Conscious Sedation Using Midazolam and Sequential Flumazenil in Cirrhotic Patients for Prophylactic Endoscopic Variceal Ligation.

Abstract:

BACKGROUND/AIMS:This study investigated the safety of endoscopic variceal ligation (EVL) under conscious sedation with midazolam and sequential flumazenil after procedure in these patients. METHODS:A total of 279 patients who underwent secondary prophylactic EVL at our institution between April 2012 and June 2014, were enrolled. Conscious sedation was achieved using intravenous midazolam, and flumazenil was routinely used as an antidote immediately after EVL. Patients with sleep (n = 165) and non-sleep (n = 55) endoscopy were matched using propensity score analysis (3:1). Frequencies of overt hepatic encephalopathy (HEP) and patient' satisfactions with EVL were compared between the 2 groups. RESULTS:Of the 279 patients, 155 (55.6%) were of Child-Turcotte-Pugh (CTP) class, B or C, and 224 (80.3%) patients underwent sleep endoscopy. After propensity score analysis, overt HEP was observed in 1 (0.4%) of the 165 patients in the sedated group, but not found in any in the non-sedated group. Patient' satisfaction with EVL was better in the sedated group (p < 0.001). Twenty-nine (65.9%) of the 44 patients with CTP class C underwent sleep endoscopy, and only one (3.4%) experienced overt HEP. CONCLUSIONS:Prophylactic EVL under conscious sedation using midazolam and flumazenil is probably safe in cirrhotic patients without experience of HEP, even in those of CTP class C.

journal_name

Digestion

journal_title

Digestion

authors

Kim SI,Jin YJ,Lee SH,Lee JW,Lee DH,Lee D

doi

10.1159/000440715

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

220-6

issue

4

eissn

0012-2823

issn

1421-9867

pii

000440715

journal_volume

92

pub_type

杂志文章
  • Current Standard and Future Perspectives in First- and Second-Line Treatment of Metastatic Pancreatic Adenocarcinoma.

    abstract:BACKGROUND:Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a median 5-year survival of <8%. At the time of diagnosis, a vast majority of pancreatic cancer patients were found to be with either metastatic spread of the disease or locally advanced tumors. Despite relatively low efficacy, ge...

    journal_title:Digestion

    pub_type: 杂志文章,评审

    doi:10.1159/000447739

    authors: Ellenrieder V,König A,Seufferlein T

    更新日期:2016-01-01 00:00:00

  • Evaluation of the 75Se-l-selenomethionine test for pancreatic disease. Studies on gel filtration.

    abstract::Radioselenium-secretin-pancreozymin tests have been performed in 22 normal subjects and in 23 patients with pancreatic exocrine insufficiency. Each subject received an intravenous injection of 40-100 mu Ci 75Se-l-selenomethionine as a bolus which was followed by an intravenous infusion of secretin-CCK-PZ (1 CU/kg/h) f...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000198444

    authors: Pointner H,Kletter K

    更新日期:1980-01-01 00:00:00

  • Inhibitory effect of somatostatin on cholera toxin-induced diarrhea and glycoenzyme secretion in rat intestine.

    abstract::The effects of somatostatin on cholera toxin-induced secretory diarrhea and the appearance of glycoenzymes in the intestinal lumen and intestinal lymph were investigated in rat small intestine. After exposure to cholera toxin, marked fluid accumulation in the small intestinal tract and elevation of the jejunal mucosal...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000199411

    authors: Yoshioka M,Asakura H,Hamada Y,Miura S,Kobayashi K,Morishita T,Morita A,Tsuchiya M

    更新日期:1987-01-01 00:00:00

  • Advances in the Treatment of Cholinergic Anti-Inflammatory Pathways in Gastrointestinal Diseases by Electrical Stimulation of Vagus Nerve.

    abstract:BACKGROUND:The cholinergic anti-inflammatory pathway (CAIP) has been proposed as a key mechanism by which the brain, through the vagus nerve (VN), modulates the immune system in the body. Recent studies of VN stimulation (VNS) in vivo systems have shown that it plays an anti-inflammatory role through CAIP. Inflammatory...

