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| 1 | Acute recurrent pancreatitis:Etiopathogenesis, diagnosis and treatment显示文摘Acute recurrent pancreatitis(ARP)refers to a clinical entity characterized by episodes of acute pancreatitis which occurs on more than one occasion.Recurrence of pancreatitis generally occurs in a setting of normal morpho-functional gland,however,an established chronic disease may be found either on the occasion of the first episode of pancreatitis or during the follow-up.The aetiology of ARP can be identified in the majority of patients.Most common causes include common bile duct stones or sludge and bile crystals;sphincter of oddi dysfunction;anatomical ductal variants interfering with pancreatic juice outflow;obstruction of the main pancreatic duct or pancreatico-biliary junction;genetic mutations;alcohol consumption.However,despite diagnostic technologies,the aetiology of ARP still remains unknown in up to 30%of cases:in these cases the term'idiopathic'is used.Because occult bile stone disease and sphincter of oddi dysfunction account for the majority of cases,cholecystectomy,and eventually the endoscopic biliary and/or pancreatic sphincterotomy are curative in most of cases.Endoscopic biliary sphincterotomy appeared to be a curative procedure per se in about 80%of patients.Ursodeoxycholic acid oral treatment alone has also been reported effective for treatment of biliary sludge.In uncertain cases toxinbotulin injection may help in identifying some sphincter of oddi dysfunction,but this treatment is not widely used.In the last twenty years,pancreatic endotherapy has been proven effective in cases of recurrent pancreatitis depending on pancreatic ductal obstruction,independently from the cause of obstruction,and has been widely used instead of more aggressive approaches. | Pier Alberto Testoni | 2014 | World Journal of Gastroenterology2014，20，45： | 27 |
| 2 | Optical coherence tomography in detection of dysplasia and cancer of the gastrointestinal tract and bilio-pancreatic ductal system显示文摘Optical coherence tomography(OCT) is an optical imaging modality that performs high-resolution,cross-sectional,subsurface tomographic imaging of the microstructure of tissues.The physical principle of OCT is similar to that of B-mode ultrasound imaging,except that it uses infrared light waves rather than acoustic waves.The in vivo resolution is 10-25 times better(about 10 μm) than with high-frequency ultrasound imaging,but the depth of penetration is limited to 1-3 mm,depending upon tissue structure,depth of focus of the probe used,and pressure applied to the tissue surface.In the last decade,OCT technology has evolved from an experimental laboratory tool to a new diagnostic imaging modality with a wide spectrum of clinical applications in medical practice,including the gastrointestinal(GI) tract and pancreatic-biliary ductal system.OCT imaging from the GI tract can be done in humans by using narrow-diameter,catheter-based probes that can be inserted through the accessory channel of either a conventional front-view endoscope,for investigating the epithelial structure of the GI tract,or a side-view endoscope,inside a standard transparent ERCP catheter,for investigating the pancreatico-biliary ductal system.Esophagus and the esophago-gastric junction has been the most widely investigated organ so far;more recently,also duodenum,colon and pancreatico-biliary ductal system have been extensively investigated.OCT imaging of the gastro-intestinal wall structure is characterized by a multiple-layer architecture that permits an accurate evaluation of the mucosa,lamina propria,muscularis mucosae,andpart of the submucosa.The technique may be,therefore,used to identify pre-neoplastic conditions of the GI tract,such as Barrett's epithelium and dysplasia,and evaluate the depth of penetration of early-stage neoplastic lesions.OCT imaging of the pancreatic and biliary ductal system could improve the diagnostic accuracy for ductal epithelial changes and the differential diagnosis between neoplastic and non-neoplastic lesions. | Pier Alberto Testoni Benedetto Mangiavillano | 2008 | World Journal of Gastroenterology2008，14，42： | 18 |
