scholarly journals Endoscopic Retrieval Technique of Proximally Migrated Pancreatic Stents: A Retrospective Study in a Tertiary Centre

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yi Lu ◽  
Zheng Jin ◽  
Jia-chuan Wu ◽  
Li-ke Bie ◽  
Biao Gong
Keyword(s):  
Retrospective Study ◽  
Adverse Events ◽  
Pancreatic Duct ◽  
Clinical Information ◽  
Stent Migration ◽  
Point Of View ◽  
Pancreatic Stent ◽  
Success Rates ◽  
Tertiary Centre ◽  
Endoscopic Retrieval

Background. There were scarce trials concerning the treatments and outcomes of proximal pancreatic stent migration. Herein, we did a retrospective study to discuss this problem from an endoscopist’s point of view.Patients and Methods. From January 2009 to June 2014, patients with proximally migrated pancreatic duct stents were identified. Their clinical information was viewed. Retrieval techniques, success rates, and adverse events were analyzed.Results. A total of 36 procedures were performed in 34 patients; the median age of the patients was 53 years, with 17 males and 17 females. Eight patients’ pancreatic duct stents could still be seen in the major or minor papilla and were pulled out with a snare forceps or a grasping forceps; in the remaining 28 procedures, the management was somewhat thorny; the retrieval called for several devices. Final success was achieved in 31 patients. No adverse event was observed in the process of ERCP procedures, 5 patients developed post-ERCP pancreatitis (PEP), 1 patient got infection, and 1 patient had haemorrhage.Conclusions. Endoscopic retrieval of migrated pancreatic stent is safe and less invasive; nonetheless, attention should be paid so as to reduce the incidence and degree of related adverse events, especially PEP.

scholarly journals The EDGI new take on EDGE: EUS-directed transgastric intervention (EDGI), other than ERCP, for Roux-en-Y gastric bypass anatomy: a multicenter study

2019 ◽  
Vol 07 (10) ◽  
pp. E1231-E1240 ◽  
Author(s):  
Matthew R. Krafft ◽  
William Hsueh ◽  
Theodore W. James ◽  
Thomas M. Runge ◽  
Todd H. Baron ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Retrospective Study ◽  
Adverse Events ◽  
Multicenter Study ◽  
Clinical Success ◽  
Endoscopic Biopsy ◽  
Success Rates ◽  
Moderate Severity ◽  
Excluded Stomach ◽  
Heterogenous Group

Abstract Background and study aims Indications for accessing the duodenum, and/or excluded stomach in Roux-en-Y gastric bypass (RYGB) patients extend beyond diagnosis and treatment of pancreaticobiliary maladies. Given the high technical and clinical success of EUS-directed transgastric ERCP (EDGE) in RYGB anatomy, we adopted this transgastric (anterograde) approach to evaluate and treat luminal and extraluminal pathology in and around the excluded gut in RYGB patients. EUS-directed transgastric intervention (“EDGI”), other than ERCP, is the terminology we have chosen to describe this heterogenous group of transgastric diagnostic and/or interventional endoscopic procedures (transgastric interventions) performed via a lumen-apposing mental stent (LAMS) in select patients with RYGB. Patients and methods A multicenter (n = 4), retrospective study of RYGB patients with suspected luminal or extraluminal pathology, in or around the duodenum and/or excluded stomach, underwent EDGI using LAMS between December 2015 and January 2019. Results A total of 14 patients (78.6 % women; mean age, 55.7 + 12.4 years) underwent EDGI via LAMS. Technical and clinical success rates of EDGI were 100 %. The most common transgastric interventions were diagnostic EUS of extraluminal pathology (n = 6, 42.7 %) and endoscopic biopsy of gastroduodenal luminal abnormalities (n = 5, 35.7 %). Two moderate-severity adverse events due to LAMS maldeployment occurred during EUS-JG creation (14.3 %), and each instance was successfully rescued with a bridging stent. Conclusions A variety of gastroduodenal luminal and extraluminal disorders in RYGB patients can be effectively diagnosed and managed using EDGI via LAMS.

scholarly journals Endoscopic Sphincterotomy before Fully Covered Metal Stent Placement Is Not Required for Distal Malignant Biliary Stricture due to a Pancreatic Head Tumor

