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Treatment of a duodenal perforation secondary to an endoscopic sphincterotomy with clips

World Journal of Gastroenterology 2005年第39期11卷 6232-6234页

作者： Panagiotis Katsinelos George Paroutoglou basilios papaziogas Athanasios Beltsis Stavros Dimiropoulos Konstantinos Atmatzidis Department of Endoscopy and Motility Unit "G.Gennimatas" Hospital Ethnikis Aminis 4154635 ThessalonikiGreece 2nd Surgical Clinic "G.Gennimatas" Hospital Aristotle University of ThessalonikiEthnikis Aminis 4154635 ThessalonikiGreece

Perforation is one of the most serious complications of endoscopic sphincterotomy (ES) necessitating immediate surgical intervention. We present a case of successful management of such a complication with endoclipping. A85-year-old woman developed duodenal perforation after ES. The perforation was identified early and its closure was achieved using three metallic clips in a single *** was no procedure-related morbidity or complications and our patient was discharged from hospital 10 d *** of duodenal perforation induced by ES is a safe, effective and alternative to surgery treatment.

关键词：十二指肠穿孔内窥镜括约肌切开术治疗方法病理机制

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Long-term results of pneumatic dilation for achalasia: A15 years' experience

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World Journal of Gastroenterology 2005年第36期11卷 5701-5705页

作者： Panagiotis Katsinelos Jannis Kountouras George Paroutoglou Athanasios Beltsis Christos Zavos basilios papaziogas Kostas Mimidis Department of Endoscopy and Motility Unit Central Hospital Thessaloniki Greece Department of Medicine Second Medical Clinic Aristotle University of Thessaloniki Ippokration Hospital Thessaloniki Greece

AIM: Although most patients with achalasia respond to pneumatic dilation, one-third experienced recurrence, and prolonged follow-up studies on parameters associated with various outcomes are scanty. In this retrospective study, we reported a 15-years' experience with pneumatic dilation treatment in patients with primary achalasia, and determined whether previously described predictors of outcome remain significant after endoscopic ***: Between September 1989 and September 2004, 39 consecutive patients with primary symptomatic achalasia (diagnosed by clinical presentation, esophagoscopy,barium esophagogram, and manometry) who received balloon dilation were followed up at regular intervals in person or by phone interview. Remission was assessed by a structured interview and a previous symptoms *** median dysphagia-free duration was calculated by Kaplan-Meier ***: Symptoms were dysphagia (n = 39, 100%),regurgitation (n =23, 58.7%), chest pain (n = 4, 10.2%),and weight loss (n = 26, 66.6%). A total of 74 dilations were performed in 39 patients; 13 patients (28%) underwent a single dilation, 17 patients (48.7%) required a second procedure within a median of 26.7 mo (range 5-97 mo), and 9 patients (23.3%) underwent a third procedure within a median of 47.8 mo (range 37-120 mo). Post-dilation lower esophageal sphincter (LES) pressure, assessed in 35 patients, has decreased from a baseline of 35.8±10.4-10.0±7.1 mmHg after the procedure. The median follow-up period was 9.3 years (range 0.5-15 years). The dysphagiafree duration by Kaplan-Meier analysis was 78%, 61%and 58.3% after 5, 10 and 15 years ***: Balloon dilation is a safe and effective treatment for primary achalasia. Post-dilation LES pressure estimation may be useful in assessing response.

关键词：气囊扩张压力测量法食管弛缓不能治疗方法

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Endoscopic treatment and follow-up of gastrointestinal Dieulafoy's lesions

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World Journal of Gastroenterology 2005年第38期11卷 6022-6026页

作者： Panagiotis Katsinelos George Paroutoglou Kostas Mimidis Athanasios Beltsis basilios papaziogas George Gelas Yiannis Kountouras Department of Endoscopy and Motility Unit 2nd Surgical Clinic 2nd Department of Internal Medicine

AIM: To investigate retrospectively the clinical and endoscopic features of bleeding Dieulafoy's lesions and to assess the short- and long-term effectiveness of endoscopic ***: Twenty-three patients who had gastrointestinal bleeding from Dieulafoy's lesions underwent endoscopic therapy. Demographic data, mode of presentation, riskfactors for gastrointestinal bleeding, blood transfusion requirements, endoscopic findings, details of endoscopic therapy, recurrence of bleeding, and mortality rates were collected and analyzed ***: Hemostasis was attempted by dextrose 50% plus epinephrine in 10 patients, hemoclipping in 8 patients,heater probe in 2 patients and ethanolamine oleate in 2 patients. Comorbid conditions were present in 17 patients (74%). Overall permanent hemostasis was achieved in 18 patients (78%). Initial hemostasis was successful with no recurrent bleeding in patients treated with hemoclipping, heater probe or ethanolamine injection. In the group of patients who received dextrose 50% plus epinephrine injection treatment, four (40%) had recurrent bleeding and one (10%) had unsuccessful initial *** the four patients who had rebleeding, three had unsuccessful hemostasis with similar treatment. Surgical treatment was required in five patients (22%) owing to uncontrolled bleeding, recurrent bleeding with unsuccessful retreatment and inability to approach the lesion. One patient (4.3%) died of sepsis after operation during hospitalization. There were no side-effects related to endoscopic therapy. None of the patients in whom permanent hemostasis was achieved presented with rebleeding from Dieulafoy's lesion over a mean long-term follow-up of 29.8 ***: Bleeding from Dieulafoy's lesions can be managed successfully by endoscopic methods, which should be regarded as the first choice. Endoscopic hemoclipping therapy is recommended for bleeding Dieulafoy's lesions.

关键词：内窥镜胃疾病肠疾病病理机制临床表现

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Pancreatitis complicating mucin-hypersecreting common bile duct adenoma

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World Journal of Gastroenterology 2006年第30期12卷 4927-4929页

作者： Panagiotis Katsinelos George Basdanis Grigorios Chatzimavroudis Giorgia Karagiannoulou Taxiarchis Katsinelos George Paroutoglou basilios papaziogas George Paraskevas Department of Endoscopy and Motility Unit "G.Gennimatas" Hospital Ethnikis Aminis 41 Thessaloniki 54635 Greece Department of Pathology Aristotle University of Thessaloniki Greece

胆汁管的覆有一层绒毛的腺瘤是极其不平常的。我们描述与临床的符号和尖锐胰腺炎和妨碍的黄疸的实验室调查结果介绍的一个 58 岁的人。外科手术前的调查在远侧的胆总管表明了一个扩大的乳突的孔，粘液(鱼嘴符号) 和充盈缺损退出。他经... 详细信息

胆汁管的覆有一层绒毛的腺瘤是极其不平常的。我们描述与临床的符号和尖锐胰腺炎和妨碍的黄疸的实验室调查结果介绍的一个 58 岁的人。外科手术前的调查在远侧的胆总管表明了一个扩大的乳突的孔，粘液(鱼嘴符号) 和充盈缺损退出。他经历了修改惠普尔操作，外科的标本的组织学的检查与粘液的富有的分泌物显示出覆有一层绒毛的腺瘤。

关键词：胰腺炎并发症胆管瘤治疗

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