The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology最新文献

{"title":"Cirrhosis with ascites: Is the presence of hemorrhagic ascites an indicator of poor prognosis?","authors":"Hakan Yıldız,&nbsp;Meral Akdoğan,&nbsp;Nuretdin Suna,&nbsp;Erkin Öztaş,&nbsp;Ufuk B Kuzu,&nbsp;Zülfükar Bilge,&nbsp;Onur Aydınlı,&nbsp;İsmail Taşkıran","doi":"10.5152/tjg.2016.160042","DOIUrl":"https://doi.org/10.5152/tjg.2016.160042","url":null,"abstract":"<p><strong>Background/aims: </strong>Hemorrhagic ascites in patients with cirrhosis is described as a RBC (Red Blood cell) > 50,000/mm³ and leads to increased morbidity and mortality. Positive red blood cells at a level of less than 50,000/mm³ (10,000-50,000) may be encountered in the ascites but it is not known whether this is clinically significant or not. This study aimed to examine the outcome of hemorrhagic ascites in patients with advanced cirrhosis.</p><p><strong>Materials and methods: </strong>Data from 329 cirrhotic patients with ascites who received paracentesis at least once due to ascites was retrospectively analyzed from the period of 2007-2013 from the Türkiye Yüksek İhtisas Hospital, Department of Gastroenterology. Patients were divided according to the number of RBC, with greater than 10,000/mm³ being described as hemorrhagic ascites, and less than 10,000/mm³ described as the normal or control group. Patient data included: number of accepted intensive unit service stays, acute kidney injury (AKI), hepatic encephalopathy (HES), model for end-liver disease (MELD) score, Child Pugh score (CPS), degree of esophageal varices, spleen size and mortality rates.</p><p><strong>Results: </strong>Patients were defined as having hemorrhagic ascites with a RBC count greater than 10,000/mm³ in 118 (35.9%) patients and as a non-hemorrhagic ascites group with less than 10,000/mm³ in 211 (64.1%) patients. The hemorrhagic ascites group had advanced liver disease symptoms compared to the control group. Meld score in the hemorrhagic group was statistically higher than in the control group (21.5±8.3 vs. 17.3±6.6; p value: 0.001). The median value of bilirubin was 5.9 (0.45-33) in the hemorrhagic ascites group and 4.01 (0.39-33) in the non-hemorrhagic group (p value: 0.001). Using multivariate logistic regression analysis, hemorrhagic ascites was also an independent predictor of mortality (HR 2.7 1.4-6.3), with other mortality indicators being HCC (HR 3.1 1.5-6.4) and HRS (HR 2.6 1.2-5.5).</p><p><strong>Conclusion: </strong>Patients with hemorrhagic ascites had higher HRS, SBP and admissions to the intensive care unit. We believe that the presence of hemorrhagic ascites can be used as a marker for advanced liver disease and for predicting mortality.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"349-53"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34439484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Galactin-3 and brain natriuretic peptide versus conventional echocardiography in the early detection of cirrhotic cardiomyopathy.","authors":"Wael A Abbas,&nbsp;Soheir M Kasem Ahmed,&nbsp;Amal M Abdel Aal,&nbsp;Amal A Mahmoud,&nbsp;Mohamed O Abdelmalek,&nbsp;Mohamed A Mekky,&nbsp;Mohamed A A Abozaid,&nbsp;Ahmed K Ibrahim","doi":"10.5152/tjg.2016.16100","DOIUrl":"https://doi.org/10.5152/tjg.2016.16100","url":null,"abstract":"<p><strong>Background/aims: </strong>Cirrhotic cardiomyopathy (CCM) is defined as an abnormal heart structure and function in cirrhotic patients. CCM includes systolic and diastolic dysfunction, electrophysiological abnormalities, and structural changes, both microscopic and macroscopic. Currently, there is no one diagnostic test that can identify patients with CCM. Evaluation of the validity of galactin-3 and brain natriuretic peptide (BNP) as biomarkers in the early detection of CCM in comparison to conventional echocardiography.</p><p><strong>Materials and methods: </strong>A case control study was carried out in the Departments of internal medicine and tropical Medicine, Assuit University, Egypt. Seventy-one subjects were divided into the following three groups: 26 cirrhotic patients without ascites, 25 cirrhotic patients with ascites, and 20 healthy controls. All groups underwent clinical examination, and laboratory investigation including BNP, galactin-3, and echocardiography.</p><p><strong>Results: </strong>There was a significant difference between the three groups (p < 0.001) with regard to corrected QT (cQT), BNP and galactin-3. Left ventricular diastolic dysfunction with different grades was the most recorded cardiac abnormality in the patient group I and II (88.5% and 96%; respectively) with significantly increased frequency and severity in ascetic patients and with the advancement of liver cirrhosis. BNP and galactin-3 were sensitive and specific biomarkers for the detection of diastolic dysfunction in cirrhotic patients (77.6%, 95.5%, 89.9% and 86.4%; respectively).