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World Journal of Gastroenterology 2006年第11期12卷 1782-1785页

作者： Gaetano La Greca Michele Di Blasi Francesco Barbagallo Manuela Di Stefano Saverio Latteri Domenico russello Department of Surgical Sciences Transplantation and Advanced Technologies University of Catania Cannizzaro HospitalVia Messina 829-95100CataniaItaly

Acute biliary pancreatitis （ABP） is rare in childhood and endoscopic sphincterotomy should be avoided in the child due to the risk of both early and late complications but, when necessary, the optimal timing between endoscopic procedure and cholecystectomy is still uncertain, A nine years old child with acute biliary pancreatitis underwent successfull laparo-endoscopic ＂Rendez-Vous＂ procedure in which endoscopic drainage of the common bile duct and laparoscopic cholecystectomy were performed simultaneously. This is the first case reported of laparo-endoscopic RendezoVous in a child. The excellent outcome of this patient and the review of the literature concerning other available options for the treatment of such cases suggest that this procedure offers great advantages, especially in children, of reducing the required number of treatments, the risk of ineffectiveness, the number of anaesthesia, the length of hospital stay and the risk of iatrogenic morbidity.

关键词： Acute biiiary pancreatitis Gallstones ERCP Laparoscopic cholecystectomy Endoscopic sphyncterotomy

Adjusting CA19-9 values to predict malignancy in obstructive jaundice:Influence of bilirubin and C-reactive protein

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World Journal of Gastroenterology 2012年第31期18卷 4150-4155页

作者： Gaetano La Greca Maria Sofia Rosario Lombardo Saverio Latteri Agostino Ricotta Stefano Puleo Domenico russello Department of Surgical Sciences Organ Transplantation and Advanced TechnologiesUniversity of Catania95125 CataniaItaly

AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice(BJ) and malignant jaundice(MJ).METHODS:All patients admitted for obstructive jaundice,in the period 2005-2009,were prospectively enrolled in the study,obtaining a total of 102 *** admission,all patients underwent complete standard blood test examinations including C-reactive protein(CRP),bilirubin,*** were considered eligible for the study when they presented obstructive jaundice confirmed by instrumental examinations and increased serum bilirubin levels(total bilirubin > 2.0 mg/dL).The standard cut-off level for CA19-9 was 32 U/mL,whereas for CRP this was 1.5 mg/*** CA19-9 level was adjusted by dividing it by the value of serum bilirubin or by the CRP *** patients were divided into 2 groups,MJ and BJ,and after the adjustment a comparison between the 2 groups of patients was ***,specificity and positive predictive values were calculated before and after the ***:Of the 102 patients,51 were affected by BJ and 51 by *** CA19-9 levels were found in 71.7% of the *** the group of 51 BJ patients there were 29(56.9%) males and 22(43.1%) females with a median age of 66 years(range 24-96 years),whereas in the MJ group there were 24(47%) males and 27(53%) females,with a mean age of 70 years(range 30-92 years).Pathologic CA19-9 serum level was found in 82.3% of *** levels were pathologic in 66.6% of the patients with BJ and in 49% with *** and CA19-9 average levels were significantly higher in MJ compared with BJ(P = 0.000 and P = 0.02),while the CRP level was significantly higher in BJ(P = 0.000).Considering a CA19-9 cut-off level of 32 U/mL,82.3% in the MJ group and 54.9% in the BJ group were positive for CA19-9(P = 0.002).A CA19-9 cut-off of 100 U/mL increases the difference between the two groups:35.3% in BJ and 68.6% in MJ(P = 0.0007).Adjusting the CA1

关键词： Tumor marker CA19-9 C-reactive protein Bilirubin Pancreato-biliary malignancy Biliary stones

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective,safe and simplifies the endoscopist’s work

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World Journal of Gastroenterology 2008年第18期14卷 2844-2850页

作者： Gaetano La Greca Francesco Barbagallo Michele Di Blasi Andrea Chisari Rosario Lombardo Rosario Bonaccorso Saverio Latteri Andrea Di Stefano Domenico russello Department of Surgical Sciences Transplantation and Advanced Technologies University of Catania Cannizzaro Hospital Via Messina 829 Catania 95126 Italy Endoscopic Unit Cannizzaro Hospital Via Messina 829 Catania 95126 Italy

AIM: To investigate our clinical experience with combined laparo-endoscopic Rendezvous (RV) for the treatment of patients affected by gallstones and common bile duct (CBD) stones and especially to study the never evaluated opinion of the endoscopist concerning the difficulty of the intraoperative endoscopic procedure during the RV in comparison with standard endoscopic retrograde cholangio-pancreatography (ERCP). METHODS: Eighty consecutive patients affected by cholecystolithiasis and diagnosed or suspected CBD stones were treated with a standardized "tailored" RV. The relevant technical features, the feasibility, the effectiveness in stone clearance, the safety but also the simple evaluation of difficulty and agreement of the endoscopist were analyzed with a questionnaire. RESULTS: The feasibility was 97.5% and the effectiveness 100% concerning CBD clearance and solution of coexisting problems at the papilla. Minor morbidity was 3.3%, the operating time was prolonged by a mean of 14 min, the mean hospital stay was 3.8 d and only one stone’s recurrence occurred. The endoscopist evaluated the procedure to be simpler than standard ERCP-ES in 81.2% of the ***: Simultaneous RV carries higheffectiveness and safety at least comparable to those reported for other options. The endoscopist is very often satisfied with this approach because of the minimization of some steps of the endoscopic procedure and avoidance of relevant iatrogenic risk factors. If the mandatory collaboration between surgeons and endoscopists is guaranteed, this approach can often be preferable for the patient, the surgeon, the endoscopist and the hospital.

