Ujas Patel, Thammasak Mingbunjerdsuk, A. Gabr, Meir Mizrahi, F. Salama, Moamen Gabr
Extrahepatic portal hypertension (EPH) is hypertension that occurs in the extrahepatic portal vasculature in the absence of liver cirrhosis. Portal hypertension (PHTN) is defined as a pressure gradient between the portal vein and hepatic vein/inferior vena cava (IVC) exceeding more than 5 mm Hg. PHTN is more commonly known as a manifestation of cirrhosis and the related elevation in hepatic to venous pressure gradient (HVPG); however, there are other extrahepatic etiologies to PHTN that are important for review. Per our literary review, EPH as a complication of pancreatitis has been known as a manifestation since at least the 1970s. Among the severities of pancreatitis, it occurs most commonly with acute necrotizing pancreatitis and chronic pancreatitis. In this review, we plan to provide an understanding of mechanisms by which EPH occurs, discuss the treatments (e.g., anticoagulation, splenic artery embolization, and splenectomy) for the complications that result from prolonged EPH, and discuss the current endoscopic interventions available to counteract these complications.
{"title":"Advances in Management of Pancreatitis Related Portal Hypertension","authors":"Ujas Patel, Thammasak Mingbunjerdsuk, A. Gabr, Meir Mizrahi, F. Salama, Moamen Gabr","doi":"10.1055/s-0042-1745864","DOIUrl":"https://doi.org/10.1055/s-0042-1745864","url":null,"abstract":"Extrahepatic portal hypertension (EPH) is hypertension that occurs in the extrahepatic portal vasculature in the absence of liver cirrhosis. Portal hypertension (PHTN) is defined as a pressure gradient between the portal vein and hepatic vein/inferior vena cava (IVC) exceeding more than 5 mm Hg. PHTN is more commonly known as a manifestation of cirrhosis and the related elevation in hepatic to venous pressure gradient (HVPG); however, there are other extrahepatic etiologies to PHTN that are important for review. Per our literary review, EPH as a complication of pancreatitis has been known as a manifestation since at least the 1970s. Among the severities of pancreatitis, it occurs most commonly with acute necrotizing pancreatitis and chronic pancreatitis. In this review, we plan to provide an understanding of mechanisms by which EPH occurs, discuss the treatments (e.g., anticoagulation, splenic artery embolization, and splenectomy) for the complications that result from prolonged EPH, and discuss the current endoscopic interventions available to counteract these complications.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89624961","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}
Abstract Colorectal cancer (CRC) remains a leading cause of death in the United States. CRC is the second to third most common cancer globally and it impacts both genders. Screening initiatives are of paramount importance to eradicate the disease at a precancerous or early stage. Recommendations for screening are based on multiple factors including age, ethnicity, individual patient risk factors, and family history. Short- and long-term outcomes and survival data correlate with the stage of disease at the time of diagnosis emphasizing the need for appropriate baseline staging. Furthermore, stage of disease determines the necessity for any neoadjuvant or adjuvant therapy and provides recommendations for long-term oncologic follow-up. Preoperative workup includes physical examination, blood tests such as tumor markers and liver function tests, endoscopic evaluation, and cross-sectional imaging. In a select group of patients, genetic testing is part of the initial evaluation as it can impact the treatment plan, long-term follow-up, and testing of potential offspring. In general, surgical intervention remains the predominant treatment modality for stage I to III colon cancers with chemotherapy administration as adjuvant therapy for stages II to III to minimize recurrence or as a palliative modality for patients with stage IV disease. The treatment of rectal cancer remains more complex. Traditionally, early rectal cancer has been treated with surgical resection and locally advanced rectal cancer with neoadjuvant chemoradiation followed by surgical resection and postoperative chemotherapy. In the last decade, several protocols have been implemented to modify the neoadjuvant treatment with a trend toward more extended chemotherapy with the intent to further downstage the rectal cancer. Furthermore, the introduction of various protocols of total neoadjuvant chemoradiation may offer in a select group of patients with complete pathologic response, the possibility of observation without surgery. Finally, the management of stage IV CRC is in continuous evolution with the palliative goal of prolonging survival in most patients while offering the opportunity in some patients with limited metastatic disease to become potential candidates for resection of the primary lesion in addition to the metastatic disease.
