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Kullman, Erik
Alternative names
Publications (10 of 21) Show all publications
Björnsson, B., Kullman, E., Gasslander, T. & Sandström, P. (2015). Early endoscopic treatment of blunt traumatic pancreatic injury. Scandinavian Journal of Gastroenterology, 50(12), 1435-1443
Open this publication in new window or tab >>Early endoscopic treatment of blunt traumatic pancreatic injury
2015 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 50, no 12, p. 1435-1443Article, review/survey (Refereed) Published
Abstract [en]

Blunt pancreatic trauma is a rare and challenging situation. In many cases, there are other associated injuries that mandate urgent operative treatment. Morbidity and mortality rates are high and complications after acute pancreatic resections are common. The diagnosis of pancreatic injuries can be difficult and often requires multimodal approach including Computed Tomography scans, Magnetic resonance imaging and Endoscopic retrograde cholangiopancreaticography (ERCP). The objective of this paper is to review the application of endoprothesis in the settings of pancreatic injury. A review of the English literature available was conducted and the experience of our centre described. While the classical recommended treatment of Grade III pancreatic injury (transection of the gland and the pancreatic duct in the body/tail) is surgical resection this approach carries high morbidity. ERCP was first reported as a diagnostic tool in the settings of pancreatic injury but has in recent years been used increasingly as a treatment option with promising results. This article reviews the literature on ERCP as treatment option for pancreatic injury and adds further to the limited number of cases reported that have been treated early after the trauma.

Place, publisher, year, edition, pages
TAYLOR and FRANCIS LTD, 2015
Keywords
endoscopic retrograde cholangiopancreaticography; pancreatic trauma; The American Association for the Surgery of Trauma (AAST)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121930 (URN)10.3109/00365521.2015.1060627 (DOI)000361325700001 ()26096464 (PubMedID)
Available from: 2015-10-13 Created: 2015-10-12 Last updated: 2017-12-01
Nilsson, A., Grossmann, B., Kullman, E., Uustal, E., Sjöberg, F. & Nilsson, L. (2015). Sedation during endoscopic retrograde cholangiopancreatography: A randomised controlled study of patient-controlled propofol sedation and that given by a nurse anaesthetist. Scandinavian Journal of Gastroenterology, 50(10), 1285-1292
Open this publication in new window or tab >>Sedation during endoscopic retrograde cholangiopancreatography: A randomised controlled study of patient-controlled propofol sedation and that given by a nurse anaesthetist
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2015 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 50, no 10, p. 1285-1292Article in journal (Refereed) Published
Abstract [en]

Objective: Different regimens are used for sedation during ERCP (endoscopic retrograde cholangiopancreatography). Our objectives were to compare safety, ease of treatment, time to recovery and patients’ experiences using PCS (patient-controlled sedation) with propofol as well as sedation given by a nurse anaesthetist (ACS) with propofol or midazolam during ERCP.

Material and methods: The study included 281 adults in 301 procedures. The PCS group (n=101) delivered bolus doses of 5 mg of propofol according to their need for sedation. The ACS group (n=100) had 2-8 mg/kg/hour of propofol infused, with the target for sedation being Level 3 of the Observer’s Assessment of Alertness/Sedation scale (OAA/S). The control group was given 2-3 mg of midazolam for induction and additional 1 mg if required.

Results: PCS and ACS increased the ease of the procedure and reduced the numbers of sedation failures compared to midazolam sedation (ACS n=0; PCS n=4; midazolam n=20). The ACS group had more deeply sedated patients (OAA/S Level 2), desaturations and obstructed airways than the PCS and midazolam groups. Over 90% of all patients had recovered (Aldrete score≥9) by the time they returned to the ward. PCS resulted in the least fatigue and pain after the procedure. Patients’ preference for PCS and ACS were the same.

Conclusion: PCS with propofol is superior to midazolam and comparable to ACS. PCS resulted in a rapid recovery, tended to be the safest and was almost as effective as ACS in ensuring a successful examination.

