ID: 3524376 CHOLANGIOSCOPY-GUIDED DOUBLE GUIDE WIRE TECHNIQUE FOR COMPLEX MALIGNANT HILAR OBSTRUCTION

2021 ◽  
Vol 93 (6) ◽  
pp. AB121
Author(s):  
Margaret G. Keane ◽  
Bachir Ghandour ◽  
Michael Bejjani ◽  
Manol Jovani ◽  
Mouen A. Khashab
Keyword(s):  
Guide Wire ◽  
Malignant Hilar Obstruction

Outcome of Upper Ureteric Stone Management by Semirigid Ureterorenoscope and Intracorporeal Pneumatic Lithotripsy

2020 ◽  
Vol 16 (2) ◽  
pp. 47-50
Author(s):  
Md Ruhul Quddus ◽  
Md Asaduzzaman ◽  
Md shariful Islam ◽  
Kaiser Ahmed ◽  
MA Awal ◽  
...  
Keyword(s):  
Kidney Diseases ◽  
Guide Wire ◽  
Ureteral Injury ◽  
Ureteric Stone ◽  
Stone Clearance ◽  
Stone Fragment ◽  
Ureteric Calculi ◽  
Ureteric Orifice ◽  
Distal Obstruction ◽  
Ureteric Stricture

Objective: To evaluate the outcome of upper ureteric stone management using semirigid URS + ICPL. Materials and Methods: Patients undergoing URS + ICPL in patient department were included in the study. Total 38 patient were included in the study from March 2009 to June 2010 in National Institute of Kidney diseases & Urology, Dhaka. Stone size was 8 mm to 1.5 cm, patients were with good renal function, well excreation on both side, without any distal obstruction, infection or multiple ureteric calculi. The procedure was done under SAB.Cystoscopy was done for identification of ureteric orifice and guide wire was passed within ureteric orifice under visual monitoring.46 cm 10 Fr Storz Uretroscope was advanced next to the guide wire.At time a tortuous portion of the ureter was encountered a second guide wire was helpful. As soon as the stone was seen the pneymatic probe was pushed toward the stone.After fixing to the stone, pneumatic source was on and stone fragmentation was started. Care was taken to avoid injury of the ureter and keeping eye one stone fragment migration within the ureter was achieved. Placement of D-J stent was done at the conclusion of the procedure in most of the cases Result: The patients were followed upto 3 months post-operatively. Within immediate complications fever occured in 10 (26.3%) patients, severe haematurea occured in 8 (21.3%) patients, ureteral injury in 8 (21.3%) & ureteric perforation in 2 (4.8%) patients underwent URS+ ICPL. Stone clearance rate after 01 month of intervention was 30 (78.9%). Almost half of the patients developed UTI after 01 month of intervention. Pyelonephritis occured in 2 ( 4.8%) patient in this group. After 03 months of intervention 84.2% patients exibited complete clearance of stone. Only 02 (4.8%) patients developed ureteric stricture. Conclusion: For management of selective sized upper ureteric stone ureterorenoscopy with semirigid one using pneumatic source of energy is a good option for it’s high stone clearance & resonably low complications. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.47-50

Treatment of Malignant Esophageal Fistulas: Fluoroscopic Placement of Esophageal SEMS, Endoscopically-assisted through Surgical Gastrostomy. A Case Report

2016 ◽  
Vol 25 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Gabriel Constantinescu ◽  
Vasile Şandru ◽  
Mădălina Ilie ◽  
Cristian Nedelcu ◽  
Radu Tincu ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Guide Wire ◽  
Subsequent Development ◽  
Covered Stent ◽  
Metallic Stents ◽  
Fistula Formation ◽  
Life Threatening ◽  
Endoscopic Placement ◽  
Surgical Gastrostomy ◽  
Methods Of Treatment

Progressive esophageal carcinoma can infiltrate the surrounding tissues with subsequent development of a fistula, most commonly between the esophagus and the respiratory tract. The endoscopic placement of covered self-expanding metallic stents (SEMS) is the treatment of choice for malignant esophageal fistulas and should be performed immediately, as a fistula formation represents a potential life-threatening complication. We report the case of a 64-year-old male diagnosed with esophageal carcinoma, who had a 20Fr surgical gastrostomy tube inserted before chemo- and radiotherapy and was referred to our department for complete dysphagia, cough after swallowing and fever. The attempt to insert a SEMS using the classic endoscopic procedure failed. Then, a fully covered stent was inserted, as the 0.035” guide wire was passed through stenosis retrogradely by using an Olympus Exera II GIF-N180 (4.9 mm in diameter endoscope) via surgical gastrostomy, with a good outcome for the patient. The retrograde approach via gastrostomy under endoscopic/fluoroscopic guidance with the placement of a fully covered SEMS proved to be the technique of choice, in a patient with malignant esophageal fistula in whom other methods of treatment were not feasible. Abbreviations: ERCP: endoscopic retrograde cholangio-pancreatography; GI: gastrointestinal; SEMS: self-expandable metallic stents.