{"title":"Preoperative Workup, Staging, and Treatment Planning of Colorectal Cancer","authors":"M. Abbass, M. Abbas","doi":"10.1055/s-0043-1760733","DOIUrl":"https://doi.org/10.1055/s-0043-1760733","url":null,"abstract":"Abstract Colorectal cancer (CRC) remains a leading cause of death in the United States. CRC is the second to third most common cancer globally and it impacts both genders. Screening initiatives are of paramount importance to eradicate the disease at a precancerous or early stage. Recommendations for screening are based on multiple factors including age, ethnicity, individual patient risk factors, and family history. Short- and long-term outcomes and survival data correlate with the stage of disease at the time of diagnosis emphasizing the need for appropriate baseline staging. Furthermore, stage of disease determines the necessity for any neoadjuvant or adjuvant therapy and provides recommendations for long-term oncologic follow-up. Preoperative workup includes physical examination, blood tests such as tumor markers and liver function tests, endoscopic evaluation, and cross-sectional imaging. In a select group of patients, genetic testing is part of the initial evaluation as it can impact the treatment plan, long-term follow-up, and testing of potential offspring. In general, surgical intervention remains the predominant treatment modality for stage I to III colon cancers with chemotherapy administration as adjuvant therapy for stages II to III to minimize recurrence or as a palliative modality for patients with stage IV disease. The treatment of rectal cancer remains more complex. Traditionally, early rectal cancer has been treated with surgical resection and locally advanced rectal cancer with neoadjuvant chemoradiation followed by surgical resection and postoperative chemotherapy. In the last decade, several protocols have been implemented to modify the neoadjuvant treatment with a trend toward more extended chemotherapy with the intent to further downstage the rectal cancer. Furthermore, the introduction of various protocols of total neoadjuvant chemoradiation may offer in a select group of patients with complete pathologic response, the possibility of observation without surgery. Finally, the management of stage IV CRC is in continuous evolution with the palliative goal of prolonging survival in most patients while offering the opportunity in some patients with limited metastatic disease to become potential candidates for resection of the primary lesion in addition to the metastatic disease.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"52 1","pages":"003 - 009"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73349531","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}
R. Varma, Karan Bir Singh, E. Bready, Deepak Singh, T. Caridi, Mohamed Shoreibah
Ascites is the most common complication of end stage liver disease. Refractory ascites is considered a poor prognostic indicator and impacts quality of life, overall survival and contributes significantly to the cost associated with its management. Serial large volume paracentesis (LVP) and transjugular intrahepatic portosystemic shunt (TIPS) placement are the most utilized procedures for the management of refractory ascites and have their advantages and disadvantages. The pathophysiology of ascites in cirrhosis is multifactorial which makes management complex, requiring the consideration of multiple clinical and biochemical variables to guide the appropriate management. This article provides a broad overview of LVP and TIPS, with review of the latest clinical trials and meta-analyses to help guide the management of refractory ascites and improve patient outcomes.
{"title":"LVP vs TIPS for Refractory Ascites: Where Do We Stand?","authors":"R. Varma, Karan Bir Singh, E. Bready, Deepak Singh, T. Caridi, Mohamed Shoreibah","doi":"10.1055/s-0042-1745863","DOIUrl":"https://doi.org/10.1055/s-0042-1745863","url":null,"abstract":"Ascites is the most common complication of end stage liver disease. Refractory ascites is considered a poor prognostic indicator and impacts quality of life, overall survival and contributes significantly to the cost associated with its management. Serial large volume paracentesis (LVP) and transjugular intrahepatic portosystemic shunt (TIPS) placement are the most utilized procedures for the management of refractory ascites and have their advantages and disadvantages. The pathophysiology of ascites in cirrhosis is multifactorial which makes management complex, requiring the consideration of multiple clinical and biochemical variables to guide the appropriate management. This article provides a broad overview of LVP and TIPS, with review of the latest clinical trials and meta-analyses to help guide the management of refractory ascites and improve patient outcomes.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"311 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76745184","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}
Abstract Complete mesocolic excision (CME) with central vascular ligation is a relatively new technique in the surgical treatment of right-sided colon cancer. Although the technique was originally designed for open surgery, minimally invasive CME has quickly been embraced by colorectal surgeons. Robotic-assisted laparoscopic surgery has some certain advantages over open and standard laparoscopic surgery, and is increasingly utilized in colorectal surgery. In this review, the technical aspects and outcomes of robotic-assisted laparoscopic complete mesocolic excision will be described.
