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      • KCI등재후보

        Ultimate outcomes of three modalities for non-surgical gallbladder drainage in acute cholecystitis with or without concomitant common bile duct stones

        Wiriyaporn Ridtitid,Thanawat Luangsukrerk,Panida Piyachaturawat,Nicha Teeratorn,Phonthep Angsuwatcharakon,Pradermchai Kongkam,Rungsun Rerknimitr 한국간담췌외과학회 2022 Annals of hepato-biliary-pancreatic surgery Vol.26 No.1

        Backgrounds/Aims: In moderate and high-surgical risk patients with acute cholecystitis, studies comparing percutaneous cholecystostomy (PC) vs. endoscopic transpapillary gallbladder stenting (ETGS) vs. endoscopic ultrasound-guided transmural gallbladder stenting (EUGS) are limited. Thus, the aim of this study was to compare efficacy and recurrence of cholecystitis after PC, ETGS, or EUGS during follow-up. Methods: We reviewed 143 moderate and high-surgical risk patients with acute cholecystitis with or without concomitant common bile duct stones who underwent PC, ETGS, or EUGS at our hospital. Technical success rate (TSR), clinical success rate (CSR), and recurrence were compared. Results: TSR in PC or EUGS group was higher than that in the ETGS group for those with concomitant common bile duct stones (100% vs. 100% vs. 73.2%; p = 0.07) and for those without concomitant common bile duct stones (100% vs. 100% vs. 77.3%; p < 0.001). CSR in ETGS or EUGS group was higher than that in the PC group for those with concomitant common bile duct stones (96.2% vs. 100% vs. 87.5%; p = 0.41) and for those without concomitant common bile duct stones (94.1% vs. 100% vs. 63.0%; p = 0.006). Using Kaplan–Meier analysis, the overall recurrent risk was the highest in the PC group (p = 0.004). Conclusions: In moderate and high-surgical risk patients with acute cholecystitis, EUGS provides significantly higher CSR with comparable TSR to PC. Thus, ETGS should be the first choice in those with concomitant common bile duct stones. Among the three patient groups, those who received PC had the highest rate of recurrence.

      • KCI등재

        Liver Fluke-Associated Biliary Tract Cancer

        ( Piyapan Prueksapanich ),( Panida Piyachaturawat ),( Prapimphan Aumpansub ),( Wiriyaporn Ridtitid ),( Roongruedee Chaiteerakij ),( Rungsun Rerknimitr ) 대한간학회 2018 Gut and Liver Vol.12 No.3

        Cholangiocarcinoma (CCA) is an aggressive cancer arising from epithelial cells of the bile duct. Most patients with CCA have an unresectable tumor at the time of diagnosis. In Western countries, the risk of CCA increases in patients with primary sclerosing cholangitis, whereas liver fluke infection appears to be the major risk factor for CCA in Asian countries. A diagnosis of liver fluke infection often relies on stool samples, including microscopic examination, polymerase chain reaction-based assays, and fluke antigen detection. Tests of serum, saliva and urine samples are also potentially diagnostic. The presence of liver fluke along with exogenous carcinogens magnifies the risk of CCA in people living in endemic areas. The “liver fluke-cholangiocarcinoma” carcinogenesis pathways consist of mechanical damage to the bile duct epithelium, immunopathologic and cellular reactions to the liver fluke’s antigens and excretory/secretory products, liver fluke-induced changes in the biliary tract microbiome and the effects of repeated treatment for liver fluke. A vaccine and novel biomarkers are needed for the primary and secondary prevention of CCA in endemic areas. Importantly, climate change exerts an effect on vector-borne parasitic diseases, and awareness of liver fluke should be enhanced in potentially migrated habitat areas. (Gut Liver 2018;12:236- 245)

      • Identification of Pancreatic Cancer in Biliary Obstruction Patients by FRY Site-specific Methylation

        Angsuwatcharakon, Phonthep,Rerknimitr, Rungsun,Kongkam, Pradermchai,Ridtitid, Wiriyaporn,Ponauthai, Yuwadee,Srisuttee, Ratakorn,Kitkumthorn, Nakarin,Mutirangura, Apiwat Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.9

        Background: Methylation at cg 16941656 of FRY is exclusively found in normal pancreatic tissue and has been proven to be specific for pancreatic-in-origin among several adenocarcinomas. Here, we investigated methylated DNA in the bile as a biomarker to differentiate the cause of obstruction between pancreatic cancer and benign causes. Materials and Methods: Bile samples of 45 patients with obstructive jaundice who underwent ERCP were collected and classified into pancreatic cancer (group 1) and benign causes (group 2) in 24 and 21 patients, respectively. DNA was extracted from bile and bisulfite modification was performed. After, methylation in cg 16941656 of FRY was identified by real-time PCR, with beta-actin used as a positive control. Results: Methylated DNA was identified in 10/24 (41.67%) and 1/21 (4.8%) of cases in groups 1 and 2, respectively (P= 0.012). The sensitivity, specificity, positive predictive value and negative predictive value to differentiate pancreatic cancer from benign causes were 42%, 95%, 91%, and 59%, respectively. Conclusions: Detecting a methylation at cg 16941656 of FRY in bile has high specificity, with an acceptable positive likelihood rate, and may therefore be helpful in distinguish pancreatic cancer from benign strictures.

      • KCI등재

        Perception of Gastrointestinal Endoscopy Personnel on Society Recommendations on Personal Protective Equipment, Case Selection, and Scope Cleaning During Covid-19 Pandemic: An International Survey Study

        Parit Mekaroonkamol,Kasenee Tiankanon,Rapat Pittayanon,Wiriyaporn Ridtitid,Fariha Shams,Ghias Un Nabi Tayyab,Julia Massaad,Saurabh Chawla,Stanley Khoo,Siriboon Attasaranya,Nonthalee Pausawasdi,Qiang C 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.2

        Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopyduring the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of therecommendations and the perceptions of endoscopy personnel on them. Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%)from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scopecleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between thevariables. Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), theirpracticality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, andp=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), lessworking experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalentcountries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations lesspractical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19patients was associated with less agreement with PPE recommendations (p=0.039). Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resourceavailability and local prevalence are critical factors influencing the adoption of the current guidelines.

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