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2. Long-term follow-up of the PROTDILAT study; LONG-PROTDILAT Prospective multicenter randomized comparative study of endoscopic treatment of strictures in Crohn's disease (CD): self-expandable metal stent (SEMS) vs endoscopic balloon dilatation (EBD)

Author

Ruiz- Ramírez, P., additional, Loras, C., additional, Gornals, J. B., additional, Bosca-Watts, M. Maia, additional, Brunet, E., additional, Iglesias, E., additional, Barrio, J., additional, Sicilia, B., additional, Dueñas, C., additional, Foruny-Olcina, J. R., additional, Martín-Arranz, M. J., additional, Busquets, D., additional, Cerrillo, E., additional, García-Morales, N., additional, Monfort, D., additional, Pérez-Roldán, F., additional, Pijoan, E., additional, Gonzalez, B., additional, Reyes, J., additional, Torres, G., additional, Maristany, E., additional, Sanchiz-Soler, V., additional, Guardiola, J., additional, and Esteve, M., additional

Published
2024
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3. P649 Long-term follow-up of the PROTDILAT study; LONG-PROTDILAT Prospective multicenter randomized comparative study of endoscopic treatment of strictures in Crohn's disease (CD): self-expandable metal stent (SEMS) vs endoscopic balloon dilatation (EBD)

Author

Ruiz Ramírez, P, primary, Loras, C, additional, Gornals, J, additional, Maia Bosca-Watts, M, additional, Brunet, E, additional, Iglesias, E, additional, Barrio, J, additional, Sicilia, B, additional, Dueñas, C, additional, Foruny, J R, additional, Martín-Arranz, M D, additional, Busquets, D, additional, Cerrillo, E, additional, García Morales, N, additional, Monfort, D, additional, Pérez-Roldán, F, additional, Pijoan, E, additional, González, B, additional, Reyes, J, additional, Torres, G, additional, Maristany, E, additional, Sanchiz, V, additional, Guardiola, J, additional, and Esteve, M, additional

Published
2024
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5. Results of the national survey on "Women in Spanish Endoscopy"

Author

Martínez-Moreno, B., additional, García-Campos, M., additional, Urquiza, M. Pellise, additional, Gonzalez-Suárez, B., additional, Sanjuán, C. Mangas, additional, Villagrasa, R., additional, Romero, L. Martí, additional, Loras, C., additional, and Aparicio Tormo, J. R., additional

Published
2023
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6. Lumen-apposing metal stents with or without pigtail stent for endoscopic ultrasound-guided biliary drainage of malignant obstruction: an open-label multicentre randomised trial (BAMPI Trial)

Author

Garcia-Sumalla, A., additional, Sanz, R. Pedraza, additional, Aparicio, J. R., additional, Sanchiz, V., additional, De La Serna-Higuera, C., additional, Vazquez-Sequeiros, E., additional, Puigcerver-Mas, M., additional, Barbera, T., additional, Martínez, B., additional, Capilla, M., additional, Martinez-Ortega, A., additional, Andújar, X., additional, Foruny-Olcina, J. R., additional, Luna-Rodriguez, D., additional, Busquets, J., additional, Tebe, C., additional, Videla, S., additional, Laquente, B., additional, Perez-Miranda, M., additional, Loras, C., additional, and Gornals, J. B., additional

Published
2023
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8. Endoscopic vacuum therapy for the treatment of upper gastrointestinal defects. Results of a Spanish multicenter registry

Author

Sendino, O. Garcia, additional, Momblan, D., additional, Busquets, D., additional, Gimeno-Garcia, A., additional, Juzgado, D., additional, García-Lledó, J., additional, Ferrero, E., additional, Tejedor, J., additional, Junquera, F., additional, Díaz-Tasende, J., additional, Moris, M., additional, Gornals, J. B., additional, Garrido, C., additional, Gonzalez, S., additional, Guarner-Argente, C., additional, Repiso, A., additional, Esteban, J. M., additional, Loras, C., additional, Seoane, A., additional, Cardenas, A., additional, Cordova, H., additional, Fernandez-Simon, A., additional, Morales, X., additional, Ibarzabal, A., additional, Llach, J., additional, and De Lacy, A. M., additional

Published
2023
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11. IMPACT OF DOUBLE-PIGTAIL PLASTIC STENTS IN THE ADVERSE EVENT RATE OF PANCREATIC FLUID COLLECTIONS, GALLBLADDER DRAINAGES AND CHOLEDOCHAL DRAINAGES USING LUMEN-APPOSING METAL STENTS

