Laparoscopic transgastric access to the common bile duct after Roux-en-Y gastric bypass

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Single-incision transumbilical laparo-endoscopic gastric benign tumor resection.

The authors report resection of a gastric benign tumor through single-incision laparoscopy, guided by peroperative gastroscopy. VIDEO: A 25-year-old man consulted after diagnosis of a 40 × 20 cm(2) endoluminal lesion of the gastric cardia. Preoperative work-up showed a stromal tumor with invasion of the muscular layer. The umbilical scar was incised and, after placement of a purse-string suture, an 11-mm nondisposable trocar was inserted for a 10-mm 30° angled scope. Curved and reusable instruments (Karl Storz-Endoskope, Tuttlingen, Germany) and straight ultrasonic shears (Ethicon Endosurgery, Cincinnati, OH, US) were inserted transumbilically. Peroperative gastroscopy located the lesion on the smaller gastric curvature, 1 cm from the gastroesophageal junction. A stitch was placed in the center of the lesion, and gastroscopic grasper helped in maintaining the limits of resection. Gastrostomy was closed using two converting absorbable running sutures. Because of the curves of the instruments there was no conflict between the instruments' tips inside the abdomen (Fig. 1a), or between the surgeon's hands outside the abdomen (Fig. 1b). Leak test with the gastroscope checked the integrity of the suture. The specimen was retrieved transumbilically in a plastic bag. Operative time was 150 min, and the umbilical incision was less than 15 mm. The patient was discharged after 5 days, and he is doing well 3 months postoperatively. Laparoscopic gastric resection can be safely performed through a single-access. Peroperative gastroscopy permits the limits of resection to be precisely determine, and use of curved and reusable instruments allows surgeon to achieve ergonomic conditions as in classic laparoscopy, without increasing the laparoscopic cost.SCOPUS: ar.jSCOPUS: ar.jinfo:eu-repo/semantics/publishe

The liver involvement of the hydatid disease: A systematic review designed for the hepato-gastroenterologist

Hydatidosis is not uncommon in Western Europe, mainly due to the presence of immigrants from endemic countries, and hepato-gastroenterologist must then be able to manage this infectious disease. The hepatic hydatidosis is due to development in the liver of the larvae of Echinococcus granulosus that causes liver cysts. It can grow in size throughout the years and can give rise to complications, mainly pain, super-infection or cyst rupture. Recent progresses in imaging modalities play an important role in diagnosis, classification and evaluation of response to treatment of the cysts. Imaging techniques led to both Gharbi's and WHO's classifications. Those can provide markers of cyst activity and can help to determine the best therapeutic strategy. By combining two immunodiagnostic techniques, the diagnostic accuracy of laboratory tests is excellent. During the last decade, treatment has improved: the main therapeutic modality in the past was surgery, until the discovery of PAIR procedure (Puncture, Aspiration, Injection, Re-aspiration). Albendazole also plays an important role in the treatment of hydatid cysts either alone or as a pre-procedure or post procedure prophylaxis. This review will cover the major aspects of the disease emphasizing the recent diagnostic and therapeutic advances.SCOPUS: re.jinfo:eu-repo/semantics/publishe

A rare cause of colic polyp in a patient with ischemic colitis.

A 50-year-old woman was admitted for a rectal bleeding after an episode of defecation 2 days prior to her admission. The patient had also suffered from lower abdominal pain for 3 days, but did not complain about any other pain. The patient had no personal or familial medical history. The clinical examination only revealed a sensitive abdomen in the left inferior quadrant of the abdomen without defence or rebound. The vital parameters were normal. The blood sample showed the following: haemoglobin 15.2 g/dL (12-16), MCV 105 (85-95), leucocytes 11800/ mm3 (4200-9000) among which 8470/mm3 neutrophils (1900-7000), platelets 225000/mm3 (150000-400000) and CRP 171.5 mg/dL (< 12). We noticed that the haemoglobin had decreased from 15.2 g/dL to 11.6 g/ dL between the emergency and our gastroenterological department. [...

A retrospective endoscopic cohort study in HIV+ patients before and after HAART

info:eu-repo/semantics/nonPublishe

Profile of HIV-helicobacter pylori co-infected patients in the higly active antiretroviral therapy era

info:eu-repo/semantics/nonPublishe

A Retrospective Endoscopic Cohort Study in HIV+ Patients Before and After HAART.

info:eu-repo/semantics/nonPublishe

Helicobacter pylori et lesions malignes gastriques: Une piste pour la prevention et le traitement?

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Comparison of Demographic Characteristics and Upper Gastrointestinal Endoscopy Findings in HIV-Positive, Antiretroviral-Treated Patients With and Without Helicobacter pylori Coinfection

Objectives: We evaluated demographic characteristics in HIV-positive patients receiving highly active antiretroviral therapy (HAART) who had upper gastrointestinal (UGI) symptoms requiring UGI endoscopy and compared the findings in patients with and without H. Pylori coinfection. Methods: We prospectively observed all HIV-infected patients treated with antiretroviral therapy who underwent UGI endoscopy for the first time and were tested for H. pylori from January 2004 to December 2008. Data collected included the following: demographics (age, gender, ethnicity, body mass index [BMI], tobacco use, alcohol intake, and HIV risk behavior); comorbidity (viral hepatitis B or C, any organ dysfunction, or opportunistic disease); medication, including antibiotics, H2 blockers, proton pump inhibitors, and NSAIDs; CD4 cell counts, viral load; symptoms; and endoscopic and histologic diagnoses (H. pylori determined by Giemsa staining). Patients were compared according to H. pylori status (presence vs absence). Results: One hundred and forty-five patients were evaluated. Compared to patients without H. pylori infection (n=97), those with H. pylori infection (n=48) had a significantly higher CD4 cell count (p=.008), were more likely to be heterosexual (p=.047), had a higher BMI (p=.027), had a greater incidence of duodenal ulcers (p=.005), had lower viral loads (p<.01), were less likely to have received macrolide antibiotics in the last 3months (p=.00), and had less comorbidity (p=.03). They were also more frequently of Black African than Caucasians. In multivariate analysis, being heterosexual and having a low viral load were independently associated with an increased risk of having H. Pylori coinfection. Conclusion: In the antiretroviral therapy era, HIV-H. pylori coinfection is associated with a greater incidence of duodenal ulcers and higher CD4 counts, higher BMI, less comorbidity, and less frequent use of macrolides. © 2012 Blackwell Publishing Ltd.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe