Bing Hu

Second Military Medical University, Shanghai, Shanghai, Shanghai Shi, China

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Publications (38)123.73 Total impact

  • Jun Wu · Dao-Jian Gao · Bing Hu ·

    Gastrointestinal Endoscopy 05/2014; 79(5):AB362-AB363. DOI:10.1016/j.gie.2014.02.421 · 5.37 Impact Factor
  • Felix W. Leung · Jun Wu · Bing Hu ·

    Gastrointestinal Endoscopy 05/2014; 79(5):AB585-AB586. DOI:10.1016/j.gie.2014.02.1006 · 5.37 Impact Factor
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    ABSTRACT: Endoscopic placement of covered self-expandable metal stent (SEMS) has gained popularity in the management of benign biliary strictures (BBS). The existing SEMS has been designed primarily to palliate malignant biliary obstruction and has a high frequency of stent migration, difficulty in retrieval and stricture recurrence after stent removal. This study aimed to design a novel retrievable SEMS dedicated to the treatment of extrahepatic BBS and evaluate its clinical efficacy and safety. A short fully covered SEMS (FCSEMS) with a retrieval lasso was designed for the specific treatment of BBS. A total of 45 patients with segmental extrahepatic BBS were included in this study. The stent was placed entirely inside the bile duct with only the retrieval lasso extending from the papilla. The stents were recommended to be in situ for 6 to 12 months before removal. The FCSEMS was successfully placed in all 45 patients. In all, 33 patients had their FCSEMS successfully removed after a mean period of 8.6 ± 3.7 (range 2-15.5) months. Stent migration occurred in 9.1% of the patients. During a mean follow-up of 18.9 months after stent removal, recurrent stricture was found in 2 (6.1%) patients and was successfully treated with a second FCSEMS. Overall, the strictures resolved in 30/33 (90.9%) patients. Intraductal placement of a short FCSEMS is suitable for the treatment of segmental extrahepatic BBS. This new removable design offered prolonged stenting and drainage for BBS for up to one year with minimal complications.
    Journal of Digestive Diseases 03/2014; 15(3):146-53. DOI:10.1111/1751-2980.12117 · 1.96 Impact Factor
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    ABSTRACT: Background and study aims: There are limited data on the role of antireflux biliary stents. This single-center randomized trial compared the endoscopic use of partly covered antireflux metal stents (pcARMS) with that of standard uncovered self-expandable metal stents (ucSEMS) for the palliation of nonhilar malignant biliary obstruction. Patients and methods: Between August 2007 and February 2012, patients with nonhilar malignant biliary obstruction were randomly assigned to treatment with either pcARMS or ucSEMS. Subsequent follow-up was conducted in clinic or by phone. The primary outcome was onset of cholangitis within 12 months of stenting. Secondary outcomes included other morbidities, stent dysfunctions, and survival. Results: Altogether 112 patients were included, 56 in each group. The stents were successfully deployed in all patients. Satisfactory jaundice control was achieved in 49 cases in the pcARMS group, compared with 47 in the ucSEMS group (P = 0.135). Fewer patients experienced cholangitis in the pcARMS group than in the ucSEMS group (10 vs. 21 patients; P = 0.035), and the frequency of episodes was less (P = 0.022). Respectively, 17 and 29 stent dysfunctions before death were observed in the pcARMS and ucSEMS groups (P = 0.051) and the median stent patency was 13.0 (standard deviation [SD] 3.4) and 10.0 (1.2) months, respectively (P = 0.044). At final follow-up, in January 2013, 50 /52 and 52 /55 patients had died and no difference in median survival was seen between the two groups (8.0 vs. 9.0 months, P = 0.56). Conclusions: Stenting with pcARMS compared with standard ucSEMS reduces risk of ascending cholangitis and has longer stent patency, but does not increase patient survival. number, ChiCTR-TRC-11001800.