Author

Bazaga, S., additional, Garcia-Alonso, F.-J., additional, Aparicio Tormo, J.R., additional, Martínez-Moreno, B., additional, Sanchiz, V., additional, Suria, C., additional, Garcia-Sumalla, A., additional, Gornals, J.B, additional, Chavarría, C., additional, Loras, C., additional, García-Fernandez, F.J., additional, Terán, Á., additional, Vazquez-Sequeiros, E., additional, Pedraza Sanz, R., additional, Pérez-Carazo, L., additional, Subtil, J.C., additional, Pérez-Millán, A., additional, Uceda Porta, F., additional, Busto Bea, V., additional, de la Serna-Higuera, C., additional, Pinto Garcia, I., additional, Colán-Hernández, J., additional, Huertas, C., additional, Vilella Martorell, A., additional, Guardiola-Arevalo, A., additional, Castro Urda, J.L., additional, Nuñez-Otero, J., additional, Sánchez-Hernández, E., additional, Gonzalez-Huix, F., additional, de la Morena, F., additional, Villanueva Pavón, R., additional, Couto-Worner, I., additional, Guarner-Argente, C., additional, and Perez-Miranda, M., additional

Published
2022
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12. SAFETY AND FEASIBILITY OF LUMEN-APOSSING METAL STENTS REMOVALS. RESULTS FROM A PROSPECTIVE NATIONWIDE REGISTRY

Author

Bazaga, S., additional, Garcia-Alonso, F.J., additional, Aparicio Tormo, J.R., additional, Martinez Moreno, B., additional, Sanchiz, V., additional, Suria, C., additional, Garcia-Sumalla, A., additional, Gornals, J.B, additional, Loras, C., additional, Chavarría, C., additional, García-Fernandez, F.J., additional, Terán, Á., additional, Vazquez-Sequeiros, E., additional, Pedraza Sanz, R., additional, Pérez-Carazo, L., additional, Súbtil, J.C., additional, Pérez-Millan, A., additional, Uceda Porta, F., additional, Busto Bea, V., additional, de la Serna-Higuera, C., additional, Pinto García, I., additional, Colán-Hernández, J., additional, Huertas, C., additional, Vilella Martorell, A., additional, Guardiola-Arévalo, A., additional, Castro Urda, J.L., additional, Nuñez-Otero, J., additional, Sánchez-Hernández, E., additional, Gonzalez-Huix, F., additional, de la Morena, F., additional, Villanueva Pavón, R., additional, Couto-Worner, I., additional, Guarner-Argente, C., additional, and Perez-Miranda, M., additional

Published
2022
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13. Multicenter study of lumen-apposing metal stents with or without pigtail in endoscopic ultrasound-guided biliary drainage for malignant obstruction-BAMPI TRIAL: an open-label, randomized controlled trial protocol

Author

Garcia-Sumalla A, Loras C, Sanchiz V, Sanz R, Vazquez-Sequeiros E, Aparicio J, De la Serna-Higuera C, Luna-Rodriguez D, Andujar X, Capilla M, Barbera T, Foruny-Olcina J, Martinez B, Dura M, Salord S, Laquente B, Tebe C, Videla S, Perez-Miranda M, and Gornals J

Subjects
Plastic stent, Choledochoduodenostomy, Biliary drainage, Endoscopic ultrasound, Lumen-apposing metal stent, Trial, Malignant biliary obstruction
Abstract

Background: It is unclear whether the insertion of an axis-orienting double-pigtail plastic stent (DPS) through biliary lumen-apposing meal stent (LAMS) in EUS-guided choledochoduodenostomy (CDS) improves the stent patency. The aim of this study is to determine whether this technical variant offers a clinical benefit in EUS-guided biliary drainage (BD) for the management of distal malignant biliary obstruction. Methods/design: This is a multicenter open-label, randomized controlled trial with two parallel groups. Eighty-four patients with malignant biliary obstruction will undergo EUS-BD (CDS type) using LAMS in 7 tertiary hospitals in Spain and will be randomized to the LAMS and LAMS plus DPS groups. The primary endpoint is the rate of recurrent biliary obstruction, as a stent dysfunction parameter, detected during follow-up. Secondary endpoints: technical and clinical success (reduction in bilirubin > 50% within 14 days of stent placement), safety, and others (number of reinterventions, time to biliary obstruction, prognostic factors, survival rate). Discussion: The BAMPI trial has been designed to determine whether the addition of a coaxial axis-orienting DPS through LAMS is superior to LAMS alone to prevent stent dysfunction.

