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| 1 | Endoscopic incisional therapy for benign esophageal strictures: Technique and results显示文摘Benign esophageal strictures refractory to the conventional balloon or bougie dilatation may be subjected to various adjunctive modes of therapy, one of them being endoscopic incisional therapy(EIT). A proper delineation of the stricture anatomy is a prerequisite. A host of electrocautery and mechanical devices may be used, the most common being the use of needle knife, either standard or insulated tip. The technique entails radial incision and cutting off of the stenotic rim. Adjunctive therapies, to prevent re-stenosis, such as balloon dilatation, oral or intralesional steroids or argon plasma coagulation can be used. The common strictures where EIT has been successfully used are Schatzki's rings(SR) and anastomotic strictures(AS). Short segment strictures(< 1 cm) have been found to have the best outcome. When compared with routine balloon dilatation, EIT has equivalent results in treatment na?ve cases but better long term outcome in refractory cases. Anecdotal reports of its use in other types of strictures have been noted. Post procedure complications of EIT are mild and comparable to dilatation therapy. As of the current evidence, incisional therapy can be used for management of refractory AS and SR with relatively short stenosis(< 1 cm) with good safety profile and acceptable long term patency. | Jayanta Samanta Narendra Dhaka Saroj Kant Sinha Rakesh Kochhar | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，19： | 14 |
| 2 | Pancreatic fluid collections: What is the ideal imaging technique?显示文摘Pancreatic fluid collections(PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liquid alone or a mixture of fluid and necrotic debris. Management of these different types of collections differs because of the variable quantity of debris; while patients with pseudocysts can be drained by straight-forward stent placement, walledoff necrosis requires multi-disciplinary approach. Differentiating these collections on the basis of clinical severity alone is not reliable, so imaging is primarily performed. Contrast-enhanced computed tomography is the commonly used modality for the diagnosis and assessment of proportion of solid contents in PFCs; however with certain limitations such as use of iodinated contrast material especially in renal failure patients and radiation exposure. Magnetic resonance imaging(MRI) performs better than computed tomography(CT) in characterization of pancreatic/peripancreatic fluid collections especially for quantification of solid debris and fat necrosis(seen as fat density globules), and is an alternative in those situations where CT is contraindicated. Also magnetic resonance cholangiopancreatography is highly sensitive for detecting pancreatic duct disruption and choledocholithiasis. Endoscopic ultrasound is an evolving technique with higher reproducibility for fluid-to-debris component estimation with the added advantage of being a single stage procedure for both diagnosis(solid debris delineation) and management(drainage of collection) in the same sitting. Recently role of diffusion weighted MRI and positron emission tomography/CT with ^(18)F-FDG labeled autologous leukocytes is also emerging for detection of infection noninvasively. Comparative studies between these imaging modalities are still limited. However we look forward to a time when this gap in literature will be fulfilled. | Narendra Dhaka Jayanta Samanta Suman Kochhar Navin Kalra Sreekanth Appasani Manish Manrai Rakesh Kochhar | 2015 | World Journal of Gastroenterology2015，21，48： | 13 |
| 3 | Characterization of biofilms in biliary stents and potential factors involved in occlusion显示文摘AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospital, all consecutive patients who required endoscopic biliary stent exchange/removal were included. Etiology of the biliary disease was diagnosed by imaging, cytology and on follow-up. Clinical details of patients with biliary stent retrieval were noted. All extracted stents were collected in sterile containers and immediatelyprocessed for quantification of biofilm proteins and polysaccharides. Molecular identification of commonly known and unknown bacteria was performed by polymerase chain reaction and density gradient gel electrophoresis methods. RESULTS Eighty one patients(41 males) with age range of 20-86 years were studied. The underlying causes for stent insertion were bile duct stones(n = 46; 56.8%) benign stricture(n = 29; 35.8%) and malignancy(n = 6; 7.4%) with cholangitis in 50(61.7%) patients. The retrieved stent sizes were 7 Fr(n = 62; 76.5%) and 10 Fr(n = 19; 23.5%) with 65 days median insertion duration. Polybacterial consortia were detected in 90.1% of the stents. The most common bacteria identified by polymerase chain reaction alone and/or sequencing were Pseudomonas(n = 38), Citrobacter(n = 23), Klebsiella(n = 22), Staphylococcus(n = 20), Serratia(n = 16), Escherichia coli(n = 14), Streptococcus(n = 13), Enterococcus(n = 13), Aeromonas(n = 12), Proteus(n = 10) and Enterobacter(n = 9). Protein concentration according to gender(0.547 ± 0.242 mg/ml vs 0.458 ± 0.259 mg/ml; P = 0.115) as well as age > 60 years and < 60 years(0.468 ± 0.295 mg/ml vs 0.386 ± 0.238 