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Post hoc validation of a tool that accurately predicts the outcome of endoscopic therapy in bouveret syndrome

Gastroenterology Report 2022年第1期10卷 298-304页

作者： Carla Swift John Ong Man Zhou Benjamin Stokell Yasseen Al-Naeeb Department of Gastroenterology Norwich University HospitalNorwichUK Department of Engineering University of CambridgeCambridgeUK Department of Medicine National University of SingaporeSingapore GKT School of Medical Education King’s College LondonLondonUK Statistical Laboratory Centre for Mathematical SciencesUniversity of CambridgeCambridgeUK Department of Gastroenterology Bedford HospitalBedfordUK

Background bouveret syndrome is characterized by gallstone impaction in the upper gastrointestinal tract causing gastric outlet *** bouveret syndrome,endoscopic gallstone removal can avert the need for ***,in cases in which endoscopic therapy is unlikely to succeed,endoscopic attempts delay definitive treatment and compound patient *** previously developed a model that predicts endoscopic outcomes from data derived through a systematic *** tool uses gallstone length,site of impaction,and the number of planned methods of lithotripsy to predict the likelihood of endoscopic success with an accuracy of 81.0%.This study aimed to evaluate our tool performance in an independent,non-training data set and assess endoscopic and surgical *** Systematic searches of the PubMed,Scopus,and Cochrane databases were performed for articles published between 16 April 2018 and 1 June *** data reported after our previous study were harvested and inputted into the tool to evaluate their ability to accurately predict outcomes when compared with actual *** Newly collated data in fields of interest showed no significant statistical differences compared with previous training data *** therapy was successful in 41.9%of *** of ≤4 cm had a higher chance of successful endoscopic intervention(odds ratio 6.7,95%confidence interval 1.7–25.8,P<0.01).Complications of surgery were reported in 29.5%;there was one fatality *** hoc evaluation of our predictive tool demonstrated an AUROC score of *** We have demonstrated in an independent data set that the tool can be used to accurately predict outcomes of endoscopic *** in whom endoscopic therapy is most likely to fail should be offered an early surgical opinion.

关键词： bouveret syndrome bouveret’s syndrome gallstone duodenal obstruction gastric outlet obstruction gallstone ileus

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bouveret syndrome masquerading as a gastric mass-unmasked with endoscopic luminal laser lithotripsy:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5701-5706页

作者： Swetha Parvataneni Harshit S Khara David L Diehl Department of Internal Medicine Geisinger Lewistown HospitalLewistownPA 17044United States Department of Gastroenterology and Hepatology Advanced EndoscopyGeisinger Health systemDanvillePA 17822United States Department of Gastroenterology and Nutrition Geisinger Medical CenterDanvillePA 17822United States

BACKGROUND bouveret syndrome,also known as gallstone ileus,is a rare form of gastric outlet obstruction accounting for 1%-3%of *** condition is most often reported in *** diagnosis can be challenging and is often missed due to atypical presentations,which occasionally mimic gastric outlet obstruction symptoms such as nausea,vomiting,loss of appetite and *** symptoms vary with stone *** stones are managed with a surgical approach,but this carries increased morbidity and *** the past decade,the endoscopic approach has emerged as an alternative mode of treatment,but it is generally unsuccessful in the management of larger-sized stones.A literature review revealed cases of successful endoscopic treatment requiring multiple sessions for stone sizes measuring up to about 4.5 *** we present a unique case of an elderly patient with bouveret syndrome with a 5 cm stone mimicking a gastric mass and causing gastric outlet obstruction,who was successfully managed in a single session using a complete endoscopic approach with laser *** SUMMARY An 85-year-old female patient presented with 1-month history of intermittent abdominal pain,vomiting,decreased appetite and weight *** abdominal computed tomography showed a 4.5 cm×4.7 cm partially calcified mass at the gastric pylorus causing gastric outlet *** showed an ulcerated fistulous opening and a large 5 cm impacted gallstone in the duodenal *** nets and baskets were used in an attempt to remove the stone,but this approach was *** her advanced age,poor physical condition and underlying comorbidities,she was deemed to be high-risk for ***,a minimally invasive approach using endoscopic laser lithotripsy was attempted and successfully treated the ***-procedure,the patient experienced complete resolution of her symptoms with no complications and was able to tolerate her *** was subsequently discharged home

关键词： Gastric outlet obstruction bouveret syndrome Laser lithotripsy Holmium laser lithotripsy Holmium and neodymium yttrium aluminum garnet lasers Case report

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Gastric Outlet Obstruction by a Hydrocholecyst. A Very Rare Variant of bouveret syndrome: A Case Report

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Surgical Science 2021年第9期12卷 332-337页

作者： Luis Daniel Betancourt Martínez Alberto Manuel González Chávez Mario Andrés González Chávez Jiroyoshi Enrique Muneta Kishigami Abraham Samra Saad General Surgery Department Hospital Espa&#241ol Mexico City Mexico Gastroenterology Department Hospital Espa&#241ol Mexico City Mexico Geriatric Medicine Department Hospital Espa&#241ol Mexico City Mexico

It is estimated that between 0.3% - 0.5% of patients with cholelithiasis have biliary ileus, of this small proportion, only between 1% - 3% is complicated by the syndrome described in 1896 by Leon Bouveret. Bouveret syndrome refers to the obstruction of the gastric outlet tract secondary to the passage and impactation of a gallstone in the duodenum, through a cholecystoduodenal fistula. It is most common in women, between the ages of 74 - 77 and is clinically characterized by pain, bloating, incoercible vomiting and anorexia.

关键词： bouveret syndrome Gastric Outlet Obstruction Gallstone Hydrocholecyst Cholelithiasis Gastromegaly

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