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A prospective study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures
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Bhavik Bharat Shah, Gajanan Ashokrao Rodge, Usha Goenka, Shivaraj Afzalpurkar, Mahesh Kumar Goenka
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Clin Endosc 2022;55(6):793-800. Published online April 4, 2022
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DOI: https://doi.org/10.5946/ce.2021.211
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Abstract
PDFPubReaderePub
- Background
/Aims: Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety of FCSEMSs in this patient group.
Methods This prospective single-center study included patients who underwent endoscopic retrograde pancreatography with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain score of >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreatic strictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events.
Results Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was 86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The mean visual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were asymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancreatitis (2.8%) were the most common adverse events.
Conclusions FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractory main pancreatic duct strictures.
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Citations
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- Citric Acid Loaded Hydrogel-Coated Stent for Dissolving Pancreatic Duct Calculi
Jing Li, Yanwei Lv, Zheng Chen, Jiulong Zhao, Shige Wang Gels.2024; 10(2): 125. CrossRef - Fully Covered Self-expandable Metallic Stents for Refractory Benign Pancreatic Duct Strictures: A Systematic Review and Meta-analysis
Gajanan Rodge, Suprabhat Giri, Kailash Kolhe, Shivaraj Afzalpurkar, Sidharth Harindranath, Sridhar Sundaram, Aditya Kale Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024;[Epub] CrossRef - Self-expanding metallic stent for refractory pancreatic duct stricture in chronic pancreatitis: A prospective follow-up study
Praveer Rai, Pankaj Kumar, Ashok Kumar, Sana Asari, Kartik Agarwal, Mayank, Ravi V. Krishna Kishore, Prabhaker Mishra Indian Journal of Gastroenterology.2023;[Epub] CrossRef - Quality of life after endoscopic procedures for chronic pancreatitis: A multicentre study
Mikael Parhiala, Camilla Nøjgaard, Andreas Bartholdy, Anne Waage, Povilas Ignatavičius, Trond Engjom, Georg Dimcevski, Ingrid Kvåle Nordaas, Evangelos Kalaitzakis, Asbjørn M. Drewes, Amer Hadi, Søren S. Olesen, Jakob L. Poulsen, Johanna Laukkarinen United European Gastroenterology Journal.2023; 11(9): 884. CrossRef - Pancreatic duct stents
Jin Hui Yi, Zhao Shen Li, Liang Hao Hu Journal of Digestive Diseases.2022; 23(12): 675. CrossRef
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Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System
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Mahesh Kumar Goenka, Bhavik Bharat Shah, Vijay Kumar Rai, Surabhi Jajodia, Usha Goenka
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Clin Endosc 2018;51(6):563-569. Published online October 5, 2018
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DOI: https://doi.org/10.5946/ce.2018.041
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Abstract
PDFPubReaderePub
- Background
/Aims: To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system.
Methods Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined.
Results Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement.
Conclusions The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.
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Citations
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- Capsule endoscopy for small bowel bleed: Current update
Uday C. Ghoshal, Akash Roy, Mahesh K. Goenka Indian Journal of Gastroenterology.2024;[Epub] CrossRef - Diagnosis and management of ectopic varices in portal hypertension
Thomas H Tranah, Jeremy S Nayagam, Stephen Gregory, Sarah Hughes, David Patch, Dhiraj Tripathi, Debbie L Shawcross, Deepak Joshi The Lancet Gastroenterology & Hepatology.2023; 8(11): 1046. CrossRef - The Role of Video Capsule Endoscopy in Liver Disease
Alexander Ross Robertson, Anastasios Koulaouzidis, Emanuele Rondonotti, Mauro Bruno, Marco Pennazio Gastrointestinal Endoscopy Clinics of North America.2021; 31(2): 363. CrossRef - Role of Video Capsule in Small Bowel Bleeding
Richard M. Wu, Laurel R. Fisher Gastrointestinal Endoscopy Clinics of North America.2021; 31(2): 277. CrossRef - The Usefulness of New-Generation Capsule Endoscopy in Patients with Portal Hypertensive Enteropathy
Seung-Joo Nam, Ji Hyun Kim, Sung Chul Park Clinical Endoscopy.2018; 51(6): 505. CrossRef
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Pancreatic Necrosectomy through Sinus Tract Endoscopy
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Mahesh Kumar Goenka, Usha Goenka, Md.Yasin Mujoo, Indrajit Kumar Tiwary, Sanjay Mahawar, Vijay Kumar Rai
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Clin Endosc 2018;51(3):279-284. Published online January 4, 2018
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DOI: https://doi.org/10.5946/ce.2017.066
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Abstract
PDFPubReaderePub
- Background
/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walled-off necrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. We evaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON.
Methods Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WON requiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adult gastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain.
Results Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean time of 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergo surgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, or recurrence during follow-up.
Conclusions Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details of the technique and end-points of STE require further evaluation.
