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At least 253 records · Page 14Linked to original sources
PubMed2006

Endoluminal surgery: past, present and future.

Flexible endoscopy has evolved from a diagnostic tool practiced predominantly by gastroenterologists to a minimally invasive surgical tool. Therapeutic endoluminal procedures have become the standard of care for many gastric, biliary, pancreatic and colonic maladies. New technologies are under investigation for endoscopic treatment of gastroesophageal reflux, morbid obesity, and ablation of premalignant tissue. In the future flexible endoscopes may play a role in "natural orifice" surgery, performing operations through the mouth or rectum without the need for external incisions.

Biliary Tract Surgical Procedures↗
PubMed2004

Endoscopic management of pancreatic fistula after pancreatic and other abdominal surgery.

Post-operative pancreatic fistulae represent a challenge for all the actors in gastroenterology: for surgeons, because they want to prevent and treat conservatively this complication since re-operation is associated with high morbidity and mortality rates; for radiologists, because they have to provide the best staging and informations without any additional risk; and for endoscopists, because endoluminal treatment is emerging as a safe and effective procedure provided it is performed in highly experienced tertiary centres in the setting of a multidisciplinary approach. Herein, we review the definitions, the causes, the staging and the possible options to prevent or treat post-operative pancreatic fistulae. Special attention is paid to the endoscopic management of this complication: including the relief of ductal obstructions, the stenting of leakages and the drainage of bulging or non-bulging fluid collections. Practical problems and issues are clearly outlined as well as the need for future improvements in staging and management of the patients having such complications.

Cholangiopancreatography, Magnetic Resonance↗
PubMed1999

[Foreign bodies of gastrointestinal tract].

153 patients with swallowed foreign bodies in gastrointestinal tract (GIT) were treated for the last 10 years (1988-1997). In 85 (55.5%) cases foreign bodies (FB) were swallowed by psychopathic persons, in 45 (29.4%)--with the aim of mutilation, in 23 (15.0%)--due to carelessness. In 105 (68.63%) patients the foreign bodies were single, in 48 (31.37%) there were multiple foreign bodies of GIT. In 73 (47.71%) cases FB were found in the stomach. Clinical picture in patients with swallowed FB was variable. Dynamic roentgenological examination together with thorough anamnesis is the most important diagnostic tool in this pathology. The indications for urgent surgical treatment were sticking of the FB, peritonitis, gastro-duodenal bleeding, gastrointestinal obstruction. Elective surgery was used in patients with sticked F.B., with multiple FB, which formed conglomerates, as well as in single FB. with the length over 12-15 cm. Active expectant policy is valid FB of GIT with tendency for passage, due to conservative treatment.

Adolescent↗
PubMed2000

[Gastrointestinal surgery and gastroenterology. VII. Proximal motility disorders in the digestive tract].

Dysphagia and chest pain are the two commonest symptoms of abnormalities of oesophageal motility. Dysphagia is to be distinguished into high or oropharyngeal and low or oesophageal dysphagia. Oropharyngeal dysphagia pertains to dysfunction of the pars cricopharyngea of the M. constrictor pharyngis inferior (M. cricopharyngeus), which is frequently associated with a Zenker diverticulum. Treatment consists of endoscopical or surgical myotomy and diverticulectomy. In achalasia there is incomplete relaxation of the lower esophageal sphincter with aperistalsis. The main treatment modalities are endoscopic pneumodilation and surgical myotomy of this sphincter. In dysphagia or non-cardiac chest pain spastic or hypocontractile abnormalities of the oesophageal motility can be involved, these are often difficult to treat. Disorders of gastric motility are mainly gastroparesis and functional dyspepsia. In diabetic gastroparesis, adequate monitoring of the blood sugar level is also necessary. New insights into the pathophysiology of functional dyspepsia concern abnormal visceral sensitivity and reduced adaptive relaxation of the stomach during intake of food.

Chest Pain↗
PubMedDate not supplied

New data in the management of digestive steroses.

The report is a review of the perendoscopic methods of treatment of stenoses at the level of the digestive tract and of the excretion canals of the annex glands. After a short description of the methods as well as of the necessary equipment, the authors discuss the indications according to the etiology of stenoses. The indications and contraindications are enumerated and an estimation is made of the therapeutic efficiency of the endoscopic methods as compared with the classical surgical methods. Emphasis is laid on the therapeutic advantages of the endoscopic palliative methods as an alternative to the surgical methods.

