11 results on '"Igor Bacchilega"'
Search Results
2. Ultrasound imaging and central venous pressure in spontaneously breathing patients: a comparison of ultrasound-based measures of internal jugular vein and inferior vena cava
- Author
-
Nicola Parenti, Luca Bastiani, Cesare Tripolino, and Igor Bacchilega
- Subjects
inferior vena cava ,internal jugular vein ,ultrasound ,spontaneously breathing patients ,Anesthesiology ,RD78.3-87.3 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Published
- 2022
- Full Text
- View/download PDF
3. EUS-guided transrectal drainage of pelvic fluid collections using electrocautery-enhanced lumen-apposing metal stents: a case series
- Author
-
Andrea Lisotti, MD, Anna Cominardi, MD, Igor Bacchilega, MD, Romano Linguerri, MD, and Pietro Fusaroli, MD
- Subjects
Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and Aims: Pelvic fluid collections (PFCs) are frequent adverse events of abdominal surgery or inflammatory conditions. A percutaneous approach to deep PFCs could be challenging and result in a longer, painful recovery. The transvaginal approach has been considered easy but is limited by the difficulty of leaving a stent in place. The transrectal approach has been described, but issues related to fecal contamination were hypothesized. Data on EUS-guided transrectal drainage (EUS-TRD) with lumen-apposing metal stents (LAMSs) are few and suggest unsatisfactory outcomes. The aim of this study was to evaluate the safety and efficacy of EUS-TRD with LAMSs in patients with PFCs. Methods: A retrospective analysis of a prospectively maintained database on therapeutic EUS was conducted. All EUS-TRD procedures were included. Results: Five patients (2 male, age 44-89 years) were included. Four patients had postoperative PFCs, and 1 presented with a pelvic abscess complicating acute diverticulitis. Two of 5 had fecal diversion; the remaining 3 had unaltered large-bowel anatomy. One case had a concomitant abdominal collection, treated with percutaneous drainage in the same session. An electrocautery-enhanced LAMS delivery system (15 × 10 mm) was used in all cases. EUS-TRD was performed with the direct-puncture technique and lasted less than 10 minutes in 4 cases; in the remaining case, needle puncture and LAMS placement over a guidewire was required, and the procedure length was 14 minutes. The clinical success rate was 100%. LAMSs were removed after a median of 14 (range, 12-24) days. One patient reported partial proximal LAMS migration after 24 days (mild adverse event). No PFC recurrence was observed. Conclusion: EUS-TRD with LAMSs is a safe and effective technique for treatment of PFCs. The use of 15- × 10-mm LAMSs allows rapid PFC resolution. EUS-TRD could be performed not only in patients with fecal diversion but also in cases of unaltered anatomy.
- Published
- 2020
- Full Text
- View/download PDF
4. Treatment of acute cholecystitis in high-risk surgical patients
- Author
-
Bertrand Napoleon, Carlo Fabbri, Pietro Fusaroli, Andrea Anderloni, Igor Bacchilega, Romano Linguerri, and Andrea Lisotti
- Subjects
medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Cholecystitis, Acute ,law.invention ,Endosonography ,Randomized controlled trial ,law ,parasitic diseases ,Internal Medicine ,Medicine ,Humans ,Aged ,Retrospective Studies ,business.industry ,Gallbladder ,General surgery ,Gastroenterology ,Retrospective cohort study ,Evidence-based medicine ,medicine.disease ,digestive system diseases ,humanities ,medicine.anatomical_structure ,Propensity score matching ,Cholecystitis ,Drainage ,Cholecystectomy ,business ,Cohort study - Abstract
