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DʼErrico F, Derhy S, Fazi M, Memeo R, Decembrino F, De Palma GD, Donatelli G. EUS-guided endoscopic internal drainage with lumen-apposing metal stent for symptomatic hepatic cysts: a case series (with video). Endosc Int Open 2023; 11:E76-E80. [PMID: 36686030 PMCID: PMC9851806 DOI: 10.1055/a-1968-7596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/25/2022] [Indexed: 01/25/2023] Open
Abstract
Background and study aims Simple hepatic cysts (SHCs) are usually asymptomatic and detected incidentally. However, larger cysts may present with clinical signs and require treatment such as percutaneous aspiration or surgery with non negligeable rate of recurrence. We report a series of 13 consecutive patients who underwent EUS-guided lumen-apposing metal stent (LAMS) drainage of SHCs of the right and left liver. Patients and methods Nine men and four women, average age 71.9 years, underwent EUS-guided LAMS cyst drainage because of significant symptoms. At 1 month, LAMS was exchanged for a double pigtail stent (DPS), which was left in place for 3 months. Nine of the SHCs were located in the right liver and four in the left. The average diameter was 22.2 cm. Results Thirteen LAMS were successful delivered in all patients. However only 12 of 13 (92.3 %) remained in place. In one case, the LAMS slipped out immediately and was promptly removed and the cyst treated percutaneously. One of 12 patients experienced bleeding, which was treated conservatively. In seven patients, the LAMS was exchanged for a DPS; in the other five, it was successfully left in place until the patients died, given their comorbidities. At 10.5 months of follow-up, none of the SHCs had recurred. Conclusions EUS-guided LAMS drainage permits treatment of symptomatic SHCs without recurrence and with few adverse events. Comparative studies are needed to consider this approach as first intention.
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Affiliation(s)
- Francesca DʼErrico
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France,Unit of Gastroenterology and Digestive Endoscopy, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
| | - Serge Derhy
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
| | - Maurizio Fazi
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
| | - Riccardo Memeo
- Unit of Hepato-Pancreatic-Biliary Surgery, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
| | - Francesco Decembrino
- Unit of Gastroenterology and Digestive Endoscopy, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
| | - Giovanni D. De Palma
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Gianfranco Donatelli
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France,Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
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D’Errico F, Derhy S, Donatelli G. Lumen-apposing metal stent placement after endoscopic ultrasound-guided duodenojejunal anastomosis for direct access to excluded jejunal limb: findings after 5 years. Endoscopy 2023; 55:E344-E345. [PMID: 36646119 PMCID: PMC9842446 DOI: 10.1055/a-1990-0930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Francesca D’Errico
- Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France,Unit of Gastroenterology and Digestive Endoscopy, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti, Italy
| | - Serge Derhy
- Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
| | - Gianfranco Donatelli
- Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France,Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
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Pérez-Cuadrado-Robles E, Bronswijk M, Prat F, Barthet M, Palazzo M, Arcidiacono P, Schaefer M, Devière J, van Wanrooij RLJ, Tarantino I, Donatelli G, Camus M, Sanchez-Yague A, Pham KDC, Gonzalez JM, Anderloni A, Vila JJ, Jezequel J, Larghi A, Jaïs B, Vazquez-Sequeiros E, Deprez PH, Van der Merwe S, Cellier C, Rahmi G. Endoscopic ultrasound-guided drainage using lumen-apposing metal stent of malignant afferent limb syndrome in patients with previous Whipple surgery: Multicenter study (with video). Dig Endosc 2022; 34:1433-1439. [PMID: 35429360 DOI: 10.1111/den.14330] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/14/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Endoscopic ultrasound-guided digestive anastomosis (EUS-A) is a new alternative under evaluation in patients presenting with afferent limb syndrome (ALS) after Whipple surgery. The aim of the present study is to analyze the safety and effectiveness of EUS-A in ALS. METHODS This is an observational multicenter study. All patients ≥18 years old with previous Whipple surgery presenting with ALS who underwent an EUS-A using a lumen-apposing metal stent (LAMS) between 2015 and 2021 were included. The primary outcome was clinical success, defined as resolution of the ALS or ALS-related cholangitis. Furthermore, technical success, adverse event rate, and mortality were evaluated. RESULTS Forty-five patients (mean age: 65.5 ± 10.2 years; 44.4% male) were included. The most common underlying disease was pancreatic cancer (68.9%). EUS-A was performed at a median of 6 weeks after local tumor recurrence. The most common approach used was the direct/freehand technique (66.7%). Technical success was achieved in 95.6%, with no differences between large (≥15 mm) and small LAMS (97.4% vs. 100%, P = 0.664). Clinical success was retained in 91.1% of patients. A complementary treatment by dilation of the stent followed by endoscopic retrograde cholangiopancreatography through the LAMS was performed in three cases (6.7%). There were six recurrent episodes of cholangitis (14.6%) and two procedure-related adverse events (4.4%) after a median follow-up of 4 months. Twenty-six patients (57.8%) died during the follow-up due to disease progression. CONCLUSION EUS-A is a safe and effective technique in the treatment of malignant ALS, achieving high clinical success with an acceptable recurrence rate.
