检索结果-南通市图书馆

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

Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

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 Oncology 2014年第9期6卷 360-368页

作者： Juana Gonzalo-Marin Juan Jose Vila Manuel Perez-Miranda unit of endoscopy Department of GastroenterologyQuirón Hospital unit of endoscopy Department of GastroenterologyComplejo Hospitalario de Navarra Department of gastroenterology Hospital Universitario Rio Hortega

Endoscopic ultrasonography(EUS) with or without fine needle aspiration has become the main technique for evaluating pancreatobiliary disorders and has proved to have a higher diagnostic yield than positron emission tomography,computed tomography(CT) and transabdominal ultrasound for recognising early pancreatic tumors.As a diagnostic modality for pancreatic cancer,EUS has proved rates higher than 90%,especially for lesions less than 2-3 cm in size in which it reaches a sensitivity rate of 99% vs 55% for CT.Besides,EUS has a very high negative predictive value and thus EUS can reliably exclude pancreatic cancer.The complication rate of EUS is as low as 1.1%-3.0%.New technical developments such as elastography and the use of contrast agents have recently been applied to EUS,improving its diagnostic capability.EUS has been found to be superior to the recent multidetector CT for T stagingwith less risk of overstaying in comparison to both CT and magnetic resonance imaging,so that patients are not being ruled out of a potentially beneficial resection.The accuracy for N staging with EUS is 64%-82%.In unresectable cancers,EUS also plays a therapeutic role by means of treating oncological pain through celiac plexus block,biliary drainage in obstructive jaundice in patients where endoscopic retrograde cholangiopancreatography is not affordable and aiding radiotherapy and chemotherapy.

关键词： modality staging potentially diagnostic transabdominal celiac retrograde plexus chemotherapy adenocarcinoma

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

Applications of endoscopic ultrasound elastography in pancreatic diseases: From literature to real life

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 2022年第9期28卷 909-917页

作者： Clara Benedetta Conti Giacomo Mulinacci Raffaele Salerno Marco Emilio Dinelli Roberto Grassia Interventional endoscopy unit ASST MonzaOspedale San GerardoMonza 20900Italy Gastroenterology and Endoscopy Unit ASST Fatebenefratelli-SaccoMilan 20121Italy Gastroenterology and Endoscopy Unit ASST CremonaCremona 26100Italy

Elastography is a non-invasive method widely used to measure the stiffness of the tissues,and it is available in most endoscopic ultrasound machines,using either qualitative or quantitative techniques.Endoscopic ultrasound elastography is a tool that should be applied to obtain a complementary evaluation of pancreatic diseases,together with other imaging tests and clinical data.Elastography can be informative,especially when studying pancreatic masses and help the clinician in the differential diagnosis between benign or malignant lesions.However,further studies are necessary to standardize the method,increase the reproducibility and establish definitive cut-offs to distinguish between benign and malignant pancreatic masses.Moreover,even if promising,elastography still provides little information in the evaluation of benign conditions.

关键词： Elastography Pancreas Pancreatic stiffness Pancreatitis Pancreatic cancer Endosonography Endoscopic ultrasound Quantitative elastography Strain elastography Pancreatic diseases

Endoscopic ultrasound fine-needle biopsy vs fine-needle aspiration for lymph nodes tissue acquisition:a systematic review and meta-analysis

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 544-551页

作者： Antonio Facciorusso Stefano Francesco Crino Paraskevas Gkolfakis Daryl Ramai Andrea Lisotti Ioannis S Papanikolaou Benedetto Mangiavillano Ilaria Tarantino Andrea Anderloni Carlo Fabbri Konstantinos Triantafyllou Pietro Fusaroli gastroenterology unit Department of Surgical and Medical SciencesUniversity of FoggiaFoggiaItaly Department of Medicine Gastroenterology and Digestive Endoscopy UnitThe Pancreas InstituteUniversity Hospital of VeronaVeronaItaly Department of gastroenterology Hepatopancreatologyand Digestive OncologyCUB Erasme HospitalUniversite Libre de Bruxelles(ULB)BrusselsBelgium gastroenterology and Hepatology University of Utah HealthSalt Lake CityUTUSA gastroenterology unit Hospital of ImolaUniversity of BolognaImolaItaly Hepatogastroenterology unit Second Department of Internal Medicine-PropaedeuticMedical SchoolNational and Kapodistrian University of Athens‘Attikon’University General HospitalAthensGreece Gastrointestinal endoscopy unit Humanitas Mater DominiCastellanzaVareseItaly endoscopy Service Department of Diagnostic and Therapeutic ServicesIRCCS-ISMETTPalermoItaly Digestive endoscopy unit Humanitas Clinical and Research Center—IRCCSRozzanoMilanoItaly gastroenterology and Digestive endoscopy unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly

