检索结果-南通市图书馆

Current diagnosis and treatment of benign biliary stricturesafter living donor liver transplantation

World Journal of Gastroenterology 2016年第4期22卷 1593-1606页

作者： Jae Hyuck Chang Inseok Lee Myung-Gyu Choi Sok Won Han Division of Gastroenterology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

Despite advances in surgical techniques, benign biliary strictures after living donor liver transplantation(LDLT) remain a significant biliary complication and play an important role in graft and patient survival. Benign biliary strictures after transplantation are classified into anastomotic or non-anastomotic strictures. These two types differ in presentation, outcome, and response to therapy. The leading causes of biliary strictures include impaired blood supply, technical errors during surgery, and biliary anomalies. Because patients usually have non-specific symptoms, a high index of suspicion should be maintained. Magnetic resonance cholangiography has gained widespread acceptance as a reliable noninvasive tool for detecting biliary complications. Endoscopy has played an increasingly prominent role in the diagnosis and treatment of biliary strictures after LDLT. Endoscopic management in LDLT recipients may be more challenging than in deceased donor liver transplantation patients because of the complex nature of the duct-to-duct reconstruction. Repeated aggressive endoscopic treatment with dilation and the placement of multiple plastic stents is considered the first-line treatment for biliary strictures. Percutaneous and surgical treatments are now reserved for patients for whom endoscopic management fails and for those with multiple, inaccessible intrahepatic strictures or Roux-en-Y anastomoses. Recent advances in enteroscopy enable treatment, even in these latter cases. Direct cholangioscopy, another advanced form of endoscopy, allows direct visualization of the inner wall of the biliary tree and is expected to facilitate stenting or stone extraction. Rendezvous techniques can be a good option when the endoscopic approach to the biliary stricture is unfeasible. These developments have resulted in almost all patients being managed by the endoscopic approach.

关键词： Biliary strictures Living donor liver transplantation Endoscopic retrograde cholangiography Percutaneous transhepatic cholangiography Biliarycomplication

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Endoscopic palliation of malignant biliary stricture

引用

World Journal of Gastrointestinal Oncology 2016年第3期8卷 240-247页

作者： Sanjay M Salgado Monica Gaidhane Michel Kahaleh Division of Gastroenterology and Hepatology Weill Cornell Medical College

Malignant biliary strictures often present late after the window for curative resection has elapsed. In such patients, the goal of therapy is typically focused on palliation. While historically, palliative measures were performed surgically, the advent of endoscopic intervention offers minimally invasive options to provide relief of symptoms, improve quality of life, and in some cases, increase survival of these patients. Some of these therapies, such as endoscopic biliary decompression, have become mainstays of treatment for decades, whereas newer modalities, including radiofrequency ablation, and photodynamic therapy offer additional options for patients with incurable biliary malignancies.

关键词： Biliary strictures Malignant Endoscopic retrograde cholangiopancreatography Photodynamic therapy Endoscopy Palliation Endoscopic ultrasound Radiofrequency ablation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Crohn’s disease: Why the ileum?

引用

World Journal of Gastroenterology 2023年第21期29卷 3222-3240页

作者： Nicolas Richard Guillaume Savoye Mathilde Leboutte Asma Amamou Subrata Ghosh Rachel Marion-Letellier University of Rouen Normandie INSERMADEN UMR 1073NutritionInflammation and Microbiota-Gut-Brain AxisRouen F-76000France CHU Rouen Department of GastroenterologyRouen University Hospital-Charles NicolleRouen F-76000France Institute for Research and Innovation in Biomedicine University of Rouen NormandieRouen F-76000France APC Microbiome Ireland Biosciences BuildingUniversity College CorkCork T12 YT20Ireland

Crohn’s disease(CD)is an inflammatory bowel disease characterized by immunemediated flares affecting any region of the intestine alternating with remission *** CD,the ileum is frequently affected and about one third of patients presents with a pure ileal ***,the ileal type of CD presents epidemiological specificities like a younger age at onset and often a strong link with smoking and genetic susceptibility *** of these genes are associated with Paneth cell dysfunction,a cell type found in the intestinal crypts of the ***,a Western-type diet is associated in epidemiological studies with CD onset and increasing evidence shows that diet can modulate the composition of bile acids and gut microbiota,which in turn modulates the susceptibility of the ileum to ***,the interplay between environmental factors and the histological and anatomical features of the ileum is thought to explain the specific transcriptome profile observed in CD ***,both immune response and cellular healing processes harbour differences between ileal and non-ileal *** together,these findings advocate for a dedicated therapeutic approach to managing ileal ***,interventional pharmacological studies have failed to clearly demonstrate distinct response profiles according to disease ***,the high rate of stricturing disease in ileal CD requires the identification of new therapeutic targets to significantly change the natural history of this debilitating disease.

