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| 1 | Pathophysiological consequences of obstructive jaundice and perioperative management显示文摘Background: Obstructive jaundice is a common problem in daily clinical practice. Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future management.Data sources: A Pub Med was searched for relevant articles published up to August 2016. The effect of obstructive jaundice on proinflammatory cytokines, coagulation status, hemodynamics and organ functions were evaluated.Results: The effects of obstructive jaundice included biliary tree, the hepatic cell and liver function as well as systemic complications. The lack of bile in the gut, the disruption of the intestinal mucosal barrier,the increased absorption of endotoxin and the subsequent endotoxemia cause proinflammatory cytokine production(TNF-α, IL-6). Bilirubin induces systemic inflammatory response syndrome which may lead to multiple organ dysfunction syndrome. The principal clinical manifestations include hemodynamic instability and acute renal failure, cardiovascular suppression, immune compromise, coagulation disorders,nutritional impairment, and wound healing defect. The proper management includes full replacement of water and electrolyte deficiency, prophylactic antibiotics, lactulose, vitamin K and fresh frozen plasma,albumin and dopamine. The preoperative biliary drainage has not been indicated in overall, but only in a few selected cases.Conclusion: The perioperative management is an essential measure in improving the outcome after the appropriate surgical operation in jaundiced patients especially those with malignancy. | Efstathios T Pavlidis Theodoros E Pavlidis | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，1： | 63 |
| 2 | Pyogenic liver abscess: Differences in etiology and treatment in Southeast Asia and Central Europe显示文摘Knowledge of etiology and timely treatment of underlying causes,when possible,play an important role in the successful therapy of patients with pyogenic liver abscess (PLA).Recent publications from Central Europe and Southeast Asia hint at considerable differences in etiology.In this article,we aim to elaborate these differences and their therapeutic implications.Apart from some special types of PLA that are comparable in Southeast Asia and Central Europe (such as posttraumatic or postprocedural PLA),there are clear differences in the microbiological spectrum,which implies different risk factors and disease courses.Klebsiella pneumoniae (K.pneumoniae) PLA is predominantly seen in Southeast Asia,whereas,in Central Europe,PLA is typically caused by Escherichia coli,Streptococcus or Staphylococcus,and these patients are more likely to be older and to have a biliary abnormality or malignancy.K.pneumoniae patients are more likely to have diabetes mellitus.Control of septic spread is crucial in K.pneumoniae patients,whereas treatment of the underlying diseases is decisive in many Central European PLA patients. | Herwig Cerwenka | 2010 | World Journal of Gastroenterology2010，16，20： | 46 |
| 3 | Surgical techniques and postoperative management to prevent postoperative pancreatic fistula after pancreatic surgery显示文摘Postoperative pancreatic fistula (POPF) is one of the most severe complications after pancreatic surgeries. POPF develops as a consequence of pancreatic juice leakage from a surgically exfoliated surface and/or anastomotic stump, which sometimes cause intraperitoneal abscesses and subsequent lethal hemorrhage. In recent years, various surgical and perioperative attempts have been examined to reduce the incidence of POPF. We reviewed several well-designed studies addressing POPF-related factors, such as reconstruction methods, anastomotic techniques, stent usage, prophylactic intra-abdominal drainage, and somatostatin analogs, after pancreaticoduodenectomy and distal pancreatectomy, and we assessed the current status of POPF. In addition, we also discussed the current status of POPF in minimally invasive surgeries, laparoscopic surgeries, and robotic surgeries. | Hiromichi Kawaida Hiroshi Kono Naohiro Hosomura Hidetake Amemiya Jun Itakura Hideki Fujii Daisuke Ichikawa | 2019 | World Journal of Gastroenterology2019，25，28： | 43 |
