Gallbladder cancer(GBC)is a rare and lethal malignancy;however,it represents the most common type of biliary tract cancer.Patients with GBC are often diagnosed at an advanced stage,thus,unfortunately,losing the opport...Gallbladder cancer(GBC)is a rare and lethal malignancy;however,it represents the most common type of biliary tract cancer.Patients with GBC are often diagnosed at an advanced stage,thus,unfortunately,losing the opportunity for curative surgical intervention.This situation leads to lower quality of life and higher mortality rates.In recent years,the rapid development of endoscopic equipment and techniques has provided new avenues and possibilities for the early and minimally invasive diagnosis and treatment of GBC.This editorial comments on the article by Pavlidis et al.Building upon their work,we explore the new needs and corresponding models for managing GBC from the endoscopic diagnosis and treatment perspective.展开更多
Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome...Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.展开更多
In this editorial,we comment on an article by Xu et al.This article describes a case of crawling-type gastric adenocarcinoma(CRA)distinguished by its rare occurrence and diagnostic complexity.We reviewed the detailed ...In this editorial,we comment on an article by Xu et al.This article describes a case of crawling-type gastric adenocarcinoma(CRA)distinguished by its rare occurrence and diagnostic complexity.We reviewed the detailed case-report findings showcasing clinical,pathological,and molecular characteristics of CRA that shed light on its elusive nature and challenges for early detection and treatment.This case underscored the significance of advanced diagnostic tools such as endoscopic submucosal dissection.Emphasis was placed on the molecular peculiarities of CRA,including the higher mutation rates of genes such as TP53 and RHOA and the notable absence of HER2 amplification,differentiating it from more conventional forms of gastric adenocarcinoma.In this editorial,we advocate for a multidisciplinary approach to effectively manage this rare subtype and highlight the necessity for precision in both diagnostic and therapeutic strategies.Moreover,a heightened awareness urging the adoption of advanced diagnostic techniques and collaborative approaches is necessary among clinicians and researchers.We aim to contribute to the ongoing discourse in gastrointestinal oncology,emphasizing the importance of recognizing and addressing the complexities associated with rare cancer subtypes such as CRA.展开更多
OBJECTIVE: To assess the value of endoscopy in the etiological diagnosis and treatment of post-cholecystectomy syndrome (PCS).METHODS: 386 patients with PCS were given endoscopic retrograde cholangiopancreatography (E...OBJECTIVE: To assess the value of endoscopy in the etiological diagnosis and treatment of post-cholecystectomy syndrome (PCS).METHODS: 386 patients with PCS were given endoscopic retrograde cholangiopancreatography (ERCP).Having been made the etiology clear, patients with choledocholithiasis were subjected to endoscopicsphincterotomy (EST) or endoscopic papillary balloon dilatation (EPBD) to extract stones, those withpapillary inflammatory stricture to EST or EPBD, those with papillary diverticulum and sphincter of Oddidysfunction (SOD) to EPBD, those with papillary tumor and hepatobiliary tumor to endoscopic metalbiliary endoprosthese (EMBE), and those with biliary stricture in the mid bile duct, purulent cholangitis,choledocholithiasis (stones not extracted one time) and bile leakage to endoscopic nose-biliary drainage(ENBD).RESULTS: ERCP was performed successfully in 371 patients (96.1%). No abnormalities were foundendoscopically in 30 patients. In 243 patients with choledocholithiasis, 235 had stones removed after oneto three times. Thirty-nine patients with papillary inflammatory stricture were successfully treated withEST or EPBD. Nine patients with papillary diverticulum which oppressed the papillary opening and 7patients with SOD were also successfully treated with EPBD. In 16 patients with stricture in the mid bileduct, 11 showed improvement after ENBD. Six patients with papillary tumor and 5 patients withhepatobiliary stricture after EMBE showed significant alleviation of jaundice. Six patients with bileleakage caused by cholecystectomy received ENBD successfully, avoiding re-operation. Six patientsdeveloped gastroduodenal ulcer and 4 residual stones in the cholecystic duct. Complications occurred in 21patients (5.7%).CONCLUSIONS: ERCP may detect the etiology of post-cholecystectomy syndrome at early stage, andtherapeutic measures can be taken accordingly in clinical practice.展开更多
