Goals: The goals are to assess the use of Double Jendo-prostheses in urinary obstructions in the Hospital General de Grand Yoff of Dakar (HOGGY). Patients and methods: This is a 4-year retrospective study (1st January...Goals: The goals are to assess the use of Double Jendo-prostheses in urinary obstructions in the Hospital General de Grand Yoff of Dakar (HOGGY). Patients and methods: This is a 4-year retrospective study (1st January 2009-31st December 2012). The study included all patients with obstruction of the upper urinary tract, and with a reversing type Double Jendo-prostheses. Findings: A total of 82 patients were chosen for this study, including 41 males. Patient’s average age was 45 years. Kidney failure accounted for 11.5% of the causes of consultations. Lithiasic obstacles (34.2%) and tumours (21.5%) were the most recurrent. Catheter was successfully placed in 78% of cases, and highly contributed to improve renal function in 69% of cases. The frequently complications found in patients with Double J Catheters were back pain and urinary tract infections. Four cases of catheters calcifications were reported. Catheter was replaced in 62.2% of patients within an average period of 6.9 months. Conclusion: Double J Catheters remain important in the preservation of renal function in case of obstruction. Its use requires a mastery of these indications and a rigorous follow-up.展开更多
BACKGROUND Percutaneous transhepatic gallbladder drainage has been the most frequently performed treatment for acute cholecystitis for patients who are not candidates for surgery.Endoscopic transpapillary gallbladder ...BACKGROUND Percutaneous transhepatic gallbladder drainage has been the most frequently performed treatment for acute cholecystitis for patients who are not candidates for surgery.Endoscopic transpapillary gallbladder drainage(ETGBD)has evolved into an alternative treatment.There have been numerous retrospective and prospective studies evaluating ETGBD for acute cholecystitis,though results have been variable.AIM To evaluate the efficacy and safety of ETGBD in the treatment of inoperable patients with acute cholecystitis.METHODS We performed a systematic review of major literature databases including PubMed,OVID,Science Direct,Google Scholar(from inception to March 2021)to identify studies reporting technical and clinical success,and post procedure adverse events in ETGBD.Weighted pooled rates were then calculated using fixed effects models for technical and clinical success,and post procedure adverse events,including recurrent cholecystitis.RESULTS We found 21 relevant articles that were then included in the study.In all 1307 patients were identified.The pooled technical success rate was 82.62%[95%confidence interval(CI):80.63-84.52].The pooled clinical success rate was found to be 94.87%(95%CI:93.54-96.05).The pooled overall complication rate was 8.83%(95%CI:7.42-10.34).Pooled rates of post procedure adverse events were bleeding 1.03%(95%CI:0.58-1.62),perforation 0.78%(95%CI:0.39-1.29),peritonitis/bile leak 0.45%(95%CI:0.17-0.87),and pancreatitis 1.98%(95%CI:1.33-2.76).The pooled rates of stent occlusion and migration were 0.39%(95%CI:0.13-0.78)and 1.3%(95%CI:0.75-1.99)respectively.The pooled rate of cholecystitis recurrence following ETGBD was 1.48%(95%CI:0.92-2.16).CONCLUSION Our meta-analysis suggests that ETGBD is a feasible and efficacious treatment for inoperable patients with acute cholecystitis.展开更多
Gas flow patterns during draining of gas from a coal seam during mining are discussed.The coal seam is treated as a dual medium with both pores and cracks.The seepage,diffusion,and desorption processes are treated usi...Gas flow patterns during draining of gas from a coal seam during mining are discussed.The coal seam is treated as a dual medium with both pores and cracks.The seepage,diffusion,and desorption processes are treated using a gas flow equation that describes flow around drill holes.MATLAB is used to solve the differential equations.The permeability tracer test results from a mined coal seam are used to study the variation in gas drainage from a coal seam during mining.The results show that mining can increase the permeability of a coal seam,which then increases the gas drainage.There are inflection points in this variation over time.A close relationship between this variation and the rate of change in coal seam permeability is observed.展开更多
