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| 1 | Impact of periampullary diverticula on the outcome and fluoroscopy time in endoscopic retrograde cholangiopancreatography显示文摘BACKGROUND: It is unclear whether the presence of periampullary diverticula (PAD) affects technical success and complication rates during endoscopic retrograde cholangio- pancreatography (ERCP). Moreover, the impact of PAD on fluoroscopy duration is still unknown. The present study aimed to investigate the success rate and difficulty of common bile duct (CBD) cannulation, post-procedure complications and fluoroscopy duration in patients with and without PAD. METHODS: Patients from January 2008 to December 2010 with PAD (group A) and without PAD (group B) and similar indications for therapeutic ERCP were prospectively compared. The comparison included patient characteristics, findings of ERCP, and details of procedure and fluoroscopy time. The influence of papilla's location with respect to the diverticulum on procedure was also investigated. RESULTS: A total of 428 consecutive patients who had undergone therapeutic ERCP for similar indications were divided in two groups according to the presence (group A, 107 patients) or absence (group B, 321 patients) of PAD. The mean age and ASA score of the patients with PAD were significantly higher than those patients without PAD. The main indication was choledocholithiasis. Successful final CBD cannulation was achieved in 97.20% of the patients in group A vs 99.69% in group B (P=0.05). CBD diameter, number of stones and the largest stone size were significantly higher in group A thangroup B (P<0.001). Complete clearance of the CBD after the first attempt was achieved in 85.86% and 94.75% of the patients in groups A and B, respectively (P=0.03). In both groups, the time needed to complete the procedure and fluoroscopy time was significantly longer in patients with PAD (22.87 vs 18.99 minutes, P<0.001; 76.51 vs 47.42 seconds, P<0.001). There was no significant difference between the two groups in the complication rate. The type of papilla's location with respect to the diverticulum did not influence the total cannulation rate and post-procedure complications. CONCLUSION: The presence of a PAD does not affect the success rate and complications of therapeutic ERCP in expert hands; however, the fluoroscopy time is significantly longer in patients with PAD. | Panagiotis Katsinelos Grigoris Chatzimavroudis Kostas Tziomalos Christos Zavos Athanasios Beltsis Georgia Lazaraki Sotiris Terzoudis Jannis Kountouras | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，4： | 15 |
| 2 | Cholangiocarcinoma:principles and current trends显示文摘BACKGROUND:Cholangiocarcinoma(CCA)is a lethal cancer of the biliary epithelium,originating from the liver(intrahepatic),at the confluence of the right and left hepatic ducts(hilar)or in the extrahepatic bile ducts.It is a rare malignancy associated with poor prognosis.DATA SOURCES:We searched the PubMed/MEDLINE database for relevant articles published from 1989 to 2008.The search terms used were related to 'cholangiocarcinoma' and its ' treatment'.Although no language restrictions were imposed initially,for the full-text review and final analysis,our resources only permitted the review of articles published in English.This review deals with the treatment of cholangiocarcinoma,the principles and the current trends.RESULTS:The risks and prognostic factors,symptoms and differential diagnosis are thoroughly discussed.In addition,the tools of preoperative diagnosis such as endoscopic retrograde cholangiopancreatography,digital image analysis,fluorescence in situ hybridization and magnetic resonance cholangiopancreatography are reviewed.Moreover,the treatment of CCA is discussed.CONCLUSIONS:The only curative treatment available is surgical management.Unfortunately,many patients present with unresectable tumors,the majority of whom die within a year of diagnosis.Surgical treatment involves major resections of the liver,pancreas and bile duct,with considerable mortality and morbidity.However,in selected cases and where indicated,appropriate management with aggressive surgery may achieve a good outcome with a prolonged survival expectancy. | George N Zografos Athanasios Farfaras Flora Zagouri Dimosthenis Chrysikos Kostas Karaliotas | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，1： | 14 |
