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Pyloric stent

Enrico Fiori, Antonietta Lamazza, Antonio V Sterpetti
We prospectively analyzed the clinical outcomes of 72 patients (2,3) and we came to similar conclusions. Conceptually, covered stents present the advantage to prevent tumor ingrowth within the stent, and, being more compliant, they could facilitate pyloric motility. However, they dislodge more easily, and distal migration of the stent can lead to serious consequences (4). This article is protected by copyright. All rights reserved.
April 29, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Douglas G Adler
No abstract text is available yet for this article.
April 4, 2017: Gastrointestinal Endoscopy
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Marlieke E Nussenbaum, Edward Y Chan, Min P Kim, Puja G Khaitan
Patients with distal esophageal pathology such as perforation, trachea-esophageal fistulae, and/ or obstructing gastroesophageal junction tumor present a challenging situation in terms of feeding access where an esophageal stent is placed across the gastroesophageal junction. In order to allow simultaneous gastric decompression and post-pyloric feeds without significant reflux up through the stent, a gastrojejunostomy (GJ) tube is a viable option. We hereby describe a hybrid approach to placing these GJ tubes in this cohort of patients using simultaneous laparoscopy, endoscopy, and fluoroscopy with minimal manipulation of the stent itself...
February 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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...
March 2017: Current Treatment Options in Gastroenterology
Hsun-Chin Chao
Endoscopic balloon dilatation (EBD) and surgical intervention are two most common and effective treatments for gastric outlet obstruction. Correction of gastric outlet obstruction without the need for surgery is an issue that has been tried to be resolved in these decades; this management has developed with EBD, advanced treatments like local steroid injection, electrocauterization, and stent have been added recently. The most common causes of pediatric gastric outlet obstruction are idiopathic hypertrophic pyloric stenosis, peptic ulcer disease followed by the ingestion of caustic substances, stenosis secondary to surgical anastomosis; antral web, duplication cyst, ectopic pancreas, and other rare conditions...
October 16, 2016: World Journal of Gastrointestinal Endoscopy
Shayan Irani, Sujai Jalaj, Andrew Ross, Michael Larsen, Ian S Grimm, Todd H Baron
BACKGROUND AND AIMS: Benign GI strictures occur typically in the esophagus and pyloric channel but can occur anywhere in the GI tract and at anastomotic sites. Such strictures can be treated with dilation, incisional therapy, steroid injection, and stents. Our aim was to describe the use of a lumen-apposing metal stent (LAMS) to treat short, benign GI strictures. PATIENTS AND METHODS: Consecutive patients who underwent LAMS placement for various benign strictures at 2 tertiary care centers from August 2014 to November 2015 were reviewed retrospectively...
September 12, 2016: Gastrointestinal Endoscopy
Seung-Young Oh, Hyuk-Joon Lee, Han-Kwang Yang
Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3...
June 2016: Journal of Gastric Cancer
Hironari Kato, Hirofumi Kawamoto, Kazuya Matsumoto, Ichiro Moriyama, Hideki Kamada, Koichiro Tsutsumi, Daisuke Goto, Nobuhiko Fukuba, Kiyohito Kato, Hiroki Sonoyama, Hajime Isomoto, Hiroyuki Okada
OBJECTIVES: Several studies report on the outcomes of self-expandable metallic stents (SEMSs) deployment for malignant gastric outlet obstruction (GOO). However, data was mostly based on the analysis of single-center studies including only a small number of patients. This study aimed to evaluate clinical outcomes after the deployment of SEMS in patients with malignant GOO and to compare the clinical outcomes of two metallic stents with different designs. METHODS: Altogether 125 consecutive patients from five institutions were included...
