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Efficacy of cap-assisted endoscopy for routine examining the ampulla of vater

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World Journal of Gastroenterology 2013年第13期19卷 2037-2043页

作者： Young Rak Choi Joung-Ho Han Young Shim Cho Hye-Suk Han Hee Bok Chae Seon Mee Park Sei Jin Youn Department of Internal Medicine College of MedicineChungbuk National University

AIM: To determine the efficacy of a cap-assisted endoscopy (CAE) to completely visualize the ampulla of vater (AV) in patients failed by conventional endoscopy. METHODS: A prospective study was conducted on 120 patients > 20 years of ages who visited the Health Promotion Center of Chungbuk National University Hospital for conscious sedation esophagogastroduodenoscopy (EGD) as a screening test from July to October, 2011. First, forward-viewing endoscopy was performed with reasonable effort using a push and pull method. We considered complete visualization of the AV when we could observe the entire AV including the orifice clearly, and reported the observation as complete or incomplete (partial or not found at all). Second, in cases of complete failure of the observation, an additional AV examination was conducted by attaching a short cap (D-201-10704, Olympus Medical Systems, Tokyo, Japan) to the tip of a forward-viewing endoscope. Third, if the second method failed, we replaced the short cap with a long cap (MH-593, Olympus Medical Systems) and performed a re-examination of the AV. RESULTS: Conventional endoscopy achieved complete visualization of the AV in 97 of the 120 patients (80.8%) but was not achieved in 23 patients (19.2%). Age (mean ± SD) and gender [male (%)] were not significantly different between the complete observation and the incomplete observation groups. Additional short CAE was performed in patients in whom we could not completely visualize the AV. This group included 13 patients (10.9%) with partial observation of the AV and 10 (8.3%) in which the AV was not found. Short CAE permitted a complete observation of the AV in 21 of the 23 patients (91.3%). Patients in whom visualization of the AV failed with short CAE had satisfactory outcomes by replacing the short cap with a long cap. The additional time for CAE took an average of 141 ± 88 s. There were no complications and no significant mucosal trauma. CONCLUSION: CAE is safe to use as a salvage me

关键词： Ampulla of vater Conventional endoscopy Cap-assisted endoscopy Screening test Complete oservation

Tubercular Papillitis of vater

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International Journal of Clinical Medicine 2012年第6期3卷 469-472页

作者： Tateki Yamane Takayuki Ishii Akira Umeda Shigeharu Takagi Hitoshi Shimao Department of Surgery The International University of Health and Welfare Shioya Hospital Yaita Japan Division of Gastroenterology Department of Internal Medicine The International University of Health and Welfare Shioya Hospital Yaita Japan Division of Neurology Department of Internal Medicine The International University of Health and Welfare Shioya Hospital Yaita Japan Division of Pulmonology Department of Internal Medicine The International University of Health and Welfare Shioya Hospital Yaita Japan Sanikukai Family Clinic Funabashi Japan

A middle-aged man with no symptom or history visited our hospital due to duodenal abnormality and fecal occult blood detected by health screening. Upper gastrointestinal endoscopy showed marked enlargement of the papilla of vater surrounded by nodules, and biopsy disclosed non-caseating granuloma. Colonoscopy yielded findings suggestive of intestinal tuberculosis such as annular ulcers. Examination of the biopsy samples failed to make a diagnosis of tuberculosis, and no pulmonary lesion was found, but whole-blood interferon gamma release assay was positive. The duodenal lesion was also suspected to be tubercular, so antitubercular drugs were administered. As this resulted in the resolution of both lesions, a definite diagnosis of tubercular papillitis of vater was made. Duodenal tuberculosis is rare, and a localized lesion of the major duodenal papilla is extremely rare. However, this case suggests that tuberculosis must be considered in the differential diagnosis of lesions of the papilla of vater.

关键词： Duodenal Tuberticulosis Papillitis of vater Intestinal Tuberculosis

Obstructive Azoospermia in a Patient with vater Association

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Open Journal of Pathology 2012年第4期2卷 159-161页

作者： Zhanyong Bing Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania Philadelphia USA

vater association was first described in 1968 by Say and Gerald and is an association of congenital anomalies including V (vertebral defect), A (anal atresia), TE (tracheoesophegeal fistula), and R (radial dysplasia and renal defects). This report described a 26 year-old man with vater association presented with infertility. Hormone tests including follicular stimulating hormone, luteinizing hormone and testosterone were normal. Semen analysis showed azoospermia. A testicular biopsy was performed and showed the presence of all of germinative components, germ cell sloughing, and mild hypospermatogenesis. The findings were compatible with obstructive azoospermia. No evidence of intratubular germ cell neoplasia unclassified was identified.

