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1. Biliary drainage in patients with malignant distal biliary obstruction: results of an Italian consensus conference

Author

Marzioni, Marco, Crinò, Stefano Francesco, Lisotti, Andrea, Fuccio, Lorenzo, Vanella, Giuseppe, Amato, Arnaldo, Bertani, Helga, Binda, Cecilia, Coluccio, Chiara, Forti, Edoardo, Fugazza, Alessandro, Ligresti, Dario, Maida, Marcello, Marchegiani, Giovanni, Mauro, Aurelio, Mirante, Vincenzo Giorgio, Ricci, Claudio, Rizzo, Giacomo Emanuele Maria, Scimeca, Daniela, Spadaccini, Marco, Arvanitakis, Marianna, Anderloni, Andrea, Fabbri, Carlo, Tarantino, Ilaria, and Arcidiacono, Paolo Giorgio

Published
2024
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2. The 1st i-EUS consensus on the management of pancreatic fluid collections – Part 2

Author

Aragona, Giovanni, Arcidiacono, Paolo Giorgio, Arvanitaki, Marianna, Badas, Roberta, Barresi, Luca, Berretti, Debora, Bocus, Paolo, Camellini, Lorenzo, Cintorino, Davide, Cugia, Luigi, Dabizzi, Emanuele, De Angelis, Claudio Giovanni, Blanco, Giovanna Del Vecchio, Matteo, Francesco Maria Di, Mitri, Roberto Di, Ercolani, Giorgio, Falconi, Massimo, Fantin, Alberto, Ligresti, Dario, Macchiarelli, Raffaele, Mangiafico, Santi, Mangiavillano, Benedetto, Manno, Mauro, Maruzzelli, Luigi, Marzioni, Marco, Pedicini, Vittorio, Piras, Enrico, Pollino, Valeria, Sethi, Amrita, Siddiqui, Uzma, Togliani, Thomas, Traina, Mario, Tringali, Alberto, Venezia, Giovanna, Zerbi, Alessandro, Capurso, Gabriele, Coluccio, Chiara, Rizzo, Giacomo Emanuele Maria, Crinò, Stefano Francesco, Cucchetti, Alessandro, Facciorusso, Antonio, Hassan, Cesare, Amato, Arnaldo, Auriemma, Francesco, Bertani, Helga, Binda, Cecilia, Cipolletta, Fabio, Forti, Edoardo, Fugazza, Alessandro, Lisotti, Andrea, Maida, Marcello, Sinagra, Emanuele, Sbrancia, Monica, Spadaccini, Marco, Tacelli, Matteo, Vanella, Giuseppe, Anderloni, Andrea, Fabbri, Carlo, and Tarantino, Ilaria

Published
2024
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3. The i-EUS consensus on the management of pancreatic fluid collections – Part 1

Author

Aragona, Giovanni, Arcidiacono, Paolo Giorgio, Arvanitaki, Marianna, Badas, Roberta, Barresi, Luca, Berretti, Debora, Bocus, Paolo, Camellini, Lorenzo, Cintorino, Davide, Cugia, Luigi, Dabizzi, Emanuele, De Angelis, Claudio Giovanni, Blanco, Giovanna Del Vecchio, Matteo, Francesco Maria Di, Mitri, Roberto Di, Ercolani, Giorgio, Falconi, Massimo, Fantin, Alberto, Ligresti, Dario, Macchiarelli, Raffaele, Mangiafico, Santi, Mangiavillano, Benedetto, Manno, Mauro, Maruzzelli, Luigi, Marzioni, Marco, Pedicini, Vittorio, Piras, Enrico, Pollino, Valeria, Sethi, Amrita, Siddiqui, Uzma, Togliani, Thomas, Traina, Mario, Tringali, Alberto, Venezia, Giovanna, Zerbi, Alessandro, Capurso, Gabriele, Rizzo, Giacomo Emanuele Maria, Coluccio, Chiara, Crinò, Stefano Francesco, Cucchetti, Alessandro, Facciorusso, Antonio, Hassan, Cesare, Amato, Arnaldo, Auriemma, Francesco, Bertani, Helga, Binda, Cecilia, Cipolletta, Fabio, Forti, Edoardo, Fugazza, Alessandro, Lisotti, Andrea, Maida, Marcello, Sinagra, Emanuele, Sbrancia, Monica, Spadaccini, Marco, Tacelli, Matteo, Vanella, Giuseppe, Anderloni, Andrea, Fabbri, Carlo, and Tarantino, Ilaria

Published
2024
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4. SIED-GISCOR recommendations for colonoscopy in screening programs: Part I – Diagnostic

Author

Parodi, Maria Caterina, Antonelli, Giulio, Galloro, Giuseppe, Radaelli, Franco, Manes, Giampiero, Manno, Mauro, Camellini, Lorenzo, Sereni, Giuliana, Caserta, Luigi, Arrigoni, Arrigo, Fasoli, Renato, Sassatelli, Romano, Pigò, Flavia, Iovino, Paola, Scimeca, Daniela, De Luca, Luca, Rizkala, Tommy, Tringali, Alberto, Campari, Cinzia, Capogreco, Antonio, Testoni, Sabrina Gloria Giulia, Bertani, Helga, Fantin, Alberto, Mitri, Roberto Di, Familiari, Pietro, Labardi, Maurizio, De Angelis, Claudio, Anghinoni, Emanuela, Rubeca, Tiziana, Cassoni, Paola, Zorzi, Manuel, Mussetto, Alessandro, Hassan, Cesare, and Senore, Carlo

Published
2024
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7. Digital single-operator cholangioscopy in diagnostic and therapeutic bilio-pancreatic diseases: A prospective, multicenter study

Author

Fugazza, Alessandro, Gabbiadini, Roberto, Tringali, Andrea, De Angelis, Claudio Giovanni, Mosca, Piergiorgio, Maurano, Attilio, Di Mitri, Roberto, Manno, Mauro, Mariani, Alberto, Cereatti, Fabrizio, Bertani, Helga, Sferrazza, Sandro, Donato, Giulio, Tarantino, Ilaria, Cugia, Luigi, Aragona, Giovanni, Cantù, Paolo, Mazzocchi, Alessandro, Canfora, Maria Laura, Venezia, Ludovica, Bendia, Emanuele, Maroni, Luca, Zulli, Claudio, Conte, Elisabetta, Soriani, Paola, Ligresti, Dario, Vilardo, Emmanuelle, Penagini, Roberto, Benedetti, Antonio, Arcidiacono, Paolo Giorgio, Khalaf, Kareem, Troncone, Edoardo, Costamagna, Guido, Repici, Alessandro, and Anderloni, Andrea

Published
2022
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9. Digital Cholangioscopic Interpretation: When North Meets the South

Author

Kahaleh, Michel, Raijman, Isaac, Gaidhane, Monica, Tyberg, Amy, Sethi, Amrita, Slivka, Adam, Adler, Douglas G., Sejpal, Divyesh, Shahid, Haroon, Sarkar, Avik, Martins, Fernanda, Boumitri, Christine, Burton, Samuel, Bertani, Helga, Tarnasky, Paul, Gress, Frank, Gan, Ian, Ardengh, Jose C., Kedia, Prashant, Arnelo, Urban, Jamidar, Priya, Shah, Raj J., and Robles-Medranda, Carlos

Published
2022
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12. ERCP/EUS Room

Author

Conigliaro, Rita, Conti, Claudio, Grande, Giuseppe, Bertani, Helga, Mutignani, Massimiliano, editor, Albert, Jörg G., editor, and Fabbri, Carlo, editor

Published
2020
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13. The 1st i-EUS consensus on the management of pancreatic fluid collections – Part 2.

Author

Capurso, Gabriele, Coluccio, Chiara, Rizzo, Giacomo Emanuele Maria, Crinò, Stefano Francesco, Cucchetti, Alessandro, Facciorusso, Antonio, Hassan, Cesare, Amato, Arnaldo, Auriemma, Francesco, Bertani, Helga, Binda, Cecilia, Cipolletta, Fabio, Forti, Edoardo, Fugazza, Alessandro, Lisotti, Andrea, Maida, Marcello, Sinagra, Emanuele, Sbrancia, Monica, Spadaccini, Marco, and Tacelli, Matteo

