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143 results on '"Vila, Juan J."'

1. Plastic pigtail vs lumen-apposing metal stents for drainage of walled-off necrosis (PROMETHEUS study): an open-label, multicenter randomized trial

Author

Gornals, Joan B., Velasquez-Rodriguez, Julio G., Bas-Cutrina, Francesc, Garcia Garcia De Paredes, Ana, Esteban, Jose-Miguel, Teran, Alvaro, Gonzalez-Huix, Ferran, Perez-Miranda, Manuel, Guarner-Argente, Carlos, Vila, Juan J., Garcia-Sumalla, Albert, Foruny, Jose Ramon, Fisac-Vazquez, Joaquin, Moris, Maria, Miquel-Salas, Isabel, De-la-Serna Higuera, Carlos, Murzi-Pulgar, Marianette, Sanchez-Yague, Andres, Salord, Silvia, Ruiz-Osuna, Sandra, Busquets, Juli, Sanllorente-Melenchon, Mireia, Videla, Sebas, Moreno, Ramon, Tebe-Cordomi, Cristian, Hereu, Pilar, and Vazquez-Sequeiros, Enrique

Published
2024
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4. Palliation of Gastric Outlet Obstruction in Case of Biliary Obstruction—A Retrospective, Multicenter Study: The B-GOOD Study.

Author

Fugazza, Alessandro, Andreozzi, Marta, Binda, Cecilia, Lisotti, Andrea, Tarantino, Ilaria, Vila, Juan J., Robles Medranda, Carlos, Amato, Arnaldo, Larghi, Alberto, Perez Cuadrado Robles, Enrique, Aragona, Giovanni, Di Matteo, Francesco, Badas, Roberta, Hassan, Cesare, Barbera, Carmelo, Mangiavillano, Benedetto, Crinò, Stefano, Colombo, Matteo, Fabbri, Carlo, and Fusaroli, Pietro

Subjects
GASTRIC outlet obstruction, PALLIATIVE treatment, LAPAROSCOPY, PATIENT safety, GASTROENTEROSTOMY, TREATMENT effectiveness, SURGICAL stents, RETROSPECTIVE studies, DESCRIPTIVE statistics, MEDICAL records, ACQUISITION of data, RESEARCH, DISEASE relapse, BILE ducts
Abstract

Simple Summary: The aim of our retrospective study was to compare EUS-guided gastroenteroanastomosis (EUS-GE) and enteral stenting (ES) for the palliation of gastric outlet obstruction (GOO) in patients already treated with EUS-guided choledocoduodenostomy (EUS-CDS) for distal malignant biliary obstruction (DMBO). Our results on 77 patients demonstrated that both EUS-GE and ES are safe and effective for palliation of GOO, but EUS-GE is associated with less recurrence of symptoms. Background: EUS-guided gastroenterostomy (EUS-GE) is a novel and effective procedure for the management of malignant gastric outlet obstruction (GOO) with more durable results when compared to enteral stenting (ES). However, data comparing EUS-GE to ES in patients already treated with EUS-guided choledocoduodenostomy (EUS-CDS) for distal malignant biliary obstruction (DMBO) are lacking. We aimed to compare outcomes of EUS-GE and ES for the palliation of GOO in this specific population of patients. Methods: A multicenter, retrospective analysis of patients with DMBO treated by EUS-CDS and subsequent GOO treated by EUS-GE or ES from 2016 to 2021 was conducted. Primary outcomes were overall AEs rate and dysfunction of the EUS-CDS after GOO treatment. Secondary outcomes included clinical success, technical success, procedure duration, length of hospital stay and relapse of GOO symptoms. Results: A total of 77 consecutive patients were included in the study: 25 patients underwent EUS-GE and 52 underwent ES. AEs rate and patency outcomes of the EUS-CDS after GOO treatment were comparable between the two groups (12.5% vs. 17.3%; p = 0.74). No recurrence of GOO symptoms was registered in the EUS-GE group while 11.5% of ES patients had symptoms recurrence, even if not statistically significant (p = 0.16), after a mean follow-up period of 63.5 days. Conclusion: EUS-GE and ES are both effective and safe for the palliation of GOO in patients already treated by EUS-CDS for DMBO with no difference in the biliary stent dysfunction rate and overall AEs. EUS-GE is associated with less recurrence of GOO symptoms. [ABSTRACT FROM AUTHOR]

