期刊文献+
共找到4,310篇文章
< 1 2 216 >
每页显示 20 50 100
Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy 预览
1
作者 Chonlada Krutsri Mitsuhiro Kida +3 位作者 Hiroshi Yamauchi Tomohisa Iwai Hiroshi Imaizumi Wasaburo Koizumi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3313-3333,共21页
Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types o... Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed. 展开更多
关键词 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY Surgically ALTERED ANATOMY ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY in Billroth II ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY post-Whipple ENDOSCOPIC ultrasonography-guided ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
在线阅读 免费下载
Risk factors for the development of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with asymptomatic common bile duct stones 预览
2
作者 Hirokazu Saito Tatsuyuki Kakuma Ikuo Matsushit 《世界胃肠内镜杂志:英文版(电子版)》 2019年第10期515-522,共8页
BACKGROUND Previous studies have revealed that patients with asymptomatic common bile duct(CBD)stones are at a high risk of developing post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).However... BACKGROUND Previous studies have revealed that patients with asymptomatic common bile duct(CBD)stones are at a high risk of developing post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).However,no studies to date have addressed the risk factors for PEP in patients with asymptomatic CBD stones.AIM To examine the risk factors for PEP in patients with asymptomatic CBD stones.METHODS Using medical records of three institutions in Japan for 6 years,we identified a total of 1135 patients with choledocholithiasis including 967 symptomatic patients and 168 asymptomatic patients with native papilla who underwent therapeutic ERCP.We performed univariate and multivariate analyses to examine the risk factors for PEP in the 168 patients with asymptomatic CBD stones.RESULTS The overall incidence rate of PEP in all the patients with during study period was 4.7%(53/1135).Of the 168 patients with asymptomatic CBD stones,24(14.3%)developed PEP.In univariate analysis,precut sphincterotomy(P=0.009)and biliary balloon sphincter dilation(P=0.043)were significant risk factors for PEP.In multivariate analysis,precut sphincterotomy(P=0.002,95%CI:2.2-27.8,odds ratio=7.7),biliary balloon sphincter dilation(P=0.015,95%CI:1.4-17.3,odds ratio=4.9),and trainee endoscopists(P=0.048,95%CI:1.01-8.1,odds ratio=2.9)were significant risk factors for PEP.CONCLUSION ERCP for asymptomatic CBD stones should be performed by experienced endoscopists.When performing precut sphincterotomy or biliary balloon sphincter dilation in patients with asymptomatic CBD stones,the placement of a prophylactic pancreatic stent is strongly recommended to prevent PEP. 展开更多
关键词 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY Post-endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS Risk factor ASYMPTOMATIC common bile duct stone
在线阅读 免费下载
Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis using pancreatic stents: A review of efficacy, diameter and length 预览
3
作者 Mitsuru Sugimoto Tadayuki Takagi +11 位作者 Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko Watanabe Jun Nakamura Hitomi Kikuchi Mika Takasumi Minami Hashimoto Takuto Hikichi Hiromasa Ohira 《世界荟萃分析杂志》 2019年第6期259-268,共10页
Although endoscopic retrograde cholangiopancreatography (ERCP) is an important procedure for the diagnosis and treatment of pancreaticobiliary diseases, post-ERCP pancreatitis (PEP) is the most frequent adverse event ... Although endoscopic retrograde cholangiopancreatography (ERCP) is an important procedure for the diagnosis and treatment of pancreaticobiliary diseases, post-ERCP pancreatitis (PEP) is the most frequent adverse event that can sometimes be fatal. However, prophylactic pancreatic stent (PS) insertion has been performed to prevent PEP in high-risk patients. In some randomized controlled trials (RCTs) and meta-analyses, the efficacy of prophylactic PS insertion has been shown to prevent PEP. In addition, several types of stents have been used to decrease PEP. In this review, we introduce the details of these RCTs and meta-analyses and reveal the specifications for stent placement, for example, the stent diameter and length and the pancreatic region into which the stent should be inserted. 展开更多
关键词 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY Post-endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS PROPHYLACTIC pancreatic stent
在线阅读 免费下载
Split-dose or hybrid nonsteroidal anti-inflammatory drugs and Nacetylcysteine therapy for prevention of post-retrograde cholangiopancreatography pancreatitis 预览
4
作者 Laura Pavel Gheorghe Gh Balan +7 位作者 Alexandra Nicorescu Georgiana Emmanuela Gilca-Blanariu Catalin Sfarti Stefan Chiriac Smaranda Diaconescu Vasile Liviu Drug Gheorghe Balan Gabriela Stefanescu 《世界临床病例杂志》 2019年第3期300-310,共11页
