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Endohepatology:Arrival at the frontier of interventional endosonography

World Journal of Gastroenterology 2024年第18期30卷 2397-2401页

作者： shane p.selvanderan Eric Lam Neal Shahidi Department of Medicine University of British ColumbiaVancouver V6Z 1Y6BCCanada

Endohepatology describes the emerging field where diagnostic and therapeutic endoscopic ultrasound(EUS)are used for the diagnosis and management of liver disease and its *** this editorial we comment on the article by Gadour et *** spectrum of EUS-guided procedures includes liver parenchymal and lesional biopsy,abscess drainage,treatment of focal liver lesions,diagnosis of portal hypertension and management of gastric *** data suggest that the application of EUS to hepatology is technically feasible and safe,heralding the arrival at a new frontier for *** data,specifically randomised trials comparing EUS to interventional radiology techniques,and continued partnership between endoscopy and hepatology are required to see this field establish itself outside expert tertiary centres.

关键词： Cancer Cirrhosis Endoscopy Endoscopic ultrasound Liver disease

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Nutritional care in hospitalized patients with chronic liver disease

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World Journal of Gastroenterology 2015年第45期21卷 12835-12842页

作者： Dep K Huynh shane p.selvanderan Hugh AJ Harley Richard H Holloway Nam Q Nguyen Discipline of Medicine University of Adelaide North Terrace Department of Gastroenterology and Hepatology Royal Adelaide Hospital North Terrace

AIM: To evaluate the practice of nutritional assessment and management of hospitalised patients with cirrhosis and the impact of malnutrition on their clinical ***: This was a retrospective cohort study on patients with liver cirrhosis consecutively admitted to the Department of Gastroenterology and Hepatology at the Royal Adelaide Hospital over 24 mo. Details were gathered related to the patients' demographics, disease severity, nutritional status and assessment, biochemistry and clinical outcomes. Nutritional status was assessed by a dietician and determined by subjective global assessment. Estimated energy and protein requirements were calculated by Simple Ratio Method. Intake was estimated from dietary history and/or food charts, and represented as a percentage of estimated daily requirements. Median duration of follow up was 14.9(0-41.4) mo. RESULTS: Of the 231 cirrhotic patients(167 male, age: 56.3 ± 0.9 years, 9% Child-pugh A, 42% Childpugh B and 49% Child-pugh C), 131(57%) had formal nutritional assessment during their admission and 74(56%) were judged to have malnutrition. In-hospitalcaloric(15.6 ± 1.2 kcal/kg vs 23.7 ± 2.3 kcal/kg, p = 0.0003) and protein intake(0.65 ± 0.06 g/kg vs 1.01 ± 0.07 g/kg, p = 0.0003) was significantly reduced in patients with malnutrition. Of the malnourished cohort, 12(16%) received enteral nutrition during hospitalisation and only 6(8%) received ongoing dietetic review and assessment following discharge from hospital. The overall mortality was 51%, and was higher in patients with malnutrition compared to those without(HR = 5.29, 95%CI: 2.31-12.1; p pitalised patients with cirrhosis and is associated with higher mortality. Formal nutritional assessment, however, is inadequate. This highlights the need for meticulous nutritional evaluation and management in these patients.

关键词： Liver cirrhosis Nutrition assessment Mortality Mal

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