Published
2024
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5. The safety and efficacy of a new 20-mm lumen apposing metal stent (lams) for the endoscopic treatment of pancreatic and peripancreatic fluid collections: a large international, multicenter study

Author

Anderloni, Andrea, Fabbri, Carlo, Nieto, Jose, Uwe, Will, Dollhopf, Markus, Aparicio, José Ramón, Perez-Miranda, Manuel, Tarantino, Ilaria, Arlt, Alexander, Vleggaar, Frank, Vanbiervliet, Geoffrey, Hampe, Jochen, Kahaleh, Michel, Vila, Juan J., Dayyeh, Barham K. Abu, Storm, Andrew C., Fugazza, Alessandro, Binda, Cecilia, Charachon, Antoine, Sevilla-Ribota, Sergio, Tyberg, Amy, Robert, Moran, Wani, Sachin, Repici, Alessandro, Sethi, Amrita, Khashab, Mouen A., and Kunda, Rastislav

Published
2021
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7. Endoscopic ultrasound‐guided gallbladder drainage with long‐term lumen‐apposing metal stent indwell: 1‐year results from a prospective nationwide observational study.

Author

Bazaga, Sergio, García‐Alonso, Francisco Javier, Aparicio Tormo, Jose Ramon, Martinez Moreno, Belen, Sanchiz, Vicente, Gornals, Joan B, Loras, Carme, Terán, Álvaro, Vazquez‐Sequeiros, Enrique, Pedraza Sanz, Rafael, Súbtil, José Carlos, Pérez‐Millan, Antonio, Uceda Porta, Francisco, Vila, Juan J, de la Serna‐Higuera, Carlos, Couto‐Worner, Ignacio, Guarner‐Argente, Carlos, and Perez‐Miranda, Manuel

Subjects
GALLBLADDER, SCIENTIFIC observation, SURGICAL drainage, LOG-rank test, SAFETY factor in engineering, ENDOSCOPIC retrograde cholangiopancreatography, TELEPHONE interviewing
Abstract

Background and Aim: This study aimed to determine safety and risk factors for adverse events (AEs) of endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) with long‐term indwell of lumen‐apposing metal stents (LAMS). Methods: This study is a multicenter prospective observational study on consecutive high surgical‐risk patients requiring gallbladder drainage who underwent EUS‐GBD with LAMS over 12 months. Centralized telephone follow‐up interviews were conducted every 3 months for 1 year. Patients were censored at LAMS removal, cholecystectomy, or death. AE‐free survival was determined using log–rank tests. Cumulative risks were estimated using life‐table analysis. Results: Eighty‐two patients were included (53.7% male, median [interquartile range] age of 84.6 [76.5–89.8] years, and 85.4% with acute cholecystitis). Technical success was achieved in 79 (96.3%), and clinical success in 73 (89%). No patient was lost to follow‐up; 45 patients (54.9%) completed 1‐year follow‐up with in situ LAMS. Median (interquartile range) LAMS indwell time was 364 (47–367) days. Overall, 12 (14.6%) patients presented 14 AEs, including 5 (6.1%) recurrent biliary events (3 acute cholangitis, 1 mild acute pancreatitis, and 1 acute cholecystitis). Patients with pancreatobiliary malignancy had an increased risk of recurrent biliary events (33% vs 1.5%, P = 0.001). The overall 1‐year cumulative risk of recurrent biliary events was 9.7% (4.1–21.8%). The 1‐year risk of AEs and of severe AEs was 18.8% (11–31.2%) and 7.9% (3.3–18.2%), respectively. Pancreatobiliary malignancy was the single risk factor for recurrent biliary events; LAMS misdeployment was the strongest risk factor for AEs. Conclusions: Long‐term LAMS indwell does not increase the risk of delayed AEs following EUS‐GBD. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Endoscopic ultrasound-guided drainage using LAMS of malignant afferent limb syndrome in patients with previous Whipple surgery: A multicenter study (with video)