</p><p><strong>Conclusion: </strong>Diastolic dysfunction is a common cardiac abnormality in cirrhotic patients that worsens with the advancement of cirrhosis. BNP and galactin-3 had higher sensitivity and specificity in the early detection of CCM compared with those of conventional echocardiography.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"367-74"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34703663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worsening jaundice induced by biliary drainage.","authors":"Hong-Xia Liang,&nbsp;Zu-Jiang Yu,&nbsp;Qing-Lei Zeng","doi":"10.5152/tjg.2016.16289","DOIUrl":"https://doi.org/10.5152/tjg.2016.16289","url":null,"abstract":"","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"399-400"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34703670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes increases morbidity and mortality rates in peptic ulcer bleeding: An updated systematic review and meta-analysis.","authors":"Fengqin Wei, Xiaoti Lin","doi":"10.5152/tjg.2016.15448","DOIUrl":"10.5152/tjg.2016.15448","url":null,"abstract":"<p><strong>Background/aims: </strong>To elucidate the relationship between diabetes mellitus (DM) and the risk of peptic ulcer complications.</p><p><strong>Materials and methods: </strong>Fixed effects and random effects models were used for calculating pooled relative risks (RRs) and/or odds ratios (ORs). Subgroup and sensitivity analyses were also performed.</p><p><strong>Results: </strong>Nineteen high-quality investigations were included in the present study. In an analysis of morbidity rates in primary peptic ulcer bleeding (PUB), we calculated a summary OR of 1.433 (95% CI=1.280-1.604) in the random effects model comparing incidence in diabetes patients and in those without diabetes. In addition, a meta-analysis using the fixed effects model indicated a higher 30-day mortality in PUB in DM patients (OR=1.442, 95% CI=1.245-1.671) than in patients without DM. Further subgroup analyses demonstrated that DM patients in prospective cohort studies had an increased risk of 30-day mortality in PUB (RR=1.407, 95% CI=1.177-1.681). A similar result was obtained in a retrospective cohort subgroup, in which DM significantly increased mortality rates in PUB (OR=1.521, 95% CI=1.171-1.976).</p><p><strong>Conclusion: </strong>We provided convincing evidence by a meta-analysis that DM was associated with a 43.3% increase in morbidity rates in PUB and a 44.2% increase in the risk of 30-day mortality in PUB patients.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"304-11"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34314590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of oxidative stress and insulin resistance in disease severity of non-alcoholic fatty liver disease.","authors":"Emine Köroğlu,&nbsp;Billur Canbakan,&nbsp;Kadri Atay,&nbsp;İbrahim Hatemi,&nbsp;Murat Tuncer,&nbsp;Ahmet Dobrucalı,&nbsp;Abdullah Sonsuz,&nbsp;Ilhami Gültepe,&nbsp;Hakan Şentürk","doi":"10.5152/tjg.2016.16106","DOIUrl":"https://doi.org/10.5152/tjg.2016.16106","url":null,"abstract":"BACKGROUND/AIMS Oxidative stress and insulin resistance (IR) are major contributors in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). The purpose of this study was to find the relation between oxidative stress parameters and histopathological findings in NAFLD patients with and without insulin resistance (IR). MATERIALS AND METHODS Thirty-two patients with no alcohol intake and biopsy-proven diagnosis of NAFLD were studied (M/F: 17/15; mean age 46.5±11.4 years). Twenty-one NAFLD patients with IR were compared with 11 patients without IR. The fasting insulin level was measured, and the insulin resistance index was calculated using the homeostasis model assessment (HOMA) method. Malondialdehyde (MDA) and superoxide dismutase (SOD) activities were measured in tissue and serum specimens. Glutathione (GH) was measured in tissue homogenates. Nitric oxide (NO), vitamin E and C levels were measured in serum. RESULTS Patients with IR had significantly higher tissue MDA levels (p=0.001) and significantly decreased tissue SOD and GH levels (p=0.001 and 0.002, respectively) than those without IR. The steatosis grade, necroinflammatory grade and stage were significantly higher in patients with IR (p=0.035, 0.003 and 0.001, respectively). HOMA IR significantly correlated with the necroinflammatory grade, stage, tissue MDA, SOD and GH (p=0.013, 0.001, 0.008, 0.001 and 0.001, respectively). Serum MDA (β=1.88, p=0.002), serum SOD (β=0.57, p=0.006), tissue MDA (β=0.22, p=0.006), tissue SOD (β=1.48, p=0.071) and stage (β=2.81, p=0.003) were independently associated with