{"title":"Robotic-Assisted Laparoscopic Complete Mesocolic Excision","authors":"I. Sahin, B. Baca","doi":"10.1055/s-0042-1760369","DOIUrl":"https://doi.org/10.1055/s-0042-1760369","url":null,"abstract":"Abstract Complete mesocolic excision (CME) with central vascular ligation is a relatively new technique in the surgical treatment of right-sided colon cancer. Although the technique was originally designed for open surgery, minimally invasive CME has quickly been embraced by colorectal surgeons. Robotic-assisted laparoscopic surgery has some certain advantages over open and standard laparoscopic surgery, and is increasingly utilized in colorectal surgery. In this review, the technical aspects and outcomes of robotic-assisted laparoscopic complete mesocolic excision will be described.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"114 1","pages":"024 - 029"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88046932","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}
M. Abdalbary, M. Sobh, Mostafa Abdelsalam, A. El-Husseini
Bone loss is an early and major problem in cirrhotic patients. The majority of cirrhotic patients demonstrate evidence of hepatic osteodystrophy (HOD). This includes decreased bone volume, turnover abnormalities, and rarely mineralization defects. Moreover, the degree of bone disease usually correlates with the severity of liver dysfunction. The mechanism of HOD is multifactorial. Vitamin D insufficiency/deficiency, secondary hyperparathyroidism, hypogonadism, inhibitors of bone formation, and mediators/promoters of bone resorption are frequent findings and essential coplayers in HOD. Early and proper identification of HOD is challenging. DXA is the most widely used tool; however, it has fundamental limitations. Bone turnover biomarkers are used to understand the mechanism of bone loss. Bone biopsy with histomorphometry is the gold standard to evaluate bone structure. The evidence for the effectiveness of nonpharmacological and pharmacological management of HOD is limited. Adequate nutrition, weight-bearing exercise, smoking cessation, and limitation of alcohol consumption improve bone health and quality of life. The use of antiresorptive therapies prevents bone loss particularly in patients with high bone turnover. However, osteoanabolics are essential in patients with low bone turnover. Herein, we are discussing the magnitude of the problem, pathogenesis, diagnosis of HOD, and various interventions to improve bone health in cirrhotic patients.
{"title":"Impact of Liver Cirrhosis on Bone Metabolism","authors":"M. Abdalbary, M. Sobh, Mostafa Abdelsalam, A. El-Husseini","doi":"10.1055/s-0042-1743554","DOIUrl":"https://doi.org/10.1055/s-0042-1743554","url":null,"abstract":"Bone loss is an early and major problem in cirrhotic patients. The majority of cirrhotic patients demonstrate evidence of hepatic osteodystrophy (HOD). This includes decreased bone volume, turnover abnormalities, and rarely mineralization defects. Moreover, the degree of bone disease usually correlates with the severity of liver dysfunction. The mechanism of HOD is multifactorial. Vitamin D insufficiency/deficiency, secondary hyperparathyroidism, hypogonadism, inhibitors of bone formation, and mediators/promoters of bone resorption are frequent findings and essential coplayers in HOD. Early and proper identification of HOD is challenging. DXA is the most widely used tool; however, it has fundamental limitations. Bone turnover biomarkers are used to understand the mechanism of bone loss. Bone biopsy with histomorphometry is the gold standard to evaluate bone structure. The evidence for the effectiveness of nonpharmacological and pharmacological management of HOD is limited. Adequate nutrition, weight-bearing exercise, smoking cessation, and limitation of alcohol consumption improve bone health and quality of life. The use of antiresorptive therapies prevents bone loss particularly in patients with high bone turnover. However, osteoanabolics are essential in patients with low bone turnover. Herein, we are discussing the magnitude of the problem, pathogenesis, diagnosis of HOD, and various interventions to improve bone health in cirrhotic patients.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83261668","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}
Abstract While the incidence of colorectal cancer is decreasing for adults older than 50 years, there is a rise in colorectal cancer among individuals younger than 50 (termed early-onset colorectal cancer). This increase is multifactorial and reflects differences in screening, changes in environmental factors, and other influences. In this article, we review the molecular and genetic basis of sporadic colorectal cancer as well as inherited colorectal cancer syndromes. We also summarize the epidemiology of early-onset colorectal cancer and considerations for the treatment of this population of patients.
