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| 1 | Endoscopic extraction of large common bile duct stones:A review article显示文摘Since therapeutic endoscopic retrograde cholangiopancreatography replaced surgery as the first approach in cases of choledocolithiasis,a plethora of endoscopic techniques and devices appeared in order to facilitate rapid,safe and effective bile duct stones extraction.Nowadays,endoscopic sphincterotomy combined with balloon catheters and/or baskets is the routine endoscopic technique for stone extraction in the great majority of patients.Large common bile duct stones are treated conventionally with mechanical lithotripsy,while the most serious complication of the procedure is 'basket and stone impaction' that is predominately resolved surgically.In cases of difficult,impacted,multiple or intrahepatic stones,more sophisticated procedures have been used.Electrohydraulic lithotripsy and laser lithotripsy are performed using conventional mother-baby scope systems,ultra-thin cholangio-scopes,thin endoscopes and ultimately using the novel single use,single operator SpyGlass Direct Visualization System,in order to deliver intracorporeal shock wave energy to fragment the targeted stone,with very good outcomes.Recently,large balloon dilation after endoscopic sphincterotomy confirmed its effectiveness in the extraction of large stones in a plethora of trials.When compared with mechanical lithotripsy or with balloon dilation alone,it proved to be superior.Moreover,dilation is an ideal alternative in cases of altered anatomy where access to the papilla is problematic.Endoscopic sphincterotomy followed by large balloon dilation represents the onset of a new era in large bile duct stone extraction and the management of 'impaction' because it seems that is an effective,inexpensive,less traumatic,safe and easy method that does not require sophisticated apparatus and can be performed widely by skillful endoscopists.When complete extraction of large stones is unsuccessful,the drainage of the common bile duct is mandatory either for bridging to the final therapy or as a curative therapy for very elderly patients with short life expectancy.Placing of more than one plastic endoprostheses is better while the administration of Ursodiol is ineffective.The great majority of patients with large stones can be treated endoscopically.In cases of unsuccessful stone extraction using balloons,baskets,mechanical lithotripsy,electrohydraulic or laser lithotripsy and large balloon dilation,the patient should be referred for extracorporeal shock wave lithotripsy or a percutaneous approach and finally surgery. | Gerasimos Stefanidis Christos Christodoulou Spilios Manolakopoulos Ram Chuttani | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，5： | 23 |
| 2 | Role of band ligation for secondary prophylaxis of variceal bleeding显示文摘AIM To summarize and critically examine the role of band ligation in secondary prophylaxis of variceal bleeding in patients with cirrhosis. METHODS A literature review was performed using the MEDLINE and PubM ed databases. The search terms consisted of the words 'endoscopic band ligation' OR 'variceal band ligation' OR 'ligation' AND 'secondary prophylaxis' OR 'secondary prevention' AND 'variceal bleeding' OR 'variceal hemorrhage' AND 'liver cirrhosis'. The data collected from relevant meta-analyses and from the most recent randomized studies that were not included in these meta-analyses were used to evaluate the role of endoscopic band ligation in an effort to demonstrate the most recent advances in the treatment of esophageal varices. RESULTS This study included 11 meta-analyses published from 2002 to 2017 and 10 randomized trials published from 2010 to 2017 that evaluated the efficacy of band ligation in the secondary prophylaxis of variceal bleeding. Overall, the results proved that band ligation was superior to endoscopic sclerotherapy. Moreover, the use of β-blockers in combination with band ligation increased the treatment effectiveness, supporting the current recommendations for secondary prophylaxis of variceal bleeding. The use of transjugular intrahepatic portosystemic shunt was superior to combination therapy regarding rebleeding prophylaxis, with no difference in the survival rates; however, the results concerning the hepatic encephalopathy incidence were conflicting. Recent advances in the management of secondary prophylaxis of variceal bleeding have targeted a decrease in portal pressure based on the pathophysiological mechanisms of portal hypertension.CONCLUSION This review suggests that future research should be conducted to enhance current interventions and/or to develop innovative treatment options with improved clinical endpoints. | Ioanna Aggeletopoulou Christos Konstantakis Spilios Manolakopoulos Christos Triantos | 2018 | World Journal of Gastroenterology2018，24，26： | 9 |
