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ENDOSCOPY OF GI TRACT Edited by Somchai Amornyotin Endoscopy of GI Tract http://dx.doi.org/10.5772/45916 Edited by Somchai Amornyotin Contributors Arjuna De Silva, Ghoshal, Waleed Al-Khyatt, Farhan Rashid, S Y Iftikhar, Hiroto Kita, Yasutoshi Ochiai, Shin Arai, Keiko Ishikawa, Masamitsu Nakao, Osamu Togawa, Makoto Nishimura, Takashi Shono, Kouichi Nonaka, Naohisa Yoshida, Naito, Maria Teresa Mascellino, Alessandra Oliva, Barbara Porowska, Michele Molinari, Karim Mohamed Eltawil, Bassam Abu Wasel, Akash Nabh, Muhammed Sherid, Marco Gasparetto, Graziella Guariso, David Gorard, Neil Rajoriya, Borislav Vladimirov, Radina Ivanova, Ivan Terziev, Urszula Grzybowska-Chlebowczyk, Ludwik Stołtny, Halina Woś, Anna Stołtny, Kin Fah Chin, Eng Hong Pok, Somchai Amornyotin Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2013 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Iva Simcic Technical Editor InTech DTP team Cover InTech Design team First published March, 2013 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Endoscopy of GI Tract, Edited by Somchai Amornyotin p. cm. ISBN 978-953-51-1034-7 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface VII Section 1 General Aspects 1 Chapter 1 Pediatric Sedation Related to Endoscopy 3 Ludwik Grzegorz Stołtny, Urszula Grzybowska–Chlebowczyk, Halina Woś and Anna Agata Stołtny Chapter 2 Cardiorespiratory Complications During Moderate and Deep Sedation for Gastrointestinal Endoscopic Procedures 13 Somchai Amornyotin Chapter 3 Pre–Endoscopy Screening of Helicobacter pylori Infection: Implication and Advantages 23 Maria Teresa Mascellino, Alessandra Oliva and Barbara Porowska Chapter 4 Diagnostic Endoscopy 37 Akash Nabh, Muhammed Sherid, Charles Spurr and Subbaramia Sridhar Chapter 5 Capsule Endoscopy: A New Era of Gastrointestinal Endoscopy 75 Uday C Ghoshal Section 2 Upper Gastrointestinal Tract 89 Chapter 6 Diagnostic Value of Upper Gastrointestinal Endoscopy Prior to Cholecystectomy 91 Waleed Al-Khyatt, Farhan Rashid and S.Y. Iftikhar Chapter 7 Endoscopic Management of Oesophageal and Gastric Varices 99 Neil Rajoriya and David A. Gorard Chapter 8 Diagnosis and Management of Barrett’s Esophagus with and Without Dysplasia 129 Borislav Vladimirov, Radina Ivanova and Ivan Terziev Chapter 9 Clinical Outcome of Endoscopic Submucosal Dissection for 352 Lesions of Superficial Gastric Neoplasms in 284 Patients 179 Yasutoshi Ochiai, Shin Arai, Masamitsu Nakao, Makoto Nishimura, Takashi Shono, Kouichi Nonaka, Osamu Togawa, Keiko Ishikawa and Hiroto Kita Chapter 10 The Current Role of Endoscopic Stenting in Upper Gastrointestinal Surgery 197 Pok Eng Hong and Chin Kin Fah Section 3 Lower Gastrointestinal Tract 221 Chapter 11 Ileoscopy; How and Why to Do It 223 Arjuna P. De Silva Chapter 12 Therapeutic and Diagnostic Approaches in Colonoscopy 233 Naohisa Yoshida, Nobuaki Yagi, Yutaka Inada, Munehiro Kugai, Akio Yanagisawa and Yuji Naito Section 4 Special Population 265 Chapter 13 Peculiarities of Paediatric Digestive Endoscopy 267 Marco Gasparetto and Graziella Guariso Chapter 14 Liver Transplantation and Endoscopic Management of Bile Duct Complications 311 Bassam Abu-Wasel, Paul D. Renfrew and Michele Molinari ContentsVI Preface Endoscopy is a fast moving field, and new techniques are constantly emerging. Gastrointestinal endoscopy has a central role in the evaluation of gastrointestinal complaints and in the diagnosis and management of gastrointestinal diseases. It is a very safe procedure in the general population as demonstrated by numerous studies. Several data provide a better understanding of pathogenic mechanisms. In recent decades, gastrointestinal endoscopy has evolved and branched out from a visual diagnostic modality to impressive interventional capabilities. Some new endoscopic techni‐ ques will be too complex or expensive to make the leap into general gastroenterology practice, others already show major progress in the management of digestive diseases. In this chapter the authors will discuss some of the emerging techniques and technologies used to increase the diag‐ nostic and therapeutic yield in the gastrointestinal tract. As in any field, demands of service deliv‐ ery by conventional equipment and newer, more glamorous, and usually more expensive technologies are often in competition. Modern endoscopic equipment provides us with the benefit of many technical advances. New video- endoscopes, magnification endoscopes and confocal of narrow band imaging endoscopes emerged. An increased knowledge of normal and pathologic endoscopic patterns has been increasing in the last decades. Endoscopy is an effective and safe procedure even in special populations including pediatric patients, geriatric patients, pregnant patients and liver transplant patients. In addition, many diagnostic techniques and therapeutic interventions documented real improvement. The contributions in this book are very valuable. InTech Open Access Publisher selected several known names from many countries with different levels of development. Multiple specific points of view were presented together with various topics regarding diagnostic or therapeutic endos‐ copy. The readers can take