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Evaluating the risk of adverse events with interventional endoscopic retrograde cholangiopancreatography and endoscopic ultrasound procedures in cirrhotic patients

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World Journal of Gastrointestinal Endoscopy 2019年第11期11卷 523-530页

作者： Timothy Yoo Raisa Epistola Jordan Epistola Lawrence Ku Michael W Fleischman Sofiya Reicher Viktor E Eysselein Linda A Hou Department of Internal Medicine Harbor-UCLA Medical CenterTorranceCA 90509United States Department of Psychology SocialDecisionand Organizational Sciences ProgramUniversity of MarylandCollege ParkMD 20742United States Department of Internal Medicine Division of GastroenterologyHarbor-UCLA Medical CenterTorranceCA 90509United States

BACKGROUND Hepatic cirrhosis is associated with greater adverse event rates following surgical procedures and is thought to have a higher risk of complications with interventional procedures in ***,these same patients often require interventional gastrointestinal procedures such as endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS).While studies examining this scenario exist,the overall body of evidence for adverse event rates associated with ERCP/EUS procedures is more *** sought add to the literature by examining the incidence of adverse events after ERCP/EUS procedures in our safety-net hospital population with the hypothesis that severity of cirrhosis correlates with higher adverse event *** To examine whether increasing severity of cirrhosis is associated with greater incidence of adverse events after interventional ERCP/EUS *** We performed a retrospective study of patients diagnosed with hepatic cirrhosis who underwent ERCP and/or EUS-guided fine needle aspirations/fine needle biopsies from January 1,2016 to March 14,2019 at our safety net *** recorded Child-Pugh and Model for End-stage Liver Disease(MELD-Na)scores at time of procedure,interventions completed,and 30-day post-procedural adverse *** analyses were done to assess whether Child-Pugh class and MELD-Na score were associated with greater adverse event rates and whether advanced techniques(single-operator cholangioscopy,electrohydraulic lithotripsy/laser lithotripsy,or needle-knife techniques)were associated with higher complication *** 77 procedures performed on 36 patients were *** study population consisted primarily of middle-aged Hispanic males.30-d procedure-related adverse events included gastrointestinal bleeding(7.8%),infection(6.5%),and bile leak(2%).The effect of Child-Pugh class C vs class A and B significantly predicted adverse events(β=0.55,P<0.01).MELD-Na scores also signifi

关键词： Endoscopic retrograde cholangiopancreatography Endoscopic ultrasound Fine-needle aspiration Fine-needle biopsy Hepatic cirrhosis Model for End-stage Liver Disease Child-Pugh Class Adverse events

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Comments on Thermal effect of holmium laser lithotripsy under ureteroscopy

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Chinese Medical Journal 2020年第1期133卷 86-87页

作者： Jing-Fei Teng Kai Wang Xing Ai Department of Urology The Seventh Medical Center of PLA General HospitalBeijing 100700China Department of Urology Zhejiang Xiaoshan HospitalHangzhouZhejiang 311202China

To the Editor:We appreciate the work Wang et al[1]have done on thermal effect of holmium laser lithotripsy under *** laser is considered as the optimum lithotripter for ureteroscopy due to its effectiveness.[2]With the application of high-power laser system,the potential risk of ureter thermal injury *** in-vitro and animal experiments have been carried out to assess temperature changes of lavage solution during laser activation recent *** the best of our knowledge,this is the first human study revealing temperature changes of ureter lavage solution during holmium laser ureteroscopic lithotripsy.

关键词： laser effect thermal

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Research and developments of laser assisted methods for translation into clinical application

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Frontiers of Optoelectronics 2017年第3期10卷 239-254页

作者： Ronald SROKA Nikolas DOMINIK Max EISEL Anna ESIPOVA Christian FREYMULLER Christian HECKL Georg HENNIG Christian HOMANN Nicolas HOEHNE Robert KAMMERER Thomas KELLERER Alexander LANG Niklas MARKWARDT Heike POHLA Thomas PONGRATZ Claus-Georg SCHMEDT Herbert STEPP Stephan STROBL Keerthanan ULAGANATHAN Wolfgang ZIMMERMANN Adrian RUEHM Laser-Forschungslabor LIFE-Center Hospital of University Ludwig-Maximilians University Munich Munich Germany Department of Urology Hospital of University Ludwig-Maximilians University Munich Munich Germany Department of Vascular Surgery Diakonie Klinikum Schwaibisch Hall Germany Labor fur Tumorimmunologie LIFE-Center Hospital of University Ludwig-Maximilians University Munich Munich Germany Friedrich-Loeftter-Institute Federal Research Institute for Animal-Health Greifswald- Insel Riems Germany

