检索结果-南通市图书馆

A new technique of combined endoscopic sclerotherapy and ligation for variceal bleeding

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 2003年第5期9卷 1090-1093页

作者： Radha K.Dhiman Yogesh K.Chawla Department of Hepatology Postgraduate Institute of Medical Education & ResearchChandigarh 160012India

AIM: To develop a technique of combined endoscopic sclerotherapy and ligation (ESL) in which both techniques of endoscopic sclerotherapy (ES) and endoscopic variceal ligation (EVL) can be optimally ***: ESL was performed in 10 patients (age 46.4±7.9;9 males, 1 female) with cirrhosis of liver using sclerotherapy needle and Speedband, Superview multiple band ligater (Boston Scientific, Microvasive, Watertown, MA). A single band was placed 5-10 cm proximal to the gastro-esophageal junction over each varix from proximal to distal margin,followed by intravariceal injection of 1.5 % ethoxysclerol (4 ml each) 2 to 3 cm proximal to the gastroesophageal junction on the ligated varices distal to deployed band. EVL was then performed at the injection site. Similarly other varices were also injected and ligated from distal to proximally. In the subsequent sessions, ES alone was performed to sclerose small varices at the gastroesophageal ***: ESL was successfully performed in all patients.A median of 3 (ESL 1, ES 2) sessions (ranged 1-4) were required to eradicate the varices in 9 (90 %) of 10 *** of varices without bleed was seen in 1 patient during a mean follow-up of 10.3 months (ranged 6-15).Two patients died of liver failure. None died of variceal bleeding. None of the patients had procedure related ***: ESL may be useful in the fast eradication of esophageal varices. However, randomised controlled trials are required to find out its relative efficacy and impact on variceal recurrence in comparison to ES or EVL.

关键词： Adult Endoscopy, Digestive System esophageal and gastric varices Female Gastrointestinal Hemorrhage Humans Ligation Liver Cirrhosis Male Middle Aged Pilot Projects Sclerotherapy

Percutaneous transsplenic embolization of esophageal and gastrio-fundal varices in 18 patients

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 2001年第6期7卷 880-883页

作者： Gao-Quan Gong Xiao-Lin Wang Jian-Hua Wang Zhi-Ping Yan Jie-Min Cheng Sheng Qian Yi Chen Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China Department of Radiology Zhongshan Hospital Fudan University Shanghai 200032 China. ggqjj@***

AIM: Clinical application and potential complication of percutaneous transsplenic varices embolization (PTSVE) of esophageal or gastrio-fundal varices in patients with hepatocellular carcinoma (HCC) complicated with portal vein cancerous thrombosis (PVCT).METHODS: 18 patients with HCC complicated with PVCT and esophageal or gastrio-fundal varices who underwent PTSVE were collected. The rate of success, complication, mortality of the procedure and postoperative complication were recorded and analyzed.RESULTS: PTSVE were successfully performed in 16 of 18cases, and the rate of success was 89%. After therapy erythrocyte counts decreased in all of the natunts. 5 of patients needed blood transfusion, 2 patients requiredsurgical intervention because of and 11 patients with ascites were alleviated by diuresis. Among these 18patients, the procedure-related mortality was 11% (2/18),one died of acute hepatic failure on the forth day after procedure, another died of acute renal failure on the fifth day. The patients were follow up for 112 mon exceptone. 13of them died of their tumors but none of them experienced variceal bleeding.CONCLUSION: PTSVE is a relatively safe and effective method to treat esophageal or gastrio-fundal varices in HCCpatients with PVCT when percutaneous transhepatic varices embolization (PTHVE) of varices is impossible.

关键词： Embolization, Therapeutic Adult Aged Carcinoma, Hepatocellular esophageal and gastric varices Female Humans Liver Neoplasms Male Middle Aged Portal Vein Research Support, Non-U.S. Gov't Venous Thrombosis

Experience in sclerotherapy for esophagogastric variceal bleeding

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2002年第6期115卷 919-922,157-158页

