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Therapeutic outcomes of endoscopic resection for superficial non-ampullary duodenal tumor.

BACKGROUND AND AIM: Endoscopic resection (ER) is widely used as a minimally invasive therapy to remove superficial non-ampullary duodenal tumor (SNADT). However, the indication criteria have not yet been clearly determined. At our institute, ER is done only for SNADT measuring ≤ 20 mm. We report our findings on the therapeutic outcomes of ER of SNADT. METHODS: We carried out ER in 47 patients with SNADT. Indication criteria for ER included a lesion suspected as high-grade dysplasia or mucosal cancer and measuring ≤ 20 mm. The ER methods used to carry out en bloc resection were endoscopic muco

Difficult biliary cannulation: use of physician-controlled wire-guided cannulation over a pancreatic duct stent to reduce the rate of precut sphincterotomy (with video).

BACKGROUND: Successful cannulation of the common bile duct (CBD) remains the benchmark for ERCP. Use of a pancreatic duct (PD) stent to facilitate biliary cannulation has been described, although the majority of patients require precut sphincterotomy to achieve CBD cannulation. OBJECTIVE: To report the performance characteristics of using a PD stent in conjunction with physician-controlled wire-guided cannulation (WGC) to facilitate bile duct cannulation. DESIGN: Retrospective cohort. SETTING: Two tertiary care, academic medical centers. PATIENTS: All undergoing ERCP with native papillae.

Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?

BACKGROUND/AIMS: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. METHODS: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. RESULTS: Of 77,864 participants, 128 (0.16%) h…

Comparison of p.o. or i.v. proton pump inhibitors on 72-h intragastric pH in bleeding peptic ulcer.

BACKGROUND AND AIMS: After successful endoscopic hemostasis in bleeding peptic ulcer, addition of proton pump inhibitors reduce the rate of recurrent bleeding by maintaining intragastric pH at neutral level. The aim of the present study was to evaluate the effect of various proton pump inhibitors given through different routes on intragastric pH over 72 h after endoscopic hemostasis in bleeding peptic ulcer. METHODS: Ninety consecutive patients who had successful endoscopic therapy of bleeding peptic ulcer underwent 72-h continuous ambulatory intragastric pH study, were randomly assigned to r

Duodenal mucosal resurfacing with a GLP-1 receptor agonist increases postprandial unconjugated bile acids in patients with insulin-dependent type 2 diabetes.

Duodenal mucosal resurfacing (DMR) is a new endoscopic ablation technique aimed at improving glycemia and metabolic control in patients with type 2 diabetes mellitus (T2DM). DMR appears to improve insulin resistance, which is the root cause of T2DM, but its mechanism of action is largely unknown. Bile acids function as intestinal signaling molecules in glucose and energy metabolism via the activation of farnesoid X receptor and secondary signaling [e.g., via fibroblast growth factor 19 (FGF19)], and are linked to metabolic health. We investigated the effect of DMR and glucagon-like peptide-1 (

The effects of eradication of Helicobacter pylori on the recurrence of duodenal ulcers in patients with cirrhosis.

BACKGROUND: The role of Helicobacter pylori in patients with cirrhosis and increased prevalence of peptic ulcers is still poorly defined. The objective is to evaluate the effect of H pylori eradication on ulcer recurrence in patients with cirrhosis. METHODS: The study was conducted at a single, tertiary, referral hospital with 1200 beds. Patients with cirrhosis and duodenal ulcers were tested for H pylori and were enrolled in the study. Patients with positive H pylori received eradication therapy. Patients with duodenal ulcers received antisecretory therapy and regular endoscopic examinations

Duodenal Helicobacter pylori associated duodenal ulcer depend on gastric Helicobacter pylori status.

Gastric Helicobacter pylori (H. pylon) plays an important role in the pathogenesis of duodenal ulcer (DU), although not all H. pylori infected persons will develop disease. Duodenal H. pylori was supposed to be one of the factors related with DU. The aim of this study was to investigate whether H. pylori in the duodenum of patients with DU plays a critical role in the pathogenesis of DU regarding the gastric H. pylori status. Furthermore, it was to determine the prevalence of duodenal H. pylori infection in Thailand. Ninety three patients were included in the study. They underwent gastroscopic

Primary aortoenteric fistula following disseminated bacillus Calmette-Guérin infection: a case report.

The aim of this paper is to illustrate a rare case of primary aortoenteric fistula in the presence of disseminated infection and review the critical decision-making process. A clinical case was reviewed for its initial presentation, planning of treatment strategy and outcome. A secondary literature search for discussion on current accepted recommendations for primary aortoenteric fistula was then completed. Aortoenteric fistulas are rare pathologies with highly morbid potential. Their diagnosis requires a high index of suspicion and prompt intervention is critical to patient survival. In concl

Cure of refractory duodenal ulcer and infection caused by Helicobacter pylori by high doses of omeprazole and amoxicillin in a homozygous CYP2C19 extensive metabolizer patient.

A 53-year old female patient with duodenal ulcer and Helicobacter pylori infection was treated three times with a proton pump inhibitor-based triple therapy, such as lansoprazole-clarithromycin-amoxicillin (INN, amoxicilline) and lansoprazole-minocycline-cefaclor. However, the H pylori infection was not cured. A culture test revealed that her infection was a clarithromycin-resistant but amoxicillin-sensitive strain of H pylori. Moreover, a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis revealed that she was a homozygous extensive metabolizer of cytochrom

Temporary placement of a covered duodenal stent can avoid riskier anterograde biliary drainage when ERCP for obstructive jaundice fails due to duodenal invasion.

