Background/Aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding. Therefore, we evaluated the efficacy and safety of EUS-HGS as an alternative treatment for biliary obstruction in patients with HCC. Methods: This was a retrospective study of all EUS-HGS procedures performed in patients with HCC at the Aichi Cancer Center Hospital, Japan, from February 2017 to August 2023. Results: A total of 14 EUS-HGS procedures (42.9% primary) were attempted in 10 HCC patients (mean age 71.5 years, 80.0% male). Clinical and technical success rates were 92.9% and 90.9%, respectively. The observed procedure details in the 13 successful procedures included B3 puncture (53.8%), 22-G needle (53.8%), fully covered self-expandable metal stent (100%), and mean procedure time (32.7 minutes). There was no bleeding. Mild complications occurred in 27.3%. All patients resumed oral intake within 24 hours. Conclusions EUS-HGS is a technically feasible and clinically effective initial or salvage drainage option for the treatment of biliary obstruction in patients with HCC.

Purpose: This study evaluated the sensitivity, specificity, and accuracy of computed tomographic angiography (CTA) versus handheld Doppler (HHD) in detecting perforators for anterolateral thigh (ALT) flap surgery. Methods: This study was conducted on 20 patients randomly assigned to two groups from April 2023 to November 2024: One group received CTA and HHD, while the other group received only HHD. Perforators were evaluated for their number, location, and source and compared with intraoperative findings. Results: The sensitivity and specificity of CTA were 86.0% and 98.0%, respectively, while those of HHD were 81.0% and 86.5%. CTA exhibited an accuracy of 92.0% for perforator identification, whereas that of HHD was 83.5%. Conclusion CTA offers higher sensitivity, specificity, and accuracy in identifying ALT flap perforators than HHD. Its superior imaging capabilities can enable improved surgical planning, minimizing intraoperative challenges, reducing the risk of complications, and potentially increasing flap survival rates. As such, CTA could be considered a valuable standard tool in preoperative planning for ALT flap surgery, particularly in cases where anatomical variation poses a challenge.

Purpose: This study evaluated the sensitivity, specificity, and accuracy of computed tomographic angiography (CTA) versus handheld Doppler (HHD) in detecting perforators for anterolateral thigh (ALT) flap surgery. Methods: This study was conducted on 20 patients randomly assigned to two groups from April 2023 to November 2024: One group received CTA and HHD, while the other group received only HHD. Perforators were evaluated for their number, location, and source and compared with intraoperative findings. Results: The sensitivity and specificity of CTA were 86.0% and 98.0%, respectively, while those of HHD were 81.0% and 86.5%. CTA exhibited an accuracy of 92.0% for perforator identification, whereas that of HHD was 83.5%. Conclusion CTA offers higher sensitivity, specificity, and accuracy in identifying ALT flap perforators than HHD. Its superior imaging capabilities can enable improved surgical planning, minimizing intraoperative challenges, reducing the risk of complications, and potentially increasing flap survival rates. As such, CTA could be considered a valuable standard tool in preoperative planning for ALT flap surgery, particularly in cases where anatomical variation poses a challenge.

Background/Aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding. Therefore, we evaluated the efficacy and safety of EUS-HGS as an alternative treatment for biliary obstruction in patients with HCC. Methods: This was a retrospective study of all EUS-HGS procedures performed in patients with HCC at the Aichi Cancer Center Hospital, Japan, from February 2017 to August 2023. Results: A total of 14 EUS-HGS procedures (42.9% primary) were attempted in 10 HCC patients (mean age 71.5 years, 80.0% male). Clinical and technical success rates were 92.9% and 90.9%, respectively. The observed procedure details in the 13 successful procedures included B3 puncture (53.8%), 22-G needle (53.8%), fully covered self-expandable metal stent (100%), and mean procedure time (32.7 minutes). There was no bleeding. Mild complications occurred in 27.3%. All patients resumed oral intake within 24 hours. Conclusions EUS-HGS is a technically feasible and clinically effective initial or salvage drainage option for the treatment of biliary obstruction in patients with HCC.

