DDW 2016 review: Advances in therapeutic upper gastrointestinal endoscopy

Chan, Shannon M.; Yeung, Baldwin Po Man; Chiu, Philip Wai Yan

doi:10.1111/den.12767

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…A small number of studies have described the relationship of adverse events with the Child-Pugh score. These studies consistently demonstrated that the patients with higher Child-Pugh class scores had more complications overall[ 16 - 18 , 20 ]. Inamdar et al[ 13 ] demonstrated a similar risk of adverse events between the non-cirrhosis group and patients with compensated cirrhosis.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, one study also observed lower rates of bleeding when the ERCPs in cirrhosis patients were performed in medium- and large-sized hospitals[ 5 ]. Since only a limited number of studies have described hemorrhage or other adverse events in terms of Child-Pugh class or the type of intervention, no separate analysis could be obtained in our meta-analysis[ 16 - 18 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic retrograde cholangiopancreatography in cirrhosis - a systematic review and meta-analysis focused on adverse events

Mashiana

Dhaliwal

Sayles

et al. 2018

WJGE

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AIMTo investigate indications and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhotics, especially adverse events. Patients with cirrhosis undergoing ERCP are believed to have increased risk. However, there is a paucity of literature describing the indications and outcomes of ERCP procedures in patients with cirrhosis, especially focusing on adverse events.METHODSWe performed a systematic appraisal of major literature databases, including PubMed and EMBASE, with a manual search of literature from their inception until April 2017.RESULTSA total of 6,505 patients from 15 studies were analyzed (male ratio 59%, mean age 59 years), 11% with alcoholic and 89% with non-alcoholic cirrhosis, with 56.2% Child-Pugh class A, and 43.8% class B or C. Indications for ERCP included choledocholithiasis 60.9%, biliary strictures 26.2%, gallstone pancreatitis 21.1% and cholangitis 15.5%. Types of interventions included endoscopic sphincterotomy 52.7%, biliary stenting 16.7% and biliary dilation 4.6%. Individual adverse events included hemorrhage in 4.58% (95%CI: 2.77-6.75%, I2 = 85.9%), post-ERCP pancreatitis (PEP) in 3.68% (95%CI: 1.83-6.00%, I2 = 89.5%), cholangitis in 1.93% (95%CI: 0.63-3.71%, I2 = 87.1%) and perforation in 0.00% (95%CI: 0.00-0.23%, I2 = 37.8%). Six studies were used for comparison of ERCP-related complications in cirrhosis vs non-cirrhosis, which showed higher overall rates of complications in cirrhosis patients with pooled OR of 1.63 (95%CI: 1.27-2.09, I2 = 65%): higher rates of hemorrhage with OR of 2.05 (95%CI: 1.62-2.58, I2 = 2.1%) and PEP with OR of 1.33 (95%CI: 1.04-1.70, I2=65%), but similar cholangitis rates with OR of 1.23 (95%CI: 0.67-2.26, I2 = 44.3%).CONCLUSIONThere is an overall higher rate of adverse events related to ERCP in patients with cirrhosis, especially hemorrhage and PEP. A thorough risk/benefit assessment should be performed prior to undertaking ERCP in patients with cirrhosis.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography in cirrhosis - a systematic review and meta-analysis focused on adverse events

Mashiana

Dhaliwal

Sayles

et al. 2018

WJGE

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“…ESD is an interventional procedure for the removal of gastrointestinal lesions that uses a high-frequency electric knife and other equipment to dissect or resect lesions and the surrounding mucosal tissue to achieve complete resection. ESD is noted for its minimal invasiveness, but this technique still has some risks of complications, such as perforation and massive bleeding [7,8]. Although most of the perforations and bleeding are endoscopically manageable, secondary infection and gastrointestinal fistula can occur [9].…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Submucosal Tunneling Endoscopic Resection (STER) and Other Resection Modules for Esophageal Muscularis Propria Tumors: A Retrospective Study

Zhang

2019

Med Sci Monit

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Background Surgery has been considered to be the primary approach for resection of esophageal muscularis propria tumors. With the development of endoscopic technology, new techniques such as endoscopic submucosal dissection (ESD) and submucosal tunneling endoscopic resection (STER) have emerged for resecting these lesions. Previous studies have demonstrated that STER might be an intriguing alternative. This study aimed to evaluate the clinical value of STER by comparing it to other resecting modules. Material/Methods Clinical outcome and data were retrospectively collected from patients with esophageal muscularis propria tumors who underwent resection either endoscopically or thoracoscopically. The clinical data were statistically analyzed. Results A total of 137 patients were enrolled. They were divided into 3 groups: a STER group (27 patients), an ESD group (42 patients), and a thoracoscopic enucleation (TE) group (68 patients). There were no significant differences among the 3 groups in gender, age, pathological type of tumors, or major adverse events (P>0.05). However, the STER group had the shortest duration of hospitalization and the lowest cost (P<0.05). Furthermore, the STER group was superior in operation time and the location of tumors to the TE group. Moreover, STER outperformed ESD in the resection of large tumors (P<0.05). Although STER had the lowest en bloc resection rate, no recurrence or metastasis was noted during a mean follow-up of 22.14 months (range 3 to 60 months). Conclusions STER is a feasible, safe, and effective approach for the resection of esophageal muscularis propria tumors ≤40 mm. We recommend STER as a potent alternative for these tumors.

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Minimally invasive treatment of complications of submucosal tunnel endoscopic resection of non-epithelial esophagus formation

Гасанов¹,

Danielyan²,

Тарабрин³

et al. 2020

Endosk. khir.

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DDW 2016 review: Advances in therapeutic upper gastrointestinal endoscopy

Abstract: This is a review of the abstracts presented at Digestive Disease Week 2016, 21–24 May 2016 in San Diego, CA, USA, focusing on novel advances in therapeutic endoscopy of the upper gastrointestinal tract.

Cited by 3 publications

References 22 publications

Endoscopic retrograde cholangiopancreatography in cirrhosis - a systematic review and meta-analysis focused on adverse events

Endoscopic retrograde cholangiopancreatography in cirrhosis - a systematic review and meta-analysis focused on adverse events

Comparison Between Submucosal Tunneling Endoscopic Resection (STER) and Other Resection Modules for Esophageal Muscularis Propria Tumors: A Retrospective Study

Minimally invasive treatment of complications of submucosal tunnel endoscopic resection of non-epithelial esophagus formation

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