scholarly journals Outcomes and Loop Pattern Analysis of a Road-Map Technique for ERCP with Side-Viewing Duodenoscope in Patients with Billroth II Gastrectomy (with Video)

2021 ◽  
Vol 11 (5) ◽  
pp. 404
Author(s):  
Min Jae Yang ◽  
Jin Hong Kim ◽  
Jae Chul Hwang ◽  
Byung Moo Yoo ◽  
Yu Ji Li ◽  
...  
Keyword(s):  
Bowel Perforation ◽  
Success Rates ◽  
Billroth Ii ◽  
Therapeutic Success ◽  
Afferent Limb ◽  
The Road ◽  
Road Map ◽  
Billroth Ii Gastrectomy ◽  
Axis Alignment ◽  
Loop Pattern

Endoscopic retrograde cholangiopancreatography (ERCP) in patients who have undergone a Billroth II gastrectomy is a major challenge. This study aimed to evaluate the outcomes of the road-map technique for duodenal intubation using a side-viewing duodenoscope for ERCP in Billroth II gastrectomy patients with naïve papilla, and to analyze the formation and release patterns of common bowel loops that occur when the duodenoscope navigates the afferent limb. The duodenoscopy approach success rate was 85.8% (97/113). In successful duodenoscopy approach patients, there were five bowel looping patterns that occurred when the preceding catheter-connected duodenoscope was advanced into the duodenum: (1) reverse ɣ-loop (29.9%), (2) fixed reverse ɣ-loop (5.2%), (3) simple U-loop (22.7%), (4) N-loop (28.9%), and (5) reverse alpha loop (13.4%). The duodenoscopy cannulation and duodenoscopy therapeutic success rates were 81.4% (92/113) and 80.5% (91/113), respectively, while the overall cannulation and therapeutic success rates were 92.0% (104/113) and 87.6% (99/113), respectively. Bowel perforation occurred in three patients (2.7%). The road-map technique may benefit duodenoscope-based ERCP in Billroth II gastrectomy patients by minimizing the tangential axis alignment between the duodenoscopic tip and driving of the afferent limb, and by predicting and counteracting bowel loops that occur when the duodenoscope navigates the afferent limb.

scholarly journals Acute Cholangitis following Biliary Obstruction after Duodenal OTSC Placement in a Case of Large Chronic Duodenocutaneous Fistula

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Yaseen Alastal ◽  
Tariq A. Hammad ◽  
Mohamad Nawras ◽  
Basmah W. Khalil ◽  
Osama Alaradi ◽  
...  
Keyword(s):  
Acute Cholangitis ◽  
Eosinophilic Gastroenteritis ◽  
Efficacy And Safety ◽  
Duodenal Stump ◽  
Billroth Ii ◽  
Afferent Limb ◽  
Billroth Ii Gastrectomy ◽  
Close Proximity ◽  
History Of ◽  
Over The Scope Clip

Over-the-Scope Clip system, also called “Bear Claw,” is a novel endoscopic modality used for closure of gastrointestinal defect with high efficacy and safety. We present a patient with history of eosinophilic gastroenteritis and multiple abdominal surgeries including Billroth II gastrectomy complicated by a large chronic duodenocutaneous fistula from a Billroth II afferent limb to the abdominal wall. Bear Claw clip was used for closure of this fistula. The patient developed acute cholangitis one day after placement of the Bear Claw clip. Acute cholangitis due to papillary obstruction is a potential complication of Bear Claw placement at the dome of the duodenal stump (afferent limb) in patient with Billroth II surgery due to its close proximity to the major papilla.

scholarly journals Specifics of endoscopic retrograde cholangiopancreatographyin patients with altered anatomy of gastrointestinal tract (a literature review)

2021 ◽  
Vol 23 (6) ◽  
pp. 872-881
Author(s):  
A. V. Klymenko ◽  
A. O. Steshenko ◽  
V. S. Tkachov ◽  
M. M. Sofilkanych
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
World Literature ◽  
Surgical Reconstruction ◽  
Papilla Of Vater ◽  
Success Rates ◽  
Endoscopic Retrograde ◽  
Therapeutic Success ◽  
Afferent Limb ◽  
Advantages And Disadvantages

