Hepato Gastroenterol
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Hepato Gastroenterol · Jan 1996
Endoscopic sphincterotomy prior to laparoscopic cholecystectomy for the treatment of cholelithiasis.
Laparoscopic cholecystectomy is the standard treatment for symptomatic cholecystolithiasis; however, there is debate on the management of patients with concomitant common bile duct stones. Several options have been suggested; endoscopic sphincterotomy and laparoscopic common bile duct exploration seemed to be the preferred methods at this moment. ⋯ Endoscopic sphincterotomy combined with laparoscopic cholecystectomy is a safe and effective therapy for symptomatic cholecystolithiasis with concomitant choledocholithiasis. Recurrent stones did occur, but further studies are needed to compare the incidence of recurrent stones after endoscopic sphincterotomy and after laparoscopic common bile duct exploration.
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Hepato Gastroenterol · Nov 1995
Review Case ReportsResection of a fibrolamellar carcinoma of the liver originating in the caudate lobe.
Liver tumors rarely arise in the caudate lobe and resection of such tumors is even more rare. Spigel's lobe resection, first described by Ton Thac Tung, is a very unusual operation and the technique has not been clearly established. Recently, successful resections of the caudate lobe of the liver have been reported. ⋯ This tumor presents a high resectability rate (48-100%) with a good prognosis and a mean survival of 68 months. We report a case of fibrolamellar carcinoma arising in the caudate lobe of the liver. Resection of the caudate lobe of the liver was carried out with no morbidity.
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Hepato Gastroenterol · Nov 1995
Case ReportsSequential treatment of hepatorenal syndrome and posthepatic cirrhosis by intrahepatic portosystemic shunt (TIPSS) and liver transplantation.
The results of liver transplantation are compromised in cirrhotic patients presenting with renal insufficiency from hepatorenal syndrome. A case of cirrhosis and hepatorenal syndrome, treated sequentially with transjugular intrahepatic porto-systemic stent shunting (TIPSS) and liver transplantation, is discussed. TIPSS may be useful for correcting renal dysfunction and/or hepatorenal syndrome in end-stage cirrhotics, thus permitting subsequent elective liver transplantation under good conditions.
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Hepato Gastroenterol · Sep 1995
Surgical treatment of pancreatic ascites and pancreatic pleural effusions.
Massive ascites and pleural effusions are uncommon but well-documented complications of chronic pancreatitis. The present study reviews the results of surgical management of pancreatic ascites and pleural effusions of pancreatic origin. ⋯ Internal pancreatic drainage was the ideal surgical treatment for patients with pancreatic ascites and/or pleural effusion that did not respond to medical treatment. When this was not feasible external drainage was successfully used as an alternative to pancreatic resection.
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Hepato Gastroenterol · Jul 1995
The afferent circulation of the liver in patients with primary hepatocellular carcinoma.
The data on the afferent circulation of the liver, in patients with primary hepatocellular carcinoma, are controversial or non-existent. ⋯ On the basis of our initial results, it seems probable that the ratio of the two circulations represents a diagnostic tool for the altered circulation in patients with hepatocellular carcinoma. The significance of this phenomena is not yet quite clear, but a review of the literature shows that similar observations have not been reported. In practical terms this phenomenon may be useful from the point of view of US and Doppler US diagnosis, e.g. in the case of a hypo-echoic or hyperechoir, mass in the liver, increased blood flow in the hepatic, artery, and decreased portal venous flow, a malignant liver tumor is virtually certain. The authors hypothesise that any pathology in the liver may lead to a primary decrease in PVF and a subsequent increase in HAF.