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| 1 | Role and timing of endoscopy in acute biliary pancreatitis显示文摘The role and timing of endoscopy in the setting of acute biliary pancreatitis(ABP) is still being debated. Despite numerous randomized trials have been published,there is an obvious lack of consensus on the indications and timing of endoscopic retrograde cholangiopancreatography(ERCP) in ABP in metaanalyses and nationwide guidelines. The present editorial has been written to clarify the role of endoscopy in ABP. In clinical practice the decision to perform an ERCP is often based on biochemical and radiological criteria despite they already have been shown to be unreliable predictors of common bile duct stone presence. Endoscopic ultrasonography(EUS) is not currently a worldwide standard diagnostic procedure early in the course of acute biliary pancreatitis,but it has been shown to be accurate,safe and cost effective in diagnosing biliary obstructions compared with magnetic resonance cholangiopancreatography and ERCP and therefore in preventing unnecessary ERCP and its related complications. Early EUS in ABP allows,if appropriate,immediate endoscopic treatment and significant spare of unnecessary operative procedures thus reducing possible related complications. | Andrea Anderloni Alessandro Repici | 2015 | World Journal of Gastroenterology2015,21,40: | 24 |
| 2 | Loss of interstitial cells of Cajal network in severe idiopathic gastroparesis显示文摘AIM: To report a case of severe idiopathic gastroparesis in complete absence of Kit-positive gastric interstitial cells of Cajal (ICC). METHODS: Gastric tissue from a patient with severe idiopathic gastroparesis unresponsive to medical treatment and requiring surgery was analyzed by conventional histology and immunohistochemistry. RESULTS: Gastric pacemaker cells expressing Kit receptor had completely disappeared while the local level of stem cell factor, the essential ligand for its development and maintenance, was increased. No signs of cell death were observed in the pacemaker region. CONCLUSION: These results are consistent with the hypothesis that a lack of Kit expression may lead to impaired functioning of ICC. Total gastrectomy proves to be curative. | Edda Battaglia Gabrio Bassotti Graziella Bellone Luca Dughera Anna Maria Serra Luigi Chiusa Alessandro Repici Pierroberto Mioli Giorgio Emanuelli | 2006 | World Journal of Gastroenterology2006,12,38: | 20 |
| 3 | Narrow-band imaging endoscopy to assess mucosal angiogenesis in inflammatory bowel disease: A pilot study显示文摘AIM: To investigate whether narrow band imaging (NBI) is a useful tool for the in vivo detection of angiogenesis in inflammatory bowel disease (IBD) patients. METHODS: Conventional and NBI colonoscopy was performed in 14 patients with colonic inflammation (8 ulcerative colitis and 6 Crohn’s disease). Biopsy samples were taken and CD31 expression was assayed immuno- histochemically; microvascular density was assessed by vessel count. RESULTS: In areas that were endoscopically normal but positive on NBI, there was a significant (P < 0.05) increase in angiogenesis (12 ± 1 vessels/field vs 18 ± 2 vessels/field) compared with areas negative on NBI. In addition, in areas that were inflamed on white light endoscopy and positive on NBI, there was a significant (P < 0.01) increase in vessel density (24 ± 7 vessels/f ield) compared with NBI-negative areas.CONCLUSION: NBI may allow in vivo imaging of intestinal angiogenesis in IBD patients. | Silvio Danese Gionata Fiorino Erika Angelucci Stefania Vetrano Nico Pagano Giacomo Rando Antonino Spinelli Alberto Malesci Alessandro Repici | 2010 | World Journal of Gastroenterology2010,16,19: | 9 |
| 4 | Endoscopic management of difficult common bile duct stones:Where are we now?A comprehensive review显示文摘Endoscopic management for difficult common bile duct(CBD)stones still presents a challenge for several reasons,including anatomic anomalies,patients’individual conditions and stone features.In recent years,variable methods have emerged that have attributed to higher stone removal success rates,reduced cost and lower adverse events.In this review,we outline a stepwise approach in CBD stone management.As first line therapy,endoscopic sphincterotomy and large balloon dilation are recommended,due to a 30%-50%reduction of the use of mechanical lithotripsy.On the other hand,cholangioscopy-assisted lithotripsy has been increasingly reported as an effective and safe alternative technique to mechanical lithotripsy but remains to be reserved in special settings due to limited large-scale evidence.As discussed,findings suggest that management needs to be tailored to the patient’s characteristics