Biophotonics and laser medicine are very dynamic and continuously increasing fields ecologically as well as economically. Direct communication with medical doctors is necessary to identify specific requests and unmet needs. Information on innovative, new or renewed techniques is necessary to design medical devices for introduction into clinical application and finally to become established after positive clinical trials as well as medical approval. The long-term endurance in developing light based innovative clinical concepts and devices are described based on the Munich experience. Fluorescence technologies for laboratory medicine to improve non- invasive diagnosis or for online monitoring are described according with new approaches in improving photody- namic therapeutic aspects related to immunology. Regard- ing clinically related thermal laser applications, the introduction of new laser wavelengths and laser parameters showed potential in the treatment of varicose veins as well as in lithotripsy. Such directly linked research and development are possible when researchers and medical doctors perform their daily work in immediate vicinity, thus have the possibility to share their ideas in meetings by day.

关键词： translational biophotonics thermal laser appli-cation fluorescence diagnosis on-line monitoring litho-tripsy phlebology photodynamic therapy (PDT),laboratory medicine

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Diagnostic and therapeutic single-operator cholangiopancreatoscopy in biliopancreatic diseases:Prospective multicenter study in Japan

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World Journal of Gastroenterology 2016年第5期22卷 1891-1901页

作者： Toshio Kurihara Ichiro Yasuda Hiroyuki Isayama Toshio Tsuyuguchi Taketo Yamaguchi Ken Kawabe Yoshinobu Okabe Keiji Hanada Tsuyoshi Hayashi Takao Ohtsuka Syuhei Oana Hiroshi Kawakami Yoshinori Igarashi Kazuya Matsumoto Kiichi Tamada Shomei Ryozawa Hiroki Kawashima Yutaka Okamoto Iruru Maetani Hiroyuki Inoue Takao Itoi Department of Gastroenterology and Hepatology Tokyo Medical University6-7-1 NishishinjukuShinjuku-kuTokyo 160-0023Japan First Department of Internal Medicine Gifu University HospitalGifu 501-1194Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology and Nephrology Chiba University Graduate School of MedicineChiba 260-8677Japan Department of Gastroenterology Chiba Cancer CenterFunabashi Municipal HospitalChiba 260-8717Japan Department of Gastroenterology Clinical Research InstituteNational Hospital OrganizationKyushu Medical CenterFukuoka 810-8563Japan Division of Gastroenterology Department of MedicineKurume University School of MedicineKurume 830-0011Japan Department of Gastroenterology Onomichi General HospitalOnomichi 722-8508Japan Department of Medical Oncology and Hematology Sapporo Medical University School of MedicineSapporo 060-8543Japan Department of Surgery and Oncology Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan Department of Gastroenterology Iwate Medical UniversityMorioka 020-0023Japan Department of Gastroenterology and Hepatology Graduate School of MedicineHokkaido UniversitySapporo 060-8648Japan Division of Gastroenterology and Hepatology Omori Medical CenterToho UniversityTokyo 143-0015Japan Department of Gastroenterology Tottori University HospitalYonago 683-8504Japan Department of Internal Medicine Division of GastroenterologyJichi Medical UniversityShimotsuke 329-0498Japan Department of Gastroenterology Digestive Disease CenterShowa UniversityNorthern Yokohama HospitalYokohama 224-0032Japan Department of Gastroenterology and Hepatology Graduate School of MedicineNagoya UniversityNagoya 466-8550Japan Department of Gastroenterology Mutsu General HospitalMutsu 035-0071Japan Division of Gastroenterology Department of Internal MedicineOhashi Medical CenterToho UniversityTokyo 153-0044Japan Department of Gastroenterology Mie University

