Gastrointestinal Intervention最新文献

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Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy for diagnosis of solid pancreatic lesions 超声引导下针基共聚焦激光内镜在胰腺实性病变诊断中的应用
Gastrointestinal Intervention Pub Date : 2016-10-31 DOI: 10.18528/GII160025
R. Pittayanon, P. Kongkam, R. Rerknimitr
{"title":"Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy for diagnosis of solid pancreatic lesions","authors":"R. Pittayanon, P. Kongkam, R. Rerknimitr","doi":"10.18528/GII160025","DOIUrl":"https://doi.org/10.18528/GII160025","url":null,"abstract":"An accurate diagnosis of solid pancreatic lesions (SPLs) is important because pancreatic cancer cannot be ignored if curative treatment is possible. Prompt and reliable diagnostic procedures are greatly needed for patients presenting with SPLs, particularly where resection is possible for a malignant mass. Several endoscopic ultrasound (EUS)-related technologies including a novel EUS-guided needle-based confocal laser endomicroscopy (EUS-nCLE) can provide real-time images at the cellular level (1,000-fold magnification). A 19-gauge EUS-guided fine needle aspiration (EUS-FNA) needle is recommended because its channel is large enough for the 0.85-mm diameter nCLE miniprobe. The procedure is performed by standard EUSFNA techniques with either preor post-loading technique. Ten percent fluorescein sodium (2.5–5 mL) is used as an enhancing agent and is intravenously injected immediately before puncturing the lesion. Only a few studies have used the technique and reported results. A recent study from 19 malignant and 3 benign SPLs classified EUS-nCLE findings according to 4 signs: dark clumps, and dilated vessels (predominantly seen in malignant SPLs) and fine white fibrous bands and normal acini (predominantly seen in benign SPLs). Using these criteria, researchers correctly diagnosed 18 of the malignant SPLs (94.7%). Another study described 2 lesions as having “dark cells aggregates with pseudo-glandular aspects, and straight hyperdense elements more or less thick corresponding to tumoral fibrosis” in 17 of 18 malignant SPLs. Thus far, no large and systematic study has been performed to evaluate the potential clinical use of EUS-nCLE for diagnosing SPLs. However, based on available information from a few studies and the current limitations of EUS-FNA, EUS-nCLE can potentially provide a complementary role in diagnosing such lesions. Nevertheless, more studies are certainly needed. Copyright © 2016, Society of Gastrointestinal Intervention. All rights reserved.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"265 1","pages":"212-215"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68272883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical role of contrast-enhanced harmonic endoscopic ultrasound in differentiating pancreatic solid lesions 超声造影增强谐波内镜鉴别胰腺实性病变的临床意义
Gastrointestinal Intervention Pub Date : 2016-10-31 DOI: 10.18528/GII150016
C. Shim, T. Lee, Y. Cheon
{"title":"Clinical role of contrast-enhanced harmonic endoscopic ultrasound in differentiating pancreatic solid lesions","authors":"C. Shim, T. Lee, Y. Cheon","doi":"10.18528/GII150016","DOIUrl":"https://doi.org/10.18528/GII150016","url":null,"abstract":"Accurate diagnosis of pancreatic solid lesions is often difficult using conventional imaging modalities. With the recent introduction of contrastenhanced harmonic endoscopic ultrasound (CEH-EUS), it is now possible to evaluate the microvascular environment and dynamic enhancement of a variety of pancreatic lesions. With CEH-EUS, three patterns of pancreatic lesion enhancement compared with the normal pancreatic tissue (fast, simultaneous, or slow), two washout patterns (fast or slow) and two distribution patterns (homogeneous, inhomogeneous) can be described. By evaluating the microvasculature, enhancement speed, and washout pattern, CEH-EUS may help to differentiate pancreatic adenocarcinoma from other masses and differentiate between pancreatic neuroendocrine tumor (pNET) and inflammatory masses. The finding of a hyperenhancing lesion on CEH–EUS, both with homogeneous and inhomogeneous patterns, was a strong predictor of histology different from adenocarcinoma (94% positive predictive value). pNET was the most common hyperenhancing lesions overall. Although CEH-EUS is useful for ruling out pancreatic ductal adenocarcinoma, making the differential diagnosis between pNETs and pseudotumoral pancreatic masses is difficult because both may share an isovascular or hypervascular appearance. Currently the interpretation of CEH-EUS findings is examiner-dependent. In the future, digital image analysis by image-processing techniques should allow more objective interpretation. Copyright © 2016, Society of Gastrointestinal Intervention. All rights reserved.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"177-182"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68271405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Contrast-enhanced endoscopic ultrasound for pancreatobiliary disease 内镜超声造影对胰胆道疾病的诊断价值
Gastrointestinal Intervention Pub Date : 2016-10-31 DOI: 10.18528/GII160017
Raymond S. Y. Tang