| 4 | Preoperative biliary drainage in hilar cholangiocarcinoma: When and how?显示文摘Hilar cholangiocarcinoma is a tumor of the extrahepatic bile duct involving the left main hepatic duct, the right main hepatic duct, or their confluence. Biliary drainage in hilar cholangiocarcinoma is sometimes clinically challenging because of complexities associated with the level of biliary obstruction. This may result in some adverse events, especially acute cholangitis. Hence the decision on the indication and methods of biliary drainage in patients with hilar cholangiocarcinoma should be carefully evaluated. This review focuses on the optimal method and duration of preoperative biliary drainage(PBD) in resectable hilar cholangiocarcinoma. Under certain special indications such as right lobectomy for Bismuth type ⅢA or Ⅳ hilar cholangiocarcinoma, or preoperative portal vein embolization with chemoradiation therapy, PBD should be strongly recommended. Generally, selective biliary drainage is enough before surgery, however, in the cases of development of cholangitis after unilateral drainage or slow resolving hyperbilirubinemia, total biliary drainage may be considered. Although the optimal preoperative bilirubin level is still a matter of debate, the shortest possible duration of PBD is recommended. Endoscopic nasobiliary drainage seems to be the most appropriate method of PBD in terms of minimizing the risks of tract seeding and inflammatory reactions. | Woo Hyun Paik Nerenthran Loganathan Jin-Hyeok Hwang | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，3： | 37 |
| 5 | Preoperative biliary drainage in patients with hilar cholangiocarcinoma undergoing major hepatectomy显示文摘AIM:To investigate the effect of preoperative biliary drainage(PBD)in jaundiced patients with hilar cholangiocarcinoma(HCCA)undergoing major liver resections.METHODS:An observational study was carried out by reviewing a prospectively maintained database of HCCA patients who underwent major liver resection for curative therapy from January 2002 to December 2012.Patients were divided into two groups based on whether PBD was performed:a drained group and an undrained group.Patient baseline characteristics,preoperative factors,perioperative and short-term postoperative outcomes were compared between the two groups.Risk factors for postoperative complications were also analyzed by logistic regression test with calculating OR and 95%CI.RESULTS:In total,78 jaundiced patients with HCCA underwent major liver resection:32 had PBD prior to operation while 46 did not have PBD.The two groups were comparable with respect to age,sex,body mass index and co-morbidities.Furthermore,there was no significant difference in the total bilirubin(TBIL)levels between the drained group and the undrained group at admission(294.2±135.7 vs 254.0±63.5,P=0.126).PBD significantly improved liver function,reducing not only the bilirubin levels but also other liver enzymes.The preoperative TBIL level was significantly lower in the drained group as compared to the undrained group(108.1±60.6 vs 265.7±69.1,P=0.000).The rate of overall postoperative complications(53.1%vs 58.7%,P=0.626),reoperation rate(6.3%vs 6.5%,P=1.000),postoperative hospital stay(16.5 vs 15.0,P=0.221)and mortality(9.4%vs 4.3%,P=0.673)were similar between the two groups.In addition,there was no significant difference in infectious