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Liver non surgical intervention

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https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#1
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28069526/opportunities-to-improve-care-of-hepatocellular-carcinoma-in-vulnerable-patient-populations
#2
Richard S Hoehn, Dennis J Hanseman, Vikrom Dhar, Derek E Go, Michael J Edwards, Shimul A Shah
BACKGROUND: Hepatocellular carcinoma (HCC) patients with Medicaid or no health insurance have inferior survival compared to privately-insured patients. Safety-net hospitals that care for these patients are often criticized for their inferior outcomes. We hypothesized that HCC survival was related to appropriate surgical management. STUDY DESIGN: The American College of Surgeons National Cancer Data Base was queried for patients diagnosed with HCC (n=111,481) from 1998-2010...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28028561/management-of-paediatric-liver-trauma
#3
REVIEW
A B van As, Alastair J W Millar
Of all the intra-abdominal solid organs, the liver is the most vulnerable to blunt abdominal trauma. The majority of liver ruptures present in combination with other abdominal or extra-abdominal injuries. Over the last three decades, the management of blunt liver trauma has evolved from obligatory operative to non-operative management in over 90% of cases. Penetrating liver injuries more often require operative intervention and are managed according to adult protocols. The greatest clinical challenge remains the timely identification of the severely damaged liver with immediate and aggressive resuscitation and expedition to laparotomy...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/28018098/therapeutic-approaches-for-portal-biliopathy-a-systematic-review
#4
REVIEW
Irene Franceschet, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Marco Senzolo
Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC (77%-100%), only a part of these (5%-38%) are symptomatic...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28017845/endoscopic-sleeve-gastroplasty-significantly-reduces-body-mass-index-and-metabolic-complications-in-obese-patients
#5
Reem Z Sharaiha, Nikhil A Kumta, Monica Saumoy, Amit P Desai, Alex M Sarkisian, Andrea Benevenuto, Amy Tyberg, Rekha Kumar, Leon Igel, Elizabeth C Verna, Robert Schwartz, Christina Frissora, Alpana Shukla, Louis J Aronne, Michel Kahaleh
BACKGROUND & AIMS: Endoscopic sleeve gastroplasty (ESG) is an incisionless, minimally invasive bariatric procedure that reduces the length and width of the gastric cavity to facilitate weight loss. We performed a prospective study to evaluate the effects of ESG on total body weight loss and obesity-related comorbidities. METHODS: We collected data from 91 consecutive patients (mean age, 43.86 ± 11.26 years; 68% female) undergoing ESG from August 2013 through March 2016...
December 22, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28008992/acylated-and-desacyl-ghrelin-are-associated-with-hepatic-lipogenesis-%C3%AE-oxidation-and-autophagy-role-in-nafld-amelioration-after-sleeve-gastrectomy-in-obese-rats
#6
Silvia Ezquerro, Leire Méndez-Giménez, Sara Becerril, Rafael Moncada, Víctor Valentí, Victoria Catalán, Javier Gómez-Ambrosi, Gema Frühbeck, Amaia Rodríguez
Bariatric surgery improves non-alcoholic fatty liver disease (NAFLD). Our aim was to investigate the potential role of ghrelin isoforms in the resolution of hepatic steatosis after sleeve gastrectomy, a restrictive bariatric surgery procedure, in diet-induced obese rats. Male Wistar rats (n = 161) were subjected to surgical (sham operation and sleeve gastrectomy) or dietary interventions [fed ad libitum a normal (ND) or a high-fat (HFD) diet or pair-fed]. Obese rats developed hepatosteatosis and showed decreased circulating desacyl ghrelin without changes in acylated ghrelin...
December 23, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27922112/plasma-cathepsin-d-correlates-with-histological-classifications-of-fatty-liver-disease-in-adults-and-responds-to-intervention
#7
Sofie M A Walenbergh, Tom Houben, Sander S Rensen, Veerle Bieghs, Tim Hendrikx, Patrick J van Gorp, Yvonne Oligschlaeger, Mike L J Jeurissen, Marion J J Gijbels, Wim A Buurman, Anita C E Vreugdenhil, Jan Willem M Greve, Jogchum Plat, Marten H Hofker, Satish Kalhan, Jussi Pihlajamäki, Patrick Lindsey, Ger H Koek, Ronit Shiri-Sverdlov
Non-alcoholic steatohepatitis (NASH) is characterized by liver lipid accumulation and inflammation. The mechanisms that trigger hepatic inflammation are poorly understood and subsequently, no specific non-invasive markers exist. We previously demonstrated a reduction in the plasma lysosomal enzyme, cathepsin D (CatD), in children with NASH compared to children without NASH. Recent studies have raised the concept that non-alcoholic fatty liver disease (NAFLD) in adults is distinct from children due to a different histological pattern in the liver...
