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Colangiopancreatografía endoscópica. Disminuyendo las complicaciones Colangiopancreatografía endoscópica。减少并发症
Pub Date : 2020-07-17 DOI: 10.24875/end.m20000198
Héctor Espino-Cortés
Correspondencia: *Héctor Espino-Cortés E-mail: drhespinoc@hotmail.com Endoscopia. 2020;32(Supl 1):65-68 www.endoscopia-ameg.com DOI: 10.24875/END.M20000198 0188-9893/© 2020. Asociación Mexicana de Endoscopia Gastrointestinal, publicado por Permanyer México SA de CV, todos los derechos reservados. Durante el congreso mundial de endoscopia (WEO 2020) realizado en Brasil, en relación con complicaciones de la CPRE, hubo 13 resúmenes de trabajos (abstracts), que fueron publicados en Digestive Endoscopy 2020; 32 (Suppl. 1): 17–256. Para la DDW se enviaron 15 abstracts con el mismo tema, publicados en Gastrointestinal Endoscopy 2020; 91 (5S):AB 2 – 627 y el 3 de junio en el seminario en línea: Best abstracts from ESGE Days 2020: EUS and ERCP, se comentó un trabajo de prevención de pancreatitis. En este año se publicó la guía de eventos adversos en CPRE de la Asociación Europea de Endoscopía Gastrointestinal (ESGE). En este escrito se comentan las medidas recomendadas para disminuir las complicaciones de la CPRE, que se presentaron en los eventos mencionados. Los efectos adversos (término que debe substituir al de complicaciones) tienen una incidencia global entre 5 y 10% de las CPREs. Las más frecuentes y directamente relacionados con el procedimiento son: pancreatitis (con incidencia (I) de 3.5-9.7%, de la que 0.1-0.5% es grave, con mortalidad (M) de 0.1 0.7%); hemorragia (I: 0.3-9.6%, M: 0.04%); colangitis (I: 0.53%, M: 0.1%), y perforación (I: 0.08-0.6%, M:0.06%) estas cifras son mencionadas en la guía de efectos adversos en CPRE de la ESGE1. Estos datos concuerdan con los de un estudio prospectivo, de cohorte, sobre eventos adversos asociados a CPRE en 36 hospitales de Japón, con 15,732 CPRE. Las incidencias fueron: pancreatitis 6.9%, hemorragia 0.87%, infección 0.99% y perforación 0.45%2. Para disminuir los efectos adversos, resalta la importancia de seleccionar a los pacientes en quienes está realmente indicado el procedimiento, pues como lo estableció el Dr. Cotton: la CPRE es más peligrosa en quien menos la necesita3. Debe evitarse entonces el procedimiento solo con fines diagnósticos. Hay que evaluar los factores de riesgo relativos al paciente, los riesgos durante el procedimiento y aplicar las medidas preventivas, principalmente en los pacientes de alto riesgo1-3. PANCREATITIS POR CPRE (PpCPRE). Los factores de riesgo (FR) definitivos relacionados con el paciente en orden descendente de importancia son: antecedente de PpCPRE, sospecha de función anormal (disfunción) del esfínter de Oddi, antecedente de pancreatitis aguda de otra etiología y género femenino. Los FR definitivos relacionados con el procedimiento también en importancia descendente son: canulación difícil, más de un paso de la guía al conducto pancreático u opacificación de este. También se incluye la ampulectomía endoscópica. El corte inicial para acceso al colédoco (precorte) no parece ser un FR definitivo cuando Palabras clave: Pancreatitis por CPRE (PpCPRE). Factor de Riesgo (
通信:* hector espino - cortes E-mail: drhespinoc@hotmail.com Endoscopia. 2020;32(Supl 1):65-68 www.endoscopia-ameg.com DOI: 10.24875/END。M20000198 0188-9893/©2019。墨西哥胃肠道内窥镜协会,由Permanyer mexico SA de CV出版,版权所有。在巴西举行的世界内窥镜大会(WEO 2020)期间,关于ercp并发症,有13篇论文摘要发表在《消化内窥镜2020》杂志上;他的父亲是一名律师,母亲是一名律师。DDW提交了15篇相同主题的摘要,发表在《胃肠道内窥镜2020》上;91 (5S):AB 2 - 627和6月3日的在线研讨会:ESGE Days 2020最佳摘要:EUS和ERCP,讨论了胰腺炎预防工作。今年,欧洲胃肠内窥镜协会(ESGE)发布了ercp不良事件指南。在这篇文章中,我们讨论了在上述事件中出现的减少ercp并发症的建议措施。不良反应(应取代并发症的术语)的总体发生率在5 - 10%之间。最常见和与手术直接相关的是:胰腺炎(发病率(I) 3.5-9.7%,其中0.1-0.5%严重,死亡率(M) 0.1 0.7%);出血(I: 0.3-9.6%, M: 0.04%);胆管炎(I: 0.53%, M: 0.1%)和穿孔(I: 0.08-0.6%, M:0.06%)这些数字在ESGE1的ercp不良反应指南中提到。这些数据与一项关于日本36家医院ercp相关不良事件的前瞻性队列研究一致,共有15,732家ercp。在本研究中,我们评估了两种不同类型的胰腺炎的发生率:胰腺炎6.9%,出血0.87%,感染0.99%,穿孔0.45%2。为了减少不良反应,强调了选择真正需要手术的患者的重要性,因为正如Cotton博士所指出的:ercp在最不需要手术的人身上更危险因此,仅出于诊断目的应避免进行手术。应评估与患者相关的危险因素、手术过程中的风险并采取预防措施,特别是对高危患者1-3。胰腺炎(PpCPRE)。与患者相关的明确危险因素(FR)按重要性递减顺序为:PpCPRE病史、怀疑Oddi括约肌功能异常(功能障碍)、其他病因急性胰腺炎病史和女性。与手术相关的最终FR也具有下行重要性:插管困难,从导管到胰管的一个以上步骤或其混浊。内窥镜下的沙漏切除术也包括在内。当研究关键词:ecprc胰腺炎(PpCPRE)时,最初的胆囊切开术(预切开术)似乎不是确定的FR。危险因素(FR)。通道切割(预切割)。预防性胰腺假体(PPP)。
