Usefulness of endoscopic metal stent placement for malignant afferent loop obstruction
ConclusionsThe success rate of EMSP for mALO was high in patients with poor general conditions due to advanced-stage malignant tumors and it was able to be safely performed, suggesting its high clinical efficacy. The incidence of mALO recurrence after EMSP was low.
This study aimed to analyze our experience and evaluate potential factors affecting CBD stone extraction.MethodsA retrospective analysis of CBD stones patients with a history of Billroth II gastrectomy, who underwent therapeutic ERCP for stone extraction at our center from August 1999 to December 2017, was conducted. The outcomes of ERCP and potential factors affecting stone extraction were examined.ResultsA total of 227 patients were enrolled, and 176 patients (77.5%) achieved technical success. The success rate of duodenal ampullary access and selective biliary cannulation was 84.1% (191/227) and 92.1% (176/191), respect...
AbstractAnastomotic intraluminal bleeding is a well-known complication after total gastrectomy. Nevertheless, few data are published on acute bleeding obstruction pancreatitis (BOP) due to a bleeding from the jejunojejunostomy (JJ). In this paper we describe our experience. A total of 140 gastrectomies for EGJ cancer were performed in our Institute from January 2012 to January 2017. All reconstructions were performed with a Roux-en-Y anastomosis: a mechanical end-to-side esophago-jejunostomy and a mechanical end-to-side JJ. Three patients suffered from a bleeding at the JJ with a consequent BOP. We analyzed the time of dia...
ConclusionsAlthough minimally invasive radical gastrectomy is currently established as a valid alternative to open surgery for the treatment of gastric cancer, a higher risk of pancreas-related morbidity should be taken into account.
Endoscopic drainage is now considered a first-line therapy for symptomatic obstruction of the main pancreatic duct.1 Such drainage is usually performed by endoscopic pancreatic sphincterotomy, dilation, and stenting for patients having pain, acute relapsing pancreatitis, or symptomatic leaks. There are, however, patients in whom such a transpapillary drainage cannot be technically performed because of postsurgical anatomy (gastrectomy, Roux-en-Y anastomosis, Whipple procedure), a tight stricture in the setting of chronic pancreatitis, or a disconnected pancreatic tail syndrome after acute pancreatitis or pancreatic trauma.
EndoscopyDOI: 10.1055/s-0042-108641This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE suggests that difficult biliary cannulation is defined by the presence of one or more of the following: more than 5 contacts with the papilla whilst attempting ...
Conclusions: The side-viewing duodenoscope is a useful instrument for performing successful ERCP in patients postgastrectomy. In addition, retrieval balloon–assisted enterography may improve the enterography success rate in postgastrectomy patients with Billroth II and Roux-en-Y reconstruction.
A needle-knife papillotome (NKP) has been used instead of a standard sphincterotome knife for difficult endoscopic sphincterotomy (ES) in patients with a surgically altered anatomy such as Billroth II gastrectomy. However, use of an NKP may increase the risk of postprocedure pancreatitis because its tip is more directly in contact with the pancreatic duct, causing electric damage. The newly developed isolated-tip NKP (ITNKP) (Iso-Tome, second generation, MTW Endoskopie, Wesel, Germany) is a modified NKP that has a round tip made of sapphire to prevent electrical damage.
CONCLUSIONS: Patients with perforation during EPBD in B-II showed different clinical courses. Tailored treatment strategies are necessary for improving the clinical outcomes. PMID: 26473126 [PubMed]
CONCLUSIONS: The gastric lipoma is a rare benign entity that can mimic a malignancy, in our case an incidental finding which was managed by partial gastrectomy with satisfactory postoperative results. PMID: 26055284 [PubMed - as supplied by publisher]
Conclusions: DBE permits therapeutic ERCP in patients who have a difficult Billroth II gastrectomy with a high success rate and acceptable complication rates. EPLBD is effective and safe for the removal of common bile duct stones in patients with Billroth II anatomy.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | open access Full text