17 results on '"Konradsson, M."'
Search Results
2. Correction: ERAS guidelines-driven upper gastrointestinal contrast study after esophagectomy can detect delayed gastric conduit emptying and improve outcomes
- Author
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Klevebro, F., Konradsson, M., Han, S., Luttikhold, J., Nilsson, M., Lindblad, M., Andersson, M., and Low, D. E.
- Published
- 2023
- Full Text
- View/download PDF
3. Incidence and outcomes in patients with acute cholangitis: a population-based study.
- Author
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Fridgeirsson, H. F., Konradsson, M., Vesteinsdottir, E., and Bjornsson, E. S.
- Subjects
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CHOLANGITIS , *GALLSTONES , *ENDOSCOPIC retrograde cholangiopancreatography , *TREATMENT effectiveness - Abstract
The importance of early ERCP (endoscopic retrograde cholangiopancreatography) in patients with acute cholangitis (AC) is controversial. The aims were to compare outcomes in those who had early ERCP within 24 h from diagnosis and those who had ERCP undertaken later and examine the general prognosis of AC patients. A prospective endoscopic database was used to identify all patients who underwent ERCP 2010–2021 at Landspitali University Hospital, diagnosed with cholangitis (k83.0) or calculus of bile duct with cholangitis (k80.3) according to ICD-10 diagnostic codes. Tokyo guidelines were used to verify the diagnosis and severity. Sepsis was analyzed by the Sepsis-3 criteria. A total of 240 patients met the inclusion criteria, 107 women (45%), median age 74 years, mostly due to gallstones (75%) and malignancy (19%), 61 (25%) underwent ERCP early. Overall 30-day mortality was 3.3% and was not significantly different between the early and late ERCP groups (4.9% vs 2.5% respectively). Patients who underwent early ERCP were more likely to have severe cholangitis according to the Tokyo guidelines criteria than those who underwent ERCP later (31% vs 18%, p = 0.047) but had a shorter median hospital stay (4 vs. 6 days, p = 0.006). Sepsis was more common among those who had ERCP early than those who had late ERCP (33% vs 19%, p = 0.033). The results indicate that for patients with AC the timing of ERCP is an important factor influencing the hospital stay, with shorter hospital stay for patients receiveing ERCP within 24 h, despite more severe cholangitis at diagnosis. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
4. ERAS guidelines-driven upper gastrointestinal contrast study after esophagectomy can detect delayed gastric conduit emptying and improve outcomes
- Author
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Klevebro, F., primary, Konradsson, M., additional, Han, S., additional, Luttikhold, J., additional, Nilsson, M., additional, Lindblad, M., additional, Andersson, M., additional, and Low, D. E., additional
- Published
- 2022
- Full Text
- View/download PDF
5. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified delphi process
- Author
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Konradsson, M, van Berge Henegouwen, Mark I, et al, Gutschow, Christian A, Moorthy, Krishna, Schneider, P M, and University of Zurich
- Subjects
gastric emptying ,consensus ,Gastroenterology ,esophagectomy ,610 Medicine & health ,2715 Gastroenterology ,General Medicine ,malnutrition ,10217 Clinic for Visceral and Transplantation Surgery - Published
- 2020
6. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process
- Author
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Konradsson, M., Berge Henegouwen, M.I. van, Bruns, C., Chaudry, M.A., Cheong, E., Cuesta, M.A., Darling, G.E., Gisbertz, S.S., Griffin, S.M., Gutschow, C.A., Hillegersberg, R. van, Hofstetter, W., Hölscher, A.H., Kitagawa, Y., Lanschot, J.Jan B. van, Lindblad, M., Ferri, L.E., Low, D.E., Luyer, M.D., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C.R., Nafteux, P., Nieuwehuijzen, G.A.P., Pattyn, P., Rosman, C., Ruurda, J.P., Räsänen, J., Schneider, P.M., Schröder, W., Sgromo, B., Veer, H. van der, Wijnhoven, B.P., Nilsson, M., Konradsson, M., Berge Henegouwen, M.I. van, Bruns, C., Chaudry, M.A., Cheong, E., Cuesta, M.A., Darling, G.E., Gisbertz, S.S., Griffin, S.M., Gutschow, C.A., Hillegersberg, R. van, Hofstetter, W., Hölscher, A.H., Kitagawa, Y., Lanschot, J.Jan B. van, Lindblad, M., Ferri, L.E., Low, D.E., Luyer, M.D., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C.R., Nafteux, P., Nieuwehuijzen, G.A.P., Pattyn, P., Rosman, C., Ruurda, J.P., Räsänen, J., Schneider, P.M., Schröder, W., Sgromo, B., Veer, H. van der, Wijnhoven, B.P., and Nilsson, M.
