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https://www.readbyqxmd.com/read/28093301/protocol-driven-management-of-suspected-common-duct-stones
#1
Anthony Manning, Richard Frazee, Stephen Abernathy, Claire Isbell, Travis Isbell, Justin Regner, Yolanda Munoz Maldanado, Randall Smith
INTRO: Common duct stones can be diagnosed by magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound/endoscopic retrograde cholangiopancreatography (EUS/ERCP), and intra-operative cholangiogram (IOC). In 2015, our group adopted a standard approach of preoperative EUS/ERCP followed by laparoscopic cholecystectomy for patients with an admission bilirubin over 4.0 (mg/dL). For bilirubin less than 4.0, laparoscopic cholecystectomy with IOC was the initial procedure. Post-operative EUS/ERCP with endoscopic sphincterotomy was pursued for positive IOC...
January 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28071059/accuracy-of-asge-criteria-for-the-prediction-of-choledocholithiasis
#2
Jacobo Dib
I read with interest the article "Accuracy of ASGE criteria for the prediction of choledocholithiasis" by Nárvaez et al. Patients with suspicion of choledocholithiasis (CL) were categorized according to the American Society for Gastrointestinal Endoscopy (ASGE) recommendations. Those patients classified into high or intermediate-probability for CL underwent an endoscopic retrograde cholangiopancreatography (ERCP) without any further non-endoscopic biliary imaging modalities. In the ASGE recommendations for intermediate risk CL patients, they mention options for the evaluation of these patients including endoscopic ultrasound (EUS) and magnetic resonance cholangiography (MRC)...
January 10, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28066947/training-in-eus-an-asian-perspective
#3
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
#4
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/28058079/zollinger-ellison-syndrome-a-rare-case-of-chronic-diarrhea
#5
Ali Aamar, Kamraan Madhani, Hafeezulhassan Virk, Zeeshan Butt
Zollinger-Ellison syndrome (ZES) is caused by hypersecretion of gastrin from duodenal or pancreatic gastrinomas. We report a case of a 57-year-old female who presented with chronic diarrhea. CT abdomen showed multiple liver masses. Liver biopsy suggested metastatic well-differentiated neuroendocrine tumor. Serum gastrin level was markedly elevated. MRI abdomen, somatostatin receptor scintigraphy and endoscopic ultrasound failed to reveal primary site of the tumor. Upper gastrointestinal endoscopy showed hyperplastic gastric folds and multiple duodenal ulcers consistent with ZES...
December 2016: Gastroenterology Research
https://www.readbyqxmd.com/read/28058020/high-flow-nasal-oxygen-availability-for-sedation-decreases-the-use-of-general-anesthesia-during-endoscopic-retrograde-cholangiopancreatography-and-endoscopic-ultrasound
#6
Roman Schumann, Nikola S Natov, Klifford A Rocuts-Martinez, Matthew D Finkelman, Tom V Phan, Sanjay R Hegde, Robert M Knapp
AIM: To examine whether high-flow nasal oxygen (HFNO) availability influences the use of general anesthesia (GA) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) and associated outcomes. METHODS: In this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras (era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era (era 2)...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28054258/transduodenal-ampullectomy-for-ampullary-tumors
#7
Verushka M Mansukhani, Gunjan S Desai, Sasi Mouli, Keval Shirodkar, Rajiv C Shah, Jagannath Palepu
Transduodenal ampullectomy (TDA) is indicated for large ampullary tumors, for presence of dysplasia on endoscopic biopsy, for poor surgical candidates for pancreaticoduodenectomy, and in cases not indicated for endoscopic ampullectomy. Retrospective review of data from 2009 to 2015 revealed 11 patients who underwent TDA. Magnetic resonance imaging cholangiopancreatography (MRI-MRCP), contrast-enhanced computed tomography (CECT) scan, side-viewing endoscopy, and endoscopic ultrasound (EUS) were used for investigating the patients as required...