关键词： Ileum Crohn’s disease Bile acids Paneth cells Diet Genetics strictures

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Biodegradable stents in gastrointestinal endoscopy

引用

World Journal of Gastroenterology 2014年第9期20卷 2212-2217页

作者： Vicente Lorenzo-Zú?iga Vicente Moreno-de-Vega Ingrid Marín Jaume Boix Endoscopy Unit Department of Gastroenterology Hospital Universitari Germans Trias i Pujol 08916 Badalona Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD) 08916 Badalona Spain

Biodegradable stents(BDSs)are an attractive option to avoid ongoing dilation or surgery in patients with benign stenoses of the small and large *** experience with the currently the only BDS for endoscopic placement,made of Poly-dioxanone,have shown promising *** some aspects should be improved as are the fact that BDSs lose their radial force over time due to the degradable material,and that can cause stent-induced mucosal or parenchymal *** complication rate and modest clinical efficacy has to be carefully considered in individual patients prior to placement of ***,the price of these stents therefore it is nowadays an important limitation.

关键词： Biodegradable stents strictures Endoscopy Endoscopic placement Stenoses

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis: A review of the literature

引用

World Journal of Gastrointestinal Surgery 2019年第2期11卷 53-61页

作者： Benedetto Mangiavillano Mouen A Khashab Ilaria Tarantino Silvia Carrara Rossella Semeraro Francesco Auriemma Mario Bianchetti Leonardo Henry Eusebi Chen Yen-I Luca De Luca Mario Traina Alessandro Repici Gastrointestinal Endoscopy Unit Humanitas-Mater Domini Humanitas Huniversity Division of Gastroenterology and Hepatology Johns Hopkins Hospital Gastroenterology and Endoscopy Unit Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) Digestive Endoscopy Unit Division of Gastroenterology Humanitas Clinical and Research Center IRCCS Digestive Endoscopy Unit Istituto Clinico Humanitas Research Hospital Unit of Gastroenterology Department of Medical and Surgical Sciences S. Orsola-Malpighi Hospital University of Bologna Gastroenterology and Digestive Endoscopy Unit Ospedali Riuniti Marche Nord Digestive Endoscopy Unit Division of Gastroenterology Humanitas Research Hospital

Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary, peri-ampullary, and pancreatic head neoplasia. Surgical bypass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique, with a high technical success in expert hands. In recent years, endoscopic ultrasonography(EUS) has evolved from a diagnostic to a therapeutic procedure, and is now increasingly used to guide biliary drainage, especially in cases of failed endoscopic retrograde cholangiopancreatography(ERCP). The advent of lumen-apposing metal stents(LAMS) has expanded EUS therapeutic options, and changed the management of synchronous bilioduodenal stenosis. The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach, also considering the advent of an interventional EUS approach using LAMS.

关键词： Malignant biliary strictures Malignant duodenal stenosis Bilio-duodenal stenosis Biliary self-expandable metal stent Duodenal self-expandable metal stent Lumen-apposing metal stents Gastro-jejunostomy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Endoscopic management and prevention of migrated esophageal stents

引用

World Journal of Gastrointestinal Endoscopy 2014年第2期6卷 49-54页

作者： Bruno da Costa Martins Felipe Alves Retes Bruno Frederico Medrado Marcelo Simas de Lima Caterina Maria Pia Simione Pennacchi Fabio Shiguehissa Kawaguti Adriana Vaz Safatle-Ribeiro Ricardo Sato Uemura Fauze Maluf-Filho Department of Gastroenterology Endoscopy DivisionCancer Institute of the University of So Paulo

The use of self-expandable metallic stents has increased recently to palliate inoperable esophageal neoplasia and also in the management of benign strictures. Migration is one of the most common complications after stent placement and the endoscopist should be able to recognize and manage this situation. Several techniques for managing migrated stents have been described, as well as new techniques for preventing stent migration. Most stents have a "lasso" at the upper flange which facilitates stent repositioning or removal. An overtube, endoloop and large polypectomy snare may be useful for the retrieval of stents migrated into the stomach. External fixation of the stent with Shim's technique is efficient in preventing stent migration. Suturing the stent to the esophageal wall, new stent designs with larger flanges and double-layered stents are promising techniques to prevent stent migration but they warrant validation in a larger cohort of patients.

