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Pediatric T-tube in adult liver transplantation:Technical refinements of insertion and removal

World Journal of Gastrointestinal Surgery 2021年第12期13卷 1628-1637页

作者： Gabriele Spoletini Giuseppe Bianco Antonio Franco Francesco Frongillo Erida Nure Francesco Giovinazzo Federica Galiandro andrea tringali Vincenzo Perri Guido Costamagna Alfonso Wolfango Avolio Salvatore Agnes General Surgery and Liver Transplantation Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy

BACKGROUND With the increasing use of extended-criteria donor organs,the interest around Ttubes in liver transplantation(LT)was restored whilst concerns regarding T-tuberelated complications *** To describe insertion and removal protocols implemented at our institution to safely use pediatric rubber 5-French T-tubes and subsequent outcomes in a consecutive series of adult *** Data of consecutive adult LT patients from brain-dead donors,treated from March 2017 to December 2019,were collected(i.e.,biliary complications,adverse events,treatment after T-Tube removal).Patients with upfront hepaticojejunostomy,endoscopically removed T-tubes,those who died or received retransplantation before T-tube removal were *** Seventy-two patients were included in this study;T-tubes were removed 158 d(median;IQR 128-206 d)after *** four(5.6%)patients accidental T-tube removal occurred requiring monitoring only;in 68(94.4%)patients Nelaton drain insertion was performed according to our protocol,resulting in 18(25%)patients with a biliary output,subsequently removed after 2 d(median;IQR 1-4 d).Three(4%)patients required endoscopic retrograde cholangiopancreatography(ERCP)due to persistent Nelaton drain ***(4%)patients developed suspected biliary peritonitis,requiring ERCP with sphincterotomy and nasobiliary drain insertion(only one revealing contrast extravasation);no patient required percutaneous drainage or emergency *** The use of pediatric rubber 5-French T-tubes in LT proved safe in our series after insertion and removal procedure refinements.

关键词： Liver transplantation T-tube Kehr Biliary fistula Endoscopic retrograde cholangio-pancreatography Biliary drainage

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Endoscopic retrieval of a duodenal perforating teaspoon

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World Journal of Gastrointestinal Endoscopy 2013年第4期5卷 186-188页

作者： Ivo Bokoski andrea tringali Rosario Landi Pietro Familiari Anna Chiara Iolanda Contini Claudio Pintus Guido Costamagna Digestive Endoscopy Unit Catholic University of Rome Pediatrics Department Catholic University of Rome Digestive Endoscopy Unit Catholic University of Rome

Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall.

关键词： Foreign body ingestion Upper endoscopy Bowel perforation Bulimia

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Endoscopic management of difficult common bile duct stones:Where are we now?A comprehensive review

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World Journal of Gastroenterology 2021年第44期27卷 7597-7611页

作者： Alberto tringali Deborah Costa Alessandro Fugazza Matteo Colombo Kareem Khalaf Alessandro Repici andrea Anderloni Gastroenterology and Endoscopy Unit Department of MedicineConegliano HospitalULSS 2 Marca TrevigianaConegliano 31015Italy Digestive Endoscopy Unit Department of GastroenterologyHumanitas Research Hospital IRCCSRozzano 20089MilanItaly Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20072MilanItaly

Endoscopic management for difficult common bile duct(CBD)stones still presents a challenge for several reasons,including anatomic anomalies,patients’individual conditions and stone *** recent years,variable methods have emerged that have attributed to higher stone removal success rates,reduced cost and lower adverse *** this review,we outline a stepwise approach in CBD stone *** first line therapy,endoscopic sphincterotomy and large balloon dilation are recommended,due to a 30%-50%reduction of the use of mechanical *** the other hand,cholangioscopy-assisted lithotripsy has been increasingly reported as an effective and safe alternative technique to mechanical lithotripsy but remains to be reserved in special settings due to limited large-scale *** discussed,findings suggest that management needs to be tailored to the patient’s characteristics and anatomical ***,we evaluate the management of CBD stones in various surgical altered anatomy(Billroth II,Roux-en-Y and Roux-en-Y gastric bypass).Moreover,we could conclude that cholangioscopy-assisted lithotripsy needs to be evaluated for primary use,rather than following a failed management *** addition,we discuss the importance of dissecting other techniques,such as the primary use of interventional endoscopic ultrasound for the management of CBD stones when other techniques have *** conclusion,we recognize that endoscopic sphincterotomy and large balloon dilation,mechanical lithotripsy and intraductal lithotripsy substantiate an indication to the management of difficult CBD stones,but emerging techniques are in rapid evolution with encouraging results.

关键词： Common bile duct stones Balloon dilation Endoscopic retrograde cholangiopancreatography Endoscopic ultrasonography Anastomoses,Roux en y Double balloon enteroscopy Mechanical lithotripsy Cholangioscopy

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Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients

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Asian Journal of Urology 2019年第3期6卷 270-274页

作者： Luca Carmignani Maria Chiara Clementi Claudia Signorini Gloria Motta Sebastiano Nazzani Franco Palmisano Elisa De Lorenzis Michele Catellani Alessandro Francesco Mistretta andrea Conti Valeria tringali Maria Beatrice Costa Damiano Vizziello Policlinico San Donato UrologySan DonatoMilaneseItaly Ospedale Maggiore Policlinico UrologyMilanItaly Istituto Europeo di Oncologia UrologyMilanItaly Ospedale San Giuseppe UrologyMilanItaly

Objective:We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate(ThuVEP)for treatment of obese patients affected by benign prostatic hyperplasia(BPH).Methods:We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single *** were divided into three groups according to body mass index(BMI,kg/m^2):Normal weight(18.5≤BMI0.05).There was no statistically significant difference among three groups as for hospital stay and days of catheterization(p>0.05).Conclusion:Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.

关键词： Laser Thulium Prostate Overweight

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Acute lobar nephritis in children: Not so easy to recognize and manage

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World Journal of Clinical Pediatrics 2016年第1期5卷 136-142页

作者： Cristina Bibalo andrea Apicella Veronica Guastalla Pierluigi Marzuillo Floriana Zennaro Carmela tringali andrea Taddio Claudio Germani Egidio Barbi Depart-ment of Pediatrics University of Trieste Department of Womenand Children and General and Specialized Surgery Seconda Università degli Studi di Napoli Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" Pediatric Ward Ospedale di San Daniele San Daniele del Friuli

Acute lobar nephritis(ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.

关键词： Acute lobar nephritis Children Computed tomography Magnetic resonance imagine Upper urinary tract infection

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