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Laparoscopic fundoplication for gastroesophageal reflux disease

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World Journal of Gastroenterology 2014年第39期20卷 14272-14279页

作者： Marzio Frazzoni Micaela Piccoli rita conigliaro Leonardo Frazzoni Gianluigi Melotti Digestive Pathophysiology Unit Baggiovara Hospital 41100 Modena Italy Digestive Endoscopy Unit Baggiovara Hospital 41100 Modena Italy Department of General Surgery Baggiovara Hospital 41100 Modena Italy

Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms and/or complications. Heartburn is the cardinal symptom, often associated with regurgitation. In patients with endoscopy-negative heartburn refractory to proton pump inhibitor (PPI) therapy and when the diagnosis of GERD is in question, direct reflux testing by impedance-pH monitoring is warranted. Laparoscopic fundoplication is the standard surgical treatment for GERD. It is highly effective in curing GERD with a 80% success rate at 20-year follow-up. The Nissen fundoplication, consisting of a total (360°) wrap, is the most commonly performed antireflux operation. To reduce postoperative dysphagia and gas bloating, partial fundoplications are also used, including the posterior (Toupet) fundoplication, and the anterior (Dor) fundoplication. Currently, there is consensus to advise laparoscopic fundoplication in PPI-responsive GERD only for those patients who develop untoward side-effects or complications from PPI therapy. PPI resistance is the real challenge in GERD. There is consensus that carefully selected GERD patients refractory to PPI therapy are eligible for laparoscopic fundoplication, provided that objective evidence of reflux as the cause of ongoing symptoms has been obtained. For this purpose, impedance-pH monitoring is regarded as the diagnostic gold standard.

关键词： Gastroesophageal reflux disease Refractory gastroesophageal reflux disease Laparoscopic fundoplication Impedance-pH monitoring Proton pump inhibitors

Linear endoscopic ultrasonography vs magnetic resonance imaging in ampullary tumors

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World Journal of Gastroenterology 2010年第44期16卷 5592-5597页

作者： Raffaele Manta rita conigliaro Danilo Castellani Alessandro Messerotti Helga Bertani Giuseppe Sabatino Elena Vetruccio Luisa Losi Vincenzo Villanacci Gabrio Bassotti Gastroenterology and Endoscopy Unit Nuovo Ospedale Civile Sant'Agostino EstenseViale Giardini 135541121 BaggiovaraModenaItaly Gastroenterology and Hepatology Section Department of Clinical and Experimental MedicineUniversity of Perugia Medical School06156 PerugiaItaly Department of Radiology S.Agostino Estense Civil Hospital41121 BaggiovaraModenaItaly Department of Pathology University of Modena41121 ModenaItaly Department of 2nd Pathology Spedali Civili25100 BresciaItaly

AIM:To assess linear endoscopic ultrasound (L-EUS) and magnetic resonance imaging (MRI) in biliary tract dilation and suspect small ampullary ***:L-EUS and MRI data were compared in 24 patients with small ampullary tumors;all with subsequent histological *** were collected prospectively and the accuracy of detection,histological characterization and N staging were assessed retrospectivelyusing the results of surgical or endoscopic treatment as a ***:A suspicion of ampullary tumor was present in 75% of MRI and all L-EUS examinations,with 80% agreement between EUS and histological findings at ***,L-EUS and histological TN staging at surgery showed moderate agreement (κ=0.54).CONCLUSION:L-EUS could be a useful adjunct as a diagnostic tool in the evaluation of patients with sus-pected ampullary tumors.

