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1. EUS-guided sampling with 25G biopsy needle as a rescue strategy for diagnosis of small subepithelial lesions of the upper gastrointestinal tract

Author

Filippo Antonini, Sara Giorgini, Lorenzo Fuccio, Lucia Angelelli, and Giampiero Macarri

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background and study aims This study was designed to evaluate the impact of additional tissue obtained with endoscopic ultrasound (EUS)-guided 25-gauge core biopsy needle (25G-PC) following an unsuccessful fine-needle biopsy (FNB) performed with larger-bore needles for the characterization of gastrointestinal subepithelial lesions (GI-SELs). Patients and methods We prospectively collected and retrospectively analyzed information in our database from January 2013 to June 2017 for all patients with GI-SELs who received a EUS-guided FNB (EUS-FNB) with 25G-PC during the same procedure after failure of biopsy performed with larger-bore needle. Diagnostic yield, diagnostic accuracy and procedural complications were evaluated. Results Sixteen patients were included in this study, 10 men and 6 women, median age 67.8 (range 43 to 76 years). Five patients were found to have a SEL localized in the distal duodenum, five in the gastric antrum, two in the gastric fundus and four in the gastric body. The mean size of the lesions was 20.5 mm (range 18 – 24 mm). EUS-FNB with 25G-PC enabled final diagnosis in nine patients (56.2 %). Regarding the subgroup of duodenal lesions, the procedure was successful in four of five (80 %). Final diagnoses with EUS-guided sampling were GIST (n = 6), leiomyoma (n = 2) and metastatic ovarian carcinoma (n = 1). No procedure-related complications were recorded. Conclusion In patients with small GI-SELs, additional tissue obtained with 25G-PC could represents a “rescue” strategy after an unsuccessful procedure with larger-bore needles, especially when lesions are localized in the distal duodenum.

Published
2018
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3. I-CARE, a European Prospective Cohort Study Assessing Safety and Effectiveness of Biologics in Inflammatory Bowel Disease

