Hepato Gastroenterol
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Hepato Gastroenterol · Oct 2013
Risk factors of bile leakage after hepatectomy for hepatocellular carcinoma.
To identify the risk factors for postoperative biliary complications after hepatic resection for hepatocellular carcinoma. ⋯ Prolonged operation time and hepatectomy including segment 4 led to a high risk for postoperative bile leakage in this series of patients.
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Hepato Gastroenterol · Oct 2013
Reducing the gastroesophageal reflux with lip-type reinforcement technique during intrathoracic esophagogastrostomy.
Gastroesophageal reflux is a significant problem after esophagogastrostomy, and impact considerably upon the quality of patients' lives. Aims of this study were to evaluate the operative effects in prevention of reflux with lip-type reinforcement during intrathoracic esophagogastric anastomosis. ⋯ Lip-type reinforcement is simple to perform, and effective in controlling gastroesophageal reflux and decreasing anastomotic leakage in majority of patients after esophagogastrostomy.
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Hepato Gastroenterol · Sep 2013
A splenic volume increase due to preoperative chemotherapy may impair the long-term outcome after hepatectomy in patients with initially non-optimally resectable colorectal cancer liver metastases.
In patients with colorectal cancer liver metastases (CRCLM), chemotherapy-associated hepatotoxicity (CAH) has been shown to be associated with splenomegaly. The aim of the present study was to investigate whether a higher splenic volume increase (SVI) after preoperative chemotherapy was associated with a worse long-term outcome after hepatectomy in patients with CRCLM. ⋯ In patients with non-optimally resectable CRCLM, the SVI during the first 12 weeks of preoperative chemotherapy may be a significant predictor of the long-term survival after hepatectomy.
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Hepato Gastroenterol · Sep 2013
POSSUM and P-POSSUM for risk assessment in general surgery in the elderly.
The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth POSSUM (P-POSSUM) use preoperative and intraoperative factors to evaluate risk. We examined our surgical results to investigate predictive factors for morbidity and mortality, and evaluate the accuracy of the POSSUM and P-POSSUM. ⋯ Even though POSSUM tended to underestimate the morbidity rate, POSSUM and P-POSSUM accurately predicted the mortality rate after general surgical procedures.
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Hepato Gastroenterol · Sep 2013
Effects of biliary drainage on the intestinal barrier function in obstructive jaundice.
Despite advances in preoperative evaluation and postoperative care, intervention, especially surgery, for relief of obstructive jaundice still carries high morbidity and mortality rates. In obstructive jaundice, intestinal barrier dysfunction has been postulated to be a key factor contributing to high postoperative morbidity and mortality rates. Since surgery in patients with jaundice is thought to increase the risk of postoperative complications, preoperative biliary drainage (PBD) was introduced to improve the postoperative outcome. To date, whether biliary drainage should be routinely performed in patients with jaundice undergoing a pancreatoduodenectomy remains controversial, and the effect of biliary drainage on the intestinal barrier function in obstructive jaundice remains unknown. ⋯ PBD should not be performed routinely, unless further improved PBD techniques would become available in clinical studies. Future studies should focus on PBD techniques, and then on the effects of biliary drainage on intestinal mucosa in obstructive jaundice in clinical.