Abstract:
OBJECTIVE:The chemical composition and clinical significance of white bile in patients with malignant biliary obstruction were evaluated in a prospective study. METHODS:Consecutive patients (January 1996 through December 1997) with inoperable malignant biliary obstruction underwent endoscopic placement of 10F straight, plastic biliary stents. Bile was aspirated during the endoscopic procedure. Patients were divided into 2 groups: those with white and those with yellow bile. The chemical composition of bile was analyzed. Levels of bile acids in the serum and bile (11 samples) were estimated by high-performance thin-layer chromatography. The groups were compared for decremental fall in bilirubin (b value), cholangitis after stent insertion, and survival. RESULTS:Thirty-five patients (15 men, 20 women; mean age 54 years) underwent endoscopic drainage for malignant obstruction (29 hilar, 6 distal bile duct). Eighteen patients had white bile. Refractory jaundice (b > -0.025) was seen in 9 (50%) patients with white bile compared with 3 (17.6%) with yellow bile; mean difference -42.2 (95% CI [-62.4, -22.0]) and -45.7 (95% CI [-72.0, -19.4]), respectively. The bilirubin (0.48 mg/L) and bile acid (15.6 mmol/L) concentrations in white bile were significantly less than bilirubin (42.7 mg/L) and bile acid (61.3 mmol/L) concentrations in yellow bile; mean difference -42.2 (95% CI [-62.4, -22.0]) and mean difference -45.7 (95% CI [-72.0, -19.4]), respectively. Cholangitis developed in 66.6% of patients with white bile compared with 35% of those with yellow bile (OR 3.67: 95% CI [0.74, 19.25]). Kaplan-Meier curves showed that median survival (interquartile range) was shorter in patients with white bile (35 [23-60] versus 77 [35-220] days) (p = 0.004, log rank test), which was significant even after adjusting for potential confounders with Cox proportional hazards regression. CONCLUSION:White bile is largely devoid of bilirubin and bile acids. The presence of white bile was associated with significantly worse survival in patients with malignant biliary obstruction.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Ahuja V,Garg PK,Kumar D,Goindi G,Tandon RKdoi
10.1067/mge.2002.121336keywords:
subject
Has Abstractpub_date
2002-02-01 00:00:00pages
186-91issue
2eissn
0016-5107issn
1097-6779pii
S0016-5107(02)99933-5journal_volume
55pub_type
杂志文章abstract:BACKGROUND:The optimal endoscopic approach to the drainage of malignant hilar strictures remains controversial, especially with regard to the extent of desirable drainage and unilateral or bilateral stenting. OBJECTIVE:To identify useful criteria for predicting successful endoscopic drainage. DESIGN AND SETTING:Retro...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2010.06.040
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:In contrast to laparoscopic tubal ligation, oophorectomy, and appendectomy, laparoscopic distal pancreatectomy is associated with a morbidity rate of more than 50% and a mortality rate of more than 3%. OBJECTIVE:To develop a minimally invasive, transgastric endoscopic technique for distal pancreatectomy in ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.02.042
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Endoscopic submucosal dissection (ESD) was developed to overcome the problem caused by incomplete resection by conventional EMR for early gastric cancer. However, the technique of ESD had a relative higher incidence rate of complications such as bleeding and perforation because of its large wound incidence a...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析
doi:10.1016/j.gie.2012.06.014
更新日期:2012-10-01 00:00:00
abstract::The long-term effects of endoscopic dilation of colonic or ileo-colonic Crohn's disease strictures were analyzed. In 18 patients with a Crohn's disease-related low gastrointestinal stricture, the stenosis was dilated using through-the-scope (TTS) balloon catheters. A dilation to a diameter of 18 mm was always attempte...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70379-4
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Preoperative diagnosis of solid pancreatic lesions remains challenging despite advancement in imaging technologies. EUS has the benefit of being a minimally invasive, well-tolerated procedure, although results are operator-dependent. The addition of FNA (EUS-guided FNA) provides samples for cytopathologic an...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析
doi:10.1016/j.gie.2011.08.049
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND AND AIMS:False positive (FP) results by computer-aided detection (CADe) hamper the efficiency of colonoscopy by extending examination time. Our aim was to develop a classification of the causes and clinical relevance of CADe FPs, and to assess the relative distribution of FPs in a real-life setting. METHODS...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.06.021
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Endoscopic nasobiliary drainage (NBD) for the treatment of acute cholangitis is an accepted method. A recently developed ultrathin transnasal videoendoscope is minimally invasive, even for patients who are critically ill. OBJECTIVE:To evaluate the clinical efficacy and safety of 1-step NBD by transnasal vid...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.11.050
更新日期:2008-07-01 00:00:00
abstract::This is one of a series of documents prepared by the ASGE Training Committee. This curriculum document contains recommendations for training, intended for use by endoscopy training directors, endoscopists involved in teaching endoscopy, and trainees in endoscopy. It was developed as an overview of techniques currently...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.09.023
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:There is increasing interest in the use of propofol, an ultrashort-acting hypnotic agent, for sedation during endoscopic examinations. A protocol was developed for administration of propofol, combined with small doses of midazolam and meperidine, for endoscopic sedation under the direction of a gastroenterol...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02010-8
更新日期:2003-11-01 00:00:00
abstract::We compared the results of ultrasonically guided fine needle aspiration biopsy and laparoscopy in 63 patients who underwent both procedures. In this series, fine needle biopsy showed a sensitivity of 75.6% with a 84.1% overall accuracy. Laparoscopy demonstrated a 74.3% sensitivity with an overall accuracy of 82.7%. Th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(88)71318-8
更新日期:1988-05-01 00:00:00
abstract::Meperidine is routinely proscribed during sphincter of Oddi manometry because narcotics have been associated with spasm of the sphincter of Oddi. We have performed a prospective study of the effect of meperidine on sphincter of Oddi manometry in 18 patients undergoing manometry for suspected sphincter dysfunction. Aft...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(94)70002-8
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND AND AIMS:The effect of Helicobacter pylori eradication on de novo gastric cancer is controversial, although meta-analyses suggest a reduction in gastric cancer after eradication. The effect of high-density lipoprotein (HDL) on gastric cancer has been rarely reported. METHODS:In this large retrospective coho...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.04.232