Abstract

Pancreatic fluid collections (PFCs), including pancreatic pseudocysts (PPs) and walled-off pancreatic necrosis (WON), are common complications of pancreatitis and pancreatic surgery. Historically, the treatment of these conditions has relied on surgical and radiological approaches. The treatment of patients with PFCs has already focused toward an endoscopy-based approach, and with the development of dedicated lumen-apposing metal stents (LAMS), it has almost totally shifted towards interventional Endoscopic Ultrasound (EUS)-guided procedures. However, there is still limited consensus on several aspects of PFCs treatment within the multidisciplinary management. The interventional endoscopy and ultrasound (i-EUS) group is an Italian network of clinicians and scientists with special interest in biliopancreatic interventional endoscopy, especially interventional EUS. This manuscript focuses on the second part of the results of a consensus conference organized by i-EUS, with the aim of providing evidence-based guidance on several intra- and post-procedural aspects of PFCs drainage, such as clinical management and follow-up. [ABSTRACT FROM AUTHOR]

Published
2024
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14. The i-EUS consensus on the management of pancreatic fluid collections – Part 1.

Author

Capurso, Gabriele, Rizzo, Giacomo Emanuele Maria, Coluccio, Chiara, Crinò, Stefano Francesco, Cucchetti, Alessandro, Facciorusso, Antonio, Hassan, Cesare, Amato, Arnaldo, Auriemma, Francesco, Bertani, Helga, Binda, Cecilia, Cipolletta, Fabio, Forti, Edoardo, Fugazza, Alessandro, Lisotti, Andrea, Maida, Marcello, Sinagra, Emanuele, Sbrancia, Monica, Spadaccini, Marco, and Tacelli, Matteo

Abstract

Pancreatic fluid collections (PFCs), including pancreatic pseudocysts (PPs) and walled-off pancreatic necrosis (WON), are common complications of pancreatitis and pancreatic surgery. Historically, the treatment of these conditions has relied on surgical and radiological approaches; however, it has later shifted toward an endoscopy-based approach. With the development of dedicated lumen-apposing metal stents (LAMS), interventional Endoscopic Ultrasound (EUS)-guided procedures have become the standard approach for PFC drainage. However, there is still limited consensus on several aspects of the multidisciplinary management of PFCs. The interventional endoscopy and ultrasound (i-EUS) group is an Italian network of clinicians and scientists with special interest in biliopancreatic interventional endoscopy, especially interventional EUS. This manuscript describes the first part of the results of a consensus conference organized by i-EUS with the aim of providing evidence-based guidance on aspects such as indications for treating PFCs, the timing of intervention, and different technical strategies for managing patients with PFCs. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Corrigendum: Adherence to European society of gastrointestinal endoscopy quality performance measures for upper and lower gastrointestinal endoscopy: a nationwide survey from the Italian society of digestive endoscopy

Author

Zagari, Rocco Maurizio, primary, Frazzoni, Leonardo, additional, Fuccio, Lorenzo, additional, Bertani, Helga, additional, Crinò, Stefano Francesco, additional, Magarotto, Andrea, additional, Dajti, Elton, additional, Tringali, Andrea, additional, Da Massa Carrara, Paola, additional, Cengia, Gianpaolo, additional, Ciliberto, Enrico, additional, Conigliaro, Rita, additional, Germanà, Bastianello, additional, Lamazza, Antonietta, additional, Pisani, Antonio, additional, Spinzi, Giancarlo, additional, Capelli, Maurizio, additional, Bazzoli, Franco, additional, and Pasquale, Luigi, additional

Published
2024
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18. Use of probe‐based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence

Author

Wang, Kenneth K, Carr-Locke, David L, Singh, Satish K, Neumann, Helmut, Bertani, Helga, Galmiche, Jean-Paul, Arsenescu, Razvan I, Caillol, Fabrice, Chang, Kenneth J, Chaussade, Stanislas, Coron, Emmanuel, Costamagna, Guido, Dlugosz, Aldona, Gan, S Ian, Giovannini, Marc, Gress, Frank G, Haluszka, Oleh, Ho, Khek Y, Kahaleh, Michel, Konda, Vani J, Prat, Frederic, Shah, Raj J, Sharma, Prateek, Slivka, Adam, Wolfsen, Herbert C, and Zfass, Alvin

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Digestive Diseases, Endomicroscopy, gastroenterology, recommendations, Barrett's oesophagus, biliary strictures, colorectal polyps, small polyps, inflammatory bowel diseases, training, credentialling, advanced endoscopy, optical biopsy, Barrett’s oesophagus, Clinical sciences
Abstract

