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2. Difficult biliary stones in the elderly: Endoscopic retrograde cholangiography - A single surgical tertiary centre experience with follow-up

Author

Antypas, Pavlos, Cereatti, Fabrizio, Fiocca, Fausto, Cappello, Annalisa, Eberspacher, Chiara, Fanello, Gianfranco, Mascagni, Domenico, and Donatelli, Gianfranco

Subjects
Aged patients -- Care and treatment, Endoscopy -- Health aspects, Health
Abstract

Byline: Pavlos. Antypas, Fabrizio. Cereatti, Fausto. Fiocca, Annalisa. Cappello, Chiara. Eberspacher, Gianfranco. Fanello, Domenico. Mascagni, Gianfranco. Donatelli Background: Pancreaticobiliary diseases and choledocholithiasis are common in elderly patients. Endoscopic treatment of [...]

Published
2021

4. Augmented reality (AR) in minimally invasive surgery (MIS) training: where are we now in Italy? The Italian Society of Endoscopic Surgery (SICE) ARMIS survey

Author

Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, Antonino, Agrusa, Daniele, Aguzzi, Mariantonietta, Alagia, Laura, Alberici, Marco Ettore Allaix, Luisa, Ambrosio, Alfonso, Amendola, Michele, Ammendola, Pietro Maria Amodio, Gabriele, Anania, Jacopo, Andreuccetti, Alfredo, Annichiarico, Pietro, Anoldo, Alessandro, Anselmo, Giovanni, Aprea, Giacomo, Arcuri, Alberto, Arezzo, Giulia, Armatura, Giulia, Bagaglini, Francesco, Bagolini, Beatrice, Bailetti, Gianluca, Baiocchi, Edoardo, Baldini, Elisa, Bannone, Mirko, Barone, Gianluca, Baronio, Raffaele, Basile, Bellucci, Marco, Andrea Benedetti Cacciaguerra, Ilaria, Benzoni, Francesco, Bianco, Giuseppe, Boccia, Cristina, Bombardini, Luigi, Boni, Dario, Bono, Luca Domenico Bonomo, Giulia, Bonventre, Andrea, Bottari, Claudio, Botti, Giacomo, Brentegani, Mattia, Buonomo, Umberto, Bracale, Cosimo, Callari, Luca, Calligaris, Pietro Giorgio Calò, Angelo, Cangiano, Lorenzo, Capezzuoli, Gabriella Teresa Capolupo, Marianna, Capuano, Filippo, Carannante, Eugenia, Cardamone, Teresa, Carfora, Chiara, Caricato, Pietro, Carnevali, Francesco Maria Carrano, Lorenzo, Casali, Gianmaria Casoni Pataccini, Gianluca, Cassese, Simone, Castiglioni, Flavia, Cavicchi, Ceccarelli, Graziano, Giovanni, Cestaro, Pasquale, Cianci, Claudio, Cimmino, Marco, Clementi, Coletta, Diego, Riccardo, Conventi, Corallino, Diletta, Maurizio, Costantini, Lorenzo, Crepaz, Diego, Cuccurullo, Curci, FABIO PIO, Giuseppe, Currò, Giorgio, Dalmonte, Giovanni, D'Alterio, Michele, D'Ambra, D'Ambrosio, Giancarlo, Anna, D'Amore, Michele De Capua, Simona, Deidda, Daniele, Delogu, Maurizio De Luca, Nicolò De Manzini, DE STEFANI, Elena, Giuseppe Di Buono, Marcello Di Martino, DI TOMASO, Anna, Ugo, Elmore, CORDOVA HERENCIA, INGRID