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Therapeutic endoscopy

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https://www.readbyqxmd.com/read/28106923/ercp-cannulation-in-the-difficult-duct-which-technique-should-you-pull-out-of-your-bag
#1
EDITORIAL
A M Ahmed, C M Wilcox
Golf and endoscopic retrograde cholangiopancreaticography (ERCP) share a commonality where the highs of the successes are balanced by the lows of the frustrations. ERCP cannulation is one of the most difficult maneuvers in gastrointestinal endoscopy and is a requirement for the procedure's therapeutic benefit. As such, many different techniques have been developed to facilitate cannulation. The mission of the procedure is to provide access to the biliary or pancreatic duct typically with a guidewire, which can then be utilized as a platform for therapeutic and diagnostic procedures...
January 20, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#2
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28090473/three-year-old-male-with-multiple-dieulafoy-lesions-treated-with-epinephrine-injections-via-therapeutic-endoscopy
#3
Christina L Baldwin, Michael Wilsey
Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28066947/training-in-eus-an-asian-perspective
#4
REVIEW
J Y Y Wong, P Kongkam, K Y Ho
Training of endoscopic ultrasound (EUS) in Asia faces two major challenges: (i) the ever-increasing demand for skills to handle a growing range of interventional EUS procedures; and (ii) a continual shortage of EUS training programs. As the therapeutic application of EUS continues to expand,(1, 2) the need to train more new endosonographers and upgrade skills of existing ones has become more critical than ever before. A formal fellowship to acquire EUS knowledge and skills in an advanced endoscopy centre has always been perceived as the best way of training novices, but such opportunities remain limited in most Asian countries...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28063840/efficacy-and-safety-of-eus-guided-biliary-drainage-in-comparison-with-percutaneous-biliary-drainage-when-ercp-fails-a-systematic-review-and-meta-analysis
#5
REVIEW
Reem Z Sharaiha, Muhammad Ali Khan, Faisal Kamal, Amy Tyberg, Claudio R Tombazzi, Bilal Ali, Claudio Tombazzi, Michel Kahaleh
BACKGROUND AND AIMS: Endoscopic ultrasound-guided biliary drainage (EUS-BD) is being increasingly used as an alternate therapeutic modality to percutaneous transhepatic biliary drainage (PTBD) for biliary obstruction in patients who fail ERCP. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 procedures. METHODS: We searched several databases from inception to September 4, 2016, to identify comparative studies evaluating the efficacy and safety of EUS-BD and PTBD...
January 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28056333/-recommendation-for-the-prevention-and-treatment-of-non-steroidal-anti-inflammatory-drug-induced-gastrointestinal-ulcers-and-its-complications
#6
(no author information available yet)
Non-steroidal anti-inflammatory drugs (NSAIDs) are a broad class of non glucocorticoid drugs which are extensively used in anti-inflammatory, analgesic, and antipyretic therapies. However, NSAIDs may cause many side effects, most commonly in gastrointestinal(GI) tract. Cardiovascular system, kidney, liver, central nervous system and hematopoietic system are also involved. NSAID-induced GI side effects not only endanger the patients' health, increase mortality, but also greatly increase the cost of medical care...
January 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28039646/learning-curve-and-clinical-outcome-of-gastric-endoscopic-submucosal-dissection-performed-by-trainee-operators
#7
Masao Yoshida, Naomi Kakushima, Keita Mori, Kimihiro Igarashi, Noboru Kawata, Masaki Tanaka, Kohei Takizawa, Sayo Ito, Kenichiro Imai, Kinichi Hotta, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Hiroyuki Ono
BACKGROUND: Although endoscopic submucosal dissection (ESD) represents a significant progress in therapeutic endoscopy, little is known about how trainees attain its technical proficiency. The aims of this study were to evaluate the learning curve and clinical outcomes of gastric ESD performed by trainee endoscopists. METHODS: Between April 2009 and March 2014, 334 gastric ESD procedures were performed by seven trainees (42-50 consecutive cases per trainee). The learning curve for gastric ESD was evaluated using the cumulative sum (CUSUM) method...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28031534/autophagy-inhibition-enhances-photocytotoxicity-of-photosan-ii-in-human-colorectal-cancer-cells
#8
Li Xiong, Zhipeng Liu, Guoqing Ouyang, Liangwu Lin, He Huang, Hongxiang Kang, Wei Chen, Xiongying Miao, Yu Wen
Photodynamic therapy (PDT) has emerged as an attractive therapeutic treatment for colorectal cancer because of its accessibility through endoscopy and its ability to selectively target tumors without destroying the anatomical integrity of the colon. We therefore investigated the therapeutic relevance of the interplay between autophagy and apoptosis in Photosan-II (PS-II)-mediated photodynamic therapy (PS-PDT) in in vitro and in vivo models for human colorectal cancer. We observed that PS-PDT-induced dose-dependently triggered apoptosis and autophagy in both SW620 and HCT116 cells...
