Objective: To validate endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis andtreatment of pancreaticobiliary disease and to improve the methodology of ERCP. Methods: From January 1977 toJune 1998, ...Objective: To validate endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis andtreatment of pancreaticobiliary disease and to improve the methodology of ERCP. Methods: From January 1977 toJune 1998, Seven thousand two hundred and thirty eight patients who were suspected to have pancreaticobiliaryduct diseases were examined with ERCP. Those who had therapeutic indications received ERCP treatment such asdrainage, dilatation and lithotomy. All cases were reviewed retrospectively, and analyzed for the clinical value andcomplications of ERCP. Results: In 7 238 patienls who underwent 7 579 ERCPs, the total success rate was94. 8%, with a 75. 7% showing rate of pancreatic duct. and 89. 1 % of the binary duct, revealing 3 492 cases ofbinary duct disease, 570 cases of pancreatic duct disease. 821 cases of diverticula and 171 cases of fistula. of which921 cases were treated endoscopically. The rate of complications arising from diagnostic ERCP was 1. 01%.without a single death, the rate of complications arising from therapeutic ERCP was 1. 3 %, two patients died(0. 22 % ). Conclusion: ERCP has important clinical value in the diagnosis and treatment of pancreaticobiliary ductdisease.展开更多
BACKGROUND: The study aimed to estimate the value of embryonal natural orifice transluminal endoscopic surgery(ENOTES) in treating severe acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS).ME...BACKGROUND: The study aimed to estimate the value of embryonal natural orifice transluminal endoscopic surgery(ENOTES) in treating severe acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS).METHODS: The patients, who were randomized into an ENOTES group and an operative group, underwent ENOTES and laparotomy, respectively. The results and complications of the two groups were compared.RESULTS: Enterocinesia was observed earlier in the ENOTES group than in the operative group. Acute Physiology and Chronic Health Evaluation II(APACHE II) score of patients in the ENOTES group was lower than that of the operative group on the 1st, 3rd and 5th post-operative day(P<0.05). The cure rate was 96.87% in the ENOTES group, which was statistically different from 78.12% in the operative group(P<0.05). There were significant differences in complications and mortality between the two groups(P<0.01).CONCLUSION: Compared with surgical decompression, ENOTES associated with flexible endoscope therapy is an effective and minimal invasive procedure with less complications.展开更多
Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapie...Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapies. Methods A systematic search of literature from the PubMed database was conducted for identifying eligible studies on implantation of thyroid hyperplastic or neoplastic cells after endoscopic thyroid surgery. Results Overall, 5 reported cases on patients suffering from endoscopic thyroid surgery with implantation of thyroid hyperplastic or neoplastic cells were included in the systematic review. Conclusions Unskilled surgeons, rough intraoperative surgical treatment, scarification or rupture of tumor, contamination of instruments, chimney effect, aerosolization of tumor cells may be associated with the implantation after endoscopic thyroidectomy. To minimize the risk of such complication, we should be more meticulous and strict the endoscopic surgery indications.展开更多
Automatic segmentation of early esophagus cancer(EEC)in gastrointestinal endoscopy(GIE)images is a critical and challenging task in clinical settings,which relies primarily on labor-intensive and time-consuming routin...Automatic segmentation of early esophagus cancer(EEC)in gastrointestinal endoscopy(GIE)images is a critical and challenging task in clinical settings,which relies primarily on labor-intensive and time-consuming routines.EEC has often been diagnosed at the late stage since early signs of cancer are not obvious,resulting in low survival rates.This work proposes a deep learning approach based on the U-Net++method to segment EEC in GIE images.A total of 2690 GIE images collected from 617 patients at the Digestive Endoscopy Center,West China Hospital of Sichuan University,China,have been utilized.The experimental result shows that our proposed method achieved promising results.Furthermore,the comparison has been made between the proposed and other U-Net-related methods using the same dataset.The mean and standard deviation(SD)of the dice similarity coefficient(DSC),intersection over union(IoU),precision(Pre),and recall(Rec)achieved by the proposed framework were DSC(%)=94.62±0.02,IoU(%)=90.99±0.04,Pre(%)=94.61±0.04,and Rec(%)=95.00±0.02,respectively,outperforming the others.The proposed method has the potential to be applied in EEC automatic diagnoses.展开更多