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Kazunari Nakahara ◽  
Yosuke Michikawa ◽  
Ryo Morita ◽  
Keigo Suetani ◽  
Nozomi Morita ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endoscopic Sphincterotomy ◽  
Biliary Stricture ◽  
Pancreatic Head ◽  
Stent Migration ◽  
Success Rates ◽  
Tumor Treatment ◽  
Metal Stent ◽  
Malignant Biliary Stricture ◽  
Pancreatic Head Tumor

Background/Aims. Endoscopic sphincterotomy (EST) is often performed before fully covered self-expandable metal stent (FCSEMS) placement in order to prevent pancreatitis. However, it is not clear whether EST prevents pancreatitis or affects other adverse events (AEs). This study is conducted to evaluate the necessity of EST before FCSEMS placement for distal malignant biliary strictures due to a pancreatic head tumor. Methods. This study included 68 patients who underwent FCSEMS placement for distal malignant biliary stricture due to a pancreatic head tumor. Treatment outcomes and AEs were retrospectively compared between 32 patients with EST before FCSEMS placement (EST group) and 36 patients without EST (non-EST group). Results. The success rates of drainage for the EST and non-EST groups were 100% and 97.2%, respectively (P=0.95). The incidence of pancreatitis in the EST and non-EST groups was 3.1% and 0%, respectively (P=0.95). The incidence of hyperamylasemia in the EST and non-EST groups was 12.5% and 13.9%, respectively (P=0.85). The incidence of all AEs in the EST and non-EST groups was 15.6% (pancreatitis: 1, cholecystitis: 2, and stent migration: 2) and 13.9% (cholecystitis: 3, stent migration: 2), respectively (P=0.89). Conclusions. EST before FCSEMS placement for distal malignant biliary stricture due to a pancreatic head tumor does not affect the successful drainage and incidence of adverse events. The necessity of EST to prevent pancreatitis before FCSEMS placement was deemed low.

scholarly journals Comparison between transpancreatic sphincterotomy and needle-knife fistulotomy in difficulty biliary access, a retrospective study in Taiwan

2020 ◽  
Author(s):  
Kai-Shun Liang ◽  
Chieh-Chang Chen ◽  
Wei-Chih Liao ◽  
Yu-ting Kuo ◽  
Liang-Wei Tseng ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bile Duct ◽  
Adverse Events ◽  
Pancreatic Duct ◽  
Complication Rate ◽  
University Hospital ◽  
Biliary Cannulation ◽  
Access Rate ◽  
Needle Knife ◽  
Transpancreatic Sphincterotomy

Abstract Background Selective deep biliary cannulation is the first and the most important step before further biliary therapy. Transpancreatic sphincterotomy(TPS), and needle knife fistulotomy(NKF) were commonly used in patients with difficult cannulation, but few studies compare the outcome between TPS and NKF.Methods A total of 78 patients who met the criteria of difficult cannulation in the National Taiwan University hospital from October 2015 to October 2017 were retrospectively reviewed. Their baseline demographics, success rate of biliary cannulation, and the rate of adverse events were assessed.Results 31 patients and 47 patients underwent TPS and NKF for difficult biliary access, respectively. The characteristics of the 2 groups were similar, but patients in TPS group had more frequent pancreatic duct cannulation. Bile duct cannulation was successful in 23 patients (74.2 %) in the TPS group and 39 (83.0%) in the NKF group (P=0.34). There was no difference between the TPS and NKF in the rate of adverse events, including post-ERCP pancreatitis (PEP) (16.1% vs. 6.4%, p = 0.17), and hemorrhage (3.2% vs. 8.5%, p = 0.35). No perforation occurred.Conclusions Both TPS and NKF have good biliary access rate in patient with difficult cannulation. TPS has acceptable successful rate and similar complication rate, compared with NKF.

scholarly journals Risk Factors for Migration, Fracture, and Dislocation of Pancreatic Stents

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yoshiaki Kawaguchi ◽  
Jung-Chun Lin ◽  
Yohei Kawashima ◽  
Atsuko Maruno ◽  
Hiroyuki Ito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Stent Migration ◽  
Success Rates ◽  
Patient Factors ◽  
Minor Papilla ◽  
Stent Retrieval ◽  
Duct Stenosis ◽  
Pancreatic Sphincterotomy

Aim. To analyze the risk factors for pancreatic stent migration, dislocation, and fracture in chronic pancreatitis patients with pancreatic strictures.Materials and Methods. Endoscopic stent placements (total 386 times) were performed in 99 chronic pancreatitis patients with pancreatic duct stenosis at our institution between April 2006 and June 2014. We retrospectively examined the frequency of stent migration, dislocation, and fracture and analyzed the patient factors and stent factors. We also investigated the retrieval methods for migrated and fractured stents and their success rates.Results. The frequencies of stent migration, dislocation, and fracture were 1.5% (5/396), 0.8% (3/396), and 1.2% (4/396), respectively. No significant differences in the rates of migration, dislocation, or fracture were noted on the patient factors (etiology, cases undergoing endoscopic pancreatic sphincterotomy, location of pancreatic duct stenosis, existence of pancreatic stone, and approach from the main or minor papilla) and stent factors (duration of stent placement, numbers of stent placements, stent shape, diameter, and length). Stent retrieval was successful in all cases of migration. In cases of fractured stents, retrieval was successful in 2 of 4 cases.Conclusion. Stent migration, fracture, and dislocation are relatively rare, but possible complications. A good understanding of retrieval techniques is necessary.

scholarly journals Fishing line assisted endoscopic placement of multiple plastic biliary stents for unresectable malignant hilar biliary obstruction: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huahui Zhang ◽  
Fengdong Li ◽  
Jian Huang ◽  
Chunyan Huo ◽  
Jin Huang
Keyword(s):  
Adverse Events ◽  
Biliary Obstruction ◽  
Migration Rate ◽  
Stent Migration ◽  
Success Rates ◽  
Technical Success ◽  
Biliary Stents ◽  
Hilar Biliary Obstruction ◽  
Endoscopic Placement ◽  
Malignant Hilar Biliary Obstruction

Abstract Background and aims Stent migration is one of the most common complications during the placement of multiple plastic biliary stents (MPBS) under endoscopy. This study aims to evaluate the feasibility and efficiency of the fishing line assisted (FLA) method for preventing the complication. Methods Patients with unresectable malignant hilar biliary obstruction (MHBO) who undergone endoscopic placement of MPBS using the FLA or conventional method from May 2018 to April 2021 in our center were enrolled in the study. The endpoints of this study were the stent migration rate, technical success rates, adverse events rates, times of stent migration, and the procedure time. Results FLA group (N = 19) and conventional group (N = 22) had similar baseline characteristics of the patients. The technical success rates (100% vs. 95.5%; P > 0.05), ERCP-related adverse events rates (5.3% vs. 4.5%; P > 0.05), and the stent-related adverse events rates (0% vs. 4.5%; P > 0.05) were no significant differences between the FLA and conventional groups. MPBS inserted using the conventional method consumed more time (median, 33.9 min vs. 15.6 min; P < 0.05) method and increased the times of stent migration (median, 3 times vs. 0 times; P < 0.05) than using the FLA method. Even if no statistical difference was detected in the stent migration rate between groups, this rate was lower in the FLA group than the conventional group (0% vs. 13.6%; P > 0.05). Conclusions FLA method is an effective technique for MPBS implantation to prevent stent migration during endoscopic retrograde cholangiography (ERCP). The method should be applied to patients with unresectable MHBO who need to place MPBS.

Predicting early post-chemotherapy adverse events in patients with hematological malignancies: a retrospective study

2016 ◽  
Vol 24 (6) ◽  
pp. 2727-2733
Author(s):  
Xiaoming Fei ◽  
Fang Lei ◽  
Haifeng Zhang ◽  
Hua Lu ◽  
Yan Zhu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Adverse Events ◽  
Hematological Malignancies

scholarly journals Radiological Parameters Review for Choanal Atresia

2021 ◽  
Vol 13 (2) ◽  
pp. 302-311
Author(s):  
Daniela Messineo ◽  
Maryia Chernikava ◽  
Valeria Pasquali ◽  
Serena Bertin ◽  
Mario Ciotti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Resolution ◽  
Surgical Approach ◽  
Choanal Atresia ◽  
Point Of View ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Imaging Parameters ◽  
Multiplanar Imaging

