The Gastroenterologist最新文献_第5页

Endoscopic management of pancreatic pseudocysts. 胰腺假性囊肿的内镜治疗。

The Gastroenterologist Pub Date : 1997-03-01

S K Lo, A Rowe

{"title":"Endoscopic management of pancreatic pseudocysts.","authors":"S K Lo, A Rowe","doi":"","DOIUrl":"","url":null,"abstract":"Pancreatic pseudocyst is a major complication of acute and chronic pancreatitis. Surgical drainage, the mainstay of therapy for this condition, is associated with 5% mortality, 25% morbidity, and 10% recurrence rates. Efforts to improve these figures and reduce the typically long hospitalizations have brought about percutaneous and endoscopic drainages. This article describes the endoscopic techniques and attempts to summarize their results based on a literature review. Before endoscopic drainage is carried out, other cystic lesions must be excluded with clinical history, computed tomography findings, and perhaps cyst fluid CEA content and cytology. Endoscopic techniques include wide transmural incision, transmural puncture and stenting, and transpapillary stenting. Either transgastric or transduodenal drainages can be carried out depending on the proximity of the pseudocyst to the gastrointestinal lumen. Endosonography has become an integral part of the transmural procedure because it can help diagnose cystic neoplasms, localize pseudocysts, detect submucosal vessels, and measure the cyst to mucosal distance for transmural punctures. Temporary nasocystic drains are often used to complement stenting during the initial treatment phase. Overall, the endoscopic experience in expert hands is associated with 94% initial technical success, 90% cyst resolution, and 16% recurrence rates. Additional nonendoscopic interventions, mostly surgical, are necessary in 17% of patients. Complication rate is 20%, with < 1% mortality. These data suggest that endoscopic drainage should become an accepted modality in the treatment of pseudocysts. Because of significant technical difficulty and potential risks, endoscopic drainages should only be carried out by experienced endoscopists and at well-equipped facilities.","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"5 1","pages":"10-25"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20029537","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

Therapeutic modalities for treatment of peptic ulcer bleeding. 消化性溃疡出血的治疗方法。

The Gastroenterologist Pub Date : 1997-03-01

J G Lee, J W Leung

引用次数: 0

Jejunoileal diverticula. Jejunoileal憩室。

The Gastroenterologist Pub Date : 1997-03-01

D C Chow, M Babaian, H L Taubin

引用次数: 0

Gastric volvulus: an old disease process with some new twists. 胃扭转:一种有新变化的古老疾病。

The Gastroenterologist Pub Date : 1997-03-01

D C Schaefer, P Nikoomenesh, C Moore

引用次数: 0

Laparoscopic Nissen fundoplication for severe gastroesophageal reflux disease: pros and cons. 腹腔镜尼森底术治疗严重胃食管反流病:利弊。

The Gastroenterologist Pub Date : 1997-03-01

E J DeMaria, M Siuta, J Widmeyer, A M Zfass

{"title":"Laparoscopic Nissen fundoplication for severe gastroesophageal reflux disease: pros and cons.","authors":"E J DeMaria, M Siuta, J Widmeyer, A M Zfass","doi":"","DOIUrl":"","url":null,"abstract":"The advent of the laparoscopic approach to Nissen fundoplication has led to a resurgence in enthusiasm for the surgical treatment of gastroesophageal reflux disease (GERD). However, controversy exists as to which subgroups of GERD patients are best treated surgically. The relative success of treatment with medical and surgical intervention in terms of both symptom control and objective resolution of esophageal injury must be weighed against the relative costs of each therapeutic strategy in both the short and long term, given that GERD tends to be a lifelong disorder. The following is the transcribed text of a debate held at the Medical College of Virginia as part of a continuing medical education program in which the statement \"Laparoscopic antireflux surgery is superior to medical treatment for severe gastroesophageal reflux disease\" was contested. Representatives from the departments of surgery and gastroenterology provided arguments supporting their respective sides of this issue. The purpose was not to promote polarization in treatment selection, but to review the available data in a forum that could promote development of a rational algorithm for clinical decision-making in patients with GERD who might benefit from antireflux surgery. Final comments from the authors are provided in an attempt to synthesize the arguments into a reasonable strategy for individual case management.","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"5 1","pages":"85-93"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20029470","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

Postsurgical biliary tract complications. 术后胆道并发症。

The Gastroenterologist Pub Date : 1997-03-01

G G Ghahremani

{"title":"Postsurgical biliary tract complications.","authors":"G G Ghahremani","doi":"","DOIUrl":"","url":null,"abstract":"Cholecystectomy and other biliary tract operations are being performed with an increasing frequency due to the prevalence of gallstones and pancreaticobiliary disorders among the aging population of the United States. Even in the current era of modern medicine, however, a wide spectrum of postsurgical biliary complications are encountered. Most are the result of preventable iatrogenic trauma or technical mishaps that occur with a much higher incidence during laparoscopic cholecystectomy than the conventional open procedure. These include bile leakage from an overlooked transection of normal or aberrant bile ducts, obstructive jaundice due to inadvertent ligation of the common duct or its postsurgical stricture, instrumentation injuries induced during biliary tract exploration, and the various types of biliary fistulas. These lesions are detectable by intraoperative or T-tube cholangiography, if the examination is performed and interpreted correctly. In most instances, however, the postoperative evaluation of the abdomen by computed tomography or ultrasonography will provide the initial clues to an otherwise unsuspected lesion. Radiologic imaging and interventional techniques play a crucial role in the diagnosis and management of postsurgical biliary tract complications, as illustrated in this review article.","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"5 1","pages":"46-57"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20029541","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

Detection of chronic liver disease: costs and benefits. 慢性肝病的检测:成本和收益。

The Gastroenterologist Pub Date : 1997-03-01

P G Quinn, D E Johnston

引用次数: 0

Endoscopic ultrasound. 内窥镜超声检查。

The Gastroenterologist Pub Date : 1997-01-01 DOI: 10.1016/b978-1-4160-3256-4.50025-9

W. Wassef, A. Zfass

引用次数: 0

Diagnosis and management of peptic esophageal strictures. 消化性食管狭窄的诊断与治疗。

The Gastroenterologist Pub Date : 1996-12-01

R D Marks, M Shukla