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The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Management of Intra-Biliary Rupture of Liver Hydatid Cysts (IBRH): Follow-Up of 12 Cases

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Case Reports in Clinical Medicine 2014年第9期3卷 533-543页

作者： Mohammad Abdulrahman Alshekhani Taha A. Alkarbuli Naser Abdullah Mohammed Alqazi hiwa A. hussein Qalandar H. Kasnazan Ali hussein Ali Kurdistan Center for Gastroenterology & Hepatology Asulaimaneyah Iraqi Kurdistan Iraq

Background: Intra-biliary rupture of hydatid cyst [IBRH] is not a rare complication of hydatid disease of the liver and surgery until recently is the only definitive treatment. With the introduction of ERCP preoperatively or postoperatively there was a great reduction in the operative complications. There were reports in which the ERCP was the sole treatment of this condition. Objective: To evaluate role of ERCP in the management of cases of IBRH. Design: A retrospective study of 7 cases of IBRH and prospective study of 5 cases of IBRH managed by ERCP. Setting: The ERCP Unit of Kurditan Center for Gastroenterology & Hepatology, Asulaimaneyah-Iraqi, Kurdistan, Iraq. Main Outcome Measurements: Improvement in the symptoms, obstructive liver functions pattern and ultrasonic findings in these patients following ERCP management. Methods: This is a study of 12 cases of IBRH managed by ERCP in the Kurdistan Center of Gastroenterology (KCGE) in Asulaimaneyah-Iraq, from 2007-2010. Seven cases of these were studied retrospectively from the available information on the center computers and on follow-up of these patients, while the other five patients were studied prospectively during the study period. We collected the available information: laboratory investigations, trans-abdominal ultrasonography (TAUS), computed tomography (CT) or magnetic resonance images (when available), before and after ERCP. We depended on the liver functions, trans-abdominal ultrasound and the clinical presentation before and after the ERCP;some patients were contacted via mobile phone for follow-up. Results: Cases were more males than females (58% vs 42%);most were from the ages between 30 - 50 years. The clinical presentation was fever, jaundice, itching and right hypochondrial pain in most patients. The liver function tests were obstructive pattern with elevated direct bilirubin and alkhaline phosphates in most patients. The trans-abdominal ultrasound revealed dilated common bile duct and single liv

关键词： Intra-Biliary Rupture of Hydatid Cyst ERCP Obstructive Jaundice

Comparative Study between Endoscopic Ultrasonography and Transabdominal Ultrasonography in the Assessment of Pancreatobiliary Diseases (with Literatures Review)

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Open Journal of Gastroenterology 2016年第2期6卷 17-30页

作者： Taha Ahmed M. Alkarboly Mohammad Omer Mohammad hiwa Abubaker hussein Surkew Lateef Mahummod Kurdistan Centre for Gastroenterology & Hepatology (KCGH) Sulaimani Iraqi Kurdistan

Background: Endoscopic ultrasonography (EUS) and transadominal ultrasonography (TUS) are two imaging investigations which can be used to assess pancreatobiliary status, although both of these imaging techniques are operator and machine dependent, but they have different sensitivity and specificity in detecting pancreatobiliary diseases. Objective: To compare the diagnostic value of EUS versus TUS in the assessment of pancreatobiliary diseases. Patients and Methods: This study was conducted in KCGH (Kurdistan Center for Gastroenterology and Hepatology) in Sulaimani city. Iraqi Kurdistan;the duration of study was 14 months and conducted after approval of Iraqi board ethical committee. One hundred cases were enrolled in the study: 52 of them were females and 48 were males;their ages ranged between 16 - 90 years;informed consent was taken from all patients;all patients underwent proper clinical evaluation;TUS, EUS and Oesophagogastroduodenoscopy (OGD), and in some of them (25 patients) Endoscopic Retrograde Cholangiopancreatography (ERCP), CT scan of abdomen and laboratory investigations were done. Results: EUS detected more cases with common bile duct (CBD) dilatation, CBD stones and pancreatic space occupying lesion (SOL) than TUS, but the differences in the results were not statistically significant. Also EUS detected more cases of intra-abdominal lymph nodes (LNs) and ampullary/peri-ampullary neoplasms than TUS and the differences in the results were statistically significant. Conclusions: Eus is more sensitive than TUS in diagnosing CBD dilatation;it has higher sensitivity than TUS in suspected pancreatobiliary neoplasms;furthermore, EUS can be used for staging and resectability assessment of pancreatobiliary neoplasia.

