AIM: To study the efficacy and the safety of laser lithotripsy without direct visual control by using a balloon catheter in patients with bile duct stones that could not be extracted by standard technique. METHODS: Th...AIM: To study the efficacy and the safety of laser lithotripsy without direct visual control by using a balloon catheter in patients with bile duct stones that could not be extracted by standard technique. METHODS: The seventeen patients (7 male and 10 female; mean age 67.8 years) with difficult common bile duct (CBD) stones were not amenable for conventional endoscopic maneuvers such as sphincterotomy and mechanical lithotripsy were included in this study. Laser wavelengths of 532 nm and 1064 nm as a double pulse were applied with pulse energy of 120 mJ. The laser fiber was advanced under fluoroscopic control through the ERCP balloon catheter. Laser lithotripsy was continued until the fragment size seemed to be less than 10 mm. Endoscopic extraction of the stones and fragments was performed with the use of the Dormia basket and balloon catheter. RESULTS: Bile duct clearance was achieved in 15 of 17 patients (88%). The mean number of treatment sessions was 1.7 ± 0.6. Endoscopic stone removal could not be achieved in 2 patients (7%). Adverse effects were noted in three patients (hemobilia, pancreatitis, and cholangitis). CONCLUSION: The Frequency Doubled Double Pulse Nd:YAG (FREDDY) laser may be an effective and safe technique in treatment of difficult bile duct stones.展开更多
目的比较双球囊、单球囊应用于妊娠晚期促宫颈成熟的有效性与安全性。方法检索MEDLINE、EMBASE、Cochrane图书馆、VIP、CNKI和万方数据库,收集符合纳入标准的随机或半随机对照试验。运用Rev M an 5.2软件进行统计分析。结果纳入6项临床...目的比较双球囊、单球囊应用于妊娠晚期促宫颈成熟的有效性与安全性。方法检索MEDLINE、EMBASE、Cochrane图书馆、VIP、CNKI和万方数据库,收集符合纳入标准的随机或半随机对照试验。运用Rev M an 5.2软件进行统计分析。结果纳入6项临床对照试验共计1 278例患者。荟萃分析显示:双球囊与单球囊导管的剖宫产率[RR=1.06,95%CI(0.79,1.44),P=0.69〗、24小时阴道分娩率[RR=0.94,95%CI(0.82,1.09),P=0.42]差异无统计学意义,两者平均分娩时间相当[MD=1.11,95%CI(-1.05,3.27),P=0.31]。两组孕妇不良事件发生率[RR=1.47,95%CI(0.73,2.94),P=0.28],新生儿低Apgar评分率[RR=0.56,95%CI(0.16,1.98),P=0.37]差异无统计学意义。结论双球囊、单球囊用于妊娠晚期促进宫颈成熟的效果相当,本系统评价的结论需要大样本的临床随机对照研究加以验证。展开更多
AIM: To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.METHODS: From September 2009 to March 2013, a total of 176 measurements of hepatic venous p...AIM: To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.METHODS: From September 2009 to March 2013, a total of 176 measurements of hepatic venous pressure gradient (HVPG) were done in 146 patients. Each transjugular HVPG was measured twice, first using an end whole catheter (EH-HVPG), and then using a balloon catheter (B-HVPG). The HVPG was compared with the endoscopic grade of esophageal varices (according to the general rules for recording endoscopic findings of esophagogastric varices), which was recorded within a month of the measurement of HVPG.RESULTS: The study included 110 men and 36 women, with a mean age of 56.1 years (range, 43-76 years). The technical success rate of the pressure measurements was 100% and there were no complication related to the procedures. Mean HVPG was 15.3 mmHg as measured using the end hole catheter method and 16.5 mmHg as measured using the balloon catheter method. Mean HVPG (both EH-HVPG and B-HVPG) was not significantly different among patients with different characteristics, including sex and comorbid factors, except for cases with hepatocellular carcinoma (B-HVPG, P = 0.01; EH-HVPG, P = 0.02). Portal hypertension (> 12 mmHg HVPG) occurred in 66% of patients according to EH-HVPG and 83% of patients according to B-HVGP, and significantly correlated with Child’s status (B-HVPG, P < 0.000; EH-HVGP, P < 0.000) and esophageal varies observed upon endoscopy (EH-HVGP, P = 0.003; B-HVGP, P = 0.006). One hundred and thirty-five endoscopies were performed, of which 15 showed normal findings, 27 showed grade 1 endoscopic esophageal varices, 49 showed grade 2 varices, and 44 showed grade 3 varices. When comparing endoscopic esophageal variceal grades and HVPG using univariate analysis, the P value was 0.004 for EH-HVPG and 0.002 for B-HVPG.CONCLUSION: Both EH-HVPG and B-HVPG showed a positive correlation with the endoscopic grade of esophageal varices, with B-HVPG showing a stronger corr展开更多
