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Short-and long-term outcomes of endoscopically treated superficial non-ampullary duodenal epithelial tumors 预览
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作者 Yuko Hara Kenichi Goda +7 位作者 Akira Dobashi Tomohiko Richard Ohya Masayuki Kato Kazuki Sumiyama Takehiro Mitsuishi Shinichi Hirooka Masahiro Ikegami Hisao Tajiri 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第6期707-718,共12页
BACKGROUND It is widely recognized that endoscopic resection(ER)of superficial nonampullary duodenal epithelial tumors(SNADETs)is technically challenging and may carry high risks of intraoperative and delayed bleeding... BACKGROUND It is widely recognized that endoscopic resection(ER)of superficial nonampullary duodenal epithelial tumors(SNADETs)is technically challenging and may carry high risks of intraoperative and delayed bleeding and perforation.These adverse events could be more critical than those occurring in other levels of the gastrointestinal tract.Because of the low prevalence of the disease and the high risks of severe adverse events,the curability including short-and long-term outcomes have not been standardized yet.AIM To investigate the curability including short-and long-term outcomes of ER for SNADETs in a large case series.METHODS This retrospective study included cases that underwent ER for SNADETs at our university hospital between March 2004 and July 2017.Short-term outcomes of ER were measured based on en bloc and R0 resection rates as well as adverse events.Long-term outcomes included local recurrence detected on endoscopic surveillance and disease-specific mortality in patients followed up for≥12 mo after ER.RESULTS In the study,131 patients with 147 SNADETs were analyzed.The 147 ERs consisted of 136 endoscopic mucosal resections(EMRs)(93%)and 11 endoscopic submucosal dissections(ESDs)(7%).The median tumor diameter was 10 mm.The pathology diagnosis was adenocarcinoma(56/147,38%),high-grade intraepithelial neoplasia(44/147,30%),or low-grade intraepithelial neoplasia(47/147,32%).The R0 resection rate was 68%(93/136)in the EMR group and 73%(8/11)in the ESD group,respectively.Cap-assisted EMR(known as EMR-C)showed a higher rate of R0 resection compared to the conventional method of EMR using a snare(78%vs 62%,P=0.06).No adverse event was observed in the EMR group,whereas delayed bleeding,intraoperative perforation,and delayed perforation in 3,3,and 5 patients occurred in the ESD group,respectively.One patient with perforation required emergency surgery.In the 43 mo median follow-up period,local recurrence was found in four EMR cases and all cases were treated endoscopically.No patient died due to tumor recu 展开更多
关键词 DUODENAL ADENOMA DUODENAL cancer ENDOSCOPIC resection ENDOSCOPIC SUBMUCOSAL DISSECTION Long-term outcome
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Endoscopic identification of endoluminal esophageal landmarks for radial and longitudinal orientation and lesion location 预览
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作者 Fabian Emura Rene Gomez-Esquivel +4 位作者 Carlos Rodriguez-Reyes Petros Benias Javier Preciado Michael Wallace Luis Giraldo-Cadavid 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第4期498-508,共11页
AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for t... AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for the main left bronchus and the left atrium landmarks in 207 consecutive patients using white light examination.A sub-study was also performed using white light followed by endoscopic ultrasound(EUS)in 25 consecutive patients to confirm the findings.The scope orientation throughout the exam was maintained at the natural axis,where the left esophageal quadrant corresponds to the area between 6 and 9 o'clock.When an anatomical landmark was identified,it was recorded with a photograph and its quadrant orientation and distance from the incisors were determined.The reference points to obtain the distances and radial orientation were as follows:the midpoint of the left main bronchus and the most intense pulsatile zone of the left