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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 PDFA Comparative Study of Propofol-Dexmedetomidine Versus Propofol-Ketamine for the Anesthetic Management of Patients During Endoscopic Retrograde Cholangiopancreatography.
Cureus
November 2024
Anaesthesiology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil University (Deemed to be University), Pune, IND.
Introduction Endoscopic retrograde cholangiopancreatography (ERCP) requires effective sedation for patient comfort and procedural success. This study compares propofol-dexmedetomidine (group DP) and propofol-ketamine (group KP) for anesthetic management during ERCP. Methods This randomized, double-blinded study enrolled 50 patients (aged 18-60 years) scheduled for ERCP at Dr.
View Article and Find Full Text PDFNext-generation Sequencing Improves The Detection of Malignant Biliary Strictures and Changes Management.
Gastrointest Endosc
December 2024
Division of Digestive and Liver Diseases, University of Texas Southwestern, Dallas, TX. Electronic address:
Background And Aims: Malignant biliary strictures (MBS) pose diagnostic and therapeutic challenges due to the frequent indeterminate results after initial sampling. Next generation sequencing (NGS) panel (BiliSeq) offers promise in MBS detection, but real-world performance remains uncertain. This study aimed to assess standard sampling techniques alone and with BiliSeq for malignancy detection in biliary strictures, and to evaluate management changes based on NGS.
View Article and Find Full Text PDFPost Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Novel Mechanisms and Prevention by Drugs.
United European Gastroenterol J
December 2024
Division of Gastroenterology, Department of Pediatrics, School of Medicine, Stanford University, Stanford, California, USA.
Endoscopic retrograde cholangiopancreatography (ERCP) is becoming more common than first-line therapy for pancreaticobiliary duct disorders. However, post-ERCP pancreatitis is the most common complication of ERCPs, and affects about 10% of cases. In this review, we provide an overview of the mechanisms purported to cause post-ERCP pancreatitis as well as associated risk factors.
View Article and Find Full Text PDFSingle-stage laparoendoscopic management of cholecystocholedocholithiasis: A retrospective study comparing starting with ERCP versus with laparoscopic cholecystectomy.
Ann Hepatobiliary Pancreat Surg
December 2024
Department of General Surgery, Faculty of Medicine, Assiut University, Asyut, Egypt.
Backgrounds/aims: Endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) remains the most common therapeutic strategy used for cholecystocholedocholithiasis (CCL). Recently, single-stage ERCP + LC has gained popularity for treating CCL due to patient satisfaction and financial considerations. In this study, we aimed to compare the feasibility and efficacy of the two variants of single-stage ERCP + LC (starting with ERCP followed by LC versus starting with LC followed by ERCP) for treatment of CCL.
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