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Pancreatic stent improves the success rate of needle-knife papillotomy in patients with difficult biliary cannulation

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World Journal of Gastroenterology 2025年第1期31卷 58-67页

作者： Mu-Hsien Lee Cheng-Hui Lin Chi-Huan Wu Yung-Kuan Tsou kai-feng sung Sheng-Fu Wang Nai-Jen Liu Department of Gastroenterology and Hepatology Chang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuan 33305Taiwan School of Medicine Chang Gung UniversityTaoyuan 33305Taiwan

BACKGROUND Needle-knife precut papillotomy(NKP)is typically performed ***,it remains unclear whether pancreatic stent(PS)placement can improve the outcomes of *** To explore whether PS placement improves the success rate of NKP in patients with difficult biliary *** This single-center retrospective study included 190 patients who underwent NKP between January 2017 and December 2021 after failed conventional biliary *** cases with incidental pancreatic duct cannulation during conventional biliary cannulation,the decision for pre-NKP PS placement was made at the endoscopist's *** primary outcome was the difference in the NKP success rate between patients with and without PS placement;the secondary outcome was the adverse event *** Among the 190 participants,82 received pre-NKP PS(PS-NKP group)whereas 108 did not[freehand or freehand NKP(FH-NKP)group].Post-NKP selective biliary cannulation was successful in 167(87.9%)patients,and the PS-NKP had a significantly higher success rate than the FH-NKP group(93.9%vs 83.3%,P=0.027).The overall adverse event rates were 7.3%and 11.1%in the PS-NKP and FH-NKP groups,respectively(P=0.493).A periampullary diverticulum(PAD)and significant intraoperative bleeding during NKP were independently associated with NKP failure;however,a pre-NKP PS was the only predictor of NKP *** the 44 participants with PADs,the PS-NKP group had a non-significantly higher NKP success rate than the FH-NKP group(87.5%and 65%,respectively;P=0.076).CONCLUSION PS significantly improved the success rate of NKP in patients with difficult biliary cannulation.

关键词： Difficult biliary cannulation Endoscopic retrograde cholangiopancreatography Needle-knife papillotomy Pancreatic stent Selective biliary cannulation

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Residual common bile duct stones on direct peroral cholangioscopy using ultraslim endoscope

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World Journal of Gastroenterology 2013年第30期19卷 4966-4972页

作者： Shu-Wei Huang Cheng-Hui Lin Mu-Shien Lee Yung-Kuan Tsou kai-feng sung Department of Gastroenterology and Hepatology Division of Digestive Therapeutic EndoscopyChang Gung Memorial HospitalChang Gung University College of Medicine

AIM:To detect and manage residual common bile duct(CBD)stones using ultraslim endoscopic peroral cholangioscopy(POC)after a negative balloon-occluded ***:From March 2011 to December 2011,a cohort of 22 patients with CBD stones who underwent both endoscopic retrograde cholangiography(ERC)and direct POC were prospectively enrolled in this *** patients who were younger than 20 years of age,pregnant,critically ill,or unable to provide informed consent for direct POC,as well as those with concomitant gallbladder stones or CBD with diameters less than 10 mm were *** POC using an ultraslim endoscope with an overtube balloon-assisted technique was carried out immediately after a negative balloon-occluded cholangiography was ***:The ultraslim endoscope was able to be advanced to the hepatic hilum or the intrahepatic bile duct(IHD)in 8 patients(36.4%),to the extrahepatic bile duct where the hilum could be visualized in 10 patients(45.5%),and to the distal CBD where the hilum could not be visualized in 4 patients(18.2%).The procedure time of the diagnostic POC was 8.2 ± 2.9 min(range,5-18 min).Residual CBD stones were found in 5(22.7%)of the *** was one residual stone each in 3 of the patients,three in 1 patient,and more than five in 1 *** diameter of the residual stones ranged from 2-5 *** 2 of the patients,the residual stones were successfully extracted using either a retrieval balloon catheter(n = 1)or a basket catheter(n = 1)under direct endoscopic *** the remaining 3 patients,the residual stones were removed using an irrigation and suction method under direct endoscopic *** were no serious procedure-related complications,such as bleeding,pancreatitis,biliary tract infection,or perforation,in this ***:Direct POC using an ultraslim endoscope appears to be a useful tool for both detecting and treating residual CBD stones after conventional ERC.

