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https://www.readbyqxmd.com/read/29768348/a-new-strategy-for-enteral-nutrition-using-a-deflection-flexible-visual-gastric-tube-a-randomized-crossover-manikin-trial
#1
Jie Li, Yan-Mei Feng, Dong Wan, Hui-Sheng Deng, Rui Guo
BACKGROUND: Enteral nutrition via gastric tube insertion is a routine clinical practice for critically ill patients, although complications due to blind manipulation are occasionally reported. METHODS: An 8.4Fr deflection flexible ureteroscope was delivered into a 15Fr conventional gastric tube to create a gastric visual guidance system. Twenty inexperienced physicians were randomly assigned to perform 5 repeated orogastric tube placements in a manikin using both the conventional method and the deflection visual gastric tube, for a total of 10 procedures per physician...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764388/clinicopathological-features-surgical-strategy-and-prognosis-of-duodenal-gastrointestinal-stromal-tumors-a-series-of-300-patients
#2
Zhen Liu, Gaozan Zheng, Jinqiang Liu, Shushang Liu, Guanghui Xu, Qiao Wang, Man Guo, Xiao Lian, Hongwei Zhang, Fan Feng
BACKGROUND: The relatively low incidence of duodenal gastrointestinal stromal tumors (GISTs) and the unique anatomy make the surgical management and outcomes of this kind of tumor still under debate. Thus, this study aimed to explore the optimal surgical strategy and prognosis of duodenal GISTs. METHODS: A total of 300 cases of duodenal GISTs were obtained from our center (37 cases) and from case reports or series (263 cases) extracted from MEDLINE. Clinicopathological features, type of resections and survivals of duodenal GISTs were analyzed...
May 15, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29761508/the-microscopic-anatomy-of-the-esophagus-including-the-individual-layers-specialized-tissues-and-unique-components-and-their-responses-to-injury
#3
REVIEW
Xuchen Zhang, Deepa Patil, Robert D Odze, Lei Zhao, Mikhail Lisovsky, Maha Guindi, Robert Riddell, Andrew Bellizzi, Rhonda K Yantiss, Ilke Nalbantoglu, Henry D Appelman
The esophagus, a straight tube that connects the pharynx to the stomach, has the complex architecture common to the rest of the gastrointestinal tract with special differences that relate to its function as a conduit of ingested substances. For instance, it has submucosal glands that are unique and have a specific protective function. It has a squamous lining that exists nowhere else in the gut except the anus and it has a different submucosal nerve plexus when compared to the stomach and intestines. All of the layers of the esophageal wall and the specialized structures including blood and lymphatic vessels and nerves have specific responses to injury...
May 15, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29755007/structure-of-the-alimentary-tract-in-the-atlantic-mudskipper-periophthalmus-barbarus-gobiidae-oxudercinae-anatomical-histological-and-ultrastructural-studies
#4
Katarzyna Wołczuk, Maciej Ostrowski, Agnieszka Ostrowska, Teresa Napiórkowska
The alimentary tract of oxudercine gobies is characterized by a lack of an anatomically distinct stomach, owing to which they are classified as stomachless. Since the environment, food requirements, and feeding habits have a significant impact on the anatomy of the alimentary tract of fish, it was assumed that predominantly carnivorous, semi-terrestrial mudskippers would have a stomach. In order to verify this hypothesis, anatomical, histological, histochemical and ultrastructural analysis of the alimentary tract of the Atlantic mudskipper Periophthalmus barbarus was performed...
April 26, 2018: Zoology: Analysis of Complex Systems, ZACS
https://www.readbyqxmd.com/read/29731403/-bariatric-surgical-procedures
#5
Laurent Brunaud, Claire Nomine-Criqui, Thibaut Fouquet, Marie-Aude Sirveaux, Nicolas Reibel, Didier Quilliot
Obesity physioptahology is complex and involves several factors (genetic, behavioral, psychological…). In this still undefined context, bariatric surgery modifies gastrointestinal tract anatomy, reduces the caloric intake and modifies gastrointestinal hormonal secretions for some of them. Aim of this work was to describe bariatric surgical procedures (sleeve, gastric band, short-gastric gastric, biliopancreatic diversion), specifying their historical context and considering possible evolutions.