    journal_title:Digestion

    pub_type: 杂志文章,评审

    doi:10.1159/000504474

    authors: Lei W,Duan Z

    更新日期:2019-11-29 00:00:00

  • Treatment of postoperative Crohn's disease.

    abstract::At 1 year after a first resection, up to 80% of patients show an endoscopic recurrence, 10-20% have clinical relapse, and 5% have surgical recurrence. Smoking is one of the most important risk factors for postoperative recurrence. Preoperative disease activity and the severity of endoscopic lesions in the neoterminal ...

    journal_title:Digestion

    pub_type: 杂志文章,评审

    doi:10.1159/000083873

    authors: Froehlich F,Juillerat P,Felley C,Mottet C,Vader JP,Burnand B,Michetti P,Gonvers JJ

    更新日期:2005-01-01 00:00:00

  • Kinetics of anti-hepatitis C virus response during acute hepatitis in an immunosuppressed HCV chronically infected patient.

    abstract::A hepatitis C virus (HCV) chronically infected patient developed an episode of acute hepatitis during the course of immunosuppressive therapy given for a lymphoproliferative disease. It was noted that anti-HCV antibody response, seen to be relatively stable during the follow-up, lowered dramatically in coincidence wit...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000200740

    authors: Sansonno D,Procaccio P,Dammacco F

    更新日期:1991-01-01 00:00:00

  • A Randomized, Double-Blind, Pilot Study of the Effect of Famotidine on Acotiamide Treatment for Functional Dyspepsia.

    abstract:BACKGROUND/AIMS:Acotiamide, a prokinetic drug, is used to treat functional dyspepsia (FD), especially postprandial distress syndrome (PDS). However, a treatment for FD patients with PDS and/or epigastric pain syndrome (EPS) has not been established. We investigated the efficacy of famotidine in combination with acotiam...

    journal_title:Digestion

    pub_type: 杂志文章,随机对照试验

    doi:10.1159/000477345

    authors: Hojo M,Nagahara A,Asaoka D,Takeda T,Izumi K,Matsumoto K,Ueyama H,Shimada Y,Matsumoto K,Nojiri S,Watanabe S

    更新日期:2017-01-01 00:00:00

  • Feasibility and Safety of Endoscopic Submucosal Dissection for Recurrent Rectal Lesions that after Transanal Endoscopic Microsurgery: A Case Series.

    abstract:OBJECTIVES:Recently, several studies have demonstrated the usefulness of endoscopic submucosal dissection (ESD) for residual or locally recurrent colorectal lesions after endoscopic treatment. However, the feasibility of ESD for recurrent rectal lesions after transanal endoscopic microsurgery (TEM) has not been fully i...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000505619

    authors: Ikezawa N,Toyonaga T,Tanaka S,Nakano Y,Ishida T,Yoshihara T,Uraoka M,Morita Y,Suzuki N,Haji A,Kodama Y

    更新日期:2020-02-05 00:00:00

  • Effect of intestinal diamine oxidase (DAO) depletion by heparin on mucosal polyamine metabolism.

    abstract::The aim of this study was to examine the relative importance of the enzymes ornithine decarboxylase (ODC) and diamine oxidase (DAO) in intestinal polyamine metabolism in normal rats. To study this we measured jejunal and ileal DAO and ODC activities and polyamine levels 2 h after injecting, in non-fasting male Wistar ...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000200411

    authors: Rokkas T,Vaja S,Taylor P,Murphy GM,Dowling RH

    更新日期:1990-01-01 00:00:00

  • Proctitis and proctosigmoiditis--a need to identify the extent of disease in epidemiological surveys.

    abstract::Proctitis and proctosigmoiditis may be distinct clinical entities. The lesions are restricted to the rectum or extend proximally to involve the sigmoid colon, respectively. Barium enema examination should be normal proximal to the rectum and sigmoid colon. Histology is used merely to confirm the disease process. We pr...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000201013

    authors: Jayanthi V,Chuah SY,Probert CS,Mayberry M,Mayberry JF

    更新日期:1993-01-01 00:00:00

  • Gastric carcinoid with histamine production, histamine transporter and expression of somatostatin receptors.

