Japanese journal of gastroenterology and hepatology最新文献

{"title":"Palliative Cholecysto-Jejunostomy for Extra-Hepatic Billiary Obstruction Under Local Anaesthesia: A Rewarding Experience","authors":"A. S, Ningi Ab","doi":"10.47829/JJGH.2021.61301","DOIUrl":"https://doi.org/10.47829/JJGH.2021.61301","url":null,"abstract":"Extra-hepatic billiary obstruction is a common disorder seen in surgical practice, and it greatly affects the quality of life of patients afflicted with such disorder. In its severe form, it may be life threatening due to complications such as, hepatic encephalopathy, Hepato-renal syndrome, fulminant cholangitis and jaundice related coagulopathy. Obstructive Jaundice is the most common presentation following extra-hepatic billiary obstruction and carcinoma of the head of the pancreas and choledocholithiasis are the most common malignant and benign causes. Most patients present with advanced disease where palliation is the only viable option. However, such patients may not be suitable for surgery under General Anaesthesia due to advanced age, poor nutritional state with hypolbuminaemia, extra-abdominal metastasis producing respiratory compromise or a high risk for hepatic encephalopathy. Objectives: We aim to assess the safety and effectiveness of a palliative Cholecysto-Jejunostomy done under local Anaesthesia. Methods: This is a prospective cross-sectional study of total of 54 patients, both males and females, aged 16 years and above, who presented at the General Surgery units of State Specialist Hospital Damaturu and General Hospital Potiskum, both in Yobe State Nigeria; with Obstructive Jaundice. All had clinical and Radiological evidence of extra-hepatic Billiary obstruction and were managed surgically with a palliative Cholecysto-Jejunostomy under local Anaesthesia involving infiltrative cutaneous field block and USS guided Oblique Subcostal Transversus Abdominis Plain Block (OSTAPB). It is a 6-year study done from January 2015-December 2020. Informed consent was obtained from all patients according to Helsinki guidelines and Ethical clearance was granted by the leadership of both hospitals. All data were analysed with SPSS 20.0 software for correlation of outcomes. Results: The study population were 54 patients, 59.3% males and 40.7% females. The mean age is 50.5 years and an age range of 16-75 years. Malignant lesion is the most common cause of extra-hepatic billiary obstruction, with exocrine pancreatic cancer responsible for 48.1% of all causes. Chronic pancreatitis (16.7%) and impacted common bile duct (CBD) stones at 14.8%, are the two most common benign causes. All the patients had an abdominal USS for diagnosis or non-contrast enhanced abdominal CT Scan if there is ambiguity. A total of 77.8% had palliative Cholecysto-Jejunostomy done under local Anaesthesia involving cutaneous field block with Lignocaine with Adrenaline at a standardised dose of 4mg/kg body weight and USS guided Subcostal TAP Block. The remaining had a palliative Cholecystostomy or no surgery done. All abandoned cases were because of an involved or fibrosed Gallbladder. The most common post-operative complications are Surgical Site Infection (SSI) at 24.1%, excessive Primary Haemorrhage and reactionary haemorrhage, at 9.3% each. The total fatality rate was 7.4%. Con","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44027459","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 Antibiotics on the Gut Microbiota in Children With Chronic Pancreatitis","authors":"W. Wang, Yuan Xiao, Shuang Ma, Xin-qiong Wang, Yiran Zhou, Ting Wang, Chun Xv, B. Gong, B. Shen","doi":"10.21203/rs.3.rs-622663/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-622663/v1","url":null,"abstract":"\u0000 OBJECTIVES: Little is known about the effect of antibiotic treatment on the gut microbiota in children with chronic pancreatitis (CCP). Our objective was to identify the main gut microbiota genera and characterize these patients’ functional mutations after using antibiotics.METHODS: The 16S rRNA sequencing method was used to compare the gut microbiota of healthy controls (HCs) with CCP using and not using antibiotics.RESULTS: All CCP demonstrated a significantly reduced alpha diversity of the gut microbiota (P＜0.01). The gut microbiota's alpha diversity and the abundance