and anatomical conditions.Furthermore,we evaluate the management of CBD stones in various surgical altered anatomy(Billroth II,Roux-en-Y and Roux-en-Y gastric bypass).Moreover,we could conclude that cholangioscopy-assisted lithotripsy needs to be evaluated for primary use,rather than following a failed management option.In addition,we discuss the importance of dissecting other techniques,such as the primary use of interventional endoscopic ultrasound for the management of CBD stones when other techniques have failed.In conclusion,we recognize that endoscopic sphincterotomy and large balloon dilation,mechanical lithotripsy and intraductal lithotripsy substantiate an indication to the management of difficult CBD stones,but emerging techniques are in rapid evolution with encouraging results. | Alberto Tringali Deborah Costa Alessandro Fugazza Matteo Colombo Kareem Khalaf Alessandro Repici Andrea Anderloni | 2021 | World Journal of Gastroenterology2021,27,44: | 8 |
| 5 | European evidence based consensus for endoscopy in inflammatory bowel disease显示文摘 | Vito Annese Marco Daperno Matthew D. Rutter Aurelien Amiot Peter Bossuyt James East Marc Ferrante Martin G?tz Konstantinos H. Katsanos Ralf Kie?lich Ingrid Ordás Alessandro Repici Bruno Rosa Shaji Sebastian Torsten Kucharzik Rami Eliakim | 2013 | Journal of Crohn’s and Colitis2013,,12: | 7 |
| 6 | Malignant gastric outlet obstruction:Which is the best therapeutic option?显示文摘Malignant gastric outlet obstruction(MGOO)is a clinical condition characterized by the mechanical obstruction of the pylorus or the duodenum due to tumor compression/infiltration,with consequent reduction or impossibility of an adequate oral intake.MGOO is mainly secondary to advanced pancreatic or gastric cancers,and significantly impacts on patients’survival and quality of life.Patients suffering from this condition often present with intractable vomiting and severe malnutrition,which further compromise therapeutic chances.Currently,palliative strategies are based primarily on surgical gastrojejunostomy and endoscopic enteral stenting with self-expanding metal stents.Several studies have shown that surgical approach has the advantage of a more durable relief of symptoms and the need of fewer re-interventions,at the cost of higher procedure-related risks and longer hospital stay.On the other hand,enteral stenting provides rapid clinical improvement,but have the limit of higher stent dysfunction rate due to tumor ingrowth and a subsequent need of frequent reinterventions.Recently,a third way has come from interventional endoscopic ultrasound,through the development of endoscopic ultrasound-guided gastroenterostomy technique with lumen-apposing metal stent.This new technique may ideally encompass the minimal invasiveness of an endoscopic procedure and the long-lasting effect of the surgical gastrojejunostomy,and brought encouraging results so far,even if prospective comparative trial are still lacking.In this Review,we described technical aspects and clinical outcomes of the above-cited therapeutic approaches,and discussed the open questions about the current management of MGOO. | Edoardo Troncone Alessandro Fugazza Annalisa Cappello Giovanna Del Vecchio Blanco Giovanni Monteleone Alessandro Repici Anthony Yuen Bun Teoh Andrea Anderloni | 2020 | World Journal of Gastroenterology2020,26,16: | 7 |
| 7 | Retrograde-viewing device improves adenoma detection rate in colonoscopies for surveillance and diagnostic workup显示文摘AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye Retroscope Randomized Clinical Evaluation(TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TERRACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy(SC) and Third Eye colonoscopy(TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects(51.0%),surveillance after previous polypectomy in 87(25.2%) and diagnostic workup in 82(23.8%).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate(ADR) with TEC of 23.2% compared to SC.Relative risk(RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92(P = 0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11(P = 0.815) for screening,3.15(P = 0.014) for surveillance,8.64(P = 0.039) for diagnostic and 3.34(P = 0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically significant.Age,bowel prep quality and withdrawal time did not significantly affect the RR of missing adenomas with SC vs TEC.Mean sizes of adenomas detected with TEC and SC were similar at 0.59 cm and 0.56 cm,respectively(P = NS).CONCLUSION:TEC allows detection of significantly more adenomas compared to SC in patients undergoing surveillance or diagnostic workup,but not in screening patients(ClinicalTrials.gov Identifier:NCT01044732). | Peter D Siersema Amit Rastogi Anke M Leufkens Paul A Akerman Kassem Azzouzi Richard I Rothstein Frank P Vleggaar Alessandro Repici Giacomo Rando Patrick I Okolo Olivier Dewit Ana Ignjatovic Elizabeth Odstrcil James East Pierre H Deprez Brian P Saunders Anthony N Kalloo Bradley Creel Vikas Singh Anne Marie Lennon Daniel C DeMarco | 2012 | World Journal of Gastroenterology2012,18,26: | 6 |