January 5, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28043931/similar-efficacies-of-endoscopic-ultrasound-gallbladder-drainage-with-a-lumen-apposing-metal-stent-vs-percutaneous-transhepatic-gallbladder-drainage-for-acute-cholecystitis
#8
Shayan Irani, Saowanee Ngamruengphong, Anthony Teoh, Uwe Will, Jose Nieto, Barham K Abu Dayyeh, S Ian Gan, Michael Larsen, Hon Chi Yip, Mark D Topazian, Michael J Levy, Christopher C Thompson, Andrew C Storm, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Majidah Bukhari, Yamile Haito Chavez, Vivek Kumbhari, Mouen A Khashab
BACKGROUND & AIMS: Acute cholecystitis in patients who are not candidates for surgery is often managed with percutaneous transhepatic gallbladder drainage (PT-GBD). Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with a lumen-apposing metal stent (LAMS) is an effective alternative to PT-GBD. We compared the technical success of EUS-GBD vs PT-GBD, as well as patient outcomes, numbers of adverse events (AEs), length of hospital stay, pain scores, and repeat interventions. METHODS: We performed a retrospective study to compare EUS-GBD vs PT-GBD at 7 centers (5 in the United States, 1 in Europe, and 1 in Asia), from 2013 through 2015, in management of acute cholecystitis in patients who are not candidates for surgery...
December 30, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28040528/role-of-diagnostic-endoscopy-in-posterior-segment-evaluation-for-definitive-prognostication-in-eyes-with-corneal-opacification
#9
Rajeev R Reddy Pappuru, Mudit Tyagi, Remya M Paulose, Vivek P Dave, Taraprasad Das, Jay Chhablani, Raja Narayanan, Rushil K Saxena, Divya Balakrishnan, Sayan Basu, Virender S Sangwan
PURPOSE: Direct visualization of the posterior segment is not possible with conventional imaging techniques in eyes with corneal opacification. This study evaluated the efficacy of video-endoscopy in visualising and hence prognosticating the visual outcomes in such eyes . DESIGN: Prospective non-comparative consecutive interventional case series. METHODS: This study included 64 eyes of 64 patients with corneal opacification who underwent diagnostic ophthalmic endoscopy procedure from March 2014 to May 2016...
December 28, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28029328/when-what-and-why-of-perioperative-treatment-of-potentially-curable-pancreatic-adenocarcinoma
#10
Kimberly Perez, Thomas E Clancy, Joseph D Mancias, Michael H Rosenthal, Brian M Wolpin
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28028429/gastric-schwannoma-a-case-report
#11
Hayfa Romdhane, Myriam Cheikh, Zeineb Mzoughi, Sana Ben Slama, Rym Ennaifer, Najet Belhadj
Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis via endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28007409/sensitivity-of-cytology-specimens-from-bronchial-aspirate-or-washing-during-bronchoscopy-in-the-diagnosis-of-lung-malignancies-an-update
#12
Philippe Girard, Raffaele Caliandro, Agathe Seguin-Givelet, Stéphane Lenoir, Dominique Gossot, Pierre Validire, Jean-Baptiste Stern
BACKGROUND: Routine collection of cytology specimens from bronchial aspirate or washing is thought to increase the sensitivity of bronchoscopy for diagnosing malignant lung lesions. However, the added value of this practice has not been reappraised in a context of changing epidemiology. PATIENTS AND METHODS: In a retrospective monocenter study, all cytology specimens from bronchial aspirate or washing collected between May 2011 and December 2014 and the corresponding patients' files were reviewed...
November 21, 2016: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28000626/role-of-contrast-enhanced-harmonic-endoscopic-ultrasound-in-submucosal-tumors
#13
REVIEW
Maria Victoria Alvarez-Sanchez, Rodica Gincul, Christine Lefort, Bertrand Napoleon
With the widespread use of endoscopy, gastrointestinal submucosal lesions are now more commonly discovered. Although endoscopic ultrasound (EUS) is superior to all other imaging techniques for the diagnosis of submucosal tumors (SMTs), it is still suboptimal for differentiating hypoechoic lesions arising from the fourth sonographic gastrointestinal wall layer, which encompass tumors with very different prognosis. EUS tissue acquisition has provided with the unique opportunity to obtain histological confirmation, but it is not accurate enough to evaluate the malignant potential of gastrointestinal stromal tumors (GISTs)...
