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RISS 인기검색어
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- 저자 : Keshav Kukreja (검색결과 2 건)
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Closing the Gaps: Endoscopic Suturing for Large Submucosal and Full-Thickness Defects
Keshav Kukreja,Suma Chennubhotla,Bharat Bhandari,Ankit Arora,Shashideep Singhal 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.4
This article is a systematic review of relevant literature on endoscopic suturing as a primary closure technique for large submucosaland full-thickness defects after endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and endoscopic fullthicknessresection (EFTR). A comprehensive literature search was conducted through 2016 by using PubMed, to find peer-reviewedoriginal articles. The specific factors considered were the procedural indications and details, success rates, clinical outcomes includingcomplications, and study limitations. Six original articles were included in the final review: two with non-human subjects and fourwith human subjects. The mean success rate of endoscopic suturing was 97.4% (100% for human subjects and 95.4% for non-humansubjects). The procedural time ranged from 7 to 89 min. The average size and depth of lesions were 2.71 cm (3.74 cm [human] and1.96 cm [non-human]) and 1.52 cm, respectively. The technique itself had no reported impact on mortality. In conclusion, endoscopicsuturing is a minimally invasive technique for the primary closure of defects caused by EMR, ESD, and EFTR, with a high success andlow complication rate.
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Hao Chi Zhang,Monica Tamil,Keshav Kukreja,Shashideep Singhal 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.2
Concomitant malignant gastric outlet obstruction and biliary obstruction may occur in patients with advanced cancers affecting theseanatomical regions. This scenario presents a unique challenge to the endoscopist in selecting an optimal management approach. Wesought to determine the effcacy and safety of endoscopic techniques for treating simultaneous gastric outlet and biliary obstruction(GOBO) with endoscopic ultrasound (EUS) guidance for biliary drainage. An extensive literature search for peer-reviewed publishedcases yielded 6 unique case series that either focused on or included the use of EUS-guided biliary drainage (EUS-BD) withsimultaneous gastroduodenal stenting. In our composite analysis, a total of 51 patients underwent simultaneous biliary drainagethrough EUS, with an overall reported technical success rate of 100% for both duodenal stenting and biliary drainage. EUS-guidedcholedochoduodenostomy or EUS-guided hepaticogastrostomy was employed as the initial technique. In 34 cases in which clinicalsuccess was ascribed, 100% derived clinical benefit. The common adverse effects of double stenting included cholangitis, stent migration,bleeding, food impaction, and pancreatitis. We conclude that simultaneous double stenting with EUS-BD and gastroduodenal stentingfor GOBO is associated with high success rates. It is a feasible and practical alternative to percutaneous biliary drainage or surgery forpalliation in patients with associated advanced malignancies.
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