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Simultaneous endoscopic ultrasound fine needle aspiration and endoscopic retrograde cholangio-pancreatography:Evaluation of safety

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World Journal of Gastroenterology 2007年第28期13卷 3861-3863页

作者： Ilaria Tarantino Luca Barresi Marta Di Pisa mario traina Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione University of Pittsburgh Medical CenterItaly

AIM: To investigate the rate of complications of endoscopic retrograde cholangio-pancreatography (ERCP) performed immediately after endoscopic ultrasound fine needle aspiration (EUS-FNA) in a large series of patients. METHODS: Patients with the following conditions were considered candidates for EUS-FNA and ERCP: diagnosis of locally advanced or metastatic pancreatic lesion not eligible for surgery, and patients with pancreatic lesion of unknown nature causing jaundice. Data were prospectively collected on the following parameters: indication for FNA, EUS findings, pathological diagnosis, procedure duration of EUS-FNA and combined EUS-FNA and ERCP, and immediate and late complications. RESULTS: From January 2004 to October 2006, 72 patients were deemed eligible for combined EUS and ERCP. In 25/72 EUS-FNA was performed to obtain a pathology diagnosis of lesions causing biliary obstruction, and ERCP sequentially performed to drain the biliary system. No immediate complications occurred except for two mild bleeding episodes post sphincterotomy. No late complications were recorded except for one patient who experienced fever, promptly recovered with antibiotic therapy. CONCLUSION: Simultaneous approach appears to be feasible and safe. When possible, this can be considered the reference standard to avoid double sedation and reduce duration of the procedure and hospital stay.

关键词： Pancreatic mass Endoscopic ultrasound fine needle aspiration Biliary stent Jaundice Endoscopictherapy

Endoscopic treatment of biliary complications after liver transplantation

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World Journal of Gastroenterology 2008年第26期14卷 4185-4189页

作者： Ilaria Tarantino Luca Barresi Ioannis Petridis Riccardo Volpes mario traina Bruno Gridelli Department of Gastroenterology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT)University of Pittsburgh Medical Center (UPMC)Palermo 90100Italy Department of Surgery Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT)University of Pittsburgh Medical CenterPalermo 90100Italy

AIM： To evaluate the efficacy of endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. METHODS： This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography （ERCP） was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after i year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach （PTC） or surgery was adopted. RESULTS： From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3%, while in the LRLTx group was 64.7%. The rate of ERCP failure was 19.4% in the OLTx group and 38.6% in LRLTx group. In OLTx group, i patient was retransplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3±13.13 mo and 21.02± 14.10 mo, ***： Albhough ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whebher obher endoscopic protocols or new devices, could improve bhe current results.

关键词： Endoscopic retrograde cholangiopancreatography Biliary complication Liver transplant Benignstenosis Biliary leak

Gastric duplication associated with pancreas divisum diagnosed by a multidisciplinary approach before surgery

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World Journal of Gastroenterology 2010年第8期16卷 1031-1033页

作者： Marta Di Pisa Gabriele Curcio Gianluca Marrone Mariapina Milazzo Marco Spada mario traina mario traina Gastroenterology Service Department of Radiology IsMeTT-UPMC Department of Surgery IsMeTT-UPMC

We report a unique case of communicating gastric duplication associated with pancreas divisum,diagnosed with a multidisciplinary approach,including X-rays,computed tomography,magnetic resonance imaging,esophagogastro duodenoscopy,ultrasound endoscopy and histology. We believe that this approach constitutes a fuller diagnostic evaluation,resulting in better and safer surgery.

关键词： Gastric duplication Pancreas divisum Computed tomography Magnetic resonance imaging Ultra-sonic endoscopy

Tulip bundle technique and fibrin glue injection:Unusual treatment of colonic perforation

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World Journal of Gastroenterology 2011年第8期17卷 1088-1090页

作者： Filippo Mocciaro Gabriele Curcio Ilaria Tarantino Luca Barresi Marco Spada Sergio Li Petri mario traina Department of Gastroenterology IsMeTT UPMC Surgery Unit IsMeTT UPMC

We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic *** lesion was large and irregular with three discrete perforations,therefore,we decided to close it by placing one clip per perforation,and then connecting all the clips with two *** we chose to use a fibrin glue injection to obtain a complete *** days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in *** of the sigma showed complete repair of the *** report underlines how a conservative approach,together with a combination of various endoscopic techniques,can resolve complicated iatrogenic perforations of the colon.