关键词： vater Association Obstructive Azoospermia

Signet Ring Cell Carcinoma of Ampulla of vater: Report of a Rare Malignancy and Literature Review

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Case Reports in Clinical Medicine 2014年第3期3卷 145-148页

作者： Ihsane Souaf Kawtar Znati Sanae Chahbouni Imane Hafid Hassania Ameurtesse Nawale Hammas Leila Chbani Hinde El Fatemi Tawfik Harmouch Afaf Amarti Department of Pathology Hassan II University Hospital of Fez Hassan Morocco

Introduction: Signet ring cell carcinoma is a rare tumor that generally originates in the gastrointestinal tract. Signet-ring cell carcinoma of the ampulla of vater is extremely uncommon and a very rare clinical entity, which is infrequently reported in medical literature and only 31 cases have been mentioned. Most tumors affecting vater’s Ampulla are adenocarcinomas and other histological variants are less frequent. It mainly occurs in elderly patients. Case Presentation: We report a case of signet ring cell carcinoma of vater’s Ampulla. The tumour had infiltrated the duodenal, but local lymph nodes were clear (T3N0M0). Duodenopancreatectomy with pylorus preservation is the treatment of choice. Conclusions: Etiology and survival are not well-defined in the literature due to the extreme rarity of this disease.

关键词： Ampulla of vater Carcinoma Signet Ring Cell Pancreas

Trends in incidence and management of cancer of the ampulla of vater

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World Journal of Gastroenterology 2014年第29期20卷 10144-10150页

作者： Florian Rostain Samia Hamza Antoine Drouillard Jean Faivre Anne-Marie Bouvier C?me Lepage Registre Bourguignon des Cancers Digestifs INSERM U866CHU de DijonFaculté de Médecine21079 Dijon CedexFrance

AIM:To provide trends in incidence,management and survival of cancer of the ampulla of vater in a welldefined French ***:Data were obtained from the populationbased digestive cancer registry of Burgundy over a34-year ***-standardized incidence rates were computed using the world standard *** annual variations in incidence rates were estimated using a poisson regression.A univariate and multivariate relative survival analysis was ***:Age-standardized incidence rates were0.46 and 0.30 per 100000 inhabitants for men and women,*** rate increased from0.26(1976-1984)to 0.58(2003-2009)for men and remained stable for *** for cure was performed in 48.3%of *** proportion was stable over the study *** cases with curative resection,pancreatico-duodenectomy was performed in94.0%of cases and ampullectomy in 6.0%of cases.A total of 50.8%of cancers of the ampulla of vater were diagnosed at an advanced *** proportion remained stable throughout the study *** overall1-and 5-year relative survival rates were 60.2%and27.7%,*** survival did not vary over *** and stage at diagnosis were the most important determinants of *** 5-year relative survival rate was 41.5%after resection for cure,9.5%after palliative surgery and 6.7%after symptomatic *** multivariate analysis,only stage at diagnosis significantly influenced the risk of ***:Cancer of the ampulla of vater is still uncommon,but its incidence increased for men in *** is often made at an advanced stage,dramatically worsening the prognosis.

关键词： Cancer of the ampulla of vater Incidence Survival

Gastrointestinal stromal tumor of the ampulla of vater:A case report

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World Journal of Gastroenterology 2014年第16期20卷 4817-4821页

作者： Masayoshi Kobayashi Nobuto Hirata So Nakaji Toshiyasu Shiratori Hiroyuki Fujii Eiji Ishii Department of Gastroenterology Kameda Medical CenterChiba 296-0041Japan

Gastrointestinal stromal tumors(GISTs)usually develop in the stomach and small intestine and only rarely occur at the ampulla of vater,with only 11 cases reported in the *** report a case of a GIST of the ampulla of vater.A 36-year-old,previously healthy man presented with a loss of consciousness lasting a few minutes.A gastroduodenal endoscopy revealed a submucosal tumor with central ulceration at the ampulla of *** enhanced computed tomography scan revealed a smooth-outlined hypervascular solid mass(24 mm×30 mm)in the second part of the *** lymphadenopathy nor metastasis was *** resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography showed normal bile and pancreatic *** were collected from the ulcerative lesion,and the tumor was diagnosed as a GIST.A submucosal tumor with central ulceration may be a characteristic form of GISTs of the ampulla of vater,and biopsy studies are useful for the diagnosing such *** patient underwent pancreatoduodenectomy,and the operative specimen revealed a 2.2-cm GIST with 1 mitosis per 50 highpower *** gold standard for treatment of GISTs is surgical resection without rupture of a *** technically possible,local resection may be ***,when the location of the lesion presents challenges,a pancreatoduodenectomy should be performed for GIST of the ampulla of vater.