    Endoscopy 02/2014; 46(2):120-6. DOI:10.1055/s-0034-1364872 · 5.05 Impact Factor
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    ABSTRACT: Endoscopic management of benign biliary stricture (BBS) remains challenging. There is no reported method for the amelioration of biliary fibroplasia endoscopically. We report our initial experience of radiofrequency ablation (RFA) for the management of BBS. Nine patients with BBS (postoperation stricture four, liver transplant three, and chronic inflammation two), seven of whom had previously unsuccessful endoscopic or percutaneous interventions, were enrolled. Intraductal bipolar RFA was delivered at power of 10 W for 90 s per stricture segment, followed by balloon dilatation with/without stent placement. All patients had immediate stricture improvements after RFA. No severe adverse event occurred except for one patient with mild post-endoscopic retrograde cholangiopancreatography pancreatitis. During median (SD) follow-up duration of 12.6 (3.9) months, BBS resolution without the need for further stenting was achieved in four patients whereas two patients had stent(s) in situ waiting scheduled removal. However, one patient had stricture relapse after initial resolution, one underwent surgery, and another patient died of other cause. Endobiliary RFA appears to be safe and effective for the treatment of BBS, especially for refractory cases. Further studies are warranted.
    Digestive Endoscopy 01/2014; 26(4). DOI:10.1111/den.12225 · 2.06 Impact Factor
  • Xiao-Ming Yang · Bing Hu ·
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    ABSTRACT: To perform a meta-analysis of large-balloon dilation (LBD) plus endoscopic sphincterotomy (EST) vs EST alone for removal of bile duct stones. Databases including PubMed, EMBASE, the Cochrane Library, the Science Citation Index, and important meeting abstracts were searched and evaluated by two reviewers independently. The main outcome measures included: complete stone removal, stone removal in the first session, use of mechanical lithotripsy, procedure time, and procedure-related complications. A fixed-effects model weighted by the Mantel-Haenszel method was used for pooling the odds ratio (OR) when heterogeneity was not significant among the studies. When a Q test or I(2) statistic indicated substantial heterogeneity, a random-effects model weighted by the DerSimonian-Laird method was used. Six randomized controlled trials involving 835 patients were analyzed. There was no significant heterogeneity for most results; we analyzed these using a fixed-effects model. Meta-analysis showed EST plus LBD caused fewer overall complications than EST alone (OR = 0.53, 95%CI: 0.33-0.85, P = 0.008); subcategory analysis indicated a significantly lower risk of perforation in the EST plus LBD group (Peto OR = 0.14, 95%CI: 0.20-0.98, P = 0.05). Use of mechanical lithotripsy in the EST plus LBD group decreased significantly (OR = 0.26, 95%CI: 0.08-0.82, P = 0.02), especially in patients with a stone size larger than 15 mm (OR = 0.15, 95%CI: 0.03-0.68, P = 0.01). There were no significant differences between the two groups regarding complete stone removal, stone removal in the first session, post-endoscopic retrograde cholangiopancreatography pancreatitis, bleeding, infection of biliary tract, and procedure time. EST plus LBD is an effective approach for the removal of large bile duct stones, causing fewer complications than EST alone.