Author

Laurent Peyrin-Biroulet, Jean-François Rahier, Julien Kirchgesner, Vered Abitbol, Sebastian Shaji, Alessandro Armuzzi, Konstantinos Karmiris, Javier P. Gisbert, Peter Bossuyt, Ulf Helwig, Johan Burisch, Henit Yanai, Glen A. Doherty, Fernando Magro, Tamás Molnar, Mark Löwenberg, Jonas Halfvarson, Edyta Zagorowicz, Hélène Rousseau, Cédric Baumann, Filip Baert, Laurent Beaugerie, Jean-Marc Gornet, Jean-Marie Reimund, Xavier Hebuterne, Aurélien Amiot, Franco Armelao, Pierre Blanc, Claudio Papi, Guillaume Pineton De Chambrun, Xavier Roblin, null Chu, Sohail Shariq, Nikolaos Viazis, Jimmy Limdi, Piotr Eder H, Georgios Michalopoulos, Andrew Bell, Livia Biancone, Marie Dewitte, Zia Mazhar, Denis Franchimont, Stephane Nancey, Gilles Macaigne, Maria Beatrice Principi, Mathurin Fumery, Gareth Parkes, Jean-Christophe Valats, Glen Doherty, Guillaume Bouguen, Hersin Tsai, Mohsin Gangi, Natalia Pedersen, Frédéric Heluwaert, Richard Shenderey, Sebastian Zeissig, Jeffrey Butterworth, Fabiana Castiglione, Lynsey Corless, Camille Zallot, Salil Singh, Sunil Sonwalkar, Elizabeth Clayton, Deven Vani, Guy Bellaiche, Martine De Vos, Uri Kopylov, Triana Lobaton, Christophe Locher, Gerassimos Mantzaris, George Abouda, Katie Smith, Michael Sprakes, Angeliki Theodoropoulou, Emma Wesley, Joëlle Bonnet, David Elphick, Cyrielle Gilletta, John Gordon, David Laharie, Antoine Nakad, Ambrogio Orlando, Patrick Dubois, Peter Hasselblatt, Christophe Michiels, Cathryn Preston, Anca Staicu, Lucine Vuitton, Mehdi Kaassis, Ally Speight, Deb Ghosh, Nicolas Mathieu, Anne-Laure Pelletier, Anne Phillips, Romain Altwegg, Irit Avni, null biron, Jonathon Landy, Maria Nachury, Achuth Shenoy, Caroline Trang, Georgios Bamias, Klaudia Farkas, Christian Maaser, Ariella Shitrit, Britta Siegmund, Jérôme Filippi, Colm O'morain, Laurent Costes, David Hobday, Zoltán Szepes, Emma Calabrese, Helen Dallal, Michael Fung, Arvind Ramadas, Bijay Baburajan, Konrad Koss, Christophe Barberis, Anthony Buisson, Morgane Amil, Paola Balestrieri, Matthew Johnson, Maria Tzouvala, Stéphanie Viennot, Ferenc Nagy, Nick Thompson, Laurent Alric, Sunil Samuel, Anne Bourrier, Elise Chanteloup, Emilie Del Tedesco, Marcus Harbord, Alan Lobo, Sally Myers, Richard Pollok, Tariq Ahmad, Rakesh Chaudhary, Christos Karakoidas, Ashraf Soliman, Carmen Stefanescu, Georgios Theocharis, Stijn Vanden Branden, Belén Beltran, Yoram Bouhnik, Arnaud Bourreille, Joana Branco, Ben Colleypriest, Rami Eliakim, Paul Knight, Aoibhlinn O'toole, Virgina Robles, Konstantinos Triantafyllou, Marta Maia Bosca, Guy Lambrecht, Lucia Marquez Mosquera, Simon Panter, Aikaterini Pappa, Marion Simon, Ganesh Sivaji, Christophe Bellanger, Arthur Belle, Natalia Borruel, Laurence Egan, Harald Peeters, Daniel Sharpstone, Ramesh Arasaradnam, José Manuel Benitez, Jens Frederik Dahlerup, Olga Giouleme, Miguel Minguez, Eftychia Tsironi, Angela Variola, Patrick Allen, Lucille Boivineau, Andy Cole, Nina Dib, Fernando Gomollon, Richard Johnston, Konstantinos Katsanos, Nick Kennedy, Marianne Kiszka-Kanowitz, Ignacio Marin-Jimenez, Pál Miheller, Pilar Nos, Othman Saraj, Lars Vinter-Jensen, Eran Zittan, Clotilde Baudry, Xavier Calvet, Marie-Christine Cazelles-Boudier, Jean-Louis Coenegrachts, Garret Cullen, Marco Daperno, Anjan Dhar, Romain Gerard, Nanna Jensen, Nitsan Maharshak, Mark Mcalindon, Simon Mcloughlin, Miles Parkes, Kamal Patel, Armando Peixoto, Dimitrios Polymeros, Francisco Portela, Rodolfo Rocca, Philippe Seksik, Sreedhar Subramanian, Ruth Tennenbaum, Raja Atreya, Oliver Bachmann, Arthur Berger, Renáta Bor, Maire Buckley, Daniel Carpio, María Chaparro, Francesco Costa, Eugeni Domenech, Maria Esteve, Stephen Foley, Jordi Guardiola, Ioannis Koutroubakis, Tanja Kuehbacher, Cécilia Landman, Alessandro Lavagna, Noemí Manceñido, Míriam Mañosa, Maria Dolores Martín-Arranz, Laurianne Plastaras, Maria Lia Scribano, Subhasish Sengupta, Nils Teich, My-Linh Tran-Minh, Evanthia Zampeli, Leila Amininejad, Teresa Arroyo, Alain Attar, Ann-Sofie Backman, Anita Bálint, John Beckly, Shomron Ben Horin, Sónia Bernardo, Ludovic Caillo, Bénédicte Caron, María Shanika de Silva, Anna FábiáN, Gionata Fiorino, Ana Gutierrez, Adi Lahat, Mohamed Masmoudi, Marco Mendolaro, Vinciane Muls, Florian Poullenot, Christopher Probert, Catherine Reenaers, Mariann Rutka, Zaman Sarwari, Joanne Sayer, Beatriz Sicilia, Helena Sousa, Catherine van Kemseke, Yamile Zabana, Marco Astegiano, Paul Banim, Dominik Bettenworth, Médina Boualit, Jacob Broder Brodersen, Angeliki Christidou, Rachel Cooney, João Cortez Pinto, Portugal Marília Cravo, Anneline Cremer, Silvio Danese, Antonio di Sabatino, Jan Fallingborg, Antonio Ferronato, Esther Garcia Planella, Sanjay Gupta, Eran Israeli, Samantha Kestenbaum, Lone Larsen, Elisabeth Macken, Nicoletta Mathou, Ágnes Milassin, Joanna Pofelski, Chiara Ricci, Francisco Rodriguez-Moranta, Martin Schmidt-Lauber, Ian Shaw, Marta Soares, Heithem Soliman, Christos Triantos, Konstantinos Zografos, Anurag Agrawal, Alexandre Aubourg, Manuel Barreiro-de Acosta, Jesús Barrio, Daniel Bergemalm, Fernando Bermejo, Giorgia Bodini, Johan Bohr, Dimitrios Christodoulou, Christophe Claessens, Paul Collins, Ruth de Francisco, Santiago Garcia, Sotirios Georgopoulos, Felix Goutorbe, Chrisostomos Kalantzis, Anastasia Kourikou, Vincent Mace, Georgia Malamut, Paula Ministro, Isabelle Nion Larmurier, Elena Ricart, Mélanie Serrero, Juliette Sheridan, Petra Weimers, Vibeke Andersen, Bruno Arroja, Bernd Bokemeyer, Luis Bujanda, Thibault Degand, Carl Eriksson, Cécile Garceau, Henning Glerup, Idan Goren, Lucina Jackson, Stéphane Koch, Francisco Mesonero, Ingrid Ordas, Pauline Riviere, Simone Saibeni, João Soares, Noémie Tavernier, Klaus Theede, Bella Ungar, Elke Bästlein, Antonio Gasbarrini, Andreas Protopapas, Wolfgang Reindl, Fabrizio Bossa, Ailsa Hart, Franz-Josef Heil, Anthony O'Connor, Bas Oldenburg, Luca Pastorelli, null Stephen patchett, Subramaniam Ramakrishnan, John de Caestecker, Ana Echarri, David Kevans, Jürgen Büning, Rosa Coelho, Jeroen Jansen, Benjamin Koslowski, Christopher Wells, Daniel Ceballos, Ingrid König, Hari Padmanabhan, Timi Patani, Raheel Qureshi, Matthieu Allez, Emmanouil Archavlis, Delphine Bonnet, Luisa Guidi, Deirdre Mcnamara, Piero Vernia, Michael Weidenhiller, Lang Alon, Trine Boysen, Charlotte Delattre, Richard Farrell, Rolf-Achim Krüger, Thierry Paupard, Ida Vind, Flavio Caprioli, Vladimir Gancho, Vincent Quentin, Benjamin Avidan, Geert D’Haens, Jane Mccarthy, Jonathon Snook, Konstantinos Soufleris, Frank Zerbib, Dan Carter, Annekatrien Depla, Thomas Eisenbach, Walter Fries, Nikolaos Grammatikos, Saskia Ilegems, Antonio Lopez-Sanroman, Jacques Moreau, Gabriele Riegler, Svend Rietdijk, Marta Rocha, Isabelle Rosa, Barbara Ryan, Yelena Yeremenko, Arnaud Boruchowicz, Filipe Damião, Foteini Laoudi, Andreas Lügering, Giampiero Macarri, Konstantinos Thomopoulos, Luísa Barros, Thomas Blixt, Aurélien Garros, Sam Khorrami, Harry Sokol, Andreas Sturm, Dan Livovsky, Jochen Maul, Heinrich Miks, Vasileios Papadopoulos, Carsten Schmidt, Yifat Snir, Lise Svenningsen, Wafaa Ahmed, Yelena Broitman, Emmanuel Cuillerier, Prashant Kant, Jan Leyden, Lev Lichtenstein, Susana Lopes, Chloé Martineau, Hugh Mulcahy, Axel Schweitzer, Fiona Van Schaik, Hagar Banai, Pauline Danion, Charlotte Dulery, Herma Fidder, Claire Gay, Hervé Hagege, Florence Harnois, Søren Peter Jørgensen, Jens Müller-Ziehm, Michail Oikonomou, Carolina Palmela, Jörg Schulze/Röske, Mark Smith, Tamar Thurm, Francesca Bresso, Hedia Brixi, John Jones, Padraig Macmathuna, Claire Painchart, Yulia Ron, Marianne Vester-Andersen, Gonçalo Alexandrino, Norbert Börner, Mariana Cardoso, Cristina Chagas, Axel Dignaß, Iris Dotan, Charlotte Hedin, Pantelis Karatzas, Panagiotis Kasapidis, Károly Palatka, Georgios Sakizlis, Ana Wilson, Nick Bosanko, Paulo Caldeira, Charlotte Gagniere, Louise Libier, Camille Meunier, Gero Moog, Audrey Pasquion, Roberta Pica, Ayesha Akbar, Nadia Arab, Guillaume Cadiot, João Carvalho, Claire Charpignon, Laus Fellermann, Sigal Fishman, Gerald Fraser, Nathan Gluck, Mark Hoesl, Jarosław Kierkus, Maria Klopocka, Eduardo Martin Arranz, Luis Menchen, Susanna Nikolaus, Anca Petrache, Cyriel Ponsioen, Sabino Riestra, Pilar Robledo, Cristina Rodriguez, Misheal Samer, Matthias Tischer, Joanna Wypych, Julien Baudon, Cristina Bezzio, Gilles Boschetti, Tom Creed, Maria Giulia Demarzo, Stefano Festa, Andrés Figueroa, Mette Julsgaard, Pablo Navarro, Pablo Perez-Galindo, Cléa Rouillon, Emanuele Sablich, Joan Tosca, Mathias Vidon, Marine Vidon, René-Louis Vitte, Anne Wampach, Isabelle Clerc Urmes, Marc Borie, Mathieu Uzzan, Kelly Chatten, Rimmer Peter, Iqbal Tariq, Marta Cossignani, Fiorella Cañete, Tom Holvoet, Susanne Krasz, Sandra Dias, Hadas Abalia, Aziza Abaza, Gal Abramovich, Ingrid Ackzell, Carol Adams, Catherine Addleton, Erika Alfambra, Alicia Algaba, Clare Allcock, Joanna Allison, Karine Amouriaux, Julie Anderson, Emma Anderson, Saskia Appelmans, Lisa Armstrong, Stacey Atkins, Masoumeh Attaran-Bandarabadi, Yvonne Bailey, Stephanie Bardot, Natasha Beck, Lillie Bennett, Jonathan Phil Bergfeld, Ramdane Berkane, Hanne Boey, Louise Bowlas, Joanne Bradley-Potts, Tracy Brear, Nicole Bretlander-Peters, Ellen Brown, Johanna Brown, Elizabeth Buckingham, Katrien Buellens, Rhian Bull, Maura Burke, Leighanne Burns, Julie Burton, Agness Bwalya, Karine Cabanas, Muriel Callaghan, Océane Camou, Debbie Campbell, Elvira Capoferro, Mandy Carnahan, Cornelia Carnio, Anne Carter, Concetta Casali Clack, Leïla Chedouba, Bessie Cipriano, Sophie Claeys, Manon Closset, Dilek Coban, Sara Cococcia, Carolann Coe, Helen Cole, Emilie Collet, Kayleigh Collins, Isabelle Combes, Emma Connor, Kathryn Constantin, Susan Cooke, Nathanaëlle Cornet, Estelle Corrihons, Pilar Corsino, Rosie Cortaville, Donna Cotterill, Amanda Cowton, Harriet Cox, Viktoria Cripps, Amanda Crowder, Tzufit Cukier, Amelia Daniel, Chris Dawe, Jose de Haan, Rosanna de la Croix, Evva Dejonckheere, Juan Delare Villanegro, Guillaume Delaval, Mariangela Delliponti, Aude Delommez, Emilie Detry, Melanie Dhanaratne, Laura Diez Galan, Marie Dodel, Emma Dooks, Joseph Du Cheyron, Linda Duane, Jennifer Dulling Vulgo Cochran, Simona Dyer, Harvey Dymond, Charlotte Ekblad, Kerry Elliott, Ingrid Emmerson, Irène Eugene-Jolchine, Lorna Fleming, Eve Fletcher, Sarah Ford, Greg Forshaw, Angela Foulds, Caroline Francois, Nicole Fuge, Gal Gafni, Miri Ganon, Olga Garcia Nuñez, Laura Garcia Ramirez, Sophie Gelder, Raimonda Gettkowski, Daniela Gilardi, Paolo Giuffrida, Vincent Gobert, Jo Godden, Nuala Godwin, Kay Goulden, Sharon Graham, Charlotte Green, Marie Green, Aboubakar Gueye, Tuba Guler, Ida Gustavsson, Helena Hadjisavvas, Fiona Hammonds, Christina Hantzi, Marion Hauke, Julie Haydock, Orla Hayes, Lizette Helbo Nislev, Jessica Hochstodter, Ashleigh Hogg, Manuela Hölbing, Maureen Holland, Maartje Holsbergen, Linda Howard, Aviya Hoyda, Robert Hull, Jane Irish, Wendy Jackson, Wendy Janssen, Lesley Jeffrey, Sofia Jourdan, Izabela Jutrowska, Chava Kaniel, Theofilos Karezos, Niamh Kelly, Jessica Kelly, Mary Kennedy, Una Kennedy, Joyce Kibaru, Gemma Kirkman, Janine Klaproth, Corinna Kneese, Andrea Koch, Kathleen Kokke, Martha Koppelow, Sabine Krause, Sabine Krauspe, Petra Kwakkenbos, Nunzia Labarile, Hannah Lang, Marianne Lassailly, Martine Leconte, Linda Lepczynski, Emma Levell, Nina Levhar, Kerstin Lindhort, Jessica Lisle, Beatriz Lopez Cauce, Gabriele Lorenz, Ambra Lovati, Tracey Lowry, Margareta Lund, Anne Lutz Vorderbrügge, Suzanne Maansson, Videsheka Madapathage, Maelys Cheviakoff, Alison Magness, Orla Manley, Catherine Manyoni, Ingke Marg, Antonella Marra, Carole Martins, Arianna Massella, Aurore Mathias, Danielle Mervyn, Charlotte Minsart, Sally Mitchell, Kathleen Monks, Mélanie Montero, Alson Moore, Maren Moser, Alison Moss, Angela Mullen, M. Francisca Murciano, Deanna Naylor, Ansgar Nehus, Anne Nicholson, Sarah Nöding, Sinead Nolan, Janet Nörenberg, Clare Northcott, Jim O'Connell, Alison O’Kelly, Noam Orbach-Zingboim, Judit Orobitg, Charlene Otieno, Charlotte Owen, Sarah Patch, Maor Pauker, Renate Pauli, Harriet Pearson, Falgon Peggy, Séverine Petit, Christine Petrissans, Simona Piergallini, Lucy Pippard, Laura Pitt, Gabriella Pócsik, Yoann Poher, Chloé Pomes, Lucy Pritchard, Laura Puchades, Sheena Quaid, Aleem Rana, Dana Raynard, Mykla Reilly, Sonja Reinert, Manuela Reinknecht, Baerbel Renner, Rob Reynolds, Giulia Rizzuto, Matthew Robinson, Joke Robrechts, Eva M. Rodriguez, Efrat Rosenblum, Tamlyn Russel, Ibiyemi Sadare, Noa Salama, Toos Schakel, Anja Schauer, Elisa Schiavoni, Caroline Shaw, Sarah Shelton, Virginie Sicart, Elodie Siouville, Orla Smith, Théo Soude, Sophie Stephenson, Elaine Stephenson, Marjan Steppe, An Sterkx, Jo Stickley, Kathleen Sugrue, Natalia Swietec, Charlotte Tasiaux, Bhavneet Thamu, Susane Thomas, Ogwa Tobi, Kahina Touabi, Shifra Tovi, Julie Tregonning, Laura Turchini, Julia Unkhoff, Olesya Unruh, Nurcan Uzun, Frauke Van Aert, Sandrine Vanden Bergh, Louise Vandenbroucke, Laura Vansteenkiste, Shay Vardit, Valentin Vergriete, Elaine Walker, Eleanor Warner, Olivia Watchorn, Ekaterina Watson, Marie-Claire Wauthier, Belgium Maria Weetman, Margaret Weston, Wiebke West-Petroschka, Susann Wienecke, Kerstin Wierling, Miriam Wiestler, Rebecca Wilcox, Elva Wilhelmsen, Angharad Williams, Georgina Williamson, Deborah Wilson, Kate Wistance, Nicolas Wortmann, Subie Wurie, Karin Yadgar, Gail Young, Megan Young, Julien Aucouturier, Marie- Jo Bertin, Hasnae Bougrine, Marie Coisnon, Antoine Defrance, Kati Gutierrez, Amel Harouz, Laure Jerber, Aida Khlifi, Amina Kirati, Nasaladjine Liworo, Maude Logoltat, Charlotte Mailhat, Chancely M'Bayi, Yasmina Medane, Dalal Merkhoufa, Saouda Mohamed Elhad, Bertille Monthe, Fanny Moyon, Pascaline Rabiega, Jennifer Sekela, Charlotte Thilloy, Naima Hamamouche, Frederic Partisotti, Patrick Blandin, Hocine Mokhtari, Laure Coutard, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de gastro-entérologie, Gastroenterology and hepatology, Gastroenterology and Hepatology, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Biological Products, Hepatology, Efficacy, Lymphoma, Tumor Necrosis Factor-alpha, Inflammatory Bowel Disease, Gastroenterology, Biologics, Crohn Disease/diagnosis, Inflammatory Bowel Diseases/chemically induced, Colitis, Ulcerative/diagnosis, Cohort Studies, Necrosis, Immunologic Factors/adverse effects, Humans, Female, 03.02. Klinikai orvostan, Prospective Studies, Safety, I-CARE, Cancer, Immunosuppressive Agents
Abstract

BACKGROUND AND AIMS: There is a need to evaluate the benefit-risk ratio of current therapies in inflammatory bowel disease (IBD) patients to provide the best quality of care. The primary objective of I-CARE (IBD Cancer and serious infections in Europe) was to assess prospectively safety concerns in IBD, with specific focus on the risk of cancer/lymphoma and serious infections in patients treated with anti-tumor necrosis factor and other biologic monotherapy as well as in combination with immunomodulators.METHODS: I-CARE was designed as a European prospective longitudinal observational multicenter cohort study to include patients with a diagnosis of Crohn's disease, ulcerative colitis, or IBD unclassified established at least 3 months prior to enrollment.RESULTS: A total of 10,206 patients were enrolled between March 2016 and April 2019, including 6169 (60.4%) patients with Crohn's disease, 3853 (37.8%) with ulcerative colitis, and 184 (1.8%) with a diagnosis of IBD unclassified. Thirty-two percent of patients were receiving azathioprine/thiopurines, 4.6% 6-mercaptopurine, and 3.2% methotrexate at study entry. At inclusion, 47.3% of patients were treated with an anti-tumor necrosis factor agent, 8.8% with vedolizumab, and 3.4% with ustekinumab. Roughly one-quarter of patients (26.8%) underwent prior IBD-related surgery. Sixty-six percent of patients had been previously treated with systemic steroids. Three percent of patients had a medical history of cancer prior to inclusion and 1.1% had a history of colonic, esophageal, or uterine cervix high-grade dysplasia.CONCLUSIONS: I-CARE is an ongoing investigator-initiated observational European prospective cohort study that will provide unique information on the long-term benefits and risks of biological therapies in IBD patients. (EudraCT, Number: 2014-004728-23; ClinicalTrials.gov, Number: NCT02377258).

