scholarly journals Safety and efficacy of digital single-operator pancreatoscopy for obstructing pancreatic ductal stones

2019 ◽  
Vol 07 (07) ◽  
pp. E896-E903 ◽  
Author(s):  
Olaya I. Brewer Gutierrez ◽  
Isaac Raijman ◽  
Raj J. Shah ◽  
B. Joseph Elmunzer ◽  
George J.M. Webster ◽  
...  
Keyword(s):  
Combined Treatment ◽  
The United States ◽  
Laser Lithotripsy ◽  
Technical Failure ◽  
Single Session ◽  
Technical Success ◽  
Safety And Efficacy ◽  
Single Operator ◽  
Pancreatic Duct Stones

Abstract Background and study aims The role of the digital single-operator pancreatoscopy (D-SOP) with electrohydraulic (EHL) or laser lithotripsy (LL) in treating pancreatic ductal stones is unclear. We investigated the safety and efficacy of D-SOP with EHL or LL in patients with obstructing pancreatic duct stones. Patients and methods Retrospective analysis of 109 patients who underwent D-SOP for pancreatic stones at 17 tertiary centers in the United States and Europe from February 2015 to September 2017. Logistic regression was performed to identify factors associated with the need for more than one D-SOP with EHL/LL. Results Most patients were males (70.6 %),mean age 54.7 years. Fifty-nine (54.1 %) underwent EHL and 50 (45.9 %) underwent LL. Mean procedure time was longer in the EHL group (74.4 min vs 53.8 min; P < 0.001). Ducts were completely cleared (technical success) in 89.9 % of patients (94.1 % in EHL vs 100 % in LL; P = 0.243), achieved in a single session in 73.5 % of patients (77.1 % by EHL and 70 % by LL; P= 0.5).D-SOP failed in 11 patients (10.1 %); 6 patients were treated with extracorporeal shockwave lithotripsy (ESWL), 1 with surgery,1 with combined treatment (ESWL + D-SOP EHL) and 3 with other. Fourteen adverse events occurred in 11 patients (10.1 %). Patients with more than three ductal stones were more likely to have technical failure compared to those with less than three stones (17 % vs. 4.8 %; P = 0.04). Having more than three stones was independently associated with the need for more than one D-SOC EHL/LL session (OR 2.94, 95 % CI 1.13 – 7.65). Conclusion D-SOP with EHL or LL is effective and safe in patients with pancreatic ductal stones.

scholarly journals Initial results of new technological approach to visualization and treatment of bile and pancreatic duct disease

2019 ◽  
Vol 24 (2) ◽  
pp. 105-116
Author(s):  
S. A. Budzinskiy ◽  
S. G. Shapovalyants ◽  
E. D. Fedorov ◽  
D. V. Bakhtiozina ◽  
L. M. Mikhaleva ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Laser Lithotripsy ◽  
Pancreatic Ducts ◽  
Duodenal Papilla ◽  
Technical Success ◽  
Technical Success Rate ◽  
Pancreatic Duct Stones ◽  
Spyglass Ds ◽  
Complications And Mortality ◽  
Initial Results

Objective. To evaluate possibilities and advantages of SpyGlass DS system (Boston Scientific) in the diagnosis and treatment of pancreato-biliary diseases. Material and methods. SpyGlass DS has been applied in 24 interventions in 22 patients for the period from December 6, 2017 to July 6, 2018. There were 21 cholangioscopies, 2 pancreaticoscopies and one cholangiopancreaticoscopy. The indications for cholangioscopy were undifferentiated strictures (n = 14), suspected Mirizzi syndrome (n = 2), large choledocholithiasis and need for laser lithotripsy (n = 1). There was a need to pass a guidewire under visual control (n = 2) and to control bile duct stones extraction (n = 1). Scheduled removal of ligature after laparoscopic cholecystectomy was in 1 case. Indication for pancreaticoscopy was suspected malignancy within the strictures associated with chronic pancreatitis, for cholangiopancreaticoscopy – assessment of spread of major duodenal papilla tumor into common bile and pancreatic ducts. Results. Overall technical success rate was 95.8% (23/24). Intraductal biopsy was successfully performed in 13 out of 14 (92.9%) cases. Cholangiocarcinoma was histologically confirmed in 6 cases. Curative interventions were performed in all 4 cases. There were no complications and mortality. Conclusion. The main indications for endoscopic peroral intraductal interventions are various types of undifferentiated and complicated biliary and pancreatic strictures, as well as “difficult” bile and pancreatic duct stones. The technology of diagnostic and curative endoscopic interventions using the SpyGlass DS system is relatively simple while morbidity and mortality rates are similar to those after conventional transpapillary interventions.

scholarly journals Safety and efficacy of arteriovenous fistula angioplasties performed by nephrologists: report from a Brazilian interventional nephrology center

2021 ◽  
Author(s):  
Ricardo P. Franco ◽  
Miguel C. Riella ◽  
Domingos C. Chula ◽  
Marcia T. de Alcântara ◽  
Marcelo M. do Nascimento
Keyword(s):  
Success Rate ◽  
Low Income ◽  
Complication Rates ◽  
Technical Failure ◽  
Success Rates ◽  
Technical Success ◽  
Safety And Efficacy ◽  
Technical Success Rate ◽  
Venous Stenosis ◽  
First Choice

