P Carucci

Publications (19)53.48 Total impact

• Article: Negative predictive value of endoscopic ultrasound in patients referred for fine-needle aspiration.

  M Bruno, P Carucci, A Repici, R Pellicano, L Mezzabotta, M Goss, S Fagoonee, P Allegranza, D Reggio, M Rizzetto, C De Angelis
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  ABSTRACT: Endoscopic ultrasound (EUS) is a valuable diagnostic tool in pancreatic diseases and its high negative predictive value (NPV) in excluding malignancies is universally recognized. Moreover, EUS with fine-needle aspiration (EUS-FNA) can significantly impact on diagnosis and management of many clinical conditions. However, there are circumstances in which EUS-FNA cannot or should not be performed. We evaluated the factors that prevented us from performing or induced us not to perform FNA. The study was conducted in a tertiary university hospital. A total of 211 patients suspected of having solid pancreatic malignancy on the basis of clinical presentation and computed tomography and/or magnetic resonance imaging was included. When FNA was withheld because not deemed necessary by the operator, the NPV of EUS was calculated. In 9 patients (4.3% of the procedures), FNA was withheld because of contraindications that should have been foreseen by the referring physician. In 30 subjects, FNA was not accomplished as no lesions requiring biopsy were actually found at EUS exploration. In this group, EUS reached a NPV of 96.7% in excluding malignancy, but it reached 100% in patients without chronic pancreatitis. In a cohort of patients with high pre-test probability of malignancy, the high NPV of EUS was confirmed. False negative results should be expected in patients with chronic pancreatitis and they need a strict follow-up.
  Panminerva medica 09/2011; 53(3):179-83. · 1.11 Impact Factor
• Article: Analysis of cyst fluid obtained by endoscopic ultrasound-guided fine-needle aspiration supporting the diagnosis of a pancreatic neuroendocrine neoplasm.

  F Maletta, D Pacchioni, P Carucci, G Accinelli, M Bruno, F Brizzi, P Allegranza, M Rizzetto, G Bussolati, C De Angelis
  Endoscopy 01/2011; 43 Suppl 2 UCTN:E34-5. · 5.21 Impact Factor
• Article: Diagnosis of deep-seated lymphomas by endoscopic ultrasound-guided fine needle aspiration combined with flow cytometry.

  A Stacchini, P Carucci, D Pacchioni, G Accinelli, A Demurtas, S Aliberti, M Bosco, M Bruno, A Balbo Mussetto, M Rizzetto, G Bussolati, C De Angelis
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  ABSTRACT: Although endoscopic ultrasound combined with fine needle aspiration (EUS-FNA) is rapidly becoming the preferred diagnostic approach for the sampling and diagnosis of gastrointestinal and mediastinal malignancies, there are limited data as to its use in the diagnosis of lymphoproliferative disorders. Therefore, we carried out a retrospective evaluation of the performance of EUS-guided FNA combined with flow cytometry (FC) as a tool to improve overall sensitivity and specificity in the diagnosis of lymphoma. Of 1560 patients having EUS-guided FNA during the period of the study, a total of 56 patients were evaluated by cytology with FC after EUS-FNA. There was adequate material to perform FC analysis for all but one case. EUS-FNA-FC gave a diagnosis of lymphoma in 11 cases and of reactive lymphadenopathy in 20. A specific histological type was defined by FC alone in eight cases. The remaining cases were diagnosed later by cytology and cell block sections: 13 carcinomas, nine granulomatous lymphadenopathies and one mediastinal extramedullary haematopoiesis. One case was considered only suspicious for lymphoma on cytology and FC but was not confirmed on molecular analysis and one had insufficient material for FC. Our results show that a combination of EUS-FNA-FC is a feasible and highly accurate method, which may be used for the diagnosis and subtyping of deep-seated lymphoma, providing a significant improvement to cytomorphology alone both for diagnosis and treatment planning, as long as immunocytochemistry is available for non-lymphoma cases.
  Cytopathology 01/2011; 23(1):50-6. · 1.59 Impact Factor
• Article: Endoscopic ultrasound-guided fine needle aspiration diagnosis of extramedullary hematopoiesis in mediastinum.

