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https://www.readbyqxmd.com/read/28078463/endoscopic-vacuum-therapy-for-various-defects-of-the-upper-gastrointestinal-tract
#1
Florian Kuehn, Gunnar Loske, Leif Schiffmann, Michael Gock, Ernst Klar
BACKGROUND: Postoperative, iatrogenic or spontaneous upper gastrointestinal defects result in significant morbidity and mortality of the patients. In the last few years, endoscopic vacuum therapy (EVT) has been recognized as a new promising method for repairing upper gastrointestinal defects of different etiology. However, probably due to insufficient data and no commercially available system for EVT of the upper gastrointestinal tract, until the end of 2014, covering of esophageal defects with self-expanding metal stents (SEMS) were still the mainstay of endoscopic therapy...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28049283/application-of-photodynamic-therapy-in-gastrointestinal-disorders-an-outdated-or-re-emerging-technique
#2
REVIEW
Han Hee Lee, Myung-Gyu Choi, Tayyaba Hasan
Photodynamic therapy (PDT) is a promising therapeutic modality that involves the administration of a photosensitizer followed by local illumination with a specific wavelength of light in the presence of oxygen. PDT is minimally invasive, has high selectivity for cancer, and has good patient compliance due to the simplicity of the procedure; therefore, PDT is widely used as a palliative and salvage treatment in patients with various gastrointestinal malignancies. When used as a salvage treatment for locoregional failures after definitive chemoradiotherapy for esophageal cancer, favorable results have been reported...
January 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28045757/left-colonic-bleeding-secondary-to-inferior-mesenteric-vein-stenosis
#3
Thang Q Le, Donald Romanelli
Lower gastrointestinal bleeding is most commonly associated with diverticulosis, ischemic colitis, vascular ectasia, and anorectal disease and less commonly associated with colonic malignancy. Infrequently, it is associated with mesenteric varices, a rare etiology that is not well documented in the radiology literature. We present a case of a 50-year-old man diagnosed as having intermittent left colonic bleeding from mesenteric varices due to a critical stenosis at the portal vein-inferior mesenteric vein confluence...
December 29, 2016: Journal of Computer Assisted Tomography
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
#4
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/28042233/gastrointestinal-endoscopy-in-patients-on-anticoagulant-therapy-and-antiplatelet-agents
#5
REVIEW
Angelo Zullo, Cesare Hassan, Franco Radaelli
Periprocedural management of antithrombotics for gastrointestinal endoscopy is a common clinical issue, given the widespread use of these drugs for primary and secondary cardiovascular prevention. For diagnostic procedures, with or without biopsy, no adjustments in antithrombotics are usually needed. For operative procedures, balancing the risk of periprocedural hemorrhage with the continuation of antithrombotics against the chance of recurrent thromboembolic events with their discontinuation may be challenging...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28039647/a-multicenter-experience-of-through-the-scope-balloon-assisted-enteroscopy-in-surgically-altered-gastrointestinal-anatomy
#6
Jennifer X Cai, David L Diehl, Ralf Kiesslich, Andrew C Storm, Mohamad H El Zein, Alan H Tieu, Arthur Hoffman, Vikesh K Singh, Mouen A Khashab, Patrick I Okolo, Vivek Kumbhari
BACKGROUND: Surgically altered gastrointestinal anatomy poses challenges for deep enteroscopy. Current overtube-assisted methods have long procedure times and utilize endoscopes with smaller working channels that preclude use of standard accessories. A through-the-scope balloon-assisted enteroscopy (TTS-BAE) device uses standard endoscopes with a large working channel to allow metallic and plastic stent insertion. We aim to determine the efficacy and safety of TTS-BAE in patients with altered surgical anatomy...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28029534/the-influence-of-fellowship-training-on-the-practice-of-pancreatoduodenectomy
#7
Gregory T Kennedy, Matthew T McMillan, Michael H Sprys, Claudio Bassi, Paul D Greig, Paul D Hansen, Dhiresh R Jeyarajah, Tara S Kent, Giuseppe Malleo, Giovanni Marchegiani, Rebecca M Minter, Charles M Vollmer
BACKGROUND: There has been a proliferation of gastrointestinal surgical fellowships; however, little is known regarding their association with surgical volume and management approaches. METHODS: Surveys were distributed to members of GI surgical societies. Responses were evaluated to define relationships between fellowship training and surgical practice with pancreatoduodenectomy (PD). RESULTS: Surveys were completed by 889 surgeons, 84.1% of whom had completed fellowship training...