| 3 | Current treatment indications and strategies in chronic hepatitis B virus infection显示文摘The optimal approach to the management of several marginal cases with chronic hepatitis B virus (HBV) infection is controversial. Serum HBV DNA and ami-notransferase levels, and the degree of necroinflammation and fibrosis determine the therapeutic decisions. All patients with elevated aminotransferase (> twice the upper limit of normal) and serum HBV DNA above 20 000 IU/mL should be treated. Liver biopsy is important for therapeutic decisions in cases with mild aminotransferase elevations and serum HBV DNA below 20 000 IU/mL. Chronic HBV patients who do not receive treatment should be followed for life. There are seven agents licensed for chronic hepatitis B: standard and pegylated interferon-alpha, lamivudine, adefovir, entecavir, telbivudine and tenofovir. One-year courses with pegylated interferon-alpha induce sustained off-therapy remission in 30%-32% of patients with HBeAg-positive chronic hepatitis B and in a smaller proportion of patients with HBeAg-negative chronic hepatitis B. Oral antivirals achieve initial on-therapy responses in the majority of patients, but are intended as long-term therapies. Viral suppression has favourable effects on patients' outcome and modifies the natural course of the disease. Viral resistance, however, is the major drawback of long-term oral antiviral therapy. Lamivudine monotherapy is associated with the highest and ente-cavir monotherapy with the lowest resistance rate so far. There has been no resistance to tenofovir, but afteronly 18 mo of treatment to date. The optimal first-line anti-HBV therapy with the best long-term cost/benefit ratio remains unclear. If oral antiviral agents are used, compliance should always be ascertained and HBV DNA levels should be regularly tested. | George V Papatheodoridis Spilios Manolakopoulos Athanasios J Archimandritis | 2008 | World Journal of Gastroenterology2008，14，45： | 7 |
| 4 | Interferon-a plus lamivudine vslamivudine reduces breakthroughs, but does not affect sustained response in HBeAg negative chronic hepatitis B显示文摘AIM: To investigate the efficacy of combination treatment of IFN-α and lamivudine compared to lamivudine monotherapy, after 24 mo of administration in HBeAg-negative hepatitis B patients.METHODS: Fifty consecutive patients were randomly assigned to receive IFN-α-2b (5 MU thrice per week, n = 24) plus lamivudine (100 mg daily) or lamivudine only (n = 26) for 24 mo. Patients were followed up for further 6 mo. The primary outcome was the proportion with sustained virological response (undetectable serum HBV DNA concentrations) and or sustained biochemical response (transaminase levels within normal range) at 30 mo (6 mo after the end of therapy). Secondary end-points were timed from initial virological (biochemical) response to VBR (BBR, respectively) and the emergence of YMDD mutants across the two arms.RESULTS: Five of twenty-four (21%) patients in the combination arm vs 3/26 (12%) in the lamivudine arm had sustained response (i.e., normal serum transaminase levels and undetectable HBV DNA by PCR assay) 6 mo after treatment discontinuation. A reduction in the emergence of YMDD mutants and in the development of virological breakthroughs was observed in patients receiving combination treatment (10% vs46%, P= 0.01 and 14% vs46%, P= 0.03,respectively).Time from initial virologic response to virologic breakthrough (VBR) was greater among initial responders receiving combination treatment compared to those receiving lamivudine (22.9 mo vs 15.9 mo, respectively; P = 0.005).CONCLUSION: Our results demonstrate that IFN-α plus lamivudine combination therapy does not increase the sustained response, compared to lamivudine. However,combination therapy reduces the likelihood of VBR due to YMDD mutants and prolongs the time period until the breakthrough development. | Michalis Economou Spilios Manolakopoulos Thomas A Trikalinos Spyros Filis Sotiris Bethanis Dimitrios Tzourmakliotis Alec Avgerinos Sotiris Raptis Epameinondas V Tsianos | 2005 | World Journal of Gastroenterology2005，11，37： | 6 |
