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Endoscopic treatment of biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants: Lessons learned from single-balloon enteroscopy-assisted ERCP

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hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 509-514页

作者： Rodrigo Garcés-Durán Laurent Monino pierre h deprez hubert Piessevaux Tom G Moreels Department of Gastroenterology and hepatology Universitécatholique de LouvainCliniques Universitaires Saint-LucAvenue Hippocrates 101200 BrusselsBelgium

Background: Endoscopic treatment of biliopancreatic pathology is challenging due to surgically altered anatomy after Whipple's pancreaticoduodenectomy. This study aimed to evaluate the feasibility and safety of single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography(SBE-ERCP) to treat biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants. Methods: We retrospectively analyzed 106 SBE-ERCP procedures in 46 patients with Whipple's variants. Technical and clinical success rates and adverse events were evaluated. Results: Biliary SBE-ERCP was performed in 34 patients and pancreatic SBE-ERCP in 17, including 5 with both indications. From a total of 106 SBE-ERCP procedures, 76 were biliary indication with technical success rate of 68/76(90%) procedures and clinical success rate of 30/34(88%) patients. Mild adverse event rate was 8/76(11%), without serious adverse events. From a total of 106 SBE-ERCP procedures, 30 were pancreatic indication with technical success rate of 24/30(80%) procedures( P = 0.194 vs. biliary SBEERCP) and clinical success rate of 11/17(65%) patients( P = 0.016 vs. biliary SBE-ERCP). Mild adverse event rate was 6/30(20%)( P = 0.194 vs. biliary SBE-ERCP), without serious adverse events. After SBE-ERCP failure, endoscopic ultrasound-guided drainage, percutaneous drainage and redo surgery were alternative therapeutic options. Conclusions: Biliopancreatic pathology after Whipple's pancreaticoduodenectomy variants can be treated using SBE-ERCP without serious adverse events. Technical and clinical success rates are high for biliary indications, whereas clinical success rate of pancreatic indications is significantly lower. SBE-ERCP can be considered as first-line treatment option in this patient group with surgically altered anatomy.

关键词： Enteroscopy Endoscopic retrograde cholangiopancreatography Pancreaticoduodenectomy Surgically altered anatomy Whipple’s procedure

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how to treat intestinal obstruction due to malignant recurrence after Whipple's resection for pancreatic head cancer: description of 2 new endoscopic techniques

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World Journal of Gastroenterology 2017年第33期23卷 6181-6186页

作者： Christina Mouradides Alaa Taha Ivan Borbath pierre h deprez Tom G Moreels Cliniques universitaires Saint-Luc

The prognosis of pancreatic cancer remains poor,even after initial surgical therapy. Local recurrence after Whipple's pancreatico-duodenectomy may lead to intestinal obstruction at the level of the afferent limb or the alimentary limb. Endoscopic insertion of a selfexpandable metal stent(SEMS) into the intestinal malignant stricture is the preferred method of choice for palliation. We describe two new endoscopic techniques to treat a malignant intestinal obstruction with the insertion of a SEMS into the afferent limb and the alimentary limb. A case of malignant gastric outlet obstruction after a Whipple's resection was treated by the creation of an endoscopic gastrojejunostomy by the insertion of a lumen apposing hot Axios stent in between the stomach and the alimentary limb under fluoroscopic and endoscopic ultrasound control. Biliary obstruction and jaundice caused by a malignant stricture of the afferent limb after a Roux-en-Y Whipple's resection was treated by the insertion of a SEMS by means of the single-balloon overtube-assisted technique under fluoroscopic control. Feasibility and advantages of both techniques are discussed.

关键词： Intestinal obstruction Self-expandable metal stent Whipple’s pancreatico-duodenectomy

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Expanding the horizons of endoscopic ultrasound:diagnosis of non-digestive pathologies

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Gastroenterology Report 2014年第1期2卷 63-69页

作者： Georgios Mavrogenis hocine hassaini Alain Sibille Sofia Feloni pierre h.deprez Cedric Gillain Philippe Warzee Department of Gastroenterology Grand Hopital de CharleroiCharleroiBelgium Department of hepato-Gastroenterology Cliniques universitaires Saint-LucUniversite Catholique de LouvainBrusselsBelgium

Endoscopic ultrasound(EUS)is mainly used for the evaluation and sampling of mediastinal and abdominal lymph nodes,luminal and submucosal lesions of the upper and lower gastrointestinal tract,as well as in the diagnostic approach for pancreatic,biliary and liver ***,several non-digestive pathologies may be encountered as well,expanding the diagnostic potential of *** this article,we present nine examples of extra-digestive abnormalities detected by means of EUS,including pathologies of the thyroid gland,mediastinal and abdominal vessels,lungs,kidney and the urinary *** purpose of this article is to review the capabilities of EUS beyond routine evaluation of gastrointestinal organs.

