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Esophageal duplication cysts:Endosonographic findings in asymptomatic patients

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World Journal of Gastroenterology 2012年第11期18卷 1270-1272页

作者： Anna Wiechowska-Kozlowska Ewa Wunsch Marek Majewski piotr milkiewicz Department of Endoscopy Ministry of Internal Affairs Hospital Liver Unit Pomeranian Medical University

Esophageal duplication cysts are rare inherited lesions usually diagnosed in early childhood. Most of them are found in the mediastinum and manifest themselves as separate masses along or in continuity with the native esophagus. Their prevalence remains unknown and they are treated either surgically or endoscopically. In this report we describe a series of four adult patients in whom esophageal duplication cysts were Iocalised intramurally as masses pressing on the esophageal lumen and who were diagnosed with endoscopic ultrasonography. All patients were initially referred to other centres for upper gastroduodenoscopy due to nonspecific dyspeptic symptoms. After finding suspicious lesions in the esophagus their endoscopists referred them for endoscopic ultrasound examination at our centre. In two of the cases lesions mimicked esophageal varices and the other two submucosal tumours. In all four patients endoscopic ultrasonography has shown esophageal duplication cysts. Patients had no symptoms suggesting disease of the esophagusand required no treatment. As the true prevalence of esophageal cysts is unknown, it is very likely that in many patients, like in these four described by us, they may cause no symptoms, remain undetected and require no intervention. Increasing availability of new diagnostic modalities such as endoscopic ultrasonography may change the current view regarding the prevalence of esophageal duplication cysts and prove that they may1 in fact, not be such rare findings.

关键词： Esophageal cyst Endoscopic ultrasonogra-phy Endovascular surgery

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World Journal of Hepatology 2021年第11期13卷 1642-1652页

作者： Romée JALM Snijders piotr milkiewicz Christoph Schramm Tom JG Gevers Department of Gastroenterology and Hepatology RadboudumcNijmegen 6525GAThe Netherlands European Reference Network RARE-LIVER HamburgGermany Liver and Internal Medicine Unit Medical University of WarsawWarsaw 02-091Poland Translational Medicine Group Pomeranian Medical UniversitySzczecin 70-204Poland First Department of Medicine University Medical Center Hamburg EppendorfHamburg 20246Germany Martin Zeitz Center for Rare Diseases and Hamburg Center for Translational Immunology(HCTI) University Medical Center Hamburg EppendorfHamburg 20246Germany Division of Gastroenterology and Hepatology Maastricht University Medical CenterMaastricht 6229HXThe Netherlands

Autoimmune hepatitis(AIH)is a severe chronic autoimmune disease and has a significant impact on the patient’s quality of life,in particular regarding psychological problems such as anxiety and *** evidence on which patient-related,disease-related or physician-related factors cause health-related quality of life(HRQoL)impairment in patients with AIH is *** studies on HRQoL in AIH are mainly single-centered,comprising small numbers of patients,and difficult to compare because of the use of different questionnaires,patient populations,and cutoff *** in the pediatric field is sparse,but suggests that children/adolescents with AIH have a lower *** of HRQoL and cohesive factors in AIH are important to improve healthcare for AIH patients,for example by developing an AIH-specific chronic healthcare *** recognizing the importance of quality of life beyond the concept of biochemical and histological remission,clinicians allow us to seek enhancements and possible interventions in the management of AIH,aiming at improved health.

关键词： Autoimmune hepatitis Quality of life Depression Anxiety Corticosteroids

Endoscopic submucosal dissection for the treatment of neoplastic lesions in the gastrointestinal tract

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World Journal of Gastroenterology 2013年第12期19卷 1953-1961页

作者： Andrzej Biaek Anna Wiechowska-Kozowska Jan Pertkiewicz Katarzyna Karpińska Wojciech Marlicz piotr milkiewicz Teresa Starzyńska Gastroenterology Department Pomeranian Medical University Department of Endoscopy Ministry of Internal Affairs Hospital Endotherapy Ltd Cell Pathology Department Pomeranian Medical University Liver Unit Pomeranian Medical University

AIM: To investigate the indications, resection rate, and safety of endoscopic submucosal dissection (ESD) for neoplastic lesions in the gastrointestinal tract at a European referral center. METHODS: We carried out a retrospective analysis of the ESD procedures performed in our center for mucosal neoplastic and submucosal lesions of the gastrointestinal tract. The duration of the procedure, en bloc and complete (R0) resection rates, and complication rates were evaluated. Variables were reported as mean ± SD or simple proportions. Univariate analysis and comparisons of procedure times and resection rates were performed using Mann-Whitney U tests, or χ2 tests for dichotomous ***: Between 2007 and 2011, ESD was performed in a total of 103 patients (46.7% male, mean age 64.0 ± 12.7 years). The indications for the procedure were epithelial tumor (n = 54), submucosal tumor (n = 42), or other (n = 7). The total en bloc resection rate was 90.3% (93/103) and R0 resection rate 80.6% (83/103). The median speed of the procedure was 15.0 min/cm2 . The complete resection rate was lower for submucosal tumors arising from the muscle layer (68%, 15/22, P < 0.05). Resection speed was quicker for submucosal tumors localized in the submucosal layer than for lesions arising from the muscularis propria layer (8.1 min/cm 2 vs 17.9 min/cm 2 , P < 0.05). The R0 resection rate and speed were better in the last 24 mo (90.1%, 49/54 and 15.3 min/cm 2 ) compared to the first 3 years of treatment (73.5%, 36/49, P < 0.05 and 22.0 min/cm2 , P < 0.05). Complications occurred in 14.6% (n = 15) of patients, including perforation in 5.8% (n = 6), pneumoperitoneum in 3.9% (n = 4), delayed bleeding in 1.9% (n = 2), and other in 2.9% (n = 3). Only one patient with delayed perforation required surgical treatment. During the mean follow-up of 26 ± 15.3 mo, among patients with R0 resection, recurrence occurred in one patient (1.2%).CONCLUSION: ESD is an effective and safe method for resection of

关键词： Endoscopic submucosal dissection Gastrointestinal neoplasms Gastrointestinal stromal tumors Treatment

Isolated right posterior bile duct injury following cholecystectomy:Report of two cases

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World Journal of Gastroenterology 2013年第36期19卷 6118-6121页

作者： Maciej Wojcicki Waldemar Patkowski Tomasz Chmurowicz Andrzej Bialek Anna Wiechowska-Kozlowska Rafal Stankiewicz piotr milkiewicz Marek Krawczyk Department of General Transplant and Liver Surgery Medical University of Warsaw Department of General Surgery and Transplantation District Hospital Department of Gastroenterology Pomeranian Medical University Department of Endoscopy MSW Hospital Liver Research Laboratories Pomeranian Medical University

Anatomic variations of the right biliary system are one of the most common risk factors for sectoral bile duct injury(BDI)during *** right posterior BDI may in particular be a challenge for both diagnosis and *** we describe two cases of isolated right posterior sectoral BDI that took place during laparoscopic *** effective external biliary drainage from the liver hilum in both cases,there was a persistent biliary leak observed which was not visible on endoscopic *** evaluation of images from both endoscopic and magnetic resonance cholangiograms revealed the diagnosis of an isolated right posterior sectoral *** were treated with a delayed bisegmental(segments 6 and 7)liver resection and a Roux-en-Y hepaticojejunostomy respectively with good outcomes at 24 and 4 mo of *** paper discusses strategies for prevention of such injuries along with the diagnostic and therapeutic challenges it offers.

关键词： Cholecystectomy Bile duct injury Sectoral bile duct Hepaticojejunostomy Liver resection