  M Bosco, P Carucci, D Pacchioni, M Bruno, M Rizzetto, G Bussolati, C De Angelis
  Endoscopy 02/2009; 41 Suppl 2:E6-7. · 5.21 Impact Factor
• Article: Endoscopic ultrasonography in hepatology: focus on portal hypertension.

  C De Angelis, R Pellicano, P Carucci, M Bruno, A Repici, M Goss, S Fagoonee, G Saracco, M Rizzetto
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  ABSTRACT: Portal hypertension (PHT) is more frequently caused by cirrhosis. Increase in portal pressure induces development of collateral circulation with shunting resulting in disturbances such as gastroesophageal varices (GEV). Prevention and therapy of bleeding from GEV are mandatory. Therefore, the diagnosis of PHT represents a crucial step. Endoscopic ultrasound (EUS), with its combination of endoscopic imaging and ultrasonic capabilities, can offer an almost comprehensive evaluation of portal venous system and porto-systemic collateral circulation. The improved endoscopic view of several video-echoendoscopes has filled the gap between EUS and standard video-endoscopy in diagnosing GEV and in assessing endoscopic criteria of bleeding risk. EUS combined with Color-Doppler capabilities are able to provide hemodynamic information. Furthermore, EUS data allow to stratify patients on the basis of PHT severity and first bleeding risk, monitor the results of pharmacologic and/or endoscopic therapy, predict the response to treatment, quantify the risk of variceal recurrence and recurrent bleeding after GEV obliteration and guide or assist EGD therapy. Despite having this amount of information, there is lack of scientific evidence that EUS imaging and EUS-assisted therapy can have a clear-cut clinical impact and affect patients outcome.
  Minerva gastroenterologica e dietologica 07/2008; 54(2):131-9.
• Article: Instruments and accessories for diagnostic endoscopic ultrasound (radial scanning and miniprobes).

  C De Angelis, M Martini, A Repici, R Pellicano, M Goss, P Carucci, M Bruno, S Peyre, M Rissone, G Saracco, M Rizzetto
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  ABSTRACT: Endoscopic ultrasound (EUS) is a relatively new technology developed in the early 80's, but introduced into the clinical practice only in the late 80's. Nowadays there is an increase in demand for EUS examinations and services, because this technique is more and more recognized as an important and integral part in the diagnostic and staging algorithm of many gastrointestinal (GI) and nongastrointestinal pathologies. Even if today the EUS panorama enrich itself with a large number of different instruments, mechanical and electronic scopes, radial and linear ones, several types of miniprobes and specialty probes, for diagnostic purposes the dedicated radial scanning instruments remain the more adopted choice while miniprobes can have applications only in niche areas, like superficial GI cancers staging, small subepithelial lesions evaluation or intraductal ultrasound and some technological advances are needed to solve the potential drawbacks of this miniaturized probes. At last the EUS equipment borrowed most of the electronic sophistication from the mainstream ultrasonography, this made the choice of an EUS instrument even more difficult and challenging, but you must consider that there is no right or wrong equipment, there is only the right instrument for that specific clinical need or situation.
  Minerva medica 09/2007; 98(4):253-60. · 0.90 Impact Factor
• Article: Role of endoscopic ultrasound in biliary and unexplained pancreatitis.

  R Pellicano, A Repici, M Goss, P Carucci, R Rocca, M Bruno, S Peyre, G Saracco, S Fagoonee, M Rizzetto, C De Angelis
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  ABSTRACT: In the Western world, gallstone disease accounts for approximately half of the cases of acute pancreatitis. The benefit of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) has been clearly proven for this disease. On the basis of history, laboratory, and noninvasive imaging studies, about 10-30% of patients with acute pancreatitis have no apparent aetiology. This is critical because it limits the optimal therapeutic management and the prevention of recurrence. Endoscopic ultrasound (EUS) has emerged as an important procedure to clarify the aetiology of acute pancreatitis. After extensive investigation that included EUS, 8-20% of episodes remained idiopathic. Moreover, EUS carried minimal risk when compared to ERCP. The present short review attempts to update on the indications for the employment of EUS in the diagnosis of biliary stones as well as in the clarification of aetiology in the case of unexplained pancreatitis.
  Minerva medica 09/2007; 98(4):361-5. · 0.90 Impact Factor
• Article: Endoscopic ultrasound-fine needle aspiration (EUS-FNA) for pancreatic lesions: effectiveness in clinical practice.