increased HOMA IR. Increased MDA [OR: 1.51; 95% CI: (1.03-2.22); p=0.034] was a risk factor for non-alcoholic steatohepatitis (NASH), and increased SOD activity had a preventive effect against NASH [OR: 0.008; 95% CI: (0.001-0.98); p=0.04]. CONCLUSION This study shows that insulin resistance in NAFLD correlates with enhanced oxidative stress. Histopathological disease severity significantly correlated with oxidative stress parameters. These data show that NAFLD patients with IR may have increased risk for disease progression.","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"361-6"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34703662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early combined immunosupression for the management of Crohn's disease.","authors":"Nilay Danış,&nbsp;Fatih Tekin","doi":"10.5152/tjg.2016.160003","DOIUrl":"https://doi.org/10.5152/tjg.2016.160003","url":null,"abstract":"","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"401-2"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34703671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic evaluation of acute intestinal graft-versus-host disease after allogeneic hematopoietic cell transplantation.","authors":"Reskan Altun,&nbsp;Ayla Gökmen,&nbsp;İbrahim Tek,&nbsp;Ender Soydan,&nbsp;Meltem Kurt Yüksel","doi":"10.5152/tjg.2016.15353","DOIUrl":"https://doi.org/10.5152/tjg.2016.15353","url":null,"abstract":"<p><strong>Background/aims: </strong>Acute graft-versus-host disease (GVHD) is a common complication of haematopoietic cell transplantation (HCT), with the gastrointestinal tract (GIT) as one of the main target organs. There is a lack of consensus regarding the site in GIT with the highest sensitivity for biopsy. The present study aimed to determine the endoscopic and histological findings in acute GVHD.</p><p><strong>Materials and methods: </strong>The data of 111 patients who had received allogeneic HCT were retrospectively reviewed.</p><p><strong>Results: </strong>Allogeneic HCT was performed in 111 patients, of whom 27 (24.3%) had developed acute GVHD. Nineteen of the 111 patients with intestinal symptoms were evaluated for intestinal involvement, and 17 were diagnosed with acute intestinal GVHD. Upper endoscopic findings had a sensitivity of 64.7%, a specificity of 50%, a positive predictive value of 91.6% and a negative predictive value of 14.2%. The diagnostic accuracy of upper endoscopy was 63.1%. Lower endoscopic findings had a sensitivity of 40% and a specificity of 0%. The diagnostic accuracy of upper endoscopy with duodenal biopsy and sigmoidoscopy was 94.1%.</p><p><strong>Conclusion: </strong>Endoscopic findings are nonspecific in acute intestinal GVHD. There is little agreement between endoscopic findings and histopathology; thus, biopsies are essential. In patients with intestinal symptoms after HCT, upper endoscopy with duodenal biopsy and sigmoidoscopy has an acceptable diagnostic yield for intestinal involvement.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"312-6"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34314591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between single nucleotide polymorphisms in prospective genes and susceptibility to ankylosing spondylitis and inflammatory bowel disease in a single centre in Turkey.","authors":"Orhan Küçükşahin,&nbsp;Aşkın Ateş,&nbsp;Nuran Türkçapar,&nbsp;Murat Törüner,&nbsp;Murat Turgay,&nbsp;Türker Duman,&nbsp;Ali Şahin,&nbsp;Mustafa Turgut Yıldızgören,&nbsp;Alexis K Okoh,&nbsp;Emre Külahçıoğlu,&nbsp;Şükran Erten,&nbsp;Gülay Kınıklı,&nbsp;Saeid Assadpour,&nbsp;Nurşen Düzgün","doi":"10.5152/tjg.2016.15466","DOIUrl":"https://doi.org/10.5152/tjg.2016.15466","url":null,"abstract":"<p><strong>Background/aims: </strong>To establish the prevalence of the single nucleotide polymorphisms (SNPs) of endoplasmic reticulum aminopeptidase 1 (ERAP1), IL-23 receptor (IL-23R), signal transducer and activator of transcription 3 (STAT-3) and Janus kinase 2 (JAK-2) in ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) in a Turkish population.</p><p><strong>Materials and methods: </strong>A total of 562 subjects who presented at the Ankara University internal medicine departments of rheumatology and gastroenterology outpatient clinics were recruited in this study, including 365 patients with AS, 197 patients with IBD and 230 healthy controls. ERAP1, IL-23R, STAT-3 and JAK-2) were genotyped in competitive allele-specific polymerase chain reactions.</p><p><strong>Results: </strong>The ERAP1 (rs26653) polymorphism was found to increase the disease risk in patients with AS and IBD compared with the control group (p=0.02 and p=0.01, respectively). In addition, this polymorphism revealed a significant relationship with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI) in patients with AS (r=0.829, p < 0.001 and r=0.731, p < 0.001, respectively).