基金The 2007 research fund of Wonkwang University and Wonkwang Clinical Research Institute
文摘AIM: To study the efficacy and the safety of laser lithotripsy without direct visual control by using a balloon catheter in patients with bile duct stones that could not be extracted by standard technique. METHODS: The seventeen patients (7 male and 10 female; mean age 67.8 years) with difficult common bile duct (CBD) stones were not amenable for conventional endoscopic maneuvers such as sphincterotomy and mechanical lithotripsy were included in this study. Laser wavelengths of 532 nm and 1064 nm as a double pulse were applied with pulse energy of 120 mJ. The laser fiber was advanced under fluoroscopic control through the ERCP balloon catheter. Laser lithotripsy was continued until the fragment size seemed to be less than 10 mm. Endoscopic extraction of the stones and fragments was performed with the use of the Dormia basket and balloon catheter. RESULTS: Bile duct clearance was achieved in 15 of 17 patients (88%). The mean number of treatment sessions was 1.7 ± 0.6. Endoscopic stone removal could not be achieved in 2 patients (7%). Adverse effects were noted in three patients (hemobilia, pancreatitis, and cholangitis). CONCLUSION: The Frequency Doubled Double Pulse Nd:YAG (FREDDY) laser may be an effective and safe technique in treatment of difficult bile duct stones.
文摘目的比较双球囊、单球囊应用于妊娠晚期促宫颈成熟的有效性与安全性。方法检索MEDLINE、EMBASE、Cochrane图书馆、VIP、CNKI和万方数据库,收集符合纳入标准的随机或半随机对照试验。运用Rev M an 5.2软件进行统计分析。结果纳入6项临床对照试验共计1 278例患者。荟萃分析显示:双球囊与单球囊导管的剖宫产率[RR=1.06,95%CI(0.79,1.44),P=0.69〗、24小时阴道分娩率[RR=0.94,95%CI(0.82,1.09),P=0.42]差异无统计学意义,两者平均分娩时间相当[MD=1.11,95%CI(-1.05,3.27),P=0.31]。两组孕妇不良事件发生率[RR=1.47,95%CI(0.73,2.94),P=0.28],新生儿低Apgar评分率[RR=0.56,95%CI(0.16,1.98),P=0.37]差异无统计学意义。结论双球囊、单球囊用于妊娠晚期促进宫颈成熟的效果相当,本系统评价的结论需要大样本的临床随机对照研究加以验证。
基金Supported by the Research Program of the National Research Foundation of Koreafunded by the Ministry of Education and Science and Technology No.2010-0011678and the Soonchunhyang University Research Fund
文摘AIM: To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.METHODS: From September 2009 to March 2013, a total of 176 measurements of hepatic venous pressure gradient (HVPG) were done in 146 patients. Each transjugular HVPG was measured twice, first using an end whole catheter (EH-HVPG), and then using a balloon catheter (B-HVPG). The HVPG was compared with the endoscopic grade of esophageal varices (according to the general rules for recording endoscopic findings of esophagogastric varices), which was recorded within a month of the measurement of HVPG.RESULTS: The study included 110 men and 36 women, with a mean age of 56.1 years (range, 43-76 years). The technical success rate of the pressure measurements was 100% and there were no complication related to the procedures. Mean HVPG was 15.3 mmHg as measured using the end hole catheter method and 16.5 mmHg as measured using the balloon catheter method. Mean HVPG (both EH-HVPG and B-HVPG) was not significantly different among patients with different characteristics, including sex and comorbid factors, except for cases with hepatocellular carcinoma (B-HVPG, P = 0.01; EH-HVPG, P = 0.02). Portal hypertension (> 12 mmHg HVPG) occurred in 66% of patients according to EH-HVPG and 83% of patients according to B-HVGP, and significantly correlated with Child’s status (B-HVPG, P < 0.000; EH-HVGP, P < 0.000) and esophageal varies observed upon endoscopy (EH-HVGP, P = 0.003; B-HVGP, P = 0.006). One hundred and thirty-five endoscopies were performed, of which 15 showed normal findings, 27 showed grade 1 endoscopic esophageal varices, 49 showed grade 2 varices, and 44 showed grade 3 varices. When comparing endoscopic esophageal variceal grades and HVPG using univariate analysis, the P value was 0.004 for EH-HVPG and 0.002 for B-HVPG.CONCLUSION: Both EH-HVPG and B-HVPG showed a positive correlation with the endoscopic grade of esophageal varices, with B-HVPG showing a stronger corr