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Intrahepatic stones are characterized by high treatment failure and recurrence rates. In the past, surgery played a major role in the management of this disease, but surgical intervention may not be feasible in previously operated patients or those classified as poor surgical risks. The development of percut...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70236-9
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Quality endoscopy reporting is essential when community endoscopists perform colonoscopies for veterans who cannot be scheduled at a Veterans Administration (VA) facility. OBJECTIVE:To examine the quality of colonoscopy reports received from community practices and to determine factors associated with more ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.03.002
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND AIMS:The technical difficulties inherent in endoscopic submucosal dissection (ESD) for colorectal neoplasms may result in the failure of en bloc resection or perforation. The aim of this retrospective study was to assess the predictors of en bloc resection failure or perforation by using preoperatively a...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.08.024
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The aim of therapy for advanced esophageal cancer is relief of dysphagia with minimal treatment-related morbidity. This study assessed the efficacy of endoscopic intratumoral injection of cisplatin/epinephrine gel to relieve obstruction and improve swallowing. The gel is designed to minimize diffusion of act...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1067/mge.2002.129212
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Ileoscopy is the criterion standard for mucosal lesions of terminal ileum but is performed in 5% of colonoscopy activity, and the need for training is undefined. OBJECTIVE:To assess the learning curve and skill-keeping line of ileoscopy. DESIGN:Prospective randomized study. SETTING:Single GI endoscopy uni...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2005.09.029
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Forming anastomoses between two hollow organs at flexible endoscopy might reduce the need for surgery for obstructing malignancy. Current methods require access to both lumens. The aim of this work was to develop methods of forming an anastomosis at flexible endoscopy, such as a gastrojejunostomy or cholecys...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/s0016-5107(03)02006-6
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND AND AIMS:Symptomatic pancreatic walled-off necrosis (WON) may be managed by endoscopic transmural drainage and endoscopic transmural necrosectomy, with stent placement at endoscopic drainage sites. The optimal stent choice is yet to be determined. We compared outcomes after endoscopic management of WON using...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.04.032
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:A simple and safe method for controlled ablation of esophageal mucosa is not currently available. Therefore, an endoscopic cryotherapy device was developed and its efficacy and safety were assessed in a swine model. METHODS:The device consists of a cryogenic system that delivers cold nitrogen gas via a cath...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70352-4
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Split-dose bowel preparation for colonoscopy results in superior preparation quality. However, some endoscopy units remain hesitant to prescribe split-dose preparation given theoretical concerns about possible aspiration caused by gastric residual fluid when a second dose is given close to the time ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.08.081
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND AND AIMS:In chronic pancreatitis (CP), fibrotic pancreatic duct (PD) strictures pose a therapeutic challenge, because endoscopic dilatation requires multiple procedures with suboptimal results. Biodegradable self-expandable stents (BD-SESs) may serve as an alternative in this setting. METHODS:Patients with ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.08.018
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND AIMS:Pancreatic cancer (PC) is a deadly disease that is most commonly diagnosed at an incurable stage. Different high-risk genetic variants and cancer syndromes increase the lifetime risk of developing PC. This study aims to assess the yield of initial PC screening in patients with high-risk germline mut...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.12.019
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:EUS provides excellent imaging of the gastric wall. The utility of EUS imaging in guiding the placement of a gastric pacemaker was investigated. METHODS:Fourteen patients underwent gastric pacemaker implantation for refractory gastroparesis at laparotomy. Placement of the lead into the muscle layer of the a...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2002.123275
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue. OBJECTIVE:To examine PDR variation with the MCR shift schedule. DESIG...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.07.025
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Secretin, a 27 amino acid polypeptide released in response to duodenal luminal acidification, stimulates secretion of water and bicarbonate from pancreatic ductal cells. To date the only secretin available for clinical use has been a biologically derived compound extracted from porcine duodenums. Although us...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mge.2003.195
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Routine endoscopic mucosal biopsies are generally considered safe. However, the outcomes of performing large numbers of biopsies in subjects enrolled in research protocols have not been reported. OBJECTIVE:Our purpose was to assess the safety of taking numerous mucosal biopsy specimens during endoscopic pro...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.05.015
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Although the utility and safety of EUS and EUS-guided FNA is well known, there is a need for more data on outcomes and complications of EUS-guided drainage procedures. OBJECTIVE:To evaluate the rates of technical success, treatment success, and complications of the graded dilation technique for performing E...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.03.1091
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND AND AIMS:Endocuff (Arc Medical Design, Leeds, UK) and Endocuff Vision (Arc Medical Design, Leeds, UK) are effective mucosal exposure devices for improving polyp detection during colonoscopy. AmplifEYE (Medivators Inc, Minneapolis, Minn, USA) is a device that appears similar to the Endocuff devices but has re...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.06.046
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the effectiveness of endoscopic sphincterotomy for preoperative and postoperative complications of hepatic hydatid disease. METHODS:Nineteen patients underwent endoscopic treatment for complications of hepatic hydatid disease. Indications for ERCP in 5 patients treated ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.118256
更新日期:2001-10-01 00:00:00