complications(40.6%vs 23.9%,P=0.116)and noninfectious complications(31.3%vs 47.8%,P=0.143)between the two groups.Univariate and multivariate analyses revealed that preoperative TBIL>170μmol/L(OR=13.690,95%CI:1.275-147.028,P=0.031),Bismuth-Corlette classification(OR=0.013,95%CI:0.001-0.166,P=0.001)and extended liver resection(OR=14.010,95%CI:1.130-173.646,P=0.040)were independent risk factors for postoperative complications.CONCLUSION:Overall postoperative morbidity and mortality rates after major liver resection are not improved by PBD in HCCA patients with jaundice.Preoperative TBIL>170μmol/L,Bismuth-Corlette classification and extended liver resection are independent risk factors linked to postoperative complications. | Jun-Jie Xiong Quentin M Nunes Wei Huang Samir Pathak Ai-Lin Wei Chun-Lu Tan Xu-Bao Liu | 2013 | World Journal of Gastroenterology2013，19，46： | 33 |
| 6 | Retrospective cohort study Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma显示文摘AIM:To identify the most effective endoscopic biliary drainage technique for patients with hilar cholangiocarcinoma.METHODS:In total,118 patients with hilar cholangiocarcinoma underwent endoscopic management[endoscopic nasobiliary drainage(ENBD)or endoscopic biliary stenting]as a temporary drainage in our institution between 2009 and 2014.We retrospectively evaluated all complications from initial endoscopic drainage to surgery or palliative treatment.The risk factors for biliary reintervention,post-endoscopic retrograde cholangiopancreatography(post-ERCP)pancreatitis,and percutaneous transhepatic biliary drainage(PTBD)were also analyzed using patient-and procedure-related characteristics.The risk factors for bilateral drainage were examined in a subgroup analysis of patients who underwent initial unilateral drainage.RESULTS:In total,137 complications were observed in92(78%)patients.Biliary reintervention was required in 83(70%)patients.ENBD was significantly associated with a low risk of biliary reintervention[odds ratio(OR)=0.26,95%CI:0.08-0.76,P=0.012].Post-ERCP pancreatitis was observed in 19(16%)patients.An absence of endoscopic sphincterotomy was significantly associated with post-ERCP pancreatitis(OR=3.46,95%CI:1.19-10.87,P=0.023).PTBD was required in 16(14%)patients,and Bismuth type III or IV cholangiocarcinoma was a significant risk factor(OR=7.88,95%CI:1.33-155.0,P=0.010).Of 102 patients with initial unilateral drainage,49(48%)required bilateral drainage.Endoscopic sphincterotomy(OR=3.24,95%CI:1.27-8.78,P=0.004)and Bismuth II,III,or IV cholangiocarcinoma(OR=34.69,95%CI:4.88-736.7,P<0.001)were significant risk factors for bilateral drainage.CONCLUSION:The endoscopic management of hilar cholangiocarcinoma is challenging.ENBD should be selected as a temporary drainage method because of its low risk of complications. | Kazumichi Kawakubo Hiroshi Kawakami Masaki Kuwatani Shin Haba Taiki Kudo Yoko A Taya Shuhei Kawahata Yoshimasa Kubota Kimitoshi Kubo Kazunori Eto Nobuyuki Ehira Hiroaki Yamato Manabu Onodera Naoya Sakamoto | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，9： | 26 |
| 7 | Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review显示文摘Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure. | Yang Li Pei-Yuan Li Shi-Jing Sun Yuan-Zhang Yao Zhan-Fei Li Tao Liu Fan Yang Lian-Yang Zhang Xiang-Jun Bai Jing-Shan Huo Wu-Bing He Jun Ouyang Lei Peng Ping Hu Yan-An Zhu Ping Jin Qi-Feng Shao Yan-Feng Wang Rui-Wu Dai Pei-Yang Hu Hai-Ming Chen Ge-Fei Wang Yong-Gao Wang Hong-Xu Jin Chang-Ju Zhu Qi-Yong Zhang Biao Shao Xi-Guang Sang Chang-Lin Yin | 2019 | Chinese Journal of Traumatology2019，22，1： | 26 |
