Digestive disease interventions最新文献

{"title":"Management of Unresectable Cholangiocarcinoma Using Modern Radiation Therapy Techniques","authors":"Deniz Demircioglu, Lou-Anne Acevedo Moreno, William A. Hall","doi":"10.1055/s-0044-1788557","DOIUrl":"https://doi.org/10.1055/s-0044-1788557","url":null,"abstract":"Cholangiocarcinoma (CCA) is a malignancy of epithelial cells in the bile duct, categorized based on its anatomical location as intrahepatic, perihilar, or extrahepatic. It has a low prevalence of ∼1.6 cases per 100,000 people in the United States, but has a poor prognosis. All stages included, CCA has a 5-year survival rate of less than 10%. The preferred curative treatment for intrahepatic, perihilar, and extrahepatic CCA is surgical resection combined with systemic chemotherapy. However, resection is not always a viable option for many patients, as the disease is often discovered at the time of diagnosis to be either metastatic or locally advanced precluding surgical resection. In this setting, a variety of options can be used, one of which is radiation therapy (RT). The administration of RT has evolved tremendously over the past decades. Total doses given can be limited by a tumor's proximity to regional normal organs such as the liver, stomach, bile duct, and small and large bowel. When a CCA is unresectable, it is often in close proximity to radiosensitive organs. Delivering RT in this setting therefore requires precise delivery techniques. An emerging technique known broadly as stereotactic body radiation therapy (SBRT) or stereotactic ablative body radiation therapy gives a highly focused, often ablative, form of RT to a defined and specific target. Categorically, SBRT offers a quick and efficient management option, in some cases only one to three total treatments. This narrative reviews various applications of SBRT for cholangiocarcinoma including SBRT alone, SBRT with chemotherapy, SBRT with chemotherapy followed by a liver transplantation (orthotopic liver transplantation), and finally novel combinations of SBRT with immunotherapy.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":" 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830037","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":"Developing an Interventional Radiology Service","authors":"Luan D. Nguyen","doi":"10.1055/s-0044-1787097","DOIUrl":"https://doi.org/10.1055/s-0044-1787097","url":null,"abstract":"Interventional radiology (IR) is a rapidly developing field among medical activities. This review summarizes the history of IR since the inception of angiography, the present situation regarding IR's position in the clinical setting, and proposal of standardized education and further cooperation in the field. This review also focuses on sharing the author's experience in establishing an extensive IR service line, and how this will become the standard model for the Vietnamese Society of Interventional Radiology.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"4 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646165","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":"Plug-Assisted Retrograde Transvenous Obliteration: A Modified Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices","authors":"Dong Il Gwon, Hyun-Ki Yoon","doi":"10.1055/s-0044-1786794","DOIUrl":"https://doi.org/10.1055/s-0044-1786794","url":null,"abstract":"Gastric varices (GVs) and hepatic encephalopathy (HE) are major complications of portal hypertension in patients with liver cirrhosis. As most of the GVs drain into the left renal vein via a portosystemic shunt, the concept of retrograde treatment approach such as balloon-occluded retrograde transvenous obliteration using sclerosing agents has been introduced. Recently, plug-assisted retrograde transvenous obliteration (PARTO) has been alternatively performed, which uses vascular plug and gelfoam. PARTO utilizes a permanent vascular plug to reduce postprocedural monitoring time as well as to avoid the risk of balloon rupture–related complications. It also eliminates the sclerosing agents–related complications with the use of gelfoam as an embolics. In this review, we introduce technical aspects of PARTO and outline its potential for use as the treatment of GVs and HE.