Abstract:
BACKGROUND:Because sphincterotomy accounts for a major portion of the morbidity and mortality associated with ERCP, we have proposed endoscopic balloon papillary dilation or sphincteroplasty as an alternative. METHODS:We report the outcome in a series of 100 patients in whom balloon sphincteroplasty was attempted for bile duct stones up to 20 mm in diameter, with a median follow-up of 16 months (range 6 to 30). RESULTS:During one ERCP session using sphincteroplasty alone, the bile duct was cleared in 78%, mechanical lithotripsy being required in 10% for stones greater than 12 mm in diameter. Incomplete duct clearance was achieved in a further 4%, all of whom underwent repeat ERCP with successful duct clearance without recourse to sphincterotomy. Failure to clear the bile duct with sphincteroplasty in the remaining 18% was primarily related to large stone size ( > 15 mm). Sphincterotomy was required to clear the duct in 7%. Another 6% comprised elderly high-risk patients with multiple large stones greater than 15 mm who were treated by stent insertion plus ursodeoxycholic acid. No papillary hemorrhage was observed; uncomplicated pancreatitis occurred in 5%. During a median follow-up of 16 months, 2% had recurrent symptomatic bile duct stones considered to have been unrecognized following the initial ERCP: these were removed after repeat sphincteroplasty. No clinical evidence of papillary stenosis was observed during follow-up. CONCLUSIONS:Endoscopic balloon papillary dilation or sphincteroplasty is a safe and effective alternative to sphincterotomy in the management of bile duct stones less than 12 mm; larger stones may require mechanical lithotripsy to facilitate duct clearance.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Mathuna PM,White P,Clarke E,Merriman R,Lennon JR,Crowe Jdoi
10.1016/s0016-5107(95)70052-8subject
Has Abstractpub_date
1995-11-01 00:00:00pages
468-74issue
5eissn
0016-5107issn
1097-6779pii
S0016-5107(95)70052-8journal_volume
42pub_type
杂志文章abstract:BACKGROUND:The efficient management of the endoscopy unit involves issues of scheduling. The aim of this study was to assess efficient use of an endoscopy unit and its relationship to patient waiting. METHODS:Formulas of queueing theory are applied to patient scheduling in endoscopy. The M/M/n queueing model assumes e...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2000.108625
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND AND AIMS:In 2015, the U.S. Food and Drug Administration and Centers for Disease Control and Prevention (CDC) issued guidance for duodenoscope culturing and reprocessing in response to outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) duodenoscope-related infections. Based on this guidance, we implem...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.05.001
更新日期:2018-01-01 00:00:00
abstract::Forceful dilation of the lower esophageal sphincter is considered primary therapy for achalasia. The Witzel pneumatic balloon dilator, unlike fluoroscopically placed dilators, is placed over a standard gastroscope allowing positioning and dilation under direct vision. We report our experience with the Witzel dilator i...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71120-0
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND AND AIMS:Direct injection of chemotherapy into the portal vein for treatment of liver metastases may increase hepatic tissue levels while decreasing systemic levels and toxicities. We aimed to evaluate EUS-guided portal injection chemotherapy (EPIC) by using drug-eluting microbeads or nanoparticles and compa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.08.064
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The presence of a duodenal stent may hinder attempts at ERCP for treatment of malignant biliary obstruction. OBJECTIVE:We describe 2 patients in whom endoscopic fenestration of indwelling duodenal stents with an argon plasma coagulator facilitated successful ERCP. DESIGN:Single-center retrospective case se...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.08.026
更新日期:2009-01-01 00:00:00
abstract::Fifty-two self-expanding metal stents were implanted in 39 patients with malignant (35 patients) or benign (4 patients) biliary stenoses. The stents were inserted and properly released by means of a 7 or 9 French gauge delivery catheter via the percutaneous (20 patients) or transpapillary (19 patients) route. In all c...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(91)70617-2
更新日期:1991-01-01 00:00:00
abstract::Colonoscopic removal of large, sessile polyps is difficult, but can be successfully carried out by experienced endoscopists. "Piecemeal" resection with an electrocautery snare was performed at our institution in 108 patients with 132 such lesions. The mean size of the unresected polyps was 3.0 cm. Complications occurr...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70421-0
更新日期:1992-05-01 00:00:00
abstract::A double-blind, placebo-controlled randomized clinical study was performed in 69 outpatients scheduled for endoscopy and sedated with midazolam to assess the efficacy, safety, and usefulness of flumazenil in reversing the effects of midazolam-induced sedation. Midazolam was administered intravenously before endoscopy ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-05-01 00:00:00
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:Duodenal adenomas are extremely common in patients with familial adenomatous polyposis. However, it is uncertain whether patients with duodenal adenomas without familial adenomatous polyposis are at greater risk for colorectal neoplasia and, therefore, should routinely undergo surveillance colonoscopy. The a...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01712-2
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:EUS-FNA has limitations in cancer diagnosis/staging. New contrast agents, transducers, and processors have improved the potential of contrast-enhanced harmonic (CEH)-EUS. OBJECTIVE:To determine optimal settings and preliminary accuracy of CEH-EUS by using a second-generation perflutren lipid microsphere con...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.09.014
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:By assessing the intrapapillary capillary loop in esophageal mucosa, magnifying endoscopy can play an important role in the evaluation of superficial esophageal lesions. A newly developed narrow-band imaging system was applied to magnifying endoscopy in a clinical setting; the benefit of the narrow-band imag...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02532-x
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:The risk of exacerbating subclinical hepatic encephalopathy associated with the administration of sedative drugs in patients with cirrhosis undergoing diagnostic upper gastrointestinal (GI) endoscopy for portal hypertension remains to be determined. METHODS:Ten adult patients with cirrhosis completed number...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(99)70283-x