| 8 | Effects of multimodal fast-track surgery on liver transplantation outcomes显示文摘BACKGROUND:Fast-track surgery and enhanced recovery after surgery have been applied to many surgical procedures;however,data on fast-track surgery and enhanced recovery after surgery following liver transplantation is limited.This study aimed to conduct a prospective study to determine the effects of fast-track surgery on prognosis after liver transplantation.METHODS:This was a prospective,single-blinded,randomized study.One hundred twenty-eight patients undergoing liver transplantation were selected for the fast-track(FT group,n=54) or conventional process(NFT group,n=74).The primary endpoints were intensive care unit(ICU) stay and hospital stay.The secondary endpoints were as follows:operative time,anhepatic phase time,intraoperative blood loss,intraoperative blood transfusion volume,postoperative complications,readmission rate,and postoperative mortality.RESULTS:There was no significant difference in preoperative demographics between the two groups.The median ICU stay was 2 days(range 1-7 days) in the FT group and 5 days(range 3-12 days) in the NFT group(P<0.01).Furthermore,the hospital stay was also significantly reduced in the FT group(P<0.01).The operative time,anhepatic phase time,intraoperative blood loss,and intraoperative blood transfusion volume were decreased in the FT group compared with the NFT group(P<0.05).Based on Spearman correlation analysis,the ICU stay and hospital stay may be positively correlated with operative time,anhepatic phase time and intraoperative blood loss.There were no differences in the incidence of postoperative complications,readmissions,and postoperative mortality between the two groups.CONCLUSION:Fast-track procedures effectively reduce the ICU stay and hospital stay without adversely affecting prognosis.This study demonstrated that fast-track protocols are safe and feasible in liver transplantation. | Jian-Hua Rao Feng Zhang Hao Lu Xin-Zheng Dai Chuan-Yong Zhang Xiao-Feng Qian Xue-Hao Wang Ling Lu | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，4： | 23 |
| 9 | 重度脑室内出血尿激酶溶栓单双管引流效率比较显示文摘目的:在尿激酶脑室内溶栓( IVF)治疗下,比较重度脑室内出血( IVH)患者在进行单管或双管脑室外引流( EVD)时的引流效率。方法选择2010-01~2013-06符合纳入标准的47例重度IVH患者随机分为单侧脑室外引流组(单管引流组)和双侧脑室外引流组(双管引流组),各组患者均接受同样的脑室内尿激酶溶栓方案,剂量为2万U q 12 h,双管引流组左右侧药物注入选择为随机;记录并比较脑室内溶栓前及溶栓后1、3、5、7 d时的平均每日脑脊液( CSF )引流量、颅内压(ICP)、GCS评分及ICU监护时间、脑室外引流管放置时间(IVC放置时间)、IVH体积、Graeb评分、颅内感染率,并随访比较发病后6个月时的GOS评分及病死率等。结果两组患者的基线IVH体积、初次Graeb评分、GCS评分、年龄及性别例数比较差异均无统计学意义( P>0.05),具有可比性。两组ICU监护时间和IVC放置时间比较差异无统计学意义(P>0.05),平均每日CSF引流量比较差异有统计学意义( P<0.05),双管引流组平均每日CSF引流量更多。两组溶栓前及溶栓后1、3、5、7 d时IVH体积下降程度比较差异有统计学意义,双管引流组优于单管引流组(P<0.05),而Graeb评分、ICP、GCS两组比较差异无统计学意义(P>0.05);两组引流期间均未发现颅内感染。随访比较6个月时的GOS评分(t=12.63,P=0.000)和病死率(χ2=7.57, P=0.006)发现,双管引流组明显优于单管引流组。结论对于严重、体积大的IVH,相同IVF治疗条件下,放置双管EVD引流较单管清除血肿效率更高,并能改善预后和降低病死率,且不增加颅内感染率和延长IVC放置时间及ICU监护时间。 | 杜波 单爱军 王进 钟贤良 | 2014 | 中国急救医学2014，34，4： | 21 |
| 10 | Endoscopic Surgery versus External Ventricular Drainage Surgery for Severe Intraventricular Hemorrhage显示文摘The efficacy and applied value of endoscopic hematoma evacuation vs. external ventricular drainage (EVD) in the treatment of severe ventficular hemorrhage (IVH) were explored and compared.From Jan.2015 to Dec.2016,the clinical data of 42 cases of IVH were retrospectively analyzed,including 18 patients undergoing endoscopic hematoma evacuation (group A),and 24patients receiving EVD (group B).The hematoma clearance rate was calculated by 3D Slicer software,and complications and outcomes were compared between the two groups.There were no significant differences in age,sex and Graeb score between groups A and B (P>0.05).The hematoma clearance rate was 70.81%±27.64% in group A and 48.72%±36.58% in group B with a statistically significant difference (P<0.05).The operative time in groups A and B was 72.45±25.26 min and 28.54±15.27min,respectively (P<0.05).The Glasgow Coma Scale (GCS) score increased from 9.28±2.72 at baseline to 11.83±2.91 at 1 week