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| 1 | Characterization of functional biliary pain and dyspeptic symptoms in patients with sphincter of Oddi dysfunction:Effect of papillotomy显示文摘AIM: To characterize functional biliary pain and other gastrointestinal (GI) symptoms in postcholecystectomy syndrome (PCS) patients with and without sphincter of Oddi dysfunction (SOD) proved by endoscopic sphincter of Oddi manometry (ESOM), and to assess the post- endoscopic sphincterotomy (EST) outcome. METHODS: We prospectively investigated 85 cholecystectomized patients referred for ERCP because of PCS and suspected SOD. On admission, all patients completed our questionnaire. Physical examination, laboratory tests, abdominal ultrasound, quantitative hepatobiliary scintigraphy (QHBS), and ERCP were performed in all patients. Based on clinical and ERCP findings 15 patients had unexpected bile duct stone disease and 15 patients had SOD biliary typeⅠ. ESOM demonstrated an elevated basal pressure in 25 patients with SOD biliary-type Ⅲ. In the remaining 30 cholecystectomized patients without SOD, the liver function tests, ERCP, QHBS and ESOM were all normal. As a control group, 30 ‘asymptomatic’ cholecystectomized volunteers (attended to our hospital for general cardiovascular screening) completed our questionnaire, which is consisted of 50 separate questions on GI symptoms and abdominal pain characteristics. Severity of the abdominal pain (frequency and intensity) was assessed with a visual analogue scale (VAS). In 40 of 80 patients having definite SOD (i.e. patients with SOD biliary typeⅠand those with elevated SO basal pressure on ESOM), an EST was performed just after ERCP. In these patients repeated questionnaires were filled at each follow-up visit (at 3 and 6 mo) and a second lookQHBS was performed 3 mo after the EST to assess the functional response to EST. RESULTS: The analysis of characteristics of the abdominal pain demonstrated that patients with common bile duct stone and definite SOD had a significantly higher score of symptomatic agreement with previously determined biliary-like pain features than patient groups of PCS without SOD and controls. In contrary, no significant differences were found when the pain severity scores were compared in different groups of PCS patients. In patients with definite SOD, EST induced a significant acceleration of the transpapillary bile flow; and based on the comparison of VASs obtained from the pre- and post-EST questionnaires, the severity scores of abdominal pain were significantly improved, however, only 15 of 35 (43%) patients became completely pain free. Post-EST severity of abdominal pain by VASs was significantly higher in patients with predominant dyspepsia at initial presentation as compared to those without dyspeptic symptoms. CONCLUSION: Persistent GI symptoms and general patient dissatisfaction is a rather common finding after EST in patients with SOD, and correlated with the presence of predominant dyspeptic symptoms at the initial presentation, but does not depend on the technical and functional success of EST. | László Madácsy Roland Fejes Gábor Kurucsai Ildikó Joó András Székely Viktória Bertalan Attila Szepes János Lonovics | 2006 | World Journal of Gastroenterology2006，12，42： | 33 |
| 2 | Endoscopic transluminal pancreatic necrosectomy using a self-expanding metal stent and high-flow water-jet system显示文摘Walled-off pancreatic necrosis and a pancreatic abscess are the most severe complications of acute pancreatitis. Surgery in such critically ill patients is often associated with significant morbidity and mortality within the first few weeks after the onset of symptoms. Minimal invasive approaches with high success and low mortality rates are therefore of considerable interest. Endoscopic therapy has the potential to offer safe and effective alternative treatment. We report here on 3 consecutive patients with infected walled-off pancreatic necrosis and 1 patient with a pancreatic abscess who underwent direct endoscopic necrosectomy 19-21 d after the onset of acute pancreatitis. The infected pancreatic necrosis or abscess was punctured transluminally with a cystostome and, after balloon dilatation, a non-covered self-expanding biliary metal stent was placed into the necrotic cavity. Following stent deployment, a nasobiliary pigtail catheter was placed into the cavity to ensure continuous irrigation. After 5-7 d, the metal stent was removed endoscopically and the necrotic cavity was entered with a therapeutic gastroscope. Endoscopic debridement was performed via the simultaneous application of a high-flow water-jet system; using a flush knife, a Dormia basket, and hot biopsy forceps. The transluminal endotherapy was repeated 2-5 times daily during the next 10 d. Supportive care included parenteral antibiotics and jejunal feeding. All patients improved dramatically and with resolution of their septic conditions; 3 patients were completely cured without any further complications or the need for surgery. One patient died from a complication of prolonged ventilation severe bilateral pneumonia, not related to the endoscopic procedure. No procedure related complications were observed. Transluminal endoscopic necrosectomy with temporary application of a self-expanding metal stent and a high-flow water-jet system shows promise for enhancing the potential of this endoscopic approach in patients with walled-off pancreatic necrosis and/or a pancreatic abscess. | István Hritz Roland Fejes András Székely Iván Székely László Horváth gnes Sárkány ron Altorjay László Madácsy | 2013 | World Journal of Gastroenterology2013，19，23： | 10 |
| 3 | Detection of independent motion using directional motion estimation显示文摘 | Fejes S Davis L | | 0，，02： | 1 |
| 4 | Inequalities Concerning Polygons and Polyhedra显示文摘 | FEJES TOTH L | 1948 | Duke Math J1948，15，： | 1 |
| 5 | Prophylactic pancreas stenting followed by needle-knife fistulotomy in patients with sphincter of Oddi dysfunction and difficult cannulation:new method to prevent post-ERCP pancreatitis显示文摘 | MADáCSY L KURUCSAI G FEJES R | 2009 | Dig Endosc2009，21，1： | 1 |
| 6 | Extremum properities of regular polyto- pes显示文摘 | FEJES T L | 1955 | Acta Math Acad Sci Hunger1955，，6： | 1 |
| 7 | Crystallinity and microstructures of aluminum nitride films deposited on Si(111) substrates显示文摘 | Liaw H M Doyle R Fejes P L | 2000 | Solid-State Electronics2000，44，： | 1 |
| 8 | Prophylactic pancreas stenting followed by needle-knife fistulotomy in pa- tients with sphincter of oddi dysfunction and difficult cannula- tion: new method to prevent post-ERCP pancreatitis显示文摘 | MADACSY L KURUCSAI G FEJES R | 2009 | Dig En- dosc2009，21，1： | 1 |
| 9 | Prophylactic pan-creas stenting followed by needle - knife fistulotomy in patients withsphincter of oddi dysfunction and difficult cannulation: new methodto prevent post - ERCP pancreatitis显示文摘 | MADCSY L KURUCSAI G FEJES R | 2009 | Dig Endosc2009，21，21： | 1 |
| 10 | Clinical characteristics of cannabis-induced schizophrenia spectrum disorder 显示文摘 | Makkos Z Fejes L Inczdy-Farkas G | 2011 | Neuropsycho- pharmacol Hung2011，13，3： | 1 |
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