| 5 | Risk of hepatitis B reactivation in patients treated with direct-acting antivirals for hepatitis C显示文摘The recent introduction of direct-acting antiviral drugs(DAAs) for treatment of the hepatitis C virus(HCV) has greatly improved the management of HCV for infected patients. These viral protein inhibitors act rapidly, allowing HCV clearance and increasing the sustained virological response rates. However, hepatitis B virus(HBV) reactivation has been reported in HCV/HBV co-infected patients. Hepatitis B reactivation refers to an abrupt increase in the HBV and is welldocumented in patients with previously undetected HBV DNA due to inactive or resolved HBV infection. Reactivation can occur spontaneously, but in most cases, it is triggered by various factors. Reactivation can be transient, without clinical symptoms; however, it usually causes a hepatitis flare. HBV reactivation may occur regardless of HCV genotype and type of DAA regimen. HBV screening is strongly recommended for co-infected HCV/HBV patients before initiation and during DAA therapy regardless of HBV status, HCV genotype and class of DAAs used. HBV reactivation can be prevented with pretreatment screening and prophylactic treatment when necessary. Additional data are required to evaluate the underlying mechanisms of HBV reactivation in this setting. | Ioanna Aggeletopoulou Christos Konstantakis Spilios Manolakopoulos Christos Triantos | 2017 | World Journal of Gastroenterology2017，23，24： | 5 |
| 6 | A prospective cross-over study using a sphincterotome and a guidewire to increase the success rate of common bile duct cannulation显示文摘AIM: During endoscopic retrograde cholangiopancreatography (ERCP), selective cannulation of the common bile duct (CBD) is required in most of the cases.METHODS: From June 2001 till December 2002, all patients referred to our unit for ERCP were considered for entry into the study. Selective CBD cannulation was first attempted with a standard catheter with or without the use of a guidewire. In cases, where CBD cannulation was considered unsuccessful, patients were crossed over to a double-lumen sphincterotome and a guidewire. All patients were hospitalized for 24 h after the procedure in order to assess the incidence of post-ERCP complications.RESULTS: The study sample consisted of 158 patients.Selective CBD cannulation using a standard ERCP catheter with or without the assistance of a guidewire, was accomplished in 129 patients (success rate: 81.65%).From the 29 patients who were crossed over to a sphincterotome and a guidewire, selective CBD cannulation was achieved in 24; the overall success rate rising to 96.8%. Meanwhile, the use of this technique did not increase the incidence of post-ERCP complications.CONCLUSION: The use of a sphincterotome and a guidewire increases the success rate of selective bile duct cannulation in cases that this has not been accomplished with a standard catheter. | Georgios Karamanolis Aikaterini Katsikani Nikos Viazis Gerasimos Stefanidis Spilios Manolakopoulos Spiros Sgouros Efthimia Papadopoulou Apostolos Mantides | 2005 | World Journal of Gastroenterology2005，11，11： | 3 |
| 7 | Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide therapy: A systematic review显示文摘 | George V. Papatheodoridis Pietro Lampertico Spilios Manolakopoulos Anna Lok | 2010 | Journal of Hepatology2010，，2： | 3 |
| 8 | Follow-up and indications for liver biopsy in HBeAg-negative chronic hepatitis B virus infection with persistently normal ALT: A systematic review显示文摘 | George V. Papatheodoridis Spilios Manolakopoulos Yun-Fan Liaw Anna Lok | 2012 | Journal of Hepatology2012，，1： | 3 |
| 9 | Therapeutic strategies in the management of patients with chronic hepatitis B virus infection显示文摘 | George V Papatheodoridis Spilios Manolakopoulos Geoffrey Dusheiko Athanasios J Archimandritis | 2008 | The Lancet Infectious Diseases2008，，3： | 2 |
| 10 | Therapeutic strategies in the management of patients with chronic hepatitis B virus infection显示文摘 | George V Papatheodoridis Spilios Manolakopoulos Geoffrey Dusheiko Athanasios J Archimandritis | 2008 | The Lancet Infectious Diseases2008，，3： | 2 |