May 3, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29730732/mechanisms-underlying-the-weight-loss-effects-of-rygb-and-sg-similar-yet-different
#6
REVIEW
A Pucci, R L Batterham
The worldwide obesity epidemic continues unabated, adversely impacting upon global health and economies. People with severe obesity suffer the greatest adverse health consequences with reduced life expectancy. Currently, bariatric surgery is the most effective treatment for people with severe obesity, resulting in marked sustained weight loss, improved obesity-associated comorbidities and reduced mortality. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), the most common bariatric procedures undertaken globally, engender weight loss and metabolic improvements by mechanisms other than restriction and malabsorption...
May 5, 2018: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29730228/an-international-multicenter-comparative-trial-of-eus-guided-gastrogastrostomy-assisted-ercp-versus-enteroscopy-assisted-ercp-in-patients-with-roux-en-y-gastric-bypass-anatomy
#7
Majidah Bukhari, Thomas Kowalski, Jose Nieto, Rastislav Kunda, Nitin K Ahuja, Shayan Irani, Apeksha Shah, David Loren, Olaya Brewer, Omid Sanaei, Lea Fayad, Yen-I Chen, Saowanee Ngamruengphong, Vivek Kumbhari, Vikesh Singh, Hanaa Dakour Aridi, Mouen A Khashab
BACKGROUND & AIMS: ERCP is challenging in patients with Roux-en-Y gastric bypass (RYGB) anatomy. EUS-guided gastrogastrostomy (GG) creation is a promising novel technique to access the excluded stomach in order to facilitate conventional ERCP. We aimed to compare procedural outcomes and adverse events (AEs) between EUS-guided gastrogastrostomy-assisted ERCP (EUS-GG-ERCP) and enteroscopy assisted ERCP (e-ERCP) in patients with RYGB. METHODS: Patients with RYGB anatomy who underwent EUS-GG-ERCP or e-ERCP between 2014 and 2016 at 5 tertiary centers were included...
May 3, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29729226/eus-guided-hepaticoenterostomy-as-a-portal-to-allow-definitive-antegrade-treatment-of-benign-biliary-diseases-in-patients-with-surgically-altered-anatomy
#8
Theodore W James, Y Claire Fan, Todd H Baron
BACKGROUND & AIMS: EUS-guided hepaticoenterostomy (EUS-HE) is usually reserved for palliation of malignant biliary obstruction after failed endoscopic retrograde cholangiography (ERC) or inaccessible biliary tree in surgically altered anatomy (SAA). We describe outcome of EUS-HE and antegrade therapy for benign biliary disease in patients with SAA. METHODS: Retrospective review of 20 consecutive patients with surgically altered anatomy and benign biliary obstruction who underwent EUS-HE performed by one endoscopist at a tertiary center over a three-year period...
May 2, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29728987/gastrogastric-fistula-an-unusual-cause-for-severe-bile-reflux-following-conversion-of-sleeve-gastrectomy-to-one-anastomosis-gastric-bypass
#9
Ashraf Haddad, Ahmad Bashir, Abdelrahman Nimeri
INTRODUCTION: One anastomosis gastric bypass/mini-gastric bypass (OAGB/MGB) was first described in 2001 as a safe and effective procedure. It has been gaining popularity worldwide. Multiple authors have reported the need to re-operate on patients for bile reflux. We report a patient with severe bile reflux after laparoscopic conversion of sleeve gastrectomy (LSG) to OAGB/MGB. METHODS: A 33-year-old patient underwent a LSG in 2014. Postoperatively, she developed severe gastroesophageal acid reflux...
May 4, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29716802/perforated-duodenal-ulcers-after-roux-y-gastric-bypass
#10
Denise Pohl, Gregoire Schmutz, Gabriel Plitzko, Dino Kröll, Philipp Nett, Yves Borbély
Even though the incidence of complicated peptic ulcer disease (PUD) has decreased in the last decades, it remains a condition with a significant mortality. Whilst diagnosis and treatment of PUD in morbidly obese patients can be challenging, patients with excluded segments - such as after Roux-Y Gastric Bypass (RYGB) - present an even greater problem, as the subsequent altered anatomy impedes the common modalities used for diagnostic and therapeutic measures. We report the cases of two patients after RYGB with perforated duodenal ulcers in the intention to highlight problems regarding diagnosis and treatment...
