1,417 results match your criteria Gastrointestinal Endoscopy Clinics of North America [Journal]


Gastroparesis: Current Opinions and New Endoscopic Therapies.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):xv-xvi

Division of Digestive Diseases, Emory University School of Medicine, Atlanta 30322, GA, USA. Electronic address:

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http://dx.doi.org/10.1016/j.giec.2018.09.001DOI Listing
January 2019
7 Reads

Gastroparesis: New Approaches in Management.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):xiii-xiv

Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA. Electronic address:

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http://dx.doi.org/10.1016/j.giec.2018.09.002DOI Listing
January 2019

Botulinum Toxin Injection for Treatment of Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan 28;29(1):97-106. Epub 2018 Sep 28.

Department of Gastroenterology, Johns Hopkins Hospital, Ross 958, 720 Rutland Avenue, Baltimore, MD 21205, USA. Electronic address:

Refractory gastroparesis is among the most difficult therapeutic challenges in gastroenterology. Pyloric dysfunction has been described in a subset of patients with gastroparesis, prompting experimentation with botulinum toxin injections into the pylorus, which is relatively safe and has been successfully used in other gastrointestinal disorders. However, causality between pyloric dysfunction and symptoms of gastroparesis has never been demonstrated. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223662PMC
January 2019
1 Read

Surgical Management for Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan 22;29(1):85-95. Epub 2018 Sep 22.

Division of GI/MIS, The Oregon Clinic, 4805 Northeast Glisan, 6N60, Portland, OR 97213, USA; IHU-Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France. Electronic address:

Gastroparesis is a debilitating chronic condition of indeterminate cause. Although conservative management is the mainstay of treatment, a significant percentage of patients will need interventions. Interventions range from supportive measures, such as feeding tubes, to more radical surgeries, including endoscopic pyloromyotomy (per oral pyloromyotomy), laparoscopic pyloroplasty, laparoscopic gastric stimulator placement, and even subtotal or total gastrectomy. Read More

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January 2019
5 Reads

Gastric Electrical Stimulator for Treatment of Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):71-83

Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 South Jackson Street, ACB A3L15, Louisville, KY 40202, USA. Electronic address:

Patients with gastroparesis sometimes suffer from intractable nausea and vomiting, abdominal pain, and bloating, as well as a host of other symptoms that can often be difficult to control. Initially, patients are treated conservatively; some do well with conservative management but unfortunately some do not. Over the years, studies have shown the benefits of gastric electrical stimulation, which often results in symptomatic improvement and improvement in gastric emptying times. Read More

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http://dx.doi.org/10.1016/j.giec.2018.08.013DOI Listing
January 2019
3 Reads

Symptomatic Management of Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan 11;29(1):55-70. Epub 2018 Sep 11.

Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.

Gastroparesis is a chronic and debilitating neuromuscular disorder of the upper gastrointestinal tract. Symptoms of gastroparesis include nausea, vomiting, epigastric pain, early satiety, and weight loss. Treating gastroparesis can be difficult. Read More

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January 2019
9 Reads

Evaluation of Patients with Suspected Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan 11;29(1):39-54. Epub 2018 Sep 11.

Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

There is substantial overlap between the symptoms of gastroparesis and a variety of alternative disorders. These conditions include rumination syndrome, drug-induced gastric emptying delay, cannabinoid hyperemesis syndrome, and eating disorders, which can be identified based on the history alone. The remaining patients require a diagnostic approach of physical examination, laboratory tests, evaluation with esophagogastroduodenoscopy or contrast radiography, and a test to measure gastric emptying. Read More

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January 2019
3 Reads

Clinical Manifestation and Natural History of Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):27-38

Division of Gastroenterology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX 79905, USA. Electronic address:

Although gastroparesis was described more than 60 years ago, the natural history and the long-term outcome are still being clarified. The patients with more severe gastroparesis often seek health care treatment in university medical centers specializing in gastrointestinal motility disorders and hence reports in the literature tend to be based on this population and may not be representative of the entire spectrum. The clinical manifestations of gastroparesis are heterogeneous but a significant proportion of patients end up with substantially poorer quality of life. Read More

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January 2019
2 Reads

Outcomes of Per Oral Endoscopic Pyloromyotomy in the United States.

