Day 2 :
Harbin Medical University, China
Time : 09.00- 09.45 AM
Bing-Rong Liu has completed his MD in 2002 from Chongqing Medical University. He was appointed as the Director of Gastrointestinal Department of the Second Affiliated Hospital of Harbin Medical University in June 2004. He has developed so many endoscopic new techniques and published more than 20 papers in reputed journals.
Endoscopic Retrograde Appendicitis Therapy (ERAT): Inspired by the success of emergency endoscopic retrograde cholangiopancreatography (ERCP) in treating acute cholangitis, we developed a minimally invasive method named ERAT to diagnose and treat acute appendicitis. We first reported this technique in DDW 2011. At present, there are more than 20 medical centers in China to carry out the ERAT technique. ERAT provide a new procedure for the treatment of acute appendicitis with rapid pain relief and short recovery time.
Liu Peroral Endoscopic Myotomy (Liu-POEM): Peroral endoscopic myotomy (POEM) has emerged as one approach to treat esophageal achalasia. Tunnellization and the myotomy are the key procedures. Submucosal tunneling requires one-third to one-half of the total operation time. For improvement of POEM procedure, we performed myotomy and tunneling as one step and then closed the entry site as before. We performed the modified procedure more than 60 cases.
Endoscopic Fenestration: The treatment of pancreatic pseudocyst is challenging and difficult. Although endoscopic therapy of pancreatic pseudocyst is considering first line therapy, there are some cases requiring surgical intervention or repeated endoscopic drainage procedures. We described endoscopic fenestration for treatment of large pancreatic pseudocyst in 3 cases. Endoscopic fenestration could be obtaining sufficient drainage which avoids pancreatic pseudocyst recurrence. The pseudocyst cavity was gradually reduced and healed after endoscopic fenestration.
Transrectal Gallbladder-Preserving Cholecystolithotomy (TRGPC): Transcolonic NOTES was not used in human cases due to the fecal contamination. We have developed a detachable balloon to keep the distal colonic cavity sterile and performed cholecystolithotomy and polypectomy with gallbladder preserved in 36 patients by the end of May 2016. Transrectal NOTES gallbladder-preserving operation provides a novel alternative approach of treating gallbladder polyps and stones.
Endoscopic Submucosal Dissection for Losing Weight: The gastric endoscopic submucosal dissection (ESD) as a new bariatric technique can affect weight gain. Previous animal experimental study suggested that ESD of one thirds of the stomach fundus can effectively and durably decrease the volume of stomach, thus significantly affect weight gain.
University of Alberta, Canada
Keynote: Integration of palliative principles in the management of patients with compensated and decompensated cirrhosis
Time : 09.45- 10.30 AM
Amanda Brisebois is an Internal Medicine and Palliative Care Specialist, who works in Edmonton, Alberta, Canada. She undertook her undergraduate education and Master’s degree at Queen’s University in Kingston, Ontario Canada. She completed her medical school training in Calgary, Alberta, and her General Medicine Specialty at the Mayo Clinic Rochester Minnesota, University of Calgary in Calgary, Alberta, and University of Alberta, in Edmonton. Since 2000, she has been practicing General Internal Medicine in both inpatient and outpatient settings. She also is a certified Palliative Care Specialist.
Introduction: Patients with chronic illnesses such as cirrhosis, often have significant symptoms, psychosocial needs, and desires for heightened knowledge about their illness. Historically, cirrhosis management has focused on controlling or modifying cirrhosis progression, and complications of liver dysfunction. Work has started to focus on a parallel pathway of care, involving symptom management, early advance care planning, and other interventions aimed at improving a patient’s ability to cope with chronic illness.
Discussion: A recent paper was published on August 2016 (Brisebois and Tandon 2016), suggesting various ways to heighten cirrhosis care early in the disease trajectory. This discussion will provide detailed strategies for GI specialists to integrate palliative principles into cirrhosis care early in the disease trajectory. Principles to be outlined include modern definitions of palliative care, how palliative principles can be integrated during acute decompensations, how non-palliative specialists can provide this type of care, and how palliative care services can aid the Family Practitioners and Gastroenterology Specialists at various stages of the cirrhosis disease trajectory. This discussion will aim to provide tools for non-palliative care practitioner to heighten patient support in these areas. Evidence for this care approach will be provided, based on the current literature.
Conclusion: Evidence is increasing for integration of palliative principles early in the cirrhosis disease trajectory. With continued work, perhaps interdisciplinary collaborations can heighten inclusive patient care and result in increased patient preparedness for the challenges that come with progressive decline in hepatic function.