关键词： EUS TUS ERCP Pancreatobiliary Diseases KCGH Sulaimani Iraqi Kurdistan

Argon Plasma Coagulation in Enhancing the Healing of Solitary Rectal Ulcer Syndrome &Controlling Its Bleeding

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Case Reports in Clinical Medicine 2014年第5期3卷 257-261页

作者： Mohammad Shaikhani Taha Karbuli Nasir A. Alqazi hiwa Abu Bakir hussein Bakhtyar Salim Kalandar Kasnazan Kurdistan Center for GIT/Hepatology Asulaimaneyah-Iraqi Kurdistan Iraq

Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder of defecation. Its management is usually unsatisfactory and responds best to surgery especially when there is rectal prolapse. There is a new report of the use of Argon plasma coagulation (APC) to enhance healing of these ulcers & control its bleeding in a study involving 16 patients. We involved a larger number of 18 patients in this case series to examine the role of APC in enhancing healing of SRUS & control its bleeding.

关键词： Solitary Rectal Ulcer Syndrome Argon Plasma Coagulation Rectal Prolapse

The Accuracy of Transabdominal Ultrasound in Detection of the Common Bile Duct Stone as Compared to Endoscopic Retrograde Cholangiopancreatography (with Literature Review)

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Open Journal of Gastroenterology 2016年第10期6卷 275-299页

作者： Taha Ahmed M. Alkarboly Salah Mohamad Fatih hiwa Abubaker hussein Talar M. Ali Heero Ismael Faraj Sulaimani School of Medicine Kurdistan Centre for Gastroenterology & Hepatology (KCGH) Sulaimani Iraq

Introduction: Common bile duct stone (CBDS) is a common clinical problem that can cause serious complications, such as acute cholangitis and pancreatitis. It is important to have an accurate, safe, and reliable method for the definitive diagnosis of CBDS before proceeding to therapeutic endoscopic retrograde cholangiopancrea-tography (ERCP). Objective: To compare the accuracy of trans-abdominal ultra-sound (TAUS) as a diagnostic tool at our institution—Kurdistan Centre for Gastroen-terology & Hepatology (KCGH)—with invasive tool like ERCP in the diagnosis of bile duct stones, using specificity, sensitivity, and positive and negative predictive values. Patient and Method: After obtaining ethical committee approval & informed consent from every patient. This was a prospective study conducted on 71 patients (24 male patients and 47 females patients) where suspected to have CBDS depending on history, clinical suspicion and blood tests. Their ages range between (2 - 88 years). Both TAUS and ERCP were performed. Final diagnosis was confirmed de-pending on ERCP as it served as a diagnostic standard in diagnosing CBDS. Result: In 71 patients suspected to have CBDS by TAUS, only 46 patients had stone (65%), and 55 patients had stone by ERCP (77%). In our result, sensitivity, specificity, pos-itive predictive value and negative predictive value for TAUS were 80%, 87.5%, 65.5% and 56%, respectively. Conclusion: TAUS can play an important role as an initial screening procedure for CBDS detection because of the various advantages like easy availability, cost effectiveness, no requirement of contrast material and lack of ionizing radiation but should done with other imaging modality to avoid se-rious complication of ERCP.