Gastrointest Endosc Clin N Am 2019 Jan 22;29(1):151-160. Epub 2018 Sep 22.

Division of Digestive Diseases, Emory University School of Medicine, 615 Michael Street, Suite 201, Atlanta, GA 30322, USA. Electronic address:

Per oral endoscopic pyloromyotomy (POP) has emerged as an endoscopic intervention for refractory gastroparesis. Early experience in the United States showed exciting clinical response rate, reduced gastroparesis symptoms, improved quality of life, and decreased gastric-emptying time during midterm follow-up up to 18 months. One recent study also showed that the number of patient emergency room visits and hospitalizations decreased significantly after POP. Read More

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http://dx.doi.org/10.1016/j.giec.2018.08.009DOI Listing
January 2019
8 Reads

Diabetic Gastroparesis and Nondiabetic Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan 11;29(1):15-25. Epub 2018 Sep 11.

Division of Digestive Diseases, Emory University, 1365 Clifton Road, Atlanta, GA 30322, USA. Electronic address:

Gastroparesis can be divided into diabetic and nondiabetic, and the 3 main causes of gastroparesis are diabetic, postsurgical, and idiopathic. Delayed gastric emptying is the main manifestation of motility disorders for gastroparesis. Symptoms of gastroparesis are nonspecific and severity can vary. Read More

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January 2019
2 Reads

Outcomes and Future Directions of Per-Oral Endoscopic Pyloromyotomy: A View from France.

Gastrointest Endosc Clin N Am 2019 Jan 24;29(1):139-149. Epub 2018 Sep 24.

Gastroenterology Department, Rouen University Hospital, 1 rue de Germont, Rouen 76038, France.

Gastroparesis is a challenging functional gastroenterological disorder, the complex pathophysiology of which hampers development of therapeutic modalities. Per-oral pyloromyotomy (POP) is a promising endoscopic therapy with a short-term clinical success rate of greater than 80%. Interest in POP is increasing, particularly in France, a country in which there is considerable expertise in submucosal endoscopy and functional disorders. Read More

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January 2019
3 Reads

Gastric Emptying Scintigraphy Before Gastric per Oral Endoscopic Myotomy: Imaging May Inform Treatment.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):127-137

Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA. Electronic address:

Gastric emptying scintigraphy (GES) helps to diagnose gastroparesis and is typically only used for whole stomach retention patterns. However, it may provide significantly more information when looking specifically at proximal and distal retention patterns. This article reviews global GES changes following gastric per oral endoscopic myotomy; how global, proximal, and distal GES measurements correlate to gastroparesis symptoms; and how proximal and distal GES may serve as proxies for the various mechanisms involved in gastroparesis. Read More

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January 2019
5 Reads

Technical Aspects of Peroral Endoscopic Pyloromyotomy.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):117-126

Division of Digestive Disease, Emory University School of Medicine, 1365 Clifton RD NE, Suite B 1262, Atlanta, GA 30322, USA; Advanced Endoscopy Fellowship, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA. Electronic address:

Gastric peroral endoscopic pyloromyotomy (G-POEM or POP) is a feasible and effective procedure for the treatment of refractory gastroparesis. G-POEM is a technically demanding endoscopic procedure. As of yet, there is no consensus on the technique. Read More

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January 2019
6 Reads

Stent Placement for the Treatment of Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):107-115

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Sheikh Zayed Building, 1800 Orleans Street, Suite 7125G, Baltimore, MD 21287, USA. Electronic address:

Gastroparesis is a syndrome of delayed gastric emptying. First-line treatment includes prokinetic medications. Those refractory to medical treatment are occasionally considered for endoscopic or surgical treatment options, with unpredictable response. Read More

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January 2019
3 Reads

Epidemiology and Pathophysiology of Gastroparesis.

Gastrointest Endosc Clin N Am 2019 Jan;29(1):1-14

Global Research, Digestive and Health Neurogastroenterology, New Lambton, NSW 2305, Australia.

