scholarly journals Double endoscopic bypass for gastric outlet obstruction and biliary obstruction

2017 ◽  
Vol 05 (09) ◽  
pp. E893-E899 ◽  
Author(s):  
Olaya Brewer Gutierrez ◽  
Jose Nieto ◽  
Shayan Irani ◽  
Theodore James ◽  
Renata Pieratti Bueno ◽  
...  

Abstract Background and study aims Double endoscopic bypass entails EUS-guided gastroenterostomy (EUS-GE) and EUS-guided biliary drainage (EUS-BD) in patients who present with gastric outlet and biliary obstruction. We report a multicenter experience with double endoscopic bypass. Patients and methods Retrospective, multicenter series involving 3 US centers. Patients who underwent double endoscopic bypass for malignant gastric and biliary obstruction from 1/2015 to 12/2016 were included. Primary outcome was clinical success defined as tolerance of oral intake and resolution of cholestasis. Secondary outcomes included technical success, re-interventions and adverse events (AE). Results Seven patients with pancreatic head cancer (57.1 % females; mean age 64.6 ± 12.5 years) underwent double endoscopic bypass. Four patients had EUS-GE and EUS-BD performed during the same session with a mean procedure time of 70 ± 20.4 minutes. EUS-GE and EUS-BD were technically successful in all patients, all of whom were able to tolerate oral intake with resolution of cholestasis in 6 (87.5 %). One patient had a repeat EUS-BD with normalization of bilirubin. There were no adverse events. Conclusions Double endoscopic bypass is feasible and effective when performed by experienced operators. Studies comparing this novel concept to existing techniques are warranted.

Author(s):  
Fabio Ausania ◽  
Santiago Sanchez-Cabus ◽  
Paula Senra del Rio ◽  
Alex Borin ◽  
Juan Ramon Ayuso ◽  
...  

2010 ◽  
Vol 34 (2) ◽  
pp. 352-361 ◽  
Author(s):  
Miltiadis Krokidis ◽  
Fabrizio Fanelli ◽  
Gianluigi Orgera ◽  
Dimitrios Tsetis ◽  
Ioannis Mouzas ◽  
...  

Surgery Today ◽  
2004 ◽  
Vol 34 (7) ◽  
Author(s):  
Noriyuki Miyamoto ◽  
Yoshihisa Kodama ◽  
Hideho Endo ◽  
Tadashi Shimizu ◽  
Kazuo Miyasaka ◽  
...  

2017 ◽  
Vol 8 (17) ◽  
pp. 3575-3584 ◽  
Author(s):  
Jingyong Xu ◽  
Xiaodong Tian ◽  
Yiran Chen ◽  
Yongsu Ma ◽  
Chang Liu ◽  
...  

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S54
Author(s):  
L. Yin ◽  
L. Xiao ◽  
Y. Gao ◽  
G. Wang ◽  
H. Gao ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Dionysios Dellaportas ◽  
James A. Gossage ◽  
Andrew R. Davies

Introduction. With the improving survival of cancer patients, the development of a secondary primary cancer is an increasingly common phenomenon. Extensive surgery during initial treatment may pose significant challenges to surgeons managing the second primary cancer.Case Presentation. A 69-year-old male, who had a pancreaticoduodenectomy three years ago for pancreatic head adenocarcinoma, underwent an uneventful extended total gastrectomy for gastroesophageal junctional adenocarcinoma. The reconstruction controversies and considerations are highlighted.Discussion. Genetic, environmental, and lifestyle factors are common for several gastrointestinal malignancies. However, the occurrence of a second unfavorable cancer such as gastroesophageal adenocarcinoma after pancreatic head cancer treatment is extremely uncommon. This clinical scenario possesses numerous difficulties for the surgeon, since surgical resection is the mainstay of treatment for both malignancies. Gastrointestinal reconstruction becomes challenging and requires careful planning and meticulous surgical technique along with sound intraoperative judgement.


2022 ◽  
pp. 32-36
Author(s):  
D. A. Sklyar ◽  
A. V. Pavlovsky ◽  
A. A. Polikarpov ◽  
S. A. Popov ◽  
V. E. Moiseenko ◽  
...  

The aim of this study was to assess the safety and efficacy of treating patients with operable pancreatic cancer after preoperative intra-arterial infusion of chemotherapy combined with conformal radiation therapy in a multi-fractionation mode. Patients (n = 40) were randomized into two groups: the main one – intra-arterial infusion of chemotherapy + radiation therapy + surgery (n = 20), and control – intra-arterial infusion of chemotherapy + surgery (n = 20). Neoadjuvant therapy consisted of intra-arterial infusion of chemotherapy (chemoembolization of a pancreatic head tumor with oxaliplatin 85 mg/m2) followed by intra-arterial chemo infusion with gemcitabine 1000 mg/m2. In the main group, radiation therapy was also carried out in two fractions per day, 2 Gy with an interval of 4–6 hours, 5 days a week, up to a total dose of 50 Gy. In the main group, the lower incidence of postoperative pancreatitis and the pancreatic fistulas were statistically confirmed, the incidence of grade 2 therapeutic pathomorphisis increased, as well as the median life expectancy.


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