Purpose: This study evaluated the sensitivity, specificity, and accuracy of computed tomographic angiography (CTA) versus handheld Doppler (HHD) in detecting perforators for anterolateral thigh (ALT) flap surgery. Methods: This study was conducted on 20 patients randomly assigned to two groups from April 2023 to November 2024: One group received CTA and HHD, while the other group received only HHD. Perforators were evaluated for their number, location, and source and compared with intraoperative findings. Results: The sensitivity and specificity of CTA were 86.0% and 98.0%, respectively, while those of HHD were 81.0% and 86.5%. CTA exhibited an accuracy of 92.0% for perforator identification, whereas that of HHD was 83.5%. Conclusion CTA offers higher sensitivity, specificity, and accuracy in identifying ALT flap perforators than HHD. Its superior imaging capabilities can enable improved surgical planning, minimizing intraoperative challenges, reducing the risk of complications, and potentially increasing flap survival rates. As such, CTA could be considered a valuable standard tool in preoperative planning for ALT flap surgery, particularly in cases where anatomical variation poses a challenge.

Background/Aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding. Therefore, we evaluated the efficacy and safety of EUS-HGS as an alternative treatment for biliary obstruction in patients with HCC. Methods: This was a retrospective study of all EUS-HGS procedures performed in patients with HCC at the Aichi Cancer Center Hospital, Japan, from February 2017 to August 2023. Results: A total of 14 EUS-HGS procedures (42.9% primary) were attempted in 10 HCC patients (mean age 71.5 years, 80.0% male). Clinical and technical success rates were 92.9% and 90.9%, respectively. The observed procedure details in the 13 successful procedures included B3 puncture (53.8%), 22-G needle (53.8%), fully covered self-expandable metal stent (100%), and mean procedure time (32.7 minutes). There was no bleeding. Mild complications occurred in 27.3%. All patients resumed oral intake within 24 hours. Conclusions EUS-HGS is a technically feasible and clinically effective initial or salvage drainage option for the treatment of biliary obstruction in patients with HCC.

AIM: To determine and compare clinico-sociodemographic profiles of primary open angle glaucoma(POAG)with non-glaucoma eye patients in Gwagwalada, Nigeria.METHODS:A cross-sectional comparative study. A total of 235 adult patients including 96 with POAG and 139 non-glaucoma were included. General characteristics such as age, gender, education, vocation, ethnicity, family history of glaucoma, ocular itching, diabetes mellitus, and hypertension were recorded. Ocular examinations included visual acuity, central visual field, cup disc ratio, anterior chamber angle assessment, and intraocular pressure.RESULTS:Mean age was 49.88+13.75 years and 114(48.5%)were males. Patients with POAG comprised 42 ethnics with Igbo(24/96, 25.0%)and Yoruba(20/96, 20.8%)being most common. Most POAG(74/96, 77.1%)were in the age range 40-69. The POAG(73/96, 76.0%)had varied visual impairment. The POAG versus non-glaucoma as follows: positive family history of glaucoma(34/96, 35.4%)vs (25/139, 18.0%; P=0.012); history of diabetes mellitus(8/96, 8.3%)vs(6/139, 4.3%); hypertension(24/96, 25.0%)vs(28/139, 20.1%); combined diabetes mellitus and hypertension(1/96, 1.0%)vs(4/139, 2.9%; P=0.268); antidiabetic drugs(5/96, 5.2%)vs(7/139, 5.0%); antihypertensives drugs(24/96, 25.0%)vs(23/139, 16.5%); combined antidiabetic and antihypertensive drugs(4/96, 4.2%)vs(5/139, 3.6%; P=0.328); ocular itching(18/96, 18.7%)vs(37/139, 26.6%; P=0.328); visual impairment [right eye(RE):51/96, 53.1%; left eye(LE):60/96, 62.5%] vs(RE:40/139, 28.7%; LE:37/139, 26.6%; P=0.000); vertical cup disc ratio>0.4(RE: 96/96, 100.0%; LE:96/96, 100.0%)vs(RE:131/139, 94.2%; LE:124/139, 89.2%)(RE: P=0.307; LE: P=0.006); intraocular pressure >22 mmHg(RE: 17/96, 17.7%; LE: 22/96, 22.9%)vs(RE: 2/139, 1.4%; LE: 2/139, 1.4%; P=0.006). Most POAG(60/96, 62.5%)were on antiglaucoma drugs and(23/96, 24.0%)were yet to commence medication(P=0.000). Many POAG(32/96, 33.3%)were on combination antiglaucoma drugs of beta blockers, prostaglandin inhibitors and carbonic anhydrase inhibitors.CONCLUSION:Glaucoma has distinguishing clinico-sociodemographic features from other eye conditions. Many participants affirmed family history of glaucoma, and most glaucoma participants were on antiglaucoma treatment. The visual impairment including blindness was significantly associated with glaucoma. The study affirmed open angle glaucoma was associated with high cup-disc ratio and high intra ocular pressure.