关键词： Colonic perforation Endoscopic treatment Fibrin glue injection Tulip bundle technique

Completely obstructed colorectal anastomosis: A new non-electrosurgical endoscopic approach before balloon dilatation

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World Journal of Gastroenterology 2010年第37期16卷 4751-4754页

作者： Gabriele Curcio Marco Spada Fabrizio di Francesco Ilaria Tarantino Luca Barresi Gaetano Burgio mario traina Department of Gastroenterology IsMeTT UPMC

Benign stricture is a relatively common complication of colorectal anastomosis after low anterior resection. On occasion, the anastomosis may close completely. A variety of endoscopic techniques have been described, but there is a lack of data from controlled prospective trials as to the optimal approach. Through-the-scope balloon dilatation is well known and easy to perform. Some case reports describe different endoscopic approaches, including endoscopic electrocision with a papillotomy knife or hook knife. We report a case of a colorectal anastomosis web occlusion, treated without electrocision. Gastrografin enema and sigmoidoscopy showed complete obstruction at the anastomotic site due to the presence of an anastomotic occlusive web. In order to avoid thermal injuries, we decided to use a suprapapillary biliary puncture catheter. The Artifon catheter was inserted into the center of the circular staple line at the level of the anastomosis, and fluoroscopic identification of the proximal bowel was obtained with dye injection. A 0.025-inch guidewire was then passed through the catheter into the colon and progressive pneumatic dilatation was performed. The successful destruction of the occlusive web facilitated passage of the colonoscope, allowing evaluation of the entire colon and stoma closure after three months of follow-up. The patient tolerated the procedure well, with no complications. This report highlights an alternative non-electrosurgical approach that uses a new device that proved to be safe and useful.

关键词： Anastomosis Dilation Balloon Obstructed Artifon

Exposed endoscopic full-thickness resection for duodenal submucosal tumors: Current status and future perspectives

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World Journal of Gastrointestinal Endoscopy 2022年第2期14卷 77-84页

作者： Antonino Granata Alberto Martino Francesco Paolo Zito Dario Ligresti Michele Amata Giovanni Lombardi mario traina Endoscopy Service Department of Diagnostic and Therapeutic ServicesIRCCS–ISMETTPalermo 90127Italy Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy

Exposed endoscopic full-thickness resection(EFTR),with or without laparoscopic assistance,is an emergent natural orifice transluminal endoscopic surgery technique with promising safety and efficacy for the management of gastrointestinal submucosal tumors(SMTs)arising from the muscularis propria(MP),especially of the gastric *** date,evidence concerning duodenal exposed EFTR is lacking,mainly due to both the technical difficulty involved because of the special duodenal anatomy and concerns about safety and effectiveness of transmural wall defect ***,given the non-negligible morbidity and mortality associated with duodenal surgery,the recent availability of dedicated endoscopic tools for tissue-approximation capable to realize full-thickness defect closure could help in promoting the adoption of this endosurgical technique among referral *** aim of our study was to review the current evidence concerning exposed EFTR with or without laparoscopic assistance for the treatment of MP-arising duodenal SMTs.

关键词： Endoscopic full-thickness resection Exposed endoscopic full-thickness resection Laparoscopy-assisted endoscopic full-thickness resection Duodenal submucosal tumors Novel oral transluminal endoscopic surgery

A case of biliary stones and anastomotic biliary stricture after liver transplant treated with the rendez-vous technique and electrokinetic lithotritor

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World Journal of Gastroenterology 2008年第18期14卷 2920-2923页

作者： Marta Di Pisa mario traina Roberto Miraglia Luigi Maruzzelli Riccardo Volpes Salvatore Piazza Angelo Luca Bruno Gridelli Department of Gastroenterology IsMeTT UPMC Via Tricomi Palermo 90100 Italy Department of Radiology IsMeTT UPMC Via Tricomi 1 Palermo 90100 Italy Department of Hepatology IsMeTT UPMC Palermo 90100 Italy Civico Hospital Via Tricomi Palermo 90100 Italy Department of Radiology IsMeTT UPMC Palermo 90100 Italy Department of Surgery IsMeTT UPMC Palermo 90100 Italy