BackgroundProbe-based confocal laser endomicroscopy (pCLE) provides microscopic imaging during an endoscopic procedure. Its introduction as a standard modality in gastroenterology has brought significant progress in management strategies, affecting many aspects of clinical care and requiring standardisation of practice and training.ObjectiveThis study aimed to provide guidance on the standardisation of its practice and training in Barrett's oesophagus, biliary strictures, colorectal lesions and inflammatory bowel diseases.MethodsInitial statements were developed by five group leaders, based on the available clinical evidence. These statements were then voted and edited by the 26 participants, using a modified Delphi approach. After two rounds of votes, statements were validated if the threshold of agreement was higher than 75%.ResultsTwenty-six experts participated and, among a total of 77 statements, 61 were adopted (79%) and 16 were rejected (21%). The adoption of each statement was justified by the grade of evidence.ConclusionpCLE should be used to enhance the diagnostic arsenal in the evaluation of these indications, by providing microscopic information which improves the diagnostic performance of the physician. In order actually to implement this technology in the clinical routine, and to ensure good practice, standardised initial and continuing institutional training programmes should be established.

Published
2015

19. Digital Single-operator Cholangioscopy (DSOC) Improves Interobserver Agreement (IOA) and Accuracy for Evaluation of Indeterminate Biliary Strictures: The Monaco Classification

Author

Sethi, Amrita, Tyberg, Amy, Slivka, Adam, Adler, Douglas G., Desai, Amit P., Sejpal, Divyesh V., Pleskow, Douglas K., Bertani, Helga, Gan, Seng-Ian, Shah, Raj, Arnelo, Urban, Tarnasky, Paul R., Banerjee, Subhas, Itoi, Takao, Moon, Jong Ho, Kim, Dong Choon, Gaidhane, Monica, Raijman, Isaac, Peterson, Bret T., Gress, Frank G., and Kahaleh, Michel

Published
2022
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24. Outcome of both-bare type nitinol metal stents in distal biliary malignant obstruction: A post-market clinical follow-up study

Author

Cocca, Silvia, primary, Mangiafico, Santi, additional, Bertani, Helga, additional, Pignata, Luca, additional, De Gennaro, Nicola, additional, Pigò, Flavia, additional, Grande, Giuseppe, additional, Marocchi, Margherita, additional, Russo, Salvatore, additional, Lupo, Marinella, additional, and Conigliaro, Rita, additional

Published
2023
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25. Repeated endoscopic ultrasound‐guided fine‐needle biopsy of solid pancreatic lesions after previous nondiagnostic or inconclusive sampling.

Author

Lisotti, Andrea, Cominardi, Anna, Conti Bellocchi, Maria Cristina, Crinò, Stefano Francesco, Larghi, Alberto, Facciorusso, Antonio, Arcidiacono, Paolo Giorgio, De Angelis, Claudio, Di Matteo, Francesco Maria, Fabbri, Carlo, Bertani, Helga, Togliani, Thomas, Rizzatti, Gianenrico, Brancaccio, Mario, Grillo, Antonino, Fantin, Alberto, Pezzoli, Alessandro, D'Errico, Francesca, Amato, Arnaldo, and Antonini, Filippo

Subjects
ENDOSCOPIC ultrasonography, SURGICAL pathology, BIOPSY, NEEDLE biopsy, MULTIVARIATE analysis, MEDICAL referrals
Abstract

Objectives: Repeated endoscopic ultrasound (EUS)‐guided tissue acquisition represents the standard practice for solid pancreatic lesions after previous nondiagnostic or inconclusive results. Since data are lacking, we aimed to evaluate the diagnostic performance of repeated EUS fine‐needle biopsy (rEUS‐FNB) in this setting. The primary outcome was diagnostic accuracy; sample adequacy, sensitivity, specificity, and safety were secondary outcomes. Methods: Consecutive patients undergoing rEUS‐FNB for solid pancreatic lesions at 23 Italian centers from 2019 to 2021 were retrieved. Pathology on the surgical specimen, malignant histology together with ≥6‐month follow‐up, and benign pathology together with ≥12‐month follow‐up were adopted as gold standards. Results: Among 462 patients, 56.5% were male, with a median age of 68 (59–75) years, malignancy prevalence 77.0%. Tumor size was 26 (20–35) mm. Second‐generation FNB needles were used in 89.6% cases. Diagnostic accuracy, sensitivity, and specificity of rEUS‐FNB were 89.2%, 91.4%, and 81.7%, respectively (19 false‐negative and 12 false‐positive results). On multivariate analysis, rEUS‐FNB performed at high‐volume centers (odds ratio [OR] 2.12; 95% confidence interval [CI] 1.10–3.17; P = 0.03) and tumor size (OR 1.03; 95% CI 1.00–1.06; P = 0.05) were independently related to diagnostic accuracy. Sample adequacy was 94.2%. Use of second‐generation FNB needles (OR 5.42; 95% CI 2.30–12.77; P < 0.001) and tumor size >23 mm (OR 3.04; 95% CI 1.31–7.06; P = 0.009) were independently related to sample adequacy. Conclusion: Repeated EUS‐FNB allowed optimal diagnostic performance after nondiagnostic or inconclusive results. Patients' referral to high‐volume centers improved diagnostic accuracy. The use of second‐generation FNB needles significantly improved sample adequacy over standard EUS‐FNB needles. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Adherence to European Society of Gastrointestinal Endoscopy Quality Performance Measures for Upper and Lower Gastrointestinal Endoscopy: A Nationwide Survey From the Italian Society of Digestive Endoscopy.

