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        • KCI등재후보

          Transjugular intrahepatic portosystemic shunt creation for portal hypertension in patients with hepatocellular carcinoma: A systematic review

          He Zhao,Jiaywei Tsauo,Tao Gong,Jinggui Li,Xiao Li 소화기인터벤션의학회 2018 Gastrointestinal Intervention Vol.7 No.3

          Background: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of portal hypertension in patients with hepatocellular carcinoma (HCC). Methods: A literature search of the MEDLINE/PubMed and Embase databases was conducted. All articles reporting the outcomes of TIPS creation for variceal bleeding and refractory ascites and hepatic hydrothorax in patients with HCC were included. Exclusion criteria were non-English language, sample size < 5, data not extractable, and data reported in another article. Results: A total of 280 patients (mean age, 48–58; male gender, 66%) from five articles were included. TIPS creation was performed for variceal bleeding in 79% and refractory ascites and/or hepatic hydrothorax in 26% of patients. Technical and clinical success was achieved in 99% and 64% of patients, respectively. Clinical failure occurred in 36% of patients due to rebleeding or recurrent bleeding (n = 77) or no resolution or improvement of refractory ascites and hepatic hydrothorax (n = 24). One percent of patient had major complications, including accelerated liver failure (n = 1) and multi-organ failure resulting from hemorrhagic shock (n = 1), all of which resulted in early (i.e., within 30 days) death. Hepatic encephalopathy occurred in 40% of patients after TIPS creation. Lung metastasis was found 1% of patient 5 months (n = 1) and 72 months (n = 1) after TIPS creation. Conclusion: TIPS creation seems to be safe and effective for the management of portal hypertension in patients with HCC.

        • KCI등재

          Recent advances of endoscopic retrograde cholangiopancreatography in surgically altered anatomy

          Jin Hong Kim,Min Jae Yang 소화기인터벤션의학회 2021 Gastrointestinal Intervention Vol.10 No.3

          Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy (SAA) of the upper gastrointestinal tract is a more technically challenging and arduous procedure accompanied by a low success rate of reaching the target orifice and a relatively high rate of complications, compared to those with normal anatomy. Since the introduction of device-assisted enteroscopies such as balloon enteroscopy (BE) and manual spiral enteroscopy (SE) for small bowel disorders, they have also been used for ERCP in patients with SAA. The recent development of short-type BE makes ERCP in patients with SAA technically easier with high success rates and short procedural duration, and then short-type BE is considered the gold standard endoscopic procedure in these patients. Laparoscopy-assisted ERCP is another therapeutic option, especially for patients with a long excluded afferent limb of SAA. The choice of procedure for high success rates should be individualized according to patient characteristics and available physician competence. Moreover, novel motorized SE is a promising alternative procedure for the successful performance of ERCP.

        • KCI등재

          A case with combined postoperative bile leakage and anastomotic stricture after liver transplantation treated with magnet compression anastomosis

          Sang Jo Han,장성일,Sung Hwan Yoo,이동기 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.1

          Liver transplantation (LT) is a viable treatment for fatal end-stage liver disease. Anastomotic bile leakage and anastomotic stricture are considered as major post-LT complications. Stent insertion by endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage is the conventional treatment for post-LT anastomotic biliary stricture. In cases in which these conventional modalities fail, magnet compression anastomosis (MCA) can be applied. We reported a case in which post-LT bile leakage and anastomotic stricture were treated by MCA and using a fully covered self-expandable metal stent (FCSEMS). The FCSEMS was removed 3 months later, at which time the stricture and the leakage had resolved.