ELVA, Giovanni, Emiliani, Sofia, Esposito, Fazio, Federico, Federico, Festa, Marcello, Filotico, Fiocca, Fausto, Irene, Fiume, Francesco, Fleres, Giulia, Fontana, Tommaso, Fontana, Edoardo, Forcignanò, Giampaolo, Formisano, Laura, Fortuna, Uberto Fumagalli Romario, Andrea, Galderisi, Raffaele, Galleano, Carlo, Gazia, Alessio, Giordano, Giorgio, Giraudo, Maria Carmela Giuffrida, Simona, Giura, Anna, Guida, Antonio Maria Iannello, Marco, Inama, Sara, Ingallinella, Iossa, Angelo, Livio, Iudici, Laracca, GIOVANNI GUGLIELMO, LARGHI LAUREIRO, Zoe, Saverio, Latteri, Luca, Leonardi, Pasquale, Lepiane, Edelweiss, Licitra, Paolo, Locurto, Sarah Lo Faso, Nicola, Luciani, Luzza, Luigi, Magaletti, Sara, Michele, Manigrasso, Alessandra, Marano, Francesco, Marchetti, Alessandra, Marello, Nicolò, Mariani, Jacopo Nicolò Marin, Gennaro, Martines, Laura, Mastrangelo, Antonio, Matarangolo, Marco, Materazzo, Mazzarella, Gennaro, Giorgio, Mazzarolo, Maria Paola Menna, Meoli, Francesca, Marco, Milone, Elisabetta, Moggia, Davide, Moioli, Sarah, Molfino, Vitantonio, Mongelli, Roberto, Montalti, Giulia, Montori, Luca, Morelli, Gianluigi, Moretto, Muttillo, EDOARDO MARIA, Irnerio, Muttillo, Francesca, Notte, Alessandro, M Paganini, Gianluca, Pagano, Palmieri, Livia, Giuseppe, Palomba, Valentina, Palumbo, Panetta, Cristina, Giulia, Paradiso, Beniamino, Pascotto, Passannanti, Daniele, Renato, Patrone, Francesca, Pecchini, Francesca, Pego, Fabio, Pelle, Perrotta, Nicola, Wanda, Petz, Biagio, Picardi, Picchetto, Andrea, Chiara, Piceni, Pietricola, Giulia, Enrico, Pinotti, Felice, Pirozzi, Paolo, Pizzini, Poillucci, Gaetano, Ilaria, Puccica, Lorenzo, Ramaci, Rapanotti, Eleonora, Daniela, Rega, Angelica, Reggiani, Giorgio, Romano, Gregorio, Romeo, Luigi, Romeo, Gianluca, Rompianesi, Stefano, Rossi, Edoardo, Saladino, Roberto, Santambrogio, Federica, Saraceno, Giuliano, Sarro, Diego, Sasia, Grazia, Savino, Rosa, Scaramuzzo, Antonio, Sciuto, Michela, Scollica, Giovanni, Scudo, Ardit, Seitaj, Carlo, Serra, Francesco, Serra, Pierpaolo, Sileri, Leandro, Siragusa, Carmen, Sorrentino, Giuseppe, Surfaro, Ernesto, Tartaglia, Beatrice, Torre, Andrea, Tufo, Matteo, Uccelli, Alessandro, Ussia, Vaccari, Samuele, Marina, Valente, Sara, Vertaldi, Alessandro, Vitali, Luca, Zaccherini, Luigi, Zorcolo, Noemi, Zorzetti, Balla, A., Sartori, A., Botteri, E., Podda, M., Ortenzi, M., Silecchia, G., Guerrieri, M., Agresta, F., Agrusa, A., Aguzzi, D., Alagia, M., Alberici, L., Allaix, M. E., Ambrosio, L., Amendola, A., Ammendola, M., Amodio, P. M., Anania, G., Andreuccetti, J., Annichiarico, A., Anoldo, P., Anselmo, A., Aprea, G., Arcuri, G., Arezzo, A., Armatura, G., Bagaglini, G., Bagolini, F., Bailetti, B., Baiocchi, G., Baldini, E., Bannone, E., Barone, M., Baronio, G., Basile, R., Bellucci, M., Cacciaguerra, A. B., Benzoni, I., Bianco, F., Boccia, G., Bombardini, C., Boni, L., Bono, D., Bonomo, L. D., Bonventre, G., Bottari, A., Botti, C., Brentegani, G., Buonomo, M., Bracale, U., Callari, C., Calligaris, L., Calo, P. G., Cangiano, A., Capezzuoli, L., Capolupo, G. T., Capuano, M., Carannante, F., Cardamone, E., Carfora, T., Caricato, C., Carnevali, P., Carrano, F. M., Casali, L., Pataccini, G. C., Cassese, G., Castiglioni, S., Cavicchi, F., Ceccarelli, G., Cestaro, G., Cianci, P., Cimmino, C., Clementi, M., Coletta, D., Conventi, R., Corallino, D., Costantini, M., Crepaz, L., Cuccurullo, D., Curci, F. P., Curro, G., Dalmonte, G., D'Alterio, G., D'Ambra, M., D'Ambrosio, G., D'Amore, A., De Capua, M., Deidda, S., Delogu, D., De Luca, M., De Manzini, N., De Stefani, E., Di Buono, G., Di Martino, M., Di Tomaso, A., Elmore, U., Herencia, I. E. C., Emiliani, G., Esposito, S., Fazio, F., Festa, F., Filotico, M., Fiocca, F., Fiume, I., Fleres, F., Fontana, G., Fontana, T., Forcignano, E., Formisano, G., Fortuna, L., Romario, U. F., Galderisi, A., Galleano, R., Gazia, C., Giordano, A., Giraudo, G., Giuffrida, M. C., Giura, S., Guida, A., Iannello, A. M., Inama, M., Ingallinella, S., Iossa, A., Iudici, L., Laracca, G. G., Laureiro, Z. L., Latteri, S., Leonardi, L., Lepiane, P., Licitra, E., Locurto, P., Faso, S. L., Luciani, N., Luzza, L., Magaletti, S., Manigrasso, M., Marano, A., Marchetti, F., Marello, A., Mariani, N., Marin, J. N., Martines, G., Mastrangelo, L., Matarangolo, A., Materazzo, M., Mazzarella, G., Mazzarolo, G., Menna, M. P., Meoli, F., Milone, M., Moggia, E., Moioli, D., Molfino, S., Mongelli, V., Montalti, R., Montori, G., Morelli, L., Moretto, G., Muttillo, E. M., Muttillo, I., Notte, F., Paganini, A. M., Pagano, G., Palmieri, L., Palomba, G., Palumbo, V., Panetta, C., Paradiso, G., Pascotto, B., Passannanti, D., Patrone, R., Pecchini, F., Pego, F., Pelle, F., Perrotta, N., Petz, W., Picardi, B., Picchetto, A., Piceni, C., Pietricola, G., Pinotti, E., Pirozzi, F., Pizzini, P., Poillucci, G., Puccica, I., Ramaci, L., Rapanotti, E., Rega, D., Reggiani, A., Romano, G., Romeo, G., Romeo, L., Rompianesi, G., Rossi, S., Saladino, E., Santambrogio, R., Saraceno, F., Sarro, G., Sasia, D., Savino, G., Scaramuzzo, R., Sciuto, A., Scollica, M., Scudo, G., Seitaj, A., Serra, C., Serra, F., Sileri, P., Siragusa, L., Sorrentino, C., Surfaro, G., Tartaglia, E., Torre, B., Tufo, A., Uccelli, M., Ussia, A., Vaccari, S., Valente, M., Vertaldi, S., Vitali, A., Zaccherini, L., Zorcolo, L., Zorzetti, N., Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, de Manzini, Nicolo, and ARMIS (Augmented Reality in Minimally Invasive Surgery) Collaborative, Group

