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Ligation-assisted endoscopic mucosal resection of gastric heterotopic pancreas

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World Journal of Gastroenterology 2009年第22期15卷 2805-2808页

作者： mouen a khashab Oscar W Cummings John M DeWitt Division of Gastroenterology and Hepatology Department of MedicineIndiana University School of Medicine Department of Pathology Indiana University School of Medicine

Heterotopic pancreas is a congenital anomaly characterized by ectopic pancreatic *** of heterotopic pancreas may include expectant observation,endoscopic resection or *** aim of this report was to describe the technique of ligation-assisted endoscopic mucosal resection(EMR) for resection of heterotopic pancreas of the *** patients(both female,mean age 32 years) were referred for management of gastric subepithelial *** ultrasound in both disclosed small hypoechoic masses in the mucosa and *** ligation-assisted EMR was performed in both cases without *** from the resected tumors revealed heterotopic pancreas arising from the *** were free of pancreatic ***-assisted EMR is technically feasible and may be considered for the endoscopic management of heterotopic pancreas.

关键词： Endoscopic mucosal resection Endoscopic ultrasound Heterotopic pancreas

Current endoscopic approach to indeterminate biliary strictures

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World Journal of Gastroenterology 2012年第43期18卷 6197-6205页

作者： David W Victor Stuart Sherman Tarkan Karakan mouen a khashab Department of Medicine Johns Hopkins Hospital Baltimore MD 21287 United States Department of Medicine Indiana University School of Medicine Indianapolis IN 46202 United States Department of Medicine Gazi University 06710 Ankara Turkey

Biliary strictures are considered indeterminate when basic work-up, including transabdominal imaging and endoscopic retrograde cholangiopancreatography with routine cytologic brushing, are non-diagnostic. Indeterminate biliary strictures can easily be mischaracterized which may dramatically affect patient's outcome. Early and accurate diagnosis of malignancy impacts not only a patient's candidacy for surgery, but also potential timely targeted chemotherapies. A significant portion of patients with indeterminate biliary strictures have benign disease and accurate diagnosis is, thus, paramount to avoid unnecessary surgery. Current sampling strategies have suboptimal accuracy for the diagnosis of malignancy. Emerging data on other diagnostic modalities, such as ancillary cytology techniques, single operator cholangioscopy, and endoscopic ultrasonography-guided fine needle aspiration, revealed promising results with much improved sensitivity.

关键词： Indeterminate stricture Bile duct Single operator cholangioscope Cholangioscopy Endoscopic ultrasound Endoscopic retrograde cholangiopancrea-tography Bile duct stricture Indeterminate biliary stricture Confocal microscopy Transpapillary biopsy Cholangiocarcinoma Primary sclerosing cholangitis Spyglass

Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis: A review of the literature

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World Journal of Gastrointestinal Surgery 2019年第2期11卷 53-61页

作者： Benedetto Mangiavillano mouen a khashab Ilaria Tarantino Silvia Carrara Rossella Semeraro Francesco Auriemma Mario Bianchetti Leonardo Henry Eusebi Chen Yen-I Luca De Luca Mario Traina Alessandro Repici Gastrointestinal Endoscopy Unit Humanitas-Mater Domini Humanitas Huniversity Division of Gastroenterology and Hepatology Johns Hopkins Hospital Gastroenterology and Endoscopy Unit Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) Digestive Endoscopy Unit Division of Gastroenterology Humanitas Clinical and Research Center IRCCS Digestive Endoscopy Unit Istituto Clinico Humanitas Research Hospital Unit of Gastroenterology Department of Medical and Surgical Sciences S. Orsola-Malpighi Hospital University of Bologna Gastroenterology and Digestive Endoscopy Unit Ospedali Riuniti Marche Nord Digestive Endoscopy Unit Division of Gastroenterology Humanitas Research Hospital

Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary, peri-ampullary, and pancreatic head neoplasia. Surgical bypass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique, with a high technical success in expert hands. In recent years, endoscopic ultrasonography(EUS) has evolved from a diagnostic to a therapeutic procedure, and is now increasingly used to guide biliary drainage, especially in cases of failed endoscopic retrograde cholangiopancreatography(ERCP). The advent of lumen-apposing metal stents(LAMS) has expanded EUS therapeutic options, and changed the management of synchronous bilioduodenal stenosis. The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach, also considering the advent of an interventional EUS approach using LAMS.