Published
2022

4. EUS-guided tissue acquisition in chronic pancreatitis: Differential diagnosis between pancreatic cancer and pseudotumoral masses using EUS-FNA or core biopsy

Author

Giampiero Macarri, Filippo Antonini, Gianpiero Manes, Fabrizio Cereatti, Maurizio Vecchi, Germana de Nucci, Giulia Tanzi, Nicola Imperatore, Mario Martinotti, Massimiliano Mutignani, Edoardo Forti, R. Grassia, Pietro Capone, and Federico Buffoli

Subjects
medicine.medical_specialty, pancreatic cancer, Malignancy, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Pancreatic cancer, Biopsy, medicine, Radiology, Nuclear Medicine and imaging, EUS, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, medicine.disease, digestive system diseases, Tissue acquisition, FNA, 030220 oncology & carcinogenesis, fine-needle biopsy, Pancreatitis, 030211 gastroenterology & hepatology, Original Article, Radiology, Differential diagnosis, business, Core biopsy
Abstract

Background and Objective: EUS-FNA sensitivity for malignancy in parenchymal masses of patients with concurrent chronic pancreatitis (CP) has been reported to be unsatisfactory. The aim of the present study was to directly compare the diagnostic accuracy of EUS-FNA and EUS-fine-needle biopsy (FNB) in differentiating between inflammatory masses and malignancies in the setting of CP. Methods: We performed a retrospective analysis of prospective, multicentric databases of all patients with pancreatic masses and clinico-radiological-endosonographic features of CP who underwent EUS-FNA or FNB. Results: Among 1124 patients with CP, 210 patients (60% males, mean age: 62.7 years) with CP and pancreatic masses met the inclusion criteria and were enrolled. In the FNA group (110 patients), a correct diagnosis was obtained in all but 18 cases (diagnostic accuracy 83.6%, sensitivity 69.5%, specificity 100%, positive predictive value [PPV] 100%, and negative predictive value [NPV] 73.9%); by contrast, among 100 patients undergoing FNB, a correct diagnosis was obtained in all but seven cases (diagnostic accuracy 93%, sensitivity 86.8%, specificity 100%, PPV 100%, and NPV 87%) (P = 0.03, 0.03, 1, 1, and 0.07, respectively). At binary logistic regression, focal pancreatitis (odds of event occurrence [OR]: 4.9; P < 0.001), higher Ca19-9 (OR: 2.3; P = 0.02), and FNB (OR: 2.5; P < 0.01) were the only independent factors associated with a correct diagnosis. Conclusion: EUS-FNB is effective in the differential diagnosis between pseudotumoral masses and solid neoplasms in CP, showing higher diagnostic accuracy and sensitivity than EUS-FNA. EUS-FNB should be considered the preferred diagnostic technique for diagnosing cancer in the setting of CP.

Published
2020

5. Stylet slow-pull vs. standard suction technique for endoscopic ultrasound-guided fine needle biopsy in pancreatic solid lesions using 20 Gauge Procore™ needle: A multicenter randomized trial

Author

Daniela Scimeca, Elettra Unti, Elisabetta Conte, Filippo Antonini, Filippo Mocciaro, Roberto Di Mitri, Alberto Larghi, Cecilia Binda, Nunzia Scibetta, A. Bonaccorso, Adele Fornelli, Carlo Fabbri, Sara Giorgini, and Giampiero Macarri

Subjects
Male, Suction (medicine), Endoscopic ultrasound, Blood contamination, Suction, Sensitivity and Specificity, Likelihood ratios in diagnostic testing, Fine needle biopsy, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Humans, Medicine, Prospective Studies, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Aged, Aged, 80 and over, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Middle Aged, Stylet, Pancreatic Neoplasms, Neuroendocrine Tumors, Fine-needle aspiration, Needles, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, business, Nuclear medicine
Abstract

Background Standard suction and slow-pull techniques have been utilized during endoscopic ultrasound-guided fine needle aspiration of pancreatic solid lesions, but the correct sampling technique remains unclear. New needles designed to obtain samples suitable for histological evaluation have become available. We performed a study comparing the two sampling methods during endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) in patients with pancreatic solid lesions. Methods We performed EUS-FNB with a 20 Gauge FNB needle using slow-pull or standard suction techniques in a prospective, randomized, multicenter study. The primary aim was bloodiness of the collected specimens. Secondary aims were technical success and performance of the two techniques. Results 110 patients were included (55 per group). No difference in blood contamination was observed (slow-pull 80% vs. suction 74%, p = 0.917). Technical success was 95% (96% vs. 94%, p = 0315). Sensitivity (96% vs. 93%), specificity (100% vs. 100%), positive likelihood ratio (NA), negative likelihood ratio (0.04 vs. 0.07), diagnostic accuracy (96 vs. 93%) did not differ between the two groups. Conclusion EUS-FNB with slow-pull and standard suction techniques are comparable in terms of blood contamination providing similar high diagnostic sensitivity and accuracy in pancreatic solid lesions. The use of the new generation FNB needle allows to reach such high level of diagnostic adequacy regardless of the technique utilized.

Published
2020

6. Impact of biliary stents on the diagnostic accuracy of EUS-guided fine-needle biopsy of solid pancreatic head lesions: A multicenter study

Author

StefanoFrancesco Crinò, MariaCristina Conti Bellocchi, Filippo Antonini, Giampiero Macarri, Silvia Carrara, Laura Lamonaca, Roberto Di Mitri, Elisabetta Conte, Carlo Fabbri, Cecilia Binda, Andrew Ofosu, Enrico Gasparini, Chiara Turri, Caterina Stornello, Ciro Celsa, Alberto Larghi, Erminia Manfrin, Armando Gabbrielli, Antonio Facciorusso, Matteo Tacelli, Crino S., Conti Bellocchi M., Antonini F., MacArri G., Carrara S., Lamonaca L., Di Mitri R., Conte E., Fabbri C., Binda C., Ofosu A., Gasparini E., Turri C., Stornello C., Celsa C., Larghi A., Manfrin E., Gabbrielli A., Facciorusso A., and Tacelli M.

Subjects
endoscopic retrograde cholangiopancreatography, pancreatic cancer, Hepatology, fine-needle biopsy, Gastroenterology, Radiology, Nuclear Medicine and imaging, Original Article, fine-needle aspiration, biliary drainage
Abstract

Background and Objectives: There is no clear evidence of a negative impact of biliary stents on the diagnostic yield of EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing pancreatic head lesions. We aimed to evaluate the association between the presence of biliary stents and the diagnostic accuracy of EUS-FNB. Materials and Methods: A multicenter retrospective study including all jaundiced patients secondary to pancreatic head masses was performed. Patients were divided into two groups according to the presence of a biliary stent placed before EUS-FNB. Pathological results were classified according to the Papanicolaou classification and compared against the final diagnosis. Diagnostic measures in the two groups were compared. Multivariate logistic regression analyses including potential factors affecting EUS-FNB accuracy were performed. Results: Overall, 842 patients were included, 495 (58.8%) without and 347 (41.2%) with biliary stent. A plastic or a metal stent was placed in 217 (62.5%) and 130 (37.5%) cases, respectively. Diagnostic sensitivity and accuracy were significantly higher in patients without biliary stent than in those with stent (91.9% and 92.1% vs. 85.9% and 86.4%, P = 0.010 At multivariate analyses, lesion size (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.02–1.09, P = 0.01) and presence of biliary stent (OR: 0.51, 95% CI: 0.32–0.89, P = 0.01) were independently associated with diagnostic accuracy. In the subgroup of patients with biliary stent, the type of stent (plastic vs. metal) did not impact EUS-FNB yield, whereas the use of larger bore needles enhanced diagnostic accuracy (OR: 2.29, 95% CI: 1.28–4.12, P = 0.005). Conclusions: In this large retrospective study, an indwelling biliary stent negatively impacted the diagnostic accuracy of EUS-FNB. Preferably, EUS-FNB should precede endoscopic retrograde cholangiopancreatography, especially in the case of small tumors.

Published
2021

7. EUS-GUIDED TISSUE ACQUISITION IN CHRONIC PANCREATITIS: DIFFERENTIAL DIAGNOSIS BETWEEN PANCREATIC CANCER AND PSEUDOTUMORAL MASSES USING EUS-FINE NEEDLE ASPIRATION OR CORE BIOPSY

Author

R. Grassia, Filippo Antonini, Fabrizio Cereatti, Nicola Imperatore, Maurizio Vecchi, Mario Martinotti, G DeNucci, Edoardo Forti, Giulia Tanzi, Gianpiero Manes, M. Mutignani, Clara Benedetta Conti, Giampiero Macarri, Federico Buffoli, and Pietro Capone

Subjects
Tissue acquisition, medicine.medical_specialty, Fine-needle aspiration, medicine.diagnostic_test, business.industry, Pancreatic cancer, medicine, Pancreatitis, Radiology, Differential diagnosis, business, Core biopsy, medicine.disease
Published
2020

8. The Applicability of a Checklist for the Diagnosis and Treatment of Exocrine Pancreatic Insufficiency: Results of the Italian Exocrine Pancreatic Insufficiency Registry

Author

Raffaele Pezzilli, Alfredo Di Leo, Alessandro Zerbi, Gabriele Capurso, Guido Costamagna, Massimo Falconi, Giampiero Macarri, P. Salacone, Antonio Carroccio, Luca Frulloni, Pezzilli R., Capurso G., Falconi M., Frulloni L., MacArri G., Costamagna G., Di Leo A., Salacone P., Carroccio A., and Zerbi A.