October 28, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27999650/subclavian-artery-esophageal-fistula-after-placement-of-a-self-expanding-metal-stent-in-a-patient-with-esophagogastric-anastomosis-stenosis
#8
Mohammadreza Seyedmajidi, Maryam Tavassoli, Mojtaba Kianti, Jamshid Vafaeimanesh
BACKGROUND: There have been reports on stent-related vascular erosions about patients with benign or malignant stenosis of the esophagus who received endoscopic stent insertion for palliative intention for oral intake. CASE PRESENTATION: A 61-year-old woman with esophageal cancer located in the middle part of esophagus was treated with esophagectomy. Two years following the surgery, malignant stenosis recurred in the esophagogastric anastomosis. A non-covered self-expanding metal stent (10 cm length with a diameter of 18 mm at expanded state) was inserted...
2016: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/27995468/alpha-fetoprotein-producing-esophageal-adenocarcinoma-a-mimicker-of-hepatocellular-carcinoma
#9
Jeremy Wang, Wendy Liu, Keyur Parikh, Anthony Benjamin Post
Alpha-fetoprotein (AFP)-producing esophageal adenocarcinoma (EAC) is a rare occurrence. Elevation of serum AFP is commonly associated with hepatocellular carcinoma and yolk sac tumors, but rarely with esophageal carcinoma. Here, we report a rare case of AFP-producing EAC. A 51-year-old man presented with two weeks of acid reflux and a 35-lb weight loss. Laboratory data were notable for transaminitis and AFP was 2524 ng/mL. Computed tomography of the abdomen revealed abnormal thickening of the esophagus and multiple metastatic masses throughout the liver...
December 19, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27995197/eus-guided-biliary-drainage-or-enteroscopy-assisted-ercp-in-patients-with-surgical-anatomy-and-biliary-obstruction-an-international-comparative-study
#10
Mouen A Khashab, Mohamad H El Zein, Kaveh Sharzehi, Fernando P Marson, Oleh Haluszka, Aaron J Small, Yousuke Nakai, Do Hyun Park, Rastislav Kunda, Anthony Y Teoh, Irene Peñas, Manuel Perez-Miranda, Vivek Kumbhari, Schalk Van der Merwe, Everson L Artifon, Andrew S Ross
Background and study aims: How enteroscopy-assisted ERCP (e-ERCP) and endoscopic ultrasound-guided biliary drainage (EUS-BD) compare in patients with surgically altered upper gastrointestinal anatomy is currently unknown. The aims of this study were to compare efficacy and safety of both techniques and study predictors of these outcomes. Patients and methods: This was an international, multicenter comparative cohort study at 10 tertiary centers. Outcomes data included technical success (biliary access with cholangiography and stent placement [when indicated]), clinical success (resolution of biliary obstruction) and adverse events (AEs) (graded according to the ASGE lexicon)...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27981372/first-report-of-urinary-endoscopic-vacuum-therapy-for-large-bladder-defect-after-abdomino-perineal-excision-of-the-rectum-video-paper
#11
G Loske, T Schorsch, R U Kiesow, C T Müller
PURPOSE: The technique of active urinary endoscopic vacuum therapy (uEVT) is described. The surgical technique is demonstrated in detail with the help of a video of the operation, which is available online. Vesical fistulas are a rare complication following rectal surgery. The EVT technique is a novel method for the treatment of gastrointestinal leakage. This endoscopic procedure has been adapted to treat a large bladder defect after abdomino-perineal resection of the rectum with urine flowing out of the perineal wound...