{"title":"The Molecular Genetics of Colorectal Cancer, Hereditary Colorectal Cancer Syndromes, and Early-Onset Colorectal Cancer","authors":"Joceline V. Vu, J. Sommovilla","doi":"10.1055/s-0042-1757325","DOIUrl":"https://doi.org/10.1055/s-0042-1757325","url":null,"abstract":"Abstract While the incidence of colorectal cancer is decreasing for adults older than 50 years, there is a rise in colorectal cancer among individuals younger than 50 (termed early-onset colorectal cancer). This increase is multifactorial and reflects differences in screening, changes in environmental factors, and other influences. In this article, we review the molecular and genetic basis of sporadic colorectal cancer as well as inherited colorectal cancer syndromes. We also summarize the epidemiology of early-onset colorectal cancer and considerations for the treatment of this population of patients.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"1 1","pages":"058 - 070"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77631695","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}
Abstract While initially conceived and designed for adults, percutaneous image-guided drainage of abdominal pelvic and fluid collections has revolutionized the management of several pediatric pathologies. Interventional radiology procedures markedly reduce morbidity and mortality by offering a definitive minimally invasive approach or allowing a cleaner and less challenging subsequent open approach. These procedures are associated with improved patient comfort and rapid recovery. While similar techniques apply to children and adults, successful adaptation of image-guided interventional techniques in children requires consideration of several critical differences. This review aims to discuss the indications, contraindications, and technical aspects of percutaneous image-guided drainage of abdominal and pelvic fluid collections in children.
{"title":"Percutaneous Image-Guided Drainage of Abdominal Fluid Collections in Children: Technical Considerations and Clinical Scenarios","authors":"S. Gallo-Bernal, A. Cahalane, M. Gee","doi":"10.1055/s-0042-1759547","DOIUrl":"https://doi.org/10.1055/s-0042-1759547","url":null,"abstract":"Abstract While initially conceived and designed for adults, percutaneous image-guided drainage of abdominal pelvic and fluid collections has revolutionized the management of several pediatric pathologies. Interventional radiology procedures markedly reduce morbidity and mortality by offering a definitive minimally invasive approach or allowing a cleaner and less challenging subsequent open approach. These procedures are associated with improved patient comfort and rapid recovery. While similar techniques apply to children and adults, successful adaptation of image-guided interventional techniques in children requires consideration of several critical differences. This review aims to discuss the indications, contraindications, and technical aspects of percutaneous image-guided drainage of abdominal and pelvic fluid collections in children.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"29 1","pages":"187 - 201"},"PeriodicalIF":0.0,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78835669","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}
Eamon Lagha, D. Mulholland, Catharine Tadros, M. Faris, T. Sabharwal, A. Diamantopoulos, I. Ahmed
Abstract A multi-institutional retrospective review in four oncology centers was performed during a 5-year period (2015–2020) identifying all patients who underwent placement of the Hilzo esophageal stent for the management of malignant esophageal obstruction. Patient notes, imaging, and reports of each procedure were reviewed for demographics, lesion, and tumor-specific characteristics. The primary outcome was an improvement in symptoms of dysphagia using the Mellow–Pinkas dysphagia score. Secondary outcomes were periprocedural mortality, 30-day mortality, tumor overgrowth/restenosis, stent migration, stent compression/failure-to-expand, worsening dysphagia of unidentified cause, and procedure-related complications. A total of 58 patients met the inclusion criteria for this study and were analyzed. The median follow-up was 151 days (range: 6–627). The median dysphagia score improved from 3 to 1. Improvement was noted on 90% of the cases reporting dysphagia data. The 30-day mortality rate was 16%. No major complications were noted related to the procedure (grade: 4–6). Minor complications (grade: 1–3) included chest pain/odynophagia/heartburn in 17 (29%) of patients which all settled with symptomatic management. Secondary outcomes were as follows: tumor overgrowth/restenosis, 13 (22%); stent migration, 9 (16%); stent compression/failure to expand, 3 (5%); and worsening dysphagia of unidentified cause, 4 (7%). The Hilzo stent performed in line with the performance of other esophageal stents on the market. Hilzo stent insertion improved dysphagia scores with no major complications reported.
