Abstract:
BACKGROUND AND AIMS:The standard of care for managing pancreaticobiliary disease in altered Roux-en-Y gastric bypass patients is laparoscopy-assisted endoscopic retrograde cholangiopancreatography (LA-ERCP), but is limited by cost and adverse events. Recently a minimally invasive, completely endoscopic approach using endoscopic ultrasound (EUS) directed transgastric ERCP (EDGE) has been described. We aim to compare EDGE to LA-ERCP in this study. METHODS:Patients from May 2005 to June 2017 with Roux-en-Y gastric bypass anatomy having undergone LA-ERCP or EDGE at 4 tertiary centers were captured in a registry. Patient demographics, procedural details, and clinical outcomes were measured for each group. RESULTS:Seventy-two patients (n=29 EDGE, n=43 LA-ERCP) were included in this study. There was no significant difference in the technical success of EDGE gastrogastric fistula (96.5%) versus LA-gastrostomy creation (100%). The success rate of achieving therapeutic ERCP (EDGE 96.5% vs. LA-ERCP 97.7%) and number of ERCP (EDGE 1.2 vs. LA-ERCP 1.02) needed to achieve clinical resolution was similar between both groups. Adverse event rate for EDGE, 24% (7/29) and LA-ERCP, 19% (8/43) was similar. The total procedure time (73 vs. 184 min) and length of hospital stay (0.8 vs. 2.65 d) was significantly shorter for EDGE compared to LA-ERCP. The overall weight change after EDGE was -6.6 lbs at an average 28-week follow-up. CONCLUSIONS:This study suggests that the EDGE procedure has similar technical success and adverse events compared with LA-ERCP with the benefit of significantly shorter procedure times and hospital stay. EDGE may offer a minimally invasive, effective option, with less resource utilization, and without significant weight gain.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Kedia P,Tarnasky PR,Nieto J,Steele SL,Siddiqui A,Xu MM,Tyberg A,Gaidhane M,Kahaleh Mdoi
10.1097/MCG.0000000000001037subject
Has Abstractpub_date
2019-04-01 00:00:00pages
304-308issue
4eissn
0192-0790issn
1539-2031journal_volume
53pub_type
杂志文章,多中心研究abstract::We describe, to our knowledge, the first reported case of nortriptyline-induced fulminant hepatic failure. This tricyclic antidepressant drug was taken by a postmenopausal woman for 64 days before her presentation. The absence of fever, rash, or marked eosinophilia, the predominant zone 3 necrosis with bridging, and t...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199501000-00014
更新日期:1995-01-01 00:00:00
abstract::Abdominal pain, excruciating and recurrent, is the dominant feature of chronic pancreatitis that initially brings most of the patients to the physician's attention. The pathogenesis of pancreatic pain is often multifactorial and explains why not all patients respond to the same mode of therapy. Increased intraductal p...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199809000-00002
更新日期:1998-09-01 00:00:00
abstract:GOALS:Our primary goal was to evaluate whether anti-tumor necrosis factor (TNF)-α trough levels above author-determined thresholds are associated with increased rates of mucosal healing among patients with Crohn's disease and ulcerative colitis. BACKGROUND:The introduction of anti-TNF agents has considerably advanced ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MCG.0000000000000441
更新日期:2016-10-01 00:00:00
abstract::Helicobacter pylori infection has proven to be extraordinarily difficult to eradicate. Antimicrobial monotherapies have been particularly disappointing, with most eradication rates in the range of 0-15%. Clarithromycin has potential advantages over other macrolides to which H. pylori is susceptible because of its acid...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199306000-00004
更新日期:1993-06-01 00:00:00
abstract::Between 1984 and 1992, 14 cases of "secondary" achalasia were diagnosed at our institution, five due to malignancy and nine as a result of esophageal or paraesophageal surgery. Preoperative manometry had excluded preexistent achalasia in eight of nine of the latter patients. Dysphagia developed immediately postoperati...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199503000-00004
更新日期:1995-03-01 00:00:00
abstract:GOALS:We investigated the prognosis of Crohn's disease (CD) in Korean patients with jejunal involvement. BACKGROUND:Although jejunal involvement is considered a poor prognostic factor of CD in whites, it has never been validated in Asian populations. METHODS:We retrospectively reviewed the medical records of 1403 Kor...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3182705f9e
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Gastrointestinal angiodysplasias (GIAD) are commonly diagnosed in the small bowel but can be located in other areas of the gastrointestinal tract. About half of patients diagnosed with GIAD have more than 1 lesion and 20% of patients have GIAD in both the small bowel and a source outside of the small bowel (...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000836
