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Characteristics of patients with columnar-lined Barrett's esophagus and risk factors for progression to esophageal adenocarcinoma

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World Journal of Gastroenterology 2005年第43期11卷 6807-6814页

作者： Kamal E Bani-Hani Bayan K Bani-Hani Iain G Martin Department of Surgery academic surgical unit and center for digestive diseases

AIM： To determine the risk factors for the development of esophageal adenocarcinoma in these patients with columnar-lined esophagus （CLE）. METHODS： Data collected retrospectively on 597 consecutive patients diagnosed at endoscopy and histology to have CLE at Leeds General Infirmary between 1984 and 1995 were analyzed. Factors evaluated included age, sex, length of columnar segment, smoking, and drinking habits, history of non-steroidal ingestion, presence of endoscopic esophagitis, ulceration or benign strictures and presence of Helicobacter pylori in esophageal biopsies. Univariate and multivariate analyses were performed to identify risk factors for the development of adenocarcinoma. RESULTS： Forty-four patients presented or developed esophageal adenocarcinoma during follow-up. Independent risk factors for the development of adenocarcinoma in palJents with CLE were males （OR 5.12, 95%CI 2.04-12.84, P = 0.0005）, and benign esophageal stricture （OR 4.37, 95%CI 2.02-9.45, P = 0.0002）. Male subjects and patients who developed benign esophageal stricture constituted 86% （n = 38） of all patients who presented or developed esophageal adenocarcinoma. The presence of esophagitis was associated with a significant reduction in the development of esophageal carcinoma （OR 0.28, 95%CI 0.13-0.57, P = 0.0006）. No other clinical characteristics differentiate between the non-malignant and malignant group. CONCLUSION： In patients with CLE, endoscopic surveillance for the early detection of adenocarcinoma may be restricted to male subjects, as well as patients who develop benign esophageal strictures.

关键词： Barrett's esophagus Adenocarcinoma Risk factors Esophageal adenocarcinoma Esophagealstricture

Combined application of the preclosure technique and traction approach facilitates endoscopic full-thickness resection of gastric submucosal tumors

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World Journal of Gastrointestinal Surgery 2025年第3期17卷 79-86页

作者： Qing-Qing Zu Yan You Ai-Zhi Chen Xiu-Rong Wang Si-Han Zhang Feng-Lin Chen Miao Liu Department of Gastrointestinal Endoscopy Nursing Union HospitalFujian Medical UniversityFuzhou 350001Fujian ProvinceChina Fujian Clinical Research center for digestive System Tumors and Upper Gastrointestinal diseases Fuzhou 350001Fujian ProvinceChina Department of Gastroenterology Union HospitalFujian Medical UniversityFuzhou 350001Fujian ProvinceChina

BACKGROUND Gastrointestinal submucosal tumors(SMTs)mostly grew in the lumen,but also some of the lesions were extraluminal,in which the stomach was the most co-mmon *** stromal tumor account for a large proportion of *** to the deep lesion location of gastric SMT,endoscopic submucosal dissection related techniques are difficult to operate,while endoscopic full-thickness rese-ction(EFTR)has been widely used in clinical practice because it is less invasive and can preserve the physiological structure and function of the ***-wever,complete closure of the gastrectomy site after EFTR is *** the closure is incomplete,it may cause peritonitis,late perforation and other conditions,and even require further surgical *** there are currently a number of suture devices and techniques that can be used to promote closure,they have the problem of requiring additional equipment or being inconvenient to *** metal clips are widely used,their effectiveness depends on the size and tension of the ***,an effective and convenient endoscopic closure technique is urgently needed to solve the closure problem of gastric SMTs after *** To investigate the effect of combined application of the preclosure technique and dental floss traction in gastric wound closure following *** In this study,the data of 94 patients treated for gastric SMTs at the Gastrointestinal Endoscopy center of the Affiliated Union Hospital of Fujian Medical University from April 2022 to May 2023 were retrospectively *** patients were divided into a preclosure group(54 patients)and a non-preclosure group(40 patients)on the basis of the timing of wound closure with titanium clips after dental floss traction-assisted *** patient in the preclosure group had their wounds preclosed with titanium clips after subtotal lesion resection,whereas each patient in the non-preclosure group had their wounds closed with titanium cl

关键词： Gastric submucosal tumor Dental floss traction Endoscopic full-thickness resection Preclosure technique

Can endoscopic atrophy predict histological atrophy? Historical study in united Kingdom and Japan

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World Journal of Gastroenterology 2015年第46期21卷 13113-13123页

