Hepato Gastroenterol
-
Hepato Gastroenterol · Sep 2010
Repeated rendezvous treatment of PTBD and ERCP in patients with recurrent obstructive jaundice.
Repeated applications of rendezvous technique combining percutaneous transhepatic biliary drainage (PTBD) with endoscopic retrograde cholangiopancreatography (ERCP) (PE) in patients with recurrent obstructive jaundice have not been reported. The present study aimed to evaluate treatment effects of this technique in patients who previously received the same rendezvous treatment. ⋯ Rendezvous procedure of PTBD and ERCP could be used repeatedly and effectively for patients who present recurrent obstructive jaundice after ERCP failure.
-
Hepato Gastroenterol · Jul 2010
Intraoperative ultrasonography for reducing bile duct injury during laparoscopic cholecystectomy.
Laparoscopic cholecystectomy has become a standard procedure for gallstone disease. Bile duct injury during laparoscopic cholecystectomy is one of the most serious complications. The cause of such injury is usually the erroneous interpretation of bile duct anatomy, especially mistaking common bile duct for the cystic duct. A method for the prevention of this injury has not been established. The objective of this study was to test the usefulness of intraoperative ultrasonography for preventing bile duct injury. ⋯ Identification of the junction of the cystic duct and common bile duct before intraoperative cholangiography may reduce bile duct injury in laparoscopic cholecystectomy.
-
Hepato Gastroenterol · Jul 2010
Postconditioning prevents ischemia/reperfusion injury in rat liver transplantation.
Ischemic postconditioning (Postcon) is a phenomenon that intermittent interruptions of blood flow in the early phase of reperfusion can protect organ against ischemia/ reperfusion (I/R) injury. The potential application of postconditioning to liver is not available. In the present study, we investigated the effects of Postcon in liver I/R injury in rat liver transplantation models. ⋯ These results indicate that Post-con ameliorates liver I/R injury. This protective effect is likely mediated by up-regulation of HO-1 expression.
-
Hepato Gastroenterol · May 2010
Randomized Controlled TrialProspective randomized controlled study of short-term perioperative oral nutrition with branched chain amino acids in patients undergoing liver surgery.
Early prospective randomized clinical trials demonstrated that perioperative parenteral nutrition (PN) with branched chain amino acids (BCAA) is beneficial in cirrhotic patients with hepatocellular carcinoma who undergo hepatectomy. However, PN support is expensive and requires a long hospital stay. Moreover, PN support has not been evaluated in patients with a normal liver who undergo hepatectomy. It was studied the benefits of perioperative oral nutrition (ON) with BCAA in patients who underwent hepatectomy, including those with a non-hepatitis liver. ⋯ Short-term ON support with BCAA was associated with higher serum EPO levels than was a normal diet in patients with non-hepatitis who underwent curative hepatic resection. Higher EPO levels might be beneficial in protecting liver cells from ischemic injury and preventing intraoperative hemorrhage associated with lower perioperative levels of alanine aminotransferase and aspartate aminotransferase in serum. This is the first study to demonstrate an effect of EN support with BCAA in patients with non-hepatitis, as well as those with hepatitis.
-
Hepato Gastroenterol · May 2010
The peculiar processing of pancreatic hormone glucagon seen in traumatized patients.
The kinetics of the pancreatic hormone glucagon in traumatized patients has not been minutely investigated as well as that of insulin, despite its significant influence on energy metabolism. In the present study, we examined the kinetics of glucagon and glucagon-related peptides assessed by radioimmunoassay, and the molecular forms of these peptides using gel filtration chromatography. In addition, we discuss glucagon processes in the pancreas and intestine in traumatized patients in the early operative days. ⋯ The kinetics and processing of glucagon in traumatized patients was different from those of healthy subjects. In traumatized patients, the peculiar processing of glucagon was processed in the intestine, which is different from the ordinary glucagon processing either in the pancreas or the intestine, generating a peculiar glicentin-like peptide (GLLP).