atrium.With the video processor system set to moderate insufflation,measurements were obtained at the end of the patients'air expiration.RESULTS The left main bronchus and left atrium esophageal landmarks were identified using white light in 99%and 100%of subjects at a mean distance of 25.8 cm(SD 2.3),and 31.4 cm(SD 2.4)from the incisors,respectively.The left main bronchus landmark was found to be a tubular,concave,non-pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.The left atrium landmark was identified as a round,convex,pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.Both landmarks were identified using white light on the anterior esophageal quadrant.In the substudy,the left main bronchus was identified in 24(92%)patients at 25.4 cm(SD 2.1)and 26.7 cm(SD 1.9)from the incisors,by white light and EUS,respectively.The left atrium was recognized in all patients at 30.5 cm(SD 1.9),and 31.6 cm(SD 2.3)from the incisors,by both white light and EUS,respectively.EUS confirmed that the landmarks correspond 展开更多
关键词 Esophagus Natural landmark RADIAL ORIENTATION Longitudinal ORIENTATION Four-quadrants LEFT main BRONCHUS LEFT atrium
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New flexible endoscopic controlled stapler technique for the treatment of Zenker’s diverticulum:A case series 预览
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作者 Johanna Wilmsen Robert Baumbach +7 位作者 Dietmar Stüker Vincens Weingart Frank Neser Stefan Karl G?lder Christof Pfundstein Ellen Claudia N?tzel Thomas R?sch Siegbert Faiss 《世界胃肠病学杂志:英文版》 SCIE CAS 2017年第17期3084-3091,共8页
AIM To report about the combination and advantages of a tapler-assisted diverticulotomy performed by flexible endoscopy.METHODS From November 2014 till December 2015 17 patients(8 female, 9 male, average age 69.8 year... AIM To report about the combination and advantages of a tapler-assisted diverticulotomy performed by flexible endoscopy.METHODS From November 2014 till December 2015 17 patients(8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum(mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler(Micro Cutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum. The septum was divided by the staple rows under flexible endoscopic control.RESULTS In eleven patients(64.7%) the stapler successfully divided the septum completely. Mean procedure time was 21 min, medium size of the septum was 2.8 cm(range 1.5 cm to 4 cm). In four patients the septum was shorter than 3 cm, in seven longer than 3 cm. To divide the septum, averagely 1.3 stapler cartridges were used. Two minor bleedings occurred. Major adverse events like perforation or secondary haemorrhage did not occur. After an average time of two days patients were discharged from the hospital. In 6 patients(35.3%) the stapler failed due to a thick septum or insufficient reclination of the head. Follow up endoscopy was performed after an average of two months in 9 patients; 4 patients(44.4%) were free of symptoms, 5 patients(55.6%) stated an improvement. A relapse of symptoms did not occur. CONCLUSION Flexible endoscopic Zenker diverticulotomy by using a surgical stapler is a new, safe and efficient treatment modality. A simultaneously tissue opening and occlusion prevents major complications. 展开更多
关键词 Zenkers 憩室 灵活内视镜的治疗 Stapler 技术 Overtube 外科的 stapler
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Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology 预览
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作者 David M Ray Indu Srinivasan +4 位作者 Shou-jiang Tang Andreas S Vilmann Peter Vilmann Timothy C McCowan Akash M Patel 《世界放射学杂志:英文版(电子版)》 2017年第3期97-111,共15页
Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main tre... Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions. 展开更多
关键词 胃肠的出血 Enteral 营养 Interventional 辐射学 肠胃病学 内视镜检查法
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Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy 预览
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作者 Akira Dobashi Kenichi Goda +7 位作者 Noboru Yoshimura Tomohiko R Ohya Masayuki Kato Kazuki Sumiyama Masato Matsushima Shinichi Hirooka Masahiro Ikegami Hisao Tajiri 《世界胃肠病学杂志:英文版》 SCIE CAS 2016年第41期9196-9204,共9页
AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis... AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: 'intervascular background coloration'; 'proliferation of intrapapillary capillary loops(IPCL)'; and 'dilation', 'tortuosity', 'change in caliber', and 'various shapes(VS)' of IPCLs(i.e., Inoue’s tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue’s criteria.RESULTS Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue’s tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue’s tetrad criteria, respectively.CONCLUSION The combination 展开更多
关键词 简化标准 缩小乐队成像 放大内视镜检查法 食道的癌症 有鳞的房间癌 内视镜的诊断 分类 表面的有鳞的房间癌 逐步的逻辑回归分析
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One hundred and one over-the-scope-clip applications forsevere gastrointestinal bleeding, leaks and fistulas 预览 被引量:2
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作者 Edris Wedi, Susana Gonzalez, Detlev Menke, Elena Kruse, Kai Matthes Juergen Hochberger 《世界胃肠病学杂志:英文版》 SCIE CAS 2016年第5期1844-1853,共10页
AIM To investigate the efficacy and clinical outcomeof patients treated with an over-the-scope-clip (OTSC)system for severe gastrointestinal hemorrhage,perforations and fistulas.METHODS: From 02-2009 to 10-2012, 84... AIM To investigate the efficacy and clinical outcomeof patients treated with an over-the-scope-clip (OTSC)system for severe gastrointestinal hemorrhage,perforations and fistulas.METHODS: From 02-2009 to 10-2012, 84 patients were treated with 101 OTSC clips. 41 patients (48.8%)presented with severe upper-gastrointestinal (GI)bleeding, 3 (3.6%) patients with lower-GI bleeding,7 patients (8.3%) underwent perforation closure,18 patients (21.4%) had prevention of secondaryperforation, 12 patients (14.3%) had control ofsecondary bleeding after endoscopic mucosal resectionor endoscopic submucosal dissection (ESD) and 3patients (3.6%) had an intervention on a chronicfistula.RESULTS: In 78/84 patients (92.8%), primarytreatment with the OTSC was technically successful.Clinical primary success was achieved in 75/84 patients(89.28%). The overall mortality in the study patientswas 11/84 (13.1%) and was seen in patients withlife threatning upper GI hemorrhage. There was nomortality in any other treatment group. In detail OTSCapplication lead to a clinical success in 35/41 (85.36%)patients with upper GI bleeding and in 3/3 patientswith lower GI bleeding. Technical success of perforationclosure was 100% while clinical success was seen in4/7 cases (57.14%) due to attendant circumstancesunrelated to the OTSC. Technical and clinic success wasachieved in 18/18 (100%) patients for the preventionof bleeding or perforation after endoscopic mucosalresection and ESD and in 3/3 cases of fistula closure.Two application-related complications were seen (2%).CONCLUSION: This largest single center experiencepublished so far confirms the value of the OTSC forGI emergencies and complications. Further clinicalexperience will help to identify optimal indications forits targeted and prophylactic use. 展开更多
关键词 Over-the-scope-clip Endoscopic therapy Gastrointestinal bleeding Perforation Fistula
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Endoscopic multiple metal stenting for the treatment of enteral leaks near the biliary orifice: A novel effective rescue procedure 预览
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作者 Massimiliano Mutignani Lorenzo Dioscoridi +7 位作者 Stefanos Dokas Paolo Aseni Pietro Carnevali Edoardo Forti Raffaele Manta Mariano Sica Alberto Tringali Francesco Pugliese 《世界胃肠内镜杂志:英文版(电子版)》 2016年第15期533-540,共8页