BACKGROUND Appendiceal mucocele is a rare disease that causes obstructive dilatation of the appendix due to the intraluminal accumulation of mucin.We report a case of endoscopic diagnosis and treatment of an appendice...BACKGROUND Appendiceal mucocele is a rare disease that causes obstructive dilatation of the appendix due to the intraluminal accumulation of mucin.We report a case of endoscopic diagnosis and treatment of an appendiceal mucocele.CASE SUMMARY A 47-year-old man presented with a protrusion around the orifice of the appendix discovered by colonoscopy incidentally.He was admitted to our hospital for a routine checkup without any symptoms.Abdominal computed tomography showed a cystic mass approximately 3 cm in diameter with fat stranding.The preoperative diagnosis was non-neoplastic appendiceal mucocele,and endoscopic treatment was performed.The endoscopic findings and pathological results supported our preoperative diagnosis.The endoscopic treatment of appendiceal mucocele was feasible and effective,which was confirmed by repeated endoscopy and post-operative computed tomography after 7 mo.CONCLUSION Endoscopic therapy provides a new method for the treatment of appendiceal mucocele.展开更多
Background:Wireless capsule endoscopy(WCE)is an effective,minimally invasive tool used for evaluation of the small intestine.To date,there are no studies evaluating the diagnostic yield of WCE in patients with surgica...Background:Wireless capsule endoscopy(WCE)is an effective,minimally invasive tool used for evaluation of the small intestine.To date,there are no studies evaluating the diagnostic yield of WCE in patients with surgically altered upper gastrointestinal anatomy.Aim:To evaluate the diagnostic yield,technical success and safety of WCE in patients with surgically altered upper gastrointestinal anatomy.Methods:Retrospective chart review of all patients with surgically altered upper GI anatomy who underwent WCE between 2006 and 2016 at the Medical University of South Carolina.Technical success,diagnostic yield,adverse events and therapeutic yield data was collected.Results:Thirty-one cases met inclusion criteria.Two were excluded as they did not undergo WCE due to failed patency capsule.The mean age was 58(69%female).The capsule was ingested in 18 cases and endoscopically placed in 11.The most common surgical anatomy was Roux-en-Y gastric bypass(n=13).Technical success,defined as the capsule reaching the cecum,was achieved in 89.7%of cases.The diagnostic yield was 44.8%,with the most common finding being angioectasia.No intra-or postprocedural adverse events were noted.Discussion:Capsule endoscopy in patients with surgically altered upper GI anatomy appears to show no elevated risk of adverse events and shows similar technical success and diagnostic yield as in patients with native anatomy.展开更多
Artificial neural networks(ANNs)are one of the primary types of artificial intelligence and have been rapidly developed and used in many fields.In recent years,there has been a sharp increase in research concerning AN...Artificial neural networks(ANNs)are one of the primary types of artificial intelligence and have been rapidly developed and used in many fields.In recent years,there has been a sharp increase in research concerning ANNs in gastrointestinal(GI)diseases.This state-of-the-art technique exhibits excellent performance in diagnosis,prognostic prediction,and treatment.Competitions between ANNs and GI experts suggest that efficiency and accuracy might be compatible in virtue of technique advancements.However,the shortcomings of ANNs are not negligible and may induce alterations in many aspects of medical practice.In this review,we introduce basic knowledge about ANNs and summarize the current achievements of ANNs in GI diseases from the perspective of gastroenterologists.Existing limitations and future directions are also proposed to optimize ANN’s clinical potential.In consideration of barriers to interdisciplinary knowledge,sophisticated concepts are discussed using plain words and metaphors to make this review more easily understood by medical practitioners and the general public.展开更多
AIM To investigate and summarise the current evidence surrounding management of Bouveret's syndrome(BS).METHODS A MEDLINE search was performed for the BS. The search was conducted independently by two clinicians(Y...AIM To investigate and summarise the current evidence surrounding management of Bouveret's syndrome(BS).METHODS A MEDLINE search was performed for the BS. The search was conducted independently by two clinicians(Yahya ALHabbal and Matthew Ng) in April 2016. A case of BS is also described.RESULTS A total of 315 articles, published from 1967 to 2016, were found. For a clinically meaningful clinical review, articles published before 01/01/1990 and were excluded, leaving 235 unique articles to review. Twenty-seven articles were not available(neither by direct communication nor through inter-library transfer). These were also excluded. The final number of articles reviewed was 208. There were 161 case reports, 13 reviews, 23 images(radiological and clinical images), and 11 letters to editor. Female to male ratio was 1.82. Mean age was 74 years. Treatment modalities included laparotomy in the majority of cases, laparoscopic surgery, endoscopic surgery and shockwave lithotripsy.CONCLUSION There is limited evidence in the literature about the appropriate approach. We suggest an algorithm for management of BS.展开更多