更新日期:2018-09-01 00:00:00
abstract::Eighty-four patients who were endoscopically confirmed to have healed duodenal ulcers were entered into this 1-year, double-blind, placebo-controlled trial of sucralfate, 1g twice daily, in the prevention of duodenal ulcer recurrence. Patients remained in the study until recurrence of ulceration was endoscopically con...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-198709011-00006
更新日期:1987-01-01 00:00:00
abstract::Silybum marianum (milk thistle) and its derivatives have been used for centuries for the treatment of liver disease. This review focuses exclusively on published literature pertaining to the potential use of Silybum marianum or its derivatives for the treatment of alcoholic liver disease. Clinical studies have varied ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mcg.0000165668.79530.a0
更新日期:2005-07-01 00:00:00
abstract::Ingestion of a corrosive substance can produce severe injury to the gastrointestinal tract and can even result in death. The degree and extent of damage depends on several factors like the type of substance, the morphologic form of the agent, the quantity, and the intent. In the acute stage, perforation and necrosis m...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200308000-00005
更新日期:2003-08-01 00:00:00
abstract::Radiation therapy directed at the abdomen may damage the digestive tract, the type and extent of injury depending on the dose of the radiation and the radiation sensitivity of the gut. Characteristic early changes are manifest in the mucosa of the gut: for later ulceration, changes in the collagen tissues and particul...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-197903000-00003
更新日期:1979-03-01 00:00:00
abstract::A unique case of granulomatous gastritis of unknown etiology is reported. The patient, a 43-year-old Haitian woman, suffered a gastric perforation from a disease process limited to the stomach. The stomach was markedly enlarged and edematous with transmural, serpiginous granulomatous tracks throughout the gastric wall...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198302000-00013
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:Management of diverticular disease (DD) remains a point of debate. GOALS:To investigate the current opinion of participants of the 2nd International Symposium on Diverticular Disease, on real-life management of patients with DD of the colon. STUDY:Twelve questions were aimed at the diagnosis, treatment, an...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000645
更新日期:2016-10-01 00:00:00
abstract::Sigmoid volvulus in young adults is rare. It usually presents as chronic recurrent attacks of abdominal pain. The diagnosis is usually delayed because of a low level of suspicion. We present the case of a 17-year-old girl with recurrent episodes of sigmoid volvulus, to illustrate the problem. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198708000-00023
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND AND AIMS:The efficacy of 6-mercaptopurine (6-MP) in the treatment and long-term maintenance of remission of inflammatory bowel disease and prevention of recurrence after resection in Crohn's disease have been established. Concern about 6-MP toxicity remains, especially the development of neoplasm. The aim of...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200309000-00006
更新日期:2003-09-01 00:00:00
abstract::Autoantibodies are nonpathogenic manifestations of immune reactivity, and they may occur in acute and chronic liver diseases. Autoantibodies may be consequences rather than causes of the liver injury, and they should be regarded as diagnostic clues rather than etiologic markers. Conventional autoantibodies used in the...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200310000-00011
更新日期:2003-10-01 00:00:00
abstract:GOALS AND BACKGROUND:Nearly 40% of cytochrome P450 3A (CYP3A) activity is located in the small intestine. An earlier study has shown that cirrhotics with transjugular intrahepatic portosystemic shunts (TIPS) have diminished intestinal CYP3A activity. We hypothesized that oral CYP3A substrates known to prolong QT interv...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181f8c522
更新日期:2011-08-01 00:00:00
abstract::Helicobacter pylori is absent in the antrum of approximately 5, 25, and 35% of patients with duodenal ulcer, gastric ulcer, and non-ulcer dyspepsia respectively and in the majority of asymptomatic healthy subjects from the West. The absence of H. pylori from the antrum could result from failure of exposure to (Group A...
journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:
更新日期:1991-10-01 00:00:00
abstract::Adrenal neoplasm is a rare cause of Budd-Chiari syndrome. We report a case of fulminant acute Budd-Chiari syndrome due to inferior vena cava thrombosis stemming from invasion by a clinically nonfunctioning adrenal neoplasm. We also review briefly the clinical characteristics of the seven previously reported cases. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199703000-00015
更新日期:1997-03-01 00:00:00
abstract::One patient's story is recounted. Relatively asymptomatic for 20 years, the patient reflects on factors that contributed to his healing. Psychosocial and spiritual dimensions are described as well as biomedical aspects. The story concludes that dealing with Crohn's disease triggered a spiritual quest which in turn con...
journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:10.1097/00004836-199806000-00002
更新日期:1998-06-01 00:00:00
abstract::The term "diverticulitis" indicates the inflammation of a diverticulum or diverticula, which is accompanied by detectable or microscopical perforation. Diverticulitis is a common condition with an estimated incidence of 25%. At present, elective sigmoid resection is recommended after 2 episodes of uncomplicated divert...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e3181886ee4
更新日期:2008-11-01 00:00:00
abstract::Two cases of multiple lymphomatous polyposis (MLP) are presented, involving different segments of the gastrointestinal tract. Both cases display the characteristic clinical and pathologic features of MLP. In addition, we were able to document, for the first time, the endoscopic ultrasonographic findings in this diseas...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200202000-00010
更新日期:2002-02-01 00:00:00
abstract::Although relatively frequent. diabetic involvement of digestive tract motility has not been investigated extensively in different organs. The authors studied esophageal, gastric, and gallbladder motor function in 35 type 2 (noninsulin-dependent) diabetic patients to determine the extent of gut involvement. Of these pa...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199909000-00014
更新日期:1999-09-01 00:00:00
abstract::Clinical reports suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) use might induce esophageal symptoms and damage, including esophagitis, but experimental data are conflicting, and some indicate that NSAIDs improve mucosal damage. It is not known whether patients with endoscopically diagnosed esophagitis dur...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199812000-00007
更新日期:1998-12-01 00:00:00
abstract::Forty-five patients with systemic lupus erythematosus (SLE) underwent a cross-sectional study to evaluate intestinal secretory immunity. Peroral jejunal biopsy with histologic and immunohistochemical assessment of the mucosa were carried out in the patients and in 12 healthy volunteers. It was observed that an altered...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200001000-00009
更新日期:2000-01-01 00:00:00
abstract::Hepatic iron deposition is common in patients with chronic hepatitis C (HCV) and may play a role in progression of liver disease. This pilot study examines the relationship between hepatic iron concentration (HIC) and histologic progression over time in patients with HCV. HIC was retrospectively measured in 14 patient...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200311000-00012
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Beneficial findings concerning probiotics are increasing day by day. However, one of the most important parameter which affects the probiotic activity of a microorganism is its survival during the gastroduodenal transit. Some microencapsulation techniques could be applied to bacterial cells to improve this p...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,随机对照试验
doi:10.1097/MCG.0b013e3181ed0e71
更新日期:2010-09-01 00:00:00
abstract::A selection of landmark articles for a given year in any subject risks being somewhat subjective, and subjectivity is best avoided in scientific endeavor. However, the very nature of such a selection process invites judgment. Like most judges, I, too, claim to avoid conscious bias, but no one who has ever graced the b...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199704000-00003
更新日期:1997-04-01 00:00:00
abstract::Inflammatory bowel disease (IBD) commonly affects women of childbearing age, leading to concerns about the effects of the disease on fertility and pregnancy, the effect of pregnancy on the disease, and the diagnosis and treatment of IBD in the pregnancy women. The literature regarding these issues is reviewed, and a r...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-198206000-00008
更新日期:1982-06-01 00:00:00
abstract::The mechanism of drug resistance of gastric cancer cells has rarely been investigated. We specifically examine the magnitude and the biologic significance of multidrug resistance-1 (MDR-1) expression in human gastric cancer. All patients had previously been treated in prospective clinical trials for advanced gastric c...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199806000-00012
更新日期:1998-06-01 00:00:00