关键词： Balloon-occluded cholangiography Common bile duct stones Endoscopic retrograde cholangiography Peroral cholangioscopy Residual stones

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Predictors of re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy bleeding

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World Journal of Gastroenterology 2016年第11期22卷 3196-3201页

作者： Mu-Hsien Lee Yung-Kuan Tsou Cheng-Hui Lin Ching-Song Lee Nai-Jen Liu kai-feng sung Hao-Tsai Cheng Department of Gastroenterology and Hepatology Chang Gung Memorial Hospital and Chang Gung University College of Medicine

AIM: To predict the re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy(ES) ***: Over a 15-year period, data from 161 patients with delayed post-ES bleeding were retrospectively collected from a single medical center. To identify risk factors for re-bleeding after initial successful endoscopic hemostasis, parameters before, during and after the procedure of endoscopic retrograde cholangiopancreatography were analyzed. These included age, gender, blood biochemistry, comorbidities, endoscopic diagnosis, presence of periampullary diverticulum, occurrence of immediate postES bleeding, use of needle knife precut sphincterotomy, severity of delayed bleeding, endoscopic features on delayed bleeding, and type of endoscopic ***: A total of 35 patients(21.7%) had rebleeding after initial successful endoscopic hemostasis for delayed post-ES bleeding. Univariate analysis revealed that malignant biliary stricture, serum bilirubin level of greater than 10 mg/d L, initial bleeding severity, and bleeding diathesis were significant predictors of rebleeding. By multivariate analysis, serum bilirubin level of greater than 10 mg/d L and initial bleeding severity remained significant predictors. Re-bleeding was controlled by endoscopic therapy in a single(n = 23) or multiple(range, 2-7; n = 6) sessions in 29 of the 35 patients(82.9%). Four patients required transarterial embolization and one went for surgery. These five patients had severe bleeding when delayed post-ES bleeding occurred. One patient with decompensated liver cirrhosis died from ***: Re-bleeding occurs in approximately one-fifth of patients after initial successful endoscopic hemostasis for delayed post-ES bleeding. Severity of initial bleeding and serum bilirubin level of greater than 10 mg/d L are predictors of re-bleeding.

关键词： Delayed bleeding Endoscopic hemostasis Endoscopic sphincterotomy Predictors Re-bleeding

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Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity

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World Journal of Gastroenterology 2022年第38期28卷 5602-5613页

作者： Yao-Chi Huang Chi-Huan Wu Mu Hsien Lee Sheng Fu Wang Yung-Kuan Tsou Cheng-Hui Lin kai-feng sung Nai-Jen Liu Department of Medicine College of MedicineChang Gung UniversityTaoyuan 333Taiwan Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalTaoyuan 333Taiwan