postoperatively in group A,and from 8.25±2.62 at baseline to 10.79±4.12 at 1 week postoperatively in group B (P<0.05).The length of hospital stay was 12.67±5.97 days in group A and 17.33±8.91 days in group B with a statistically significant difference (P<0.05).The GOS scores at 6 months after surgery were 3.83±1.12 in group A,and 2.75±1.23 in group B (P<0.05). These results suggested that endoscopic hematoma evacuation has an advantage of a higher hematoma clearance rate,fewer complications and better outcomes in the treatment of severe IVH,indicating it is a safe,effective and promising approach for severe IVH. | Ping SONG Fa-liang DUAN Qiang CAI Jing-lei WU Xiao-bin CHEN Yuan WANG Cong-gang HUANG Ji-qiang LI Zhu-qiang HE Qiao-chun HUANG Mei LIU Yan-gao ZHANG Ming LUO | 2018 | Current Medical Science2018，38，5： | 21 |
| 11 | Abdominal paracentesis drainage ameliorates severe acute pancreatitis in rats by regulating the polarization of peritoneal macrophages显示文摘AIM To investigate the role of peritoneal macrophage(PM) polarization in the therapeutic effect of abdominal paracentesis drainage(APD) on severe acute pancreatitis(SAP).METHODS SAP was induced by 5% Na-taurocholate retrograde injection in Sprague-Dawley rats. APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after the induction of SAP. To verify the effect of APD on macrophages, PMs were isolated and cultured in an environment, with the peritoneal inflammatory environment simulated by the addition of peritoneal lavage in complete RPMI 1640 medium. Hematoxylin and eosin staining was performed. The levels of pancreatitis biomarkers amylase and lipase as well as the levels of inflammatory mediators in the blood and peritoneal lavage were determined. The polarization phenotypes of the PMs were identified by detecting the marker expression of M1/M2 macrophages via flow cytometry, qPCR and immunohistochemical staining. The protein expression in macrophages that had infiltrated the pancreas was determined by Western blot.RESULTS APD treatment significantly reduced the histopathological scores and levels of amylase, lipase, tumor necrosis factor-α and interleukin(IL)-1β, indicating that APD ameliorates the severity of SAP. Importantly, we found that APD treatment polarized PMs towards the M2 phenotype, as evidenced by the reduced number of M1 macrophages and the reduced levels of proinflammatory mediators, such as IL-1β and L-selectin, as well as the increased number of M2 macrophages and increased levels of anti-inflammatory mediators, such as IL-4 and IL-10. Furthermore, in an in vitro study wherein peritoneal lavage from the APD group was added to the cultured PMs to simulate the peritoneal inflammatory environment, PMs also exhibited a dominant M2 phenotype, resulting in a significantly lower level of inflammation. Finally, APD treatment increased the proportion of M2 macrophages and upregulated the expression of the anti-inflammatory protein Arg-1 in the pancreas of SAP model rats.CONCLUSION These findings suggest that APD treatment exerts antiinflammatory effects by regulating the M2 polarization of PMs, providing novel insights into the mechanism underlying its therapeutic effect. | Ruo-Hong Liu Yi Wen Hong-Yu Sun Chun-Yu Liu Yu-Fan Zhang Yi Yang Qi-Lin Huang Jia-Jia Tang Can-Chen Huang Li-Jun Tang | 2018 | World Journal of Gastroenterology2018，24，45： | 20 |
| 12 | 负压封闭引流技术在骨科的临床应用进展显示文摘负压封闭引流技术(vacuum sealing drainage,VSD)于1992年由德国乌尔姆大学创伤外科Fleischmann等人首创,最早即应用于骨科创伤的治疗。华中科技大学同济医学院附属同济医院裘华德教授于1994年将其从德国引进、改良并发展,其在国内应用已有20年历史,经过多年的临床使用,该技术已日臻完善,覆盖骨科疾病治疗的范围也越来越广,并且取得了良好的临床疗效。 | 谢志进 方跃 王彦川 | 2015 | 实用骨科杂志2015，21，2： | 20 |