    World Journal of Gastroenterology 12/2013; 19(48):9453-9460. DOI:10.3748/wjg.v19.i48.9453 · 2.37 Impact Factor
  • Jun Wu · Ya-Min Pan · Tian-Tian Wang · Dao-Jian Gao · Bing Hu ·
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    ABSTRACT: Esophagectomy is the conventional treatment for Barrett's esophagus with high-grade dysplasia and intramucosal cancer. Endotherapy is an alternative treatment. To compare the efficacy and safety of these 2 treatments. PubMed, Web of Science, EMBASE, Cochrane Library and momentous meeting abstracts were searched. Studies comparing endotherapy with esophagectomy were included in the meta-analysis. Pooling was conducted in a random-effects model. Tertiary-care facility. Seven studies involving 870 patients were included. Endotherapy and esophagectomy. Neoplasia remission rate, neoplasia recurrence rate, overall survival rate, neoplasia-related death, and major adverse events. Meta-analysis showed that there was no significant difference between endotherapy and esophagectomy in the neoplasia remission rate (relative risk [RR] 0.96; 95% CI, 0.91-1.01); overall survival rate at 1 year (RR 0.99; 95% CI, 0.94-1.03), 3 years (RR 1.03; 95% CI, 0.96-1.10), and 5 years (RR 1.00; 95% CI, 0.93-1.06); and neoplasia-related mortality (risk difference [RD] 0; 95% CI, -0.02 to 0.01). Endotherapy was associated with a higher neoplasia recurrence rate (RR 9.50; 95% CI, 3.26-27.75) and fewer major adverse events (RR 0.38; 95% CI, 0.20-0.73). Relatively small number of retrospective studies available, different types of endoscopic treatments were used. Endotherapy and esophagectomy show similar efficacy except in the neoplasia recurrence rate, which is higher after endotherapy. Prospective, randomized, controlled trials are needed to confirm these results.
    Gastrointestinal endoscopy 09/2013; 79(2). DOI:10.1016/j.gie.2013.08.005 · 5.37 Impact Factor
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    Gastrointestinal Endoscopy 05/2013; 77(5):AB320. DOI:10.1016/j.gie.2013.03.1080 · 5.37 Impact Factor
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    Felix W. Leung · Bing Hu · Jun Wu ·

    Gastrointestinal Endoscopy 05/2013; 77(5):AB427. DOI:10.1016/j.gie.2013.03.309 · 5.37 Impact Factor
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    Ya-Min Pan · Tian-Tian Wang · Jun Wu · Bing Hu ·
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    ABSTRACT: Intramural duodenal hematoma (IDH) is a rare complication following endoscopic retrograde cholangiopancreatography (ERCP). Blunt damage caused by the endoscope or an accessory has been suggested as the main reason for IDH. Surgical treatment of isolated duodenal hematoma after blunt trauma is traditionally reserved for rare cases of perforation or persistent symptoms despite conservative management. Typical clinical symptoms of IDH include abdominal pain and vomiting. Diagnosis of IDH can be confirmed by imaging techniques, such as magnetic resonance imaging or computed tomography and upper gastrointestinal endoscopy. Duodenal hematoma is mainly treated by drainage, which includes open surgery drainage and percutaneous transhepatic cholangial drainage, both causing great trauma. Here we present a case of massive IDH following ERCP, which was successfully managed by minimally invasive management: intranasal hematoma aspiration combined with needle knife opening under a duodenoscope.
    World Journal of Gastroenterology 04/2013; 19(13):2118-2121. DOI:10.3748/wjg.v19.i13.2118 · 2.37 Impact Factor
  • Ya-Min Pan · Bing Hu ·
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    ABSTRACT: Liver transplantation (LT) has become an important treatment for end stage hepatobiliary disorders. However, biliary complications following LT are common and greatly hamper the clinical efficacy. Endoscopic therapy has been the first-line modality for these biliary problems, though technically difficult and complex. We have managed more than 1 000 cases of complications following LT via endoscopic approach. Here we summarized the therapeutic methods and strategies of our center, hoping to provide evidence for better clinical practice.
