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Acute left-sided malignant colonic obstruction:Is there a role for endoscopic stenting?

World Journal of Clinical Oncology 2023年第5期14卷 190-197页

作者： Salvatore Russo Rita Conigliaro Francesca Coppini Emanuela Dell'Aquila Giuseppe Grande Flavia Pigò santi mangiafico Marinella Lupo Margherita Marocchi Helga Bertani Silvia Cocca Gastroenterology and Digestive Endoscopy Unit Modena University HospitalModena 41126Italy Gastroenterology and Digestive Endoscopy Unit Azienda USLIRCCs di Reggio EmiliaReggio Emilia 42122Italy Medical Oncology 1 IRCCS Regina Elena National Cancer InstituteRome 0144Italy

The therapy of left-sided malignant colonic obstruction continues to be one of the largest problems in clinical *** studies on colonic stenting for neoplastic colonic obstruction have been reported in the last *** the role of self-expandable metal stents(SEMS)in the treatment of malignant colonic obstruction has become better ***,numerous prospective and retrospective investigations have highlighted serious concerns about a possible worse outcome after endoscopic colorectal stenting as a bridge to surgery,particularly in case of *** review analyzes the most recent evidence in order to highlight pros and cons of SEMS placement in left-sided malignant colonic obstruction.

关键词： Colorectal neoplasm Intestinal obstruction Endoscopy Self expandable metallic stents Colorectal surgery Chemotherapy

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Dilation assisted stone extraction for complex biliary lithiasis:Technical aspects and practical principles

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World Journal of Gastrointestinal Endoscopy 2021年第2期13卷 33-44页

作者： Giuseppe Grande Silvia Cocca Helga Bertani Angelo Caruso Flavia Pigo' santi mangiafico Salvatore Russo Marinella Lupo Graziella Masciangelo Paolo Cantu' Raffaele Manta Rita Conigliaro Gastroenterology and Digestive Endoscopy Unit Azienda Ospedaliero Universitaria di ModenaModena 41126Italy Gastroenterology and Endoscopy Unit Department of Pathophysiology and TransplantationFondazione IRCCS Ca’GrandaOspedale Maggiore Policlinico and Universitàdegli Studi di MilanoMilano 20122Italy Gastroenterology and Digestive Endoscopy Unit General Hospital of PerugiaPerugia 06129Italy

Common bile duct stones are frequently diagnosed worldwide and are one of the main indications for endoscopic retrograde *** sphincterotomy(EST)has been used for the removal of bile duct stones for the past 40 years,providing a wide opening to allow *** to 15%of patients present with complicated *** this context,additional therapeutic approaches have been proposed such as endoscopic mechanical lithotripsy,intraductal or extracorporeal lithotripsy,or endoscopic papillary large balloon dilation(EPLBD).EPLBD combined with EST was introduced in 2003 to facilitate the passage of large or multiple bile duct stones using a balloon greater than 12 mm in *** without EST was introduced as a simplified technique in ***-assisted stone extraction(DASE)is the combination of two techniques:EPLBD and sub-maximal *** studies have reported this technique as safe and effective in patients with large bile duct stones,without any increased risk of adverse events such as pancreatitis,bleeding,or ***,it is difficult to analyze the outcomes of DASE because there are no standard techniques and definitions between *** purpose of this paper is to provide technical guidance and specific information about the main issues regarding DASE,based on current literature and daily clinical experience in biliary referral centers.

关键词： Dilation-assisted stone extraction Endoscopic papillary large balloon dilation Macrolithiasis Difficult choledochiolithiasis Stone treatment Common bile duct stones Endoscopic retrograde cholangiopancreatography

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Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy

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World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 582-592页

作者： Helga Bertani Marzio Frazzoni santi mangiafico Angelo Caruso Mauro Manno Vincenzo Giorgio Mirante Flavia Pigò Carmelo Barbera Raffaele Manta Rita Conigliaro Digestive Endoscopy Unit Baggiovara Hospital Digestive Pathophysiology Unit Baggiovara Hospital

In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neoplastic disease at early stage, thus the diagnosis of cholangiocarcinoma is achieved usually at unresectable stage. In the last decades the role of endoscopy has moved from a diagnostic role to an invaluable therapeutic tool for patients affected by malignant bile duct obstruction. One of the major issues for cholangiocarcinoma is bile ducts occlusion, leading to jaundice, cholangitis and hepatic failure. Currently, endoscopy has a key role in the work up of cholangiocarcinoma, both in patients amenable to surgical intervention as well as in those unfit for surgery or not amenable to immediate surgical curative resection owing to locally advanced or advanced disease, with palliative intention. Endoscopy allows successful biliary drainage and stenting in more than 90% of patients with malignant bile duct obstruction, and allows rapid reduction of jaundice decreasing the risk of biliary sepsis. When biliary drainage and stenting cannot be achieved with endoscopy alone, endoscopic ultrasound-guided biliary drainage represents an effective alternative method affording successful biliary drainage in more than 80% of cases. The purpose of this review is to focus on the currently available endoscopic management options in patients with cholangiocarcinoma.

关键词： Cholangiocarcinoma Malignant bile ductobstruction Interventional endoscopy Endoscopictherapy Self-expandable metal stent

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