Hepato Gastroenterol
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Patients with advanced or metastatic cancer have compromised nutritional, metabolic, and immune conditions. Little is known about gastroduodenal perforation in cancer patients. ⋯ Gastroduodenal perforation occurring in cancer patients without chemotherapy had favorable short-term operative results.
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Hepato Gastroenterol · Jul 1999
Should the bile duct be preserved or removed in radical surgery for gallbladder cancer?
It is unclear whether resection of the extrahepatic bile duct in radical surgery for gallbladder cancer should be performed when direct infiltration into the hepatoduodenal ligament is absent. ⋯ Considering the adverse effect of bilioenteric anastomosis, preservation of the extrahepatic bile duct is recommended in radical surgery for gallbladder cancer when the tumor is less advanced than stage IV and does not extend to the hepatoduodenal ligament.
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Hepato Gastroenterol · Jul 1999
Comparative Study Clinical TrialEffect of omeprazole and amoxicillin plus metronidazole on the eradication of Helicobacter pylori and the healing of duodenal ulcer: comparison with a historical control.
To test the hypothesis of equivalence of an omeprazole 7-day triple therapy without subsequent acid suppression and a historical ranitidine 12-day triple therapy (recruiting phase 1989-91) with subsequent acid suppression in their effect on the eradication of Helicobacter pylori (H. pylori) and the healing of duodenal ulcer. ⋯ The effect of amoxicillin plus metronidazole plus antisecretory agent on the eradication of H. pylori has decreased markedly during the past 6 years due to the escalation of PMR. Doubling of the omeprazole dose does not affect outcome. Cure of the infection as well as metronidazole susceptibility enhance duodenal ulcer healing and symptom relief. Acid suppression following a successful 1-week anti-HP therapy is not required for duodenal ulcer treatment.
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Injury of the bile duct after blunt trauma is rare but injury and rupture of the intrapancreatic portion of the bile duct is extremely rare. Injury is very difficult to recognize even if explorative laparotomy is done. Elevation of the liver tests, especially gamma GT and alkaline phosphatase, is very often the first sign of injury. ⋯ If there is no sign of great injury to the head of the pancreas we have to perform normal biliary flow. Here we report a rare case of intrapancreatic rupture of the common bile duct without high degree of pancreatic injury after blunt injury. Cholecystectomy and choledochojejunostomy were performed.
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Hepato Gastroenterol · Jul 1999
Leptin levels in nonalcoholic steatohepatitis and chronic hepatitis C.
Leptin is a peptide which regulates food intake and energy expenditure. Moreover, it is involved in the homeostasis of body composition and is linked to the regulation of insulin signaling, thus playing an important role in liver fat storage. Steatosis is a common finding in chronic hepatitis C, and both viral and metabolic factors have been suggested to explain the presence of this histological characteristic. In order to study leptin in chronic liver disease characterized by the presence of steatosis, we evaluated its serum levels in patients with nonalcoholic steatohepatitis (NASH), in chronic hepatitis C (CHC) patients with no histological findings of steatosis, and CHC patients with steatosis but no risk factors for its development. ⋯ The increasing trend observed in leptin serum levels among the different groups of patients showed that in chronic liver disease characterized by the presence of steatosis, leptin signaling is preserved. Moreover, CHC factors different from the metabolic ones should be investigated in order to explain the presence of steatosis. Further studies on broader groups of patients are needed to verify these preliminary results.