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引用次数: 0
En este número de Endoscopia 在本期内窥镜中
Pub Date : 2020-05-26 DOI: 10.24875/end.m20000175
F. I. Téllez-Ávila
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引用次数: 0
La obesidad incrementa la probabilidad de presentar pólipos adenomatosos colorrectales 肥胖增加了结直肠腺瘤性息肉的可能性
Pub Date : 2020-04-29 DOI: 10.24875/end.20000030
Cristián Díaz-Solleiro, Estefanía E. de la Cruz-Castillo, Hugo López-Acevedo, C. Mata-Quintero
Introduction: In recent studies a relationship between obesity and colorectal polyps has been found. In Mexico, a significant percentage of the population suffers from obesity, which isn’t considered an independent risk factor for colorectal cancer screening. Objectives: Determine whether obese patients have colorectal adenomatous polyps more frequently in comparison with non-obese patients, as these lesions represent the precursor of colon cancer. Materials and methods: A cross-sectional, retrospective study was carried out, with patients undergoing colonoscopy
近年来的研究发现肥胖与结直肠息肉之间的关系。在墨西哥,有相当大比例的人口患有肥胖症,这并不被认为是结肠直肠癌筛查的独立风险因素。目的:确定肥胖患者是否比非肥胖患者更容易发生结直肠腺瘤性息肉,因为这些病变是结肠癌的前兆。材料和方法:对接受结肠镜检查的患者进行横断面回顾性研究
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引用次数: 0
Características endoscópicas del linfoma gástrico primario
Pub Date : 2020-04-29 DOI: 10.24875/end.20000013
Ricard Balanzà, Nicole Somerville, Fernando Rojas-Mendoza, Nancy E. Aguilar-Olivos
lesiones elevadas y 2 (15.38%) pseudopólipos. La localización fue 13 (100.00%) en cuerpo, 7 (53.85%) en fondo y cardias, 3 (23.08%) en antro, 11 (84.62%) lesiones extensas y 2 (15.38%) lesiones focales. Conclusiones: El diagnóstico de linfoma gástrico primario se realiza principalmente por medio de esofagogastroduodenoscopia, por lo que es de suma importancia conocer sus características endoscópicas. En nuestra serie de casos las características endoscópicas más frecuentemente asociadas a linfoma gástrico primario fueron engrosamiento de pliegues gástricos y localización en cuerpo. Abstract Introduction and objective: Primary gastric lymphoma accounts for 5% of all gastric neoplasia. Esophagogastroduodenos-copy is frequently the diagnostic method of choice, although no pathognomonic lesions have been described since it may manifest as superficial alterations of the mucosa, protrusion, diffuse infiltration, ulceration, thickened gastric folds, and even as apparently normal mucosa. The objective of this study is to evaluate a series of cases of primary gastric lymphoma in order to describe and report the most frequent endoscopic characteristics, morphology and localization, of this pathology. Material and methods: We searched for all the primary gastric lymphoma cases in the Anatomic Pathology database at our hospital from January 2015 to January 2020. The endoscopic characteristics of the patients diagnosed by esophagogastro-Correspondencia: duodenoscopy analyzed. Results: We analyzed 13 cases of primary gastric lymphoma. Thickened gastric folds were observed in all patients and none had apparently normal mucosa. Eight patients (61.54%) presented ulcers, 6 (46.15%) superficial mucosal alterations, 3 (23.08%) elevated lesions, and 2 (15.38%) pseudopolyps. Thirteen cases (100%) were lo-cated in the body of the stomach, 7 (53.85%) in the cardias and fundus, 3 (23.08%) in the antrum, 11 (84.62%) were extend-ed lesions, and 2 (15.38%) were focal lesions. Conclusions: The diagnosis of primary gastric lymphoma is usually performed by esophagogastroduodenoscopy, resulting crucial to recognize and describe its endoscopic characteristics. In our case series the most frequently associated endoscopic characteristics to primary gastric lymphoma were the presence of thickened gastric folds and the involvement of the gastric body.