    Academic Journal of Second Military Medical University 03/2013; 33(3):235-239. DOI:10.3724/SP.J.1008.2013.00235
  • Ya-Min Pan · Jun Wu · Tian-Tian Wang · Dao-Jian Gao · Bing Hu ·
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    ABSTRACT: Objective To investigate the value, safety and efficacy of fully-covered self-expandable metallic stent (FCSEMS) in endoscopic retrograde cholangiopancreatography (ERCP) procedures for pancreatic-biliary diseases. Methods The clinical data of 56 patients with pancreatic-biliary diseases, who underwent FCSEMS treatment via ERCP from January 2008 to June 2012, were retrospectively analyzed. The stents of different lengths and types were chosen according to the condition of patients. The stentswere removed under endoscope. The therapeutic effects at end point, stent removing rate and associated complicationswere observed. Results FCSEMS was placed in 49 patients with benign stricture, including pos-- liver transplant stricture (32), iatrogenic biliary stricture (12) and chronic pancreatitis-associated stricture (5). The mean follow time was (15±8. 6) months (range 5-38 months), -the mean stent duration was (8.4±5. 3) months (1-15 months), and the effective rate was 89.8% (44/49). FCSEMS was placed in 7 patients with biliary complications, including bleeding after endoscopic sphincterotomy (EST) (4), perforation after EST (1), and bile leakage following liver transplantation (2). The mean follow time was (5±3. 7) months (range 1-12 months), themean stent duration was (1. 8±0. 5) months (1-8 months), and the effective rate was 100%. All FCSEMS were successfully retrieved. The short-term complication rate associated with stentwas 8.9% (5/56), including post-ERCP pancreatitis (2), early cholangitis (2) and cholecystitis (1). The long-term complication ratewas 12. 5% (7/56), including stent slip (2), stent translocation (3) and stent-associated cholangitis (2). Conclusion FCSEMS can not only be used to treat traditional benign pancreatic-biliary strictures, but alto serve as a potential substitute for safe and effective treatment of serious biliary complications.
    Academic Journal of Second Military Medical University 03/2013; 33(3):240-246. DOI:10.3724/SP.J.1008.2013.00240
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    ABSTRACT: Objective To evaluate the safety and long-term outcomes of endoscopic deployment ofmultiple plastic stents for treatment of biliary stricture after living donor liver transplantation (LDLT). Methods Between June 2005 and June 2012, 31 patients with biliary strictures after LDLT received endoscopic retrograde cholangiopancreatography (ERCP) and multiple plastic stents placement. The technical success rate and ERCP-related complications were observed. The patients were followed up and the duration of stents treatment, stricture eliminating rate, and sustained clinical success rate were recorded. Results The ERCP findings revealed stricture in 22 cases and stricture plus leakage in 9. The endoscopic technical success rate was 87. 1% (27/31). ERCP-related complications included acute pancreatitis in 1 case, acute cholangitis 2 and partial stent migration in 2. There were no procedure-related deaths. The median period from stent deployment to removal was 9. 6 months. The stricture eliminating rate was 95% (19/20) and sustained clinical success rate was 88. 2% (15/17) during a follow-up of 5-43 months (median 38 months). Conclusion Endoscopic deployment of multiple plastic stents is safe and effective for biliary stricture after LDLT, with acceptable long-termoutcomes, and the method may be a firtt-line therapy option for biliary stricture after LDLT.
    Academic Journal of Second Military Medical University 03/2013; 33(3):247-251. DOI:10.3724/SP.J.1008.2013.00247
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    ABSTRACT: Objective To compare the safety and efficacy of simultaneous bilateral biliary metal stents with plastic stents under endoscope for treatment of malignant hilar biliary obstruction (MHBO). Methods From May 2007 to December 2011, 142 MHBO patients were selected for this study, with 32 receiving bilateral metal stent drainage and 110 receiving bilateral plastic stent drainage. The success rate of endoscopic operations, postoperative jaundice-reducing effect, post-endoscopic retrograde cholangiopancreatography (ERCP) complications, and stent patency period were observed. Results The procedures were successful in all patients in the two groups. The postoperative jaundice-reducing effect rates were 96. 9% (31/32) in the metal stent group and 88.2%(97/110) in the plastic stent group (P>0. 05). Two patients in the metal stent group and six in the plastic stent group had post-ERCP cholangitis, which was relieved by anti-inflammatory intervention, replacement of stents or endoscopic nasobiliary drainage. Two patients in the plastic stent group had stent slip. There were no pancreatitis, gastrointestinal bleeding, perforation or ERCP-related deaths in the two groups. Two patients in the metal stent group and 4 in the plastic stent group died, and the biliary stents were patent until they died. Eight patients in metal stent group and 29 patients in the plastic stent group developed recurrent obstructive jaundice, which were treated by reimplantation or replacement of the plastic stents. The post-ERCP complication rates were similar in the two groups (P>0. 05). Themedian patency period of the metal stent was (248. 53± 138. 61) d and that of the plastic stent was (101. 76±38. 53) d, showing significant difference byLog-rank test (P<0. 001). Conclusion For Bismuth II-type, bilateral bile duct invaded, or non-resectable MHBO patients, if biliary drainage range permits and the expected survival period >3 months, double metal stent biliary drainage has more advantages.