关键词： Endoscopic ultrasound thyroid cyst renal tumor pulmonary embolism aortic aneurysm pneumonia cardiac failure

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Endoscopic ultrasound-guided drainage of the biliary system:Techniques,indications and future perspectives

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World Journal of Gastrointestinal Endoscopy 2019年第2期11卷 103-114页

作者： Pieter hindryckx helena Degroote David J Tate pierre h deprez Department of Gastroenterology University Hospital of Ghent hepato-Gastroenterology Department Cliniques universitaires Saint-Luc

Over the last decade, endoscopic ultrasound-guided biliary drainage(EUS-BD)has evolved into a widely accepted alternative to the percutaneous approach in cases of biliary obstruction with failed endoscopic retrograde cholangiopancreaticography(ERCP). The available evidence suggests that, in experienced hands, EUS-BD might even replace ERCP as the first-line procedure in specific situations such as malignant distal bile duct obstruction. The aim of this review is to summarize the available data on EUS-BD and propose an evidence-based algorithm clarifies the role of the different EUS-BD techniques in the management of benign and malignant biliary obstructive disease.

关键词： Endoscopic ultrasound Endoscopic retrograde cholangiopancreaticography Biliary drainage Rendez-vous hepaticogastrostomy Choledochoduodenostomy

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Retrograde-viewing device improves adenoma detection rate in colonoscopies for surveillance and diagnostic workup

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World Journal of Gastroenterology 2012年第26期18卷 3400-3408页

作者： Peter D Siersema Amit Rastogi Anke M Leufkens Paul A Akerman Kassem Azzouzi Richard I Rothstein Frank P Vleggaar Alessandro Repici Giacomo Rando Patrick I Okolo Olivier Dewit Ana Ignjatovic Elizabeth Odstrcil James East pierre h deprez Brian P Saunders Anthony N Kalloo Bradley Creel Vikas Singh Anne Marie Lennon Daniel C DeMarco Department of Gastroenterology and hepatology University Medical Center Utrecht3508 GA UtrechtThe Netherlands Division of Gastroenterology and hepatology Kansas City Veterans Administration Medical CenterKansas CityMO 64128United States Department of Gastroenterology Bayside Endoscopy Center33 Staniford StreetProvidenceRI 02905United States Department of Gastroenterology Cliniques Universitaires Saint-LucUniversité Catholique de LouvainB-1200 BrusselsBelgium Department of Gastroenterology and hepatology Dartmouth-Hitchcock Medical CenterOne Medical Center DriveLebanonNH 03756United States Department of Gastroenterology Istituto Clinico Humanitas20089 RozzanoItaly Department of Internal Medicine Division of Gastroenterology and HepatologyJohns Hopkins HospitalBaltimoreMD 21205United States Wolfson Unit for Endoscopy St.Mark's HospitalHarrow HA1 3UJUnited Kingdom Department of Internal Medicine Division of GastroenterologyBaylor University Medical CenterDallasTX 75246United States

AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial ***:The Third Eye Retroscope Randomized Clinical Evaluation(TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward *** performed a post-hoc analysis of the TERRACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the *** were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy(SC) and Third Eye colonoscopy(TEC),randomized to SC followed by TEC or vice ***:Indication for colonoscopy was screening in 176/345 subjects(51.0%),surveillance after previous polypectomy in 87(25.2%) and diagnostic workup in 82(23.8%).In 4 subjects no indication was *** reported overall results had shown a net additional adenoma detection rate(ADR) with TEC of 23.2% compared to *** risk(RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92(P = 0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic *** RR of missing adenomas with SC vs TEC was 1.11(P = 0.815) for screening,3.15(P = 0.014) for surveillance,8.64(P = 0.039) for diagnostic and 3.34(P = 0.003) for surveillance and diagnostic *** a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically ***

关键词： Colonoscopy Colorectal cancer Adenomas Miss rates Retrograde-viewing

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The importance of increasing primary vaccinations against COVID-19 in Europe

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Infectious Disease Modelling 2024年第1期9卷 1-9页

作者： pierre-Yves Boelle Eugenio Valdano Sorbonne Universite INSERMInstitut Pierre Louis d’Epidemiologie et de Sante PubliqueF75012ParisFrance

