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Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy

World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 582-592页

作者： Helga Bertani Marzio Frazzoni Santi Mangiafico angelo caruso Mauro Manno Vincenzo Giorgio Mirante Flavia Pigò Carmelo Barbera Raffaele Manta Rita Conigliaro Digestive Endoscopy Unit Baggiovara Hospital Digestive Pathophysiology Unit Baggiovara Hospital

In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neoplastic disease at early stage, thus the diagnosis of cholangiocarcinoma is achieved usually at unresectable stage. In the last decades the role of endoscopy has moved from a diagnostic role to an invaluable therapeutic tool for patients affected by malignant bile duct obstruction. One of the major issues for cholangiocarcinoma is bile ducts occlusion, leading to jaundice, cholangitis and hepatic failure. Currently, endoscopy has a key role in the work up of cholangiocarcinoma, both in patients amenable to surgical intervention as well as in those unfit for surgery or not amenable to immediate surgical curative resection owing to locally advanced or advanced disease, with palliative intention. Endoscopy allows successful biliary drainage and stenting in more than 90% of patients with malignant bile duct obstruction, and allows rapid reduction of jaundice decreasing the risk of biliary sepsis. When biliary drainage and stenting cannot be achieved with endoscopy alone, endoscopic ultrasound-guided biliary drainage represents an effective alternative method affording successful biliary drainage in more than 80% of cases. The purpose of this review is to focus on the currently available endoscopic management options in patients with cholangiocarcinoma.

关键词： Cholangiocarcinoma Malignant bile ductobstruction Interventional endoscopy Endoscopictherapy Self-expandable metal stent

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Single balloon enteroscopy: Technical aspects and clinical applications

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World Journal of Gastrointestinal Endoscopy 2012年第2期4卷 28-32页

作者： Mauro Manno Carmelo Barbera Helga Bertani Raffaele Manta Vincenzo Giorgio Mirante Emanuele Dabizzi angelo caruso Flavia Pigo Giampiero Olivetti Rita Conigliaro Gastroenterology and Digestive Endoscopy Unit New S. Agostino Estense Civil Hospital 41126 Baggiovara di Modena Italy

The small bowel has long been considered a black box for endoscopists because of its long length and the presence of multiple complex loop. Most of the small bowel is inaccessible by traditional endoscopic means. In addition, radiographic studies have significant limitations with regard to diagnostic yield, and surgery is an invasive alternative. This limitation was overcome through the development of balloon enteroscopy that becomes established throughout the world for diagnostic and therapeutic examinations of the small bowel. The single-balloon enteroscope (SBE) system (Olympus, Tokyo, Japan) was introduced into the commercial market in 2007. Several study demonstrated its efficacy and safety. Early reports on the use of singleballoon enteroscopy have suggested a high diagnostic yield and similar therapeutic potential to that of the double-balloon endoscope. SBE is viable technique for in the management of small bowel disease. Technically, it is easy to perform, may be efficient, and in the literature data available, seems to provide high diagnostic and therapeutic yield.

关键词： Single balloon enteroscopy Small bowel Enteroscopy

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Dilation assisted stone extraction for complex biliary lithiasis:Technical aspects and practical principles

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World Journal of Gastrointestinal Endoscopy 2021年第2期13卷 33-44页

作者： Giuseppe Grande Silvia Cocca Helga Bertani angelo caruso Flavia Pigo' Santi Mangiafico Salvatore Russo Marinella Lupo Graziella Masciangelo Paolo Cantu' Raffaele Manta Rita Conigliaro Gastroenterology and Digestive Endoscopy Unit Azienda Ospedaliero Universitaria di ModenaModena 41126Italy Gastroenterology and Endoscopy Unit Department of Pathophysiology and TransplantationFondazione IRCCS Ca’GrandaOspedale Maggiore Policlinico and Universitàdegli Studi di MilanoMilano 20122Italy Gastroenterology and Digestive Endoscopy Unit General Hospital of PerugiaPerugia 06129Italy