    Academic Journal of Second Military Medical University 03/2013; 33(3):252-256. DOI:10.3724/SP.J.1008.2013.00252
  • Jun Wu · Ya-Min Pan · Tian-Tian Wang · Dao-Jian Gao · Bing Hu ·
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    ABSTRACT: Objective To evaluate the safety and clinical effectiveness of biliary drainage combined with endoscopic intraductal radiofrequency ablation (RFA) for treatment of malignant biliary obstruction. Methods Eighteen patients with malignant biliary obstruction, who were unsuitable for surgical resection, were prospectively selected for this study. During endoscopic retrograde cholangiopancreatography (ERCP), when biliary cannulation was successfully done, a bipolar radiofrequency probe was introduced into the bile duct via a guide wire. RFA was done under fluoroscopy, which was followed by stent placement. The patients were closely observed and followed up after procedure. Results All patients received successful RFA and biliary drainage. Twelve patients were implanted with plastic stents and 6 with metal stents; 3 patients were also implanted with pancreatic stents. Four patients developed mild complications (2 cholangitis and 2 pancreatitis), which were controlled by conservative therapy. Jaundice was promptly controlled in 61% (11/18) patients. The patients were followed up for a median of 10. 9 months (range 2. 0-15. 4 months). The stent patency rates of 3 months, 6 months and 12 months were 87%(13/15), 64% (9/14) and 25% (2/8), respectively. The 6 month- and 12 month-survival rates were 67% (8/12) and 50% (4/8), respectively. Conclusion Biliary drainage combined with endoscopic intraductal RFA is technically feasible and safe for tteatment of malignant biliary obstruction.
    Academic Journal of Second Military Medical University 03/2013; 33(3):257-260. DOI:10.3724/SP.J.1008.2013.00257
  • Ya-Min Pan · Tian-Tian Wang · Dao-Jian Gao · Jun Wu · Bing Hu ·
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    ABSTRACT: Objective To investigate the therapeutic strategies, methods, safety and efficacy of simultaneous placement of sel--expanding metallic stent (SEMS) in the bile duct and duodenum under endoscope for treatment ofmalignant biliary and duodenal obstruction. Methods The clinical data of patients with obstructive jaundice combined with severe duodenal stricture, who were treated with simultaneous placement of biliary SEMS and duodental SEMS under endoscope during January 2009 to June 2012, were retrospectively analyzed. The success rate of endoscopic management, complications, relief of jaundice and results of gastric outlet obstruction scoring system (GOOSS) were analyzed. Results Totally ten patients meeting the criteria were analyzed in this study. The patients included 5 cases with pancreatic cancer, 2 with gallbladder cancer, 2 with cancer of bile duct and one with duodenal papilla caner. Five patients with type I duodenal stricture (without invading duodenal papilla) successfully received biliary stents through endoscopic retrograde cholangiopancreatography (ERCP) after placement of duodenal stents. One patient with type I duodenal stricture was implanted with a 9 cm duodenal stent before endoscopic anterograde cholangiopancreatography (EACP), then a SEMS was implanted in the bile duct through endoscopic ultrasonography-guided biliary drainage (EUS-BD). Three patientswith type H duodenal stricture (with invading duodenal papilla) underwent EACP and biliary stent placement through EUS-BD, and then the duodenal stent was deployed in duodenum after EACP. The patient with type m (away from the duodenal papilla) was implanted with biliary and duodenal stents. The success rate of endoscopic management was 100%. Two patients had self-controlled bleeding of intestinal mucosa, which was caused by endoscope friction when passing through the duodenal stricture, but without any continuous bleeding or perforation. Symptoms of jaundice and gastric outlet obstruction were greatly relieved after treatment. Conclusion For patients with unresectable malignant biliary obstruction combined with duodenal stricture, endoscopic placement of SEMS in the bile duct and duodenum simultaneously is a safe and effective method to palliate dual malignant obstruction via different endoscopic managements.