BACKGROUND Despite significant technical and training improvements,the incidence of postendoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)has not significantly dropped.Although many studies have eva... BACKGROUND Despite significant technical and training improvements,the incidence of postendoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)has not significantly dropped.Although many studies have evaluated the efficacy of various agents,e.g.nonsteroidal anti-inflammatory drugs,octreotide,antioxidants,administered via various dosages,routes(oral,intrarectal or parenteral),and schedules(before or after the procedure),the results have been conflicting.AIM To evaluate efficacy of three pharmacologic prophylactic methods for prevention of PEP.METHODS In this prospective,single-center randomized trial,patients who underwent firsttime ERCP for choledocholithiasis were randomly assigned to three groups.The first group received 600 mg N-acetylcysteine 15 min prior to ERCP,and perrectum administration of 50 mg indomethacin both prior to and after completion of the ERCP.The second group was administered only the 50 mg indomethacin per-rectum both prior to and after the ERCP.The third group was administered per-rectum 100 mg indomethacin only after the ERCP,representing the control group given the guideline-recommended regimen.The primary end-point was PEP prevention.RESULTS Among the total 211 patients evaluated during the study,186 fulfilled the inclusion criteria and completed the protocol.The percentages of patients who developed PEP in each of the three groups were not significantly different(χ2=2.793,P=0.247).Among the acute PEP cases,for all groups,14 patients developed mild pancreatitis(77.77%)and 4 moderate.No severe cases of PEP occurred,and in all PEP cases the resolution was favorable.No adverse events related to the medications(digestive hemorrhage,rectal irritation,or allergies)occurred.CONCLUSION The efficacies of split-dose indomethacin and combined administration(Nacetylcysteine with indomethacin)for preventing PEP were similar to that of the standard regimen. 展开更多
关键词 Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY Prophylaxis Postendoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS NONSTEROIDAL ANTIINFLAMMATORY drugs N-ACETYLCYSTEINE
在线阅读 免费下载
Pancreatic stents to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis:A meta-analysis 预览
5
作者 Mitsuru Sugimoto Tadayuki Takagi +11 位作者 Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko Watanabe Jun Nakamura Hitomi Kikuchi Mika Takasumi Minami Hashimoto Takuto Hikichi Hiromasa Ohira 《世界荟萃分析杂志》 2019年第5期249-258,共10页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)plays a major role in the investigation and treatment of pancreaticobiliary diseases.However,post-ERCP pancreatitis(PEP)is a severe adverse effect.Prior m... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)plays a major role in the investigation and treatment of pancreaticobiliary diseases.However,post-ERCP pancreatitis(PEP)is a severe adverse effect.Prior meta-analyses have shown that prophylactic PS was useful for preventing PEP.However,abstract reports and patients who underwent endoscopic ampullectomy were included in the previous analyses.In addition,two meta-analyses involved non-randomized controlled trials(RCTs).The efficacy of PS for preventing severe PEP was different in each meta-analysis.Therefore,we performed the current metaanalysis,which included only full-text articles,and added new findings.AIM To reveal the efficacy of prophylactic pancreatic stent(PS)placement for preventing PEP.METHODS We searched the MEDLINE,Cochrane Library and PubMed databases for related RCTs.Among the reports retrieved,11 studies were included in this metaanalysis.All full-text articles were published between 1993 and 2016.A total of 1475 patients were enrolled in the included studies;of these patients,734 had a PS inserted,and 741 did not have a PS inserted.PEP and severe PEP occurrence were evaluated in this meta-analysis.RESULTS PEP was observed in all studies and occurred in 39(5.3%)patients who received a PS.On the other hand,PEP occurred in 141(19%)patients who did not receive a PS.The occurrence of PEP was significantly lower in the patients who underwent PS placement than in the patients who did not receive a PS(OR=0.32;95%CI:0.23-0.45;P<0.001).In addition,the occurrence of severe PEP was evaluated.Notably,the occurrence of severe PEP was not observed in the stent group;however,the occurrence of severe PEP was observed in 8(1.3%)patients who did not have a PS inserted.Severe PEP occurred significantly less often in the stent group than in the no stent group(OR=0.24;95%CI:0.06-0.94;P=0.04).CONCLUSION In conclusion,prophylactic PS placement is useful for preventing PEP and severe PEP. 展开更多
关键词 Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY Pancreatic STENT Postendoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS META-ANALYSIS
在线阅读 免费下载
Difficult biliary cannulation: Historical perspective, practical updates, and guide for the endoscopist 预览
6
作者 Rani Berry James Y Han James H Tabibian 《世界胃肠内镜杂志:英文版(电子版)》 2019年第1期5-20,共16页