作者： Shin Kono Takuji Gotoda Shigeaki Yoshida Ichiro Oda Hitoshi Kondo Luigi Gatta Greg Naylor Michael Dixon Fuminori Moriyasu Anthony Axon Department of Gastroenterology and Hepatology Tokyo Medical University Aomori Prefectural Central Hospital Endoscopy Division National Cancer Center Hospital center for digestive diseases Tonan Hospital Gastroenterology and digestive Endoscopy unit Versilia Hospital Chesterfield Royal Hospital academic unit of Pathology University of Leeds Centre for digestive Disease Leeds General Infirmary

AIM: To assess the diagnostic concordance between endoscopic and histological atrophy in the united Kingdom and ***: Using published data,a total of 252 patients,126 in the united Kingdom and 126 in Japan,aged 20 to 80 years,were evaluated. The extent of endoscopic atrophy was classified into five subgroups according to a modified Kimura-Takemoto classification system and was compared with histological findings of atrophy at five biopsy sites according to the updated Sydney ***: The strength of agreement of the extent of atrophy between histology and visual endoscopic inspection showed good reproducibili ty,wi th a weighted kappa value of 0.76(P < 0.001). Multivariate analysis showed that three factors were associated with decreased concordance: Japanese ethnicity [odds ratio(OR) 0.22,95% confidence interval(CI) 0.11-0.43],older age(OR = 0.32,95%CI: 0.16-0.66) and endoscopic atrophy(OR = 0.10,95%CI: 0.03-0.36). The strength of agreement between endoscopic and histological atrophy,assessed by cancer risk-oriented grading,was reproducible,with a kappa value of 0.81(95%CI: 0.75-0.87). Only nine patients(3.6%) were endoscopically underdiagnosed with antral predominant rather than extensive atrophy and were considered false ***: Endoscopic grading can predict histological atrophy with few false negatives,indicating that precancerous conditions can be identified during screening endoscopy,particularly in patients in western countries.

关键词： Gastritis Atrophy Histology Endoscopy Diagnosis

Endosonography guided management of pancreatic fluid collections

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World Journal of Gastroenterology 2015年第41期21卷 11842-11853页

作者： Andreas S Vilmann John Menachery Shou-Jiang Tang Indu Srinivasan Peter Vilmann Department of surgical Gastroenterology Copenhagen University Hospital Herlev Department of Gastroenterology Rajagiri Hospital Aluva Division of digestive diseases Department of Medicine University of Mississippi Medical Center

The revised Atlanta classification of acute pancreatitis was adopted by international consensus, and is based on actual local and systemic determinants of disease severity. The local determinant is pancreatic necrosis(sterile or infected), and the systemic determinant is organ failure. Local complications of pancreatitis can include acute peri-pancreatic fluid collection, acute necrotic collection, pseudocyst formation, and walledoff necrosis. Interventional endoscopic ultrasound(EUS) has been increasing utilized in managing these local complications. After performing a Pub Med search, the authors manually applied pre-defined inclusion criteria or a filter to identify publications relevant to EUS and pancreatic collections(PFCs). The authors then reviewed the utility, efficacy, and risks associated with using therapeutic EUS and involved EUS devices in treating PFCs. Due to the development and regulatory approval of improved and novel endoscopic devices specifically designed for transmural drainage of fluid and necrotic debris(access and patency devices), the authors predict continuing evolution in the management of PFCs. We believe that EUS will become an indispensable part of procedures used to diagnose PFCs and perform image-guided interventions. After draining a PFC, the amount of tissue necrosis is the most important predictor of a successful outcome. Hence, it seems logical to classify these collections based on their percentage of necrotic component or debris present when viewed by imaging methods or EUS. Finally, the authors propose an algorithm for managing fluid collections based on their size, location, associated symptoms, internal echogenic patterns, and content.

关键词： Endoscopic ultrasound Drainage Pancreatic fluid co

Hepatic applications of endoscopic ultrasound:Current status and future directions

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World Journal of Gastroenterology 2015年第44期21卷 12544-12557页

作者： Indu Srinivasan Shou-Jiang Tang Andreas S Vilmann John Menachery Peter Vilmann Division of digestive diseases Department of Medicine University of Mississippi Medical Center Jackson Department of surgical Gastroenterology Copenhagen University Hospital Herlev Department of Gastroenterology Rajagiri Hospital Aluva

The diagnosis and staging of various gastrointestinal malignancies have been made possible with the use of endoscopic ultrasound, which is a relatively safe procedure. The field of endoscopic ultrasound is fast expanding due to advancements in therapeutic endoscopic ultrasound. Though various studies have established its role in gastrointestinal malignancies and pancreatic conditions, its potential in the field of hepatic lesions still remains vastly untapped. In this paper the authors attempt to review important and landmark trials, case series and case studies involving hepatic applications of endoscopic ultrasound, thus not only providing an overview of utilization of endoscopic ultrasound in various liver conditions but also speculating its future role.