| 13 | Minimally invasive treatment of pancreatic pseudocysts显示文摘A pancreatic pseudocyst(PPC) is typically a complication of acute and chronic pancreatitis, trauma or pancreatic duct obstruction. The diagnosis of PPC can be made if an acute fluid collection persists for 4 to 6 wk and is enveloped by a distinct wall.Most PPCs regress spontaneously and require no treatment, whereas some may persist and progress until complications occur. The decision whether to treat a patient who has a PPC, as well as when and with what treatment modalities, is a difficult one. PPCs can be treated with a variety of methods: percutaneous catheter drainage(PCD), endoscopic transpapillary or transmural drainage, laparoscopic surgery, or open pseudocystoenterostomy. The recent trend in the management of symptomatic PPC has moved toward less invasive approaches such as endoscopic- and image-guided PCD. The endoscopic approach is suitable because most PPCs lie adjacent to the stomach. The major advantage of the endoscopic approach is that it creates a permanent pseudocysto-gastric track with no spillage of pancreatic enzymes. However, given the drainage problems, the monitoring, catheter manipulation and the analysis of cystic content are very difficult or impossible to perform endoscopically, unlike in the PCD approach. Several conditions must be met to achieve the complete obliteration of the cyst cavity.Pancreatic duct anatomy is an important factor in the prognosis of the treatment outcome, and the recovery of disrupted pancreatic ducts is the main prognostic factor for successful treatment of PPC, regardless of the treatment method used. In this article, we review and evaluate the minimally invasive approaches in the management of PPCs. | Enver Zerem Goran Hauser Svjetlana Loga-Zec Suad Kunosi Predrag Jovanovi Dino Crnki | 2015 | World Journal of Gastroenterology2015，21，22： | 18 |
| 14 | Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction显示文摘AIM: To determine the optimal method of endoscopic preoperative biliary drainage for malignant distal biliary obstruction.METHODS: Multicenter retrospective study was conducted in patients who underwent plastic stent(PS) or nasobiliary catheter(NBC) placement for resectable malignant distal biliary obstruction followed by surgery between January 2010 and March 2012. Procedurerelated adverse events, stent/catheter dysfunction(occlusion or migration of PS/NBC, developmentof cholangitis, or other conditions that required repeat endoscopic biliary intervention), and jaundice resolution(bilirubin level < 3.0 mg/d L) were evaluated. Cumulative incidence of jaundice resolution and dysfunction of PS/NBC were estimated using competing risk analysis. Patient characteristics and preoperative biliary drainage were also evaluated for association with the time to jaundice resolution and PS/NBC dysfunction using competing risk regression analysis.RESULTS: In total, 419 patients were included in the study(PS, 253 and NBC, 166). Primary cancers included pancreatic cancer in 194 patients(46%), bile duct cancer in 172(41%), gallbladder cancer in three(1%), and ampullary cancer in 50(12%). The median serum total bilirubin was 7.8 mg/d L and 324 patients(77%) had ≥ 3.0 mg/d L. During the median time to surgery of 29 d [interquartile range(IQR), 30-39 d]. PS/NBC dysfunction rate was 35% for PS and 18% for NBC [Subdistribution hazard ratio(SHR) = 4.76; 95%CI: 2.44-10.0, P < 0.001]; the pig-tailed tip was a risk factor for PS dysfunction. Jaundice resolution was achieved in 85% of patients and did not depend on the drainage method(PS or NBC).CONCLUSION: PS has insufficient patency for preoperative biliary drainage. Given the drawbacks of external drainage via NBC, an alternative method of internal drainage should be explored. | Naoki Sasahira Tsuyoshi Hamada Osamu Togawa Ryuichi Yamamoto Tomohisa Iwai Kiichi Tamada Yoshiaki Kawaguchi Kenji Shimura Takero Koike Yu Yoshida Kazuya Sugimori Shomei Ryozawa Toshiharu Kakimoto Ko Nishikawa Katsuya Kitamura Tsunao Imamura Masafumi Mizuide Nobuo Toda Iruru Maetani Yuji Sakai Takao Itoi Masatsugu Nagahama Yousuke Nakai Hiroyuki Isayama | 2016 | World Journal of Gastroenterology2016，22，14： | 18 |
