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Salin G, Corpechot C, Ouazana S, Dong C, Becq A, Lemoinne S, Ben Belkacem K, Leenhardt R, Chaput U, Chazouillères O, Kirchgesner J, Camus M. Endoscopic features of low-phospholipid-associated cholelithiasis syndrome: A retrospective cohort study. Clin Res Hepatol Gastroenterol 2024; 48:102324. [PMID: 38527568 DOI: 10.1016/j.clinre.2024.102324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/17/2024] [Accepted: 03/23/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND AND OBJECTIVE LPAC (low phospholipid-associated cholelithiasis) syndrome is a rare genetic form of cholelithiasis. ERCP (endoscopic retrograde cholangiopancreatography) is often used to remove gallstones in the bile duct. No published data is available on the role of ERCP in LPAC syndrome. PATIENTS AND METHODS In this retrospective cohort study, we included patients diagnosed with LPAC syndrome in a single tertiary referral center between 2009 and 2021. Our aim was to assess the frequency, indications, modalities, results, and complications of ERCP, as well as predictive factors for ERCP, in LPAC syndrome. Independent factors associated with ERCP occurrence were identified using a multivariable Cox regression analysis. RESULTS ERCP was required in 31.2 % of the 269 patients included for analysis. Among patients who required ERCPs, 78.6 % had the procedure before diagnosis (i.e., starting UDCA). Most common indications were choledocholithiasis (53.6 %) and acute cholangitis (29.5 %). Post ERCP pancreatitis, perforation and bleeding rates were 7.2 %, 2.6 %, and 1.3 %, respectively. Age and history of cholelithiasis in first-degree relatives were associated with a higher risk of ERCP (Hazard-ratio [HR]=1.30 [95 %confidence-interval [CI] 1.04-1.62] and HR=1.88 [95 %CI 1.15-3.07] respectively). Female gender and UDCA intake ≥ 1 year were associated with a lower risk of ERCP (HR=0.49 [95 %CI 0.29-0.82] and HR=0.44 [95 %CI 0.22-0.90] respectively). Median follow-up was 10.8 years. CONCLUSION One-third of patients with LPAC syndrome undergo sphincterotomy. However, most procedures are performed before diagnosis and UDCA is associated with a lower risk of endoscopic procedure. Earlier diagnosis and treatment with UDCA may further reduce the need for ERCP in patients with LPAC syndrome.
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Affiliation(s)
- G Salin
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France.
| | - C Corpechot
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - S Ouazana
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - C Dong
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - A Becq
- Paris-Est Creteil University, Department of Gastroenterology, Henri Mondor Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
| | - S Lemoinne
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - K Ben Belkacem
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - R Leenhardt
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - U Chaput
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - O Chazouillères
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - J Kirchgesner
- Sorbonne University, Department of Gastroenterology, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - M Camus
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
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Guilloux A, Blaise L, Simon D, Leenhardt R, Camus M, Chaput U. Endoscopic ultrasound-guided glue injection for refractory bleeding from gastric varices: A safe and effective therapeutic option (with video). Clin Res Hepatol Gastroenterol 2023; 47:102208. [PMID: 37696415 DOI: 10.1016/j.clinre.2023.102208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023]
Affiliation(s)
- A Guilloux
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - L Blaise
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France
| | - D Simon
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - R Leenhardt
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - M Camus
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - U Chaput
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France.
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Romain AS, Mornand P, Chaput U, Guedj R, Grimprel E. Pancreatic tuberculosis diagnosed by endoscopic ultrasound-guided fine needle aspiration in a 14-year-old adolescent. Med Mal Infect 2019; 50:91-93. [PMID: 31506208 DOI: 10.1016/j.medmal.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 01/03/2019] [Accepted: 08/27/2019] [Indexed: 10/26/2022]
Affiliation(s)
- A S Romain
- Department of Pediatrics, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, 26 avenue du Dr Arnold Netter, 75012 Paris, France.
| | - P Mornand
- Department of Pediatrics, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, 26 avenue du Dr Arnold Netter, 75012 Paris, France
| | - U Chaput
- Department of Hepatogastroenterology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, 26 avenue du Dr Arnold Netter, 75012 Paris, France
| | - R Guedj
- Pediatric Emergency, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, 26 avenue du Dr Arnold Netter, 75012 Paris, France
| | - E Grimprel
- Department of Pediatrics, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, 26 avenue du Dr Arnold Netter, 75012 Paris, France
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Abstract
Endoscopy has an ever-increasing role in the treatment of complications in digestive surgery. Endoscopic treatment is essentially used for (i) fistula or intra-abdominal collection secondary to anastomotic dehiscence and (ii) anastomotic stricture, especially esophagogastric, but also sometimes after colorectal surgery. First intention treatment of fistula following esophagogastric surgery is the insertion of an extractable self-expandable metallic stent (partially or entirely covered); this is supported by a low level of scientific evidence, but clinical experience has been satisfactory. Other techniques for treatment of anastomotic leak have also been reported anecdotally (clip placement, sealing with glue). There are few data available in the literature on endoscopic management (stents essentially) of postoperative colonic fistula. Whatever the approach chosen to treat a postoperative digestive tract fistula, management is medico-surgical and cannot be limited to simple closure of the digestive tube wall defect. Drainage of any collections by endoscopic, radiologic or surgical approach, systemic treatment of infection and nutritional support are essential adjuvant treatment modalities. Treatment of postoperative esophageal or colonic strictures is essentially endoscopic and is based on initial dilatation (endoscopic with hydrostatic balloon or bougie), and placement of extractable metallic stents (partially or entirely covered) in case of refractory outcome.