关键词： Endoscopic ultrasound Drainage Liver Intrahepatic

Entry of hepatitis C virus into the cell: A therapeutic target

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World Journal of Gastroenterology 2012年第33期18卷 4481-4485页

作者： José Antonio Del Campo ngela Rojas Manuel Romero-Gómez unit for Medical and surgical Management of digestive diseases Center for Biomedical Research in Digestive and Liver Diseases Network (CIBERehd) Valme University Hospital University of Seville E-41014 Sevilla Spain

Several receptors have been identified as implicated on viral entry into the hepatocyte; and, this interaction between the virus and potential receptors could modulate infection, spontaneous viral clearance, persistence of the infection and the widespread of the virus as outbreak. Nevertheless, the playing role of each of them remains controversial. The NiemannPick type C1 like 1 gene (NPC1L1) receptor has been recently implicated on hepatitis C virus (HCV) entry into the cell and ezetimibe, an anti-cholesterol drug seems to block that, emerging the idea to control hepatitis C outbreak modulating lipid-related receptors. Hepatitis C infection seems to modulate lipid metabolism according to host genetic background. Indeed, it circulates like a lipoviroparticle. The main aim of this field of vision would be to discuss the role of hepatocyte receptors implicated on virus entry, especially NPC1L1 and the therapeutic options derived from the better knowledge about HCV-lipidsreceptors interaction.

关键词： Hepatitis C virus entry Niemann-Pick type C1 like 1 gene Lipid metabolism Ezetimibe

Particular Chinese contributions to extracorporeal liver surgery

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Hepatobiliary & Pancreatic diseases International 2025年第1期24卷 57-66页

作者： Abudusalamu Aini Qian Lu Hao Wen Wen-Tao Wang Tuerganaili Aji Zhi-Yu Chen Lei-Da Zhang Zhan-Yu Yang Jia-Yin Yang Hai-Ning Fan Wei-Lin Wang Xiang-Cheng Li Yu Zhang Jia-Hong Dong Hepatopancreatobiliary center Organ Transplantation CenterBeijing Tsinghua Changgung HospitalTsinghua UniversityBeijing 102218China Key Laboratory of Digital Intelligence Hepatology(Chinese Ministry of Education) School of Clinical MedicineTsinghua UniversityBeijing 100084China Research unit of Precision Hepatobiliary Surgery Paradigm Chinese Academy of Medical SciencesBeijing 100010China Institute for Organ Transplantation and Bionics Institute for Precision MedicineSchool of Clinical MedicineTsinghua UniversityBeijing 100010China Hepatobiliary&Echinococcosis Surgery Digestive&Vascular Surgery CenterThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054China Department of Liver Surgery&Liver Transplantation center West China Hospital of Sichuan UniversityChengdu 610041China Department of Hepatobiliary Surgery Southwest HospitalThe Army Medical UniversityChongqing 100089China Faculty of Hepato-Pancreato-Biliary Surgery Chinese People’s Army General HospitalBeijing 400038China Liver Transplantation center&Organ Transplantation center West China Hospital of Sichuan UniversityChengdu 610041China Hepatopancreatobiliary Surgery School of Clinical MedicineQinghai University Affiliated HospitalXining 810006China Department of Hepatobiliary Surgery The Second Affiliated HospitalZhejiang Univeristy School of MedicineHangzhou 310009China Department of Hepatobiliary Surgery The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029China Department of Hepatobiliary Surgery Sichuan Provincial People’s HospitalChengdu 610072China

Extracorporeal liver surgery(ELS), also known as liver autotransplantation, is a hybrid(cross-fertilized) surgery incorporating the technical knowledge from extreme liver and transplant liver surgeries, and recently became more embraced and popularized among leading centers. ELS could be summarized into three major categories, namely, ex-situ liver resection and autotransplantation(ELRA), ante-situm liver resection and autotransplantation(ALRA) and auxiliary partial liver autotransplantation(APLA). The successful development of ELS during the past 37 years is definitely inseparable from continuous effort s done by Chinese surgeons and researchers. Especially, the precision liver surgery paradigm has allowed to transform ELS into a modularized, more simplified, and standardized surgery, to upgrade surgical skills, to improve peri-operative outcome and long-term survival, to increase the capability of surgeons to select more complex diseases and to expand the level of medical service to the population. This review highlights the Chinese contributions to the field of ELS, focusing thereby on features of different surgical types, technical innovations, disease selection and surgical indication, patient prognosis and future perspectives.