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"24 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141645832","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":"Role of Interventional Radiology in the Management of Liver Transplant Complications in Children","authors":"Ritu Shah, Pareena Sharma, Darshan Variyam, Michael Leshen, Fredric J. Bertino, Vaz Zavaletta, Jay Shah","doi":"10.1055/s-0044-1785200","DOIUrl":"https://doi.org/10.1055/s-0044-1785200","url":null,"abstract":"Liver transplantation (LT) is a common solid organ transplant in the pediatric population. The common indications for LT, as well as its complications, differ between adults and children. This difference necessitates unique pediatric interventional radiology (IR) interventions. This article focuses on unique vascular complications occurring post-pediatric LT and highlights the importance of IR in their management. It explores IR's involvement in the workup of patients' pre-LT and management of complications following portosystemic shunts. We discuss advantages and disadvantages of different access routes as well as the prevalence, clinical picture, diagnosis, and management of complications after pediatric LT. These complications encompass portal vein stenosis, portal vein thrombosis, hepatic artery stenosis, hepatic artery thrombosis, hepatic artery pseudoaneurysm, arterioportal fistula, hepatic vein stenosis, and inferior vena cava stenosis. The choice of endovascular technique for a clinical indication depends on vascular anatomy, time since LT, and patient-specific factors. Transsplenic access is a useful alternative to transhepatic or transjugular access. The decision to place a stent in a child is influenced by the expected growth of the child and risk of focal narrowing at stent edge (because of recipient growth). Technical challenges in pediatric patient management, including uncooperative patients and sedation issues, must be considered. Pediatric LT complications can present with significant challenges in the posttransplant care of recipients and may lead to serious morbidity and graft failure if not managed effectively. IR techniques like balloon angioplasty, stent placement, thrombolysis, and embolization have demonstrated success in treating these complications, improving patient outcomes, and reducing long-term morbidity and mortality. By enhancing the understanding of medical practitioners and interventional radiologists about complex vascular complications, this article aims to contribute to better posttransplant care and improved outcomes for LT in pediatric populations. Continued collaboration between specialties and research will advance the field of pediatric LT and IR, to create even more effective treatment strategies.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"2 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099065","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":"Pediatric Liver Interventions","authors":"Sameer Gadani, Gerd Grözinger","doi":"10.1055/s-0044-1785477","DOIUrl":"https://doi.org/10.1055/s-0044-1785477","url":null,"abstract":"","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"74 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101617","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":"Advances in Immunooncology and Precision Medicine in Cholangiocarcinoma","authors":"Timothy J. Brown, T. Karasic","doi":"10.1055/s-0044-1787013","DOIUrl":"https://doi.org/10.1055/s-0044-1787013","url":null,"abstract":"Cholangiocarcinoma (CCA) is an uncommon but morbid cancer arising from the intrahepatic or extrahepatic bile ducts. CCA is frequently asymptomatic at early stages and is often unresectable or metastatic at the time of initial diagnosis. While chemotherapy remains the mainstay of treatment for most patients with advanced disease, the addition of immunotherapy to frontline treatment has improved survival and provided an alternative to perpetual chemotherapy. Furthermore, a variety of targeted therapies have demonstrated benefit in patients with specific biomarkers including FGFR2 fusions, IDH1 mutations, HER2 overexpression, and tumor agnostic markers such as NTRK and RET fusions, among others. This review will summarize the established roles of immunotherapy, targeted therapies, and their combinations in CCA as well as treatment strategies that are under development with potential to impact clinical practice in the coming years.