The paper studies the combined radiologic and endoscopic approach (rendez vous technique) to the treatment of the biliary complications following liver transplant. The "rendez-vous" technique was used with an electrokinetic lithotripter, in the treatment of a biliary anastomotic stricture with multiple biliary stones in a patient who underwent orthotopic liver transplant. In this patient, endoscopic or percutaneous transhepatic management of the biliary complication failed. The combined approach, percutaneous transhepatic and endoscopic treatment (rendez-vous technique) with the use of an electrokinetic lithotritor, was used to solve the biliary stenosis and to remove the stones. Technical success, defined as disappearance of the biliary stenosis and stone removal, was obtained in just one session, which definitively solved the complications. The combined approach of percutaneous transhepatic and endoscopic (rendez-vous technique) treatment, in association with an electrokinetic lithotritor, is a safe and feasible alternative treatment, especially after the failure of endoscopic and/or percutaneous trans-hepatic isolated procedures.

关键词： Biliary complications Liver transplant Endoscopic retrograde cholangiopancreatography Percutaneous TranshepatJc Cholangiography Percutaneous libhot^ipsy

Closure techniques in exposed endoscopic full-thickness resection:Overview and future perspectives in the endoscopic suturing era

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World Journal of Gastrointestinal Surgery 2021年第7期13卷 645-654页

作者： Antonino Granata Alberto Martino Dario Ligresti Francesco Paolo Zito Michele Amata Giovanni Lombardi mario traina Digestive Endoscopy Service Department of Diagnostic and Therapeutic ServicesIRCCS–ISMETTPalermo 90127Italy Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy

Exposed endoscopic full-thickness resection(EFTR)without laparoscopic assistance is a minimally invasive natural orifice transluminal endoscopic surgery technique that is emerging as a promising effective and safe alternative to surgery for the treatment of muscularis propria-originating gastric submucosal *** date,various techniques have been used for the closure of the transmural postEFTR defect,mainly consisting in clip-and endoloop-assisted closure ***,the recent advent of dedicated tools capable of providing full-thickness defect suture could further improve the efficacy and safety of the exposed EFTR *** aim of our review was to evaluate the efficacy and safety of the different closure methods adopted in gastric-exposed EFTR without laparoscopic assistance,also considering the recent advent of flexible endoscopic suturing.

关键词： Endoscopic full-thickness resection Exposed endoscopic full-thickness resection Full-thickness resection Natural orifice transluminal endoscopic surgery Endoscopic surgery Endoscopic suturing

Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis: A review of the literature

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World Journal of Gastrointestinal Surgery 2019年第2期11卷 53-61页

作者： Benedetto Mangiavillano Mouen A Khashab Ilaria Tarantino Silvia Carrara Rossella Semeraro Francesco Auriemma mario Bianchetti Leonardo Henry Eusebi Chen Yen-I Luca De Luca mario traina Alessandro Repici Gastrointestinal Endoscopy Unit Humanitas-Mater Domini Humanitas Huniversity Division of Gastroenterology and Hepatology Johns Hopkins Hospital Gastroenterology and Endoscopy Unit Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) Digestive Endoscopy Unit Division of Gastroenterology Humanitas Clinical and Research Center IRCCS Digestive Endoscopy Unit Istituto Clinico Humanitas Research Hospital Unit of Gastroenterology Department of Medical and Surgical Sciences S. Orsola-Malpighi Hospital University of Bologna Gastroenterology and Digestive Endoscopy Unit Ospedali Riuniti Marche Nord Digestive Endoscopy Unit Division of Gastroenterology Humanitas Research Hospital

Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary, peri-ampullary, and pancreatic head neoplasia. Surgical bypass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique, with a high technical success in expert hands. In recent years, endoscopic ultrasonography(EUS) has evolved from a diagnostic to a therapeutic procedure, and is now increasingly used to guide biliary drainage, especially in cases of failed endoscopic retrograde cholangiopancreatography(ERCP). The advent of lumen-apposing metal stents(LAMS) has expanded EUS therapeutic options, and changed the management of synchronous bilioduodenal stenosis. The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach, also considering the advent of an interventional EUS approach using LAMS.

关键词： Malignant biliary strictures Malignant duodenal stenosis Bilio-duodenal stenosis Biliary self-expandable metal stent Duodenal self-expandable metal stent Lumen-apposing metal stents Gastro-jejunostomy