Author

Pérez-Cuadrado-Robles, Enrique, Bronswijk, Michiel, Prat, Fréderic, Barthet, Marc, Palazzo, Maxime, Arcidiacono, Paolo, Schaefer, Marion, Devière, Jacques, van Wanrooij, Roy L J, Tarantino, Ilaria, Donatelli, Gianfranco, Camus, Marine, Sanchez-Yague, Andres, Pham, Khanh Do-Cong, Gonzalez, Jean-Michel, Anderloni, Andrea, Vila, Juan J, Jezequel, Julien, Larghi, Alberto, Jaïs, Bénédicte, Vazquez-Sequeiros, Enrique, Deprez, Pierre H, Van der Merwe, Schalk, Cellier, Christophe, Rahmi, Gabriel, Pérez-Cuadrado-Robles, Enrique, Bronswijk, Michiel, Prat, Fréderic, Barthet, Marc, Palazzo, Maxime, Arcidiacono, Paolo, Schaefer, Marion, Devière, Jacque, van Wanrooij, Roy L J, Tarantino, Ilaria, Donatelli, Gianfranco, Camus, Marine, Sanchez-Yague, Andre, Pham, Khanh Do-Cong, Gonzalez, Jean-Michel, Anderloni, Andrea, Vila, Juan J, Jezequel, Julien, Larghi, Alberto, Jaïs, Bénédicte, Vazquez-Sequeiros, Enrique, Deprez, Pierre H, Van der Merwe, Schalk, Cellier, Christophe, and Rahmi, Gabriel

Subjects
LAMS, stent, Endoscopic ultrasound, gastrojejunostomy, anastomosi
Abstract

Objectives: Endoscopic ultrasound-guided digestive anastomosis (EUS-A) is a new alternative under evaluation in patients presenting with afferent limb syndrome (ALS) after Whipple surgery. The aim of the present study is to analyze the safety and effectiveness of EUS-A in ALS. Methods: This is an observational multicenter study. All patients ≥18 years-old with previous Whipple surgery presenting with ALS who underwent an EUS-A using a lumen apposing metal stent between 2015 and 2021 were included. The primary outcome was clinical success, defined as resolution of the ALS or ALS-related cholangitis. Furthermore, technical success, adverse event rate and mortality were evaluated. Results: Forty-five patients (mean age: 65.5±10.2 years, 44.4% male) were included. The most common underlying disease was pancreatic cancer (68.9%). EUS-A was performed at a median of 6 weeks after local tumor recurrence. The most common approach used was the direct/freehand technique (66.7%). Technical success was achieved in 95.6%, with no differences between large (≥15mm) and small LAMS (97.4% vs. 100%, p=0.664). Clinical success was retained in and 91.1% of patients. A complementary treatment by dilation of the stent followed by ERCP through the LAMS was performed in three cases (6.7%). There were six recurrent episodes of cholangitis (14.6%) and two procedure-related adverse events (4.4%) after a median follow-up of 4 months. Twenty-six patients (57.8%) died during the follow-up due to disease progression. Conclusions: EUS-A is a safe and effective technique in the treatment of malignant ALS, achieving high clinical success with an acceptable recurrence rate.

Published
2022

10. Initial experience with EUS-guided cholangiopancreatography for biliary and pancreatic duct drainage: a Spanish national survey

Author

Vila, Juan J., Pérez-Miranda, Manuel, Vazquez-Sequeiros, Enrique, Abadia, Monder Abu-Suboh, Pérez-Millán, Antonio, González-Huix, Ferrán, Gornals, Joan, Iglesias-Garcia, Julio, De la Serna, Carlos, Aparicio, José R., Subtil, José C., Álvarez, Alberto, de la Morena, Felipe, García-Cano, Jesús, Casi, María A., Lancho, Angel, Barturen, Angel, Rodríguez-Gómez, Santiago J., Repiso, Alejandro, Juzgado, Diego, Igea, Francisco, Fernandez-Urien, Ignacio, González-Martin, Juan A., and Armengol-Miró, José R.

Published
2012
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12. Endoscopic ultrasound‐guided drainage using lumen‐apposing metal stent of malignant afferent limb syndrome in patients with previous Whipple surgery: Multicenter study (with video).