Published
2022

14. Self-expandable metal stents versus endoscopic balloon dilation for the treatment of strictures in Crohn's disease (ProtDilat study): an open-label, multicentre, randomised trial

Author

Loras C, Andujar X, Gornals J, Sanchiz V, Brullet E, Sicilia B, Martin-Arranz M, Naranjo A, Barrio J, Duenas C, Foruny J, Busquets D, Monfort D, Pineda J, Gonzalez-Huix F, Perez-Roldan F, Pons V, Gonzalez B, Reyes Moreno J, Sainz E, Guardiola J, Bosca-Watts M, Fernandez-Banares F, Mayor V, Esteve M, and Grupo Espanol de Trabajo de la Enfermedad de Crohn y Colitis Ulcerosa (GETECCU)

Subjects
OUTCOMES, LONG-TERM, INTESTINAL STRICTURES, DILATATION, SAFETY, MANAGEMENT, EFFICACY, THERAPY, METAANALYSIS
Abstract

BACKGROUND: Endoscopic balloon dilation (EBD) is the established endoscopic treatment for short strictures in Crohn's disease. Fully covered self-expandable metal stents (FCSEMS) have been used for endoscopic treatment of patients for whom EBD was unsuccessful. We aimed to determine the efficacy and safety of the two endoscopic treatments in patients with Crohn's disease with stenosis and compare the mean cost of both treatments.; METHODS: This multicentre, open-label, randomised trial was done in 19 tertiary and secondary hospitals in Spain. Patients with Crohn's disease with obstructive symptoms and predominantly fibrotic strictures of less than 10 cm in length were eligible for inclusion. We excluded patients with stenosis treated with SEMS or EBD in the previous year and stenosis not accessible to a colonoscope. Patients were randomly assigned (1:1) to receive either EBD (EBD group) or FCSEMS (FCSEMS group) using a digital en-block randomisation system (block size of four). In the EBD group, dilation was done with a CRE Boston Scientific (Marlborough, MA, USA) pneumatic balloon with the diameter set at the discretion of the endoscopist; a maximum of two sessions of dilation were allowed with a minimum interval of 15-30 days between them. In the FCSEMS group, a 20 mm diameter Taewoong (Gimpo-si, South Korea) fully covered metal stent was placed; stent length was set at the discretion of the endoscopist. The primary outcome was to assess the efficacy of the endoscopic treatment, defined by the proportion of patients free of a new therapeutic intervention (EBD, FCSEMS, or surgery) due to symptomatic recurrence at 1 year of follow-up. Patients were analysed according to the intention-to-treat principle. Adverse events were recorded for all the patients; events were considered associated to be with the procedure when a causal association was possible, probable, or definite. This trial is registered with ClinicalTrials.gov, NCT02395354.; FINDINGS: From Aug 28, 2013, to Oct 9, 2017, we assessed the eligibility of 99 patients, of whom 19 (19%) patients were excluded. Thus, 80 (81%) patients were randomly assigned to treatment: 39 (49%) patients to the FCSEMS group and 41 (51%) patients to the EBD group. 33 (80%) of 41 patients in the EBD group and 20 (51%) of 39 patients in the FCSEMS group were free of a new therapeutic intervention at 1 year (odds ratio [OR] 3·9 [95% CI 1·4-10·6]; p=0·0061). Two (3%) of 80 patients had severe adverse events (one [2%] patient in the EBD group and one [3%] patient in the FCSEMS group); both patients had perforations.; INTERPRETATION: EBD is more effective than FCSEMS for Crohn's disease strictures, with a good safety profile for both treatments.; FUNDING: Spanish National Institute of Health, Foundation of Spanish Society of Digestive Endoscopy, Catalan Society of Gastroenterology, and Taweoong. Copyright © 2022 Elsevier Ltd. All rights reserved.

Published
2022

15. Is a coaxial plastic stent within a lumen-apposing metal stent useful for the management of distal malignant biliary obstruction?

