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Efficacy and complications of covered Wallstents in malignant distal biliary obstruction 总被引:9,自引:0,他引:9
Kahaleh M Tokar J Conaway MR Brock A Le T Adams RB Yeaton P 《Gastrointestinal endoscopy》2005,61(4):528-533
BACKGROUND: This study evaluated the efficacy and the complications associated with the use of the covered Wallstent in the setting of unresectable malignant biliary obstruction. METHODS: Between March 2001 and January 2003, all patients with distal malignant biliary obstruction that required drainage were treated with a covered Wallstent. Every 2 months, the patients were evaluated clinically and biochemical tests of liver function were obtained. Data were recorded for the following variables: early complications (within 30 days of stent placement), early and late stent occlusion, duration of stent patency, need for subsequent biliary intervention, and patient survival. RESULTS: A total of 88 covered Wallstents were inserted in 80 patients. Stent patency rates at 3, 6, and 12 months were 90%, 82%, and 78%, respectively. Complications included stent migration (5), stent occlusion (12), episodes of cholecystitis (3), and episodes of post-ERCP pancreatitis (5). Biliary intervention was required in 9 patients subsequent to placement of the initial covered Wallstent. CONCLUSIONS: Deployment of a covered Wallstent is safe and relatively easy. It achieves biliary drainage with an acceptable risk to benefit ratio in the majority of patients with distal malignant biliary obstruction. 相似文献
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Comparison of the grading of esophageal varices by transnasal endoluminal ultrasound and esophagogastroduodenoscopy. 总被引:1,自引:0,他引:1
Leonard Kane Michel Kahaleh Vanessa M Shami Steven H Caldwell Carl L Berg Khalouck M Abdrabbo C M Yoshida Kristin O Arseneau Paul Yeaton 《Clinical gastroenterology and hepatology》2005,3(8):806-810
BACKGROUND & AIMS: Esophagogastroduodenoscopy (EGD) is the current standard for evaluating esophageal varices, yet there is no universally accepted system of grading varices endoscopically and several studies have shown interobserver variability of endoscopic grading. High-resolution endoluminal ultrasound 20 MHz (HRES) has been shown to detect varices accurately and can be performed without sedation. Our aim was to compare the detection of esophageal varices by transnasal HRES and EGD. METHODS: We prospectively studied 37 cirrhotic patients being evaluated for esophageal varices. HRES was used to measure the largest esophageal variceal diameter and then EGD was performed. Photographs were taken for both procedures. Three blinded investigators graded the EGD photographs at 2 periods. End points were as follows: (1) the correlation of HRES variceal diameter and EGD grading of varices, and (2) the assessment of interobserver and intraobserver variation in varix grading by EGD. RESULTS: The correlation between the transnasal HRES and EGD was .63, with a 95% confidence interval of .37-.80. The HRES detected early varices that were not seen by EGD. The interobserver correlation for EGD scoring was .87 or greater in all comparisons and the intraobserver correlation was .91 or greater. CONCLUSIONS: In conclusion, there is a significant correlation between transnasal HRES size measurement of esophageal varices and EGD. HRES is much more sensitive in detecting early esophageal varices and may not require sedation, suggesting that it may be more tolerable to patients and is worth further study. 相似文献
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Kabbani SS Izzat MB Jamil H Akasheh B Hanania D Raffa H 《Asian cardiovascular & thoracic annals》2003,11(2):99-101
Heart transplantation is not yet socially acceptable in the Middle East, and left ventricular assist facilities are not generally available in this region. Therefore, left ventricular volume reduction surgery was attempted in 41 patients with end-stage heart failure (33 males; median age, 36.3 years) in 4 Middle Eastern tertiary referral centers between February 1996 and January 2001. Heart failure was due to idiopathic cardiomyopathy in 21 patients, ischemia in 11, rheumatic valvular disease in 8, and viral myocarditis in 1. Associated procedures were aortic valve replacement in 5 patients, mitral valve repair in 25, mitral valve replacement in 7, tricuspid valve repair in 6, and coronary bypass grafting in 8. Hospital mortality was 31.7%. Five patients were lost to follow-up. The survival rate of hospital survivors at 18 months was 65.2%. Three of the surviving patients did not benefit from the operation. Although our results were somewhat disappointing, this operation remains an option for surgeons working in developing areas of the world. It is hoped that better patient selection and new techniques of left ventricular volume reduction that avoid resection of viable muscle will further improve the outcome of this operation. 相似文献
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Martínez-Hernández Miryam Reda Bashar Hannig Matthias 《Clinical oral investigations》2020,24(11):3843-3853
Clinical Oral Investigations - This in situ study aims to evaluate the effects of chlorhexidine (CHX) mouth rinsing on biofilm formation and moreover on the disruption of existing mature dental... 相似文献
9.
Yamile Haito-Chavez Joanna K. Law Thomas Kratt Alberto Arezzo Mauro Verra Mario Morino Reem Z. Sharaiha Jan-Werner Poley Michel Kahaleh Christopher C. Thompson Michele B. Ryan Neel Choksi B. Joseph Elmunzer Sonia Gosain Eric M. Goldberg Rani J. Modayil Stavros N. Stavropoulos Drew B. Schembre Christopher J. DiMaio Vinay Chandrasekhara Muhammad K. Hasan Shyam Varadarajulu Robert Hawes Victoria Gomez Timothy A. Woodward Sergio Rubel-Cohen Fernando Fluxa Frank P. Vleggaar Venkata S. Akshintala Gottumukkala S. Raju Mouen A. Khashab 《Gastrointestinal endoscopy》2014