World journal of gastroenterology : WJG
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World J. Gastroenterol. · Sep 2015
ReviewCoagulopathy in liver disease: Lack of an assessment tool.
There is a discrepancy between the information from clotting tests which have routinely been used in clinical practice and evidence regarding thrombotic and bleeding events in patients with liver disease. This discrepancy leads us to rely on other variables which have been shown to be involved in haemostasis in these patients and/or to extrapolate the behaviour of these patients to other settings in order to decide the best clinical approach. The aims of the present review are as follows: (1) to present the information provided by clotting tests in cirrhotic patients; (2) to present the factors that may influence clotting in these patients; (3) to review the clinical evidence; and (4) to put forward a clinical approach based on the first 3 points.
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World J. Gastroenterol. · Sep 2015
Platelet count combined with right liver volume and spleen volume measured by magnetic resonance imaging for identifying cirrhosis and esophageal varices.
To determine whether the combination of platelet count (PLT) with spleen volume parameters and right liver volume (RV) measured by magnetic resonance imaging (MRI) could predict the Child-Pugh class of liver cirrhosis and esophageal varices (EV). ⋯ The combination of PLT with SV and RV could predict Child-Pugh class of liver cirrhosis and identify the presence of esophageal varices.
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World J. Gastroenterol. · Sep 2015
Correlation between non-alcoholic fatty liver with metabolic risk factors and brachial-ankle pulse wave velocity.
To assess the relationship between non-alcoholic fatty liver disease (NAFLD) with metabolic risk factors and brachial ankle pulse wave velocity (baPWV). ⋯ NAFLD is closely correlated with baPWV, particularly in females. NAFLD has a large impact on baPWV, no matter whether the metabolic index is increased or not. NAFLD may be a useful indicator for assessing early arteriosclerosis.
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World J. Gastroenterol. · Sep 2015
Comparative StudyClinical comparison of antrum-preserving double tract reconstruction vs roux-en-Y reconstruction after gastrectomy for Siewert types II and III adenocarcinoma of the esophagogastric junction.
To explore a reasonable method of digestive tract reconstruction, namely, antrum-preserving double-tract reconstruction (ADTR), for patients with adenocarcinoma of the esophagogastric junction (AEG) and to assess its efficacy and safety in terms of long-term survival, complications, morbidity and mortality. ⋯ ADTR by jejunal interposition presents similar rates of tumor recurrence, metastasis and long-term survival compared with classical reconstruction with RY esophagojejunostomy; however, it offers considerably improved near-term quality of life, especially in terms of early recovery and decreased reflux esophagitis. Thus, ADTR is recommended as a worthwhile digestive tract reconstruction method for Siewert types II and III AEG.
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World J. Gastroenterol. · Sep 2015
EditorialInternational guidelines for the management of pancreatic intraductal papillary mucinous neoplasms.
The management of intraductal papillary mucinous neoplasms (IPMN) is presently evolving as a result of the improved understanding of the natural history and biological behavior of the different pancreatic cystic neoplasms; and better preoperative diagnosis of these neoplasms due to advancement in preoperative diagnostic tools. International consensus guidelines for the management of IPMN were first formulated in 2006 and subsequently revised in 2012. Both these guidelines were constructed based on expert opinion and not on robust clinical data. ⋯ Furthermore, although both guidelines were associated with high negative predictive values, several investigators have demonstrated that some malignant IPMNs may be missed. Finally, it is imperative to emphasize that major considerations when managing a patient with IPMN including the patient's surgical risk, life-expectancy and even cost of investigations are not taken into account in current guidelines. The management of a patient with IPMN should be individualized and tailored according to a patient's risk benefit profile for resection vs surveillance.