Publications by authors named "Lorenzo Dioscoridi"
Background And Aim: In surgically altered anatomy (SAA), endoscopic retrograde cholangiopancreatography (ERCP) can be challenging, and it remains debatable the choice of the optimal endoscopic approach within this context. We aim to show our experience and evaluate the technical and clinical success of endoscopic treatment performed in the setting of adverse events (AE) after pancreaticoduodenectomy (PD).
Methods: This study was conducted on a retrospective cohort of patients presenting biliopancreatic complications after PD from 01/01/2012 to 31/12/2022.
Article Synopsis
- Endoscopic papillectomy (EP) is considered a safe method for removing ampullary lesions, but information on handling leftover or returning adenomas is limited.
- In a study of 95 patients who underwent EP from 2011 to 2022, 28.4% showed residual adenomas, and 11.6% experienced recurrences, highlighting the need for ongoing monitoring.
- Despite complications in 25% of patients, most recurrences were successfully managed endoscopically, suggesting EP is a viable long-term treatment for these tumors.
Article Synopsis
- Endoscopic stenting, particularly using lumen-apposing metal stents (LAMS), is a key treatment for benign biliary strictures, which can recur or cause stent migration.
- A study involving 70 patients showed a 100% technical success rate and an 85.7% clinical success rate for treating these strictures with bi-flanged LAMS over six years.
- While 17.1% of patients experienced adverse events like stent migration, LAMS demonstrated effectiveness, especially in post-surgical cases, suggesting it is a safe option for managing short benign biliary strictures.
Background: First-line over-the-scope (OTS) clip treatment has shown higher efficacy than standard endoscopic therapy in acute nonvariceal upper gastrointestinal bleeding (NVUGIB) from different causes. We compared OTS clips with through-the-scope (TTS) clips as first-line mechanical treatment in the specific setting of peptic ulcer bleeding.
Methods: We conducted an international, multicenter randomized controlled trial on consecutive patients with suspected NVUGIB.
Since 2014, we have been using a new endoscopic approach to improve management of biliary adverse events (BAEs) after bilio-digestive anastomosis. We provide an update about our experience at 7 years. Patients with BAEs on hepatico-jejunostomy underwent entero-enteral endoscopic by-pass (EEEB) creation between the duodenal/gastric wall and the biliary jejunal loop.
View Article and Find Full Text PDFBackground And Study Aim: Advance biliopancreatic endoscopies are nowadays performed in non-operating room anesthesia (NORA) under general anesthesia (GA). We evaluate the outcomes of non-intubated patients in prone position who received GA for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in a tertiary referral center for digestive endoscopy.
Patients And Methods: Anesthesiological records, anamnestic, and intraoperative data of patients who underwent advanced therapeutic biliopancreatic endoscopies at our tertiary referral center from January 2019 until January 2020 were collected in the present observational study.
Gallbladder biliary lithotripsy: A new rationale applied to old treatment.
World J Gastroenterol
February 2022
Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) approaches. This endotherapy permits to treat biliary stones in the main bile duct by standard ERCP and gallbladder stones by EUS-guided cholecystoduodenostomy eventually associated to intracorporeal lithotripsy to achieve optimal results.
View Article and Find Full Text PDFInflammation and immunity are linked to intestinal adenoma (IA) and colorectal cancer (CRC) development. The gut microbiota is associated with CRC risk. Epithelial barrier dysfunction can occur, possibly leading to increased intestinal permeability in CRC patients.
View Article and Find Full Text PDFEndoscopic Vacuum Therapy (EVT) for Persistent Duodenal Stump Dehiscence After Upper Gastrointestinal Surgery in Selected Patients: A Tertiary Referral Center Case Series.
Surg Laparosc Endosc Percutan Tech
February 2021
Article Synopsis
- Endoscopic vacuum therapy (EVT) is effective for treating postoperative gastrointestinal leaks, specifically for duodenal stump dehiscence after upper GI surgeries, despite standard EVT limitations.
- A study involving 7 patients utilized large-bore suction tubes with continuous negative pressure, successfully promoting healing through granulation tissue formation.
- This technique demonstrated complete clinical success in all participants, providing a safe endoscopic alternative for managing duodenal stump leaks post-surgery.
Leaks/dehiscence of the enteral stump associated with infected peri-enteric collections after upper gastrointestinal surgery are a life-threatening adverse event, not usually endoscopically treatable. We describe a new endoscopic approach to treat complex entero-cutaneous fistulas (CECF) by creating a "suction room" through placement of multiple stents (enteral, biliary and/or pancreatic) and a large nose-enteral suction tube inside the enteral stent maintained on a continuous negative aspiration suction. Between January 2016 and December 2019, six consecutive patients referred to our unit with CECF of the enteral stump after failed redo surgeries underwent creation of a "suction room.
View Article and Find Full Text PDFArticle Synopsis
- * A retrospective study was conducted on patients treated endoscopically for pancreatic leaks from January 2013 to May 2019, employing four main methods tailored to the leak's characteristics, including different types of stents.
- * Out of 13 patients treated, technical success was achieved in all cases, with a clinical success rate of 83.3% and an average time for leak closure of 4.8 days, with no recorded leak recurrences during follow-up.