EVERSON LUIZ DE ALMEIDA ARTIFON

(Fonte: Lattes)
Índice h a partir de 2011
21
Lattes
Projetos de Pesquisa
Unidades Organizacionais
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder

Filtros

Mostrar mais
Limpar filtros

Configurações

search.filters.applied.f.dateIssued: 2018 × Assunto: Gastroenterology & Hepatology ×

Resultados de Busca

Agora exibindo 1 - 10 de 13
  • conferenceObject
    EUS-FNA OF PANCREATIC SOLID MASSES: A PROSPECTIVE RANDOMIZED TRIAL COMPARING SUCTION WITH SLOW PULL
    (2018) CHENG, Spencer; DANIELLE, Chacon A.; ARTIFON, Everson L.; MATUGUMA, Sergio E.; SANTOS, Marcos E. dos; SAKAI, Christiano M.; CHAVES, Dalton; MOURA, Diogo T. De; MOURA, Eduardo T.
  • article 0 Citação(ões) na Scopus
    Rendez-Vous laparoendoscopic after ERCP failure in patient with Billroth II gastrectomy
    (2018) KREVE, Fernanda; LOSS, Francisco S; GATTO, Janaina; TAKADA, Jonas; DANTAS, Juliana; INOUE, Karina; JACOMO, Alfredo L; ARTIFON, Everson L.A
    Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice in patients with choledocholithiasis. However, despite its high success rate, in some cases it is not successful, requiring alternative therapy. Billroth II partial gastrectomy is a condition associated with an important failure rate of ERCP. When endoscopic treatment fails, surgical exploration of the bile duct is the most common approach. However, the surgery is related to a greater complexity of execution and morbimortality. We describe the case of a patient with choledocholithiasis and Billroth II partial gastrectomy, submitted to the combined treatment called rendez-vous laparoendoscopic, after failure of ERCP, which unites in a single stage the endoscopic treatment of choledocholithiasis and laparoscopic removal of the gallbladder. We conclude that this therapeutic approach was effective, safe, with low cost and without complications.
  • article 74 Citação(ões) na Scopus
    Endoscopic retrograde cholangiopancreatography versus endoscopic ultrasound for tissue diagnosis of malignant biliary stricture: Systematic review and meta-analysis
    (2018) MOURA, Diogo Turiani Hourneaux De; MOURA, Eduardo Guimaraes Hourneaux De; BERNARDO, Wanderlei Marques; MOURA, Eduardo Turiani Hourneaux De; BARACAT, Felipe I.; KONDO, Andre; MATUGUMA, Sergio Eijii; ARTIFON, Everson Luis Almeida
    Background and Aims: There are no systematic reviews comparing the use of endoscopic retrograde cholangiopancreatography (ERCP)-based brush cytology and forceps biopsy and endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) for the diagnosis of malignant biliary stricture; so in this revision, we will compare ERCP against EUS-FNA for tissue diagnosis of malignant biliary stricture. Design: A systematic review was conducted of comparative studies (prospective or retrospective) analyzing EUS and ERCP for tissue diagnosis of malignant biliary stricture. Materials and Methods: The databases Medline, EMBASE, Cochrane, LILACS, CINAHL, and Scopus were searched for studies dated previous to November 2014. We identified three prospective studies comparing EUS-FNA and ERCP for the diagnosis of malignant biliary stricture and five prospective studies comparing EUS-FNA with the same diagnosis of the other three studies. All patients were subjected to the same gold standard method. We calculated study variables (sensitivity, specificity, prevalence, positive and negative predictive values, and accuracy) and performed a meta-analysis using the Review Manager (RevMan) 5.3 software. Results: A total of 294 patients were included in the analysis. The pretest probability for malignant biliary stricture was 76.66%. The mean sensitivities of ERCP and EUS-FNA for tissue diagnosis of malignant biliary stricture were 49% and 75%, respectively; the specificities were 96.33% and 100%, respectively. The posttest probabilities positive predictive value (98.33% and 100%, respectively) and negative predictive value (34% and 47%, respectively) were determined. The accuracies were 60.66% and 79%, respectively. Conclusion: We found that EUS-FNA was superior to ERCP with brush cytology and forceps biopsy for diagnosing malignant biliary strictures. However, a negative EUS-FNA or ERCP test may not exclude malignant biliary stricture because both have low negative posttest probabilities.
