Journal of hepatology
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Journal of hepatology · Mar 2010
Meta Analysis Comparative StudyClinical outcomes of radiofrequency ablation, percutaneous alcohol and acetic acid injection for hepatocelullar carcinoma: a meta-analysis.
Radiofrequency ablation (RFA) is often the preferred local ablation therapy for hepatocellular carcinoma (HCC). Percutaneous ethanol injection (PEI) is less frequently used, and percutaneous acetic acid injection (PAI) has been mostly abandoned. Robust evidence showing benefit of one therapy versus another is lacking. Our aim was to evaluate the evidence comparing RFA, PEI and PAI using meta-analytical techniques. ⋯ RFA seems to be a superior ablative therapy than PEI for HCC, particularly for tumours >2 cm. PAI did not differ significantly from PEI for all the outcomes evaluated. RFA and PAI have similar survival rates. For tumours 2 cm outcome benefits comparing RFA and PEI are similar. PAI needs re-evaluation versus both PEI and RFA for tumours 2 cm.
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Journal of hepatology · Mar 2010
Randomized Controlled TrialThe use of beta-adrenergic drugs improves hepatic oxygen metabolism in cirrhotic patients undergoing liver resection.
Hepatic resection is associated with hemodynamic and oxygen metabolism disturbances of the residual liver resulting from liver regeneration. In underlying liver disease, the remnant liver responds inadequately to increased energy demands leading to a less efficient recovery process. The aim of this study was to assess the effect of vasoactive drugs on hepatic oxygen metabolism and hemodynamics in cirrhotic patients that have undergone liver resection. ⋯ Low doses of vasoactive drugs, especially dobutamine, improved hepatic oxygen supply and uptake preserving immediate function of the remnant cirrhotic liver.