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Affiliation(s)
- X Dray
- Université Paris Diderot, Paris 7, AP-HP, Service d'Hépatogastroentérologie, Hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
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Barral M, Sebbag-Sfez D, Hoeffel C, Chaput U, Dohan A, Eveno C, Boudiaf M, Soyer P. Caractérisation des lésions pancréatiques focales par la mesure du coefficient de diffusion apparent en IRM à 1,5 tesla : expérience préliminaire. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jradio.2012.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Barral M, Sebbag-Sfez D, Hoeffel C, Chaput U, Dohan A, Eveno C, Boudiaf M, Soyer P. Characterization of focal pancreatic lesions using normalized apparent diffusion coefficient at 1.5-Tesla: preliminary experience. Diagn Interv Imaging 2013; 94:619-27. [PMID: 23545001 DOI: 10.1016/j.diii.2013.02.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To compare the capabilities of apparent diffusion coefficient (ADC) and normalized ADC using the pancreatic parenchyma as reference organ in the characterization of focal pancreatic lesions. PATIENTS AND METHODS Thirty-six patients with focal pancreatic lesions (malignant, n=18; benign tumors, n=10; focal pancreatitis, n=8) underwent diffusion-weighted MR imaging (DWI) at 1.5-Tesla using 3 b values (b=0, 400, 800 s/mm(2)). Lesion ADC and normalized lesion ADC (defined as the ratio of lesion ADC to apparently normal adjacent pancreas) were compared between lesion types using nonparametric tests. RESULTS Significant differences in ADC values were found between malignant (1.150 × 10(-3)mm(2)/s) and benign tumors (2.493 × 10(-3)mm(2)/s) (P=0.004) and between benign tumors and mass-forming pancreatitis (1.160 × 10(-3)mm(2)/s) (P=0.0005) but not between malignant tumors and mass-forming pancreatitis (P=0.1092). Using normalized ADC, significant differences were found between malignant tumors (0.933 × 10(-3)mm(2)/s), benign tumors (1.807 × 10(-3)mm(2)/s) and mass-forming pancreatitis (0.839 × 10(-3)mm(2)/s) (P<0.0001). CONCLUSION Our preliminary results suggest that normalizing ADC of focal pancreatic lesions with ADC of apparently normal adjacent pancreatic parenchyma provides higher degrees of characterization of focal pancreatic lesions than the conventional ADC does.
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Affiliation(s)
- M Barral
- Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise-Paré, 75010 Paris, France
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Gourcerol G, Huet E, Vandaele N, Chaput U, Leblanc I, Bridoux V, Michot F, Leroi AM, Ducrotté P. Long term efficacy of gastric electrical stimulation in intractable nausea and vomiting. Dig Liver Dis 2012; 44:563-8. [PMID: 22387288 DOI: 10.1016/j.dld.2012.01.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 01/04/2012] [Accepted: 01/22/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although the efficacy of gastric electrical stimulation has been reported in short-term studies, there is a lack of data on the long-term improvement of nausea and vomiting by gastric electrical stimulation in patients with delayed or normal gastric emptying. METHODS Thirty-one patients were implanted at our centre for medically refractory severe and chronic nausea and/or vomiting. Patients were evaluated at baseline, 6 months then 5 years after implantation (mean follow-up 80±4 months) using a symptomatic and quality of life scores. KEY RESULTS Amongst the 31 patients, 4 were lost to follow-up, 6 explanted due to lack of improvement, and 1 patient died. Out of the 20 patients evaluated over 5 years, the quality of life score showed 27% improvement (p<0.01), including nausea (62%; p<0.01), vomiting (111%; p=0.03), satiety (158%; p<0.01), bloating (67%; p<0.01) and epigastric pain (43%; p=0.03). Over 5 years, 15/20 patients reported a 50% improvement with a global satisfaction rated at 64±6%. Therefore, 15/27 patients (56%) were improved by gastric electrical stimulation over 5 years in intention to treat. Improvement of nausea 6 months after implantation was predictive of 5-year success of gastric electrical stimulation (p=0.04). Finally, patients with delayed gastric emptying or with normal gastric emptying rate before surgery were similarly improved over 5 years (60% versus 50% respectively). CONCLUSION Gastric electrical stimulation is safe and effective in the long term in patients with medically refractory nausea and vomiting, with an efficacy over 50% beyond 5 years in intention to treat. Gastric emptying measured before implantation did not influence the response rate over 5 years.