Acute cholecystitis (AC) is the most common biliary stone disease complication. While there is consensus regarding cholecystectomy for AC, gallbladder drainage is indicated in elderly or high-risk surgical patients. We systematically reviewed available evidence in the field of EUS-guided gallbladder drainage (EUS-GBD) for AC in high-risk surgical patients. The studies were classified according to their level of evidence (LE) according to the Oxford Centre for Evidence Based Medicine classification. Literature search retrieved 175 manuscripts; most of them were expert opinions (LE V, no. 53) or caseseries (LE IV, no. 29). There was no meta-analysis of RCT (LE Ia), while two randomized controlled trials (LE Ib) demonstrated that EUS-GBD was superior to percutaneous trans-hepatic-GBD (PT-GBD) regarding longterm outcomes (adverse events, recurrent cholecystitis, and reintervention). Several meta-analyses of cohort studies (LE IIa, no. 11) were designed to compare the three available drainage strategies (endoscopic, echoendoscopic and percutaneous) and to assess the pooled risk of adverse events. Comparison between surgery and EUS-GBD was done in a single retrospective study with a propensity score analysis (LE III). The outcomes of conversion from PT-GBD to EUS-GBD were covered by few retrospective studies (LE III). Several manuscripts (no. 69) were published on EUS-GBD as a rescue strategy in case of malignant biliary obstruction. The levels of evidence of EUS-GBD in the literature have evolved from initial descriptive studies to recent randomized controlled trials and meta-analysis of cohort studies. While several articles addressed the comparison among different techniques for GBD, in our opinion some topics and questions have not been adequately investigated. are still debated.
- Published
- 2021
5. Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study
- Author
-
Antonio Poerio, Andrea Castelli, Sara Piciucchi, Giulia Falò, Davide Allegri, Marco Verri, Andrea Marudi, Massimiliano Mazzolini, Michele Imbriani, Loredana Franchini, Carlo Coniglio, Mirco Leo, Antonella Potalivo, Luigi Lazzari Agli, Roberta Nicali, Marco Cavagnino, Guglielmo Consales, Marina Terzitta, Harri Sintonen, Raffaella Papa, Maria Teresa Minguzzi, Cristiana Laici, Paolo Orlandi, Federica Damiani, Carlo Alberto Mazzoli, Silvia Orlando, Vito Marco Ranieri, Iacopo Cappellini, Valentina Chiarini, Elisa Marinangeli, Stefano Oldani, Virginia Buldini, Marco Tartaglione, Gianluca Zani, Lorenzo Mellini, Carlo Alberto Volta, Irene Ottaviani, Silvia Candini, Filippo Becherucci, Emanuela Giampalma, Maria Concetta Lanza, Federica Ciccarese, Irene Cavalli, Annalisa Marchio, Bruno Balbi, Fabrizio Racca, Matteo Monari, Luca Morini, Anna Malfatto, Elisabetta Bertellini, Francesco Boni, Emanuele Russo, Lorenzo Viola, Michele Valli, Savino Spadaro, Martina Ferioli, Emanuele Matteo, Giovanni Gordini, Marco Contoli, Ilaria Valentini, Chiara Tartivita, Alessia Guzzo, Lorenzo Giuntoli, Gaetano Scaramuzzo, Davide Colombo, Jessica Maccieri, Luca Bissoni, Stefano Nava, Angela Bellocchio, Patrizio Goti, Laura Bernabé, Jonathan Montomoli, Stefano Maitan, Tommaso Meconi, Angelo Senzi, Lorenzo Gamberini, Silvia Pareschi, Stefania Taddei, Angelica Venni, Fabio Ferrari, Marco Miceli, Chiara Capozzi, Elisabetta Marangoni, Lorenzo Tutino, Giulia Felloni, Antonio Siniscalchi, Giacinto Pizzilli, Francesco Muratore, Giorgia Dalpiaz, Federico Moro, Daniele Fecarotti, Vanni Agnoletti, Gabriele Melegari, Rita Golfieri, Federico Domenico Baccarini, Francesca Facondini, Patrizia Pompa Cleta, Marianna Padovani, Eva Bernardi, Tommaso Tonetti, Angelina Adduci, Federico Daniele, Anna Filomena