Papers by Guido Costamagna
World journal of gastroenterology : WJG, Jan 7, 2014
Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also aff... more Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also affected by a small, but definite, risk of major complications (cardiopulmonary complications, perforation, hemorrhage) and even mortality. To improve both acceptability and safety, PillCam Colon Capsule Endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) has been developed. CCE represents a non-invasive technique that is able to explore the colon without sedation and air insufflation. The Second Generation of Colon Capsule Endoscopy (PillCam Colon 2) (CCE-2) was proven to be an accurate tool to detect colonic neoplastic lesions when used in average risk individuals. To date, the evidence supports the use of CCE-2 in case of colonoscopy failure, in patients unwilling to perform colonoscopy and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease need to be clarified. In this paper, th...
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Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology, 2014
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Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology, 2013
Endoscopy is a widely used approach for the treatment of benign biliary strictures. Most common b... more Endoscopy is a widely used approach for the treatment of benign biliary strictures. Most common benign biliary strictures amandable to endoscopic treatment are post-cholecystectomy, dominant biliary strictures due to primary sclerosing cholangitis, biliary anastomotic strictures occurring after liver transplantation, and common bile duct strictures due to chronic pancreatitis. Surgery is a valid option in cases of complete transection or ligation of the common bile duct, in selected patients with benign strictures related to chronic pancreatitis, and in noncompliant patients. In any case, even in these patients, endoscopy should always be attempted, because it is safe and repeatable. Endoscopic treatment consists of passing the stricture and placement of at least one large bore plastic stent, followed by further sessions of stenting with multiple plastic stents. Temporary placement of multiple plastic stents is the recommended approach in patients with benign biliary strictures. Sel...
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... GASBARRINI Antonio ; DI CARO Simona ; MUTIGNANI Massimiliano ; CAMMAROTA Giovanni ; FINI Luci... more ... GASBARRINI Antonio ; DI CARO Simona ; MUTIGNANI Massimiliano ; CAMMAROTA Giovanni ; FINI Lucia ; PACELLI Fabio ; POLA Paolo ; DOGLIETTO Giovanni ; COSTAMAGNA Guido ; GASBARRINI Giovanni ; ... Gastrointestinal endoscopy ISSN 0016-5107 CODEN GAENBQ ...
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Abdominal …, 1989
Twenty-nine patients with symptomatic hydatid disease of the liver were evaluated preoperatively ... more Twenty-nine patients with symptomatic hydatid disease of the liver were evaluated preoperatively by endoscopic retrograde cholangiopancreatography (ERCP) in the years 1982-1987. In the same period, 6 patients who previously underwent surgery for the parasitic disease also underwent ERCP because of postoperative symptoms of biliary obstruction. Findings at ERCP excluded biliary tract involvement in 11 cases. Positive findings were shown in 24 patients, including compression of the bile ducts in 4, small cysto-biliary communications in 5, intrabiliary rupture in 9, residual hydatid material in the common bile duct, and sclerosing cholangitis in 3. Endoscopic removal of migrated hydatid debris was achieved in 8 patients, avoiding reoperation in 4.
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The American journal …, 2008
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The aim of the study was to compare two steerable endoscopic retrograde cholangiopancreatography ... more The aim of the study was to compare two steerable endoscopic retrograde cholangiopancreatography (ERCP) catheters with regard to speed and safety in cannulating the common bile duct. A standard cannula, a short-nosed sphincterotome, and a bendable catheter were used. At two tertiary centres, a total of 312 patients were randomly assigned to receive treatment with one of three catheters and either by a trainee or an expert endoscopist. When cannulation failed, a further attempt was made with a different catheter. If this failed, a change in operator or other manoeuvres followed. The following were assessed: time to cholangiography and deep cannulation, number of attempts and success rates of cannulation, number of pancreatic duct injections, success of catheter cross-over, and complication rates. Both steerable catheters were significantly better for the initial cholangiogram than the standard catheter (standard catheter 75 %, bendable catheter 84 %, sphincterotome 88 %; P = 0.038), with no significant differences between the bendable catheter and the sphincterotome. Both were also better for deep cannulation of the bile duct (standard cannula 66 %, bendable catheter 69 %, sphincterotome 78 %; P = 0.15). When the standard catheter failed, a steerable catheter succeeded in 26 % of cases. Trainees experienced greater benefit from using steerable catheters. For experts, the bendable catheter was the quickest to achieve cholangiography and deep cannulation. Further manoeuvres had an 85-90 % success rate in allowing biliary access. Twenty of 23 needle-knife papillotomies (87 %) were successful when other methods had failed. The overall ERCP success rate was 97 %. Pancreatitis occurred in 5.3 % of cases. Steerable catheters allow faster access and can succeed when a standard catheter fails. If cannulation is difficult, changing the catheter should be considered at an early stage. Needle-knife papillotomy is a successful technique in expert hands.
