Gastrointestinal endoscopy clinics of North America
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Gastrointest. Endosc. Clin. N. Am. · Apr 2020
ReviewMagnetic Sphincter Augmentation for Gastroesophageal Reflux Disease.
Magnetic sphincter augmentation is an effective and safe surgical method for the treatment of gastroesophageal reflux disease (GERD). The device has been compared with twice-daily proton pump inhibitor therapy and laparoscopic fundoplication (in randomized trials and prospective cohort studies, respectively). ⋯ Recent research focuses on implanting the device into more complex patients, such as those with larger hiatal hernias or those with Barrett's esophagus. Additional novel research topics include cost analysis and predicting and minimizing postoperative dysphagia.
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Gastrointest. Endosc. Clin. N. Am. · Oct 2018
ReviewTotal Pancreatectomy with Autologous Islet Cell Transplantation.
First described in the early 1980s, total pancreatectomy with autologous islet cell transplantation for the treatment of chronic pancreatitis is still only offered in select centers worldwide. Indications, process details including surgery as well as islet isolation, and results are reviewed. In addition, areas for further research to optimize results are identified.
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Gastrointest. Endosc. Clin. N. Am. · Oct 2018
ReviewUncomplicated Acute Pancreatitis: Evidenced-Based Management Decisions.
Acute pancreatitis is among the most common gastrointestinal disorders requiring hospitalization worldwide. Establishing the cause of acute pancreatitis ensures appropriate management and proper health care resource utilization. ⋯ Fluid therapy remains the cornerstone of managing acute pancreatitis. This article provides a brief summary of current evidence-based practices in the diagnosis and management of uncomplicated acute pancreatitis.
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Gastrointest. Endosc. Clin. N. Am. · Jul 2018
ReviewInitial Assessment, Risk Stratification, and Early Management of Acute Nonvariceal Upper Gastrointestinal Hemorrhage.
Inhospital mortality from nonvariceal upper gastrointestinal bleeding has improved with advances in medical and endoscopy therapy. Initial management includes resuscitation, hemodynamic monitoring, proton pump inhibitor therapy, and restrictive blood transfusion. ⋯ Emergent endoscopy within 12 hours does not improve clinical outcomes, including mortality, rebleeding, or need for surgery, despite an increased use of endoscopic treatment. There may be a benefit to emergent endoscopy in patients with evidence of active bleeding.
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Gastrointest. Endosc. Clin. N. Am. · Jul 2017
ReviewWho Deserves Endoscopic Screening for Esophageal Neoplasia?
Despite the availability of safe and effective endoscopic treatment of Barrett's esophagus (BE)-related dysplasia and neoplasia, the incidence and mortality from esophageal adenocarcinoma (EAC) have continued to increase. This likely stems from the large population of patients that develop EAC outside of a BE screening and surveillance program. Identification of BE with screening followed by enrollment in an appropriate surveillance/risk stratification program could be a strategy to address both the incidence of and mortality from EAC. This article summarizes the rationale and challenges for BE screening, the risk factors for BE, and the currently described BE risk assessment tools.