  • article 11 Citação(ões) na Scopus
    Papillary fistulotomy vs conventional cannulation for endoscopic biliary access: A prospective randomized trial
    (2018) FURUYA, Carlos Kiyoshi; SAKAI, Paulo; MARINHO, Fabio Ramalho Tavares; OTOCH, Jose Pinhata; CHENG, Spencer; PRUDENCIO, Livia Lemes; MOURA, Eduardo Guimaraes Hourneaux de; ARTIFON, Everson Luiz de Almeida
    AIM To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access. METHODS From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire (Group.) and papillary fistulotomy (Group.). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications (pancreatitis, bleeding, perforation) were recorded. RESULTS We included 102 patients (66 females and 36 males, mean age 59.11 +/- 18.7 years). Group. and Group. had 51 patients each. The successful cannulation rates were 76.5% and 100%, respectively (P = 0.0002). Twelve patients (23.5%) in Group. had a difficult cannulation and underwent fistulotomy, which led to successful secondary biliary access (Failure Group). The complication rate was 13.7% (2 perforations and 5 mild pancreatitis) vs 2.0% (1 patient with perforation and pancreatitis) in Groups. and., respectively (P = 0.0597). CONCLUSION Papillary fistulotomy was more effective than guidewire cannulation, and it was associated with a lower profile of amylase and lipase. Complications were similar in both groups.
  • article
    EUS-FNA versus ERCP for tissue diagnosis of suspect malignant biliary strictures: a prospective comparative study
    (2018) MOURA, Diogo Turiani Hourneaux; GUIDAMARAES, Eduardo; MOURA, Hourneaux de; MATUGUMA, Sergio Eiji; SANTOS, Marcos Eduardo dos; MOURA, Eduardo Turiani Hourneaux; BARACAT, Felipe Iankelevich; ARTIFON, Everson L. A.; CHENG, Spencer; BERNARDO, Wanderley Marque; CHACON, Danielle; TANIGAWA, Ryan; JUKEMURA, Jose
    Background and study aims Biliary strictures are frequently a challenging clinical scenario and the anatomopathological diagnosis is essential in the therapeutic management, whether for curative or palliative purposes. The acquisition of specimens is necessary since many benign diseases mimic biliopancreatic neoplasms. Endscopic retrograde cholangiopancreatography (ERCP) is the traditionally used method despite the low sensitivity of biliary brush cytology and forceps biopsy. On the other hand, several studies reported good accuracy rates using endoscopic ultrasound- guided fine-needle aspiration (EUS-FNA). The aim of this prospective study was to compare, the accuracy of EUS-FNA and ERCP for tissue sampling of biliary strictures. Patients and methods After performing the sample size calculation, 50 consecutive patients with indeterminate biliary strictures were included to undergo ERCP and EUS on the same sedation. The gold-standard was surgery or 6 months' follow-up. Evaluation of the diagnostic indices (sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio), concordance and adverse events among the methods were performed. Also, subtype analyses of the techniques, anatomical localization and size of the lesion were included. Results The final diagnoses reported in 50 patients were 47 malignant, 1 suspicious and 2 benign lesions. 31 lesions were extraductal and 19 intraductal, 35 were distal and 15 proximal strictures. In the intention-to-treat analysis, the sensitivity and accuracy of EUS-FNA were superior than ERCP tissue sampling (93,8%, 94% vs. 60,4%, 62%, respectively) (P = 0.034), with similar adverse events. There was no concordance between the methods and combining both methods improved the sensitivity and accuracy for 97.9% and 98%, respectively. In the subtype analyses, the EUS-FNA was superior, with a higher accuracy than ERCP tissue sampling in evaluating extraductal lesions (100% vs. 54.8 %, P = 0.019) and in those larger than 1.5 cm (95.8% vs. 61.9%, P = 0.031), but were similar in evaluating intraductal lesions and lesions smaller than 1.5 cm. There was no significant difference between the methods in the analyzes of proximal, distal and pancreatic lesions. Conclusion EUS-FNA is better than ERCP with brush cytology and intraductal forceps biopsy in diagnosing malignant biliary strictures, mainly in the assessment of extraductal lesions and in those larger than 1.5 cm. Combining ERCP with tissue sampling and EUS-FNA is feasible, the techniques have similar complication rates, and the combination greatly improves diagnostic accuracy.