病变增多,2例(15.38%)假肉瘤。体位13例(100.00%),心底和心头7例(53.85%),窦3例(23.08%),广泛性病变11例(84.62%),局灶性病变2例(15.38%)。结论:原发性胃淋巴瘤的诊断主要通过食管胃十二指肠镜检查,因此了解其内镜特征具有重要意义。在我们的病例系列中,原发性胃淋巴瘤最常见的内镜特征是胃皱襞增厚和体内定位。摘要简介和目的:原发性胃癌占所有胃癌的5%。食管胃十二指肠镜检查通常是首选的诊断方法,尽管没有病理性病变的描述,因为它可能表现为粘膜表面改变、突出、弥漫性浸润、溃疡、增厚的胃褶,甚至明显正常的粘膜。本研究的目的是评估一系列原发性胃淋巴瘤病例,以描述和报告最常见的内镜特征、形态和位置。材料和方法:我们在2015年1月至2020年1月的解剖病理数据库中搜索了所有原发性胃癌病例。食管胃对应诊断患者的内窥镜特征:十二指肠镜分析。结果:我们分析了13例原发性胃淋巴瘤。所有患者均有增厚的胃褶皱,无明显粘膜正常。溃疡8例(61.54%),粘膜表面改变6例(46.15%),加重病变3例(23.08%),假息肉2例(15.38%)。13例(100%)发生在胃体,7例(53.85%)发生在心和底,3例(23.08%)发生在窦,11例(84.62%)发生在延伸性损伤,2例(15.38%)发生在局灶性损伤。结论:原发性胃淋巴瘤的诊断通常采用食管胃十二指肠镜检查,对内镜检查特征的识别和描述至关重要。In our case the most频繁序列相关endoscopic分离器小学gastric lymphoma被在场thickened gastric、and the参与of the gastric body。
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引用次数: 1
Endoscopia en pancreatitis crónica 慢性胰腺炎的内窥镜检查
Pub Date : 2019-11-18 DOI: 10.24875/end.m19000172
J. A. López-Cossío, Everardo Muñoz-Anaya, F. T. Ávila, F. Téllez-Ávila
Until recently, the role of endoscopy in patients with chronic pancreatitis was limited only for diagnosis and generally, it was reach in advanced stages of the disease when the changes were evident in other non-invasive methods. Regarding treatment, the role of endoscopy was very limited too with questionable results, it was related mainly to inadequate selection of the
直到最近,内镜在慢性胰腺炎患者中的作用仅限于诊断,通常在疾病晚期,当其他非侵入性方法的变化明显时,才能达到内镜的作用。在治疗方面,内窥镜的作用也非常有限,结果令人怀疑,这主要与选择不充分有关
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引用次数: 0
Apego al cumplimiento de los indicadores de calidad en endoscopia del tracto gastrointestinal superior en el Hospital General Dr. Manuel Gea González Manuel Gea博士综合医院上胃肠道内窥镜质量指标依从性gonzalez
Pub Date : 2019-11-18 DOI: 10.24875/end.m19000174
J. R. Ramírez-Nava, R. Délano-Alonso, María del C. Ávila-Langarica, Enrique Rentería-Palomo, Ricardo Pineda-Leguízamo, C. Valenzuela-Salazar, J. Herrera-Esquivel
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引用次数: 0
Experiencia del uso de polvo hemostático en el manejo endoscópico de sangrado variceal y no variceal en un hospital de tercer nivel en México. El primer reporte en pacientes pediátricos en Latinoamérica 在墨西哥一家三级医院使用止血粉治疗静脉曲张和非静脉曲张出血的经验。拉丁美洲儿科患者的第一份报告
Pub Date : 2019-09-11 DOI: 10.24875/end.m19000039
J. Cadena-Leon, Jaime Alfaro-Bolaños, L. Tovar-Correa, Mayra Medranda-Cedeño, M. Cazares-Méndez, E. Montijo-Barrios, F. Zarate-Mondragon, E. Toro-Monjaraz, K. Ignorosa-Arellano, R. Cervantes, J. Ramírez-Mayans
Gastrointestinal bleeding is a life-threatening condition in the pediatric age and is one of the main indications for diagnostic and therapeutic endoscopy, although there are multiple techniques for managing both mortality and recurrence of bleeding being very high in childhood. Currently, the use of hemostatic powder has been proposed as a practical and effective alternative for the management of digestive tract bleeding. Objective: To describe the experience of the use of hemostatic powder as an alternative endoscopic treatment for variceal and non-variceal gastrointestinal bleeding in pediatric patients. Material and methods: Retrospective, observational and descriptive study of pediatric patients aged 1-18 years with upper and lower gastrointestinal bleeding, in whom hemostatic powder was applied as an alternative treatment of bleeding at the National Institute of Pediatrics between January 2017 and November 2018. Results: We included 10 pediatric patients with upper and lower gastrointestinal bleeding from different causes, in whom the bleeding was anemic. Hemospray ® was applied, achieving control of bleeding in 90% of patients with one application. Conclusion: The use of Hemospray ® is an easy and fast alternative with good results for the control of both variceal and non-variceal gastrointestinal bleeding.