关键词： Ampullary tumors Endoscopic ultrasound Magnetic resonance imaging

Post-trans-arterial chemoembolization hepatic necrosis and biliary stenosis: Clinical charateristics and endoscopic approach

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World Journal of Clinical Cases 2023年第36期11卷 8434-8439页

作者： Silvia Cocca Lorenzo Carloni Margherita Marocchi Giuseppe Grande Marcello Bianchini Antonio Colecchia rita conigliaro Helga Bertani Gastroenterology and Endoscopy Unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy Department of Medical and Surgical Sciences IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 00100Italy Department of Internal Medicine Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy

Liver cancer is the fifth most common tumor and the second highest death-related cancer in the ***(HCC)represents 90%of liver *** to the Barcelona Clinic Liver Cancer group,different treatment options could be offered to patients in consideration of tumor burden,liver function,pa-tient performance status and biochemical marker serum concentration such as ***-arterial chemoembolization(TACE)is the treatment of choice in patients with diagnosis of unresectable HCC not eligible for liver trans-plantation,and preserved arterial *** is known to be safe and its com-plications are generally mild such as post-TACE syndrome,a self-resolving adverse event that occurs in about 90%of patients after the ***,albeit rarely,more severe adverse events such as biloma,sepsis,hepatic failure,chemoagents induced toxicities,and post-TACE liver necrosis can occur.A prompt diagnosis of these clinical conditions is fundamental to prevent further *** a result,biliary stenosis could be a rare post-TACE necrosis complication and can be difficult to *** from untreated biliary strictures include recurring infections,jaundice,chronic cholestasis,and secon-dary biliary cirrhosis.

关键词： Hepatocarcinoma Trans-arterial Chemoembolization Biliary stenosis Multistenting

Endoscopic ultrasonography findings in autoimmune pancreatitis

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World Journal of Gastroenterology 2011年第16期17卷 2080-2085页

作者： Elisabetta Buscarini Stefania De Lisi Paolo Giorgio Arcidiacono Maria Chiara Petrone Arnaldo Fuini rita conigliaro Guido Manfredi Raffaele Manta Dario Reggio Claudio De Angelis Department of Gastroenterology Maggiore Hospital Department of Gastroenterology Di.Bi.M.I.S.University of Palermo Department of Gastroenterology I.R.C.C.S San RaffaeleUniversità Vita e Salute San Raffaele Department of Gastroenterology and Digestive Endoscopy Ospedale Civile Maggiore Department of Gastroenterology and Digestive Endoscopy New Civil Hospital S.Agostino Estense Chirurgia Trapianti di Fegato San Giovanni Battista Hospital Department of Gastroenterology San Giovanni Battista Hospital

Endoscopic ultrasonography is an established diagnostic tool for pancreatic masses and chronic *** recent years there has been a growing interest in the worldwide medical community in autoimmune pancreatitis (AIP),a form of chronic pancreatitis caused by an autoimmune *** paper reviews the current available literature about the endoscopic ultrasonographic findings of AIP and the role of this imaging technique in the management of this protean disease.

关键词： Pancreatitis Autoimmune Endoscopic ultrasound IgG4 cholangitis

Needle-based confocal endomicroscopy in the discrimination of mucinous from non-mucinous pancreatic cystic lesions

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World Journal of Gastrointestinal Endoscopy 2021年第11期13卷 555-564页

作者： Helga Bertani Raffaele Pezzilli Flavia Pigo Mauro Bruno Claudio De Angelis Guido Manfredi Gabriele Delconte rita conigliaro Elisabetta Buscarini Gastroenterology and Digestive Endoscopy Unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41124Italy Department of Internal Medicine Policlinico S.Orsola MalpighiBologna 40121Italy Gastroenterology and Digestive Endoscopy Unit AOU Cittàdella Salute e della ScienzaUniversity of TurinTurin 10100Italy Gastroenterology and Digestive Endoscopy Department Ospedale MaggioreCrema 26013Italy Department of Diagnostic Endoscopy and Endoscopic Surgery Istituto Nazionale TumoriMilano 20019Italy