Ferravante, Maurizio Fusari, Igor Bacchilega, Claudia Ravaglia, Nicola Cilloni, Martina Mughetti, Vittorio Pavoni, Ersenad Neziri, Irene Prediletto, Aline Pagni, Gamberini L., Mazzoli C.A., Prediletto I., Sintonen H., Scaramuzzo G., Allegri D., Colombo D., Tonetti T., Zani G., Capozzi C., Dalpiaz G., Agnoletti V., Cappellini I., Melegari G., Damiani F., Fusari M., Gordini G., Laici C., Lanza M.C., Leo M., Marudi A., Papa R., Potalivo A., Montomoli J., Taddei S., Mazzolini M., Ferravante A.F., Nicali R., Ranieri V.M., Russo E., Volta C.A., Spadaro S., Tartaglione M., Chiarini V., Buldini V., Coniglio C., Moro F., Orlando S., Fecarotti D., Cilloni N., Giuntoli L., Bellocchio A., Matteo E., Pizzilli G., Siniscalchi A., Tartivita C., Cavalli I., Castelli A., Marchio A., Bacchilega I., Bernabe L., Facondini F., Morini L., Bissoni L., Viola L., Meconi T., Pavoni V., Venni A., Pagni A., Cleta P.P., Cavagnino M., Guzzo A., Malfatto A., Adduci A., Pareschi S., Bertellini E., Maccieri J., Marinangeli E., Racca F., Verri M., Falo G., Marangoni E., Ottaviani I., Boni F., Felloni G., Baccarini F.D., Terzitta M., Maitan S., Tutino L., Senzi A., Consales G., Becherucci F., Imbriani M., Orlandi P., Candini S., Golfieri R., Ciccarese F., Poerio A., Muratore F., Ferrari F., Mughetti M., Giampalma E., Franchini L., Neziri E., Miceli M., Minguzzi M.T., Mellini L., Piciucchi S., Monari M., Valli M., Daniele F., Ferioli M., Nava S., Lazzari Agli L.A., Valentini I., Bernardi E., Balbi B., Contoli M., Padovani M., Oldani S., Ravaglia C., and Goti P.
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,Health-related quality of life ,Population ,Article ,NO ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,DLCO ,Acute respiratory distress syndrome ,COVID-19 ,Dyspnea ,Respiratory function tests ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Survivors ,education ,Aged ,Mechanical ventilation ,Health related quality of life ,education.field_of_study ,Respiratory Distress Syndrome ,business.industry ,Middle Aged ,Respiration, Artificial ,Patient Discharge ,humanities ,3. Good health ,Intensive Care Units ,030228 respiratory system ,Italy ,Quality of Life ,Female ,business ,Icu discharge ,Follow-Up Studies - Abstract
Background Health-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes. We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested. Methods We followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters. Results We found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified: full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV. Conclusions HRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations. Trial registration NCT04411459.
- Published
- 2021
6. Endoscopic ultrasound-guided jejuno-jejunal anastomosis for malignant outlet obstruction after total gastrectomy
- Author
-
Martina Valgiusti, Claudio Calvanese, Pietro Fusaroli, Igor Bacchilega, Andrea Lisotti, Lisotti, Andrea, Calvanese, Claudio, Valgiusti, Martina, Bacchilega, Igor, and Fusaroli, Pietro
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Anastomosis, Surgical ,Gastroenterology ,Jejuno-jejunal ,Anastomosis ,Surgery ,Endosonography ,Jejunum ,Gastrectomy ,Intestine, Small ,medicine ,Humans ,business ,Ultrasonography, Interventional - Abstract
NA
- Published
- 2020
7. EUS-guided gallbladder drainage in high-risk surgical patients with acute cholecystitis-procedure outcomes and evaluation of mortality predictors
- Author
-
Gianmarco Marocchi, Anna Cominardi, Romano Linguerri, Pietro Fusaroli, Igor Bacchilega, Andrea Lisotti, Lisotti A., Linguerri R., Bacchilega I., Cominardi A., Marocchi G., and Fusaroli P.
