检索结果-南通市图书馆

endoscopic papillary large balloon dilation vs endoscopic sphincterotomy for retrieval of common bile duct stones:A meta-analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第18期20卷 5548-5556页

作者： Piao-Piao Jin Jian-Feng Cheng Dan Liu Mei Mei Zhao-Qi Xu Lei-Min Sun Department of Gastroenterology Sir Run Run Shaw HospitalSchool of MedicineZhejiang University Internal Medicine Division of GastroenterologyCarolinas Medical CenterCharlotteNC 28203United States Department of Statistics Texas A and M UniversityCollege StationTX 77843United States Doppler Ultrasonic Department The Second Affiliated Hospital of Zhejiang University School of Medicine Fifth People’s Hospital of Yuhang District

AIM:To compare the efficacy and safety of endoscopic papillary large balloon dilation(EPLBD)with endoscopic sphincterotomy(EST)in retrieval of common bile duct stones(≥10 mm).METHODS:PubMed,Web of Knowledge,EBSCO,the Cochrane Library,and EMBASE were searched for eligible *** controlled trials(RCTs)that compared EPLBD with EST were *** extraction and quality assessment were performed by two independent reviewers using the same *** disagreement was discussed with a third reviewer until a final consensus was *** outcomes of complete bile duct stone clearance,stone clearance in one session,requirement for mechanical lithotripsy,and overall complication rate were determined using relative risk and 95%*** separate post-endoscopic retrograde cholangiopancreatography complications were pooled and determined with the Peto odds ratio and95%CI because of the small number of *** was evaluated with the chi-squared test with P≤0.1 and I2 with a cutoff of≥50%.A fixed effects model was used primarily.A random effects model was applied when significant heterogeneity was *** analysis was applied to explore the potential ***:Five randomized controlled trials with 621participants were *** compared with EST had similar outcomes with regard to complete stone removal rate(93.7%vs 92.5%,P=0.54)and complete duct clearance in one session(82.2%vs 77.7%,P=0.17).Mechanical lithotripsy was performed less in EPLBD in the retrieval of whole stones(15.5%vs25.2%,P=0.003),as well as in the stratified subgroup of stones larger than 15 mm(24.2%vs 40%,P=0.001).There was no statistically significant difference in the incidence of overall adverse events(7.9%vs 10.7%,P=0.25),post-ERCP pancreatitis(4.0%vs 5.0%,P=0.54),hemorrhage(1.7%vs 2.8%,P=0.32),perforation(0.3%vs 0.9%,P=0.35)or acute cholangitis(1.3%vs 1.3%,P=0.92).CONCLUSION:EPLBD could be advocated as an alternative to EST in the retrieval of large

关键词： endoscopic papillary large balloon dilation endosc

Capsule endoscopy in Crohn's disease: Are we seeing any better?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第36期20卷 13044-13051页

作者： David Hudesman Jonathan Mazurek Arun Swaminath Inflammatory Bowel Disease Center Division of Digestive Diseases Mount Sinai Beth Israel New York NY 10003 United States Division of Digestive Diseases Mount Sinai Beth Israel New York NY 10003 United States Division of Gastroenterology NSLIJ Lenox Hill Hospital New York NY 10075 United States

Crohn's disease(CD) is a complex, immune-mediated disorder that often requires a multi-modality approach for optimal diagnosis and management. While traditional methods include ileocolonoscopy and radiologic modalities, increasingly, capsule endoscopy(CE) has been incorporated into the algorithm for both the diagnosis and monitoring of CD. Multiple studies have examined the utility of this emerging technology in the management of CD, and have compared it to other available modalities. CE offers a noninvasive approach to evaluate areas of the small bowel that are difficult to reach with traditional endoscopy. Furthermore, CE maybe favored in specific sub segments of patients with inflammatory bowel disease(IBD), such as those with IBD unclassified(IBD-U), pediatric patients and patients with CD who have previously undergone surgery.