AIM:To evaluate the clinical usefulness of singleballoon endoscopy(SBE) in patients in whom a colonoscope was technically difficult to insert previously.METHODS:The study group comprised 15 patients(8 men and 7 women)...AIM:To evaluate the clinical usefulness of singleballoon endoscopy(SBE) in patients in whom a colonoscope was technically difficult to insert previously.METHODS:The study group comprised 15 patients(8 men and 7 women) who underwent SBE for colonoscopy(30 sessions).The number of SBE sessions was 1 in 7 patients,2 in 5 patients,3 in 1 patient,4 in 1 patient,and 6 in 1 patient.In all patients,total colonoscopy was previously unsuccessful.The reasons for difficulty in scope passage were an elongated colon in 6 patients,severe intestinal adhesions after open surgery in 4,an elongated colon and severe intestinal adhesions in 2,a left inguinal hernia in 2,and multiple diverticulosis of the sigmoid colon in 1.Three endoscopists were responsible for SBE.The technique for inserting SBE in the colon was basically similar to that in the small intestine.The effectiveness of SBE was assessed on the basis of the success rate of total colonoscopy and the presence or absence of complications.We also evaluated the diagnostic and treatment outcomes of colonoscopic examinations with SBE.RESULTS:Total colonoscopy was successfully accomplished in all sessions.The mean insertion time to the cecum was 22.9 ± 8.9 min(range 9 to 40).Abnormalities were found during 21 sessions of SBE.The most common abnormality was colorectal polyps(20 sessions),followed by radiation colitis(3 sessions) and diverticular disease of the colon(3 sessions).Colorectal polyps were resected endoscopically in 15 sessions.A total of 42 polyps were resected endoscopically,using snare polypectomy in 32 lesions,hot biopsy in 7 lesions,and endoscopic mucosal resection in 3 lesions.Fifty-six colorectal polyps were newly diagnosed on colonoscopic examination with SBE.Histopathologically,these lesions included 2 intramucosal cancers,42 tubular adenomas,and 2 tubulovillous adenomas.The mean examination time was 48.2 ± 20.0 min(range 25 to 90).Colonoscopic examination or endoscopic treatment with SBE was not associated with any serious complications.CONCLUSION:SBE is a useful and safe procedure in patients in whom a colonoscope is technically difficult to insert.展开更多
After the introduction of flexible fiber optic endoscopy to pediatric gastroenterology in the 1970 s, upper gastrointestinal(UGI) endoscopy can be performed for the diagnosis and treatment of all age groups of childre...After the introduction of flexible fiber optic endoscopy to pediatric gastroenterology in the 1970 s, upper gastrointestinal(UGI) endoscopy can be performed for the diagnosis and treatment of all age groups of children. We review indications, contraindications, preparation of patients for the procedure, and details of diagnostic and therapeutic UGI endoscopy used in pediatric surgery. We also discuss potential complications of endoscopy.展开更多
基金the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305the Program for Youth Innovation in Future Medicine,Chongqing Medical University,No.W0138.
文摘Gallbladder cancer(GBC)is a rare and lethal malignancy;however,it represents the most common type of biliary tract cancer.Patients with GBC are often diagnosed at an advanced stage,thus,unfortunately,losing the opportunity for curative surgical intervention.This situation leads to lower quality of life and higher mortality rates.In recent years,the rapid development of endoscopic equipment and techniques has provided new avenues and possibilities for the early and minimally invasive diagnosis and treatment of GBC.This editorial comments on the article by Pavlidis et al.Building upon their work,we explore the new needs and corresponding models for managing GBC from the endoscopic diagnosis and treatment perspective.
文摘Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.
基金The Third Central Hospital of Tianjin,No.2019YNR3.
文摘In this editorial,we comment on an article by Xu et al.This article describes a case of crawling-type gastric adenocarcinoma(CRA)distinguished by its rare occurrence and diagnostic complexity.We reviewed the detailed case-report findings showcasing clinical,pathological,and molecular characteristics of CRA that shed light on its elusive nature and challenges for early detection and treatment.This case underscored the significance of advanced diagnostic tools such as endoscopic submucosal dissection.Emphasis was placed on the molecular peculiarities of CRA,including the higher mutation rates of genes such as TP53 and RHOA and the notable absence of HER2 amplification,differentiating it from more conventional forms of gastric adenocarcinoma.In this editorial,we advocate for a multidisciplinary approach to effectively manage this rare subtype and highlight the necessity for precision in both diagnostic and therapeutic strategies.Moreover,a heightened awareness urging the adoption of advanced diagnostic techniques and collaborative approaches is necessary among clinicians and researchers.We aim to contribute to the ongoing discourse in gastrointestinal oncology,emphasizing the importance of recognizing and addressing the complexities associated with rare cancer subtypes such as CRA.
