Abstract:
BACKGROUND:Management of leakages of the gastrojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass (LRYGB) can be complex. New endoscopic techniques such as covered stents and over-the-scope clips (OTCs) have been developed and are valuable alternative therapeutic options to reoperation and drainage. The aim of this study was to compare the value of stents and OTCs with surgical treatment options for the therapy of anastomotic leakages after LRYGB. METHODS:Results of patients who were treated surgically with reoperation, local irrigation and drain placement (n = 9) were compared with results of patients who were treated endoscopically with stent and/or OTC placement (n = 5). Success rate, length of hospital stay, mortality, number of OTC applications/stent placement and percutaneous drainage placements were analyzed. RESULTS:Overall, 14 of 1,046 patients (1.34%) developed a leakage of their gastrojejunal anastomosis after LRYGB between 2000 and 2012. While the success rate in surgically treated patients was 88%, the endoscopic treatment using a sequential approach with stenting, OTC application and percutaneous placement of drainages resulted in a 100% closure rate. The mortality rate and length of stay were not substantially different after both treatment regimens. CONCLUSION:Endoscopic management of anastomotic leakages after LRYGB may constitute a valuable alternative therapeutic option to surgical reoperation and drainage placement.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Schiesser M,Kressig P,Bueter M,Nocito A,Bauerfeind P,Gubler Cdoi
10.1159/000358849subject
Has Abstractpub_date
2014-01-01 00:00:00pages
67-70issue
1eissn
0253-4886issn
1421-9883pii
000358849journal_volume
31pub_type
杂志文章abstract:BACKGROUND/AIMS:The surgical treatment of duodenogastric reflux (DGR), resistant to medical therapy, in patients with intact stomach is difficult to standardize. The aim of this study is to present our experience on 5 patients, all cholecystectomized, with severe DGR disease treated surgically. METHODS:Out of a group ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018583
更新日期:1998-01-01 00:00:00
abstract::Minimally invasive surgery has been shown to offer many advantages to general surgical patients but has not been widely adopted for colorectal disease. Initial fears surrounding the oncological safety of laparoscopic colectomies have largely subsided but the technical challenges still remain. Surgical robots or telema...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000081350
更新日期:2004-01-01 00:00:00
abstract::Anastomotic leakage after colorectal surgery is correlated with considerable morbidity and mortality. Although many studies focus on risk factors and detection, studies on the treatment strategy for colorectal anastomotic leakage are scarce. A national questionnaire amongst 350 members of the Dutch Society for Gastroi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000346348
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Different results and opinions exist concerning the use of a standard or an extended lymphadenectomy, and about the indications for portal vein resection in the surgical treatment of pancreatic cancer. The site of recurrence of pancreatic cancer may help to define the usefulness of different treatments in av...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000018735
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Long-term functional results of ileal pouch-anal anastomosis (IPAA) with mucosal proctectomy (MP) for ulcerative colitis (UC) are satisfactory but may be compromised by perianal fistulae. METHODS:We analyzed the effect of the level of MP (above or below the dentate line) on the risk of perianal fistulae in ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000351443
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:In the management of pancreatic cystic neoplasms (PCN), size plays a crucial role as the expression of disease progression. While many evidences regarding the natural history of growing pancreatic cysts exist, almost no data are available regarding cysts with a reduction in size. METHODS:Radiological and ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000485199
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:Approximately 20% of patients undergoing surgery for ulcerative colitis will retain their rectum. A single-stage proctocolectomy could be an appropriate procedure in patients who are definitely not candidates for a later restorative procedure, but it is generally not advised in acutely ill patients. The...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000381033
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The conservative treatment of acute necrotizing pancreatitis has greatly improved due to broad antibiotic treatment and improved organ support in intensive care units. Nevertheless, infected necrosis or persistent multi-organ dysfunction are predictors of poor outcome. In these patients, there is still a nee...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000345620
更新日期:2012-01-01 00:00:00
abstract::One of the main reasons for the dismal prognosis of pancreatic ductal adenocarcinoma (PDAC) is its late diagnosis. At the time of presentation, only approximately 15-20% of all patients with PDAC are considered resectable and around 30% are considered borderline resectable. A surgical approach, which is the only curat...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000493466
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND/AIMS:Strictureplasty (SP) or miniresective 'bowel-sparing' techniques (MR) can prevent the risk of intestinal stomia and short bowel syndrome in patients affected by Crohn's disease (CD). The aim of this study was to analyze the perioperative morbidity and mortality in 104 of 138 consecutive patients treated...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018845
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIMS:Postoperative urinary retention (POUR) is one of the most frequent complications of epidural anesthesia. This study aims to clarify risk factors of POUR and to estimate the appropriate timing of urethral catheter removal. METHODS:Between September and December 2014, a retrospective cohort study was con...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000490199
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure. OBJECTIVE:The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opin...