| 8 | Endoscopic mucosal resection for high-grade dysplasia and intramucosal carcinoma in Barrett's esophagus: An Italian experience显示文摘AIM: To evaluate endoscopic mucosal resection (EMR)in patients with high-grade dysplasia (HGD) and/or intramucosal cancer (IMC) in Barrett's esophagus (BE).METHODS: Between June 2000 and December 2003,39 consecutive patients with HGD (35) and/or IMC (4)underwent EMR. BE >30 mm was present in 27 patients.In three patients with short segment BE (25.0%), HGDwas detected in a normal appearing BE. Lesions had a mean diameter of 14.8±10.3 mm. Mucosal resection was carried out using the cap method.RESULTS: The average size of resections was 19.7±9.4×14.6±8.2 mm. Histopathologic assessment postresection revealed 5 low-grade dysplasia (LGD) (12.8%),27 HGD (69.2%), 2 IMC (5.1%), and 5 SMC (-12.8%).EMR changed the pre-treatment diagnosis in 10 patients (25.6%). Three patients with SMC underwehtsurgery.Histology of the surgical specimen revealed 1 T0N0 and 2 T1N0 lesions. The remaining two patients were cancer free at 32.5 and 45.6 mo, respectively. A metachronous lesion was detected after 25 mo in one patient with HGD. Intra-procedural bleeding, controlled at endoscopy,occurred in four patients (10.3%). After a median followup of 34.9 mo, all patients remained in remission.CONCLUSION: In the medium term, EMR is effective and safe to treat HGD and/or IMC within BE and is a valuable staging method. It could become an alternative to surgery. | Massimo Conio Alessandro Repici Renzo Cestari Sabrina Blanchi Gabriella Lapertosa Guido Missale Domenico Della Casa Vincenzo Villanacci Pier Gigi Calandri Rosangela Filiberti | 2005 | World Journal of Gastroenterology2005,11,42: | 6 |
| 9 | Effect of a retrograde-viewing device on adenoma detection rate during colonoscopy: the TERRACE study显示文摘 | Anke M. Leufkens Daniel C. DeMarco Amit Rastogi Paul A. Akerman Kassem Azzouzi Richard I. Rothstein Frank P. Vleggaar Alessandro Repici Giacomo Rando Patrick I. Okolo Olivier Dewit Ana Ignjatovic Elizabeth Odstrcil James East Pierre H. Deprez Brian P. Sau | 2011 | Gastrointestinal Endoscopy2011,,3: | 5 |
| 10 | Endoscopy-guided ablation of pancreatic lesions:Technical possibilities and clinical outlook显示文摘Endoscopic ultrasound(EUS) and endoscopic retrograde cholangiopancreatography(ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer(LAPC), pancreatic neuroendocrine tumours(PNETs), and pancreatic cystic lesions(PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as wel as hybrid cryotherm probe combining radiofrequency with cryotechnology. To date, many reports and case series have confirmed the safety and feasibility of that kind of ablation technique in the pancreatic setting.Moreover, EUS-guided fine-needle injection is emerging as a method to deliver ablative and anti-tumoral agents inside the tumuor. Ethanol injection has been proposed mostly for the treatment of PCLs and for symptomatic functioning PNETs, and the use of gemcitabine and paclitaxel is also interesting in this setting. EUS-guided injection of chemical or biological agents including mixed lymphocyte culture, oncolytic viruses, and immature dendritic cells has been investigated for the treatment of LAPC. Data on the long-term efficacy of these approaches,and large prospective randomized studies are needed to confirm the real clinical benefits of these techniques for the management of pancreatic lesions. | Marianna Signoretti Roberto Valente Alessandro Repici Gianfranco Delle Fave Gabriele Capurso Silvia Carrara | 2017 | World Journal of Gastrointestinal Endoscopy2017,9,2: | 5 |
| 11 | The role of K- ras gene mutation analysis in EUS-guided FNA cytology specimens for the differential diagnosis of pancreatic solid masses: a meta-analysis of prospective studies显示文摘 | Lorenzo Fuccio Cesare Hassan Liboria Laterza Loredana Correale Nico Pagano Paolo Bocus Carlo Fabbri Antonella Maimone Vincenzo Cennamo Alessandro Repici Guido Costamagna Franco Bazzoli Alberto Larghi | 2013 | Gastrointestinal Endoscopy2013,,: | 4 |
