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世界胃肠病学杂志（英文版）
世界胃肠病学杂志（英文版）

潘伯荣

周刊

1007-9327

wjg@wjgnet.com

010-85381901-628

100025

北京市朝阳区东四环中路62号楼远洋国际中心D座903室

世界胃肠病学杂志（英文版）/Journal World Journal of GastroenterologyCSCDCSTPCDSCI
查看更多>>主要报道和刊登国内外、特别是我国消化病学者具有创造性的、有较高学术水平的基础和临床研究论文、研究快报等. 对具有中国特色的研究论文, 如食管癌、胃癌、肝癌、大肠癌、病毒性肝炎、幽门螺杆菌、中医中药、中西医结合和基于作者自己研究工作为主的综述性论文, 将优先发表. 读者对象为基础研究或临床研究的消化专业工作者。
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    Is hepatic arterial infusion chemotherapy effective treatment for advanced hepatocellular carcinoma resistant to transarterial chemoembolization?

    Hiroyuki KirikoshiMasato YonedaHironori MawatariKoji Fujita...
    1933-1939页
    查看更多>>摘要：AIM:To evaluate the effectiveness of hepatic arterial infusion chemotherapy (HAIC) for advanced hepatocellular carcinoma (HCC) resistant to transarterial chemoembolization (TACE).METHODS:This study was conducted on 42 patients who received HAIC for advanced HCC between 2001 and 2010 at our hospital.5-fluorouracil (5-FU) was administered continuously for 24 h from day 1 to day 5 every 2-4 wk via an injection reservoir.Intra-arterial cisplatin or subcutaneous interferon was administered in combination with the 5-FU.The patients enrolled in this retrospective study were divided into two groups according to whether or not they fulfilled the criteria for resistance to TACE proposed by the Japan Society of Hepatology in 2010 (written in Japanese); one group of patients who did not fulfill the criteria for TACE resistance (group A,n =23),and another group who fulfilled the criteria for TACE resistance (group B,n =19).We compared the outcomes in terms of the response and survival rates between the two groups.RESULTS:Both the response rate and tumor suppression rate following HAIC were significantly superior in group A than in group B (response rate:48％ vs 16％,P =0.028,tumor suppression rate:87％ vs 53％,P =0.014).Furthermore,both the progression-free survival rate and survival time were significantly superior in group A than in group B (3-,6-,12-,and 24-mo =83％,70％,29％ and 20％ vs 63％,42％,16％ and 0％,respectively,P =0.040,and 9.8 mo vs 6.2 mo,P =0.040).A multivariate analysis (Cox proportional hazards regression model) showed that resistance to TACE was an independent predictor of poor survival (P =0.007).CONCLUSION:HAIC administrating 5-FU was not effective against advanced HCC resistant to TACE.Other tools for treatment,i.e.,molecular-targeting agents may be considered for these cases.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Preoperative microcoil embolization of the common hepatic artery for pancreatic body cancer

    Isao TakasakaNobuyuki KawaiMorio SatoHirohiko Tanihata...
    1940-1945页
    查看更多>>摘要：AIM:To evaluate safety and feasibility of microcoil embolization of the common hepatic artery under proper or distal balloon inflation in preoperative preparation for en bloc celiac axis resection for pancreatic body cancer.METHODS:Fifteen patients (11 males,4 females;median age,67 years) with pancreatic body cancer involving the nerve plexus surrounding the celiac artery underwent microcoil embolization.To alter the total hepatic blood flow from superior mesenteric artery (SMA),microcoil embolization of the common hepatic artery (CHA) was conducted in 2 cases under balloon inflation at the proximal end of the CHA and in 13 cases under distal microballoon inflation at the distal end of the CHA.RESULTS:Of the first two cases of microcoil embolization with proximal balloon inflation,the first was successful,but there was microcoil migration to the proper hepatic artery in the second.The migrated microcoil was withdrawn to the CHA by an inflated microballoon catheter.Microcoil embolization was successful in the other 13 cases with distal microballoon inflation,with no microcoil migration.Compact microcoil embolization under distal microballoon inflation created sufficient resistance against the vascular wall to prevent migration.Distal balloon inflation achieved the requisite 1 cm patency at the CHA end for vascular clamping.All patients underwent en bloc celiac axis resection without arterial reconstruction or liver ischemia.CONCLUSION:To impede microcoil migration to the proper hepatic artery during CHA microcoil embolization,distal microballoon inflation is preferable to proximal balloon inflation.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Hepatocellular carcinoma in Budd-Chiari syndrome: A single center experience with long-term follow-up in South Korea