- Abstract
Contains fulltext : 225948.pdf (Publisher’s version ) (Open Access), Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated web-based questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.
- Published
- 2020
7. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process
- Author
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Konradsson, M. (M.), van Berge Henegouwen, M.I., Bruns, C. (C.), Chaudry, M.A. (M. A.), Cheong, E. (E.), Cuesta, M.A. (M. A.), Darling, G.E. (Gail E.), Gisbertz, S.S. (Suzanne S.), Griffin, S.M. (Michael), Gutschow, C.A. (C. A.), Hillegersberg, R. (Richard) van, Hofstetter, W.L. (Wayne), Hölscher, A. (Arnulf), Kitagawa, Y. (Y.), Lanschot, J.J.B. (Jan) van, Lindblad, M. (M.), Ferri, L.E. (L. E.), Low, D.E. (D. E.), Luyer, M. (Misha), Ndegwa, N. (N.), Mercer, S. (S.), Moorthy, K. (K.), Morse, C.R. (C. R.), Nafteux, P. (P.), Nieuwehuijzen, G.A.P. (G. A.P.), Pattyn, P. (Piet), Rosman, C. (Camiel), Ruurda, J.P. (Jelle), Räsänen, J. (J.), Schneider, P.M. (P. M.), Schröder, W. (W.), Sgromo, B. (B.), Van Veer, H. (H.), Wijnhoven, B.P.L. (Bas), Nilsson, M. (M.), Konradsson, M. (M.), van Berge Henegouwen, M.I., Bruns, C. (C.), Chaudry, M.A. (M. A.), Cheong, E. (E.), Cuesta, M.A. (M. A.), Darling, G.E. (Gail E.), Gisbertz, S.S. (Suzanne S.), Griffin, S.M. (Michael), Gutschow, C.A. (C. A.), Hillegersberg, R. (Richard) van, Hofstetter, W.L. (Wayne), Hölscher, A. (Arnulf), Kitagawa, Y. (Y.), Lanschot, J.J.B. (Jan) van, Lindblad, M. (M.), Ferri, L.E. (L. E.), Low, D.E. (D. E.), Luyer, M. (Misha), Ndegwa, N. (N.), Mercer, S. (S.), Moorthy, K. (K.), Morse, C.R. (C. R.), Nafteux, P. (P.), Nieuwehuijzen, G.A.P. (G. A.P.), Pattyn, P. (Piet), Rosman, C. (Camiel), Ruurda, J.P. (Jelle), Räsänen, J. (J.), Schneider, P.M. (P. M.), Schröder, W. (W.), Sgromo, B. (B.), Van Veer, H. (H.), Wijnhoven, B.P.L. (Bas), and Nilsson, M. (M.)
- Abstract
Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated web-based questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.
- Published
- 2020
- Full Text
- View/download PDF
8. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified delphi process
- Author
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Konradsson, M; https://orcid.org/0000-0001-7215-236X, van Berge Henegouwen, Mark I; https://orcid.org/0000-0001-8689-3134, et al, Gutschow, Christian A; https://orcid.org/0000-0001-6171-4427, Moorthy, Krishna, Schneider, P M, Konradsson, M; https://orcid.org/0000-0001-7215-236X, van Berge Henegouwen, Mark I; https://orcid.org/0000-0001-8689-3134, et al, Gutschow, Christian A; https://orcid.org/0000-0001-6171-4427, Moorthy, Krishna, and Schneider, P M
- Abstract
Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated web-based questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air–fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have ‘quite a bit’ or ‘very much’ of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: ‘not at all’, ‘a little’, ‘quite a bit’, or ‘very much’, generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.
