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Embolization combined with endoscopic variceal ligation for the treatment of esophagogastric variceal bleeding in patients with cirrhosis

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Chinese Medical Journal 2007年第1期120卷 36-40页

作者： HUANG Liu-ye CUI Jun WU Cheng-rong LIU Yun-xiang Department of Gastroenterology Yuhuangding Hospital MedicalCollege of Qingdao University Yantai 264000 China

Background Esophagogastric variceal bleeding caused by cirrhosis is a kind of emergent condition in the clinic. This study was conducted to explore the therapeutic effect and superiority of embolization of gastric fundus vadces combined with endoscopic variceal ligation （EVL） of esophageal varices for the treatment of patients with esophagogastric variceal bleeding caused by cirrhosis. Methods Totally 172 patients were diagnosed by endoscopic examination within 24 hours of hospitalization with active gastric fundus variceal bleeding and grade II above esophageal varices caused by cirrhosis. Other causes leading to upper digestive tract bleeding were excluded. Patients were randomly divided into a control group （n=82） and a therapy group （n=-90） following a random number table method. For the former, embolization for gastric fundus varices was performed, then an EVL for esophageal varices was performed 2 months later. For the therapy group, embolization for gastric fundus varices and EVL for esophageal varices were performed at the same time. Results The rate of emergency hemostasis in the therapy group was 100.0%, higher than that in the control group （87.8%, P〈0.05）. The rate of early rebleeding in the therapy group was 6.7% while the rate in the control group was 23.6% （P〈0.05）. No complications related to treatment occurred in both groups. Conclusion Embolization for gastric fundus varices combined with EVL for esophageal varices is a safe and effective method for the treatment of patients with esophagogastric variceal bleeding caused by cirrhosis.

关键词： esophagogastric varices embolization endoscopic variceal ligation cirrhosis

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Endoscopic therapy for gastric stromal tumors originating from the muscularis propria

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World Journal of Gastroenterology 2012年第26期18卷 3465-3471页

作者： liu-ye huang jun cui yun-xiang liu cheng-rong wu De-Liang Yi Department of Gastroenterology Yantai Yu Huang Ding HospitalYantai 264000Shandong ProvinceChina

AIM:To explore endoscopic therapy methods for gastric stromal tumors originating from the muscularis propria.METHODS:For 69 cases diagnosed as gastric stromal tumors originating from the muscularis propria,three types of endoscopic therapy were selected,based on the size of the tumor.These methods included endoscopic ligation and resection(ELR),endoscopic submucosal excavation(ESE) and endoscopic full-thickness resection(EFR).The wound surface and the perforation of the gastric wall were closed with metal clips.Immunohistostaining for CD34,CD117,Dog-1,S-100 and smooth muscle actin(SMA) was performed on the resected tumors.RESULTS:A total of 38 cases in which the tumor size was less than 1.2 cm were treated with ELR;three cases were complicated by perforation,and the perforations were closed with metal clips.Additionally,18 cases in which the tumor size was more than 1.5 cm were treated with ESE,and no perforation occurred.Finally,13 cases in which the tumor size was more than 2.0 cm were treated with EFR;all of the cases were complicated by artificial perforation,and all of the perforations were closed with metal clips.All of the 69 cases recovered with medical treatment,and none required surgical operation.Immunohistostaining demonstrated that among all of the 69 gastric stromal tumors diagnosed by gastroscopy,12 cases were gastric leiomyomas(SMA-positive),and the other 57 cases were gastric stromal tumors.CONCLUSION:Gastric stromal tumors originating from the muscularis propria can be treated successfully with endoscopic techniques,which could replace certain surgical operations and should be considered for further application.

