Hepato Gastroenterol
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Hepato Gastroenterol · Nov 2012
Randomized Controlled TrialEffect of stroke volume variability- guided intraoperative fluid restriction on gastrointestinal functional recovery.
To investigate the effect of stroke volume variability(SVV)-guided intraoperative fluid restriction on gastrointestinal functional recovery and postoperative outcome after gastrointestinal surgery. Forty ASA I-II patients undergoing elective gastrointestinal surgery were randomly divided into 2 groups (n=20 each):group A routine fluid administration and group B restricted fluid administration. SW value was maintained at 5-7 in group A and 11-13 in group B. ⋯ Urine output in group A was significant less than in group B (p<0.05). Stroke volume variation measured from Edwards Flotrac sensor and Edwards Vigileo monitor could be a security and sensitive parameter as an index of volume administration. In elective gastrointestinal surgery, volume resuscitation with a goal SVV of11-13 not only reduced intravenous fluid volume but also maintained the stable hemodynamic and tissue perfusion, enhanced gastrointestinal functional recovery and reduced the length of hospital stay
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Hepato Gastroenterol · Nov 2012
Risk factors of pancreatic fistula after pancreaticoduodenectomy - patients with low drain amylase level on postoperative day 1 are safe from developing pancreatic fistula.
Based on the criteria of International Study Group on Pancreatic Fistula (ISGPF), the risk factors for grade B/C pancreatic fistula (PF) after pancreaticoduodenectomy (PD) were analyzed in this study. ⋯ Although our study demonstrated that the non-dilated pancreatic duct is significantly correlated with the increased incidence of grade B/CPE patients with low amylase level of drainage fluid on POD 1 are thought to be safe from developing PE.
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Hepato Gastroenterol · Nov 2012
Can pre-endoscopic assessment predict active upper gastrointestinal bleeding? A retrospective study in patients with symptoms of upper gastrointestinal bleeding outside regular working hours.
To evaluate the usefulness of pre-endoscopic assessment for predicting active up-per gastrointestinal bleeding (UGI-B) at emergency esophagogastroduodenoscopy (E-EGD, within 6 hours). ⋯ No relevant pre-endoscopic variables for the prediction of active UGI-B at E-EGD could be found. Our data suggest that pre-endoscopic evaluation cannot replace rapid endoscopy.
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Hepato Gastroenterol · Nov 2012
The usefulness of P-POSSUM score in patients undergoing elective liver resection for benign disease, metastatic colorectal cancer and non-colorectal cancer.
P-POSSUM predicts operative risk and mortality, although few reports describe its use in elective liver resection. We analysed P-POSSUM scores in patients undergoing resection for colorectal liver metastases, non-colorectal cancer and benign liver dis-ease. ⋯ Predicted mortality is over estimated in patients undergoing liver resection. Pre-operative,physiological score and predicted mortality may have a role predicting morbidity. P-POSSUM is ineffective in predicting prognosis following colorectal cancer metastases resection, although may be used to stratify risk in high risk cancer patients.
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Hepato Gastroenterol · Nov 2012
Adjuvant chemotherapy increase survival and decrease recurrence in stage IIA colon cancer.
The aim of the present study is to evaluate the prognostic factors and efficacy of adjuvant chemotherapy in stage IIA colon cancer patients. ⋯ Lymphovascular invasion and adjuvant chemotherapy were independent prognostic factors. Adjuvant chemotherapy was effective in preventing recurrence and improving survival for the stage IIA colon cancer patients, especially for those patients with less than 15 harvested lymph nodes.