Author

Pérez‐Cuadrado‐Robles, Enrique, Bronswijk, Michiel, Prat, Fréderic, Barthet, Marc, Palazzo, Maxime, Arcidiacono, Paolo, Schaefer, Marion, Devière, Jacques, van Wanrooij, Roy L. J., Tarantino, Ilaria, Donatelli, Gianfranco, Camus, Marine, Sanchez‐Yague, Andres, Pham, Khanh Do‐Cong, Gonzalez, Jean‐Michel, Anderloni, Andrea, Vila, Juan J., Jezequel, Julien, Larghi, Alberto, and Jaïs, Bénédicte

Subjects
CHOLANGITIS, ENDOSCOPIC retrograde cholangiopancreatography, AFFERENT pathways, DISEASE relapse, PANCREATIC cancer, DEEP brain stimulation
Abstract

Objectives: Endoscopic ultrasound‐guided digestive anastomosis (EUS‐A) is a new alternative under evaluation in patients presenting with afferent limb syndrome (ALS) after Whipple surgery. The aim of the present study is to analyze the safety and effectiveness of EUS‐A in ALS. Methods: This is an observational multicenter study. All patients ≥18 years old with previous Whipple surgery presenting with ALS who underwent an EUS‐A using a lumen‐apposing metal stent (LAMS) between 2015 and 2021 were included. The primary outcome was clinical success, defined as resolution of the ALS or ALS‐related cholangitis. Furthermore, technical success, adverse event rate, and mortality were evaluated. Results: Forty‐five patients (mean age: 65.5 ± 10.2 years; 44.4% male) were included. The most common underlying disease was pancreatic cancer (68.9%). EUS‐A was performed at a median of 6 weeks after local tumor recurrence. The most common approach used was the direct/freehand technique (66.7%). Technical success was achieved in 95.6%, with no differences between large (≥15 mm) and small LAMS (97.4% vs. 100%, P = 0.664). Clinical success was retained in 91.1% of patients. A complementary treatment by dilation of the stent followed by endoscopic retrograde cholangiopancreatography through the LAMS was performed in three cases (6.7%). There were six recurrent episodes of cholangitis (14.6%) and two procedure‐related adverse events (4.4%) after a median follow‐up of 4 months. Twenty‐six patients (57.8%) died during the follow‐up due to disease progression. Conclusion: EUS‐A is a safe and effective technique in the treatment of malignant ALS, achieving high clinical success with an acceptable recurrence rate. [ABSTRACT FROM AUTHOR]

Published
2022
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15. Diagnostic accuracy and interobserver agreement of digital single-operator cholangioscopy for indeterminate biliary strictures.

Author

Stassen, Pauline M.C., Goodchild, George, de Jonge, Pieter Jan F., Erler, Nicole S., Anderloni, Andrea, Cennamo, Vincenzo, Church, Nicholas I., Fernandez-Urien Sainz, Ignacio, Huggett, Matthew T., James, Martin W., Joshi, Deepak, Kylänpää, Leena, Laleman, Wim, Nayar, Manu K., Oppong, Kofi W., Poley, Jan-Werner, Potts, Jonathan R., Repici, Alessandro, Udd, Marianne, and Vila, Juan J.

Abstract

Digital single-operator cholangioscopy (d-SOC) with cholangioscopic biopsy sampling has shown promise in the evaluation of indeterminate biliary strictures. Some studies have suggested higher sensitivity for visual impression compared with biopsy sampling, although assessors were not blinded to previous investigations. We aimed to investigate the diagnostic accuracy and interobserver agreement (IOA) of d-SOC in the visual appraisal of biliary strictures when blinded to additional information. A multicenter, international cohort study was performed. Cholangioscopic videos in patients with a known final diagnosis were systematically scored. Pseudonymized videos were reviewed by 19 experts in 2 steps: blinded for patient history and investigations and unblinded. Forty-four high-quality videos were reviewed of 19 benign and 25 malignant strictures. The sensitivity and specificity for the diagnosis of malignancy was 74.2% and 46.9% (blinded) and 72.7% and 62.5% (unblinded). Cholangioscopic certainty of a malignant diagnosis led to overdiagnosis (sensitivity, 90.6%; specificity, 33%), especially if no additional information was provided. The IOA for the presence of malignancy was fair for both assessments (Fleiss' κ =.245 [blinded] and κ =.321 [unblended]). For individual visual features, the IOA ranged from slight to moderate for both assessments (κ =.059-.400 vs κ =.031-.452). This study showed low sensitivity and specificity for blinded and unblinded d-SOC video appraisal of indeterminate biliary strictures, with considerable interobserver variation. Although reaching a consensus on the optical features of biliary strictures remains important, optimizing visually directed biopsy sampling may be the most important role of cholangioscopy in biliary stricture assessment. [ABSTRACT FROM AUTHOR]