Gastroparesis is a complex syndrome with symptoms that include nausea, vomiting, and postprandial abdominal pain, and is frequently accompanied by significant delays in gastric emptying. The pathophysiology of diabetic gastroparesis is fairly well understood; however, idiopathic gastroparesis, which accounts for one-third of all cases, may stem from infections, or autoimmune or neurologic disorders, among other causes. To date, few population-based studies have estimated the true prevalence and incidence of gastroparesis. Read More

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January 2019
3 Reads

Preface.

Authors:
John M Poneros

Gastrointest Endosc Clin N Am 2018 Oct;28(4):xv-xvi

Columbia University College of Physicians and Surgeons, Division of Digestive and Liver Diseases, New York Presbyterian Hospital/Columbia, 161 Fort Washington Avenue, Herbert Irving Pavilion, Room 1344, New York, NY 10032, USA. Electronic address:

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http://dx.doi.org/10.1016/j.giec.2018.07.001DOI Listing
October 2018
1 Read

Management of Benign Pancreatic Diseases.

Gastrointest Endosc Clin N Am 2018 Oct;28(4):xiii-xiv

Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA. Electronic address:

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October 2018

Total Pancreatectomy with Autologous Islet Cell Transplantation.

Authors:
Beth Schrope

Gastrointest Endosc Clin N Am 2018 Oct 13;28(4):605-618. Epub 2018 Jul 13.

Department of Surgery, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 8th Floor, New York, NY 10032, USA. Electronic address:

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. Read More

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http://dx.doi.org/10.1016/j.giec.2018.05.003DOI Listing
October 2018
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The Role of Genetics in Pancreatitis.

Gastrointest Endosc Clin N Am 2018 Oct;28(4):587-603

Division of Digestive and Liver Diseases, Columbia University Medical Center, Herbert Irving Comprehensive Cancer Center, 161 Fort Washington Avenue, Suite 862, New York, NY 10032, USA. Electronic address:

Individuals with acute recurrent and chronic pancreatitis may have an inherited predisposition to the development of the disease. Pancreatitis in the setting of a significant family history of the disease can be classified as hereditary or familial pancreatitis. In this article, the authors closely examine the specific genes implicated in pancreatitis, investigate the role of genetic testing for diagnosis, and describe the impact of genetic testing results on clinical management. Read More

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http://dx.doi.org/10.1016/j.giec.2018.06.001DOI Listing
October 2018
1 Read

Celiac Plexus Block and Neurolysis: A Review.

Gastrointest Endosc Clin N Am 2018 Oct 3;28(4):579-586. Epub 2018 Aug 3.

Division of Digestive and Liver Diseases, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA.

Pain is often associated with chronic pancreatitis and pancreatic cancer. Often times opioids are used to treat pain; however, the use of opioids is frequently difficult. Endoscopic ultrasound-guided celiac plexus block and celiac plexus nuerolysis are safe and effective modalities used to alleviate pain. Read More

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http://dx.doi.org/10.1016/j.giec.2018.06.004DOI Listing
October 2018
1 Read

Interventional Endoscopic Ultrasonography in the Pancreas.

Gastrointest Endosc Clin N Am 2018 Oct 3;28(4):569-578. Epub 2018 Aug 3.

Division of Digestive and Liver Disease, Department of Medicine, Columbia University Medical Center, New York Presbyterian Hospital, 630 West 168th Street, Box 83, P&S3-401, New York, NY 10032, USA. Electronic address:

Endoscopic ultrasonography (EUS) has enabled therapeutic endoscopists to intervene on conditions that have otherwise not been accessible with conventional endoscopy. Inflammatory fluid collections of the pancreas that may benefit from drainage are often not identifiable without EUS. Furthermore, EUS may improve the safety of transmural drainage by allowing for the identification of intervening blood vessels and reducing the need for fluoroscopy, and is complemented by new devices that simplify the access and stent delivery process. Read More

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October 2018

The Use of Biomarkers in the Risk Stratification of Cystic Neoplasms.

Gastrointest Endosc Clin N Am 2018 Oct 2;28(4):549-568. Epub 2018 Aug 2.