关键词： TAUS ERCP CBDS KCGH Sulaimani

Role of macroscopic on-site evaluation of endoscopic ultrasoundguided fine-needle aspiration/biopsy:Results of a multicentric prospective study

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World Journal of Gastrointestinal Endoscopy 2024年第11期16卷 595-606页

作者： hussein H Okasha hiwa A hussein Khaled M Ragab Omar Abdallah Fedoua Rouibaa Borahma Mohamed Fahd Ghalim Mahmoud Farouk Mohamed Lasheen Mohamed A Elbasiony Ahmed E Alzamzamy Ahmed El Deeb Hassan Atalla Mahmoud El-Ansary Sahar Mohamed Moaz Elshair Wafaa Khannoussi Mohamed Z Abu-Amer Amine Elmekkaoui Mohammed S Naguib Adil Ait Errami Ahmed El-Meligui Ahmed H El-Habashi Mahmoud G Ameen Dalia Abdelfatah Mona Kaddah Hanane Delsa Division of Gastroenterology and Hepatology Department of Internal MedicineKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt Sulaimani Center for Advanced Gastrointestinal Endoscopy Sulaimani College of MedicineSulaymaniyah 46001Iraq Department of Hepatology and Gastroenterology Theodor Bilharz Research InstituteCairo 11211Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineMansoura UniversityFaculty of MedicineMansoura 35516Egypt Gastrointestinal Endoscopy Center Military Hospital Mohamed VFaculty of Medicine of RabatRabat 10100Rabat-Salé-KénitraMorocco Department of Gastroenterology“C” Ibn Sina HospitalMohammed V University in RabatRabat 10000Rabat-Salé-KénitraMorocco Digestive Endoscopy Unit Mekka ClinicCasablanca 20000Casablanca-SettatMorocco Department of Tropical Medicine and Gastroenterology Luxor UniversityLuxor 85951Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineFaculty of MedicineMansoura UniversityMansoura 35516Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11841Egypt Department of Gastroenterology National Hepatology and Tropical Medicine Research InstituteCairo 12556Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineAl-Azhar UniversityCairo 11651Egypt Department of Gastroenterology and Endoscopy Center Cheikh Khalifa International University HospitalMohammed VI University of Sciences and HealthCasablanca 82403Casablanca-SettatMorocco Research Unit Mohammed VI Center for Research and InnovationRabat 10100Rabat-Salé-KénitraMorocco Department of Hepato-Gastroenterology Hassan II University Hospital of FezFaculty of MedicinePharmacy and Dentistry of FezSidi Mohamed Ben Abdellah UniversityFes 30003Fès-MeknèsMorocco Department of Gastroenterology Ahmed Maher Teaching HospitalCairo 11451Egypt Department of Gastroenterology Cadi Ayyad UniversityMohammed VIth University HospitalMarrakech

BACKGROUND The concept of macroscopic on-site evaluation(MOSE)was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on MOSE was superior to 4 *** studies suggest that MOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation,and some classi-fications have been *** studies have assessed the adequacy of histologic cores in MOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy(EUS-FNA/FNB).AIM To evaluate the performance of MOSE during EUS-FNA/*** This multicentric prospective study was conducted in 16 centers in 3 countries(Egypt,Iraq,and Morocco)and included 1108 patients with pancreatic,biliary,or gastrointestinal pathology who were referred for EUS *** prospectively analyzed the MOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core *** management and analysis were performed using a Statistical Package for Social Sciences(SPSS)version *** A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological *** age was 59 years,and 509 patients(50.5%)were *** mean lesion size was 38 *** most frequently utilized needles were FNB-Franseen(74.5%)and 22 G(93.4%),with a median of 2 *** to 2 classifications,618 non-bloody cores(61.3%)and 964 good samples(95.6%)were adequate for histological *** overall diagnostic yield of cytopathology was 95.5%.The cytological examination confirmed the diagnosis of malignancy in 861 patients(85.4%),while 45 samples(4.5%)were ***-procedural adverse events occurred in 33 patients(3.3%).Statistical analysis showed a difference between needle types(P=0.035)with a high sensitivity of FNB(97%).The analysis of the relationship between the MOSE-score and the final diagnosis showed a significant difference between the different

关键词： Macroscopic on-site evaluation Fine-needle aspiration Fine-needle biopsy Endoscopic ultrasound Specimen