关键词：手术治疗肌动蛋白胃壁内镜间质起源免疫组化染色 S-100

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Narrow-band imaging in the diagnosis of early esophageal cancer and precancerous lesions

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Chinese Medical Journal 2009年第7期122卷 776-780页

作者： HUANG Liu-ye CUI Jun WU Cheng-rong LIU Yun-xiang XU Ning Department of Gastroenterology Yantai Yuhuangding HospitalAffiliated to Medical College of Qingdao University YantaiShandong 264000 China

Background In the recent years, the incidence of esophageal cancer in China has increased. The key point for raising the survival rate is the diagnosis and treatment at an early stage. Narrow-band imaging （NBI） can enhance the contrast of the mucous membrane of the esophagus without staining. This study aimed to explore the value of NBI in the diagnosis of early esophageal cancer and precancerous lesions. Methods The esophagus was examined with ordinary endoscopy and NBI endoscopy. Pit patterns and blood capillary forms were examined with routine magnifying endoscopy and NBI endoscopy. Finally, a 1.2% Lugoul＇s iodine solution was used to stain the esophageal mucosal surface and a biopsy was taken at all the sites where NBI or iodine staining was positive. NBI and iodine staining scales were compared with pathologic diagnosis, which was considered as the gold standard. Results A total of 90 cases （138 lesions in total） were diagnosed as early esophageal cancer or precancerous lesions; 104 lesions （75.4%） were detected with ordinary endoscopy, 120 lesions （87.0%） were detected with NBI endoscopy, and 138 lesions （100%） were detected with iodine staining. The lesion detection rate of NBI was significantly lower than that of iodine staining （X2=17.176, P 〈0.01）. However, there was no significant difference between NBI and iodine staining for the diagnosis of high grade intraepithelial neoplasia （X2=1.362, P 〉0.05）, while the detection rate of NBI was significantly lower than that of iodine staining for the diagnosis of low grade intraepithelial neoplasia （X2=13.388, P 〈0.01）. The pit pattern and blood capillary form of early esophageal cancer and precancerous lesions could be demonstrated clearer with NBI than with ordinary endoscopy. Conclusions NBI can enhance the contrast of the mucous membrane of the esophagus without staining. The combination of NBI and iodine staining can raise the diagnostic rate of early esophageal cancer and precancerous lesions.

关键词： esophageal neoplasms endoscopy narrow-band imaging

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Measurement of liver function for patients with cirrhosis by ^13C-methacetin breath test compared with Child-Pugh score and routine liver function tests

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Chinese Medical Journal 2006年第18期119卷 1563-1566页

作者： liu yun-xiang huang liu-ye wu cheng-rong cui jun Department of Gastroenterology Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University Yantai 264000 China

^13C-methacetin breath test was used for the evaluation of liver function, as for quantitative data could be achieved using this method, it had the characteristics of safety, quantification, and repetition and got recognition gradually through the world. We began this ^13C- methacetin test to assess liver function of patients with cirrhosis from January 2002. The aim of this study was to explore the characteristic of this test for liver function evaluation and explore the correlation of this method with some clinical liver biochemical parameters and Child-Pugh score.

关键词： ^13 C-methacetin breath test cirrhosis liver function

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Sequential therapy for patients with cirrhosis complicated by common bile duct stones and moderate to severe gastroesophageal varices

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Chinese Medical Journal 2012年第23期125卷 4312-4314页

作者： huang liu-ye ZHANG Bo cui jun liu yun-xiang wu cheng-rong LIN Shu-juan Department of Gastroenterology Yantai Yuhuangding HospitalYantaiShandong 264000China

Cirrhosis complicated by common bile duct stones is a common clinical finding.1 Currently, good therapeutic results occur in patients with cirrhosis complicated by moderate to severe gastroesophageal varices and common bile duct stones using endoscopic variceal ligation （EVL） and/or embolization followed two weeks later by calculus removal with endoscopic retrograde cholangiopancreatography （ERCP）.

关键词： cirrhosis common bile duct stone gastroesophageal varices endoscopic retrograde cholangiopancreatography endoscopic variceal ligation embolization

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Application of endoscopic retrograde cholangiopancreatography in biliary-pancreatic diseases

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Chinese Medical Journal 2009年第24期122卷 2967-2972页

作者： huang liu-ye liu yun-xiang wu cheng-rong cui jun ZHANG Bo Department of Gastroenterology Yantai Yuhuangding HospitalAffiliated to Medical College of Qingdao University YantaiShandong 264000 China