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"35 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140975822","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":"Placing Plastic Stent via Percutaneous Transhepatic Biliary Drainage following Failure of Endoscopic Retrograde Cholangiopancreatography: Review of Case Series","authors":"Antonius Gunawan Santoso, Nurdopo Baskoro, Novia Nathania Beatrice, Tanya Edwina, Bernadus Parish Budiono","doi":"10.1055/s-0044-1786696","DOIUrl":"https://doi.org/10.1055/s-0044-1786696","url":null,"abstract":"The aim of this study is to describe the technical procedure, patency, and complications of percutaneous biliary plastic stent insertion following failure of the endoscopic approach. The data from 11 patients who underwent percutaneous plastic biliary stent placement following endoscopic approach failure between March 2022 and December 2023 were retrospectively evaluated. Stent placement was successful in all patients. Reduction of the total serum bilirubin level was achieved in all patients. No major complications occurred in all patients. A plastic stent provided enough drainage for patients with patency in our studies for up to 5 months.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141025953","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":"Lymphatic Interventional Radiology for Postoperative Lymphatic Leakage","authors":"Yozo Sato, Kiyoshi Matsueda, Yoshitaka Inaba, Satoshi Tsuchiya, Masayoshi Yamamoto, Tetsuya Abe","doi":"10.1055/s-0044-1786040","DOIUrl":"https://doi.org/10.1055/s-0044-1786040","url":null,"abstract":"Lymphatic leakage is a relatively rare complication following various surgical procedures. Occasionally, conservative treatments fail to control postoperative lymphatic leakage. Refractory lymphatic leakage causes severe morbidities, including malnutrition, immunodeficiency, and impaired wound healing. Lymphangiography is a useful method for identifying various types of lymphatic leakage. Recently, lipiodol lymphangiography has been popular for its potential therapeutic effects on refractory lymphatic leakage, but this technique remains underdeveloped. This review discusses lymphatic interventional radiology for postoperative lymphatic leakage.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140688563","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":"Evaluation of Imaging-Guided Peritoneal Biopsy in Diagnosis of Ascites of Unknown Origin","authors":"Prof. Nadia Abdelaaty Abdelkader, Prof. Mohammed El-Naggar, Prof. Waheed Tantawy, Prof. Mohammad Amin Sakr, Prof. Eman Abdel-Salam Ibrahim, Mohammed Abo Zaid, Ahmad F. Sherief, Assoc. Prof. Ahmed S. Abdelmoaty","doi":"10.1055/s-0043-1772580","DOIUrl":"https://doi.org/10.1055/s-0043-1772580","url":null,"abstract":"Ascites is a common clinical problem, which can be a result of liver cirrhosis, neoplasm, tuberculous or pyogenic peritonitis, heart failure, nephrosis, and pancreatic disorders. This study aimed to evaluate the role of imaging-guided peritoneal biopsy in the diagnosis of ascites of unknown origin (ascites of local cause). Sixty-three patients with ascites of unknown etiology were included. Abdominal ultrasonography (US) with colored Duplex was performed, followed by laboratory investigations such as, ascitic fluid samples, magnetic resonance imaging, multislice computed tomography (CT), or PET/CT scan (if indicated). Imaging-guided peritoneal biopsy such as US-guided or CT-guided percutaneous peritoneal biopsy (in cases of failure of US-guided technique) of omentum or extravisceral masses was performed. Cytological and histopathological examinations of the tissue specimens were done by a single experienced pathologist. Other more invasive procedures (e.g., laparoscopy) were needed when the imaging-guided biopsy was not diagnostic. Fifty-four patients underwent US-guided biopsies, 48 patients were successfully diagnosed, and other 9 patients underwent CT-guided biopsies (not accessible by US-guided modality); laparoscopy was needed only in 6 patients. Malignant peritoneal pathology was found in 48 patients, while tuberculous peritonitis was diagnosed in 14 patients. Imaging-guided biopsies had perfect sensitivity (100%) and negative predictive value (100%) in differentiating neoplastic lesions. Percutaneous imaging-guided biopsy (US/CT guided) of the peritoneum, omenta, and mesentery has been established as a safe, simple, noninvasive, and well-tolerated procedure with high diagnostic accuracy. It can minimize further unnecessary invasive procedures such as laparoscopy.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"73 S326","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694792","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":"DDI Meets Latin America","authors":"M. B. Bayona Molano, G. Salazar","doi":"10.1055/s-0043-1774336","DOIUrl":"https://doi.org/10.1055/s-0043-1774336","url":null,"abstract":"","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140413203","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}