检索结果-南通市图书馆

Ventilation after pancreaticoduodenectomy increases perioperative mortality: Identification of risk factors and their relevance in Germany that do not apply in England

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2019年第4期18卷 379-388页

作者： Rieke-Sophie Homeyer Keith JRoberts Robert P Sutcliffe Alexander Kaltenborn Darius Mirza Zhi Qu Jurgen Klempnauer Harald Schrem Core Facility Quality Management Transplantation Integrated Research and Treatment Center Transplantation(IFB-Tx)Hannover Medical SchoolCarl-Neuberg-Str.130625 HannoverGermany General Visceral and Transplant SurgeryHannover Medical SchoolCarl-Neuberg-Str.130625 HannoverGermany Department of HPB Surgery Queen Elizabeth Hospital BirminghamMindelsohn Way EdgbastonBirmingham B15 2GWUnited Kingdom Department of General Visceral and Transplant SurgeryMedical University GrazAuenbrugger Platz 58036 GrazAustria

Background:Pre-operative risk factors for post-operative ventilation and their influence on survival after pancreaticoduodenectomy for malignancy are ***:Totally 391 patients operated in Hannover,Germany were investigated with multivariable logistic regression and Cox regression modeling to identify independent risk factors for post-operative ventilation≥6 h,patient survival and 90-day *** 84 patients operated in Birmingham,United Kingdom were analyzed to assess the external relevance of ***:Longer operations,history of thrombosis,intra-operative blood transfusion,lower estimated glomerular filtration rates(eGFR)and higher values of the age at operation divided by the Horovitz Quotient independently increased the risk of post-operative ventilation≥6 h in German patients(n=108;27.6%)(P75 years,had a history of thrombosis,received blood transfusions,and had significantly worse lung function ***4 tumors were detected in 18 German patients(4.6%),but not in the English ***:Identified risk factors for post-operative ventilation are clinically relevant in Germany but not in England and may be used to lower mortality *** German and the English cohorts displayed significant differences in the approach to patient selection and early post-operative extubation.

关键词： Pancreatic cancer cholangiocellular carcinoma Periampullary carcinoma Comorbidity Outcome

Liver transplantation for malignancy:current treatment strategies and future perspectives

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第18期20卷 5331-5344页

作者： Christina Hackl Hans J Schlitt Gabriele I Kirchner Birgit Knoppke Martin Loss Department of Surgery University Hospital Regensburg93053 RegensburgGermany Department of Internal Medicine I University Hospital Regensburg93053 RegensburgGermany Department of Pediatrics and Juvenile Medicine University Hospital Regensburg93053 RegensburgGermany

In 1967,Starzl et al performed the first successful liver transplantation for a patient diagnosed with *** the following,liver transplantation was considered ideal for complete tumor resection and potential cure from primary hepatic *** reports of liver transplantation for primary and metastatic liver cancer however showed disappointing results and the strategy was soon ***1996,Mazzaferro et al introduced the Milan criteria,offering liver transplantation to patients diagnosed with limited hepatocellular *** then,liver transplantation for malignant disease is an ongoing subject of preclinical and clinical *** this context,several aspects must be considered:(1)Given the shortage of deceased-donor organs,long-term overall and disease free survival should be comparable with results obtained in patients transplanted for nonmalignant disease;(2)In this regard,living-donor liver transplantation may in selected patients help to solve the ethical dilemma of optimal individual patient treatment vs organ allocation justice;and(3)Ongoing research focusing on perioperative therapy and antiproliferative immunosuppressive regimens may further reduce tumor recurrence in patients transplanted for malignant disease and thus improve overall *** present review gives an overview of current indications and future perspectives of liver transplantation for malignant disease.

关键词： Hepatocellular Fibrolamellar Carcinoma cholangiocellular Hepatoblastoma Liver metastases

Biliary phosphatidylcholine and lysophosphatidylcholine profiles in sclerosing cholangitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第33期19卷 5454-5463页

作者： Annika Gauss Robert Ehehalt Wolf-Dieter Lehmann Gerhard Erben Karl-Heinz Weiss Yvonne Schaefer Petra Kloeters-Plachky Adolf Stiehl Wolfgang Stremmel Peter Sauer Daniel Nils Gotthardt Gastroenterology and Hepatology Unit Department of Internal MedicineUniversity Hospital Heidelberg Department of Spectroscopy German Cancer Research Center