BACKGROUND The optimal timing of endoscopic retrograde cholangiopancreatography(ERCP)in acute cholangitis(AC) is uncertain,especially in patients with AC of varying *** To report whether the timing of ERCP is associated with outcomes in AC patients with different *** According to the 2018 Tokyo guidelines,683 patients who met the definite diagnostic criteria for AC were retrospectively *** results were first compared between patients receiving ERCP ≤ 24 h and>24 h and then between patients receiving ERCP ≤ 48 h and>48 *** analyses were performed in patients with grade Ⅰ,Ⅱ or Ⅲ *** primary outcome was 30-d *** outcomes were intensive care unit(ICU) admission rate,length of hospital stay(LOHS) and 30-d readmission *** Taking 24 h as the critical value,compared with ERCP>24 h,malignant biliary obstruction as a cause of AC was significantly less common in the ERCP ≤ 24 h group(5.2% vs 11.5%).The proportion of cardiovascular dysfunction(11.2% vs 2.6%),respiratory dysfunction(14.2% vs 5.3%),and ICU admission(11.2% vs 4%)in the ERCP ≤ 24 h group was significantly higher,while the LOHS was significantly shorter(median,6 d vs 7 d).Stratified by the severity of AC,higher ICU admission was only observed in grade Ⅲ AC and shorter LOHS was only observed in grade Ⅰ and Ⅱ *** were no significant differences in 30-d mortality between groups,either in the overall population or in patients with grade Ⅰ,Ⅱ or Ⅲ *** 48 h as the critical value,compared with ERCP>48 h,the proportion of choledocholithiasis as the cause of AC was significantly higher in the ERCP ≤ 48 h group(81.5% vs 68.3%).The ERCP ≤ 48 h group had significantly lower 30-d mortality(0 vs 1.9%) and shorter LOHS(6 d vs 8 d).Stratified by AC severity,lower 30-d mortality(0 vs 6.1%) and higher ICU admission rates(22.2% vs 10.2%) were only observed in grade Ⅲ AC,and shorter LOHS was only observed in grade I and Ⅱ *** the multivariate analysis,cardi

关键词： Acute cholangitis Endoscopic retrograde cholangiopancreatography severity Timing Thirtyday mortality Length of hospital stay

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Achalasia combined with esophageal intramural hematoma:Case report and literature review

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World Journal of Gastroenterology 2010年第42期16卷 5391-5394页

作者： Yin-Yi Chu kai-feng sung Soh-Ching Ng Hao-Tsai Cheng Cheng-Tang Chiu Division of Gastroenterology Department of Internal MedicineShin Kong Wu Ho-Su Memorial HospitalTaipei 111TaiwanChina Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalChang Gung University College of MedicineKweishanTaoyuan 333TaiwanChina Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalChang Gung University College of Medicine KweishanTaoyuan 333TaiwanChina Department of Internal Medicine Chang Gung Memorial HospitalChang Gung University College of MedicineKeelung 204TaiwanChina

A 62-year-old male patient was admitted to our hospital due to severe chest pain,odynophagia,and *** computed tomography showed an esophageal submucosal ***(EGD) revealed a longitudinal purplish bulging tumor of the *** ultrasound(EUS) showed a mixed echoic tumor with partial liquefaction from the submucosal *** patient was diagnosed with esophageal intramural hematoma as well as achalasia by upper gastrointestinal endoscopy,esophagography and esophageal *** patient was managed conservatively with intravenous nutrition,and oral feeding was ***-up EGD and EUS showed complete recovery of the esophageal wall,and finally,the patient underwent endoscopic dilatation for *** patient was symptom free at the time when we wrote this manuscript.

关键词： Esophageal intramural hematoma Achalasia Endoscopic ultrasound

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Treating delayed endoscopic sphincterotomy-induced bleeding:Epinephrine injection with or without thermotherapy

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World Journal of Gastroenterology 2009年第38期15卷 4823-4828页

作者： Yung-Kuan Tsou Nai-Jen Liu Jui-Hsiang Tang kai-feng sung Chi-Liang Cheng Ching-Song Lee Department of Hepato-Gastroenterology Division of Therapeutic EndoscopyChang Gung Memorial Hospital & Chang Gung University College of Medicine

AIM： To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed postendoscopic sphincterotomy （ES） bleeding. METHODS： Cases with delayed post-ES bleeding undergoing epinephrine injection alone （epinephrine injection group, n = 26） or epinephrine combined with thermotherapy （combination therapy group, n = 33） in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were： initial endoscopic hemostasis, rebleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS： The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy （P = 0.44）. There were four patients with re-bleeding in each group （16.0% vs 12.1%, P = 0.72）. There was only one complication of pancreatitis from the combination therapy group. Three patients （11.5%） in the epinephrine injection group and one patient （3%） in the combination therapy group required angiographic embolization or surgery （P = 0.31）. The total number of blood transfusions was not significantly different between the two groups （3.5 ± 4.6 U vs 3.5 ± 4.5 U, P = 0.94）. There was no bleeding-related death in either group. CONCLUSION： Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post- ES bleeding.

