Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

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Novel Endoscopic Clip For Effective Management of Gastrointestinal Perforations: A Feasibility Study in a Porcine Model. 新型内镜夹有效治疗胃肠道穿孔:猪模型的可行性研究。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-18 DOI: 10.1097/SLE.0000000000001397
Jeongho Sohn, Sunseok Yoon, Kwang Dae Hong
{"title":"Novel Endoscopic Clip For Effective Management of Gastrointestinal Perforations: A Feasibility Study in a Porcine Model.","authors":"Jeongho Sohn, Sunseok Yoon, Kwang Dae Hong","doi":"10.1097/SLE.0000000000001397","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001397","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal (GI) perforations typically occur as complications following endoscopic procedures or intestinal anastomosis surgery. Endoscopic closure of these perforations is desirable as it avoids the risks associated with surgery. Although several endoscopic devices have been developed to address this issue, none have yet demonstrated consistently effective clinical outcomes. This study introduces a novel endoscopic clip assembly designed to overcome these challenges.</p><p><strong>Materials and methods: </strong>The Z-shaped clip, named the kinetic utility (KU) clip, was constructed with nitinol, allowing it to operate at 45 °C. When the clip is delivered endoscopically, it can close perforations with a predeformed configuration that is triggered by temperature. Ex vivo experiments were conducted using porcine stomach tissue to compare the performance of the KU clip with through-the-scope clips (TTSCs). Maximal force and area under the curve (AUC) on the force-displacement curve were measured to assess the retention capability of the clip in tissue. The in vivo experiment involved creating iatrogenic perforations in a pig, applying the KU clip, and monitoring its healing and safety outcomes.</p><p><strong>Results: </strong>Ex vivo experiments showed a difference between the TTSC and KU groups with a P-value of 0.08 for maximal force and 0.01 for AUC. The in vivo experiment validates the effectiveness of the KU clip, as there was complete healing of the perforation site with no significant adverse reactions during the experimental period.</p><p><strong>Conclusions: </strong>The KU clip demonstrates potential as a versatile and effective tool for endoscopic management of GI perforations.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Learning Curve for da Vinci Single-Port Robotic System Cholecystectomy. 达芬奇单端口机器人系统胆囊切除术的学习曲线。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-17 DOI: 10.1097/SLE.0000000000001394
Niccolò Ramacciotti, Francesco Celotto, Federico Pinto, Jessica Cassiani, Giacomo Danieli, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco
{"title":"Learning Curve for da Vinci Single-Port Robotic System Cholecystectomy.","authors":"Niccolò Ramacciotti, Francesco Celotto, Federico Pinto, Jessica Cassiani, Giacomo Danieli, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco","doi":"10.1097/SLE.0000000000001394","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001394","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery is recognized as the gold standard for cholecystectomy, with various approaches having been implemented over time. Since 2018, the da Vinci Single-Port (DVSP) robotic system (Intuitive) has been used in experimental surgical contexts, revitalizing interest in single-site surgical techniques. The authors' aim is to describe the learning curve associated with single-port robotic cholecystectomy (SPRC).</p><p><strong>Methods: </strong>A prospective series of 266 consecutive off-label SPRC performed by a single surgeon experienced in laparoscopy, single-site surgery, and multiport robotic surgery was analyzed. These procedures were conducted under an Institutional Review Board-approved protocol. Preoperative, intraoperative, and postoperative data were collected and organized. Indications for SPRC included symptomatic cholelithiasis, acute cholecystitis, chronic cholecystitis, porcelain gallbladder, gallbladder polyps, choledocholithiasis, and gallstone pancreatitis. A learning curve was generated using the cumulative sum analysis (CUSUM) to assess changes in overall operation time, docking time, pre-console time, and surgeon console time.</p><p><strong>Results: </strong>Our analysis demonstrated a statistically significant reduction in docking time and pre-console time (P<0.001) in the 3 phases identified by the CUSUM analysis. The CUSUM analysis identified only 1 phase regarding the console time with a mean time of 20 (7 to 113) minutes. The average overall time was 59 (19 to 175) minutes. CUSUM analysis identified 3 phases for overall time, with reduction from 59 to 46 minutes (P<0.001). The general characteristics of the groups identified for OT were homogeneous. Analysis of early surgical outcomes did not differ between the groups.