BACKGROUND The migration rate of fully covered self-expandable metal stents(FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a doublepigtail plastic stent(DPS) may decrease migration.AIM...BACKGROUND The migration rate of fully covered self-expandable metal stents(FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a doublepigtail plastic stent(DPS) may decrease migration.AIM To compare stent migration rates between patients who received FCSEMS alone and those who received both an FCSEMS and anchoring DPS.METHODS We conducted a retrospective analysis of endoscopy reporting system and medical records of 1366 patients who underwent endoscopic retrograde cholangiopancreatography(ERCP) with FCSEMS placement at the University of Kentucky health care. Between July 2015 and April 2017,203 patients with FCSEMS insertion for the treatment of malignant biliary stricture,benign biliary stricture,post-sphincterotomy bleeding,bile leak,and cholangitis drainage were identified. The review and analysis were conducted through our endoscopy reporting system(ProVation~? MD) and medical records. Categorical data were analyzed using Chi-Square and Fischer exact test and continuous data using nonparametric tests. A regression analysis was performed to identify factors independently associated with increased risk of stent migration. We determinedan FCSEMS migration endoscopically if the stent was no longer visible in the major papilla.RESULTS1366 patients had undergone ERCP by three advanced endoscopists over 21-mo period; among these,203 patients had FCSEMSs placed. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 95 patients had a malignant stricture,82 patients had a benign stricture,12 patients had bile leak,12 patients had cholangitis,and nine patients had post-sphincterotomy bleeding. The migration rate in patients with anchored FCSEMSs with DPS was 6%,and those without anchoring DPS was 10%(P = 0.35). Overall,migration was reported in 18 patients with FCSEMSs placement out of 203 patients with an overall migration rate of 9.7%. There was no significant association between anchoring the FCSEMSs with DPS and the risk of stent migration. Only patients with the previous sphincterotomy and begin biliary stricture were found to have a statistically significant difference in the migration rate between patients who had FCSEMS with DPS and FCSEMS alone(P = 0.01).CONCLUSION The risk of migration of biliary FCSEMS was 9.7 %. Anchoring an FCSEMS with DPS does not decrease the risk of stent migration.展开更多
文摘Goals: The goals are to assess the use of Double Jendo-prostheses in urinary obstructions in the Hospital General de Grand Yoff of Dakar (HOGGY). Patients and methods: This is a 4-year retrospective study (1st January 2009-31st December 2012). The study included all patients with obstruction of the upper urinary tract, and with a reversing type Double Jendo-prostheses. Findings: A total of 82 patients were chosen for this study, including 41 males. Patient’s average age was 45 years. Kidney failure accounted for 11.5% of the causes of consultations. Lithiasic obstacles (34.2%) and tumours (21.5%) were the most recurrent. Catheter was successfully placed in 78% of cases, and highly contributed to improve renal function in 69% of cases. The frequently complications found in patients with Double J Catheters were back pain and urinary tract infections. Four cases of catheters calcifications were reported. Catheter was replaced in 62.2% of patients within an average period of 6.9 months. Conclusion: Double J Catheters remain important in the preservation of renal function in case of obstruction. Its use requires a mastery of these indications and a rigorous follow-up.