Published
2021
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17. 430 THE CURRENT DIAGNOSTIC ACCURACY AND INTER-OBSERVER AGREEMENT OF VISUAL IMPRESSION WITH DIGITAL SINGLE-OPERATOR CHOLANGIOSCOPY FOR THE DIAGNOSIS OF INDETERMINATE BILIARY STRICTURES

Author

Stassen, Pauline M., Goodchild, George, de Jonge, P.J.F., Erler, Nicole S., Poley, Jan-Werner, Anderloni, Andrea A., Cennamo, Vincenzo, Church, Nick, Fernandez-Urien, Ignacio, Huggett, Matthew T., James, Martin W., Joshi, Deepak, Kylänpää, Leena, Laleman, Wim, Nayar, Manu K., Oppong, Kofi, Potts, Jonathan R., Repici, Alessandro, Udd, Marianne, Vila, Juan J., Wong, Terence, Bruno, Marco J., and Webster, George

Published
2020
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18. 106 THE CURRENT DIAGNOSTIC ACCURACY AND INTER-OBSERVER AGREEMENT OF VISUAL IMPRESSION WITH DIGITAL SINGLE-OPERATOR CHOLANGIOSCOPY FOR THE DIAGNOSIS OF INDETERMINATE BILIARY STRICTURES

Author

Stassen, Pauline M., Goodchild, George, de Jonge, P.J.F., Erler, Nicole S., Poley, Jan-Werner, Anderloni, Andrea A., Cennamo, Vincenzo, Church, Nick, Fernandez-Urien, Ignacio, Huggett, Matthew T., James, Martin W., Joshi, Deepak, Kylänpää, Leena, Laleman, Wim, Nayar, Manu K., Oppong, Kofi, Potts, Jonathan R., Repici, Alessandro, Udd, Marianne, Vila, Juan J., Wong, Terence, Bruno, Marco J., and Webster, George

Published
2020
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20. Su1431 SAFETY AND EFFICACY OF THE NEW 20 MM LUMEN APPOSING METAL STENT (LAMS) FOR ENDOSCOPIC TREATMENT OF PANCREATIC AND PERIPANCREATIC FLUID COLLECTIOS: A LARGE, INTERNATIONAL, MULTICENTER STUDY

Author

Anderloni, Andrea A., Uwe, Will, Dollhopf, Markus, Fabbri, Carlo, Perez-Miranda, Manuel, Nieto, Jose, Aparicio, Jose Ramon, Tarantino, Ilaria, Vleggaar, Frank P., Vanbiervliet, Geoffroy, Hampe, Jochen, Kahaleh, Michel, Vila, Juan J., Abu Dayyeh, Barham K., Fugazza, Alessandro, Binda, Cecilia, Arlt, Alexander, Charachon, Antoine, Tyberg, Amy, Moran, Robert, Wani, Sachin B., Repici, Alessandro, Sethi, Amrita, Khashab, Mouen A., and Kunda, Rastislav

Published
2018
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21. Endoscopic submucosal dissection in Spain: outcomes and development possibilities

Author

Vila, Juan J., Kutz, Marcos, Fernández-Esparrach, Gloria, López-Rosés, Leopoldo, Rodríguez, Sarbelio, and Sánchez-Yague, Andrés

Subjects
Early gastric cancer, Gastric neoplasms, Neoplasias gástricas, Curva de aprendizaje, Endoscopy, Cáncer gástrico precoz, Endoscopia, Endoscopic submucosal dissection, Disección submucosa endoscópica, Learning curve
Abstract