of genera’s beta diversity did not show statistical differences between the non-antibiotics and antibiotics groups. There were 15 altered genera with common abundance in the non-antibiotics and antibiotics groups compared to the HC group. The area under the curve (AUC) of the top three probiotics, i.e., Faecalibacterium, Eubacterium, and Subdoligranulum, was 0.91. Among the 13 genera altered in the non-antibiotics group, the top three genera were not appropriate as biomarkers for cases receiving antibiotics. Compared to these 13 genera, the differences between the genera and the proportion of gram-positive bacteria in the 17 genera altered only in the antibiotics group were not statistically significant. The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis indicated that the antibiotics caused alterations in the abundance of certain genera. The enriched functions and the altered gut microbiota in the two groups had their enriched functions.CONCLUSIONS: The use of antibiotics affects the gut microbiota of CCP, but the effect of disease on gut microbiota is still obvious.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49608880","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":"Updates on The Management of Hepatocellular Adenomas","authors":"Shafaee Z, Bansal R, Aron J","doi":"10.47829/JJGH.2021.6902","DOIUrl":"https://doi.org/10.47829/JJGH.2021.6902","url":null,"abstract":"Zahra Shafaee, Department of Surgery, NYC Health + Hospitals/ Elmhurst, NY 11373, USA, Tel: 3125439642, E-mail: Shafaeez1@nychhc.org Received: 23 Mar 2021 Accepted: 12 Apr 2021 Published: 20 Apr 2021 Copyright: ©2021 Shafaee Z, This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70926579","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":"Gastric Plexiform Fibromyxoma in Children - A New Case Report and Review of Pediatric Literature","authors":"Moglia C, Parolini F, Villanacci V, Gaetano Gd, M. D., Domenico Dc, Pignata G, A. D.","doi":"10.47829/jjgh.2021.7301","DOIUrl":"https://doi.org/10.47829/jjgh.2021.7301","url":null,"abstract":"Introduction: Plexiform Fibromyxoma (PF), also known as Plexi form Angiomyxoid Myofibroblastic Tumour (PAMT) is a rare mesen chymal myxoid tumour originating in different areas of the digestive system. Symptoms and signs are usually elusive: the most common are abdominal discomfort, dyspepsia, nausea and gastrointestinal bleeding with anemia and hematemesis. Imaging tests are useful to identify plexiform fibromyxoma, but only pathology provides the definitive diagnosis and differentiate it from other mesenchymal tu -mours. PF seems to display a benign behaviour and the only com plete surgical removal of the mass represents the gold standard of treatment; no recurrence or metastasis has been described so far. A little more than 100 cases have been described in adulthood with only 14 cases reported up to now in pediatrics. Case report and review: We report the case of a gastric plexiform fibromyxoma occurred in an 8-year old girl went to our observation with a story of dyspepsia, vomiting, weight loss and anemia. A 4 X 2.5 cm mass was found in the gastric antrum. The tumour was re moved by laparoscopic antrectomy and the pathological exam was consistent with PF. A detailed review of PF pediatric literature is also provided.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70926967","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":"Self-Expandable Metal Stents for the Management of Gastric Outlet Obstruction: Experience from A Tertiary-Care Facility in Pakistan","authors":"S. Niaz, Syed Zea-Ul-Islam Farrukh, S. A. Haqqi, A. Siddiqui, Abdul Samad Dheddi, Aisha Rumman","doi":"10.47829/jjgh.2021.7903","DOIUrl":"https://doi.org/10.47829/jjgh.2021.7903","url":null,"abstract":"1. Abstract 1.1. Aim Gastric outlet obstruction is commonly considered as advanced malignancies of the stomach, duodenum, pancreas, hepatobiliary, and ampullary regions. Surgical bypass and chemotherapy are the common treatment modalities for gastric obstruction. This study was done to determine the outcomes of self-expandable metal stents in patients with gastric outlet obstruction. 