Author

Zagari, Rocco Maurizio, Frazzoni, Leonardo, Fuccio, Lorenzo, Bertani, Helga, Crinò, Stefano Francesco, Magarotto, Andrea, Dajti, Elton, Tringali, Andrea, Carrara, Paola Da Massa, Cengia, Gianpaolo, Ciliberto, Enrico, Conigliaro, Rita, Germanà, Bastianello, Lamazza, Antonietta, Pisani, Antonio, Spinzi, Giancarlo, Capelli, Maurizio, Bazzoli, Franco, and Pasquale, Luigi

Published
2024
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34. Optical coherence tomography (OCT) prior to peroral endoscopic myotomy (POEM) reduces procedural time and bleeding: a multicenter international collaborative study

Author

Desai, Amit P., Tyberg, Amy, Kedia, Prashant, Smith, Michael S., Martinez, Guadalupe, Zamarripa, Felipe, Schneider, Yecheskel, Bertani, Helga, Frazzoni, Marzio, Casas, Fernando, Khanna, Lauren G., Lambroza, Arnon, Kumta, Nikhil A., Khan, Ali, Sharaiha, Reem Z., Salgado, Sanjay, Gaidhane, Monica, Sethi, Amrita, and Kahaleh, Michel

Published
2016
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37. Adherence to European Society of Gastrointestinal Endoscopy Quality Performance Measures for Upper and Lower Gastrointestinal Endoscopy: A Nationwide Survey From the Italian Society of Digestive Endoscopy

Author

Zagari, Rocco Maurizio, Frazzoni, Leonardo, Fuccio, Lorenzo, Bertani, Helga, Crinò, Stefano Francesco, Magarotto, Andrea, Dajti, Elton, Tringali, Andrea, Da Massa Carrara, Paola, Cengia, Gianpaolo, Ciliberto, Enrico, Conigliaro, Rita, Germanà, Bastianello, Lamazza, Antonietta, Pisani, Antonio, Spinzi, Giancarlo, Capelli, Maurizio, Bazzoli, Franco, Pasquale, Luigi, Zagari, Rocco Maurizio, Frazzoni, Leonardo, Fuccio, Lorenzo, Bertani, Helga, Crinò, Stefano Francesco, Magarotto, Andrea, Dajti, Elton, Tringali, Andrea, Da Massa Carrara, Paola, Cengia, Gianpaolo, Ciliberto, Enrico, Conigliaro, Rita, Germanà, Bastianello, Lamazza, Antonietta, Pisani, Antonio, Spinzi, Giancarlo, Capelli, Maurizio, Bazzoli, Franco, and Pasquale, Luigi

Subjects
quality, Settore MED/18 - CHIRURGIA GENERALE, ESGE, guidelines, General Medicine, endoscopy, guideline, performance measure
Abstract