- Subjects
Male ,medicine.medical_specialty ,Multivariate analysis ,Cholecystitis, Acute ,Article ,Endosonography ,03 medical and health sciences ,LAMS ,ERCP ,0302 clinical medicine ,AKI ,Internal medicine ,Medicine ,Humans ,PT-GBD ,Adverse effect ,Aged ,Retrospective Studies ,Univariate analysis ,business.industry ,Gallbladder ,Hazard ratio ,Acute kidney injury ,Hepatology ,medicine.disease ,Hot-axios ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Hot-axio ,Drainage ,030211 gastroenterology & hepatology ,Surgery ,Female ,Stents ,business ,Charlson Comorbidity Index ,Abdominal surgery - Abstract
Background Recent evidences suggest that gallbladder drainage is the treatment of choice in elderly or high-risk surgical patients with acute cholecystitis (AC). Despite better outcomes compared to other approaches, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is burdened by high mortality. The aim of the study was to evaluate predictive factors for mortality in high-risk surgical patients who underwent EUS-GBD for AC. Methods A retrospective analysis of a prospectively maintained database was performed. Electrocautery-enhanced lumen-apposing metal stents were used; all recorded variables were evaluated as potential predictive factors for mortality. Results Thirty-four patients underwent EUS for suspected AC and 25 (44% male, age 78) were finally included. Technical, clinical success rate and adverse events rate were 92%, 88%, and 16%, respectively. 30-day and 1-year mortality were 12% and 32%. On univariate analysis, age-adjusted Charlson Comorbidity Index (CCI) (OR 20.8[4–68.2]), acute kidney injury (AKI) (OR 21.4[2.6–52.1]) and clinical success (OR 8.9[1.2–11.6]) were related to 30-day mortality. On multivariate analysis, CCI and AKI were independently related to long-term mortality. Kaplan–Meier curves showed an increased long-term mortality in patients with CCI > 6 (hazard ratio 7.6[1.7–34.6]) and AKI (hazard ratio 11.3[1.4–91.5]). Conclusions Severe comorbidities and AKI were independent predictive factors confirming of long-term mortality after EUS-GBD. Outcomes of EUS-GBD appear more influenced by patients’ conditions rather than by procedure success. Supplementary Information The online version of this article (10.1007/s00464-021-08318-z) contains supplementary material, which is available to authorized users.
- Published
- 2020
8. Endoscopic ultrasound-guided gallbladder drainage as a strategy to overcome shortage of operating rooms and intensive care unit beds during Covid-19 crisis
- Author
-
Igor Bacchilega, Romano Linguerri, Pietro Fusaroli, Andrea Lisotti, Lisotti, Andrea, Bacchilega, Igor, Linguerri, Romano, and Fusaroli, Pietro
- Subjects
Endoscopic ultrasound ,2019-20 coronavirus outbreak ,China ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,Economic shortage ,Risk Assessment ,Severity of Illness Index ,law.invention ,Endosonography ,Betacoronavirus ,law ,Cholecystitis ,Cholecystiti ,Medicine ,Humans ,Minimally Invasive Surgical Procedures ,Drainage ,E-Videos ,Pandemics ,Ultrasonography, Interventional ,Aged, 80 and over ,Betacoronaviru ,Pandemic ,medicine.diagnostic_test ,Coronavirus Infection ,business.industry ,SARS-CoV-2 ,Gallbladder ,Gastroenterology ,COVID-19 ,Minimally Invasive Surgical Procedure ,medicine.disease ,Intensive care unit ,medicine.anatomical_structure ,Treatment Outcome ,Surgery, Computer-Assisted ,Hospital Bed Capacity ,Female ,Medical emergency ,Patient Safety ,business ,Coronavirus Infections ,Human - Abstract
ND
- Published
- 2020
9. EUS-guided transrectal drainage of pelvic fluid collections using electrocautery-enhanced lumen-apposing metal stents: a case series
- Author
-
Pietro Fusaroli, Andrea Lisotti, Anna Cominardi, Romano Linguerri, Igor Bacchilega, Lisotti A., Cominardi A., Bacchilega I., Linguerri R., and Fusaroli P.
