Digestive disease interventions最新文献

{"title":"Portal Vein Embolization: Indications, Outcomes, and Complications","authors":"Chandler Fountain","doi":"10.1055/s-0043-1762566","DOIUrl":"https://doi.org/10.1055/s-0043-1762566","url":null,"abstract":"Abstract Portal vein embolization (PVE) is performed with the goal of causing hypertrophy of the future liver remnant (FLR) in patients prior to partial liver resections for either hepatocellular carcinoma or metastatic liver tumors. Since its earliest description in 1984, PVE has evolved technically and has proven to be a safe and effective means of causing predictable FLR hypertrophy. PVE allows patients who would have otherwise not been candidates to proceed with safe hepatic resection, particularly extended hepatic resections. Despite advances in equipment and techniques, complications do occur with PVE. This article discusses the indications, outcomes, and complications of PVE while providing historical perspective and technical insights.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"14 1","pages":"118 - 127"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89884789","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":"Iatrogenic Injuries Related to Thermal Ablation of the Liver and Pancreas","authors":"C. HonShideler, Liz Lin, Kelsey HonShideler, D. Guez, M. Bader","doi":"10.1055/s-0043-1763292","DOIUrl":"https://doi.org/10.1055/s-0043-1763292","url":null,"abstract":"Abstract Thermal ablation is a widely utilized treatment option for tumors of the liver and pancreas; procedures may be performed intraoperatively or percutaneously, under image guidance (more recently, endoscopy-guided ablation of pancreatic tumors has also been introduced). Through differing mechanisms, radiofrequency ablation, microwave ablation, and cryoablation aim to precisely eradicate tumor, with adequate margins and minimal injury to normal surrounding tissue. Knowledge of thermal ablative risks and complications is crucial for both therapeutic planning and postprocedural management to optimize outcomes and avoid significant patient injury. In this review, we discuss iatrogenic injuries related to thermal ablation of hepatic and pancreatic malignancies.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"22 1","pages":"103 - 109"},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75053428","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":"Transarterial Radioembolization for Hepatic Malignancies in North and South America","authors":"W. Kawakami, A. D. de Assis, E. Cohen, N. Frenk","doi":"10.1055/s-0043-1772164","DOIUrl":"https://doi.org/10.1055/s-0043-1772164","url":null,"abstract":"Abstract Transarterial radioembolization (TARE) with yttrium 90 is increasingly utilized for the treatment of hepatic neoplasms, whether primary (particularly hepatocellular carcinoma [HCC]) or metastatic (particularly colorectal). Extensive data and practical experience have led to a better understanding of its most appropriate usage and optimal techniques, particularly regarding dosimetry. Different clinical contexts and technical parameters allow its use with either palliative or curative intent. Improved patient outcomes have led to its inclusion in management guidelines of HCC and colorectal cancer. While available in multiple centers in the United States and Canada, its availability in South America is still very limited. The objective of this article is to review available treatment platforms, indications, techniques, recent advances, and clinical results, as well as briefly explore the disparities in availability throughout the United States.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"90 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90975866","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":"Nonvariceal Upper Gastrointestinal Hemorrhage: The Interventional Radiologist's Perspective","authors":"O. Rapalino, L. G. García, David Fernando Torres Cortes","doi":"10.1055/s-0043-1771314","DOIUrl":"https://doi.org/10.1055/s-0043-1771314","url":null,"abstract":"Abstract Nonvariceal upper gastrointestinal (GI) bleeding is one of the most common diseases of the GI tract and represents a high percentage of emergency room admissions. Eighty percent to 90% of upper GI bleeds are nonvariceal, with a mortality of 1 to 10% of patients. Selective embolization of the arterial source can be achieved with many therapeutic alternatives available in the interventional radiologist's arsenal, such as particles, coils, liquid emboli, selectively infused vasoconstrictor agents, or a combination of these techniques. Up to 95% of patients can obtain initial hemostasis without angiographic intervention. However, rebleeding is common, occurring in up to 50% of patients and persistent hemorrhage has been described in 7 to 30% of patients with mortality rates up to 14%.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77331248","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":"Inflammatory Bowel Disease and Colorectal Cancer","authors":"T. Glyn, A. Lightner","doi":"10.1055/s-0042-1760425","DOIUrl":"https://doi.org/10.1055/s-0042-1760425","url":null,"abstract":"Abstract The prevalence of inflammatory bowel disease (IBD) continues to rise with the increasing rates in the developing world and the improving longevity of IBD patients. A diagnosis of colonic IBD is associated with an increased risk of colorectal cancer (CRC) and this accounts for approximately 15% of the estimated mortality from IBD. CRC in IBD appears to be a pathologically distinct entity and progress is being made to understand the unique components of this process with a view to better predicting outcomes and potentially improving surveillance, treatments, and eventually modifying risk. In the interim, patients are entered into surveillance programs designed to identify at-risk patients early and improve outcomes. Dramatic evolution of technology in this area has changed the landscape of surveillance and dysplasia management over the last decade and promises to continue to do so. This review aims to provide a contemporary overview of IBD-associated CRC in terms of its epidemiology, pathogenesis, surveillance, and management.