BACKGROUND Pancreatic cystic lesions(PCLs)are considered a precursor of pancreatic ***-based confocal endomicroscopy(nCLE)is an imaging technique that enables visualization of the mucosal layer to a micron *** application has demonstrated promising results in the distinction of *** study evaluated the utility of nCLE in patients with indeterminate PCLs undergoing endoscopic ultrasound fine-needle aspiration(EUS-FNA)to distinguish mucinous from non-mucinous *** To evaluate the accuracy of nCLE in indeterminate PCLs undergoing EUS-FNA to distinguish mucinous from non-mucinous *** Patients who required EUS-FNA between 2015 and 2017 were enrolled *** EUS-FNA,confocal imaging,analyses of the tumor markers carcinoembryonic antigen and amylase,and cytologic examination were *** patients were followed for at least 12 mo and underwent laboratory testing and computed tomography scanning or magnetic resonance *** videos were independently reviewed by 6 observers to reach a final diagnosis(mucinous vs non-mucinous)based on criteria derived from previous studies;if there was disagreement>20%,a final diagnosis was discussed after consensus *** sensitivity,specificity,and accuracy of nCLE were *** events were *** Fifty-nine patients were included in this *** diagnoses were derived from surgery in 10 patients,cytology in 13,and imaging and multidisciplinary team review in *** patients were excluded from final diagnosis due to problems with nCLE ***-six patients were included in the final *** sensitivity,specificity,and accuracy of nCLE were 80%[95%confidence interval(CI):65-90],100%(95%CI:72-100),and 84%(95%CI:72-93),*** acute pancreatitis occurred in 5%.CONCLUSION EUS-nCLE performs better than standard EUS-FNA for the diagnosis of indeterminate PCL.

关键词： Needle-based confocal endomicroscopy Pancreatic cystic lesion Pancreatic adenocarcinoma Endoscopic ultrasound Endoscopic ultrasound fine-needle aspiration Intraductal papillary mucinous neoplasm Serous cyst adenoma

Acute left-sided malignant colonic obstruction:Is there a role for endoscopic stenting?

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World Journal of Clinical Oncology 2023年第5期14卷 190-197页

作者： Salvatore Russo rita conigliaro Francesca Coppini Emanuela Dell'Aquila Giuseppe Grande Flavia Pigò Santi Mangiafico Marinella Lupo Margherita Marocchi Helga Bertani Silvia Cocca Gastroenterology and Digestive Endoscopy Unit Modena University HospitalModena 41126Italy Gastroenterology and Digestive Endoscopy Unit Azienda USLIRCCs di Reggio EmiliaReggio Emilia 42122Italy Medical Oncology 1 IRCCS Regina Elena National Cancer InstituteRome 0144Italy

The therapy of left-sided malignant colonic obstruction continues to be one of the largest problems in clinical *** studies on colonic stenting for neoplastic colonic obstruction have been reported in the last *** the role of self-expandable metal stents(SEMS)in the treatment of malignant colonic obstruction has become better ***,numerous prospective and retrospective investigations have highlighted serious concerns about a possible worse outcome after endoscopic colorectal stenting as a bridge to surgery,particularly in case of *** review analyzes the most recent evidence in order to highlight pros and cons of SEMS placement in left-sided malignant colonic obstruction.

关键词： Colorectal neoplasm Intestinal obstruction Endoscopy Self expandable metallic stents Colorectal surgery Chemotherapy

Common bile duct lesions-how cholangioscopy helps rule out intraductal papillary neoplasms of the bile duct:A case report

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World Journal of Gastrointestinal Endoscopy 2020年第12期12卷 555-559页

作者： Helga BertaniEndoscopy Unit Silvia Cocca Giuseppe Grande Luca Reggiani Bonetti Paolo Magistri Stefano Di Sandro Fabrizio DiBenedetto rita conigliaro Helga Bertani Endoscopy Unit Azienda Ospedaliero-Universitaria di ModenaModena 41121MOItaly Department of Pathologic Anatomy University of Modena and Reggio EmiliaModena 41124MOItaly Hepato-pancreato-biliary Surgery and Liver Transplantation Unit University of Modena and Reggio EmiliaModena 41124MOItaly

BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a rare variant of bile duct tumors,characterized by an exophytic growth exhibiting a papillary mass within the bile duct lumen and it can be localized anywhere along the biliary tree,with morphological variations and occasional *** SUMMARY We present a patient with obstructive jaundice who was diagnosed with IPNB using cholangioscopy during endoscopic retrograde *** the SpyGlass DS Ⅱ technology,we were able to define tumor extension and obtain targeted Spy-byte *** multidisciplinary evaluation,the patient was scheduled for surgical resection of the tumor,which was radically *** Cholangioscopy appears to be crucial for the rapid and clear diagnosis of lesions in the bile duct to achieve radical surgical resection.

