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Martinez-Moreno B, López-Roldán G, Martínez-Sempere J, de-Madaria E, Jover R, Aparicio JR. Long-term results after EUS gallbladder drainage in high-surgical-risk patients with acute cholecystitis: A 3-year follow-up registry. Endosc Int Open 2023; 11:E1063-E1068. [PMID: 37954111 PMCID: PMC10637859 DOI: 10.1055/a-2180-9817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/21/2023] [Indexed: 11/14/2023] Open
Abstract
Background and study aims Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has become the favorite drainage option for high surgical-risk patients with acute cholecystitis. However, data on long-term outcomes regarding efficacy and security over 1 year are scarce. Patients and methods We performed a retrospective review of a prospectively maintained database to analyze the 3-year long-term outcomes of EUS-GBD with lumen apposing metal stents (LAMS) in high-surgical-risk patients with acute cholecystitis. Results Fifty patients with acute cholecystitis who underwent EUS-GBD with LAMS and 3-year follow-up or until death were included in this study. No endoscopic revisions were scheduled unless an adverse event (AE) or suspected LAMS dysfunction occurred. AEs occurred in 18%, 20%, and 26% of patients in the first, second, and third years, respectively. Thirteen patients developed at least one AE, and six presented with a second AE during follow-up. Recurrence of cholecystitis occurred in two patients (4%). Seven stent migrations (14%) occurred but all were asymptomatic. Symptomatic LAMS-related AEs (LAMS-RAEs) (37.5%) were related to gastric location of the stent compared with duodenal location (66.7% vs. 12.5%, P = 0.03). No stent-related bleeding or stent-related mortality was observed. Conclusions EUS-GBD with LAMS without scheduled removal is an effective and safe long-term treatment in high-surgical-risk patients with acute cholecystitis. Late LAMS-RAEs tend to be more asymptomatic over time. Symptomatic LAMS-RAEs are associated with gastric location, and overall, AEs tend to recur.
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Affiliation(s)
| | | | | | - Enrique de-Madaria
- Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain
| | - Rodrigo Jover
- Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain
| | - José Ramón Aparicio
- Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain
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Martínez-Moreno B, Martínez-Sempere J, Ruíz Gómez F, Compañy L, Mangas-Sanjuan C, Casellas JA, Aparicio JR. Usefulness of intraductal cholangioscopy biopsy forceps in critical strictures of the biliary anastomosis after liver transplantation. Endoscopy 2022; 54:E834. [PMID: 35561991 PMCID: PMC9735353 DOI: 10.1055/a-1838-4154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Belén Martínez-Moreno
- Endoscopy Unit, Digestive Medicine Service, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitari d’Alacant, Alicante, Spain
| | - Juan Martínez-Sempere
- Endoscopy Unit, Digestive Medicine Service, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitari d’Alacant, Alicante, Spain
| | - Francisco Ruíz Gómez
- Endoscopy Unit, Digestive Medicine Service, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitari d’Alacant, Alicante, Spain
| | - Luis Compañy
- Endoscopy Unit, Digestive Medicine Service, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitari d’Alacant, Alicante, Spain
| | - Carolina Mangas-Sanjuan
- Endoscopy Unit, Digestive Medicine Service, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitari d’Alacant, Alicante, Spain
| | - Juan Antonio Casellas
- Endoscopy Unit, Digestive Medicine Service, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitari d’Alacant, Alicante, Spain
| | - José Ramón Aparicio
- Endoscopy Unit, Digestive Medicine Service, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitari d’Alacant, Alicante, Spain