Subjects
Adult, Male, medicine.medical_specialty, Pancreatic disease, Settore MED/09 - Medicina Interna, Endocrinology, Diabetes and Metabolism, Pancreatic Extracts, medicine.medical_treatment, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Weight loss, Internal medicine, Outpatients, Internal Medicine, medicine, Humans, Enzyme Replacement Therapy, Prospective Studies, Registries, Exocrine pancreatic insufficiency, Pancreas enzyme, Aged, Hepatology, business.industry, digestive, oral, and skin physiology, Feces analysis, exocrine pancreatic insufficiency, fecal elastase-1, maldigestion, pancreatic diseases, steatorrhea, Middle Aged, medicine.disease, Checklist, Steatorrhea, Pancreatic Function Tests, Italy, ROC Curve, 030220 oncology & carcinogenesis, Pancreatectomy, Exocrine Pancreatic Insufficiency, Female, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract

Objective To evaluate a rapid checklist capable of identifying exocrine pancreatic insufficiency in outpatients. Methods Prospective observational study of a multicenter cohort. Results One hundred and two patients were enrolled; 61.8% of the patients had medically-treated benign or malignant pancreatic disease, and 38.2% had a pancreatic resection. Visual examination of the feces was evaluated in 84 patients and it was related to steatorrhea in 51 patients (50.0%). Receiver operating characteristic curves were evaluated for each symptom or clinical sign and four of them (ie, increase in daily bowel movements, number of bowel movements, fatty stools, >10% weight loss) had a satisfactory area under the curve. At multivariate analysis, fatty stools and >10% weight loss entered into this analysis having an area under the curve of 0.916 (95% confidence interval, 0.851-0.981). At 1 month and at one year of follow-up, the pancreatic enzyme replacement therapy administered showed that pancreatic extracts were able to significantly improve the increase in daily bowel movements, the number of bowel movements, fatty and bulky stools and >10% weight loss. Conclusion Both fatty stools and >10% weight loss were able to clinically evaluate steatorrhea, and their improvement was sufficient to evaluate substitution therapy. © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Published
2020

9. Epidemiology, clinical features and diagnostic work-up of cystic neoplasms of the pancreas: Interim analysis of the prospective PANCY survey

Author

Silvia Giovanelli, Matteo Tacelli, Romano Sassatelli, Renato Cannizzaro, Luigi Veneroni, Bastianello Germanà, E.D. Mandelli, Cosimo Sperti, Andrea Galli, Fabio Monica, Carlo Fabbri, Luca Frulloni, Saverio Alicante, Riccardo Casadei, C. Vattiato, Massimo Falconi, Luca Barresi, Germana de Nucci, Domenico Stillittano, Mauro Frego, Giovanna Del Vecchio Blanco, Claudio Ricci, Filippo Antonini, A. Pezzullo, Gabriele Capurso, Silvia Carrara, Vincenzo Giorgio Mirante, Giulia De Marchi, Lucia Moletta, Paolo Cecinato, Mariano Quartini, Rita Conigliaro, Massimo Graffeo, Milena Di Leo, Elisabetta Buscarini, Gioia Pozza, Deborah Bonamini, Giampiero Macarri, Tommaso Pollini, Giovanni Marchegiani, Raffaele Pezzilli, Giulio Belfiori, Alberto Fantin, Giampiero Manes, and Stefano Crippa

Subjects
Endoscopic ultrasound, Male, Epidemiology, Endosonography, Settore MED/12, 0302 clinical medicine, Surveys and Questionnaires, Prospective Studies, Prospective cohort study, Aged, 80 and over, medicine.diagnostic_test, Cystadenoma, Serous, Gastroenterology, Middle Aged, Magnetic Resonance Imaging, Neuroendocrine Tumors, medicine.anatomical_structure, Italy, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, 030211 gastroenterology & hepatology, Female, Radiology, Pancreas, Adult, medicine.medical_specialty, Adolescent, Cystic neoplasm, Adenocarcinoma, Multidetector computed tomography, 03 medical and health sciences, Young Adult, Cystadenoma, Mucinous, medicine, Humans, Mucinous cystadenoma, Aged, Hepatology, Intraductal papillary mucinous neoplasm, business.industry, Pancreatic cyst, Serous Cystadenoma, medicine.disease, Cystic Neoplasm, Pancreatic Neoplasms, Biomarkers, Cytology, Magnetic resonance imaging, Cystadenoma, business
Abstract

Introduction A prospective survey to evaluate the diagnostic workup of cystic pancreatic neoplasms (CPNs) according to the Italian guidelines. Methods An online data sheet was built. Results Fifteen of the 1385 patients (1.1%) had non cystic neoplastic lesions. Forty percent (518/1295) had at least one 1st degree relative affected by a solid tumor of the digestive and extra-digestive organs. Symptoms/signs associated with the cystic lesion were present in 24.5% of the patients. The cysts were localized in the head of the pancreas in 38.5% of patients. Of the 2370 examinations (1.7 examinations per patient) which were carried out for the diagnosis, magnetic resonance imaging was performed as a single test in 48.4% of patients and in combination with endoscopic ultrasound in 27% of the cases. Of the 1370 patients having CPNs, 89.9% had an intraductal papillary mucinous neoplasm (IPMN) (70.1% a branch duct IPMN, 6.2% a mixed type IPMN and 4.6% a main duct IPMN), 12.7% had a serous cystadenoma, 2.8% a mucinous cystadenoma, 1.5% a non-functioning cystic neuroendocrine neoplasm, 0.7% a solid-pseudopapillary cystic neoplasm, 0.3% a cystic adenocarcinoma, and 1.2% an undetermined cystic neoplasm. Seventy-eight (5.7%) patients were operated upon after the initial work-up. Conclusions This prospective study offers a reliable real-life picture of the diagnostic work-up CPN.

Published
2019

10. EUS-guided tissue sampling with a 20-gauge core biopsy needle for the characterization of gastrointestinal subepithelial lesions: A multicenter study

Author

Carlo Fabbri, Adele Fornelli, Lorenzo Fuccio, Pietro Occhipinti, E.D. Mandelli, Giampiero Macarri, Gabriele Delconte, Filippo Antonini, A. Magarotto, E. Armellini, Gianpiero Manes, Germana de Nucci, Enzo Masci, and Leonardo Frazzoni

Subjects
Endoscopic ultrasound, medicine.medical_specialty, submucosal mass, gastrointestinal stromal tumor, Lesion, 03 medical and health sciences, 0302 clinical medicine, Core biopsy needle, Biopsy, Medicine, Radiology, Nuclear Medicine and imaging, fine-needle aspiration, Major complication, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Tissue sampling, Fine-needle aspiration, Multicenter study, 030220 oncology & carcinogenesis, subepithelial lesion, 030211 gastroenterology & hepatology, Original Article, Radiology, medicine.symptom, business
Abstract

Background and Objective: A new 20-gauge (G) biopsy needle with a core-trap technology has been developed with a large core size and enhanced flexibility. The aim of this multicenter study was to determine the feasibility, efficacy, and safety of EUS-guided fine-needle biopsy (EUS-FNB) with the new 20G needle in diagnosing subepithelial lesions (SELs). Materials and Methods: Retrospectively collected data from consecutive patients with SELs undergoing EUS-FNB with the 20G needle at five centers were analyzed. Results: A total of 50 SELs were included. The mean lesion size was 43.1 ± 17.5 mm. The lesion locations were esophagus (n = 1), stomach (n = 37), distal duodenum (n = 5), rectum (n = 6), and colon (n = 1). The procedure was technically feasible in all patients. Definitive diagnosis with full histological assessment including immunohistochemistry was obtained in 88% (44/50) of the patients. Considering malignant versus benign lesions, the sensitivity, specificity, positive predictive value, and negative predictive value were 85% (95% confidence interval [CI] 70.2–94.3), 100% (95% CI 58.7%–100%), 100% (95% CI 85.1%–100%), and 62.5 (95% CI 27.7–84.8), respectively. No major complications requiring additional care have been observed. Conclusions: In this multicenter study, we found that EUS-FNB with the new 20G core needle is an effective and safe method for the diagnosis of SELs with a high rate of producing adequate histological material and high diagnostic accuracy even from difficult-to-approach anatomical locations.

Published
2018

11. Pancreatic enzyme replacement therapy after gastric resection: An update

Author

Stefano Crippa, Filippo Antonini, Giampiero Macarri, Raffaele Pezzilli, and Massimo Falconi

Subjects
medicine.medical_specialty, Food intake, medicine.medical_treatment, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Gastrointestinal Agents, Gastrectomy, Internal medicine, medicine, Humans, Enzyme Replacement Therapy, In patient, Gastric resection, Exocrine pancreatic insufficiency, Pancreas, Randomized Controlled Trials as Topic, Hepatology, business.industry, digestive, oral, and skin physiology, medicine.disease, digestive system diseases, Review article, 030220 oncology & carcinogenesis, Exocrine Pancreatic Insufficiency, 030211 gastroenterology & hepatology, SMALL BOWEL BACTERIAL OVERGROWTH, business, Pancreatic enzymes
Abstract

Exocrine pancreatic insufficiency (EPI) is one of the possible mechanisms of fat maldigestion following gastric surgery, together with reduced food intake, loss of gastric reservoir, small bowel bacterial overgrowth and rapid small bowel transit. Oral pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for EPI. The efficacy and safety of pancreatic enzyme substitution in patients following gastric resection remains unclear. This review article summarizes relevant studies addressing PERT after gastric resection.

Published
2018

12. OC.01.3 EUS-GUIDED TISSUE ACQUISITION IN CHRONIC PANCREATITIS: DIFFERENTIAL DIAGNOSIS BETWEEN PANCREATIC CANCER AND PSEUDOTUMORAL MASSES USING EUS-FINE NEEDLE ASPIRATION OR CORE BIOPSY

Author

Giulia Tanzi, M. Mutignani, R. Grassia, Filippo Antonini, Maurizio Vecchi, Gianpiero Manes, Mario Martinotti, Giampiero Macarri, Edoardo Forti, G. De Nucci, Federico Buffoli, Pietro Capone, Nicola Imperatore, and Fabrizio Cereatti

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, medicine.disease, Tissue acquisition, Fine-needle aspiration, Pancreatic cancer, medicine, Pancreatitis, Radiology, Differential diagnosis, business, Core biopsy
Published
2020

13. HIGH DIAGNOSTIC ADEQUACY AND ACCURACY OF THE NEW 20G PROCORE NEEDLE FOR EUS-GUIDED TISSUE ACQUISITION: RESULTS OF A LARGE MULTICENTRE RETROSPECTIVE STUDY

Author

Dario de Biase, Mario Traina, Giampiero Macarri, Carlo Fabbri, Silvia Giovanelli, Luca Barresi, Leonardo Frazzoni, Filippo Antonini, Vincenzo Cennamo, Siro Fiorino, Paolo Gusella, Adele Fornelli, Lorenzo Fuccio, Elio Jovine, Rosa Liotta, Marina La Marca, Ilaria Tarantino, Alberto Larghi, Fabbri C., Fornelli A., Fuccio L., Giovanelli S., Tarantino I., Antonini F., Liotta R., Frazzoni L., Gusella P., La Marca M., Barresi L., MacArri G., Traina M., De Biase D., Fiorino S., Jovine E., Larghi A., and Cennamo V.

Subjects
medicine.medical_specialty, 03 medical and health sciences, ProCore needle, 0302 clinical medicine, Tissue core, Biopsy, medicine, Radiology, Nuclear Medicine and imaging, pancreas, Transduodenal approach, EUS, Cancer, Access route, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Outcome measures, Retrospective cohort study, Tissue acquisition, pancrea, medicine.anatomical_structure, 030220 oncology & carcinogenesis, fine-needle biopsy, Original Article, 030211 gastroenterology & hepatology, Radiology, Pancreas, Nuclear medicine, business
Abstract

Background and Objective: EUS-guided fine-needle biopsy has become the standard for tissue sampling. A new 20G ProCore™ (PC) needle has been developed to overcome the limitations of tissue acquisition of the smaller needles (22G, 25G) and the rigidity of the larger one (19G). The aim of this study is to assess the performance of the 20G PC needle. Materials and Methods: Patients who underwent EUS-guided tissue acquisition with the 20G PC needle of pancreatic and extra-pancreatic mass lesions were retrospectively identified at three Italian centers (Bologna, Fermo, and Palermo). Diagnostic adequacy, accuracy, and tissue core acquisition were the outcome measures. All the cases were performed without rapid on-site evaluation. Results: A total of 384 patients with pancreatic (62.2%) and extra-pancreatic lesions were included in the study. For pancreatic lesions, adequacy, accuracy, sensitivity, and specificity were 92.4%, 91.5%, 90.8%, and 100%, respectively, with a number needed to misdiagnose (NNM) of 11.8. The tissue core was obtained in 72% of cases. Transduodenal approach was performed in 150 pancreatic lesions; adequacy, accuracy, and tissue core acquisition were 88.7%, 90%, and 66%, respectively (NNM 10). For extrapancreatic lesions, adequacy, accuracy, sensitivity, specificity, and tissue core sampling were 95.3%, 95.3%, 92.6%, 100%, and 84.5% (NNM 21.3). Conclusions: The 20G PC needle showed high diagnostic adequacy and accuracy, regardless the access route.