Author

Garcia-Sumalla, A, Loras, C, Guarner-Argente, C, Velasquez-Rodriguez, JG, Andujar, X, Salord, S, Busquets, J, Tebe, C, Laquente, B, and Gornals, JB

Subjects
Therapeutic endoscopy, Plastic stent, Lumen apposing stent, Biliary drainage, Endoscopic ultrasound, Pancreatic neoplasm
Abstract

Background There are uncertainties concerning the possible benefits derived from the insertion of double-pigtail plastic stents (DPS) within lumen-apposing metal stents (LAMS) in EUS-guided choledochoduodenostomy (CDS). The aim of this study was to determine whether a DPS within a biliary LAMS offers a potential benefit in EUS-guided CDS for the palliative management of malignant biliary obstruction. Methods This was a multicentre retrospective study at three tertiary institutions. Period: May 2015 to August 2020. Two interventional strategies (LAMS alone and LAMS plus DPS) were compared. The choice was the endoscopist's discretion. Inclusion: unresectable/inoperable biliopancreatic tumours with previous failed ERCP. Clinical success: bilirubin decrease > 30% at 4 weeks. Results Forty-one consecutive cases of EUS-CDS using biliary LAMS were treated (22 women; mean age, 72.3 years) during the study period. The procedure was technically successful in 39 (95.1%), who were managed using the two strategies (22 LAMS alone; 17 LAMS plus DPS). No differences between the groups, in terms of clinical success (77.3 vs 87.5%, p = 0.67), adverse events (AEs, 13.6 vs 11.8%, p = 0.99), recurrent biliary obstruction (RBO, 13.6 vs 23.5%, p = 0.67), or survival rate (p = 0.67) were encountered. The LAMS alone group had a shorter length of procedure (50 min vs 66 min, p = 0.102). No risk factors related to clinical success, AEs, RBO, or survival were detected. Conclusions The technical variant of adding a coaxial DPS within LAMS in EUS-CDS seems not to be enough to prevent biliary morbidities, and it is a time-consuming strategy. Although prospective studies are needed, these results do not support its routine use.

Published
2021

16. Liver dysfunction related to hepatitis B and C in patients with inflammatory bowel disease treated with immunosuppressive therapy

Author

Loras, C., Gisbert, J.P., Minguez, M., Merino, O., Bujanda, L., Saro, C., Domenech, E., Barrio, J., Andreu, M., Ordas, I., Vida, L., Bastida, G., Gonzalez-Huix, F., Piqueras, M., Ginard, D., Calvet, X., Gutierrez, A., Abad, A., Torres, M., Panes, J., Chaparro, M., Pascual, I., Rodriguez-Carballeira, M., Fernandez-Banares, F., Viver, J.M., and Esteve, M.

Subjects
Liver diseases -- Risk factors, Inflammatory bowel diseases -- Care and treatment, Inflammatory bowel diseases -- Patient outcomes, Immunosuppressive agents -- Usage, Immunosuppressive agents -- Health aspects, Hepatitis B -- Risk factors, Health
Published
2010

18. Prevalence and Characteristics of Missed Gastric Cancer

Author

Salvador, I, additional, Arau, B, additional, Andújar, X, additional, Ferrer, C, additional, Zabana, Y, additional, Ruiz, L, additional, Espinós, J, additional, Aceituno, M, additional, Fernández-Bañares, F, additional, Esteve, M, additional, and Loras, C, additional

Published
2021
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19. Endoscopic Band Ligation Without Resection Of Small-Sized Subepithelial Tumours: Results In Long-Term Follow Up Of A Multicentre Prospective Study (Banding-Set)

Author

Bas-Cutrina, F, additional, Loras, C, additional, Pardo, A, additional, Ballester-Clau, R, additional, Huertas, C, additional, Guarner-Argente, C, additional, Colán-Hernández, J, additional, Consiglieri, CF, additional, Andujar, X, additional, Vilanova-Serra, M, additional, González-Huix, F, additional, Pardo-Grau, L, additional, Maisterra, S, additional, Ruiz-Ramírez, P, additional, Garcia-Sumalla, A, additional, and Gornals, JB, additional

Published
2021
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20. Anxiety and Cancerophobia in Patients With Small Gastrointestinal Subepithelial Lesions and Tumours: Baseline Results of a Prospective Study (QUALI-BANDING-SET)

Author

Bas-Cutrina, F, additional, Loras, C, additional, García-Ibáñez, ME, additional, Andujar, X, additional, Casellas-Grau, A, additional, Gil, FL, additional, Tebé, C, additional, Galán, M, additional, Fernández-Aranda, F, additional, Videla, S, additional, and Gornals, JB, additional