    abstract::A case of sporadic, histamine-producing gastric carcinoid with liver metastases is reported. The patient was treated with somatostatin analogue (octreotide) combined with cortisone and blockade of histamine receptors prior to surgery, which included subtotal gastrectomy, excision of lymph node metastases and superfici...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000007482

    authors: Kölby L,Wängberg B,Ahlman H,Jansson S,Forssell-Aronsson E,Erickson JD,Nilsson O

    更新日期:1998-01-01 00:00:00

  • Capnographic monitoring during endoscopic submucosal dissection with patients under deep sedation: a prospective, crossover trial of air and carbon dioxide insufflations.

    abstract:BACKGROUND AND AIMS:The safety of carbon dioxide (CO(2)) insufflation has not been fully established for esophageal and gastric endoscopic submucosal dissection (ESD) under deep sedation, because CO(2) retention is not only caused by CO(2) insufflation but also by the sedation level and the patient's respiratory status...

    journal_title:Digestion

    pub_type: 杂志文章,随机对照试验

    doi:10.1159/000328694

    authors: Takano A,Kobayashi M,Takeuchi M,Hashimoto S,Mizuno K,Narisawa R,Aoyagi Y

    更新日期:2011-01-01 00:00:00

  • Effect of rioprostil, a synthetic prostaglandin E1 on meal-stimulated gastric acid secretion and plasma gastrin levels in humans.

    abstract::The effects of rioprostil (a newly developed synthetic prostaglandin E1 analogue) on meal-stimulated gastric acid secretion was evaluated in 8 healthy human volunteers. Gastric acid output was measured by intragastric titration on 4 different occasions. The following procedure was invariably employed: after a basal pe...

    journal_title:Digestion

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1159/000199413

    authors: Schulte K,Singer MV,Eysselein V,Demol P,Goebell H

    更新日期:1987-01-01 00:00:00

  • Inhibition of bile acid and water absorption by phenethylbiguanide in rat ileum in vivo.

    abstract::Since biguanides are known to inhibit hexose and amino acid absorption in vivo and in vitro as well as vitamin B12 absorption the effect of phenethylbiguanide on taurocholate (TC) and water absorption was measured in rat ileum in vivo. Phenethylbiguanide exhibited a time-dependent inhibitory effect on TC- and water ab...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000197672

    authors: Caspary WF,Lücke H

    更新日期:1975-01-01 00:00:00

  • Proximal gastric motility functions are normal in severe obesity.

    abstract::The role of altered gastric motor functions for the development of obesity is still unclear. In this study, we investigated whether severe obesity is related to gastric dysfunctions or to abnormal perception in response to distension. 31 obese patients and 20 healthy volunteers were studied using an electronic barosta...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000201433

    authors: Klatt S,Pieramico O,Güthner C,Ditschuneit HH,Glasbrenner B,Beckh K,Adler G

    更新日期:1997-01-01 00:00:00

  • Reduced expression of epidermal growth factor receptor-related protein in hepatocellular carcinoma: implications for cancer growth.

    abstract:BACKGROUND/AIMS:The mitogenic signaling pathway of epidermal growth factor receptor (EGFR) is activated in a variety of cancers, including hepatocellular carcinoma (HCC). The recently cloned EGFR-related protein (ERRP) has been proposed to be a negative regulator of EGFR. The expression of ERRP in non-malignant liver c...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000079151

    authors: Moon WS,Chang KJ,Majumdar AP,Tarnawski AS

    更新日期:2004-01-01 00:00:00

  • Subcutaneous administration of the synthetic trypsin inhibitor Foy-305 induces hypertrophy of the exocrine pancreas.

    abstract::The serine protease inhibitor camostate (Foy-305; 200 mg/kg body weight) had been administered twice daily either subcutaneously or orally to mice for 5, 10 and 15 days. Within 5 days, pancreatic weight, concentration of trypsin, amylase and protein were significantly increased and even more increased after 10 and 15 ...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000199491

    authors: Wereszczyńska-Siemiatkowska U,Pohl U,Otto J,Lankisch PG

    更新日期:1987-01-01 00:00:00

  • Endoscopic Evaluation of Neoadjuvant Chemotherapeutic Efficacy in Gastric Cancer before Gastrectomy Might be as Useful as Histological Assessment after Gastrectomy.

