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Metal stents placement for refractory pancreatic duct stricture in children

World Journal of Gastroenterology 2018年第3期24卷 408-414页

作者： In Sook Jeong Sung hee Lee seak hee oh Do Hyun Park Kyung Mo Kim Department of Pediatrics University of Ulsan College of MedicineAsan Medical Center Children’s Hospital Department of Internal Medicine University of Ulsan College of MedicineAsan Medical Center

AIM To evaluate the use of fully covered self-expandable metal stents(FCSEMSs) for pancreatic duct strictures in children with chronic *** Eight patients with refractory benign dominant stricture of the main pancreatic duct(MPD) were enrolled through chart reviews between December 2014 and June 2017 in a single center. Endoscopic retrograde cholangiopancreatography(ERCP) with placement of a 6-mm FCSEMS with dual flaps was performed. Endoscopic removal of FCSEMSs was performed with a snare or rat-tooth forceps. All procedures were performed by a pediatric gastroenterologist. For the assessment of outcomes, technical and clinical success, adverse events, and stent patency were evaluated *** The placement and removal of the FCSEMSs were successful in all 8 patients. Five patients were boys and 3 were girls. The median age at initial FCSEMS placement was 12 years(range, 5-18 years). The diameters of all the inserted stents were 6 mm, and the lengths were 4-7 cm. The median indwelling time was 6 mo(range, 3-10 mo). No pancreatic sepsis, pancreatitis, cholestasis, or mortality occurred. There was no proximal and distal migration. All subjects showed a patent stent. On follow-up ERCP, the mean diameter of the stricture improved from 1.1 mm to 2.8 mm(P < 0.05), whereas that of upstream dilation improved from 8.4 mm to 6.3 mm(P < 0.05).CONCLUSION This initial experience showed that temporary FCSEMS placement is feasible and safe for the management of refractory benign MPD stricture in children.

关键词： Chronic pancreatitis Pancreatic duct Selfexpandable metal stent Child Endoscopic retrograde cholangiopancreatography

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Endoscopic cyanoacrylate injection for the treatment of gastric varices in children

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World Journal of Gastroenterology 2015年第9期21卷 2719-2724页

作者： seak hee oh Seung Jin Kim Kang Won Rhee Kyung Mo Kim Department of Pediatrics Asan Medical Center Children’s HospitalUniversity of Ulsan College of MedicineSeoul 138-736South Korea

AIM:To evaluate the efficacy and safety of N-butyl-2-cyanoacrylate in treating acute bleeding of gastric varices in ***:The retrospective study included 21 children with 47 episodes of active gastric variceal bleeding who were treated by endoscopic injection of N-butyl-2-cyanoacrylate at Asan Medical Center Children's Hospital between August 2004 and December *** reduce the risk of embolism,each injection consisted of 0.1-0.5 mL of 0.5 mL N-butyl-2-cyanoacrylate diluted with 0.5 or 0.8 mL *** primary outcome was incidence of hemostasis after variceal obliteration and the secondary outcome was complication of the ***:The 21 patients experienced 47 episodes of active gastric variceal bleeding,including rebleeding,for which they received a total of 52 cyanoacrylate *** 42 bleeding episodes,hemostasis was achieved after one injection and following five bleeding episodes it was achieved after two *** mean volume of each single aliquot of cyanoacrylate injected was 0.3 ± 0.1 mL(range:0.1-0.5 m L).Injection achieved hemostasis in 45 of 47(95.7%) episodes of acute gastric variceal *** patients(52.4%) developed rebleeding events,with the mean duration of hemostasis being 11.1 ± 11.6 mo(range:1.0-39.2 mo).No treatment-related complications such as distal embolism were noted with the exception of abdominal pain in one patient(4.8%).Among four mortalities,one patient died of variceal ***:Endoscopic variceal obliteration using a small volume of aliquots with repeated cyanoacrylate injection was an effective and safe option for the treatment of gastric varices in children.