| 12 | Helicobacter pylori eradication and reflux disease onset:Did gastric acid get 'crazy'?显示文摘Gastroesophageal reflux disease (GORD) is highly prevalent in the general population.In the last decade,a potential relationship between Helicobacter pylori (H.pylori) eradication and GORD onset has been claimed.The main putative mechanism is the gastric acid hypersecretion that develops after bacterial cure in those patients with corpus-predominant gastritis.We performed a critical reappraisal of the intricate pathogenesis and clinical data available in this field.Oesophagitis onset after H.pylori eradication in duodenal ulcer patients has been ascribed to a gastric acid hypersecretion,which could develop following body gastritis healing.However,the absence of an acid hypersecretive status in these patients is documented by both pathophysiology and clinical studies.Indeed,duodenal ulcer recurrence is virtually abolished followingH.pylori eradication.In addition,intra-oesophageal pH recording studies failed to demonstrated increased acid reflux following bacterial eradication.Moreover,oesophageal manometric studies suggest that H.pylori eradication would reduce-rather than favor-acid reflux into the oesophagus.Finally,data of clinical studies would suggest that H.pylori eradication is not significantly associated with eitherreflux symptoms or erosive oesophagitis onset,some data suggesting also an advantage in curing the infection when oesophagitis is already present.Therefore,the legend of 'crazy acid' remains-as all the others a fascinating,but imaginary tale. | Angelo Zullo Cesare Hassan Alessandro Repici Vincenzo Bruzzese | 2013 | World Journal of Gastroenterology2013,19,6: | 4 |
| 13 | Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement显示文摘 | Gregorios Paspatis Jean-Marc Dumonceau Marc Barthet S?ren Meisner Alessandro Repici Brian Saunders Antonios Vezakis Jean Gonzalez Stine Turino Zacharias Tsiamoulos Paul Fockens Cesare Hassan | 2014 | Endoscopy2014,,: | 4 |
| 14 | Radiofrequency and malignant biliary strictures:An update显示文摘Malignant biliary strictures are usually linked to different types of tumors,mainly cholangiocarcinoma, pancreatic and hepatocellular carcinomas. Palliative measures are usually adopted in patients with nonresectable or borderline resectable biliary disease. Stent placement is a well-known and established treatment in patients with unresectable malignancy. Intraductal radiofrequency ablation(RFA) represents a procedure that involves the use of a biliary catheter device, via an endoscopic approach. Indications for biliary RFA described in literature are: Palliative treatment of malignant biliary strictures, avoiding stent occlusion, ablating ingrowth of blocked metal stents, prolonging stent patency,ablating residual adenomatous tissue after endoscopic ampullectomy. In this mini-review we addressed focus on technical success defined as deployment of the RF catheter, virtually succeeded in all patients included in the studies. About efficacy, three main outcome measures have been contemplated: Biliary decompression and stent patency, survival. Existing studies suggest a beneficial effect on survival and stent patency with RFA, but current impression is limited because most of studies have been performed using a retrospective design, on diminutive and dissimilar cohorts of patients. | Francesco Auriemma Luca De Luca Mario Bianchetti Alessandro Repici Benedetto Mangiavillano | 2019 | World Journal of Gastrointestinal Endoscopy2019,11,2: | 3 |
| 15 | Lumen-apposing metal stents for malignant biliary obstruction: Is this the ultimate horizon of our experience?显示文摘In the last years, endoscopic ultrasonography (EUS) has evolved from a purely diagnostic technique to a more and more complex interventional procedure, with the possibility to perform several type of therapeutic interventions. Among these, EUS-guided biliary drainage (BD) is gaining popularity as a therapeutic approach after failed endoscopic retrograde cholangiopancreatography in distal malignant biliary obstruction (MBO), due to the avoidance of external drainage, a lower rate of adverse events and re-interventions, and lower costs compared to percutaneous trans-hepatic BD. Initially, devices created for luminal procedures (e.g., luminal biliary stents) have been adapted to the new trans-luminal EUSguided interventions, with predictable shortcomings in technical success, outcome and adverse events. More recently, new metal stents specifically designed for transluminal drainage, namely lumen-apposing metal stents (LAMS), have been made available for EUS-guided procedures. An electrocautery enhanced delivery system (EC-LAMS), which allows direct access of the delivery system to the target lumen, has subsequently simplified the classic multi-step procedure of EUS-guided drainages. EUS-BD using LAMS and ECLAMS has been demonstrated effective and safe, and currently seems one of the most performing techniques for EUS-BD. In this Review, we summarize the evolution of the EUS-BD in distal MBO, focusing on the novelty of LAMS and analyzing the unresolved questions about the possible role of EUS as the first therapeutic option to achieve BD in this setting of patients. | Andrea Anderloni Edoardo Troncone Alessandro Fugazza Annalisa Cappello Giovanna Del Vecchio Blanco Giovanni Monteleone Alessandro Repici | 2019 | World Journal of Gastroenterology2019,25,29: | 3 |