In the European Union,mass vaccination against COVID-19 staved off the strict restrictions that had characterized early epidemic ***,vaccination campaigns are focusing on booster doses,and primary vaccinations have all but ***,52 million European adults are *** investigated if reaching the still unvaccinated population in future vaccination campaigns would substantially decrease the current burden of COVID-19,which is *** focused on vaccination homophily,whereby those who are unvaccinated are mostly in contact with other unvaccinated,making COVID-19 circulation *** quantified vaccination homophily and estimated its impact on COVID-19 *** used an online survey of 1,055,286 people from 22 European countries during early *** computed vaccination homophily as the association between reported vaccination status and perceived vaccination uptake among one's own social contacts,using a case-referent design and a hierarchical logistic *** used this information in an analysis of the COVID-19 reproduction ratio to determine the impact of vaccine homophily in *** homophily was present and strong everywhere:the average odds ratio of being vaccinated for a 10-percentage-point increase in coverage among contacts was 1.66(95%CI=(1.60,1.72)).homophily was positively associated with the strictness of COVID-19-related restrictions in 2020(Pearson=0.49,P=.03).In the countries studied,12%-to-18%of the reproduction ratio would be attributable to vaccine *** vaccination homophily may curb the reproduction ratio substantially even to the point of preventing recurrent epidemic *** addition to boosting those already vaccinated,increasing primary vaccination should remain a high priority in future vaccination campaigns,to reduce vaccination homophily:this combined strategy may decrease COVID-19 burden.

关键词： COVID-19 Vaccination campaign Reproduction ratio Vaccination homophily Survey Europe

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Application of novel constrained friction processing method to produce fine grained biomedical Mg-Zn-Ca alloy

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Journal of Magnesium and Alloys 2024年第2期12卷 516-529页

作者： Ting Chen Banglong Fu Junjun Shen Uceu F.h.R.Suhuddin Björn Wiese Yuanding huang Min Wang Jorge F.dos Santos Jean pierre Bergmann Benjamin Klusemann Solid State Materials Processing Institute of Material MechanicsHelmholtz-Zentrum HereonMax-Planck-Str.1Geesthacht 21502Germany Functional Magnesium Materials Institute of Metallic BiomaterialsHelmholtz-Zentrum HereonMax-Planck-Str.1Geesthacht 21502Germany Shanghai Key Laboratory of Materials Laser Processing and Modification Shanghai Jiao Tong UniversityDongchuan Road 800Shanghai 200240China Applied Materials and Manufacturing Energy and Environment DivisionPacific Northwest National LaboratoryPO Box 999RichlandWA 99352USA Production Technology Group Technisiche Universität IlmenauGustav-Kirchhoff-Platz 2Ilmenau 98693Germany Institute for Production Technology and Systems Leuphana University of LüneburgUniversitätsallee 1Lüneburg 21335Germany

In order to obtain Mg alloys with fine microstructures and high mechanical performances,a novel friction-based processing method,name as“constrained friction processing(CFP)”,was *** CFP,defect-free Mg-Zn-Ca rods with greatly refined grains and high mechanical properties were *** to the previous as-cast microstructure,the grain size was reduced from more than 1 mm to around 4μm within 3 s by a single process *** compressive yield strength was increased by 350%while the ultimate compressive strength by 53%.According to the established material flow behaviors by“tracer material”,the plastic material was transported by shear *** the base material to the rod,the material experienced three stages,*** by the tool,upward flow with additional tilt,followed by upward *** microstructural evolution was revealed by“stop-action”*** microstructural development at regions adjacent to the rod is mainly controlled by twinning,dynamic recrystallization(DRX)as well as particle stimulated nucleation,while that within the rod is related to DRX combined with grain growth.

关键词： Constrained friction processing Magnesium alloys Microstructure Mechanical properties Grain refinement Plastic deformation

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Room-Temperature Electroreductiveα-Alkylation of N-heteroarenes with Styrenes

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CCS Chemistry 2024年第2期6卷 342-352页

作者： Maorui Wang Chengqian Zhang he Zhao huanfeng Jiang pierre hDixneuf Min Zhang Key Lab of Functional Molecular Engineering of Guangdong Province School of Chemistry and Chemical EngineeringSouth China University of TechnologyGuangzhou 510641 ISCR UMR CNRS 6226 Univ.RennesRennes 35000

Despite their interesting applications,direct and diverse syntheses of aryl-fused 2-alkyl cyclic amines still remain ***,the concept of incorporating a C–C coupling process into the N-heteroaryl reduction was successfully applied to fulfill such a synthetic *** to our use of controllable electroreduction coupled with proton abstraction,we can report a room-temperature reductiveα-alkylation of the inert N-heteroarenes with abundantly available styrenes in an undivided Zn(+)/C(−)*** proceeds with good substrate compatibility and operational simplicity,utilizes cost-effective sacrificial Zn-anode,exhibits high selectivity,and does not need pressurized h2 gas and transition-metal *** current work offers a useful platform for direct construction of valuable aryl-fused 2-alkyl cyclic amines that are difficult to access with conventional methods.

