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Ercp, colonoscopy, endoscopy

K Leslie, M L Allen, E Hessian, A Y-S Lee
We conducted a survey of Australian specialist anaesthetists about their practice of sedation for elective and emergency gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP), and colonoscopy. A 24-item survey was emailed to 1,000 anaesthetists in August 2015. Responses were received from 409 anaesthetists (response rate=41%) with responses from 395 anaesthetists analysed. Pulse oximetry and oxygen administration were routine for all procedures for all respondents. Blood pressure was routinely measured by most respondents during gastroscopy (elective=88%; emergency=97%), ERCP (elective=99%; emergency=99%) and colonoscopy (elective=91%; emergency=98%)...
July 2016: Anaesthesia and Intensive Care
Alastair Dorreen, Sarvee Moosavi, Myriam Martel, Alan N Barkun
Background. The safety of endoscopy after an acute coronary syndrome (ACS) is poorly characterized. We thus performed a systematic review assessing the safety of endoscopy following ACS. Methods. Searches in EMBASE, Medline, and Web of Science identified articles for inclusion. Data abstraction was completed by two independent reviewers. Results. Fourteen retrospective studies yielded 1178 patients (mean 71.3 years, 59.0% male) having suffered an ACS before endoscopy. Patients underwent 1188 endoscopies primarily to investigate suspected gastrointestinal bleeding (81...
2016: Canadian Journal of Gastroenterology & Hepatology
Alicia Alvarez, Cesar J Garcia, Yi Jia, Darius Boman, Marc J Zuckerman
OBJECTIVES: Streptococcus bovis bacteremia has been associated with gastrointestinal diseases, especially colon cancer, neoplastic colon polyps, and other malignancies of the gastrointestinal tract. Studies have suggested an association with chronic liver parenchymal and biliary tract disorders. We report a series of patients with S. bovis bacteremia in a county hospital in a US city on the border of Mexico to examine the demographic and clinical associations. METHODS: We characterized the demographics, clinical features, and the endoscopic and histopathologic findings in all patients with blood cultures positive for S...
July 2015: Southern Medical Journal
Chun-Yan Zeng, Guo-Hua Li, Yin Zhu, Xiao-Jiang Zhou, Nong-Hua Lv, You-Xiang Chen
BACKGROUND AND STUDY AIMS: Gastrointestinal endoscopy procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic submucosal dissection (ESD), and colonoscopy are widely used for the diagnosis or treatment of digestive diseases. Perforation is a rare but potentially lethal complication. Large perforations usually require immediate endoscopic or surgical repair. Endoscopic closure using a nylon loop pouch suture is usually performed with a double-channel endoscope...
August 2015: Endoscopy
M Rathmayer, H Scheffer, M Braun, W Heinlein, B Akoglu, T Brechmann, S K Gölder, T Lankisch, H Messmann, A Schneider, M Wagner, S Fleßa, A Meier, B Lewerenz, L Gossner, S Faiss, T Toermer, T Werner, M H Wilke, M M Lerch, W Schepp
BACKGROUND: The German hospital reimbursement system (G-DRG) is incomplete for endoscopic interventions and fails to differentiate between complex and simple procedures. This is caused by outdated methods of personnel-cost allocation. METHODS: To establish an up-to-date service catalogue 50 hospitals made their anonymized expense-budget data available to the German-Society-of-Gastroenterology (DGVS). 2.499.900 patient-datasets (2011-2013) were used to classify operation-and-procedure codes (OPS) into procedure-tiers (e...
March 2015: Zeitschrift Für Gastroenterologie
Elisabeth Lippert, Hans H Herfarth, Nicole Grunert, Esther Endlicher, Frank Klebl
PURPOSE: Endoscopy of the gastrointestinal tract offers simultaneously diagnostic and therapeutic options and is increasingly performed in elderly patients due to a continuously growth of this population segment. Whereas safety data of diagnostic and interventional endoscopy in patients younger than 65 years are well characterized, only scarce data exist for elderly patients older than 75 years. METHODS: We analyzed outcomes and complications of endoscopic procedures with focus on colonoscopy in patients aged 75 and older at a single tertiary referral center in Germany between 1996 and 2006...