The aim of the work: analysis and integration of literature data regarding the technical and methodological implementation of endoscopic retrograde cholangiopancreatography in altered anatomy of the gastrointestinal tract after gastric resection. Results. World literature data convincingly indicate the need for a staged approach to performing endoscopic retrograde cho langiopancreatography in patients with altered anatomy of the gastrointestinal tract. Scientific works state that the main stages are detailed examination of a past surgical history in patients, careful selection of suitable endoscopic instruments, afferent limb intubation, papilla of Vater cannulation and papillary interventions. The article describes the existing endoscopic instruments, modern techniques and approaches, their advantages and disadvantages, and the influence of various factors on the success of their use in comparison with traditional techniques for various types of surgical reconstruction for each of the above stages. The length of the afferent limb is one of the main factors that affect the success rates of the procedure. Conclusions. Endoscopic retrograde cholangiopancreatography in patients with altered anatomy is complex and faces a number of challenges. Thanks to the development of special instruments and techniques, it can be performed even in patients with a long Roux-en-Y limb, reaching therapeutic success rates close to those in patients with normal anatomy, but this requires extensive experience of an endoscopist. There are currently no clear recommendations for the use of a particular technique; therefore the choice of the optimal strategy depends on the type of surgical reconstruction, surgeon skill level and endoscopy center facilities.  

A2. PA PRIME MINISTER MAHMUD ABBAS AND ISRAELI PRIME MINISTER ARIEL SHARON, STATEMENTS FOLLOWING THE AQABA SUMMIT, AQABA, JORDAN, 4 JUNE 2003 (EXCERPTS).

2003 ◽  
Vol 33 (1) ◽  
pp. 149-151
Keyword(s):  
Prime Minister ◽  
Jewish State ◽  
The Road ◽  
Road Map ◽  
Associated Press ◽  
Occupied Territories ◽  
Arab States ◽  
President Bush

The quadrilateral meeting at Aqaba, intended to ““kick off implementation”” of the road map, was attended by King Abdallah, Prime Minister Abbas, Prime Minister Sharon, and President Bush. All four leaders made statements at the end of the meeting, but only those by Abbas and Sharon are reproduced below. President Bush's statement was noteworthy for its mention of Israel as a ““vibrant Jewish state”” (““America is strongly committed and I am strongly committed to Israel's security as a vibrant Jewish state””) and of Palestinian ““hopes”” for a ““viable”” state, and for reiterating that the Arab states ““have promised to cut off assistance and the flow of money and weapons to terrorists groups and to help Prime Minister Abbas rid Palestinian areas of terrorism.”” The statements by Abbas and Sharon were drafted with U.S. officials prior to the meeting. Though Abbas did not comply with the Israeli demand of Palestinian acknowledgment of Israel as a ““Jewish state,”” his speech provoked indignation in the occupied territories for its reference to ““the suffering of the Jews”” without mention of Palestinian suffering, its reiterated call for ending the ““armed intifada,”” and its ““renunciation”” of terrorism. Sharon resisted U.S. suggestions to refer to ““settlements,”” but did mention ““unauthorized outposts.”” In reference to Sharon's mention of ““territorial contiguity”” for a ““viable”” Palestinian state, a spokesman indicated that the contiguity would be ensured by ““bridges and tunnels.”” The text of the statements, transcribed by eMediaMill- Works and carried by the Associated Press, was posted on the Washington Post's Website.

