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335. Influence of pancreas transection with cavitron ultrasonic surgical aspirator (CUSA) on incidence of postoperative pancreatic fistula after pancreatoduodenectomy (PANCUT) : study protocol for a randomised controlled trialBenjamin Hadžialjević, Hana Zavrtanik Čarni, Miha Petrič, Mihajlo Djokić, Blaž Trotovšek, Aleš Tomažič, David Badovinac, 2025, izvirni znanstveni članek Povzetek: Background: Complications after pancreatoduodenectomy occur in up to 40% of patients. Postoperative pancreatic fistula (POPF) remains the most common complication after pancreatoduodenectomy and is associated with increased postoperative mortality. The cavitron ultrasonic surgical aspirator (CUSA) is a surgical instrument commonly used in liver and neurosurgery. The CUSA selectively dissects tissue parenchyma, leaving blood vessels and bile ducts undamaged, which are then selectively ligated or clipped. Only a few studies have investigated the relationship between the transection of pancreatic tissue with CUSA and the formation of POPF. The results were inconsistent and were published before the updated ISGPS consensus on the definition of POPF. Methods: The PANCUT study is a randomised controlled trial initiated at the Department of Abdominal Surgery, University Medical Centre Ljubljana. The aim of the study is to determine whether precise dissection of the pancreatic tissue with CUSA reduces the incidence of POPF. Patients scheduled for pancreatoduodenectomy will be randomly assigned to either the experimental group, in which the pancreatic tissue will be dissected with CUSA, or the control group, in which pancreas will be conventionally transected with scalpel. A total of 180 patients will be included in the study. The primary endpoint is the formation of POPF. Secondary endpoints include operation time, amount of intraoperative blood loss, postoperative infectious complications, postoperative bleeding, length of hospital stay and mortality. Discussion: To our knowledge, the PANCUT study is the first randomized controlled trial to investigate the role of CUSA in the transection of pancreatic tissue during pancreatoduodenectomy. Trial registration: ClinicalTrials.gov NCT06135012. Registered on 18 November 2023.
Ključne besede: pancreatic fistula, postoperative complications, pancreas resection, cusa, pancreatoduodenectomy, pancreatic ducts
Objavljeno v DiRROS: 26.11.2025; Ogledov: 191; Prenosov: 125
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337. Study of the neutron radiation hardness of MAPD-3NK2 silicon photomultipliersKlemen Ambrožič, Anže Jazbec, M. Holik, S. Nuruyev, F. Ahmadov, G. Ahmadov, O. Okhrimenko, A. Mammadli, A. Sadygov, Z. Sadygov, 2025, izvirni znanstveni članek Povzetek: The radiation hardness of MAPD-3NK2 photodiodes with deep-buried pixel structures was evaluated under neutron irradiation at fluences ranging from 3.6 × 109to 3.6 × 1012neq/cm². Irradiation induced dark current increase of up to 2060 times, a breakdown voltage shift of (0.37 ± 0.08) V, a photo signal amplitude reduction of (90.1 ± 0.4) %, and a tenfold degradation in amplitude resolution. Partial recovery was observed after 40 days of room-temperature annealing, with dark current decreasing by 35%.Similar performance changes were observed in photodiodes with artificially elevated dark current, indicating that excess current is the primary driver of degradation. This current likely impedes photoelectron detection by occupying pixels or failing to fully quench the avalanche process, thereby reducing photocurrent.
Ključne besede: neutron irradiation, radiation hardness, silicon photomultipliers, photodiodes, dark current degradation
Objavljeno v DiRROS: 26.11.2025; Ogledov: 149; Prenosov: 62
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338. Segmental analysis of aortic basal ring dimensions in normal and dilated tricuspid aortic rootsMatija Jelenc, Blaž Jelenc, Sara Habjan, Christian Giebels, Peter Fries, Hector I. Michelena, Thomas Foley, Hans Joachim Schäfers, 2024, izvirni znanstveni članek Povzetek: Objectives: In patients with aortic root aneurysm, the aortic basal ring is frequently dilated. It has been speculated that the muscular part of the basal ring dilates most. The purpose of this study was to analyse the segmental dilatation of the basal ring, comparing normal and dilated roots in patients with tricuspid aortic valves. Methods: Retrospective analysis of computed tomography studies in patients with normal and dilated aortic roots was performed. Lengths of segments of the basal ring corresponding to each of the 3 sinuses, and to the muscular and fibrous parts were measured. Fractions of these segments relative to the total basal ring perimeter were calculated. Results: We analysed 152 normal and 126 dilated aortic roots and 86 propensity-matched pairs. Basal ring dilatation was present in all segments of dilated aortic roots with subtle differences between the segments corresponding to the 3 sinuses. The muscular part of the basal ring dilated proportionately to its fibrous part, with no difference in fractions of measured muscular part in normal and dilated roots [42.2% (interquartile range 4.3%) vs 42.1% (interquartile range 6.3%)]. CONCLUSIONS: Basal ring dilatation was present in all segments corresponding to the 3 sinuses in dilated aortic roots. Both muscular and fibrous parts dilated equally, supporting the need to stabilize the entire basal ring when performing aortic valve repair surgery.