    Hana ParkJin Young YoonKyeong Hye ParkDo Young Kim...
    1946-1952页
    查看更多>>摘要：AIM:To evaluate long-term clinical course of BuddChiari syndrome (BCS) and predictive factors associated with the development of hepatocellular carcinoma (HCC)and survival.METHODS:We analyzed 67 patients with BCS between June 1988 and May 2008.The diagnosis of BCS was confirmed by hepatic venous outflow obstruction shown on abdominal ultrasound sonography,computed tomography,magnetic resonance imaging,or venography.The median follow-up period was 103 ± 156 [interquartile range (IQR)] mo.RESULTS:The median age of the patients was 47 ±16 (IQR) years.At diagnosis,54 patients had cirrhosis,25 (37.3％) Child-Pugh class A,23 (34.3％) Child-Pugh class B,and six (9.0％) patients Child-Pugh class C.During the follow-up period,HCC was developed in 17 patients,and the annual incidence of HCC in patients with BCS was 2.8％.Patients in HCC group (n =17)had higher hepatic venous pressure gradient (HVPG)than those in non-HCC group (n =50) (21 ± 12 mmHg vs 14 ± 7 mmHg,P =0.019).The survival rate of BCS patients was 86.2％ for 5 years,73.8％ for 10 years,and 61.2％ for 15 years.In patients with BCS and HCC,survival was 79％ for 5 years,43.1％ for 10 years,and 21.5％ for 15 years.CONCLUSION:The incidence of HCC in patients with BCS was similar to that in patients with other etiologic cirrhosis in South Korea.The HVPG is expected to provide additional information for predicting HCC development in BCS patients.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Transparent-cap-fitted colonoscopy shows higher performance with cecal intubation time in difficult cases

    Hyung Hun KimSeun Ja ParkMoo In ParkWon Moor...
    1953-1958页
    查看更多>>摘要：AIM:To investigate the efficacy of cap-fitted colonoscopy (CFC) with regard to cecal intubation time.METHODS:Two hundred and ninety-five patients undergoing screening colonoscopy at Gospel Hospital,Kosin University College of Medicine were enrolled in this randomized controlled trial between January and December 2010.Colonoscopies were conducted by a single endoscopist.Patient characteristics including age,sex,body mass index,history of abdominal surgery,quality of preparation,and the presence of diverticulosis were recorded.RESULTS:One hundred and fifty patients were allocated into a CFC group and 145 into a non-CFC (NCF)group.Cecal intubations were achieved in all patients.Cecal intubation time in the CFC group was significantly shorter than in the NCF group for specific conditions:age ≥ 60 years,prior abdominal surgery,and poor bowel preparation.The number of detected adenomas was higher in the CFC group than in the NCF group (P =0.040).CONCLUSION:CFC facilitated shortening of the cecal intubation time in difficult cases,and was more sensitive for detecting adenomas than was NCF.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Laparoscopic distal pancreatectomy is as safe and feasible as open procedure: A meta-analysis

    Kun XieYi-Ping ZhuXiao-Wu XuKe Chen...
    1959-1967页
    查看更多>>摘要：AIM:To evaluate the feasibility and safety of laparoscopic distal pancreatectomy (LDP) compared with open distal pancreatectomy (ODP).METHODS:Meta-analysis was performed using the databases,including PubMed,the Cochrane Central Register of Controlled Trials,Web of Science and BIOSIS Previews.Articles should contain quantitative data of the comparison of LDP and ODP.Each article was reviewed by two authors.Indices of operative time,spleen-preserving rate,time to fluid intake,ratio of malignant tumors,postoperative hospital stay,incidence rate of pancreatic fistula and overall morbidity rate were analyzed.RESULTS:Nine articles with 1341 patients who underwent pancreatectomy met the inclusion criteria.LDP was performed in 501 (37.4％) patients,while ODP was performed in 840 (62.6％) patients.There were significant differences in the operative time,time to fluid intake,postoperative hospital stay and spleen-preserving rate between LDP and ODP.There was no difference between the two groups in pancreatic fistula rate [random effects model,risk ratio (RR) 0.996 (0.663,1.494),P =0.983,I2 =28.4％] and overall morbidity rate [random effects model,RR 0.81 (0.596,1.101),P =0.178,I2 =S5.6％].CONCLUSION:LDP has the advantages of shorter hospital stay and operative time,more rapid recovery and higher spleen-preserving rate as compared with ODP.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction

    Xiao-Li ChenFena JiQi LinYi-Peng Chen...
    1968-1974页
    查看更多>>摘要：AIM:To study the therapeutic efficacy of a new transnasal ileus tube advanced endoscopically for adhesive small bowel obstruction.METHODS:A total of 186 patients with adhesive small bowel obstruction treated from September 2007 to February 2011 were enrolled into this prospective randomized controlled study.The endoscopically advanced new ileus tube was used for gastrointestinal decompression in 96 patients and ordinary nasogastric tube (NGT) was used in 90 patients.The therapeutic efficacy was compared between the two groups.RESULTS:Compared with the NGT group,the ileus tube group experienced significantly shorter time for relief of clinical symptoms and improvement in the findings of abdominal radiograph (4.1 ± 2.3 d vs 8.5 ± 5.0 d) and laboratory tests (P ＜ 0.01).The overall effectiveness rate was up to 89.6％ in the ileus tube group and 46.7％ in the NGT group (P ＜ 0.01).And 10.4％ of the patients in the ileus tube group and 53.3％ of the NGT group underwent surgery.For recurrent adhesive bowel obstruction,ileus tube was also significantly more effective than NGT (95.8％ vs 31.6％).In the ileus tube group,the drainage output on the first day and the length of hospital stay were significantly different depending on the treatment success or failure (P ＜ 0.05).The abdominal radiographic improvement was correlated with whether or not the patient underwent surgery.CONCLUSION:Ileus tube can be used for adhesive small bowel obstruction.Endoscopic placement of the ileus tube is convenient and worthy to be promoted despite the potential risks.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Analysis of infections in the first 3-month after living donor liver transplantation