AIM:To analyze phospholipid profiles in intrahepatic bile from patients with primary sclerosing cholangitis(PSC)and secondary sclerosing cholangitis(SSC).METHODS:Intrahepatic bile specimens collected via endoscopic retrograde cholangiography from 41 patients were *** of these patients were diagnosed with PSC,10 with SSC,11 with choledocholithiasis or no identifiable biliary disease,and 6 with cholangiocellular carcinoma(CCC).Bile acid,cholesterol,protein,and bilirubin contents as well as pancreas lipase activity in bile were determined by biochemical ***(PC)and lysophosphatidylcholine(LPC)species were quantified using nanoelectrospray ionization tandem mass ***:Bile from all the examined patient groups showed a remarkably similar PC and LPC species composition,with only minor statistical *** biliary PC concentrations were highest in controls(8030±1843 mol/L)and lowest in patients with CCC(1969±981 mol/L)(P=0.005,controls vs SSC and CCC,respectively,P<0.05).LPC contents in bile were overall low(4.2%±1.8%).Biliary LPC/PC ratios and ratios of biliary PC to bilirubin,PC to cholesterol,PC to protein,and PC to bile acids showed no intergroup ***:PC and LPC profiles being similar in patients with or without sclerosing cholangitis,these phospholipids are likely not of major pathogenetic importance in this disease group.

关键词： Primary sclerosing cholangitis Secondary sclerosing cholangitis cholangiocellular carcinoma Phosphatidylcholine Lysophosphatidylcholine Bile Mass spectrometry

Characterization of focal liver masses using acoustic radiation force impulse elastography

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第2期19卷 219-226页

作者： Hana Park Jun Yong Park Do Young Kim Sang Hoon Ahn Chae Yoon Chon Kwang-Hyub Han Seung Up Kim Division of Gastroenterology Department of Internal MedicineCHA Bundang Medical CenterCHA UniversityGyeonggi-do 463-712South Korea Department of Internal Medicine Yonsei University College of MedicineSeoul 120-752South Korea

AIM:To investigate the diagnostic performance of acoustic radiation force impulse(ARFI) elastography for characterizing focal liver mass by quantifying their ***:This prospective study included 62 patients with a focal liver mass that was well visualized on conventional ultrasonography performed in our institution from February 2011 to November *** them,12 patients were excluded for ARFI measurement failure due to a lesion that was smaller than the region of the interest and at an inaccessible location(deeper than 8 cm)(n = 7) or poor compliance to hold their breath as required(n = 5).Finally,50 patients with valid ARFI measurements were *** a patient had multiple liver masses,only one mass of interest was *** masses were diagnosed by histological examination or clinical diagnostic *** ultrasonographic evaluation,stiffness,expressed as velocity,was checked 10 times per focal liver mass and the surrounding liver ***:After further excluding three masses that were non-diagnostic on biopsy,a total of 47 focal mass lesions were tested,including 39(83.0%) malignant masses [24 hepatocellular carcinomas(HCC),seven cholangiocellular carcinomas(CCC),and eight liver metastases] and eight(17.0%) benign masses(five hemangiomas and three focal nodular hyperplasias,FNH).Thirty-seven(74.0%) masses were confirmed by histological *** mean velocity was 2.48 m/s in HCCs,1.65 m/s in CCCs,2.35 m/s in metastases,1.83 m/s in hemangiomas,and 0.97 m/s in *** considerable overlap was still noted between malignant and benign masses,significant differences in ARFI values were observed between malignant and benign masses(mean 2.31 m/s vs 1.51 m/s,P = 0.047),as well as between HCCs and benign masses(mean 2.48 m/s vs 1.51 m/s,P = 0.006).The areas under the receiver operating characteristics curves(AUROC) for discriminating the malignant masses from benign masses was 0.724(95%CI,0.566-0.883,P = 0.048),and the AUROC

关键词： Acoustic radiation force impulse Focal liver mass Hepatocellular carcinoma Hemangioma Focal nodular hyperplasia cholangiocellular carcinoma Liver metastasis

Management of primary sclerosing cholangitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Hepatology 2011年第6期3卷 137-141页

作者： Holger H Lutz Jens JW Tischendorf Medical Department Ⅲ (Gastroenterology Hepatology and Metabolic Diseases)University Hospital Aachen (RWTH)AachenGermany

Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease with major morbidity and *** management is difficult,due to lack of conclusive data and individual disease ***-dose UDCA was used for years as a pharmacotherapeutic agent to prevent disease progression,based on a positive trend in pilot studies,but has recently been proven to have a negative effect in advanced *** might be useful in patients with overlap *** bile duct stenoses should be treated endoscopically,and cholangiocellular carcinoma (CCC) still remains a therapeutic challenge in PSC *** diagnosis of CCC must be improved and new strategies such as neoadjuvant radiochemotherapy with subsequent liver transplantation in selected patients are further options to be considered.

关键词： Primary sclerosing cholangitis Ursodeoxycholic acid NorUDCA cholangiocellular carcinoma Cholestatic liver disease Endoscopy Dominant stenoses