Endoscopic submucosal dissection (ESD) allows endoscopic, curative, en-bloc resection of superficial malignant or premalignant lesions. This procedure was conceived over 10 years ago in Japan, but has not experienced great expansion in Western countries for different reasons. This article reviews ESD indications and outcomes, and reflects on the reasons that prevent ESD from becoming common clinical practice in Western hospitals. Finally, recommendations on ESD training in our setting are made. La disección submucosa endoscópica (DSE) permite la resección curativa mediante endoscopia de lesiones malignas o premalignas superficiales digestivas en una sola pieza. Esta técnica, nacida hace algo más de 10 años en Japón, no ha experimentado una gran difusión en países occidentales por diferentes motivos. En este artículo se hace una revisión de las indicaciones y resultados de la DSE, así como una discusión de los motivos por los que todavía son escasos los centros en occidente que realizan esta técnica. Por último se hacen unas recomendaciones de formación en DSE en nuestro medio.

Published
2013

26. Cricopharyngeal peroral endoscopic myotomy for achalasia of the cricopharynx: "to do or not to do".

Author

Albéniz, Eduardo, Estremera-Arevalo, Fermín, Rosón, Pedro J., Fernandez Cano, Francisco, Heredia, María L., Ishaq, Sauid, and Vila, Juan J.

Abstract

A neck ultrasound and computed tomography (CT) without intravenous contrast supported the diagnosis. Previous gastroscopy, barium transit, and high resolution manometry (HRM) were compatible with cricopharyngeal achalasia. [Extracted from the article]

Published
2022
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28. Endoscopic ultrasound-guided rendezvous for extrahepatic bile duct recanalization after surgical transection.

Author

Martínez-Acitores de la Mata, Diego, Zabalza, Lucía, Ubieto, Verónica, Moya, José Luis, Carrascosa, Juan, Montón, Soledad, and Vila, Juan J.

Subjects
BILE ducts, INTRAHEPATIC bile ducts, ENDOSCOPIC ultrasonography, ENDOSCOPIC retrograde cholangiopancreatography, BILIARY tract
Abstract

Dr. Juan J. Vila is a consultant for Boston Scientific and has lectured for Olympus and Cook Endoscopy. We report a case in which extrahepatic bile duct transection was successfully managed with a purely endoscopic approach combining EUS-guided rendezvous and ERCP, which, so far as we know, has not been described previously. Extraluminal percutaneous-endoscopic rendezvous with a self-expanding metal stent for restoring continuity in major bile duct injury: a case series. [Extracted from the article]

Published
2022
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29. Su1647 Cost-Effectiveness of Prophylactic Clipping After Colorectal Endoscopic Mucosal Resection and Economic Impact According to a Bleeding Risk Score

Author

Albeniz, Eduardo, Gonzalez, Maria Fraile, Martínez-Ares, David, Alonso, Pedro, Guarner-Argente, Carlos, Mugica, Fernando, Cobian, Julyssa, Herreros-de-Tejada, Alberto, Garcia, Jose Santiago, Alvarez-Gonzalez, Marco A., Rincon, Oscar Nogales, Zabala, Felipe Ramos, Soto, Santiago, Remedios Espino, David R., Ripa, Alba Zuñiga, Pardeiro, M. Remedios, Valdivielso, Eduardo, Huelin, Patricia, Gargallo, Carla J., Cerezo, Eduardo Redondo, Martinez-Cara, Juan Gabriel, Pellise, Maria, Sanchez, Liseth Rivero, Rodríguez-Téllez, Manuel, Rodríguez-Sánchez, Joaquín, Viedma, Bartolomé L., López-Rosés, Leopoldo, Peña, Joaquin de la, Saperas, Esteban, Navajas Leon, F. Javier, Ono, Akiko, Alberca, Fernando, Pérez-Roldán, Francisco, Eguaras, Javier, and Vila, Juan J.

Published
2016
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36. Biliary hitch and ride technique for blind pancreatic duct cannulation.

Author

Vila, Juan J., Carrascosa, Juan, Fernández-Urién, Ignacio, Yeaton, Paul, González, Gonzalo, Aburruza, Leire, and Zozaya, José Manuel

Subjects
*PANCREATIC duct, *CATHETERIZATION, *ENDOSCOPIC ultrasonography, *CHOLANGITIS, *FLUOROSCOPY, *ENDOSCOPIC retrograde cholangiopancreatography, *ENDOSCOPIC gastrointestinal surgery
Abstract

If the tip of the cannula is not deeply advanced into the common bile duct, the preloaded guidewire exits the cannula with a perpendicular orientation into the pancreatic duct. Several attempts may be needed to achieve pancreatic duct cannulation with the preloaded guidewire. [Extracted from the article]

Published
2021
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37. Prospective observational study of the incidental findings on endoscopic ultrasonography: Should a complete exploration always be performed?