关键词： electroreductive C-C cross-coupling N-heteroarenes styrenes 2-alkyl cyclic amines alkylation

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An ethically guided preclinical device for phenotyping h_(2)production in laboratory rodents

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Animal Models and Experimental Medicine 2024年第4期7卷 553-561页

作者： Victor Pascal-Moussellard Emilie Boucher Stéphane Tanguy Philippe Cinquin pierre-Alain Barraud ChloéDavin Cordélia Salomez-Ihl Dalil hannani François Boucher Jean-pierre Alcaraz University Grenoble Alpes CNRSUMR 5525VetAgro SupGrenoble INPTIMCGrenobleFrance

Background:Dihydrogen(h_(2))is produced endogenously by the intestinal microbiota through the fermentation of diet *** the past few years,numer-ous studies have demonstrated the significant therapeutic potential of h_(2)in various pathophysiological contexts,making the characterization of its production in labora-tory species of major preclinical ***:This study proposes an innovative solution to accurately monitor h_(2)pro-duction in free-moving rodents while respecting animal welfare *** devel-oped device consisted of a wire rodent cage placed inside an airtight chamber in which the air quality was maintained,and the h_(2)concentration was continuously *** the airtightness and efficiency of the systems used to control and maintain air quality in the chamber were checked,tests were carried out on rats and mice with different metabolic phenotypes,over 12 min to 1-h experiments and repeatedly.h_(2)production rates(hPR)were obtained using an easy calculation algorithm based on a first-order moving ***:hPR in hyperphagic Zucker rats was found to be twice as high as in control Wistar rats,respectively,2.64 and 1.27 nmol.s^(−1)per *** addition,the ingestion of inulin,a dietary fiber,stimulated h_(2)production in *** were 0.46 nmol.s^(−1)for animals under control diet and 1.99 nmol.s^(−1)for animals under inulin ***:The proposed device coupled with our algorithm enables fine analysis of the metabolic phenotype of laboratory rats or mice with regard to their endogenous h_(2)production.

关键词： hydrogen therapy laboratory rodents microbiota molecular hydrogen noninvasive monitoring device

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Neonatal Intestinal Obstruction in Acute Renal Failure in Premature Infant: A Case Report

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Open Journal of Pediatrics 2024年第2期14卷 338-343页

作者： Ondima Lucienne Irène Patricia Okiemy Niendet Cardinale Princilia Gandzali-Ngabe pierre Eric Caryne Mboutol-Mandavo Bosseba Missengui Rhodia hélène Akobande Nuptia Erica Department of Paediatric Surgery CHU Brazzaville Brazzaville Congo Faculty of health Sciences Marien Ngouabi University Brazzaville Congo Department of Nephrology and Dialysis Brazzaville University Hospital Brazzaville Congo

Introduction: Intestinal obstruction is a common cause of abdominal surgery in the neonate. Diagnosis is straightforward using standard radiology, and surgical technique depends on the underlying anatomical lesion. Peritoneal dialysis (PD) is an effective, albeit invasive, therapy for neonatal renal failure. We report a case of neonatal obstruction with severe renal failure treated by PD to highlight our hospital practice and possible remedies in a context of limited resources. Case Presentation: This was a female neonate of moderate prematurity admitted on day 4 of life for management of a flat neonatal obstruction. Radiological diagnosis suggested small bowel atresia. Biological tests revealed severe renal failure with creatinine levels of 416 micromoles per liter and blood urea of 27.1 micromoles per liter. Management consisted of preoperative peritoneal dialysis for 48 hours followed by laparotomy. The intraoperative diagnosis was GROSFELD type IIIa digestive atresia. The postoperative course was favourable, transit was resumed on day 5 and the patient returned home on day 12. Progress at 3 months was satisfactory. Conclusion: Neonatal intestinal obstruction with renal failure in premature infants is associated with a poor prognosis, even more so if there is a delay in treatment. Peritoneal dialysis seems to be a suitable alternative for this management in our working conditions with limited resources.

关键词： Neonate Occlusion Peritoneal Dialysis Case Report

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