December 15, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27981370/-first-report-of-urinary-endoscopic-vacuum-therapy-for-large-bladder-defect-after-abdomino-perineal-excision-of-the-rectum-video-paper-german-version
#12
G Loske, T Schorsch, R U Kiesow, C T Müller
PURPOSE: The technique of active urinary endoscopic vacuum therapy (uEVT) is described. The surgical technique is demonstrated in detail with the help of a video of the operation and which is available online. Vesical fistulas are a rare complication following rectal surgery. The EVT technique is a novel method for treatment of gastrointestinal leakage. This endoscopic procedure has been adapted to treat a large bladder defect after abdominoperineal resection of the rectum with urine flowing out of the perineal wound...
December 15, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27965903/atypical-aortoesophageal-fistula-with-atypical-and-delayed-presentation-and-negative-imaging-studies
#13
Seifeldin Hakim, Mihajlo Gjeorgjievski, Lohit Garg, Molly Orosey, Tusar Desai
A 59-year-old man with past medical history of thoracic aortic aneurysm treated with thoracic endovascular aortic repair presented with melena for 2 weeks. Initial EGD did not reveal the source of bleeding and showed normal esophagus; abdominal arteriogram did not reveal a fistulous communication and initial CTA showed normal position of the aortic graft stent without endoleak. The sixth EGD revealed a submucosal tumor-like projection in the upper esophagus and stigmata of recent bleeding. Another thoracic endovascular aortic repair with stent was placed over the old graft for presumed aortoesophageal fistula...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#14
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931632/complications-of-therapeutic-gastroscopy-colonoscopy-other-than-resection
#15
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/27904860/interventional-therapy-for-pancreatic-cancer
#16
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/27904252/hemobilia
#17
REVIEW
Rakesh Navuluri
Hemobilia is a rare source of upper gastrointestinal bleeding, though the incidence is increasing along with the rise in minimally invasive biliary interventions. Prompt diagnosis and treatment rests on having appropriate clinical suspicion which should be based on the patient's presenting signs and symptoms, as well as history including recent instrumentation. Endoscopy should be reserved for cases of upper gastrointestinal bleeding with low suspicion for hemobilia. Interventional radiology may be the first-line diagnostic and therapeutic option for patients with a high suspicion of hemobilia...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27895378/intravesical-foreign-body-tertiary-care-center-experience-from-pakistan
#18
Hussam Uddin Soomro, Imran Jalbani, Nuzhat Faruqui
Foreign body in bladder is relatively uncommon condition with variable presentations. Literature is limited to case reports and small series from region. Therefore, we planned this study to review our experience regarding intravesical foreign body. This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised 14 patients having intravesical foreign bodies from March 1989 to March 2013. Demographics, presentation, mode of insertion, type of foreign body and management were noted...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27886406/disrupted-pancreatic-duct-treated-with-a-combination-of-endoscopic-cystoduodenostomy-and-pancreatic-duct-fistualization-through-a-pseudocyst-wall-using-a-lumen-apposing-metal-stent
#19
Robert M Wilechansky, Ali S Khan, Amrita Sethi
Management of disconnected pancreatic duct syndrome is complex and is increasingly approached using emerging endoscopic techniques. Herein, we present a case of recurrent pancreatitis in an elderly woman complicated by pseudocyst formation and complete pancreatic duct disruption. Her condition was treated with a novel combination of transpapillary stenting and cystduodenostomy in which a pancreatic duct stent was placed into an opening in the pseudocyst wall through a lumen-apposing metal stent. This allowed for effective drainage into the gastrointestinal tract and resolution of duct disruption...
November 25, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27882097/effect-of-a-paclitaxel-eluting-metallic-stent-on-rabbit-esophagus
#20
Yin Zhang, Ying Gao, Jianping Chen, Limei Ma, Li Liu, Xiang Wang, Zhining Fan
The use of self-expanding metallic stents (SEMS) is the current treatment of choice for malignant gastrointestinal obstructions. A paclitaxel-eluting metallic SEMS (PEMS) may have an antitumor effect on esophageal tissue. PEMS with 10% paclitaxel or conventional SEMS were inserted into the lower esophagus of rabbits. Following the insertion of the stents for 1, 2, 4 and 6 weeks, the rabbits were sacrificed and the status of the stent insertion was examined, as well as any macroscopic or microscopic mucosal changes in the esophageal tissue...
November 2016: Experimental and Therapeutic Medicine
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