Small bowel intervention and application of enteroscopy for altered small bowel anatomy —endoscopic advanced therapy using double balloon enteroscopy
Publication date: December 2014 Source:Gastrointestinal Intervention, Volume 3, Issue 2 Author(s): Masaaki Shimatani, Norimasa Fukata, Ryo Suzuki, Sachi Miyamoto, Kota Kato, Toshiyuki Mitsuyama, Hideaki Miyoshi, Tsukasa Ikeura, Makoto Takaoka, Kazuichi Okazaki The management of patients with small bowel obstruction distal to the third part of the duodenum and altered gastrointestinal anatomy is challenging. Until recently, surgery had been the mainstay of treatment for obstruction, which had however posed a risk of serious complications. The difficulty with the endoscopic approach in the deep area o...
Source: Gastrointestinal Intervention - June 17, 2016 Category: Gastroenterology Source Type: research
Endoscopic ultrasonography-guided biliary drainage: an alternative to percutaneous transhepatic puncture
Publication date: Available online 20 May 2015 Source:Gastrointestinal Intervention Author(s): Nobuhito Ikeuchi , Takao Itoi Endoscopic retrograde cholangiopancreatography (ERCP) is the first-choice treatment for patients with obstructive jaundice. However, there are patients in whom bile duct access is not possible. In these patients, percutaneous transhepatic biliary drainage (PTBD) may be performed as an alternative biliary drainage method. PTBD is reportedly associated with a moderate mortality rate. In recent years, endoscopic ultrasonography-guided biliary drainage (EUS-BD) in patients with failed ERCP has been...
Source: Gastrointestinal Intervention - June 6, 2015 Category: Gastroenterology Source Type: research
Endoscopic stent placement combined with tumor ablation therapy
Publication date: Available online 3 June 2015 Source:Gastrointestinal Intervention Author(s): Rajesh Gupta , D. Nageshwar Reddy The palliative therapy of advanced pancreato-biliary cancers is focused primarily on biliary stenting in majority of patients. However, biliary stent occlusion or dysfunction is a main concern. Several types of stents have bleed designed and studied to improve stent function, but with limited success. The local ablative therapy, such as photodynamic therapy (PDT) and radiofrequency ablation (RFA) in combination with biliary stenting is a paradigm shift in the management of advanced pancreat...
Source: Gastrointestinal Intervention - June 3, 2015 Category: Gastroenterology Source Type: research
EUS-guided biliary drainage: an alternative to percutaneous transhepatic puncture
Publication date: Available online 20 May 2015 Source:Gastrointestinal Intervention Author(s): Nobuhito Ikeuchi , Takao Itoi Endoscopic retrograde cholangiopancreatography (ERCP) is the first-choice treatment for patients with obstructive jaundice. However, there are patients in whom bile duct access is not possible. In these patients, percutaneous transhepatic biliary drainage (PTBD) may be performed as an alternative biliary drainage method. PTBD is reportedly associated with a moderate mortality rate. In recent years, endoscopic ultrasonography-guided biliary drainage (EUS-BD) in patients with failed ERCP has been...
Source: Gastrointestinal Intervention - May 20, 2015 Category: Gastroenterology Source Type: research
Development of an ideal self-expandable metallic stent design
Publication date: Available online 25 March 2015 Source:Gastrointestinal Intervention Author(s): Hiroyuki Isayama , Yousuke Nakai , Tsuyoshi Hamada , Natsuyo Yamamoto , Kazuhiko Koike There are various types of self-expandable metallic stent (SEMS) for biliary obstruction, but it is unknown which one is ideal. Ideal SEMS should prevent recurrent biliary obstruction or other complications after SEMS placement until the patient's death. In this review, risk factors for recurrent biliary obstruction or complications are discussed. Based on the current literature, the combination of a high radial force and a low axial...
Source: Gastrointestinal Intervention - April 29, 2015 Category: Gastroenterology Source Type: research
Endoscopic approach to benign biliary obstruction
Publication date: Available online 29 April 2015 Source:Gastrointestinal Intervention Author(s): Andrea Tringali , Vincenzo Bove , Guido Costamagna During the last 30-years endoscopic approach to benign biliary strictures (BBS) become the preferred “mini-invasive” treatment modality for benign diseases in usually young patients. Endoscopic plastic or metallic stenting, and balloon dilation represents the “armamentarium” to treat BBS. Side-by-side multiple plastic stents insertion is a very effective treatment option for BBS following cholecystectomy or liver transplantation. This strategy has a low-recurrenc...
Source: Gastrointestinal Intervention - April 29, 2015 Category: Gastroenterology Source Type: research
Stents with specialized functions: drug-eluting stents and stents with antireflux devices
Publication date: Available online 20 March 2015 Source:Gastrointestinal Intervention Author(s): Sung Ill Jang , Dong Ki Lee Biliary drainage in malignant biliary obstruction improves patient survival and quality of life. Although bypass surgery was historically the main method of treating malignant biliary obstruction, stent insertion using endoscopy or interventional radiology is currently recognized as the first-line of treatment. Biliary stents have undergone various modifications in terms of material and structure, with the aim of increasing stent patency. One such modification is the antitumor-agent-eluting ste...
