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eISSN 2636-0012
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pISSN 2636-0004
eISSN 2636-0012
pISSN 2636-0004
eISSN 2636-0012
and Juan Santiago Rubio Abstract : Gastrointestinal surgery is a vast field with many types of procedures, of which hepato-pancreato-biliary (HPB) operations are among the most frequently performed worldwide. Several complications of HPB surgery may occur. Most of these complications, such as wound infection, bleeding, abdominal wall eventrations, and intestinal obstruction, also occur with other procedures. This review analyzes surgical management-related complications associated with HPB surgery, including pancreatic fistula, bile leakage, biliary stenosis, and bile duct damage. Most of the complications of HPB surgery can be managed conservatively or with minimally invasive procedures. Nevertheless, surgical management still plays an important role.
, Xiao-Hui Zhao , Hai-Liang Li et al.Abstract : Percutaneous abscess drainage (PAD) has been proven to be a safe, effective, and widely used technique for the treatment of patients with abscesses after gastrointestinal surgery. The indications for PAD are expanding and most postoperative abscesses of the gastrointestinal tract are susceptible to PAD. PAD uses various imaging methods, including ultrasound, computed tomography, and several safe and reliable catheter insertion methods.
*, Kazuo Hara , Nobumasa Mizuno et al.Abstract : Endoscopic ultrasound (EUS)-guided interventions, including EUS-guided biliary drainage and EUS-guided cystic drainage, are now well developed and in widespread use. Intraperitoneal abscess requires drainage because mortality associated with an undrained abscess is high. Percutaneous or surgical drainage has traditionally been performed, but there have been numerous reports of EUS-guided drainage for intraperitoneal abscesses in recent years. EUS-guided abscess drainage has the advantage of being less invasive and enabling direct access to the cavity via the trans-luminal route as well as clear visualization of interposed vessels using color Doppler ultrasonography. It is necessary to consider the advantages and disadvantages when selecting a drainage method. This article reviews the current status of EUS-guided abscess drainage at three sites: the liver, pelvis, and mediastinum.
, Ji Hoon Shin , and Jung Suk Oh Abstract : Gastrointestinal (GI) leakages after surgery are significant complications that are associated with high morbidity and mortality. Due to recent technology advancements, interventional management of postoperative GI leakage may be a better alternative than surgical treatments in terms of less invasiveness, decreased mortality, morbidity, and hospital stay. Furthermore, new interventional management techniques are still being developed. We discuss GI fistulas’ clinical and radiological characteristics as well as its interventional management. This study intends to highlight the many GI organ-specific interventional management techniques for the treatment of postoperative GI leakage.
Abstract : Anastomotic leakage is a potentially life-threatening adverse event that can occur after gastrectomy or gastric bypass surgery, ranging in severity from minor anastomotic defects to fulminant cases. The management of anastomotic leakage varies according to the time of diagnosis and the severity of the leakage; therefore, some cases can be managed conservatively, while others require urgent exploration. Despite aggressive medical and/or surgical management, some patients develop sepsis with multiple organ failure, leading to death. Hence, the management of anastomotic leakage imposes a significant burden on hospital resources. Due to the poor success rate of conservative therapy, anastomotic leakage management is usually performed surgically, which is associated with high morbidity and mortality. Given these concerns, non-operative treatment by endoscopic management, which uses sealants, hemoclips, self-expandable metal stents, and vacuum-assisted sponge closure, may be a valid alternative modality. According to recent studies, the results of endoscopic management for postoperative leakage have improved due to developments in instruments. Therefore, endoscopic management can be considered as an appropriate treatment option for properly selected patients with postoperative leakage.
, Kiyoshi Matsueda , Marie Osawa et al.Abstract : Postoperative arterial bleeding after gastrointestinal surgery is a potentially fatal complication. Transcatheter arterial embolization is considered the first-line treatment because of efficacy and less invasiveness despite the risk of organ infarction. With the recent advances in endovascular devices, stent-graft placement, which can preserve arterial flow, has been an alternative treatment option in patients with extrahepatic artery hemorrhage. Moreover, clinical outcomes of stent-graft placement for pseudoaneurysms in relative long term have been reported recently. Herein, we review the techniques and clinical outcomes for interventional management for postoperative arterial bleeding.
