Aim: To evaluate the success rates of performing therapy utilizing a rotational assisted enteroscopy device in endoscopic retrograde cholangiopancreatography (ERCP) in surgically altered anatomy patients.
Methods: Between June 1, 2009 and November 8, 2012, we performed 42 ERCPs with the use of rotational enteroscopy for patients with altered anatomy (39 with gastric bypass Roux-en-Y, 2 with Billroth II gastrectomy, and 1 with hepaticojejunostomy associated with liver transplant). The indications for ERCP were: choledocholithiasis: 13 of 42 (30.9%), biliary obstruction suggested on imaging: 20 of 42 (47.6%), suspected sphincter of Oddi dysfunction: 4 of 42 (9.5%), abnormal liver enzymes: 1 of 42 (2.4%), ascending cholangitis: 2 of 42 (4.8%), and bile leak: 2 of 42 (4.8%). All procedures were completed with the Olympus SIF-Q180 enteroscope and the Endo-Ease Discovery SB overtube produced by Spirus Medical.
Results: Successful visualization of the major ampulla was accomplished in 32 of 42 procedures (76.2%). Cannulation of the bile duct was successful in 26 of 32 procedures reaching the major ampulla (81.3%). Successful therapeutic intervention was completed in 24 of 26 procedures in which the bile duct was cannulated (92.3%). The overall intention to treat success rate was 64.3%. In terms of cannulation success, the intention to treat success rate was 61.5%. Ten out of forty two patients (23.8%) required admission to the hospital after procedure for abdominal pain and nausea, and 3 of those 10 patients (7.1%) had a diagnosis of post-ERCP pancreatitis. The average hospital stay was 3 d.
Conclusion: It is reasonable to consider an attempt at rotational assisted ERCP prior to a surgical intervention to alleviate biliary complications in patients with altered surgical anatomy.
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http://dx.doi.org/10.4253/wjge.v7.i3.278 | DOI Listing |
Sci Rep
January 2025
Department of Breast Surgery, Mindong Hospital Affiliated to Fujian Medical University, No. 89, Heshan Road, Fu'an, 355000, Fujian Province, China.
Granulomatous mastitis (GM) poses challenges in diagnosis and treatment due to its similarities with other breast diseases like cancer. The comparative study evaluated the efficacy and safety of a vacuum-assisted biopsy device with minimally invasive excisions compared to traditional wide local excisions. The vacuum-assisted biopsy device technique offers benefits such as precise tissue removal, reduced damage to healthy tissue, shorter surgery and recovery times, and lower postoperative complication risks.
View Article and Find Full Text PDFPM R
January 2025
Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
Background: Rock climbing offers numerous health benefits, but accessibility and safety concerns limit its therapeutic use, especially for individuals with disabilities. No prior studies have explored the potential benefits of integrating the Treadwall, a rotating climbing wall with improved accessibility and safety, into rehabilitation protocols.
Objective: To evaluate the safety and feasibility of implementing a Treadwall climbing intervention as a novel therapy tool for children with hemiplegic cerebral palsy.
Cureus
December 2024
Trauma and Orthopaedics, PSG Institute of Medical Sciences and Research, Coimbatore, IND.
Background Numerous classifications exist for intertrochanteric (IT) fractures, commonly focused on stability. However, the currently utilized Arbeitsgemeinschaft Osteosynthesefragen and Orthopaedic Trauma Association (AO/OTA) classification has limitations in identifying irreducible fractures. This study aims to answer the following questions: does fracture stability imply irreducibility; which fracture fragments complicate reduction; and which reduction techniques should be employed? Materials and methods Eligibility criteria included fractures in adult long bones without pathological fractures being treated by native conservative means.
View Article and Find Full Text PDFAdv Mater
January 2025
School of Electronic Engineering, Soongsil University, Seoul, 06938, South Korea.
Recent advances in mass transfer technology are expected to bring next-generation micro light-emitting diodes (µLED) displays into reality, although reliable integration of the active-matrix backplane with the transferred µLEDs remains as a challenge. Here, the µLED display technology is innovated by demonstrating pixel circuit-integrated micro-LEDs (PIMLEDs) and integrating them onto a transparent glass substrate. The PIMLED comprises of low-temperature poly-silicon transistors and GaN µLED.
View Article and Find Full Text PDFRes Theory Nurs Pract
January 2025
School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
There is currently no scale to measure the self-care knowledge of patients with hypertensive nephropathy. This study aimed to develop the Hypertensive Nephropathy Self-Care Knowledge (HN-SCK) scale for these patients and to test its reliability and validity. A methodological study was conducted in two stages.
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