    Academic Journal of Second Military Medical University 03/2013; 33(3):261-265. DOI:10.3724/SP.J.1008.2013.00261
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    ABSTRACT: BACKGROUND: Endoscopic management of biliary or pancreatic strictures by stent insertion is well established. However, some high-grade strictures are refractory to dilation and stent placement with conventional methods. OBJECTIVE: To evaluate the safety and efficacy of the wire-guided electrotomy technique in dilating stiff biliary and/or pancreatic stenoses when ordinary methods failed. DESIGN: Retrospective analysis of a prospective database. SETTING: Tertiary referral university hospital. PATIENTS: This study involved 279 patients with biliary or pancreatic strictures who underwent ERCP for stenting. INTERVENTION: After conventional dilation failed, wire-guided needle-knife electrocautery was attempted to facilitate insertion of the dilating devices and eventually endoprosthesis. MAIN OUTCOME MEASUREMENTS: The successful treatment and drainage of biliary or pancreatic strictures. RESULTS: With wire-guided needle-knife cauterization, the success rate of stricture dilatation increased from 95.7% (267 of 279 patients) to 98.9% (276 of 279 patients). Dilation of stenoses was successful in 9 of 10 patients (90%) by using electrocautery with the wire-guided needle-knife technique. Postprocedure adverse events included self-limited bleeding, mild acute pancreatitis, hyperamylasemia, cholangitis, and biliary perforation. No procedure-related death occurred. LIMITATIONS: Retrospective, single-center study and small sample size. CONCLUSIONS: Wire-guided needle-knife electroincision appears to be effective for traversing refractory biliary or pancreatic strictures and can be considered as an alternative approach to conventional methods. However, the safety of such a technique needs to be further evaluated.
    Gastrointestinal endoscopy 01/2013; 77(5). DOI:10.1016/j.gie.2012.11.023 · 5.37 Impact Factor
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    Jun Wu · Bing Hu ·
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    ABSTRACT: Adequate visualization during endoscopic retrograde cholangiopancreatography (ERCP) procedure requires distention of the bowel lumen, usually insufflated with room air. Patients often complain of abdominal pain post-procedure. The use of carbon dioxide insufflation in colonoscopy has been shownto result in less post-procedure abdominal pain and distension. Recently, it has been reported the use of carbon dioxide (CO2) insufflation during ERCP procedure is similarly helpful. The purpose of this study was to evaluate the efficiency, safety and comfort of ERCP involving carbon dioxide insufflation through a meta-analysis of published randomized control trials. Databases including PubMed, EMBASE, the Cochrane Library, the Science Citation Index and momentous meeting abstracts were searched and evaluated by two reviewers independently. Five randomized control trials involving 446 patients were analyzed. Meta-analysis showed that patientsin the CO2 insufflation group had lower pain score (VAS) at 1-hour [MD -12.37, 95%CI(-20.96,-3.78)], 3-hours [MD -9.81, 95%CI (-17.05, -2.57)) and 6-hours [MD -8.78, 95%CI (-13.71, -3.85)] compared with air insufflation group after procedure. However, there were no significant differences between the two groups regardingtotal procedure time and procedure complication. Insufflation with carbon dioxide during ERCP may decrease post-procedure abdominal discomfort without any additional adverse reactions. Thus, CO2 insufflation seems appropriate to use during ERCP procedure. Large trials are required to prove any additional advantages to carbon dioxide insufflation during ERCP.