关键词： Malignant biliary strictures Malignant duodenal stenosis Bilio-duodenal stenosis Biliary self-expandable metal stent Duodenal self-expandable metal stent Lumen-apposing metal stents Gastro-jejunostomy

Consensus on the digestive endoscopic tunnel technique

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World Journal of Gastroenterology 2019年第7期25卷 744-776页

作者： Ning-Li Chai Hui-Kai Li En-Qiang Linghu Zhao-Shen Li Shu-Tian Zhang Yu Bao Wei-Gang Chen Philip WY Chiu Tong Dang Wei Gong Shu-Tang Han Jian-Yu Hao Shui-Xiang He Bing Hu1 Bing Hu2 Xiao-Jun Huang Yong-Hui Huang Zhen-Dong Jin mouen a khashab James Lau Peng Li Rui Li De-Liang Liu Hai-Feng Liu Jun Liu Xiao-Gang Liu Zhi-Guo Liu Ying-Cai Ma Gui-Yong Peng Long Rong Wei-Hong Sha Pateek Sharma Jian-Qiu Sheng Shui-Sheng Shi Dong Wan Seo Si-Yu Sun Gui-Qi Wang Wen Wang Qi Wu Hong Xu Mei-Dong Xu Ai-Ming Yang Fang Yao Hong-Gang Yu Ping-Hong Zhou Bin Zhang Xiao-Feng Zhang Ya-Qi Zhai Department of Gastroenterology and Hepatology Chinese PLA General HospitalBeijing 100853China Department of Gastroenterology Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Department of Gastroenterology the First Affiliated Hospital of Xi’an Jiao Tong UniversityXi’an 710000Shaanxi ProvinceChina Department of Gastroenterology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Endoscopy Eastern Hepatobiliary Surgical Hospital Affiliated to Naval Medical UniversityShanghai 200438China Department of Gastroenterology the Second Hospital of Lanzhou UniversityLanzhou 730030Gansu ProvinceChina Department of Gastroenterology Peking University Third HospitalBeijing 100191China Division of Gastroenterology and Hepatology the Johns Hopkins University School of MedicineBaltimoreMD 21218United States Department of Gastrointestinal Endoscopy Prince of Wales Hospitalthe Chinese University of Hong KongHong KongChina Department of Gastroenterology the First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina Department of Gastroenterology Second Xiangya Hospital of Central South UniversityChangsha 410000Hunan ProvinceChina Department of Gastroenterology Changhai HospitalNaval Medical UniversityShanghai 200433China Department of Gastroenterology General Hospital of Chinese People’s Armed Police ForcesBeijing 100039China Division of Gastroenterology Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022Hubei ProvinceChina Department of Gastroenterology Sichuan Provincial People’s HospitalChengdu 610072Sichuan ProvinceChina Department of Gastroenterology Xijing HospitalAir Force Medical UniversityXi’an 710032Shaanxi ProvinceChina Department of Digestion Qinghai Provincial People’s HospitalXining 810007Qinghai ProvinceChina Department of Gastroenterology Southwest HospitalArmy Medical UniversityChongqing 400038China Department of Gastroenterology Peking Univ

With the digestive endoscopic tunnel technique(DETT), many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and muscularis propria(MP). Through the tunnel, endoscopic diagnosis or treatment is performed for lesions in the mucosa, in the MP, and even outside the gastrointestinal(GI) *** present, the tunnel technique application range covers the following:(1)Treatment of lesions originating from the mucosal layer, e.g., endoscopic submucosal tunnel dissection for oesophageal large or circular early-stage cancer or precancerosis;(2) treatment of lesions from the MP layer, per-oral endoscopic myotomy, submucosal tunnelling endoscopic resection, etc.; and(3) diagnosis and treatment of lesions outside the GI tract, such as resection of lymph nodes and benign tumour excision in the mediastinum or abdominal cavity. With the increasing number of DETTs performed worldwide, endoscopic tunnel therapeutics, which is based on DETT, has been gradually developed and optimized. However, there is not yet an expert consensus on DETT to regulate its indications, contraindications, surgical procedure, and postoperative *** International DETT Alliance signed up this consensus to standardize the procedures of DETT. In this consensus, we describe the definition, mechanism,and significance of DETT, prevention of infection and concepts of DETTassociated complications, methods to establish a submucosal tunnel, and application of DETT for lesions in the mucosa, in the MP and outside the GI tract(indications and contraindications, procedures, pre-and postoperative treatments, effectiveness, complications and treatments, and a comparison between DETT and other operations).

关键词： Digestive endoscopic tunnel technique Endoscopic submucosal tunnel dissection Per-oral endoscopic myotomy Submucosal tunnelling endoscopic resection Gastrointestinal tract