Subjects
Virtual reality (VR), minimally invasive surgery (MIS), Augmented reality (AR), Minimally invasive surgery (MIS), Mixed reality (MR), Survey, Training, training, augmented reality (AR), mixed reality (MR), survey, virtual reality (VR), Settore MED/18 - Chirurgia Generale, Surgery
Abstract

Minimally invasive surgery (MIS) is a widespread approach in general surgery. Computer guiding software, such as the augmented reality (AR), the virtual reality (VR) and mixed reality (MR), has been proposed to help surgeons during MIS. This study aims to report these technologies' current knowledge and diffusion during surgical training in Italy. A web-based survey was developed under the aegis of the Italian Society of Endoscopic Surgery (SICE). Two hundred and seventeen medical doctors' answers were analyzed. Participants were surgeons (138, 63.6%) and residents in surgery (79, 36.4%). The mean knowledge of the role of the VR, AR and MR in surgery was 4.9 ± 2.4 (range 1-10). Most of the participants (122, 56.2%) did not have experience with any proposed technologies. However, although the lack of experience in this field, the answers about the functioning of the technologies were correct in most cases. Most of the participants answered that VR, AR and MR should be used more frequently for the teaching and training and during the clinical activity (170, 80.3%) and that such technologies would make a significant contribution, especially in training (183, 84.3%) and didactic (156, 71.9%). Finally, the main limitations to the diffusion of these technologies were the insufficient knowledge (182, 83.9%) and costs (175, 80.6%). Based on the present study, in Italy, the knowledge and dissemination of these technologies are still limited. Further studies are required to establish the usefulness of AR, VR and MR in surgical training.

Published
2023

14. ATOM Classification of Bile Duct Injuries During Laparoscopic Cholecystectomy: Analysis of a Single Institution Experience

Author

Balla, Andrea, primary, Quaresima, Silvia, additional, Corona, Mario, additional, Lucatelli, Pierleone, additional, Fiocca, Fausto, additional, Rossi, Massimo, additional, Bezzi, Mario, additional, Catalano, Carlo, additional, Salvatori, Filippo M., additional, Fingerhut, Abe, additional, and Paganini, Alessandro M., additional

Published
2019
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15. Magnetic resonance cholangiopancreatography in the diagnosis of biliopancreatic diseases

Author

Lomanto, David, Pavone, Paolo, Laghi, Andrea, Panebianco, Valerie, Mazzocchi, Paolo, Fiocca, Fausto, Lezoche, Emanuele, Passariello, Roberto, and Speranza, Vincenzo

Subjects
Biliary tract diseases -- Diagnosis, Endoscopic retrograde cholangiopancreatography -- Innovations, Magnetic resonance imaging, Common bile duct calculi -- Diagnosis, Pancreatitis -- Diagnosis, Health
Abstract

BACKGROUND: Magnetic resonance cholangiopancreatography (MRCP) is a new, noninvasive imaging technique for the visualization of the biliary ducts with cholangiographic images similar to those obtained with endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. No contrast medium injection is used. The aim of this study was to assess the feasibility of MRCP versus ERCP in the diagnosis of biliary tract and pancreatic diseases. PATIENTS AND METHODS: One hundred and thirty-six patients were submitted to MRCP. They were referred to MR study according to four inclusion criteria: (1) evidence or suspicion of choledocholithiasis, (2) benign or malignant bile ducts stenosis, (3) follow-up of patients submitted to biliary-enteric anastomosis, and (4) chronic pancreatitis with Wirsung duct dilatation. The MRCP was performed with a 0.5T superconducting magnet (Philips Gyroscan T5). When neoplastic disease was detected, additional images on axial planes were acquired. MRCP allowed images of diagnostic value to be obtained in all the cases. RESULTS: In choledocholithiasis, MRCP showed 91.6% sensitivity, 100% specificity, and overall diagnostic accuracy 96.8%. Of 48 patients with stenotic lesions, 16 were correctly characterized as benign and 30 as malignant. Two cases of focal chronic pancreatitis were misdiagnosed as pancreatic head carcinoma. In the patients submitted to biliary-enteric anastomosis, MCRP was able to detect the dilatation of the intrahepatic ducts, the stenosis, and associated stones in all 8 positive cases. In the remaining 7 patients with mild signs of cholangitis, MCRP showed irregular aspects of the biliary tree in the main ducts. In the 11 patients with chronic pancreatitis, MCRP was able to depict the dilated Wirsung duct and the stenotic tract, although the fine details of the secondary ducts were not evaluated due to the low spatial resolution as compared with conventional films. CONCLUSIONS: MRCP can be considered a technique able to completely replace diagnostic ERCP. Further studies are necessary for a better evaluation of the potential advantages and disadvantages of this technique. Am J Surg. 1997;174:33-38. [C] 1997 by Excerpta Medica, Inc.