BackgroundThe quality of gastrointestinal (GI) endoscopy has been recently identified as a major priority being associated with many outcomes and patient's experience.ObjectiveTo assess adherence of endoscopists to the European Society of Gastrointestinal Endoscopy (ESGE) quality performance measures for upper and lower GI endoscopy in Italy.MethodsAll endoscopist members of the Italian Society of Digestive Endoscopy (SIED) were invited from October 2018 to December 2018 to participate to a self-administered questionnaire-based survey. The questionnaire included questions on demographics and professional characteristics, and the recent ESGE quality performance measures for upper and lower GI endoscopy.ResultsA total of 392 endoscopists participated in the study. Only a minority (18.2%) of participants recorded the duration of esophagogastroduodenoscopy (EGD) and 51% provided accurate photo documentation in the minimum standard of 90% of cases. Almost all endoscopists correctly used Prague and Los Angeles classifications (87.8% and 98.2%, respectively), as well as Seattle and Management of precancerous conditions and lesions in the stomach (MAPS) biopsy protocols (86.5% and 91.4%, respectively). However, only 52.8% of participants monitored complications after therapeutic EGD, and 40.8% recorded patients with a diagnosis of Barrett's esophagus (BE). With regard to colonoscopy, almost all endoscopists (93.9%) used the Boston Bowel Preparation Scale for measuring bowel preparation quality and reported a cecal intubation rate ≥90%. However, about a quarter (26.2%) of participants reported an adenoma detection rate of ConclusionThe adherence of endoscopists to ESGE performance measures for GI endoscopy is sub-optimal in Italy. There is a need to disseminate and implement performance measures and endorse educational and scientific interventions on the quality of endoscopy.

Published
2022

39. Peroral endoscopic myotomy as salvation technique post‐Heller: International experience

Author

Tyberg, Amy, Sharaiha, Reem Z., Familiari, Pietro, Costamagna, Guido, Casas, Fernando, Kumta, Nikhil A., Barret, Maximilien, Desai, Amit P., Schnoll‐Sussman, Felice, Saxena, Payal, Martínez, Guadalupe, Zamarripa, Felipe, Gaidhane, Monica, Bertani, Helga, Draganov, Peter V., Balassone, Valerio, Sharata, Ahmed, Reavis, Kevin, Swanstrom, Lee, Invernizzi, Martina, Seewald, Stefan, Minami, Hitomi, Inoue, Haruhiro, and Kahaleh, Michel

Published
2018
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42. DIGITAL SINGLE-OPERATOR CHOLANGIOSCOPY IN DIAGNOSTIC AND THERAPEUTIC BILIO-PANCREATIC DISEASES: A PROSPECTIVE, MULTICENTER STUDY

Author

Fugazza, Alessandro, primary, Gabbiadini, Roberto, additional, Tringali, Andrea, additional, De Angelis, Claudio, additional, Mosca, Piergiorgio, additional, Maurano, Attilio, additional, Di Mitri, Roberto, additional, Manno, Mauro, additional, Mariani, Alberto, additional, Cereatti, Fabrizio, additional, Bertani, Helga, additional, Sferrazza, Sandro, additional, Donato, Giulio, additional, Tarantino, Ilaria, additional, Cugia, Luigi, additional, Aragona, Giovanni, additional, Cantù, Paolo, additional, Mazzocchi, Alessandro, additional, Canfora, Maria Laura, additional, Venezia, Ludovica, additional, Bendia, Emanuele, additional, Maroni, Luca, additional, Zulli, Claudio, additional, Conte, Elisabetta, additional, Soriani, Paola, additional, Ligresti, Dario, additional, Vilardo, Emanuelle, additional, Penagini, Roberto, additional, Benedetti, Antonio, additional, Arcidiacono, Paolo G., additional, Khalaf, Kareem, additional, Troncone, Edoardo, additional, Costamagna, Guido, additional, Repici, Alessandro, additional, and Anderloni, Andrea A., additional

Published
2022
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43. Migration rate using Fully-covered metal stent in anastomotic strictures after liver transplantation: Results from the BASALT Study Group

