Nutritional therapy has an important role in the management of patient with severe acute pancreatitis.This article reviews the endoscopist's approach to manage nutrition in such cases.Enteral feeding has been clea...Nutritional therapy has an important role in the management of patient with severe acute pancreatitis.This article reviews the endoscopist's approach to manage nutrition in such cases.Enteral feeding has been clearly validated as the preferred route of feeding,and should be started early on admission.Parenteral nutrition should be reserved for patients with contraindications to enteral feeding such as small bowel obstruction.Moreover,nasogastric feeding is safe and as effective as nasojejunal feeding.If a prolonged course of enteral feeding(>30d) is required,endoscopic placement of feeding gastrostomy or jejunostomy tubes should be considered.展开更多
Pancreatic pseudocysts,abscesses,and walled-off pancreatic necrosis are types of pancreatic fluid colle-ctions that arise as a consequence of pancreatic injury.Pain,early satiety,biliary obstruction,and infection are ...Pancreatic pseudocysts,abscesses,and walled-off pancreatic necrosis are types of pancreatic fluid colle-ctions that arise as a consequence of pancreatic injury.Pain,early satiety,biliary obstruction,and infection are all indications for drainage.Percutaneous-radiologic drainage,surgical drainage,and endoscopic drainage are the three traditional approaches to the drainage of pancreatic pseudocysts.The endoscopic approach to pancreatic pseudocysts has evolved over the past thirty years and endoscopists are often capable of draining these collections.In experienced centers endoscopic ultrasound-guided endoscopic drainage avoids complications related to percutaneous drainage and is less invasive than surgery.展开更多
AIM： To study a cohort of patients undergoing 48 h Bravo pH testing receiving deep sedation with propofol. METHODS： We retrospectively reviewed the charts of 197 patients （81 male, 116 female） who underwent Bravo ...AIM： To study a cohort of patients undergoing 48 h Bravo pH testing receiving deep sedation with propofol. METHODS： We retrospectively reviewed the charts of 197 patients （81 male, 116 female） who underwent Bravo esophageal pH monitoring from July 2003 to January 2008. All patients underwent Bravo pH probe placement via esophagogastroduodenoscopy （EGD） and received propofol for sedation. Patients on a proton pump inhibitor （89 patients） were excluded. Acid reflux variables measured included the total, upright, and supine fractions of time at pH 〈 4 and DeMeester score, and were compared between day I and day 2. RESULTS： Of the 108 patients that were included in the study, the most common indication for Bravo pH monitoring was heartburn, with chest pain being the second most common. A signed rank test revealed no statistically significant difference between day I and day 2 reflux episodes. CONCLUSION： Patients who received propofol for sedation for EGD with Bravo pH capsule placement did not experience any significant difference in reflux episodes from day 1 to day 2.展开更多
文摘Nutritional therapy has an important role in the management of patient with severe acute pancreatitis.This article reviews the endoscopist's approach to manage nutrition in such cases.Enteral feeding has been clearly validated as the preferred route of feeding,and should be started early on admission.Parenteral nutrition should be reserved for patients with contraindications to enteral feeding such as small bowel obstruction.Moreover,nasogastric feeding is safe and as effective as nasojejunal feeding.If a prolonged course of enteral feeding(>30d) is required,endoscopic placement of feeding gastrostomy or jejunostomy tubes should be considered.
文摘Pancreatic pseudocysts,abscesses,and walled-off pancreatic necrosis are types of pancreatic fluid colle-ctions that arise as a consequence of pancreatic injury.Pain,early satiety,biliary obstruction,and infection are all indications for drainage.Percutaneous-radiologic drainage,surgical drainage,and endoscopic drainage are the three traditional approaches to the drainage of pancreatic pseudocysts.The endoscopic approach to pancreatic pseudocysts has evolved over the past thirty years and endoscopists are often capable of draining these collections.In experienced centers endoscopic ultrasound-guided endoscopic drainage avoids complications related to percutaneous drainage and is less invasive than surgery.
文摘AIM： To study a cohort of patients undergoing 48 h Bravo pH testing receiving deep sedation with propofol. METHODS： We retrospectively reviewed the charts of 197 patients （81 male, 116 female） who underwent Bravo esophageal pH monitoring from July 2003 to January 2008. All patients underwent Bravo pH probe placement via esophagogastroduodenoscopy （EGD） and received propofol for sedation. Patients on a proton pump inhibitor （89 patients） were excluded. Acid reflux variables measured included the total, upright, and supine fractions of time at pH 〈 4 and DeMeester score, and were compared between day I and day 2. RESULTS： Of the 108 patients that were included in the study, the most common indication for Bravo pH monitoring was heartburn, with chest pain being the second most common. A signed rank test revealed no statistically significant difference between day I and day 2 reflux episodes. CONCLUSION： Patients who received propofol for sedation for EGD with Bravo pH capsule placement did not experience any significant difference in reflux episodes from day 1 to day 2.