{"title":"Contrast-enhanced endoscopic ultrasound for pancreatobiliary disease","authors":"Raymond S. Y. Tang","doi":"10.18528/GII160017","DOIUrl":"https://doi.org/10.18528/GII160017","url":null,"abstract":"Endoscopic ultrasound (EUS), with or without fine needle aspiration (FNA), has become an essential tool in the evaluation of pancreatobiliary diseases. Although conventional EUS is superior to multidetector computed tomography in tumor detection and staging, there are situations when characterization of various pancreatobiliary lesions remains difficult. Contrast-enhanced EUS (CE EUS) can further improve the detection and characterization of pancreatic solid lesions such as ductal adenocarcinoma, neuroendocrine tumor, or mass-forming autoimmune pancreatitis based on differences in the enhancement pattern of the target lesions. It is also useful in differentiating between mural nodules and mucous clots in pancreatic cystic neoplasms, and characterizing various lesions in the gallbladder and bile duct. CE EUS is complementary to FNA and has the potential to increase the diagnostic yield on the first FNA needle pass. Copyright © 2016, Society of Gastrointestinal Intervention. All rights reserved.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"183-186"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68272299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic intervention for persistent bile leakage after cholecystectomy 胆囊切除术后持续性胆漏的内镜干预治疗
Gastrointestinal Intervention Pub Date : 2016-10-31 DOI: 10.18528/GII160021
Hong-Joo Kim
{"title":"Endoscopic intervention for persistent bile leakage after cholecystectomy","authors":"Hong-Joo Kim","doi":"10.18528/GII160021","DOIUrl":"https://doi.org/10.18528/GII160021","url":null,"abstract":"","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"224-225"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68272735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Development of the Asian EUS Group consensus in pancreatic pseudocyst drainage 亚洲EUS组胰腺假性囊肿引流共识的发展
Gastrointestinal Intervention Pub Date : 2016-10-31 DOI: 10.18528/GII160016
A. Teoh, V. Dhir, Z. Jin, M. Kida, D. Seo, K. Ho
{"title":"Development of the Asian EUS Group consensus in pancreatic pseudocyst drainage","authors":"A. Teoh, V. Dhir, Z. Jin, M. Kida, D. Seo, K. Ho","doi":"10.18528/GII160016","DOIUrl":"https://doi.org/10.18528/GII160016","url":null,"abstract":"Drainage of pseudocyst and walled-off pancreatic necrosis has traditionally been achieved by surgical means. Recently, there has been a progressive shift in paradigm to performing endoscopic drainage for these conditions. Endoscopic ultrasound (EUS)-guided drainage is the preferred approach for drainage of pancreatic pseudocyst. However, many controversies still exist on the optimal management and wide variations in techniques exist. There is a pressing need for establishment of a consensus for safe practices in EUS-guided pseudocyst drainage.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"93 1","pages":"199-202"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68272250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
How to manage gastric polyps 如何治疗胃息肉
Gastrointestinal Intervention Pub Date : 2016-10-31 DOI: 10.18528/GII150035
G. Lanke, A. Agarwal, Jeffrey H. Lee
{"title":"How to manage gastric polyps","authors":"G. Lanke, A. Agarwal, Jeffrey H. Lee","doi":"10.18528/GII150035","DOIUrl":"https://doi.org/10.18528/GII150035","url":null,"abstract":"Gastric cancer is the second leading cause of cancer related death in the world. In United States, gastric polyps are found in approximately 6% of up - per endoscopy. The incidence of gastric polyps increased with widespread use of esophagogastroduodenoscopy and more liberal use of proton pump inhibitors. They are usually asymptomatic, but infrequently cause symptoms of bleeding, pain and gastric outlet obstruction. It is important to distin- guish premalignant conditions and mimickers of malignancy. Helicobacter pylori eradication therapy leads to regression of hyperplastic polyps but it is not clear for adenoma. Endoscopy plays key role not only in diagnosis but also in surveillance. With narrow band imaging and chromo endos - copy, we are much better today in detecting and discerning these. Also, with endoscopic mucosal resection and endoscopic submucosal dissection, we can manage these better. In this review article we will discuss the various diagnostic tools and therapeutic options for hyperplastic polyp, fundic gland polyp, gastrointestinal stromal tumor, adenoma, neuroendocrine tumor, linitis plastica, and intestinal metaplasia. Copyright All rights reserved.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"159-169"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68272045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Through the keyhole: Radiological management of malignant gastric outflow obstruction beyond the pylorus 锁眼透视:幽门外恶性胃流出梗阻的影像学处理
Gastrointestinal Intervention Pub Date : 2016-07-31 DOI: 10.18528/GII150026
R. Stockwell, J. Shin