Published
2019

14. T03.02.8 DUODENOSCOPE-RELATED INFECTIONS: AN ITALIAN PICK IN 2019

Author

C. De Angelis, Alessandro Fugazza, Guido Costamagna, Costanza Alvisi, Enzo Masci, Marco Bassi, Roberta Maselli, Antonio Benedetti, M. Ayoubi, Pietro Occhipinti, Giovanni Aragona, Calcedonio Calcara, N. Mantovani, Lorenzo Camellini, G. Diamantis, F. De Grazia, R. Salerno, Alberto Mariani, Paolo Cantù, A. Gabrielli, P. Gambitta, Giovanna Venezia, Laura Lamonaca, M.L. Canfora, M. de Bellis, Gianpiero Manes, E. Di Giulio, Marco Dinelli, Paolo Beretta, Gianpaolo Cengia, Franco Radaelli, Alberto Tringali, Piera Leoni, A. Lauri, L. Cugia, M. Berni Canani, M. Paganelli, Andrea Anderloni, A. Cambareri, P. Mosca, G. Pellegatta, Mario Traina, Silvia Carrara, E.C. Ferrara, C. Luigiano, Giuseppe Feliciangeli, P.A. Galtieri, Guido Manfredi, Giampiero Macarri, Vincenzo Craviotto, Massimiliano Mutignani, Guido Missale, Marco Spadaccini, Alessandro Mussetto, Carlo Fabbri, Fabrizio Cereatti, M. Di Leo, G. Del Vecchio Blanco, R. Gullotta, and Mauro Manno

Subjects
medicine.medical_specialty, Hepatology, business.industry, General surgery, Gastroenterology, Medicine, business
Published
2020

15. Su1536 DUODENOSCOPE-RELATED INFECTIONS: AN ITALIAN PICK IN 2019

Author

Carmelo LuigianoS, Matteo Badalamenti, Armando Gabbrielli, Federico De Grazia, Renzo Gllotta, Nicola Mantovani, Alberto Mariani, Alessandro Fugazza, Andrea Anderloni, Arianna Dal Buono, Franco Radaelli, Pietro Occhipinti, Paolo Beretta, Paolo Cantù, Alessandro Repici, Roberto Gabbiadini, Guido Manfredi, Marco Dinelli, L. Cugia, Gianpiero Manes, Alberto Tringali, Adriano Lauri, Fabrizio Cereatti, D. Paduano, Massimiliano Mutignani, Giuseppe Feliciangeli, Pietro Gambitta, Edoardo Vespa, Roberta Maselli, Giovanni Aragona, Guido Missale, Matteo Colombo, Silvia Carrara, Carlo Fabbri, Piera Leoni, Antonio Capogreco, Alessandro Mussetto, Claudio De Angelis, G. Diamantis, R. Salerno, Marco Paganelli, Mauro Manno, Laura Lamonaca, Mario De Bellis, Cambareri Antonio, Calcedonio Calcara, Giovanna Del Vecchio Blanco, Antonio Benedetti, Mario Traina, Giampiero Macarri, Maria Caterina Parodi, Piegiorgio Mosca, Marco Spadaccini, Lorenzo Camellini, Giovanna Venezia, Mohammad Ayoubi, Nicola Pugliese, Vincenzo Craviotto, Marcella Berni Canani, Marco Bassi, Maria Laura Canfora, Emilio Di Giulio, Gianpaolo Cengia, Costanza Alvisi, Guido Costamagna, and Enzo Masci

Subjects
medicine.medical_specialty, business.industry, General surgery, Gastroenterology, medicine, Radiology, Nuclear Medicine and imaging, business
Published
2020

16. EUS ELASTOGRAPHY STRAIN RATIO IN THE DIFFERENTIAL DIAGNOSIS OF GASTROINTESTINAL SUBEPITHELIAL LESIONS: PRELIMINARY RESULTS OF A MULTICENTER STUDY

Author

V. Belfiori, Fillipo Antonini, A. Repici, Pietro Fusaroli, Sara Giorgini, Lorenzo Fuccio, Francesco Auriemma, Marta Serrani, Giampiero Macarri, Leonardo Frazzoni, Andrea Lisotti, Daoud Rahal, and Silvia Carrara

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Strain (injury), medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Multicenter study, 030220 oncology & carcinogenesis, Medicine, 030211 gastroenterology & hepatology, Radiology, Elastography, Differential diagnosis, business
Published
2018

18. P.05.1 PANCREATIC CANCER AND PSEUDOTUMORAL MASSES IN CHRONIC PANCREATITIS: DIAGNOSTIC ACCURACY OF ENDOSCOPIC ULTRASOUND AND FINE NEEDLE BIOPSY (EUS-FNB)

Author

R. Grassia, Maurizio Vecchi, Filippo Antonini, Giampiero Macarri, Mario Martinotti, G. De Nucci, Giulia Tanzi, Edoardo Forti, Pietro Capone, M. Mutignani, Nicola Imperatore, Fabrizio Cereatti, Federico Buffoli, and Gianpiero Manes

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Diagnostic accuracy, medicine.disease, Fine needle biopsy, Pancreatic cancer, medicine, Pancreatitis, Radiology, business
Published
2019

19. Life-threatening GI bleeding secondary to multiple gastric metastases from urothelial carcinoma of the renal pelvis

Author

P. Rossetti, Lucia Angelelli, Filippo Antonini, and Giampiero Macarri

Subjects
Male, medicine.medical_specialty, GI bleeding, medicine.medical_treatment, Stomach Diseases, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, Fatal Outcome, X ray computed, Stomach Neoplasms, medicine, Carcinoma, Humans, Radiology, Nuclear Medicine and imaging, Kidney Pelvis, Urothelial carcinoma, Neoplasm Grading, Carcinoma, Transitional Cell, business.industry, General surgery, Gastroenterology, Anemia, Hematemesis, Middle Aged, medicine.disease, Hemostasis, Surgical, Kidney Neoplasms, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Hemostasis, Multiple Pulmonary Nodules, Radiology, Ureter, business, Gastrointestinal Hemorrhage, Tomography, X-Ray Computed, Renal pelvis
Published
2017

20. Endoscopic ultrasound-guided tissue acquisition of pancreatic masses with core biopsy needles using wet suction technique

Author

Filippo Antonini, Giampiero Macarri, Carlo Fabbri, Lorenzo Fuccio, Antonini, Filippo, Fuccio, Lorenzo, Fabbri, Carlo, and Macarri, Giampiero

Subjects
Suction (medicine), Endoscopic ultrasound, medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Cancer, medicine.disease, Letter to Editor, Tissue acquisition, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, medicine, Pancrea, 030211 gastroenterology & hepatology, Radiology, Nuclear Medicine and imaging, Radiology, Pancreas, business, Core biopsy
Abstract

NA

Published
2017

21. Endoscopic Ultrasonography May Select Subjects Having Asymptomatic Chronic Pancreatic Hyperenzymemia Who Require a Stricter Follow-up

Author

Samuele De Minicis, Filippo Antonini, Nico Pagano, P. Rossetti, S. Piergallini, Elisabetta Buscarini, V. Belfiori, Massimiliano Lo Cascio, B. Marraccini, Raffaele Pezzilli, Elena Andrenacci, Giampiero Macarri, Antonini F., Belfiori V., Pagano N., Buscarini E., De Minicis S., Lo Cascio M., Marraccini B., Piergallini S., Rossetti P., Andrenacci E., MacArri G., and Pezzilli R.

Subjects
Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Endoscopic ultrasonography, hyperamylasemia, Asymptomatic, Endosonography, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Endocrinology, Text mining, Pancreatitis, Chronic, Internal Medicine, Medicine, Humans, Trypsin, pancreatic hyperenzymemia, EUS, Aged, Retrospective Studies, Aged, 80 and over, Hepatology, business.industry, pancreatic cyst, Reproducibility of Results, Lipase, Middle Aged, pancrea, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Pancreatic cyst, Amylases, Hyperamylasemia, 030211 gastroenterology & hepatology, chronic pancreatiti, Female, Imaging technique, Radiology, medicine.symptom, business, Pancreas, Follow-Up Studies
Abstract

Objectives We have previously shown that at least 50% of patients with asymptomatic chronic pancreatic hyperenzymemia (ACPH) may develop morphological pancreatic alterations. Endoscopic ultrasonography (EUS) may detect small lesions, and its sensitivity seems to be higher than other imaging techniques. The aim of this study was to evaluate whether EUS may modify the management of patients having ACPH. Methods In 2 referral centers for pancreatic disease, a retrospective analysis of prospectively enrolled patients with ACPH was conducted. Results Seventy-three patients with ACPH were enrolled for the purpose of this study. Endoscopic ultrasonography was performed as the last examination in 45 subjects who resulted negative at previous imaging studies (abdominal ultrasound, computed tomography, magnetic resonance imaging associated with cholangiopancreatography). Using EUS in 7 subjects, abnormalities were found in the following: 3 branch-duct intraductal papillary mucinous neoplasms, 1 duodenal diverticulum, 1 annular pancreas, 1 findings suggestive of chronic pancreatitis, and 1 undefined cyst (

Published
2017

22. Gastric metastasis from ovarian adenocarcinoma presenting as a subepithelial tumor and diagnosed by endoscopic ultrasound-guided tissue acquisition

Author

Lucia Angelelli, Corrado Rubini, Liboria Laterza, Lorenzo Fuccio, Giampiero Macarri, Filippo Antonini, Massimo Marcellini, Sonia Calcina, Antonini, Filippo, Laterza, Liboria, Fuccio, Lorenzo, Marcellini, Massimo, Angelelli, Lucia, Calcina, Sonia, Rubini, Corrado, and Macarri, Giampiero

Subjects
Endoscopic ultrasound, Oncology, medicine.medical_specialty, endocrine system diseases, Case Report, Endoscopic ultrasonography, Metastasi, Subepithelial lesion, Metastasis, Text mining, Internal medicine, medicine, Ovarian adenocarcinoma, medicine.diagnostic_test, business.industry, Gastric metastasis, Gastroenterology, medicine.disease, digestive system diseases, Tissue acquisition, Ovarian, Radiology, business, Gastric cancer
Abstract

We describe an uncommon case of a patient with a metastatic adenocarcinoma of ovarian origin presented as a gastric subepithelial tumor (SET) and that was diagnosed by endoscopic ultrasound fine-needle biopsy (EUS-FNB). Malignant gastric lesions are rarely metastatic and the primary tumor is mainly breast, lung, esophageal cancer or cutaneous melanoma. Gastric metastasis from ovarian cancer is unusual, presenting synchronously with the primary tumor but also several years later than the initial diagnosis. From an endoscopic point of view, gastric metastasis does not present specific features. They may mimic both a primary gastric tumor or, less frequently, an SET. This case demonstrates the importance of EUS-FNB in distinguishing SETs and how this may alter treatment and prognosis.