| 11 | Serum zonulin levels in patients with liver cirrhosis:Prognostic implications显示文摘BACKGROUND Increased gut permeability and bacterial translocation play an important role in liver cirrhosis.Zonulin is a recently recognized protein involved in the disintegration of the intestinal barrier.AIM To investigate possible differences in serum zonulin levels among patients with different cirrhosis stages and their potential prognostic implications.METHODS Consecutive cirrhotic patients who attended our liver clinic were included in the study.Serum zonulin levels,clinical,radiological and biochemical data were collected at baseline.Patients who accepted participation in a regular surveillance program were followed-up for at least 12 mo.RESULTS We enrolled 116 cirrhotics[mean Child-Turcotte-Pugh(CTP)score:6.2±1.6;model for end-stage liver disease score:11±3.9].The causes of cirrhosis were viral hepatitis(39%),alcohol(30%),non-alcoholic fatty liver disease(17%),and other(14%).At baseline,53% had decompensated cirrhosis,48% had ascites,and 32% had history of hepatic encephalopathy.Mean zonulin levels were significantly higher in patients with CTP-B class than CTP-A class(4.2±2.4 ng/dL vs 3.5±0.9 ng/dL,P=0.038),with than without ascites(P=0.006),and with than without history of encephalopathy(P=0.011).Baseline serum zonulin levels were independently associated with the probability of decompensation at 1 year(P=0.039),with an area under the receiving operating characteristic of 0.723 for predicting hepatic decompensation.Higher CTP score(P=0.021)and portal vein diameter(P=0.022)were independent predictors of mortality.CONCLUSION Serum zonulin levels are higher in patients with more advanced chronic liver disease and have significant prognostic value in identifying patients who will develop decompensation. | Theodoros A Voulgaris Dimitrios Karagiannakis E Hadziyannis Spilios Manolakopoulos Georgios P Karamanolis George Papatheodoridis John Vlachogiannakos | 2021 | World Journal of Hepatology2021，13，10： | 2 |
| 12 | Clinical course of lamivudine monotherapy in patients with decompensated cirrhosis due to HBeAg negative chronic HBV infection 显示文摘 | Manolakopoulos S Karatapanis S Elefsiniotis J et a! | 2004 | Am J Gastroenterol2004，99，： | 1 |
| 13 | The role of tenofovir in preventing and treating hepatitis B virus (HBV) reactivation in immunosuppressed patients. A real life experience from a tertiary center显示文摘 | J.S. Koskinas M. Deutsch S. Adamidi M. Skondra M. Tampaki A. Alexopoulou S. Manolakopoulos D. Pectasides | 2014 | European Journal of Internal Medicine2014，，8： | 1 |
| 14 | Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide therapy: A systematic review显示文摘 | George V. Papatheodoridis Pietro Lampertico Spilios Manolakopoulos Anna Lok | 2010 | Journal of Hepatology2010，，2： | 1 |
| 15 | Antiviral therapy reduces portal pressure in patients with cirrhosis due to HBeAg -negative chronic hepatitis B and significant portal hypertension 显示文摘 | MANOLAKOPOULOS S TRIANTOS C THEODOROPOULOS J | 2009 | J Hepatol2009，51，3： | 1 |
| 16 | Incidence and predictors of hepatocellular carcinoma in Caucasian chronic hepatitis B patients receiving entecavir or tenofovir显示文摘 | George V. Papatheodoridis George N. Dalekos Cihan Yurdaydin Maria Buti John Goulis Pauline Arends Vana Sypsa Spilios Manolakopoulos Giampaolo Mangia Nikolaos Gatselis Onur Kesk?n Savvoula Savvidou Bettina E. Hansen Christos Papaioannou Kostantinos Galanis | 2014 | Journal of Hepatology2014，，： | 1 |
| 17 | Therapeutic strategies in the management of patients with chronic hepatitis B virus infection显示文摘 | George V Papatheodoridis Spilios Manolakopoulos Geoffrey Dusheiko Athanasios J Archimandritis | 2008 | The Lancet Infectious Diseases2008，，3： | 1 |
| 18 | An assessment of serum leptin levels in patients with chronic viral hepatitis: a prospective study显示文摘 | Manolakopoulos S Bethanis S Liapi C | 2007 | BMC Gastroenterol2007，7，1： | 1 |
| 19 | Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nu- cleos(t)ide therapy: a systematic review显示文摘 | Papatheodoridis GV Lampertico P Manolakopoulos S | 2010 | J Hepatol2010，53，： | 1 |
| 20 | Antiviral therapy reduces portal pressure in patients with cirrhosis due to HBeAg-negative chronic hepatitis B and significant portal hypertension显示文摘 | Spilios Manolakopoulos Christos Triantos Jiannis Theodoropoulos Jiannis Vlachogiannakos Anastasios Kougioumtzan George Papatheodoridis Dimitrios Tzourmakliotis Dimitrios Karamanolis Andrew K. Burroughs Athanasios Archimandritis Sotirios Raptis Alec Avgeri | 2009 | Journal of Hepatology2009，，3： | 1 |
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