    Chuan LiTian-Fu WenKai MiChuan Wang...
    1975-1980页
    查看更多>>摘要：AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation (LDLT).METHODS:In the present study,the data of 207patients from 2004 to 2011 were reviewed.The pre-,intra-and post-operative factors were statistically analyzed.All transplantations were approved by the ethics committee of West China Hospital,Sichuan University.Patients with definitely preoperative infections and infections within 48 h after transplantation were excluded from current study.All potential risk factors were analyzed using univariate analyses.Factors significant at a P ＜ 0.10 in the univariate analyses were involved in the multivariate analyses.The diagnostic accuracy of the identified risk factors was evaluated using receiver operating curve.RESULTS:The serious bacterial and fungal infection rates were 14.01％ and 4.35％ respectively.Enterococcus faecium was the predominant bacterial pathogen,whereas Candida albicans was the most common fungal pathogen.Lung was the most common infection site for both bacterial and fungal infections.Recipient age older than 45 years,preoperative hyponatremia,intensive care unit stay longer than 9 d,postoperative bile leak and severe hyperglycemia were independent risk factors for postoperative bacterial infection.Massive red blood cells transfusion and postoperative bacterial infection may be related to postoperative fungal infection.CONCLUSION:Predictive risk factors for bacterial and fungal infections were indentified in current study.Pre-,intra-and post-operative factors can cause postoperative bacterial and fungal infections after LDLT.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Individualized peri-operative fluid therapy facilitating early-phase recovery after liver transplantation

    Guo-Qing JiangPing ChenDou-Sheng BaiJing-Wang Tan...
    1981-1986页
    查看更多>>摘要：AIM:To investigate the correlation between peri-operative fluid therapy and early-phase recovery after liver transplantation (LT) by retrospectively reviewing 102 consecutive recipients.METHODS:Based on whether or not the patients had pulmonary complications,the patients were categorized into non-pulmonary and pulmonary groups.Twentyeight peri-operative variables were analyzed in both groups to screen for the factors related to the occurrence of early pulmonary complications.RESULTS:The starting hemoglobin (Hb) value,an intra-operative transfusion ＞ 100 mL/kg,and a fluid balance ≤-14 mL/kg on the first day and the second or third day post-operatively were significant factors for early pulmonary complications.The extubation time,time to initial passage of flatus,or intensive care unit length of stay were significantly prolonged in patients who had not received an intra-operative transfusion ≤100 mL/kg or a fluid balance ≤-14 mL/kg on the first day and the second or the third day post-operatively.Moreover,these patients had poorer results in arterial blood gas analysis.CONCLUSION:It is important to offer a precise and individualized fluid therapy during the peri-operative period to the patients undergoing LT for cirrhosis-associated hepatocellular carcinoma.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Acute chylous peritonitis due to acute pancreatitis

    Georgios K GeorgiouHaralampos HarissisMichalis MitsisHaralampos Batsis...
    1987-1990页
    查看更多>>摘要：We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse.The development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal distention.However,when accumulation of "chyle" occurs rapidly,the patient may present with signs of peritonitis.Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral ischemia.Less than 100 cases of acute chylous peritonitis have been reported.Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis.This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis.The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal range.Moreover,abdominal computed tomography imaging was not diagnostic for pancreatitis.Following abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Paroxysmal drastic abdominal pain with tardive cutaneous lesions presenting in Henoch-Sch(o)nlein purpura

    Xiao-Liang ChenHong TianJian-Zhong LiJin Tao...
    1991-1995页
    查看更多>>摘要：Henoch-Sch(o)nlein purpura (HSP) is a small-vessel vasculitis mediated by IgA-immune complex deposition.It is characterized by the clinical tetrad of non-thrombocytopenic palpable purpura,abdominal pain,arthritis and renal involvement.The diagnosis of HSP is difficult,especially when abdominal symptoms precede cutaneous lesions.We report a rare case of paroxysmal drastic abdominal pain with gastrointestinal bleeding presented in HSP.The diagnosis was verified by renal damage and the occurrence of purpura.
      原文链接:
    • NETL
    • NSTL
    • 万方数据