European journal of gastroenterology & hepatology
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Eur J Gastroenterol Hepatol · Sep 2015
A training program for primary care physicians improves the effectiveness of ultrasound surveillance of hepatocellular carcinoma.
Cirrhosis is the main risk factor of hepatocellular carcinoma (HCC), but only a minority of cirrhotic patients are referred to the hepatologist by primary care physicians (PCP) and receive regular ultrasound surveillance. The aim of this study was to determine whether a training program targeted to PCP could enhance the effectiveness of surveillance in a real-life setting. ⋯ Specific training of PCP aimed at the identification and referral of cirrhotic patients efficiently improves HCC survival.
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Eur J Gastroenterol Hepatol · Aug 2015
Comparative StudyAppropriate treatment strategies for intrahepatic recurrence after curative resection of hepatocellular carcinoma initially within the Milan criteria: according to the recurrence pattern.
The aim of this study was to investigate appropriate treatment strategies for recurrent intrahepatic hepatocellular carcinoma (HCC) in patients who fulfilled the Milan criteria at primary hepatectomy. ⋯ TACE may be as effective as RR or RFA for early intrahepatic recurrence, whereas RR/RFA is the preferred option for patients with late recurrence after curative resection of HCC who initially fulfilled the Milan criteria. Prognosis was determined by the number of recurrent tumors and the Child-Pugh class at the time of recurrence.
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Eur J Gastroenterol Hepatol · May 2015
Outpatient management of low-risk patients with upper gastrointestinal bleeding: can we safely extend the Glasgow Blatchford Score in clinical practice?
The Glasgow Blatchford Score (GBS) is a validated prognostic score for patients presenting with upper gastrointestinal (GI) bleeding (UGIB). The score predicts the need for therapeutic intervention or death, and studies have suggested that outpatient management is safe for patients with a GBS of zero. Our aim was to assess whether we could safely extend the threshold for outpatient management to patients with GBS≤1. ⋯ GBS≤1 has a high NPV for adverse outcomes in UGIB. This suggests outpatient management of patients with UGIB and that GBS≤1 is safe in our population.
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Eur J Gastroenterol Hepatol · Apr 2015
Clinical TrialDeterminants of long-term complications of endoscopic sphincterotomy are infections and high risk factors of bile duct and not sphincter of Oddi dysfunction.
With the popularity of endoscopic sphincterotomy (EST), long-term complications of EST are receiving increasingly more attention, but the mechanisms have not been sufficiently elucidated. ⋯ Weakened SO function is not a decisive factor for long-term complications of EST, which were mainly influenced by biliary tract infection and high risk factors of the biliary tract.