| 3 | Sedation and analgesia in gastrointestinal endoscopy: What’s new?显示文摘Various types of sedation and analgesia technique have been used during gastrointestinal endoscopy procedures.The best methods for analgesia and sedation during gastrointestinal endoscopy are still debated.Providing an adequate regimen of sedation/analgesia might be considered an art,influencing several aspects of endoscopic procedures: the quality of the examination,the patient’s cooperation and the patient’s and physician’s satisfaction with the sedation.The properties of a model sedative agent for endoscopy would include rapid onset and offset of action,analgesic and anxiolytic effects,ease of titration to desired level of sedation,rapid recovery and an excellent safety prof ile.Therefore there is an impulse for development of new approaches to endoscopic sedation.This article provides an update on the methods of sedation today available and future directions in endoscopic sedation. | Lorella Fanti Pier Alberto Testoni | 2010 | World Journal of Gastroenterology2010，16，20： | 12 |
| 4 | High-definition colonoscopy with i-Scan:Better diagnosis for small polyps and flat adenomas显示文摘AIM:To investigate if high-definition (HD) colonoscope with i-Scan gave a higher detection rate of mucosal lesions vs standard white-light instruments. METHODS:Data were collected from the computerized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 consecutive colonoscopies that were performed over 1 year with standard white-light (n = 849) or HD+ with i-Scan (n = 252) instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients' main details and family history for colorectal cancer, indication for colonoscopy (screening, diagnostic or surveillance), type of instrument used (standard white-light or HD+ plus i-Scan), name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or immediately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protrudinglesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. RESULTS:Eight hundred and forty-nine colonoscopies were carried with the standard white-light video colonoscope and 252 with the HD+ plus i-Scan video colonoscope. The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6%, 24.0%, 21.7% and 24.1% of them with the HD+ plus i-Scan technique. There were no significant differences between the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures (47.4%). The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD+ plus i-Scan mode (171/252 = 67.9%) than with the standard white-light technique (408/849 = 48.1%) (P < 0.0001). HD+ with i-Scan colonoscopies identified more lesions than standard white-light imaging (459/252 and 807/849, P < 0.0001), in the right or left colon (mean ± SD, 1.62 ± 1.36 vs 1.33 ± 0.73, P < 0.003 and 1.55 ± 0.98 vs 1.17 ± 0.93, P = 0.033), more lesions < 10 mm (P < 0.0001) or nonprotruding (P < 0.022), and flat polyps (P = 0.04). The cumulative mean number of lesions per procedure detected by the four endoscopists was significantly higher with HD+ with i-Scan than with standard white-light imaging (1.82 ± 2.89vs 0.95 ± 1.35,P < 0.0001). CONCLUSION:HD imaging with i-Scan during the withdrawal phase of colonoscopy significantly increased the detection of colonic mucosal lesions, particularly small and nonprotruding polyps. | Pier Alberto Testoni Chiara Notaristefano Cristian Vailati Milena Di Leo Edi Viale | 2012 | World Journal of Gastroenterology2012，18，37： | 12 |
| 5 | Endoscopic ultrasound and magnetic resonance imaging for re-staging rectal cancer after radiotherapy显示文摘AIM:To compare the sensitivity and specificity of two imaging techniques,endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI),in patients with rectal cancer after neoadjuvant chemoradiation therapy. And we compared EUS and MRI data with histological fi ndings from surgical specimens. METHODS:Thirty-nine consecutive patients (51.3% Male; mean age:68.2 ± 8.9 years) with histologically confirmed distal rectal cancer were examined for staging. All patients underwent EUS and MRI imaging before and after neoadjuvant chemoradiation therapy. RESULTS:After neoadjuvant chemoradiation,EUS and MRI correctly classified 46% (18/39) and 44% (17/39) of patients,respectively,in line with their histological T stage (P > 0.05). These proportions were higher for both techniques when nodal involvement was considered:69% (27/39) and 62% (24/39). When patients were sorted into T and N subgroups,the diagnostic accuracy of EUS was better than MRI for patients withT0-T2 (44% vs 33%,P > 0.05) and N0 disease (87% vs 52%,P = 0.013). However,MRI was more accurate than EUS in T and N staging for patients with more advanced disease after radiotherapy,though these differences did not reach statistical significance. CONCLUSION:EUS and MRI are accurate imaging techniques for staging rectal cancer. However,after neoadjuvant RT-CT,the role of both methods in the assessment of residual rectal tumors remains uncertain. | Gianni Mezzi Paolo Giorgio Arcidiacono Silvia Carrara Francesco Perri Maria Chiara Petrone Francesco De Cobelli Simone Gusmini Carlo Staudacher Alessandro Del Maschio Pier Alberto Testoni | 2009 | World Journal of Gastroenterology2009，15，44： | 9 |