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND AND AIMS:EUS-guided biliary drainage (EUS-BD) is increasingly used as an alternate therapeutic modality to percutaneous transhepatic biliary drainage (PTBD) for biliary obstruction in patients who fail ERCP. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 proc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.gie.2016.12.023
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:When choledochoscopic lithotomy with basket and electrohydraulic lithotripsy is used to remove intrahepatic duct stones, fragments or small stones usually remain in the bile duct that are too small to be captured with a basket. METHODS:An attempt was made to remove stone fragments in 16 patients with intrah...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.116881
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Curability is associated with resection width and depth in polypectomy. We evaluated the resection width and depth achieved with hot snare polypectomy (HSP) and cold snare polypectomy (CSP) for small colorectal polyps. METHODS:In this single-center, prospective, randomized controlled study, patient...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2017.10.041
更新日期:2018-04-01 00:00:00
abstract::Endosonography was performed in 76 patients who had endoscopically detected gastroesophageal varices or questionable submucosal lesions, or who were being evaluated for pancreatic carcinoma or pancreatitis. The result were compared with surgery or autopsy results. The patients were divided retrospectively into four gr...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70071-4
更新日期:1995-08-01 00:00:00
abstract:PURPOSE:The safety and efficacy of esophageal dilation is enhanced when direct visualization is possible, tactile sensation and feedback from resistance is maintained, and multiple dilations with a single passage of the dilating device is an option. The InScope Optical Dilator (InScope, a Division of Ethicon Endo-Surge...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.08.042
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Transgastric flexible endoscopic anastomosis might offer advantages over open and laparoscopic surgery, especially for bariatrics or patients with obstructive malignancy. OBJECTIVE:To develop methods for performing transgastric anastomosis. DESIGN/RESULTS:Twelve gastrojejunal anastomoses were formed in pig...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.09.035
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Complications with EUS-guided fine needle aspiration cytology (EUS-guided FNA) are rare and include perforation, infection, pancreatitis, and intraluminal bleeding. To date, the ultrasound appearance and clinical significance of perilesional bleeding during EUS-guided FNA have not been described. The aim of ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.111391
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Acute GI bleeding is a life-threatening complication of warfarin therapy. Acute GI bleeding in patients with an international normalized ratio of 4.0 or greater (supratherapeutic) is often attributed to trivial mucosal lesions. The aim of the study was to determine the frequency of potentially significant le...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND AND AIMS:Self-expandable metal stents (SEMSs) are used to relieve malignant biliary obstructions. We aimed to compare stent patency, the adverse events rate, and overall survival of covered versus uncovered self-conformable metal stents in patients with primary malignant extrahepatic biliary strictures, not ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2018.03.029
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Annular pancreas is a congenital anomaly whereby pancreatic tissue encircles the duodenum. Current knowledge of endoscopic findings of annular pancreas is limited to small case series. The aim of this study was to describe the endoscopic and pancreatographic findings of patients with annular pancrea...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.09.008
更新日期:2019-02-01 00:00:00
abstract::This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal. ...
journal_title:Gastrointestinal endoscopy
pub_type: 撤回出版物
doi:10.1016/j.gie.2019.06.012
更新日期:2019-06-19 00:00:00
abstract:BACKGROUND:Unsedated endoscopy has not gained wide acceptance in the United States. Factors that may predict tolerance and acceptance of unsedated endoscopy are ill defined. METHODS:Outpatients referred for standard EGD were recruited to undergo unsedated ultrathin esophagoscopy (UUE) with a new 3.1-mm battery-powered...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.123274
更新日期:2002-05-01 00:00:00
abstract::Seventeen patients, 15 women and 2 men with upper abdominal pain categorized to biliary group I suspected sphincter of Oddi dysfunction, underwent thorough clinical evaluation including ERCP and endoscopic sphincter of Oddi manometry. All the patients were subsequently treated by endoscopic (n = 15) or surgical (n = 2...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70264-3
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Nonvariceal upper GI bleeding (NVUGIB) that occurs in patients already hospitalized for another condition is associated with increased mortality, but outcome predictors have not been consistently identified. OBJECTIVE:To assess clinical outcomes of NVUGIB and identify predictors of mortality from NVUGIB in ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2013.10.009
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Ex vivo training of ERCP by using simulators is desirable before trainees perform endoscopy in patients. OBJECTIVE:We aimed to construct a simple and inexpensive but realistic simulator for ERCP training. DESIGN:Construction and establishment of an ERCP simulator. SETTING:Endoscopy suite. INTERVENTION:An...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.01.006
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:There are limited data regarding work-related injury among endoscopists. OBJECTIVE:To define the prevalence of endoscopy-related musculoskeletal injuries and their impact on clinical practice and to identify physician and practice characteristics associated with their development. DESIGN:Survey. SETTING:E...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.06.036
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:To assess capacity for colonoscopy, we need to understand current utilization of colonoscopy in diverse clinical practice settings. The objective of this study was to determine the utilization of colonoscopy in diverse clinical practice settings. METHODS:The Clinical Outcomes Research Initiative (CORI) data...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.06.037
更新日期:2005-12-01 00:00:00