</p><p><strong>Conclusion: </strong>The ERAP1 gene polymorphism might be a risk factor in the pathogenesis of AS and IBD. In contrast, IL-23R gene polymorphisms may serve a protective role in AS and IBD.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"317-24"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34314592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual cause of paediatric abdominal pain: Mesenteric masses accompanied with volvulus.","authors":"Chao Yang,&nbsp;Shan Wang,&nbsp;Jun Zhang,&nbsp;Xiang Ru Kong,&nbsp;Zhenzhen Zhao,&nbsp;Chang Chun Li","doi":"10.5152/tjg.2016.15481","DOIUrl":"https://doi.org/10.5152/tjg.2016.15481","url":null,"abstract":"<p><strong>Background/aims: </strong>Volvulus caused by mesenteric masses is rare and may result in serious consequences. This study aimed to better characterize volvulus caused by mesenteric masses in children.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted in 24 patients who underwent surgical treatment between January 1994 and January 2014 in one single institution.</p><p><strong>Results: </strong>There were 10 boys and 14 girls. The most frequent findings were abdominal pain (100%), emesis (91.7%) and nausea (83.3%). Physical examination showed positive ileus signs in majority cases, and palpable mass was found in half of the patients. Ultrasound and CT scans revealed mesenteric masses in 21 and 24 patients, and 'whirlpool sign' was observed in 19 and 22 patients, respectively. Emergency laparotomy was performed in all patients. Histological examination revealed that 18 cystic masses were lymphangioma, 5 solid cases were lipoma and the remaining one was lipoblastoma. The postoperative course was uneventful in 22 patients, and postoperative obstruction and incision infection occurred in 2 patients. There was no evidence of recurrence at follow-up.</p><p><strong>Conclusion: </strong>Volvulus caused by mesenteric masses is a rare but potentially life-threatening cause of abdominal pain, which should be considered in the differential diagnosis of paediatric acute abdominal pain.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"325-9"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34314593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of coronary-caval shunt combined with partial pericardial devascularisation on oesophageal and gastric variceal bleeding caused by portal hypertension.","authors":"Jigang Bai,&nbsp;Meng Xu,&nbsp;Ruitao Wang,&nbsp;Yiping Mu,&nbsp;Shunbin Dong,&nbsp;Zheng Wu,&nbsp;Shengli Wu,&nbsp;Chan Liu","doi":"10.5152/tjg.2016.16086","DOIUrl":"https://doi.org/10.5152/tjg.2016.16086","url":null,"abstract":"<p><strong>Background/aims: </strong>To investigate the effect of coronary-caval shunt combined with partial pericardial devascularisation on oesophageal and gastric variceal bleeding caused by portal hypertension.</p><p><strong>Materials and methods: </strong>Between January 2005 and January 2015, coronary-caval shunt operations combined with partial pericardial devascularisation were performed electively on 15 cirrhotic patients with portal hypertension. All of these patients had a history of oesophageal and gastric variceal bleeding. The clinical and follow-up data of these patients were reviewed retrospectively. Another 15 patients receiving non-surgical treatments in a similar follow-up period were used as controls to compare the preventive effects of different treatment strategies on rebleeding.</p><p><strong>Results: </strong>All of the 15 surgical procedures were performed successfully, and no severe complications occurred. Among these, autogenous splenic veins were used as bridge vessels in 6 cases, whereas the coronary vein and inferior vena cava were anastomosed directly in 9 cases. All surgical patients were followed up from 5 months to 10 years with an average of 63 months; 2 patients died due to liver failure induced by reactivation of hepatitis B virus and oesophageal/gastric variceal rebleeding, respectively. The rebleeding rates for surgical and non-surgical patients were 6.7% and 66.7% (p < 0.05), respectively, whereas the 5-year survival rates for the two groups were 85.7% and 33.3% (p < 0.05), respectively.</p><p><strong>Conclusion: </strong>Patients with oesophageal and gastric variceal bleeding caused by portal hypertension may benefit from a coronary-caval shunt combined with partial pericardial devascularisation due to decreased coronary vein pressure, unaffected hepatic blood inflow, and reduced incidence of rebleeding.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"354-60"},"PeriodicalIF":1.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34314596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}