  R Rocca, C De Angelis, M Daperno, P Carucci, N Ravarino, M Bruno, L Crocellà, A Lavagna, M Fracchia, D Pacchioni, G Masoero, C Rigazio, E Ercole, R Sostegni, M Motta, G Bussolati, B Torchio, M Rizzetto, A Pera
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  ABSTRACT: Diagnosis of pancreatic masses is often difficult. Endoscopic ultrasound-fine needle aspiration has been proposed as the best single-step strategy. To prospectively evaluate feasibility, effectiveness and safety of endoscopic ultrasound-fine needle aspiration of pancreatic masses in a consecutive study of unselected patients. Two hundred ninety-three patients were enrolled in two referral Hospitals in Northern Italy. All patients were referred either due to the presence of imaging test abnormalities (suspected or evident masses, or features indirectly suggesting the presence of a mass) or due to clinical or biochemical findings suggesting pancreatic cancer in the absence of positive imaging. All patients underwent linear array endoscopic ultrasound and, when indicated, fine needle aspiration. All procedures were recorded prospectively. The final diagnosis was established at the end of follow-up or when the patients underwent surgery or died. Fine needle aspiration was indicated in 246 of 293 cases (84%), considered technically feasible in 232 of 246 cases (94%) and gave adequate samples for histopathological diagnosis in 204 of 232 cases (88%). Endoscopic ultrasound sensitivity, specificity and accuracy were 79, 60 and 72%, respectively; the corresponding figures for endoscopic ultrasound-fine needle aspiration were 80, 86 and 82%. There was good agreement with final diagnosis for endoscopic ultrasound-fine needle aspiration (kappa 0.673, 95%CI 0.592-0.753), greater than that for endoscopic ultrasound alone (kappa 0.515, 95%CI 0.425-0.605). There was one case of intracystic haemorrhage and one case of transient hyperthermia (0.3%). Endoscopic ultrasound-fine needle aspiration of pancreatic masses seems to be feasible, effective and safe in this consecutive study of patients.
  Digestive and Liver Disease 09/2007; 39(8):768-74. · 3.05 Impact Factor
• Article: Multicentre retrospective study on endoscopic ultrasound complications.

  E Buscarini, C De Angelis, P G Arcidiacono, R Rocca, G Lupinacci, R Manta, P Carucci, A Repici, S Carrara, D Vallisa, L Buscarini, F Cosentino, A Pera, M Rizzetto, P A Testoni, A Zambelli
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  ABSTRACT: Endoscopic ultrasonography, both conventional and interventional, has been used increasingly during the past 20 years and is deemed a safe technique. Its complication rate, however, has been studied to only a limited extent. This multicentre investigation sought to establish the complication rate for a large number of endoscopic ultrasonography procedures. By means of a questionnaire, we collected data from six centres on the number of endoscopic ultrasonography examinations performed and divided them into conventional and interventional examinations of the upper and lower gastrointestinal tract. Information was obtained on technical modalities such as instruments and sedation and, for interventional endoscopic ultrasonography, indications, pre-procedural exams and technical details (needle calibre, number of passes) had to be specified. Complications were classified as mild, moderate, severe or fatal and their onset as immediate, early or late. Variables that entered into the analysis of complication rate included type of endoscopic ultrasonography instrument used, type and site of lesion biopsied, number of needle passes and operator experience. Eleven thousand five hundred thirty nine endoscopic ultrasonographic procedures were reported, of which 10,731 were conventional and 808 interventional. No deaths occurred; there were 14 (0.12%) complications, 5 (0.046%) of them following conventional endoscopic ultrasonography and 9 (1.11%) after interventional endoscopic ultrasonography. Seven complications were mild, four moderate and three severe. Both conventional and interventional endoscopic ultrasonography were confirmed to be acceptably safe techniques.
  Digestive and Liver Disease 11/2006; 38(10):762-7. · 3.05 Impact Factor
• Article: Emergency catheter probe endoscopic sonography (CP-EUS): an effective procedure in the assessment of a bleeding gangliocytic paraganglioma.