(1) Background: The study aims to identify which imaging parameters are necessary for a new correct surgical approach in the study of choanal atresia, and which anatomical findings are essential for correct planning of endoscopic treatment in choanal atresia. (2) Methods: In this retrospective study, 19 patients with choanal atresia had high-resolution multiplanar imaging (14 cases aged ≤1 year and 5 cases aged 1 to 3 years) and 35 patients in the control group similarly distributed by age. Fourteen variables, the most relevant from a surgical point of view, were selected and measured. A comparison was made between the averages of the study group and the different control groups, either directly observed or selected from the literature, using Pearson’s correlation. (3) Results: In 14 out of 26 cases, the differences were statistically significant. There was a correlation between the structures assessed, such as choanal height, rostrum height, and age. (4) Conclusions: Thanks to volumetric reformatting, this work identified and provided the clinician with useful information that helped choose the correct surgical approach. Furthermore, it focused on which imaging parameters are necessary to improve the planning of the surgical correction of choanal atresia.

scholarly journals Endoscopic transmural drainage is associated with improved outcomes in disconnected pancreatic duct syndrome: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eric Chong ◽  
Chathura Bathiya Ratnayake ◽  
Samantha Saikia ◽  
Manu Nayar ◽  
Kofi Oppong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Duct ◽  
Meta Analysis ◽  
Fluid Collection ◽  
Significant Heterogeneity ◽  
Success Rates ◽  
Surgical Interventions ◽  
Transmural Drainage ◽  
Transpapillary Drainage ◽  
Duct Syndrome

Abstract Background Disconnected pancreatic duct syndrome (DPDS) is a complication of acute necrotizing pancreatitis in the neck and body of the pancreas often manifesting as persistent pancreatic fluid collection (PFC) or external pancreatic fistula (EPF). This systematic review and pairwise meta-analysis aimed to review the definitions, clinical presentation, intervention, and outcomes for DPDS. Methods The PubMed, EMBASE, MEDLINE, and SCOPUS databases were systematically searched until February 2020 using the PRISMA framework. A meta-analysis was performed to assess the success rates of endoscopic and surgical interventions for the treatment of DPDS. Success of DPDS treatment was defined as long-term resolution of symptoms without recurrence of PFC, EPF, or pancreatic ascites. Results Thirty studies were included in the quantitative analysis comprising 1355 patients. Acute pancreatitis was the most common etiology (95.3%, 936/982), followed by chronic pancreatitis (3.1%, 30/982). DPDS commonly presented with PFC (83.2%, 948/1140) and EPF (13.4%, 153/1140). There was significant heterogeneity in the definition of DPDS in the literature. Weighted success rate of endoscopic transmural drainage (90.6%, 95%-CI 81.0–95.6%) was significantly higher than transpapillary drainage (58.5%, 95%-CI 36.7–77.4). Pairwise meta-analysis showed comparable success rates between endoscopic and surgical intervention, which were 82% (weighted 95%-CI 68.6–90.5) and 87.4% (95%-CI 81.2–91.8), respectively (P = 0.389). Conclusions Endoscopic transmural drainage was superior to transpapillary drainage for the management of DPDS. Endoscopic and surgical interventions had comparable success rates. The significant variability in the definitions and treatment strategies for DPDS warrant standardisation for further research.

Tocilizumab in Giant Cell Arteritis: A Multicenter Retrospective Study of 34 Patients

2016 ◽  
Vol 43 (8) ◽  
pp. 1547-1552 ◽  
Author(s):  
Alexis Régent ◽  
Serge Redeker ◽  
Alban Deroux ◽  
Pierre Kieffer ◽  
Kim Heang Ly ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study ◽  
Efficacy And Safety ◽  
Severe Adverse Events ◽  
Retrospective Multicenter Study

Objective.To report the efficacy and safety of tocilizumab (TCZ) for giant cell arteritis (GCA).Methods.A retrospective multicenter study that included 34 patients receiving TCZ for GCA.Results.TCZ was effective in all but 6 patients, who still had mild symptoms. Mean glucocorticoid dose was tapered. One patient died and 3 patients had to stop TCZ therapy because of severe adverse events. Twenty-three patients stopped treatment; 8 of these experienced relapses after a mean of 3.5 ± 1.3 months.Conclusion.TCZ is effective in GCA. However, side effects occur. Whether this treatment has only a suspensive effect remains to be determined.

Sign in / Sign up

Export Citation Format

Share Document