作者：程留芳王志强李长政蔡逢春令狐恩强毛永平黄启阳中国人民解放军总医院消化科北京100853

Objective To evaluate the efficacy of endoscopic variceal sclerotherapy (EVS) for esophagogastric variceal *** A retrospective analysis was made on 1010 patients with esophagogastric variceal bleeding who underwent sclerotherapy, among whom there were 834 patients with cirrhosis, 160 with hepatocarcinoma, 12 with Budd-Chiari syndrome and 4 with congenital liver fibrosis. Totally, 3203 sessions of sclerotherapy were performed, including 602 sessions of emergency sclerotherapy and 2601 of selective surgery. The average number of sessions of sclerotherapy for the initial treatment in 710 cirrhosis patients who received continuous sclerotherapy was 3.2±1.1 times. Follow-up was done in 579 cirrhosis patients for 3-157 months, with an average period of 42.5±32.8 *** The rate of emergency hemostasis in the whole group was 97.0%. The rate of complications was 13.4%, and the mortality rate was 1.8%. The rate of complete eradication and basically complete eradication of esophagogastric varices in cirrhosis patients was 84.1%. The late rebleeding rate was 23.7%, and the survival rates were 95.8%±0.8%, 86.1%±1.6%, 74.5%±2.4%, 53.6%±3.8% at 1, 3, 5 and 10 years, respectively, according to Kaplan-Meier *** EVS is an important method for the treatment of esophagogastric variceal bleeding.

关键词： Sclerotherapy Adolescent Adult Aged Aged, 80 and over Child esophageal and gastric varices Female Follow-Up Studies Gastrointestinal Hemorrhage Humans Male Middle Aged Retrospective Studies

Computed tomography combined with gastroscopy for assessment of pancreatic segmental portal hypertension

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 Clinical Cases 2022年第24期10卷 8568-8577页

作者： Yu-Li Wang Han-Wen Zhang Fan Lin Department of Radiology The First Affiliated Hospital of Shenzhen UniversityHealth Science CenterShenzhen Second People’s HospitalShenzhen 518035Guangdong ProvinceChina

BACKGROUND Pancreatic segmental portal hypertension(PSPH) is the only type of portal hypertension that can be completely cured. However, it can easily cause varicose veins in the esophagus and stomach and hemorrhage in the digestive *** To explore the application of computed tomography(CT) to examine the characteristics of PSPH and assess the risk *** This was a retrospective analysis of CT images of 22 patients diagnosed with PSPH at our center. Spearman correlation analysis was performed using the range of esophageal and gastric varices(measured by the vertical gastric wall), the ratio of the width of the splenic portal vein to that of the compression site(S/C ratio), the degree of splenomegaly, and the stage determined by gastroscopy. This study examined whether patients experienced gastrointestinal bleeding within 2 wk and combined CT and gastroscopy to explore the connection between bleeding and CT *** The range of esophageal and gastric varices showed the best correlation in the diagnosis of PSPH(P < 0.001), and the S/C ratio(P = 0.007) was correlated with the degree of splenomegaly(P = 0.021) and PSPH(P < 0.05). This study revealed that male patients were more likely than females to progress to grade 2 or grade 3 as determined by gastroscopy. CT demonstrated excellent performance, with an area under the curve of *** CT can be used to effectively analyze the imaging signs of PSPH, and CT combined with gastroscopy can effectively predict the risk level of gastrointestinal bleeding.

关键词： Computed tomography Pancreatic segmental portal hypertension esophageal and gastric varices Gastrointestinal bleeding Curable portal hypertension

Construction of Transjugular Intrahepatic Portosystemic Shunt： Bare Metal Stent/Stent-graft Combination versus Single Stent-graft, a Prospective Randomized Controlled Study with Long-term Patency and Clinical Analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2016年第11期129卷 1261-1267页

作者： Chang-MingWang Xuan Li Jun Fu Jing-Yuan Luan Tian-Run Li Jun Zhao Guo-Xiang Dong Department of Interventional Radiology and Vascular Surgery Peking University Third Hospital Beijing 100191 China

Background： Balanced adjustment of the portal vein shunt volume during a transjugular intrahepatic portosystemic shunt （TIPS） is critical for maintaining liver perfusion and decreasing the incidence of liver insufficiency. A stent-graft is proved to be superior to a bare metal stent （BMS） for the construction of a TIPS. However, the clinical results of the combination application of stents and stent-grafts have not been determined. This study aimed to compare the technique of using a combination of stents and stent-grafts with using a single stent-graft to construct a TIPS. Methods： From April 2011 to November 2014, a total of fifty patients were randomly assigned to a stents-combination group （Group I, n = 28） or a stent-graft group （Group II, n - 22）. Primary patency rates were calculated. Clinical data, including the technical success rate, bleeding control results, incidence of encephalopathy, liver function preservation, and survival rate, were assessed. Results; Technically, the success rate was 100% for both groups. The primary patency rates at 1,2, and 3 years for Group I were 96%, 84%, and 77%, respectively; for Group II, they were 90%, 90%, and 78%, respectively. The survival rates at 1, 2, and 3 years for Group I were 79%, 74%, and 68%, respectively; for Group II, they were 82%, 82%, and 74%, respectively. The incidence of hepatic encephalopathy was 14.3% for Group I and 13.6% for Group II. The Child-Pugh score in Group I was stable at the end of the follow-up but had significantly increased in Group II （t - -2.474, P = 0.022）. Conclusions： The construction of a TIPS with either the single stent-graft or BMS/stent-graft combination is effective for controlling variceal bleeding. The BMS/stent-graft combination technique is superior to the stent-graft technique in terms of hepatic function preservation indicated by the Child-Pugh score. However, considering the clinical results of the TIPS, the two techniques are comparable in their primary shunt patency,

