scholarly journals Su1282 EUS-GUIDED, MINIMALLY INVASIVE ENTEROANASTOMOSIS IN CHOLESTASIS DUE TO MALIGNANT TUMOR GROWTH AND AFFERENT-LOOP SYNDROME REPLACING SURGICAL INTERVENTION (E.G., IN MALIGNANT TUMOR LESIONS OF THE PANCREAS AND THE PAPILLA OF VATER AS WELL AS PERIAMPULLARY MALIGNOMAS) – AN INTERIMS ANALYSIS OF THE CLINICAL INAUGURATION OF THE APPRAOCH USING AN AXIOS STENT TM

2018 ◽  
Vol 87 (6) ◽  
pp. AB311
Author(s):  
Uwe Will ◽  
Viliam Masaryk ◽  
Frank Fueldner ◽  
Frank Meyer
Keyword(s):  
Minimally Invasive ◽  
Tumor Growth ◽  
Malignant Tumor ◽  
Surgical Intervention ◽  
Papilla Of Vater ◽  
Afferent Loop ◽  
Afferent Loop Syndrome

scholarly journals Afferent Loop Syndrome with Intestinal Ischemia due to Internal Hernia after Whipple Operation for T2N1M0 Pancreatic Cancer

2020 ◽  
Vol 10 ◽  
pp. 43
Author(s):  
Marijan Pejic ◽  
Arthur A. Parsee
Keyword(s):  
Intestinal Ischemia ◽  
Surgical Intervention ◽  
Whipple Procedure ◽  
Bowel Ischemia ◽  
Whipple Operation ◽  
Afferent Loop ◽  
Afferent Loop Syndrome ◽  
Delay In Diagnosis ◽  
Characteristic Features ◽  
Uncommon Complication

Afferent loop syndrome is an uncommon complication of Whipple procedure. The often vague and non-specific presentation results in difficulty and/or delay in diagnosis, which may lead to bowel ischemia or perforation. CT can demonstrate characteristic features, yield the diagnosis of afferent loop syndrome, and predict the cause before surgical intervention. We present a rare etiology of acute afferent loop syndrome in a patient 6 weeks after Whipple procedure who was reportedly recovering well, which resulted in prompt surgical intervention.

scholarly journals Case 1: Afferent loop syndrome.

1998 ◽  
Vol 171 (3) ◽  
pp. 852-852 ◽  
Author(s):  
M Doherty ◽  
R S Perret
Keyword(s):  
Afferent Loop ◽  
Afferent Loop Syndrome

Afferent Loop Syndrome Revisited

1981 ◽  
Vol 74 (5) ◽  
pp. 599-601 ◽  
Author(s):  
C. DALE BROWN ◽  
JOHN W. KRAUS
Keyword(s):  
Afferent Loop ◽  
Afferent Loop Syndrome

Case 24: Afferent Loop Syndrome

Radiology ◽  
2000 ◽  
Vol 216 (1) ◽  
pp. 142-145 ◽  
Author(s):  
Scott W. Wise
Keyword(s):  
Afferent Loop ◽  
Afferent Loop Syndrome

RA05.04: MANAGEMENT & OUTCOMES OF ANASTOMOTIC LEAKS FOLLOWING ESOPHAGECTOMY: A PROSPECTIVE 10-YEAR SINGLE-SITE EXPERIENCE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 28-28
Author(s):  
Joel Lambert ◽  
Sanya Caratella ◽  
Eloise Lawrence ◽  
Bilal Alkhaffaf
Keyword(s):  
Minimally Invasive ◽  
Anastomotic Leak ◽  
Surgical Intervention ◽  
Type I ◽  
Oral Contrast ◽  
Open Approach ◽  
Type Ii ◽  
Anastomotic Leaks ◽  
Type Iii ◽  
Significant Difference

Abstract Background Anastomotic leak after esophagectomy is associated with high levels of morbidity and may impact negatively on oncological outcomes. The aim of this single centre study was to describe our experience in managing these complications Methods From 2007–2017 data was reviewed retrospectively from our prospectively maintained electronic database. All patients underwent either 2 or 3 phase esophagectomy for cancer of the oesophagus or esophago-gastric junction. All histological sub-types and stage of cancer were included in the analysis. Anastomotic leaks were classified according to the Esophagectomy Complications Consensus Group (ECCG) guidelines; type I—conservative management, type II—non-surgical intervention, type III—surgical intervention. Results 224 esophagectomies were included in our analysis (104 (46%) minimally invasive, 120 (54%) open approach). The incidence of all anastomotic leaks was 10% (23/224). Surgical approach did not influence the incidence of anastomotic leak (minimally invasive 10 (43%), open approach 13(57%), P = 0.76). Five patients (22%) had a type I leak, 9 patients (39%) type II and 9 (39%) had a type III leak. There was an increase in the number of leaks managed non-surgically over the last 5 years compared to those in the first five years of our dataset (2012–2017: 11/23 (48%) vs 2007–2012: 4/23 (17%) P = 0.08). The median time for leak diagnosis was 8 days. Most leaks were diagnosed with oral contrast CT 19 (83%). Median hospital stay after anastomotic leak was 58.5 days. Type III leaks were associated with an increased length of stay (median 84 days) compared to type I&II leaks (median (38.5 days) (P = 0.002 95% CI 18.19- 74.41). There was no significant difference in 30-day mortality between type I&II (0 patients) and type III leaks (1 patient) P = 0.260. Conclusion Low mortality rates with anastomotic leak can be achieved. In centres with experienced radiological and endoscopic skills, most anastomotic leaks can be managed non-surgically. Disclosure All authors have declared no conflicts of interest.