Published
2021
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21. Efficacy and safety of endoscopic balloon dilation in inflammatory bowel disease: results of the large multicenter study of the ENEIDA registry (vol 34, pg 1112, 2020)

Author

Andujar, X, Loras, C, Gonzalez, B, Socarras, M, Sanchiz, V, Bosca, M, Domenech, E, Calafat, M, Rodriguez, E, Sicilia, B, Calvet, X, Barrio, J, Guardiola, J, Iglesias, E, Casanova, MJ, Ber, Y, Monfort, D, Lopez-Sanroman, A, Rodriguez-Lago, I, Bujanda, L, Marquez, L, Martin-Arranz, MD, Zabana, Y, Fernandez-Banares, F, and Esteve, M

Abstract

Javier P. Gisbert was listed incorrectly as Javier Perez-Gisbert.

Published
2020

22. Efficacy and safety of endoscopic balloon dilation in inflammatory bowel disease: results of the large multicenter study of the ENEIDA registry (vol 34, pg 1112, 2020)

Author

And?jar X, Loras C, Gonz?lez B, Socarras M, Sanchiz V, Bosc? M, Domenech E, Calafat M, Rodr?guez E, Sicilia B, Calvet X, Barrio J, Guardiola J, Iglesias E, Casanova M, Ber Y, Monfort D, L?pez-Sanroman A, Rodr?guez-Lago I, Bujanda L, M?rquez L, Mart?n-Arranz M, Zabana Y, Fernandez-Ba?ares F, Esteve M, and ENEIDA Registry GETECCU

Abstract

Javier P. Gisbert was listed incorrectly as Javier Perez-Gisbert.

Published
2020

26. PREVALENCE AND CHARACTERISTICS OF MISSED GASTRIC CANCER

Author

Salvador, I, additional, Arau, B, additional, Andújar, X, additional, Ferrer, C, additional, Zabana, Y, additional, Ruiz-Campos, L, additional, Espinós, J, additional, Aceituno, M, additional, Fernández-Bañares, F, additional, Esteve, M, additional, and Loras, C, additional

Published
2020
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27. LUMEN APPOSING METAL STENTS RELATED ADVERSE EVENTS. RESULTS FROM A NATIONWIDE PROSPECTIVE REGISTRY

Author

Bazaga, S, additional, Aparicio, JR, additional, Sanchiz, V, additional, Gornals, J, additional, Loras, C, additional, Pedraza, R, additional, Terán, A, additional, Vazquez-Sequeiros, E, additional, Vila, J, additional, Guardiola, A, additional, Guarner, C, additional, Huertas, C, additional, Garcia-Fernandez, F, additional, Bernad, B, additional, Perez, A, additional, Villanueva, R, additional, Gonzalez-Huix, F, additional, Pinto, I, additional, Vilella, A, additional, Castro, JL, additional, Colán, J, additional, Nuñez-Otero, J, additional, Subtil, JC, additional, Pérez-Carazo, L, additional, Couto, I, additional, Sanchez, E, additional, Uceda, F, additional, Martinez, B, additional, Garcia-Alonso, FJ, additional, de la Serna, C, additional, and Perez-Miranda, M, additional

Published
2020
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30. MULTICENTER PROSPECTIVE RANDOMIZED STUDY TO COMPARE ENDOSCOPIC TREATMENT OF STRICTURES IN CROHN´S DISEASE (CD): SELF-EXPANDING METAL STENTS (SEMS) VS ENDOSCOPIC BALLOON DILATION (EBD). PROTDILAT STUDY

Author

Andújar, X, additional, Loras, C, additional, Gornals, JB, additional, Guardiola, J, additional, Sanchiz, V, additional, Bosca, M, additional, Brullet, E, additional, Sicilia, B, additional, Naranjo, A, additional, Dueñas, C, additional, Foruny, JR, additional, Busquets, D, additional, Monfort, D, additional, Martín-Arranz, MD, additional, Barrio, J, additional, Pineda, JR, additional, González-Huix, F, additional, Pérez-Roldán, F, additional, Pons, V, additional, González, B, additional, Sainz, E, additional, Reyes-Moreno, J, additional, Fernández-Bañares, F, additional, and Esteve, M, additional

Published
2020
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34. ENDOSCOPIC BAND LIGATION WITHOUT RESECTION OF SMALL-SIZED SUBMUCOSAL TUMOURS: RESULTS IN SHORT-MEDIUM FOLLOW-UP TERM OF A MULTICENTER PROSPECTIVE STUDY (BANDING-SMT)