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Affiliation(s)
- Enrique Pérez-Cuadrado-Robles
- Department of Gastroenterology, University of Paris, Georges-Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Michiel Bronswijk
- Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Leuven, Belgium.,Department of Gastroenterology and Hepatology, Imelda General Hospital, Bonheiden, Belgium
| | - Fréderic Prat
- Department of Endoscopy, Hopital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France
| | - Marc Barthet
- Department of Gastroenterology and Endoscopy, Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - Maxime Palazzo
- Department of Endoscopy, Hopital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France
| | - Paolo Arcidiacono
- Division of Pancreato-Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
| | - Marion Schaefer
- Department of Endoscopy and Hepatogastroenterology, Regional University Hospital of Nancy, Nancy, France
| | - Jacques Devière
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme University Hospital - Université Libre de Bruxelles, Brussels, Belgium
| | - Roy L J van Wanrooij
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ilaria Tarantino
- Endoscopy Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS - ISMETT), Palermo, Italy
| | - Gianfranco Donatelli
- Department of Surgical, Interventional Endoscopy Unit, Private Hospital Peupliers-Ramsay Santé, Paris, France
| | - Marine Camus
- Sorbonne University, Endoscopic Unit, Saint Antoine Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Khanh Do-Cong Pham
- Section of Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Jean-Michel Gonzalez
- Department of Gastroenterology and Endoscopy, Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - Andrea Anderloni
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Juan J Vila
- Endoscopy Unit, Gastroenterology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Julien Jezequel
- Department of Gastroenterology, University Hospital of Brest, Brest, France
| | - Alberto Larghi
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bénédicte Jaïs
- Department of Endoscopy, Hopital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France
| | - Enrique Vazquez-Sequeiros
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain
| | - Pierre H Deprez
- Department of Gastroenterology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Schalk Van der Merwe
- Department of Surgical, Interventional Endoscopy Unit, Private Hospital Peupliers-Ramsay Santé, Paris, France
| | - Christophe Cellier
- Department of Gastroenterology, University of Paris, Georges-Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Gabriel Rahmi
- Department of Gastroenterology, University of Paris, Georges-Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
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Chua TY, Kyanam Kabir Baig KR, Leung FW, Ashat M, Jamidar PA, Mulki R, Singh A, Yu JX, Lightdale JR. GIE Editorial Board top 10 topics: advances in GI endoscopy in 2020. Gastrointest Endosc 2021; 94:441-451. [PMID: 34147512 DOI: 10.1016/j.gie.2021.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 02/08/2023]
Abstract
The American Society for Gastrointestinal Endoscopy's Gastrointestinal Endoscopy Editorial Board reviewed a systematic literature search of original endoscopy-related articles published during 2020 in Gastrointestinal Endoscopy and 10 other high-impact medical and gastroenterology journals. Votes from each individual board member were tallied to identify a consensus list of the 10 most significant topic areas in GI endoscopy over the calendar year of study using 4 criteria: significance, novelty, impact on national health, and impact on global health. The 10 areas identified were as follows: artificial intelligence in endoscopy, coronavirus disease 2019 and GI practice, third-space endoscopy, lumen-apposing metal stents, single-use duodenoscopes and other disposable equipment, endosonographic needle technology and techniques, endoscopic closure devices, advances in GI bleeding management, improvements in polypectomy techniques, and bariatric endoscopy. Each board member contributed a summary of important articles relevant to 1 to 2 topic areas, leading to a collective summary that is presented in this document of the "top 10" endoscopic advances of 2020.
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Affiliation(s)
- Tiffany Y Chua
- Division of Digestive Diseases, Harbor-University of California Los Angeles, Torrance, California, USA
| | - Kondal R Kyanam Kabir Baig
- Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Felix W Leung
- VA Sepulveda Ambulatory Care Center, North Hills, California, USA
| | - Munish Ashat
- Division of Gastroenterology and Hepatology, Indiana School of Medicine, Indianapolis, Indiana, USA
| | - Priya A Jamidar
- Section of Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ramzi Mulki
- Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ajaypal Singh
- Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, Illinois, USA
| | - Jessica X Yu
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jenifer R Lightdale
- Division of Pediatric Gastroenterology and Nutrition, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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