  P Carucci, N Leone, A Repici, P De Paolis, D Garabello, D Galliano, F Curri, M Rizzetto, C De Angelis
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  ABSTRACT: Catheter probe endoscopic sonography is a relatively rapid and safe procedure, carried out during standard endoscopy, capable of distinguishing solid from cystic lesions and vascular from avascular masses. Herein we discuss the role of catheter probe endoscopic sonography in the emergency assessment of a patient with recent and severe bleeding from an ulcerated polyp, arising from the papilla. During the endoscopy, catheter probe endoscopic sonography showed the solid and submucosal nature of the lesion, suggesting its localised and benign nature and, most importantly, demonstrating the high risk of rebleeding from vascular structures communicating with the ulcer. Because of this finding three metallic endoclips were positioned. The lesion was not removed endoscopically because of its difficult position and the high risk of haemorrhage. The mass, removed through a duodenotomy, was shown to be a gangliocytic paraganglioma, an uncommon tumour, frequently resulting in surgery because of abdominal pain and gastrointestinal bleeding.
  Digestive and Liver Disease 03/2006; 38(2):134-7. · 3.05 Impact Factor
• Article: Place de l’échoendoscople en Italie

  C. de Angelis, P. Carucci, A. Repici, A. Isabello, M. Rizzetto
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  ABSTRACT: L’échoendoscopie a fait ses débuts en Italie en 1981 grâce au travail d’un groupe de pionniers de l’Université de Bologne. A compter de cette date, l’échoendoscopie italienne a fait de considérables progrès en termes de technique et d’organisation tant sur le plan quantitatif que qualitatif, mais beaucoup de travail reste à faire surtout en ce qui concerne la ponction guidée sous écho-endoscopie (EUS-FNA) à visée diagnostique et thérapeutique. Dans ce domaine, une collaboration active entre le Groupe de Travail Italien pour l’échoendoscopie et les Clubs Français et Belge est largement souhaitable. Endoscopic Ultrasound in Italy started in 1981 thanks to the work of a pioneeristic group at the University of Bologna. In the following years endoscopic ultrasound in Italy has made good progress in terms of number of examinations, quality of the technique and organization, but a huge quantity of work still remains to be done particularly in the field of diagnostic and therapeutic EUS-FNA. For this purpose an active collaboration between the Italian Group of Work for Endosonography and the French and Belgian Clubs would really be highly desirable.
  Acta Endoscopica 01/2003; 33(1):162-169. · 0.09 Impact Factor
• Article: Adrenaline plus cyanoacrylate injection for treatment of bleeding peptic ulcers after failure of conventional endoscopic haemostasis.

  A Repici, A Ferrari, C De Angelis, S Caronna, C Barletti, S Paganin, A Musso, P Carucci, W Debernardi-Venon, M Rizzetto, G Saracco
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  ABSTRACT: Endoscopic therapy is a safe and effective method for treating non-variceal upper gastrointestinal bleeding. However failure of therapy, in terms of continuing bleeding or rebleeding, is seen in up to 20%. Cyanoacrylate is a tissue glue used for variceal bleeding that has occasionally been reported as an alternative haemostatic technique in non-variceal haemorrhage. To retrospectively describe personal experience using cyanoacrylate injection in the management of bleeding ulcers after failure of first-line endoscopic modalities. Between January 1995 and March 1998, 18 [12 M/6 F, mean age 68.1 years) out of 176 patients, referred to our Unit for non-variceal upper gastrointestinal bleeding, were treated with intralesional injection of adrenaline plus undiluted cyanoacrylate. Persistent bleeding after endoscopic haemostasis or early rebleeding were the indications for cyanoacrylate treatment. Definitive haemostasis was achieved in 17 out of 18 patients treated with cyanoacrylate. One patient needed surgery. No early or late rebleeding occurred during the follow-up. No complications or instrument lesions related to cyanoacrylate were recorded. In our retrospective series, cyanoacrylate plus adrenaline injection was found to be a potentially safe and effective alternative to endoscopic haemostasis when conventional treatment modalities fail in controlling bleeding from gastroduodenal ulcers.
  Digestive and Liver Disease 06/2002; 34(5):349-55. · 3.05 Impact Factor
• Article: Focal intrahepatic storage of oligomannosides mimicking a primitive liver neoplasm.

  F Brunello, N Leone, L Delsedime, M Gaido, P Carucci, M Rizzetto
  Journal of Hepatology 01/2002; 35(6):827. · 9.26 Impact Factor
• Article: Covered metal stents for management of inoperable malignant colorectal strictures.