| 15 | Urgent endoscopic ultrasound-guided choledochoduodenostomy for acute obstructive suppurative cholangitis-induced sepsis显示文摘Acute obstructive suppurative cholangitis(AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography(ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy(EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis. | Kosuke Minaga Masayuki Kitano Hajime Imai Kentaro Yamao Ken Kamata Takeshi Miyata Shunsuke Omoto Kumpei Kadosaka Tomoe Yoshikawa Masatoshi Kudo | 2016 | World Journal of Gastroenterology2016，22，16： | 18 |
| 16 | Endoscopic ultrasound-guided treatments: Are we getting evidence based- a systematic review显示文摘The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancreatic fluid collections,EUS-guided necrosectomy,EUS-guided cholangiography and biliary drainage,EUSguided pancreatography and pancreatic duct drainage,EUS-guided gallbladder drainage,EUS-guided drainage of abdominal and pelvic fluid collections,EUS-guided celiac plexus block and celiac plexus neurolysis,EUSguided pancreatic cyst ablation,EUS-guided vascular interventions,EUS-guided delivery of antitumoral agents and EUS-guided fiducial placement and brachytherapy.However these procedures are technically challenging and require expertise in both EUS and interventional endoscopy,such as endoscopic retrograde cholangiopancreatography and gastrointestinal stenting.We undertook a systematic review to record the entire body of literature accumulated over the past 2decades on EUS-guided interventions with the objective of performing a critical appraisal of published articles,based on the classification of studies according to levels of evidence,in order to assess the scientific progress made in this field. | Carlo Fabbri Carmelo Luigiano Andrea Lisotti Vincenzo Cennamo Clara Virgilio Giancarlo Caletti Pietro Fusaroli | 2014 | World Journal of Gastroenterology2014，20，26： | 18 |
| 17 | Biliary drainage for obstructive jaundice caused by unresectable hepatocellular carcinoma: the endoscopic versus percutaneous approach显示文摘BACKGROUND: For palliative treatment of the obstructive jaundice associated with unresectable hepatocellular carcinoma (HCC), percutaneous transhepatic biliary drainage (PTBD) or endoscopic retrograde biliary drainage (ERBD) has been performed. PTBD is preferred as an initial procedure. Little is known about the better option for patients with obstructive jaundice caused by unresectable HCC. METHODS: Sixty patients who had received ERBD or PTBD for the palliative treatment of obstructive jaundice caused by unresectable HCC between January 2006 and May 2010 were included in this retrospective study. Successful drainage, drainage patency, and the overall survival of patients were evaluated. RESULTS: Univariate analysis revealed that the overall frequency of successful drainage was higher in the ERBD group (22/29, 75.9%) than in the PTBD group (15/31, 48.4%) (P=0.029); but multivariate analysis showed marginal significance (P=0.057). The duration of drainage patency was longer in the ERBD group than in the PTBD group (82 vs 37 days, respectively, P=0.020). Regardless of what procedure was performed, the median survival time of patients who had a successful drainage was much longer than that of the patients who did not have a successful drainage (143 vs 38 days, respectively, P<0.001).CONCLUSION: Besides PTBD, ERBD may be used as the initial treatment option to improve obstructive jaundice in patients with unresectable HCC if there is a longer duration of drainage patency after a successful drainage. | Jongkyoung Choi Ji Kon Ryu Sang Hyub Lee Dong-Won Ahn Jin-Hyeok Hwang Yong-Tae Kim Yong Bum Yoon Joon Koo Han | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，6： | 17 |
