Early surgical intervention was previously advocated in patients > 60 years with bleeding pepticulcer presenting with haemodynamic instability or ongoing transfusion requirements... Medical therapy with proton pump inhibitor and subsequent eradication of Helicobacterpylori following endoscopic treatment has been shown to be beneficial to outcomes. Should surgery be deemed necessary, it is likely that laparoscopic techniques to control bleeding, with ...
Many perforated pepticulcers (PPUs) require surgical repair due to diffuse peritonitis. However, few studies have examined the clinical effects of postoperative drainage after PPU repair. This study aimed to investigate the drain insertion rates in patients who underwent PPU repair in Japan, and to clarify the impact of drain insertion on the postoperative clinical course.A retrospective nationwide cohort ...
DescriptorName: PepticUlcer... Abstract: The aim of this study was to investigate the association between urinary incontinence (UI) and pepticulcer (PU) and how this is related to psychological stress in Korean women by analyzing the data from the Korea National Health and Nutrition Examination Survey IV (KNHANES).A nationally ...
Urology (3) Urinary Incontinence (3), Peptic Ulcer (3), more mentions
... outcomes after transcatheter arterial embolization (TAE) with conventional surgery for pepticulcer bleeding when endoscopic intervention fails to achieve hemostasis AbstractText: Mortality in pepticulcer bleeding remains high, especially in patients who require surgical treatment ... that TAE compares favorably with surgery regarding prognosis after refractory pepticulcer bleeding, and the shorter length of hospital stay and fewer ...
This report presents our experience with laparoscopic repair performed in 118 consecutive patients diagnosed with a perforated pepticulcer (PPU. We compared the surgical outcome of simple closure with modified Cellan-Jones omentopexy and report the safety and benefit of simple closure.From January 2010 to December 2014, 118 patients with PPU underwent laparoscopic repair with simple closure (n = 27 ...
Pepticulcer bleeding (PUB) is among the most common causes of hospitalization worldwide ... Despite the considerable incidence of pepticulcers with 6-33% and high recurrence rate of PUB in patients with cirrhosis (4), the specific mechanisms responsible for pepticulcers remain largely unknown in the setting of cirrhosis (4 ...
A rare case for esophagealulcers related to BD is presented AbstractText: In China, BD is ... Traditional Chinese and Western Medicine Hospital, for multiple discrete, elliptical esophagealulcers related to BD AbstractText: The esophagealulcers were treated with corticosteroid treatment for 12 weeks AbstractText: The esophagealulcers were cured AbstractText: Our report might give further strength to ...
In most cases, celiac axis (CA) stenting is not needed since revascularization of the superior mesenteric artery (SMA) alone results in symptomatic resolution. This report describes a case of a patient with chronic mesenteric ischemia and diffuse gastriculcers found to have a common origin of the SMA and CA that was treated endovascularly using a bifurcated stent technique.
... individually or in combination, to distinguish between gastric cancer and gastriculcer... study involved 194 patients with gastric cancer, 191 patients with gastriculcer, and 185 control subjects... increased and PDW levels are significantly reduced in patients with gastriculcer and in control subjects compared with those in gastric cancer ...
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AbstractText: To assess the non-inferiority of vonoprazan to lansoprazole for secondary prevention of non-steroidal anti-inflammatory drug (NSAID)-induced pepticulcer (PU) and the safety of vonoprazan during extended use AbstractText: A phase 3, 24-week, multicenter, randomised, double-blind (DB), active-controlled study, followed ... Keyword: pepticulcer.
Immune System Diseases (1), Muscular and Skeletal Diseases (1) Peptic Ulcer (2), Rheumatoid Arthritis (1), Osteoarthritis (1), more mentions
OBJECTIVE: Endoscopic transpapillary or endoscopic ultrasound (EUS)-guided stent placement is used for nonresectable distal malignant biliary obstruction. We conducted a retrospective study to evaluate endoscopic biliary drainage in patients with duodenal obstruction.
METHODS: We included consecutive patients who underwent endoscopic biliary drainage combined with a duodenal stent at 16 referral centers in four Asian countries. The primary outcome was time to recurrent biliary obstruction (TRBO). We assessed TRBO according to the sequence of biliary and duodenal obstruction (group 1/2/3, biliary obstruction first/concurrent/duodenal obstruction first, respectively) or the location of duodenal obstruction (type I/II/III, proximal to/affecting/distal to the ampulla, respectively). We also evaluated functional success and adverse events.