Common bile duct stones are frequently diagnosed worldwide and are one of the main indications for endoscopic retrograde *** sphincterotomy(EST)has been used for the removal of bile duct stones for the past 40 years,providing a wide opening to allow *** to 15%of patients present with complicated *** this context,additional therapeutic approaches have been proposed such as endoscopic mechanical lithotripsy,intraductal or extracorporeal lithotripsy,or endoscopic papillary large balloon dilation(EPLBD).EPLBD combined with EST was introduced in 2003 to facilitate the passage of large or multiple bile duct stones using a balloon greater than 12 mm in *** without EST was introduced as a simplified technique in ***-assisted stone extraction(DASE)is the combination of two techniques:EPLBD and sub-maximal *** studies have reported this technique as safe and effective in patients with large bile duct stones,without any increased risk of adverse events such as pancreatitis,bleeding,or ***,it is difficult to analyze the outcomes of DASE because there are no standard techniques and definitions between *** purpose of this paper is to provide technical guidance and specific information about the main issues regarding DASE,based on current literature and daily clinical experience in biliary referral centers.

关键词： Dilation-assisted stone extraction Endoscopic papillary large balloon dilation Macrolithiasis Difficult choledochiolithiasis Stone treatment Common bile duct stones Endoscopic retrograde cholangiopancreatography

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Over-the-scope clips in the treatment of gastrointestinal tract iatrogenic perforation:A multicenter retrospective study and a classification of gastrointestinal tract perforations

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World Journal of Gastrointestinal Surgery 2016年第4期8卷 315-320页

作者： Benedetto Mangiavillano angelo caruso Raffaele Manta Roberto Di Mitri Alberto Arezzo Nico Pagano Giuseppe Galloro Filippo Mocciaro Massimiliano Mutignani Carmelo Luigiano Enrico Antonucci Rita Conigliaro Enzo Masci Gastroenterology and Gastrointestinal Endoscopy Borea Hospital18038 SanremoItaly Gastroenterology and Gastrointestinal Endoscopy Sant’Agostino Estense1355 BaggiovaraItaly Gastrointestinal Endoscopy Operative Endoscopy Unit Niguarda-Ca Granda Hospital20162 MilanItaly Gastroenterology and Endoscopy Unit ARNAS Civico Hospital90127 PalermoItaly Department of Surgical Sciences University of Torino10126 TorinoItaly Unit of Gastroenterology S.Orsola-Malpighi University Hospital40138 BolognaItaly Department of Clinical Medicine and Surgery Special Unit of Surgical Digestive EndoscopyUniversity of Naples Federico II-School of Medicine80138 NapoliItaly Gastrointestinal Endoscopy San Paolo Universitary Hospital20142 MilanItaly Division of Surgical and Gastrointetsinal Products Euromedical s.r.l25010 San Zeno NaviglioItaly Gastroenterology and Gastrointestinal Endoscopy National Tumori Institute20162 MilanoItaly

AIM:To determine the outcome of the management of iatrogenic gastrointestinal tract perforations treated by over-the-scope clip(OTSC)***:We retrospectively enrolled 20 patients(13 female and 7 male;mean age:70.6±9.8 years)in eight high-volume tertiary referral centers with upper or lower iatrogenic gastrointestinal tract perforation treated by OTSC *** tract perforation could be with oval-shape or with *** perforations were closed by OTSC only by suction and the round-shape by the"twin-grasper"plus ***:Main perforation diameter was 10.1±4.3 mm(range 3-18 mm).The technical success rate was 100%(20/20 patients)and the clinical success rate was 90%(18/20 patients).Two patients(10%)who did not have complete sealing of the defect underwent *** upon our observations we propose two types of perforation:Round-shape"type-1 perforation"and oval-shape"type-2 perforation".Eight(40%)out of the 20 patients had a type-1 perforation and 12 patients a type-2(60%).CONCLUSION:OTSC placement should be attempted after perforation occurring during diagnostic or therapeutic endoscopy.A failed closure attempt does not impair subsequent surgical treatment.