Author

Bas-Cutrina, F, additional, Consiglieri, CF, additional, Loras, C, additional, Andújar, X, additional, Huertas, C, additional, Albert, M, additional, Ballester, R, additional, González-Huix, F, additional, Guarner-Argente, C, additional, Pardo, A, additional, Bosch-Schips, J, additional, and Gornals, JB, additional

Published
2019
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35. ANTIBIOTIC PROPHYLAXIS FOR EUS GUIDED FNA OF PANCREATIC CYSTIC LESIONS: A MULTICENTER, RANDOMIZED AND DOUBLE BLINDED CLINICAL TRIAL

Author

Colan Hernandez, J, additional, Sendino, O, additional, Loras, C, additional, Andujar, X, additional, Pardo, A, additional, Gornals, J, additional, Concepcion, M, additional, Sanchez Montes, C, additional, Murzi, M, additional, Fernandez Esparrach, G, additional, Gines, A, additional, and Guarner Argente, C, additional

Published
2019
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42. Estudio comparativo prospectivo multicéntrico aleatorizado del tratamiento endoscópico de las estenosis en la Enfermedad de Crohn: prótesis metálica autoexpandible vs. dilatación con balón (estudio PROTDILAT)

Author

Andújar Murcia, X, additional, Loras, C, additional, Gornals, JB, additional, Sanchiz, V, additional, Brullet, E, additional, Sicilia, B, additional, Naranjo, A, additional, Dueñas, C, additional, González-Huix, F, additional, and Esteve Comas, M, additional

Published
2017
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43. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography: Can they be successfully combined?

Author

Gornals, JB, Esteban, JM, Guarner-Argente, C, Marra-Lopez, C, Repiso, A, Sendino, O, and Loras, C

Subjects
Digestive system, procedure, Endoscopic, ultrasound, retrograde cholangiopancreatography, Single-session, Endoscopy, Therapeutics, Biliary drainage
Abstract

Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) have much in common, including their main indications (biliopancreatic disorders), powerful therapeutic capacities and a steep learning curve. Over the years they have evolved from novel diagnostic procedures to interventional therapeutic techniques, but along different paths (different scopes or devices and endoscopists specializing exclusively in one or the other technique). However, EUS has gradually developed into a therapeutic technique that requires skills in the use of ERCP devices and stents, leading some ERCP specialists to explore the therapeutic potential of EUS. The corresponding literature, which has grown exponentially, includes recent experiments on combining the two techniques, which have gradually come to be used in routine care in a number of centers, with positive technical, clinical and financial outcomes. We review EUS and ERCP as individual or combined procedures for managing biliopancreatic disorders. (C) 2016 Elsevier Espana, S.L.U., AEEH y AEG. All rights reserved.

Published
2016

44. Evaluation of the short- and long-term effectiveness and safety of fully covered self-expandable metal stents for drainage of pancreatic fluid collections: results of a Spanish nationwide registry

Author

Vazquez-Sequeiros, E, Baron, T, Perez-Miranda, M, Sanchez-Yague, A, Gornals, J, Gonzalez-Huix, F, de la Serna, C, Angel Gonzalez Martin, J, Gimeno-Garcia, A, Marra-Lopez, C, Castellot, A, Alberca, F, Fernandez-Urien, I, Aparicio J, Luisa Legaz, M, Sendino, O, Loras, C, Carlos Subtil, J, Nerin, J, Perez-Carreras, M, Diaz-Tasende, J, Perez, G, Repiso, A, Vilella, A, Dolz, C, Alvarez, A, Rodriguez, S, Miguel Esteban, J, Juzgado, D, Albillos, A, and Spanish Grp FCSEMS Pancreas Collec

