The Experts below are selected from a list of 2811 Experts worldwide ranked by ideXlab platform
Sadao Amano - One of the best experts on this subject based on the ideXlab platform.
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modified devine exclusion with vertical stomach reconstruction for gastric outlet obstruction a novel technique
Journal of Gastrointestinal Surgery, 2009Co-Authors: Takatsugu Oida, Kenji Mimatsu, Atsushi Kawasaki, Hisao Kano, Youichi Kuboi, Sadao AmanoAbstract:Background A Gastroenterostomy is the most commonly performed palliative procedure in patients with gastroduodenal outflow obstruction (GOO) caused by unresectable advanced gastric and pancreatic cancer. We developed a new technique—modified Devine exclusion with vertical stomach reconstruction—and evaluated the efficacy of this procedure.
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a novel technique of laparoscopic gastrojejunostomy modified devine exclusion with vertical stomach reconstruction for gastric outlet obstruction to preventing blow out of the distal gastric remnant and delayed in return of gastric emptying
Hepato-gastroenterology, 2009Co-Authors: Takatsugu Oida, Kenji Mimatsu, Atsushi Kawasaki, Hisao Kano, Youichi Kuboi, Sadao AmanoAbstract:Abstract A loop Gastroenterostomy is the most commonly applied palliative procedure in patients with gastroduodenal outflow obstruction (GOO) caused by unresectable advanced gastric and pancreatic cancer. We developed a laparoscopic modified Devine exclusion with vertical stomach reconstruction, and assessed this alternative laparoscopic technique. We consider that our laparoscopic modified Devine exclusion with vertical stomach reconstruction is an easy and feasible technique for GOO.
Janak N Shah - One of the best experts on this subject based on the ideXlab platform.
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endoscopic ultrasound guided Gastroenterostomy using novel tools designed for transluminal therapy a porcine study
Endoscopy, 2012Co-Authors: Kenneth F Binmoeller, Janak N ShahAbstract:Background and study aims: Surgical Gastroenterostomy is associated with appreciable morbidity and mortality. We evaluated the technical feasibility and outcomes of a new method of endoscopic ultrasound (EUS)-guided Gastroenterostomy using novel tools designed for transluminal therapy. Methods: In one acute and four survival female pigs, a Gastroenterostomy was created under EUS guidance. Novel tools used included: (i) an anchor wire; (ii) an access device; (iii) a fully covered metal stent with bilateral lumen-apposing anchors. The anchor guide wire was inserted through a standard 19-G fine needle aspiration (FNA) needle to appose the small-bowel and stomach walls. The access device created a 3.5-mm fistula opening for insertion of the stent delivery catheter. The stent lumen was dilated to 10 mm to pass a gastroscope into the small bowel. Results: The procedure was technically successful in all animals. No bleeding occurred. In one acute animal, necropsy showed good stent position and no tissue injury. In four survival animals, the stents remained fully patent and all animals showed normal eating behavior without signs of infection. Stents were easily removed without tissue trauma at 4.5 weeks (n = 3) or 5.5 weeks (n = 1). After stent removal, the tracts appeared mature and were easily intubated with the gastroscope. Necropsy and histopathology showed complete fusion of the stomach and small-bowel wall layers at the site of Gastroenterostomy. Conclusions: EUS-guided Gastroenterostomy is feasible using novel tools with no adverse outcomes in a survival porcine model. Further study of this is indicated as an alternative to surgical bypass for the palliation of malignant gastric outlet obstruction in appropriately selected patients.
Lars N Jorgensen - One of the best experts on this subject based on the ideXlab platform.
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risk factors for morbidity and mortality following Gastroenterostomy
Journal of Gastrointestinal Surgery, 2009Co-Authors: Martin Poulsen, Mauro Trezza, Ghayyath H Atimash, Lars Tue Sorensen, Finn Kallehave, Ulla Hemmingsen, Lars N JorgensenAbstract:Morbidity and mortality following traditional surgical treatment of gastric outlet obstruction is high. The aim of this work was to identify risk factors predictive of postoperative complications and mortality following Gastroenterostomy. One-hundred sixty-five consecutive patients subjected to open Gastroenterostomy from January 1996 through July 2003 were included. Data on vital signs and operative variables were retrieved from medical records and recorded retrospectively. Risk factors for postoperative complications and mortality within 30 days after operation were analyzed with multiple logistic regression. The 30-day complication and death rates were higher after emergency operations (80% and 60%) than after elective operations (32% and 25%). A multivariate analysis disclosed that hypoalbuminemia (≤32 g/l), comorbidity, high age, and hyponatremia (<135 μmol/l) were significantly associated with postoperative death, whereas hypoalbuminemia, comorbidity, high age, and emergency operation were predictors of postoperative complications. Complications and mortality after Gastroenterostomy due to gastric outlet obstruction are associated with modifiable and non-modifiable risk factors. Prior to surgery means should be taken to correct low albumin and sodium levels to prevent complications. In addition, the surgeon should consider alternative treatment modalities including laparoscopic Gastroenterostomy, self-expanding metallic stents, or tube gastrostomy to relieve or palliate gastric outlet obstruction.
