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https://www.readbyqxmd.com/read/28209556/palliation-of-malignant-gastroduodenal-obstruction-fluoroscopic-metallic-stent-placement-with-different-approaches
#1
Elif Bulut, Türkmen Çiftçi, Okan Akhan, Devrim Akıncı
PURPOSE: We aimed to evaluate the safety and effectiveness of fluoroscopy-guided gastroduodenal metallic stent placement with different approaches in malignant obstruction. METHODS: We retrospectively assessed 53 patients (33 men and 20 women; mean age, 58.7±15 years) who underwent stent placement between February 2004 and April 2014. All patients had unresectable tumors. The most common causes of obstruction were gastric (38%) and pancreatic cancers (36%). Uncovered self-expandable metallic stents (SEMS) were placed under fluoroscopic guidance...
February 17, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28208004/a-novel-partially-covered-self-expandable-metallic-stent-with-proximal-flare-in-patients-with-malignant-gastric-outlet-obstruction
#2
Naminatsu Takahara, Hiroyuki Isayama, Yousuke Nakai, Shuntaro Yoshida, Tomotaka Saito, Suguru Mizuno, Hiroshi Yagioka, Hirofumi Kogure, Osamu Togawa, Saburo Matsubara, Yukiko Ito, Natsuyo Yamamoto, Minoru Tada, Kazuhiko Koike
Background/Aims: Endoscopic placement of self-expandable metal stents (SEMSs) has emerged as a palliative treatment for malignant gastric outlet obstruction (GOO). Although covered SEMSs can prevent tumor ingrowth, frequent migration of covered SEMSs may offset their advantages in preventing tumor ingrowth. Methods: We conducted this multicenter, single-arm, retrospective study at six tertiary referral centers to evaluate the safety and efficacy of a partially covered SEMS with an uncovered large-bore flare at the proximal end as an antimigration system in 41 patients with symptomatic malignant GOO...
February 17, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28203132/modified-devine-exclusion-for-unresectable-distal-gastric-cancer-in-symptomatic-patients
#3
María Carmen Fernández-Moreno, Roberto Martí-Obiol, Fernando López, Joaquín Ortega
BACKGROUND: In patients with outlet obstruction syndrome and/or severe anemia secondary to unresectable gastric cancer (GC), partial stomach-partitioning gastrojejunostomy, or modified Devine exclusion, is a surgical alternative. METHODS: A retrospective study was conducted on patients with unresectable distal GC treated with modified Devine exclusion as palliative surgery between February 2005 and December 2015. It consisted of a series of 10 patients with outlet obstruction syndrome and/or severe anemia...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28192804/one-step-exchange-free-single-balloon-assisted-endoscopic-ultrasound-guided-gastroenterostomy-with-lumen-apposing-metal-stent-in-malignant-gastric-outlet-obstruction
#4
Ilaria Tarantino, Dario Ligresti, Luca Barresi, Gabriele Curcio, Antonino Granata, Mario Traina
No abstract text is available yet for this article.
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28190361/ball-valve-syndrome-caused-by-a-giant-gastric-vanek-s-tumor
#5
Cláudio Rodrigues Martins, Élia Gamito, Ana Paula Oliveira
Inflammatory fibroid polyps (Vanek's tumor) are rare, accounting for 0.1% of all gastric polyps. This letter describes an unusual case of an intermittent gastric outlet obstruction by a large Vanek's tumor.
February 13, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28189119/roux-en-y-duodenojejunostomy-for-surgical-management-of-isolated-duodenal-obstruction-due-to-chronic-pancreatitis
#6
Himanshu Sharma, Sanjay Marwah, Priyanka Singla, Amit Garg, Bittu Bhukkal
INTRODUCTION: Duodenal obstruction in case of chronic pancreatitis is a very rare occurrence and usually presents with gastric outlet obstruction. These cases sometimes require surgical intervention when conservative treatment fails. Gastrojejunostomy and vagotomy has conventionally been performed for management of these cases. PRESENTATION OF CASE: In this report, we present two cases of isolated duodenal obstruction due to chronic pancreatitis that were managed with Roux-en-Y duodenojejunostomy...