文摘OBJECTIVE: To assess the value of endoscopy in the etiological diagnosis and treatment of post-cholecystectomy syndrome (PCS).METHODS: 386 patients with PCS were given endoscopic retrograde cholangiopancreatography (ERCP).Having been made the etiology clear, patients with choledocholithiasis were subjected to endoscopicsphincterotomy (EST) or endoscopic papillary balloon dilatation (EPBD) to extract stones, those withpapillary inflammatory stricture to EST or EPBD, those with papillary diverticulum and sphincter of Oddidysfunction (SOD) to EPBD, those with papillary tumor and hepatobiliary tumor to endoscopic metalbiliary endoprosthese (EMBE), and those with biliary stricture in the mid bile duct, purulent cholangitis,choledocholithiasis (stones not extracted one time) and bile leakage to endoscopic nose-biliary drainage(ENBD).RESULTS: ERCP was performed successfully in 371 patients (96.1%). No abnormalities were foundendoscopically in 30 patients. In 243 patients with choledocholithiasis, 235 had stones removed after oneto three times. Thirty-nine patients with papillary inflammatory stricture were successfully treated withEST or EPBD. Nine patients with papillary diverticulum which oppressed the papillary opening and 7patients with SOD were also successfully treated with EPBD. In 16 patients with stricture in the mid bileduct, 11 showed improvement after ENBD. Six patients with papillary tumor and 5 patients withhepatobiliary stricture after EMBE showed significant alleviation of jaundice. Six patients with bileleakage caused by cholecystectomy received ENBD successfully, avoiding re-operation. Six patientsdeveloped gastroduodenal ulcer and 4 residual stones in the cholecystic duct. Complications occurred in 21patients (5.7%).CONCLUSIONS: ERCP may detect the etiology of post-cholecystectomy syndrome at early stage, andtherapeutic measures can be taken accordingly in clinical practice.
文摘BACKGROUND Appendiceal mucocele is a rare disease that causes obstructive dilatation of the appendix due to the intraluminal accumulation of mucin.We report a case of endoscopic diagnosis and treatment of an appendiceal mucocele.CASE SUMMARY A 47-year-old man presented with a protrusion around the orifice of the appendix discovered by colonoscopy incidentally.He was admitted to our hospital for a routine checkup without any symptoms.Abdominal computed tomography showed a cystic mass approximately 3 cm in diameter with fat stranding.The preoperative diagnosis was non-neoplastic appendiceal mucocele,and endoscopic treatment was performed.The endoscopic findings and pathological results supported our preoperative diagnosis.The endoscopic treatment of appendiceal mucocele was feasible and effective,which was confirmed by repeated endoscopy and post-operative computed tomography after 7 mo.CONCLUSION Endoscopic therapy provides a new method for the treatment of appendiceal mucocele.
文摘Background:Wireless capsule endoscopy(WCE)is an effective,minimally invasive tool used for evaluation of the small intestine.To date,there are no studies evaluating the diagnostic yield of WCE in patients with surgically altered upper gastrointestinal anatomy.Aim:To evaluate the diagnostic yield,technical success and safety of WCE in patients with surgically altered upper gastrointestinal anatomy.Methods:Retrospective chart review of all patients with surgically altered upper GI anatomy who underwent WCE between 2006 and 2016 at the Medical University of South Carolina.Technical success,diagnostic yield,adverse events and therapeutic yield data was collected.Results:Thirty-one cases met inclusion criteria.Two were excluded as they did not undergo WCE due to failed patency capsule.The mean age was 58(69%female).The capsule was ingested in 18 cases and endoscopically placed in 11.The most common surgical anatomy was Roux-en-Y gastric bypass(n=13).Technical success,defined as the capsule reaching the cecum,was achieved in 89.7%of cases.The diagnostic yield was 44.8%,with the most common finding being angioectasia.No intra-or postprocedural adverse events were noted.Discussion:Capsule endoscopy in patients with surgically altered upper GI anatomy appears to show no elevated risk of adverse events and shows similar technical success and diagnostic yield as in patients with native anatomy.
