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IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/S1521-6918(24)00043-X

引用次数: 0

Prevention of delayed bleeding after resection of large colonic polyps 预防大结肠息肉切除术后延迟出血

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101907

Hein Htet, Gaius Longcroft-Wheaton

引用次数: 0

Management of ERCP complications ERCP并发症的处理

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101897

Partha Pal , Mohan Ramchandani

{"title":"Management of ERCP complications","authors":"Partha Pal , Mohan Ramchandani","doi":"10.1016/j.bpg.2024.101897","DOIUrl":"10.1016/j.bpg.2024.101897","url":null,"abstract":"<div><p>Managing complications of ERCP poses a significant clinical challenge to endoscopists. ERCP complications can occur even after all preventive measures, which can lead to significant morbidity and even mortality. Major complications include pancreatitis, bleeding, perforation, cholangitis, and sedation-related adverse events. Early recognition of post-ERCP pancreatitis (PEP) is feasible by monitoring clinical parameters and specific cutoffs of serum amylase and lipase at 2–6 h post-ERCP. Pancreatic stenting for PEP is not recommended and can increase the incidence of infected necrosis in addition to being technically challenging. Post-sphincterotomy bleeds can be treated by diluted epinephrine with or without thermal therapy, or mechanical therapy (clips or fully covered metallic stents) failing which angiographic embolization and rarely open surgical vessel ligation may be warranted. Post-ERCP perforations can lead to significant morbidity and are usually treated with endoscopic closure of the defect, diverting bile flow, draining collections, and reducing fluid load at the site of perforation failing which surgery may be warranted. Broad-spectrum antibiotics with endoscopic or radiologic drainage of undrained segments help treat post-ERCP cholangitis. Hypoxia and hypertension are the most common sedation-related adverse events without long-term consequences except aspiration pneumonia (<0.5%). Awareness with a high index of suspicion is crucial for timely diagnosis and management of uncommon post-ERCP complications.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140010203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 endoscopic management of oesophageal strictures 食道狭窄的内窥镜治疗

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101899

Benjamin Charles Norton , Apostolis Papaefthymiou , Nasar Aslam , Andrea Telese , Charles Murray , Alberto Murino , Gavin Johnson , Rehan Haidry

{"title":"The endoscopic management of oesophageal strictures","authors":"Benjamin Charles Norton , Apostolis Papaefthymiou , Nasar Aslam , Andrea Telese , Charles Murray , Alberto Murino , Gavin Johnson , Rehan Haidry","doi":"10.1016/j.bpg.2024.101899","DOIUrl":"10.1016/j.bpg.2024.101899","url":null,"abstract":"<div><p>An oesophageal stricture refers to a narrowing of the oesophageal lumen, which may be benign or malignant. The cardinal feature is dysphagia, and this may result from intrinsic oesophageal disease or extrinsic compression. Oesophageal strictures can be further classified as simple or complex depending on stricture length, location, diameter, and underlying aetiology. Many endoscopic options are now available for treating oesophageal strictures including dilatation, injectional therapy, stenting, stricturotomy, and ablation. Self-expanding metal stents have revolutionised the palliation of malignant dysphagia, but oesophageal dilatation with balloon or bougienage remains first-line therapy for most benign strictures. The increase in endoscopic and surgical interventions on the oesophagus has seen more benign refractory oesophageal strictures that are difficult to treat, and often require advanced endoscopic techniques. In this review, we provide a practical overview on the evidence-based management of both benign and malignant oesophageal strictures, including a practical algorithm for managing benign refractory strictures.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140010199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Complications and management of interventional endoscopic ultrasound: A critical review 介入性内窥镜超声的并发症和处理：重要综述

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101888

Carlo Fabbri , Davide Scalvini , Giuffrida Paolo , Cecilia Binda , Aurelio Mauro , Chiara Coluccio , Stefano Mazza , Margherita Trebbi , Francesca Torello Viera , Andrea Anderloni

{"title":"Complications and management of interventional endoscopic ultrasound: A critical review","authors":"Carlo Fabbri , Davide Scalvini , Giuffrida Paolo , Cecilia Binda , Aurelio Mauro , Chiara Coluccio , Stefano Mazza , Margherita Trebbi , Francesca Torello Viera , Andrea Anderloni","doi":"10.1016/j.bpg.2024.101888","DOIUrl":"10.1016/j.bpg.2024.101888","url":null,"abstract":"<div><p>In the last decades, Endoscopic ultrasound (EUS) has rapidly grown and evolved from being mainly a diagnostic procedure, to being an interventional and therapeutic tool in several pathological clinical scenarios. With the progressive growth in technical expertise and dedicated devices, interventional endoscopic ultrasound procedures (IEUSP) have shown high rates of technical and clinical success, together with a relatively safe profile. However, the description and the standardization of different and specific types of adverse events (AEs) are still scarce in literature, and, consequently, even less the management of AEs. The aim of this study is to critical review and to describe AEs related to each of the main IEUSP, and to provide an overview on the possible management strategies of endoscopic complications. Future studies and guidelines are surely required to reach a better standardization of different AEs and their best management.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139668922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Prevention of post-ERCP complications 预防ERCP术后并发症