Abstract

Background and Aims: Initial reports suggest that fully covered self-expandable metal stents (FCSEMSs) may be better suited for drainage of dense pancreatic fluid collections (PFCs), such as walled-off pancreatic necrosis. The primary aim was to analyze the effectiveness and safety of FCSEMSs for drainage of different types of PFCs in a large cohort. The secondary aim was to investigate which type of FCSEMS is superior. Methods: This was a retrospective, noncomparative review of a nationwide database involving all hospitals in Spain performing EUS-guided PFC drainage. From April 2008 to August 2013, all patients undergoing PFC drainage with an FCSEMS were included in a database. The main outcome measurements were technical success, short-term (2 weeks) and long-term (6 months) effectiveness, adverse events, and need for surgery. Results: The study included 211 patients (pseudocyst/walled-off pancreatic necrosis, 53%/47%). The FCSEMSs used were straight biliary (66%) or lumen-apposing (34%). Technical success was achieved in 97% of patients (95% confidence interval [CI], 93%-99%). Short-term- and long-term clinical success was obtained in 94% (95% CI, 89%-97%) and 85%(95% CI, 79%-89%) of patients, respectively. Adverse events occurred in 21% of patients (95% CI, 16%-27%): infection (11%), bleeding (7%), and stent migration and/or perforation (3%). By multivariate analysis, patient age (> 58 years) and previous failed drainage were the most important factors associated with negative outcome. Conclusions: An FCSEMS is effective and safe for PFC drainage. Older patients with a history of unsuccessful drainage are more likely to fail EUS-guided drainage. The type of FCSEMS does not seem to influence patient outcome.

Published
2016

47. EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study.

Author

Martin-Cardona, A., Fernandez-Esparrach, G., Subtil, J. C., Iglesias-Garcia, J., Garcia-Guix, M., Barturen Barroso, A., Gimeno-Garcia, A. Z., Esteban, J. M., Pardo Balteiro, A., Velasco-Guardado, A., Vazquez-Sequeiros, E., Loras, C., Martinez-Moreno, B., Castellot, A., Huertas, C., Martinez-Lapiedra, M., Sanchez-Yague, A., Teran, A., Morales-Alvarado, V. J., and Betes, M.

Subjects
ADRENAL glands, CYTOLOGY, POSITRON emission tomography, PHYSICAL sciences, TISSUES
Abstract

Background: There are limited data about the role of endoscopic ultrasound-guided tissue acquisition (EUS-TA), by fine needle aspiration (EUS-FNA) or biopsy (EUS-FNB), in the evaluation of the adrenal glands (AG). The primary aim was to assess the diagnostic yield and safety. The secondary aims were the malignancy predictors, and to create a predictive model of malignancy. Methods: This was a retrospective nationwide study involving all Spanish hospitals experienced in EUS-TA of AGs. Inclusion period was from April-2003 to April-2016. Inclusion criteria: all consecutive cases that underwent EUS-TA of AGs. EUS and cytopathology findings were evaluated. Statistical analyses: diagnostic accuracy of echoendoscopist's suspicion using cytology by EUS-TA, as gold standard; multivariate logistic regression model to predict tumor malignancy. Results: A total of 204 EUS-TA of AGs were evaluated. Primary tumor locations were lung70%, others19%, and unknown11%. AG samples were adequate for cytological diagnosis in 91%, and confirmed malignancy in 60%. Diagnostic accuracy of the endosonographer's suspicion was 68%. The most common technique was: a 22-G (65%) and cytological needle (75%) with suction-syringe (66%). No serious adverse events were described. The variables most associated with malignancy were size>30mm (OR2.27; 95%CI, 1.16–4.05), heterogeneous echo-pattern (OR2.11; 95%CI, 1.1–3.9), variegated AG shape (OR2.46; 95%CI, 1–6.24), and endosonographer suspicion (OR17.46; 95%CI, 6.2–58.5). The best variables for a predictive multivariate logistic model of malignancy were age, sex, echo-pattern, and AG-shape. Conclusions: EUS-TA of the AGs is a safe, minimally invasive procedure, allowing an excellent diagnostic yield. These results suggest the possibility of developing a pre-EUS procedure predictive malignancy model. [ABSTRACT FROM AUTHOR]

Published
2019
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49. ESTUDIO MULTICÉNTRICO, LONGITUDINAL Y PROSPECTIVO PARA EVALUAR LAS COMPLICACIONES DERIVADAS DE LA POLIPECTOMÍA GÁSTRICA Y DUODENAL

Author

Córdova, H, primary, Loras, C, additional, Argüello, L, additional, Naranjo, A, additional, Riu, F, additional, Gornals, J, additional, Nicolás, D, additional, Hernández, L, additional, Santolaria, S, additional, Pérez-Cuadrado Robles, E, additional, Leal, C, additional, Pons, C, additional, García, O, additional, Papo, M, additional, Ulla José, L, additional, Rojas, N, additional, and Fernández Esparrach, G, additional

Published
2015
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