文摘BACKGROUND Percutaneous transhepatic gallbladder drainage has been the most frequently performed treatment for acute cholecystitis for patients who are not candidates for surgery.Endoscopic transpapillary gallbladder drainage(ETGBD)has evolved into an alternative treatment.There have been numerous retrospective and prospective studies evaluating ETGBD for acute cholecystitis,though results have been variable.AIM To evaluate the efficacy and safety of ETGBD in the treatment of inoperable patients with acute cholecystitis.METHODS We performed a systematic review of major literature databases including PubMed,OVID,Science Direct,Google Scholar(from inception to March 2021)to identify studies reporting technical and clinical success,and post procedure adverse events in ETGBD.Weighted pooled rates were then calculated using fixed effects models for technical and clinical success,and post procedure adverse events,including recurrent cholecystitis.RESULTS We found 21 relevant articles that were then included in the study.In all 1307 patients were identified.The pooled technical success rate was 82.62%[95%confidence interval(CI):80.63-84.52].The pooled clinical success rate was found to be 94.87%(95%CI:93.54-96.05).The pooled overall complication rate was 8.83%(95%CI:7.42-10.34).Pooled rates of post procedure adverse events were bleeding 1.03%(95%CI:0.58-1.62),perforation 0.78%(95%CI:0.39-1.29),peritonitis/bile leak 0.45%(95%CI:0.17-0.87),and pancreatitis 1.98%(95%CI:1.33-2.76).The pooled rates of stent occlusion and migration were 0.39%(95%CI:0.13-0.78)and 1.3%(95%CI:0.75-1.99)respectively.The pooled rate of cholecystitis recurrence following ETGBD was 1.48%(95%CI:0.92-2.16).CONCLUSION Our meta-analysis suggests that ETGBD is a feasible and efficacious treatment for inoperable patients with acute cholecystitis.
基金funded by the State Key Basic Research Program of China(No.2011CB201206)the National Science and Technology Significant Special Project(No.2011ZX05040-001)
文摘Gas flow patterns during draining of gas from a coal seam during mining are discussed.The coal seam is treated as a dual medium with both pores and cracks.The seepage,diffusion,and desorption processes are treated using a gas flow equation that describes flow around drill holes.MATLAB is used to solve the differential equations.The permeability tracer test results from a mined coal seam are used to study the variation in gas drainage from a coal seam during mining.The results show that mining can increase the permeability of a coal seam,which then increases the gas drainage.There are inflection points in this variation over time.A close relationship between this variation and the rate of change in coal seam permeability is observed.
文摘BACKGROUND The migration rate of fully covered self-expandable metal stents(FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a doublepigtail plastic stent(DPS) may decrease migration.AIM To compare stent migration rates between patients who received FCSEMS alone and those who received both an FCSEMS and anchoring DPS.METHODS We conducted a retrospective analysis of endoscopy reporting system and medical records of 1366 patients who underwent endoscopic retrograde cholangiopancreatography(ERCP) with FCSEMS placement at the University of Kentucky health care. Between July 2015 and April 2017,203 patients with FCSEMS insertion for the treatment of malignant biliary stricture,benign biliary stricture,post-sphincterotomy bleeding,bile leak,and cholangitis drainage were identified. The review and analysis were conducted through our endoscopy reporting system(ProVation~? MD) and medical records. Categorical data were analyzed using Chi-Square and Fischer exact test and continuous data using nonparametric tests. A regression analysis was performed to identify factors independently associated with increased risk of stent migration. We determinedan FCSEMS migration endoscopically if the stent was no longer visible in the major papilla.RESULTS1366 patients had undergone ERCP by three advanced endoscopists over 21-mo period; among these,203 patients had FCSEMSs placed. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 95 patients had a malignant stricture,82 patients had a benign stricture,12 patients had bile leak,12 patients had cholangitis,and nine patients had post-sphincterotomy bleeding. The migration rate in patients with anchored FCSEMSs with DPS was 6%,and those without anchoring DPS was 10%(P = 0.35). Overall,migration was reported in 18 patients with FCSEMSs placement out of 203 patients with an overall migration rate of 9.7%. There was no significant association between anchoring the FCSEMSs with DPS and the risk of stent migration. Only patients with the previous sphincterotomy and begin biliary stricture were found to have a statistically significant difference in the migration rate between patients who had FCSEMS with DPS and FCSEMS alone(P = 0.01).CONCLUSION The risk of migration of biliary FCSEMS was 9.7 %. Anchoring an FCSEMS with DPS does not decrease the risk of stent migration.