| 6 | Endoscopic ultrasonography for evaluating patients with recurrent pancreatitis显示文摘Acute recurrent pancreatitis (ARP) is still a complex diagnostic and therapeutic challenge in clinical practice. In up to 30% of cases of ARP, it is not possible to establish the etiology of the disease. In the other 70%, many factors play an etiological role in ARP: microlithiasis, sphincter of Oddi dysfunction (SOD), pancreas divisum, hereditary pancreatitis, cystic fibrosis, a choledochocele, annular pancreas, an anomalous pancreatobiliary junction, pancreatic tumors or chronic pancreatitis are diagnosed. EUS should be useful in ARP as it is sensitive for diagnosing bile duct stones, gallbladder sludge, pancreatic lesions, ductal abnormalities and chronic pancreatitis. Endoscopic ultrasound (EUS) appears to be diagnostic in the majority of patients with previously unexplained pancreatitis, and offers an alternative to endoscopic retrograde cholangiopancreatography (ERCP) as the initial diagnostic test in patients with ARP. | Maria Chiara Petrone Paolo G Arcidiacono Pier Alberto Testoni | 2008 | World Journal of Gastroenterology2008，14，7： | 7 |
| 7 | Transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes显示文摘Gastro-esophageal reflux disease(GERD)is a verycommon disorder that results primarily from the loss of an effective antireflux barrier,which forms a mechanical obstacle to the retrograde movement of gastric content.GERD can be currently treated by medical therapy,surgical or endoscopic transoral intervention.Medical therapy is the most common approach,though concerns have been increasingly raised in recent years about the potential side effects of continuous longterm medication,drug intolerance or unresponsiveness,and the need for high dosages for long periods to treat symptoms or prevent recurrences.Surgery too may in some cases have consequences such as longlasting dysphagia,flatulence,inability to belch or vomit,diarrhea,or functional dyspepsia related to delayed gastric emptying.In the last few years,transoral incisionless fundoplication(TIF)has proved an effective and promising therapeutic option as an alternative to medical and surgical therapy.This review describes the steps of the TIF technique,using the Esophy X®device and the MUSETM system.Complications and their management are described in detail,and the recent literature regarding the outcomes is reviewed.TIF reconfigures the tissue to obtain a full-thickness gastroesophageal valve from inside the stomach,by serosato-serosa plications which include the muscle layers.To date the procedure has achieved lasting improvement of GERD symptoms(up to six years),cessation or reduction of proton pump inhibitor medication in about 75%of patients,and improvement of functional findings,measured by either p H or impedance monitoring. | Pier Alberto Testoni Giorgia Mazzoleni Sabrina Gloria Giulia Testoni | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，2： | 7 |
| 8 | Is acute recurrent pancreatitis a chronic disease?显示文摘Whether acute recurrent pancreatitis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis. There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association. Cystic fibrosis transmembrane con-ductance regulator (CFTR) gene mutation, hereditary and obstructive pancreatitis seem an acute disease that progress to chronic pancreatitis, likely as a consequence of the activation and proliferation of pancreatic stellate cells that produce and activate collagen and therefore fibrosis. From the diagnostic point of view, in patients with acute recurrent pancreatitis Endoscopic ultrasound (EUS) seems the more reliable technique for an accurate evaluation and follow-up of some ductal and parenchymal abnormalities suspected for early chronic pancreatitis. | Alberto Mariani Pier Alberto Testoni | 2008 | World Journal of Gastroenterology2008，14，7： | 6 |
