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- 저자 : Damien Tan Meng Yew (검색결과 3 건)
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endoscopic Therapy in Chronic Pancreatitis
( Damien Meng Yew Tan ),( Stuart Sherman ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.4
Chronic pancreatitis (CP) is a debilitating disease that can result in chronic abdominal pain, malnutrition, and other related complications. The main aims of treatment are to control symptoms, prevent disease progression, and correct any complications. A multidisciplinary approach involving medical, endoscopic, and surgical therapy is important. Endoscopic therapy plays a specific role in carefully selected patients as primary interventional therapy when medical measures fail or in patients who are not suitable for surgery. Endoscopic therapy is also used as a bridge to surgery or as a means to assess the potential response to pancreatic surgery. This review addresses the role of endoscopic therapy in relief of obstruction of the pancreatic duct (PD) and bile du ct, closure of PD leaks, and drainage of pseudocysts in CP. The role of endoscopic ultrasound-guided celiac plexus block for pain in chronic pancreatitis is also discussed.
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Yung Ka Chin,Clement Chun Ho Wu,Damien Meng Yew Tan 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.1
The prevalence of pancreatic cystic lesions (PCLs) has increased recently due to the increased use of cross-sectional abdominalimaging and the ageing global population. Current diagnostic techniques are inadequate to distinguish between PCLs thatrequire surgery, close surveillance, or expectant management. This has resulted in increased morbidity from both inappropriatelyaggressive and conservative management strategies. Needle-based confocal laser endomicroscopy (nCLE) has allowed microscopicexamination and visual delineation of the surface epithelium of PCLs. Landmark studies in this decade have correlated nCLE andhistological findings and identified characteristics differentiating various types of PCLs. Subsequent studies have confirmed thehigh diagnostic yield of nCLE and its diagnostic utility in PCLs with an equivocal diagnosis. Moreover, nCLE has been shown toimprove the diagnostic yield of PCLs. This will help avoid unnecessary pancreatic surgery, which carries significant morbidity andmortality risks. The early detection of high-grade dysplasia in PCLs will provide early surgical treatment and improve outcomes forpancreatic cancer. Despite the high upfront cost of nCLE, the improved diagnostic accuracy and resultant appropriate managementhave resulted in improved cost effectiveness. Refining the procedure technique and limiting the procedure length have significantlyimproved the safety of nCLE. A structured training program and device improvements to allow more complete mapping of thepancreatic cyst epithelium will be crucial for the widespread adoption of this promising technology.
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Shivakumar Vignesh,Amna Subhan Butt,Mohamed Alboraie,Bruno Costa Martins,Alejandro Piscoya,Quang Trung Tran,Damien Tan Meng Yew,Shahriyar Ghazanfar,Pezhman Alavinejad,Edna Kamau,Ajay M Verma,Robin B M 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5
Background/Aims: The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical traineesinternationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective ofendoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education. Methods: Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-basedsurvey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopytraining, including what factors decisions were based on. Results: The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training,with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with Europeanprograms reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americaswere allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support forendoscopy teaching. Conclusions: This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopytraining internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competenciesare necessary to ensure adequate endoscopy training.
KCI
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