Place, publisher, year, edition, pages
Taylor & Francis, 2015
Keywords
Conscious sedation, propofol, Cholangiopancreatography, Endoscopic Retrograde
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-112371 (URN)10.3109/00365521.2015.1038848 (DOI)000361324600013 ()
Available from: 2014-11-24 Created: 2014-11-24 Last updated: 2019-05-13Bibliographically approved
Kullman, E. (2011). Letter: Covered biliary metal stent: which are worse-the concepts, current models, or insertion methods? Response [Letter to the editor]. Gastrointestinal Endoscopy, 73(6), 1331-1331
Open this publication in new window or tab >>Letter: Covered biliary metal stent: which are worse-the concepts, current models, or insertion methods? Response
2011 (English)In: Gastrointestinal Endoscopy, ISSN 0016-5107, E-ISSN 1097-6779, Vol. 73, no 6, p. 1331-1331Article in journal, Letter (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
Elsevier Science B. V., Amsterdam, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-69890 (URN)10.1016/j.gie.2011.02.003 (DOI)000291366200052 ()
Available from: 2011-08-09 Created: 2011-08-08 Last updated: 2017-12-08Bibliographically approved
Kullman, E., Frozanpor, F., Söderlund, C., Linder, S., Sandström, P., Lindhoff-Larsson, A., . . . Eriksson, O. (2010). Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study. GASTROINTESTINAL ENDOSCOPY, 72(5), 915-923
Open this publication in new window or tab >>Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study
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2010 (English)In: GASTROINTESTINAL ENDOSCOPY, ISSN 0016-5107, Vol. 72, no 5, p. 915-923Article in journal (Refereed) Published
Abstract [en]

Background: Covered biliary metal stents have been developed to prevent tumor ingrowth. Previous comparative studies are limited and often include few patients. Objective: To compare differences in stent patency, patient survival, and complication rates between covered and uncovered nitinol stents in patients with malignant biliary obstruction. Design: Randomized, multicenter trial conducted between January 2006 and October 2008. Setting: Ten sites serving a total catchment area of approximately 2.8 million inhabitants. Patients: A total of 400 patients with unresectable distal malignant biliary obstruction. Interventions: ERCP with insertion of covered or uncovered metal stent. Follow-up conducted monthly for symptoms indicating stent obstruction. Main Outcome Measurements: Time to stent failure, survival time, and complication rate. Results: The patient survival times were 116 days (interquartile range 242 days) and 174 days (interquartile range 284 days) in the covered and uncovered stent groups, respectively (P = .320). The first quartile stent patency time was 154 days in the covered stent group and 199 days in the uncovered stent group (P = .326). There was no difference in the incidence of pancreatitis or cholecystitis between the 2 groups. Stent migration occurred in 6 patients (3%) in the covered group and in no patients in the uncovered group (P = .030). Limitations: Randomization was not blinded. Conclusions: There were no significant differences in stent patency time, patient survival time, or complication rates between covered and uncovered nitinol metal stents in the palliative treatment of malignant distal biliary obstruction. However, covered stents migrated significantly more often compared with uncovered stents, and tumor ingrowth was more frequent in uncovered stents.

Place, publisher, year, edition, pages
Elsevier Science B. V., Amsterdam, 2010
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-62740 (URN)10.1016/j.gie.2010.07.036 (DOI)000284101500002 ()21034892 (PubMedID)
Available from: 2010-12-03 Created: 2010-12-03 Last updated: 2011-01-19
Halldestam, I., Kullman, E. & Borch, K. (2009). Incidence of and potential risk factors for gallstone disease in a general population sample. BRITISH JOURNAL OF SURGERY, 96(11), 1315-1322
Open this publication in new window or tab >>Incidence of and potential risk factors for gallstone disease in a general population sample
2009 (English)In: BRITISH JOURNAL OF SURGERY, ISSN 0007-1323, Vol. 96, no 11, p. 1315-1322Article in journal (Refereed) Published
Abstract [en]

Background: Several epidemiological studies have been published, but there are few reports on relations between gallstone incidence, symptomatology and risk factors. Methods: Of 621 randomly selected individuals aged 35-85 years in a general population who been screened previously, with ultrasonography and found to have no gallbladder stones, 503 (81.0 per cent) were re-examined after a minimum interval of 5 years. At baseline and re-examination, heredity for gallstone disease was explored and body mass index, digestive symptoms including abdominal pain, quality of life, alcohol and smoking habits, use of non-steroidal anti-inflammatory drugs and oestrogen, parity and blood lipid levels were recorded. Results: Forty-two (8.3 per cent) of the 503 subjects developed stones. Subjects were followed for a total of 3025.8 person-years, yielding an incidence for newly developed gallstones of 1.39 per 100 person-years. A positive association for gallstone development,was found only for length of follow-up and plasma low-density lipoprotein-cholesterol levels at baseline. Weekly alcohol consumption was inversely related to gallstone development. Conclusion: The incidence of gallstones in this population was 1.39 per 100 person-years. Gallstone development was related to length of follow-up and LDL-cholesterol levels, and inversely related to alcohol consumption.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-51895 (URN)10.1002/bjs.6687 (DOI)
Available from: 2009-11-23 Created: 2009-11-23 Last updated: 2009-11-23
Halldestam, I., Kullman, E. & Borch, K. (2008). Defined indications for elective cholcystectomy for gallstone disease. British Journal of Surgery, 95(5), 620-626
Open this publication in new window or tab >>Defined indications for elective cholcystectomy for gallstone disease
2008 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 95, no 5, p. 620-626Article in journal (Refereed) Published
Abstract [en]

Background: This study examined symptomatology and quality of life following elective cholecystectomy for symptomatic gallstone disease with defined indications for surgery.