Between April 2013 and October 2015, 6 patients developed periampullary duodenal or jejunal/biliary leaks after major abdominal surgery. In all patients, percutaneous drainage of the collection or re-operation with pr... Between April 2013 and October 2015, 6 patients developed periampullary duodenal or jejunal/biliary leaks after major abdominal surgery. In all patients, percutaneous drainage of the collection or re-operation with primary surgical repair was attempted at first but failed. A fully covered enteral metal stent was placed in all patients to seal the leak. Subsequently, we cannulated the common bile duct and, in some cases, and the main pancreatic duct inserting hydrophilic guidewires through the stent after dilating the stent mesh with a dilatation balloon or breaking the meshes with Argon Plasma Beam. Finally, we inserted a fully covered biliary metal stent to drain the bile into the lumen of the enteral stent. In cases of normal proximal upper gastrointestinal anatomy, a pancreatic plastic stent was also inserted. Oral food intake was initiated when the abdominal drain outflow stopped completely. Stent removal was scheduled four to eight weeks later after a CT scan to confirm the complete healing of the fistula and the absence of any perilesional residual fluid collection. The leak resolved in five patients. One patient died two days after the procedure due to severe, pre-existing,sepsis. The stents were removed endoscopically in four weeks in four patients. In one patient we experienced stent migration causing small bowel obstruction. In this case, the stents were removed surgically. Four patients are still alive today. They are still under follow-up and doing well. Bilio-enteral fully covered metal stenting with or without pancreatic stenting was feasible, safe and effective in treating postoperative enteral leaks near the biliopancreatic orifice in our small series. This minimally invasive procedure can be implemented in selected patients as a rescue procedure to repair these challenging leaks. 展开更多
关键词 ENDOSCOPIC retrograde PANCREATIC duct Fully covered metal STENT Duodenal LEAK Postoperative complications ENTERAL LEAK ENTERAL STENT BILIARY STENT PANCREATIC STENT
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Diagnosis and management of primary sclerosingcholangitis-perspectives from a therapeutic endoscopist 预览
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作者 Kunjam Modha Udayakumar Navaneethan 《世界肝病学杂志:英文版(电子版)》 2015年第5期799-805,共7页
主要 sclerosing 胆管炎(PSC ) 是一长期, cholestatic 肝状况由 intra- 和 extrahepatic 胆汁管的发炎,纤维变性,和破坏描绘了。治疗学的 endoscopist 在 PSC 的诊断和管理起一个关键作用。在与 cholestatic 侧面介绍的病人,内视... 主要 sclerosing 胆管炎(PSC ) 是一长期, cholestatic 肝状况由 intra- 和 extrahepatic 胆汁管的发炎,纤维变性,和破坏描绘了。治疗学的 endoscopist 在 PSC 的诊断和管理起一个关键作用。在与 cholestatic 侧面介绍的病人,内视镜后退 cholangiopancreatography (ERCP ) 为 PSC 的明确的诊断被保证。胆汁管的主导的苛评发生在 PSC 病人的 36%-57% 。内视镜的汽球膨胀与或没有 stenting 在主导的苛评的管理被采用了。另外, PSC 病人在与 20% 一生风险开发 cholangiocarcinoma 的增加的风险。在 situ 杂交在荧光的 ERCP 和使用期间获得的刷子细胞学与主导的胆汁的苛评在病人的调查形成起始的诊断的步。我们的评论试图总结在 PSC 病人的管理支持治疗学的 endoscopist 的角色的当前的证据。 展开更多
关键词 内视镜检查法 治疗学的内视镜检查法 主要 sclerosing 胆管炎 胆汁 主导的苛评
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What is the current role of endoscopy in primary sclerosingcholangitis? 预览
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作者 Benjamin Tharian Nayana Elizabeth George Tony Chiew Keong Tham. 《世界胃肠内镜杂志:英文版(电子版)》 2015年第10期920-927,共8页
Endoscopy has important roles in the managementof primary sclerosing cholangitis (PSC), ranging fromnarrowing down the differential diagnoses, screeningfor complications, determining prognosis and therapy.While the ... Endoscopy has important roles in the managementof primary sclerosing cholangitis (PSC), ranging fromnarrowing down the differential diagnoses, screeningfor complications, determining prognosis and therapy.While the need for a diagnostic endoscopic retrogradecholangiopancreatography (ERCP) may be obviated by apositive magnetic resonance cholangiopancreatography(MRCP), a negative MRCP does not exclude PSC andmay therefore necessitate an ERCP, which is traditionallyregarded as the gold standard. In this editorial we havenot covered the endoscopic management of inflammatorybowel disease in the context of PSC nor of endoscopicsurveillance and treatment of portal hypertension complicatingPSC. 展开更多
关键词 SCLEROSING CHOLANGITIS Endoscopic retrogradecholangiopancreatography ENDOSONOGRAPHY CHOLANGIOCARCINOMA STENTS Fluorescence in SITU hybridizationtechnique Biochemical markers
