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| 1 | Extracorporeal shock wave lithotripsy for pancreatic and large common bile duct stones显示文摘Extraction of large pancreatic and common bile duct(CBD)calculi has always challenged the therapeutic endoscopist.Extracorporeal shockwave lithotripsy(ESWL)is an excellent tool for patients with large pancreatic and CBD calculi that are not amenable to routine endotherapy.Pancreatic calculi in the head and body are targeted by ESWL,with an aim to fragment them to<3 mm diameter so that they can be extracted by subsequent endoscopic retrograde cholangio-pancreatography(ERCP).In our experience,complete clearance of the pancreatic duct was achieved in 76% and partial clearance in 17%of 1006 patients.Short-term pain relief with reduction in the number of analgesics ingested was seen in 84%of these patients.For large CBD calculi,a nasobiliary tube is placed to help target the calculi,as well as bathe the calculi in salinea simple maneuver which helps to facilitate fragmenta-tion.The aim is to fragment calculi to<5 mm size and clear the same during ERCP.Complete clearance of the CBD was achieved in 84.4%of and partial clearance in 12.3%of 283 patients.More than 90%of the patients with pancreatic and biliary calculi needed three or fewer sessions of ESWL with 5000 shocks being de-livered at each session.The use of epidural anesthesia helped in reducing patient movement.This,together with the better focus achieved with newer third-gen-eration lithotripters,prevents collateral tissue damage and minimizes the complications.Complications in our experience with nearly 1300 patients were minimal,and no extension of hospital stay was required.Similar rates of clearance of pancreatic and biliary calculi with minimal adverse effects have been reported from the centers where ESWL is performed regularly.In view of its high efficiency,non-invasive nature and low complication rates,ESWL can be offered as the first-line therapy for selected patients with large pancreatic and CBD calculi. | Manu Tandan D Nageshwar Reddy | 2011 | World Journal of Gastroenterology2011，17，39： | 36 |
| 2 | Epidural anesthesia is effective for extracorporeal shock wave lithotripsy of pancreatic and biliary calculi显示文摘AIM: To evaluate the efficacy of thoracic epidural analgesia for extracorporeal shock wave lithotripsy (ESWL). METHODS: ESWL is an effective, non-invasive technique for the treatment of difficult pancreatic and large bile duct calculi. The procedure is often painful and requires large doses of analgesics. Many different anesthetic techniques have been used. Patients with either large bile duct calculi or pancreatic duct calculi which could not be extracted by routine endoscopic methods were selected. Thoracic epidural anesthesia (TEA) was routinely used in all the subjects unless contraindicated. Bupivacaine 0.25% with or without clonidine was used to block the segments D6 to D12. The dose was calculated depending on the age, height and weight of the patient. It was usually 1-2 mL per segment blocked.RESULTS: Ninety eight percent of the 1509 patients underwent ESWL under TEA. The subjects selected were within American Society of Anesthesiologists grade Ⅰ to Ⅲ. ESWL using EA permitted successful elimination of bile duct or pancreatic calculi with minimal morbidity. The procedure time was shorter in patients with TEA than in those who underwent ESWL under total intravenous anesthesia. CONCLUSION: Almost all patients undergoing ESWL with EA had effective blocks with a single catheter insertion and local anesthetic injection. | Santosh Darisetty Manu Tandan Duvvuru Nageshwar Reddy Rama Kotla Rajesh Gupta Mohan Ramchandani Sandeep Lakhtakia Guduru Venkat Rao Rupa Banerjee | 2010 | World Journal of Gastrointestinal Surgery2010，2，5： | 13 |
| 3 | Efficacy of low dose peginterferon alpha-2b with ribavirin on chronic hepatitis C显示文摘AIM: To assess the effi cacy of peginterferon alpha 2b at doses of 50 μg weekly and 80 μg weekly (based on body weight) plus ribavirin in HCV genotype 2 and genotype 3 chronic hepatitis C patients. METHODS: During the study period of Jan 2002 to Dec 2003, all patients diagnosed as chronic hepatitis C or HCV related compensated cirrhosis were treated with peginterferon alpha 2b 50 μg S/C weekly (body weight < 60 kg) or 80 μg S/C weekly (body weight > 60 kg) plus ribavirin 800 mg/d for 24 wk. RESULTS: Overall 28 patients, 14 patients in each group (based on body weight) were treated during the period. Out of 28 patients, 75% were genotype 3, 18% were genotype 2 and 7% were genotype 1. The mean dose of peginterferon alpha 2b was 0.91 μg/kg in group 1 and 1.23 μg/kg in group 2 respectively. The end of treatment and sustained virologic response rates were 82% and 78% respectively. Serious adverse effects were seen in 3.5% patients. CONCLUSION: Low dose peginterferon alpha 2b in combination with ribavirin for 24 wk is effective in HCV genotype 2 and 3 chronic hepatitis C patients. | Rajesh Gupta CH Ramakrishna Sandeep Lakhtakia Manu Tandan Rupa Banerjee D Nageshwar Reddy | 2006 | World Journal of Gastroenterology2006，12，34： | 10 |
