Prospective validation to prevent symptomatic portal vein thrombosis after liver resection

BACKGROUND Portal vein thrombosis(PVT)after liver resection is rare but can lead to lifethreatening liver failure.This prospective study evaluated patients using contrastenhanced computed tomography(E-CT)on the first day after liver resection for early PVT detection and management.AIM To evaluate patients by E-CT on the first day after liver resection for early PVT detection and immediate management.METHODS Patients who underwent liver resection for primary liver cancer from January 2015 were enrolled.E-CT was performed on the first day after surgery in patients undergoing anatomical resection,multiple resections,or with postoperative bile leakage in the high-risk group for PVT.When PVT was detected,anticoagulant therapy including heparin,warfarin,and edoxaban was administered.E-CT was performed monthly until PVT resolved.RESULTS The overall incidence of PVT was 1.57%(8/508).E-CT was performed on the first day after surgery in 235 consecutive high-risk patients(165 anatomical resections,74 multiple resections,and 28 bile leakages),with a PVT incidence of 3.4%(8/235).Symptomatic PVT was not observed in the excluded cohort.Multivariate analyses revealed that sectionectomy was the only independent predictor of PVT[odds ratio(OR)=12.20;95%confidence interval(CI):2.22-115.97;P=0.003].PVT was found in the umbilical portion of 75.0%(6/8)of patients,and sectionectomy on the left side showed the highest risk of PVT(OR=14.10;95%CI:3.17-62.71;P<0.0001).CONCLUSION Sectionectomy on the left side should be chosen with caution as it showed the highest risk of PVT.E-CT followed by anticoagulant therapy was effective in managing early-phase PVT for 2 mo without adverse events.

Acute and Prolonged Effects of a Polyherbal Formulation on Blood Glucose, Lipid Profile and Liver Function in Normal and Streptozotocin-Induced Diabetic Rats

Background: Few studies have often focused on medicinal plant mixtures, yet the most used in low-and middle-income areas as alternative drug to treat diseases. Objective: To evaluate the antidiabetic effects of Emilia coccinea (Ec) (Asteraceae), Scoparia dulcis (Sd) (Plantaginaceae) and Tetracarpidium conophorum (Tc) (Euphorbiaceae) aqueous extracts mixture (EcSdTc) in rats. Methodology: Single plant aqueous extracts (Ec, Sd and Tc) and their mixtures (EcSd, EcTc, SdTc and EcSdTc) (each at the doses of 125 and 250 mg/kg body weight respectively) were evaluated in acute administration on blood glucose in normal, glucose-overloaded and diabetic rats;then EcSdTc mixture was assessed in prolonged administration (21 days) on blood glucose, body weight, serum biochemical and antioxidant parameters in diabetic rats. Diabetes was induced by single intraperitoneal administration of streptozotocin (STZ;50 mg/kg), and glibenclamide (10 mg/kg) was used as standard drug. Results: In acute administration, EcTc250, EcSdTc125, SdTc250, SdTc125, EcSd250, and EcSdTc250 extracts mixtures reduced (p Conclusion: EcSdTc aqueous extracts mixture has potent hypoglycemic and antidiabetic effects, probably due to their bioactive compounds synergistic and/or additive actions, justifying its traditional use as alternative remedies.