关键词： Crohn’s disease Diagnosis Prognosis Capsule endosc

Comparison of the efficacy and safety of sedation between dexmedetomidine-remifentanil and propofol-remifentanil during endoscopic submucosal dissection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第12期21卷 3671-3678页

作者： Namo Kim Young-Chul Yoo Sang Kil Lee Hyunzu Kim Hyang Mi Ju Kyeong Tae Min Department of Anesthesiology and Pain Medicine Severance Hospital Yonsei University College of Medicine Department of Internal Medicine Yonsei University College of Medicine Department of Anesthesiology and Pain Medicine Kangdong Sacred Heart Hospital Hallym University College of Medicine

AIM: To compare the efficacy and safety of sedation protocols for endoscopic submucosal dissection(ESD) between dexmedetomidine-remifentanil and ***: Fifty-nine patients scheduled for ESD were randomly allocated into a dexmedetomidineremifentanil(DR) group or a propofol-remifentanil(PR) group. To control patient anxiety, dexmedetomidine or propofol was infused to maintain a score of 4-5 on the Modified Observer's Assessment of Alertness/Sedation scale. Remifentanil was infused continuously at a rate of 6 μg/kg per hour in both groups. The ease of advancing the scope into the throat, gastric motility grading, and satisfaction of the endoscopist and patient were assessed. Hemodynamic variables and hypoxemic events were compared to evaluate patient ***: Demographic data were comparable between the groups. The hemodynamic variables and pulse oximetry values were stable during the procedure in both groups despite a lower heart rate in the DR group. No oxygen desaturation events occurred in either group. Although advancing the scope into the throat was easier in the PR group("very easy" 24.1% vs 56.7%, P = 0.010), gastric motility was moresuppressed in the DR group("no + mild" 96.6% vs 73.3%, P = 0.013). The endoscopists felt that the procedure was more favorable in the DR group("very good + good" 100% vs 86.7%, P = 0.042), whereas patient satisfaction scores were comparable between the groups. En bloc resection was performed 100% of the time in both groups, and the complete resection rate was 94.4% in the DR group and 100% in the PR group(P = 0.477). CONCLUSION: The efficacy and safety of dexmedetomidine and remifentanil were comparable to propofol and remifentanil during ESD. However, the endoscopists favored dexmedetomidine perhaps due to lower gastric motility.

关键词： Dexmedetomidine Efficacy Peristalsis Safety endosc

Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第7期20卷 1839-1845页

作者： Sho Suzuki Akiko Chino Teruhito Kishihara Naoyuki Uragami Yoshiro Tamegai Takanori Suganuma Junko Fujisaki Masaaki Matsuura Takao Itoi Takuji Gotoda Masahiro Igarashi Fuminori Moriyasu Department of Gastroenterology Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan Fuminori Moriyasu Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyo 160-0023Japan Bioinformatics Group Genome Centerand Division of Cancer GenomicsCancer InstituteJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

AIM:To investigate the risk factors for delayed bleeding following endoscopic submucosal dissection(ESD)treatment for colorectal ***:We retrospectively reviewed the medical records of 317 consecutive patients with 325 lesions who underwent ESD for superficial colorectal neoplasms at our hospital from January 2009 to *** post-ESD bleeding was defined as bleeding that resulted in overt hematochezia 6 h to 30d after ESD and the observation of bleeding spots as confirmed by repeat colonoscopy or a required blood *** analyzed the relationship between risk factors for delayed bleeding following ESD and the following factors using univariate and multivariate analyses:age,gender,presence of comorbidities,use of antithrombotic drugs,use of intravenous heparin,resected specimen size,lesion size,lesion location,lesion morphology,lesion histology,the device used,procedure time,and the presence of significant bleeding during ***:Delayed post-ESD bleeding was found in14 lesions from 14 patients(4.3%of all specimens,4.4%patients).Patients with episodes of delayed postESD bleeding had a mean hemoglobin decrease of2.35 g/*** episodes were treated successfully using endoscopic hemostatic *** surgery was not required in any of the *** transfusion was needed in 1 patient(0.3%).Univariate analysis revealed that lesions located in the cecum(P=0.012)and the presence of significant bleeding during ESD(P=0.024)were significantly associated with delayed post-ESD *** risk of delayed bleeding was higher for larger lesion sizes,but this trend was not statistically *** analysis revealed that lesions located in the cecum(OR=7.26,95%CI:1.99-26.55,P=0.003)and the presence of significant bleeding during ESD(OR=16.41,95%CI:2.60-103.68,P=0.003)were independent risk factors for delayed post-ESD ***:Location in the cecum and significant bleeding during ESD predispose patients to delayed pos

