JOSE CELSO ARDENGH
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
12 resultados
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bookPart Tumores neuroendócrinos gastroduodenais(2013) ARDENGH, José Celso- LAPAROSCOPIC UNCINATECTOMY: A MORE CONSERVATIVE APPROACH TO THE UNCINATE PROCESS OF THE PANCREAS(2017) SURJAN, Rodrigo Cañada; BASSERES, Tiago; MAKDISSI, Fabio Ferrari; MACHADO, Marcel Autran Cesar; ARDENGH, José CelsoABSTRACT Background: The isolate resection of the uncinate process of the pancreas is a rarely described procedure but is an adequate surgery to treat benign and low grade malignancies of the uncinate process of the pancreas. Aim: To detail laparoscopic uncinatectomy technique and present the initial results. Method: Patient is placed in supine position with the surgeon between legs. Three 5-mm, one 10-mm and one 12-mm trocars were used to perform the isolated resection of the uncinate process of the pancreas. Parenchymal transection is performed with harmonic scalpel. A hemostatic absorbable tissue is deployed over the area previously occupied by the uncinate process. A Waterman drain is placed. Result: This procedure was applied to an asymptomatic 62-year-old male with biopsy proven low grade neuroendocrine tumor of the pancreatic uncinate process. A laparoscopic pancreaticoduodenectomy was proposed. During the initial surgical evaluation, intraoperative sonography was performed and disclosed that the lesion was a few millimeters away from the Wirsung. The option was to perform a laparoscopic uncinatectomy. Postoperative period until full recovery was swift and uneventful. Conclusion: Laparoscopic uncinatectomy is a safe and efficient procedure when performed by surgical teams with large experience in minimally invasive biliopancreatic procedures.
conferenceObject PREDICTIVE FACTORS FOR EUS-GUIDED DRAINAGE OF PANCREATIC FLUID COLLECTIONS: A MULTICENTER INTERNATIONAL COLLABORATIVE STUDY COMPARING CYSTGASTROSTOMY TO CYSTODUODENOSTOMY(2023) TYBERG, Amy; SHAHID, Haroon; SARKAR, Avik; PATEL, Ankoor; BAIG, Muhammad; AGUON, Paul Muna; GAIDHANE, Monica; ABDELQADER, Abdelhai; GJEORGJIEVSKI, Mihajlo; MUHLGEIER, Brittany; SIMON, Alexa; VANELLA, Giuseppe; CUNTO, Domenica; ALCIVAR-VASQUEZ, Juan; GORNALS, Joan; KOWALSKI, Thomas; VEMULA, Sudheshna; CHIANG, Austin; KUMAR, Anand; BILELLO, Justin; SCHLACHTERMAN, Alexander; LOREN, David; ROBLES-MEDRANDA, Carlos; ARDENGH, Jose; ARCIDIACONO, Paolo; KAHALEH, Michel- II Brazilian consensus statement on endoscopic ultrasonography(2017) MALUF-FILHO, Fauze; OLIVEIRA, Joel Fernandez de; MENDONCA, Ernesto Quaresma; CARBONARI, Augusto; MACIENTE, Bruno Antonio; SALOMAO, Bruno Chaves; MEDRADO, Bruno Frederico; DOTTI, Carlos Marcelo; LOPES, Cesar Vivian; BRAGA, Claudia Utsch; DUTRA, Daniel Alencar M.; RETES, Felipe; NAKAO, Frank; SOUSA, Giovana Biasia de; PAULO, Gustavo Andrade de; ARDENGH, Jose Celso; SANTOS, Juliana Bonfim dos; SAMPAIO, Luciana Moura; OKAWA, Luciano; ROSSINI, Lucio; CARDOSO, Manoel Carlos de Brito; CAMUNHA, Marco Antonio Ribeiro; CLARENCIO, Marcos; SANTOS, Marcos Eduardo Lera dos; FRANCO, Matheus; SCHNEIDER, Nutianne Camargo; MASCARENHAS, Ramiro; RODA, Rodrigo; MATUGUMA, Sergio; GUARALDI, Simone; FIGUEIREDO, VivianeBackground and Objectives: At the time of its introduction in the early 80s, endoscopic ultrasonography (EUS) was indicated for diagnostic purposes. Recently, EUS has been employed to assist or to be the main platform of complex therapeutic interventions. Methods: From a series of relevant new topics in the literature and based on the need to complement the I Brazilian consensus on EUS, twenty experienced endosonographers identified and reviewed the pertinent literature in databases. The quality of evidence, strength of recommendations, and level of consensus were