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Baile-Maxía S, Mangas-Sanjuan C, Medina-Prado L, Martínez-Sempere J, Murcia O, Ruíz-Gómez F, Casellas JA, Zapater P, Jover R. Diagnostic yield of early repeat colonoscopy after suboptimal bowel preparation in a fecal immunochemical test-based screening program. Endoscopy 2020; 52:1093-1100. [PMID: 32583393 DOI: 10.1055/a-1191-3011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Current guidelines regarding surveillance after screening colonoscopy assume adequate bowel preparation. However, follow-up intervals after suboptimal cleansing are highly heterogeneous. We aimed to determine the diagnostic yield of early repeat colonoscopy in patients with suboptimal bowel preparation in fecal immunochemical test (FIT)-based screening colonoscopy. METHODS An observational study including patients who underwent colonoscopy with suboptimal bowel preparation after positive FIT screening and then repeat colonoscopy within 1 year. Suboptimal preparation was defined as a Boston Bowel Preparation Scale (BBPS) score of 1 in any segment. Patients with a BBPS score of 0 in any segment or incomplete examination were excluded. The adenoma detection rate (ADR), advanced ADR (AADR), and colorectal cancer rate were calculated for the index and repeat colonoscopies. RESULTS Of the 2474 patients with FIT-positive colonoscopy at our center during this period, 314 (12.7 %) had suboptimal preparation. Of the 259 (82.5 %) patients who underwent repeat colonoscopy, suboptimal cleansing persisted in 22 (9 %). On repeat colonoscopy, the ADR was 38.7 % (95 %CI 32.6 % to 44.8 %) and the AADR was 14.9 % (95 %CI 10.5 % to 19.4 %). The per-adenoma miss rate was 27.7 % (95 %CI 24.0 % to 31.6 %), and the per-advanced adenoma miss rate was 17.6 % (95 %CI 13.3 % to 22.7 %). After repeat colonoscopy, the post-polypectomy surveillance recommendation changed from 10 to 3 years in 14.7 % of the patients with previous 10-year surveillance recommendation. CONCLUSIONS Patients with suboptimal bowel preparation on FIT-positive colonoscopy present a high rate of advanced adenomas in repeat colonoscopy, with major changes in post-polypectomy surveillance recommendations.
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Affiliation(s)
- Sandra Baile-Maxía
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
| | - Carolina Mangas-Sanjuan
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
| | - Lucía Medina-Prado
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
| | - Juan Martínez-Sempere
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
| | - Oscar Murcia
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
| | - Francisco Ruíz-Gómez
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
| | - Juan A Casellas
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
| | - Pedro Zapater
- Clinical Pharmacology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, CIBERehd, Alicante, Spain
| | - Rodrigo Jover
- Gastroenterology Department, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain
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Medina-Prado L, Baile-Maxía S, Bozhychko M, Mangas-Sanjuan C, Martínez-Sempere J, Casellas JA, Aparicio JR. Recurrent upper gastrointestinal ulcer bleeding treated by coil embolization guided by endoscopic ultrasonography. Endoscopy 2020; 52:E424-E425. [PMID: 32375191 DOI: 10.1055/a-1158-8488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Lucía Medina-Prado
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial), Alicante, Spain
| | - Sandra Baile-Maxía
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial), Alicante, Spain
| | - Maryana Bozhychko
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial), Alicante, Spain
| | - Carolina Mangas-Sanjuan
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial), Alicante, Spain
| | - Juan Martínez-Sempere
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial), Alicante, Spain
| | - Juan Antonio Casellas
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial), Alicante, Spain
| | - José Ramón Aparicio
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial), Alicante, Spain
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Medina-Prado L, Mangas-Sanjuan C, Martínez-Moreno B, Martínez-Sempere J, Berzin TM, Aparicio JR. Endoscopic ultrasound-guided gallbladder drainage after distension with a high density solution (hyaluronic acid). Endoscopy 2020; 52:E400-E401. [PMID: 32303083 DOI: 10.1055/a-1149-1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Lucía Medina-Prado
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | - Carolina Mangas-Sanjuan
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | - Belén Martínez-Moreno
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | - Juan Martínez-Sempere
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | - Tyler M Berzin
- Division of Gastroenterology, Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - José Ramón Aparicio
- Endoscopy Unit, Department of Gastroenterology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
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