关键词： Adverse event Bleeding Colorectal neoplasms endosc

Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第7期21卷 2108-2115页

作者： Yasuharu Maeda Kazuo Ohtsuka Shin-ei Kudo Kunihiko Wakamura Yuichi Mori Noriyuki Ogata Yoshiki Wada Masashi Misawa Akihiro Yamauchi Seiko Hayashi Toyoki Kudo Takemasa Hayashi Hideyuki Miyachi Fuyuhiko Yamamura Fumio Ishida Haruhiro Inoue Shigeharu Hamatani Digestive Disease Center Showa University Northern Yokohama Hospital Department of Gastroenterology and Hepatology Tokyo Medical and Dental University Hospital endoscopy Center Showa Hospital Department of Pathology Showa University Northern Yokohama Hospital

AIM:To assess the efficacy of endocytoscopic narrowband imaging(EC-NBI)for evaluating the severity of inflammation in ulcerative colitis(UC).METHODS:This retrospective study was conducted at a single tertiary care referral *** included UC patients who underwent colonoscopy with endocytoscopy from July 2010 to December *** was performed,and the images were evaluated by assessing visibility,increased vascularization,and the increased calibers of capillaries and were classified as Obscure,Visible or *** was indicative of inactive disease,while Visible and Dilated were indicative of acute *** study received Institutional Review Board *** primary outcome measures included the diagnostic ability of EC-NBI to distinguish between active and inactive UC on the basis of histological *** conventional endoscopic images were classified according to the Mayo endoscopic score.A score of 0 or 1 indicated inactive disease,whereas a score of 2 indicated active ***:Fifty-two patients were *** was a strong correlation between the EC-NBI findings and the histological assessment(r=0.871,Pendoscopic score were 100%,40.7%,100%,61.0%,and 69.2%,*** with conventional endoscopy,EC-NBI was superior in diagnostic specificity,negative predictive value,and accuracy(P<0.001,P=0.001 and P=0.047,respectively).CONCLUSION:The EC-NBI finding of capillaries in the rectal mucosa was strongly correlated with histological inflammation and aided in the differential diagnosis between active and inactive UC.

关键词： Endosytoscopy Narrow-band imaging Magnified endosc

Paclitaxel-eluting balloon dilation of biliary anastomotic stricture after liver transplantation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第3期21卷 977-981页

作者： Anna Hüsing Holger Reinecke Vito R Cicinnati Susanne Beckebaum Christian Wilms Hartmut H Schmidt Iyad Kabar Department of Transplant Medicine University Hospital Münster48149 MünsterGermany Division of Angiology Department of Cardiology and AngiologyUniversity Hospital Münster48149 MünsterGermany

AIM:To investigate the safety and effectiveness of endoscopic therapy with a paclitaxel-eluting balloon(PEB) for biliary anastomotic stricture(AS) after liver transplantation(LT).METHODS:This prospective pilot study enrolled 13 consecutive eligible patients treated for symptomatic AS after LT at the University Hospital of Münster between January 2011 and March *** patients were treated by endoscopic therapy with a PEB and followed up every 8 wk by endoscopic retrograde cholangiopancreatography(ERCP).In cases of re-stenosis,further balloon dilation with a PEB was ***-up was continued until 24 mo after the last ***:Initial technical feasibility,defined as successful balloon dilation with a PEB during the initial ERCP procedure,was achieved in 100% of ***-term clinical success(LTCS),defined as no need for further endoscopic intervention for at least 24 mo,was achieved in 12 of the 13 patients(92.3%).The mean number of endoscopic interventions required to achieve LTCS was only 1.7 ± *** failure,defined as the need for definitive alternative treatment,occurred in only one patient,who developed recurrent stenosis with increasing bile duct dilatation that required stent ***:endoscopic therapy with a PEB is very effective for the treatment of AS after LT,and seems to significantly shorten the overall duration of endoscopic treatment by reducing the number of interventions needed to achieve LTCS.

关键词： Liver transplantation Anastomotic stricture endosc