laboratory, Ahmedabad, Gujarat, India.

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http://dx.doi.org/10.4103/jiaps.JIAPS_245_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752069PMC
October 2019

Extraskeletal Ewing's sarcoma/peripheral primitive neuroectodermal tumor of the small bowel presenting with gastrointestinal perforation.

Clin Exp Gastroenterol 2019 25;12:279-285. Epub 2019 Jun 25.

Department of surgery, SSR Medical College, Belle Rive, Mauritius.

Extraskeletal Ewing's sarcoma (E-EWS)/peripheral primitive neuroectodermal tumor (pPNET) is a rare soft tissue tumor that arises from a multipotent progenitor cell and is considered to be of neuroectodermal origin. Although soft tissue E-EWS/pPNETs are common, they are exceedingly rare in the small bowel. Only 30 cases of E-EWS/pPNET of the small bowel have been reported. However, only one case of gastrointestinal perforation has been reported till today. Here, we report the second case of E- EWS/pPNET with gastrointestinal perforation.
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http://dx.doi.org/10.2147/CEG.S203697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600760PMC
June 2019

Re: Lipomatosis of the ileocaecal valve: an unusual cause of small bowel obstruction.

ANZ J Surg 2019 07;89(7-8):981

Surgery, Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius.

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http://dx.doi.org/10.1111/ans.15102DOI Listing
July 2019

Re: Axial torsion of Meckel's diverticulum.

ANZ J Surg 2019 03;89(3):267

Department of GI Surgery, Samved Multispecialty Hospital, Patan, India.

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http://dx.doi.org/10.1111/ans.15019DOI Listing
March 2019

Re: Inflammatory myofibroblastic tumour of sigmoid mesocolon in a child.

Authors:
Vipul D Yagnik

ANZ J Surg 2019 01;89(1-2):133-134

Department of General Surgery, Ronak Endo-Laparoscopy and General Surgical Hospital, Patan, India.

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http://dx.doi.org/10.1111/ans.15004DOI Listing
January 2019

Re: Management of gallstone pancreatitis in the vagrant liver.

Authors:
Vipul D Yagnik

ANZ J Surg 2019 01;89(1-2):132-133

Department of General Surgery, Ronak Endo-Laparoscopy and General Surgical Hospital, Patan, India.

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http://dx.doi.org/10.1111/ans.14966DOI Listing
January 2019

Re: Minimally invasive management of gallstone ileus with cholecystoduodenal fistula.

ANZ J Surg 2019 01;89(1-2):133

Department of GI Surgery, Samved Multispeciality Hospital, Patan, India.

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http://dx.doi.org/10.1111/ans.14995DOI Listing
January 2019

Re: Duodeno-iliac fistula secondary to ingested toothpick.

ANZ J Surg 2019 01;89(1-2):134-135

Department of GI Surgery, Vivaan hospital, Ahmedabad, India.

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http://dx.doi.org/10.1111/ans.15017DOI Listing
January 2019
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