Hepato Gastroenterol
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Hepato Gastroenterol · Nov 2006
Effect of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy.
Preoperative biliary drainage (PBD) in jaundiced patients undergoing pancreaticoduodenectomy remains controversial. ⋯ Preoperative biliary drainage did not increase postoperative morbidity and mortality rate in pancreaticoduodenectomy patients, but should be used judiciously.
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Hepato Gastroenterol · Jul 2006
Esophageal perforation--associated risk with balloon tamponade after endoscopic therapy. Myth or reality?
Variceal bleeding is still associated with high mortality and balloon tamponade may be a lifesaving measure when endoscopic therapy is not available or feasible. The risk of esophageal perforation with balloon tamponade after endoscopic therapy is still uncertain. The aims of the study were to investigate balloon tamponade effectiveness and safety after endoscopic therapy. ⋯ Currently balloon tamponade is only used as a temporary bridge to other strategies, when other forms of hemostatic therapies do not succeed. Balloon tamponade was more effective in patients with less severe hepatic dysfunction. Previous attempts to perform endoscopic therapy may augment tamponade effectiveness without increasing the risk of esophageal perforation.
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Hepato Gastroenterol · May 2006
Comparative StudyThe etiology and clinical characteristics of acute lower gastrointestinal bleeding in patients hospitalized for comorbid illnesses.
To determine whether there are different causes of acute lower gastrointestinal bleeding and different clinical courses in patients (a) with comorbid illnesses vs. (b) patients with only severe hematochezia. ⋯ Patients with acute lower gastrointestinal bleeding that starts after hospitalization for other comorbid illnesses have distinctive etiologies and clinical characteristics compared with ordinary patients admitted to the hospital with only bleeding. Rectal ulcer is an important but obscure cause of acute lower gastrointestinal bleeding in elderly patients with significant comorbid diseases.
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Hepato Gastroenterol · May 2006
Comparative StudymRNA expression of inducible nitric oxide synthase, endothelial nitric oxide synthase and vascular endothelial growth factor in esophageal mucosa biopsy specimens from patients with reflux esophagitis.
Nitric oxide (NO) production is elevated in the intestine and may contribute to intestinal injury during inflammation. However, how the expression of inducible NO synthase (iNOS) mRNA and endothelial NO synthase (eNOS) mRNA in the esophageal mucosa contribute to mucosal damage caused by reflux esophagitis remains unknown. Since vascular endothelial growth factor (VEGF) exerts its action on microcirculation, contributing to angiogenesis and inflammation, we examined the role of VEGF together with iNOS and eNOS on development of reflux esophagitis. ⋯ The accumulation of NO, produced by iNOS, was considered to be related to the exacerbation of reflux esophagitis. Therapeutic intervention that reduces NO production may thus be of use in preventing development of esophageal mucosal injury in patients with reflux esophagitis.
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Hepato Gastroenterol · May 2006
Aggressive endoscopic hemostasis for severe gastrointestinal bleeding in critically ill patients to decrease mortality.
In critically ill patients, with gastrointestinal (GI) bleeding achieving endoscopic hemostasis has been reported to be often difficult, with a high rebleeding rate. The purpose of this study was to examine the efficacy of endoscopic hemoclipping for severe GI bleeding in critically ill patients. ⋯ Endoscopic hemostasis is useful in critically ill patients with the severe GI bleeding that occurs during critical care in the intensive care unit.