mg/ml; P = 0.205) was non-significant. However, polysaccharide concentration was significant both according to gender(0.052 ± 0.021 mg/ml vs 0.049 ± 0.016 mg/ml; P < 0.0001) and age(0.051 ± 0.026 mg/ml vs 0.038 ± 0.016 mg/ml; P < 0.011). Protein concentration in the biofilm was significantly higher(0.555 ± 0.225 mg/ml vs 0.419 ± 0.276 mg/ml; P = 0.018) in patients with cholangitis, lower(0.356 ± 0.252 mg/ml vs 0.541 ± 0.238 mg/ml; P = 0.005) in the 10 Fr group than the 7 Fr group, and significantly higher(0.609 ± 0.240 mg/ml vs 0.476 ± 0.251 mg/ml; P = 0.060) in stents of ≥ 6 mo of indwelling time. However presence/absence of cholangitis, size of stent, indication of stent insertion and indwelling time did not affect the quantity of polysaccharide concentration.CONCLUSION Plastic stents retrieved from patients with biliary tract disease showed polymicrobial organisms with higher protein content among patients with cholangitis and those with smaller diameter stents. longer indwelling duration had more biofilm formation. | Chetana Vaishnavi Jayanta Samanta Rakesh Kochhar | 2018 | World Journal of Gastroenterology2018，24，1： | 8 |
| 4 | Dengue and its effects on liver显示文摘Dengue has emerged as an important arboviral disease with significant impact on the disease burden in population residing in tropical countries. Dengue is spread by the bite of Aedes mosquito. The virus seems to have some hepatotoxic effects. Affliction of liver in form of derangements in the liver function tests is common and may include mild elevations in serum bilirubin, elevated transaminases and derangements in serum albumin. Although asymptomatic in most cases, clinical manifestations like jaundice, and acute liver failure(ALF) may occasionally complicate the clinical picture. Indeed, dengue has been implicated as an important cause of ALF in endemic countries. The present review focuses on the hepatic manifestations and the pathogenesis of the liver injury in dengue. | Jayanta Samanta Vishal Sharma | 2015 | World Journal of Clinical Cases2015，3，2： | 4 |
| 5 | Value of neutrophil-lymphocyte ratio in evaluating response to percutaneous catheter drainage in patients with acute pancreatitis显示文摘BACKGROUND Early prediction of response to percutaneous catheter drainage(PCD)of necrotic collections in acute pancreatitis(AP)using simple and objective tests is critical as it may determine patient prognosis.The role of white blood cell(WBC)count and neutrophil-lymphocyte ratio(NLR)has not been assessed as a tool of early prediction of PCD success and is the focus of this study.AIM To assess the value of WBC and NLR in predicting response to PCD in AP.METHODS This retrospective study comprised consecutive patients with AP who underwent PCD between June 2018 and December 2019.Severity and fluid collections were classified according to the revised Atlanta classification and organ failure was defined according to the modified Marshall Score.WBC and NLR were monitored 24 h prior PCD(WBC-0/NLR-0)and 24 h(WBC-1/NLR-1),48 h(WBC-2/NLR-2)and 72 h(WBC-3/NLR-3)after PCD.NLR was calculated by dividing the number of neutrophils by the number of lymphocytes.The association of success of PCD(defined as survival without the need for surgery)with WBC and NLR was assessed.The trend of WBC and NLR was also assessed post PCD.RESULTS One hundred fifty-five patients[median age 40±13.6(SD),64.5%males,53.5%severe AP]were included in the final analysis.PCD was done for acute necrotic collection in 99(63.8%)patients and walled-off necrosis in 56(36.1%)patients.Median pain to PCD interval was 24±69.89 d.PCD was successful in 109 patients(group 1)and 46 patients(group 2)who failed to respond.There was no significant difference in the baseline characteristics between the two groups except the severity of AP and frequency of organ failure.Both WBC and NLR showed an overall decreasing trend.There was a significant difference between WBC-0 and WBC-1(P=0.0001).WBC-1 and NLR-1 were significantly different between the two groups(P=0.048 and 0.003,respectively).The area under the curve of WBC-1 and NLR-1 for predicting the success of PCD was 0.602 and 0.682,respectively.At a cut-off value of 9.87 for NLR-1,the sensitivity and specificity for predicting the success of PCD were calculated to be 75%and 65.4%respectively.CONCLUSION WBC and NLR can be used as simple tests for predicting response to PCD in patients with acute necrotizing pancreatitis. | Pankaj Gupta Gaurav Chayan Das Akash Bansal Jayanta Samanta Harshal S Mandavdhare Vishal Sharma Shano Naseem Vikas Gupta Thakur Deen Yadav Usha Dutta Neelam Varma Manavjit Singh Sandhu Rakesh Kochhar | 2022 | World Journal of Clinical Cases2022，10，1： | 1 |