Objective To compare outcomes of patients undergoing either open or endoscopic carpal tunnel release for the treatment of idiopathic carpal tunnel syndrome. Methods A prospective, randomized study was performed on 70 ...Objective To compare outcomes of patients undergoing either open or endoscopic carpal tunnel release for the treatment of idiopathic carpal tunnel syndrome. Methods A prospective, randomized study was performed on 70 hands in 62 patients with idiopathic carpal tunnel syndrome from April 2000 to April 2004. Either open (36 hands in 30 patients) or endoscopic (34 hands in 32 patients) carpal tunnel release was performed randomly. Symptom improvement, complications, and the time of operation, in-hospital stay, and return to work between the two groups were assessed with average 2 years of follow-up. The electromyography was tested pre- and 3 months post-operation. Results There were no significant differences between the two surgical groups with regard to postoperative improvements of symptom, electromyography tests, and the incidence of complications. But it was statistically less in the rate of scar tenderness, the time of operation, in-hospital stay, and return to work in the endoscopic group compared with the open group (P<0.05). Conclusions The endoscopic carpal tunnel release is a reliable method in the treatment of idiopathic carpal tunnel syndrome. And it has the advantages of slight scar tenderness, less operation time, less in-hospital stay, early functional recovery, safety, and high satisfaction rate compared with open methods.展开更多
Twenty-five patients with upper gastrointestinal(GI) tract submucosal tumor were treated endoscopically using high frequency snare.Twenty-two tumors were resected through single high frequency electroectomy.Two tumors...Twenty-five patients with upper gastrointestinal(GI) tract submucosal tumor were treated endoscopically using high frequency snare.Twenty-two tumors were resected through single high frequency electroectomy.Two tumors were resected at two steps,first maki展开更多
Objective To explore the semi-supervised learning(SSL) algorithm for long-tail endoscopic image classification with limited annotations.Method We explored semi-supervised long-tail endoscopic image classification in H...Objective To explore the semi-supervised learning(SSL) algorithm for long-tail endoscopic image classification with limited annotations.Method We explored semi-supervised long-tail endoscopic image classification in HyperKvasir,the largest gastrointestinal public dataset with 23 diverse classes.Semi-supervised learning algorithm FixMatch was applied based on consistency regularization and pseudo-labeling.After splitting the training dataset and the test dataset at a ratio of 4:1,we sampled 20%,50%,and 100% labeled training data to test the classification with limited annotations.Results The classification performance was evaluated by micro-average and macro-average evaluation metrics,with the Mathews correlation coefficient(MCC) as the overall evaluation.SSL algorithm improved the classification performance,with MCC increasing from 0.8761 to 0.8850,from 0.8983 to 0.8994,and from 0.9075 to 0.9095 with 20%,50%,and 100% ratio of labeled training data,respectively.With a 20% ratio of labeled training data,SSL improved both the micro-average and macro-average classification performance;while for the ratio of 50% and 100%,SSL improved the micro-average performance but hurt macro-average performance.Through analyzing the confusion matrix and labeling bias in each class,we found that the pseudo-based SSL algorithm exacerbated the classifier’ s preference for the head class,resulting in improved performance in the head class and degenerated performance in the tail class.Conclusion SSL can improve the classification performance for semi-supervised long-tail endoscopic image classification,especially when the labeled data is extremely limited,which may benefit the building of assisted diagnosis systems for low-volume hospitals.However,the pseudo-labeling strategy may amplify the effect of class imbalance,which hurts the classification performance for the tail class.展开更多
文摘Objective: To validate endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis andtreatment of pancreaticobiliary disease and to improve the methodology of ERCP. Methods: From January 1977 toJune 1998, Seven thousand two hundred and thirty eight patients who were suspected to have pancreaticobiliaryduct diseases were examined with ERCP. Those who had therapeutic indications received ERCP treatment such asdrainage, dilatation and lithotomy. All cases were reviewed retrospectively, and analyzed for the clinical value andcomplications of ERCP. Results: In 7 238 patienls who underwent 7 579 ERCPs, the total success rate was94. 8%, with a 75. 7% showing rate of pancreatic duct. and 89. 1 % of the binary duct, revealing 3 492 cases ofbinary duct disease, 570 cases of pancreatic duct disease. 821 cases of diverticula and 171 cases of fistula. of which921 cases were treated endoscopically. The rate of complications arising from diagnostic ERCP was 1. 01%.without a single death, the rate of complications arising from therapeutic ERCP was 1. 3 %, two patients died(0. 22 % ). Conclusion: ERCP has important clinical value in the diagnosis and treatment of pancreaticobiliary ductdisease.
文摘BACKGROUND: The study aimed to estimate the value of embryonal natural orifice transluminal endoscopic surgery(ENOTES) in treating severe acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS).METHODS: The patients, who were randomized into an ENOTES group and an operative group, underwent ENOTES and laparotomy, respectively. The results and complications of the two groups were compared.RESULTS: Enterocinesia was observed earlier in the ENOTES group than in the operative group. Acute Physiology and Chronic Health Evaluation II(APACHE II) score of patients in the ENOTES group was lower than that of the operative group on the 1st, 3rd and 5th post-operative day(P<0.05). The cure rate was 96.87% in the ENOTES group, which was statistically different from 78.12% in the operative group(P<0.05). There were significant differences in complications and mortality between the two groups(P<0.01).CONCLUSION: Compared with surgical decompression, ENOTES associated with flexible endoscope therapy is an effective and minimal invasive procedure with less complications.