ABSTRACT Introduction: Arteriovenous fistulas (AVF) are the first choice vascular access for hemodialysis. However, they present a high incidence of venous stenosis leading to thrombosis. Although training in interventional nephrology may improve accessibility for treatment of venous stenosis, there is limited data on the safety and efficacy of this approach performed by trained nephrologists in low-income and developing countries. Methods: This study presents the retrospective results of AVF angioplasties performed by trained nephrologists in a Brazilian outpatient interventional nephrology center. The primary outcome was technical success rate (completion of the procedure with angioplasty of all stenoses) and secondary outcomes were complication rates and overall AVF patency. Findings: Two hundred fifty-six angioplasties were performed in 160 AVF. The technical success rate was 88.77% and the main cause of technical failure was venous occlusion (10%). The incidence of complications was 13.67%, with only one patient needing hospitalization and four accesses lost due to the presence of hematomas and/or thrombosis. Grade 1 hematomas were the most frequent complication (8.2%). The overall patency found was 88.2 and 80.9% at 180 and 360 days after the procedure, respectively. Conclusion: Our findings suggest that AVF angioplasty performed by trained nephrologists has acceptable success rates and patency, with a low incidence of major complications as well as a low need for hospitalization.

scholarly journals Safety and efficacy of emergency transarterial embolization for mesenteric bleeding

2022 ◽  
Vol 5 (1) ◽  
Author(s):  
Chloé Extrat ◽  
Sylvain Grange ◽  
Clément Chevalier ◽  
Nicolas Williet ◽  
Jean-Marc Phelip ◽  
...  
Keyword(s):  
Clinical Success ◽  
Transarterial Embolization ◽  
Hemodynamic Instability ◽  
Radiology Department ◽  
Technical Failure ◽  
Technical Success ◽  
Contrast Extravasation ◽  
Percutaneous Embolization ◽  
Safety And Efficacy ◽  
Tertiary Center

Abstract Background Patients with spontaneous or traumatic active mesenteric bleeding cannot be treated endoscopically. Transarterial embolization can serve as a potential alternative to emergency surgery. Literature on transarterial embolization for mesenteric bleeding remains very scarce. The objective of this study was to evaluate the safety and efficacy of transarterial embolization for mesenteric bleeding. We reviewed all consecutive patients admitted for mesenteric bleeding to the interventional radiology department, in a tertiary center, between January 2010 and March 2021. Mesenteric bleeding was defined as mesenteric hematoma and contrast extravasation and/or pseudoaneurysm visible on pre-operative CT scan. We evaluated technical success, clinical success, and complications. Results Among the 17 patients admitted to the interventional department for mesenteric bleeding, 15 presented with active mesenteric bleeding requiring transarterial embolization with five patients with hemodynamic instability. Mean age was 67 ± 14 years, including 12 (70.6%) males. Technical success was achieved in 14/15 (93.3%) patients. One patient with technical failure was treated by percutaneous embolization with NBCA-Lipiodol mixture. Three patients (20%) had early rebleeding: two were treated by successful repeat embolization and one by surgery. One patient (6.7%) had early death within 30 days and two patients (13.3%) had late death after 30 days. Mean length of hospitalization was 12.8 ± 7 days. There were no transarterial embolization-related ischemic complications. Conclusion Transarterial embolization is a safe and effective technique for treating mesenteric bleeding even in patients with hemodynamic instability. Transarterial embolization doesn’t close the door to surgery and could be proposed as first intention in case of mesenteric bleeding.

The Role of Gender and Sensation Seeking in Film Choice

2008 ◽  
Vol 20 (3) ◽  
pp. 97-105 ◽  
Author(s):  
Smita C. Banerjee ◽  
Kathryn Greene ◽  
Marina Krcmar ◽  
Zhanna Bagdasarov ◽  
Dovile Ruginyte
Keyword(s):  
United States ◽  
Undergraduate Students ◽  
Sensation Seeking ◽  
Negative Mood ◽  
Positive Mood ◽  
The United States ◽  
High Arousal ◽  
Subject Design ◽  
Happy Mood

This study demonstrates the significance of individual difference factors, particularly gender and sensation seeking, in predicting media choice (examined through hypothetical descriptions of films that participants anticipated they would view). This study used a 2 (Positive mood/negative mood) × 2 (High arousal/low arousal) within-subject design with 544 undergraduate students recruited from a large northeastern university in the United States. Results showed that happy films and high arousal films were preferred over sad films and low-arousal films, respectively. In terms of gender differences, female viewers reported a greater preference than male viewers for happy-mood films. Also, male viewers reported a greater preference for high-arousal films compared to female viewers, and female viewers reported a greater preference for low-arousal films compared to male viewers. Finally, high sensation seekers reported a preference for high-arousal films. Implications for research design and importance of exploring media characteristics are discussed.

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