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 EUS-guided drainage of peripancreatic fluid collections (PFCs) in a large cohort of patients. Also, the technical proficiency for performing EUS-guided drainage of PFCs was evaluated. DESIGN:A prospective study of all patients undergoing EUS-guided drainage of PFC. SETTING:A tertiary-referral center. INTERVENTIONS:After passage of a 0.035-inch guidewire into the PFC by using a 19-gauge needle, graded dilation of the tract was sequentially performed by using a 4.5F ERCP cannula, a 10F ERCP inner guiding catheter, and an 8-mm balloon dilator. A transmural stent and/or drainage catheter was then deployed. MAIN OUTCOME MEASUREMENTS:To evaluate the technical success, treatment success, and complications of the graded dilation technique. Technical proficiency was evaluated by comparing the procedural duration between the first 25 cases (group A), with a later cohort of patients (group B, n = 29) who underwent EUS-guided drainage of a single PFC. RESULTS:Sixty patients (41 men; mean age 51 years [range 20-79 years], 6 multiple PFCs) underwent EUS-guided drainage of a PFC (types included 36 pseudocyst, 15 abscess, and 9 necrosis) over a 42-month period. The rates of technical and treatment success were 95% and 93%, respectively. A minor complication of stent migration was encountered in 1 of 60 patients (1.7%). There was no significant difference in patient or clinical characteristics between group A and B patients who were undergoing drainage of a single PFC. Although there was no significant difference in technical or treatment outcome, median procedural duration was significantly shorter for group B than for group A patients (25 vs 70 minutes; P < .001). Procedural duration for performing EUS-guided drainage of a single PFC was more likely to be <30 minutes in group B than in group A patients (crude odds ratio [OR] 18.8; P < .001), which remained significant (adjusted OR 11.8; P = .01), even after adjusting for patient age; serum albumin; type, location, and size of PFCs; drainage modality (stent vs stent plus drainage catheter); and site of endoscopic access for establishing drainage. CONCLUSIONS:In this study, EUS-guided drainage of a PFC could be performed safely by using the graded dilation technique, with a successful outcome in a majority of patients. Technical proficiency, with regard to procedural duration, improved significantly after the first 25 cases.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Varadarajulu S,Tamhane A,Blakely Jdoi
10.1016/j.gie.2008.03.1091subject
Has Abstractpub_date
2008-10-01 00:00:00pages
656-66issue
4eissn
0016-5107issn
1097-6779pii
S0016-5107(08)01571-Xjournal_volume
68pub_type
杂志文章abstract:BACKGROUND AND AIMS:Optical diagnosis allows for real-time endoscopic assessment of colorectal polyp histology and consists of the resect and discard and diagnose and leave paradigms. This survey assessed patient acceptance of optical diagnosis and their responses to a hypothetical doomsday scenario. METHODS:We conduc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2016.11.031
更新日期:2017-08-01 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 AND AIMS:EMR and endoscopic submucosal dissection (ESD) are widely accepted in Asia for treatment of early gastric cancer (EGC). Few studies have examined lymph node (LN) metastasis of EGC in Western populations. We sought to examine EGC and LN metastasis in a heterogeneous Western population. METHODS:Patie...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.10.039
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:EUS determination of lymph nodal spread of intestinal cancer based on imaging alone is problematic. A noninvasive, reliable means of determining tumor spread to lymph nodes is desirable. This study investigated the feasibility of a computer-assisted evaluation of lymph nodes detected by EUS in patients with ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.128920
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Surveillance and treatment of small-bowel polyps in patients with Peutz-Jeghers syndrome (PJS) can be challenging and may require intraoperative enteroscopy. While initial reports that used double-balloon enteroscopy (DBE) for the resection of small-bowel polyps in patients with PJS appear promising, complet...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.05.031
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND AND AIMS:We developed a suturing method with string and clips for a single-channel endoscope. The feasibility of the string clip suturing method is evaluated in this prospective pilot study. METHODS:This study involved 10 consecutive patients who underwent endoscopic submucosal dissection (ESD) for a duoden...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.11.007
更新日期:2018-04-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.11.033
更新日期:2018-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.gie.2008.03.008
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Patients with malignant esophagorespiratory fistulas have a poor prognosis. Treatment is palliative and involves restoration of the ability to ingest food and prevention of aspiration by insertion of esophageal or tracheobronchial stents. Because insertion of a single stent may be insufficient for palliation...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.119731
更新日期:2002-01-01 00:00:00
abstract:BACKGROUNDS AND AIMS:The Japan NBI Expert Team (JNET) classification is the first universal narrow-band imaging magnifying endoscopic classification of colorectal tumors. Considering each type in this classification, the diagnostic ability of Type 2B is the weakest. Generally, clinical behavior is believed to be differ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.02.018
更新日期:2017-10-01 00:00:00