关键词： Esophageal disease Esophageal cancer Laparoscopic Robotic da Vinci Heller Reflux disease Esophageal diverticula

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Therapeutic targeting of cellular prion protein: toward the development of dual mechanism anti-prion compounds

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Neural Regeneration Research 2025年第4期20卷 1009-1014页

作者： Antonio Masone Chiara Zucchelli Enrico caruso Giovanna Musco Roberto Chiesa Laboratory of Prion Neurobiology Department of NeuroscienceIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly Biomolecular NMR Unit Division of Genetics and Cell BiologyIRCCS Ospedale San RaffaeleMilanItaly Department of Biotechnology and Life Sciences University of InsubriaVareseItaly

PrPSc,a misfolded,aggregation-prone isoform of the cellular prion protein(PrPC),is the infectious prion agent responsible for fatal neurodegenerative diseases of humans and other *** adopt different pathogenic conformations(prion strains),which can be resistant to potential drugs,or acquire drug resistance,posing challenges for the development of effective *** PrPCis the obligate precursor of any prion strain and serves as the mediator of prion neurotoxicity,it represents an attractive therapeutic target fo r prion *** this minireview,we briefly outline the approaches to target PrPCand discuss our recent identification of Zn(Ⅱ)-Bn PyP,a PrPC-targeting porphyrin with an unprecedented bimodal mechanism of *** argue that in-depth understanding of the molecular mechanism by which Zn(Ⅱ)-Bn PyP targets PrPCmay lead toward the development of a new class of dual mechanism anti-prion compounds.

关键词： anti-prion drug anti-PrPC antibody antisense oligonucleotide neurodegeneration pharmacological chaperone porphyrin prion disease PrPC degrader PrPC shedding zinc finger repressor

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Imaging in liver transplantation

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World Journal of Gastroenterology 2009年第6期15卷 675-683页

作者： Settimo caruso Roberto Miraglia Luigi Maruzzelli Salvatore Gruttadauria angelo Luca Bruno Gridelli Department of Diagnostic and Interventional Radiology Mediterranean Institute for Transplantation and Advanced Specialized Therapies(IsMeTT)University of Pittsburgh Medical Center ItalyVia Tricomi 1Palermo 90127Italy Department of Transplantation Surgery Mediterranean Institute for Transplantation and Advanced Specialized Therapies(IsMeTT) University of Pittsburgh Medical Center ItalyVia Tricomi 1 Palermo 90127Italy

The aim of this study was to illustrate the role of noninvasive imaging tools such as ultrasonography,multidetector row computed tomography,and magnetic resonance imaging in the evaluation of pediatric and adult liver recipients and potential liver donors,and in the detection of potential complications arising from liver transplantation.

关键词： Complications Liver donor Liver transplantation Magnetic resonance Multi detector computed tomography

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Mitochondrial DNA alterations in the progression of gastric carcinomas:Unexplored issues and future research needs

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World Journal of Gastroenterology 2014年第43期20卷 16159-16166页

作者： Luciana Rigoli Rosario Alberto caruso Department of Pediatrics School of MedicineUniversity of Messina98122 MessinaItaly Department of Human Pathology School of MedicineUniversity of Messina98122 MessinaItaly

Gastric cancer is the second most frequent cause of cancer death *** infected with Helicobacter pylori(***)are at increased risk of gastric *** induces genomic instability in both nuclear and mitochondrial(mt)DNA of gastric epithelial *** in mt DNA represent an early event during gastric tumorigenesis,and thus may serve as potential biomarkers for early detection and prognosis in gastric *** review article summarizes the mt DNA mutations that have been reported in gastric carcinomas and their precancerous *** research topics,such as the role of mt DNA alterations in an alternative pathway of gastric carcinogenesis,are identified and directions for future research are suggested.