关键词： Bleeding Endoscopic retrograde cholangiopancreatography Endoscopic sphincterotomy Epinephrine Thermotherapy

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Effect of Cu/HZSM-5 sorbents with different Si/Al ratios on the adsorption and oxidation performance of H_(2)S

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Journal of Environmental Sciences 2025年第5期151卷 161-173页

作者： kaini Ma kai Li Ping Ning Jiayu feng Jiacheng Bao Lei Shi Xiangyu Wang Xin Sun Faculty of Environmental Science and Engineering Kunming University of Science and TechnologyKunming 650500China National-Regional Engineering Center for Recovery of Waste Gases from Metallurgical and Chemical Industries Kunming University of Science and TechnologyKunming 650500China

This study employed a wet impregnation method to synthesize five types of Cu/HZSM-5 adsorbents with Si/Al ratios of 25,50,85,200,and 300,used for the removal of H_(2)S in lowtemperature,low-oxygen *** impact of different Si/Al ratios on the adsorption oxidative performance of Cu_(30)/HZSM-5–85 adsorbents was *** to the performance test results,Cu_(30)/HZSM-5–85 exhibited the highest breakthrough capacity,reaching 231.75 mg H_(2)S/g_(sorbent).Cu/HZSM-5 sorbent maintains a strong ability to remove H_(2)S even under humid conditions and shows excellent water ***,BET,and XPS results revealed that CuO is the primary active species,with Cu_(30)/HZSM-5–85 having the largest surface area and highest CuO content,providing more active sites for H_(2)S adsorption.H_(2)-TPR and O_(2)-TPD results confirmed that Cu_(30)/HZSM-5–85 sorbent exhibits outstanding redox properties and oxygen storage capacity,contributing to excellent oxygen transferability in the molecular sieve adsorption-oxidation *** notable characteristics such as a large surface area,high desulfurization efficiency,and water resistance,Cu_(30)/HZSM-5–85 sorbents hold significant importance for industrial applications.

关键词： H_(2)S Si/Al ratio Adoration-oxidation Cu/HZSM-5-85(HZSM-5 with Si/Al ratio of 85 loaded Cu)

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Poorly expandable common bile duct with stones on endoscopic retrograde cholangiography

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World Journal of Gastroenterology 2012年第19期18卷 2396-2401页

作者： Chi-Liang Cheng Yung-Kuan Tsou Cheng-Hui Lin Jui-Hsiang Tang hien-Fu Hung kai-feng sung Ching-Song Lee Nai-Jen Liu Division of Therapeutic Endoscopy Department of Gas-troenterology and Hepatology Chang Gung Memorial HospitalCollege of Medicine Chang Gung University Taoyuan 333Taiwan China Division of Radiology Department of Gastro-enterology and Hepatology College of Medicine Chang GungUniversity Taoyuan 333 Taiwan China

