118 / 172
Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
e179
P.10.5
BERBERINE, TOCOTRIENOLS AND GREEN DECAFFEINATED
COFFEE IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER
DISEASE: EFFECT OF FULL AND HALF DOSE TREATMENT. SINGLE-
CENTRE OBSERVATIONAL STUDY
De Bortoli N.*
1
, Guidi G.
1
, Laino G.
1
, Pianadei S.
1
, Martinucci I.
1
,
Albano E.
1
, Bolognesi V.
1
, Ussia V.
1
, Urbano M.T.
1
, Savarino E.V.
2
,
Marchi S.
1
1
University of Pisa, Pisa, Italy,
2
University of Padua, Padua, Italy
Background and aim:
Clinical and epidemiological studies showed
a correlation between hypercholesterolemia and non-alcoholic
fatty liver disease (NAFLD). Recently, it has been described that a
synergistic action of Berberine, Tocotrienols and green decaffeinated
Coffee (Trixy® – Nathura) is able to regulate several physiological
pathways to achieve a balanced hepatic metabolism. The aim of this
study was to observe the effects of Trixy® in reducing cholesterol,
triglycerides, glycemia, aspartic-transaminase (AST), alanine-
transaminase (ALT), and gamma-glutamil-transferase (GGT) in
overweight and obese patients with NAFLD.
Material and methods:
We enrolled 70 consecutive patients with
NAFLD, presenting moderate to severe grade of hepatic steatosis,
abnormal hepatic-necrotic indexes (AST, ALT, GGT), and abnormal
values of metabolic parameters (cholesterol, triglycerides, gly
caemia), albumin and platelets count. No patients had acute or
chronic hepatic viral infections. All patients give their consensus
to undergo 6-month therapy with Trixy® (1 tab per day before
overnight rest). Hematological examinations (metabolic parameters
and hepatic-necrotic indexes) have been performed after 6 months.
Eco-tomography was performed after 6 months. After 6-months
25 patients continued a full dose treatment (Group A), 24 patients
halved their dosage (Group B) and 20 stopped their treatment
(Group C).
Results:
Male/female ratio was 0.63 (29M and 46F). Mean age
was 53.4±10.2yrs. All parameters showed a significant reduction
compared with baseline: Glycaemia (114.9 to 106.2; p=0.01);
Cholesterol (278.4 to 211.3; p=0.01); Triglyceride (263.7 to 178.5;
p=0.01); ALT (49.1 to 29.7; p=0.01); GGT (97.2 to 51.8; p=0.01) and
NAFLD score (0.41 to -0.56; p=0.01). There were no differences in
mean age and sex between 3 sub-group. In Group A we did not
observe any change after 6 and 9 month of full dosage treatment. In
Group B we found minimal but not significant differences between
6 and 9 months. In Group C, all metabolic parameters increased after
treatment interruption. All data are reported in Table 1.
Table 1
Details of all evaluated parameters (all data are expressed in median and IQR)
NAFLD
Glycaemia Cholesterol Triglyceride
ALT
score
Group A
Basal
112.1±11.3 277.3±17.5 267.1±15.5 49.3±11.4 0.7±0.1
6 months
104.5±7.5 210.5±13.4 183.5±12.8 30.1±6.7 -0.8±0.2
9 months
102.8±9.6 209.3±9.9 181.4±16.9 29.1±5.5 -0.6±0.1
Group B
Basal
115.1±13.7 278.9±19.1 264.7±17 51.5±10.6 0.8±0.1
6 months
106.2±9.8 208.7±21.6 179.2±14.6 28.7±8.4 -0.6±0.1
9 months
108.5±7.7 211.5±17.8 188.5±17.2 29.9±6.1 -0.6±0.1
Group C
Basal
114.8±14.6 279.5±15.9 262±18.3 50.3±12 0.9±0.1
6 months
107.1±10 221.1±11.5 177.4±11.8 29±9.9 -0.5±0.1
9 months
113.2±9.4 277.5±19.4 253.5±17.2 48.8±11.7 0.8±0.1
P <0.05 for all values at basal versus 6 months, and basal versus 9 months.