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Risk factors for morbidity and mortality following Gastroenterostomy.
Journal of Gastrointestinal Surgery, 2009Co-Authors: Martin Poulsen, Mauro Trezza, Ghayyath H Atimash, Lars Tue Sorensen, Finn Kallehave, Ulla Hemmingsen, Lars N JorgensenAbstract:Morbidity and mortality following traditional surgical treatment of gastric outlet obstruction is high. The aim of this work was to identify risk factors predictive of postoperative complications and mortality following Gastroenterostomy. One-hundred sixty-five consecutive patients subjected to open Gastroenterostomy from January 1996 through July 2003 were included. Data on vital signs and operative variables were retrieved from medical records and recorded retrospectively. Risk factors for postoperative complications and mortality within 30 days after operation were analyzed with multiple logistic regression. The 30-day complication and death rates were higher after emergency operations (80% and 60%) than after elective operations (32% and 25%). A multivariate analysis disclosed that hypoalbuminemia (≤32 g/l), comorbidity, high age, and hyponatremia (
Takatsugu Oida - One of the best experts on this subject based on the ideXlab platform.
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modified devine exclusion with vertical stomach reconstruction for gastric outlet obstruction a novel technique
Journal of Gastrointestinal Surgery, 2009Co-Authors: Takatsugu Oida, Kenji Mimatsu, Atsushi Kawasaki, Hisao Kano, Youichi Kuboi, Sadao AmanoAbstract:Background A Gastroenterostomy is the most commonly performed palliative procedure in patients with gastroduodenal outflow obstruction (GOO) caused by unresectable advanced gastric and pancreatic cancer. We developed a new technique—modified Devine exclusion with vertical stomach reconstruction—and evaluated the efficacy of this procedure.
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a novel technique of laparoscopic gastrojejunostomy modified devine exclusion with vertical stomach reconstruction for gastric outlet obstruction to preventing blow out of the distal gastric remnant and delayed in return of gastric emptying
Hepato-gastroenterology, 2009Co-Authors: Takatsugu Oida, Kenji Mimatsu, Atsushi Kawasaki, Hisao Kano, Youichi Kuboi, Sadao AmanoAbstract:Abstract A loop Gastroenterostomy is the most commonly applied palliative procedure in patients with gastroduodenal outflow obstruction (GOO) caused by unresectable advanced gastric and pancreatic cancer. We developed a laparoscopic modified Devine exclusion with vertical stomach reconstruction, and assessed this alternative laparoscopic technique. We consider that our laparoscopic modified Devine exclusion with vertical stomach reconstruction is an easy and feasible technique for GOO.
Kenneth F Binmoeller - One of the best experts on this subject based on the ideXlab platform.
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endoscopic ultrasound guided Gastroenterostomy using novel tools designed for transluminal therapy a porcine study
Endoscopy, 2012Co-Authors: Kenneth F Binmoeller, Janak N ShahAbstract:Background and study aims: Surgical Gastroenterostomy is associated with appreciable morbidity and mortality. We evaluated the technical feasibility and outcomes of a new method of endoscopic ultrasound (EUS)-guided Gastroenterostomy using novel tools designed for transluminal therapy. Methods: In one acute and four survival female pigs, a Gastroenterostomy was created under EUS guidance. Novel tools used included: (i) an anchor wire; (ii) an access device; (iii) a fully covered metal stent with bilateral lumen-apposing anchors. The anchor guide wire was inserted through a standard 19-G fine needle aspiration (FNA) needle to appose the small-bowel and stomach walls. The access device created a 3.5-mm fistula opening for insertion of the stent delivery catheter. The stent lumen was dilated to 10 mm to pass a gastroscope into the small bowel. Results: The procedure was technically successful in all animals. No bleeding occurred. In one acute animal, necropsy showed good stent position and no tissue injury. In four survival animals, the stents remained fully patent and all animals showed normal eating behavior without signs of infection. Stents were easily removed without tissue trauma at 4.5 weeks (n = 3) or 5.5 weeks (n = 1). After stent removal, the tracts appeared mature and were easily intubated with the gastroscope. Necropsy and histopathology showed complete fusion of the stomach and small-bowel wall layers at the site of Gastroenterostomy. Conclusions: EUS-guided Gastroenterostomy is feasible using novel tools with no adverse outcomes in a survival porcine model. Further study of this is indicated as an alternative to surgical bypass for the palliation of malignant gastric outlet obstruction in appropriately selected patients.