胃肠出血是儿童时期危及生命的疾病,是内镜诊断和治疗的主要适应症之一,尽管有多种技术可以控制儿童时期出血的死亡率和复发率。目前,使用止血粉被认为是治疗消化道出血的一种实用有效的方法。目的:描述使用止血粉作为一种替代内镜治疗儿科患者静脉曲张和非静脉曲张消化道出血的经验。材料和方法:对2017年1月至2018年11月美国国家儿科研究所1-18岁的上消化道和下消化道出血患儿进行回顾性、观察性和描述性研究,这些患儿使用止血粉作为出血的替代治疗方法。结果:我们纳入了10例不同原因的上消化道和下消化道出血患儿,其中出血为贫血性。应用了hemspray®,一次应用就能控制90%的患者出血。结论:止血喷雾是控制静脉曲张及非静脉曲张消化道出血的一种简便、快捷的方法。
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引用次数: 1
Cierre endoscópico de fístula gastrocutánea posterior al retiro de sonda de gastrostomía: reporte de caso 胃造口管取出后胃皮肤瘘的内镜闭合:病例报告
Pub Date : 2019-09-11 DOI: 10.24875/end.m19000038
R. Zamarripa-Mottú, E. Murcio-Pérez, G. Blanco-Velasco, O. Solórzano-Pineda, Ó. V. Hernández-Mondragón
Occasionally, the indication of the gastrostomy tube is resolved, and it is removed. Among the complications due to withdrawal is the gastro-cutaneous fistula (GCF). We present the case of a 45-year-old woman with GCF after gastrostomy catheter removal, in whom a successful closure with an Ovesco® endoscopic device was performed. The most effective endoscopic therapies are those that combine de-epithelization of the fistulous tract with mechanical method or monotherapy with Ovesco®. Endoscopic closure devices have high efficacy and safety as an FGC treatment and should be considered as the first treatment option.
偶尔,胃造口管的指征被解决,并将其移除。停药引起的并发症包括胃-皮瘘(GCF)。我们报告了一例45岁的女性胃造口导管拔除后GCF的病例,其中使用Ovesco®内窥镜装置成功闭合。最有效的内镜治疗方法是将瘘道去上皮化与机械方法或Ovesco®单药治疗相结合。内镜封闭装置作为FGC治疗具有较高的疗效和安全性,应考虑作为首选治疗方案。
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引用次数: 0
Ascariasis hepatobiliar: caso clínico y revisión de la literatura 肝胆蛔虫病:临床病例及文献综述
Pub Date : 2019-08-15 DOI: 10.24875/end.19000016
Argentina Paredes-Soto, Julio Fernando Toledo-Cuque
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引用次数: 0
Impacto del uso de los inhibidores de la bomba de protones en el fenotipo endoscópico de pacientes con reflujo gastroesofágico 质子泵抑制剂的使用对胃食管反流患者内镜表型的影响
Pub Date : 2019-08-15 DOI: 10.24875/end.19000021
A. Pérez-Mendoza, Rafael R. Jiménez-Córdoba, Reyna M. López-Alcaraz, Francisco J. Sepúlveda-Cañamar
{"title":"Impacto del uso de los inhibidores de la bomba de protones en el fenotipo endoscópico de pacientes con reflujo gastroesofágico","authors":"A. Pérez-Mendoza, Rafael R. Jiménez-Córdoba, Reyna M. López-Alcaraz, Francisco J. Sepúlveda-Cañamar","doi":"10.24875/end.19000021","DOIUrl":"https://doi.org/10.24875/end.19000021","url":null,"abstract":"","PeriodicalId":143133,"journal":{"name":"Revista Endoscopia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121688071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Revista Endoscopia
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