- Published
- 2020
9. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer:International expert consensus based on a modified Delphi process
- Author
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Konradsson, M., Van Berge Henegouwen, M. I., Bruns, C., Chaudry, M. A., Cheong, E., Cuesta, M. A., Darling, G. E., Gisbertz, S. S., Griffin, S. M., Gutschow, C. A., Van Hillegersberg, R., Hofstetter, W., Hölscher, A. H., Kitagawa, Y., Van Lanschot, J. J.B., Lindblad, M., Ferri, L. E., Low, D. E., Luyer, M. D.P., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C. R., Nafteux, P., Nieuwehuijzen, G. A.P., Pattyn, P., Rosman, C., Ruurda, J. P., Räsänen, J., Schneider, P. M., Schröder, W., Sgromo, B., Van Veer, H., Wijnhoven, B. P.L., Nilsson, M., Konradsson, M., Van Berge Henegouwen, M. I., Bruns, C., Chaudry, M. A., Cheong, E., Cuesta, M. A., Darling, G. E., Gisbertz, S. S., Griffin, S. M., Gutschow, C. A., Van Hillegersberg, R., Hofstetter, W., Hölscher, A. H., Kitagawa, Y., Van Lanschot, J. J.B., Lindblad, M., Ferri, L. E., Low, D. E., Luyer, M. D.P., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C. R., Nafteux, P., Nieuwehuijzen, G. A.P., Pattyn, P., Rosman, C., Ruurda, J. P., Räsänen, J., Schneider, P. M., Schröder, W., Sgromo, B., Van Veer, H., Wijnhoven, B. P.L., and Nilsson, M.
- Abstract
Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated webbased questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.
- Published
- 2020
10. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process
- Author
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Cancer, MS CGO, Konradsson, M, van Berge Henegouwen, M I, Bruns, C, Chaudry, M A, Cheong, E, Cuesta, M A, Darling, G E, Gisbertz, S S, Griffin, S M, Gutschow, C A, van Hillegersberg, R, Hofstetter, W, Hölscher, A H, Kitagawa, Y, van Lanschot, J J B, Lindblad, M, Ferri, L E, Low, D E, Luyer, M D P, Ndegwa, N, Mercer, S, Moorthy, K, Morse, C R, Nafteux, P, Nieuwehuijzen, G A P, Pattyn, P, Rosman, C, Ruurda, J P, Räsänen, J, Schneider, P M, Schröder, W, Sgromo, B, Van Veer, H, Wijnhoven, B P L, Nilsson, M, Cancer, MS CGO, Konradsson, M, van Berge Henegouwen, M I, Bruns, C, Chaudry, M A, Cheong, E, Cuesta, M A, Darling, G E, Gisbertz, S S, Griffin, S M, Gutschow, C A, van Hillegersberg, R, Hofstetter, W, Hölscher, A H, Kitagawa, Y, van Lanschot, J J B, Lindblad, M, Ferri, L E, Low, D E, Luyer, M D P, Ndegwa, N, Mercer, S, Moorthy, K, Morse, C R, Nafteux, P, Nieuwehuijzen, G A P, Pattyn, P, Rosman, C, Ruurda, J P, Räsänen, J, Schneider, P M, Schröder, W, Sgromo, B, Van Veer, H, Wijnhoven, B P L, and Nilsson, M
- Published
- 2020
11. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process
- Author
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Konradsson, M, primary, van Berge Henegouwen, M I, primary, Bruns, C, primary, Chaudry, M A, primary, Cheong, E, primary, Cuesta, M A, primary, Darling, G E, primary, Gisbertz, S S, primary, Griffin, S M, primary, Gutschow, C A, primary, van Hillegersberg, R, primary, Hofstetter, W, primary, Hölscher, A H, primary, Kitagawa, Y, primary, van Lanschot, J J B, primary, Lindblad, M, primary, Ferri, L E, primary, Low, D E, primary, Luyer, M D P, primary, Ndegwa, N, primary, Mercer, S, primary, Moorthy, K, primary, Morse, C R, primary, Nafteux, P, primary, Nieuwehuijzen, G A P, primary, Pattyn, P, primary, Rosman, C, primary, Ruurda, J P, primary, Räsänen, J, primary, Schneider, P M, primary, Schröder, W, primary, Sgromo, B, primary, Van Veer, H, primary, Wijnhoven, B P L, primary, and Nilsson, M, primary
- Published
- 2019
- Full Text
- View/download PDF
12. Focus on technical advances.
- Author
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Ørntoft, Torben F., Arnold, N., Hein, Jotun, Liehr, T., Nietzel, A., Starke, H., Heller, A., Weise, A., Mrasek, K., Claussen, U., Alfredsson, A., Johannsdottir, J., Konradsson, M., Kristjansdottir, S., Asmussen, J., and Jonsson, J.J.