| 16 | Endoscopic management of GI perforations with a new over-the-scope clip device (with videos)显示文摘 | Andrea Parodi Alessandro Repici Antonietta Pedroni Sabrina Blanchi Massimo Conio | 2010 | Gastrointestinal Endoscopy2010,,4: | 3 |
| 17 | Intestinal metaplasia surveillance:Searching for the roadmap显示文摘Atrophic gastritis and intestinal metaplasia(IM) of the stomach are common and are associated with an increased risk for gastric cancer.In the absence of guidelines,a pragmatic management has been performed in Western countries in patients with these premalignant conditions.Recently,formal European guidelines have been delivered on this topic.Basically,it has been recommended that patients with extensive atrophic gastritis(AG) and/or extensive IM should be offered endoscopic surveillance every 3 years.On the contrary,no scheduled endoscopic/histological control has been advised for those patients with precancerous conditions confined to the antrum.In this commentary,we highlighted some potential weaknesses in the management formally recommended by the new guidelines.In detail,we discussed that AG and IM patients do not share the same gastric cancer risk,at least in Western countries,deserving a different approach.Some factors significantly associated with gastric cancer risk,such as IM type,first-degree family history of gastric cancer,and smoking habit have not been considered in tailoring the endoscopic follow-up.Finally,some data would suggest that a 3-year follow-up in patients with extensive gastric precancerous conditions could result in an inadequate secondary prevention. | Angelo Zullo Cesare Hassan Alessandro Repici Bruno Annibale | 2013 | World Journal of Gastroenterology2013,19,10: | 2 |
| 18 | Balanced propofol sedation administered by nonanesthesiologists:The first Italian experience显示文摘AIM:To assess the efficacy and safety of a balanced approach using midazolam in combination with propofol,administered by nonanesthesiologists,in a large series of diagnostic colonoscopies.METHODS:Consecutive patients undergoing diagnostic colonoscopy were sedated with a single dose of midazolam(0.05 mg/kg)and lowdose propofol(starter bolus of 0.5 mg/kg and repeated boluses of 10 to 20 mg).Induction time and deepest level of sedation,adverse and serious adverse events,as well as recovery times,were prospectively assessed.Cecal intubation and adenoma detection rates were also collected.RESULTS:Overall,1593 eligible patients were included.The median dose of propofol administered was 70 mg(range:40120 mg),and the median dose of midazolam was 2.3 mg(range:24 mg).Median induction time of sedation was 3 min(range:14 min),and median recovery time was 23 min(range:1040 min).A moderate level of sedation was achieved in 1561(98%) patients,whilst a deep sedation occurred in 32(2%) cases.Transient oxygen desaturation requiring further oxygen supplementation occurred in 8(0.46%;95% CI:0.2%0.8%)patients.No serious adverse event was observed.Cecal intubation and adenoma detection rates were 93.5%and 23.4%(27.8%for male and 18.5%for female,subjects),respectively.CONCLUSION:A balanced sedation protocol provided a minimalization of the dose of propofol needed to target a moderate sedation for colonoscopy,resulting in a high safety profile for nonanesthesiologist propofol sedation. | Alessandro Repici Nico Pagano Cesare Hassan Alessandra Carlino Giacomo Rando Giuseppe Strangio Fabio Romeo Angelo Zullo Elisa Ferrara Eva Vitetta Daniel de Paula Pessoa Ferreira Silvio Danese Massimo Arosio Alberto Malesci | 2011 | World Journal of Gastroenterology2011,17,33: | 2 |
| 19 | Polyflex stents for malignant oesophageal and oesophagogastric stricture: a prospective, multicentric study显示文摘 | Rita Conigliaro Giorgio Battaglia Alessandro Repici Giovanni De Pretis Luigi Ghezzo Max Bittinger Helmut Messmann Jean-Fran?ois Demarquay Michele Togni Sabrina Blanchi Rosangela Filiberti Massimo Conio | 2007 | European Journal of Gastroenterology & Hepatology2007,,3: | 2 |
| 20 | Endoscopic submucosal dissection of early gastric neoplastic lesions: a western series显示文摘 | Alessandro Repici Angelo Zullo Cesare Hassan Paola Spaggiari Giuseppe Strangio Eva Vitetta Elisa Ferrara Alberto Malesci | 2013 | European Journal of Gastroenterology & Hepatology2013,,11: | 2 |