December 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27920483/outcomes-of-partial-splenic-embolization-in-patients-with-massive-splenomegaly-due-to-idiopathic-portal-hypertension
#8
Omer Ozturk, Gonca Eldem, Bora Peynircioglu, Taylan Kav, Aysegul Görmez, Barbaros Erhan Cil, Ferhun Balkancı, Cenk Sokmensuer, Yusuf Bayraktar
AIM: To determine the outcomes of partial splenic embolization (PSE) for massive splenomegaly due to idiopathic portal hypertension (IPH). METHODS: In this prospective study, we evaluated the characteristics and prognosis of consecutive patients with IPH who underwent PSE for all indications at a single medical center between June 2009 and January 2015. The inclusion criteria were: presence of hypersplenism, massive splenomegaly, and resultant pancytopenia. The exclusion criteria were: presence of other diseases causing portal hypertension...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27899118/surgical-intervention-for-paediatric-liver-injuries-is-almost-history-a-12-year-cohort-from-a-major-scandinavian-trauma-centre
#9
Tomohide Koyama, Jorunn Skattum, Peder Engelsen, Torsten Eken, Christine Gaarder, Pål Aksel Naess
BACKGROUND: Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. METHODS: Patients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27843598/cancer-and-liver-cirrhosis-implications-on-prognosis-and-management
#10
REVIEW
Matthias Pinter, Michael Trauner, Markus Peck-Radosavljevic, Wolfgang Sieghart
Liver cirrhosis, the end-stage of every chronic liver disease, is not only the major risk factor for the development of hepatocellular carcinoma but also a limiting factor for anticancer therapy of liver and non-hepatic malignancies. Liver cirrhosis may limit surgical and interventional approaches to cancer treatment, influence pharmacokinetics of anticancer drugs, increase side effects of chemotherapy, render patients susceptible for hepatotoxicity, and ultimately result in a competitive risk for morbidity and mortality...
2016: ESMO Open
https://www.readbyqxmd.com/read/27784971/racial-ethnic-disparities-in-hepatocellular-carcinoma-treatment-and-survival-in-california-1988-2012
#11
Susan L Stewart, Sandy L Kwong, Christopher L Bowlus, Tung T Nguyen, Annette E Maxwell, Roshan Bastani, Eric W Chak, Moon S Chen
AIM: To describe racial/ethnic differences in treatment and survival among liver cancer patients in a population-based cancer registry. METHODS: Invasive cases of primary hepatocellular carcinoma, n = 33270, diagnosed between January 1, 1988-December 31, 2012 and reported to the California Cancer Registry were analyzed by race/ethnicity, age, gender, geographical region, socio-economic status, time period of diagnosis, stage, surgical treatment, and survival. Patients were classified into 15 racial/ethnic groups: non-Hispanic White (White, n = 12710), Hispanic (n = 8500), Chinese (n = 2723), non-Hispanic Black (Black, n = 2609), Vietnamese (n = 2063), Filipino (n = 1479), Korean (n = 1099), Japanese (n = 658), American Indian/Alaskan Native (AIAN, n = 281), Laotian/Hmong (n = 244), Cambodian (n = 233), South Asian (n = 190), Hawai`ian/Pacific Islander (n = 172), Thai (n = 95), and Other Asian (n = 214)...
October 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27764891/hepatic-resection-for-post-operative-solitary-liver-metastasis-from-oesophageal-squamous-cell-carcinoma
#12
Jingeng Liu, Zhiru Wei, Yuebin Wang, Zongjiang Xia, Gaofeng Zhao
BACKGROUND: Liver metastasis is common in patients with oesophageal cancer. The effect of operative intervention for post-operative solitary liver metastasis from oesophageal squamous cell carcinoma (ESCC) has not previously been examined. This research was to compare the effect of surgery and non-surgical therapy in patients with post-operative solitary liver metastasis from ESCC. METHODS: We retrospectively analysed the clinical data of 69 consecutive patients with solitary hepatic metastasis who had undergone oesophagectomy for ESCC and were subsequently referred to the First Affiliated Hospital of Zhengzhou University from January 2005 to December 2013...
October 20, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27744725/management-of-patients-with-colorectal-liver-metastasis-in-eleven-questions-and-answers
#13
Axel Andres, Pietro Majno, Sylvain Terraz, Philippe Morel, Arnaud Roth, Laura Rubbia-Brandt, Eduardo Schiffer, Frederic Ris, Christian Toso
Colorectal liver metastasis (CRLM) is the most frequent indication for liver resection in many centers. Recent improvements in oncology, surgery, interventional radiology, pathology and anesthesiology allow curative treatment in a larger proportion of patients with CRLM. Areas covered: We illustrate the various aspects of the management of CRLM through 11 questions that summarize the topic, from the current obtained survival to future perspectives such as transplantation. The limits of a curative treatment are also presented from different angles, such as the benefits of pathology, the surgical options for extreme resections, the available chemotherapies and their efficacy, or the non-surgical ablative treatments...
December 2016: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/27722159/nash-cirrhosis-the-new-burden-in-liver-transplantation-how-should-it-be-managed
#14
REVIEW
Ali Canbay, Jan-Peter Sowa, Wing-Kin Syn, Jürgen Treckmann
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a continuously increasing cause of chronic liver disease and a health burden in all populations affected by the obesity and metabolic syndrome pandemic. Cirrhotic alterations or hepatocellular carcinoma developing from NAFLD may require liver transplantation (LTx). METHODS: Current literature was screened for data on LTx in the setting of NAFLD. RESULTS: NAFLD-associated LTx is expected to increase in number and relevance during the next decade...