关键词： Intraductal papillary neoplasm Cholangioscopy Bile duct Surgical resection SpyGlass Case report

Single balloon enteroscopy: Technical aspects and clinical applications

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World Journal of Gastrointestinal Endoscopy 2012年第2期4卷 28-32页

作者： Mauro Manno Carmelo Barbera Helga Bertani Raffaele Manta Vincenzo Giorgio Mirante Emanuele Dabizzi Angelo Caruso Flavia Pigo Giampiero Olivetti rita conigliaro Gastroenterology and Digestive Endoscopy Unit New S. Agostino Estense Civil Hospital 41126 Baggiovara di Modena Italy

The small bowel has long been considered a black box for endoscopists because of its long length and the presence of multiple complex loop. Most of the small bowel is inaccessible by traditional endoscopic means. In addition, radiographic studies have significant limitations with regard to diagnostic yield, and surgery is an invasive alternative. This limitation was overcome through the development of balloon enteroscopy that becomes established throughout the world for diagnostic and therapeutic examinations of the small bowel. The single-balloon enteroscope (SBE) system (Olympus, Tokyo, Japan) was introduced into the commercial market in 2007. Several study demonstrated its efficacy and safety. Early reports on the use of singleballoon enteroscopy have suggested a high diagnostic yield and similar therapeutic potential to that of the double-balloon endoscope. SBE is viable technique for in the management of small bowel disease. Technically, it is easy to perform, may be efficient, and in the literature data available, seems to provide high diagnostic and therapeutic yield.

关键词： Single balloon enteroscopy Small bowel Enteroscopy

Dilation assisted stone extraction for complex biliary lithiasis:Technical aspects and practical principles

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World Journal of Gastrointestinal Endoscopy 2021年第2期13卷 33-44页

作者： Giuseppe Grande Silvia Cocca Helga Bertani Angelo Caruso Flavia Pigo' Santi Mangiafico Salvatore Russo Marinella Lupo Graziella Masciangelo Paolo Cantu' Raffaele Manta rita conigliaro Gastroenterology and Digestive Endoscopy Unit Azienda Ospedaliero Universitaria di ModenaModena 41126Italy Gastroenterology and Endoscopy Unit Department of Pathophysiology and TransplantationFondazione IRCCS Ca’GrandaOspedale Maggiore Policlinico and Universitàdegli Studi di MilanoMilano 20122Italy Gastroenterology and Digestive Endoscopy Unit General Hospital of PerugiaPerugia 06129Italy

Common bile duct stones are frequently diagnosed worldwide and are one of the main indications for endoscopic retrograde *** sphincterotomy(EST)has been used for the removal of bile duct stones for the past 40 years,providing a wide opening to allow *** to 15%of patients present with complicated *** this context,additional therapeutic approaches have been proposed such as endoscopic mechanical lithotripsy,intraductal or extracorporeal lithotripsy,or endoscopic papillary large balloon dilation(EPLBD).EPLBD combined with EST was introduced in 2003 to facilitate the passage of large or multiple bile duct stones using a balloon greater than 12 mm in *** without EST was introduced as a simplified technique in ***-assisted stone extraction(DASE)is the combination of two techniques:EPLBD and sub-maximal *** studies have reported this technique as safe and effective in patients with large bile duct stones,without any increased risk of adverse events such as pancreatitis,bleeding,or ***,it is difficult to analyze the outcomes of DASE because there are no standard techniques and definitions between *** purpose of this paper is to provide technical guidance and specific information about the main issues regarding DASE,based on current literature and daily clinical experience in biliary referral centers.

关键词： Dilation-assisted stone extraction Endoscopic papillary large balloon dilation Macrolithiasis Difficult choledochiolithiasis Stone treatment Common bile duct stones Endoscopic retrograde cholangiopancreatography