1.2. Methods Forty-seven symptomatic patients with gastric outlet obstruction who underwent self-expandable metal stents in Patel hospital, Karachi-Pakistan from January 2013 till January 2020 were selected for the study. Data on the relief of obstructive symptoms such as; nausea and vomiting and improvement in food intake was the primary clinical success outcome, measured by the gastric outlet obstruction score. Data were statistically analyzed using SPSS version 21.0 (SPSS Inc., Chicago, IL, USA). 1.3. Results Number of 47 patients received uncovered self-expandable stent (Boston Scientific WallFlex) placements during the study period with n=22 (46.8%) single stents, while n=25 (53.2%) dual stents (enteral and biliary), with a mean ±SD age of 60.6 (±14.1) years. Fifteen (31.9%) participants showed good improvement, n=23 (48.9%) patients showed mild improvements, n=04 (8.5%) reported moderate improvement, while only n=05 (10.6%) patients showed no improvements at all after placement of the intervention. The median survival time after the intervention was 8.5 weeks (95% CI: 5.469 – 11.674) in the study population. 1.4. Conclusion The endoscopic stenting for malignant gastric outlet obstruction appears to be an effective alternative to surgical palliative bypass. 2. Introduction Gastric outlet obstruction (GOO) is a result of mechanical gastroduodenal obstruction. Moreover, the incursion of upper abdominal carcinomatosis or metastases from advanced extra-abdominal cancer may also incite GOO. GOO is primarily divided into three major categories, which are benign mechanical, malignant mechanical, and motility disorders [1]. The malignant gastric outlet obstruction (MGOO) typically distresses the areas of the distal stomach or proximal duodenum, resulting in poor prognosis due to gastric and pancreatic malignancies [2]. However, malignant infiltration by neoplasms from adjacent organs and compression by malignant regional lymphadenopathy may also contribute to an exacerbation of existing obstruction [3]. Obstruction is an advanced occurrence in GOO manifesting with nausea, vomiting, poor appetite, and an overall reduction in the quality of life of these patients adding to quality-adjusted life years (QALYs) alongside a significant burden on the healthcare resources [4, 6]. In some patients, symptoms including abdominal pain, esoph-","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927409","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":"Surgical Management of a Caustic Ingestion in a Gastric Bypass Patient: A Case Report","authors":"Boxstael Ve, Terwagne N, Deswysen Y","doi":"10.47829/jjgh.2021.61002","DOIUrl":"https://doi.org/10.47829/jjgh.2021.61002","url":null,"abstract":"","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70926013","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":"Differential Diagnosis of Clinical, Imaging and Pathological Features Between Focal Nodular Hyperplasia and Hepatocellular Carcinoma","authors":"Wen-Hui B, Li- Cheng, Wu Y, Mao-Ming W, Liang-Kun X, W. W, Kai-Huan Y","doi":"10.47829/jjgh.2021.7104","DOIUrl":"https://doi.org/10.47829/jjgh.2021.7104","url":null,"abstract":"Differential Diagnosis of Clinical, Imaging and Pathological Features Between Focal Nodular Hyperplasia and Hepatocellular Carcinoma Wen-Hui B1, Li-Cheng2, Wu Y3, Mao-Ming W1, Liang-Kun X1, Wei-Xing W1* and Kai-Huan Y1* 1Department of Hepatobiliary Surgery, Eastern Campus, Renmin Hospital of Wuhan University, Wuhan, China 2Department of Critical Care Medicine, Eastern Campus, Renmin Hospital of Wuhan University, Wuhan, China 3Department of Pathology, Affiliated Tianyou Hospital of Wuhan University of Science and Technology, Wuhan, China","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70926737","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":"Bowel Preparation Instructions for Outpatient Colonoscopy Delivered by a Specialist Endoscopy Nurse was Superior to That Delivered by an Endoscopist","authors":"Chee K Hui, Kit Hui","doi":"10.47829/jjgh.2021.7701","DOIUrl":"https://doi.org/10.47829/jjgh.2021.7701","url":null,"abstract":"1.3. Results: Four-thousand-eight-hundred-and-seventy-seven subjects (85.0%) were in the Nurse group while 860 subjects (15.0%) were in the Endoscopist group. A total Boston Bowel Preparation Score ≥6 was achieved in 4721 of the 4877 (96.8%) subjects in the Nurse group when compared with 807 of the 860 (93.8%) subjects in the Endoscopist group (p<0.001). A