Published
1997

17. Probiotic supplementation promotes a reduction in T-cell activation, an increase in Th17 frequencies, and a recovery of intestinal epithelium integrity and mitochondrial morphology in ART-treated HIV-1-positive patients

Author

D'Ettorre, Gabriella, Rossi, Giacomo, Scagnolari, Carolina, Andreotti, Mauro, Giustini, Noemi, Serafino, Sara, Schietroma, Ivan, Corano Scheri, Giuseppe, Fard, Saeid Najafi, Trinchieri, Vito, Mastromarino, Paola, Selvaggi, Carla, Scarpona, Silvia, Fanello, Gianfranco, Fiocca, Fausto, Ceccarelli, Giancarlo, Antonelli, Guido, Brenchley, Jason M, and Vullo, Vincenzo

Subjects
Adult, Male, Tc17, CD8-Positive T-Lymphocytes, Lymphocyte Activation, t-cell activation, Th1, galt, gut, hiv-1, hsp60, iels, tc1, tc17, th1, th17, apoptosis, immunity, probiotics, HIV Seropositivity, GALT, Humans, GUT, Intestinal Mucosa, Original Research, Probiotics, HIV‐1, Middle Aged, Th1 Cells, Mitochondria, Anti-Retroviral Agents, T‐cell activation, HIV-1, IELs, Th17 Cells, Th17, HSP60, Tc1
Abstract

Introduction HIV infection is characterized by a persistent immune activation associated to a compromised gut barrier immunity and alterations in the profile of the fecal flora linked with the progression of inflammatory symptoms. The effects of high concentration multistrain probiotic (Vivomixx®, Viale del Policlinico 155, Rome, Italy in EU; Visbiome®, Dupont, Madison, Wisconsin in USA) on several aspects of intestinal immunity in ART‐experienced HIV‐1 patients was evaluated. Methods A sub‐study of a longitudinal pilot study was performed in HIV‐1 patients who received the probiotic supplement twice a day for 6 months (T6). T‐cell activation and CD4+ and CD8+ T‐cell subsets expressing IFNγ (Th1, Tc1) or IL‐17A (Th17, Tc17) were stained by cytoflorimetric analysis. Histological and immunohistochemical analyses were performed on intestinal biopsies while enterocytes apoptosis index was determined by TUNEL assay. Results A reduction in the frequencies of CD4+ and CD8+ T‐cell subsets, expressing CD38+, HLA‐DR+, or both, and an increase in the percentage of Th17 cell subsets, especially those with central or effector memory phenotype, was recorded in the peripheral blood and in gut‐associated lymphoid tissue (GALT) after probiotic intervention. Conversely, Tc1 and Tc17 levels remained substantially unchanged at T6, while Th1 cell subsets increase in the GALT. Probiotic supplementation was also associated to a recovery of the integrity of the gut epithelial barrier, a reduction of both intraepithelial lymphocytes density and enterocyte apoptosis and, an improvement of mitochondrial morphology sustained in part by a modulation of heat shock protein 60. Conclusions These findings highlight the potential beneficial effects of probiotic supplementation for the reconstitution of physical and immunological integrity of the mucosal intestinal barrier in ART‐treated HIV‐1‐positive patients.