  • article 75 Citação(ões) na Scopus
    EUS-guided Choledochoduodenostomy Versus Hepaticogastrostomy A Systematic Review and Meta-analysis
    (2018) UEMURA, Ricardo S.; KHAN, Muhammad Ali; OTOCH, Jose P.; KAHALEH, Michel; MONTERO, Edna F.; ARTIFON, Everson L. A.
    Background and Aims: Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as an alternative in cases of endoscopic retrograde cholangiopancreatography (ERCP) failure. Two types of EUS-BD methods for achieving biliary drainage when ERCP fails are choledochoduodenostomy (CDS) or hepaticogastrostomy (HGS). However, there is no consensus if one approach is better than the other. Therefore, we conducted a systematic review and meta-analysis to evaluate these 2 main EUS-BD methods. Methods: We searched MEDLINE, Embase, Scopus, Cochrane database, LILACS from inception through April 8, 2017, using the following search terms in various combinations: biliary drainage, biliary stent, transluminal biliary drainage, choledochoduodenostomy, hepaticogastrostomy, endoscopic ultrasound-guided biliary drainage. We selected studies comparing CDS and HGS in patients with malignant biliary obstruction with ERCP failure. Pooled odds ratio (OR) were calculated for technical success, clinical success, and adverse events and difference of means calculated for duration of procedure and survival after procedure. Results: A total of 10 studies with 434 patients were included in the meta-analysis: 208 underwent biliary drainage via HGS and the remaining 226 via CDS. The technical success for CDS and HGS was 94.1% and 93.7%, respectively, pooled OR = 0.96 [95% confidence interval (CI) = 0.39-2.33, I-2 = 0%]. Clinical success was 88.5% in CDS and 84.5% in HGS, pooled OR = 0.76 (95% CI = 0.42-1.35, I-2 = 17%). There was no difference for adverse events OR = 0.97 (95% CI = 0.60-1.56), I-2 = 37%. CDS was about 2 minutes faster with a pooled difference in means of was -2.69 (95% CI = -4.44 to -0.95). Conclusion: EUS-CDS and EUS-HGS have equal efficacy and safety, and are both associated with a very high technical and clinical success. The choice of approach may be selected based on patient anatomy.
  • conferenceObject
    CONVENTIONAL CANNULATION OR PAPILLARY FISTULOTOMY: A PROSPECTIVE RANDOMIZED TRIAL
    (2018) FURUYA, Carlos K.; MARINHO, Fabio R.; CHENG, Spencer; SAKAI, Paulo; ARTIFON, Everson L.
  • article 50 Citação(ões) na Scopus
    A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction
    (2018) GUO, Jintao; GIOVANNINI, Marc; V, Anand Sahai; SAFTOIU, Adrian; DIETRICH, Christoph F.; SANTO, Erwin; FUSAROLI, Pietro; SIDDIQUI, Ali A.; BHUTANI, Manoop S.; TEOH, Anthony Yuen Bun; IRISAWA, Atsushi; ARIAS, Brenda Lucia Arturo; ACHANTA, Chalapathi Rao; JENSSEN, Christian; SEO, Dong-Wan; ADLER, Douglas G.; KALAITZAKIS, Evangelos; ARTIFON, Everson; ITOKAWA, Fumihide; POLEY, Jan Werner; MISHRA, Girish; HO, Khek Yu; WANG, Hsiu-Po; OKASHA, Hussein Hassan; LACHTER, Jesse; VILA, Juan J.; IGLESIAS-GARCIA, Julio; YAMAO, Kenji; YASUDA, Kenjiro; KUBOTA, Kensuke; PALAZZO, Laurent; SABBAGH, Luis Carlos; SHARMA, Malay; KIDA, Mitsuhiro; EL-NADY, Mohamed; NGUYEN, Nam Q.; VILMANN, Peter; GARG, Pramod Kumar; RAI, Praveer; MUKAI, Shuntaro; CARRARA, Silvia; PARUPUDI, Sreeram; SRIDHAR, Subbaramiah; LAKHTAKIA, Sundeep; RANA, Surinder S.; OGURA, Takeshi; BARON, Todd H.; DHIR, Vinay; SUN, Siyu