January 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28184377/novel-use-of-a-uniquely-designed-lumen-apposing-metal-stent-in-benign-gastric-outlet-obstruction-in-two-patients
#7
Ross Pinson, Induruwa Pathirana, John Magulick, Jeremy Domanski, Emuejevoke Okoh, Craig Womeldorph
Current guidelines recommend management of benign gastric outlet obstruction (GOO) with serial dilations. Self-expanding metal stents are effective, but their use is complicated by high rates of migration. We present two cases from our institution where a uniquely designed, lumen-apposing metal stent (LAMS) was successfully used to alleviate benign GOO without stent migration.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28181708/interventional-eus-where-are-we-headed
#8
REVIEW
Marco J Bruno
EUS is an essential endoscopic tool within the diagnostic and therapeutic armamentarium of gastrointestinal and hepatic diseases. EUS-guided tissue acquisition will develop towards facilitating personalized treatment by obtaining large representative tissue specimens for elaborate immunohistochemical and biomolecular typing of the tumor. Intra-tumoral or intra-vascular delivery of drugs potentially offer many advantages over systemic injection. Intratumoral application of radiofrequency ablation and photodynamic therapy show promise but need to be explored further...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28174384/-eleven-patients-with-gastric-cancer-who-received-chemotherapy-after-stent-placement-for-gastric-outlet-obstruction
#9
Shunji Endo, Tomo Nakagawa, Ken Konishi, Masakazu Ikenaga, Katsuya Ohta, Shinsuke Nakashima, Kenichi Matsumoto, Kazuhiro Nishikawa, Takeshi Ohmori, Terumasa Yamada
Endoscopic placement of self-expandable metallic stents is reportedly effective for gastric outlet obstructions due to advanced gastric cancer, and is less invasive than gastrojejunostomy. For patients who have good performance status, we administer chemotherapy after stent placement, although the safety and feasibility of this chemotherapy have not yet been discussed in full. Between 2011 and 2015, 15 patients at our institution underwent endoscopic gastroduodenal stent placement for gastric outlet obstruction due to gastric cancer...
January 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28160331/long-term-outcomes-and-risk-factors-of-biliary-stent-dysfunction-after-endoscopic-double-stenting-for-malignant-biliary-and-duodenal-obstructions
#10
Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Sho Mizukawa, Syuntaro Yabe, Hiroyuki Seki, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Kenji Kuwaki, Hiroyuki Okada
BACKGROUND AND AIMS: Few reports describe the endoscopic double stenting procedure for malignant biliary and duodenal obstructions. We evaluated the clinical outcomes from double stenting, and analyzed the risk factors for biliary stent dysfunction following double stenting. METHODS: Eighty-one patients who underwent endoscopic double stenting for malignant biliary and duodenal obstructions were retrospectively analyzed. We determined the stent dysfunction rate and the biliary stent dysfunction risk factors, and analyzed the endoscopic reintervention results...
February 3, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28159802/ranitidine-forgotten-drug-of-delayed-gastric-emptying
#11
Abbie E Veevers, Stephen G Oxberry
Delayed gastric emptying in the presence or absence of mechanical bowel obstruction can cause distressing symptoms in palliative care patients. We present two patients, both with vomiting due to delayed gastric emptying and gastric outlet obstruction secondary to pancreatic cancer, treated with subcutaneous ranitidine resulting in a symptomatic response. We hypothesise that ranitidine is a useful adjunct to standard treatment with prokinetic agents or octreotide in such patients and potentially those with proximal mechanical bowel obstruction from other malignancies with associated delayed gastric emptying...
February 3, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28156641/in-search-of-the-optimal-outcome-measure-for-patients-with-advanced-cancer-and-gastrointestinal-obstruction-a-qualitative-research-study
#12
Loretta A Williams, Eduardo Bruera
: 100 Background: Gastrointestinal obstruction (GIO) is the most common indication for palliative surgical consultation in patients with advanced cancer. The purpose of this study was to delineate the symptom burden and experience of patients with GIO. METHODS: Twenty patients with advanced cancer and GIO described symptoms at the time of surgical consultation. We used content analysis of interview transcripts and symptoms were ranked by frequency and compared to a general symptom assessment survey (MD Anderson Symptom Inventory)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28124202/pyloric-therapies-for-gastroparesis
#13
REVIEW
Nitin K Ahuja, John O Clarke
Gastroparesis is a syndrome that can be difficult to treat effectively and likely represents the common clinical presentation of multiple underlying mechanisms. One of these presumed mechanisms involves pyloric dysfunction, tied perhaps to spasm or fibrosis, manifesting as functional gastric outlet obstruction. Various diagnostic modalities have been used to better characterize this hypothesized abnormality, including most recently antroduodenal manometry and impedance planimetry. A variety of therapeutic interventions specific to the pylorus have also been proposed in the last several years, including intrapyloric injections of botulinum toxin, transpyloric stenting, surgical pyloroplasty, and endoscopic pyloromyotomy...
January 25, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28101304/gastric-antral-webs-in-adults-a-case-series-characterizing-their-clinical-presentation-and-management-in-the-modern-endoscopic-era
#14
Shannon J Morales, Neha Nigam, Walid M Chalhoub, Dalia I Abdelaziz, James H Lewis, Stanley B Benjamin
AIM: To investigate the current management of gastric antral webs (GAWs) among adults and identify optimal endoscopic and/or surgical management for these patients. METHODS: We reviewed our endoscopy database seeking to identify patients in whom a GAW was visualized among 24640 esophagogastroduodenoscopies (EGD) over a seven-year period (2006-2013) at a single tertiary care center. The diagnosis of GAW was suspected during EGD if aperture size of the antrum did not vary with peristalsis or if a "double bulb" sign was present on upper gastrointestinal series...