Despite improvements in endoscopic technologies and accessories, development of advanced endoscopy fellowship programs, and advances in ancillary imaging techniques, biliary cannulation in endoscopic retrograde cholan... Despite improvements in endoscopic technologies and accessories, development of advanced endoscopy fellowship programs, and advances in ancillary imaging techniques, biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) can still be unsuccessful in up to 20% of patients, even in referral centers. Once cannulation has been deemed to be difficult, the risk of post-ERCP pancreatitis and technical failure inherently increases. A number of factors, including endoscopist experience and patient anatomy, have been associated with difficult biliary cannulation, but predicting a case of difficult cannulation a priori is often not possible. Numerous techniques such as pancreatic guidewire and stenting, early pre-cut, and rendezvous may be employed when standard approaches fail. Data regarding the rate of success and adverse events of these techniques have been variable, though most studies suggest that pancreatic duct stenting generally reduces the rate of post-ERCP pancreatitis in instances of difficult biliary cannulation. Here we provide a review on difficult biliary cannulation and discuss how the choice of which techniques to employ and how to best employ them should be individualized and take into account the skill of the endoscopist, the disorder being treated, the anatomy of the patient, and the available biomedical literature. 展开更多
关键词 Selective BILIARY CANNULATION Post-endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY pancreatitis Periampullary diverticulum PRECUT technique ENDOSCOPIC ultrasound Rendezvous ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
在线阅读 免费下载
Usefulness of serum lipase for early diagnosis of post-endoscopic retrograde cholangiopancreatography pancreatitis 预览
7
作者 Masayoshi Tadehara Kosuke Okuwaki +9 位作者 Hiroshi Imaizumi Mitsuhiro Kida Tomohisa Iwai Hiroshi Yamauchi Toru Kaneko Rikiya Hasegawa Eiji Miyata Yusuke Kawaguchi Hironori Masutani Wasaburo Koizumi 《世界胃肠内镜杂志:英文版(电子版)》 2019年第9期477-485,共9页
BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)is new onset acute pancreatitis after ERCP.This complication is sometimes fatal.As such,PEP should be diagnosed early so that therap... BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)is new onset acute pancreatitis after ERCP.This complication is sometimes fatal.As such,PEP should be diagnosed early so that therapeutic interventions can be carried out.Serum lipase(s-Lip)is useful for diagnosing acute pancreatitis.However,its usefulness for diagnosing PEP has not been sufficiently investigated.AIM This study aimed to retrospectively examine the usefulness of s-Lip for the early diagnosis of PEP.METHODS We retrospectively examined 4192 patients who underwent ERCP at our two hospitals over the last 5 years.The primary outcomes were a comparison of the areas under the receiver operating characteristic(ROC)curves(AUCs)of s-Lip and serum amylase(s-Amy),s-Lip and s-Amy cutoff values based on the presence or absence of PEP in the early stage after ERCP via ROC curves,and the diagnostic properties[sensitivities,specificities,positive predictive values(PPV),and negative predictive value(NPV)]of these cutoff values for PEP diagnosis.RESULTS Based on the eligibility and exclusion criteria,804 cases were registered.Over the entire course,PEP occurred in 78 patients(9.7%).It occurred in the early stage after ERCP in 40 patients(51.3%)and in the late stage after ERCP in 38 patients(48.7%).The AUCs were 0.908 for s-Lip[95%confidence interval(CI):0.880-0.940,P<0.001]and 0.880 for s-Amy(95%CI:0.846-0.915,P<0.001),indicating both are useful for early diagnosis.By comparing the AUCs,s-Lip was found to be significantly more useful for the early diagnosis of PEP than s-Amy(P=0.023).The optimal cutoff values calculated from the ROC curves were 342 U/L for s-Lip(sensitivity,0.859;specificity,0.867;PPV,0.405;NPV,0.981)and 171 U/L for s-Amy(sensitivity,0.859;specificity,0.763;PPV,0.277;NPV,0.979).CONCLUSION S-Lip was significantly more useful for the early diagnosis of PEP.Measuring s-Lip after ERCP could help diagnose PEP earlier;hence,therapeutic interventions can be provided earlier. 展开更多
关键词 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY Post-endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS PANCREATITIS Lipase AMYLASE
在线阅读 免费下载
Post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review for prevention and treatment 预览
8
作者 Murat Pekgoz 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第29期4019-4042,共24页
BACKGROUND Post endoscopic retrograde cholangiopancreatography (ERCP) is comparatively complex application. Researchers has been investigated prevention of post-ERCP pancreatitis (PEP), since it has been considered to... BACKGROUND Post endoscopic retrograde cholangiopancreatography (ERCP) is comparatively complex application. Researchers has been investigated prevention of post-ERCP pancreatitis (PEP), since it has been considered to be the most common complication of ERCP. Although ERCP can lead various complications, it can also be avoided. AIM To study the published evidence and systematically review the literature on the prevention and treatment for PEP. METHODS A systematic literature review on the prevention of PEP was conducted using the electronic databases of ISI Web of Science, PubMed and Cochrane Library for relevant articles. The electronic search for the review was performed by using the search terms “Post endoscopic retrograde cholangiopancreatography pancreatitis” AND “prevention” through different criteria. The search was restricted to randomized controlled trials (RCTs) performed between January 2009 and February 2019. Duplicate studies were detected by using EndNote and deleted by the author. PRISMA checklist and flow diagram were adopted for evaluation and reporting. The reference lists of the selected papers were also scanned to find other relevant studies. RESULTS 726 studies meeting the search criteria and 4 relevant articles found in the edited books about ERCP were identified. Duplicates and irrelevant studies were excluded by screening titles and abstracts and assessing full texts. 