AIM: To assess the utility and safety of single-operator cholangiopancreatoscopy(SOCPS) using the Spy Glass system in widespread clinical application for biliary and pancreatic ***: This study was a prospective case series conducted in 20 referral centers in Japan. There were 148 patients who underwent SOCPS; 124 for biliary diseases and 24 for pancreatic diseases. The attempted interventions were SOCPS examination, SOCPS-directed tissue sampling, and therapy for stone removal, among others. The main outcomes were related to the procedure success rate in terms of visualizing the target lesions, SOCPS-directed adequate tissue sampling, and complete stone removal. RESULTS: A total of 148 patients were enrolled for the diagnosis of indeterminate biliary and pancreatic lesions or treatment of biliary and pancreatic disease. The overall procedure success rate of visualizing the target lesions was 91.2%(135/148). The overall procedural success rates of visualizing the target lesions of diagnostic SOCPS in the bile duct and pancreatic duct were 95.5%(84/89) and 88.2%(15/17), respectively. Diagnosis: the overall adequate tissue for histologic examination was secured in 81.4% of the 86 patients who underwent biopsy under SOCPS(bile duct, 60/75, 80.0%; pancreatic duct, 10/11, 90.9%). The accuracy of histologic diagnosis using SOCPS-directed biopsies in indeterminate bile duct lesions was 70.7%(53/75). In the pancreatic duct, the accuracy of SOCPS visual impression of intraductal papillary mucinous neoplasm was 87.5%(14/16). Stone therapy: complete biliary and pancreatic stone clearance combined with SOCPS-directed stone therapy using electrohydraulic lithotripsy or laser lithotripsy was achieved in 74.2%(23/31) and 42.9%(3/7) of the patients, respectively. Others: SOCPS using the Spy Glass system was used in cannulation of the cystic duct in two patients and for passing across the obstructed self-expandable metallic stent for a malignant biliary stricture in two

关键词： Cholangioscopy Endoscopic retrogradecholangiopancreatography Pancreatoscopy Singleoperator SpyGlass

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Endoscopic papillary balloon dilation:Revival of the old technique

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World Journal of Gastroenterology 2013年第45期19卷 8258-8268页

作者： Seung Uk Jeong Sung-Hoon Moon Myung-Hwan Kim Department of Internal Medicine Jeju National University School of Medicine Jeju 690-767 South Korea Department of Internal Medicine Hallym University Sacred Heart Hospital Hallym University College of Medicine Anyang 431-070 South Korea Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine Seoul 138-736 South Korea

Radiologists first described the removal of bile duct stones using balloon dilation in the early ***,there has been renewed interest in endoscopic balloon dilation with a small balloon to avoid the complications of endoscopic sphincterotomy(EST)in young patients undergoing laparoscopic ***,there is a disparity in using endoscopic balloon papillary dilation(EPBD)between the East and the West,depending on the origin of the *** the early 2000s,EST followed by endoscopic balloon dilation with a large balloon was introduced to treat large or difficult biliary *** balloon dilation with a large balloon has generally been recognized as an effective and safe method,unlike ***,fatal complications have occurred in patients with endoscopic papillary large balloon dilation(EPLBD).The safety of endoscopic balloon dilation is still a debatable ***,guidelines of indications and techniques have not been established in performing endoscopic balloon dilation with a small balloon or a large *** this article,we discuss the issue of conventional and large balloon endoscopic *** also suggest the indications and optimal techniques of EPBD and EPLBD.

关键词： Endoscopic papillary balloon dilation Endoscopic papillary large balloon dilation Common bile duct stone Endoscopic sphincterotomy Mechanical lithotripsy

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Coca-Cola consumption vs fragmentation in the management of patients with phytobezoars:A prospective randomized controlled trial

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World Journal of Gastrointestinal Endoscopy 2024年第2期16卷 83-90页

作者： Fu-Guo Liu De-Feng Meng Xia Shen Dan Meng Ying Liu Ling-Yun Zhang Department of Gastroenterology The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina Endoscopy center The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina

BACKGROUND Gastric phytobezoars(GPBs)are very common in northern *** therapy involving carbonated beverage consumption and endoscopic lithotripsy has been shown to be effective and *** studies on this subject are often case reports highlighting the successful dissolution of phytobezoars through Coca-Cola ***,large-scale prospective investigations in this domain remain ***,we conducted a randomized controlled trial to examine the effects of Coca-Cola consumption on *** To evaluate the impact of Coca-Cola on GPBs,including the dissolution rate,medical expenses,ulcer rate,and operation *** A total of 160 consecutive patients diagnosed with GPBs were allocated into two groups(a control group and an intervention group)through computer-generated *** in the intervention group received a Coca-Cola-based regimen(Coca-Cola 2000-4000 mL per day for 7 d),while those in the control group underwent emergency *** Complete dissolution of GPBs was achieved in 100% of the patients in the intervention *** disparity in expenses between the control group and intervention group(t=25.791,P=0.000)was statistically significant,and the difference in gastric ulcer occurrence between the control group and intervention group(χ^(2)=6.181,P=0.013)was also statistically *** Timely ingestion of Coca-Cola yields significant benefits,including a complete dissolution rate of 100%,a low incidence of gastric ulcers,no need for fragmentation and reduced expenses.

关键词： Coca-Cola Bezoars Solubility lithotripsy Gastrosco

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Multimodal treatments of “gallstone cholangiopancreatitis”

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World Journal of Gastrointestinal Endoscopy 2022年第7期14卷 467-470页

作者： Serafino Vanella Mario Baiamonte Francesco Crafa Division of General and Surgical Oncology St.Giuseppe Moscati HospitalCenter of National Excellence and High SpecialtyAvellino 83100Italy General and Emergency Surgery Unit Civico Benfratelli Di Cristina HospitalPalermo 90121Italy Oncological and General Surgery Unit St.Giuseppe Moscati HospitalCenter of National Excellence and High SpecialtyAvellino 83100Italy

Gallstone cholangiopancreatitis is a potentially life-threatening pathology which requires quick intervention involving endoscopists,interventional radiologists,anesthesiologists and surgeons in relation to clinical *** possibilities are varied,especially with current progress in advanced endoscopy,interventional radiology,and minimally invasive *** following treatments are available:endoscopic sphincterotomy(ES)with stone extraction followed by laparoscopic cholecystectomy;simultaneous endoscopic stone extraction with laparoscopic cholecystectomy(rendezvous technique);combined laparoscopic cholecystectomy and common bile duct(CBD)exploration;open CBD exploration;ES post-cholecystectomy;percutaneous placement of biliary drains for unstable patients,followed by percutaneous cholangioscopy;and lithotripsy with different approaches,including a laser and balloon dilation of the sphincter of *** technique has its strengths and weaknesses,and there is great discussion in the literature on choosing the ideal approach based on the patient’s clinical conditions.

关键词： Cholangiopancreatitis Common bile duct stones Endoscopic retrograde cholangiopancreatography Endoscopic sphincterotomy Laparoscopic common bile duct exploration Percutaneous

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

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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).

关键词： Endoscopic papillary large balloon dilation Endoscopic sphincterotomy Mechanical lithotripsy Common bile duct stones Meta analysis.

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Percutaneous nephrolithotomy and laparoscopic surgery efficacy and renal function outcomes for large and complex renal calculi

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Current Urology 2024年第4期18卷 268-272页

作者： Yuriy Pak Nina Kalyagina Daniel Yagudaev CUC City Multidisciplinary Hospital No.2 City Center of UrologyNur-SultanKazakhstan Prokhorov General Physics Institute of the Russian Academy of Sciences MoscowRussia National Research Nuclear University MEPhI MoscowRussia Peoples’Friendship University of Russia(RUDN University) MoscowRussia Central Clinical Hospital Russian Railways-MedicineMoscowRussia

