Hepato Gastroenterol
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Hepato Gastroenterol · Sep 2003
Clinical significance and prediction factors of gastric varices in patients with hepatocellular carcinoma.
Hepatocellular carcinoma is part of the natural history of liver cirrhosis. Gastrointestinal bleeding and hepatic failure are the leading causes of death in hepatocellular carcinoma patients. With gastrointestinal bleeding, variceal bleeding is the most prominent, and most variceal bleeding is of esophageal origin. Gastric varices bleeding is often a massive and severe bleeding episode. The role of gastric varices among patients with hepatocellular carcinoma remains to be clarified. In this study, we aimed to evaluate the prevalence, clinical significance and prediction of gastric varices in patients with hepatocellular carcinoma. ⋯ The prevalence of gastric varices in patients with hepatocellular carcinoma is 6.9% and the risk of bleeding is low in this study. The Predictors of gastric varices among hepatocellular carcinoma are related to liver cirrhosis, Child-Pugh classification, hepatic encephalopathy, portal vein or splenic vein dilatation, ascites, splenomegaly, albumin level, prothrombin time and platelet count.
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Hepato Gastroenterol · Sep 2003
Case ReportsProphylactic transileocolic obliteration of esophageal varices after balloon-occluded retrograde transvenous obliteration of gastric varices with a gastrorenal shunt.
Several non-surgical techniques have been developed to treat esophagogastric varices that occur secondary to portal hypertension, including those performed endoscopically or with interventional radiologic therapies. In patients with large gastric fundal varices and associated gastrorenal shunting, controversy still remains in defining the most appropriate non-surgical intervention. Balloon-occluded retrograde transvenous obliteration has been shown to be one effective treatment for gastric varices in these instances. ⋯ We report a patient with gastric fundal varices that were successfully treated using balloon-occluded retrograde transvenous obliteration and in whom prophylactic transileocolic obliteration of esophageal varices was additionally performed. This 46-year-old man was diagnosed with severe gastric varices and gastrorenal shunting with only mild esophageal varices. Five years after therapy, the patient demonstrates no evidence of recurrence of either gastric or esophageal varices and has remained otherwise healthy.
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Hepato Gastroenterol · Sep 2003
Simple closure of chronic duodenal ulcer perforation in the era of Helicobacter pylori: an old procedure, today's solution.
To evaluate the risk of recurrence in our patients with chronic duodenal ulcer perforation, who underwent a simple closure and postoperative Helicobacter pylori eradication therapy. ⋯ Simple closure of perforated chronic duodenal ulcer in combination with postoperative Helicobacter pylori eradication, seems to be an accepted treatment, so the immediate acid-reduction surgery (vagotomy) in the contaminated environment caused by perforation, is probably unnecessary.
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Hepato Gastroenterol · Sep 2003
Surgical technique influences bowel function after low anterior resection and sigmoid colectomy.
Since June 1996, we have changed surgical strategies to preserve the pelvic autonomic nerve and abandon high ligation of the inferior mesenteric artery. The aim of this study was to clarify the influence of this surgical technique on subjective bowel function of patients with low anterior resection and sigmoid colectomy for cancer. ⋯ Surgical technique had a significant impact on bowel function following low anterior resection and sigmoid colectomy for cancer. When high ligation of the inferior mesenteric artery is abandoned and the pelvic autonomic nerve is preserved by careful technique, postoperative bowel dysfunction in patients with rectosigmoid colon cancer can be minimized.