Roque Saenz

Ablation with argon plasma coagulator (APC) for barrett's esophagus

1. Horigome H, Nomura T, Saso K, et al. Artificial ascites method: Percutaneous treatments for hepatocellular carcinoma located just beneath the diaphragm. Am J Gastroenterol 2000;95: 2404–5. 2. Ohmoto K, Tsuzuki M, Yamamoto S. Percutaneous microwave coagulation therapy with intraperitoneal saline infusion for hepatocellular carcinoma in the hepatic dome. AJR Am J Roentgenol 1999;173:65–6. 3. Ohmoto K, Tsuduki M, Shibata N, et al. Percutaneous microwave coagulation therapy for hepatocellular carcinoma located on the surface of the liver. AJR Am J Roentgenol 1999;173: 1231–3. 4. Ohmoto K, Yamamoto S. Percutaneous microwave coagulation therapy for superficial hepatocellular carcinoma on the liver surface. Am J Gastroenterol 2000;95:2401–3. 5. Tabuse K, Katsumi M. Application of a microwave tissue coagulation to hepatic surgery. The hemostatic effects on spontaneous rupture of hepatoma and tumor necrosis. Arch Jpn Chir 1981;50:571–9.

Esfinterotomía pancreática: cuándo y cómo

Endoscopic pancreatic sphincterotomy (EPS) has fallen into disuse for some time because of the risk of severe complications. More recently, EPS has been advocated as an effective treatment modality for several pancreatic disorders, including severe chronic pancreatitis, pancreatic pseudocyst, ampulloma, pancreas divisum, and pancreatic sphincter dysfunction. Favorable outcomes in patients undergoing EPS to facilitate further interventions, in whom long-term follow-up was available, was 70%; complications occurred in 14% and reintervention was required in 23%. The results were as good as those of surgery after long-term follow-up. Patients who underwent some form of pancreatic drainage after sphincterotomy had fewer complications (p = 0.03). Approximately 75% of patients with pancreas divisum who presented with idiopathic acute recurrent pancreatitis improved after endoscopic therapy, but only 25% of patients experienced pain reduction of at least 50%. The National Institutes of Health Consensus recommends EPS in patients with type I sphincter of Oddi dysfunction (SOD). In patients with type II SOD, prior manometry should be performed. In our series of 17 patients, we obtained results similar to those of other studies, although the number of patients was small. EPS appears to be a safe and effective technique, but further, well-designed, multicenter, prospective and long-term studies are required to evaluate these results and settle current controversies.