Division of Digestive and Liver Diseases, Department of Medicine, Columbia University, 161 Fort Washington Avenue, New York, NY 10032, USA. Electronic address:

Cyst fluid biomarkers may be used to identify pancreatic cyst subtypes. Biomarkers are selected based on their ability to accurately distinguish mucinous from nonmucinous cysts and to risk stratify cysts based on malignant potential. Biomarkers of interest include but are not limited to amylase, oncogenes, DNA analysis, and epigenetic markers. Read More

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October 2018

Current Guideline Controversies in the Management of Pancreatic Cystic Neoplasms.

Gastrointest Endosc Clin N Am 2018 Oct 1;28(4):529-547. Epub 2018 Aug 1.

Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029, USA. Electronic address:

Pancreatic cystic lesions are a common clinical entity. The majority are neoplastic and have the potential for malignant transformation. To assist with patient management, a number of clinical guidelines have been developed over the past decade. Read More

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October 2018
6 Reads

Pancreatic Insufficiency: What Is the Gold Standard?

Gastrointest Endosc Clin N Am 2018 Oct 25;28(4):521-528. Epub 2018 Jun 25.

Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, Ohio State University Wexner Medical Center, Columbus, OH, USA.

Endoscopic pancreatic function testing assesses exocrine insufficiency and chronic pancreatitis. Indirect pancreatic function tests have limited sensitivity and specificity in early disease stages. Magnetic resonance cholangiopancreatography shows promise in detecting early changes as a direct measure of pancreatic function. Read More

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October 2018
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Management of Autoimmune Pancreatitis.

Gastrointest Endosc Clin N Am 2018 Oct 1;28(4):493-519. Epub 2018 Aug 1.

Section of Digestive Diseases, Yale University School of Medicine, Yale Center for Pancreatic Disease, Yale University, LMP 1080, 15 York Street, New Haven, CT 06510, USA. Electronic address:

Type 1 autoimmune pancreatitis (AIP) is an IgG-4-related systemic disease that can manifest as a pancreatic disorder or another disorder of presumed autoimmune origin. Type 2 disease is typically characterized by absent IgG-4-positive cells. As patients often present with acute pancreatitis, obstructive jaundice, or pancreatic mass, it is imperative to exclude malignancy, a more common diagnosis. Read More

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http://dx.doi.org/10.1016/j.giec.2018.05.002DOI Listing
October 2018
1 Read

Systematic Review of Endoscopic Cyst Gastrostomy.

Gastrointest Endosc Clin N Am 2018 Oct 3;28(4):477-492. Epub 2018 Aug 3.

Division of Gastroenterology, Lenox Hill Hospital, 100 East 77th Street, 2nd Floor, New York, NY 10075, USA. Electronic address:

Since the original description of pancreatic fluid collections (PFC) in 1761 by Morgagni, their diagnosis, description, and management have continued to evolve. The mainstay of therapy for symptomatic PFCs has been the creation of a communication between a PFC and the stomach, to enable drainage. Surgical creation of these drainage conduits had been the gold standard of therapy; however, there has been a paradigm shift in recent years with an increasing role of endoscopic drainage. Read More

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October 2018

The Role of Endotherapy in Recurrent Acute Pancreatitis.

Gastrointest Endosc Clin N Am 2018 Oct 1;28(4):455-476. Epub 2018 Aug 1.

Columbia University Medical Center, 161 Fort Washington Avenue, Suite 852, New York, NY 10032, USA. Electronic address:

Patients with recurrent acute pancreatitis (RAP) have few treatment options available to them to manage their symptoms or prevent progression to chronic pancreatitis. At present, endotherapy is typically pursued as a means to achieve symptom remission and reduce rates of recurrence, hospitalization, abdominal pain, narcotic use, and surgical intervention. However, evidence that endotherapy effectively alters the natural history of disease remains limited. Read More

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http://dx.doi.org/10.1016/j.giec.2018.05.001DOI Listing
October 2018
7 Reads

How to Avoid Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.

