Hepato Gastroenterol
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Hepato Gastroenterol · Sep 2004
Comparative StudyLaparoscopic and open approach in perforated peptic ulcer.
To improve the perioperative course and quality of life of the patients with perforated peptic ulcer, we investigated the conversion risk factors in laparoscopic simple closure and omental patch repair for perforated peptic ulcer. ⋯ These conversion factors are useful to achieve appropriate surgical treatments for perforated peptic ulcer.
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Hepato Gastroenterol · Sep 2004
Case ReportsHilar bile duct cancer associated with preoperatively undetectable von Meyenburg complex--report of a case.
A 56-year-old man was admitted to our hospital with a diagnosis of hilar bile duct cancer. Abdominal ultrasonography, computed tomography and endoscopic retrograde cholangiopancreatography showed no other concomitant disease. Biochemical data showed 0.6 mg/dL of total bilirubin, 104 IU/L of alanine aminotransferase and 469 mg/dL of alkaline phosphatase. ⋯ The possibility of a preoperative imaging diagnosis for von Meyenburg complex seems to depend on the size of the bile duct structure in each hamartoma. To the best of our knowledge, this is the fourteenth case of bile duct cancer associated with von Meyenburg complex reported in the literature. The following case is being reported because of the rarity of the disease and to stress the importance of intraoperative histology to avoid misdiagnosis as the disseminated disease, particularly when malignant neoplasia is surgically treated.
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Hepato Gastroenterol · Sep 2004
Risk factors of pancreatic fistula following pancreaticoduodenectomy for periampullary cancer.
Pancreatic fistula remains one of the most common complications of pancreaticoduodenectomy. This study was carried out to identify relevant risk factors for the development of pancreatic fistula and to evaluate whether prophylactic administration of octreotide decreases their incidence. ⋯ The only surgeon-dependent factor which may reduce the incidence of stump-related complications is anastomosis of the pancreatic remnant with the alimentary tract. Carried out single-institution analysis showed octreotide to be ineffective in the prevention of pancreatic fistula following pancreaticoduodenectomy.
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The ingestion of caustic substances is a common condition, which may result in serious injuries of the upper gastrointestinal system. The purpose of this study is to assess the outcomes of patients who had a history of the ingestion of caustic substances. ⋯ Suicidal caustic ingestion and acid ingestion seem to cause more severe injuries. Early admission to the hospital with clinical and endoscopic evaluation and early surgery when required may reduce morbidity and mortality.
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Hepato Gastroenterol · Jul 2004
Case ReportsIntraoperative massive pulmonary tumor embolism from clear cell sarcoma in the retroperitoneum: successful treatment using cardiopulmonary bypass.
Malignant neoplasms rarely extend into the inferior vena cava and up to the right side of the heart. Although massive pulmonary tumor embolism occurs relatively rarely, it can be a catastrophic problem. Intraoperative pulmonary tumor embolism and cardiac arrest occurred in a 68-year-old woman while dissecting the inferior vena cava to resect a pararenal tumor extending into the retrohepatic inferior vena cava. ⋯ A postoperative pulmonary perfusion scintigram showed no defect in the pulmonary circulation. She is well now 8 months after surgery. Safe prevention measures should be accomplished as a part of the perioperative management of patients with inferior vena cava tumor thrombus that may be fragile, and cardiopulmonary bypass should always be stand-by on surgery.