    Background and Objectives: EUS-guided biliary drainage (EUS-BD) w as shown to be useful for malignant bill obstruction (MBO). However. there is lack of consensus on how EUS-BD should be performed. Methods: This was a worldivide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD. Results; Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stewing technique should be the first choice. Self-expandable metal steins (SEMSs) mere recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach. longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach. 6-cm SEMS was recommended. During the intrahepatic (IH) approach. the IH segment 3 eras recommended. Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice. and randomized studies arc urgently needed to establish the best approach for the management of this condition.
  • article 12 Citação(ões) na Scopus
    EUS-FNA WITH 19 OR 22 GAUGES NEEDLES FOR GASTRIC SUBEPITHELIAL LESIONS OF THE MUSCLE LAYER
    (2018) LOPES, Cesar Vivian; HARTMANN, Antonio Atalibio; ARTIFON, Everson Luiz de Almeida
    Background: Tissue diagnosis is required for gastric subepithelial lesions for differential diagnosis of GISTs. However, there has not been consensus about the best needle for EUS-guided sampling of these lesions. Aim: To evaluate the diagnostic yield of EUS-FNA for gastric subepithelial lesions of the proper muscle layer with large-bore 19 gauge needles. Methods: A prospectively maintained database was retrospectively reviewed to identify consecutive patients who underwent EUS-FNA with 19 and 22 gauge needles for gastric subepithelial lesions of the fourth endosonographic layer in a tertiary care referral center. EUS-FNA was performed by the same endosonographer, using the fanning technique, without on-site cytopathologist. Specimens were analysed through cell blocks by the same pathologist. Procedure results were categorized into diagnostic, defined as enough material for histopathology and immunohistochemistry, or nondiagnostic. Results: Eighty-nine patients (mean age: 59 years, 77% women) underwent 92 EUS-FNA with 19 (75) or 22 (17) gauge needles. Mean lesion size was 22.6 mm. Overall diagnostic yield was 88%. The diagnostic yield of 19 gauge was higher than that of 22 gauge needle (92%x70.6%; p=0.0410), and similar for lesions >2 cm and <= 2 cm (93.7%x90.7%; p=0.9563). The best performance for 19 gauge needles was obtained performing <3 needle passes. Complication rate was 2.8%. Conclusions: Diagnostic yield of EUS-FNA with 19 gauge needles is 92% for gastric subepithelial lesions of the proper muscle layer. It is safe and highly valuable for differentiation between GIST and leiomyoma, no matter the size of the lesion.
  • article 1 Citação(ões) na Scopus
    Upper gastrointestinal endoscopy applied in pediatrics: endoscopic and histological findings, including Helicobacter pylori
    (2018) SOARES COCA, Diego; SANTOS, Carolina Manna; OLIVEIRA, Osmar Silvio Garcia de; PEREIRA, Dayse Aparício; FURUYA JÚNIOR, Carlos Kiyoshi; ARTIFON, Everson L.A.
    Objective: To present and discuss the endoscopic and histological results, as well as the incidence of Helicobacter pylori and other diseases, indications and characteristics of upper digestive endoscopies performed in children. Material and methods: Twenty-five endoscopies were performed in children aged six months to 11 years (mean 7.69 years), from February 2013 to January 2016. In 200 patients, endoscopies were diagnostic and serial biopsies were performed (esophagus, stomach and duodenum), in 120 of them. Results: The indication of endoscopy was diagnosed in 88.89% of the patients, and in 26 patients, a therapeutic procedure was performed. The most frequent endoscopic findings were esophagitis in 49 patients, gastritis in 84 and duodenitis in 16 patients. Four duodenal ulcers were diagnosed. In the therapeutic endoscopies, six gastrostomies were performed, 14 foreign body withdrawals, five nasoenteral tube passages and esophageal dilatation. The H. pylori survey was performed by anatomopathological method and was positive in 26 (13%) of the 200 patients in whom it was searched. Conclusion: pediatric endoscopy is an important niche of the digestive endoscopy, where it is important to emphasize the relevance of the institutional structure that performs these procedures, in order to conduct them safely, being able to treat possible and feasible complications