</p><p><strong>Conclusions: </strong>SPRC is a safe and feasible procedure, the docking time, pre-console time, and overall time were improving over time, meanwhile the console time was stable throughout the case series demonstrating a significant ability transfer between other mininvasive approaches and DVSP Platform.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Endoscopic Pancreatic Stenting for Traumatic Pancreatic Fistula. 内镜胰支架置入术治疗外伤性胰瘘的疗效和安全性。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-10 DOI: 10.1097/SLE.0000000000001395
Juanjuan Zhang, Xiaoli Qian, Binlin Da, Lin Zhu, Gefei Wang, Zhiming Wang
{"title":"Efficacy and Safety of Endoscopic Pancreatic Stenting for Traumatic Pancreatic Fistula.","authors":"Juanjuan Zhang, Xiaoli Qian, Binlin Da, Lin Zhu, Gefei Wang, Zhiming Wang","doi":"10.1097/SLE.0000000000001395","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001395","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic pancreatic fistula is challenging and complicated to manage. Our aim was to assess the efficacy of endoscopic pancreatic duct stenting in the treatment of traumatic pancreatic fistula.</p><p><strong>Methods: </strong>Patients with pancreatic trauma treated by endoscopic pancreatic duct stenting at Jinling Hospital from May 2016 to October 2022 were enrolled. We recorded clinical data, the cause of pancreatic trauma, the location of injuries, pancreatic injury grade, the timing and duration of stent placement and removal, and long-term outcomes.</p><p><strong>Results: </strong>Twenty-six patients with traumatic pancreatic fistula who underwent 33 endoscopic pancreatic duct stenting procedures were enrolled. Most patients (20/26, 76.9%) were grade IV. The median time interval from injury to endoscopic stenting was 48 (range: 1 to 959) days. The main pancreatic duct (MPD) was visualized in all patients, and the average diameter of the MPD was 1.73±0.45 mm. Serum amylase levels, drain amylase levels, and drainage volume were significantly decreased after stent placement. One patient had a pancreatic duct stricture at the neck, 1 patient had poor drainage after stenting, and there were no other complications. The technical success rate was 93.9% (31/33), and the clinical efficacy rate was 76.9% (20/26). Univariate analysis revealed that the interval from injury to stenting (HR: 10.500, 95% CI: 1.115-98.914, P=0.040) was associated with stent success.</p><p><strong>Conclusion: </strong>Pancreatic duct stenting is a safe and effective treatment modality and should be an optional treatment for the management of traumatic pancreatic fistula. Before stent placement, the duration of pancreatic fistula should be assessed since it is related to fistula healing.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Tattoo Trap: A Cautionary Note on Lesion Localization in Laparoscopic Bowel Resection. 刺青陷阱:腹腔镜肠切除术中病灶定位的警示。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-10 DOI: 10.1097/SLE.0000000000001396
Khalid Hureibi
{"title":"The Tattoo Trap: A Cautionary Note on Lesion Localization in Laparoscopic Bowel Resection.","authors":"Khalid Hureibi","doi":"10.1097/SLE.0000000000001396","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001396","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advances in Disposable Gastrointestinal Endoscopes: A Review of Research Progress. 一次性胃肠道内窥镜的研究进展
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-09 DOI: 10.1097/SLE.0000000000001391
Yanning Zhang, Yaoping Zhang, Jinyong Hao, Xiaojun Huang
{"title":"Advances in Disposable Gastrointestinal Endoscopes: A Review of Research Progress.","authors":"Yanning Zhang, Yaoping Zhang, Jinyong Hao, Xiaojun Huang","doi":"10.1097/SLE.0000000000001391","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001391","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal endoscopes are essential for diagnosing and treating digestive disorders, although some drawbacks exist, such as patient discomfort and sedation.</p><p><strong>Methods: </strong>Disposable, minimally invasive gastrointestinal endoscopes have garnered attention among endoscopists due to portability, improved patient comfort, and lack of post-procedural requirements. This innovation shows potential as an alternative to traditional endoscopy methods, with several studies confirming efficacy and safety in clinical settings.</p><p><strong>Results: </strong>This review discusses the latest advances and ongoing research involving disposable gastrointestinal endoscopes with a focus on technological enhancements, patient outcomes, and the practical implications of integration into standard medical procedures.