Background There is limited published evidence regarding the incidence of intraoperative and postoperative events and the effect of percutaneous nephrolithotomy(PCNL)in supine and prone positions and laparoscopic pyelolithotomy on kidney function in patients with large and complex *** and methods We evaluated the surgical outcomes of 97 patients with large and complex kidney *** patients were divided into 3 groups:those who underwent PCNL in the prone position,PCNL in the supine position,and pyelolithotomy by laparoscopy and *** surgical outcomes,size of residual stones,stone-free rate,glomerular filtration rate(GFR),and split GFR obtained from Tc-99m renal dynamic scintigrams were *** Percutaneous nephrolithotomy in the prone position was correlated with improved function of the affected *** the supine PCNL group,none of the analyzed indicators demonstrated a significant *** nephroscintigrams revealed negative changes in terms of accumulation and secretion of the affected kidney.A slight decrease in creatinine clearance was ***,positive dynamics in split GFR and secretory index were seen in this *** laparoscopic group showed positive results in all analyzed ***,full assessment of the function of the affected kidney in this group was limited due to restricted use of laparoscopic pyelolithotomy for complex *** Percutaneous nephrolithotomy in the prone position resulted in the most favorable renal functional outcomes for patients with high-grade renal calculi,whereas a laparoscopic approach may be preferred for patients with stones of lower *** most significant factors that adversely affected renal function were intraoperative bleeding volume,kidney stone size and density,and body mass index.

关键词： Dynamic nephroscintigraphy Large and complex renal calculi lithotripsy Percutaneous nephrolithotomy Prone and supine positions Renal function

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Comparison between endoscopic sphincterotomy vs endoscopic sphincterotomy associated with balloon dilation for removal of bile duct stones:A systematic review and meta-analysis based on randomized controlled trials

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World Journal of Gastrointestinal Endoscopy 2018年第8期10卷 130-144页

作者： Cesar Capel de Clemente Junior Wanderley Marques Bernardo Tomazo Prince Franzini Gustavo Oliveira Luz Marcos Eduardo Lera dos Santos Jonah Maxwell Cohen Diogo Turiani Hourneaux de Moura Fábio Ramalho Tavares Marinho Martin Coronel Paulo Sakai Eduardo Guimaraes Hourneaux de Moura Gastrointestinal Endoscopy Unit Department of GastroenterologyUniversity of Sao Paulo Medical SchoolSao Paulo 05403-010Brazil Beth Israel Deaconess Medical center Harvard Medical SchoolBostonMA 02215United States

AIM To compare gallstones removal rate and incidence of bleeding, pancreatitis, use of mechanical lithotripsy, cholangitis and perforation between isolated sphincterotomy vs sphincterotomy associated with balloon dilation of papilla in choledocholithiasis through the meta-analysis of randomized clinical trials. METHODS We conducted a systematic review according to the PRISMA guidelines. Literature search was restricted to randomized controlled trials(RCTs) on Med Line, Cochrane Library, LILACS, and EMBASE database platforms in July 2017. The manual search included references of retrieved articles. We extracted data focusing on outcomes: The primary endpoint was the stones removal rate; Secondary endpoints were rates of pancreatitis, bleeding, use of mechanical lithotripsy(ML), perforation and cholangitis. RESULTS Eleven RCTs with 1824 patients were included. EST was associated with more post-endoscopic retrograde cholangiopancreatography(ERCP) bleeding [FE RD-0.02, CI(-0.03,-0.00), I2 = 33%, P = 0.05] and more need of mechanical lithotripsy in general [RE RD-0.16, CI(-0.25,-0.06), I2 = 90%, P = 0.002] and in subgroup analysis of stones greater than 15 mm [RE RD-0.20, CI(-0.38,-0.02), I2 = 82%, P = 0.003]. Incidence of pancreatitis [FE RD-0.01, CI(-0.03, 0.01), I2 = 0, P = 0.36], cholangitis [FE RD-0.00, CI(-0.01, 0.01), I2 =0, P = 0.97] and perforation [FE RD-0.01, CI(-0.01, 0.00), I2 = 0, P = 0.23] was similar between the groups as well as similar stone removal rates in general [FE RD-0.01, CI(-0.01, 0.04), I2 = 0, P = 0.23] and pooled analysis of stones greater than 15 mm [FE RD-0.02, CI(-0.02, 0.07), I2 = 11%, P = 0.31]. CONCLUSION Through meta-analysis of randomized clinical trials we found that isolated sphincterotomy was associated with more post-ERCP bleeding and more need for mechanical lithotripsy. However, there was no statistical difference in the stone removal rate between isolated sphincterotomy and sphincterotomy associated with balloon dilation in the

关键词： Sphincterotomy Papillotomy Dilation Cholangiopancreatography Endoscopic retrograde Endoscopic retrograde cholangiopancreatography Cholangiography

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