54 studies were evaluated for full text review. Prevention methods were categorized into three groups as (1) assessment of patient related factors;(2) pharmacoprevention;and (3) procedural techniques for prevention. Most of studies in the literature showed that young age, female gender, absence of chronic pancreatitis, suspected Sphincter of Oddi dysfunction, recurrent pancreatitis and history of previous PEP played a crucial role in posing high risks for PEP. 37 studies designed to assess the impact of 24 different pharmacologic agents to reduce the development of PEP delivered through various administration methods w 展开更多
关键词 Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS Prevention Treatment INDOMETHACIN Stent replacement PROPHYLAXIS
在线阅读 免费下载
New antireflux plastic stent for patients with distal malignant biliary obstruction 预览
9
作者 Xiang-Lei Yuan Bin Wei +8 位作者 Lian-Song Ye Chun-Cheng Wu Qing-Hua Tan Ming-Hong Yao Yu-Hang Zhang Xian-Hui Zeng Yan Li Yu-Yan Zhang Bing Hu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第19期2373-2382,共10页
BACKGROUND Endoscopic biliary stenting is a well-established palliative treatment for patients with unresectable distal malignant biliary obstruction (MBO). However, the main problem with stent placement is the relati... BACKGROUND Endoscopic biliary stenting is a well-established palliative treatment for patients with unresectable distal malignant biliary obstruction (MBO). However, the main problem with stent placement is the relatively short duration of stent patency. Although self-expanding metal stents (SEMSs) have a longer patency period than plastic stents (PSs), the higher costs limit the wide use of SEMSs. A PS with an antireflux valve is an attractive idea to prolong stent patency, but no ideal design for an antireflux PS (ARPS) has been proposed. We developed a new ARPS with a “duckbilled” valve attached to the duodenal end of the stent. AIM To compare the patency of ARPSs with that of traditional PSs (TPSs) in patients with unresectable distal MBO. METHODS We conducted a single-center, prospective, randomized, controlled, double-blind study. This study was conducted at the West China Hospital of Sichuan University. Consecutive patients with extrahepatic MBO were enrolled prospectively. Eligible patients were randomly assigned to receive either an ARPS or a TPS. Patients were followed by clinic visits or telephone interviews every 1-2 mo until stent exchange, death, or the final study follow-up in October 2018. The primary outcome was the duration of stent patency. Secondary outcomes included the rate of technical success, the rate of clinical success,adverse events, and patient survival. RESULTS Between February 2016 and December 2017, 38 patients were randomly assigned to two groups, with 19 patients in each group, to receive ARPSs or TPSs. Stent insertion was technically successful in all patients. There were no significant differences between the two groups in the rates of clinical success or the rates of early or late adverse events (P = 0.660, 1.000, and 1.000, respectively). The median duration of stent patency in the ARPS group was 285 d [interquartile range (IQR), 170], which was significantly longer than that in the TPS group (median, 130 d;IQR, 90, P = 0.005). No significant difference in patient surviva 展开更多
关键词 ANTIREFLUX valve Plastic BILIARY STENT DISTAL malignant BILIARY obstruction STENT PATENCY Endoscopic retrograde CHOLANGIOPANCREATOGRAPHY
在线阅读 免费下载
Recent advances in endoscopic retrograde cholangiopancreatography in Billroth Ⅱ gastrectomy patients:A systematic review 预览
10
作者 Tae Young Park Tae Jun Song 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第24期3091-3107,共17页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)in patients with Billroth Ⅱ gastrectomy has been considered a challenging procedure due to the surgically altered gastrointestinal anatomy.However,there ... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)in patients with Billroth Ⅱ gastrectomy has been considered a challenging procedure due to the surgically altered gastrointestinal anatomy.However,there has been a paucity of comparative studies regarding ERCP in Billroth Ⅱ gastrectomy cases because of procedure-related morbidity and mortality and practical and ethical limitations.This systematic and comprehensive review was performed to obtain a recent perspective on ERCP in Billroth Ⅱ gastrectomy patients.AIM To systematically review the literature regarding ERCP in Billroth Ⅱ gastrectomy patients.METHODS A systematic review was performed on the literature published between May 1975 and January 2019.The following electronic databases were searched:PubMed,EMBASE,and Cochrane Library.The outcomes of successful afferent loop intubation and successful selective cannulation and occurrence of adverse events were assessed.RESULTS A total of 43 studies involving 2669 patients were included.The study designs were 36(83.7%)retrospective cohort studies,4(9.3%)retrospective comparative studies,2(4.7%)prospective comparative studies,and 1(2.3%)prospective cohort study.Of a total of 2669 patients,there were 1432 cases(55.6%)of sideviewing endoscopy,664(25.8%)cases of forward-viewing endoscopy,171(6.6%)cases of balloon-assisted enteroscopy,169(6.6%)cases of anterior obliqueviewing endoscopy,64(2.5%)cases of dual-lumen endoscopy,31(1.2%)cases of colonoscopy,and 14(0.5%)cases of multiple bending endoscopy.The overall success rate of afferent loop intubation was 91.3%(2437/2669),and the overall success rate of selective cannulation was 87.9%(2346/2437).A total of 195 cases(7.3%)of adverse events occurred.The success rates of afferent loop intubation and the selective cannulation rate for each type of endoscopy were as follows:side-viewing endoscopy 98.2%and 95.3%;forward-viewing endoscopy 97.4%and 95.2%;balloon-assisted enteroscopy 95.4%and 97.5%;oblique-viewing endoscopy 94.1%and 97.5%;and dual-lumen endosco 展开更多
关键词 Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY Therapeutic ENDOSCOPE BILLROTH operation ADVERSE event Systematic review
在线阅读 免费下载
Mitochondrion-processed TERC regulates senescence without affecting telomerase activities
11
作者 Qian Zheng Peipei Liu +11 位作者 Ge Gao Jiapei Yuan Pengfeng Wang Jinliang Huang Leiming Xie Xinping Lu Fan Di Tanjun Tong Jun Chen Zhi Lu Jisong Guan Geng Wang 《蛋白质与细胞:英文版》 SCIE CAS CSCD 2019年第9期631-648,共18页
Mitochondrial dysfunctions play major roles in ageing.How mitochondrial stresses invoke downstream responses and how specificity of the signaling is achieved, however, remains unclear. We have previously discovered th... Mitochondrial dysfunctions play major roles in ageing.How mitochondrial stresses invoke downstream responses and how specificity of the signaling is achieved, however, remains unclear. We have previously discovered that the RNA component of Telomerase TERC is imported into mitochondria, processed to a shorter form TERC-53, and then exported back to the cytosol. Cytosolic TERC-53 levels respond to mitochondrial functions, but have no direct effect on these functions, suggesting that cytosolic TERC-53 functions downstream of mitochondria as a signal of mitochondrial functions. Here, we show that cytosolic TERC-53 plays a regulatory role on cellular senescence and is involved in cognition decline in 10 months old mice, independent of its telomerase function. Manipulation of cytosolic TERC-53 levels affects cellular senescence and cognition decline in 10 months old mouse hippocampi without affecting telomerase activity, and most importantly, affects cellular senescence in terc^-/- cells. These findings uncover a senescence-related regulatory pathway with a non-coding RNA as the signal in mammals. 展开更多
关键词 mitochondria RETROGRADE signal nucleus transcription regulation NON-CODING RNA TELOMERASE
Age,socioeconomic features,and clinical factors predict receipt of endoscopic retrograde cholangiopancreatography in pancreatic cancer 预览
12
作者 Sheila D Rustgi Sunil P Amin +5 位作者 Michelle K Kim Satish Nagula Nikhil A Kumta Christopher J DiMaio Paolo Boffetta Aimee L Lucas 《世界胃肠内镜杂志:英文版(电子版)》 2019年第2期133-144,共12页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is the recommended technique for biliary decompression in pancreatic cancer.Previous studies have suggested racial,socioeconomic and geographic difference... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is the recommended technique for biliary decompression in pancreatic cancer.Previous studies have suggested racial,socioeconomic and geographic differences in diagnosis,treatment and outcomes of pancreatic cancer patients.AIM To examine geographic,racial,socioeconomic and clinical factors associated with utilization of ERCP.METHODS Surveillance,Epidemiology and End Results and linked Medicare claims data were used to identify pancreatic cancer patients between 2000-2011.Claims data were used to identify patients who had ERCP and other treatments.The primary outcome was receipt of ERCP.Chi-squared analyses were used to compare demographic information.Trends in use of ERCP over time were assessed using Cochran Armitage test.Adjusted odds ratios(aORs)and 95%confidence intervals(CIs)for receipt ERCP were calculated using logistic regression,RESULTS Among 32510 pancreatic cancer patients,14704(45.2%)underwent ERCP.Patients who had cancer located in the head of the pancreas(aOR 3.27,95% CI:2.99-3.57),had jaundice(aOR 7.59,95% CI:7.06-8.17),cholangitis(aOR 4.22,95% CI:3.71-4.81)or pruritus(aOR 1.42,95% CI:1.22-1.66)and lived in lower education zip codes(aOR 1.14,95%CI:1.04-1.24)were more likely to receive ERCP.In contrast,patients who were older(aOR 0.88,95% CI:0.83,0.94),not married(aOR 0.92,95% CI:0.86,0.98),and lived in a non-metropolitan area(aOR 0.89,95% CI:0.82,0.98)were less likely to receive ERCP.Compared to white patients,non-white/non-black patients(aOR 0.83,95% CI:0.70-0.97)were less likely to receive ERCP.Patients diagnosed later in the study period were less likely to receive ERCP(aOR 2004-2007 0.85,95% CI:0.78-0.92;aOR 2008-2011 0.76,95% CI:0.70-0.83).After stratifying by indications for ERCP including jaundice,racial differences persisted(aOR black patients 0.80,95% CI:0.67-0.95,nonwhite/nonblack patients 0.73,95% CI:0.58-0.91).Among patients with jaundice,those who underwent surgery were less likely to undergo ERCP(aOR 0.60,95% CI:0.52,0.69). 展开更多