into consideration of practical knowledge in the gastroenterology field. This book actually represents a valuable tool for formation and continuous medical educa‐ tion in the gastrointestinal endoscopy procedure considering the performances or technical possi‐ bilities in different parts of the world. I very much appreciate and thank to all authors of this book. Many thanks to InTech Open Access Publisher which offered me the possibility of editing this attractive book. It was a real pleasure to read such interesting works by so many experts from all over the world. Finally, I also thank Ms. Iva Simcic for her perfect, prompt and efficient co-operation. Assoc. Prof. Somchai Amornyotin MD, FRCAT Department of Anesthesiology and Siriraj GI Endoscopy Center Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok Thailand Section 1 General Aspects [...]... under the age of 45 years using Hp serology Three strategies are proposed after serology screening: 1 endoscopy of Hp seropositive patients and treatment of seronegative patients sympto‐ matically; 2 treatment of seropositive patients for Hp and endoscopy of seronegative patients 3 eradication of infection from Hp seropositive patients, treatment of seronegative patients symptomatically and endoscopy for... gastroenterologist) and appropriate doses of pharmacological agents Pharmacological agents used for premedication include sedatives and soporifics, antiemetics and antacids From 120 to 60 minutes before the sched‐ uled surgery, to neutralize and reduce the volume of gastric juice ranitidine or omeprazole is used in doses of: ranitidine from 2 to 4 mg / kg, omeprazole from 0.5 to 3.5 mg / kg 5 6 Endoscopy of GI Tract. .. is propofol at a dose of 2 to 3.5 mg / kg, which lowers the blood pressure (positively works during intubation and implantation of laryngeal mask what prevent a sudden stroke of blood pressure) During intravenous anesthesia without tracheal intubation in spontane‐ 9 10 Endoscopy of GI Tract ously breathing planned dose should be administered slowly (in fractions) to prevent apnea Induction of anesthesia... activation of the sympathetic nervous system, resulting in hemodynamic changes causing an increase in cardiac demand Prevention or minimization of myocardial ischemia/infarction during GIE procedure 1 Pre-oxygenation in risk patients and give continuous supplemental oxygen 2 Give patients on their normal anti-hypertensive and/or anti-anginal therapy right up to the time of the endoscopy 3 Angina developing... higher incidence of pulmonary aspiration because of the better sensitivity of 2-[18F] fluoro-2-deoxy-D-glucose positron tomography However, the low incidence of clinical events needed intervention may still reflect the safety of sedation used for gastrointestinal endoscopy [22] Treatments of pulmonary aspiration include suction of fluids from oral cavity and throat, increasing the rate of supplemental... controlled trial of preprocedure administration of parecoxib for therapeutic endoscopic retrograde cholangiopancreatography Journal of Pain Research 2012; 5: 251-256 [29] Amornyotin S, Chalayonnawin V, Kongphlay S Recovery pattern and home-readiness after gastrointestinal endoscopy Journal of Medical Association of Thailand 2007; 90(11): 2352-2358 Chapter 3 Pre Endoscopy Screening of Helicobacter pylori... reproduction in any medium, provided the original work is properly cited 24 Endoscopy of GI Tract 2 Serological markers Serological testing has been recommended for initial pre -endoscopy or pre-treatment screen‐ ing in dyspeptic patients Serology is cheap and convenient and thus should be preferred in situations where the additional information yielded by an endoscopy is not needed Patients are prone... induction of anesthesia should be done close monitoring of the movements of the chest, breath sounds, respiratory additional phenomena in the form of wheezing, rales or rhonchi, skin color, saturation of hemoglobin, heart rate For inhalational induction in children only sevoflurane is suitable because of the least irritating effect on the respiratory mucosa The safest method of introduc‐ tion of anesthesia... and results of laboratory tests should be analyzed Physical examination is aimed at an accurate assessment of the work of the lungs, heart, presence of the heart rate and accurate looking into and assessment of the throat, nasal patency, breathing circuit and possible prediction of difficult intubation The anesthetic examination of the child before anesthesia is always done in the presence of the parent,... at risk of deep sedation Additionally, the standardized discharge criteria should be used to determine the patient’s readiness for discharge Lastly, the physicians should remember that the risk for un-intended deeper level of sedation may be more common after the stimulation of the endoscopic procedure has been removed 19 20 Endoscopy of GI Tract Author details Somchai Amornyotin* Department of Anesthesiology . ENDOSCOPY OF GI TRACT Edited by Somchai Amornyotin Endoscopy of GI Tract http://dx.doi.org/10.5772/45916 Edited. of anesthesia can be started by giving intravenous anesthetics this way. However, in the absence Endoscopy of GI Tract 8 of such catheter or in the case