Hepato Gastroenterol
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Hepato Gastroenterol · Jul 2014
Thoracic 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.
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Hepato Gastroenterol · Jul 2014
Multicenter StudyC-reactive protein as a prognostic factor for mortality in pneumonia patients with liver cirrhosis.
C-reactive protein (CRP) is considered a useful predictor of mortality from community- acquired pneumonia (CAP). Serum CRP concentration reflects its production in the liver, and impaired liver function may affect CRP level. The purpose of this study was to evaluate whether the initial CRP level is a prognostic factor for mortality from CAP in patients with liver cirrhosis (LC). ⋯ Higher initial serum CRP level is associated with lower mortality risk in CAP patients with LC.
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Hepato Gastroenterol · Jul 2014
Nomogram to predict anastomotic leakage after laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis for rectal cancer.
Laparoscopic rectal cancer surgery involving rectal division with intracorporeal stapling devices is technically difficult. This study aimed to identify risk factors for anastomotic leakage associated with laparoscopic anterior resection for rectal cancer. ⋯ Our results suggest that we found that tumor localization, preservation of the left colic artery and operation time are predictive factors for clinical anastomotic leakage in laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique (DST) anastomosis for rectal cancer.
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Hepato Gastroenterol · Jul 2014
C-reactive protein as a prognostic factor for mortality in pneumonia patients with liver cirrhosis.
C-reactive protein (CRP) is considered a useful predictor of mortality from community- acquired pneumonia (CAP). Serum CRP concentration reflects its production in the liver, and impaired liver function may affect CRP level. The purpose of this study was to evaluate whether the initial CRP level is a prognostic factor for mortality from CAP in patients with liver cirrhosis (LC). ⋯ Higher initial serum CRP level is associated with lower mortality risk in CAP patients with LC.
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Hepato Gastroenterol · Jul 2014
Case ReportsCentral hepatic resection under hypothermic total vascular exclusion using ante-situm techniques while maintaining liver blood supply.
Ante-situm liver resection under hypothermic total vascular exclusion is used to resect large tumours that involve the hepatic veins close to the vena cava or the cava itself. This procedure traditionally requires venovenous bypass when it is necessary to clamp the cava, or portocaval shunt when caval continuity is maintained by piggyback dissection of the liver. We present a technique of ante-situm liver resection, operating on one side of the liver at a time while maintaining prograde portal flow through the opposite side of the liver, thereby avoiding venovenous bypass, portacaval shunt and portal vein reconstruction.