abstract::Explosions are a rare complication of electrocautery in the colon. The cause of these explosions is ignition of gas containing hydrogen (greater than 4%) or methane (greater than 5%), and oxygen. Hydrogen and methane are products of colonic bacterial metabolism. Oral solutions used for colonoscopy preparation are desi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71168-6
更新日期:1990-11-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2019.11.039
更新日期:2020-04-01 00:00:00
abstract::We investigated the endoscopic and histologic features of 74 nonpolypoid neoplasias of the colorectum measuring 15 mm or less in diameter. Colonoscopically, they were characterized by flat growth, being either slightly elevated with a central depression or else completely flat against the surrounding mucosa. Of the 54...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)80595-4
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy can usually be treated by periodic dilation. Occasionally, however, conservative treatment is insufficient, and patients require long-term tube feeding. We describe 4 cases with stricture after laryngopharyngectomy who underwent inserti...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2009.12.050
更新日期:2010-06-01 00:00:00
abstract::The complication rate for diagnostic laparoscopy reported in the literature is very low (1.07%, 0.3%, and 0.03% for minor and major complications, and deaths, respectively). A prospective study of the complications of diagnostic laparoscopy by 17 gastroenterologists in the Dallas-Fort Worth metropolitan area is report...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(84)72394-7
更新日期:1984-08-01 00:00:00
abstract:BACKGROUND:The pharyngoesophageal segment commonly referred to as the upper esophageal sphincter (UES) generates a high-pressure zone (HPZ) between the pharynx and the esophagus. However, the exact anatomical components of the UES-HPZ remain incompletely determined. OBJECTIVE:To systematically define the US signature ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.04.029
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Effective hemostatic treatment is mandatory for patients with actively bleeding Mallory-Weiss syndrome. This study evaluated the respective efficacy and the safety of endoscopic band ligation and endoscopic epinephrine injection in Mallory-Weiss syndrome. METHODS:Thirty-four consecutive patients with active...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(04)01284-2
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Endoscopic multiband mucosectomy (EMBM) has been used to treat early Barrett's esophagus and esophagogastric junction neoplasia, yet it is seldom reported for the treatment of early esophageal squamous cell neoplasia. Here we retrospectively evaluated the feasibility, safety, and efficacy of EMBM fo...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2016.04.015
更新日期:2016-12-01 00:00:00
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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
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.112711
更新日期:2001-06-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.118950
更新日期:2001-11-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70013-7
更新日期:1995-12-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.02.021
更新日期:2008-08-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2000.110729
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND AND AIMS:Patients with previous colorectal adenomas are at increased risk of colorectal cancer. Current guidelines for postpolypectomy surveillance intervals treat all tubular adenomas 1 to 9 mm in size with low-grade dysplasia as carrying the same level of risk. We evaluated whether 6 to 9 mm adenomas detec...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.08.047
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Image-guided radiation therapy allows the delivery of precisely aimed radiation beams to tumors while minimizing radiation to adjacent normal tissue. This is particularly important in the prostate, a moving target whose positioning depends on the dynamics of its neighboring bladder and rectum. Targeted radia...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2009.03.001
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Cardiopulmonary unplanned events (CUE) related to conscious sedation constitute a major proportion of GI endoscopy-associated complications. OBJECTIVES:Our purpose was to study the incidence of CUE during GI endoscopy and to determine factors that may predict CUE. DESIGN:Retrospective CORI (Clinical Outcom...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.12.040
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Methylene blue has been used to selectively stain areas of specialized intestinal metaplasia in Barrett's esophagus. The sensitivity, specificity, and negative and positive predictive values for the detection of specialized intestinal metaplasia by methylene blue chromoendoscopy were determined in patients w...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2003.137
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:The use of disposable biopsy forceps seems to be effective and safer than reusable biopsy forceps with respect to the risk of infection transmission. The results of cost analysis studies comparing reusable versus disposable biopsy forceps are conflicting. This study compared the cost of reusable versus dispo...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2003.341
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Mechanical lithotripsy is used to break large bile duct stones. This study investigated the predictors of unsuccessful mechanical lithotripsy. METHODS:Consecutive patients with bile duct stones underwent endoscopic retrograde cholangiography, sphincterotomy, and basket removal of stones. Mechanical lithotri...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)00295-0
更新日期:2004-05-01 00:00:00