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- A New Step-Up Dual Endoscopic Approach for Large-Size Infected Pancreatic Necrosis: Percutaneous Endoscopic Necrosectomy Followed by Transluminal Endoscopic Drainage/Necrosectomy
Santi Mangiafico, Helga Bertani, Flavia Pigò, Salvatore Russo, Marinella Lupo, Silvia Cocca, Giuseppe Grande, Ugo Germani, Raffaele Manta, Rita Conigliaro Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(2): 156. CrossRef - Metal stent and percutaneous endoscopic necrosectomy as dual approach for the management of complex walled-off pancreatic necrosis
Cecilia BINDA, Barbara PERINI, Chiara COLUCCIO, Paolo GIUFFRIDA, Stefano FABBRI, Giulia GIBIINO, Antonio VIZZUSO, Emanuela GIAMPALMA, Carlo FABBRI Minerva Surgery.2024;[Epub] CrossRef - Necrosis pancreática extensa, manejo exitoso con necrosectomía endoscópica percutánea
Daniela Giraldo Campillo, Juliana Lucía Molina Valencia, Juan Camilo Ricaurte Ciro, Carlos Andrés Delgado López Revista colombiana de Gastroenterología.2024; 39(2): 194. CrossRef - Management of Pancreatic Fluid Collections
Sohini Sameera, Tayyaba Mohammad, Kelvin Liao, Haroon Shahid, Avik Sarkar, Amy Tyberg, Michel Kahaleh Journal of Clinical Gastroenterology.2023; 57(4): 346. CrossRef - Placement of Plastic Stents after Direct Endoscopic Necrosectomy through a Novel Lumen-Apposing Metal Stent for Effective Treatment of Laterally Extended Walled-Off Necrosis: A Pilot Study
Kyong Joo Lee, Se Woo Park, Da Hae Park, Jung Hee Kim, Jang Han Jung, Dong Hee Koh, Jin Lee, Mi Gang Kim Journal of Clinical Medicine.2023; 12(3): 1125. CrossRef - Percutaneous endoscopic necrosectomy (PEN) for treatment of necrotizing pancreatitis: a systematic review and meta-analysis
Mihajlo Gjeorgjievski, Abishek Bhurwal, Abhishek A. Chouthai, Abdelhai Abdelqader, Monica Gaidhane, Haroon Shahid, Amy Tyberg, Avik Sarkar, Michel Kahaleh Endoscopy International Open.2023; 11(03): E258. CrossRef - Percutaneous Endoscopic Necrosectomy
Soumya Jagannath Mahapatra, Pramod Kumar Garg Gastrointestinal Endoscopy Clinics of North America.2023; 33(4): 737. CrossRef - Controversies in EUS-guided treatment of walled-off necrosis
Michael Hocke, Sean Burmeister, Barbara Braden, Christian Jenssen, PaoloGiorgio Arcidiacono, Julio Iglesias-Garcia, André Ignee, Alberto Larghi, Kathleen Möller, Mihai Rimbas, Sun Siyu, Giuseppe Vanella, ChristophF Dietrich Endoscopic Ultrasound.2022; 11(6): 442. CrossRef - Interventional strategies in infected necrotizing pancreatitis: Indications, timing, and outcomes
Birte Purschke, Louisa Bolm, Max Nikolaus Meyer, Hiroki Sato World Journal of Gastroenterology.2022; 28(27): 3383. CrossRef - Percutaneous direct endoscopic pancreatic necrosectomy
Manoj A Vyawahare, Sushant Gulghane, Rajkumar Titarmare, Tushar Bawankar, Prashant Mudaliar, Rahul Naikwade, Jayesh M Timane World Journal of Gastrointestinal Surgery.2022; 14(8): 731. CrossRef - EUS-guided drainage using lumen apposing metal stent and percutaneous endoscopic necrosectomy as dual approach for the management of complex walled-off necrosis: a case report and a review of the literature
Cecilia Binda, Monica Sbrancia, Marina La Marca, Dora Colussi, Antonio Vizzuso, Matteo Tomasoni, Vanni Agnoletti, Emanuela Giampalma, Luca Ansaloni, Carlo Fabbri World Journal of Emergency Surgery.2021;[Epub] CrossRef - Technical aspects of minimally invasive percutaneous approach for local complications of acute pancreatitis
S. V. Novikov, M. L. Rogal, R. A. Yartsev, Yu. S. Teterin Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2021; 26(3): 60. CrossRef - Endoscopic transmural drainage and necrosectomy in acute necrotizing pancreatitis: A review
Linlin Feng, Jintao Guo, Sheng Wang, Xiang Liu, Nan Ge, Guoxin Wang, Siyu Sun Journal of Translational Internal Medicine.2021; 9(3): 168. CrossRef - Percutaneous endoscopic necrosectomy in a patient with emphysematous pancreatitis
Shin Hee Lee, Kyu-hyun Paik, Ji Chang Kim, Won Suk Park Medicine.2021; 100(46): e27905. CrossRef - Optimal Therapeutic Options for Complex Walled-Off Necrosis: Endoscopic and Percutaneous Drainage
Hoonsub So, Seokjung Jo, Tae Jun Song The Korean Journal of Pancreas and Biliary Tract.2019; 24(1): 6. CrossRef
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Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study
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Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary
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Clin Endosc 2017;50(1):58-63. Published online October 31, 2016
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DOI: https://doi.org/10.5946/ce.2016.028
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Abstract
PDFPubReaderePub
- Background
/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC.
Methods Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip.
Results All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding.
Conclusions In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.
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