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Intraductal papillary mucinous neoplasm (IPMN) of the main pancreatic duct is usually treated by surgical excision of the affected pancreas. Nonoperative ablative therapies have not been described. We treated IPMN of the pancreatic duct with photodynamic therapy (PDT) in a patient who was a poor operative candidate. Porfimer sodium was administered intravenously, and laser light was delivered by a diffusing catheter placed in the pancreatic duct during endoscopic retrograde cholangiopancreatography (ERCP). Imaging and biopsy findings of IPMN resolved after PDT, and symptoms also resolved. Metastatic cancer was diagnosed 2 years after PDT had been initiated. Pancreatic PDT was well tolerated in this case, and may be a therapeutic option for selected patients with IPMN of the main pancreatic duct. 相似文献
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Barham K. Abu Dayyeh Saurabh Mukewar Shounak Majumder Raja Zaghlol Eric J. Vargas Valls Fateh Bazerbachi Michael J. Levy Todd H. Baron Christopher J. Gostout Bret T. Petersen John Martin Ferga C. Gleeson Randall K. Pearson Suresh T. Chari Santhi S. Vege Mark D. Topazian 《Gastrointestinal endoscopy》2018,87(1):141-149
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There are limited data on the outcome of emergency endoscopic retrograde cholangiopancreatography (ERCP) performed in the intensive care unit (ICU). We sought to assess the frequency, indications, and clinical outcomes of ERCPs performed in ICU patients who were too unstable to be transported to the endoscopy unit. An electronic endoscopy database was used to identify the patients (n = 22) and to assess procedural success, complications, and mortality. The indications for ERCP included suspected biliary sepsis, suspected gallstone pancreatitis, and known choledocholithiasis with cholangitis. Biliary cannulation, which was attempted in all patients, was successful in 19 patients (86 %), and of these 18 (95 %) underwent a technically successful endoscopic therapy. There were no apparent endoscopic complications. Therefore, emergency bedside ERCP in ICU patients, which is primarily performed for the management of suspected biliary sepsis and gallstone pancreatitis, can achieve high technical success rates when performed by experienced endoscopists, although the 30-day mortality rate remains high due to multiorgan dysfunction. 相似文献
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Hillary M. Topazian Debanjali Kundu Kathryn Peebles Silvina Ramos Karen Morgan Chan Joo Kim Karin L. Richter Noel T. Brewer Mercè Peris Jennifer S. Smith 《Journal of pediatric and adolescent gynecology》2018,31(6):575-582.e2