关键词： Ex-situ ex-vivo liver resection Ex-situ in-vivo liver resection Semi-ex-vivo liver resection Ex-situ liver resection after in-situ hepatectomy Liver autotransplantation Autologous liver transplantation Bench hepatectomy Back-table liver resection Precision liver surgery

Effect of hepatic artery embolization on liver hypertrophy response in a rabbit liver VX2tumor model

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Hepatobiliary & Pancreatic diseases International 2013年第6期12卷 622-629页

作者： Krijn P van Lienden Lisette T Hoekstra Jessica D van Trigt Joris J Roelofs Otto M van Delden Thomas M van Gulik Department of Radiologyacademic Medical center University of Amsterdam Department of Surgery (surgical Laboratory)academic Medical center University of Amsterdam Department of Pathologyacademic Medical center University of Amsterdam

BACKGROUND:Portal vein embolization not only induces hypertrophy of the non-embolized liver,but also enhances tumor *** latter could be prevented by embolizing the hepatic arteries supplying the tumor-bearing liver *** study aimed to determine the effects of transcatheter arterial embolization(TAE)on tumor volume and liver regeneration in a rabbit VX2 tumor ***:Twenty-three rabbits underwent subcapsular tumor implantation with a VX2 *** weeks after implantation,18 rabbits were used for TAE experiments,5were for sham *** response and liver regeneration response of the embolized cranial and non-embolized caudal liver lobes were assessed by CT volumetry,liver to body weight index,and the amount of proliferating ***:All super-selective arterial tumor embolization procedures were performed *** embolization,the tumor volume increased after an initial steady *** tumor volume after embolization was smaller than that of the sham group,but this difference was not *** necrosis of the tumor,however,was seen after embolization,without damage of the surrounding liver *** was a significant atrophy response of the tumor bearing cranial lobe after super-selective arterial embolization of the tumor with a concomitant hypertrophy response of the non-embolized,caudal *** regeneration response was confirmed histologically by a significantly higher number of proliferating hepatocytes on the Ki-67 stained ***:Super-selective,bland arterial coil embolization causes massive necrosis of the tumor,despite increase of volume on CT *** of the tumor bearing liver lobe is seen after arterial embolization of the tumor with a concomitant hypertrophy response of the non-embolized lobe,despite absence of histological damage of the tumor-surrounding liver parenchyma.

关键词： hypertrophy liver regeneration animal model transarterial embolization hepatic artery

Isolated segmental,sectoral and right hepatic bile duct injuries

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World Journal of Gastroenterology 2009年第12期15卷 1415-1419页

作者： Radoje B Colovic Institute of digestive diseases First Surgical ClinicClinical Center of Serbia6 Koste Todorovica11000 BelgradeSerbia

The treatment of isolated segmental, sectoral and right hepatic bile duct injuries is controversial. Nineteen patients were treated over a 26-year period. Group one was comprised of 4 patients in whom the injury was primarily repaired during the original surgery; 3 over a T-tube, 1 with a Roux-en-Y. These patients had an uneventful recovery. The second group consisted of 5 patients in whom the duct was ligated; 4 developed infection, 3 of which required drainage and biliary repair. Two patients had good long-term outcomes; the third developed a late anastomotic stricture requiring further surgery. The fourth patient developed a small bile leak and pain which resolved spontaneously. The fifth patient developed complications from which he died. The third group was comprised of 4 patients referred with biliary peritonitis; all underwent drainage and lavage, and developed biliary fistulae, 3 of which resolved spontaneously, 1 required Roux-en-γ repair, with favorable outcomes. The fourth group consisted of 6 patients with biliary fistulae. Two patients, both with an 8-wk history of a fistula, underwent Roux-en-γ repair. Two others also underwent a Roux-en-γ repair, as their fistulae showed no signs of closure. The remaining 2 patients had spontaneous closure of their biliary fistulae. A primary repair is a reasonable alternative to ligature of injured duct. Patients with ligated ducts may develop complications. Infected ducts require further surgery. Patients with biliary peritonitis must be treated with drainage and lavage. There is a 50% chance that a biliary fistula will close spontaneously. In cases where the biliary fistula does not close within 6 to 8 wk, a Roux-en-γ anastomosis should be considered.

关键词： Segmental bile duct Sectoral bile duct Right hepatic bile duct Injury Treatment