In patients with a malignant biliary obstruction who require biliary drainage,a self-expandable metallic stent(SEMS) provides longer patency duration than a plastic stent(PS).Nevertheless,a stent occlusion by tumor in...In patients with a malignant biliary obstruction who require biliary drainage,a self-expandable metallic stent(SEMS) provides longer patency duration than a plastic stent(PS).Nevertheless,a stent occlusion by tumor ingrowth,tumor overgrowth and biliary sludge may develop.There are several methods to manage occluded SEMS.Endoscopic management is the preferred treatment,whereas percutaneous intervention is an alternative approach.Endoscopic treatment involves mechanical cleaning with a balloon and a second stent insertion as stent-in-stent with either PS or SEMS.Technical feasibility,patient survival and cost-effectiveness are important factors that determine the method of re-drainage and stent selection.展开更多
Acute pancreatitis is of one the most common gastroenterology-related indications for hospital admissions worldwide.With the widespread reliance on endoscopic retrograde cholangiopancreatography(ERCP)for the managemen...Acute pancreatitis is of one the most common gastroenterology-related indications for hospital admissions worldwide.With the widespread reliance on endoscopic retrograde cholangiopancreatography(ERCP)for the management of pancreaticobiliary conditions,post-ERCP pancreatitis(PEP)has come to represent an important etiology of acute pancreatitis.Despite many studies aiming to better understand the pathogenesis and prevention of this iatrogenic disorder,findings have been heterogeneous,and considerable variation in clinical practice exists.Herein,we review the literature regarding PEP with the goal to raise awareness of this entity,discuss recent data,and present evidence-based best practices.We believe this manuscript will be useful for gastrointestinal endoscopists as well as other specialists involved in the management of patients with PEP.展开更多
文摘In patients with a malignant biliary obstruction who require biliary drainage,a self-expandable metallic stent(SEMS) provides longer patency duration than a plastic stent(PS).Nevertheless,a stent occlusion by tumor ingrowth,tumor overgrowth and biliary sludge may develop.There are several methods to manage occluded SEMS.Endoscopic management is the preferred treatment,whereas percutaneous intervention is an alternative approach.Endoscopic treatment involves mechanical cleaning with a balloon and a second stent insertion as stent-in-stent with either PS or SEMS.Technical feasibility,patient survival and cost-effectiveness are important factors that determine the method of re-drainage and stent selection.
文摘Acute pancreatitis is of one the most common gastroenterology-related indications for hospital admissions worldwide.With the widespread reliance on endoscopic retrograde cholangiopancreatography(ERCP)for the management of pancreaticobiliary conditions,post-ERCP pancreatitis(PEP)has come to represent an important etiology of acute pancreatitis.Despite many studies aiming to better understand the pathogenesis and prevention of this iatrogenic disorder,findings have been heterogeneous,and considerable variation in clinical practice exists.Herein,we review the literature regarding PEP with the goal to raise awareness of this entity,discuss recent data,and present evidence-based best practices.We believe this manuscript will be useful for gastrointestinal endoscopists as well as other specialists involved in the management of patients with PEP.