Published
2017

18. Treatment of leaks following sleeve gastrectomy by endoscopic internal drainage (EID)

Author

DONATELLI, Gianfranco, Dumont, Jl, CEREATTI, FABRIZIO, Ferretti, Stefano, Vergeau, Bm, Tuszynski, T, Pourcher, G, Tranchart, H, MEDURI, ANTONELLA, Catheline, Jm, Dagher, I, FIOCCA, Fausto, Marmuse, Jp, Donatelli, Gianfranco, Dumont, Jl, Cereatti, Fabrizio, Ferretti, Stefano, Vergeau, Bm, Tuszynski, T, Pourcher, G, Tranchart, H, Meduri, Antonella, Catheline, Jm, Dagher, I, Fiocca, Fausto, and Marmuse, Jp

Subjects
surgery, obesity, drainage
Abstract

BACKGROUND: Leaks are considered one of the major complications of laparoscopic sleeve gastrectomy (LSG) with a reported rate up to 7 %. Drainage of the collection coupled with SEMS deployment is the most frequent treatment. Its success is variable and burdened by high morbidity and not irrelevant mortality. The aim of this paper is to suggest and establish a new approach by endoscopic internal drainage (EID) for the management of leaks. METHODS: Since March 2013, 67 patients presenting leak following LSG were treated with deployment of double pigtail plastic stents across orifice leak, positioning one end inside the collection and the other end in remnant stomach. The aim of EID is to internally drain the collection and at the same time promote leak healing. RESULTS: Double pigtails stent were successfully delivered in 66 out of 67 patients (98.5 %). Fifty patients were cured by EID after a mean time of 57.5 days and an average of 3.14 endoscopic sessions. Two died for event not related to EID. Nine are still under treatment; five failure had been registered. Six patients developed late stenosis treated endoscopically. CONCLUSIONS: EID proved to be a valid, curative, and safe mini-invasive approach for treatment of leaks following SG. EID achieves complete drainage of perigastric collections and stimulates mucosal growth over the stent. EID is well tolerated, allows early re-alimentation, and it is burdened by fewer complications than others technique. Long-term follow-up confirms good outcomes with no motility or feeding alterations.

Published
2015

22. Probiotic supplementation promotes a reduction in T-cell activation, an increase in Th17 frequencies, and a recovery of intestinal epithelium integrity and mitochondrial morphology in ART-treated HIV-1-positive patients

Author

d'Ettorre, Gabriella, primary, Rossi, Giacomo, additional, Scagnolari, Carolina, additional, Andreotti, Mauro, additional, Giustini, Noemi, additional, Serafino, Sara, additional, Schietroma, Ivan, additional, Scheri, Giuseppe Corano, additional, Fard, Saeid Najafi, additional, Trinchieri, Vito, additional, Mastromarino, Paola, additional, Selvaggi, Carla, additional, Scarpona, Silvia, additional, Fanello, Gianfranco, additional, Fiocca, Fausto, additional, Ceccarelli, Giancarlo, additional, Antonelli, Guido, additional, Brenchley, Jason M., additional, and Vullo, Vincenzo, additional

Published
2017
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23. Effective treatment of benign biliary strictures with a removable, fully covered, self‐expandable metal stent: A prospective, multicenter European study

Author

Schmidt, Arthur, primary, Pickartz, Tilman, additional, Lerch, Markus M, additional, Fanelli, Fabrizio, additional, Fiocca, Fausto, additional, Lucatelli, Pierleone, additional, Cereatti, Fabrizio, additional, Hoffmeister, Albrecht, additional, Steenbergen, Werner, additional, Kraft, Matthias, additional, Meier, Benjamin, additional, and Caca, Karel, additional

Published
2017
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30. Su1607 Endoscopic Treatment of Benign Biliary Strictures With a Removable Fully Covered Self-Expandable Metal Stent: a Prospective Multicenter European Study

Author

Schmidt, Arthur R., primary, Lerch, Markus M., additional, Pickartz, Tilman, additional, Hoffmeister, Albrecht, additional, Fanelli, Fabrizio, additional, Fiocca, Fausto, additional, Lucatelli, Pierleone, additional, Cereatti, Fabrizio, additional, Van Steenbergen, Werner, additional, and Caca, Karel, additional

Published
2015
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40. Reconstitution of Intestinal CD4 and Th17 T Cells in Antiretroviral Therapy Suppressed HIV-Infected Subjects: Implication for Residual Immune Activation from the Results of a Clinical Trial