关键词 Pancreatic cancer Endoscopic retrograde CHOLANGIOPANCREATOGRAPHY SOCIOECONOMIC DISPARITIES RACIAL DISPARITIES JAUNDICE Outcomes research
在线阅读 免费下载
Electrohydraulic lithotripsy and rendezvous nasal endoscopic cholangiography for common bile duct stone:A case report 预览
13
作者 Koichi Kimura Kensuke Kudo +8 位作者 Tomoharu Yoshizumi Takeshi Kurihara Shohei Yoshiya Yohei Mano Kazuki Takeishi Shinji Itoh Noboru Harada Toru Ikegami Tetsuo Ikeda 《世界临床病例杂志》 2019年第10期1149-1154,共6页
BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotrips... BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal endoscope.CASE SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm.She was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary drainage.We attempted to fragment the stone by transhepatic cholangioscopy using EHL.However,the stones were too large and partly soft clay-like for lithotripsy.Next,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete lithotomy.No complication was observed at the end of this procedure.CONCLUSION Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones. 展开更多
关键词 Common BILE duct stone Electrohydraulic LITHOTRIPSY RENDEZVOUS technique ENDOSCOPIC retrograde CHOLANGIOGRAPHY NASAL endoscop Case report
在线阅读 免费下载
Intravascular ultrasound-guided “extended” reverse controlled antegrade and retrograde subintimal tracking technique using a cutting balloon for recanalizing chronic coronary total occlusion with a side branch 预览
14
作者 Yong-Tai GONG Jian-Qiang LI +2 位作者 Li SHENG Dang-Hui SUN Yue LI 《老年心脏病学杂志:英文版》 SCIE CAS CSCD 2019年第6期498-501,共4页
Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) represents the most technically challenging procedure in contemporary interventional cardiology.[1] Blunt lesions and presence of proximal side... Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) represents the most technically challenging procedure in contemporary interventional cardiology.[1] Blunt lesions and presence of proximal side branch are considered to be strong predictors of reduced technical success.[ 2,3] For such lesions, the antegrade approach may not be feasible or desirable, and the retrograde approach can be used as the initial crossing strategy. However, when treating the blunt CTO with a large side branch proximal to the occlusion, the side branch might be occluded after stent implantation if the retrograde guidewire passed the occluded segment through the subintimal space and re-entered into the true lumen at the opposite side of the side branch.[4] We reported a useful method to solve the above issue which utilizes intravascular ultrasound (IVUS) to guide “extended” reverse controlled antegrade and retrograde subintimal tracking (CART) technique with a cutting balloon. 展开更多
关键词 Chronic total OCCLUSION Cutting balloon INTRAVASCULAR ultrasound Percutaneous CORONARY intervention REVERSE controlled ANTEGRADE and RETROGRADE tracking technique
在线阅读 下载PDF
Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis 预览
15
作者 Fernanda P Logiudice Wanderlei M Bernardo +9 位作者 Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura 《世界胃肠内镜杂志:英文版(电子版)》 2019年第4期281-291,共11页
BACKGROUND For palliation of malignant biliary obstruction (MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography (ERCP) with the placement of metallic stents. Endoscopic... BACKGROUND For palliation of malignant biliary obstruction (MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography (ERCP) with the placement of metallic stents. Endoscopic ultrasound (EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP failure. Recently, however, there have been robust randomized clinical trials (RCTs) comparing EUS-guided drainage and ERCP as primary approaches to MBO. AIM To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO. METHODS This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients (112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96% and 91.81%, respectively, with a risk difference (RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97;I2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of ?0.01%(95%CI:-0.12, 0.10;P = 0.90;I2 = 0%). The mean difference (MD) for the duration of the procedure was -0.12%(95%CI:-8.20, 7.97;P = 0.98;I2 = 84%). In the EUS and ERCP groups, there were 14 and 25 adverse events, respectively, with an RD of -0.06%(95%CI:-0.23, 0.12;P = 0.54;I2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18;P = 0.19;I2 = 44%). The stent dysfunction rate was significantly lower in the EUS group (MD =-0. 展开更多
关键词 Common bile duct neoplasms ENDOSCOPIC retrograde CHOLANGIOPANCREATOGRAPHY ENDOSONOGRAPHY Ultrasonography Interventional/methods ENDOSCOPIC ultrasound Systematic review META-ANALYSIS
在线阅读 免费下载
Percutaneous transhepatic cholangioscopy and lithotripsy in treating difficult biliary ductal stones: Two case reports 预览