  A Repici, D Reggio, C De Angelis, C Barletti, P Marchesa, A Musso, P Carucci, W Debernardi, M Falco, M Rizzetto, G Saracco
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  ABSTRACT: Metal stents have been reported as an effective alternative to surgery for the palliation of patients with colorectal neoplastic obstruction. Because most of the published series describe the use of uncovered stents, the purpose of our study was to prospectively evaluate the effectiveness, feasibility, safety, and outcome of covered stents for the palliative treatment of malignant colorectal strictures. Sixteen patients with advanced distal colorectal cancer underwent placement of 10 and 12 cm long, 23 mm diameter covered stents under fluoroscopic and endoscopic control. Clinical and endoscopic follow-up was scheduled at 3- to 6-week intervals. Stent insertion was successful in 15 of 16 patients (93%). Perforation occurred in one patient during stent placement requiring colostomy. Relief of bowel obstruction was documented in all successfully treated patients. The median follow-up was 21 weeks (range 1 to 46). No recurrence of obstruction was observed during the follow-up period. Stent migration occurred in 2 patients, 7 and 21 days after stent placement. Covered stents may provide safe and effective palliation of patients with malignant rectosigmoid strictures. Prolonged luminal patency and sealing of fistulous tracts are potential advantages of covered versus uncovered stents in the palliative treatment of colorectal malignancies. ¿
  Gastrointestinal Endoscopy 01/2001; 52(6):735-40. · 4.88 Impact Factor
• Article: Endosonography in decision making and management of gastrointestinal endocrine tumors.

  C De Angelis, P Carucci, A Repici, M Rizzetto
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  ABSTRACT: gastroenteropancreatic (GEP) neuroendocrine tumors, suspected on clinical basis, are often difficult to localize. We report our experience with endoscopic ultrasonography (EUS) in the preoperative localization of pancreatic endocrine tumors (PETs), compared to other imaging modalities, and in staging and following up carcinoid tumors (CTs) of the gastrointestinal (GI) wall. 50 patients (20 males; mean age 54 years), 39 with suspected PETs and 11 with GI CTs underwent EUS (Olympus GF-UM2 or GF-UM3). EUS data could be compared with resected specimens in 25 out of the 39 PETs and five out of the 11 CTs. in the PETs group 42 tumors (35<20 mm) were removed: 23 in the pancreas, eight in the duodenum, and 11 in the lymph nodes. EUS correctly localized 20 out of the 23 (87%) pancreatic tumors, included 11 out of the 12 (91.6%) insulinomas, three out of the eight (37.5%) duodenal gastrinomas, and ten out of the 11 (90.9%) metastatic lymph nodes. Furthermore EUS accurately evaluated the depth of parietal invasion of CTs in three out of four patients (75%) (two after and one prior to endoscopic resection). In three patients EUS was confirmed as normal on resected specimens (two pancreas and one stomach). In the PETs group, a correct localization was obtained by ultrasonography (US) only in 17.4% of cases, by computed tomography (CT) in 30.4%, by magnetic resonance imaging (MRI) in 25%, by angiography in 26.6%, and by somatostatin receptor scintigraphy in 15.4%. EUS must be considered the first-intention method in localizing PETs and is helpful in decision making and management of GEP endocrine tumors.
  European Journal of Ultrasound 11/1999; 10(2-3):139-50.
• Article: Epithelioid haemangioendothelioma of the liver: report of a case submitted to orthotopic liver transplantation.

  W Debernardi Venon, F Brunello, L Gubetta, B Lavezzo, P Gastaldi, P Pasquero, P Carucci, A Ciancio, A Marzano, M Salizzoni, M Rizzetto
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  ABSTRACT: A case of hepatic epithelioid haemangio-endothelioma is described in a 42-year-old female who presented with abdominal pain and hepatomegaly. The radiographic finding showed multiple hepatic lesions in both lobes. Diagnosis was based on the liver biopsy. The tumour cells were immunoreactive with factor VIII related antigen and vimentine. A liver transplantation was performed. Although at the time of diagnosis there was no clinical evidence of metastasis, the intra-operatorive examination revealed multiple mesenteric and pulmonary neoplastic nodules. The patient is alive and well seven months after liver transplantation.
  The Italian journal of gastroenterology 02/1996; 28(1):28-30.
• Article: Long-term response to interferon-alfa 2b re-treatment in chronic hepatitis C.