Gastrointest Endosc Clin N Am 2018 Oct;28(4):439-454

Division of Gastroenterology and Hepatology, Medical University of South Carolina, MSC 702, 114 Doughty Street, Suite 249, Charleston, SC 29425, USA. Electronic address:

Pancreatitis remains the most common and potentially devastating complication of endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Recent advances in prophylaxis have improved but not eliminated this problem, underscoring the importance of ongoing research toward this goal. This review aims to provide an evidence-based approach to post-ERCP pancreatitis prevention through patient selection, risk stratification, procedural technique, and multimodality prophylaxis, and discusses ongoing and future research initiatives in this important area. Read More

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October 2018
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Uncomplicated Acute Pancreatitis: Evidenced-Based Management Decisions.

Gastrointest Endosc Clin N Am 2018 Oct 17;28(4):425-438. Epub 2018 Jul 17.

Division of Gastroenterology, Johns Hopkins Medical Institutions, 1830 East Monument Street, Room 428, Baltimore, MD 21205, USA.

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. Causes of acute pancreatitis include biliary, alcohol use, hypertriglyceridemia, hypercalcemia, drug-induced, autoimmune, hereditary/genetic, and anatomic abnormalities. Read More

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http://dx.doi.org/10.1016/j.giec.2018.05.008DOI Listing
October 2018
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Prevention of Recurrent Lower Gastrointestinal Hemorrhage.

Gastrointest Endosc Clin N Am 2018 Jul 17;28(3):409-424. Epub 2018 Apr 17.

Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1069, New York, NY 10029-6574, USA.

This article summarizes current knowledge regarding the incidence of and risk factors associated with recurrent lower gastrointestinal hemorrhage. The literature regarding medical, endoscopic, and surgical methods to prevent rebleeding from diverticulosis, angioectasia, and chronic hemorrhagic radiation proctopathy is reviewed. In addition, the evidence for endoscopic clipping as primary prophylaxis against postpolypectomy bleeding is explored. Read More

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http://dx.doi.org/10.1016/j.giec.2018.02.011DOI Listing
July 2018
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The Role of Endoscopic Hemostasis Therapy in Acute Lower Gastrointestinal Hemorrhage.

Gastrointest Endosc Clin N Am 2018 Jul;28(3):391-408

Clinical Medicine, University of California, San Francisco, Veterans Affairs San Francisco Medical Center, San Francisco, CA, USA.

Acute severe lower gastrointestinal bleeding (LGIB) can be treated by endoscopy safely and effectively. At present, the data on the efficacy of endoscopy in the treatment of patients with LGIB are still being collected. Thus, guidelines to manage patients with LGIB are still in development. Read More

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July 2018
4 Reads

Colonoscopy in Acute Lower Gastrointestinal Bleeding: Diagnosis, Timing, and Bowel Preparation.

Gastrointest Endosc Clin N Am 2018 Jul;28(3):379-390

Department of Medicine, University of California San Francisco, 505 Parnassus Avenue S-357, San Francisco, CA 94143, USA; Department of Medicine, San Francisco Veteran's Affairs Hospital, 4150 Clement Street, VA 111B/GI Section, San Francisco, CA 94121, USA. Electronic address:

Lower gastrointestinal bleeding is bleeding from a colonic source. Rapid colon purge using 4 to 6 L of polyethylene glycol followed by early colonoscopy, within 24 hours of presentation, is recommended to optimize the detection and management of bleeding sources. Although the data are mixed, early colonoscopy seems to be associated with higher detection of bleeding lesions and therapeutic interventions. Read More

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http://dx.doi.org/10.1016/j.giec.2018.02.009DOI Listing
July 2018
14 Reads

Patient Presentation, Risk Stratification, and Initial Management in Acute Lower Gastrointestinal Bleeding.

Gastrointest Endosc Clin N Am 2018 Jul;28(3):363-377

Division of Gastroenterology, The McGill University Health Center, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada; Division of Clinical Epidemiology, The McGill University Health Center, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada. Electronic address:

The approach to lower gastrointestinal bleeding (LGIB) has evolved over the last few years to incorporate a multidisciplinary management strategy. Although the causes of LGIB vary depending on the age and comorbid conditions of patients, the initial resuscitation and principles of optimizing patients' condition before endoscopic evaluation, when appropriate, are the cornerstones to clinical care. The role of risk stratification is to triage patients as well as to mobilize health care resources based on predicted outcomes. Read More

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http://dx.doi.org/10.1016/j.giec.2018.02.008DOI Listing
July 2018
8 Reads

Managing Antithrombotic Agents in the Setting of Acute Gastrointestinal Bleeding.