| 18 | 负压封闭引流技术在皮瓣移植术中同期应用的初步观察显示文摘负压封闭引流(vacuum sealing drainage,VSD)作为一项新兴的外科引流技术目前正逐渐被应用于治疗后各种问题创面。我科自2012年3月至2014年10月对收治的7例难治性创面患者进行扩创后皮瓣移植修复,术中同时行负压封闭引流治疗,取得满意的疗效,现报告如下。 | 徐刚 练慧斌 周杰 罗艺 鞠海宾 主父中印 刘森 | 2015 | 实用医学杂志2015，31，21： | 17 |
| 19 | Endosonography-guided cholangiopancreatography as a salvage drainage procedure for obstructed biliary and pancreatic ducts显示文摘Endoscopic ultrasound allows transmural access to the bile or pancreatic ducts and subsequent contrast injection to provide ductal drainage under fluoroscopy using endoscopic retrograde cholangiopancreatography (ERCP)-based techniques.Differing patient specifics and operator techniques result in six possible variant approaches to this procedure,known as endosonography-guided cholangiopancreatography(ESCP). ESCP has been in clinical use for a decade now,with over 300 cases reported.It has become established as a salvage procedure after failed ERCP in the palliation of malignant biliary obstruction.Its role in the management of clinically severe chronic/relapsing pancreatitis remains under scrutiny.This review aims to clarify the concepts underlying the use of ESCP and to provide technical tips and a detailed step-by-step procedural description. | Manuel Perez-Miranda Carlos de la Serna Pilar Diez-Redondo Juan J Vila | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，6： | 15 |
| 20 | Endoscopic ultrasonography guided biliary drainage: Summary of consortium meeting, May 7^(th) , 2011, Chicago显示文摘Endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred procedure for biliary or pancreatic drainage in various pancreatico-biliary disorders. With a success rate of more than 90%, ERCP may not achieve biliary or pancreatic drainage in cases with altered anatomy or with tumors obstructing access to the duodenum. In the past those failures were typically managed exclusively by percutaneous approaches by interventional radiologists or surgical intervention. The morbidity associated was significant especially in those patients with advanced malignancy, seeking minimally invasive interventions and improved quality of life. With the advent of biliary drainage via endoscopic ultrasound (EUS) guidance, EUS guided biliary drainage has been used more frequently within the last decade in different countries. As with any novel advanced endoscopic procedure that encompasses various approaches, advanced endoscopists all over the world have innovated and adopted diverse EUS guided biliary and pancreatic drainage techniques. This diversity has resulted in variations and improvements in EUS Guided biliary and pancreatic drainage; and over the years has led to an extensive nomenclature. The diversity of techniques, nomenclature and recent progress in our intrumentation has led to a dedicated meeting on May 7 th , 2011 during Digestive Disease Week 2011. More than 40 advanced endoscopists from United States, Brazil, Mexico, Venezuela, Colombia, Italy, France, Austria, Germany, Spain, Japan, China, South Korea and India attended this pivotal meeting. The meeting covered improved EUS guided biliary access and drainage procedures, terminology, nomenclature, training and credentialing; as well as emerging devices for EUS guided biliary drainage. This paper summarizes the meeting's agenda and the conclusions generated by the creation of this consortium group. | Michel Kahaleh Everson LA Artifon Manuel Perez-Miranda Kapil Gupta Takao Itoi Kenneth F Binmoeller California Pacific Medical Center San Francisco CA 94115 United States Marc Giovannini | 2013 | World Journal of Gastroenterology2013，19，9： | 15 |
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