Ključne besede: aortic root dilatation, aortic valve anatomy, computed tomography angiography, tricuspid aortic valve, propensity score matching, aortic valve annulus
Objavljeno v DiRROS: 26.11.2025; Ogledov: 159; Prenosov: 67
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339. Comparison of pulmonary and aortic root and cusp dimensions in normal adults using computed tomography : potential implications for Ross procedure planningMatija Jelenc, Blaž Jelenc, Sara Habjan, Karen B. Abeln, Peter Fries, Hector I. Michelena, Hans Joachim Schäfers, 2024, izvirni znanstveni članek Povzetek: Objectives: The Ross procedure is currently receiving renewed interest. Its function and durability depend on preservation of pulmonary valve anatomy; limited data exist on normal pulmonary valve geometry. The objective was to compare aortic and pulmonary root and cusp dimensions in adults with normal tricuspid aortic and pulmonary valves. Methods: We reviewed 507 coronary computed tomography studies, selecting those with adequate visibility of both pulmonary and aortic roots for further analysis. Diastolic aortic and pulmonary root and cusp dimensions were measured. Root dimensions at different phases of the cardiac cycle were measured in 3 patients. Results: We analysed studies of 50 patients with the mean age of 54 years [standard deviation (SD): 16]. In end-diastole, pulmonary root had a smaller sinutubular to basal ring ratio than the aortic root [0.82 (SD: 0.09) vs 1.14 (SD: 0.12), P<0.001]. Aortic and pulmonary cusps had similar dimensions; however, pulmonary cusp effective height was lower [5.9 mm (SD: 1.6) vs 8.4 mm (SD: 1.2), P<0.001]. Pulmonary basal ring perimeter was largest at end-diastole and smallest at end-systole, with the relative difference of 23.5% (SD: 2.7). Conclusions: The pulmonary root has a similar cusp size compared to the aortic root, but a different shape, resulting in a lower pulmonary cusp effective height. The perimeter of the pulmonary basal ring changes during the cardiac cycle. These findings suggest that stabilizing the autograft to normal aortic, rather than pulmonary, root dimensions should result in normal autograft cusp configuration. Computed tomography angiography could become a tool for personalized planning of the Ross procedure.
Ključne besede: computed tomography angiography, pulmonary valve anatomy, ross procedure, aortic valve anatomy, cardiac cycle
Objavljeno v DiRROS: 26.11.2025; Ogledov: 140; Prenosov: 80
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340. Evaluating the effect of bile acid levels on maternal and perinatal outcomes in intrahepatic cholestasis of pregnancy : a retrospective studyPetra Gregorc, Ivan Verdenik, Polona Pečlin, 2025, izvirni znanstveni članek Povzetek: first_pagesettingsOrder Article Reprints Open AccessArticle Evaluating the Effect of Bile Acid Levels on Maternal and Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Retrospective Study by Petra Gregorc 1,Ivan Verdenik 1ORCID andPolona Pečlin 1,2,*ORCID 1 Division of Obstetrics and Gynaecology, Department of Perinatology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia 2 Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia * Author to whom correspondence should be addressed. Diagnostics 2025, 15(17), 2185; https://doi.org/10.3390/diagnostics15172185 (registering DOI) Submission received: 14 July 2025 / Revised: 21 August 2025 / Accepted: 22 August 2025 / Published: 28 August 2025 (This article belongs to the Special Issue Diagnosis and Prognosis of Gynecological and Obstetric Diseases) Downloadkeyboard_arrow_down Browse Figures Versions Notes Abstract Background: Intrahepatic cholestasis of pregnancy (ICP) is the most common reversible liver disorder linked to pregnancy, characterised by pruritus and elevated serum bile acids (BAs). Condition severity correlates with increased maternal and neonatal complications, and recent evidence highlights a significantly elevated risk of adverse perinatal outcomes, including stillbirth, when BA > 100 µmol/L. Methods: This retrospective study, conducted at a tertiary perinatology centre between 2019 and 2023, was performed in two phases. In the first phase, baseline group characteristics and pregnancy outcomes were compared between ICP and non-ICP (control) groups. In the second phase, outcomes were analysed across three ICP severity subgroups: mild (BA < 40 µmol/L), moderate (BA 40–99 µmol/L), and severe (BA ≥ 100 µmol/L). Results: A total of 210 patients diagnosed with ICP and 24,177 controls were included in the analysis. After multivariable regression, the results indicated that patients with severe ICP (BA ≥ 100 µmol/L) experienced significantly worse perinatal outcomes compared to those with mild or moderate disease: spontaneous preterm birth occurred in 26.7% of cases (p = 0.002), iatrogenic preterm birth in 36.7% (p < 0.001), meconium-stained amniotic fluid in 43.3% (p = 0.001), and neonatal intensive care unit (NICU) admission in 23.3% (p = 0.006). This subgroup also had the lowest mean birth weight (2830 g, p < 0.001). Notably, no stillbirths were recorded in any of the subgroups. Compared to controls, no major differences in maternal characteristics were noted, except in pregnancies conceived via in vitro fertilisation (IVF, p = 0.012) and those complicated by gestational diabetes (p = 0.040), both showing elevated risk for ICP development. Conclusions: This study confirms an association between ICP and increased perinatal complications, with severity of disease correlating with poorer outcomes. The findings highlight the need for standardised BA testing and improved strategies for perinatal management.
Ključne besede: intrahepatic cholestasis of pregnancy, peak bile acid, adverse perinatal outcomes, stillbirth
Objavljeno v DiRROS: 26.11.2025; Ogledov: 142; Prenosov: 48
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