{"title":"Through the keyhole: Radiological management of malignant gastric outflow obstruction beyond the pylorus","authors":"R. Stockwell, J. Shin","doi":"10.18528/GII150026","DOIUrl":"https://doi.org/10.18528/GII150026","url":null,"abstract":"This review article presents the radiological options for management of malignant gastric outflow obstruction distal to the pylorus. We place these options in context with surgical and endoscopic alternatives and recommend their use, particularly in those institutions where endoscopic alternatives may not be readily available.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2016-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68271753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Malignant gastroduodenal obstruction: An endoscopic approach 恶性胃十二指肠梗阻:内镜入路
Gastrointestinal Intervention Pub Date : 2016-07-31 DOI: 10.18528/GII160018
Fred Lee, Rehan Abdul-Halim, O. Dickinson, I. Maetani
{"title":"Malignant gastroduodenal obstruction: An endoscopic approach","authors":"Fred Lee, Rehan Abdul-Halim, O. Dickinson, I. Maetani","doi":"10.18528/GII160018","DOIUrl":"https://doi.org/10.18528/GII160018","url":null,"abstract":"Malignant gastric outlet obstruction describes a constellation of symptoms that can result as a common endpoint from a variety of primary tumours, particularly those of the upper gastrointestinal tract and pancreas. Affected patients face a dismal, undignified and rapid decline in health secondary to malnutrition, dehydration and constant nausea with associated vomiting. Palliative treatment has traditionally involved a gastrojejunostomy—a major undertaking given the functional status of these patients. More recent advances in the endoscopic placement of metal stents to relieve obstruction have clear benefits over the surgical method. We look at the factors involved in patient selection, the techniques and considerations involved in stent deployment and the potential complications associated with this method. Copyright © 2016, Society of Gastrointestinal Intervention. All rights reserved.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"105-110"},"PeriodicalIF":0.0,"publicationDate":"2016-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68272454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The challenges: Stent materials from the perspective of the manufacturer 挑战:从制造商的角度来看支架材料
Gastrointestinal Intervention Pub Date : 2016-07-31 DOI: 10.18528/GII160008
K. Volenec, I. Pohl
{"title":"The challenges: Stent materials from the perspective of the manufacturer","authors":"K. Volenec, I. Pohl","doi":"10.18528/GII160008","DOIUrl":"https://doi.org/10.18528/GII160008","url":null,"abstract":"The article presents an overview of the basic data influencing the choice of materials for the manufacture of self-expanding metallic stents to be implanted into gastrointestinal tract, particularly esophageal stents. The data are evaluated primarily in terms of the manufacturer of stents. The text emphasizes not only the importance of the materials themselves, but also the biological environment in which the stent is used. Brief history of materials used in gastrointestinal stents mentions stainless steel, cobalt-chromium and nickel titanium alloys and polymers (polyester and polydioxa-none). The text describes the properties of metal materials (composition, corrosion, mechanical properties) with particular focus on nickel-titanium alloy—nitinol. It lists advantages and disadvantages of nitinol. At the end of the review the authors briefly present their opinion on future materials of gastrointestinal stents and their covering.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"98-104"},"PeriodicalIF":0.0,"publicationDate":"2016-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68272657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Endoscopic approaches to afferent and Roux-en-Y limb obstruction 内镜入路治疗传入和Roux-en-Y肢体梗阻
Gastrointestinal Intervention Pub Date : 2016-07-31 DOI: 10.18528/GII150017
R. Kozarek
{"title":"Endoscopic approaches to afferent and Roux-en-Y limb obstruction","authors":"R. Kozarek","doi":"10.18528/GII150017","DOIUrl":"https://doi.org/10.18528/GII150017","url":null,"abstract":"Afferent limb syndrome can be seen following Billroth II gastric resection, Whipple procedure with duodenojejunostomy, or in association with an obstructed Roux-en-Y limb following hepaticojejunostomy. This syndrome classically presents with jaundice or cholangitis but may also be associated with abdominal pain alone or pancreatitis, especially in patients with surgically created pancreaticojejunostomies. Obstructions may be a consequence of benign or malignant disorders. Historically treated with surgery or percutaneous transhepatic biliary drainage, this review describes currently applied and evolving endoscopic techniques to include balloon dilation, double pigtail plastic stent placement, and insertion of self-expandable metal stents or lumen-apposing stents. Copyright © 2016, Society of Gastrointestinal Intervention. All rights reserved.","PeriodicalId":32516,"journal":{"name":"Gastrointestinal Intervention","volume":"5 1","pages":"124-128"},"PeriodicalIF":0.0,"publicationDate":"2016-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68271502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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