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101906

Lotfi Triki , Andrea Tringali , Marianna Arvanitakis , Tommaso Schepis

引用次数: 0

Endoscopic management of intraprocedural bleeding during endoscopic interventions 内窥镜介入治疗过程中的术中出血内窥镜处理方法

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101912

Ali A. Alali , Asma A. Alkandari

{"title":"Endoscopic management of intraprocedural bleeding during endoscopic interventions","authors":"Ali A. Alali , Asma A. Alkandari","doi":"10.1016/j.bpg.2024.101912","DOIUrl":"10.1016/j.bpg.2024.101912","url":null,"abstract":"<div><p>Endoscopic resection techniques have evolved over time, allowing effective and safe resection of the majority of pre-malignant and early cancerous lesions in the gastrointestinal tract. Bleeding is one of the most commonly encountered complications during endoscopic resection, which can interfere with the procedure and result in serious adverse events. Intraprocedural bleeding is relatively common during endoscopic resection and, in most cases, is a mild and self-limiting event. However, it can interfere with the completion of the resection and may result in negative patient-related outcomes in severe cases, including the need for hospitalization and blood transfusion as well as the requirement for radiological or surgical interventions. Appropriate management of intraprocedural bleeding can improve the safety and efficacy of endoscopic resection, and it can be readily achieved with the use of several endoscopic hemostatic tools. In this review, we discuss the recent advances in the approach to intraprocedural bleeding complicating endoscopic resection, with a focus on the various endoscopic hemostatic tools available to manage such events safely and effectively.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 contribution of EUS to the management of endoscopic and surgical complications EUS 对治疗内镜和手术并发症的贡献

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101914

N. Tehami, K. Kaushal, B. Maher

{"title":"The contribution of EUS to the management of endoscopic and surgical complications","authors":"N. Tehami, K. Kaushal, B. Maher","doi":"10.1016/j.bpg.2024.101914","DOIUrl":"10.1016/j.bpg.2024.101914","url":null,"abstract":"<div><p>Endoscopic Ultrasound (EUS) stands as a remarkable innovation in the realm of gastroenterology and its allied disciplines. EUS has evolved to such an extent that it now assumes a pivotal role in both diagnosis and therapeutics. In addition, it has developed as a tool which is also capable of addressing complications arising from endoscopic and surgical procedures. This minimally invasive technique combines endoscopy with high-frequency ultrasound, facilitating, high-resolution images of the gastrointestinal tract and adjacent structures.</p><p>Complications within the gastrointestinal tract, whether stemming from endoscopic or surgical procedures, frequently arise due to disruption in the integrity of the gastrointestinal tract wall. While these complications are usually promptly detected, there are instances where their onset is delayed. EUS plays a dual role in the management of these complications. Firstly, in its ability to assess and increasingly to definitively manage complications through drainage procedures.</p><p>It is increasingly employed to manage post-surgical collections, abscesses biliary strictures and bleeding. Its high-resolution imaging capability allows precise real-time visualisation of these complications.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 management of surgical complications 手术并发症的内窥镜治疗

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101898

Mayank Goyal , Anmol Bains , Yadwinder Singh , Fnu Deepali , Anmol Singh , Shubham Sood , Navtej S. Buttar

引用次数: 0

Management of non-curative endoscopic resection of T1 colon cancer T1 结肠癌非根治性内窥镜切除术的处理方法

IF 3.2 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101891

Linn Bernklev , Jens Aksel Nilsen , Knut Magne Augestad , Øyvind Holme , Nastazja Dagny Pilonis

{"title":"Management of non-curative endoscopic resection of T1 colon cancer","authors":"Linn Bernklev , Jens Aksel Nilsen , Knut Magne Augestad , Øyvind Holme , Nastazja Dagny Pilonis","doi":"10.1016/j.bpg.2024.101891","DOIUrl":"10.1016/j.bpg.2024.101891","url":null,"abstract":"<div><p>Endoscopic resection techniques enable en-bloc resection of T1 colon cancers. A complete removal of T1 colon cancer can be considered curative when histologic examination of the specimens shows none of the high-risk factors for lymph nodes metastases. Criteria predicting lymph nodes metastases include deep submucosal invasion, poor differentiation, lymphovascular invasion, and high-grade tumor budding. In these cases, complete (R0), local endoscopic resection is considered sufficient as negligible risk of lymph nodes metastases does not outweigh morbidity and mortality associated with surgical resection. Challenges arise when endoscopic resection is incomplete (RX/R1) or high-risk histological features are present. The risk of lymph node metastasis in T1 CRC ranges from 1% to 36.4%, depending on histologic risk factors. Presence of any risk factor labels the patient “high risk,” warranting oncologic surgery with mesocolic lymphadenectomy. However, even if 70%–80% of T1-CRC patients are classified as high-risk, more than 90% are without lymph node involvement after oncological surgery. Surgical overtreatment in T1 CRC is a challenge, requiring a balance between oncologic safety and minimizing morbidity/mortality. This narrative review explores the landscape of managing non-curative T1 colon cancer, focusing on the choice between advanced endoscopic resection techniques and surgical interventions. We discuss surveillance strategies and shared decision-making, emphasizing the importance of a multidisciplinary approach.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521691824000106/pdfft?md5=c94d8b61155331408a5a5f9e20d2c4bd&pid=1-s2.0-S1521691824000106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139954125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0