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"23 1","pages":"051 - 057"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90958300","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":"Complications of Transcatheter Arterial Chemoembolization for Treatment of Primary Liver Cancer","authors":"P. Novelli, Christopher Gustafson, P. Orons","doi":"10.1055/s-0043-1761632","DOIUrl":"https://doi.org/10.1055/s-0043-1761632","url":null,"abstract":"Abstract Transcatheter arterial chemoembolization (TACE) is the standard practice in treating both primary and metastatic liver neoplasms. TACE is a practical, minimally invasive procedure involving the delivery of chemotherapeutic agents into the artery supplying a tumor while simultaneously embolizing its blood supply. This approach can be used for curative and palliative intent across multiple cancer types. Historically, TACE has been instrumental in the treatment algorithms for hepatocellular carcinoma, allowing patients with unresectable disease to be downstaged and to slow disease progression, affording opportunities for transplantation and increased survival. Although benefits of TACE include lower morbidity and mortality versus systemic chemotherapy and surgical approaches, the procedure has risks and complications. Interventional radiologists and physicians involved in the care of these patients should be aware of the associated complications including avoidance and treatment strategies.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"1 1","pages":"128 - 137"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85396001","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":"Review of Percutaneous Transesophageal Gastrostomy: A Multi-Hospital Academic Institution's Case Series of 24 Patients","authors":"J. Frenkel, Steven Krausz, J. Cynamon, Y. Golowa, D. Hirschl","doi":"10.1055/s-0043-1771481","DOIUrl":"https://doi.org/10.1055/s-0043-1771481","url":null,"abstract":"Abstract Percutaneous transesophageal gastrostomy (PTEG) is a minimally invasive technique involving percutaneous placement of an enteral tube via an esophagostomy in patients for whom conventional gastrostomy is contraindicated. We present a series of 24 patients who received PTEG, discuss indications for the procedure, and review outcomes. A retrospective chart review of the EMR was performed for patients who received PTEG from March 2016 through October 2021. Twenty-four patients were identified, and their records were reviewed for placement indication, technical success, adverse events, feeding complications, and replacement. Twenty-four patients (aged 29–91) required gastric tube placement for either enteral feeding or palliative venting. Conventional gastrostomy was contraindicated for reasons including difficult anatomy (eight), gastric surgery (five), malignancy (four), ascites (four), and wounds/infections (three). Technical success rate for placement was 100%. Minor postprocedural complications included local cellulitis, significant tube clogging, and dislodgement. There was one major complication, a significant bleed through the catheter entry site, which was successfully treated with a carotid covered stent. PTEG is safe and effective and should be strongly considered for gastric drainage or provisional supplemental nutrition in patients for whom percutaneous gastrostomy is contraindicated or technically not feasible.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78706796","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":"Technical Considerations and Management of Complications in GI Interventions","authors":"K. Quencer","doi":"10.1055/s-0042-1758466","DOIUrl":"https://doi.org/10.1055/s-0042-1758466","url":null,"abstract":"","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86525289","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":"Partial Splenic Artery Embolization to Treat Portal Hypertension","authors":"Shanmukha Srinivas, Akhilesh Yeluru, Z. Berman, J. Redmond, J. Minocha","doi":"10.1055/s-0042-1757762","DOIUrl":"https://doi.org/10.1055/s-0042-1757762","url":null,"abstract":"Portal hypertension (PH) commonly occurs in the setting of underlying liver disease and can precipitate variceal bleeding and ascites among other complications. Traditionally, PH is managed with medication or lifestyle changes with refractory cases treated with transjugular intrahepatic portosystemic shunts or splenectomy. Partial splenic artery embolization (PSE) is an alternative treatment which may reduce PH by decreasing splenic vein inflow into the portal vein. In this article, we review the efficacy of PSE and present illustrative cases with a focus on technical and clinical considerations for embolization. We queried the PubMed database from August 1976 to September 2021 for clinical studies of PSE for the treatment of portal hypertension. For each article, the author, year, title, study design, number of patients, age, sex, liver function, technical considerations, adverse effects, and outcomes were recorded. We also review two successful and unsuccessful cases from our institution. A total of 12 studies were identified with 258 patients undergoing 290 PSE treatments. The mean age of patients was 44.1 years (range: 6–77). Most patients had well-compensated liver disease (Child–Pugh (CP) A; 35.1%) or significant functional compromise (CP-B; 44.4%), but a few had decompensated disease (CP-C; 8.9%). The majority (91.7%) of procedures were performed distally within the splenic artery, and on average, 59.5% (20–100) of the spleen underwent infarction. Common complications included symptoms of postembolization syndrome such as abdominal pain (58.5%) and fever (53.2%) as well as atelectasis (9.0%). Five PSE procedures (1.7%) resulted in death secondary to pleuropneumonia, splenic abscess, sepsis, intracranial hemorrhage, and pulmonary embolism, respectively. PSE is an effective but often underutilized treatment for PH. These benefits have risk for minor complications including postembolization syndrome and major complications such as splenic abscess formation. This article will introduce the reader to important technical and clinical considerations regarding PSE.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90103115","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":"Complications of 90 Y Radioembolization Treatment for Liver Tumors","authors":"Mason Eghbali, Z. Haber, R. Srinivasa, S. Padia","doi":"10.1055/s-0043-1760730","DOIUrl":"https://doi.org/10.1055/s-0043-1760730","url":null,"abstract":"Abstract Y90 radioembolization has been demonstrated to be a safe and effective treatment for patients with HCC and for certain liver metastases, such as neuroendocrine tumors, uveal melanomas, and breast cancer. Although the procedure is relatively safe, the complications associated with radioembolization vary greatly in their locations, presentation, and severity. This review aims to discuss and increase awareness of the potential complications associated with radioembolization.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"58 1","pages":"138 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86768650","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}