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The Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios.
J Clin Med
December 2024
Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
Endoscopic ultrasound (EUS)-guided interventions have revolutionized the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), providing minimally invasive alternatives with improved outcomes. These procedures have significantly reduced the need for high-risk surgical interventions or percutaneous alternatives and have provided effective palliative care for patients with advanced gastrointestinal and bilio-pancreatic malignancies. EUS-guided biliary drainage (EUS-BD) techniques, including hepaticogastrostomy (EUS-HGS), choledochoduodenostomy (EUS-CDS), and antegrade stenting (EUS-AS), offer high technical and clinical success rates, with a good safety profile particularly when Endoscopic Retrograde Cholangiopancreatography (ERCP) is not feasible.
View Article and Find Full Text PDFCoronary Intervention Outcomes in Patients with Liver Cirrhosis.
Curr Cardiol Rep
January 2025
Division of Cardiology, NYU Grossman School of Medicine, New York, NY, USA.
Purpose Of Review: This review assesses the outcomes of coronary interventions in patients with liver cirrhosis and coronary artery disease (CAD), focusing on the clinical challenges posed by cirrhosis-related hemodynamic and coagulopathic changes. It highlights essential considerations for managing these patients, who have an increased risk of adverse events during coronary procedures.
Recent Findings: Recent studies have shown that patients with liver cirrhosis undergoing PCI experience significantly higher mortality rates compared to non-cirrhotic patients, particularly in the context of STEMI and NSTEMI.
Randomized control trial to compare mini-PCNL vs standard-PCNL for treatment of 1-2 cm size inferior calyceal renal stone.
Med J Armed Forces India
December 2024
CSO Medical, Andaman & Nicobar Command HQ, India.
Background: Lower calyceal anatomy makes the stone clearance a difficult task across all treatment formats. Improvement in optics and miniaturization of instruments have offered an effective and safer alternative to percutaneous nephrolithotomy (PCNL). The study was conducted to compare the efficacy and complications associated with mini-PCNL vs standard-PCNL.
View Article and Find Full Text PDFA Modern Education Theory Approach to Development of a Benchtop Simulation Model for Ultrasound-Guided Percutaneous Nephrolithotomy.
J Endourol
December 2024
Department of Urology, University of California San Francisco, San Francisco, California, USA.
Article Synopsis
- Developed a nonbiohazardous simulator for ultrasound-guided percutaneous nephrolithotomy using expert feedback and modern education theory.
- A prototype was created with realistic anatomical features through 3D printing and hydrogel molding, and validated by expert surgeons and participants in multicenter trials.
- The simulator showed high satisfaction ratings and significant skill improvements for residents, making it an effective training tool for urologic education.
Long-term enteral nutrition with a nasogastric tube can be safe and effective: A case report.
Nutr Clin Pract
December 2024
Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Home enteral nutrition (HEN) is a vital feeding practice for those who have chronic disorders that prevent them from eating normally. Although short-term feeding is predominantly done via nasogastric (NG) tubes and long-term feeding is done via percutaneous endoscopic gastrostomy (PEG) tube, we present a case that demonstrates that the long-term use of NG tubes may be possible. Our case involves an adult woman who has been fed via an NG tube for >3 years with no complications.
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