关键词： esophageal and gastric varices Hypertension, Portal Radiology, Interventional Stent

Use of shear wave elastography for the diagnosis and follow-up of biliary atresia: A meta-analysis

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 2022年第32期28卷 4725-4739页

作者： Ellen S Wagner Hussien Ahmed H Abdelgawad Meghan Landry Belal Asfour Mark B Slidell Ruba Azzam Pediatric Gastroenterology Hepatologyand NutritionThe University of Chicago MedicineComer Children’s HospitalChicagoIL 60637United States Department of Medicine Zagazig UniversityZagazig 44511EgyptEgypt Department of Pediatrics The University of Chicago MedicineComer Children’s HospitalChicagoIL 60637United States Graduate School of Professional Education-Biomedical Informatics University of ChicagoChicagoIL 60637United States Department of Surgery The University of Chicago MedicineComer Children’s HospitalChicagoIL 60637United States

BACKGROUND Timely differentiation of biliary atresia(BA)from other infantile cholestatic diseases can impact patient ***,non-invasive staging of fibrosis after Kasai hepatoportoenterostomy has not been widely *** wave elastography is an ultrasound modality that detects changes in tissue *** authors propose that the utility of elastography in BA can be elucidated through meta-analysis of existing *** To assess the utility of elastography in:(1)BA diagnosis,and(2)post-Kasai fibrosis *** A literature search identified articles that evaluated elastography for BA diagnosis and for post-Kasai *** studies met criteria for meta-analysis:Eleven for diagnosis and nine for follow-up *** diagnostic odds ratio(DOR),sensitivity,and specificity of elastography were calculated through a random-effects model using Meta-DiSc *** Mean liver stiffness in BA infants at diagnosis was significantly higher than in non-BA,with overall DOR 24.61,sensitivity 83%,and specificity 79%.Post-Kasai,mean liver stiffness was significantly higher in BA patients with varices than in patients without,with DOR 16.36,sensitivity 85%,and specificity 76%.Elastography differentiated stage F4 fibrosis from F0-F3 with DOR of 70.03,sensitivity 96%,and specificity 89%.Elastography also differentiated F3-F4 fibrosis from F0-F2 with DOR of 24.68,sensitivity 85%,and specificity 81%.CONCLUSION Elastography has potential as a non-invasive modality for BA diagnosis and surveillance *** paper’s limitations include inter-study method heterogeneity and small sample ***,standardized,multi-center studies are recommended.

关键词： Biliary atresia Cholestasis Hepatic portoenterostomy Fibrosis esophageal and gastric varices Elasticity imaging techniques

Acute-on-chronic liver failure is independently associated with higher mortality for cirrhotic patients with acute esophageal variceal hemorrhage:Retrospective cohort study

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 Clinical Cases 2023年第17期11卷 4003-4018页

作者： Alana Zulian Terres Rafael Sartori Balbinot Ana Laura Facco Muscope Morgana Luisa Longen Bruna Schena Bruna Teston Cini Gilberto Luis Rost Jr Juline Isabel Leichtweis Balensiefer Louise Zanotto Eberhardt Raul Angelo Balbinot Silvana Sartori Balbinot Jonathan Soldera Clinical Gastroenterology Universidade de Caxias do SulCaxias do Sul 95020-002Brazil School of Medicine Universidade de Caxias do SulCaxias do Sul 95020-002Brazil Department of Gastroenterology University of South WalesCardiff CF371DLUnited Kingdom