关键词： Gallstones Common bile duct Endoscopic retrograde cholangio-pancreatography Endoscopic sphincterotomy Rendezvous Intra-operative cholangiography Laparoscopic cholecystectomy

Boceprevir or telaprevir in hepatitis C virus chronic infection:The Italian real life experience

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World Journal of Hepatology 2016年第22期8卷 949-956页

作者： Antonio Ascione Luigi Elio Adinolfi Pietro Amoroso Angelo Andriulli Orlando Armignacco Tiziana Ascione Sergio Babudieri Giorgio Barbarini Michele Brogna Francesco Cesario Vincenzo Citro Ernesto Claar Raffaele Cozzolongo Giuseppe D’Adamo Emilio D’Amico Pellegrino Dattolo Massimo De Luca Vincenzo De Maria Massimo De Siena Giuseppe De Vita Antonio Di Giacomo Rosanna De Marco Giorgio De Stefano Giulio De Stefano Sebastiano Di Salvo Raffaele Di Sarno Nunzia Farella Laura Felicioni Basilio Fimiani Luca Fontanella Giuseppe Foti Caterina Furlan Francesca Giancotti Giancarlo Giolitto Tiziana Gravina Barbara Guerrera Roberto Gulminetti Angelo Iacobellis Michele Imparato Angelo Iodice Vincenzo Iovinella Antonio Izzi Alfonso Liberti Pietro Leo Gennaro Lettieri Ileana Luppino Aldo Marrone Ettore Mazzoni Vincenzo Messina Roberto Monarca Vincenzo Narciso Lorenzo Nosotti Adriano Maria Pellicelli Alessandro Perrella Guido Piai Antonio Picardi Paola Pierri Grazia Pietromatera Francesco Resta Luca Rinaldi Mario Romano Angelo Rossini maurizio russello Grazia Russo Rodolfo Sacco Vincenzo Sangiovanni Antonio Schiano Antonio Sciambra Gaetano Scifo Filomena Simeone Annarita Sullo Pierluigi Tarquini Paolo Tundo Alfredo Vallone Depart-ment of Medicine Center for Liver Diseases "Buon Consiglio" -Fatebenefratelli Hospital Internal Medicine Unit Second University of Naples VI Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Division of Gastro- enterology Casa Sollievo Sofferenza Hospital IRCCS Division of Infectious Diseases Belcolle Hospital IX Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Clinical of Infectious Disease University of Sassari Infectious Disease IRCCS San Matteo Division of Infectious Diseases and Liver Unit "G. Iazzolino" Hospital Division of Infectious Diseases "Annunziata" Hospital Depart-ment of Internal Medicine Umberto I Hospital Internal Medicine Ospedale Evangelico Villa Betania Division of Gastroenterology IRCCS "S.de Bellis" Hospital Internal Medicine Unit Pescara-Penne Hospital Gastroenterology Unit Marcianise Hospital Liver Unit AORN Cardarelli Liver Unit Policlinico "Mater Domini" Service of Medical Day Hospital "Rummo" Hospital Internal Medicine Regina Margherita Hospital Division of Gastroenterology "Annunziata" Hospital Infectious Disease Matera Hospital First Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Division of Infectious Diseases AO Melacrino- Bianchi-Morelli Infectious and Tropical Disease Policlinico Umberto I Division of Infectious Disease Maria SS Addolorata Hospital Division of Infectious Diseases S. Anna and S. Sebastiano Hospital Outpatients Service for Liver Diseases "Loreto Crispi" Hospital V Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Department of Medical Surgical Neurological Geriatric and Metabolic Sciences Second Univer-sity of Naples Liver Unit Policlinico Casilino Medicine and Health Unit for Prisoners Belcolle Hospital Internal Medicine Unit "Ascalesi" Hospital Gastrointestinal and Liver Department National Institute for Health Migration and Poverty Liver Unit Azienda Ospedaliera San Camillo Forlanini VII Division of Infectious Diseases

AIM: To check the safety and efficacy of boceprevir/telaprevir with peginterferon/ribavirin for hepatitis C virus(HCV) genotype 1 in the real-world settings. METHODS: This study was a non-randomized, observational, prospective, multicenter. This study involved 47 centers in Italy. A database was prepared for the homogenous collection of the data, was used by all of the centers for data collection, and was updated continuously. All of the patients enrolled in this study were older than 18 years of age and were diagnosed with chronic infection due to HCV genotype 1. The HCV RNA testing was performed using COBAS-Taq Man2.0(Roche, LLQ 25 IU/m L). RESULTS: All consecutively treated patients were included. Forty-seven centers enrolled 834 patients as follows: Male 64%; median age 57(range 18-78), of whom 18.3% were over 65; mean body mass index 25.6(range 16-39); genotype 1b(79.4%); diagnosis of cirrhosis(38.2%); and fibrosis F3/4(71.2%). The following drugs were used: Telaprevir(66.2%) and PEG-IFN-alpha2a(67.6%). Patients were na?ve(24.4%), relapsers(30.5%), partial responders(14.8%) and null responders(30.3%). Overall, adverse events(AEs) occurred in 617 patients(73.9%) during the treatment. Anemia was the most frequent AE(52.9% of cases), especially in cirrhotic. The therapy was stopped for 14.6% of the patients because of adverse events or virological failure(15%). Sustained virological response was achieved in 62.7% of the cases, but was 43.8% in cirrhotic patients over 65 years of age. CONCLUSION: In everyday practice, triple therapy is safe but has moderate efficacy, especially for patients over 65 years of age, with advanced fibrosis, nonresponders to peginterferon + ribavirin.

关键词： Boceprevir Telaprevir Chronic hepatitis Antiviral therapy Peg-interferon Ribavirin