Gastrointestinal endoscopy
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EUS-guided radiofrequency ablation (EUS-RFA) could be used as an adjunct and effective alternative mode of treatment for unresectable locally advanced and nonmetastatic pancreatic adenocarcinoma. However, its translation into clinical practice has been restricted because of limited data and high procedure-related risk. ⋯ EUS-RFA of the pancreatic body and tail was feasible, effective, and relatively safe in a porcine model. More animal studies to assess damage to adjacent organs are required before human trials can be conducted.
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Gastrointest. Endosc. · Nov 2012
Characteristics, goals, and motivations of applicants pursuing a fourth-year advanced endoscopy fellowship.
The number of applications to advanced endoscopy fellowships has increased in past years. There is limited knowledge regarding why gastroenterology fellows pursue interventional/advanced endoscopy (AE) as a career. ⋯ Although a majority of applicants decided to pursue careers in AE during the first year of gastroenterology fellowship, making the decision was difficult for half of the applicants. Motivations for choosing AE as a career differed among applicants interested in academics versus private practice.
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Gastrointest. Endosc. · Oct 2012
Comparative StudyThe effect of colonoscopic tattooing on lymph node retrieval and sentinel lymph node mapping.
In colorectal cancer (CRC), colonoscopic tattooing is performed to mark the tumor site before laparoscopic surgery. ⋯ After tattooing of CRC, the LN yield was higher than in a control group, and it could be used as a sentinel node procedure with acceptable accuracy rates. Because LN yield and sentinel node mapping are associated with improved diagnostic accuracy of LN involvement, preoperative tattooing can refine staging.
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Gastrointest. Endosc. · Sep 2012
Resolving external pancreatic fistulas in patients with disconnected pancreatic duct syndrome: using rendezvous techniques to avoid surgery (with video).
An external pancreatic fistula (EPF) generally results from an iatrogenic manipulation of a pancreatic fluid collection (PFC), such as walled-off pancreatic necrosis (WOPN). Severe necrotizing pancreatitis can lead to complete duct disruption, causing disconnected pancreatic duct syndrome (DPDS) with viable upstream pancreas draining out of a low-pressure fistula created surgically or by a percutaneous catheter. The EPF can persist for months to years, and distal pancreatectomy, often the only permanent solution, carries a high morbidity and defined mortality. ⋯ The management of EPFs in the setting of DPDS is challenging but can be treated effectively by combined endoscopic and percutaneous rendezvous techniques. The rendezvous procedures were associated with minimal morbidity, no mortality, avoidance of surgery, and complete elimination of the EPFs.