BACKGROUND Acute esophageal variceal hemorrhage(AEVH)is a common complication of cirrhosis and might precipitate multi-organ failure,causing acute-on-chronic liver failure(ACLF).AIM To analyze if the presence and grading of ACLF as defined by European Society for the Study of the Liver-Chronic Liver Failure(EASL-CLIF)is able to predict mortality in cirrhotic patients presenting *** Retrospective cohort study executed in Hospital Geral de Caxias do *** from medical records from 2010 to 2016 were obtained by searching the hospital electronic database for patients who received *** records were reviewed in order to determine the diagnosis of cirrhosis and AEVH,including 97 ***-Meier survival analysis was used for univariate analysis and a stepwise approach to the Cox regression for multivariate *** All-cause mortality for AEVH patients was 36%,40.2%and 49.4%for 30-,90-and 365-day,*** prevalence of ACLF was 41.3%.Of these,35%grade 1,50%grade 2 and 15%grade *** multivariate analysis,the non-use of non-selective beta-blockers,presence and higher grading of ACLF and higher Model for End-Stage Liver Disease scores were independently associated with higher mortality for 30-day with the addition of higher Child-Pugh scores for 90-day *** Presence and grading of ACLF according to the EASL-CLIF criteria was independently associated with higher 30-and 90-day mortality in cirrhotic patients admitted due to AEVH.

关键词： Gastrointestinal hemorrhage Prognosis esophageal and gastric varices Liver cirrhosis Acuteon-chronic liver failure Organ dysfunction scores

Analysis of the treatment outcomes of esophageal variceal bleeding patients from multiple centers in China

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Frontiers of Medicine 2008年第2期2卷 171-173页

作者： Hepatobiliary Disease Group,Chinese Gastroenterology Association,China Zhiqiang WANG 不详 Department of Digestion PLA General HospitalChina

This study aimed to investigate the treatment outcomes of esophageal variceal bleeding(EVB)in China.A total of 1087 cases were collected from 19 hospitals in 16 large and medium sized cities across China between January 1st,2005 and January 1st,*** were 313 cases(29.0%)of mild(1500 mL)*** hemostasis was achieved in 89.8%of *** hundred and eighty-five cases were treated by medication with a hemostasis rate of 91.8%.Seventy-one cases were treated using a Sengstaken-Blakemore tube with a hemostasis rate of 54.9%.Thirty-seven cases were treated with emergency endoscopic variceal ligation with a hemostasis rate of 83.8%.Seventy-seven cases were treated with endoscopic sclerotherapy with a hemostasis rate of 94.8%.Forty-three cases were treated with emergency surgical operation with a hemostasis rate of 95.3%.Sixty-six cases were treated with combined therapy with a hemostasis rate of 97.0%.There was a significant difference(P<0.01)in the successful hemostasis rate between different *** overall mortality was 10.1%,among which 6.6%was directly caused by *** multivariate logistic regression analysis shows that the severity of bleeding,treatment methods,liver dysfunction and activation of hepatitis were predictive factors for suc-cessful *** cases of EVB were mild and mod-erate in *** first-line treatment for EVB is *** endoscopic intervention has not been widely available *** overall management out-come of EVB has been improved.

关键词： hypertension,portal esophageal and gastric varices gastrointestinal hemorrhage therapeutics

Prognosis of hepatic cirrhosis patients with esophageal or gastric variceal hemorrhage: multivariate analysis

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 2002年第3期1卷 416-419页

作者： Chao Zhao Shao-Bo Chen Jian-Pin Zhou Wen Xiao Han-Gong Fan Xue-Wei Wu Gan-Xin Feng Wei-Xiong He the Department of Gatroenterology, Zhongshan Municipal Bo’ai Hospital, Zhongshan 528403, China Department of Gastroenterology Zhongshan Municipal Bo'ai Hospital Zhongshan 528403 China

Objective: To study the effect of bacterial infection, use of antibiotics, active bleeding at endoscopy, and the severity of liver disease as prognostic factors in hepatic cirrhotic patients during the first 5 days after the episode of esophageal or gastric variceal hemor- rhage. Methods: Seventy-six hepatic cirrhosis patients with esophageal or gastric variceal bleeding were enrolled. Bleeding was managed in a standardized protocol u- sing octreotide and vasopressin in sclerotherapy or band ligation for active bleeding at endoscopy. The screening protocol for bacterial infection consisted of chest radiograph; blood, urine and ascitic fluid cul- tures; the severity of liver disease shown by Child- Pugh score. Results: Active bleeding was observed at endoscopy in 40 patients (53%). Failure to control bleeding Within 5 days occurred in 36 patients (45%). Empir- ical antibiotic treatment was used in 53 patients (67%), whereas bacterial infections were documen- ted in 43 patients (57%). Multivariate analysis showed that proven bacterial infection (Pesophageal or gastric variceal bleeding in hepatic cirrhotic patients.

关键词： hepatic cirrhosis esophageal and gastric varices gastrointestinal hemorrhage bacterial infection prognosis