August 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27688650/pediatric-non-alcoholic-fatty-liver-disease-recent-solutions-unresolved-issues-and-future-research-directions
#15
REVIEW
Maria Grazia Clemente, Claudia Mandato, Marco Poeta, Pietro Vajro
Non-alcoholic fatty liver disease (NAFLD) in children is becoming a major health concern. A "multiple-hit" pathogenetic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD. In addition to the accumulation of fat in the liver, insulin resistance (IR) and oxidative stress due to genetic/epigenetic background, unfavorable lifestyles, gut microbiota and gut-liver axis dysfunction, and perturbations of trace element homeostasis have been shown to be critical for disease progression and the development of more severe inflammatory and fibrotic stages [non-alcoholic steatohepatitis (NASH)]...
September 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27678354/co-existence-of-non-alcoholic-fatty-liver-disease-and-inflammatory-bowel-disease-a-review-article
#16
REVIEW
Che-Yung Chao, Robert Battat, Alex Al Khoury, Sophie Restellini, Giada Sebastiani, Talat Bessissow
Emerging data have highlighted the co-existence of non-alcoholic fatty liver disease (NAFLD) and inflammatory bowel disease; both of which are increasingly prevalent disorders with significant complications and impact on future health burden. Cross-section observational studies have shown widely variable prevalence rates of co-existing disease, largely due to differences in disease definition and diagnostic tools utilised in the studies. Age, obesity, insulin resistance and other metabolic conditions are common risks factors in observational studies...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27648620/reoperations-for-intraabdominal-bleeding-following-deceased-donor-liver-transplantation
#17
Wojciech Figiel, Michał Grąt, Karolina M Wronka, Waldemar Patkowski, Maciej Krasnodębski, Łukasz Masior, Jan Stypułkowski, Karolina Grąt, Marek Krawczyk
UNLABELLED: Intraabdominal hemorrhage remains one of the most frequent surgical complications after liver transplantation. The aim of the study was to evaluate risk factors for intraabdominal bleeding requiring reoperation and to assess the relevance of the reoperations with respect to short- and long-term outcomes following liver transplantation. MATERIAL AND METHODS: Data of 603 liver transplantations performed in the Department of General, Transplant and Liver Surgery in the period between January 2011 and September 2014 were analyzed retrospectively...
September 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/27633658/abdominal-intra-compartment-syndrome-a-non-hydraulic-model-of-abdominal-compartment-syndrome-due-to-post-hepatectomy-hemorrhage-in-a-man-with-a-localized-frozen-abdomen-due-to-extensive-adhesions-a-case-report
#18
Alexsander K Bressan, Andrew W Kirkpatrick, Chad G Ball
BACKGROUND: Postoperative hemorrhage is a significant cause of morbidity and mortality following liver resection. It typically presents early within the postoperative period, and conservative management is possible in the majority of cases. We present a case of late post-hepatectomy hemorrhage associated with overt abdominal compartment syndrome resulting from a localized functional compartment within the abdomen. CASE PRESENTATION: A 68-year-old white man was readmitted with sudden onset of upper abdominal pain, vomiting, and hemodynamic instability 8 days after an uneventful hepatic resection for metachronous colon cancer metastasis...
September 15, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27534659/location-of-a-biliary-leak-after-liver-resection-determines-success-of-endoscopic-treatment
#19
Anja Schaible, Peter Schemmer, Thilo Hackert, Christian Rupp, Anna E Schulze Schleithoff, Daniel N Gotthardt, Markus W Büchler, Peter Sauer
BACKGROUND: Bile leaks after hepatic resection are serious complications associated with substantial morbidity and mortality. The aim of this prospective observational study was to determine the therapeutic success of endoscopic treatment of biliary leakage after liver resection. PATIENTS AND METHODS: Grade B biliary leaks were considered for endoscopic treatment in patients after liver resection between 1/09 and 4/12. Endoscopic treatment (sphincterotomy only, plastic stent distal to leak or bridging) was defined as successful when the patient remained without symptoms after drain removal and without extravasation follow-up ERC 8 weeks later...
August 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27424619/abdominal-stab-wounds-in-lagos-a-review-of-fifty-cases
#20
Adedapo Olumide Osinowo, Olugbenga Oluseyi Olusoji, Adedoyin Adekunle Adesanya
BACKGROUND: The optimum management of patients with abdominal stab wounds (ASWs) is yet to be fully elucidated. AIMS AND OBJECTIVES: To evaluate the pattern of injury, treatment offered and outcome in patients with ASWs seen at our tertiary hospital. PATIENTS AND METHODS: This was a retrospective descriptive study of patients who sustained ASWs seen from January 2011 to December 2015. Information obtained from case notes were analysed on a personal computer using SPSS version 22 (SPSS Inc...
April 2016: Nigerian Postgraduate Medical Journal
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