关键词： Cyanoacrylate Gastric varix Children Endoscopic va

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Cholangiographic characteristics of common bile duct dilatation in children

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World Journal of Gastroenterology 2015年第20期21卷 6229-6235页

作者： seak hee oh Soo-hee Chang Hyun Jin Kim Jin Min Cho Ji-hee Hwang Jung-Man Namgoong Dae Yeon Kim Young-Ah Cho Chong Hyun Yoon Kyung Mo Kim Department of Pediatrics Asan Medical Center Children’s HospitalUniversity of Ulsan College of Medicine Department of Pediatric Surgery Asan Medical Center Children’s HospitalUniversity of Ulsan College of Medicine Department of Pediatric Radiology Asan Medical Center Children’s HospitalUniversity of Ulsan College of Medicine

AIM: To investigate whether children with congenital common bile duct dilatation(CBDD) differ from children with obstructive CBDD in cholangiographic ***: In this retrospective cohort study, the baseline data and the results of imaging analyses were reviewed among children who had endoscopic retrograde cholangiopancreatography(ERCP) due to CBDD. ERCP was performed on all pediatric patients by experienced pediatric endoscopists. The maximal transverse diameter of the common bile duct(CBD) was measured on ERCP. To assess whether ageadjusted CBDD could be used for differential diagnosis, a CBDD severity index(SI) was calculated by dividing the measured CBD diameter by the age-corrected maximal diameter of a normal CBD. RESULTS: A retrospective medical chart review revealed that 85 consecutive children under 16 years of age with hepatobiliary disease and CBDD were referred to Seoul Asan Medical Center. Fiftyfive(64.7%) children had congenital CBDD and 30(35.3%) had obstructive CBDD. The two groups did not differ significantly in terms of clinical characteristics except for sex. The congenital and obstructive CBDD groups did not differ significantly in terms of mean CBD diameter(19.3 ± 9.6 mm vs 12.2 ± 4.1 mm, P > 0.05). However, congenital CBDD cases had a significantly higher mean SI than obstructive CBDD cases(3.62 ± 1.64 vs 1.98 ± 0.71, P = 0.01). In multivariate analysis, an SI value ≥ 2.32 and comorbidity with anomalous union of pancreaticobiliary duct(APBDU) in ERCP independently predicted congenital ***: Measuring the CBD may aid the differential diagnosis of both CBDD and APBDU in children.

关键词： Endoscopic retrograde cholangiopancreatography Common bile duct Choledochal cyst Choledolithiasis Children

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Assessment of pathogens and risk factors associated with bloodstream infection in the year after pediatric liver transplantation

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World Journal of Gastroenterology 2022年第11期28卷 1159-1171页

作者： Yeong Eun Kim Ho Jung Choi Hye-Jin Lee Hyun Ju oh Mi Kyoung Ahn seak hee oh Jung-Man Namgoong Dae Yeon Kim Won Kyoung Jhang Seong Jong Park Dong-Hwan Jung Deok Bog Moon Gi-Won Song Gil-Chun Park Tae-Yong Ha Chul-Soo Ahn Ki-Hun Kim Shin Hwang Sung Gyu Lee Kyung Mo Kim Department of Pediatrics Asan Medical Center Children's HospitalUniversity of Ulsan College of MedicineSeoul 05505South Korea Division of Pediatric Surgery Department of SurgeryAsan Medical Center Children's HospitalUniversity of Ulsan College of MedicineSeoul 05505South Korea Division of Hepatobiliary Surgery and Liver Transplantation Department of SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea

BACKGROUND Bloodstream infection(BSI)is one of the most significantly adverse events that can occur after liver transplantation(LT)in *** To analyze the profile of BSI according to the postoperative periods and assess the risk factors after pediatric *** Clinical data,collected from medical charts of children(n=378)who underwent primary LT,were retrospectively *** primary outcome considered was BSI in the first year after *** and multivariate analyses were performed to identify risk factors for BSI and respective odds ratios(ORs).RESULTS Of the examined patients,106(28%)experienced 162 episodes of pathogen-confirmed BSI during the first year after *** were 1.53±0.95 episodes per children(mean±SD)among BSIcomplicated patients with a median onset of 0.4 mo *** most common pathogenic organisms identified were Coagulase-negative staphylococci,followed by Enterococcus *** Streptococcus *** half(53%)of the BSIs were of unknown *** analysis demonstrated that young age(≤1.3 year;OR=2.1,P=0.011),growth failure(OR=2.1,P=0.045),liver support system(OR=4.2,P=0.008),and hospital stay of>44 d(OR=2.3,P=0.002)were independently associated with BSI in the year after *** BSI was frequently observed in patients after pediatric LT,affecting survival *** profile of BSI may inform clinical treatment and management in high-risk children after LT.

关键词： Bloodstream infection Liver transplantation Children Pathogens

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