January 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28032663/technical-review-of-endoscopic-ultrasonography-guided-gastroenterostomy-in-2017
#15
REVIEW
Takao Itoi, Todd H Baron, Mouen A Khashab, Takayoshi Tsuchiya, Shayan Irani, Vinay Dhir, Anthony Yuen Bun Teoh
Gastric outlet obstruction (GOO) can be caused by benign and malignant diseases and often leads to a reduction in patient quality of life. Lately, endoscopic ultrasonography (EUS)-guided gastroenterostomy (EUS-GE) has emerged. At the present time, there are three types of EUS-GE using lumen-apposing biflanged metal stents (LAMS): (i) direct EUS-GE; (ii) assisted EUS-GE using retrieval/dilating balloon, single balloon overtube, nasobiliary drain and ultraslim endoscope; and (iii) EUS-guided double-balloon-occluded gastrojejunostomy bypass (EPASS)...
December 29, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28011861/an-unusual-case-of-gastric-outlet-obstruction-caused-by-multiple-giant-persimmon-phytobezoars
#16
Fengbo Tan, Hongbin Mo, Xiao He, Haiping Pei
A phytobezoar is a bezoar or trapped mass in the gastrointestinal system that consists of indigestible plant material such as fibers, skins and seeds. A persimmon phytobezoar (considered to be harder than other types of phytobezoars) is formed after frequent consumption of persimmons. The complication of gastrointestinal tract obstruction from bezoars was found to exist in the intestines but was rarely reported in the gastric tract because of its flexible volume. Here we present a 57-year-old man with persimmon phytobezoars, which ultimately led to gastric outlet obstruction...
December 23, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/27997723/covered-vs-uncovered-metal-stents-for-malignant-gastric-outlet-obstruction-a-systematic-review-and-meta-analysis
#17
REVIEW
Tsuyoshi Hamada, Ryunosuke Hakuta, Naminatsu Takahara, Takashi Sasaki, Yousuke Nakai, Hiroyuki Isayama, Kazuhiko Koike
OBJECTIVES: Self-expandable metal stents (SEMSs) are utilized for nonresectable malignant gastric outlet obstruction (GOO). Studies of covered vs. uncovered SEMSs have yielded inconsistent results due to heterogeneity in designs and patient populations. We performed a meta-analysis to compare covered and uncovered gastroduodenal SEMSs. METHODS: Using MEDLINE, Embase, and the Cochrane database, we identified 1,624 patients from 13 prospective and retrospective studies which evaluated covered and uncovered SEMSs for malignant GOO and were published until October 2016...
December 20, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27977608/risk-factors-and-management-for-pyloric-stenosis-occurred-after-endoscopic-submucosal-dissection-adjacent-to-pylorus
#18
Jae Un Lee, Moon Sik Park, So Hee Yun, Min A Yang, Shang Hoon Han, Young Jae Lee, Gum Mo Jung, Ji Woong Kim, Yong Keun Cho, Jin Woong Cho
Endoscopic submucosal dissection (ESD) has been widely accepted as a curative treatment for gastric neoplasm. Pyloric stenosis is a chronic complication that can be caused by ESD. The aim of this study is to clarify the risk factors and management for pyloric stenosis. From January 2004 to January 2014, a total of 126 patients who underwent ESD adjacent to pylorus were reviewed retrospectively. Pyloric mucosal defect was defined as when any resection margin of ESD was involved in the pyloric ring. Pyloric stenosis was defined as when a conventional endoscope could not be passed to the duodenum...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27935909/exploring-the-diagnosis-and-management-of-bouveret-s-syndrome
#19
M Bhattarai, P Bansal, B Patel, A Lalos
Bouveret's syndrome is an unusual cause of gastric outlet obstruction secondary to gallstone impaction. It is so rare that it is commonly missed in clinical practice if it is not considered in differential diagnoses of intestinal obstruction more specifically in man who does not report the history of gall stone. Furthermore, there are no definitive guidelines on approach and management of this condition. We present a seventy eight year old man who developed acute abdominal symptoms due to impaction of a gallstone in the duodenum...
January 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27920640/intussuscepting-ampullary-adenoma-an-unusual-cause-of-gastric-outlet-obstruction-leading-to-cavitating-lung-lesions
#20
Simon J McCluney, Vickna Balarajah, Alex Giakoustidis, Joanne Chin-Aleong, Bryony Lovett, Hemant M Kocher
Ampullary adenomas are a rare clinical entity, occurring at a rate of 0.04-0.12% in the general population. They are premalignant lesions which have the capability to progress to malignancy, and they should be excised if they are causing immediate symptoms and/or are likely to degenerate to carcinoma. Intestinal intussusception in adults is rare and, unlike in children, is often due to a structural pathology. Intussuscepting duodenal/ampullary adenomas have been reported in the literature on 13 previous occasions, however never before with this presentation...
September 2016: Case Reports in Gastroenterology
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