Project description:Patients with distal esophageal pathology such as perforation, trachea-esophageal fistulae, and/ or obstructing gastroesophageal junction tumor present a challenging situation in terms of feeding access where an esophageal stent is placed across the gastroesophageal junction. In order to allow simultaneous gastric decompression and post-pyloric feeds without significant reflux up through the stent, a gastrojejunostomy (GJ) tube is a viable option. We hereby describe a hybrid approach to placing these GJ tubes in this cohort of patients using simultaneous laparoscopy, endoscopy, and fluoroscopy with minimal manipulation of the stent itself. We have employed this technique of placing GJ tubes 2-3 days following placement of the esophageal stent in six consecutive patients. All patients tolerated the procedure well without any complications. Endoscopically guided laparoscopic GJ tubes are ideal for bridging patients, with distal esophageal pathology requiring esophageal stents, to oral intake.

| S-EPMC5517590 | biostudies-literature

Pars plana placement of Ahmed glaucoma valve tube through sclerotomy port in refractory glaucoma: A novel surgical technique.

Project description:We describe a case of 34-year-old male with post penetrating keratoplasty glaucoma, post trabeculectomy with aphakia in the only seeing eye, in which a modified surgical technique of inserting Ahmed glaucoma valve (AGV) tube in vitreous cavity was done to reduce the risks associated with pars plana incision during pars plana vitrectomy (PPV). A hybrid 20-25 gauge PPV was done concurrently, implant fixed to sclera, and tube inserted through the 25 gauge sclerotomy port in supero-temporal quadrant. Visual acuity and intraocular pressure remained stable during 1-year follow-up.

| S-EPMC6951159 | biostudies-literature

Transhepatic Insertion of Percutaneous Endoscopic Gastrostomy Tube.

Project description:Inadvertent injury to interposing organs during percutaneous endoscopic gastrostomy (PEG) tube placement is a feared complication of this common and generally safe procedure. Transhepatic PEG insertion is likely an underrepresented complication which may be identified incidentally on imaging or present with life-threatening conditions such as sepsis or massive bleeding. Use of ultrasound in patients with known hepatomegaly may possibly help avoid this complication. We hereby report a case of transhepatic PEG insertion, one of 16 only other cases published in the literature, and review the characteristics of the previous reported cases.

| S-EPMC7037529 | biostudies-literature

Continuous Negative Pressure Operative Field Barrier for Combined Open Tracheostomy and Percutaneous Endoscopic Gastrostomy Tube Placement During Coronavirus Disease 2019.

Project description:Respiratory failure in coronavirus disease 2019 (COVID-19) patients with prolonged endotracheal intubation may require a tracheostomy and percutaneous endoscopic gastrostomy (PEG) tube placement to facilitate recovery. Both techniques are considered high-risk aerosol-generating procedures and present a heightened risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for operating room personnel. We designed, simulated, and implemented a portable, continuous negative pressure, operative field barrier system using standard equipment available in hospitals to enhance health care provider safety during high-risk aerosol-generating procedures.

| S-EPMC7771639 | biostudies-literature

Endoscopic nasobiliary drainage tube placement through a periampullary perforation for management of intestinal leak and necrotizing pancreatitis

Project description:Video Video 1 Management of ampullary perforation by endoscopic nasobiliary drainage tube placement through the perforation for suctioning out leaked intestinal juice and indicating the presence of the hepatic portal vein.

| S-EPMC9938157 | biostudies-literature

Endoscopic management of gastrojejunocolic fistula after endoscopic gastrojejunostomy.

Project description:Video 1Endoscopic repair of gatstrojejunocolic fistala using tandem stent placement with a long covered metal stent.

| S-EPMC9669498 | biostudies-literature

Efficacy of nasal bridles in avoiding percutaneous endoscopic gastrostomy placement.

Project description:The aim of the study was to report the use of nasogastric tube bridles to avoid dislodging of percutaneous endoscopic gastrostomy tubes. Specifically it was intended to see if they reduced feeding time, medical input and costs.and setting This was a cohort study in a district hospital setting.164 patients admitted with conditions causing acutely impaired swallowing.140 of 164 patients referred received a NGT bridle.Of these, 49 (35%) died by 28 days and 68 (48.6%) at 1 year; 73 (52.1%) had regained adequate oral intake at 28 days and 27 (19.2%) had proceeded to PEG. Of those not bridled, nine (37.5%) died by 28 days and 10 (41.7%) at 1 year with the remainder eating. There was no significant difference in mortality between groups. There were no complications attributed to bridles.We conclude that nasogastric bridles are safe and represent an appropriate method to maintain nutrition while seeing if the underlying disease process will stabilise in these critically ill patients. They have the benefits of avoiding unnecessary PEG and the associated complications and cost.

| S-EPMC5517266 | biostudies-other

Endoscopic transpapillary gallbladder stent placement in the presence of uncovered biliary metal stents using a through-the-mesh technique.

Project description: Not available

| S-EPMC7332764 | biostudies-literature

Percutaneous endoscopic gastrostomy (PEG) using a novel large-caliber introducer technique kit: a retrospective analysis.

Project description:Percutaneous endoscopic gastrostomy (PEG) using the introducer technique is not only useful in patients with upper digestive tract stenosis but has been shown to reduce peristomal infection. In this study, we evaluated the safety and utility of a novel large-caliber introducer PEG kit (using 20 Fr size tube) compared with a push kit of similar size.One hundred and thirty-six patients who received PEG at our hospital between January 2014 and December 2015 were retrospectively analyzed. Baseline characteristics, laboratory biomarkers, hemodynamic changes, postoperative adverse events and clinical outcomes with both kits were compared.The new introducer PEG kit was used in 61 patients while the remaining 75 patients received tube placement using a push technique PEG kit. Except for the prevalence of dementia, which was lower in the introducer PEG kit group, baseline characteristics were similar in both groups. Tube placements were 100 % successful with both PEG kits and there were no significant differences in the change of postoperative hemodynamic or laboratory biomarkers. The Introducer PEG kit group experienced fewer incidence of feeding-related aspiration pneumonia (8.2 % vs. 24 %, P = 0.02), lower peristomal infection scores (1.2 vs. 1.6, P < 0.01), shorter postoperative length of stay (16 days vs. 23.7 days, P = 0.01) and fewer deaths at day 60 (3.3 % vs. 16 %, P = 0.02).Gastrostomy using the new large-caliber introducer PEG kit is safe and produced non-inferior (with some favourable) results when compared to the push technique using similar size tubes.

| S-EPMC5025309 | biostudies-other

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