| 9 | Oropharyngeal acid reflux and motility abnormalities of the proximal esophagus显示文摘AIM To investigate the relationship between pathological oropharyngeal(OP) acid exposure and esophageal motility in patients with extra-esophageal syndromes.METHODS In this prospective study we enrolled consecutive outpatients with extra-esophageal symptoms suspected to be related to gastroesophageal reflux disease(GERD). We enrolled only patients with a reflux symptom index(RSI) score-higher than 13 and with previous lung, allergy and ear, nose and throat evaluations excluding other specific diagnoses. All patients underwent 24-h OP pH-metry with the Dx probe and esophageal highresolution manometry(HRM). Patients were divided into two groups on the basis of a normal or pathological p H-metric finding(Ryan Score) and all manometric characteristics of the two groups were compared.RESULTS We examined 135 patients with chronic extra-esophageal syndromes. Fifty-one were considered eligible for the study. Of these, 42 decided to participate in the protocol. Patients were divided into two groups on the basis of normal or pathological OP acid exposure. All the HRM parameters were compared for the two groups. Significant differences were found in the median upper esophageal sphincter resting pressure(median 71 mmH g vs 126 mmH g, P = 0.004) and the median proximal contractile integral(median 215.5 cm·mmH g·s vs 313.5 cm·mmH g·s, P = 0.039), both being lower in the group with pathological OP acid exposure, and the number of contractions with small or large breaks, which were more frequent in the same group. This group also had a larger number of peristaltic contractions with breaks in the 20 mm Hg isobaric contour(38.7% vs 15.38%, P < 0.0001).CONCLUSION In patients with suspected GERD-related extraesophageal syndromes pathological OP acid exposure was associated with weaker proximal esophageal motility. | Sandro Passaretti Giorgia Mazzoleni Cristian Vailati Pier Alberto Testoni | 2016 | World Journal of Gastroenterology2016，22，40： | 5 |
| 10 | Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases显示文摘The role of endoscopic therapy in the management of pancreatic diseases is continuously evolving; at present most pathological conditions of the pancreas are successfully treated by endoscopic retrograde cholangio- pancreatography (ERCP) or endoscopic ultrasound (EUS), or both. Endoscopic placement of stents has played and still plays a major role in the treatment of chronic pancreatitis, pseudocysts, pancreas divisum, main pancreatic duct injuries, pancreatic fi stulae, complications of acute pancreatitis, recurrent idiopathic pancreatitis, and in the prevention of post-ERCP pancreatitis. These stents are currently routinely placed to reduce intraductal hypertension, bypass obstructing stones, restore lumen patency in cases with dominant, symptomatic strictures, seal main pancreatic duct disruption, drain pseudocysts or fluid collections, treat symptomatic major or minor papilla sphincter stenosis, and prevent procedure-induced acute pancreatitis. The present review aims at updating and discussing techniques, indications, and results of endoscopic pancreatic duct stent placement in acute and chronic in? ammatory diseases of the pancreas. | Pier Alberto Testoni | 2007 | World Journal of Gastroenterology2007，13，45： | 4 |
| 11 | Tumors and new endoscopic ultrasound-guided therapies显示文摘With the advent of linear echoendoscopes, endoscopic ultrasound (EUS) has become more operative and a new field of oncological application has been opened up. From tumor staging to tissue acquisition under EUS-guided fine-needle aspiration, new operative procedures have been developed on the principle of the EUS-guided puncture. A hybrid probe combining radiofrequency with cryotechnology is now available, to be passed through the operative channel of the echoendoscope into the tumor to create an area of ablation. EUS-guided fine-needle injection is emerging as a method to deliver anti-tumoral agents inside the tumor. Ethanol lavage, with or without paclitaxel, has been proposed for the treatment of cystic tumors in non-resectable cases and complete resolution has been recorded in up to 70%-80%. Many other chemical or biological agents have been investigated for the treatment of pancreatic adenocarcinoma: activated allogenic lymphocyte culture (Cytoimplant), a replication-deficient adenovirus vector carrying the tumor necrosis factor-α gene, or an oncolytic attenuated adenovirus (ONYX-015). The potential advantage of treatment under EUS control is the real-time imaging guidance into a deep target likethe pancreas which is extremely difficult to reach by a percutaneous approach. To date there are no randomized controlled trials to confirm the real clinical benefits of these treatments compared to standard therapy so it seems wise to reserve them only for experimental protocols approved by ethics committees. | Silvia Carrara Maria Chiara Petrone Pier Alberto Testoni Paolo Giorgio Arcidiacono | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，4： | 4 |