16
作者 Edward Alabraba Simon Travis Ian Beckingham 《世界胃肠内镜杂志:英文版(电子版)》 2019年第4期298-307,共10页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) is preferred for managing biliary obstruction in patients with bilio-enteric anastomotic strictures(BEAS) and calculi. In patients whose duodenal anatomy... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) is preferred for managing biliary obstruction in patients with bilio-enteric anastomotic strictures(BEAS) and calculi. In patients whose duodenal anatomy is altered following upper gastrointestinal(UGI) tract surgery, ERCP is technically challenging because the biliary tree becomes difficult to access by per-oral endoscopy.Advanced endoscopic therapies like balloon-enteroscopy or rendevous-ERCP may be considered but are not always feasible. Biliary sepsis and comorbidities may also make these patients poor candidates for surgical management of their biliary obstruction.CASE SUMMARY We present two 70-year-old caucasian patients admitted as emergencies with obstructive cholangitis. Both patients had BEAS associated with calculi that were predominantly extrahepatic in Patient 1 and intrahepatic in Patient 2. Both patients were unsuitable for conventional ERCP due to surgically-altered UGl anatomy. Emergency biliary drainage was by percutaneous transhepatic cholangiography(PTC) in both cases and after 6-weeks’ maturation, PTC tracts were dilated to perform percutaneous transhepatic cholangioscopy and lithotripsy(PTCSL) for duct clearance. BEAS were firstly dilated fluoroscopically,and then biliary stones were flushed into the small bowel or basket-retrieved under visualization provided by the percutaneously-inserted video cholangioscope. Lithotripsy was used to fragment impacted calculi, also under visualization by video cholangioscopy. Satisfactory duct clearance was achieved in Patient 1 after one PTCSL procedure, but Patient 2 required a further procedure to clear persisting intrahepatic calculi. Ultimately both patients had successful stone clearance confirmed by check cholangiograms.CONCLUSION PTCSL offers a pragmatic, feasible and safe method for biliary tract clearance when neither ERCP nor surgical exploration is suitable. 展开更多
关键词 Percutaneous TRANSHEPATIC CHOLANGIOGRAPHY Video CHOLANGIOSCOPY LITHOTRIPSY BILIARY calculi Endoscopic retrograde cholangiopancreatography Case report Bilio-enteric anastomotic STRICTURES
在线阅读 免费下载
Stricter national standards are required for credentialing of endoscopic-retrograde-cholangiopan-creatography in the United States 预览
17
作者 Mitchell S Cappell David M Friedel 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3468-3483,共16页
Endoscopic-retrograde-cholangiopancreatography(ERCP) is now a vital modality with primarily therapeutic and occasionally solely diagnostic utility for numerous biliary/pancreatic disorders. It has a significantly stee... Endoscopic-retrograde-cholangiopancreatography(ERCP) is now a vital modality with primarily therapeutic and occasionally solely diagnostic utility for numerous biliary/pancreatic disorders. It has a significantly steeper learning curve than that for other standard gastrointestinal(GI) endoscopies, such as esophagogastroduodenoscopy or colonoscopy, due to greater technical difficulty and higher risk of complications. Yet, GI fellows have limited exposure to ERCP during standard-three-year-GI-fellowships because ERCP is much less frequently performed than esophagogastroduodenoscopy/colonoscopy. This led to adding an optional year of training in therapeutic endoscopy. Yet many graduates from standard three-year-fellowships without advanced training intensely pursue independent/unsupervised ERCP privileges despite inadequate numbers of performed ERCPs and unacceptably low rates of successful selective cannulation of desired(biliary or pancreatic) duct. Hospital credentialing committees have traditionally performed ERCP credentialing, but this practice has led to widespread flouting of recommended guidelines(e.g., planned privileging of applicant with 20% successful cannulation rate, or after performing only 7 ERCPs);and intense politicking of committee members by applicants, their practice groups, and potential competitors. Consequently, some gastroenterologists upon completing standard fellowships train and learn ERCP 'on the job' during independent/unsupervised practice, which can result in bad outcomes: high rates of failed bile duct cannulation. This severe clinical problem is indicated by publication of ≥ 12 ERCP competency studies/guidelines during last 5 years. However, lack of mandatory, quantitative, ERCP credentialing criteria has permitted neglect of recommended guidelines. This work comprehensively reviews literature on ERCP credentialing;reviews rationales for proposed guidelines;reports problems with current system;and proposes novel criteria for competency. This work advocates for mandatory, national 展开更多
关键词 Endoscopic retrograde CHOLANGIOPANCREATOGRAPHY Privileges CREDENTIALING Gastroenterology FELLOWSHIP TRAINING Advanced gastrointestinal endoscopy TRAINING Certification Standards
在线阅读 免费下载
Treatment of upper and lower lacrimal punctal occlusion using retrograde canaliculotomy and punctoplasty
18