total of 1624 of the 5737 (28.3%) subjects had adenomas on colonoscopy. There was no significant difference in the adenoma detection rate in the Nurse group when compared with the Endoscopist group [1388/4877 (28.5%) vs. 236/860 (27.4%), p=0.285]. There was also no significant difference in the total number of adenomas detected in the Nurse group when compared with the Endoscopist group [mean± standard deviation 0.48±1.08 vs. 0.44±1.18, p=0.412].","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927050","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":"Hepatocellular Carcinoma Combined with Underlying Alveolar Echinococcosis. Clinical Case Report","authors":"Semenkov Av, Poddubskaya Ev, Yurichenko Yy, Sorokina Mi, Buzdin Aa, Kogan Y, Nekrasova Tp, Lerner Yv, Ippolitov Li, Shchekoturov Io","doi":"10.47829/jjgh.2021.7401","DOIUrl":"https://doi.org/10.47829/jjgh.2021.7401","url":null,"abstract":"Hepatocellular Carcinoma Combined with Underlying Alveolar Echinococcosis. Clinical Case Report Semenkov AV1*, Poddubskaya EV2, Yurichenko YY3, Sorokin MI4,5, Buzdin AA4,5, Kogan Y6, Nekrasova TP6, Lerner YV6, Ippolitov LI3 and Shchekoturov IO7 1Department of oncology, radiotherapy and plastic surgery of the University Clinical Hospital No1, I.M. Sechenov First Moscow State Medical University, Moscow, Russia 2The Scientific-research department of the Center of personalized oncology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia 3Department of oncological surgery No1 of the University clinical hospital No1, I.M. Sechenov First Moscow State Medical University, Moscow, Russia 4Laboratory of Clinical and Genomic Bioinformatics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia 5Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russia 6Department of anatomic pathology named after Academician A.I. Strukhov, I.M. Sechenov First Moscow State Medical University, Moscow, Russia 7Radiology department of I.M. Sechenov First Moscow State Medical University, Moscow, Russia","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927146","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":"Anesthetic Management for Patients With Pheochromocytoma : Series of Three Cases","authors":"Imbelloni Le, Lemos Neto SV, Rivoli Alc, Rosário Ar, Salo Lv, Borges Tg","doi":"10.47829/jjgh.2021.8201","DOIUrl":"https://doi.org/10.47829/jjgh.2021.8201","url":null,"abstract":"1.1. Background. This study describes a case series that addresses the complex anesthetic management of adrenalectomy for patients with pheochromocytoma. It is a rare tumor, originating in the chromaffin cells of the adrenal medulla and a catecholamine-secreting agent, whose most common triad of symptoms is headache, sweating and tachycardia. 1.2. Cases: The first case corresponds to a 47-year-old woman with a history of three acute myocardial infarctions with a lesion located unilaterally in the left adrenal gland. After adrenal removal and due to persistence of hypertension, it was necessary to perform a left nephrectomy. The second case describes the conduction of a multimodal and opioid-free anesthesia of a 26-year-old female patient with dilated cardiomyopathy who underwent video laparoscopic right adrenalectomy The first report involves the case of a 14-year-old male patient with von Hippel-Lindau Syndrome, who underwent bilateral open adrenalectomy. All three cases were successfully preoperatively prepared and operated on and were discharged home between the 5th and 6th day compensated and without physiological changes. No genetic study of the three patients was performed. Continuous epidural anesthesia was performed in two patients, without hypotension and need for vasopressor. 1.3. Conclusion: In this pathology, it is essential to emphasize the extreme importance of the multidisciplinary approaches carried out in the three cases. We can affirm affirm that the favorable outcomes were only possible thanks to a great joint effort and judicious for monitoring the Endocrinology and Pediatrics services and for the coordinated relationship between the anesthetic and surgical teams, which were essential for obtaining hospital discharge in the first six days after surgery","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927760","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}