</p><p><strong>Conclusions: </strong>Examining these developments provides a comprehensive analysis of the current disposable gastrointestinal endoscope technology status and future potential, emphasizing the role in enhancing patient care and procedural efficiency in gastroenterology.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Evaluation of Analgesic Efficacy and Recovery Outcomes: Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament Versus Transversus Abdominis Plane Block in Laparoscopic Partial Hepatectomy. 腹腔镜肝部分切除术中腰前方肌外侧弓形上韧带阻滞与腹横面阻滞镇痛效果和恢复效果的比较评价。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-09 DOI: 10.1097/SLE.0000000000001392
Lingling Jiang, Yun Li, Kui Sheng, Lili Zhang, Yang Hu, Ye Zhang
{"title":"Comparative Evaluation of Analgesic Efficacy and Recovery Outcomes: Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament Versus Transversus Abdominis Plane Block in Laparoscopic Partial Hepatectomy.","authors":"Lingling Jiang, Yun Li, Kui Sheng, Lili Zhang, Yang Hu, Ye Zhang","doi":"10.1097/SLE.0000000000001392","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001392","url":null,"abstract":"<p><strong>Objective: </strong>A comparative assessment of analgesic effectiveness and recovery quality between the anterior quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) and the transversus abdominis plane block (TAPB) in patients undergoing laparoscopic partial hepatectomy (LPH).</p><p><strong>Method: </strong>A total of 56 patients scheduled for LPH were randomly allocated to either the QLB-LSAL group or the TAPB group in a 1:1 ratio. Patients in the QLB-LSAL group received bilateral anterior quadratus lumborum block at the lateral supra-arcuate ligament, while those in the TAPB group received bilateral subcostal transversus abdominis plane block before surgery. The primary outcome was the morphine equivalent consumption (MEC) at 24 hours postoperatively. Secondary outcomes included MEC at 48 and 72 hours, as well as numeric rating scale (NRS) pain scores at rest and during movement, recorded at 2, 4, 6, 12, 24, and 48 hours postoperatively. The quality of recovery was assessed using QoR-15 scores, measured 1 day before surgery and on the first and third postoperative days.</p><p><strong>Results: </strong>The QLB-LSAL group demonstrated significantly lower MEC at 24, 48, and 72 hours postoperatively compared with the TAPB group. NRS scores for pain at rest and during movement were also significantly lower in the QLB-LSAL group at 2, 4, 6, 12, and 24 hours following surgery. In addition, the QoR-15 scores, which assess the quality of recovery, were significantly higher in the QLB-LSAL group compared with the TAPB group on both the first and third postoperative days.</p><p><strong>Conclusion: </strong>The QLB-LSAL method provides superior analgesia and enhances recovery quality compared with the TAPB approach in patients undergoing LPH.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reversal to Normal Anatomy for Patients With Excessive Weight Loss or Severe Malnutrition After Single Anastomosis Sleeve Ileal (SASI) Bypass. 单套回肠(SASI)搭桥术后体重减轻或严重营养不良患者的正常解剖逆转。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-03 DOI: 10.1097/SLE.0000000000001390
Yi-Jie Wang, Hsiang Teng, Hsin-Mei Pan, Kuo-Feng Hsu
{"title":"Reversal to Normal Anatomy for Patients With Excessive Weight Loss or Severe Malnutrition After Single Anastomosis Sleeve Ileal (SASI) Bypass.","authors":"Yi-Jie Wang, Hsiang Teng, Hsin-Mei Pan, Kuo-Feng Hsu","doi":"10.1097/SLE.0000000000001390","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001390","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery (MBS) has been an effective solution not only to obesity but also to metabolic diseases. As the demand for revisional surgery increases with the expansion of MBS, possible risks and complications of reoperation should be considered.</p><p><strong>Method: </strong>We have collected and analyzed 3 patients diagnosed with class III obesity who underwent the single anastomosis sleeve ileal bypass (SASI) as a primary operation. Due to excessive weight loss or severe malnutrition, they were indicated for revisional surgery, where SASI was reversed to sleeve gastrectomy (SG) (Fig. 1). The perioperative characteristics as well as outcomes after SASI and revisional surgery are reviewed.</p><p><strong>Results: </strong>The confirmed measurement of their common channels in 3 patients with SASI revealed 350, 250, and 250 cm, respectively. The mean operative time was 42.3 minutes and blood loss was <20 mL. There were no intraoperative or postoperative complications. The patients had uneventful postoperative courses and the mean hospital stay was 2.3 days. There was no mortality in our cases. Malabsorption with nutrition issues was improved in each patient.</p><p><strong>Conclusion: </strong>Laparoscopic revision of SASI to SG is a technically feasible and practical procedure for patients with excessive weight loss or malnutrition.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigation of Microbiological Contamination of Endoscopes After Endoscopic Debridement of Pancreatic Encapsulated Necrosis With Multidrug Resistant Bacterial Infection. 胰腺包封性坏死合并多重耐药细菌感染内镜清创后内窥镜微生物污染的调查。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-07-01 DOI: 10.1097/SLE.0000000000001383