Constriction, Pathologic↗
PubMed2005

[Psycho-autonomic aspects in patients with gastroesophageal reflux disease, and functional esophageal disorders].

The subjects of the study were 79 patients (35 with functional esophageal disorders (FED), 24 with nonerosive reflux disease (NERD), and 20 with erosive reflux disease (ERD), who were selected on the basis of clinical complaints, 24-hour ph-study, and esophagogastroduodenoscopy. All the subjects were evaluated by means of clinical questionnaires and psychological tests: Beck depression test, Spielberg State-Trait Anxiety inventory (STAI), and Toronto alexithymia test (TAS). In FED and NERD patients vs. ERD patients the following abnormalities were observed more frequently: autonomic and functional somatic symptoms (apart from gastrointestinal tract (GIT) complaints) (p < 0.01), sleep disturbances (p < 0.01), fatigue (p < 0.01), eating behavior disorders (DEBQ) (p < 0.05), maternal overprotection in childhood (p < 0.05), psychophysioligical GIT reaction in childhood (p < 0.05), higher levels of state and trait anxiety (p < 0.05), and hypochondria (p < 0.05). The clinical symptom index (CSI) (the sum of stomach and bowel complaints to the sum of esophageal complaints ratio) was calculated. CSI in FED and NERD patients was 1.8, while CSI in ERD patients--0.1 (p < 0). Thus, compared to ERD patients, patients with FED and NERD were characterized by more pronounced emotional, motivational, and autonomic disorders. Besides, CSI demonstrated that the character of gastrointestinal dysfunction was more diffuse in NERD and FED and more local--in ERD patients.

Adult↗
PubMed2002

Laparoscopic hepatobiliary and pancreatic surgery: an overview.

Although they are not widely employed, advanced laparoscopic hepatobiliary pancreatic (HBP) procedures can be performed. Laparoscopic common bile duct (CBD) exploration has gained wide acceptance, and endoscopic retro-grade cholangiopancreatography/endoscopic sphincterotomy (ERCP/ES) may become less important in the treatment of CBD stones. Choledochal cyst is another example that is suitable for laparoscopic treatment. It can be removed, and bilioenteric flow is reestablished laparoscopically. Simple cyst of the liver is an excellent indication for laparoscopic surgery. Cysts are unroofed, and recurrence is rare. Hydatid disease can also be treated laparoscopically. In liver resection, the use of laparoscopy is limited to wedge resection and left lateral segmentectomy at most. Laparoscopic staging for pancreatic cancer can demonstrate respectability in 90% of cases. This staging may obviate unnecessary laparotomy. Although laparoscopic Whipple is feasible, laparoscoic distal pancreatectomy is a realistic indication for pancreatic resection. Laparoscopic distal pancreatectomy may be indicated for cystic neoplasms of low-grade malignancy, and for islet cell tumors. When internal drainage is indicated, pseudocysts can be treated laparoscopically. If the cyst is located close to the posterior gastric wall, cystgastrostomy can also be achieved with an endoluminal surgical technique.

Biliary Tract Surgical Procedures↗
PubMed2002

[Interventions in gastroenterology and hepatology: indications and results].

Interventional therapy and above all the endoscopic interventions have gained importance in the last years. There are a lot of interventional procedures with curative or palliative intention, which value have to be compared with surgical therapy as the therapeutical gold standard. Today the endoscopic hemostasis for ulcer or variceal bleeding are the therapy of choice with very good results. Thus the need for surgery is low. The treatment of benign esophageal stenosis is a domain of the endoscopic therapy. Dilatation with bougies or balloon dilatation get comparable results. In patients with achalasia age and comorbidity of the patients are of great importance for the choice of therapy. In young patients the botulinum toxin injection should be avoided because of a very low long-term efficiency and because surgery become more difficult after botulinum toxin injection. As colorectal cancer is a frequent tumor endoscopic polypectomy and mucosectomy are very important endoscopic procedures, because there is a possibility of cancer prevention and when risk factors are be considered a curative therapy of early colorectal cancer is possible.

Botulinum Toxins↗