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RISS 인기검색어
- 검색키워드
- 저자 : ( Afonso Ribeiro ) (검색결과 3 건)
- 무료
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The Risk Factors for Acute Pancreatitis after Endoscopic Ultrasound Guided Biopsy
( Afonso Ribeiro ),( Akash Goel ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.3
Background/Aims: The risk of developing pancreatitis induced by endoscopic ultrasound-guided fine needle aspiration (EUS FNA) is relatively small. However, patients undergoing sampling through the normal pancreatic parenchyma or the pancreatic duct may have a higher rate of pancreatitis. Here, we determine the factors associated with increased risk of acute pancreatitis in patients undergoing FNA through normal pancreatic parenchyma/pancreatic duct. Methods: In this prospective study at a tertiary cancer center, patients undergoing sampling through the pancreatic duct or ≥5 mm of the normal parenchyma between December 2013 and September 2017 were included. Post-EUS induced pancreatitis was diagnosed by the presence of abdominal pain with an amylase or lipase level higher than three times normal value. Results: A total of 712 patients underwent pancreatic EUS FNA. A total of 163 patients were included in the high-risk group. Mean age was 63 years, 82 females, mean number of needle-passes was 3.3 (range, 1-7). Fifteen patients (15/163, 9.2%) developed pancreatitis after EUS FNA through the pancreatic parenchyma compared with only one case among the control group (<5 mm of normal parenchyma) (0.18%, 1/549, p<0.0001). Several factors appeared to be associated with pancreatitis, including young age, solid lesion, and a recent history of acute pancreatitis. By logistic regression, a prior history of recent pancreatitis was the only statistically significant factor associated with post-EUS-guided biopsy pancreatitis (p=0.008). Conclusions: Patients with a recent history of acute pancreatitis undergoing EUS FNA through 5 mm or more of the normal pancreatic parenchyma are at a much greater risk of acute pancreatitis. (Korean J Gastroenterol 2018;72:135-140)
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Ana Margarida Correia,Catia Ribeiro,Flavio Videira,Davide Gigliano,Ana Luisa Cunha,Luis Pedro Afonso,Mariana Peyroteo,Rita Canotilho,Catarina Baia,Fernanda Sousa,Joaquim Abreu de Sousa 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.1
Hepatocellular carcinoma (HCC) accounts for most of the hepatic neoplasms and can also occur in ectopic liver tissue. We present a case of a 55-year-old male complaining of weight loss. The imaging studies reported a 2.9 cm nodule in the pancreatic body, with a neuroendocrine tumor diagnosis by cytology. A corpo-caudal pancreatectomy was performed. Pathology showed a well-differentiated HCC developed in ectopic liver tissue with free margins and no lymph node metastases. HCC presenting in ectopic liver tissue is rare. In this case, the preoperative study did not establish the diagnosis, warranting the need for suspicion of this neoplasm.
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Marina Tucci Gammaro Baldavira Ferreira,Igor Braga Ribeiro,Diogo Turiani Hourneaux de Moura,Thomas R. McCarty,Alberto Machado da Ponte Neto,Galileu Ferreira Ayala Farias,Antônio Afonso de Miranda Neto 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.6
Background/Aims: The endoscopic management of primary sclerosing cholangitis (PSC)-associated dominant strictures remainschallenging. This systematic review and meta-analysis aimed to compare balloon dilation and stent placement in the treatment ofdominant strictures among PSC patients. Methods: Literature searches on MEDLINE, EMBASE, Cochrane CENTRAL and Lilacs/Bireme were performed for studiespublished until December 2020. Measured outcomes included clinical efficacy, stricture recurrence, cumulative recurrencefree rate,transplant rate, 5-year survival rate, and adverse events (i.e., pancreatitis, cholangitis, bleeding, perforation and death). Results: A total of 5 studies (n=467) were included. Based on pooled analyses, there were no differences in clinical efficacy (riskdifference [RD], -0.13; 95% confidence interval [CI], -0.58 to 0.33; I2=93%) or transplant rates (RD, -0.09; 95% CI, -0.19 to 0.01;I2=0%); however, the risk of occurrence of adverse events was lower with balloon dilatation than with stent placement (RD,-0.34; 95% CI, -0.45 to -0.23; I2=61%). Among the types of adverse events reported, only the rates of cholangitis/bacteremia weresignificantly lower in balloon dilation patients (RD, -0.19; 95% CI, -0.25 to -0.13; I2=51%). Conclusions: Compared to balloon dilation, stent placement for dominant strictures in PSC appeared to have higher complicationrates without significant differences in efficacy.
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