Gastrointest Endosc Clin N Am 2018 Jul;28(3):351-361

Department of Medicine & Therapeutics, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong. Electronic address:

The incidence of antithrombotic-associated gastrointestinal (GI) bleeding is increasing due to the growing advanced age population. There is consensus on ceasing anticoagulant and antiplatelet agents during an acute GI bleeding episode but clearer guidance is needed on resumption of these agents. This article reviews evidence for optimal management of antithrombotics in the setting of acute GI bleeding and highlights areas in which future studies are needed. Read More

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The Role of Transcatheter Arterial Embolization in the Management of Nonvariceal Upper Gastrointestinal Bleeding.

Gastrointest Endosc Clin N Am 2018 Jul;28(3):331-349

Medical Imaging Institute, Haemek Medical Center, Izhak Rabin Boulevard, Afula 1834111, Israel. Electronic address:

Nearly 50 years ago, catheter angiography was introduced as a means of both diagnosing and treating nonvariceal upper gastrointestinal bleeding. Technological advances and innovations have resulted in the introduction of microcatheters that, using a coaxial technique, are capable of selecting third-order arterial branches and of delivering a wide array of embolic agents. This article reviews the imaging diagnosis of nonvariceal upper gastrointestinal bleeding, the techniques of diagnostic and therapeutic angiography, the angiographic appearance of the various etiologies of nonvariceal upper gastrointestinal bleeding, the rationale behind case-specific selection of embolic agents as well as the anticipated outcome of transcatheter arterial embolization. Read More

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http://dx.doi.org/10.1016/j.giec.2018.02.006DOI Listing

The Cutting Edge: Doppler Probe in Guiding Endoscopic Hemostasis.

Gastrointest Endosc Clin N Am 2018 Jul;28(3):321-330

Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 100 Medical Plaza Driveway, Los Angeles, CA 90095, USA; CURE: Digestive Diseases Research Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Department of Medicine, VA West Los Angeles Medical Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.

This article examines use of the Doppler endoscopic probe (DEP) for risk stratification and as a guide to definitive hemostasis of nonvariceal upper gastrointestinal (NVUGI) bleeding and colonic diverticular hemorrhage. Studies report that lesions with high-risk stigmata of recent hemorrhage (SRH) have a higher rate of a positive DEP signal compared with those without such SRH. Lesions with a persistently positive DEP signal after endoscopic hemostasis have a higher 30-day rebleeding rate. Read More

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Emerging Endoscopic Treatments for Nonvariceal Upper Gastrointestinal Hemorrhage.

Gastrointest Endosc Clin N Am 2018 Jul 12;28(3):307-320. Epub 2018 Apr 12.

Department of Visceral Surgery, Division of Endoscopy, Frankenwaldklinik, Kronach, Germany. Electronic address:

Despite major improvements in endoscopic devices and therapeutic endoscopy, rebleeding rates and mortality have remained the same for several decades. Therefore, much interest has been paid to emerging therapeutic devices, such as the over-the-scope clip and hemostatic sprays. Other emerging technologies, such as radiofrequency ablation, endoscopic suturing devices, and ultrasound-guided angiotherapy, are also being investigated to improve therapeutic outcomes in specific situations. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10525157183001
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http://dx.doi.org/10.1016/j.giec.2018.02.004DOI Listing
July 2018
7 Reads

Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal Bleeding.

Gastrointest Endosc Clin N Am 2018 Jul 17;28(3):291-306. Epub 2018 Apr 17.

Division of Gastroenterology, University of California, 9500 Gilman Drive #0956, La Jolla, CA 92093-0956, USA.

Nonvariceal, nonulcer upper gastrointestinal hemorrhage (UGIH) is a less common cause for acute upper gastrointestinal bleeding. However, nonvariceal, nonulcer UGIH is an important entity to identify and treat appropriately to prevent bleeding-related morbidity and mortality. Over the past 40 years, there has been a revolution in gastrointestinal endoscopy and a similar revolution in the management of UGIH. Read More

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http://dx.doi.org/10.1016/j.giec.2018.02.003DOI Listing
July 2018
8 Reads

Endotherapy of Peptic Ulcer Bleeding.