文摘Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapies. Methods A systematic search of literature from the PubMed database was conducted for identifying eligible studies on implantation of thyroid hyperplastic or neoplastic cells after endoscopic thyroid surgery. Results Overall, 5 reported cases on patients suffering from endoscopic thyroid surgery with implantation of thyroid hyperplastic or neoplastic cells were included in the systematic review. Conclusions Unskilled surgeons, rough intraoperative surgical treatment, scarification or rupture of tumor, contamination of instruments, chimney effect, aerosolization of tumor cells may be associated with the implantation after endoscopic thyroidectomy. To minimize the risk of such complication, we should be more meticulous and strict the endoscopic surgery indications.
基金supported by the National Natural Science Foundation under Grants No.62271127,No.61872405,and No.81171411Natural Science Foundation of Sichuan Province,China under Grant No.23NSFSC0627Medico-Engineering Cooperation Funds from University of Electronic Science and Technology of China and West China Hospital of Sichuan University under Grants No.ZYGX2022YGRH011 and No.HXDZ22005.
文摘Automatic segmentation of early esophagus cancer(EEC)in gastrointestinal endoscopy(GIE)images is a critical and challenging task in clinical settings,which relies primarily on labor-intensive and time-consuming routines.EEC has often been diagnosed at the late stage since early signs of cancer are not obvious,resulting in low survival rates.This work proposes a deep learning approach based on the U-Net++method to segment EEC in GIE images.A total of 2690 GIE images collected from 617 patients at the Digestive Endoscopy Center,West China Hospital of Sichuan University,China,have been utilized.The experimental result shows that our proposed method achieved promising results.Furthermore,the comparison has been made between the proposed and other U-Net-related methods using the same dataset.The mean and standard deviation(SD)of the dice similarity coefficient(DSC),intersection over union(IoU),precision(Pre),and recall(Rec)achieved by the proposed framework were DSC(%)=94.62±0.02,IoU(%)=90.99±0.04,Pre(%)=94.61±0.04,and Rec(%)=95.00±0.02,respectively,outperforming the others.The proposed method has the potential to be applied in EEC automatic diagnoses.
文摘Objective To compare outcomes of patients undergoing either open or endoscopic carpal tunnel release for the treatment of idiopathic carpal tunnel syndrome. Methods A prospective, randomized study was performed on 70 hands in 62 patients with idiopathic carpal tunnel syndrome from April 2000 to April 2004. Either open (36 hands in 30 patients) or endoscopic (34 hands in 32 patients) carpal tunnel release was performed randomly. Symptom improvement, complications, and the time of operation, in-hospital stay, and return to work between the two groups were assessed with average 2 years of follow-up. The electromyography was tested pre- and 3 months post-operation. Results There were no significant differences between the two surgical groups with regard to postoperative improvements of symptom, electromyography tests, and the incidence of complications. But it was statistically less in the rate of scar tenderness, the time of operation, in-hospital stay, and return to work in the endoscopic group compared with the open group (P<0.05). Conclusions The endoscopic carpal tunnel release is a reliable method in the treatment of idiopathic carpal tunnel syndrome. And it has the advantages of slight scar tenderness, less operation time, less in-hospital stay, early functional recovery, safety, and high satisfaction rate compared with open methods.
文摘Twenty-five patients with upper gastrointestinal(GI) tract submucosal tumor were treated endoscopically using high frequency snare.Twenty-two tumors were resected through single high frequency electroectomy.Two tumors were resected at two steps,first maki
文摘Objective To explore the semi-supervised learning(SSL) algorithm for long-tail endoscopic image classification with limited annotations.Method We explored semi-supervised long-tail endoscopic image classification in HyperKvasir,the largest gastrointestinal public dataset with 23 diverse classes.Semi-supervised learning algorithm FixMatch was applied based on consistency regularization and pseudo-labeling.After splitting the training dataset and the test dataset at a ratio of 4:1,we sampled 20%,50%,and 100% labeled training data to test the classification with limited annotations.Results The classification performance was evaluated by micro-average and macro-average evaluation metrics,with the Mathews correlation coefficient(MCC) as the overall evaluation.SSL algorithm improved the classification performance,with MCC increasing from 0.8761 to 0.8850,from 0.8983 to 0.8994,and from 0.9075 to 0.9095 with 20%,50%,and 100% ratio of labeled training data,respectively.With a 20% ratio of labeled training data,SSL improved both the micro-average and macro-average classification performance;while for the ratio of 50% and 100%,SSL improved the micro-average performance but hurt macro-average performance.Through analyzing the confusion matrix and labeling bias in each class,we found that the pseudo-based SSL algorithm exacerbated the classifier’ s preference for the head class,resulting in improved performance in the head class and degenerated performance in the tail class.Conclusion SSL can improve the classification performance for semi-supervised long-tail endoscopic image classification,especially when the labeled data is extremely limited,which may benefit the building of assisted diagnosis systems for low-volume hospitals.However,the pseudo-labeling strategy may amplify the effect of class imbalance,which hurts the classification performance for the tail class.
