Hepato Gastroenterol
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Hepato Gastroenterol · May 2003
Comparative StudyHepatic resection under in situ hypothermic hepatic perfusion.
Temporary inflow occlusion of the portal triad has been used frequently in hepatectomy to minimize bleeding. On the other hand, Pringle's maneuver produces ischemic-reperfusion injury especially in patients with underlying liver disease. ⋯ Using the technique of in situ hypothermic perfusion, we can prolong the ischemic time safely with minimal systemic influence even in cases with underlying liver diseases. This may compare favorably with intermittent Pringle's maneuver in terms of reducing hepatic sinusoidal endothelial cell damage during hepatectomy and reperfusion.
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Hepato Gastroenterol · May 2003
Eradication therapy of Helicobacter pylori directly induces apoptosis in inflammation-related immunocytes in the gastric mucosa--possible mechanism for cure of peptic ulcer disease and MALT lymphoma with a low-grade malignancy.
A possibility that the eradication therapy not only eliminates Helicobacter pylori (H. pylori) but also influences some factors regulating pathological changes in the gastric mucosa should be taken into consideration from some phenomena. Such as non-recurrent cases of peptic ulcer long-term in spite of unsuccessful anti-H. pylori eradication therapy and the effectiveness of eradication therapy for mucosa-associated lymphoid tissue with a low-grade malignancy except stomach. We hypothesized and investigated that antibiotic treatment for elimination of H. pylori might directly affect inflammatory cells to induce apoptosis in them and protect against pathological changes of gastric mucosa. ⋯ This observation suggests that H. pylori eradication therapy itself induces apoptosis in mononuclear leukocytes in the gastric mucosa.
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Hepato Gastroenterol · May 2003
Radiofrequency ablation for treatment of hepatocellular carcinoma with cirrhosis.
The majority of hepatocellular carcinoma patients with cirrhosis are not candidates for surgical resection, and local thermal therapy producing destruction of cancer cells was one of the ideal options for treatment. Heat from radiofrequency ablation is generated through agitation caused by an alternating electrical current. The heat of radiofrequency energy results in local cell coagulation and causes cellular ablation necrosis of tumor tissue. ⋯ Radiofrequency ablation resulted in a higher rate of complete necrosis of tumor tissue and the complication rate was low as well. Therefore, we believed that radiofrequency ablation is an ideal treatment modality for most liver tumors, which cannot tolerate the conventional surgical procedures.
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Hepato Gastroenterol · May 2003
Case ReportsHepatic artery aneurysm complicating intra-arterial chemotherapy for hepatocellular carcinoma.
We present a rare case of asymptomatic hepatic artery aneurysm that developed during therapy in a 65-year-old man who received hepatic intra-arterial chemotherapy for an inoperable hepatocellular carcinoma. The aneurysm remained unchanged although the intra-arterial chemotherapy was continued for five more cycles after its appearance.
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Hepato Gastroenterol · May 2003
Factors for prolonged length of stay after elective hepatectomy for hepatocellular carcinoma. The surgeon's role in the managed care era.
Length of stay is an important marker of medical resource consumption. In the modern managed care era physicians are driven to deliver the highest quality of care while using fewest resources. Hepatectomy represents a technically challenging and resource-intensive procedure, particularly in the setting of hepatic malignancy and liver cirrhosis. For improving quality of surgical management in such cases, we aimed to identify the factors affecting length of stay after hepatectomy for patients with hepatocellular carcinoma. ⋯ Most of the independent factors for prolonged length of stay after elective hepatectomy for hepatocellular carcinoma patients are operation-related and surgeon-dependent. The surgeon plays a key role in determining length of stay. By minimizing blood transfusion, surgical complication, and the time to abdominal drain removal, length of stay can be significantly decreased in hepatocellular carcinoma patients undergoing hepatectomy.