Gastrointest Endosc Clin N Am 2018 Jul;28(3):277-289

Gastrointestinal Unit, Glasgow Royal Infirmary, Walton Building, Castle Street, Glasgow G4 0SF, UK. Electronic address:

Peptic ulcer bleeding is common and associated with significant morbidity and mortality. We discuss the endoscopic assessment of peptic ulcers and the rationale for treatment. We also review the evidence for the available endoscopic therapies, both individually and in combination, to draw conclusions on the optimum endoscopic management of peptic ulcer bleeding. Read More

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http://dx.doi.org/10.1016/j.giec.2018.02.002DOI Listing

Initial Assessment, Risk Stratification, and Early Management of Acute Nonvariceal Upper Gastrointestinal Hemorrhage.

Gastrointest Endosc Clin N Am 2018 Jul 17;28(3):261-275. Epub 2018 Apr 17.

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address:

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. Risk stratification scores help triage bleeding severity and provide prognosis. Read More

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http://dx.doi.org/10.1016/j.giec.2018.02.001DOI Listing
July 2018
6 Reads

Lumen-Apposing Stents: An Important Step Forward.

Authors:
Jacques Van Dam

Gastrointest Endosc Clin N Am 2018 04;28(2):xiii-xiv

Keck School of Medicine, The University of Southern California, 1510 San Pablo Street, Suite 322R, Los Angeles, CA 90033, USA.

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http://dx.doi.org/10.1016/j.giec.2018.01.001DOI Listing
April 2018
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Lumen-Apposing Metal Stents: An Important New Tool for Interventional Endoscopy Comes of Age.

Gastrointest Endosc Clin N Am 2018 04;28(2):xi-xii

Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA. Electronic address:

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http://dx.doi.org/10.1016/j.giec.2018.01.002DOI Listing
April 2018
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How the Experts Do It: Step-by-Step Guide.

Gastrointest Endosc Clin N Am 2018 Apr 3;28(2):251-260. Epub 2018 Feb 3.

Center for Interventional Endoscopy, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803, USA. Electronic address:

Lumen-apposing metal stents are integrated in a single-step delivery system for draining intra-abdominal fluid collections. The theoretic advantage of lumen-apposing stents is the ability to approximate the wall of the drained cavity or organ to the gastrointestinal tract lumen. The use of lumen-apposing stents now includes drainage of organs adjacent to the stomach/duodenum and creation of anastomosis between the stomach and jejunum. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.011DOI Listing
April 2018
31 Reads

Endoscopic Closure of Gastrointestinal Fistulae and Leaks.

Gastrointest Endosc Clin N Am 2018 Apr 1;28(2):233-249. Epub 2018 Feb 1.

Division of Gastrointestinal and Liver Diseases, University of Southern California Keck School of Medicine, 1510 San Pablo Street, Los Angeles, CA 90033, USA. Electronic address:

The development of new endoscopic techniques, such as gastrointestinal (GI) stenting, full-thickness suturing, clip application, and use of tissue adhesives, has had a significant impact on management of GI fistulae. These techniques have shown promising results, but further study is needed to optimize the efficacy of long-term closure. The advancement of endoscopic techniques, including the use of the lumen apposing metal stent (LAMS), has allowed for the deliberate creation of fistula tracts to apply endoscopic therapy that previously could not be achieved. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.010DOI Listing
April 2018
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Avoidance, Recognition, and Management of Complications Associated with Lumen-Apposing Metal Stents.

Gastrointest Endosc Clin N Am 2018 Apr 4;28(2):219-231. Epub 2018 Feb 4.