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Techniques and efficacy of flexible endoscopic therapy ofZenker's diverticulum 预览
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作者 Yaseen Perbtani Alejandro Suarez Mihir S Wagh 《世界胃肠内镜杂志:英文版(电子版)》 2015年第3期206-212,共7页
Zenker's diverticulum (ZD) is an abnormal hypopharyngealpouch often presenting with dysphagia. Treatment isoften sought with invasive surgical management of thediverticulum being the only mode of definitive therapy... Zenker's diverticulum (ZD) is an abnormal hypopharyngealpouch often presenting with dysphagia. Treatment isoften sought with invasive surgical management of thediverticulum being the only mode of definitive therapy.Primarily done by an open transcervical approachin the past, nowadays treatment is usually providedby otolaryngologists using a less invasive trans-oraltechnique with a rigid endoscope. When first described,this method grew into acceptance quickly due to itssimilar efficacy and vastly improved safety profilecompared to the open transcervical approach. However,the main limitation with this approach is that it may notbe suitable for all patients. Nonetheless, progress inthe field of natural orifice endoscopic surgery over thelast 10-20 years has led to the increase in utilization ofthe flexible endoscope in the treatment of ZD. Primarilyperformed by interventional gastroenterologists, thisapproach overcomes the prior limitation of its surgicalcounterpart and allows adequate visualization of thediverticulum independent of the patient's body habitus.Additionally, it may be performed without the useof general anesthesia and in an outpatient setting,thus further increasing the utility of this modality,especially in elderly patients with other comorbidities.Today, results in more than 600 patients have beendescribed in various published case series usingdifferent techniques and devices demonstrating a highpercentage of clinical symptom resolution with lowrates of adverse events. In this article, we present ourexperience with flexible endoscopic therapy of Zenker'sdiverticulum and highlight the endoscopic technique,outcomes and adverse events related to this minimallyinvasive modality. 展开更多
关键词 Zenker's DIVERTICULUM FLEXIBLE ENDOSCOPY Natural orifice endoscopic surgery Per-oral ENDOSCOPY DYSPHAGIA Cricopharyngeus MYOTOMY Cricopharyngeusseptotomy
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Biomarkers in bile-complementing advanced endoscopicimaging in the diagnosis of indeterminate biliary strictures 预览
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作者 Vennisvasanth Lourdusamy Benjamin Tharian Udayakumar Navaneethan 《世界胃肠内镜杂志:英文版(电子版)》 2015年第4期308-317,共10页
Biliary strictures present a diagnostic challenge and aconundrum, particularly when an initial work up includingabdominal imaging and endoscopic retrogradecholangiopancreatography based sampling are nondiagnostic.Adva... Biliary strictures present a diagnostic challenge and aconundrum, particularly when an initial work up includingabdominal imaging and endoscopic retrogradecholangiopancreatography based sampling are nondiagnostic.Advances in endoscopic imaging have helpedus diagnose these strictures better. However, even withmodern technology, some strictures remain a diagnosticchallenge. The proximity of bile fluid to the bile ductepithelia makes it an attractive option to investigatefor bio-markers, which might be representative of thefunctions/abnormal changes taking place in the biliarysystem. A number of biomarkers in bile have beendiscovered recently in approaching biliary strictureswith their potential future diagnostic utility, furthersupported by the immunohistochemical analysis of theresected tissue specimens. Novel biliary biomarkersespecially carcinoembryonic cell adhesion molecule 6and neutrophil gelatinase-associated lipocalin seempromising in differentiating malignant from benign biliarystrictures. Recent developments in lipidomic profiling ofbile are also very promising. Biliary biomarkers appearto complement endoscopic imaging in diagnosingmalignant etiologies of biliary stricture. Future studiesaddressing these biomarkers need to be incorporatedto the current endoscopic techniques to determine thebest approach in determining the etiology of biliarystrictures. 展开更多
