1,721,108 research outputs found
La capacitación informal en la oficina judicial
Full text linkFil: Larghi, Alberto Luis. Universidad Católica de Córdoba. Facultad de Derecho y Ciencias Sociales; Argentin
On the reliability of mitotic count on biopsy samples of gastrointestinal stromal tumors
No full textNot availabl
Should EUS-guided tissue acquisition for histologic examination replace fine needle aspiration for cytologic examination? Another brick in the wall
Full text linkSince its initial description in 1992 (1), endoscopic ultrasound-guided fine needle
aspiration (EUS-FNA) has become the procedure of choice to obtain samples to reach
the definitive diagnosis and proper lymph nodal staging of lesions of the gastrointestinal
(GI) tract and of adjacent organs (2). The sensitivity of EUS-FNA, however, is
strongly dependent on the availability of an on-site cytopathology, which has been
clearly demonstrated to significantly influence the diagnostic accuracy, as well as,
the proportions of indeterminate and unsatisfactory samples (3-5). Cytopathology,
however, requires a high degree of expertise and unfortunately, the access to rapid
on-site cytopathology evaluation (ROSE) and the availability of a cytopathologist
specifically trained to interpret EUS specimens is not possible in many centers (6).
This has created a barrier to the dissemination of EUS in the community and in many
countries because the lack of cytology expertise results in a low diagnostic accuracy
and therefore in a limited overall perceived utility of EUS (7,8)
Lumen-apposing metal stents versus double-pigtail plastic stents for infected necrotising pancreatitis: more doubts than answers
No full textEUS-guided biliary drainage versus ERCP for the primary treatment of malignant distal biliary obstruction: time for a large randomized study
No full textExternal pancreatic fistula treated by endoscopic ultrasound-guided drainage with a novel lumen-apposing metal stent mounted on a cautery-tipped delivery system
No full textOne of the most common causes of external pancreatic fistula is the iatrogenic manipulation of a complex pancreatic fluid collection concomitantly associated with a disconnected pancreatic duct [1] [2]. This situation can lead to the development of a high output (up to 400 mL/d) external pancreatic fistula that is difficult to manage and sometimes requires surgery [3].
In 2012, a 40-year-old woman underwent laparoscopic cholecystectomy with a hepaticojejunal Roux-en-Y anastomosis for a congenital Todani’s type IV common bile duct cyst. Postoperative pancreatitis resulted in the development of a complex pancreatic fluid collection in the pancreatic head, which was drained percutaneously. Subsequently, an external pancreatic fistula formed with an output of 200 mL/d.
In 2014, the patient was referred to us for further evaluation. Endoscopic retrograde cholangiopancreatography (ERCP) showed a normal main pancreatic duct that lacked a clear communication with the collection ([Fig. 1]). The injection of contrast through the percutaneous catheter showed the presence of a 4-cm fluid collection ([Fig. 2]). Endoscopic ultrasound (EUS)-guided drainage with the placement of plastic stents was planned
Endoscopic ultrasound-guided drainage and necrosectomy of walled-off pancreatic necrosis using a metal stent with an electrocautery-enhanced delivery system and hydrogen peroxide
No full textDirect endoscopic necrosectomy of walled-off pancreatic necrosis (WOPN) has recently been reported to have comparable success rates to surgery, but with lower morbidity and mortality [1] [2]. The procedure is, however, time consuming and requires multiple device exchanges [3], which may increase the risk of complications.
A novel, dedicated device, the Hot AXIOS (Xlumena Inc., Mountain View, California, USA) ([Fig. 1]), has recently become available. This consists of a large-diameter, fully covered self-expanding metal stent (FCSEMS) with antimigration flanges, which is mounted on a 10.8-Fr delivery system with an electrocautery blade at its distal tip
Endoscopic Ultrasound Guided Gallbladder Interventions: a Review of the Current Literature
Full text linkInterventional endoscopic ultrasound (EUS) is a rapidly expanding field with a wide variety of indications, including different drainage procedures and delivery of locoregional treatment mainly for pancreatic solid tumors. Transgastric or transduodenal gallbladder drainage in high-risk patients with acute cholecystitis or biliary decompression in patients with unresectable distal biliary malignant obstruction who failed endoscopic retrograde colangiography is one of the newest areas of EUS-guided intervention. The large-caliber lumen apposing metal stents placed during these procedures allow direct endoscopic gallbladder access and the possibility of performing gallstone treatment or resection of mucosal polyps. The current review presents the indications of endoscopic gallbladder interventions and discusses the results of available studies, foreseeing future potential applications
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