- Subjects
medicine.medical_specialty ,Percutaneous ,business.industry ,medicine.medical_treatment ,Video Case Series ,Gastroenterology ,PFC, pelvic fluid collection ,Lumen (anatomy) ,Stent ,digestive system diseases ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,EUS-TRD, EUS-guided trans-rectal drainage ,030220 oncology & carcinogenesis ,Concomitant ,LAMS, lumen-apposing metal stent ,Medicine ,030211 gastroenterology & hepatology ,Radiology, Nuclear Medicine and imaging ,Delivery system ,Drainage ,business ,Adverse effect ,Abdominal surgery - Abstract
Background and Aims Pelvic fluid collections (PFCs) are frequent adverse events of abdominal surgery or inflammatory conditions. A percutaneous approach to deep PFCs could be challenging and result in a longer, painful recovery. The transvaginal approach has been considered easy but is limited by the difficulty of leaving a stent in place. The transrectal approach has been described, but issues related to fecal contamination were hypothesized. Data on EUS-guided transrectal drainage (EUS-TRD) with lumen-apposing metal stents (LAMSs) are few and suggest unsatisfactory outcomes. The aim of this study was to evaluate the safety and efficacy of EUS-TRD with LAMSs in patients with PFCs. Methods A retrospective analysis of a prospectively maintained database on therapeutic EUS was conducted. All EUS-TRD procedures were included. Results Five patients (2 male, age 44-89 years) were included. Four patients had postoperative PFCs, and 1 presented with a pelvic abscess complicating acute diverticulitis. Two of 5 had fecal diversion; the remaining 3 had unaltered large-bowel anatomy. One case had a concomitant abdominal collection, treated with percutaneous drainage in the same session. An electrocautery-enhanced LAMS delivery system (15 × 10 mm) was used in all cases. EUS-TRD was performed with the direct-puncture technique and lasted less than 10 minutes in 4 cases; in the remaining case, needle puncture and LAMS placement over a guidewire was required, and the procedure length was 14 minutes. The clinical success rate was 100%. LAMSs were removed after a median of 14 (range, 12-24) days. One patient reported partial proximal LAMS migration after 24 days (mild adverse event). No PFC recurrence was observed. Conclusion EUS-TRD with LAMSs is a safe and effective technique for treatment of PFCs. The use of 15- × 10-mm LAMSs allows rapid PFC resolution. EUS-TRD could be performed not only in patients with fecal diversion but also in cases of unaltered anatomy.
- Published
- 2020
10. Failed endoscopic ultrasound-guided gallbladder drainage due to severe bleeding immediately rescued by redo-drainage under contrast-harmonic guidance
- Author
-
Igor Bacchilega, Anna Cominardi, Pietro Fusaroli, Andrea Lisotti, Lisotti A., Cominardi A., Bacchilega I., and Fusaroli P.
- Subjects
Endoscopic ultrasound ,Severe bleeding ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Gallbladder ,Gastroenterology ,Contrast (music) ,Endosonography ,medicine.anatomical_structure ,medicine ,Radiology ,Drainage ,business - Abstract
ND
- Published
- 2020
11. EUS-GUIDED GALLBLADDER DRAINAGE (EUS-GBD) WITH LUMEN-APPOSING METAL-STENT – BEYOND BILIARY ISSUES. SEDATION AND AIRWAYS MANAGEMENT, ICU ADMISSION AND GENERAL OUTCOMES
- Author
-
Elio Jovine, Andrea Lisotti, Igor Bacchilega, Pietro Fusaroli, Anna Cominardi, Claudio Calvanese, Romano Linguerri, and Marta Serrani
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Sedation ,Gallbladder ,medicine.medical_treatment ,Medicine ,Stent ,medicine.symptom ,business ,Icu admission ,Surgery ,Lumen (unit) - Published
- 2019
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.