    abstract:BACKGROUND:Neoadjuvant chemotherapy for advanced gastric cancer is expected to improve prognoses. However, as there is no method to evaluate neoadjuvant chemotherapeutic efficacy before gastrectomy, some patients at high risk for a poor prognosis undergo gastrectomy. The aim of the present study was to investigate whet...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000500907

    authors: Sugawara N,Ota K,Terazawa T,Tanaka R,Akutagawa H,Yamaguchi T,Imai Y,Harada S,Kojima Y,Tashiro K,Kii T,Lee SW,Kawai M,Egashira Y,Goto M,Uchiyama K,Hirose Y,Takeuchi T,Higuchi K

    更新日期:2020-01-01 00:00:00

  • Pancreatitis-associated protein (HIP/PAP) gene expression is upregulated in NOD mice pancreas and localized in exocrine tissue during diabetes.

    abstract::We have previously shown a specific significant overexpression in the exocrine pancreatic tissue of two members of the regenerating gene multifamily: reg I and reg II in the non-obese diabetic (NOD) mouse during active diabetogenesis. To strengthen the hypothesis that the overexpression of these genes may represent a ...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000048867

    authors: Baeza N,Sanchez D,Christa L,Guy-Crotte O,Vialettes B,Figarella C

    更新日期:2001-01-01 00:00:00

  • Effect of cycloheximide on bile flow adaptive response in selective biliary obstruction.

    abstract::The adaptive increase in bile flow was studied up to 24 h after selective biliary obstruction (SBO) in the rat. Between 6 and 12 h after SBO bile flow increased significantly, such that 12 and 24 h after SBO bile flow did not differ significantly from control. The prior administration of cycloheximide (300 micrograms/...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000198431

    authors: Mackinnon M,Kohler M

    更新日期:1980-01-01 00:00:00

  • A Multicenter Prospective Survey on Early-Onset Inflammatory Bowel Disease in Japan.

    abstract:INTRODUCTION:The incidence of early-onset inflammatory bowel disease is increasing in Japan. OBJECTIVE:This study aimed to analyze the treatment and progress of early-onset inflammatory bowel disease. METHODS:This prospective survey evaluated the data of 43 patients aged <8 years who were diagnosed with inflammatory ...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000507570

    authors: Kudo T,Fujii T,Maisawa SI,Sasaki M,Uchida K,Ida S,Kagimoto S,Yoden A,Shimizu T

    更新日期:2020-05-18 00:00:00

  • Edkins and a century of acid suppression.

    abstract::In 1905, John Edkins (1863-1940) undertook the studies of gastrin that have subsequently formed the basis for a century of investigation into the physiological basis of acid secretion and led to the elucidation of a variety of acid-suppressive pharmacological agents that have revolutionized the management of acid pept...

    journal_title:Digestion

    pub_type: 传,历史文章,杂志文章

    doi:10.1159/000088368

    authors: Modlin IM,Sachs G,Wright N,Kidd M

    更新日期:2005-01-01 00:00:00

  • Fate of pancreatic enzymes in the human intestinal lumen in health and pancreatic insufficiency.

    abstract::The activities of pancreatic enzymes decrease during their passage from the duodenum to the terminal ileum, but degradation rates of individual enzymes are different. Whereas lipase activity is lost most rapidly, proteases and amylase are more stable. The mechanism by which lipase activity is destroyed is proteolysis,...

    journal_title:Digestion

    pub_type: 杂志文章,评审

    doi:10.1159/000201097

    authors: Layer P,Gröger G

    更新日期:1993-01-01 00:00:00

  • Glutamine Blocks Interleukin-13-Induced Intestinal Epithelial Barrier Dysfunction.