March 2015: International Journal of Colorectal Disease
Douglas G Adler
Endoscopy constitutes a wide range of procedures with many indications. Esophagogastroduodenoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography, and enteroscopy comprise the most commonly performed procedures. These examinations all carry risk to the patient, and incumbent in this is some legal risk with regard to how the procedure is conducted, decisions made based on the intraprocedure findings, and the postprocedure results, in addition to events that occur following the procedure...
January 2015: Gastrointestinal Endoscopy Clinics of North America
Nurten Savas
Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions...
November 7, 2014: World Journal of Gastroenterology: WJG
David Friedel, Stavros Stavropoulos, Shahzad Iqbal, Mitchell S Cappell
About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy (EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients...
May 16, 2014: World Journal of Gastrointestinal Endoscopy
Kunjam Modha, Udayakumar Navaneethan
Endoscopy plays a key role in the diagnosis and treatment of patients with inflammatory bowel disease (IBD). Colonoscopy has been traditionally used in the diagnosis of IBD and helps in determination of an important end point in patient management, "mucosal healing". However, the involvement of an advanced endoscopist has expanded with innovations in therapeutic and newer imaging techniques. Endoscopists are increasingly being involved in the management of anastomotic and small bowel strictures in these patients...
April 7, 2014: World Journal of Gastroenterology: WJG
Ke Li, Yong-Hui Huang, Wei Yao, Hong Chang, Xue-Biao Huang, Yao-Peng Zhang, Zhi-Qiang Song
OBJECTIVE: The aim of this study was to evaluate the usefulness of adult colonoscopy or single-balloon enteroscopy (SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) in long-limb surgical bypass patients. METHODS: Retrospective analysis of 16 patients with long-limb surgical bypasses who underwent therapeutic ERCP because of suspected pancreaticobiliary diseases. Small-bowel intubation was performed by peroral adult colonoscopy or SBE. If colonoscopy success was achieved, ERCP was performed subsequently...
September 2014: Clinics and Research in Hepatology and Gastroenterology
Katie S Yang, Ashraf S Habib, Minyi Lu, M S Branch, Holly Muir, Paul Manberg, Jeffrey C Sigl, Tong J Gan
BACKGROUND: Moderate sedation is routinely performed in patients undergoing minor therapeutic and diagnostic procedures outside the operating room. The level of sedation is often monitored by sedation nurses using clinical criteria, such as sedation scores. The Bispectral Index (BIS) is derived from changes in the electroencephalograph profile that may provide an objective measure of the level of sedation. In this prospective observational study, we investigated whether using BIS values to guide sedative drug administration influences the level of sedation and the incidence of adverse events compared with using Ramsay sedation scale (RSS) only in nurse-administered moderate sedation...
July 2014: Anesthesia and Analgesia
Neal K Kaushal, Kenneth Chang, John G Lee, V Raman Muthusamy
BACKGROUND: With an increasing demand for endoscopy services, there is a greater need for efficiency within the endoscopy center. A validated methodology is important for evaluating efficiency in the endoscopy unit. OBJECTIVE: To use the principles of operations management to establish a validated methodology for evaluating and enhancing operational performance in the endoscopy center. DESIGN: Biphasic prospective study with pre-intervention and post-intervention efficiency data and analysis...
April 2014: Gastrointestinal Endoscopy
Farid Razavi, Seth Gross, Seymour Katz
There has been limited research examining the risks, benefits, and use of common endoscopic procedures in the elderly. Furthermore, gastroenterology training programs do not routinely incorporate elderly concerns when dealing with common gastrointestinal issues. There exists a broad array of endoscopic procedures with varying inherent risks that must be weighed with each elderly patient in mind. This article discusses the benefits and drawbacks of the most common procedures and indications for endoscopy including upper endoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, percutaneous endoscopic gastrostomy, and deep enteroscopy...