  G Saracco, F Rosina, M L Abate, P Carucci, A Solinas, L Chiandussi, F Bonino, G Verme, M Rizzetto
  Journal of Hepatology 09/1994; 21(2):278-9. · 9.26 Impact Factor
• Article: Serum glucose, insulin and C-peptide response to oral glucose after intravenous administration of hydrocortisone and methylprednisolone in man.

  A Bruno, P Carucci, M Cassader, P Cavallo-Perin, G Gruden, C Olivetti, G Pagano
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  ABSTRACT: Glucocorticoid-induced glucose intolerance and insulin resistance are dependent on the type of steroid, its dose and route of administration. Although the intravenous (i.v.) route is used mainly, the effects of different steroids have so far been compared using the oral route. The present study was therefore planned to compare the effects on glucose metabolism of hydrocortisone (HC) and methylprednisolone (MP) administered i.v. at equivalent antiinflammatory doses in healthy subjects. Eighteen healthy volunteers with normal glucose tolerance, divided into three groups (A,B,C) matched for age, sex and body mass index were subjected to oral glucose tolerance tests (oGTT) 12 h after HC or MP i.v. injection. The two tests were performed at a 1-month interval and in random sequence. Group A received low doses (HC 100 mg, MP 20 mg), group B intermediate doses (HC 200 mg, MP 40 mg) and group C high doses (HC 400 mg, MP 80 mg). Serum glucose, insulin and C-peptide were measured during both fasting and oGTT. Serum glucose values were not significantly different after HC or MP, during both fasting and oGTT. However, there was a positive correlation between fasting serum glucose or the area under the glucose curve and the dose.kg-1 body weight of HC (r = 0.748; r = 0.462) and MP (r = 0.708; r = 0.736). Serum insulin values were significantly higher after MP than after HC when fasting (A: 115 vs 223; B: 95 vs 215, C: 158 vs 268 pmol.l-1) and as area under the oGTT curve (A: 57.8 vs 87; B: 48.5 vs 92.1; C:57.8 vs 94.5 pmol.l-1 x 2 h).(ABSTRACT TRUNCATED AT 250 WORDS)
  European Journal of Clinical Pharmacology 02/1994; 46(5):411-5. · 2.85 Impact Factor
• Article: Multicentre retrospective study on endoscopic ultrasound complications

  E. Buscarini, C. De Angelis, P.G. Arcidiacono, R. Rocca, G. Lupinacci, R. Manta, P. Carucci, A. Repici, S. Carrara, D. Vallisa, L. Buscarini, F. Cosentino, A. Pera, M. Rizzetto, P.A. Testoni, A. Zambelli
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  ABSTRACT: BackgroundEndoscopic ultrasonography, both conventional and interventional, has been used increasingly during the past 20 years and is deemed a safe technique. Its complication rate, however, has been studied to only a limited extent. This multicentre investigation sought to establish the complication rate for a large number of endoscopic ultrasonography procedures.MethodsBy means of a questionnaire, we collected data from six centres on the number of endoscopic ultrasonography examinations performed and divided them into conventional and interventional examinations of the upper and lower gastrointestinal tract. Information was obtained on technical modalities such as instruments and sedation and, for interventional endoscopic ultrasonography, indications, pre-procedural exams and technical details (needle calibre, number of passes) had to be specified. Complications were classified as mild, moderate, severe or fatal and their onset as immediate, early or late. Variables that entered into the analysis of complication rate included type of endoscopic ultrasonography instrument used, type and site of lesion biopsied, number of needle passes and operator experience.ResultsEleven thousand five hundred thirty nine endoscopic ultrasonographic procedures were reported, of which 10,731 were conventional and 808 interventional. No deaths occurred; there were 14 (0.12%) complications, 5 (0.046%) of them following conventional endoscopic ultrasonography and 9 (1.11%) after interventional endoscopic ultrasonography. Seven complications were mild, four moderate and three severe.ConclusionsBoth conventional and interventional endoscopic ultrasonography were confirmed to be acceptably safe techniques.
  Digestive and Liver Disease.