AIM： To describe characteristics of a poorly expandable （PE） common bile duct （CBD） with stones on en- doscopic retrograde cholangiography.METHODS： APE bile duct was characterized by a rigid and relatively narrowed distal CBD with retro- grade dilatation of the non-PE segment. Between 2003 and 2006, endoscopic retrograde cholangiography （ERC） images and chart reviews of 1213 patients with newly diagnosed CBD stones were obtained from the computer database of Therapeutic Endoscopic Centerin Chang Gung Memoria acteristic PE bile duct on Hospital. Patients with char ERC were identified from the database. Data of the patients as well as the safety and technical success of therapeutic ERC were collected and analyzed retrospectively.RESULTS： A total of 30 patients with CBD stones and characteristic PE segments were enrolled in this study. The median patient age was 45 years （range, 20 to 92 years）; 66.7% of the patients were men. The di ameters of the widest non-PE CBD segment, the PE segment, and the largest stone were 14.3 ± 4.9 mm, 5.8±1.6 mm, and 11.2±4.7 mm, respectively. The length of the PE segment was 39.7±15.4 mm （range, 12.3 mm to 70.9 mm）. To remove the CBD stone（s） completely, mechanical lithotripsy was required in 25 （83.3%） patients even though the stone size was not as large as were the difficult stones that have been described in the literature. The stone size and stone/ PE segment diameter ratio were associated with the need for lithotripsy. Post-ERC complications occurred in 4 cases： pancreatitis in 1, cholangitis in 2, and an im- pacted Dormia basket with cholangitis in 1. Two （6.7%） of the 28 patients developed recurrent CBD stones at follow-up （50±14 mo） and were successfully managed with therapeutic ERC.CONCLUSION： Patients with a PE duct frequently require mechanical lithotripsy for stones extraction, To retrieve stones successfully and avoid complications, these patients should be identified during ERC,

关键词： Common bile duct stone Difficult stone Endoscopic retrograde cholangiography Mechanicallithotripsy

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High-frequency enhanced ultrafast compressed active photography

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Opto-Electronic Advances 2025年第1期8卷 32-43页

作者： Yizhao Meng Yu Lu Pengfei Zhang Yi Liu Fei Yin Lin kai Qing Yang feng Chen State Key Laboratory for Manufacturing System Engineering and Shaanxi Key Laboratory of Photonics Technology for Information School of Electronic Science and EngineeringXi’an Jiaotong UniversityXi’an 710049China School of Mechanical Engineering Xi’an Jiaotong UniversityXi’an 710049China

Single-shot ultrafast compressed imaging(UCI)is an effective tool for studying ultrafast dynamics in physics,chemistry,or material science because of its excellent high frame rate and large frame ***,the random code(Rcode)used in traditional UCI will lead to low-frequency noise covering high-frequency information due to its uneven sampling interval,which is a great challenge in the fidelity of large-frame ***,a high-frequency enhanced compressed active photography(H-CAP)is *** uniformizing the sampling interval of R-code,H-CAP capture the ultrafast process with a random uniform sampling *** sampling mode makes the high-frequency sampling energy dominant,which greatly suppresses the low-frequency noise blurring caused by R-code and achieves high-frequency information of image *** superior dynamic performance and large-frame reconstruction ability of H-CAP are verified by imaging optical self-focusing effect and static object,*** applied H-CAP to the spatial-temporal characterization of double-pulse induced silicon surface ablation dynamics,which is performed within 220 frames in a single-shot of 300 ps.H-CAP provides a high-fidelity imaging method for observing ultrafast unrepeatable dynamic processes with large frames.

关键词： ultrafast compressed imaging high-frequency enhanced sampling spectral-temporal transform transient processes high-fidelity reconstruction

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Zircon U-Pb dating of the Shazibu Pluton in the Guocheng gold belt, Jiaolai Basin, Shandong Province: Implications for metallogeny of the Jiaodong gold province

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China Geology 2025年第1期8卷 230-232页

作者： Yuan-yuan feng Ya-dong Li An-kai Geng Liu-an Duan Da-dou Li No.1 Geological Team of Shandong Province Bureau of Geology and Mineral Resources Jinan 250100China Yantai Geological Survey Center of Coastal Zone China Geological SurveyYantai 264004China

*** Three stages of Mesozoic magmatic activity have been identified in the Jiaodong area,namely early magmatic emplacement,the magmatic emplacement prior to mineralization,and magmatic activity post-mineralization,fro... 详细信息

关键词： dating belt mineralization

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