检索结果-南通市图书馆

Therapeutic approaches for portal biliopathy: A systematic review

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of gastroenterology 2016年第45期22卷 9909-9920页

作者： Irene Franceschet Alberto Zanetto Alberto Ferrarese Patrizia Burra Marco Senzolo Gastroenterology Unit Department of Surgery Oncology and Gastroenterology University Hospital of Padua Multivisceral Transplant unit Department of Surgery Oncology and Gastroenterology University Hospital of Padua

Portal biliopathy(PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/nonneoplastic extrahepatic portal vein obstruction(EHPVO) and portal cavernoma(PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC(77%-100%), only a part of these(5%-38%) are symptomatic. Clinical presentation includes jaundice, cholangitis, cholecystitis, abdominal pain, and cholelithiasis. In this subset of patients is required a specific treatment. Different therapeutic approaches aimed to diminish portal hypertension and treat biliary strictures are available. In order to decompress PC, surgical porto-systemic shunt or transjugular intrahepatic porto-systemic shunt can be performed, and treatment on the biliary stenosis includes endoscopic(Endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy, balloon dilation, stone extraction, stent placement) and surgical(bilioenteric anastomosis, cholecystectomy) approaches. Definitive treatment of PB often requires multiple and combined interventions both on vascular and biliary system. Liver transplantation can be considered in patients with secondary biliary cirrhosis, recurrent cholangitis or unsuccessful control of portal hypertension.

关键词：门 biliopathy 门 cavernoma 磁性的回声 cholangiopancreatography 内视镜后退 cholangiopancreatography 波尔图全身的分流

Effectiveness of very low-volume preparation for colonoscopy:A prospective, multicenter observational study

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 2020年第16期26卷 1950-1961页

作者： Marcello Maida Emanuele Sinagra Gaetano Cristian Morreale Sandro Sferrazza Giuseppe Scalisi Dario Schillaci Marco Ventimiglia Fabio Salvatore Macaluso Giovanni Vettori Giuseppe Conoscenti Concetta Di Bartolo Serena Garufi Domenico Catarella Michele Manganaro Clara Maria Virgilio Salvatore Camilleri gastroenterology and Endoscopy unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy gastroenterology and Endoscopy unit Istituto San Raffaele GiglioCefalu 90015Italy gastroenterology and Endoscopy unit Santa Chiara HospitalTrento 38014Italy Gastroenterology Unit ARNAS GaribaldiCatania 95100Italy Gastroenterology Unit Basarocco HospitalNiscemi 93015CaltanissettaItaly Department of Internal Medicine Villa Sofia-Cervello HospitalPalermo 90100Italy

BACKGROUND The effectiveness of colonoscopy strictly depends on adequate bowel cleansing.Recently,a 1 L polyethylene glycol plus ascorbate(PEG-ASC)solution(Plenvu;Norgine,Harefield,united Kingdom)has been introduced on the evidence of three phase-3 randomized controlled trials,but it had never been tested in the real-life.AIM To assess the effectiveness and tolerability of the 1 L preparation compared to 4 L and 2 L-PEG solutions in a real-life setting.METHODS All patients undergoing a screening or diagnostic colonoscopy after a 4,2 or 1 L PEG preparation,were consecutively enrolled in 5 Italian centers from September 2018 to February 2019.The primary endpoints of the study were the assessment of bowel cleansing success and high-quality cleansing of the right colon.The secondary endpoints were the evaluation of tolerability,adherence and safety of the different bowel preparations.Bowel cleansing was assessed through the Boston Bowel Preparation Scale.Adherence was defined as consumption of at least 75%of each dose,while tolerability was evaluated through a semiquantitative scale.Safety was systematically monitored through adverse events reporting.RESULTS Overall,1289 met the inclusion criteria and were enrolled in the study.Of these,490 patients performed a 4 L-PEG preparation(Selgesse^■),566 a 2 L-PEG cleansing(Moviprep^■or Clensia^■)and 233 a 1 L-PEG preparation(Plenvu^■).Bowel cleansing by Boston Bowel Preparation Scale was 6.5±1.5 overall and 6.3±1.5,6.2±1.5,7.3±1.5(P<0.001)in the subgroups of 4 L,2 L and 1 L-PEG preparation,respectively.Cleansing success was achieved in 72.4%,74.1%and 90.1%(P<0.001),while a high-quality cleansing of the right colon in 15.9%,12.0%and 41.4%(P<0.001)for 4 L,2 L and 1 L-PEG preparation groups,respectively.The 1 L preparation was the most tolerated compared to the 2 and 4 L-PEG solutions in the absence of serious adverse events within any of the three groups.Multiple regression models confirmed 1 L PEG-ASC preparation as an independent predictor of overall cleansing success,high-