, Miyuki Nakatani et al. Abstract : Lymphorrhea after gastrointestinal surgery may be treated conservatively or surgically, and treatment by lymphatic interventional radiology has also recently come into use. From pedal lymphangiography, intranodal lymphangiography was widely adopted, enabling the site of lymphorrhea to be identified and its approach to be planned, and embolization for lymphorrhea is now becoming feasible in an increasing number of patients. Even for patients in whom embolization is infeasible, identifying the site of leakage and providing the surgeon with this information is useful. Although this technique is still under development, interventional radiologists are now able to play a role in the treatment of lymphorrhea. Herein, we discuss lymphatic interventional radiology for lymphorrhea following gastrointestinal surgery.
, Suryaprakash Bhandari , Hardik Rajesh Shah et al.Abstract : This is a case report of the successful management of recurrent large intrahepatic stones using per-oral cholangioscopy via a gastric access loop created surgically during Roux-en-Y hepaticojejunostomy (HJ). A 55-year-old male presented with acute cholangitis. Radiodiagnostic imaging suggested hepatolithiasis in the left hepatic duct. He had experienced similar events on three occasions in the past, for which preliminary conventional endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage approaches proved only supportive. Hence definitive surgical treatment was performed with the patient's consent during his third admission in the form of cholecystectomy, intraoperative retrieval of hepatolithiasis using a rigid ureteroscope, and Roux-en-Y HJ with gastric access loop formation. The gastric conduit facilitated prompt and convenient endoscopic access to enter the intrahepatic ducts and achieve complete ductal clearance using cholangioscopy-guided laser lithotripsy of the large intrahepatic stones. The patient remained asymptomatic at subsequent follow-up visits.
Abstract : Gastrocutaneous fistula is a rare complication of gastric surgery and difficult to manage. Because only 6% of cases close spontaneously, surgical or endoscopic repair is usually required. However, in older patients who are often ineligible for aggressive treatment, more conservative treatment options are needed. Herein, we report a case of a chronic gastrocutaneous fistula secondary to distal gastrectomy with Roux-en-Y gastrojejunostomy performed 5 years prior that was managed with intestinal feeding tube insertion through the fistula tract.
, Hasan Aljaziri , Mohammed Rashid Akhtar et al.Abstract : Bowel stoma stenosis resulting in bowel obstruction can be managed conservatively by dietary changes, or by surgical revision of the stenotic/retracted stoma. Metallic stent placement is a minimally invasive procedure that can help alleviate symptoms and obviate the need for surgical interventions, especially in non-surgical candidates or patients with progressive malignant obstruction. This report demonstrates the use of image-guided metallic stent placement in patients with stenotic stomas due to different underlying pathologies.
Xudong Liu , Zhengqiang Yang , Shun He , and Guiqi Wang
Int J Gastrointest Interv 2021; 10(2): 42-48
https://doi.org/10.18528/ijgii210015
Jen-Jou Wong , Srujana Ganti, Damian Mullan, Derek Edwards, and Hans-Ulrich Laasch
Int J Gastrointest Interv 2021; 10(1): 12-16
https://doi.org/10.18528/ijgii190013
Thomas G. Morgan , Tarryn Carlsson , Eric Loveday , Neil Collin , Graham Collin , Peter Mezes , and Anne M. Pullyblank
Int J Gastrointest Interv 2021; 10(1): 17-22
https://doi.org/10.18528/ijgii200018
Nozomi Okuno, Kazuo Hara, Nobumasa Mizuno, Susumu Hijioka, Takamichi Kuwahara, Masahiro Tajika, Tsutomu Tanaka, Makoto Ishihara, Yutaka Hirayama, Sachiyo Onishi, and Yasumasa Niwa
Gastrointestinal Intervention 2017; 6(1): 82-84
https://doi.org/10.18528/gii170008
Tsuyoshi Hamada, Yousuke Nakai, and Hiroyuki Isayama
Gastrointestinal Intervention 2018; 7(2): 46-51
https://doi.org/10.18528/gii180016
Jeffrey S. Bank, and Douglas G. Adler
Gastrointestinal Intervention 2017; 6(1): 9-14
https://doi.org/10.18528/gii160033
pISSN 2636-0004
eISSN 2636-0012
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