Hepato Gastroenterol
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Hepato Gastroenterol · Jun 2012
Antecolic and retrocolic route on delayed gastric emptying after MSSPPD.
Previously, we developed a modified subtotal stomach-preserving pancreaticoduodenectomy for preventing delayed gastric emptying and achieved a decrease in the incidence of delayed gastric emptying. In this study, we compared the antecolic and retrocolic routes to determine which reconstruction route is better for decreasing the incidence of delayed gastric emptying in modified subtotal stomachpreserving pancreaticoduodenectomy. ⋯ We consider retrocolic reconstruction preferable to antecolic reconstruction for preventing delayed gastric emptying in patients who have undergone modified subtotal-stomach-preserving pancreaticoduodenectomy with pancreaticogastrostomy.
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Hepato Gastroenterol · Jun 2012
Central venous port system-related complications in outpatient chemotherapy for colorectal cancer.
The current standard chemotherapy for metastatic colorectal cancer is the FOLFOX or the FOLFIRI regimen. Although these regimens include the continuous infusion of an anticancer agent, chemotherapy is possible by using implantable central venous port systems with a portable disposable pump in an outpatient setting. This study is an evaluation of the usefulness of implantable central venous port systems for colorectal cancer chemotherapy. ⋯ Implantable central venous port systems are safe and have a low long-term complication rate. We consider port systems, such as modified FOLFOX6 ± bevacizumab or FOLFIRI ± bevacizumab regimens, useful for colorectal cancer patients receiving chemotherapy.
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Hepato Gastroenterol · Jun 2012
Intensive pulmonary support using extracorporeal membrane oxygenation in adult patients undergoing liver transplantation.
Adult liver transplantation (LT) recipients occasionally show serious acute cardiopulmonary dysfunction, requiring intensive care. We have assessed the feasibility of extracorporeal membrane oxygenation (ECMO) support in adult LT recipients facing acute pulmonary failure and refractory to conventional mechanical ventilation and concurrent nitric oxide gas inhalation. ⋯ ECMO as rescue therapy seems beneficial to be considered as a final therapeutic option for LT recipients with refractory pulmonary dysfunction who would otherwise die due to hypoxemia.
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Hepato Gastroenterol · May 2012
Case ReportsRecurrent hepatocellular carcinoma with tumor thrombus in right atrium - report of a successful liver resection with tumor thrombectomy using total hepatic vascular exclusion without concomitant cardiopulmonary bypass.
For resection of advanced hepatocellular carcinoma (HCC) in which tumor thrombus (TT) extends into inferior vena cava (IVC) or right atrium (RA) surgery is challenging and requires skillful techniques. Here, we report a case of recurrent HCC with TT extending to the RA, who underwent successful resection with tumor thrombectomy without concomitant cardiopulmonary bypass. A 71-year-old man, who had been followed- up for hepatitis C by a local hospital, was diagnosed as having HCC in segment 6 for which he had undergone segmentectomy of segment 6 in May 2009. ⋯ The postoperative course was uneventful. Histopathology was recurrent hepatocellular carcinoma with hepatic venous invasion. We report the case of resected recurrent HCC with TT extending to right atrium without concomitant cardiopulmonary bypass.
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Hepato Gastroenterol · May 2012
Comparative StudyOutcome of laparoscopy-assisted gastrectomy vs. open gastrectomy for gastric cancer: a retrospective comparative study.
Laparoscopy-assisted gastrectomy is still controversial because of scant evidence of safety and feasibility. The objective of this study was to assess the feasibility of using the laparoscopy-assisted gastrectomy in treating gastric cancer and evaluate its outcome compared with conventional open gastrectomy. ⋯ Laparoscopy-assisted gastrectomy with D2 lymph node dissection is a safe and feasible procedure with adequate lymphadenectomy for the treatment of gastric cancer.