关键词： Colonoscopy Bowel preparation Polyethylene glycol Polyethylene glycolplus ascorbate Effectiveness Tolerability

Genetic associations of inflammatory bowel disease in a South Asian population

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 Clinical Cases 2018年第15期6卷 908-915页

作者： Madunil Anuk Niriella Isurujith Kongala Liyanage Senerath Kuleesha Kodisinghe Arjuna Priyadarsin De Silva Nimna Rajapakshe Sunali D Nanayakkara Dunya Luke Thilakshi Silva Metthananda Nawarathne Ranjith K Peiris Udaya P Kalubovila Sujeewa R Kumarasena Vajira Harshadeva Weerabaddana Dissanayake Rohan W Jayasekara Hithanadura Janaka de Silva Faculty of Medicine University of Kelaniya Faculty of Medical Sciences University of Sri Jayewardenepura University Medical unit Colombo North Teaching Hospital Gastroenterology Unit National Hospital of Sri Lanka Gastroenterology Unit Colombo South Teaching Hospital Gastroenterology Unit Teaching Hospital Kandy Gastroenterology Unit Teaching Hospital Karapitiya Human Genetics unit Faculty of Medicine University of Colombo

AIM To estimate prevalence and phenotypic associations of selected inflammatory bowel disease(IBD)-associated genetic variants among Sri Lankan patients. METHODS A case study of histologically confirmed ulcerative colitis(UC) or Crohn's disease(CD) patients with ≥ 1 year disease duration, who were compared to unrelated, gender-matched, healthy individuals as controls, was conducted at four major centers in Sri Lanka. Phenotypic data of the cases were obtained and all participants were genotyped for 16 selected genetic variants: IL12 B :rs1045431, IL23 R :rs11805303, ARPC2 :rs12612347, IRGM :rs13361189, IL26/IL22 :rs1558744, CDH1 :rs1728785, IL10 :rs3024505, FCGR2 A :rs3737240, PTGER4 :rs4613763, IL17 REL/PIM3 :rs5771069, HNF4 a :rs6017342, STAT3 :rs744166, SMURF1 :rs7809799, LAMB1 :rs886774, HLA-DRB5, DQA1, DRB1, DRA :rs9268853, MST1, UBA7, and APEH :rs9822268. The genotypes of all variants were in Hardy-Weinberg Equilibrium(P > 10^(-3)). To account for multiple hypothesis testing, P-values < 0.003 were considered significant.RESULTS A total of 415 patients and 465 controls were recruited. Out of the single nucleotide polymorphisms(SNPs) tested, the majority were not associated with IBD in Sri Lankans. Significant positive associations were noted between rs886774(LAMB1-gene) and UC(odds ratio(OR) = 1.42, P = 0.001). UC patients with rs886774 had mild disease(OR = 1.66, P < 0.001) and remained in remission(OR = 1.48, P < 0.001). A positive association was noted between rs10045431(IL 12 B gene) and upper gastrointestinal involvement in CD(OR = 4.76, P = 0.002). CONCLUSION This confirms the heterogeneity of allelic mutations in South Asians compared to Caucasians. Most SNPs and disease associations reported here have not been described in South Asians.