    01/2013; 3(1):37-42. DOI:10.7178/jig.107l
  • Felix W Leung · Bing Hu · Jun Wu ·
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    ABSTRACT: Water-aided colonoscopy can be categorized by the timing of removal of infused water, predominantly during withdrawal (water immersion) or during insertion (water exchange), respectively. To assess the impact of water immersion and water exchange on insertion pain and adenoma detection rate, when compared with air insufflation colonoscopy. Published randomized controlled trial (RCT) that compared water immersion or water exchange with air insufflation. Patients undergoing colonoscopy. Medline, PubMed, Google searches (January 2008 to December 2011) to identify appropriate RCTs. Pain during insertion phase and adenoma detection rate. Review Manager Software (Version 5.1, Cochrane Collaboration, UK). Pain scores of both water-aided methods are lower than that of the air insufflation method. Subgroup analysis shows that compared with air insufflation, the water exchange group had a greater mean reduction of maximum pain during insertion -2.73 (-3.29, -2.18) than the water immersion group -1.31 (-1.64, -0.97). There is no significant difference in overall adenoma detection rate between water-aided methods and air insufflation. Subgroup analysis shows that compared with air insufflation, the water exchange group had higher adenoma detection rate, OR 1.52, (95%CI: 1.08-2.14) than the water immersion group, OR 0.92, (95%CI: 0.70-1.21). Unblinded colonoscopists exposed observations to uncertain bias. Compared with air insufflation, the data presentation in a meta-analysis format show that both water immersion and water exchange significantly reduce insertion pain. Water exchange may be superior to water immersion in minimizing insertion pain and in increasing adenoma detection rate.
    01/2013; 3(3):100-103. DOI:10.7178/jig.119
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    ABSTRACT: To evaluate the efficacy and safety of endoscopic papillary large-balloon dilation (EPLBD) combined with limited endoscopic sphincterotomy (EST) for the removal of large biliary duct stones (≥10 mm). Data of patients who underwent an attempted removal of large bile duct stones by limited EST followed by EPLBD (≥12 mm in diameter) from April 2006 to October 2011 in our center were reviewed. Clinical characteristics, endoscopic methods and outcomes of the patients were collected and analyzed. A total of 169 patients with a mean age of 69.3 years (range 19–97 years) underwent 171 procedures. Median stone size and balloon diameter was 15 mm and 13 mm, respectively. Complete stone removal in a single session was achieved in 163 procedures (95.3%) with mechanical lithotripsy (ML) used in 66 (38.6%). Patients with a larger stone size required more frequent use of ML with a comparable success rate (P < 0.01). There were no significant differences between patients with and without periampullary diverticula in stone clearance (97.3% vs 93.8%), ML requirement (36.5% vs 40.2%) and complications (2.7% vs 6.2%) (all P > 0.05). Seven patients had eight procedure-related complications including moderate or mild bleeding (n = 4), minor perforation (n = 1), mild pancreatitis (n = 2) and cholangitis (n = 1). EPLBD following limited EST is an effective and safe approach for the removal of large biliary duct stones, especially for those refractory cases.
    Journal of Digestive Diseases 11/2012; 14(3). DOI:10.1111/1751-2980.12013 · 1.96 Impact Factor

Publication Stats

350 Citations
123.73 Total Impact Points


  • 2002-2014
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China
  • 2006
    • Prince of Wales Hospital, Hong Kong
      Chiu-lung, Kowloon City, Hong Kong
  • 2005
    • The Chinese University of Hong Kong
      Hong Kong, Hong Kong