Background Endoscopic retrograde cholangiopancreatography （ERCP） has been used increasingly for the treatment of choledocholithiasis, gallstone pancreatitis, and benign or malignant bile duct or pancreatic duct stenosis. The purpose of this study was to evaluate ERCP for the diagnosis and therapy of biliary-pancreatic diseases. Methods A total of 2075 patients who underwent diagnostic and therapeutic ERCP from june 2001 to March 2009 were analyzed retrospectively. Achievement and complication rates were calculated, and the therapeutic effect was observed. Results In all the 64 cases who underwent diagnostic ERCP, the procedure was successful, in 2011 cases therapeutic ERCP was performed, and the success rate was 94.6%. In the therapeutic ERCP cases, 1434 （93.0%） were successful among the 1542 cases of choledocholithiasis, and 422 （90.0%） of the 469 cases with benign or malignant bile duct or pancreatic duct stenosis, or acute obstructive suppurative cholangitis with stent placement or endoscopic nasobiliary drainage were successful. Fifty-nine （90.8%） cases of the 65 who underwent a pre-cut for pancreatic sphincterotomy were successful. Complication rate was 5.1% and the most frequent complication was acute pancreatitis （4.4%）. Conclusions ERCP is one of the major diagnostic and therapeutic methods for biliary-pancreatic disease. Therapeutic ERCP is a minimally invasive, safe and effective treatment method for various biliary-pancreatic diseases.

关键词： endoscopic retrograde cholangiopancreatography biliary disease pancreatic disease

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Fuji Intelligent Chromo Endoscopy and staining technique for the diagnosis of colon tumor

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Chinese Medical Journal 2008年第11期121卷 977-982页

作者： liu yun-xiang huang liu-ye BIAN Xiao-ping cui jun XU Ning wu cheng-rong Department of Gastroenterology Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University Yantai Shandong 264000 China

Background Colon cancer is a common malignant tumor in the clinic with an incidence rate that is increasing in recent years. The key point for improving the survival rate is the diagnosis and treatment at an early stage. The purpose of this study was to compare the difference of the Fuji Intelligent Chromo Endoscopy （FICE） and staining technique for the diagnosis of colon tumors and non-tumor lesions. Methods From March to November 2007, 654 patients were examined with ordinary colonoscopy. Among them 223 patients with colon neoplasm or polypoid lesion were included. The patients were examined with a magnifying ordinary colonoscopy, a magnifying FICE technique and magnifying staining technique. The pit pattern and blood capillary form of the lesion were examined, an endoscopic diagnosis was made and it was compared with the pathologic diagnosis.Results Four hundred and fifty-one neoplasms were detected in the 223 patients, among those 91.1% （411/451） were detected with the magnifying ordinary endoscopy while 99.1% （447/451） were detected with the FICE technique; there was a significant difference between the two methods. FICE could clearly show the structure and form of mucosal blood capillaries （P 〈0.01） but there was no significant difference between the two methods for showing the pit pattern. The coincident rate of FICE for the diagnosis of tumor and non-tumor lesions was 91.6% （413/451）, that of the magnifying staining technique was 82.0% （370/451）（P〈0.05）. Conclusions Magnifying FICE could show the mucosal microstructure and blood capillary form and it had a superiority of high coincident rate, high sensitivity and specificity when compared with ordinary magnifying colonoscopy and magnifying staining endoscopy. In addition, it was easy to operate and a biopsy could be taken from the target, so it has a satisfactory clinical practical value.

关键词： Fuji Intelligent Chromo Endoscopy colon tumor diagnosis

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Efficacy of endoscopic therapy for gastrointestinal bleeding from Dieulafoy’s lesion

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World Journal of Gastroenterology 2011年第10期17卷 1368-1372页

作者： jun cui liu-ye huang yun-xiang liu Bo Song Long-Zhi Yi Ning Xu Bo Zhang cheng-rong wu Department of Gastroenterology Yantai Yu Huang Ding Hospital Yantai 264000 Shandong Province China

AIM: To investigate the endoscopic hemostasis for gastrointestinal bleeding due to Dieulafoy's lesion. METHODS: One hundred and seven patients with gastrointestinal bleeding due to Dieulafoy's lesion were treated with three endoscopic hemostasis methods: aethoxysklerol injection (46 cases), endoscopic hemoclip hemostasis (31 cases), and a combination of hemoclip hemostasis with aethoxysklerol injection (30 cases). RESULTS: The rates of successful hemostasis using the three methods were 71.7% (33/46), 77.4% (24/31) and 96.7% (29/30), respectively, with signif icant differences between the methods (P year follow-up. CONCLUSION: The combined therapy of hemoclip hemostasis with aethoxysklerol injection is the most effective method for gastrointestinal bleeding due to Dieulafoy's lesion.