| 3 | Endoscopic treatment and follow-up of gastrointestinal Dieulafoy's lesions显示文摘AIM: To investigate retrospectively the clinical and endoscopic features of bleeding Dieulafoy's lesions and to assess the short- and long-term effectiveness of endoscopic treatment.METHODS: Twenty-three patients who had gastrointestinal bleeding from Dieulafoy's lesions underwent endoscopic therapy. Demographic data, mode of presentation, riskfactors for gastrointestinal bleeding, blood transfusion requirements, endoscopic findings, details of endoscopic therapy, recurrence of bleeding, and mortality rates were collected and analyzed retrospectively.RESULTS: Hemostasis was attempted by dextrose 50% plus epinephrine in 10 patients, hemoclipping in 8 patients,heater probe in 2 patients and ethanolamine oleate in 2 patients. Comorbid conditions were present in 17 patients (74%). Overall permanent hemostasis was achieved in 18 patients (78%). Initial hemostasis was successful with no recurrent bleeding in patients treated with hemoclipping, heater probe or ethanolamine injection. In the group of patients who received dextrose 50% plus epinephrine injection treatment, four (40%) had recurrent bleeding and one (10%) had unsuccessful initial hemostasis.Of the four patients who had rebleeding, three had unsuccessful hemostasis with similar treatment. Surgical treatment was required in five patients (22%) owing to uncontrolled bleeding, recurrent bleeding with unsuccessful retreatment and inability to approach the lesion. One patient (4.3%) died of sepsis after operation during hospitalization. There were no side-effects related to endoscopic therapy. None of the patients in whom permanent hemostasis was achieved presented with rebleeding from Dieulafoy's lesion over a mean long-term follow-up of 29.8 mo.CONCLUSION: Bleeding from Dieulafoy's lesions can be managed successfully by endoscopic methods, which should be regarded as the first choice. Endoscopic hemoclipping therapy is recommended for bleeding Dieulafoy's lesions. | Panagiotis Katsinelos George Paroutoglou Kostas Mimidis Athanasios Beltsis Basilios Papaziogas George Gelas Yiannis Kountouras | 2005 | World Journal of Gastroenterology2005，11，38： | 8 |
| 4 | Long-term results of pneumatic dilation for achalasia: A15 years' experience显示文摘AIM: Although most patients with achalasia respond to pneumatic dilation, one-third experienced recurrence, and prolonged follow-up studies on parameters associated with various outcomes are scanty. In this retrospective study, we reported a 15-years' experience with pneumatic dilation treatment in patients with primary achalasia, and determined whether previously described predictors of outcome remain significant after endoscopic dilation.METHODS: Between September 1989 and September 2004, 39 consecutive patients with primary symptomatic achalasia (diagnosed by clinical presentation, esophagoscopy,barium esophagogram, and manometry) who received balloon dilation were followed up at regular intervals in person or by phone interview. Remission was assessed by a structured interview and a previous symptoms score.The median dysphagia-free duration was calculated by Kaplan-Meier analysis.RESULTS: Symptoms were dysphagia (n = 39, 100%),regurgitation (n =23, 58.7%), chest pain (n = 4, 10.2%),and weight loss (n = 26, 66.6%). A total of 74 dilations were performed in 39 patients; 13 patients (28%) underwent a single dilation, 17 patients (48.7%) required a second procedure within a median of 26.7 mo (range 5-97 mo), and 9 patients (23.3%) underwent a third procedure within a median of 47.8 mo (range 37-120 mo). Post-dilation lower esophageal sphincter (LES) pressure, assessed in 35 patients, has decreased from a baseline of 35.8±10.4-10.0±7.1 mmHg after the procedure. The median follow-up period was 9.3 years (range 0.5-15 years). The dysphagiafree duration by Kaplan-Meier analysis was 78%, 61%and 58.3% after 5, 10 and 15 years respectively.CONCLUSION: Balloon dilation is a safe and effective treatment for primary achalasia. Post-dilation LES pressure estimation may be useful in assessing response. | Panagiotis Katsinelos Jannis Kountouras George Paroutoglou Athanasios Beltsis Christos Zavos Basilios Papaziogas Kostas Mimidis | 2005 | World Journal of Gastroenterology2005，11，36： | 7 |