- Subjects
MEDICAL technology ,NUCLEOTIDES ,CHROMATOGRAPHIC analysis - Abstract
Presents various developments in medical technology, as of October 10, 2002. Use of microarrays for single nucleotide polymorphism (SNP) and expression analysis of clinical samples; Denaturing high performance liquid chromatography analysis for cost effective mutation and SNP screening.
- Published
- 2002
- Full Text
- View/download PDF
13. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process.
- Author
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Konradsson M, van Berge Henegouwen MI, Bruns C, Chaudry MA, Cheong E, Cuesta MA, Darling GE, Gisbertz SS, Griffin SM, Gutschow CA, van Hillegersberg R, Hofstetter W, Hölscher AH, Kitagawa Y, van Lanschot JJB, Lindblad M, Ferri LE, Low DE, Luyer MDP, Ndegwa N, Mercer S, Moorthy K, Morse CR, Nafteux P, Nieuwehuijzen GAP, Pattyn P, Rosman C, Ruurda JP, Räsänen J, Schneider PM, Schröder W, Sgromo B, Van Veer H, Wijnhoven BPL, and Nilsson M
- Subjects
- Adult, Delphi Technique, Esophageal Motility Disorders etiology, Female, Gastric Emptying, Humans, Male, Middle Aged, Postoperative Complications etiology, Treatment Outcome, Esophageal Motility Disorders diagnosis, Esophageal Neoplasms surgery, Esophagectomy adverse effects, Postoperative Complications diagnosis, Symptom Assessment standards
- Abstract
Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated web-based questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process., (© The Author(s) 2019. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus.)
- Published
- 2020
- Full Text
- View/download PDF
14. Delayed emptying of the gastric conduit after esophagectomy.
- Author
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Konradsson M and Nilsson M
- Abstract
With increasing survival after esophagectomy for cancer, a growing number of individuals living with the functional results of a surgically altered anatomy calls for attention to the effects of delayed gastric conduit emptying (DGCE) on health-related quality of life and nutritional impairment. We here give an overview of the currently available literature on DGCE, in terms of epidemiology, pathophysiology, diagnostics, prevention and treatment. Attention is given to controversies in the current literature and obstacles related to general applicability of study results, as well as knowledge gaps that may be the focus for future research initiatives. Finally, we propose that measures are taken to reach international expert agreement regarding diagnostic criteria and a symptom grading tool for DGCE, and that functional radiological methods are established for the diagnosis and severity grading of DGCE., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
- Published
- 2019
- Full Text
- View/download PDF
15. The clinical value of ERCP-guided cholangiopancreatoscopy using a single-operator system.
- Author
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Reuterwall M, Lubbe J, Enochsson L, Lundell L, Konradsson M, Swahn F, Del Chiaro M, Löhr M, and Arnelo U
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Biliary Tract Diseases therapy, Child, Child, Preschool, Cholangiopancreatography, Endoscopic Retrograde adverse effects, Clinical Decision-Making, Female, Humans, Male, Middle Aged, Pancreatic Diseases therapy, Retrospective Studies, Risk Factors, Young Adult, Bile Ducts diagnostic imaging, Biliary Tract Diseases diagnostic imaging, Cholangiopancreatography, Endoscopic Retrograde methods, Pancreatic Diseases diagnostic imaging, Pancreatic Ducts diagnostic imaging
- Abstract
Background: Single-operator, per-oral cholangiopancreatoscopy (SOPCP) enables direct biliopancreatic ductal visualization, targeted tissue sampling, and therapeutic intervention. At Karolinska University Hospital, SOPCP was introduced early and has since been extensively utilized according to a standardized protocol. We analysed the clinical value of SOPCP in the diagnosis and treatment of biliopancreatic diseases in a single high volume center., Methods: All SOPCP procedures performed between March 2007 and December 2014 were retrospectively reviewed. Each procedure's diagnostic yield and therapeutic value was evaluated using a predefined 4 grade scale; 1 - no diagnostic or therapeutic value, 2 - information gained did not impact clinical decision-making and in case of a therapeutic intervention, did not alter the clinical course of the patient, 3 - information gained had an impact on clinical decision-making and in the case of a therapeutic intervention, assisted subsequent disease management, and finally, 4 - information gained was essential and critical for clinical decision-making and in case of a therapeutic intervention, solved the clinical problem requiring no further therapeutic actions. Descriptive statistics were used to analyse results, with uni- and multivariate analyses completed to assess risk of adverse events., Results: During the study period, 365 SOPCP procedures were performed. We found SOPCP of pivotal importance (grade 4) in 19% of cases, and of great clinical significance (grade 3) in 44% of cases. SOPCP did not affect clinical decision-making or alter clinical course (grade 1 and 2) in 37% of cases., Conclusion: SOPCP offers direct access to the biliopancreatic ducts for both diagnostic and therapeutic purposes, adding significant clinical value in 64% of cases., Trial Registration: As this is a purely observational and retrospectively registered study in which the assignment of the medical intervention was not at the discretion of the investigator, it has not been registered in a registry.