Meng-Jiao Zhou, Xi Huang, Jiu-Hong Ma
{"title":"Investigation of Microbiological Contamination of Endoscopes After Endoscopic Debridement of Pancreatic Encapsulated Necrosis With Multidrug Resistant Bacterial Infection.","authors":"Meng-Jiao Zhou, Xi Huang, Jiu-Hong Ma","doi":"10.1097/SLE.0000000000001383","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001383","url":null,"abstract":"<p><strong>Background: </strong>To investigate the microbiological contamination of endoscopes after endoscopic debridement of pancreatic encapsulated necrosis with multidrug-resistant bacterial infection by 2 different reprocessing methods of peroxyacetic acid and ethylene oxide.</p><p><strong>Methods: </strong>Endoscopes with auxiliary water function after endoscopic debridement of pancreatic encapsulated necrosis and multidrug-resistant bacterial infection in a tertiary care hospital in Jiangxi Province were selected and divided into 2 groups by random number table method: group A was sterilized by peracetic acid immersion and group B was sterilized by ethylene oxide low temperature. The 3 channels of the endoscopes, namely, the working channel, the air/water channel, and the auxiliary water channel, were collected by the filter membrane method and sent to the laboratory for microbiological culture within 2 hours. The qualification rate, colony count, and isolation of bacteria were compared between the 2 groups of endoscopes.</p><p><strong>Results: </strong>In this study, 78 endoscopes were collected, 39 each from group A and group B, with a total of 312 samples. The overall pass rate of group A and group B was 61.54% and 100%, respectively. The pass rate of group A working channel was 82.05%, the pass rate of air/water channel was 89.74%, the pass rate of auxiliary water channel was 74.36%, and the pass rate of all 3 channels in group B was 100%. The pass rate of group A working channel is 82.05%. The ranges of total bacterial colonies in the channel, air/water channel, and auxiliary water channel were 0 to 6 CFU/channel, 0 to 112 CFU/channel, and 0 to 23 CFU/channel, respectively. A total of 36 strains of bacteria were isolated, mainly multidrug resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and multidrug resistant Klebsiella pneumoniae. After transferring 15 failed endoscopes in group A to low-temperature sterilization with ethylene oxide, the microbiological surveillance pass rate reached 100%.</p><p><strong>Conclusion: </strong>For endoscopes with pancreatic encapsulated necrosis and multidrug resistant bacterial infection endoscopic debridement, the ethylene oxide cryo-sterilization method is safer and more effective. Routine microbiological surveillance of endoscopes cannot be limited to the surveillance of working channels only, and endoscopes with auxiliary water function need to monitor auxiliary water channels to reduce the risk.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic Ultrasound-Guided Biliary Drainage for Acute Cholangitis Secondary to Biliary Obstruction: A Systematic Review and Meta-Analysis. 超声内镜引导下胆道引流治疗继发于胆道梗阻的急性胆管炎:系统回顾和荟萃分析。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-06-23 DOI: 10.1097/SLE.0000000000001386
Yash Shah, Sahib Singh, Dushyant S Dahiya, Ernesto Calderon-Martinez, Sneha A Sebastian, Manesh K Gangwani, Zohaib Ahmed, Saurabh Chandan, Babu Mohan, Rashmi Advani