graded and voted on. Results: Consensus was reached for eight relevant topics: treatment of gastric varices, staging of nonsmall cell lung cancer, biliary drainage, tissue sampling of subepithelial lesions (SELs), treatment of pancreatic fluid collections, tissue sampling of pancreatic solid lesions, celiac neurolysis, and evaluation of the incidental pancreatic cysts. Conclusions: There is a high level of evidence for staging of nonsmall cell lung cancer; biopsy of SELs as the safest method; unilateral and bilateral injection techniques are equivalent for EUS-guided celiac neurolysis, and in patients with visible ganglia, celiac ganglia neurolysis appears to lead to better results. There is a moderate level of evidence for: yield of tissue sampling of pancreatic solid lesions is not influenced by the needle shape, gauge, or employed aspiration technique; EUS-guided and percutaneous biliary drainage present similar clinical success and adverse event rates; plastic and metallic stents are equivalent in the EUS-guided treatment of pancreatic pseudocyst. There is a low level of evidence in the routine use of EUS-guided treatment of gastric varices.
- Molecular Basis of Hyperammonemic Encephalopathy in Fibrolamellar Hepatocellular Carcinoma(2023) SURJAN, Rodrigo Canada T.; LIMA, Thais M. de; SOUZA, Heraldo P. de; MACHADO, Marcel Cerqueira C.; ARDENGH, Jose C.Hyperammonemic encephalopathy is a potentially fatal condition associated with fibrolamellar hepatocellular carcinoma. The mechanism involved in hyperammonemia in patients with fibrolamellar carcinoma was unclear until a possible physiopathological pathway was recently proposed. An ornithine transcarboxylase dysfunction was suggested as a result of increased ornithine decarboxylase activity induced by c-Myc overexpression. This c-Myc overexpression resulted from Aurora kinase A overexpression derived from the activity of a chimeric kinase that is the final transcript of a deletion in chromosome 19, common to all fibrolamellar carcinomas. We performed the analysis of the expression of all enzymes involved and tested for the mutation in chromosome 19 in fresh frozen samples of fibrolamellar hepatocellular carcinoma, non-tumor liver, and hepatic adenomatosis. The specific DNAJB-PRKACA fusion protein that results from the recurrent mutation on chromosome 19 common to all fibrolamellar carcinoma was detected only in the fibrolamellar carcinoma sample. Fibrolamellar carcinoma and adenomyomatosis samples presented increased expression of Aurora kinase A, c-MYC, and ornithine decarboxylase when compared to normal liver, while ornithine transcarbamylase was decreased. The proposed physiopathological pathway is correct and that overexpression of c-Myc may also be responsible for hyperammonemia in patients with other types of rapidly growing hepatomas. This gives further evidence to apply new and adequate treatment to this severe complication.
- Disseminated Kaposi Sarcoma Associated With Cytomegalovirus Proctitis in People Living With Human Immunodeficiency Virus (PLHIV): A Major Diagnostic Dilemma(2023) PORTELLA, Rodrigo; PONCE, Cesar Cilento; PATZINA, Rosely Antunes; ARDENGH, Jose C.; CALANCA, RichardKaposi sarcoma (KS) is a vascular tumor of low malignancy. Lesions may vary in shape, color, and size. Angiogenesis, spindle-shaped cells, and inflammatory infiltration are the main histologic features of the condition. Human herpesvirus-8 (HHV-8) infection and immune dysfunction play a key role in the development of KS. We report a case of a 40-year-old man with disseminated KS (DKS) who underwent an endoscopic examination. Colonoscopy revealed an ulcer in the anal canal. Biopsy and immunohistochemistry (IHC) confirmed the diagnosis of cytomegalovirus (CMV) proctitis, a rare and underreported pathology.