| 4 | Per oral cholangiopancreatoscopy in pancreatico biliary diseases- Expert consensus statements显示文摘AIM: To provide consensus statements on the use of per-oral cholangiopancreatoscopy(POCPS).METHODS: A workgroup of experts in endoscopic retrograde cholangiopancreatography(ERCP), endosonography, and POCPS generated consensus statements summarizing the utility of POCPS in pancreaticobiliary disease. Recommendation grades used validated evidence ratings of publications from an extensive literature review.RESULTS: Six consensus statements were generated:(1) POCPS is now an important additional tool during ERCP;(2) in patients with indeterminate biliary strictures, POCS and POCS-guided targeted biopsy are useful for establishing a definitive diagnosis;(3) POCS and POCS-guided lithotripsy are recommended for treatment of difficult common bile duct stones when standard techniques fail;(4) in patients with main duct intraductal papillary mucinous neoplasms(IPMN) POPS may be used to assess extent of tumor to assist surgicalresection;(5) in difficult pancreatic ductal stones,POPS-guided lithotripsy may be useful in fragmentation and extraction of stones; and(6) additional indications for POCPS include selective guidewire placement,unexplained hemobilia, assessing intraductal biliary ablation therapy, and extracting migrated stents. CONCLUSION: POCPS is important in association with ERCP, particularly for diagnosis of indeterminate biliary strictures and for intra-ductal lithotripsy when other techniques failed, and may be useful for preoperative assessment of extent of main duct IPMN, for extraction of difficult pancreatic stones, and for unusua indications involving selective guidewire placement,assessing unexplained hemobilia or intraductal biliary ablation therapy, and extracting migrated stents. | Mohan Ramchandani Duvvur Nageshwar Reddy Sundeep Lakhtakia Manu Tandan Amit Maydeo Thoguluva Seshadri Chandrashekhar Ajay Kumar Randhir Sud Rungsun Rerknimitr Dadang Makmun Christopher Khor | 2015 | World Journal of Gastroenterology2015，21，15： | 8 |
| 5 | Narrow Band Imaging (NBI) Can Detect Minimal Changes in Non Erosive Reflux Disease (NERD) Which Resolve with PPI Therapy显示文摘 | Rupa Banerjee Nitesh Pratap Mohan Ramchandani Manu Tandan Guduru V. Rao D.N. Reddy | 2009 | Gastrointestinal Endoscopy2009，，5： | 1 |
| 6 | High Resolution Narrow Band Imaging (NBI) Can Identify Normal Gastric Mucosa and H. Pylori (HP) Associated Gastritis显示文摘 | Rupa Banerjee C. Ramji M.J. Mansard Anuradha Shekharan Santosh Darisetty Manu Tandan G Venkat Rao D.N. Reddy | 2007 | Gastrointestinal Endoscopy2007，，5： | 1 |
| 7 | Longterm clinical outcomes of extracorporeal shock wave lithotripsy in painful chronic calcific pancreatitis显示文摘 | Manu Tandan D Nageshwar Reddy Rupjyoti Talukdar K. Vinod D. Santosh Sundeep Lakhtakia Rajesh Gupta Mohan J. Ramchandani Rupa Banerjee K. Rakesh G. Varadaraj G. Venkat Rao | 2013 | Gastrointestinal Endoscopy2013，，： | 1 |
| 8 | Longterm clinical outcomes of extracorporeal shock wave lithotripsy in painful chronic calcific pancreatitis显示文摘 | Manu Tandan D Nageshwar Reddy Rupjyoti Talukdar K. Vinod D. Santosh Sundeep Lakhtakia Rajesh Gupta Mohan J. Ramchandani Rupa Banerjee K. Rakesh G. Varadaraj G. Venkat Rao | 2013 | Gastrointestinal Endoscopy2013，，： | 1 |
| 9 | Endotherapy in chronic pancreatitis显示文摘Chronic pancreatitis(CP)is a progressive disease with irreversible changes in the pancreas.Patients commonly present with pain and with exocrine or endocrine insufficiency.All therapeutic efforts in CP are directed towards relief of pain as well as the management of associated complications.Endoscopic therapy offers many advantages in patients with CP who present with ductal calculi,strictures,ductal leaks,pseudocyst or associated biliary strictures.Endotherapy offers a high rate of success with low morbidity in properly selected patients.The procedure can be repeated and failed endotherapy is not a hindrance to subsequent surgery.Endoscopic pancreatic sphincterotomy is helpful in patients with CP with minimal ductal changes while minor papilla sphincterotomy provides relief in patients with pancreas divisum and chronic pancreatitis.Extracorporeal shock wave lithotripsy is the standard of care in patients with large pancreatic ductal calculi.Long term follow up has shown pain relief in over 60%of patients.A transpapillary stent placed across the disruption provides relief in over 90%of patients with ductal leaks.Pancreatic ductal strictures are managed by single large bore stents.Multiple stents are placed for refractorystrictures.CP associated benign biliary strictures(BBS)are best treated with multiple plastic stents,as the response to a single plastic stent is poor.Covered self expanding metal stents are increasingly being used in the management of BBS though further long term studies are needed.Pseudocysts are best drained endoscopically with a success rate of 80%-95%at most centers.Endosonography(EUS)has added to the therapeutic armamentarium in the management of patients with CP.Drainage of pseudcysts,cannulation of inaccessible pancreatic ducts and celiac ganglion block in patients with intractable pain are all performed using EUS.Endotherapy should be offered as the first line of therapy in properly selected patients with CP who have failed to respond to medical therapy and require intervention. | Manu Tandan D Nageshwar Reddy | 2013 | World Journal of Gastroenterology2013，19，37： | 1 |
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