December 23, 2016: Oncotarget
https://www.readbyqxmd.com/read/28031412/dual-pi3k-mtor-inhibition-in-colorectal-cancers-with-apc-and-pik3ca-mutations
#9
Tyler M Foley, Susan N Payne, Cheri A Pasch, Alex E Yueh, Dana R Van De Hey, Demetra P Korkos, Linda Clipson, Molly E Maher, Kristina A Matkowskyj, Michael A Newton, Dustin A Deming
: Therapeutic targeting of the phosphoinositide 3-kinase (PI3K) pathway is an active area of research in multiple cancer types, including breast and endometrial cancers. This pathway is commonly altered in cancer and plays an integral role in numerous vital cellular functions. Mutations in the PIK3CA gene, resulting in a constitutively active form of PI3K, often occur in colorectal cancer (CRC), though the population of patients who would benefit from targeting this pathway has yet to be identified...
December 28, 2016: Molecular Cancer Research: MCR
https://www.readbyqxmd.com/read/28019036/utility-of-newly-developed-short-type-double-balloon-endoscopy-for-endoscopic-retrograde-cholangiography-in-postoperative-patients
#10
Masaaki Shimatani, Mitsuo Tokuhara, Kota Kato, Sachi Miyamoto, Masataka Masuda, Masayuki Sakao, Norimasa Fukata, Hideaki Miyoshi, Tsukasa Ikeura, Makoto Takaoka, Kazuichi Okazaki
BACKGROUND AND AIMS: The utility of conventional short-type DBE (C-short DBE) for pancreatobiliary disease in patients with postoperative anatomy had been widely acknowledged and accepted. However, some technical difficulties yet remained. In an attempt to solve these problems, the new short-type DBE (N-short DBE) was uniquely designed for therapeutic endoscopic retrograde cholangiography (ERC) in postoperative patients. The aim of this study was to evaluate the usefulness of N-short DBE for ERC in postoperative patients...
December 26, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28003672/clinical-outcomes-of-endoscopic-hemostasis-in-marginal-ulcer-bleeding
#11
Yasushi Yamasaki, Ryuta Takenaka, Keisuke Hori, Koji Takemoto, Seiji Kawano, Yoshiro Kawahara, Shigeatsu Fujiki, Hiroyuki Okada
The usefulness of endoscopy in marginal ulcer bleeding has rarely been studied, and the optimal method for preventing rebleeding is unclear. Here we assessed the efficacy of endoscopy in marginal ulcer bleeding and examined the efficacy of proton pump inhibitors (PPIs) in the prevention of rebleeding. A total of 28 patients with marginal ulcer bleeding (21 men, 7 women; median age 58.5 years) were treated by endoscopy. We analyzed the clinical characteristics, results of endoscopic therapy, characteristics of rebleeding patients, and relation between the use of PPIs and the duration of rebleeding...
December 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27994697/acute-reversible-duodenitis-following-non-therapeutic-upper-gastrointestinal-endoscopy-is-duodenal-diverticulum-a-predisposing-factor
#12
Emre Unal, Elif Nurbegum Ayan, Sibel Yazgan
BACKGROUND: Diagnostic upper gastrointestinal (UGI) endoscopy has been regarded as a safe procedure. CASE REPORT: We report of a 67-year-old woman who developed epigastric pain and dyspeptic complaints following an uneventful upper gastrointestinal endoscopy. The diagnosis of an acute reversible duodenitis was made on the basis of imaging studies. A duodenal diverticulum was also found on CT images, which raised the suspicion that duodenal diverticulum could be a predisposing factor for duodenitis...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27990484/initial-experience-of-video-capsule-endoscopy-after-intestinal-transplantation
#13
Jonas Varkey, Mihai Oltean, Andreas Bernd Pischel, Magnus Simrén, Gustaf Herlenius
BACKGROUND: Intestinal transplantation is a procedure which inflicts immunological and infectious complications that affect the transplanted graft, posing both diagnostic and therapeutic challenges. Video capsule endoscopy (VCE) offers easy access to the entire small intestine and presents itself as an interesting option. However, at present, no studies evaluating the usefulness of video capsule endoscopies in this setting have been published. Our aim was to evaluate the usefulness of VCE in detecting complications that arise after intestinal transplantation...
