Hepato Gastroenterol
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Hepato Gastroenterol · May 2003
Case ReportsHepatic artery aneurysm complicating intra-arterial chemotherapy for hepatocellular carcinoma.
We present a rare case of asymptomatic hepatic artery aneurysm that developed during therapy in a 65-year-old man who received hepatic intra-arterial chemotherapy for an inoperable hepatocellular carcinoma. The aneurysm remained unchanged although the intra-arterial chemotherapy was continued for five more cycles after its appearance.
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Hepato Gastroenterol · May 2003
Factors for prolonged length of stay after elective hepatectomy for hepatocellular carcinoma. The surgeon's role in the managed care era.
Length of stay is an important marker of medical resource consumption. In the modern managed care era physicians are driven to deliver the highest quality of care while using fewest resources. Hepatectomy represents a technically challenging and resource-intensive procedure, particularly in the setting of hepatic malignancy and liver cirrhosis. For improving quality of surgical management in such cases, we aimed to identify the factors affecting length of stay after hepatectomy for patients with hepatocellular carcinoma. ⋯ Most of the independent factors for prolonged length of stay after elective hepatectomy for hepatocellular carcinoma patients are operation-related and surgeon-dependent. The surgeon plays a key role in determining length of stay. By minimizing blood transfusion, surgical complication, and the time to abdominal drain removal, length of stay can be significantly decreased in hepatocellular carcinoma patients undergoing hepatectomy.
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Hepato Gastroenterol · May 2003
Outcome of total pelvic exenteration for locally recurrent rectal cancer.
Local recurrence occurs in 10 to 30% of patients with rectal cancer following curative resection. However treatment of choice remains controversial. We assessed the results of total pelvic exenteration for locally recurrent cancer of the rectum retrospectively. ⋯ Total pelvic exenteration for local recurrence of rectal cancer can achieve long-term survival when curative resection is possible and the disease-free interval is long.
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Hepato Gastroenterol · May 2003
Arterial embolization in the treatment of severe blunt hepatic trauma.
The Authors stress the role of arterial embolization in the treatment of severe blunt hepatic trauma, with stable hemodynamic conditions, but with continuous bleeding, demonstrated by computed tomography scan. ⋯ Our results show that arterial embolization is useful and effective in the treatment of severe blunt hepatic trauma when, in spite of stable hemodynamic state, computed tomography scan shows persistent bleeding.
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Hepato Gastroenterol · Mar 2003
Case ReportsLaparoscopic splenectomy for variceal bleeding with non-cirrhotic portal vein thrombosis: a case report.
A 57-year-old man was referred to our hospital for treatment of refractory gastric bleeding from gastric varices secondary to portal vein thrombosis. The patient's liver function tests and coagulation profile were normal. The venous phase of the superior mesenteric arteriogram, on the other hand, showed superior mesenteric vein-portal vein occlusion with surrounding hepatopetal variceal collaterals. ⋯ Extrahepatic portal vein thrombosis is the leading cause of variceal hemorrhage in patients with healthy livers. There is a consensus in the literature that splenectomy alone is of minimal value in preventing variceal bleeding in portal vein thrombosis. Splenectomy is, however, indicated in cases in which the patient has hepatopetal collaterals from the mesenteric vein system and whose hemorrhagic gastric varices are related to splenic vein thrombosis as in our case.