- Published
- 2019
- Full Text
- View/download PDF
16. [Esophageal endoscopic submucosal dissection for the treatment early esophageal neoplasia: results from a reference center in Scandinavia].
- Author
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Omae M, Konradsson M, Lindblad M, and Baldaque-Silva F
- Subjects
- Aged, Aged, 80 and over, Barrett Esophagus pathology, Carcinoma, Squamous Cell pathology, Endoscopic Mucosal Resection adverse effects, Esophageal Neoplasms pathology, Female, Humans, Male, Middle Aged, Sweden, Treatment Outcome, Barrett Esophagus surgery, Carcinoma, Squamous Cell surgery, Endoscopic Mucosal Resection methods, Esophageal Neoplasms surgery
- Abstract
Endoscopic submucosal dissection (ESD) is an established and effective treatment modality for endoscopic resection of premalignant and early-stage malignant gastrointestinal lesions. Compared to endoscopic mucosal resection (EMR), ESD is generally associated with higher rates of en bloc, R0, and curative resections and lower rates of local recurrence. As in ESD the whole lesion is resected in one piece, it enables the best possible T-staging based on pathology assessment of the resected lesion. So far, there have been few reports of esophageal ESD in the West and none from Scandinavia. We aim to describe for the first time in Scandinavia, the implementation and results of ESD for the treatment of esophageal neoplasia, namely early esophageal squamous cell neoplasia (ESCN) and Barrett's esophageal neoplasia (BEN).
- Published
- 2018
17. Delayed perforation after endoscopic submucosal dissection treated successfully by temporary stent placement.
- Author
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Omae M, Konradsson M, and Baldaque-Silva F
- Subjects
- Aged, Duodenoscopy methods, Esophageal Perforation diagnostic imaging, Esophageal Perforation etiology, Esophagoscopy methods, Gastroscopy methods, Humans, Male, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Time Factors, Tomography, X-Ray Computed, Barrett Esophagus surgery, Endoscopic Mucosal Resection adverse effects, Esophageal Perforation surgery, Postoperative Complications surgery, Self Expandable Metallic Stents
- Abstract
A 71-year-old male patient with a long-segment (C10M12) Barrett's esophagus harboring multifocal high-grade dysplasia was referred to our clinic. After a multidisciplinary team conference and the patient's informed consent, an endoscopic submucosal dissection (ESD) was performed with resection of 4/5 of the esophageal circumference along 12 cm, without any complications during or immediately after the procedure. In the day after the ESD, the patient presented suddenly with dyspnea and subcutaneous emphysema in the neck and chest. A computed tomography (CT) showed subcutaneous emphysema in the neck and pneumomediastinum, confirming the diagnosis of delayed perforation. There was gradual progression into respiratory failure with the need for ventilatory support. Endoscopic treatment was decided and 2 fully covered self-expandable metal stents were deployed in the esophagus. Patient's clinical condition improved and oral diet was resumed at day 7. Stents were retrieved at day 12 and there were no strictures on the 2 and 6-month follow-ups. This is the first report of delayed perforation after endoscopic submucosal disection in the esophagus that was successfully managed with endoscopic therapy.
- Published
- 2018
- Full Text
- View/download PDF
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