December 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27982337/right-hepatic-artery-aneurysm
#14
Astrid Del Pilar Ardila Bernal, Paulo Loures, Juan Cristóbal Ospina Calle, Beatriz Cunha, Juan Camilo Córdoba
We report a case of an aneurysm of the right hepatic artery and its multidisciplinary management by general surgery, endoscopy and radiology services. Being a case of extremely low incidence, it is important to show its diagnostic and therapeutic approach. RESUMO Relatamos um caso de aneurisma da artéria hepática direita conduzido de forma multidisciplinar pelos Serviços de Cirurgia Geral, Endoscopia e Radiologia. Em se tratando de caso de incidência baixíssima, é importante mostrar o enfoque diagnóstico e terapêutico usado em seu manejo...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27956826/nonmotor-gastrointestinal-disorders-in-older-patients-with-parkinson-s-disease-is-there-hope
#15
Doina Georgescu, Oana Elena Ancusa, Liviu Andrei Georgescu, Ioana Ionita, Daniela Reisz
Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequently reported in Parkinson's disease (PD), no therapeutic guidelines are available. This study aimed to manage some lower GI-NMS in a group of patients with PD. A total of 40 patients (17 males, 23 females; mean age 76.05±2.09 years) were randomly selected for this study. Patients were confirmed to have PD (modified Hoehn-Yars scale: 2.075±0.4) who had undergone levodopa or dopamine agonist treatment. In the non-motor symptoms questionnaire (NMS-Quest), regarding GI complaints, the following were recorded: abdominal pain, bloating, and constipation of mild-to-moderate severity...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27956164/the-cost-effectiveness-of-radiofrequency-ablation-for-barrett-s-esophagus-with-low-grade-dysplasia-results-from-a-randomized-controlled-trial-surf-trial
#16
K N Phoa, W D Rosmolen, B L A M Weusten, R Bisschops, E J Schoon, S Das, K Ragunath, G Fullarton, M DiPietro, N Ravi, J G P Tijssen, M G W Dijkgraaf, J J G H M Bergman
BACKGROUND & AIMS: The Surveillance versus RadioFrequency ablation (SURF)-trial randomized 136 patients with Barrett's esophagus (BE) containing low-grade dysplasia (LGD), to receive radiofrequency ablation (ablation, n=68) or endoscopic surveillance (control, n=68). Ablation reduced the risk of neoplastic progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) by 25% over 3 years (1.5% for ablation vs 26.5% for control). We performed a cost-effectiveness analysis from a provider perspective alongside this trial...
December 9, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27931639/complications-in-pediatric-endoscopy
#17
REVIEW
Andrea Tringali, Valerio Balassone, Paola De Angelis, Rosario Landi
The experience of the "endoscopic community" in pediatric patients is limited, but during recent years increased skills of the endoscopists and technological improvements lead to a standardization of pediatric endoscopy and the development of specialized pediatric endoscopy unit. Adverse events related to diagnostic and therapeutic endoscopy in children are usually rare. Diagnosis, prevention and treatment of complications in pediatric endoscopy is crucial when dealing with benign diseases in children. The complication rate of diagnostic EGD and colonoscopy in children are extremely low...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931632/complications-of-therapeutic-gastroscopy-colonoscopy-other-than-resection
#18
REVIEW
Zaheer Nabi
Gastrointestinal (GI) endoscopy is profoundly utilized for diagnostic and therapeutic purposes. The therapeutic potential of GI endoscopy has amplified many folds with the evolution of novel techniques as well as equipments. However, with the augmentation of therapeutic endoscopy, the extent, likelihood and severity of adverse events have increased as well. The attendant risks and adverse events with therapeutic endoscopy are many folds that of diagnostic endoscopy. Besides endoscopic resection, therapeutic endoscopy is widely utilized for hemostasis in GI bleeds, dilatation of stenosis, enteral stenting, foreign body removal, ablation of Barrett's esophagus etc...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27909548/microvasculature-of-the-esophagus-and-gastroesophageal-junction-lesson-learned-from-submucosal-endoscopy
#19
REVIEW
Roberta Maselli, Haruhiro Inoue, Haruo Ikeda, Manabu Onimaru, Akira Yoshida, Esperanza Grace Santi, Hiroki Sato, Bu'Hussain Hayee, Shin-Ei Kudo
Advanced therapeutic endoscopy, in particular endoscopic mucosal resection, endoscopic submucosal dissection, per-oral endoscopic myotomy, submucosal endoscopic tumor resection opened a new era where direct esophageal visualization is possible. Combining these information with advanced diagnostic endoscopy, the esophagus is organized, from the luminal side to outside, into five layers (epithelium, lamina propria with lamina muscularis mucosa, submucosa, muscle layer, adventitia). A specific vascular system belonging to each layer is thus visible: Mucosa with the intra papillary capillary loop in the epithelium and the sub-epithelial capillary network in the lamina propria and, at the lower esophageal sphincter (LES) level with the palisade vessels; submucosa with the drainage vessels and the spindle veins at LES level; muscle layer with the perforating vessels; peri-esophageal veins in adventitia...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27908512/single-balloon-enteroscopy
#20
REVIEW
Philipp Lenz, Dirk Domagk
Single-balloon enteroscopy is among 3 device-assisted enteroscopy systems on the market. Compared with double-balloon enteroscopy, no significant difference in diagnostic yield was found. Additionally, no significant difference was found in oral and anal insertion depth, adverse events, or procedure times. Some studies observed lower complete enteroscopy rates, which have evidently no diagnostic impact. With a learning curve of around 30 procedures, the single-balloon endoscope is a safe endoscopic tool, which seems equally suitable for diagnostic and therapeutic interventions...
January 2017: Gastrointestinal Endoscopy Clinics of North America
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