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Affiliation(s)
- Guillaume Gourcerol
- Department of Physiology and INSERM UMR-1073/IRIB, Rouen University Hospital, University of Rouen, France.
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Chaput U, Ducrotté P, Denis P, Nouveau J. Pneumatosis cystoides intestinalis: An unusual cause of distal constipation. ACTA ACUST UNITED AC 2010; 34:502-4. [DOI: 10.1016/j.gcb.2010.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 04/08/2010] [Indexed: 10/19/2022]
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Huppertz J, Coriat R, Leblanc S, Gaudric M, Brezault C, Grandjouan S, Chaput U, Prat F, Chaussade S. Application of ANAES guidelines for colonoscopy in France: a practical survey. ACTA ACUST UNITED AC 2010; 34:541-8. [PMID: 20739131 DOI: 10.1016/j.gcb.2010.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2009] [Revised: 02/22/2010] [Accepted: 03/07/2010] [Indexed: 01/09/2023]
Abstract
OBJECTIVES In 2004, the French health authorities published guidelines on the indications for colonoscopy. However, no study has evaluated the awareness of healthcare practitioners of these guidelines. The aim of this study was to determine the level of awareness of the ANAES guidelines among French gastroenterologists. PATIENTS AND METHODS A questionnaire comprising 20 multiple choice questions (MCQ) was presented to a group of 79 gastroenterologists between February and June in 2008. The questions covered screening tests for colon cancer (one question), endoscopic mucosal resection (two questions) and the ANAES guidelines (17 questions). According to the number of colonoscopies performed per year (less than 100, 100-500, more than 500), the answers to these questions were analyzed separately. RESULTS Among the practitioners carrying out less than 100, 100-500 and more than 500 colonoscopies per year, the guidelines for colon cancer screening were known by 33, 50 and 56%, respectively, the quality criteria for endoscopic mucosal resection by 0, 0 and 3.7%, respectively, and the ANAES guideline indications for colonoscopy by 34.3, 51.2 and 48.9%, respectively (P<0.001). The ANAES guidelines were significantly better known by practitioners who were performing more than 100 colonoscopies per year, while the indications for control colonoscopy were less often correctly anticipated. No differences were found concerning postponed indications. CONCLUSION The ANAES guidelines consists of the following elements: (1) awareness of the ANAES guidelines is poor, with control colonoscopy being correctly anticipated in just over a third of the gastroenterologists; (2) performing more than 100 colonoscopies per year improves knowledge of the ANAES guidelines; and (3) the ANAES guidelines need to be simplified and should be covered by continuing medical education.
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Affiliation(s)
- J Huppertz
- Service de gastroentérologie, CHU Cochin, faculté René-Descartes-Paris-V, 27 rue du Faubourg-Saint-Jacques, Paris, France
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Chaput U, Coriat R, Terris B, Brezault C, Chaussade S. [Sinusoidal obstruction syndrome induced by FOLFOX adjuvant chemotherapy]. Gastroenterol Clin Biol 2008; 32:992-994. [PMID: 19019605 DOI: 10.1016/j.gcb.2008.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Revised: 08/27/2008] [Accepted: 09/24/2008] [Indexed: 05/27/2023]
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Coriat R, Wolfers C, Chaput U, Chaussade S. Treatment of radiation-induced distal rectal lesions with argon plasma coagulation: use of a transparent cap. Endoscopy 2008; 40 Suppl 2:E270. [PMID: 19090464 DOI: 10.1055/s-2008-1077663] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- R Coriat
- Department of Gastroenterology, Cochin Hospital, Université Paris Descartes - Medicine, Paris, France.