{"title":"Endoscopic Ultrasound-Guided Biliary Drainage for Acute Cholangitis Secondary to Biliary Obstruction: A Systematic Review and Meta-Analysis.","authors":"Yash Shah, Sahib Singh, Dushyant S Dahiya, Ernesto Calderon-Martinez, Sneha A Sebastian, Manesh K Gangwani, Zohaib Ahmed, Saurabh Chandan, Babu Mohan, Rashmi Advani","doi":"10.1097/SLE.0000000000001386","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001386","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) remains the primary treatment for biliary obstruction, yet fails in 5% to 7% of cases, necessitating alternative therapeutic options like endoscopic ultrasound-guided biliary drainage (EUS-BD). With acute cholangitis posing significant morbidity and mortality risks, assessing the safety and efficacy of EUS-BD in these patients is vital. This is the first meta-analysis with a subgroup analysis assessing the outcomes of EUS-BD in patients with acute cholangitis secondary to biliary obstruction.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines, searching MEDLINE, Embase, Web of Science, Clinicaltrials.gov, and Cochrane databases until December 23, 2023. Studies involving adult patients undergoing EUS-BD for cholangitis were included. Outcomes assessed were pooled technical and clinical success rates, complications, and mortality. Standard meta-analysis methods were employed using the random-effects model, and heterogeneity was assessed using the I2% statistics.</p><p><strong>Results: </strong>Among the included 5 studies (109 patients), EUS-BD achieved a pooled technical success rate of 95.5% (95% CI: 91.0-98.5) and a clinical success rate of 92.1% (95% CI: 86.4-96.3), with low heterogeneity across studies (I2: 0.00% for both outcomes). The pooled complication rate was 12.2% (95% CI: 5.1-21.8, I2: 37.46%), with predominantly mild and self-limiting complications.</p><p><strong>Conclusion: </strong>EUS-BD demonstrated excellent pooled technical and clinical success rates, particularly when ERCP is not feasible in patients with acute cholangitis secondary to biliary obstruction. Most postprocedure complication rates are also mild and self-limiting making EUS-BD a possible alternative for the management of patients with cholangitis.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Overlap Versus π-Shaped Esophagojejunostomy After Laparoscopic Total Gastrectomy for Gastric Cancer: A Comparative Study. 腹腔镜胃癌全胃切除术后重叠与π型食管空肠吻合的比较研究。
IF 1.1 4区 医学
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-06-23 DOI: 10.1097/SLE.0000000000001388
Luyang Zhang, Junjun Ma, Jingzhu Li, Sen Zhang, Hiju Hong, Xuan Zhao, Bo Feng, Zirui He, Xiao Yang, Lu Zang, Minhua Zheng, Abe Fingerhut
{"title":"Overlap Versus π-Shaped Esophagojejunostomy After Laparoscopic Total Gastrectomy for Gastric Cancer: A Comparative Study.","authors":"Luyang Zhang, Junjun Ma, Jingzhu Li, Sen Zhang, Hiju Hong, Xuan Zhao, Bo Feng, Zirui He, Xiao Yang, Lu Zang, Minhua Zheng, Abe Fingerhut","doi":"10.1097/SLE.0000000000001388","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001388","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of medical professionals are choosing to use totally laparoscopic total gastrectomy (TLTG) as a treatment option for gastric cancer. However, the optimal reconstruction method is still under debate. The objective of this study is to evaluate the immediate results of 2 intracorporeal esophagojejunostomy techniques: overlap (isoperistaltic side-to-side) (O) and pi-shaped (π) (anisoperistaltic side-to-side) anastomosis.</p><p><strong>Methods: </strong>Hospital records of 110 patients who underwent esophagojejunostomy (group O, n=65 or group π, n=45) after TLTG from January 2016 to December 2019 were retrospectively reviewed. The demographic and clinicopathologic characteristics, along with the surgical and pathologic results, were recorded, compared, and evaluated for immediate impacts.</p><p><strong>Results: </strong>The demographic characteristics of the 2 groups exhibited no significant disparities. Moreover, there were no statistically notable differences in tumor size, lymph node count, or TNM stage between the 2 groups. All surgeries were successfully completed without any complications or need for conversion to laparotomy, and there were no occurrences of postoperative mortality. In addition, there were no statistically significant variances between the 2 groups in terms of total operation time, estimated blood loss, time to first flatus, or length of postoperative hospital stay. Time for esophagojejunostomy, however, was statistically significantly shorter in group π than in group O (27.4±5.2 vs. 36.7±5.0 min) (P<0.001). No statistically significant difference was found between the 2 groups with regard to postoperative complications: 5 grade I, 6 grade II, and 1 grade IIIa in group O (n=12) versus 5 grade I, 3 grade II, 2 grade IIIa, and 1 grade IIIb in group π (n=11). At 6-month endoscopy and oral water-soluble contrast medium follow-up, no anastomotic complication was noted.</p><p><strong>Conclusions: </strong>The π anastomosis is feasible, safe, with the need for fewer cartridges and is eventually a time-saving procedure for esophagojejunostomy with no hand-sewing involved. In this study, both methods have shown favorable short-term results in the treatment of gastric cancer.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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