{"title":"Safety and Efficacy of the Hilzo Esophageal Stent for the Management of Dysphagia in Malignant Esophageal Obstruction","authors":"Eamon Lagha, D. Mulholland, Catharine Tadros, M. Faris, T. Sabharwal, A. Diamantopoulos, I. Ahmed","doi":"10.1055/s-0042-1757544","DOIUrl":"https://doi.org/10.1055/s-0042-1757544","url":null,"abstract":"Abstract A multi-institutional retrospective review in four oncology centers was performed during a 5-year period (2015–2020) identifying all patients who underwent placement of the Hilzo esophageal stent for the management of malignant esophageal obstruction. Patient notes, imaging, and reports of each procedure were reviewed for demographics, lesion, and tumor-specific characteristics. The primary outcome was an improvement in symptoms of dysphagia using the Mellow–Pinkas dysphagia score. Secondary outcomes were periprocedural mortality, 30-day mortality, tumor overgrowth/restenosis, stent migration, stent compression/failure-to-expand, worsening dysphagia of unidentified cause, and procedure-related complications. A total of 58 patients met the inclusion criteria for this study and were analyzed. The median follow-up was 151 days (range: 6–627). The median dysphagia score improved from 3 to 1. Improvement was noted on 90% of the cases reporting dysphagia data. The 30-day mortality rate was 16%. No major complications were noted related to the procedure (grade: 4–6). Minor complications (grade: 1–3) included chest pain/odynophagia/heartburn in 17 (29%) of patients which all settled with symptomatic management. Secondary outcomes were as follows: tumor overgrowth/restenosis, 13 (22%); stent migration, 9 (16%); stent compression/failure to expand, 3 (5%); and worsening dysphagia of unidentified cause, 4 (7%). The Hilzo stent performed in line with the performance of other esophageal stents on the market. Hilzo stent insertion improved dysphagia scores with no major complications reported.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"15 1","pages":"163 - 168"},"PeriodicalIF":0.0,"publicationDate":"2022-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81051549","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}
Abstract Image-guided thermal ablation of liver cancer is a well-established treatment for patients with primary or secondary liver tumors. While the safety profile for liver ablations is high, several procedure-related complications can occur. An awareness of the potential complications, their recognition, and management are essential for the interventionist who performs liver ablation. This review will describe some of the most frequently encountered complications associated with image-guided thermal ablation of hepatic malignancies.
{"title":"Complications Associated with Image-Guided Percutaneous Thermal Ablation of Liver Tumors","authors":"R. Arellano","doi":"10.1055/s-0042-1760372","DOIUrl":"https://doi.org/10.1055/s-0042-1760372","url":null,"abstract":"Abstract Image-guided thermal ablation of liver cancer is a well-established treatment for patients with primary or secondary liver tumors. While the safety profile for liver ablations is high, several procedure-related complications can occur. An awareness of the potential complications, their recognition, and management are essential for the interventionist who performs liver ablation. This review will describe some of the most frequently encountered complications associated with image-guided thermal ablation of hepatic malignancies.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"13 1","pages":"180 - 186"},"PeriodicalIF":0.0,"publicationDate":"2022-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89140082","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}
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