关键词： Gastric carcinoma Precancerous lesions Histopathology mtDNA Molecular biology

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A rare case of omental extra-gastrointestinal stromal tumor showing two coexisting mutations on exon 14 of the PDGFRA gene

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Gastroenterology Report 2021年第4期9卷 377-379,I0003页

作者： Gianluca caruso Luca Pacini angelo Iossa Claudio Di Cristofano Daniela Bastianelli Gianfranco Silecchia Maria Mele Vincenzo Petrozza Antonella Calogero Elena De Falco Pathology Unit ICOT HospitalSapienza University of RomeLatinaItaly Clinical Pathology Unit ICOT HospitalSapienza University of RomeLatinaItaly Division of General Surgery and Bariatric Centre of Excellence Department of Medical-Surgical Sciences and BiotechnologiesSapienza University of RomeRomeItaly Department of Medical-Surgical Sciences and Biotechnologies Faculty of Pharmacy and MedicineSapienza UniversityLatinaItaly Laboratory of Clinical Pathology ICOT HospitalLatinaItaly Mediterranea Cardiocentro NaplesItaly

Introduction Gastrointestinal stromal tumors(GISTs)are neoplasms arising from mesenchymal cells localized into the muscularis propria of the gastrointestinal(GI)tract[1];5%of GISTs are extra-GISTs(EGISTs),as they differently originate from adipose tissue adjacent to the GI tract(omentum and mesentery)or from the pancreas[2].So far,both GISTs and EGISTs have been managed indistinctively by combining surgery,histopathological distinctive features,imaging,and molecular ***.

关键词：胃肠道外间质瘤 neoplasms muscular

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Inflammatory bowel disease in pediatric and adolescent patients:A biomolecular and histopathological review

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World Journal of Gastroenterology 2014年第30期20卷 10262-10278页

作者： Luciana Rigoli Rosario Alberto caruso Department of Pediatrics University of MessinaI-98125 MessinaItaly Department of Human Pathology University of MessinaI-98125 MessinaItaly

Crohn’s disease (CD) and ulcerative colitis (UC) are the two main forms of inflammatory bowel disease (IBD) with both overlapping and distinct clinical, pathological and biomolecular features. It has been suggested that pediatric IBD is a distinct disease entity, with probably different disease *** aim of this study is to review and summarize the evolution of the current concept of pediatric IBD. The results of this review reinforce the idea that pediatric CD and UC may be further classified in various clinicopathologic entities. For clinicians and pathologists convenience, practical algorithms for the distinction of the various subphenotypes of pediatric IBD are also provided.

关键词： Pediatric inflammatory bowel disease Crohn's disease Ulcerative disease Histopathology Molecular biology

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Percutaneous transarterial embolization of extrahepatic arteroportal fistula

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World Journal of Gastroenterology 2006年第34期12卷 5562-5564页

作者： Gianluca Marrone Settimo caruso Roberto Miraglia Ilaria Tarantino Riccardo Volpes angelo Luca Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IsMeTT) Palermo Italy

Arteroportal fistula is a rare cause of prehepatic portal hypertension. A 44-year-old male with hepatitis virus C infection was admitted for acute variceal bleeding. Endoscopy showed the presence of large esophageal varices. The ultrasound revealed a mass near the head of pancreas, which was characterized at the color- Doppler by a turbulent flow, and arterialization of portal vein flow. CT scan of abdomen showed a large aneurysm of the gastroduodenal artery communicating into the superior mesenteric vein. The sinusoidal portal pressure measured as hepatic vein pressure gradient was normal, confirming the pre-hepatic origin of portal hypertension. The diagnosis of extrahepatic portal hypertension secondary to arteroportal fistula was established, and the percutaneous embolization was performed. Three months later, the endoscopy showed absence of esophageal varices and ascites. At the moment, the patient is in good clinical condition, without signs of portal hypertension.

关键词： Portal hypertension Arteroportal fistula Portal shunt Esophageal varices bleeding Embolization Interventional radiology Psudoaneurysm

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