Source: Gastrointestinal Intervention - April 9, 2015 Category: Gastroenterology Source Type: research
Transcatheter embolization of small bowel bleeding in a patient with polyarteritis nodosa
We report a case of PAN in a 28-year-old male patient with abdominal pain and hematochezia. He underwent surgical resection for small-bowel ischemia and was diagnosed with PAN. Subsequent two sessions of angiography and embolization were performed for different sites of small bowel bleeding. Gelatin sponge particles and microcoils were used as embolic materials. Our patient’s outcome suggests that transcatheter embolization should be considered as an efficient method for the treatment for GI bleeding associated with PAN. (Source: Gastrointestinal Intervention)
Source: Gastrointestinal Intervention - April 7, 2015 Category: Gastroenterology Source Type: research
Percutaneous biodegradable stent insertion for a benign biliary stricture complicating choledochojejunostomy
We describe our first experience with percutaneous placement of a biodegradable stent for an anastomotic biliary stricture. Following an iatrogenic bile duct injury managed with choledochojejunostomy, a 66-year-old female patient developed a stricture at the implantation site, causing biliary obstruction. Endoscopic access was precluded because of the surgery, necessitating percutaneous transhepatic biliary intervention. The stricture was unresponsive to percutaneous balloon dilatation, requiring external drainage. A biodegradable stent was placed easily across the stricture to attempt long-term stricture remodeling. The s...
Source: Gastrointestinal Intervention - April 4, 2015 Category: Gastroenterology Source Type: research
Spontaneous circulation return after termination of resuscitation efforts for cardiac arrest following embolization of a ruptured common hepatic artery pseudoaneurysm
Publication date: Available online 18 February 2015 Source:Gastrointestinal Intervention Author(s): Zachary Wilseck , Kyung Cho Return of spontaneous circulation after termination of resuscitation attempts for cardiac arrest is an extremely rare event. Here we describe an unusual case of a 50-year-old man with massive upper gastrointestinal bleeding from a ruptured common hepatic artery pseudoaneurysm who survived after termination of resuscitation attempts for cardiac arrest during coil embolization. One month earlier, he had undergone total gastrectomy and Roux-en-Y esophagojejunostomy secondary to Stage IV gastric...
Source: Gastrointestinal Intervention - April 3, 2015 Category: Gastroenterology Source Type: research
Stent placement as a bridge to surgery in malignant biliary obstruction (pancreatic cancer, distal bile duct cancer, and hilar tumors)
Publication date: Available online 7 March 2015 Source:Gastrointestinal Intervention Author(s): Mario Rodarte-Shade , Michel Kahaleh Preoperative biliary drainage (PBD) has been a matter of controversy for years. It was initially aimed to improve the clinical status of patients with malignant obstructive jaundice prior to surgery. However, its efficacy and safety have not been proven by randomized controlled trials. Most drawbacks of PBD are related to the increase in procedure-related adverse events and inappropriate biliary decompression. Current trends in PBD show that using self-expanding metallic stents (SEMSs) ...
Source: Gastrointestinal Intervention - April 3, 2015 Category: Gastroenterology Source Type: research
Percutaneous biodegradable stent insertion for a benign biliary stricture complicating choledocho-jejunostomy
We describe our first experience with percutaneous placement of a biodegradable stent for an anastomotic biliary stricture. Following an iatrogenic bile duct injury managed with choledocho-jejunostomy, a 66 year old female patient developed a stricture at the implantation site, causing biliary obstruction. Endoscopic access was precluded due to the surgery, necessitating percutaneous transhepatic biliary intervention. The stricture was unresponsive to percutaneous balloon dilatation, requiring external drainage. A biodegradable stent was placed easily across the stricture to attempt long term stricture remodeling. The sten...
Source: Gastrointestinal Intervention - April 3, 2015 Category: Gastroenterology Source Type: research
Stents with specialized functions: drug-eluting stents and stents with anti-reflux devices
Publication date: Available online 20 March 2015 Source:Gastrointestinal Intervention Author(s): Sung Ill Jang , Dong Ki Lee Biliary drainage in malignant biliary obstruction improves patient survival and quality of life. While bypass surgery was historically the main method of treating malignant biliary obstruction, stent insertion using endoscopy or interventional radiology is currently recognized as the first-line treatment. Biliary stents have undergone various modifications in terms of material and structure, with the aim of increasing stent patency. One such modification is the antitumor-agent-eluting stent, wh...
Source: Gastrointestinal Intervention - April 3, 2015 Category: Gastroenterology Source Type: research
Fibrinolysis in the management of malignant ascites and nonfunctioning intraperitoneal tunneled catheters
Publication date: Available online 21 March 2015 Source:Gastrointestinal Intervention Author(s): Nicholas Lawrance , Nabil Kibriya , Damian Mullan , Hans-Ulrich Laasch The use of tunneled semipermanent intraperitoneal catheters is becoming increasingly widespread in the management of intractable malignant ascites. There is a lack of published data on the successful management of complications of these catheters in cases of malignant ascites. The current study reports four cases of nonfunctioning catheters due to fibrin blockage or ascitic loculation, all of which were successfully treated with intraperitoneal fibri...
Source: Gastrointestinal Intervention - April 3, 2015 Category: Gastroenterology Source Type: research
Development of ideal SEMS design
Publication date: Available online 25 March 2015 Source:Gastrointestinal Intervention Author(s): Hiroyuki Isayama , Yousuke Nakai , Tsuyoshi Hamada , Natsuyo Yamamoto , Kazuhiko Koike There are various types of self-expandable metallic stents (SEMS) for biliary obstruction, but nobody knows which one is ideal. Ideal SEMS should prevent recurrent biliary obstruction or other complications after SEMS placement till the patient's death. In this review, risk factors for recurrent biliary obstruction or complications are discussed. Based on the current literature, the combination of high radial force and low axial forc...
Source: Gastrointestinal Intervention - April 3, 2015 Category: Gastroenterology Source Type: research