journal_title:Digestive surgery
pub_type: 共识发展会议,杂志文章
doi:10.1159/000486207
更新日期:2019-01-01 00:00:00
abstract::Tumour recurrence that obstructs the afferent limb, blocking outflow of bile and pancreatic juice, constitutes a major clinical problem after a Whipple procedure. The endoscopic route is often not a possible alternative. Surgery may be difficult and perhaps dangerous to the often very sick patient and decompression wi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000071760
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Gas in the mesenteric or portal veins (PVG) is an uncommon entity. It was first described only in patients with mesenteric ischemia and bowel gangrene. Later, several reports described other causes for PVG in which conservative treatment was successful. In the past, the diagnosis was made by vague signs in a...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000069388
更新日期:2003-01-01 00:00:00
abstract::Despite the fact that laparoscopic hernia repair was already described in 1979, its value has still not been well defined. The standard treatment for uncomplicated primary hernia repair in Europe is an open anterior approach (i.e. Shouldice), and 'tension-free' mesh plug repair in the USA. At present, posterior mesh i...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000018611
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The optimal management approach to pancreatic serous cystic neoplasms (SCNs) is still evolving. METHODS:Consecutive patients with SCN managed at the Liverpool Pancreas Cancer Centre between 2000 and 2013 were retrospectively reviewed. RESULTS:There were 64 patients consisting of 39 women (60.9%) and 25 men...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000442094
更新日期:2016-01-01 00:00:00
abstract:AIMS:Describe the characteristics of extraintestinal manifestations complicating ulcerative colitis present preoperatively and determine their evolution after surgery. METHODS:Between 1976 and 1986, 281 patients with ulcerative colitis exhibiting one or more extraintestinal manifestations (EIM) before either IPAA (n =...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050097
更新日期:2001-01-01 00:00:00
abstract::Partial liver resections are the treatment of choice for patients with a malignant liver or bile duct tumor. The most frequent indications for partial liver resections are colorectal metastasis, hepatocellular carcinoma (HCC) and cholangiocarcinoma. Liver resection is the only therapy with a chance for cure in these p...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000103656
更新日期:2007-01-01 00:00:00
abstract::Ectopic pancreas is an uncommon condition and is usually found in the gastrointestinal tract, such as stomach, duodenum and jejunum. However, ectopic pancreas in the ampulla of Vater is rare and its clinical presentations may be similar to periampullary cancer. It is difficult to diagnose preoperatively. We present su...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000096158
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Both ectopic pancreatic tissue and malignant insulinoma are rare. We encountered the combination of these rare entities in a patient demonstrating hypoglycemic symptoms. METHOD:A patient with episodic hypoglycemia, non-suppressed serum insulin levels, positive fasting test and a positive localization on bot...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000090998
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:The prevalence and significance of joint symptoms appearing in patients with ulcerative colitis (UC) following a colectomy are unclear. AIM:We investigated the relationship between joint symptoms during steroid tapering following an ileal pouch-anal anastomosis (IPAA) and the cumulative risk for developing ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000093495
更新日期:2006-01-01 00:00:00
abstract::Dysgerminomas of the ovary rarely metastasize to abdominal viscera and when they do, the involvement is a part of a disseminated disease. A 30-year-old woman developed isolated duodenopancreatic dysgerminoma 14 years after salpingo-oophorectomy. The clinical picture was complicated by the presence of tuberculous lesio...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050198
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Hepatic resection for hepatocellular carcinoma (HCC) is now established as the treatment most likely to yield the best outcome. We aimed to clarify the risk factors for HCC recurrence after curative resection of single HCC in patients with normal liver function (NLF). METHODS:The clinical records of 105 pat...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000451066
更新日期:2017-01-01 00:00:00
abstract::A case of carcinoma of the colon that metastasized to the lower gingiva is described. The patient who had carcinoma of the colon developed a proliferating lesion at the site of a recent tooth extraction. A few days later, the primary site of the malignancy appeared. The clinical features in such cases were reviewed in...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050166
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Recent trials have shown promising results for the efficacy of gum chewing for the amelioration of postoperative ileus. This finding could have a major clinical impact since gum chewing is relatively harmless and cheap while postoperative ileus has a significant impact on healthcare. METHODS:Systematic revi...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000117822
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:In the treatment of gastroesophageal reflux disease (GERD), anterior fundoplications are emphasized for their lower risk of complications compared to the posterior approach. AIM:The aim of this study was to evaluate the long-term results of laparoscopic anterior 180 degrees fundoplication in consideration o...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000235959
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:To determine the best imaging modality for preoperative detection, characterization and measurement of colorectal liver metastases (CRLM) after neoadjuvant chemotherapy (NAC). METHODS:A total of 79 lesions in 15 patients with CRLM were included. Following NAC, all patients received multislice liver CT (MS...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000322390
更新日期:2011-01-01 00:00:00
abstract::Ileal J-pouch-anal anastomosis is a commonly accepted surgical treatment for patients with ulcerative colitis. However, making a J-pouch anal anastomosis can be difficult due to anatomical variations of patients. We experienced an informative case of ulcerative colitis in which the ileal pouch was damaged when it was ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000105526
更新日期:2007-01-01 00:00:00
abstract::The intestinal barrier function is considered to play an important role in protecting the penetration of luminal antigens, associated with the development of secondary infection and sepsis and the initiation of the multiple organ dysfunction syndrome. The intestinal mucosal barrier against luminal macromolecules and m...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018651
更新日期:1998-01-01 00:00:00
abstract::Local invasion of adjacent viscera by colorectal liver metastases (CRLM) is no longer considered an absolute contraindication to curative hepatic resection. A growing number of observational analyses have illustrated the feasibility of such resections; however, the evidence base is at best heterogeneous with a lack of...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000485198
更新日期:2018-01-01 00:00:00