关键词： Endoscopy Stents Esophageal cancer Benign strictures Complications

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders

引用

World Journal of Gastrointestinal Endoscopy 2019年第1期11卷 31-40页

作者： Petko Karagyozov Irina Boeva Ivan Tishkov Department of Interventional Gastroenterology Clinic of Gastroenterology Acibadem City Clinic Tokuda Hopsital

Due to the need for improvement in the diagnosis and minimally invasive therapy of the bile duct disorders new technologies for cholangioscopy have been recently developed. Per-oral cholangioscopy has become an important diagnostic and therapeutic tool leading to avoidance of aggressive and unnecessary surgery in many clinical scenarios. This paper focuses on the newly developed SpyGlass DS technology, its advantages, and the technique of single-operator cholangioscopy(SOC), biliary indications and possible adverse events. We also review the available literature; discuss the limitations and future *** SOC(D-SOC) is a useful technique, which provides endoscopic imaging of the biliary tree, optical diagnosis, biopsy under direct vision and therapeutic interventions. The implementations are diagnostic and therapeutic. Diagnostic indications are indeterminate biliary strictures, unclear filling defects, staging of cholangiocarcinoma, staging of ampullary tumors(extension into the common bile duct), unclear bile duct dilation, exploring cystic lesions of the biliary tree,unexplained hemobilia, posttransplant biliary complications. Therapeutic indications are lithotripsy of difficult stones, retrieval of migrated stents, foreign body removal, guide wire placement, transpapillary gallbladder drainage and endoscopic tumor ablative therapy. Most studied and established indications are the diagnosis of indeterminate biliary stricture and intraductal lithotripsy of difficult stones. The adverse events are not different and more common compared to those of Endoscopic retrograde cholangiopancreatography(ERCP)alone. D-SOC is a safe and effective procedure, adjunct to the standard ERCP and the newly available digital technology overcomes many of the limitations of the previous generations of cholangioscopes.

关键词： Per-oral cholangioscopy Digital single-operator cholangioscopy Difficult stones Indeterminate strictures Endoscopic retrograde cholangiopancreatography Biliary interventions

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Portal Biliopathy: A Review of Imaging Features of Nine Patients

引用

International Journal of Clinical Medicine 2017年第11期8卷 604-617页

作者： Ali Nawaz Khan Ken Uzoka Sumaira Macdonald Abeeku Afedzi Hammond Anthony Kodzo-Grey Venyo North Manchester General Hospital Manchester UK Silk Road Medical Inc. Sunnyvale CA USA Department of Trauma and Orthopaedics Royal Oldham Hospital Pennine Acute Hospitals NHS Trust Bury UK Department of Urology Delaunay North Manchester General Hospital Manchester UK

Aim: To discuss the etiology, pathogenesis, diagnosis and management of PB, supported by a series of 9 cases from a personal series. Methods: Radiological images of 9 cases of PB were retrieved from different hospitals and studied and information relating to PB was obtained from various internet databases including PUB Med, Google, Google Scholar and Educus. Results: Portal biliopathy (PB) is a rare complication of extra-portal venous obstruction. Most patients remain asymptomatic, but some may present with raised alkaline phosphatase level, abdominal pain, fever, and cholangitis. It tends to be associated with gallbladder (GB) wall abnormalities, a cavernous transformation of the portal vein and choledochal varices. Extrinsic compression of the common bile duct, (CBD), by dilated venous collaterals together with pericholedochal fibrosis from the inflammatory process can cause portal thrombosis, which may lead to biliary stricture and dilatation of the proximal biliary tree. These strictures set the scene for formation biliary stones and cholangitis. Liver function test abnormalities are common but remain non-specific. Imaging features are instrumental in the diagnosis of PB. This paper presents 9 of such cases of portal biliopathy, with discussions on their causation, the course of the disease process and management particularly minimally invasive procedure. The role of ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP) and direct puncture cholangiography is discussed. Surgical management is evaluated. An imaging atlas is provided. Conclusions: PB is a rare but significant complication of portal venous obstruction that has an insidious onset and may remain asymptomatic until late. PB has associated coagulopathies, and a variety of other disorders, which are discussed, illustrated and the diagnosis-elaborated. The role of MRI as a non-invasive imaging tool is emphasized.