        • KCI등재후보

          Suprapubic single-incision laparoscopic right colectomy with complete mesocolic excision, lateral-to-medial approach and intracorporeal anastomoses

          Giovanni Dapri,Kelly Ann Bobb,Ernesto Jesús Barzola Navarro,Angel Arabadzhiev 소화기인터벤션의학회 2019 Gastrointestinal Intervention Vol.8 No.1

          Background: Single-incision laparoscopic right colectomy (SILRC) has been reported in 2008, and since that time an increased number of reports ap-peared in literature. Currently, it remains popular between the centers with achieved experience. Adoption of suprapubic access, instead of umbilical or other access-sites, allows to enhance the final cosmetic outcomes, together with the realization of complete mesocolic excision (CME) and intra-corporeal anastomosis (ICA).Methods: Between January 2016 and August 2018, 20 patients (10 females, 10 males) were submitted to suprapubic single-incision laparoscopic right colectomy (SSILRC) for adenocarcinoma. Mean age was 74 years and mean body mass index was 24 kg/m2. Sixteen patients have already been submitted to open abdominal surgery.Results: Mean total operative time was 233.9 minutes and mean laparoscopic time was 199.4 minutes. Mean time for ICA was 34 minutes. Mean blood loss was 279.5 mL. One additional 5-mm trocar was necessary in 1 patient (5.0%). Mean length scar was 60.5 cm. Mean hospital stay was 7.8 days. A minimal use of pain killers was registered postoperatively. Mean number of lymph nodes retrieved was 24.5. Early complications were one suprapubic abscess and one suprapubic hematoma. No late complications, including suprapubic incisional hernia, were achieved. Conclusion: Since the specimen has to be removed from the abdomen after conventional laparoscopic right colectomy, the suprapubic access can be an option. SSILRC allows to join the surgical procedure, the specimen’s removal and the enhanced cosmetic results through the same access. Other advantages are the CME, the ICA, the reduced postoperative pain, and the decreased incisional hernia’s rate.

        • KCI등재

          Management of achalasia in 2020: Per-oral endoscopic myotomy, Heller’s or dilatation?

          Mohan Ramchandani,Partha Pal 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.2

          Achalasia cardia is a rare esophageal motility disorder. Although a primary neurological disorder, the treatment modalities of achalasia are primarily endoscopic or surgical. Pneumatic dilatation (PD) or laparoscopic Heller’s myotomy (LHM) have been the mainstay of achalasia management for several decades. With the introduction of third space endoscopy, the endoscopic management of achalasia has revolutionized. Randomized studies have concluded the superiority of per-oral endoscopic myotomy (POEM) over PD. In addition, the short-term outcomes of POEM are similar to LHM. POEM is a relatively new technique and long-term data is eagerly awaited. The main concern after POEM is a high incidence of gastroesophageal reflux disease (GERD) which is found in about half of the patients undergoing this procedure. GERD is higher after POEM when compared to PD and LHM with fundoplication. The management of achalasia should be individualized and based on factors like patient characteristics (age, sex, comorbidities), subtyping on high resolution manometry, patient/doctor preference, and surgical risk of the patient.

        • KCI등재

          A complete hemostasis of an appendiceal bleeding in a dialysis patient by an endoscopic traction method using endoscopic clips

          Koichi Soga 소화기인터벤션의학회 2021 Gastrointestinal Intervention Vol.10 No.3

          A 65-year-old Japanese male presented with a substantial amount of bright red and burgundy rectal bleeding. A colonoscopy confirmed the presence of fresh blood and coagulation in the orifice of the appendix. A suitable position was found using an endoscopic hood to visualize the exposed vessel clearly. We placed two hemo-clips on the appendix orifice at opposite sides of the exposed vessel and then stirred them with an endoscopic hood to visualize the exposed vessel clearly. Finally, we placed other two hemo-clips near the exposed vessels and carried out a complete hemostasis with vessel thrombosis.

        • KCI등재

          Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting

          Seung Chul Han,Tae Hwan Kim,Hee Chul Yang,Jae Uk Chong 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.3