RESULTS: We included 110 patients (group1/2/3, 67/29/14 patients; type I/II/III, 45/46/19 patients; endoscopic retrograde cholangiopancreatography [ERCP]/EUS-guided choledocoduodenostomy/EUS-guided hepaticogastrostomy, 90/10/10 patients, respectively). The median TRBO of all cases was 450 days (interquartile range, 212-666 days) and functional success was achieved in 105 cases (95%). The TRBO did not differ significantly by the timing or location of duodenal obstruction (p = .30 and .79, respectively). The TRBO of metal stents (n = 96) tended to be longer compared with plastic stents (n = 14, p = .083). Compared with ERCP, EUS-guided biliary drainage was associated with a higher rate of adverse events.
CONCLUSION: Transpapillary or transmural endoscopic biliary drainage with a duodenal stent was effective, irrespective of the timing or location of duodenal obstruction. A prospective study is required considering the tradeoff of technical success rate, stent patency, and adverse events (ClinicalTrials.gov number, NCT02376907).
BACKGROUND: The optimal treatments for gastric cancer with liver metastases (GCLM) remain controversial. This study aimed to evaluate the efficacy of hepatectomy, RFA and TACE as local treatments for GCLM.
METHODS: From 2001 to 2015, 119 consecutive patients who received multidisciplinary treatments based on curative gastrectomy and local treatments (hepatectomy, RFA and TACE) for liver metastases were enrolled in this retrospective cohort study. Patients were divided into Group A (46, hepatectomy) and Group B (73, either or both RFA and TACE). Propensity score matching analysis was employed.
RESULTS: The propensity model revealed that hepatectomy was associated with significantly longer OS compared with either or both RFA and TACE (P=0.021). The 1-, 3- and 5-year OS rates were 80.5%, 41.5% and 24.4%, respectively in Group A; and 85.4%, 21.9% and 12.2%, respectively in Group B. Subgroup analyses indicated that hepatectomy was associated with significantly longer long-term survival compared with TACE (P=0.033) and RFA (P=0.010). TACE had a similar efficacy as RFA (P=0.518), but with significantly lower costs (P=0.014) in for patients with metachronous GCLM.
CONCLUSION: Hepatectomy is the optimal local treatment for GCLM when surgical R0 resection is intended. TACE attained a similar prognosis as RFA with relatively high cost-effectiveness, particularly for patients with metachronous GCLM.
Accurate and immediate diagnosis of the intestinal perforation is vital. Herein, we present a 56-year old female patient with gastric perforation into the pericardium due to benign gastriculcer diagnosed with computed tomography (CT. We also emphasized the imaging findings in the diagnosis of intestinal perforation into the pericardium.
Purpose: We evaluated the impact of postoperative body mass index (BMI) shifts on the quality of life (QoL) following total gastrectomy in patients with gastric cancer.
Methods and Methods: QoL data collected from the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-STO22 questionnaires were obtained from 417 patients preoperatively and 1 year after surgery. Patients were divided into two groups based on changes in BMI: group 1 comprised patients whose BMI range category dropped, and group 2 included patients who maintained or rose to a higher category compared to their preoperative BMI category.
Results: There were 276 patients in group 1 and 141 in group 2. QoLs with respect to the global health status and functional scales were not significantly different between the groups 1 year after surgery. However, there were significantly greater decreases in QoL in group 1 due to gastrointestinal symptoms, such as nausea and vomiting (p=0.008), appetite loss (p=0.001), and constipation (p=0.038). Of the QLQ-STO22 parameters, dysphagia (p=0.013), pain (p=0.012), reflux symptoms (p=0.017), eating restrictions (p=0.007), taste (p=0.009), and body image (p=0.009) were associated with significantly worse QoL in group 1 than in group 2 1 year after surgery.
Conclusions: Patients have significantly different QoLs depending on the BMI shift after total gastrectomy. Efforts to reduce the gap in QoL should include intensive nutritional support and restoration of dietary behaviors. Appropriate clinical and institutional approaches, plus active medical interventions, are required for maintaining patients' BMIs after surgery.
Oncology (3), Anti-Obesity and Weight Loss (2) Stomach Neoplasms (2), Neoplasms (1), Deglutition Disorders (1), more mentions
... Implementation of LATG for gastric cancer is a safe, reliable and minimally invasive procedure with long-term outcomes similar to those of OTG. Further randomized controlled clinical trials can be conducted to provide valuable evidence of the safety and efficacy of LATG in treating gastric cancer Keyword: laparoscopy-assisted total gastrectomy. Keyword: prognosis. Keyword: propensity score matching. Keyword: stomachneoplasms.
AbstractText: Our aim was to assess, in obese patients undergoing Roux-en-Y gastric bypass (RYGB) surgery, the cumulative Helicobacterpylori (HP) eradication rates by adopting Maastricht IV guidelines in areas of high clarithromycin resistance rates (CLT)-14 days concomitant first-line therapy with proton ... Keyword: Helicobacterpylori infection, therapy.
Anti-Obesity and Weight Loss (4) Obesity (1), Infections (1), more mentions