Journal of interventional gastroenterology最新文献

{"title":"Removal of infused water predominantly during insertion (water exchange) is consistently associated with a greater reduction of pain score - review of randomized controlled trials (RCTs) of water method colonoscopy.","authors":"Fw Leung,&nbsp;Jo Harker,&nbsp;Jw Leung,&nbsp;Rm Siao-Salera,&nbsp;Sk Mann,&nbsp;Fc Ramirez,&nbsp;S Friedland,&nbsp;A Amato,&nbsp;F Radaelli,&nbsp;S Paggi,&nbsp;V Terruzzi,&nbsp;Yh Hsieh","doi":"10.4161/jig.1.3.18510","DOIUrl":"https://doi.org/10.4161/jig.1.3.18510","url":null,"abstract":"<p><p>INTRODUCTION: Variation in the outcomes in RcTs comparing water-related methods and air insufflation during the insertion phase of colonoscopy raises challenging questions regarding the approach. This report reviews the impact of water exchange on the variation in attenuation of pain during colonoscopy by water-related methods. METHODS: Medline (2008 to 2011) searches, abstracts of the 2011 Digestive Disease Week (DDW) and personal communications were considered to identify RcTs that compared water-related methods and air insufflation to aid insertion of the colonoscope. Results: Since 2008 nine published and one submitted RcTs and five abstracts of RcTs presented at the 2011 DDW have been identified. Thirteen RcTs (nine published, one submitted and one abstract, n=1850) described reduction of pain score during or after colonoscopy (eleven reported statistical significance); the remaining reports described lower doses of medication used, or lower proportion of patients experiencing severe pain in colonoscopy performed with water-related methods compared with air insufflation (Tables 1 and 2). The water-related methods notably differ in the timing of removal of the infused water - predominantly during insertion (water exchange) versus predominantly during withdrawal (water immersion). Use of water exchange was consistently associated with a greater attenuation of pain score in patients who did not receive full sedation (Table 3). CONCLUSION: The comparative data reveal that a greater attenuation of pain was associated with water exchange than water immersion during insertion. The intriguing results should be subjected to further evaluation by additional RcTs to elucidate the mechanism of the pain-alleviating impact of the water method.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"114-120"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234695/pdf/jig0103_0114.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A head-to-head comparison of the water vs. air method in patients undergoing screening colonoscopy.","authors":"Francisco C Ramirez,&nbsp;Felix W Leung","doi":"10.4161/jig.1.3.18512","DOIUrl":"https://doi.org/10.4161/jig.1.3.18512","url":null,"abstract":"<p><p>BACKGROUND: The water method facilitates colonoscope insertion in unsedated patients. OBJECTIVE: To compare quality indicators in sedated veterans. DESIGN: Performance improvement. SETTING: VA endoscopy unit. PATIENTS: 368 consecutive screening patients. INTERVENTION: Air or water method assignment (high definition colonoscope) was based on the last digit of social security number. MEASUREMENTS: Adenoma detection rate (ADR), cecal intubation rate; intubation and withdrawal times; sedation requirements and external pressure used. RESULTS: ADR was higher with the water method (57.1% vs. 46.1%, p=0.04). After controlling for age, body mass index, smoking, alcohol, withdrawal time and quality of bowel preparation, the odds of detecting an adenoma was 81% higher with the water method (OR 1.81; 95% cI: 1.12-2.90). In the proximal colon ADR was higher with the water method (45.8% vs. 34.6%, p=0.03), including adenomas <10 mm in size (41.8% vs. 31.4%, p=0.04). The water method showed significantly longer cecal intubation time (6.9±0.3 vs. 5.3±0.3 min, p=0.0001); less external pressure used (11.9% vs. 28.3%, p=0.0001); lower need for additional sedation (17.5% vs. 27.2%, p<0.03). LIMITATIONS: Predominance of males, single unblinded endoscopist with high ADR. CONCLUSIONS: The water method is an independent factor associated with significantly higher ADR. Replication by blinded colonoscopist(s) is indicated.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"130-135"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234698/pdf/jig0103_0130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning and teaching the water method (with videos).","authors":"Shai Friedland,&nbsp;Felix W Leung","doi":"10.4161/jig.1.3.18511","DOIUrl":"https://doi.org/10.4161/jig.1.3.18511","url":null,"abstract":"<p><p>The water method is an insertion technique for colonoscopy which has recently become popular owing to its demonstrated ability to decrease patient pain and sedation requirements. This review focuses on learning and teaching the water method. Data from the United States and Asia suggests that trainees at all levels of experience can safely learn and utilize the water method. Demonstrated benefits in some of the reviewed studies include lessened sedation requirements, less pain for patients and increased cecal intubation rates in minimally sedated patients. These benefits are realized without compromising safety, adenoma detection rates, or procedure times.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"127-129"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234697/pdf/jig0103_0127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confocal endomicroscopy (CEM) improves efficiency of Barrett surveillance.","authors":"V. Nguyen, C. Nguyen, G. de Petris, V. Sharma, Ananya Das","doi":"10.1016/S0016-5085(11)63148-X","DOIUrl":"https://doi.org/10.1016/S0016-5085(11)63148-X","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 2 1","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0016-5085(11)63148-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55760763","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}