Methods: In this prospective study of 200 consecutive patients (161 women; median age 46·5 (range 24-79) years), strict indications for elective cholecystectomy were stipulated. Digestive symptoms and quality of life were recorded with a self-administered questionnaire before and at 3 and 12 months after surgery.

Results: Of 149 patients who experienced abdominal pain with typical location before surgery, 136 (91·3 per cent) reported total remission or reduced frequency of that type of pain 12 months later. Of 35 patients who reported atypical or multiple pain location before operation, 27 (77 per cent) experienced reduced frequency or disappearance of that type of pain. Frequency of pain episodes, atypical or multiple pain location, specific food intolerance and frequency of disturbing abdominal gas at baseline correlated positively with the frequency of abdominal pain episodes at 12 months after surgery. There was a tendency towards an inverse relation to age.

Conclusion: The frequency of persistent abdominal pain after elective cholecystectomy was low among patients with typical pain location before surgery. Atypical pain location, and frequent pain episodes before operation significantly reduced the chance of becoming pain-free.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13294 (URN)10.1002/bjs.6020 (DOI)
Available from: 2008-05-13 Created: 2008-05-13 Last updated: 2017-12-13Bibliographically approved
Halldestam, I., Kullman, E. & Borch, K. (2008). Incidence of gallstone disease in a general population sample: relations to symptomatology and potential risk factors.
Open this publication in new window or tab >>Incidence of gallstone disease in a general population sample: relations to symptomatology and potential risk factors
2008 (English)Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13293 (URN)
Available from: 2008-05-13 Created: 2008-05-13
Escobar Kvitting, J.-P., Sandström, P., Thorelius, L., Kullman, E., Borch, K. & Svanvik, J. (2006). Radiofrequency ablation of a liver metastasis complicated by extensive liver necrosis and sepsis caused by gas gangrene. Surgery, 139(1), 123-125
Open this publication in new window or tab >>Radiofrequency ablation of a liver metastasis complicated by extensive liver necrosis and sepsis caused by gas gangrene
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2006 (English)In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 139, no 1, p. 123-125Article in journal (Refereed) Published
Abstract [en]

[No abstract available]

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35718 (URN)10.1016/j.surg.2005.06.019 (DOI)28289 (Local ID)28289 (Archive number)28289 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Halldestam, I., Enell, E.-L., Kullman, E. & Borch, K. (2004). Development of symptoms and complications in individuals with asymptomatic gallstones. British Journal of Surgery, 91(6), 734-738
Open this publication in new window or tab >>Development of symptoms and complications in individuals with asymptomatic gallstones
2004 (English)In: British Journal of Surgery, ISSN 0007-1323, Vol. 91, no 6, p. 734-738Article in journal (Refereed) Published
Abstract [en]

Background: Gallbladder stones are common in the developed world. Complications of gallstones contribute substantially to healthcare costs and may be life threatening. The identification of individuals likely to develop complications would be of benefit in clinical practice as elective cholecystectomy could then be performed.

Methods: Seven hundred and thirty-nine subjects aged 35-85 years from the general population were screened for gallbladder problems by ultrasonography and questionnaire assessment of putative risk factors and digestive symptoms. Gallstones, cholesterolosis or sludge in the gallbladder were diagnosed in 123 (16·3 per cent) of 739 subjects, 120 of whom were followed for a median of 87 (range 3-146) months to May 2003 or until treatment was required.

Results: Fourteen patients were admitted to hospital and treated for gallstone-related complications or symptoms. The cumulative risk of being treated during the first 5 years after detection of asymptomatic gallstones was 7·6 per cent and there was no indication of this risk levelling off. There were no significant differences between treated and untreated subjects with regard to digestive symptoms or any of the risk factors monitored at the initial screening, although treated subjects were significantly younger than those who were not treated.

Conclusion: Nearly one in ten individuals with asymptomatic gallbladder stones in the general population may be expected to develop symptoms or complications that require treatment within 5 years. Age may be inversely related to the incidence of complications.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13292 (URN)10.1002/bjs.4547 (DOI)
Available from: 2008-05-13 Created: 2008-05-13 Last updated: 2009-08-18
Kechagias, S., Kullman, E., Ludvigsson, J., Sjödin, I. & Almér, L.-O. (2003). Replik: Samtalskonst och kommunikation efter AT. Läkartidningen, 100, 2466-2467
Open this publication in new window or tab >>Replik: Samtalskonst och kommunikation efter AT
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2003 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 100, p. 2466-2467Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25481 (URN)9927 (Local ID)9927 (Archive number)9927 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
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