The IFLA Global Vision Project in Zimbabwe: Towards a Unified Field Road Map for Libraries

Mousaion ◽  
2020 ◽  
Vol 37 (2) ◽  
Author(s):  
Collence Takaingenhamo Chisita ◽  
Nyarai Patience Chibanda
Keyword(s):  
Economic Transformation ◽  
International Federation ◽  
Access To Information ◽  
Factors Affecting ◽  
The Road ◽  
Unified Field ◽  
Road Map ◽  
Library Associations ◽  
Global Vision ◽  
Library Profession

The development of libraries in any country is critical for its socio-economic transformation especially during this 21st century era where access to information and knowledge underpins development. The International Federation of Library Associations and Institutions (IFLA) launched the Global Vision Project in 2017 as a way of strengthening library throughout the world. The project has seen over 190 countries participating worldwide. For most nations, especially those in the developing countries, this has indeed created platforms for strong and united library associations that are powering literate, informed and participative societies. A number of countries in Africa including Zimbabwe have taken the initiatives to participate in the IFLA Global Vision. This article seeks to examine the challenges and opportunities   for librarians in Zimbabwe in building a united library field. It will also scrutinize the road travelled by librarians in Zimbabwe in their pursuit of a vision to reposition their libraries on the global library landscape. The   article will also study the factors affecting the development of a unified library sector in Zimbabwe. It will also explore how the national professional association Zimbabwe Library Association (ZIMLA) can contribute towards a unified library profession through collaboration. The article also proposes a strategy to enhance cooperation among librarians in Zimbabwe.

EMPOWERING WOMEN THROUGH ENTREPRENEURSHIP: ASPECTS AND APPROACHES

2014 ◽  
Vol 6 (01) ◽  
Author(s):  
JAVED ALAM SHEIKH
Keyword(s):  
Economic Development ◽  
Developed Countries ◽  
Substantial Contribution ◽  
Economic Empowerment ◽  
World Population ◽  
Least Developed Countries ◽  
The Road ◽  
Road Map ◽  
The World ◽  
The Status

Almost 50 per cent of the world population is constituted by the women and they have been making substantial contribution to socio-economic development. But, unfortunately their tremendous contribution remains unrecognized and unnoticed in most of the developing and least developed countries causing the problem of poverty among them. Empowering women has become the key element in the development of an economy. With women moving forward, the family moves, the village moves and the nation moves. Hence, improving the status of women by way of their economic empowerment is highly called for. Entrepreneurship is a key tool for the economic empowerment of women around the world for alleviating poverty. Entrepreneurship is now widely recognized as a tool of economic development in India also. In this paper I have tried to discuss the reasons and role of Women Entrepreneurship with the help of Push and Pull factors. In the last I have also discussed the problems and the road map of Women Entrepreneurs development in India.

Surgery for gastric remnant carcinoma following Billroth II gastrectomy

1997 ◽  
Vol 23 (6) ◽  
pp. 518-521 ◽  
Author(s):  
P. Lissens ◽  
L. Filez ◽  
R. Aerts ◽  
A. D'Hoore ◽  
E. Van Cutsem ◽  
...  
Keyword(s):  
Gastric Remnant ◽  
Billroth Ii ◽  
Billroth Ii Gastrectomy

C. Sharon Advisor Dov Weisglass, Remarks on Relations with the United States, Disengagement, the Road Map, and the Possibilities of a Palestinian State, Tel Aviv, October 2004 (excerpts)

2005 ◽  
Vol 34 (2) ◽  
pp. 203-207
Keyword(s):  
United States ◽  
National Security ◽  
Full Text ◽  
Prime Minister ◽  
The United States ◽  
Sharp Contrast ◽  
Tel Aviv ◽  
The Road ◽  
Road Map ◽  
The Relationship

Ha'Aretz's lengthy interview with Dov Weisglass, Prime Minister Ariel Sharon's ““point man”” with Washington and probably his closest advisor, was conducted by Ari Shavit and published first in excerpts and two days later in its entirety. In addition to bringing into sharp contrast the contradiction between Israel's declaratory policies and assurances and its actual policies and intentions——and in so doing eliciting a swift ““clarification”” from the Prime Minister's Office——the interview also conveys a sense of the intimacy and easy camaraderie that characterizes U.S.-Israeli interactions. The full text is available at www.haaretz.com. Tell me about the dynamics of the relationship between you [and U.S. national security advisor Condoleezza Rice], and whether it's an unusual relationship.

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