关键词： Gastrointestinal stromal tumor Ampulla of vater Su

Als vater wieder heiraten wollte

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德语人文研究 1994年第1期 1-2页

ＡｌｓＶａｔｅｒｗｉｅｄｅｒｈｅｉｒａｔｅｎｗｏｌｌｔｅＧｎｔｅｒＧｒａｓｓＡｌｓＶａｔｅｒｗｉｅｄｅｒｈｅｉｒａｔｅｎｗｏｌｌｔｅ，ｓａｇｔｅｎｗｉｒｎｅｉｎ，ＮｉｃｈｔｗｅｇｅｎＭａｍａ，ｎｕｒｓｏ．Ｓｃｈｌｉｅ... 详细信息

ＡｌｓＶａｔｅｒｗｉｅｄｅｒｈｅｉｒａｔｅｎｗｏｌｌｔｅＧｎｔｅｒＧｒａｓｓＡｌｓＶａｔｅｒｗｉｅｄｅｒｈｅｉｒａｔｅｎｗｏｌｌｔｅ，ｓａｇｔｅｎｗｉｒｎｅｉｎ，ＮｉｃｈｔｗｅｇｅｎＭａｍａ，ｎｕｒｓｏ．ＳｃｈｌｉｅｌｉｃｈｈａｔＧｉｔｔａｚｗｅｉＪ...

关键词： vater

无肛伴发多种畸形和“vater”相关图的临床意义:附12例报告

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临床儿科杂志 1992年第5期10卷 338-339页

作者：宋家其汪肇国鲍南佘亚雄上海第二医科大学附属新华医院儿外科上海第二医科大学附属新华医院儿外科 20092

先天性无肛可伴发多种畸形。根据1973年Quan和Smith提出“vater”相关图名称是表示脊椎“V”缺陷,无肛“A”,伴有食道气管瘘的食道闭锁“TE”,桡骨和/或肾“R”发育畸形的一种帮助记忆的术语,组合中可欠缺1～2种畸形,也可参入心脏“C”... 详细信息

先天性无肛可伴发多种畸形。根据1973年Quan和Smith提出“vater”相关图名称是表示脊椎“V”缺陷,无肛“A”,伴有食道气管瘘的食道闭锁“TE”,桡骨和/或肾“R”发育畸形的一种帮助记忆的术语,组合中可欠缺1～2种畸形,也可参入心脏“C”和四肢畸形“L”就成为“VACTERL”的组合。

关键词：畸形病例肛直肠 vater 无肛相关图散布图伴发临床意义

vater氏壶腹周围癌的诊断及外科治疗(附胰十二指肠切除术31例分析)

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实用癌症杂志 1986年第2期 9-13页

作者：孙格非江西医学院一附院外科教研室

vater氏壶胶与乳头,胰腺头部、十二指肠降部及胆总管远端,在解剖上紧密相邻,发生癌肿后症状往往难以区分,大多相似为阻黄,腹痛、厌食、消瘦、胆囊肿大和腹部肿块等,故统称为壶腹周围癌。在外科治疗上均适应以胰十二指肠切除术(Wh-ipple... 详细信息

vater氏壶胶与乳头,胰腺头部、十二指肠降部及胆总管远端,在解剖上紧密相邻,发生癌肿后症状往往难以区分,大多相似为阻黄,腹痛、厌食、消瘦、胆囊肿大和腹部肿块等,故统称为壶腹周围癌。在外科治疗上均适应以胰十二指肠切除术(Wh-ipple术)。此术涉及对胰腺、胃、十二指肠、空肠和胆道等多脏器部分的联合切除和消化道重建,是腹部外科最复杂的手术之一。

关键词：壶腹周围癌胆总管胆囊胆管胆道胰漏 vater 胰十二指肠切除术壶腹癌胰腺残端外科治疗