    abstract:INTRODUCTION:Impaired intestinal epithelial barrier function is a hallmark of a variety of pathological conditions such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). IBD patients with IBS-like symptoms show higher interleukin-13 (IL-13) serum levels and poor psychological well-being. Supplemen...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000502953

    authors: Li M,Oshima T,Ito C,Yamada M,Tomita T,Fukui H,Miwa H

    更新日期:2019-09-18 00:00:00

  • Diagnosis and management of non-erosive reflux disease--the Vevey NERD Consensus Group.

    abstract:BACKGROUND/AIMS:Although considerable information exists regarding gastroesophageal reflux disease with erosions, much less is known of non-erosive reflux disease (NERD), the dominant form of reflux disease in the developed world. METHODS:An expert international group using the modified Delphi technique examined the q...

    journal_title:Digestion

    pub_type: 共识发展会议,杂志文章

    doi:10.1159/000219365

    authors: Modlin IM,Hunt RH,Malfertheiner P,Moayyedi P,Quigley EM,Tytgat GN,Tack J,Heading RC,Holtman G,Moss SF,Vevey NERD Consensus Group.

    更新日期:2009-01-01 00:00:00

  • Functional renal alterations in chronic liver diseases.

    abstract::83 patients with chronic active hepatitis (CAH), 38 of them with cirrhosis, were studied and compared with 10 control subjects suffering from chronic persistent hepatitis (CPH). Tubular acidosis frequently was found in our cases. Renal plasma flow and glomerular filtration rate were significantly decreased in CAH when...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000198421

    authors: Gentilini P,Laffi G,Buzzelli G,Stefani P,Scarpelli P,Paladini S,Smorlesi C,La Villa G,Forti G

    更新日期:1980-01-01 00:00:00

  • Two common reasons of malabsorption syndromes: celiac disease and Whipple's disease.

    abstract::Malabsorption syndromes are commonly caused by pathological interferences of normal digestive processes. In the last several years major advances in the diagnosis and treatment of these syndromes has emerged. This review will focus on diseases in which the mucosal phase of the digestive process is predominately distur...

    journal_title:Digestion

    pub_type: 杂志文章,评审

    doi:10.1159/000100501

    authors: Sun DF,Fang JY

    更新日期:2006-01-01 00:00:00

  • Lactulose is highly potential in prophylaxis of hepatic encephalopathy in patients with cirrhosis and upper gastrointestinal bleeding: results of a controlled randomized trial.

    abstract:BACKGROUND AND AIMS:Upper gastrointestinal bleeding (UGB) is an important precipitating factor for the development of hepatic encephalopathy (HE) in cirrhotic patients. The aim of this study was to evaluate the efficacy of lactulose in a controlled randomized trial for prophylaxis of HE after UGB. PATIENTS AND METHODS...

    journal_title:Digestion

    pub_type: 杂志文章,随机对照试验

    doi:10.1159/000346083

    authors: Wen J,Liu Q,Song J,Tong M,Peng L,Liang H

    更新日期:2013-01-01 00:00:00

  • Interaction of growth hormone-releasing factor and somatostatin on ulcer healing and mucosal growth in rats: role of gastrin and epidermal growth factor.

    abstract::Growth hormone-releasing factor (GRF) was reported to possess the growth-promoting action on the gastroduodenal mucosa that can be augmented by removal of endogenous somatostatin. Since mucosal proliferation was considered to contribute to healing of chronic gastroduodenal ulcerations, we designed the study to determi...

    journal_title:Digestion

    pub_type: 杂志文章

    doi:10.1159/000199763

    authors: Konturek SJ,Brzozowski T,Dembinski A,Warzecha Z,Konturek PK,Yanaihara N

    更新日期:1988-01-01 00:00:00

  • A critical assessment of the current status of non-erosive reflux disease.

    abstract::Non-erosive reflux disease (NERD) has assumed increasing prominence in studies of gastroesophageal reflux disease (GERD), but it remains a challenge to define NERD precisely and to define its place in the investigation and treatment of GERD. Most simply, NERD may be defined as GERD in an individual who has no evidence...

    journal_title:Digestion

    pub_type: 杂志文章,评审

    doi:10.1159/000151255

    authors: Armstrong D

    更新日期:2008-01-01 00:00:00