关键词： Portal Biliopathy Portal Hypertension Portal Venous Thrombosis Cavernous Transformation Biliary strictures Imaging Portal Biliopathy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Percutaneous transhepatic cholangioscopy and lithotripsy in treating difficult biliary ductal stones: Two case reports

引用

World Journal of Gastrointestinal Endoscopy 2019年第4期11卷 298-307页

作者： Edward Alabraba Simon Travis Ian Beckingham Department of Hepato-Pancreato-Biliary Surgery Queen's Medical Centre Department of Radiology Queen’s Medical Centre

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) is preferred for managing biliary obstruction in patients with bilio-enteric anastomotic strictures(BEAS) and calculi. In patients whose duodenal anatomy is altered following upper gastrointestinal(UGI) tract surgery, ERCP is technically challenging because the biliary tree becomes difficult to access by per-oral *** endoscopic therapies like balloon-enteroscopy or rendevous-ERCP may be considered but are not always feasible. Biliary sepsis and comorbidities may also make these patients poor candidates for surgical management of their biliary *** SUMMARY We present two 70-year-old caucasian patients admitted as emergencies with obstructive cholangitis. Both patients had BEAS associated with calculi that were predominantly extrahepatic in Patient 1 and intrahepatic in Patient 2. Both patients were unsuitable for conventional ERCP due to surgically-altered UGl anatomy. Emergency biliary drainage was by percutaneous transhepatic cholangiography(PTC) in both cases and after 6-weeks' maturation, PTC tracts were dilated to perform percutaneous transhepatic cholangioscopy and lithotripsy(PTCSL) for duct clearance. BEAS were firstly dilated fluoroscopically,and then biliary stones were flushed into the small bowel or basket-retrieved under visualization provided by the percutaneously-inserted video cholangioscope. Lithotripsy was used to fragment impacted calculi, also under visualization by video cholangioscopy. Satisfactory duct clearance was achieved in Patient 1 after one PTCSL procedure, but Patient 2 required a further procedure to clear persisting intrahepatic calculi. Ultimately both patients had successful stone clearance confirmed by check *** PTCSL offers a pragmatic, feasible and safe method for biliary tract clearance when neither ERCP nor surgical exploration is suitable.

关键词： Percutaneous transhepatic cholangiography Video cholangioscopy Lithotripsy Biliary calculi Endoscopic retrograde cholangiopancreatography Case report Bilio-enteric anastomotic strictures

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Endoscopic management of chronic pancreatitis

引用

World Journal of Gastrointestinal Endoscopy 2013年第1期5卷 19-28页

作者： Veeral M Oza Michel Kahaleh Division of Gastroenterology and Hepatology Weill Cornell Medical CenterNew York Presbyterian HospitalNew YorkNY 10021United States

Chronic pancreatitis (CP) is a common gastrointestinal illness, which affects the quality of life with substantial morbidity and mortality. The management includes medical, endoscopic and surgical approaches with the need for interaction between various specialties, calling for a concerted multidisciplinary approach. However, at the time of this publication, guidelines to establish care of these patients are lacking. This review provides the reader with a comprehensive overview of the studies summarizing the various treatment options available, including medical, surgical and endoscopic options. In addition, technological advances such as endoscopic retrograde cholangiopancreatogrophy, endoscopic shock wave lithotripsy and endoscopic ultrasound can now be offered with reasonable success for pancreatic decompression, stricture dilatation with stent placement, stone fragmentation, pseudocyst drainage, and other endoscopic interventions such as celiac plexus block for pain relief. We emphasize the endoscopic op-tions in this review, and attempt to extract the most up to date information from the current literature. The treatment of CP and its complications are discussed extensively. Complications such as biliary strictures. pancreatic pseudocysts, and chronic pain are common issues that arise as long-term complications of CP. These often require endoscopic or surgical management and possibly a combination of approaches, however choosing amongst the various therapeutic and palliative modalities while weighing the risks and benefits, makes the management of CP challenging. Treatment goals should be not just to control symptoms but also to prevent disease progression. Our aim in this paper is to advocate and emphasize an evidence based approach for the management of CP and associated long term complications.

关键词： Chronic Pancreatitis Biliary strictures Pseudocysts Endoscopic management Pain Pancreatic stones

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：