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Treatment of recurrent sigmoid volvulus in Parkinson's disease by percutaneous endoscopic colostomy

World Journal of Gastroenterology 2012年第40期18卷 5812-5815页

作者： Susan Toebosch Vera Tudyka Ad Masclee Ger Koek Department of Gastroenterology Laurentius Hospital6043 CV RoermondThe Netherlands Department of Surgery Laurentius Hospital6043 CV RoermondThe Netherlands Division of Gastroenterology and Hepatology Department of Internal MedicineMaastricht University Medical Center6229 HX MaastrichtThe Netherlands

The exact aetiology of sigmoid volvulus in Parkinson's disease(PD) remains unclear.A multiplicity of factors may give rise to decreased gastrointestinal function in PD *** recognition and treatment of constipation in PD patients may alter complications like sigmoid *** of sigmoid volvulus in PD patients does not differ from other patients and involves endoscopic *** feasible,secondary sigmoidal resection should be ***,if the expected surgical morbidity and mortality is unacceptably high or if the patient refuses surgery,percutaneous endoscopic colostomy(PEC) should be *** describe an elderly PD patient who presented with sigmoid *** was treated conservatively with endoscopic *** was consistently refused by the *** recurrence of the sigmoid volvulus a PEC was placed.

关键词： Colonic dysfunction Colostomy endoscopictreatment Parkinson's disease Sigmoid volvulus

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Biliary leakage after urgent cholecystectomy: Optimization of endoscopic treatment

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World Journal of Gastrointestinal Endoscopy 2015年第5期7卷 547-554页

作者： Neven Ljubii Alen Bianin Tajana Pavi Marko Nikoli Ivan Budimir August Miji Ana Duzel Division of Gastroenterology Department of Internal Medicine "Sestre milosrdnice" University Hospital Division of Hepato-biliary Surgery Department of Surgery "Sestre milosrdnice" University Hospital

AIM: To investigate the results of endoscopic treatment of postoperative biliary leakage occurring after urgent cholecystectomy with a long-term ***: This is an observational database study conducted in a tertiary care center. All consecutive patients who underwent endoscopic retrograde cholangiography(ERC) for presumed postoperative biliary leakage after urgent cholecystectomy in the period between April 2008 and April 2013 were considered for this study. Patients with bile duct transection and biliary strictures were excluded. Biliary leakage was suspected in the case of bile appearance from either percutaneous drainage of abdominal collection or abdominal drain placed at the time of cholecystectomy. Procedural and main clinical characteristics of all consecutive patients with postoperative biliary leakage after urgent cholecystectomy, such as indication for cholecystectomy, etiology and type of leakage, ERC findings and post-ERC complications, were collected from our electronic database. All patients in whom the leakage was successfully treated endoscopically were followed-up after they were discharged from the hospital and the main clinical characteristics, laboratory data and common bile duct diameter were electronically recorded. RESULTS: During a five-year period, biliary leakage was recognized in 2.2% of patients who underwent urgent cholecystectomy. The median time from cholecystectomy to ERC was 6 d(interquartile range, 4-11 d). Endoscopic interventions to manage biliary leakage included biliary stent insertion with or without biliary sphincterotomy. In 23(77%) patients after first endoscopic treatment bile flow through existing surgical drain ceased within 11 d following biliary therapeutic endoscopy(median, 4 d; interquartile range, 2-8 d). In those patients repeat ERC was not performed andthe biliary stent was removed on gastroscopy. In seven(23%) patients repeat ERC was done within one to fourth week after their first ERC, depending on th

关键词： Urgent cholecystectomy Acute cholecystitischolecystectomy complications Biliary leakage Endoscopic retrograde cholangiography endoscopictreatment

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Endoscopic hemostasis state of the art-Nonvaricealbleeding

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World Journal of Gastrointestinal Endoscopy 2016年第4期8卷 205-211页

作者： Stefan Karl Goelder Juliane Brueckner Helmut Messmann Department of Internal MedicineⅢ Klinikum Augsburg86159 AugsburgGermany

New endoscopic techniques for hemostasis in nonvariceal bleeding were introduced and known methods further improved. Hemospray and Endoclot are two new compounds for topical treatment of bleeding. Initial studies in this area have shown a good hemostatic effect, especially in active large scale oozing bleeding, e.g., tumor bleedings. For further evaluation larger prospective studies comparing the substanced with other methods of endoscopic hemostasis are needed. For localized active arterial bleeding primary injection therapy in the area of bleeding as well as in the four adjacent quadrants offers a good method to reduce bleeding activity. The injection is technically easy to learn and practicable. After bleeding activity is reduced the bleeding source can be localized more clearly for clip application. Today many different through-thescope(TTS) clips are available. The ability to close and reopen a clip can aid towards good positioning at the bleeding site. Even more important is the rotatability of a clip before application. Often multiple TTS clips are required for secure closure of a bleeding vessel. One model has the ability to use three clips in series without changing the applicator. Severe arterial bleeding from vessels larger than 2 mm is often unmanageable with these conventional methods. Here is the over-the-scopeclip system another newly available method. It is similar to the ligation of esophageal varices and involves aspiration of tissue into a transparent cap before closure of the clip. Thus a greater vascular occlusion pressure can be achieved and larger vessels can be treated endoscopically. Patients with severe arterial bleeding from the upper gastrointestinal tract have a very high rate of recurrence after initial endoscopic treatment. These patients should always be managed in an interdisciplinary team of interventional radiologist and surgeons.

关键词： Gastrointestinal bleeding endoscopictreatment Intestinal hemorrhage Endoscopic clips Topical hemostatic substances

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