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RISS 인기검색어
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- 저자 : Indrajit Kumar Tiwary (검색결과 2 건)
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Pancreatic Necrosectomy through Sinus Tract Endoscopy
Mahesh Kumar Goenka,Usha Goenka,Md.Yasin Mujoo,Indrajit Kumar Tiwary,Sanjay Mahawar,Vijay Kumar Rai 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.3
Background/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walledoffnecrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. Weevaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON. Methods: Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WONrequiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adultgastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain. Results: Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean timeof 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergosurgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, orrecurrence during follow-up. Conclusions: Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details ofthe technique and end-points of STE require further evaluation.
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Mahesh Kumar Goenka,Vijay Kumar Rai,Usha Goenka,Indrajit Kumar Tiwary 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.1
Background/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC. Methods: Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip. Results: All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding. Conclusions: In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.
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