conferenceObject PREDICTIVE FACTORS FOR EUS-GUIDED DRAINAGE OF PANCREATIC FLUID COLLECTIONS: A MULTICENTER INTERNATIONAL COLLABORATIVE STUDY COMPARING CYSTGASTROSTOMY TO CYSTODUODENOSTOMY(2023) TYBERG, Amy; SHAHID, Haroon; SARKAR, Avik; PATEL, Ankoor; BAIG, Muhammad; AGUON, Paul Muna; GAIDHANE, Monica; ABDELQADER, Abdelhai; GJEORGJIEVSKI, Mihajlo; MUHLGEIER, Brittany; SIMON, Alexa; VANELLA, Giuseppe; CUNTO, Domenica; ALCIVAR-VASQUEZ, Juan; GORNALS, Joan; KOWALSKI, Thomas; VEMULA, Sudheshna; CHIANG, Austin; KUMAR, Anand; BILELLO, Justin; SCHLACHTERMAN, Alexander; LOREN, David; ROBLES-MEDRANDA, Carlos; ARDENGH, Jose; ARCIDIACONO, Paolo; KAHALEH, MichelconferenceObject RESECTABLE PANCREATIC NEUROENDOCRINE NEOPLASMS: CLINICOPATHOLOGICAL CHARACTERISTICS AND IMMUNOHISTOCHEMICAL CORRELATION(2017) NAVA, Carolin D.; COUDRY, Renata; MACHADO, Marcel C. C.; MEIRELLES, Luciana; GONCALVES, Marianne de Castro; PADUANI, Gabriela F.; CABRAL, Joao Guilherme G.; HYBNER, Luciano D.; ARDENGH, Jose Celso- EUS-guided pancreatic drainage: A steep learning curve(2020) TYBERG, Amy; BODIWALA, Vimal; KEDIA, Prashant; TARNASKY, Paul R.; KHAN, Muhammad Ali; NOVIKOV, Aleksey; GAIDHANE, Monica; ARDENGH, Jose Celso; KAHALEH, MichelBackground and Objective: EUS-guided pancreatic drainage (EUS-PD) is an efficacious, acceptable risk option for patients with pancreatic duct obstruction who fail conventional ERCP. The aim of this study was to define the learning curve (LC) for EUS-PD. Methods: Consecutive patients undergoing EUS-PD by a single operator were included from a dedicated registry. Demographics, procedural info, adverse events, and follow-up data were collected. Nonlinear regression and cumulative sum (CUSUM) analyses were conducted for the LC. Results: Fifty-six patients were included (54% of male, with a mean age of 58 years). Technical success was achieved in 47 patients (84%). Stent placement was antegrade in 36 patients (77%) and retrograde in 11 (23%). Clinical success was achieved in 46/47 (98%) patients who achieved technical success. Adverse events were seen in 13 patients (6 of whom did not achieve technical success) and included bleeding requiring embolization (n = 5), bleeding treated with clips peri-procedurally (n = 1), pancreatitis (n = 5), and a pancreatic fluid collection drained via EUS-drainage (n = 2). The median procedural time was 80 min (range 49-159 min). The CUSUM chart showed that 80-min procedural time was achieved at the 27th procedure. Durations further reduced 40th procedure onward, reaching a plateau indicating proficiency (nonlinear regression P < 0.0001). Conclusion: Endoscopists experienced in EUS-PD are expected to achieve a reduction in procedural time over successive cases, with efficiency reached at 80 min and a learning rate of 27 cases. Continued improvement is demonstrated with additional experience, with plateau indicating mastery suggested at the 40th case. EUS-PD is probably one of the hardest therapeutic endosonographic procedures to learn.
conferenceObject PATHOLOGICAL EVALUATION AND REPORTING OF INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS OF THE PANCREAS: THE CORRELATION AND ANALYZES OF THE HISPATHOTOLOGIC PATTERNS(2017) NAVA, Carolin D.; COUDRY, Renata; MACHADO, Marcel C. C.; MEIRELLES, Luciana; GONCALVES, Marianne de Castro; PADUANI, Gabriela F.; CABRAL, Joao Guilherme G.; HYBNER, Luciano D.; ARDENGH, Jose Celso