scholarly journals Life-threatening spontaneous hematoma of the chest wall treated with packing and delayed chest closure

2019 ◽  
pp. 01-03
Author(s):  
Francesco Mongelli ◽  
Francesco Proietti ◽  
Miriam Patella ◽  
Stefano Cafarotti
Keyword(s):  
Conservative Treatment ◽  
Minimally Invasive ◽  
Surgical Intervention ◽  
Endovascular Embolization ◽  
Minimally Invasive Techniques ◽  
Life Threatening ◽  
Thoracic And Abdominal ◽  
Invasive Techniques ◽  
Anticoagulated Patients ◽  
Spontaneous Hematoma

Bleeding of the thoracic and abdominal wall most commonly occur in anticoagulated patients [1]. The management is based on anticoagulant therapy reversal which is mostly effective [2]. If conservative treatment is insufficient, good results are provided by endovascular embolization techniques [2,3]. The need of surgical intervention is extremely rare and limited to cases in which minimally invasive techniques are unsuccessful or somehow contraindicated [4].

Endoscopic ultrasound-guided entero-enterostomy for the treatment of afferent loop syndrome: a multicenter experience

Endoscopy ◽  
2018 ◽  
Vol 50 (09) ◽  
pp. 891-895 ◽  
Author(s):  
Olaya Brewer Gutierrez ◽  
Shayan Irani ◽  
Saowanee Ngamruengphong ◽  
Hanaa Aridi ◽  
Rastislav Kunda ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Indirect Comparison ◽  
Procedure Time ◽  
Technical Success ◽  
Ultrasound Guided ◽  
Common Procedure ◽  
Afferent Loop ◽  
Afferent Loop Syndrome

Abstract Background Afferent loop syndrome (ALS) is traditionally managed surgically and, more recently, endoscopically. The role of endoscopic ultrasound-guided entero-enterostomy (EUS-EE) has not been well described. The aim of this study was to assess the technical and clinical success and safety of EUS-EE. Methods This was a multicenter, retrospective series at six centers in patients with ALS treated by EUS-EE. Data on patients treated with enteroscopy-assisted luminal stenting (EALS) at a single center were also collected. Results 18 patients (mean age 64.2 years, 72 % post-pancreaticoduodenectomy, 10 female) underwent EUS-EE. The most common symptoms were vomiting (27.8 %) and jaundice (33.3 %). Clinical success included resolution of symptoms in 88.9 % and improvement to allow hospital discharge in 11.1 %. Technical success was achieved in 100 % of cases, with a mean procedure time of 29.7 minutes. The most common procedure was a gastro-jejunostomy (72.2 %). Three adverse events (16.7 %) occurred (two mild, one moderate). When compared with data on EALS, patients treated with EUS-EE needed fewer re-interventions (16.6 % vs. 76.5 %; P < 0.001). Conclusion EUS-EE seems to be safe and effective in the treatment of ALS. Indirect comparison with EALS suggested that EUS-EE is associated with a reduced need for re-intervention.

Endoscopic-Assisted Microvascular Decompression

2018 ◽  
pp. 139-154
Author(s):  
M. Yashar S. Kalani ◽  
Michael R. Levitt ◽  
Celene B. Mulholland ◽  
Charles Teo ◽  
Peter Nakaji
Keyword(s):  
Trigeminal Neuralgia ◽  
Minimally Invasive ◽  
Effective Treatment ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Patient Population ◽  
Surgical Intervention ◽  
Cranial Nerves ◽  
Vascular Compression ◽  
Ephaptic Transmission

Diseases of ephaptic transmission are commonly caused by vascular compression of cranial nerves. The advent of microvascular decompression has allowed for surgical intervention for this patient population. This chapter highlights the technique of endoscopic-assisted microvascular decompression for trigeminal neuralgia and hemifacial spasm. Endoscopy and keyhole techniques have resulted in a minimally invasive and effective treatment of symptoms for patients with neuralgia.

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