Hepato Gastroenterol
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Hepato Gastroenterol · Nov 2001
Randomized Controlled Trial Multicenter Study Clinical TrialDuodenal ulcer healing rates in a one-year follow-up study with ranitidine bismuth citrate and antibiotics.
The aim of this study was to determine the one-year outcome of an eradication therapy with ranitidine bismuth citrate and antibiotics in Helicobacter pylori-positive duodenal ulcer patients in respect to ulcer and Helicobacter pylori relapse rates. ⋯ Our data confirm the reduction of duodenal ulcer relapses after the cure of Helicobacter pylori infection.
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Hepato Gastroenterol · Sep 2001
Case ReportsRetrohepatic vena cava replacement of hepatic malignancies without using total hepatic vascular exclusion or extracorporeal bypass.
Total hepatic vascular exclusion and venovenous bypass are frequently used surgical procedures when concomitant resection of the inferior vena cava is required during surgery of liver cancer involving the retrohepatic inferior vena cava close to the hepatic veins. However, the duration of total hepatic vascular exclusion is limited due to the risk of hepatic ischemia. Three patients presented with severely compressed inferior vena cava and/or hepatic veins due to liver cancer. ⋯ No graft-related complications occurred, but 2 of the 3 patients showed temporal renal dysfunction associated with renal congestion postoperatively. The surgical procedure described herein is effective for the treatment of retrohepatic inferior vena cava in some patients. However, when the case is complicated by chronic nephropathy or simultaneous nephrectomy is required, venovenous bypass should be performed.
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Hepato Gastroenterol · Jul 2001
Case ReportsSuccessful treatment for the IVC syndrome due to recurrence of colon cancer--chemotherapy in combination with the use of the expandable metallic stent placement.
A 73-year-old woman developed severe edema of the abdominal walls and legs due to rapid regrowth of unresectable paraaortic lymph node metastasis from ascending colon cancer. The expandable metallic stent was placed at the site of stenosis. Following the stent placement, she had marked improvement in her urinary output, ascitic drainage and edema of the lower extremity. ⋯ The patient is alive 22 months after primary noncurative operation. Symptoms did not recur 4 months after the placement of the stent. The authors recommend the multimodality for palliation therapy in unresectable colorectal cancer.
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Hepato Gastroenterol · Jul 2001
The effect of augmenting portal venous inflow on intrahepatic pressure and resistance in the isolated perfused porcine liver.
The literature regarding the relationship between portal venous flow and pressure is controversial. The aim of this study was to examine the effects of doubling portal venous inflow on hepatic hemodynamics. ⋯ The increases in hepatic artery pressure and intrahepatic arterial resistance are a result of the hepatic arterial 'buffer response', a phenomenon not previously demonstrated in vitro. The magnitude of the observed changes in portal venous and hepatic venous pressure leads to the conclusion that, in the porcine liver, the intrahepatic venous resistance sites react by constricting to increases in portal venous inflow.
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Hepato Gastroenterol · May 2001
Comparative StudyDiagnosis and treatment of bleeding colonic diverticula.
Colonic diverticula are the most frequent cause of major lower intestinal bleeding and pose a diagnostic and therapeutic challenge to the attending physician. Emergency surgical resection is associated with a high mortality and morbidity and patients who will stop bleeding spontaneously cannot be distinguished from those who will continue to bleed. Our aim was to evaluate the efficacy of barium enema as a sole less invasive treatment option for severe diverticular bleeding. ⋯ If diverticular bleeding is clinically suspected as the cause of major lower intestinal hemorrhage, barium enema is a more promising alternative than conservative treatment because of diagnostic and therapeutic importance in the long-term. In the event of urgent secondary surgery following the failure of barium enema to stop bleeding, we recommend a sigmoidoscopy and, optionally, an angiography before surgery in order to first localize the bleeding. We conclude that therapeutic barium enema is the treatment of choice for the first bleeding episode, while surgical resection should be performed if rebleeding occurs.