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Pancreas, 2009
From the *Division of Gastroenterology/Hepatology, Indiana University Medical Center, Indianapoli... more From the *Division of Gastroenterology/Hepatology, Indiana University Medical Center, Indianapolis, IN; †Department of Surgery, Catholic University, Rome, Italy; ‡California Pacific Medical Center, San Francisco, CA; §Department of Internal Medicine IV, Medical ...
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Gastrointestinal …, 2002
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… endoscopy clinics of North …, 2003
1. Gastrointest Endosc Clin N Am. 2003 Oct;13(4):635-48, ix. Current management of postoperative ... more 1. Gastrointest Endosc Clin N Am. 2003 Oct;13(4):635-48, ix. Current management of postoperative complications and benign biliary strictures. Costamagna G, Shah SK, Tringali A. Department of Surgery, Catholic University, Rome, Italy. ...
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World Journal of …, 2008
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Endoscopy
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Endoscopy, Jan 2, 2015
Background and study aim: Endoscopic retrograde cholangiopancreatography (ERCP) is difficult in p... more Background and study aim: Endoscopic retrograde cholangiopancreatography (ERCP) is difficult in patients with altered anatomy following Billroth II gastrectomy. Afferent loop intubation, selective cannulation, and sphincterotomy are the main issues. Experience from a tertiary referral endoscopy center is reported. Patients and methods: A total of 713 patients with Billroth II reconstruction who underwent ERCP between October 1982 and October 2012 were retrospectively identified from a prospectively collected database (mean age 69 ± 27 years; 567 males). The main indications for ERCP were common bile duct stones (51.2 %) and obstructive jaundice (24.8 %). Procedures were always started with a duodenoscope; in cases of failure to reach the papilla the duodenoscope was changed to a gastroscope. Endoscopic sphincterotomy was performed using a long-nose sigmoid inverted sphincterotome. Results: The successful duodenal intubation rate was 86.7 % (618/713 patients). The main reason for int...
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Annali italiani di chirurgia
Early Gastric Cancer (EGC) is defined as a neoplasm confined to the mucosa or submucosa regardles... more Early Gastric Cancer (EGC) is defined as a neoplasm confined to the mucosa or submucosa regardless of regional lymph node metastasis. The rate of EGC, which varies by country, is up to 40-60% of all gastric cancer cases in Japan, whilst in Western countries, the proportion remains at 5-10%. There is a strong male predominance in EGC. The average 5-year survival rate of patients with EGC reached over 90% in Japanese and European data. Many EGC patients present with symptoms suggestive of a benign gastric ulcers. The combination of serum pepsinogen and Helicobacter pylori status may provide even more sensitive information for screening. However high-quality endoscopic evaluation with biopsy is the key to diagnosis. To improve the quality of observation several endoscopic imaging modalities have been developed for the diagnosis of early gastric cancer. Endoscopic resection is a viable alternative to surgery for curative treatment of EGC, with similar long term results. Endoscopic mucos...
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Revista de gastroenterologĂa de MĂ©xico, 2005
Endoscopic retrograde cholangiopancreatography (ERCP) plays a first role both in the diagnosis an... more Endoscopic retrograde cholangiopancreatography (ERCP) plays a first role both in the diagnosis and treatment of postoperative biliary leaks as well as of benign strictures. The goal of the endoscopic treatment of biliary leaks is the elimination of the transpapillary pressure gradient, but the choice of the best approach remains to be established. ES should be sufficient to treat the leaks without an associated lesion of the extrahepatic bile ducts. In these cases, placement of a NBD for two to three days has the advantage to allow checking the healing. Placement of a plastic stent is indicated for leaks of the main ducts to remodel the healing process and try to prevent the development of strictures. An endoscopic attempt should be also considered in severely injured bile ducts especially in those cases unfit for surgery. Benign biliary strictures have been traditionally treated by surgical repair but today endoscopy represents the preferred treatment since the stricture can be com...
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Gastrointestinal Endoscopy Clinics of North America, 2015
Colon capsule endoscopy (CCE) is a minimally invasive technique specifically designed to explore ... more Colon capsule endoscopy (CCE) is a minimally invasive technique specifically designed to explore the colon without sedation and air insufflation. CCE may overcome some of the limitations of colonoscopy. Second-generation CCE (CCE-2) was proved accurate in detecting colonic neoplastic lesions when used in average-risk individuals. The evidence to date supports the use of CCE-2 in cases of colonoscopy failure, in patients unwilling to undergo colonoscopy, and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease, require clarification.
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Papers by Guido Costamagna