Published
2017

23. The presence of rapid on-site evaluation did not increase the adequacy and diagnostic accuracy of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions with core needle

Author

Giampiero Macarri, Luca Barresi, Vincenzo Cennamo, Adele Fornelli, Lorenzo Fuccio, Filippo Antonini, Silvia Paggi, Rosa Liotta, Antonella Maimone, Ilaria Tarantino, Carlo Fabbri, Anna Maria Polifemo, Alberto Larghi, Elio Iovine, Leonardo Frazzoni, Paolo Gusella, Fabbri, Carlo, Fuccio, Lorenzo, Fornelli, Adele, Antonini, Filippo, Liotta, Rosa, Frazzoni, Leonardo, Larghi, Alberto, Maimone, Antonella, Paggi, Silvia, Gusella, Paolo, Barresi, Luca, Polifemo, Anna Maria, Iovine, Elio, Macarri, Giampiero, Cennamo, Vincenzo, and Tarantino, Ilaria

Subjects
Endoscopic ultrasound, Core needle, Male, medicine.medical_specialty, Diagnostic accuracy, Site evaluation, Adenocarcinoma, Sensitivity and Specificity, 03 medical and health sciences, 0302 clinical medicine, Pancreatic cancer, medicine, Humans, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Pancreas, EUS, Aged, Retrospective Studies, Fine-needle aspiration, ROSE, medicine.diagnostic_test, business.industry, Rapid on-site evaluation, medicine.disease, digestive system diseases, Carcinoma, Neuroendocrine, Tissue acquisition, Pancreatic Neoplasms, medicine.anatomical_structure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Surgery, Radiology, business
Abstract

Background: Rapid on-site evaluation (ROSE) improves the adequacy and accuracy of EUS-guided tissue acquisition, although it is not routinely widely available. Evidence suggested that core needles might overcome the absence of ROSE. The aim of this study was to evaluate the influence of ROSE on the adequacy and accuracy of EUS-guided tissue acquisition with core needles in patients with pancreatic solid lesions. Methods: Patients who underwent EUS-guided tissue acquisition of pancreatic mass lesions were retrospectively identified at three tertiary referral centers and those performed with the core needle were included. Adequacy, defined as the rate of cases in which a tissue specimen for proper examination was achieved, with and without ROSE was the primary outcome measure. The diagnostic accuracy and tissue core acquisition were the secondary outcome measures. Results: A total of 333 patients with pancreatic solid mass lesions were included in the study; 140 cases sampled with ROSE and 193 cases without ROSE. The adequacy was 92.1 % in the group sampled with ROSE and 88.1 % in the group without ROSE (p = 0.227). In the ROSE group sensitivity, specificity, and accuracy were 90.7, 100 and 92.1 %, respectively. In the group without ROSE, sensitivity, specificity, and accuracy were 87.2, 100, and 88.1 %, respectively. No difference for all these figures was observed between the two groups. The tissue core was available in 61.4 and 53.4 % of cases with and without ROSE, respectively (p = 0.143). Conclusion: In the absence of ROSE, EUS-based tissue acquisition with Core needle should be considered since it achieves comparable tissue sampling adequacy and accuracy.

Published
2017

24. Biliary plastic stent does not influence the accuracy of endoscopic ultrasound-guided sampling of pancreatic head masses performed with core biopsy needles

Author

Lorenzo Fuccio, Filippo Antonini, Sara Giorgini, Leonardo Frazzoni, Giampiero Macarri, Carlo Fabbri, Marina Scarpelli, Antonini, Filippo, Fuccio, Lorenzo, Giorgini, Sara, Fabbri, Carlo, Frazzoni, Leonardo, Scarpelli, Marina, and Macarri, Giampiero

Subjects
Endoscopic ultrasound, Male, medicine.medical_specialty, medicine.medical_treatment, Biopsy, Biliary stent, Sensitivity and Specificity, Fine needle aspiration, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Pancreatic cancer, Pancreatic mass, medicine, Humans, Sampling (medicine), Plastic stent, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Pancreas, Accuracy, Aged, Retrospective Studies, medicine.diagnostic_test, Hepatology, business.industry, Gastroenterology, Stent, Middle Aged, medicine.disease, equipment and supplies, digestive system diseases, Pancreatic Neoplasms, Biliary Tract Surgical Procedures, Jaundice, Obstructive, Fine-needle aspiration, Italy, 030220 oncology & carcinogenesis, EUS-FNA, Multivariate Analysis, Regression Analysis, 030211 gastroenterology & hepatology, Female, Stents, Radiology, business, Plastics
Abstract

Objective: While the presence of biliary stent significantly decreases the accuracy of endoscopic ultrasound (EUS) for pancreatic head cancer staging, its impact on the EUS-guided sampling accuracy is still debated. Furthermore, data on EUS-fine needle biopsy (EUS-FNB) using core biopsy needles in patients with pancreatic mass and biliary stent are lacking. The aim of this study was to evaluate the influence of biliary stent on the adequacy and accuracy of EUS-FNB in patients with pancreatic head mass. Methods: All patients who underwent EUS-guided sampling with core needles of solid pancreatic head masses causing obstructive jaundice were retrospectively identified in a single tertiary referral center. Adequacy, defined as the rate of cases in which a tissue specimen for proper examination was achieved, with and without biliary stent, was the primary outcome measure. The diagnostic accuracy and complication rate were the secondary outcome measures. Results: A total of 130 patients with pancreatic head mass causing biliary obstruction were included in the study: 74 cases of them were sampled without stent and 56 cases with plastic stent in situ. The adequacy was 96.4% in the stent group and 90.5% in the group without stent (p = 0.190). No significant differences were observed for sensitivity (88.9% vs. 85.9%), specificity (100% for both groups), and accuracy (89.3% vs. 86.5%) between those with and without stent, respectively. The accuracy was not influenced by the timing of stenting (

Published
2017

25. White Paper of Italian Gastroenterology: Delivery of services for digestive diseases in Italy: Weaknesses and strengths

Author

Giovanni Ferrini, Antonietta Bianco, Paolo Ravelli, Michele Cicala, Aurora Bortoli, Renato Cannizzaro, Piero Leo, Emanuele Meroni, Paolo Spolaore, Gianni Gatto, Manola Lisiero, Filippo Antonini, Angelo Zullo, Antonio Balzano, Sabrina Bianchi, Emanuele Scafato, Giancarlo Spinzi, Lucio Amitrano, Luca Frulloni, Renzo Gullotta, Eugenio Brunelli, O. Triossi, Italo Sorrentini, Mario Marini, Diego Fregonese, Paolo Borro, Danilo Badiali, Giovanni Sansoè, R. Cuppone, Enrico Corazziari, Luciana Framarin, L.M. Montalbano, P. Brosolo, T. Federici, Gianni Testino, Alessandro Sumberaz, Attilio Solinas, A. Salmi, Renato Marin, L. Buri, Ivo Boskovski, Italo Stroppa, Ivano Lorenzini, Giovanni Di Matteo, Salvatore Cucchiara, Ilaria Tarantino, Cesare Hassan, Nicola Muscatiello, Giovanni M. Claar, Stefano Bellentani, Luca Barresi, Francesco Guardascione, Mario Del Piano, Mario Angelico, Luigi Vilardo, Paolo Usai-Satta, Luigi Pasquale, G. Scarpulla, Santino Marchi, Roberto Penagini, Vincenzo Gallo, Luigi Familiari, Francesco Cupella, Livio Cipolletta, Egiziano Peruzzi, Gianfranco Delle Fave, Salvatore Adamo, Luca Elli, S. Crotta, Maurizio Zilli, Antonio Cilona, Bastianello Germanà, Francesco Pallone, Leonardo Tammaro, P. Fracasso, Fabio Pace, Giovanni de Pretis, Alfredo Di Leo, Pietro Familiari, Giorgio Frosini, Giuseppe Milazzo, Maria Teresa Bardella, Michele Di Cillo, Fausto Chilovi, Enrico Ciliberto, Floriano Rosina, Alessandro Zambelli, Franco Bazzoli, Maria Rendina, Francesco Ridolfi, Franco Radaelli, Massimo Conio, Massimiliano Biagini, Massimo Bellini, Claudio De Angelis, Maria Caterina Parodi, Guido Costamagna, Pietro Fusaroli, Gioacchino Leandro, Pier Alberto Testoni, Piero Loriga, Ornella Ancarani, Giacomo Germani, Fabio Farinati, Giancarlo Caletti, Sergio Morini, Carlo Gemme, Antonio Benedetti, Adriano Lauri, Gianmarco Fava, Mauro Borzio, Mario Traina, Marcello Ingrosso, Amuso M, Giampiero Macarri, Rosa Filiberti, A. Marino, Cinzia Quondamcarlo, Francesco Bortoluzzi, L. Piazzi, Raffaele Manta, Salvatore De Stefano, Rita Conigliaro, Michele De Boni, Andrea Ederle, Clara Virgilio, Marco Soncini, Mario Cottone, G.C. Sturniolo, Anna Kohn, Maurizia Rossana Brunetto, Matteo Neri, Elisabetta Buscarini, Nicola D'Imperio, Gennaro D'Amico, Patrizia Burra, Antonio Craxì, S. Peralta, Alessandro Natali, Giuseppe Del Favero, Giovanni Actis, Andrea Nucci, Dario Conte, Stefano Fagiuoli, Santo Monastra, Fabrizio Magnolfi, Buscarini, E, Conte, D, Cannizzaro, R, Bazzoli, F, De Boni, M, Delle Fave, G, Farinati, F, Ravelli, P, Testoni, P, Lisiero, M, Spolaore, P, Fagiuoli, S, Testoni, PIER ALBERTO, Italian Association of Hospital, Gastroenterologist, Endoscopists, Italian Society of, Endoscopy, Italian Society of, Gastroenterology, Buscarini E, Conte D, Cannizzaro R, Bazzoli F, De Boni M, Fave GD, Farinati F, Ravelli P, Testoni PA, Lisiero M, Spolaore P, Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO), Italian Society of Endoscopy (SIED), Italian Society of Gastroenterology (SIGE): [.., Pietro Fusaroli, and ]

Subjects
Male, Gastrointestinal Diseases, Treatment outcome, Diseases, Medical care, Gastroenterology, Cancer, Digestive diseases, Emergency, Gastrointestinal bleeding, Hospital discharge record, Hospital stay, Mortality, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Emergencies, Female, Gastrointestinal Hemorrhage, Health Planning, Health Services, Health Services Needs and Demand, Hospital Mortality, Hospital Units, Humans, Incidence, Infant, Infant, Newborn, Italy, Length of Stay, Middle Aged, Prevalence, Societies, Medical, Treatment Outcome, Young Adult, Health services, White paper, Digestive disease, italy, 80 and over, Medicine, Hepatology, Settore MED/12 - Gastroenterologia, Incidence (epidemiology), Digestive diseases Emergency Gastroenterology Gastrointestinal bleeding Hospital discharge record Hospital stay Mortality, Christian ministry, gastroenterology, medicine.medical_specialty, Case mix index, Medical, Internal medicine, Cancer, Digestive diseases, Emergency, Gastroenterology, Gastrointestinal bleeding, Hospital discharge record, Hospital stay, Mortality, Preschool, business.industry, Newborn, Societies, business
Abstract

In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999–2009, with more than 1,500,000 admissions/year; however only 5–9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16–25% versus 29–87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies’ official report, which constitutes the “White paper of Italian Gastroenterology”

Published
2014

26. Management of serous cystic neoplasms of the pancreas

Author

Filippo Antonini, Carlo Fabbri, Lorenzo Fuccio, Giampiero Macarri, Laurent Palazzo, Antonini F, Fuccio L, Fabbri C, Macarri G, and Palazzo L

Subjects
Diagnostic Imaging, Endoscopic ultrasound, medicine.medical_specialty, Serous cystadenocarcinoma, Benign tumours, ENDOSCOPIC ULTRASONOGRAPHY, Predictive Value of Tests, Risk Factors, medicine, Animals, Humans, Genetic Testing, CONFOCAL MICROSCOPY, Endoscopic Ultrasound-Guided Fine Needle Aspiration, PANCREAS, Hepatology, medicine.diagnostic_test, business.industry, General surgery, Cystadenoma, Serous, Gastroenterology, medicine.disease, Serous Cystadenoma, Pancreatic Neoplasms, Serous fluid, Treatment Outcome, medicine.anatomical_structure, Fine-needle aspiration, PANCREATIC CYSTS, Radiology, Pancreatic Cyst, Pancreatic cysts, Tomography, X-Ray Computed, Pancreas, business
Abstract

Pancreatic serous cystadenomas are uncommon benign tumours that are often found incidentally on routine imaging examinations. Radiological imaging techniques alone have proven to be suboptimal to fully characterize cystic pancreatic lesions. Endoscopic ultrasound, with the addition of fine-needle aspiration in difficult cases, has showed greater diagnostic accuracy than conventional imaging techniques. The best management strategy of these neoplasms is still debated. Surgery should be limited only to symptomatic and highly selected cases and most of the patients should only be strictly monitored. In the current paper, we provide an updated overview on pancreatic serous cystadenomas, focusing our attention on epidemiology, clinical characteristics and diagnostic evaluation; finally, we also discuss different management strategies and areas for future research.

