检索结果-南通市图书馆

Double-balloon-enteroscopy-based endoscopic retrograde cholangiopancreatography in post-surgical patients

World Journal of Gastroenterology 2011年第18期17卷 2302-2314页

作者： martin raithel Harald Dormann Andreas Naegel Frank Boxberger Eckhart G Hahn Markus F Neurath Juergen Maiss Department of Medicine 1 University of Erlangen-Nürnberg Emergency Unit City Hospital Fürth Dean of the University Witten-Herdecke

AIM: To evaluate double balloon enteroscopy (DBE) in post-surgical patients to perform endoscopic retrograde cholangiopancreatography (ERCP) and interventions. METHODS: In 37 post-surgical patients, a stepwise approach was performed to reach normal papilla or enteral anastomoses of the biliary tract/pancreas. When conventional endoscopy failed, DBE-based ERCP was performed and standard parameters for DBE, ERCP and interventions were recorded. RESULTS: Push-enteroscopy (overall, 16 procedures) reached enteral anastomoses only in six out of 37 post-surgical patients (16.2%). DBE achieved a high rate of luminal access to the biliary tract in 23 of the remaining 31 patients (74.1%) and to the pancreatic duct (three patients). Among all DBE-based ERCPs (86 procedures), 21/23 patients (91.3%) were successfully treated. Interventions included ostium incision or papillotomy in 6/23 (26%) and 7/23 patients (30.4%), respectively. Biliary endoprosthesis insertion and regular exchange was achieved in 17/23 (73.9%) and 7/23 patients (30.4%), respectively. Furthermore, bile duct stone extraction as well as ostium and papillary dilation were performed in 5/23 (21.7%) and 3/23 patients (13.0%), respectively. Complications during DBE-based procedures were bleeding (1.1%), perforation (2.3%) and pancreatitis (2.3%), and minor complications occurred in up to 19.1%. CONCLUSION: The appropriate use of DBE yields a high rate of luminal access to papilla or enteral anastomoses in more than two-thirds of post-surgical patients, allowing important successful endoscopic therapeutic interventions.

关键词：双气囊小肠手术患者胆管造影内镜胃镜检查

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Jejunitis and brown bowel syndrome with multifocal carcinogenesis of the small bowel

引用

World Journal of Gastroenterology 2015年第36期21卷 10461-10467页

作者： martin raithel Tilman T Rau Alexander F Hagel Heinz Albrecht Thomas de Rossi Thomas Kirchner Eckhart G Hahn Department of Medicine 1 Friedrich-Alexander-University Erlangen-Nuremberg Department of Pathology Friedrich-Alexander University Erlangen-Nuremberg Department of Pathology Ludwig-Maximilians-University Munich

This is the first report describing a case where prolonged,severe malabsorption from brown bowel syndrome progressed to multifocally spread small bowel adenocarcinoma. This case involves a female patient who was initially diagnosed with chronic jejunitis associated with primary diffuse lymphangiectasia at the age of 26 years. The course of the disease was clinically,endoscopically,and histologically followed for 21 years until her death at the age 47 due to multifocal,metastasizing adenocarcinoma of the small bowel. Multiple lipofuscin deposits(so-called brown bowel syndrome) and severe jejunitis were observed microscopically,and sections of the small bowel showed dense lymphoplasmacytic infiltration of the lamina propria as well as blocked lymphatic vessels. After several decades,multifocal nests of adenocarcinoma cells and extensive,flat,neoplastic mucosal proliferations were found only in the small bowel,along with a loss of the mismatch repair protein MLH1 as a long-term consequence of chronic jejunitis with malabsorption. No evidence was found for hereditary nonpolyposis colon carcinoma syndrome. This article demonstrates for the first time multifocal carcinogenesis in the small bowel in a malabsorption syndrome in an enteritis-dysplasia-carcinoma sequence.

关键词： Brown bowel syndrome Carcinogenesis of the small b

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Conventional endoscopic retrograde cholangiopancreaticography vs the Olympus V-scope system

引用

World Journal of Gastroenterology 2013年第12期19卷 1936-1942页

作者： martin raithel Andreas Ngel Jürgen Maiss Dane Wildner Alexander Fritzkarl Hagel Sandra Braun Hiwot Diebel Eckhart Georg Hahn Department of Medicine 1 GastroenterologyEndoscopy University Erlangen-Nuremberg

AIM: To compare the new Olympus V-scope (VS) to conventional endoscopic retrograde cholangiopancreati-cography (ERCP). METHODS: Forty-nine patients with previous endoscopic papillotomy who were admitted for interventional ERCP for one of several reasons were included in this single-centre, prospective randomized study. Consecutive patients were randomized to either the VS group or to the conventional ERCP group. ERCP-nave patients who had not undergone papillotomy were excluded. The main study parameters were interventional examination time, X-ray time and dose, and premedication dose (all given below as the median, range) and were investigated in addition to each patient's clinical outcome and complications. Subjective scores to assess each procedure were also provided by the physicians and endoscopy assistants who carried out the procedures. A statistical analysis was carried out using the Wilcoxon rank-sum ***: Twenty-five patients with 50 interventions were examined with the VS ERCP technique, and 24 patients with 47 interventions were examined using the conventional ERCP technique. There were no significant differences between the two groups regarding the age, sex, indications, degree of ERCP difficulty, or interventions performed. The main study parameters in the VS group showed a nonsignificant trend towards a shorter interventional examination time (29 min, 5-50 min vs 31 min, 7-90 min, P = 0.28), shorter X-ray time (5.8 min, 0.6-14.1 min vs 6.1 min, 1.6-18.8 min, P = 0.48), and lower X-ray dose (1351 cGy/m2 , 159-5039 cGy/m2 vs 1296 cGy/m2 , 202.2-6421 cGy/m 2 , P = 0.34). A nonsignificant trend towards fewer adverse events occurred in the VS group as compared with the conventional ERCP group (cholangitis: 12% vs 16%, P = 0.12; pain: 4% vs 12.5%, P = 0.33; post-ERCP pancreatitis: 4% vs 12.5%, P = 0.14). In addition, there were no statistically significant differences in assessment by the physicians and endoscopy assistants using subjective questio

关键词： Endoscopic retrograde cholangiopancre-aticography Short guidewire endoscopic retrograde cholangiopancreaticography system X-ray protection V-scope Bile duct stenosis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：