关键词：消化道出血注射治疗病变内镜疗效观察手术操作外科手术综合治疗

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小探头超声内镜对十二指肠降部隆起性病变的诊治价值

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中国内镜杂志 2010年第10期16卷 1063-1065,1068页

作者：崔俊刘运祥吴承荣黄留业青岛大学医学院附属烟台毓璜顶医院消化内科山东烟台264000

目的研究小探头内镜超声检查(mEUS)对十二指肠降部隆起性病变的诊断价值,并行内镜下结扎或电切除治疗,探索十二指肠降部隆起性病变的诊治方法。方法对60例患者的72个十二指肠降部黏膜下隆起病变行超声内镜检查,判断其起源,确立内镜诊断... 详细信息

目的研究小探头内镜超声检查(mEUS)对十二指肠降部隆起性病变的诊断价值,并行内镜下结扎或电切除治疗,探索十二指肠降部隆起性病变的诊治方法。方法对60例患者的72个十二指肠降部黏膜下隆起病变行超声内镜检查,判断其起源,确立内镜诊断。根据不同病变选择内镜下结扎治疗或电切除术,部分病例经手术或病理证实。结果 72个十二指肠降部黏膜下病变中,间质瘤33个,囊肿27个,脂肪瘤9个,血管瘤3个,根据不同的病变选择结扎治疗或内镜下电切除术,未发生内镜治疗相关的并发症,3个月后复查见原病变处已形成瘢痕。结论小探头内镜超声检查对十二指肠降部黏膜下病变有重要的诊断价值,在其指导下的结扎或电切除术对十二指肠降部隆起病变有良好的治疗作用。

关键词：内镜超声黏膜下病变十二指肠诊断治疗

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Endoscopic full-thickness resection and laparoscopic surgery for treatment of gastric stromal tumors

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World Journal of Gastroenterology 2014年第25期20卷 8253-8259页

作者： liu-ye huang jun cui cheng-rong wu Bo Zhang Li-Xin Jiang xiang-Shu Xian Shu-Juan Lin Ning Xu Xiao-Ling Cao Zhi-Hua Wang Department of Gastroenterology Yantai Yu Huang Ding Hospital Department of Abdominal Surgery Yantai Yu Huang Ding Hospital

AIM: To assess the effectiveness of endoscopic fullthickness resection(EFR) and laparoscopic surgery in the treatment of gastric stromal tumors arising from the muscularis propria.METHODS: Out of 62 gastric stromal tumors arising from the muscularis propria, each > 1.5 cm in diameter, 32 were removed by EFR, and 30 were removed by laparoscopic surgery. The tumor expression of CD34, CD117, Dog-1, S-100, and SMA was assessed immunohistochemically. The operative time, complete resection rate, length of hospital stay, incidence of complications, and recurrence rate were compared between the two groups. Continuous data were compared using in-dependent samples t-tests, and categorical data were compared using χ2 tests.RESULTS: The 32 gastric stromal tumors treated by EFR and the 30 treated by laparoscopic surgery showed similar operative time [20-155 min(mean, 78.5 ± 30.1 min) vs 50-120 min(mean, 80.9 ± 46.7 min), P > 0.05], complete resection rate(100% vs 93.3%, P > 0.05), and length of hospital stay [4-10 d(mean, 5.9 ± 1.4 d) vs 4-19 d(mean, 8.9 ± 3.2 d), P >0.05]. None of the patients treated by EFR experienced complications, whereas two patients treated by laparoscopy required a conversion to laparotomy, and one patient had postoperative gastroparesis. No recurrences were observed in either group. Immunohistochemical staining showed that of the 62 gastric stromal tumors diagnosed by gastroscopy and endoscopic ultrasound, six were leiomyomas(SMA-positive), one was a schwannoglioma(S-100 positive), and the remaining 55 were stromal tumors.CONCLUSION: Some gastric stromal tumors arising from the muscularis propria can be completely removed by EFR. EFR could likely replace surgical or laparoscopic procedures for the removal of gastric stromal tumors.

关键词： Gastric stromal tumors Treatment Endoscopy Muscula

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