November 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27995190/learning-curve-for-endoscopic-ultrasound-guided-fine-needle-aspiration-eus-fna-of-pancreatic-lesions-in-a-novel-ex-vivo-simulation-model
#14
J M Gonzalez, J Cohen, M A Gromski, K Saito, A Loundou, K Matthes
Background: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is essential in the management of digestive cancers. However, teaching and learning this technique remain challenging due to the lack of cost-effective models. Material and methods: This was a prospective experimental study using a complete porcine upper gastrointestinal ex-vivo organ package, placed in an Erlangen Active Simulator for Interventional Endoscopy (EASIE-R), and prepared with one cyst and two solid masses (2 cm). Five fellows inexperienced in EUS-FNA were enrolled, performing 10 procedures on each lesion, alternatively...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27993699/gastroesophageal-mucosal-injury-after-cholecystectomy-an-indication-for-surveillance
#15
Syeda Nadia Shah Gilani, Gary Alan Bass, Natallia Kharytaniuk, Michelle R Downes, Emer Frances Caffrey, Iqbal Tobbia, Thomas Noel Walsh
BACKGROUND: Cholecystectomy alters bile release dynamics from pulsatile meal-stimulated to continuous, and results in retrograde duodeno-gastric bile reflux(DGR). Bile is implicated in mucosal injury following gastric surgery, but whether cholecystectomy causes esophago-gastric mucosal inflammation, thus increasing the risk of metaplasia, is unclear. STUDY DESIGN: This study examined whether cholecystectomy-induced DGR promotes chronic inflammatory mucosal changes of the stomach and/or at the esophago-gastric junction(EGJ)...
December 16, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27965838/immediate-tumor-resection-in-patients-with-locally-advanced-gastroesophageal-adenocarcinoma-with-nonresponse-to-chemotherapy-after-4%C3%A2-weeks-of-treatment-versus-resection-after-completion-of-chemotherapy-optitreat-trial-drks00004668-study-protocol-for-a-randomized
#16
Susanne Blank, Phillip Knebel, Georg-Martin Haag, Thomas Bruckner, Ulla Klaiber, Maria Burian, Anja Schaible, Leila Sisic, Thomas Schmidt, Markus K Diener, Katja Ott
BACKGROUND: Neoadjuvant chemotherapy is a standard of care for patients with adenocarcinoma of the esophagus and stomach in Europe, but still only 20-40 % respond to therapy and the critical issue; how to treat nonresponding patients is still unclear. So far, there is no randomized trial evaluating the impact of early termination of neoadjuvant chemotherapy and immediate tumor resection in nonresponding patients with locally advanced gastroesophageal cancer on postoperative outcome. With this exploratory pilot trial, we want to get first estimates about the effect of discontinuation of chemotherapy with the aim to plan and conduct a further definitive trial...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27956826/nonmotor-gastrointestinal-disorders-in-older-patients-with-parkinson-s-disease-is-there-hope
#17
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/27931106/gastric-schwannoma-presenting-as-a-casual-ultrasonographic-findings
#18
Francisco Javier Álvarez Higueras, Ana Pereñíguez López, Esther Estrella Díez, María Muñoz Tornero, Juan Egea Valenzuela, Águeda Bas Bernal, Carmen Garre Sánchez, Ángel Vargas Acosta, Eduardo Sánchez Velasco, Luis Fernando Carballo Álvarez
We present the case of a patient under study due to ascites in which a mass located on the gastric wall was observed during ultrasonography. Further studies (upper endoscopy and computed tomography) confirmed this finding. After an ultrasound-guided percutaneous biopsy, diagnosis of gastric schwannoma was made as intense S-100 expression was found. Surgery was rejected due to the bad clinical situation of the patient and because the mass was an asymptomatic benign tumor.
December 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27904860/interventional-therapy-for-pancreatic-cancer
#19
REVIEW
Jianwei Zhu, Zhendong Jin
BACKGROUND: Palliative therapy and primarily chemoradiotherapy are the mainstream treatments in patients with locally advanced or metastatic pancreatic cancer (PC). Conventional endoscopy and endoscopic ultrasound (EUS)-guided interventional therapy has emerged as an important procedure for PC management. In this review, the progress in conventional endoscopy and EUS for PC management is discussed. SUMMARY: For local palliative therapy against PC, EUS-guided fine needle injection (FNI) could deliver different kinds of agents, such as radioactive seeds and fiducials...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27894187/endoscopic-ultrasound-guided-pancreatobiliary-endoscopy-in-surgically-altered-anatomy
#20
REVIEW
Pichamol Jirapinyo, Linda S Lee
Endoscopic retrograde cholangiopancreatography (ERCP) has become the mainstay of therapy for pancreatobiliary diseases. While ERCP is safe and highly effective in the general population, the procedure remains challenging or impossible in patients with surgically altered anatomy (SAA). Endoscopic ultrasound (EUS) allows transmural access to the bile or pancreatic duct (PD) prior to ductal drainage using ERCP-based techniques. Also known as endosonography-guided cholangiopancreatography (ESCP), the procedure provides multiple advantages over overtube-assisted enteroscopy ERCP or percutaneous or surgical approaches...
November 2016: Clinical Endoscopy
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