关键词： Inflammatory bowel disease Genetics of inflammatory bowel disease Ulcerative colitis Crohn’s disease LAMB1 gene mutation IL-12B gene mutation

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

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 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

Implications of small-bowel transit time in the detection rate of capsule endoscopy: A multivariable multicenter study of patients with obscure gastrointestinal bleeding

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 2017年第4期23卷 697-702页

作者： Carlo Maria Girelli Marco Soncini Emanuele Rondonotti gastroenterology and Digestive Endoscopy unit Hospital of Busto Arsizio(VA) gastroenterology S.Carlo Hospital gastroenterology Valduce Hospital

AIM To define the role of small-bowel transit time in the detection rate of significant small-bowel lesions.METHODS Small-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lombardy Registry from October 2011 to December 2013, were included in the study if the clinical indication was obscure gastrointestinal bleeding and the capsule reached the cecum. Based on capsule findings, we created two groups: P2(significant findings) and P0-1(normal/negligible findings). Groups were compared for age, gender, small-bowel transit time, type of instrument, modality of capsule performance(outpatients vs inpatients), bowel cleanliness, and center volume.RESULTS We retrieved and scrutinized 1,433 out of 2,295 capsule endoscopy records(62.4%) fulfilling the inclusion criteria. Patients were 67 ± 15 years old, and 815(57%) were males. In comparison with patients in the P0-1 group, those in the P2 group(n = 776, 54%) were older(P < 0.0001), had a longer small-bowel transit time(P = 0.0015), and were more frequently examined in low-volume centers(P < 0.001). Age and smallbowel transit time were correlated(P < 0.001), with age as the sole independent predictor on multivariable analysis. Findings of the P2 group were artero-venous malformations(54.5%), inflammatory(23.6%) and protruding(10.4%) lesions, and luminal blood(11.5%).CONCLUSION In this selected, prospectively collected cohort of small-bowel capsule endoscopy performed for obscure gastrointestinal bleeding, a longer small-bowel transit time was associated with a higher detection rate of significant lesions, along with age and a low center volume, with age serving as an independent predictor.

关键词：囊内视镜检查法小肠的运输时间察觉率诊断产量小肠遮住胃肠的流血 Prokinetics 怀疑小肠的流血

Adherence to surveillance endoscopy following hospitalization for index esophageal variceal hemorrhage

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 Gastrointestinal Surgery 2018年第4期10卷 40-48页

作者： Brendan T Everett Steven D Lidofsky gastroenterology and Hepatology unit University of Vermont Medical Center

AIM To investigate patient adherence to surveillance endoscopy after index esophageal variceal hemorrhage and the extent to which adherence influences outcomes.METHODS We reviewed the records of patients with cirrhosis admitted to the medical intensive care unit between 2000 and 2014 for first time esophageal variceal hemorrhage treated with endoscopic variceal ligation who were subsequently discharged and scheduled for surveillance endoscopy at our medical center. Demographic and clinical data were obtained through the medical records, including etiology of cirrhosis, completion of variceal obliteration, attendance at surveillance endoscopy, zip code of primary residence, distance from home to hospital, insurance status, rehospitalization for variceal hemorrhage, beta-blocker at discharge, pharmacologically treated psychiatric disorder, and transplant free survival. RESULTS Of 99 consecutive survivors of esophageal variceal bleeding, the minority(33) completed variceal obliteration and fewer(12) adhered to annual surveillance. Completion of variceal obliteration was associated with fewer rehospitalizations for variceal rebleeding(27% vs 56%, P = 0.0099) and when rehospitalizations occurred, they occurred later in those who had completed obliteration(median 259 d vs 207 d, P = 0.0083). Incomplete adherence to endoscopic surveillance was associated with more rehospitalizations for variceal rebleeding compared to those fully adherent to annual endoscopic surveillance(51% vs 17%, P = 0.0328). Those adherent to annual surveillance were more likely to be insured privately or through Medicare compared to those who did not attend post-hospital discharge endoscopy(100% vs 63%, P = 0.0119).CONCLUSION Most patients do not complete variceal obliteration after index esophageal variceal hemorrhage and fewer adhere to endoscopic surveillance, particularly the uninsured and those insured with Medicaid.