| 5 | Integrated Assessment of Natural Hazards, Including Climate Change’s Influences, for Cultural Heritage Sites: The Case of the Historic Centre of Rethymno in Greece显示文摘Within the framework of disaster risk management, this article proposes an interdisciplinary method for the analysis of multiple natural hazards, including climate change’s influences, in the context of cultural heritage. A taxonomy of natural hazards applicable to cultural heritage was developed based on the existing theoretical and conceptual frameworks. Sudden-onset hazards, such as earthquakes and floods, and slow-onset hazards, such as wetting–drying cycles and biological contamination, were incorporated into the hazard assessment procedure. Future alteration of conditions due to climate change, such as change in heat waves’ duration, was also taken into account. The proposed hazard assessment framework was applied to the case of the Historic Centre of Rethymno, a city on the northern coast of the island of Crete in Greece,to identify, analyze, and prioritize the hazards that have the potential to cause damage to the center’s historic structures. The assessment procedure includes climate model projections, GIS spatial modeling and mapping, and finally a hazard analysis matrix to enable the sharing of a better understanding of multiple hazards with the stakeholders.The results can facilitate decision making by providing the vulnerability and risk analysis with the nature and spatial distribution of the significant hazards within the study area and its setting. | Mohammad Ravankhah Rosmarie de Wit Athanasios V.Argyriou Angelos Chliaoutakis Maria Joao Revez Joern Birkmann Maja Zuvela-Aloise Apostolos Sarris Anastasia Tzigounaki Kostas Giapitsoglou | 2019 | International Journal of Disaster Risk Science2019，10，3： | 3 |
| 6 | Fecal calprotectin measurement is a marker of shortterm clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease显示文摘AIM To evaluate the utility of fecal calprotectin(FC) in predicting relapse and endoscopic activity during follow-up in an inflammatory bowel disease(IBD) cohort.METHODS All FC measurements that were obtained during a 3-year period from patients with inflammatory bowel disease in clinical remission were identified. Data regarding the short-term(6 mo) course of the disease were extracted from the medical files. Exclusion criteria were defined as:(1) An established flare of the disease at the time of FC measurement,(2) Loss to follow up within 6 mo from baseline FC measurement, and,(3) Insufficient data on file. Statistical analysis was performed to evaluate whether baseline FC measurement could predict the short term clinical relapse and/or the presence of mucosal healing.RESULTS We included 149 [Crohn's disease(CD) = 113, Ulcerative colitis(UC) = 36, male = 77] IBD patients in our study. Within the determined 6-month period post-FC measurement, 47(31.5%) had a disease flare. Among 76 patients who underwent endoscopy, 39(51.3%) had mucosal healing. Baseline FC concentrations were significantly higher in those who had clinical relapse compared to those who remained in remission during follow up(481.0 μg/g, 286.0-600.0 vs 89.0, 36.0-180.8, P < 0.001). The significant predictive value of baseline median with IQR FC for clinical relapse was confirmed by multivariate Cox analysis [HR for 100μg/g: 1.75(95%CI: 1.28-2.39), P = 0.001]. Furthermore, lower FC baseline values significantly correlated to the presence of mucosal healing in endoscopy(69.0 μg/g, 30.0-128.0 vs 481.0, 278.0-600.0, in those with mucosal inflammation, median with IQR, P < 0.001). We were able to extract cut-off values for FC concentration with a high sensitivity and specificity for predicting clinical relapse(261 μg/g with AUC = 0.901, sensitivity 87.2%, specificity 85.3%, P < 0.001) or mucosal healing(174 μg/g with AUC = 0.956, sensitivity 91.9%, specificity 87.2%, P < 0.001). FC was better than CRP in predicting either outcome; nevertheless, having a pathological CRP(> 5 mg/L) in addition to the cutoffs for FC, significantly enhanced the specificity for predicting clinical relapse(95.1% from 85.3%) or endoscopic activity(100% from 87.2%). CONCLUSION Serial FC measurements may be useful in monitoring IBD patients in remission, as FC appears to be a reliable predictor of short-term relapse and endoscopic activity. | Athanasios Kostas Spyros I Siakavellas Charalambos Kosmidis Anna Takou Joanna Nikou Georgios Maropoulos John Vlachogiannakos George V Papatheodoridis Ioannis Papaconstantinou Giorgos Bamias | 2017 | World Journal of Gastroenterology2017，23，41： | 2 |