April 25, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29692890/management-of-a-postbulbar-duodenal-ulcer-and-stricture-causing-gastric-outlet-obstruction-a-case-report
#11
Maxwell D Mirande, Raul A Mirande
Introduction: Peptic ulcer disease has significantly decreased over the past several decades making the need for definitive surgical intervention an infrequent occurrence. Presentation of Case: A 44-year-old Caucasian female was sent to the emergency department by her primary care physician for right upper quadrant abdominal pain which had been intermittent for the past two months but acutely worsened over the last five days. During this time, she was unable to tolerate oral intake with intractable nausea and vomiting...
May 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29690014/flapper-valve-and-hayfork-functional-anatomy-and-taxonomic-potential-of-the-gastric-mill-of-bairdioidea-ostracoda-podocopida
#12
Rosalie F Maddocks
The chewing apparatus of the Bairdioidea has been described just once and is rarely illustrated, but it might have more taxonomic significance than commonly supposed. It is constructed as a flapper valve (hinged check valve), which is unique among Ostracoda and unusual among animals. It projects into the midgut and is substantially enveloped by it. It serves three functions: to move bites of food into the stomach, to close the esophagus against back-flow, and to pack strands of food and mucus onto the rotating food ball...
February 7, 2018: Zootaxa
https://www.readbyqxmd.com/read/29679149/totally-endoscopic-implant-to-effect-a-gastric-bypass-12-month-safety-and-efficacy-outcomes
#13
Bryan J Sandler, Laurent Biertho, Mehran Anvari, Roberto Rumbaut, Luis Alonso Morales-Garza, Gustavo Torres-Barrera, Simon Marceau, Dennis Hong, C Daniel Smith, Santiago Horgan
BACKGROUND: Only a small percentage of candidates for bariatric surgery ever undergo a procedure for weight loss. Devices duplicating key effects of bariatric surgeries with removable, fully trans-oral implants could extend their benefits to patients unwilling to undergo anatomy-altering abdominal surgeries. METHODS: Thirty-two obese subjects (mean BMI: 42.3) were enrolled in a prospective, multicenter, single-arm, feasibility trial of the first fully trans-oral endoscopic gastrointestinal bypass device...
April 20, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29670799/a-modified-technique-for-laparoscopic-spleen-preserving-distal-pancreatectomy
#14
Andreas Papatriantafyllou, Theodoros Mavromatis, Theano Demestiha, Dimitrios Filippou, Panagiotis Skandalakis
Spleen preserving laparoscopic distal pancreatectomy is considered as first choice operation for symptomatic benign or small malignant lesions located at the body or tail of the pancreas. The two main surgical techniques that have been proposed and widely adopted for spleen preserving laparoscopic distal pancreatectomy are the Warshaw and Kimura techniques. A novel modified approach for laparoscopic spleen preserving distal pancreatectomy is presented. The technique was initially performed in a 57-year-old female patient with mucinous cystadenoma...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29668560/eus-directed-transgastric-ercp-edge-versus-laparoscopy-assisted-ercp-la-ercp-for-roux-en-y-gastric-bypass-rygb-anatomy-a-multicenter-early-comparative-experience-of-clinical-outcomes
#15
Prashant Kedia, Paul R Tarnasky, Jose Nieto, Stephen L Steele, Ali Siddiqui, Ming-Ming Xu, Amy Tyberg, Monica Gaidhane, Michel Kahaleh
BACKGROUND AND AIMS: The standard of care for managing pancreaticobiliary disease in altered Roux-en-Y gastric bypass patients is laparoscopy-assisted endoscopic retrograde cholangiopancreatography (LA-ERCP), but is limited by cost and adverse events. Recently a minimally invasive, completely endoscopic approach using endoscopic ultrasound (EUS) directed transgastric ERCP (EDGE) has been described. We aim to compare EDGE to LA-ERCP in this study. METHODS: Patients from May 2005 to June 2017 with Roux-en-Y gastric bypass anatomy having undergone LA-ERCP or EDGE at 4 tertiary centers were captured in a registry...