Published
2014

27. Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms

Author

Buscarini, Elisabetta, Pezzilli, Raffaele, Cannizzaro, Renato, De Angelis, Claudio, Gion, Massimo, Morana, Giovanni, Zamboni, Giuseppe, Arcidiacono, Paolo, Balzano, Gianpaolo, Barresi, Luca, Basso, Daniela, Bocus, Paolo, Calculli, Lucia, Capurso, Gabriele, Canzonieri, Vincenzo, Casadei, Riccardo, Crippa, Stefano, D'Onofrio, Mirko, Frulloni, Luca, Fusaroli, Pietro, Manfredi, Guido, Pacchioni, Donatella, Pasquali, Claudio, Rocca, Rodolfo, Ventrucci, Maurizio, Venturini, Silvia, Villanacci, Vincenzo, Zerbi, Alessandro, Falconi, Massimo, Cystic Pancreatic Neoplasm Study Group, Collaborators: Luca Albarello, Lorenzo, Camellini, Cantu, Paolo, Rita, Conigliaro, Guido, Costamagna, Giuseppe Del Favero, Giovanna Del Vecchio Blanco, Pierluigi Di Sebastiano, Carlo, Fabbri, Paolo, Federici, Niccola, Funel, Andrea, Galli, Gabbrielli, Armando, Graziani, Rossella, Tiziana, Guadagnini, Andrea, Laghi, Giampiero, Macarri, Fabrizio, Magnolfi, Marco, Marzioni, Fabio, Monica, Nicola, Muscatiello, Massimiliano, Mutignani, Antonio, Pisani, Enrico, Scarano, Carla, Serra, Marco, Spada, Marco, Visconti, Alessandro, Zambelli, Buscarini, E, Pezzilli, R, Cannizzaro, R, Angelis, Cd, Gion, M, Morana, G, Zamboni, G, Arcidiacono, P, Balzano, G, Barresi, L, Basso, D, Bocus, P, Calculli, L, Capurso, G, Canzonieri, V, Casadei, R, D'Onofrio, M, Frulloni, L, Fusaroli, P, Manfredi, G, Pacchioni, D, Pasquali, C, Rocca, R, Ventrucci, M, Venturini, S., Villanacci, V., Zerbi, A., Falconi, Massimo, Crippa, Stefano, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Da definire, AREA MIN. 06 - Scienze mediche, Italian Association of Hospital Gastroenterologists and Endoscopist, Italian Association for the Study of the Pancrea, Buscarini E, Pezzilli R, Cannizzaro R, De Angelis C, Gion M, Morana G, Zamboni G, Arcidiacono P, Balzano G, Barresi L, Basso D, Bocus P, Calculli L, Capurso G, Canzonieri V, Casadei R, Crippa S, D'Onofrio M, Frulloni L, Fusaroli P, Manfredi G, Pacchioni D, Pasquali C, Rocca R, Ventrucci M, Venturini S, Villanacci V, Zerbi A, Falconi M, and Cystic Pancreatic Neoplasm Study Group

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Consensus, Delphi Technique, mucinous, Pancreatic neoplasms, Cholangiopancreatography, Magnetic Resonance, Delphi method, Modified delphi, Appropriate use, Neoplasms, cystic, mucinous, and serous, Pancreatic cyst, Endosonography, ENDOSCOPIC ULTRASONOGRAPHY, Settore MED/12, Neoplasms, Biomarkers, Tumor, medicine, Humans, In patient, cystic, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, PANCREATIC CYSTS, and serous, Work-up, Tomography x ray computed, Italy, Positron-Emission Tomography, Radiology, Tomography, X-Ray Computed, business
Abstract

none 33 no This report contains clinically oriented guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms in patients fit for treatment. The statements were elaborated by working groups of experts by searching and analysing the literature, and then underwent a consensus process using a modified Delphi procedure. The statements report recommendations regarding the most appropriate use and timing of various imaging techniques and of endoscopic ultrasound, the role of circulating and intracystic markers and the pathologic evaluation for the diagnosis and follow-up of cystic pancreatic neoplasms open Italian Association of Hospital Gastroenterologists and Endoscopists; Italian Association for the Study of the Pancreas; Buscarini E; Pezzilli R; Cannizzaro R; De Angelis C; Gion M; Morana G; Zamboni G; Arcidiacono P; Balzano G; Barresi L; Basso D; Bocus P; Calculli L; Capurso G; Canzonieri V; Casadei R; Crippa S; D'Onofrio M; Frulloni L; Fusaroli P; Manfredi G; Pacchioni D; Pasquali C; Rocca R; Ventrucci M; Venturini S; Villanacci V; Zerbi A; Falconi M; Cystic Pancreatic Neoplasm Study Group Italian Association of Hospital Gastroenterologists and Endoscopists; Italian Association for the Study of the Pancreas; Buscarini E; Pezzilli R; Cannizzaro R; De Angelis C; Gion M; Morana G; Zamboni G; Arcidiacono P; Balzano G; Barresi L; Basso D; Bocus P; Calculli L; Capurso G; Canzonieri V; Casadei R; Crippa S; D'Onofrio M; Frulloni L; Fusaroli P; Manfredi G; Pacchioni D; Pasquali C; Rocca R; Ventrucci M; Venturini S; Villanacci V; Zerbi A; Falconi M; Cystic Pancreatic Neoplasm Study Group

Published
2014

28. P.08.20 EUS ELASTOGRAPHY STRAIN RATIO IN THE DIFFERENTIAL DIAGNOSIS OF GASTROINTESTINAL SUBEPITHELIAL LESIONS: PRELIMINARY RESULTS OF A MULTICENTER STUDY

Author

Sara Giorgini, V. Belfiori, Filippo Antonini, Pietro Fusaroli, Silvia Carrara, Leonardo Frazzoni, Marta Serrani, Lorenzo Fuccio, Giampiero Macarri, Andrea Lisotti, Daoud Rahal, A. Repici, and Francesco Auriemma

Subjects
medicine.medical_specialty, Hepatology, Multicenter study, medicine.diagnostic_test, business.industry, Gastroenterology, Medicine, Strain (injury), Radiology, Elastography, Differential diagnosis, business, medicine.disease
Published
2018

29. Endoscopic Ultrasound-Guided Fine Needle Aspiration of a PET/CT-Positive Small Hilar Lymph Node for the Diagnosis of Metastatic Merkel Cell Carcinoma

Author

Roberto Vicentini, Giampiero Macarri, Fillipo Antonini, and Sara Giorgini

Subjects
Endoscopic ultrasound, PET-CT, medicine.medical_specialty, medicine.diagnostic_test, Merkel cell carcinoma, business.industry, Gastroenterology, medicine.disease, Fine-needle aspiration, medicine.anatomical_structure, medicine, Radiology, business, Lymph node
Published
2019

30. P.03.15 APPLICABILITY OF A CHECKLIST FOR THE DIAGNOSIS AND TREATMENT OF SEVERE EXOCRINE PANCREATIC INSUFFICIENCY (EPI). PRELIMINARY RESULTS OF AN EPI ITALIAN REGISTRY (EPITALY)

Author

Giampiero Macarri, Alessandro Zerbi, G. Capurso, Guido Costamagna, A. Di Leo, Massimo Falconi, P. Salacone, Luca Frulloni, Raffaele Pezzilli, and Antonio Carroccio

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, Medicine, business, Exocrine pancreatic insufficiency, medicine.disease, Checklist
Published
2019

31. Pancreatic disorders in inflammatory bowel disease

Author

Lucia Angelelli, Giampiero Macarri, Filippo Antonini, and Raffaele Pezzilli

Subjects
medicine.medical_specialty, Crohn's disease, Pancreatic disease, business.industry, Minireviews, medicine.disease, Ulcerative colitis, Inflammatory bowel disease, Gastroenterology, digestive system, digestive system diseases, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Internal medicine, medicine, Acute pancreatitis, Pancreatitis, 030211 gastroenterology & hepatology, business, Pancreas, Exocrine pancreatic insufficiency
Abstract

An increased incidence of pancreatic disorders either acute pancreatitis or chronic pancreatitis has been recorded in patients with inflammatory bowel disease (IBD) compared to the general population. Although most of the pancreatitis in patients with IBD seem to be related to biliary lithiasis or drug induced, in some cases pancreatitis were defined as idiopathic, suggesting a direct pancreatic damage in IBD. Pancreatitis and IBD may have similar presentation therefore a pancreatic disease could not be recognized in patients with Crohn's disease and ulcerative colitis. This review will discuss the most common pancreatic diseases seen in patients with IBD.

Published
2016

32. Successful closure of anastomotic dehiscence after colon–rectal cancer resection using the Apollo overstitch suturing system

Author

Fillipo Antonini, V. Belfiori, Walter Siquini, Giampiero Macarri, Samuele Deminicis, B. Marraccini, and S. Piergallini

Subjects
Male, Reoperation, medicine.medical_specialty, Treatment outcome, Anastomotic Leak, Anastomosis, Dehiscence, Resection, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Colectomy, Aged, business.industry, Anastomosis, Surgical, Suture Techniques, Gastroenterology, Endoscopy, Surgical Instruments, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Colon rectal cancer, 030211 gastroenterology & hepatology, Colorectal Neoplasms, Tomography, X-Ray Computed, business
Published
2017

33. OC.05.3: Endoscopic Ultrasound-Guided Tissue Sampling with a New 20G Biopsy Needle for the Characterization of Gastrointestinal Subepithelial Lesions: Results of a Preliminary Multicenter Study

Author

Gabriele Delconte, Filippo Antonini, E. Armellini, Giampiero Macarri, Gianpiero Manes, E.D. Mandelli, Carlo Fabbri, A. Magarotto, Adele Fornelli, Lorenzo Fuccio, G. De Nucci, Enzo Masci, Pietro Occhipinti, and Leonardo Frazzoni

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Hepatology, medicine.diagnostic_test, Multicenter study, business.industry, Biopsy, Gastroenterology, Medicine, Radiology, Tissue sampling, business
Published
2017

34. Metastatic melanoma of the gallbladder diagnosed by EUS-guided FNA

Author

Lucia Angelelli, Filippo Antonini, Luigi Acito, Stefano Sisti, and Giampiero Macarri

Subjects
Oncology, medicine.medical_specialty, Skin Neoplasms, Metastatic melanoma, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Melanoma, Melanoma diagnosis, Aged, business.industry, Gallbladder, Gastroenterology, medicine.disease, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, Gallbladder Neoplasms, 030211 gastroenterology & hepatology, Gallbladder Neoplasm, business
Published
2016