University of Minnesota Medical Center, Department of Medicine, Division of Gastroenterology and Hepatology, MMC 36 - 420 Delaware Street SE, Minneapolis, MN 55455, USA. Electronic address:

The lumen-apposing metal stent has evolved endoscopic transluminal therapies, although it has potential complications, including maldeployment, bleeding, perforation, migration, and several risks specific to necrotizing pancreatitis. Careful planning and technique mitigate these inherent risks of lumen-apposing metal sent deployment; however, setbacks occur even in the most experienced of hands. Therefore, early recognition and management of these complications are critical to alleviating morbidity and avoiding mortality. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.009DOI Listing
April 2018
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Lumen-Apposing Metal Stents: Which One and Why?

Gastrointest Endosc Clin N Am 2018 Apr 3;28(2):207-217. Epub 2018 Feb 3.

Center for Endoscopic Research and Therapeutics (CERT), The University of Chicago Medicine, 5700 South Maryland Avenue, MC 8043, Chicago, IL 60637, USA. Electronic address:

Numerous lumen-apposing metal stents (LAMS) have been designed for transluminal applications, including complex pancreatic fluid collections (PFCs) and difficult biliary access. Limited high-quality data exist directly comparing the various LAMS models, and their use remains largely dependent on availability and operator expertise. LAMS placement has been streamlined by the addition of electrocautery, allowing for single-step or modified "hot" approach, if desired. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.008DOI Listing
April 2018
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Novel Uses of Lumen-Apposing Metal Stents.

Gastrointest Endosc Clin N Am 2018 Apr;28(2):197-205

Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York Presbyterian Hospital, 1305 York Avenue, 4th Floor, New York, NY 10021, USA. Electronic address:

The lumen apposing metal stent (LAMS) has historically been used for drainage of pancreatic fluid collections. The unique design of this stent has allowed endoscopists to develop novel uses, including drainage of abscesses adjacent to gastrointestinal lumens, maintaining patency in gastrointestinal strictures, and creating a fistulous tract to bypass altered or compromised anatomy. These alternative uses for the LAMS take advantage of its ability to form a sealed, well-approximated anastomosis. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.007DOI Listing
April 2018
6 Reads

Endoscopic Ultrasound-Guided Gallbladder Drainage.

Gastrointest Endosc Clin N Am 2018 Apr 5;28(2):187-195. Epub 2018 Jan 5.

Division of Gastroenterology and Hepatology, University of North Carolina, 130 Mason Farm Road, CB 7080, Chapel Hill, NC 27599-0001, USA. Electronic address:

Recent literature has demonstrated effectiveness and safety of endoscopic ultrasound-guided gallbladder drainage, both as a primary intervention in patients with cholecystitis who are unfit for urgent surgical intervention and as a secondary intervention to internalize biliary drainage after initial placement of a percutaneous cholecystostomy catheter. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.006DOI Listing
April 2018
2 Reads

Endoscopic Ultrasound-Guided Biliary Drainage.

Gastrointest Endosc Clin N Am 2018 Apr 3;28(2):171-185. Epub 2018 Feb 3.

Pancreatic and Biliary Disease Program, Digestive Diseases, Cedars Sinai Medical Center, 8700 Beverly Boulevard, South Tower, Suite 7511, Los Angeles, CA 90048, USA.

Endoscopic ultrasound (EUS)-guided biliary drainage is an emerging technique that combines the advantages of the endoscopic and percutaneous approaches, without the inconveniences and discomfort of an indwelling external catheter. There has been growing interest and experience in EUS-biliary drainage. Several different EUS-guided techniques have been developed to access the obstructed biliary tree from either the stomach or duodenum, according to the location of the stricture, the anatomy of the patient, and the experience of the endoscopist. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.005DOI Listing
April 2018
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Endoscopic Ultrasound-Guided Drainage of Pancreatic Fluid Collections.

Authors:
Marc Giovannini

Gastrointest Endosc Clin N Am 2018 Apr;28(2):157-169

Medico-Surgical Digestive Oncology, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, Marseille 13009, France. Electronic address:

Ultrasound-guided drainage is the first-line modality for drainage of symptomatic of pancreatic fluid collections. In the context of pancreatic cancer, use of multiple double-pigtail plastic stents suffice, with high treatment efficacy. This approach provides similar success rates with low complications and better quality of life compared with surgery. Read More

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http://dx.doi.org/10.1016/j.giec.2017.11.004DOI Listing
April 2018
5 Reads