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Stent stoma: Endoscopic stent insertion for refractory small intestine fistulas.
Scand J Surg
January 2025
Interdisciplinary Endoscopy Centre, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
Background And Aims: The therapeutic management of fistulas presents significant challenges, often involving both conservative and surgical approaches. Despite these interventions, recurrence and postoperative mortality rates remain high. Endoscopic stent insertion into the fistula, along with the creation of a stent stoma, may offer a promising alternative for patients who fail surgical or conservative therapies.
View Article and Find Full Text PDFThe 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 PDFA review of endoscopic ultrasound-guided gallbladder drainage and gastroenterostomy: assisted approaches and comparison with alternative techniques.
Therap Adv Gastroenterol
December 2024
Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, Liaoning Province 110004, China.
Over the last 40 years, the role of endoscopic ultrasound (EUS) has evolved from being diagnostic to therapeutic. EUS-guided gallbladder drainage (EUS-GBD) and EUS-guided gastroenterostomy (EUS-GE) are emerging techniques in recent years; however, there are limited studies and inconsistent results regarding these techniques. In addition, EUS has become a more common alternative to traditional interventions due to its super minimally invasive nature, but the mobility of both the gallbladder and intestine makes it challenging to introduce stents.
View Article and Find Full Text PDFEndoscopic ultrasound (EUS)-guided gastrojejunostomy for management of superior mesenteric artery (SMA) syndrome.
BMJ Case Rep
November 2024
Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
The mainstay of treatment for superior mesenteric artery (SMA) syndrome involves aggressive enteral feeding distal to the area of obstruction. We present a case of palliative endoscopic ultrasound (EUS)-guided gastrojejunostomy as management of SMA syndrome in a patient with concomitant metastatic pancreatic adenocarcinoma. Following the procedure, our patient demonstrated significantly improved tolerance of oral intake.
View Article and Find Full Text PDFRefractory esophageal-mediastinal fistula successfully treated with endoluminal vacuum therapy and enteral nutrition using a double-lumen elemental diet tube: a case report.
Gen Thorac Cardiovasc Surg Cases
November 2023
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima-Shi, Kagoshima, 890-8520, Japan.
Background: Aortic-esophageal fistula (AEF) after thoracic endovascular aortic repair (TEVAR) has a high fatality rate and is difficult to treat. Endoluminal vacuum therapy (EVT) has recently appeared and proven to be a useful method for anastomotic leakage.
Case Presentation: A 76-year-old man underwent aortic arch replacement for a stent graft infection after TEVAR.
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