BACKGROUND: Duodenal stenosis is one of the most common causes of failed ERCP for obstructive jaundice. Alternative approaches include anterograde biliary drainage, with higher morbidity. We report in this study the efficacy and safety of temporary placement of a covered duodenal self-expandable metal stent (cSEMS) in order to access the papilla and achieve secondary retrograde biliary drainage in patients with obstructive jaundice and failed ERCP due to concomitant duodenal stenosis. METHODS: From June 2006 to March 2014, a total of 26 consecutive patients presenting obstructive jaundice wit

Increase in neuroendocrine cells in the duodenal mucosa of patients with refractory celiac disease.

OBJECTIVES: Several immune-mediated gastrointestinal disorders, including celiac disease (CD), are associated with neuroendocrine cell hyperplasia. However, neuroendocrine cells have never been explored in refractory CD (RCD). METHODS: Serial duodenal sections from 17 patients with RCD (6 type 1 and 11 type 2), 16 uncomplicated CD patients before and after gluten-free diet, 14 patients with potential CD, 27 patients with non-CD villous atrophy, i.e., common variable immunodeficiency (n=12), Whipple's disease (n=10) and giardiasis (n=5), and 16 healthy subjects were processed for the immunohis

Pancreas-sparing duodenectomy with regional lymph node dissection for early-stage ampullary carcinoma: A case control study using propensity scoring methods.

AIM: To investigate the outcomes of pancreas-sparing duodenectomy (PSD) with regional lymph node dissection vs pancreaticoduodenectomy (PD). METHODS: Between August 2001 and June 2014, 228 patients with early-stage ampullary carcinoma (Amp Ca) underwent surgical treatment (PD, n = 159; PSD with regional lymph node dissection, n = 69). The patients were divided into two groups: the PD group and the PSD group. Propensity scoring methods were used to select patients with similar disease statuses. A total of 138 matched cases, with 69 patients in each group, were included in the final analysis.

Radiation microsphere-induced GI ulcers after selective internal radiation therapy for hepatic tumors: an underrecognized clinical entity.

BACKGROUND: Intra-arterial infusion of yttrium-90 (Y-90) microspheres is locoregional radiation therapy for unresectable hepatic neoplasms. Literature on GI complications of this novel therapy is sparse. OBJECTIVES: Clinically and pictorially characterize selective internal radiation therapy (SIRT)-induced GI injury and review the published literature. DESIGN: Retrospective chart analysis. SETTING: Single-center tertiary referral community hospital. PATIENTS: One hundred three patients treated with SIRT for hepatic neoplasms between 2006 and 2008. INTERVENTIONS: SIRT for unresectable hepa

Endoscopic management of obesity: Impact of endoscopic sleeve gastroplasty on weight loss and co-morbidities at six months and one year.

INTRODUCTION: Endoscopic sleeve gastroplasty (ESG) is one of the new minimally invasive endoscopic treatments aimed at inducing weight loss. … m October 2016 to July 2021, of the 227 patients who underwent ESG, 99 (43.6%) had follow-up gastro-duodenoscopy at 6 and 12 months. %TWL and %EWL were respectively 16.6±7.4% and 43.3%±21.2 at 6 months, 16.6±9.6% and 42.9±25.6% at one year. Statistically significant reduction rates at 6 and 12 months were observed in T2DM (30.8 and 32.7%), AHT (18.4 and 22.1%) …

Evolution of nonspecific duodenal lymphocytosis over 2 years of follow-up.

AIM: To assess the evolution of duodenal lymphocytosis (DL), a condition characterized by increased intraepithelial lymphocytes (IELs), over 2 years of follow-up. METHODS: Consecutive patients undergoing upper endoscopy/histology for abdominal pain, diarrhea, weight loss, weakness or other extraintestinal features compatible with celiac disease (CD) were included. Evaluation of IELs infiltrate in duodenal biopsy samples was carried out by CD3-immunohistochemistry and expressed as number of positive cells/100 enterocytes. Diagnostic agreement on the IELs count was tested by calculating the wei

AGA Clinical Practice Update on Management of Ampullary Neoplasms: Expert Review.

DESCRIPTION: Although ampullary neoplasia is a rare entity and represents 0.6%-0.8% of gastrointestinal cancers, the incidence among young a … ICE 12: Following endoscopic papillectomy, surveillance should begin at 3 months, with side-viewing duodenoscopy and biopsy of the resection scar and any abnormal area. If there is no residual adenoma, surveillance should be repeated at 6 months and 12 months, and then annually for at least 5 years. Surveillance beyond 5 years should be individualized based on …

Эндоскопический диагностический и клинический курс по изолированному верхнему кишечному амилоидозу: ретроспективное исследование.

ЦЕЛИ: Ранняя диагностика амилоидоза верхней части желудочно-кишечного кишечника (УГИ) и разработка соответствующих стратегий лечения и последующей деятельности по-прежнему сопряжены с трудностями. Цель этого исследования заключалась в выяснении эндоскопических характеристик и клинических курсов пациентов с изолированным амилоидозом УГИ. МЕТОДЫ: Мы провели ретроспективный обзор 11 У пациентов был диагностирован изолированный амилоидоз УГИ в больнице Национального университета им. Чоннама и в больнице Национального университета им. Чоннама Хвасуна. Ни у одного из пациентов не было системного уча

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… In our cohort, Case 3 presented with melena, and duodenoscopy revealed large, deep gastric ulcers. Despite three sessions of successful endoscopic hemostasis, bleeding recurred, and surgical resection was recommended; however, the patient declined. …

Disorders of the Gastrointestinal System

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2018 Ежегодное совещание СНГ: Североамериканская конференция по вопросам неадекватности и регулирования.

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61st Annual Conference of Indian Society of Gastroenterology, Virtual Diamond Jubilee ISGCON 2020, 19-20th December 2020.

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