Author

d'Ettorre, Gabriella, primary, Baroncelli, Silvia, additional, Micci, Luca, additional, Ceccarelli, Giancarlo, additional, Andreotti, Mauro, additional, Sharma, Prachi, additional, Fanello, Gianfranco, additional, Fiocca, Fausto, additional, Cavallari, Eugenio Nelson, additional, Giustini, Noemi, additional, Mallano, Alessandra, additional, Galluzzo, Clementina M., additional, Vella, Stefano, additional, Mastroianni, Claudio M., additional, Silvestri, Guido, additional, Paiardini, Mirko, additional, and Vullo, Vincenzo, additional

Published
2014
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41. A Retrospective Case-Control Study Evaluating the Bowel Preparation Quality during Surveillance Colonoscopy after Colonic Resection

Author

Pontone, Stefano, primary, Leonetti, Giovanni, additional, Lamazza, Antonietta, additional, Fiocca, Fausto, additional, Filippini, Angelo, additional, Fanello, Gianfranco, additional, Cereatti, Fabrizio, additional, Fiori, Enrico, additional, Angelini, Rita, additional, Patrizi, Gregorio, additional, Brighi, Manuela, additional, Vetere, Simone, additional, Antoniozzi, Angelo, additional, Pironi, Daniele, additional, Manfredelli, Simone, additional, and Pontone, Paolo, additional

Published
2014
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44. Fully covered self-expandable metal stent in the treatment of postsurgical colorectal diseases: outcome in 29 patients.

Author

Cereatti, Fabrizio, Fiocca, Fausto, Dumont, Jean-Loup, Ceci, Vincenzo, Vergeau, Bertrand-Marie, Tuszynski, Thierry, Meduri, Bruno, and Donatelli, Gianfranco

Abstract

Background: Self-expandable metal stent (SEMS) placement is a minimally invasive treatment for palliation of malignant colorectal strictures and as a bridge to surgery. However, the use of SEMS for benign colorectal diseases is controversial. The purpose of this retrospective study is to evaluate the efficacy and safety of fully covered SEMS (FCSEMS) placement in postsurgical colorectal diseases. Methods: From 2008 to 2014, 29 patients with 32 FCSEMS deployment procedures were evaluated. The indications for stent placement were: 17 anastomotic strictures (3/17 presented complete closure of the anastomosis); four anastomotic leaks; seven strictures associated with anastomotic leak; and one rectum-vagina fistula. Results: Clinical success was achieved in 18 out of 29 patients (62.1%) being symptom-free at an average of 19 months. In the remaining 11 patients (37.9%), a different treatment was needed: four patients required multiple endoscopic dilations, 4 patients colostomy confection, one patient definitive ileostomy and three patients revisional surgery. The FCSEMS were kept in place for a mean period of 34 (range: 6–65) days. Major complications occurred in 12 out of 29 patients (41.4%) and consisted of stent migration. Minor complications included two cases of transient fever, eight cases of abdominal or rectal pain, and one case of tenesmus. Conclusion: FCSEMS are considered a possible therapeutic option for treatment of postsurgical strictures and leaks. However, their efficacy in guaranteeing long-term anastomotic patency and leak closure is moderate. A major complication is migration. The use of FCSEMS for colonic postsurgical pathologies should be carefully evaluated for each patient. [ABSTRACT FROM AUTHOR]

Published
2016
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45. Percutaneous biliary endoscopy

Author

Rossi, P., Salvatori, F. M., Bezzi, Mario, and Fiocca, Fausto

Subjects
cholangioscopy, biliary endoscopy
Published
1997

46. ESWL in the therapy of difficult bile duct stones

Author

Lomanto, D., Fiocca, Fausto, Nardovino, M. P., Grasso, E., Lezoche, E., ZARBA MELI, E., Paganini, A., and Speranza, V.

Subjects
Digestive system, Cholelithiasis, Sphincterotomy, Bile duct stones, ESWL
Published
1996

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