关键词： Liver cirrhosis Endoscopy Esophageal varices Secondary prevention Patient adherence

Drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma: Current state of the art

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 2018年第2期24卷 161-169页

作者： Antonio Facciorusso Gastroenterology Unit Department of Medical Sciences University of Foggia

Transarterial chemoembolization(TACE) represents the current gold standard for hepatocellular carcinoma(HCC) patients in intermediate stage. Conventional TACE(c TACE) is performed with the injection of an emulsion of a chemotherapeutic drug with lipiodol into the artery feeding the tumoral nodules, followed by embolization of the same vessel to obtain a synergistic effect of drug cytotoxic activity and ischemia. Aim of this review is to summarize the main characteristics of drug-eluting beads(DEB)-TACE and the clinical results reported so far in the literature. A literature search was conducted using Pub Med until June 2017. In order to overcome the drawbacks of c TACE, namely lack of standardization and unpredictability of outcomes, non-absorbable embolic microspheres charged with cytotoxic agents(DEBs) have been developed. DEBs are able to simultaneously exert both the therapeutic components of TACE, either drug-carrier function and embolization, unlike c TACE in which applying the embolic agent is a second moment after drug injection. This way, risk of systemic drug release is minimal due to both high-affinity carrier activity of DEBs and absence of a time interval between injection and embolization. However, despite promising results of preliminary studies, clear evidence of superiority of DEB-TACE over c TACE is still lacking. A number of novel technical devices are actually in development in the field of loco-regional treatments for HCC, but only a few of them have entered the clinical arena. In absence of well-designed randomized-controlled trials, the decision on whether use DEB-TACE or c TACE is still controversial.

关键词： Embolization Doxorubicin Conventional Hepatocarcinoma Liver cancer Survival

Artificial intelligence in detection of small bowel lesions and their bleeding risk:A new step forward

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 2024年第18期30卷 2482-2484页

作者： Silvia Cocca Giuseppina Pontillo Giuseppe Grande Rita Conigliaro gastroenterology and Endoscopy unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy gastroenterology and Endoscopy unit Presidio Ospedaliero San Giuseppe Moscati(AversaCE)-ASL CasertaCaserta 81100Italy Department of gastroenterology and Digestive Endoscopy Azienda Ospedaliero Universitaria di ModenaModena 41121Italy

The present letter to the editor is related to the study with the title“Automatic detection of small bowel(SB)lesions with different bleeding risk based on deep learning models”.Capsule endoscopy(CE)is the main tool to assess SB diseases but it is a time-consuming procedure with a significant error rate.The development of artificial intelligence(AI)in CE could simplify physicians’tasks.The novel deep learning model by Zhang et al seems to be able to identify various SB lesions and their bleeding risk,and it could pave the way to next perspective studies to better enhance the diagnostic support of AI in the detection of different types of SB lesions in clinical practice.

关键词： Capsule endoscopy Small bowel Artificial intelligence Bleeding risk Vascular lesions

State-of-the-art management of dysplastic Barrett’s esophagus

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

gastroenterology Report 2022年第1期10卷 195-206页

作者： Kornpong Vantanasiri Prasad G.Iyer Barrett’s Esophagus unit Division of Gastroenterology and HepatologyMayo ClinicRochesterMNUSA

Endoscopic eradication therapy(EET)has become a standard of care for treatment of dysplastic Barrett’s esophagus(BE)and early Barrett’s neoplasia.EET mainly consists of removal of any visible lesions via endoscopic resection and eradication of all remaining Barrett’s mucosa using endoscopic ablation.Endoscopic mucosal resection and endoscopic submucosal dissection are the two available resection techniques.After complete resection of all visible lesions,it is crucial to perform endoscopic ablation to ensure complete eradication of the remaining Barrett’s segment.Endoscopic ablation can be done either with thermal techniques,including radiofrequency ablation and argon plasma coagulation,or cryotherapy techniques.The primary end point of EET is achieving complete remission of intestinal metaplasia(CRIM)to decrease the risk of dysplastic recurrence after successful EET.After CRIM is achieved,a standardized endoscopic surveillance protocol needs to be implemented for early detection of BE recurrence.

关键词： Barrett’s esophagus esophageal adenocarcinoma endoscopic eradication therapy endoscopic mucosal resection endoscopic submucosal dissection