February 2014: Clinics in Geriatric Medicine
F S Gargoum, S T O'Keeffe
BACKGROUND: Informed consent requires good communication. Patient information leaflets (PILs) may be helpful, although some PILs are too hard to read for the average patient. AIMS: We sought to examine the readability of PILs provided for patients prior to endoscopic procedures in 24 gastrointestinal and 16 respiratory departments of 24 Irish public hospitals. METHODS: Readability, measured using the Flesch Reading Ease and the Flesch-Kincaid Grade Level scores, and content of all PILs were examined...
September 2014: Irish Journal of Medical Science
Koichi Soga, Osamu Handa, Minoru Yamada, Junichi Sakagami, Nobuaki Yagi, Yuji Naito, Toshikazu Yoshikawa, Yoshito Itoh, Naoki Arizono
This review examines the use of digestive endoscopy to visualize intestinal helminths. The infections caused by these parasites are responsible for high levels of morbidity and mortality. These helminths can be visualized using gastroduodenal endoscopy, endoscopic retrograde cholangiopancreatography, and colonoscopy. Endoscopic examination of the small bowel is limited by its considerable length and its distance from the mouth and anus. Since capsule endoscopy (CE) was first reported in 2000, it has been established as a noninvasive modality for the investigation of the gastrointestinal tract...
February 2014: Parasitology International
Amy L Halverson, Tyler G Hughes, David C Borgstrom, Ajit K Sachdeva, Debra A DaRosa, David B Hoyt
BACKGROUND: As new technology is developed and scientific evidence demonstrates strategies to improve the quality of care, it is essential that surgeons keep current with their skills. Rural surgeons need efficient and targeted continuing medical education that matches their broader scope of practice. Developing such a program begins with an assessment of the learning needs of the rural surgeon. The aim of this study was to assess the learning needs considered most important to surgeons practicing in rural areas...
November 2013: Journal of the American College of Surgeons
Petter Westfelt, Leif Hedman, Mikael Axelsson Lindkvist, Lars Enochsson, Li Felländer-Tsai, Peter Thelin Schmidt
OBJECTIVE: The use of nonanesthetist-administered propofol (NAAP) in GI endoscopy has long been controversial. In the setting of NAAP, acute situations can develop during endoscopy and thus training before starting with NAAPs is considered crucial. The aim was to evaluate a pilot study on crew resource management (CRM)-based training of teams of endoscopists and endoscopy nurses in NAAP in a full-scale hybrid simulation consisting of a full-scale human patient simulator and an endoscopy simulator...
November 2013: Scandinavian Journal of Gastroenterology
Michael Friedt, Simon Welsch
Advances in endoscopy and anesthesia have enabled gastrointestinal endoscopy for children since 1960. Over the past decades, the number of endoscopies has increased rapidly. As specialized teams of pediatric gastroenterologists, pediatric intensive care physicians and pediatric endoscopy nurses are available in many medical centers, safe and effective procedures have been established. Therefore, diagnostic endoscopies in children are routine clinical procedures. The most frequently performed endoscopies are esophagogastroduodenoscopy (EGD), colonoscopy and endoscopic retrograde cholangiopancreaticography (ERCP)...
2013: European Journal of Medical Research
Lukejohn W Day, Taft Bhuket, John M Inadomi, Hal F Yee
BACKGROUND: Little is known about endoscopic services provided or operational practice variation within California public hospital endoscopy centers. METHODS: A survey was distributed to all 18 California public hospitals with endoscopy centers to assess operational practices. RESULTS: Eight of 18 hospitals responded to the survey. Six of the eight responding hospitals used a closed access system for patient referrals. Mean wait time for an endoscopic procedure was 42...
2013: BMC Research Notes
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