Tumeurs de l’œsophage Le rôle de l’endoscopie dans la prise en charge thérapeutique

Introduction: L’endoscopie gastro-intestinale a evolue depuis son application purement diagnostique vers une discipline de plus en plus therapeutique. Le role de l’endoscopie dans la prise en charge therapeutique des tumeurs œsophagiennes fait la distinction entre traitement curatif ou palliatif.

Effect of intravenous application of esomeprazole 40???mg versus pantoprazole 40???mg on 24-hour intragastric pH in healthy adults

BACKGROUND: It has been demonstrated that therapy with proton pump inhibitors reduces recurrence of bleeding following initial endoscopic treatment of bleeding peptic ulcers. AIM: This study compared the effects of esomeprazole 40 mg and pantoprazole 40 mg on intragastric acid control. Both substances were administered intravenously as 15-min infusion and as bolus injection. METHODS: Healthy men and women volunteers were enrolled in this single-center, open, randomized, three-way crossover study. After administration of esomeprazole 40 mg and pantoprazole 40 mg intravenously as 15-min infusion, and pantoprazole 40 mg intravenously as bolus injection, continuous 24-h intragastric pH monitori…

Endoscopic ultrasound and early diagnosis of pancreatic cancer

Incidence of pancreatic cancer has increased, but prognosis remains poor. Curative treatment is dependent on early diagnosis. Endoscopic ultrasound (EUS) has been described as highly sensitive and accurate in staging, superior to other imaging modalities in early publications. With rapid advances in technology, other imaging techniques have reached better results. EUS still has the highest accuracy in assessing tumor size and lymph node involvement. For assessment of tumor respectability, a combination of a computed tomography (CT) scan and EUS seems to be the procedure with the highest accuracy. Promising new techniques might improve the diagnostic yield of EUS. But there are several reaso…

Management of retained bile duct stones: a prospective open trial comparing extracorporeal and intracorporeal lithotripsy.

Abstract Background: Endoscopic management of common bile duct stones has become the approach of choice, especially in patients with high surgical risk. Problems are encountered if there are large stones or a duct stenosis. For these difficult stones, shock wave technology serves as an alternative to surgical intervention. Methods: A total of 125 patients with common bile duct stones in whom conventional endoscopic treatment had failed were selected and treated either by extracorporeal piezoelectric lithotripsy (ESWL, n=79) or intracorporeal electrohydraulic lithotripsy (EHL, n=46). The average age of our patients was 70 years. Results: In the ESWL group visualization of the stones by ultra…

THE ROLE OF ENDOSCOPY IN ACUTE RECURRENT AND CHRONIC PANCREATITIS AND PANCREATIC CANCER

Endoscopy plays an important role in the diagnosis and treatment of acute and chronic pancreatitis as well as pancreatic cancer. Sphincterotomy and stone removal in biliary pancreatitis, stone extraction and drainage in chronic pancreatitis, and stent implantation in pancreatic cancer are the predominant procedures. With endoscopy, minimal invasive techniques are at hand to solve urgent and long term problems.

Colorectal Polyps

Publisher Summary Colorectal cancer (CRC) remains the second leading cause of cancer death for both women and men with more than 130,000 newly diagnosed cases and 50,000 deaths each year in the United States alone. Most colon cancers develop from nonmalignant colonic adenomas or polyps over a comparatively long time period ranging between 24 and 60 months. Reflecting this adenomatous pathogenesis of most colorectal cancers, polyp screening with subsequent polypectomy is used to constitute an effective approach for decreasing the incidence of this malignant tumor. Thus, colorectal screening for polyps may be considered one of the most promising preventive measures in medicine. Most available…

Choledochocele imaged with magnetic resonance cholangiography.

Choledochal cysts are rare developmental malformations of the biliary tree. Percutaneous and endoscopic ultrasound, as well as endoscopic retrograde cholangiopancreatography, are recommended diagnostic tools. Magnetic resonance cholangiography may also contribute to the workup and treatment plan of patients with choledochal cysts. We report a 25-yr-old white woman with episodic nausea and moderate epigastric dyscomfort. Magnetic resonance cholangiography showed a rather spherical, cyst-like, fluid-filled structure in continuity with the prepapillary segment of the common bile duct, thus making a choledochocele (type III choledochal cyst) likely. The patient was treated by endoscopic sphinct…

Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography: a prospective controlled study

Summary Background Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive and increasingly used procedure in cases involving biliary and pancreatic diseases. However, the accuracy of MRCP in differential diagnosis between pancreatic cancer and chronic pancreatitis has never been documented in a large prospective controlled study. Methods 124 patients were recruited for the study, selected from 141 consecutive patients with an average age of 55 years (range 19–80) who presented to our department between February, 1996, and January, 1998, with a strong clinical suspicion of pancreatic cancer. MRCP images were interpreted by a radiologist and a gastroenterologist who were unaware…

Split-dose versus whole-dose cleansing preparations for colonoscopy