August 2016: Journal of Digestive Diseases
Carter Lebaras, Lee L Swanstrom
A growing body of literature supports the use of laparoscopic pyloroplasty as a minimally invasive treatment of refractory gastroparesis that has failed conservative measures and for benign gastric outlet obstruction. Endoscopic pyloric dilation, stent placement, and Botox have been described for similar indications, but often with transient or mixed results. Per-oral pyloromyotomy has recently been proposed as an endoscopic alternative to surgical pyloroplasty or pylormyotomy because it is less invasive by its nature and potentially more durable than current endoscopic treatments...
April 2016: Gastrointestinal Endoscopy Clinics of North America
Michael Camilleri
This review of the pathophysiologic basis for gastroparesis and recent advances in the treatment of patients with gastroparesis shows that there are several novel approaches to advance treatment of gastroparesis including diet, novel prokinetics, interventions on the pylorus, and novel forms of gastric electrical stimulation. The field of gastroparesis is likely to advance with further studies, with help from a guidance document from the Food and Drug Administration on gastroparesis, and with recent approval of the stable isotope gastric emptying test to ensure eligibility of participants in multicenter trials...
August 2016: Clinical Gastroenterology and Hepatology
Jae Seok Bae, Se Hyung Kim, Cheong-Il Shin, Ijin Joo, Jeong Hee Yoon, Hyuk-Joon Lee, Han-Kwang Yang, Jee Hyun Baek, Tae Han Kim, Joon Koo Han, Byung Ihn Choi
PURPOSE: We retrospectively investigated the feasibility and clinical efficacy of balloon dilatation and subsequent retrievable stent insertion, when necessitated, for pyloric spasms after pylorus-preserving gastrectomy (PPG). MATERIALS AND METHODS: Forty-five patients experiencing pyloric spasms after PPG underwent fluoroscopic balloon dilations to alleviate obstructive symptoms due to delayed gastric emptying. Patients showing poor response to balloon dilation underwent subsequent retrievable stent insertion...
2015: PloS One
Chikara Ebisui, Kazuyuki Okada, Tetsu Yanagisawa, Shu Okamura, Nariaki Fukuchi, Kohei Murata, Hideoki Yokouchi, Masamitsu Tamai, Masakatsu Kinuta
A 68-year-old man presenting with anorexia was admitted to our hospital; he was diagnosed with pyloric stenosis arising from a type 3 tumor in the antrum of the stomach. Pathological examination revealed a poorly differentiated adenocarcinoma; immunohistochemical staining tested positive for alpha fetoprotein(AFP), and negative for human epidermal growth factor receptor 2(HER2). Abdominal computed tomography (CT) showed a portal vein thrombus and enlarged lymph nodes. Since the clinical finding was Stage IV(T4aN3M1), curative surgery was ruled out...
November 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
John O Clarke, William J Snape
Gastroparesis is a syndrome characterized by delayed gastric emptying with associated symptoms. Gastric emptying is a complex process and pyloric dysfunction may play a key role in select subsets of patients with gastroparesis. Diagnostic tests to measure pyloric physiology are now available and have the potential to be more widely used in clinical practice. Targeted therapies including botulinum toxin, transpyloric stent placement, surgical pyloroplasty and endoscopic pyloromyotomy have been developed. Data are emerging regarding efficacy and durability, but these therapies may play a prominent role in select patients with gastroparesis and pyloric dysfunction...
March 2015: Gastroenterology Clinics of North America
Jun Heo, Min Kyu Jung
AIM: To evaluate the safety and efficacy of partially covered self-expandable metallic stents (SEMSs) in benign pyloric obstruction. METHODS: We retrospectively analyzed data from 10 consecutive patients with peptic ulcer-related pyloric obstructive symptoms (gastric outlet obstruction scoring system (GOOSS) score of 1) between March 2012 and September 2013. The patients were referred to and managed by partially covered SEMS insertion in our tertiary academic center...
