IJGII Inernational Journal of Gastrointestinal Intervention

pISSN 2636-0004 eISSN 2636-0012
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< PreviousNext >Gastrointestinal Intervention 2017; 6(3): 151~190
  • Review Article 2017-10-30

    The use of OverStitchTM for the treatment of intestinal perforation, fistulas and leaks

    Thiruvengadam Muniraj, and Harry R. Aslanian

    Abstract : Gastrointestinal perforations, leaks and fistulas may complicate endoscopic and surgical procedures. Surgical repair is associated with significant morbidity. Therapeutic endoscopic tools and techniques have included the application of tissue sealants, clip closure, and stent placement. Endoscopic suturing is a rapidly evolving minimally invasive technique. The OverStitchTM (Apollo Endosurgery, USA) is currently the only available endoscopic suturing system. Although technically more difficult than clip closure, endoscopic suturing allows closure of larger defects. In some settings, outcomes similar to surgical management with less morbidity may be achieved. This review describes the OverStitchTM endoscopic suturing system and the published literature regarding its use for perforations, leaks and fistulas.

    Cited By: 6

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  • Review Article 2017-10-30

    Management of gastrointestinal tract perforations

    Yunho Jung

    Abstract : Digestive endoscopy has evolved from primary diagnosis to extensive therapeutic approaches for the management of gastrointestinal diseases. Increased health awareness has encouraged more people to undergo endoscopic examinations. For these reasons, the absolute number of iatrogenic perforations is likely to increase. Because of the very low incidence of perforations, clinicians are not always prepared or experienced in cases of unexpectedly encountered perforations during diagnostic or therapeutic endoscopic procedures. In this study, the proper approach to handling perforations is discussed including selection of endoscopic devices, endoscopic closure procedures, and management of patients after a perforation occurs in the gastrointestinal tract.

    Cited By: 3

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  • Review Article 2017-10-30

    Recent development of innovative resection methods for gastric neoplasms using hybrid natural orifice transluminal endoscopic surgery approach

    Sun Gyo Lim

    Abstract : There have been an evolutionary development with respect to the resection modality for the treatment of the gastric neoplasms such as gastric subepithelial tumors (SETs) or early gastric cancers (EGCs). Hybrid natural orifice transluminal endoscopic surgery (hybrid NOTES) played a central role in the process of development. In the earlier period, the non-exposure type hybrid NOTES such as laparoscopy and endoscopy cooperative surgery (LECS), endoscope-assisted wedge resection (EAWR), and laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) has been introduced by several investigators. However, a concern about a spillage of gastric content including the tumor cells has been continuously raised among the clinicians. Accordingly, the non-exposure type hybrid NOTES such as combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET), non-exposed endoscopic wall-inversion surgery (NEWS), and hybrid neo-endoscopic full-thickness resection (hybrid neo-EFTR) have been developed to the clinicians. Although most of studies about hybrid NOTES for the treatment of the gastric neoplasms have a small number of patients and require further validations, those are enough to receive our attention. Here, we describe and summarize the development process of the innovative resection methods for gastric neoplasms using hybrid NOTES approach.

    Cited By: 1

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  • Original Article 2017-10-30

    Percutaneous radiologic gastrostomy in patients with failed percutaneous endoscopic gastrostomy

    Tang-fei Lee, Young Jong Cho, Ji Hoon Shin, Heung Kyu Ko, Jihong Park, Soo Hwan Kim, Jin-Hyoung Kim, and Ho-Young Song

    Abstract : Background To determine the technical feasibility and success rate of percutaneous radiologic gastrostomy (PRG) after failure of percutaneous endoscopic gastrostomy (PEG). Methods Consecutive patients referred for PRG after failure of PEG between May 2011 and June 2016 were included in this study. The reasons for the failure of PEG, as well as the technical success and complications of PRG were noted. Results Fifteen patients (14 men, 1 woman; age, 27–93 years) were included. The most common reasons for PEG failure were esophageal stricture due to malignancies (n = 8), unfavorable abdominal wall conditions (n = 3), unstable patient condition during endoscopy (n = 2), and other miscellaneous conditions (n = 2). PRG placement was technically successful in all 15 cases. In one case, early slip-out of the gastrostomy tube occurred, which required removal and repositioning. No mortality was noted. Conclusion PRG is technically feasible in patients with failed PEG insertion, and has advantages over PEG and a high overall success rate.

    Cited By: 1

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  • Original Article 2017-10-30

    Clinical outcomes of biliary and duodenal self-expandable metal stent placements for palliative treatment in patients with periampullary cancer

    Hong Joo Kim

    Abstract : BackgroundEndoscopic self-expandable metal stent (SEMS) insertions for palliation of malignant biliary and duodenal obstructions have been revealed to be an effective treatment. We present our clinical experience with the use of SEMS for malignant biliary and duodenal obstructions caused by periampullary cancer.MethodsWe performed a retrospective review of all patients who underwent endoscopic biliary and duodenal SEMS insertion for palliation of malignant biliary and duodenal obstruction caused by periampullary cancer between July 2007 and October 2016. The patients received simultaneous or sequential endoscopic biliary stenting and duodenal stenting with COMVITM stents (partially covered; Taewoong, Seoul, Korea).ResultsThe final diagnoses of our enrolled patients were 15 pancreas head cancer, and 3 distal common bile duct (CBD) cancer. The main stricture site in the duodenum was bulb (n = 4, 22.2%), 2nd portion (n = 9, 50.0%), and 3rd portion (n = 5, 27.8%). The technical success rates of CBD and duodenal stenting were 100% (18/18), and 100% (18/18), respectively. The clinical success rates of CBD and duodenal stenting were 100% (18/18), and 88.9% (16/18), respectively. Median actuarial stent patency for biliary and duodenal SEMS were 6.5 months (range, 1–12 months) and 4.5 months (range, 1–14 months), respectively. Three patients (16.7%) had recurrent biliary obstruction and all of them underwent percutaneous trans-hepatic biliary drainage (PTBD) with biliary SEMS reinsertion. Three other patients (16.7%, totally different from patients with CBD restenosis) had recurrent duodenal obstruction and all of them underwent upper gastrointestinal endoscopy with duodenal SEMS reinsertion.ConclusionEndoscopic SEMS insertions for simultaneous palliation of malignant biliary and duodenal obstruction in patients with periampullary cancer may provide a safe, and less invasive alternative to surgical palliation with a successful clinical outcome.

    Cited By: 1

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  • Case Report 2017-10-30

    Percutaneous transhepatic hepatic venous stenting after extracorporeal hepatic resection and autotransplantation: A case report

    Jung Hwan Park, Ung Bae Jeon, Ki Seok Choo, Tae Un Kim, Chong Woo Chu, and Je Ho Ryu

    Abstract : We report a case of percutaneous transhepatic stent placement for the treatment of hepatic venous outflow obstruction after extracorporeal hepatic resection and autotransplantation. A 63-year-old woman with a large mass in the liver was asymptomatic with no hepatic virus infection. Because the tumor was unresectable by conventional means, we used extracorporeal hepatic resection and autotransplantation for operation. Two days after surgery, hepatic venous outflow obstruction of the right and right inferior hepatic veins was suspected on computed tomography. After failure of the transjugular approach, hepatic venous stenting was performed successfully via the percutaneoustranshepatic approach.

    Cited By: 1

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  • Case Report 2017-10-30

    A successful rendezvous endoscopic ultrasonography-guided gallbladder drainage in malignant cystic duct obstruction

    Hyoung Woo Kim, Jong-Chan Lee, Jongchan Lee, Jaihwan Kim, and Jin-Hyeok Hwang

    Abstract : Endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD) has been developed as an alternative drainage method in patients with malignant cystic duct obstruction. However, the procedure of track dilation is difficult in case of severe gallbladder wall thickening with tumor involvement or inflammation. The rendezvous technique via external fistulous track is considered in failed attempts to dilate an internal track between the gallbladder and the stomach/duodenum using conventional approach of EUS-GBD. This report presents a 56-year-old man with pancreatic cancer with malignant cystic duct obstruction who underwent percutaneous transhepatic gallbladder drainage. The patient was successfully treated using rendezvous EUS-GBD technique after he failed the conventional EUS-GBD procedure of internal track dilation.

    Cited By: 0

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  • Case Report 2017-10-30

    De novo hepatico-gastric stent placement for biliary stricture via percutaneous transhepatic biliary approach

    Abhimanyu Aggarwal, Auh Whan Park, and Jonathan West

    Abstract : Biliary stricture formation is a known complication of hepatic surgery in cases of adult living donor liver transplant. In our case, successful percutaneous placement of a hepatico-gastric stent was performed for the drainage of an isolated bile duct after right liver transplant with Roux-en-Y biliary anastomosis in a 42-year-old male. The patient initially presented with cholangitis and a percutaneous transhepatic cholangiogram revealed an isolated stricture of the posterior bile duct. Multiple attempts at regaining continuity of the isolated bile duct with the jejunum were unsuccessful. Thus a tract was created via a percutaneous transhepatic and transluminal approach between the isolated duct and the stomach using a covered stent. The patient had no complications at 18-month follow-up.

    Cited By: 0

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  • Complication Forum 2017-10-30

    Pancreatic perforation caused by the Soehendra® retrieval device in a patient with chronic pancreatitis

    Seung Yong Shin, Sung Ill Jang, Joon Seong Park, and Dong Ki Lee

    Abstract : Summary of EventAn endoscopic retrograde pancreatic duct (ERPD) stent was inserted in a male patient with chronic pancreatitis via endoscopic retrograde cholangiopancreatography (ERCP) to relieve chronic epigastric pain. After the procedure, an abdominal computed tomography scan showed localized peritonitis with a dislocated ERPD stent. The patient underwent an emergency operation, which revealed that the peritonitis was caused by perforation of the pancreatic parenchyma by the ERPD stent.Teaching PointA hydrophilic guide wire can puncture the pancreas during ERPD stent insertion. Therefore, it is necessary to ensure that the guide wire reaches the main pancreatic duct, especially in patients with chronic pancreatitis.

    Cited By: 1

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