Hepato Gastroenterol
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Hepato Gastroenterol · May 2014
ReviewPreoperative Cardiac, Pulmonary and Digestive Comorbidities of Morbidly Obese Patients Undergoing Bariatric Surgery: Morbidity, Assessment and Management.
To investigate a proper preoperative assessment and management of preoperative cardiac, pulmonary and digestive comorbidities in morbidly obese patients undergoing bariatric surgery. ⋯ Comprehensive preoperative evaluation and proper management is essential to appropriately select and prepare bariatric patients, and minimize surgical risk.
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Hepato Gastroenterol · May 2014
Randomized Controlled Trial Comparative StudyEffects of Delayed Enteral Nutrition on Inflammatory Responses and Immune Function Competence in Critically Ill Patients with Prolonged Fasting.
Although different studies suggest that early enteral nutrition (EEN) has benefits in reducing infectious complications, there is no data that addresses whether delayed enteral nutrition (EN) is detrimental and if it may have effects on inflammatory responses and immune function. Forty-five critically ill patients with long fasting were randomly allocated in two groups according to the type of nutritional support. The first group included patients assuming a standard enteral nutrition (EN, n = 22) and the second group assuming a parenteral nutrition (PN, n = 23). ⋯ CRP and IL-6 levels were higher in EN patients than those assuming a PN after 2 and 3 days (P < 0.05). HLA-DR levels in patients assuming an EN were found higher than those in PN at day 7 (P < 0.05). Delayed EN for critically ill patients with long-term fasting increased systemic inflammatory responses, whereas EN could modify immune function, therefore reducing hospital stay and costs.
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Hepato Gastroenterol · May 2014
The Impact of Combined Transarterial Chemoembolization on the Overall Survival of Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib.
Sorafenib has been proved to prolong survival of patients with advanced hepatocellular carcinoma (HCC), but with moderate efficacy. The present study aimed to evaluate the prognostic factors for overall survival (OS) in Chinese patients with advanced HCC treated with sorafenib who had been refractory to transarterial chemoembolization (TACE) and identify the impact of combined TACE on OS. ⋯ Albumin and combined TACE is associated with improved OS in patients with advanced HCC treated with sorafenib who had been refractory to TACE. While, BCLC stage C is an independent negative prognostic factor for the OS.
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Hepato Gastroenterol · May 2014
Thromboelastography can Identify Postoperative Active Bleeding and Evaluate Blood Product Requirements in Abdominal Surgery.
Hemorrhage after abdominal surgery remains a frequent clinical complication, and associated with prolonged length of stay, increased complications and mortality. Indication of blood product requirements accurately and promptly is very important for recovery of patients. Thrombelastography (TEG) as a tool for evaluation of bleeding and effects of blood components and blood products is increasing. We investigated that whether TEG can identify postoperative active bleeding and evaluate blood product requirements in abdominal surgery. ⋯ MA can not only identify postoperative active bleeding together with hemoglobin, hematocrit, and fibrinogen, but also evaluate blood product requirements in abdominal surgery.
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Hepato Gastroenterol · May 2014
Prediction of Pancreatic Fistula by Preoperatively Assessable Factors; Retrospective Review of Unified Operations by Single Surgeon.
This retrospective study was conducted to find preoperatively assessable risk factors for postoperative pancreatic fistula (POPF) in patients undergoing laparoscopic distal pancreatectomy (LDP) using a slow compression method with a stapler, which we call pen-firing compression (PFC). ⋯ High BMI value and thick pancreatic stump are significant risk factors for POPF after LDP. Alternative treatment of the pancreatic stump may prevent POPF in high-risk patients.