Hepato Gastroenterol
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Hepato Gastroenterol · Sep 2014
Review Meta AnalysisRadiofrequency ablation vs. surgical resection on the treatment of patients with small hepatocellular carcinoma: a system review and meta-analysis of five randomized controlled trials.
To investigate the meta-analysis of randomized controlled trials(RCTs) of the efficacy and safety between radiofrequency ablation (RFA ) and surgical resection (SR) in treating small hepatocellular carcinoma (SHCC). ⋯ SR treatment led to a higher long-term survival rate and a lower long-term recurrence rate, while RFA led to a lower complication rate than SR. However, Further research was needed to investigate the efficacy of RFA because of the inadequate research data and the heterogeneity among the included studies.
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Hepato Gastroenterol · Sep 2014
Multicenter StudyThe epidemiology and distribution of pathogens and risk factors for mortality in liver transplant recipients with Gram negative bacteremia.
More data on the epidemiology and distribution of pathogens and the risk factors for mortality in liver transplant recipients with Gram negative bacteremia are needed. METHODs: Among a cohort of 228 liver transplant recipients, we identified 35 patients with initial episodes of Gram negative bacteremia after operation. The association between the risk factors and Gram negative bacteremia related mortality was assessed. ⋯ The risk factors significantly associated with increased mortality due to Gram negative bacteremia in liver transplant recipients are decreased serum albumin level and septic shock.
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Hepato Gastroenterol · Sep 2014
ReviewEndoscopic ultrasound guided radiofrequency ablation in pancreas.
Radiofrequency ablation of the pancreas represents a more effective tumor-destruction method compared to other ablation techniques. The endoscopic ultrasound guided radiofrequency ablation is indicated for locally advanced, non-metastatic pancreatic adenocarcinoma, without the need of general anesthesia and fast recovery. ⋯ It has been successfully applied on insulinomas and pancreatic adenocarcinoma in humans, with few complications, such as duodenal bleeding or mild abdominal pain. Other side effects as biliary fistula, pancreatic fistula or acute pancreatitis seen in intraoperative settings of radiofrequency ablation, have not been reported in endoscopic ultrasound guided radiofrequency ablation.
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Hepato Gastroenterol · Sep 2014
Comparative StudyTiming of laparoscopic cholecystectomy for mild and moderate acute cholecystitis.
The timing of a laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) remains controversial. Traditionally, LC for AC is performed within 3 days. We designed this study so that the cut-off time of LC for AC was within 7 days of admission, based on severity. ⋯ DLC had no advantage over ELC. ELC for AC is preferable in cost–effect. Even if the operation cannot be scheduled early, proper initial treatment, including percutaneous cholecystectomy with or without endoscopic nasal bile drainage for moderate AC, enables DLC a safe option.
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Hepato Gastroenterol · Jul 2014
Review Meta AnalysisThoracic epidural analgesia (TEA) vs. patient controlled analgesia (PCA) in laparoscopic colectomy: a meta-analysis.
Use of thoracic epidural analgesia (TEA) in laparoscopic colorectal surgery is still controversial. Previous clinical trials have conflicting findings in terms of bowel function return, length of hospital stay and postoperative complications. This meta-analysis aims to assess the effect of TEA on clinical outcomes of laparoscopic colorectal surgery compared with patient controlled analgesia (PCA). ⋯ Use of epidural analgesia in laparoscopic colorectal surgery helps to provide better pain alleviation during the initial period after operation. This benefit is not at the expense of increased risks of any major complications, or significantly longer hospital stay. No significant benefits in return of bowel function were observed.