          Delayed massive hemorrhage after pancreaticoduodenectomy is known as a fatal complication, frequently caused by gastroduodenal artery stump bleeding or hepatic artery pseudoaneurysm. Transarterial hepatic artery embolization is one of the treatment options in such cases. However, hepatic artery embolization can also result in ischemic complications of the liver, even fatal sometimes. We report a case of a 70-year-old male patient with distal common bile duct cancer who underwent pancreaticoduodenectomy. After three weeks, there was a bloody drain component accompanied with a decreased hemoglobin level. The immediate computed tomography scan and subsequent angiography demonstrated a hepatic artery pseudoaneurysm (1.8 cm in size) with segmental narrowing of the portal vein and superior mesenteric vein. The pseudoaneurysm and common hepatic artery were embolized using microcoils, following percutaneous portomesenteric stenting. There was no such ischemic complication as hepatic infarction after the procedure, and the patient was well tolerable. We suggest that the simultaneous portomesenteric stenting prior to hepatic artery embolization may be helpful to reduce the risk of hepatic infarction/failure in a patient with hepatic artery pseudoaneurysm accompanying portomesenteric vein stenosis after pancreaticoduodenectomy.

        • KCI등재

          Giant leiomyoma in distal, intra-thoracic oesophagus: Is laparoscopic approach feasible?

          Pratik Biswas,Vishakha Kalikar,Tanveer Majeed,Roy Patankar 소화기인터벤션의학회 2021 Gastrointestinal Intervention Vol.10 No.3

          Leiomyomas are the most common benign tumor of the oesophagus. symptomatic patients are candidates for excision, we have discussed a case report of a 43-year-old male patient who had complains of progressive dysphagia. Imaging studies suggested a distal oesophageal mass with calcific foci. The tumor was enucleated laparoscopically with an operative time of 160 minutes. The patient was gradually started on oral feeds from the 3rd postoperative day after an upper gastrointestinal contrast study. The patient was discharged on the 5th postoperative day. We found this minimally invasive approach to be effective with a shorter hospital stay and a faster recovery as compared to a thoraco abdominal approach.

        • KCI등재

          Recent topics on endoscopic ultrasonography-guided celiac plexus neurolysis

          Ichiro Yasuda,Tatsuyuki Hanaoka,Kosuke Takahashi,Yasuhiro Araki,Shinpei Doi,Takuji Iwashita,Keisuke Iwata,Tsuyoshi Mukai 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.4

          Endoscopic ultrasonography-guided celiac plexus neurolysis (EUS-CPN) is a widely practiced technique. Three sets of guidelines have recently been published and this procedure has become a major EUS technique. However, there are still several unanswered questions. The purpose of this manuscript is to review the recent literature pertaining to EUS-CPN. Currently, the main indication of EUS-CPN is pancreatic cancer pain. It is also performed for patients with chronic pancreatitis, but the indication is controversial due to its limited efficacy and a high incidence of infectious complications. Various techniques, such as central and bilateral EUS-CPN, and EUS-guided direct celiac ganglia neurolysis (EUS-CGN) have been performed. However, the efficacies of these techniques remain controversial. Complications related to the procedures are generally not serious, but major adverse events, such as paraplegia and ischemic complications, have been reported. The impacts of EUS-CPN on survival have also been evaluated. Although increased survival was expected via improvements in the quality of life, data suggests that EUS-CPN related procedures, especially EUS-CGN, might reduce the survival time. However, precise mechanisms have not been elucidated. In addition to conventional techniques, new techniques, such as EUS-guided celiac ganglion radiofrequency ablation (EUS-RFA) and the use of highly viscous phenol-glycerol, dexmedetomidine, and contrast-enhanced agents, have been introduced. However, these techniques are still in experimental stages. Additional studies need to be conducted to address these gaps in the literature.

        • KCI등재후보

          Transjugular intrahepatic portosystemic shunt trends in China: A brief review

          Xiao JiangQiang,ZhuGe YuZheng 소화기인터벤션의학회 2018 Gastrointestinal Intervention Vol.7 No.1

          Transjugular intrahepatic portosystemic shunt (TIPS) is now considered as a major treatment option for cirrhotic patients with portal hypertension. Globally, it is getting markedly increase attention, and a similar phenomenon is occurring in China. On average, the number of TIPS procedures is increasing at a rate of 15% per year. Published research papers are also continuously growing every year. Similar but unique compared to western countries, most Chinese physicians follow Chinese specialized guidelines when treating patients with portal hypertension. In this review, we briefly introduce the history of TIPS in China, the present and the future of TIPS in China.

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