| 12 | SJGT14082900000151显示文摘 | Jean-Marc Dumonceau Angelo Andriulli B. Elmunzer Alberto Mariani Tobias Meister Jacques Deviere Tomasz Marek Todd Baron Cesare Hassan Pier Testoni Christine Kapral | 2014 | Endoscopy2014，，： | 3 |
| 13 | Outcome of endotherapy for pancreas divisum in patients with acute recurrent pancreatitis显示文摘AIM:To assess the rate of relapses of acute pancreatitis(AP),recurrent AP(RAP)and the evolution of endosonographic signs of chronic pancreatitis(CP)in patients with pancreas divisum(PDiv)and RAP.METHODS:Over a five-year period,patients with PDiv and RAP prospectively enrolled were divided into two groups:(1)those with relapses of AP in the year before enrollment were assigned to have endoscopic therapy(recent RAP group);and(2)those free of recurrences were conservatively managed,unless they relapsed during follow-up(previous RAP group).All patients in both groups entered a follow-up protocol that includedclinical and biochemical evaluation,pancreatic endoscopic ultrasonography(EUS)every year and after every recurrence of AP,at the same time as endoscopic retrograde cholangiopancreatography(ERCP).RESULTS:Twenty-two were treated by ERCP and 14were conservatively managed during a mean follow-up of 4.5±1.2 years.In the recent RAP group in whom dorsal duct drainage was achieved,AP still recurred in11(57.9%)after the first ERCP,in 6 after the second ERCP(31.6%)and in 5 after the third ERCP(26.3%).Overall,endotherapy was successful 73.7%.There were no cases of recurrences in the previous RAP group.EUS signs of CP developed in 57.9%of treated and 64.3%of untreated patients.EUS signs of CP occurred in 42.8%of patients whose ERCPs were successful and in all those in whom it was unsuccessful(P=0.04).There were no significant differences in the rate of AP recurrences after endotherapy and in the prevalence of EUS signs suggesting CP when comparing patients with dilated and non-dilated dorsal pancreatic ducts within each group.CONCLUSION:Patients with PDiv and recent episodes of AP can benefit from endoscopic therapy.Effective endotherapy may reduce the risk of developing EUS signs of CP at a rate similar to that seen in patients of previous RAP group,managed conservatively.However,in a subset of patients,endotherapy,although successful,did not prevent the evolution of endosonographic signs of CP. | Alberto Mariani Milena Di Leo Maria Chiara Petrone Paolo Giorgio Arcidiacono Antonella Giussani Raffaella Alessia Zuppardo Giulia Martina Cavestro Pier Alberto Testoni | 2014 | World Journal of Gastroenterology2014，20，46： | 3 |
| 14 | Feasibility and safety of EUS-guided cryothermal ablation in patients with locally advanced pancreatic cancer显示文摘 | Paolo Giorgio Arcidiacono Silvia Carrara Michele Reni Maria Chiara Petrone Stefano Cappio Gianpaolo Balzano Cinzia Boemo Stefano Cereda Roberto Nicoletti Markus Dominik Enderle Alexander Neugebauer Daniel von Renteln Axel Eickhoff Pier Alberto Testoni | 2012 | Gastrointestinal Endoscopy2012，，6： | 3 |
| 15 | Comparison of two dosing regimens of gabexate in the prophylaxis of post-ERCP pancreatitis显示文摘 | Enzo Masci Giorgio Cavallini Alberto Mariani Luca Frulloni Pier Alberto Testoni Simona Curioni Alberto Tittobello Generoso Uomo Guido Costamagna Sandro Zambelli Gianpiero Macarri Paolo Innocenti Carola Dragonetti | 2003 | The American Journal of Gastroenterology2003，，10： | 2 |
| 16 | Rectal Distensibility and Symptoms After Stapled and Milligan–Morgan Operation for Hemorrhoids显示文摘 | Maura Corsetti Paola Nardi Salvatore Pietro Sandro Passaretti Pier Alberto Testoni Carlo Staudacher | 2009 | Journal of Gastrointestinal Surgery2009，，12： | 1 |
| 17 | Why the Incidence of Post-ERCP panereatitis varies considerably factors affecting the diagnosis and the incidence of this complication,JOP显示文摘 | Pier Alberto Testoni | 2002 | J Pancreas(Online)2002，3，6： | 1 |
| 18 | Saccharomyces boulardii in Maintenance Treatment of Crohn’s Disease显示文摘 | Mario Guslandi Gianni Mezzi Massimo Sorghi Pier Alberto Testoni | 2000 | Digestive Diseases and Sciences2000，，7： | 1 |
| 19 | Pancreatic Endoscopic Ultrasound-guided Fine Needle Aspiration: Complication rate and clinical course in a single centre显示文摘 | Silvia Carrara Paolo Giorgio Arcidiacono Gianni Mezzi Maria Chiara Petrone Cinzia Boemo Pier Alberto Testoni | 2009 | Digestive and Liver Disease2009，，7： | 1 |
| 20 | Precut sphincterotomy, repeated cannulation and post-ERCP pancreatitis in patients with bile duct stone disease显示文摘 | Pier Alberto Testoni Antonella Giussani Cristian Vailati Sabrina Testoni Milena Di Leo Alberto Mariani | 2011 | Digestive and Liver Disease2011，，10： | 1 |
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