| 6 | Role of endoscopic ultrasound in the field of hepatology: Recent advances and future trends显示文摘The role of endoscopic ultrasound(EUS)as a diagnostic and therapeutic modality for the management of various gastrointestinal diseases has been expanding.The imaging or intervention for various liver diseases has primarily been the domain of radiologists.With the advances in EUS,the domain of endosonologists is rapidly expanding in the field of hepatology.The ability to combine endoscopy and sonography in one hybrid device is a unique property of EUS,together with the ability to bring its probe/transducer near the liver,the area of interest.Its excellent spatial resolution and ability to provide real-time images coupled with several enhancement techniques,such as contrast-enhanced(CE)EUS,have facilitated the growth of EUS.The concept of“Endo-hepatology”encompasses the wide range of diagnostic and therapeutic procedures that are now gradually becoming feasible for managing various liver diseases.Diagnostic advancements can enable a wide array of techniques from elastography and liver biopsy for liver parenchymal diseases,to CE-EUS for focal liver lesions to portal pressure measurements for managing various liver conditions.Similarly,therapeutic advancements range from EUS-guided eradication of varices,drainage of bilomas and abscesses to various EUS-guided modalities of liver tumor management.We provide a comprehensive review of all the different diagnostic and therapeutic EUS modalities available for the management of various liver diseases.A synopsis of all the technical details involving each procedure and the available data has been tabulated,and the future trends in this area have been highlighted. | Jahnvi Dhar Jayanta Samanta | 2021 | World Journal of Hepatology2021，13，11： | 1 |
| 7 | Single-Crystalline Hydrogen-Bonded Crosslinked Organic Frameworks and Their Dynamic Guest Sorption显示文摘CONSPECTUS:Porous organic framework materials constructed by periodically aligned molecular entities offer chemically tailored microenvironments to absorb molecules and ions for various applications.Fundamentally understanding the microenvironments of these porous organic materialsfrom pore size,shape,and dynamics to potential substrate binding sitesis critical for the rational design of porous organic materials.The solid-state structures of these porous organic materials,such as covalent organic frameworks(COFs),can provide unambiguous atomic-level structural details. | Jayanta Samanta Yunjia Zhang Mingshi Zhang Albert D.Chen Chenfeng Ke | 2022 | Accounts of Materials Research2022，3，11： | 0 |
| 8 | Drainage of pancreatic fluid collections in acute pancreatitis:A comprehensive overview显示文摘Moderately severe and severe acute pancreatitis is characterized by local and systemic complications.Systemic complications predominate the early phase of acute pancreatitis while local complications are important in the late phase of the disease.Necrotic fluid collections represent the most important local complication.Drainage of these collections is indicated in the setting of infection,persistent or new onset organ failure,compressive or pressure symptoms,and intraabdominal hypertension.Percutaneous,endoscopic,and minimally invasive surgical drainage represents the various methods of drainage with each having its own advantages and disadvantages.These methods are often complementary.In this minireview,we discuss the indications,timing,and techniques of drainage of pancreatic fluid collections with focus on percutaneous catheter drainage.We also discuss the novel methods and techniques to improve the outcomes of percutaneous catheter drainage. | Akash Bansal Pankaj Gupta Anupam K Singh Jimil Shah Jayanta Samanta Harshal S Mandavdhare Vishal Sharma Saroj Kant Sinha Usha Dutta Manavjit Singh Sandhu Rakesh Kochhar | 2022 | World Journal of Clinical Cases2022，10，20： | 0 |
| 9 | Endoscopic ultrasound-guided vascular interventions: An expanding paradigm显示文摘Endoscopic ultrasound(EUS)has expanded its arena from a mere diagnostic modality to an essential therapeutic tool in managing gastrointestinal(GI)diseases.The proximity of the GI tract to the vascular structures in the mediastinum and the abdomen has facilitated the growth of EUS in the field of vascular interventions.EUS provides important clinical and anatomical information related to the vessels'size,appearance and location.Its excellent spatial resolution,use of colour doppler with or without contrast enhancement and ability to provide images“real-time”helps in precision while intervening vascular structures.Additionally,structures such as venous collaterals or varices can be dealt with optimally using EUS.EUS-guided vascular therapy with coil and glue combination has revolutionized the management of portal hypertension.It also helps to avoid radiation exposure in addition to being minimally invasive.These advantages have led EUS to become an upcoming modality to complement traditional interventional radiology in the field of vascular interventions.EUS-guided portal vein(PV)access and therapy is a new kid on the block.EUS-guided portal pressure gradient measurement,injecting chemotherapy in PV and intrahepatic portosystemic shunt has expanded the horizons of endo-hepatology.Lastly,EUS has also forayed into cardiac interventions allowing pericardial fluid aspiration and tumour biopsy with experimental data on access to valvular apparatus.Herein,we provide a comprehensive review of the expanding paradigm of EUS-guided vascular interventions in GI bleeding,portal vein access and its related therapeutic interventions,cardiac access,and therapy.A synopsis of all the technical details involving each procedure and the available data has been tabulated,and the future trends in this area have been highlighted. | Jahnvi Dhar Jayanta Samanta | 2023 | World Journal of Gastrointestinal Endoscopy2023，15，4： | 0 |
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