November 28, 2014: World Journal of Gastroenterology: WJG
Naoki Aomatsu, Yosuke Doi, Satoru Takemura, Hiroaki Tanaka, Kazuya Muguruma, Saburo Yui, Kosei Hirakawa
We observed a case of unresectable Stage IV human epidermal growth factor receptor 2(HER2)-positive advanced gastric cancer treated by using trastuzumab combined with chemotherapy. A 55-year-old man was admitted to our hospital because of dysphagia for 4 months. He was diagnosed with advanced gastric cancer with pyloric stenosis, multiple lung metastases, multiple liver metastases, peritoneal dissemination, and rectal muscle invasion. First, we initiated weekly chemotherapy with paclitaxel. Because the biopsy tissue was HER2-positive, we added trastuzumab to the weekly paclitaxel regimen...
October 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Bin Li, Jian-Hua Zhang, Cheng Wang, Tie-Niu Song, Zhi-Qiang Wang, Yun-Jiu Gou, Jian-Bao Yang, Xiao-Ping Wei
BACKGROUND: Controversy still exists about the need for pyloric drainage procedures after esophagectomy with gastric conduit reconstruction. Although pyloric drainage may prevent postoperative delayed gastric emptying (DGE), it may also promote dumping syndrome and bile reflux. The aims of this study were to audit the incidence and management of DGE in patients without routine pyloric drainage after esophagectomy in a university medical center. PATIENTS AND METHODS: From July 2006 to June 2012, data from 356 consecutive patients who underwent esophagectomy with a gastric conduit without pyloric drainage for esophageal or gastric cardia carcinoma were reviewed...
May 2014: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Sajida Qureshi, Shahriyar Ghazanfar, Abu Bakar Hafeez, Mohammad Ali Taj, Saad Khalid Niaz, Mohammad Saeed Quraishy
OBJECTIVE: To determine the outcome of duodenal stenting in palliation of patients with malignant pyloric and duodenal obstruction. METHODS: The non-randomised prospective descriptive study was conducted at the Endoscopy Suite, Surgical Unit-IV, Civil Hospital, Karachi, from December 2007 to November 2010. All patients presenting with inoperable ampullary, pancreatic or biliary cancers causing duodenal obstruction and patients with resectable malignancy but unfit for surgery were included...
January 2014: JPMA. the Journal of the Pakistan Medical Association
Ryo Kato, Kazuyuki Okada, Chikara Ebisui, Yuma Wada, Shunichiro Makino, Tomohira Takeoka, Tetsu Yanagisawa, Shu Okamura, Nariaki Fukuchi, Kouhei Murata, Hideoki Yokouchi, Masakatsu Kinuta
Herein, we report the case of 57-year-old woman who visited our hospital for abdominal distention, difficulty in walking, and edema of the legs in January 2012. She underwent gastroendoscopy, resulting in a diagnosis of advanced gastric cancer of the pyloric antrum. A diagnosis of unresectable advanced gastric cancer was made because computed tomography (CT) showed the presence of ascites (suspected to indicate peritoneal dissemination), para-aortic lymph node metastases, and brain metastases. Stenting was performed for pyloric stenosis and cell-free and concentrated ascites reinfusion therapy (CART) was administered to facilitate oral intake...
November 2013: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Ryohei Kawabata, Yutaka Kimura, Tomono Kawase, Shinji Kitamura, Takamasa Yabuta, Yuki Tsukamoto, Daichi Mitsudo, Aya Gohara, Mutsumi Fukunaga, Hiroki Ohzato
We examined 11 gastric cancer patients undergoing gastroduodenal stent placement for the treatment of gastric outlet obstruction at our hospital, and assessed the significance and problems associated with stenting. None of the patients exhibited any complications associated with stenting, and the median post-stenting fasting period was 3 days(range, 1-7 days). Oral intake improved significantly in all the patients; in patients with nasogastric tubes, the tubes were removed after stenting. However, in patients with peritoneal dissemination, oral intake alone was not sufficient, and additional parenteral nutrition was required...
November 2013: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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