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    Endoscopic Clipping Vs Band Ligation in the Management of Bleeding Esophageal Varices
    (Springer-Verlag, 2003) Yol, S.; Belviranlı, Muaz; Toprak, Ş.; Kartal, A.
    Background: The effectiveness of endoscopic clipping in the hemostasis of bleeding esophageal varices and the eventual variceal eradication was compared with that of band ligation. Methods: Forty patients were enrolled in the study in a prospective manner, 19 of whom received endoscopic clipping (group I) and the remaining (n = 21 patients) received endoscopic band ligation (group II). All patients in this study presented with bleeding from esophageal varices. The patient characteristics (age, sex, Child-Pugh score, variceal grade) were comparable in the two groups. After initial hemostasis, the patients were assigned one of the two forms of endoscopic therapy which was continued in the follow-up sessions until varices were eradicated. Early and late results were compared. Results: Initial hemostasis was achieved in all patients in group I but two patients in group II required clip ligation for initial hemostasis because of the failure in band ligation. Those two were treated with band ligation in the follow-up sessions. A total of 224 clips in 53 treatment sessions and 296 bands in 82 treatment sessions were placed in group I and group II, respectively. The rates of complete variceal eradication were 89% and 76% in group I and group II, respectively (p > 0.05). The median number of required treatment sessions for complete eradication of the varices was significantly lower in group I than group II (3 versus 4, p = 0.013). Three patients from group I (15%) and seven patients from group II (33%) were readmitted for variceal bleeding during the follow-up period (p > 0.05). Conclusions: With the advantages of high initial hemostasis rate, decreased risk of rebleeding, and fewer treatment sessions needed for variceal eradication, endoscopic clipping is as effective as band ligation, or perhaps more effective in the treatment of bleeding esophageal varices.
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    Is Urinary Bladder Pressure a Sensitive Indicator of Intra-Abdominal Pressure?
    (GEORG THIEME VERLAG, 1998) Yol, S.; Kartal, A.; Tavlı, S.; Tatkan, Y.
    Background and Study Aims: The accuracy of transurethral bladder catheter pressure in reflecting intra-abdominal pressure is well defined in experimental studies and case reports but not in controlled clinical trials. Patients and Methods: We compared bladder pressure with insufflator pressure during laparoscopic cholecystectomy in 40 patients. Measurements were made at four pressure levels of the insufflator: 0, 5, 10 and 15 mmHg. Results: When the insufflator displayed 0, 5, 10, and 15 mmHg (0, 6.8, 13.6 and 20.4 cmH(2)O), and the mean bladder pressures measured 2.5 +/- 1.4, 7.3 +/- 1.5, 12.9 +/- 1.6 and 19.7 +/- 1.5 cmH(2)O, respectively, The two measurements correlated well with each other (r = 0.973, P < 0.0001). Conclusion: We concluded that bladder pressure measured by transurethral catheter was equal to insufflator pressure during laparoscopy, and that this was a valid indicator of intra-abdominal pressure.