关键词 Bile Pancreato-biliary MALIGNANCIES Biomarkers CHOLANGIOCARCINOMA Pancreatic CANCERS Biliary STRICTURES
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预览
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作者 Schalk Willem van der Merwe Jones Omoshoro-Jones Charles Sanyika 《世界胃肠内镜杂志:英文版(电子版)》 2013年第5期246-250,共5页
AIM:To further reduce the risk of bleeding or bile leakage.METHODS:We performed endoscopic ultrasound guided biliary drainage in 6 patients in whom endoscopic retrograde cholangiopancreatography(ERCP) had failed.Bili... AIM:To further reduce the risk of bleeding or bile leakage.METHODS:We performed endoscopic ultrasound guided biliary drainage in 6 patients in whom endoscopic retrograde cholangiopancreatography(ERCP) had failed.Biliary access of a dilated segment 2 or 3 duct was achieved from the stomach using a 19G needle.After radiologically confirming access a guide wire was placed,a transhepatic tract created using a 6 Fr cystotome followed by balloon dilation of the stricture and antegrade metallic stent placement across the malignant obstruction.This was followed by placement of an endocoil in the transhepatic tract.RESULTS:Dilated segmental ducts were observed in all patients with the linear endoscopic ultrasound scope from the proximal stomach.Transgastric biliary access was obtained using a 19G needle in all patients.Biliary drainage was achieved in all patients.Placement of an endocoil was possible in 5/6 patients.All patients responded to biliary drainage and no complications occurred.CONCLUSION:We show that placing endocoils at the time of endoscopic ultrasound guided biliary stenting is feasible and may reduce the risk of bleeding or bile leakage. 展开更多
关键词 ENDOSCOPIC ultrasound BILIARY drainage TRANSHEPATIC Endocoil
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Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: A systematic review and meta analysis 预览
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作者 Srinivas R Puli Nikhil Kalva +8 位作者 Matthew L Bechtold Smitha R Pamulaparthy Micheal D Cashman Norman C Estes Richard H Pearl Fritz-Henry Volmar Sonu Dillon Michael F Shekleton David Forcione 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2013年第23期3678-3684,共7页
AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.METHODS: Only EUS studies confirmed by surg... AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.METHODS: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model). RESULTS: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall’s tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ2 heterogeneity for all the pooled accuracy estimates was 】 0.10. CONCLUSION: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs. 展开更多
关键词 Endoscopic ULTRASOUND ULTRASOUND ENDOSONOGRAPHY Pancreatic mass NEUROENDOCRINE tumors Sensitivity SPECIFICITY Positive PREDICTIVE VALUE Negative PREDICTIVE VALUE
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Transrectal EUS-guided FNA biopsy of a presacral chordoma-report of a case and review of the literature 预览
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作者 Klaus Gottlieb Paul H Lin +1 位作者 David M Liu Karl Anders 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS CSCD 2008年第16期2586-2589,共4页
Chordomas 是从脊索的残余发源的稀罕肿瘤。这些肿瘤是局部地好攻击的并且有偏爱轴的骨骼的结束。为这些肿瘤的最佳的管理的一个重要前提是正确外科手术前的诊断。现在的案例是内视镜的超声的使用的第一份报告获得一个骶骨前脊索瘤的 tr... Chordomas 是从脊索的残余发源的稀罕肿瘤。这些肿瘤是局部地好攻击的并且有偏爱轴的骨骼的结束。为这些肿瘤的最佳的管理的一个重要前提是正确外科手术前的诊断。现在的案例是内视镜的超声的使用的第一份报告获得一个骶骨前脊索瘤的 transrectal 罚款针针吸活组织检查。扫描允许我们计算肿瘤体积双倍工资(18.3 瞬间) 的优先的计算机断层摄影术(CT ) 的评论。chordomas 的 Transrectal 活体检视是争论的,然而,我们相信如此的担心没被认为正当。 展开更多
关键词 脊索瘤 内窥镜检查 直肠活切片 症状
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内镜下食管周围纵隔脓肿清创术:一项前瞻性序列病例研究 预览
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作者 Wehrmann T. Stergiou N. +1 位作者 Vogel B. 成虹 《世界核心医学期刊文摘:胃肠病学分册》 2005年第12期31-32,共2页
关键词 纵隔脓肿 清创术 下食管 病例研究 食管穿孔 食管周围脓肿 胸导管引流 纤维蛋白胶 肠外营养治疗 穿刺治疗
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