{"title":"Per-oral cholangioscopy.","authors":"Amitabh Monga,&nbsp;Mohan Ramchandani,&nbsp;D Nageshwar Reddy","doi":"10.4161/jig.1.2.15352","DOIUrl":"https://doi.org/10.4161/jig.1.2.15352","url":null,"abstract":"<p><p>Direct endoscopic views of bile duct have been described in literature since the 1970s. Since then rapid strides have been made with the advent of technologically advanced systems with better image quality and maneuverability. The single operator semi-disposable per-oral cholangioscope and other novel methods such as the cholangioscopy access balloon are likely to revolutionize this field. Even though cholangioscopy is currently used primarily for characterization of indeterminate strictures and management of large bile duct stones, the diagnostic and therapeutic indications are likely to expand in future. The following is an overview of the currently available per-oral cholangioscopy equipments, indications for use and future directions.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 2","pages":"70-77"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4161/jig.1.2.15352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29876971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary team meeting before therapeutic ERCP: A prospective study with 1,909 cases.","authors":"Zhuan Liao,&nbsp;Liang-Hao Hu,&nbsp;Zhao-Shen Li,&nbsp;Chang-Jing Zuo,&nbsp;Li Wang,&nbsp;Gang Jin,&nbsp;Duo-Wu Zou,&nbsp;Zhen-Dong Jin,&nbsp;Shu-De Li,&nbsp;Feng Liu,&nbsp;Jie Chen,&nbsp;Xian-Bao Zhan,&nbsp;Jin-Hua Yuan,&nbsp;Luo-Wei Wang,&nbsp;Dong Wang","doi":"10.4161/jig.1.2.15047","DOIUrl":"https://doi.org/10.4161/jig.1.2.15047","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of multidisciplinary team meeting (MDTM) on the success rate and complications of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for hepato-pancreato-biliary diseases.</p><p><strong>Methods: </strong>All patients undergoing their first therapeutic ERCP over a 21-month period of time in a tertiary care medical center were included. Generally, patients scheduled for ERCP on Friday, Saturday, Sunday, and Monday were subject to MDTM group, and those on Tuesday, Wednesday, and Thursday were allocated to the control group. For each MDTM case, an MDTM was held on the Tuesday prior to the scheduled ERCP. At the meeting, the cases were discussed by a team consisting of chief physicians, radiologists, endoscopists, anesthetists, and surgeons, and a decision was made on the schedule of ERCP. For control cases, a clinical team of one chief physician and two attending physicians made the decision.</p><p><strong>Results: </strong>From April 2006 to December 2007, 912 and 997 ERCP procedures were allocated to the MDTM and control groups, respectively. There was no significant difference in the baseline characteristics and indications between the two groups. Although the success rates were not significantly different between MDTM and control groups (82.9% vs. 84.8%, P=0.321), MDTM was significantly associated with a decreased overall complication rate of (6.9% vs. 12.0%, p<0.001) and severe complication rate (0.4% vs. 2.5%, p=0.035).</p><p><strong>Conclusions: </strong>Pre-ERCP MDTM decreases the frequency and severity of ERCP-related complications, with similar success rate, compared to routine practice.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 2","pages":"64-69"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136856/pdf/jig0102_0064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29876974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of PEG: How it was.","authors":"Jeffrey L Ponsky","doi":"10.4161/jig.1.2.16831","DOIUrl":"https://doi.org/10.4161/jig.1.2.16831","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 2","pages":"88-89"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136860/pdf/jig0102_0088.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29876975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal of proximally migrated pancreatic stent using needle knife and capture forceps (with video).","authors":"Hiroyuki Matsubayashi,&nbsp;Shohei Ooka,&nbsp;Hirokazu Kimura,&nbsp;Toshitatsu Takao,&nbsp;Yuichiro Yamaguchi,&nbsp;Hiroyuki Ono","doi":"10.4161/jig.1.2.16832","DOIUrl":"https://doi.org/10.4161/jig.1.2.16832","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 2","pages":"90-92"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136861/pdf/jig0102_0090.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29876976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects on confocal laser endomicroscopy image quality by different acriflavine concentrations.","authors":"Chang-Qing Li,&nbsp;Tao Yu,&nbsp;Xiu-Li Zuo,&nbsp;Xiang-Jun Xie,&nbsp;Wen-Bo Li,&nbsp;Chuan-Lian Chu,&nbsp;Fang Zuo,&nbsp;Yan-Qing Li","doi":"10.4161/jig.1.2.16828","DOIUrl":"https://doi.org/10.4161/jig.1.2.16828","url":null,"abstract":"<p><p>BACKGROUND: Acriflavine is one of the commonly used staining agents in confocal laser endomicroscopy (CLE), a newly developed technique allows for real time histological observation of gastrointestinal mucosa, but the concentration is not unified. This study aimed to evaluate the effects of acriflavine with different concentrations on the CLE image quality and to find a sound concentration in clinical practice. METHODS: Twenty four consecutive patients who underwent upper gastrointestinal CLE were enrolled into this study. The patients randomly accepted acriflavine in four different concentrations which were the conventional 0.05% and 3 lower ones respectively: 0.02%, 0.01% and 0.005% spraying onto the same focal antrum mucosa during CLE procedures. Differences of Image quality were demonstrated by an objective score system. RESULTS: THERE WAS NO SIGNIFICANT DIFFERENCE ABOUT IMAGE QUALITY AMONG ACRIFLAVINE CONCENTRATIONS: 0.05%, 0.02% and 0.01%, but 0.005% decreased image quality significantly (P=0.012). And 0.005% was also the only one which decreased general assessment significantly (P=0.01). For the 3 diagnostic value assessment indices, there was no significant difference about nonspecific and even staining, while 0.02% showed significant better polar staining (P=0.03). CONCLUSIONS: Acriflavine concentration 0.02% is the best one applied in CLE with the best nuclei staining ability and preserved image quality.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 2","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136855/pdf/jig0102_0059.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29876970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to the second issue.","authors":"Joseph W Leung","doi":"10.4161/jig.1.2.16825","DOIUrl":"https://doi.org/10.4161/jig.1.2.16825","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 2","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136852/pdf/jig0102_0047b.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29876966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}