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Roman S, Bruley des Varannes S, Pouderoux P, Chaput U, Mion F, Galmiche JP, Zerbib F. Ambulatory 24-h oesophageal impedance-pH recordings: reliability of automatic analysis for gastro-oesophageal reflux assessment. Neurogastroenterol Motil 2006; 18:978-86. [PMID: 17040408 DOI: 10.1111/j.1365-2982.2006.00825.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Oesophageal pH-impedance monitoring allows detection of acid and non-acid gastro-oesophageal reflux (GOR) events. Visual analysis of impedance recording requires expertise. Our aim was to evaluate the efficacy of an automated analysis for GOR assessment. Seventy-three patients with suspected GORD underwent 24-h oesophageal pH-impedance monitoring. Recordings analysis was performed visually (V) and automatically using Autoscan function (AS) of Bioview software. A symptom index (SI) > or =50% was considered for a significant association between symptoms and reflux events. AS analysis detected more reflux events, especially non-acid, liquid, pure gas and proximal events. Detection of oesophageal acid exposure and acid reflux events was similar with both analyses. Agreement between V and AS analysis was good (Kendall's coefficient W > 0.750, P < 0.01) for all parameters. During pH-impedance studies, 65 patients reported symptoms. As compared to visual analysis, the sensitivity and specificity of a positive SI determined by AS were respectively 85.7% and 80% for all reflux events, 100% and 98% for acid reflux and 33% and 87.5% for non-acid reflux. Despite good agreement with visual analysis, automatic analysis overestimates the number of non-acid reflux events. Visual analysis remains the gold standard to detect an association between symptoms and non-acid reflux events.
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Affiliation(s)
- S Roman
- Department of Digestive Physiology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France.
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Roman S, Bruley des Varannes S, Pouderoux P, Chaput U, Mion F, Galmiche JP, Zerbib F. Ambulatory 24-h oesophageal impedance-pH recordings: reliability of automatic analysis for gastro-oesophageal reflux assessment. Neurogastroenterol Motil 2006. [PMID: 17040408 DOI: 10.1111/j.1365-2982.2006.00825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Oesophageal pH-impedance monitoring allows detection of acid and non-acid gastro-oesophageal reflux (GOR) events. Visual analysis of impedance recording requires expertise. Our aim was to evaluate the efficacy of an automated analysis for GOR assessment. Seventy-three patients with suspected GORD underwent 24-h oesophageal pH-impedance monitoring. Recordings analysis was performed visually (V) and automatically using Autoscan function (AS) of Bioview software. A symptom index (SI) > or =50% was considered for a significant association between symptoms and reflux events. AS analysis detected more reflux events, especially non-acid, liquid, pure gas and proximal events. Detection of oesophageal acid exposure and acid reflux events was similar with both analyses. Agreement between V and AS analysis was good (Kendall's coefficient W > 0.750, P < 0.01) for all parameters. During pH-impedance studies, 65 patients reported symptoms. As compared to visual analysis, the sensitivity and specificity of a positive SI determined by AS were respectively 85.7% and 80% for all reflux events, 100% and 98% for acid reflux and 33% and 87.5% for non-acid reflux. Despite good agreement with visual analysis, automatic analysis overestimates the number of non-acid reflux events. Visual analysis remains the gold standard to detect an association between symptoms and non-acid reflux events.
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Affiliation(s)
- S Roman
- Department of Digestive Physiology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France.
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Zerbib F, des Varannes SB, Roman S, Pouderoux P, Artigue F, Chaput U, Mion F, Caillol F, Verin E, Bommelaer G, Ducrotté P, Galmiche JP, Sifrim D. Normal values and day-to-day variability of 24-h ambulatory oesophageal impedance-pH monitoring in a Belgian-French cohort of healthy subjects. Aliment Pharmacol Ther 2005; 22:1011-21. [PMID: 16268977 DOI: 10.1111/j.1365-2036.2005.02677.x] [Citation(s) in RCA: 172] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Impedance-pH monitoring is the most sensitive method for detection and characterization of gastro-oesophageal reflux episodes. Normal values from European subjects are lacking. AIM To build a database of gastro-oesophageal reflux patterns from French and Belgian healthy subjects. METHODS Seventy-two healthy subjects (35 men, mean age 35 years, 18-72) underwent 24-h ambulatory impedance-pH studies. Gastro-oesophageal reflux episodes were detected using impedance and characterized by pH as acid, weakly acidic, or weakly alkaline. Analysis was performed visually and effects of age, gender and intra-individual reproducibility were evaluated. RESULTS The total number of gastro-oesophageal reflux episodes was 44 (25,58,75) of which 59% were acid, 28% were weakly acidic and 10% weakly alkaline. Half of gastro-oesophageal reflux episodes were mixed (liquid/gas) and 22% reached 15 cm above the lower oesophageal sphincter. The bolus clearance time was 11 s while acid was chemically cleared in 34 s. Male gender was associated with increased number and proximal extent of total and acid gastro-oesophageal reflux. Repeated studies in 27 subjects showed good reproducibility for number, acidity and air-liquid composition of reflux (Kendall's W-values = 0.72-0.85). CONCLUSIONS This study demonstrates good reproducibility of 24-h ambulatory impedance-pH studies and provides values of reflux patterns in healthy subjects for comparisons with European gastro-oesophageal reflux disease patients.
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Affiliation(s)
- F Zerbib
- Gastroenterology Department, Saint André Hospital, Bordeaux, France
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