36. Endoscopic ultrasonography in chronic asymptomatic pancreatic hyperenzymemia: Why not?

Author

Filippo Antonini, Raffaele Pezzilli, and Giampiero Macarri

Subjects
medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, MEDLINE, Endoscopic ultrasonography, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Chronic disease, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, Radiology, medicine.symptom, Ultrasonography, Pancreas, business
Published
2018

37. An Analysis of the Factors Associated With the Development of Complications in Patients Undergoing Precut Sphincterotomy: A Prospective, Controlled, Randomized, Multicenter Study

Author

Gabriele Bianchi Porro, Pietro Di Giorgio, Gianpiero Manes, Alessandro Repici, Sandro Ardizzone, and Giampiero Macarri

Subjects
medicine.medical_specialty, Hepatology, business.industry, Treatment outcome, Gastroenterology, Precut sphincterotomy, Surgery, law.invention, Randomized controlled trial, Multicenter study, law, Medicine, In patient, business, Prospective cohort study, Complication
Abstract

An Analysis of the Factors Associated With the Development of Complications in Patients Undergoing Precut Sphincterotomy: A Prospective, Controlled, Randomized, Multicenter Study

Published
2009

38. Endoscopic ultrasound diagnosis of a primary hepatoid carcinoma of the pancreas

Author

Corrado Rubini, Giampiero Macarri, Lucia Angelelli, and Filippo Antonini

Subjects
Endoscopic ultrasound, Male, Pathology, medicine.medical_specialty, Carcinoembryonic antigen, Biopsy, Carcinoma, medicine, Pancreatic mass, Humans, Endoscopic Ultrasound-Guided Fine Needle Aspiration, medicine.diagnostic_test, biology, business.industry, Gastroenterology, Chromogranin A, Middle Aged, medicine.disease, digestive system diseases, Pancreatic Neoplasms, medicine.anatomical_structure, Hepatocellular carcinoma, biology.protein, Pancreas, business
Abstract

hepatoid carcinoma of the pancreas A 59-year-old man with a history of diabetes mellitus and smoking was referred for the evaluation of weight loss and abdominal discomfort. Abdominal computed tomography revealed mild ascites, multiple liver nodules, hepatic hilar lymphadenopathy, and a 60×50-mmsolid exophytic mass in the pancreatic body (●" Fig.1). The serum lipase, transaminase, bilirubin, alpha-fetoprotein (AFP), chromogranin A, cancer antigen (CA) 19-9, and carcinoembryonic antigen (CEA) levels were within normal range. Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) of the pancreatic mass was performedwith a 19-gauge ProCore needle (Cook Medical, WinstonSalem, North Carolina, USA) (●" Fig.2). On histologic examination, the specimen exhibited monomorphic neoplastic cells, with moderate atypia and occasional mitoses, arranged in solid nests and a trabecular pattern. The cells had indistinct cytoplasmic borders, large central oval nuclei, occasional nucleoli, and abundant eosinophilic cytoplasm, with the appearance of hepatocellular carcinoma (HCC) (●" Fig.3). No bile production was identified. The tumor cells reacted strongly with Hep Par 1 and were negative for chromogranin, synaptophysin, AFP, cytokeratin (CK) 7, and CK20 (●" Fig.4). Primary pancreatic hepatoid carcinoma or metastatic/ectopic HCC was suspected. Sorafenib (Nexavar; Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals) at a reduced dose of 200mg twice daily was commenced and produced a short-term clinical benefit. The patient’s condition then quickly deteriorated, hepatic failure developed, and he died 4 months after the diagnosis. Pancreatic hepatoid carcinoma is an uncommon neoplasm sharing morphologic and immunohistochemical features with HCC. It seems to originate from ectopic liver tissue located in various organs, including the pancreas. Specifically, pancreatic hepatoid carcinoma, despite its morphologic appearance of a well-differentiated carcinoma, is a very aggressive neoplasm that is often associated with liver and lymph node metastases at the time of diagnosis, mimicking a metastatic HCC [1–3]. In this case, histologic typing was obtained by EUS-FNB of the pancreatic mass, after which immunohistochemistry and the clinical behavior led to a diagnosis of pancreatic hepatoid carcinoma.

Published
2015

40. Are we ready for early discharge of patients with mild non-alcoholic acute interstitial pancreatitis?

Author

Giampiero Macarri, Raffaele Pezzilli, Filippo Antonini, and Samuele De Minicis

Subjects
medicine.medical_specialty, Pancreatitis, Alcoholic, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Gastroenterology, Non alcoholic, Alcoholism, 03 medical and health sciences, 0302 clinical medicine, Text mining, Pancreatitis, 030220 oncology & carcinogenesis, Internal medicine, Acute Disease, Humans, Medicine, 030211 gastroenterology & hepatology, business, Early discharge, Interstitial pancreatitis
Published
2016

41. V.02.13 METASTATIC MELANOMA OF THE GALLBLADDER DIAGNOSED BY ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE BIOPSY

Author

M. Lo Cascio, Filippo Antonini, L. Acito, S. De Minicis, B. Marraccini, P. Rossetti, S. Sisti, L. Angelelli, V. Belfiori, E. Andrenacci, Giampiero Macarri, and S. Piergallini

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Hepatology, medicine.diagnostic_test, Metastatic melanoma, business.industry, General surgery, Gallbladder, Gastroenterology, Fine needle biopsy, medicine.anatomical_structure, Medicine, Radiology, business
Published
2016

42. OC.08.7 BILIARY STENT DOES NOT INFLUENCE THE ADEQUACY AND ACCURACY OF EUS-GUIDED TISSUE ACQUISITION WITH FENESTRATED NEEDLES OF PANCREATIC MASSES CAUSING OBSTRUCTIVE JAUNDICE

Author

S. De Minicis, V. Belfiori, M. Lo Cascio, S. Piergallini, Lorenzo Fuccio, Carlo Fabbri, E. Andrenacci, Giampiero Macarri, B. Marraccini, Filippo Antonini, and Leonardo Frazzoni

Subjects
Tissue acquisition, medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Biliary stent, Medicine, Obstructive jaundice, Radiology, business
Published
2016

45. P.06.25: EUS-Guided 25 GAUGE-Needle Core Biopsy as a Salvage Strategy for the Diagnosis of Small Subepithelial Tumors of the Upper Gastrointestinal Tract

Author

Filippo Antonini, Lorenzo Fuccio, S. De Minicis, P. Rossetti, Giampiero Macarri, E. Andrenacci, M. Lo Cascio, S. Calcina, B. Marraccini, S. Piergallini, V. Belfiori, L. Angelelli, and S. Traini

Subjects
medicine.medical_specialty, Hepatology, Needle core biopsy, business.industry, General surgery, Gauge (instrument), Gastroenterology, Medicine, Upper gastrointestinal, Radiology, business
Published
2017

48. Bleeding localized amyloidosis of the colon

Author

Filippo Antonini, Gaia Goteri, and Giampiero Macarri

Subjects
Male, Pathology, medicine.medical_specialty, Plasma cell dyscrasia, Rectum, Haematoxylin, chemistry.chemical_compound, Colonic Diseases, Submucosa, Biopsy, medicine, Ascending colon, Humans, Hepatology, medicine.diagnostic_test, business.industry, Amyloidosis, Gastroenterology, Middle Aged, medicine.disease, Staining, medicine.anatomical_structure, chemistry, business, Gastrointestinal Hemorrhage
Abstract

A 63-year-old male patient presented with haematochezia. here were no accompanying symptoms and routine blood tests esulted normal. A colonoscopy revealed several submucosal umours from the ascending colon to the rectum, some of them with ctive haemorrhage (Fig. 1A and B). Endoscopic haemostasis was chieved with haemoclips. Biopsy specimens of the lesions showed he deposition of amorphous, homogeneous, and acidophilic mateial mainly in the submucosa in Haematoxylin and Eosin stained issue sections (Fig. 2A). Amyloidosis was confirmed with Congoed staining that showed the typical apple-green birefringence nder polarized light (Fig. 2B). Further examinations did not reveal any evidence of extrainestinal amyloidosis nor plasma cell dyscrasia. No specific

Published
2014

49. Primary biliary cirrhosis: modalities of injury and death in biliary epithelium

Author

Luca Marucci, Laura Ugili, E. Bendia, A.M. Jezequel, F. Orlandi, Angiolo Benedetti, Giuseppe Feliciangeli, and Giampiero Macarri

Subjects
Male, medicine.medical_specialty, Pathology, Biopsy, Apoptosis, Gastroenterology, Cholangiocyte, chemistry.chemical_compound, Cytokeratin, Primary biliary cirrhosis, Cholestasis, Metaplasia, Internal medicine, medicine, Humans, Sirius Red, Hepatology, medicine.diagnostic_test, Liver Cirrhosis, Biliary, Bile duct, business.industry, Keratin-7, medicine.disease, Immunohistochemistry, Microscopy, Electron, medicine.anatomical_structure, chemistry, Keratins, Female, Bile Ducts, medicine.symptom, business, Biomarkers
Abstract

Background/Aim. Despite the number of studies on primary biliary cirrhosis, contrasting data remain concerning modalities of cholangiocyte death. Liver biopsies obtained from 40 patients with anti mitochondrial antibody-positive primary biliary cirrhosis, at various stages of the disease, were examined, and special attention was paid to the expression of subcellular damage and evidence of apoptosis. Methods. Liver sections were stained with haematoxylin/eosin or Sirius red. Ductular mass was evaluated on sections after cytokeratin 7 staining. Apoptosis was evaluated on haematoxylin/eosin stained material or after processing for terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling assay. In 16 patients, part of the biopsy was processed for electron microscopy. Twenty histologically normal liver biopsies were used for control purposes. Results. According to Scheuer's classification, 29 patients were classified as stage I–ll, and 11 as stage III–IV. A strong staining of bile ducts was evident after immunohistochemistry for cytokeratin 7, often associated with ductular metaplasia in lobular zone 1. Cytokeratin 7-positive cells occupied 3.0±1.3% of liver mass as compared to 0.25±0.03% in controls. Ductular metaplasia accounted for 1.4±0.07% of all cytokeratin 7-positive cells. Regardless of staging, apoptosic bodies were seen only exceptionally in epithelial wall of bile ducts, whereas cholangiocyte damage leading to extensive lytic necrosis appeared responsible for most of the bile duct mass loss, as also confirmed by ultrastructural studies. A few terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling-positive nuclei were occasionally associated with the inflammatory infiltrate and evidence of apoptosis in hepatocytes was frequent, especially in zone 1. Conclusion. Regardless of staging, lytic necrosis and not apoptosis accounts for most of the bile duct loss in primary biliary cirrhosis. Furthermore, ductular metaplasia appears as a late event with highly variable pattern being observed between patients.

Published
2001

50. [Endoscopic ultrasound in the diagnosis of pancreatic cystic lesions]

Author

Filippo, Antonini and Giampiero, Macarri

Subjects
Adult, Male, Pancreatic Neoplasms, Pancreatic Pseudocyst, Humans, Female, Middle Aged, Pancreatic Cyst, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Aged, Endosonography
Abstract

Pancreatic cystic lesions are increasingly being detected in clinical practice. They are commonly asymptomatic and incidentally discovered. Distinction between neoplastic and benign lesions is crucial for determining treatment but definite diagnosis is often difficult. Endoscopic ultrasound (EUS), with additional EUS-guided fine needle aspiration (EUS-FNA), has emerged as an ideal technique in the evaluation of these lesions.

Published
2013

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