April 17, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29651794/celiac-trunk-and-common-hepatic-artery-variations-in-children-an-analysis-with-ct-angiography
#16
Emine Caliskan, Turker Acar, Mehmet Ozturk, Zuhal Bayramoglu, Ravza Yilmaz, Filiz Elbuken, Ibrahim Adaletli
BACKGROUND: Understanding the celiac trunk and hepatic artery anatomy is important not only in preventing iatrogenic injuries but also in planning surgical procedures in children. Therefore, the aim of this study is to analyze the prevalence of celiac trunk (CeT) and common hepatic artery (CHA) variations in the pediatric population. MATERIALS AND METHODS: One hundred and seventy-four children (174) who underwent abdominal multidetector computed tomography (MDCT) angiography, either because of trauma or liver transplantation, were analyzed retrospectively...
April 13, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29600432/catheter-probe-extraductal-ultrasound-edus-exploration-of-the-common-bile-duct-is-safe-in-elderly-patients-with-suspicion-of-choledocholithiasis-after-distal-gastrectomy
#17
Thomas Togliani, Stefano Pilati, Andrea Lisotti, Giancarlo Caletti, Pietro Fusaroli
PURPOSE: Post-surgical upper gastrointestinal anatomy may hamper a complete bilio-pancreatic evaluation with a standard echoendoscope. The aim of this study was to assess the role of catheter probe extraductal ultrasound (EDUS) for the evaluation of the common bile duct (CBD) in patients who are status post-gastric surgery and who are suspected of having choledocholithiasis. METHODS: We retrospectively analyzed patients with a prior history of gastric surgery, who underwent EDUS for a suspicion of CBD obstruction...
March 29, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29573597/laparoscopic-roux-en-y-gastric-bypass-in-a-patient-with-situs-inversus-totalis-case-report-technical-tips-and-review-of-the-literature
#18
Abdelaziz Atwez, Zeid Keilani
INTRODUCTION: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has proven over the years to be one of the most effective bariatric procedures. It is highly technical, and therefore is mostly performed by bariatric and metabolic surgeons. Although Situs Inversus Totalis (SIT) is a very rare congenital condition, surgeons do occasionally have to operate intra-abdominally on those patients, consequently facing some challenges related to the unusual anatomy. CASE PRESENTATION: We describe a rare case of LRYGB for chronic morbid obesity on a 43 year old patient with pre-operative diagnosis of situs inversus totalis without Kartagener's syndrome, using slight modification from the usual technique based on anatomical correlation without the need to change the surgeon's position or switching trocar placements as described in previous papers...
March 15, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29572696/endoscopic-management-of-difficult-bile-duct-stones
#19
REVIEW
Murad Aburajab, Kulwinder Dua
PURPOSE OF REVIEW: In 10-15% of the cases, conventional methods for removing bile duct stones by ERCP/balloon-basket extraction fail. The purpose of this review is to describe endoscopic techniques in managing these "difficult bile duct stones." RECENT FINDINGS: Endoscopic papillary large balloon dilation with balloon extraction ± mechanical lithotripsy is the initial approach used to retrieve large bile duct stones. With advent of digital cholangioscopy, electrohydraulic and laser lithotripsy are gaining popularity...
March 23, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29571551/computed-tomography-of-internal-hernias-following-laparoscopic-roux-en-y-gastric-bypass-surgery
#20
Yoan K Kagoma, Gabriela Gayer
Internal hernia in the postoperative laparoscopic Roux-en-Y patient is a diagnosis associated with significant morbidity and risk of death. The radiologist plays an instrumental role in workup of this patient group; however, the imaging assessment of these patients is not straightforward given their complex postsurgical anatomy. Multiple radiologic signs of internal hernia have been studied in the literature. This review article presents these signs with representative cases as well as a summary of their diagnostic accuracy...
April 2018: Seminars in Ultrasound, CT, and MR
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