作者 Ai Zhuang Jing Sun Wo-Dong Shi 《国际眼科杂志:英文版》 SCIE CAS 2019年第9期1498-1502,共5页
This is a retrospective, noncomparative analysis of a case series to explore the safety and effectiveness of retrograde canaliculotomy and punctoplasty for treating epiphora due to upper and lower lacrimal punctal occ... This is a retrospective, noncomparative analysis of a case series to explore the safety and effectiveness of retrograde canaliculotomy and punctoplasty for treating epiphora due to upper and lower lacrimal punctal occlusion. During the procedure, the horizontal portion of the normal lower canaliculus was identified;the corresponding punctum was reconstructed via retrograde canaliculotomy and punctoplasty. Intubation was performed to prevent postoperative reocclusion. Patients were followed up for 12 to 24 mo. A total of 16 patients with unilateral upper and lower lacrimal punctal occlusion were included. Satisfactory outcomes were achieved: all 16 patients exhibited improvement of epiphora;31 rebuilt punctal openings and canaliculi achieved recanalization. Only one upper punctal opening could not be reconstructed because the corresponding canaliculus exhibited severe injury. No significant complications occurred as a result of the treatments. Retrograde canaliculotomy and punctoplasty appears to effective, safe, and minimally invasive for treatment of upper and lower punctal occlusion. 展开更多
关键词 punctal OCCLUSION RETROGRADE canaliculotomy punctoplasty INTUBATION
Early immune response in post endoscopic retrograde cholangiopancreatography pancreatitis as a model for acute pancreatitis 预览
19
作者 Ivana Plavsic Ivana Zitinic +3 位作者 Vera Tulic Goran Poropat Marinko Marusic Goran Hauser 《世界荟萃分析杂志》 2019年第3期96-100,共5页
This opinion review summarizes comparison of clinical presentation and immunology of post-endoscopic pancreatitis and acute pancreatitis (AP) of other etiology. The rationale for this topic was found in studies that m... This opinion review summarizes comparison of clinical presentation and immunology of post-endoscopic pancreatitis and acute pancreatitis (AP) of other etiology. The rationale for this topic was found in studies that mention differences in clinical presentation between these entities, stating that severe form of AP after endoscopic retrograde cholangiopancreatography was more severe than AP of other etiology. Found difference in clinical presentation may have a background in different immunology that needs to be further investigated. 展开更多
关键词 INNATE immunity PANCREATITIS IMMUNOLOGY POST endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS
在线阅读 免费下载
Causes associated with recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography: A large sample sized retrospective study 预览
20
作者 Feng Deng Mi Zhou +4 位作者 Ping-Ping Liu Jun-Bo Hong Guo-Hua Li Xiao- Jiang Zhou You-Xiang Chen 《世界临床病例杂志》 2019年第9期1028-1037,共10页
BACKGROUND Recurrence of primary choledocholithiasis commonly occurs after complete removal of stones by therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The potential causes of the recurrence of cho... BACKGROUND Recurrence of primary choledocholithiasis commonly occurs after complete removal of stones by therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The potential causes of the recurrence of choledocholithiasis after ERCP are unclear. AIM To analyze the potential causes of the recurrence of choledocholithiasis after ERCP. METHODS The ERCP database of our medical center for the period between January 2007 and January 2016 was retrospectively reviewed, and information regarding eligible patients who had choledocholithiasis recurrence was collected. A 1:1 case-control study was performed for this investigation. Data including general characteristics of the patients, past medical history, ERCP-related factors, common bile duct (CBD)-related factors, laboratory indicators, and treatment was analyzed by univariate and multivariate logistic regression analysis and Kaplan Meier analysisly. RESULTS First recurrence of choledocholithiasis occurred in 477 patients;among these patients, the second and several instance (≥ 3 times) recurrence rates were 19.5% and 44.07%, respectively. The average time to first choledocholithiasis recurrence was 21.65 mo. A total of 477 patients who did not have recurrence were selected as a control group. Multivariate logistic regression analysis showed that age > 65 years (odds ratio [OR]= 1.556;P = 0.018), combined history of choledocholithotomy (OR = 2.458;P < 0.01), endoscopic papillary balloon dilation (OR = 5.679;P = 0.000), endoscopic sphincterotomy (OR = 3.463;P = 0.000), CBD stent implantation (OR = 5.780;P = 0.000), multiple ERCP procedures (≥2;OR = 2.75;P = 0.000), stones in the intrahepatic bile duct (OR = 2.308;P = 0.000), periampullary diverticula (OR = 1.627;P < 0.01), choledocholithiasis diameter ≥ 10 mm (OR = 1.599;P < 0.01), bile duct-duodenal fistula (OR = 2.69;P < 0.05), combined biliary tract infections (OR = 1.057;P < 0.01), and no preoperative antibiotic use (OR = 0.528;P < 0.01) were independent risk factors for the recurrence of choledochol 展开更多
关键词 CHOLEDOCHOLITHIASIS Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY RECURRENCE Common BILE duct
在线阅读 免费下载
上一页 1 2 216 下一页 到第
使用帮助 返回顶部 意见反馈