| 7 | Endoscopic management of occluded biliary uncovered metal stents:A multicenter experience显示文摘AIM:To compare diverse endoscopic interventions in the management of occluded uncovered self-expanding metal stents(SEMSs) that had been placed for palliative treatment of unresectable malignant biliary obstruction.METHODS:A retrospective review was undertaken in 4 tertiary endoscopic centers to determine optimal management of different types of occluded SEMSs.The technical success of performed treatment in occluded SEMSs,the patency of the stent,the need for re-intervention and the financial costs of each treatment were analyzed.RESULTS:Fifty four patients were included in the analysis;21 received Hanaro,19 Wallstent and 14 Flexus.For the relief of obstruction,a plastic stent was inserted in 24 patients,a second SEMS in 25 and mechanical cleaning was performed in 5 patients.The overall median second patency rates between second SEMSs and plastic stents did not differ(133 d for SEMSs vs 106 d for plastic stents;P = 0.856).Similarly,no difference was found between the overall survival of SEMS and plastic stent groups,and no procedure-related complications occurred.Incremental cost analysis showed that successive plastic stenting was a cost-saving strategy at least in Greece.CONCLUSION:Insertion of uncovered SEMSs or plastic stents is a safe and effective treatment for occluded uncovered SEMSs;insertion of plastic stents appears to be the most cost-effective strategy. | Panagiotis Katsinelos Athanasios Beltsis Grigoris Chatzimavroudis Dimitris Paikos George Paroutoglou Dimitris Kapetanos Sotiris Terzoudis Georgia Lazaraki Ioannis Pilpilidis Kostas Fasoulas Stefanos Atmatzidis Christos Zavos Jannis Kountouras | 2011 | World Journal of Gastroenterology2011，17，1： | 2 |
| 8 | Diffusion tensor and dynamic susceptibility contrast MRI in glioblastoma显示文摘 | Anastasia K. Zikou George A. Alexiou Paraskevi Kosta Ann Goussia Loukas Astrakas Periklis Tsekeris Spyridon Voulgaris Vasiliki Malamou-Mitsi Athanasios P. Kyritsis Maria I. Argyropoulou | 2011 | Clinical Neurology and Neurosurgery2011，，6： | 1 |
| 9 | Ultrasound-guided percutaneous nephrostomy performed by urologists: 10-year experience显示文摘 | Andreas Skolarikos Gerasimos Alivizatos Athanasios Papatsoris Kostas Constantinides Anastasios Zerbas Charalambos Deliveliotis | 2006 | Urology2006，，3： | 1 |
| 10 | Intravenous N-acetylcysteine does not prevent post-ERCP pancreatitis显示文摘 | Panagiotis Katsinelos Jannis Kountouras George Paroutoglou Athanasios Beltsis Kostas Mimidis Christos Zavos | 2005 | Gastrointestinal Endoscopy2005，，1： | 1 |
| 11 | Detection of occult HER2 mRNA-positive tumor cells in the peripheral blood of patients with operable breast cancer: evaluation of their prognostic relevance显示文摘 | Stella Apostolaki Maria Perraki Galatea Kallergi Maria Kafousi Savvas Papadopoulos Athanasios Kotsakis Athanasios Pallis Nikolaos Xenidis Lyda Kalmanti Kostas Kalbakis Sofia Agelaki Antonia Kalykaki Christos Stournaras Efstathios Stathopoulos Vassilis Geo | 2009 | Breast Cancer Research and Treatment2009，，3： | 1 |
| 12 | Comparison of cisplatin-paclitaxel combination versus cisplatin-etoposidein patients with small-cell lung cancer: A Phase III study显示文摘 | John Dimitroulis Angeliki Rapti George Stathopoulos Sotiris Rigatos John Stathopoulos John Koutantos Athanasios Athanasiadis Kyriaki Tsikritsaki Dimitris Karaindros Kostas Katis Dimosthenis Antoniou Michalis Toumbis Pantelis Giamboudakis | 2008 | Oncology Reports2008，，4： | 1 |
| 13 | Large-balloon dilation of the biliary orifice for the management of basket impaction: a case series of 6 patients显示文摘 | Panagiotis Katsinelos Kostas Fasoulas Athanasios Beltsis Grigoris Chatzimavroudis Christos Zavos Sotiris Terzoudis Jannis Kountouras | 2011 | Gastrointestinal Endoscopy2011，，6： | 1 |
| 14 | Efficient decision feedback equalization for sparse wireless channels显示文摘 | Athanasios and Kostas Berberidis | 2003 | IEEE transactions onwireless communication2003，2，3： | 1 |
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