Background:Endoscopic ultrasound(EUS)-guided tissue acquisition represents the choice of methods for suspected lymph nodes(LNs)located next to the gastrointestinal tract.This study aimed to compare the pooled diagnostic performance of EUS-guided fine-needle biopsy(EUS-FNB)and fine-needle aspiration(EUS-FNA)for LNs sampling.Methods:We searched PubMed/MedLine and Embase databases through August 2021.Primary outcome was diagnostic accuracy;secondary outcomes were sensitivity,specificity,sample adequacy,optimal histological core procurement,number of passes,and adverse events.We performed a pairwise meta-analysis using a random-effects model.The results are presented as odds ratio(OR)or mean difference along with 95%confidence interval(CI).Results:We identified nine studies(1,276 patients)in this meta-analysis.Among these patients,66.4%were male;the median age was 67 years.Diagnostic accuracy was not significantly different between the two approaches(OR,1.31;95%CI,0.81–2.10;P=0.270).The accuracy of EUS-FNB was significantly higher when being performed with newer end-cutting needles(OR,1.87;95%CI,1.17–3.00;P=0.009)and in abdominal LNs(OR,2.48;95%CI,1.52–4.05;P<0.001)than that of EUSFNA.No difference in terms of sample adequacy was observed between the two approaches(OR,1.40;95%CI,0.46–4.26;P=0.550);however,histological core procurement and diagnostic sensitivity with EUS-FNB were significantly higher than those with EUS-FNA(OR,6.15;95%CI,1.51–25.07;P=0.010 and OR,1.87;95%CI,1.27–2.74,P=0.001).The number of needle passes needed was significantly lower in the EUS-FNB group than in the EUS-FNA group(mean difference,-0.54;95%CI,-0.97 to -0.12;P=0.010).Conclusions EUS-FNA and EUS-FNB perform similarly in LN sampling;however,FNB performed with end-cutting needles outperformed FNA in terms of diagnostic accuracy.

关键词： EUS FNA FNB cancer metastases lymphoma

Role and timing of endoscopy in acute biliary pancreatitis

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 2015年第40期21卷 11205-11208页

作者： Andrea Anderloni Alessandro Repici Department of gastroenterology Digestive Endoscopy UnitHumanitas Research Hospital

The role and timing of endoscopy in the setting of acute biliary pancreatitis(ABP) is still being debated. Despite numerous randomized trials have been published,there is an obvious lack of consensus on the indications and timing of endoscopic retrograde cholangiopancreatography(ERCP) in ABP in metaanalyses and nationwide guidelines. The present editorial has been written to clarify the role of endoscopy in ABP. In clinical practice the decision to perform an ERCP is often based on biochemical and radiological criteria despite they already have been shown to be unreliable predictors of common bile duct stone presence. Endoscopic ultrasonography(EUS) is not currently a worldwide standard diagnostic procedure early in the course of acute biliary pancreatitis,but it has been shown to be accurate,safe and cost effective in diagnosing biliary obstructions compared with magnetic resonance cholangiopancreatography and ERCP and therefore in preventing unnecessary ERCP and its related complications. Early EUS in ABP allows,if appropriate,immediate endoscopic treatment and significant spare of unnecessary operative procedures thus reducing possible related complications.

关键词： Acute biliary pancreatitis Choledocolithiasis Comm

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 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

Endoscopic ultrasound-guided sampling of solid pancreatic masses:the fine needle aspiration or fine needle biopsy dilemma. Is the best needle yet to come?

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 endoscopy 2019年第8期11卷 454-471页

作者： Clara Benedetta Conti Fabrizio Cereatti Roberto Grassia Digestive endoscopy and gastroenterology unit Cremona Hospital

Fine needle aspiration (FNA) is currently the standard of care for sampling pancreatic solid masses by using endoscopic ultrasound (EUS).The accuracy of the technique is reported to be high,especially if coupled with the rapid on site evaluation (ROSE),and it has a high safety profile.However,FNA presents some limitations,such as the small amount of tissue that can be collected and the inability of obtaining a core tissue with intact histological architecture,which is relevant to perform immunohistochemical analysis,molecular profiling and,therefore,targeted therapies.Moreover,the presence of the ROSE by an expert cytopathologist is very important to maximize the diagnostic yield of FNA technique;however,it is not widely available,especially in small centers.Hence,the introduction of EUS fine needle biopsy (FNB) with a new generation of needles,which show a high safety profile too and a satisfying diagnostic accuracy even in the absence of ROSE,could be the key to overcome the limitations of FNA.However,FNB has not yet shown diagnostic superiority over FNA.Considering all the technical aspects of FNA and FNB,the different types of needle currently available,comparisons in term of diagnostic yield,and the different techniques of sampling,a tailored approach should be used in order to determine the needle that is most appropriate for the different specific scenarios.

关键词： Fine needle aspiration Fine needle biopsy Endoscopic ultrasound Needle performance Diagnostic yield Diagnostic accuracy Pancreatic sampling

Radiofrequency and malignant biliary strictures:An update

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 endoscopy 2019年第2期11卷 95-102页

作者： Francesco Auriemma Luca De Luca Mario Bianchetti Alessandro Repici Benedetto Mangiavillano Gastrointestinal endoscopy unit Humanitas Mater Domini gastroenterology and Digestive endoscopy unit Ospedali Riuniti Marche Nord Digestive endoscopy unit Division of Gastroenterology Humanitas Research Hospital Humanitas Huniversity

Malignant biliary strictures are usually linked to different types of tumors,mainly cholangiocarcinoma, pancreatic and hepatocellular carcinomas. Palliative measures are usually adopted in patients with nonresectable or borderline resectable biliary disease. Stent placement is a well-known and established treatment in patients with unresectable malignancy. Intraductal radiofrequency ablation(RFA) represents a procedure that involves the use of a biliary catheter device, via an endoscopic approach. Indications for biliary RFA described in literature are: Palliative treatment of malignant biliary strictures, avoiding stent occlusion, ablating ingrowth of blocked metal stents, prolonging stent patency,ablating residual adenomatous tissue after endoscopic ampullectomy. In this mini-review we addressed focus on technical success defined as deployment of the RF catheter, virtually succeeded in all patients included in the studies. About efficacy, three main outcome measures have been contemplated: Biliary decompression and stent patency, survival. Existing studies suggest a beneficial effect on survival and stent patency with RFA, but current impression is limited because most of studies have been performed using a retrospective design, on diminutive and dissimilar cohorts of patients.

关键词： Radiofrequency Ablation Endoscopic retrograde colangiopancreatography Malignant biliary strictures