Comparison Between Supraclavicular and Infraclavicular Approach in Subclavian Vein Catheterization in Tertiary Center of Nepal

2020 ◽  
Vol 3 (2) ◽  
pp. 111-115
Author(s):  
Robin Khapung ◽  
Jeju Nath Pokharel ◽  
Kiran Kumar KC ◽  
Kripa Pradhan ◽  
Uma Gurung ◽  
...  
Keyword(s):  
Success Rate ◽  
Subclavian Vein ◽  
Guide Wire ◽  
Femoral Vein ◽  
Access Time ◽  
P Value ◽  
Central Vein ◽  
Chi Square ◽  
Tertiary Center ◽  
Vein Catheterization

Introduction: Central vein catheterization can be introduced in subclavian vein (SCV), internal jugular vein or femoral vein for volume resuscitation and invasive monitoring technique. Due to anatomical advantage and lesser risk of infection subclavian vein is preferred. Either supraclavicular (SC) or infraclavicular (IC) approach could be used for subclavian vein catheterization. The aim of the study was to compare SC and IC approach in ease of catheterization of SCV and record the complications present if any. Methods and materials: This was a hospital based comparative, interventional study conducted from November 2016 to October 2017 in Operation Theater in Bir Hospital. In this study, 70 patients for elective surgical cases meeting the inclusion criteria were randomly enrolled. Then samples were equally divided by lottery into either supraclavicular or infraclavicular approach groups. The Access time, cannulation success rate, attempts made for successful cannulation of vein, easy insertion of catheter and guide wire, approximate inserted length of catheter and associated complications in both groups were recorded. Data was entered in statistical software SPSS 16. Chi-square test was used. P value < 0.05 was considered significant. Results: The mean access time in group SC for SCV catheterization was 2.12 ± 0.81 min compared to 2.83 ± 0.99 min in group IC (p-value= 0.002). The overall success rate in catheterization of the right SCV using SC approach (34 / 35) was better as compared with group IC (33 / 35) using IC approach. First successful attempt in the SC group was 74.28% as compared with 57.14% in the IC group. Conclusion: The SC approach of SCV catheterization can be considered alternative to IC approach in terms of landmark accessibility, success rate and rate of complications.

Monitoring cyclical coronary blood flow alterations after coronary angioplasty for stent restenosis with a Doppler guide wire

1993 ◽  
Vol 125 (4) ◽  
pp. 1159-1161 ◽  
Author(s):  
Morton J Kern ◽  
Thomas Donohue ◽  
Richard Bach ◽  
Frank Aguirre ◽  
Calvin Bell
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Coronary Angioplasty ◽  
Guide Wire ◽  
Stent Restenosis

scholarly journals Biliary cannulation in endoscopic retrograde cholangiography: How to tackle the difficult papilla

2021 ◽  
Author(s):  
Mark op den Winkel ◽  
Jörg Schirra ◽  
Christian Schulz ◽  
Enrico N. De Toni ◽  
Christian J. Steib ◽  
...  
Keyword(s):  
Biliary Drainage ◽  
Guide Wire ◽  
A Priori ◽  
Endoscopic Retrograde Cholangiography ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Increased Risk ◽  
Difficult Biliary Cannulation ◽  
Needle Knife ◽  
Transpancreatic Sphincterotomy

Background: In the setting of a naïve papilla, biliary cannulation is a key step in successfully performing endoscopic retrograde cholangiography (ERC). Difficult biliary cannulation (DBC) is associated with an increased risk of post-ERCP-pancreatitis and failure of the whole procedure. Summary: Recommendations for biliary cannulation can be divided in (a) measures to reduce the likelihood of a difficult papilla-situation a priori and (b) rescue techniques in case the endoscopist is actually facing DBC. (a): careful inspection of the papillary anatomy and optimizing its accessibility by scope-positioning is fundamental. A sphincterotome in combination with a soft-tip hydrophilic guide-wire rather than a standard catheter with a standard guide-wire should be used. (b): The most important rescue techniques are needle-knife precut, double-guidewire technique and transpancreatic sphincterotomy. In few cases, anterograde techniques are needed. To this regard, the EUS-guided biliary drainage (EUS-BD) followed by rendezvous is increasingly used as an alternative to percutaneous-transhepatic biliary drainage. Key Messages: Biliary cannulation can be accomplished with alternative retrograde or less frequently by salvage-anterograde techniques, once conventional direct cannulation attempts have failed. Considering recent favorable data for the early use of transpancreatic sphincterotomy, an adopted version of the 2016 European-Society-for-Gastrointestinal-Endoscopy (ESGE)-algorithm on biliary cannulation is proposed.

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