P >0.05 between 6 and 9 months
Conclusions:
The results of our single-center observational
study showed that Trixy® (Nathura) therapy is able to reduce
cholesterolemia, triglyceridemia, glycaemia after 6 mths. Half dose
is enough to maintain the effect of a full dosage treatment. The
interruption of the treatment was associated with an increase of all
metabolic parameters.
P.10.6
MICROWAVE ABLATION OF LARGE HCCS USING A NEW DEVICE: A
CASE SERIES
Tarantino L.*
1
, Ambrosino P.
2
1
Interventional Hepatology Unit - “A.Tortora” Oncology Hospital,
Pagani (SA), Italy,
2
Department of Clinical Medicine and Surgery,
Federico II University, Napoli, Italy
Background and aim:
Evaluation of a new device designed to
achieve large volumes of necrosis in hepatocellular carcinoma (HCC)
by synchronous insertion and activation of multiple Microwave
(MW) antennae.
Material and methods:
10 consecutive patients with a single large
HCC nodule (diameter range: 3.5-6.5 cm; mean diameter: 4.6 cm)
underwent ultrasound (US) guided percutaneous MW ablation by
synchronous insertion of multiple MW antennae (SynchroWave
915 MHz antennas - MicroThermX® microwave ablation system,
Terumo, Belgium, Europe). In general anesthesia, a single insertion
of 2 antennae in 3 cases, and 3 antennae in 5 cases were performed.
2 insertions of 3 antennae in the same session were performed in
2 cases. Treatment efficacy was assessed by three-phase contrast-
enhanced computed tomography (CT) and bimonthly US follow-up.
Results:
Post-treatment CT showed complete necrosis in 8/10 HCC
nodules (80%). 2 patients with incomplete ablation underwent
an additional MW ablation session. CT showed complete necrosis
in both of them. Several major complications occurred: anaerobic
infection of the treated necrotic area in 2 cases, severe right pleural
effusion in one case, jaundice from transient liver failure. All
complications recovered with medical treatment. Follow-up in 10
patients ranges from 12 to 20months. All patients are alive. In 6/10
(60%) cases, intrahepatic recurrence occurred within 6-14 months
(mean10 months). Recurrences could be successfully treated with
ablation in 3 cases. The other 3 patients started chemotherapy with
Sorafenib.
Conclusions:
The MicroThermX microwave ablation system seems
an effective and relatively safe device for treatment of large HCC.
P.10.7
MICROWAVE ABLATION VERSUS RADIOFREQUENCY ABLATION
FOR THE TREATMENT OF HEPATOCELLULAR CARCINOMA: A
SYSTEMATIC REVIEW AND META-ANALYSIS
Facciorusso A.*, Di Maso M., Muscatiello N.
University of Foggia, Foggia, Italy
Background and aim:
Radiofrequency ablation (RFA) andMicrowave
ablation (MWA) are the two main percutaneous techniques for
the treatment of unresectable hepatocellular carcinoma (HCC).
However, to date, studies comparing the two therapies have
provided discordant results. Aim of this meta-analysis is to evaluate
the efficacy and safety of the two treatments for HCC patients.
Material and methods:
Computerized bibliographic search was
performed on PubMed/Medline, Embase, Google Scholar and
Cochrane library databases. The rates of complete response (CR),
local recurrence (LR), 3-year survival (SR) and major complications
were analyzed.
Results:
One randomized-controlled trial (RCT) and six
retrospective studies with 774 patients were included in the meta-
analysis (Table 1). A non-significant trend of higher CR rates in
the patients treated with MWA was found [Odds Ratio (OR) =1.12,
95% Confidence Interval (CI) 0.67-1.88, p=0.67]. Overall LRR was