Author

Vila, Juan J., Jiménez, F. Javier, Irisarri, Rebeca, Vicuña, Miren, Ruiz-Clavijo, David, Gonzalez de la Higuera, Belen, Fernández-Urién, Iñaki, and Borda, Fernando

Subjects
*ENDOSCOPIC ultrasonography, *BILIARY tract, *ENDOCRINE glands, *LYMPHOID tissue, *MEDICAL care
Abstract

Objectives. To quantify the additional non-suspected new diagnoses made on upper endosonography (EUS) which were unknown before the procedure, and to analyse their influence on the management of patients. A further objective was to evaluate the influence that previous radiological or endoscopic explorations have on the capacity of EUS to diagnose these unsuspected lesions. Material and methods. During a 2-year period every patient sent to our unit for upper EUS underwent a complete investigation, after signing an informed consent document. An upper EUS was considered as complete whenever the gut wall, pancreas, biliary tract, ampulla, large abdominal vessels, liver, spleen, left adrenal gland, posterior mediastinum and thyroid lobes had been explored. An additional diagnosis (AD) was defined as a diagnosis made on EUS that was previously unknown and not suspected. A significant additional diagnosis (SAD) was defined as an AD that required further study. The results of complementary explorations carried out before EUS were registered. Results. A total of 239 patients were included in the study. ADs were found in 92 patients (38.5%), which were considered to be SADs in 27 patients (11.3%). Those patients had previously undergone computed tomography (CT) and those who underwent more than one exploration had fewer incidences of ADs on EUS (p=0.03 and p=0.02, respectively). No exploration alone or in combination with others showed any influence on the capacity of EUS to find a SAD (p >0.05). Conclusions. In our series, an AD was found on upper endosonography in 38.5% of the patients studied, and a SAD in 11.3%. The probability of finding a SAD on EUS is not influenced by previous endoscopic or radiologic explorations. [ABSTRACT FROM AUTHOR]

Published
2009
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39. 246 Endoscopic Ultrasound (EUS) -Guided Therapy of Gastric Varices. Results From a Prospective Multicenter Study

Author

Romero-Castro, Rafael, Ortiz-Moyano, Carlos, Subtil, Jose Carlos, Junquera, FéLix, Gornals, Joan B., Vila, Juan J., Repiso, Alejandro, Romero-Vazquez, Javier, Munoz-Navas, Miguel a., Brullet, Enric, Romero-Gomez, Manuel, Marcos-Sanchez, Francisco, Caunedo-Alvarez, Angel, Pellicer-Bautista, Francisco, Herrerias-Gutierrez, Juan Manuel, Ellrichmann, Mark, and Fritscher-Ravens, Annette

Published
2012
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41. Mo1404 Initial Experience With EUS-Guided Cholangiopancreatography (ESCP): A Spanish National Survey

Author

Vila, Juan J., Vazquez-Sequeiros, Enrique, Millan, Antonio Perez, González-Huix, Ferrán, Iglesias-Garcia, Julio, De La Serna, Carlos, Aparicio, Jose R., Subtil, Jose Carlos, Alvarez, Alberto, De La Morena, Felipe, García-Cano, Jesús, Casi, Ma Angeles, Lancho, Angel, Barturen, Angel, Rodríguez-Gómez, Santiago-Jose, Repiso, Alejandro, Juzgado, Diego, Igea, Francisco, Fernandez-Urien, Ignacio, González-Martin, Juan Angel, and Perez-Miranda, Manuel

Published
2011
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45. Therapeutic Endoscopic Ultrasonography.

Author

Artifon, Everson L. A., Giovannini, Marc, Siyu Sun, and Vila, Juan J.

Subjects
ENDOSCOPIC ultrasonography, INTERVENTIONAL radiology, MEDICAL drainage, SOLAR plexus, PALLIATIVE treatment, TREATMENT effectiveness, ENDOVASCULAR surgery
Published
2013
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