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Iatrogenic Oesophageal Perforations in neoplastic Lesions: Management with Covered Self-Expanding Prostheses

Open Journal of Gastroenterology 2021年第6期11卷 89-104页

作者： Mario Anselmi Mendez Ana MarÍA Gemmato Pascazio Maximiliano Figueroa Silva julio salgado oyarzún Surgery Department School of Medicine University of Concepción Concepción Chile Endoscopic Surgery Diploma Program Fellow Department of Surgery School of Medicine University of Concepción Concepción Chile

Background:Perforation of the oesophagus is a serious condition. Most of them are iatrogenic and are associated with significant morbidity and mortality, especially with late diagnosis. Aim: To prospectively analyse t... 详细信息

Background:ng>ng>n>Perforation of the oesophagus is a serious condition. Most of them are iatrogenic and are associated with significant morbidity and mortality, especially with late diagnosis. Aim: To prospectively analyse the results of the endoscopic management of iatrogenic perforations in oesophageal neoplasia, through the immediate insertion of a covered self-expanding prosthesis (CSES). Materials and Methods: Between 01.01.2006 and 12.30.2016, a series of 19 consecutive patients attended the Teaching Unit of Endoscopic Surgery of the Regional de Concepción Hospital, Chile, with the diagnosis of oesophageal neoplasia confirmed by biopsy were prospectively studied. All were subjected to a prior evaluation by the oncology team and subsequently referred for endoscopic palliative management of dysphagia. The average age was 77 ± 9.3 years, 8 (42.1%) were female and 11 (57.9%) were male. In 17 patients (89.5%) the stenosis compromised the oesophagus, in 2 (10.5%) the gastro-oesophageal junction, 16 had a squamous carcinoma (84.2%) and 3 an adenocarcinoma (15.8%). Results: n style="font-family:Verdana;">Perforation was diagnosed during the procedure in 18 patients (94.7%) and in 1 (5.3%) 22 hours later. Follow-up was done for a minimum of 90 days or until death. The prostheses were inserted successfully in all cases. The immediate evolution was satisfactory in 12 patients (63.2%). In the rest (36.8%), 18 complications appeared. The most frequent were retrosternal pain, subcutaneous emphysema and fever. The early evolution was satisfactory in 12/19 cases (63.2%). Complication was evid

关键词： Iatrogenic Oesophageal Perforations Self-Expanding Prostheses Oesophageal Cancer

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Endoscopic Sphinterotomy in Patients with Mild Acute Biliary Pancreatitis, in <i>Situ</i>Gallbladder and Alithiasic Bile Duct: Is It Justified?

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Open Journal of Gastroenterology 2021年第7期11卷 118-133页

作者： Mario Anselmi Méndez Ana María Gemmato Pascazi julio salgado oyarzún Maritza Flores Opazo General and Digestive Surgery Department School of Medicine University of Concepción Concepcion Chile Public Health Department School of Medicine University of Concepción Concepcion Chile

Objective: To compare the long-term results of the treatment of mild acute biliary pancreatitis in patients with gallbladder in situ, without stones in the bile duct, treated by cholecystectomy, and endoscopic sphinct... 详细信息

ng>Objectiveng>: To compare the long-term results of the treatment of mild acute biliary pancreatitis in patients with gallbladder in situ, without stones in the bile duct, treated by cholecystectomy, and endoscopic sphincterotomy (ES) versus simple cholecystectomy in the prevention of recurrence of this pathology.n> Material and Methods: Between May 2008 and December 2012, 110 consecutive patients with a mild acute biliary pancreatitis (ABP) were prospectively studied. None had undergone cholecystectomy, and choledocholithiasis was ruled out by ERCP. Two groups of patients were created and randomized: Group I (n = 55) who underwent ERCP plus ES and Group II (n = 55) only had diagnostic ERCP. Patients were then referred for cholecystectomy. Follow up was completed in 101 patients. Group I was made up of 53 patients and Group II had 48 similar characteristics. Patients were followed for an average of 105 months. At the end of the follow-up, 12 (22.6%) from Group I and 6 (12.5%) from Group II (p = 0.143) remained with the gallbladder in situ.n> Resultsn style="font-family:Verdana;">: There were 53 patients in Group I (100%). Only 42 (87.5%) of those in Group II evolved without biliopancreatic complications (p = 0.0096). In the latter, 6 (12.5%) wer

关键词： Pancreatitis Endoscopic Sphincterotomy

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