基金National Natural Science Foundation of China,No.81773135 and No.82073192。
文摘Artificial neural networks(ANNs)are one of the primary types of artificial intelligence and have been rapidly developed and used in many fields.In recent years,there has been a sharp increase in research concerning ANNs in gastrointestinal(GI)diseases.This state-of-the-art technique exhibits excellent performance in diagnosis,prognostic prediction,and treatment.Competitions between ANNs and GI experts suggest that efficiency and accuracy might be compatible in virtue of technique advancements.However,the shortcomings of ANNs are not negligible and may induce alterations in many aspects of medical practice.In this review,we introduce basic knowledge about ANNs and summarize the current achievements of ANNs in GI diseases from the perspective of gastroenterologists.Existing limitations and future directions are also proposed to optimize ANN’s clinical potential.In consideration of barriers to interdisciplinary knowledge,sophisticated concepts are discussed using plain words and metaphors to make this review more easily understood by medical practitioners and the general public.
文摘AIM To investigate and summarise the current evidence surrounding management of Bouveret's syndrome(BS).METHODS A MEDLINE search was performed for the BS. The search was conducted independently by two clinicians(Yahya ALHabbal and Matthew Ng) in April 2016. A case of BS is also described.RESULTS A total of 315 articles, published from 1967 to 2016, were found. For a clinically meaningful clinical review, articles published before 01/01/1990 and were excluded, leaving 235 unique articles to review. Twenty-seven articles were not available(neither by direct communication nor through inter-library transfer). These were also excluded. The final number of articles reviewed was 208. There were 161 case reports, 13 reviews, 23 images(radiological and clinical images), and 11 letters to editor. Female to male ratio was 1.82. Mean age was 74 years. Treatment modalities included laparotomy in the majority of cases, laparoscopic surgery, endoscopic surgery and shockwave lithotripsy.CONCLUSION There is limited evidence in the literature about the appropriate approach. We suggest an algorithm for management of BS.
文摘AIM:To evaluate the clinical usefulness of singleballoon endoscopy(SBE) in patients in whom a colonoscope was technically difficult to insert previously.METHODS:The study group comprised 15 patients(8 men and 7 women) who underwent SBE for colonoscopy(30 sessions).The number of SBE sessions was 1 in 7 patients,2 in 5 patients,3 in 1 patient,4 in 1 patient,and 6 in 1 patient.In all patients,total colonoscopy was previously unsuccessful.The reasons for difficulty in scope passage were an elongated colon in 6 patients,severe intestinal adhesions after open surgery in 4,an elongated colon and severe intestinal adhesions in 2,a left inguinal hernia in 2,and multiple diverticulosis of the sigmoid colon in 1.Three endoscopists were responsible for SBE.The technique for inserting SBE in the colon was basically similar to that in the small intestine.The effectiveness of SBE was assessed on the basis of the success rate of total colonoscopy and the presence or absence of complications.We also evaluated the diagnostic and treatment outcomes of colonoscopic examinations with SBE.RESULTS:Total colonoscopy was successfully accomplished in all sessions.The mean insertion time to the cecum was 22.9 ± 8.9 min(range 9 to 40).Abnormalities were found during 21 sessions of SBE.The most common abnormality was colorectal polyps(20 sessions),followed by radiation colitis(3 sessions) and diverticular disease of the colon(3 sessions).Colorectal polyps were resected endoscopically in 15 sessions.A total of 42 polyps were resected endoscopically,using snare polypectomy in 32 lesions,hot biopsy in 7 lesions,and endoscopic mucosal resection in 3 lesions.Fifty-six colorectal polyps were newly diagnosed on colonoscopic examination with SBE.Histopathologically,these lesions included 2 intramucosal cancers,42 tubular adenomas,and 2 tubulovillous adenomas.The mean examination time was 48.2 ± 20.0 min(range 25 to 90).Colonoscopic examination or endoscopic treatment with SBE was not associated with any serious complications.CONCLUSION:SBE is a useful and safe procedure in patients in whom a colonoscope is technically difficult to insert.
文摘After the introduction of flexible fiber optic endoscopy to pediatric gastroenterology in the 1970 s, upper gastrointestinal(UGI) endoscopy can be performed for the diagnosis and treatment of all age groups of children. We review indications, contraindications, preparation of patients for the procedure, and details of diagnostic and therapeutic UGI endoscopy used in pediatric surgery. We also discuss potential complications of endoscopy.