Author

Conigliaro, Rita, Pigò, Flavia, Bertani, Helga, Greco, Salvatore, Burti, Cesare, Indriolo, Amedeo, Di Sario, Antonio, Ortolani, Alessio, Maroni, Luca, Tringali, Andrea, Barbaro, Federico, Costamagna, Guido, Magarotto, Andrea, Masci, Enzo, Mutignani, Massimiliano, Forti, Edoardo, Tringali, Alberto, Parodi, Maria Caterina, Assandri, Lorenzo, Marrone, Ciro, Fantin, Alberto, Penagini, Roberto, Cantù, Paolo, Di Benedetto, Fabrizio, Ravelli, Paolo, Vivarelli, Marco, Agnes, Salvatore, Mazzaferro, Vincenzo, De Carlis, Luciano, Andorno, Enzo, Cillo, Umberto, Rossi, Giorgio, Tringali, Andrea (ORCID:0000-0002-9614-3449), Costamagna, Guido (ORCID:0000-0002-8100-2731), Agnes, Salvatore (ORCID:0000-0002-3341-4221), Conigliaro, Rita, Pigò, Flavia, Bertani, Helga, Greco, Salvatore, Burti, Cesare, Indriolo, Amedeo, Di Sario, Antonio, Ortolani, Alessio, Maroni, Luca, Tringali, Andrea, Barbaro, Federico, Costamagna, Guido, Magarotto, Andrea, Masci, Enzo, Mutignani, Massimiliano, Forti, Edoardo, Tringali, Alberto, Parodi, Maria Caterina, Assandri, Lorenzo, Marrone, Ciro, Fantin, Alberto, Penagini, Roberto, Cantù, Paolo, Di Benedetto, Fabrizio, Ravelli, Paolo, Vivarelli, Marco, Agnes, Salvatore, Mazzaferro, Vincenzo, De Carlis, Luciano, Andorno, Enzo, Cillo, Umberto, Rossi, Giorgio, Tringali, Andrea (ORCID:0000-0002-9614-3449), Costamagna, Guido (ORCID:0000-0002-8100-2731), and Agnes, Salvatore (ORCID:0000-0002-3341-4221)

Abstract

Background and study aim: The traditional endoscopic therapy of anastomotic strictures (AS) after orthotopic liver transplantation (OLT) is multiple ERCPs with insertion of an increasing number of plastic stents side-by-side. Fully covered self-expanding metal stents (cSEMS) could be a valuable option to decrease the number of procedures needed or non-responders to plastic stents. This study aims to retrospectively analyze the results of AS endoscopic treatment by cSEMS and to identify any factors associated to its success. Patients and Methods Ninety-one patients (mean age 55.9 ± 7.6 DS; 73 males) from 9 Italian transplantation centers, had a cSEMS positioned for post-OLT AS between 2007 and 2017. 49 (54%) patients were treated with cSEMS as a second-line treatment. Results All the procedures were successfully performed without with no immediate complications. After ERCP, adverse events occurred in 11% of cases (2 moderate pancreatitis, 8 cholangitis). In 49 patients (54%) cSEMSs migrated. After cSEMS removal, 46 patients (51%) needed further endoscopic (45 patients) or radiologic (1 patient) treatments to solve the AS. Lastly, 7 patients underwent surgery. Multivariable stepwise logistic regression showed that cSEMS migration was the only factor associated with further treatments (OR 2.6, 95% CI 1.0-6.6; p-value 0.03); cSEMS implantation before 12 months from OLT was associated with stent migration (OR 5.2, 95% CI 1.7-16.0; p-value 0.004). Conclusions cSEMS appears to be a safe tool to treat AS. cSEMS migration is the main limitation to its routinary implantation and needs to be prevented, probably with the use of new generation anti-migration stents.

Published
2022

45. Management of biliary anastomotic strictures after liver transplantation (BASALT study): A nationwide Italian survey

Author

Cantù, Paolo, Parzanese, Ilaria, Balassone, Valerio, Di Sario, Antonio, Soggiu, Fiammetta, Lombardi, Giovanni, Barbaro, Federico, Pisani, Antonio, Baldan, Anna, Cariani, Giulio, Boarino, Valentina, Fasoli, Alberto, Bertani, Helga, Forti, Edoardo, Bulajic, Milutin, Ghinolfi, Davide, Nadal, Elena, Cerofolini, Angelo, Barresi, Luca, Catalano, Giorgia, Stroppa, Italo, Traini, Sara, Mazzaferro, Vincenzo, Cipolletta, Livio, Tringali, Andrea, Costamagna, Guido, Ravelli, Paolo, Bazzoli, Franco, Merighi, Alberto, Parodi, Maria Caterina, Conigliaro, Rita, Mutignani, Massimiliano, Zilli, Maurizio, Filipponi, Franco, Fantin, Alberto, Rodella, Luca, Tarantino, Ilaria, Traina, Mario, Salizzoni, Mauro, Rosa, Roberto, Malinverno, Federica, Invernizzi, Federica, Angelo Manini, Matteo, Donato, Maria Francesca, Colombo, Massimo, Conte, Dario, Rossi, Giorgio, and Penagini, Roberto

Published
2017
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