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1. EUS-guided Gastroenterostomy

Author

Kahaleh, Michel, Tyberg, Amy, Sameera, Sohini, Sarkar, Avik, Shahid, Haroon M., Abdelqader, Abdelhai, Gjeorgjievski, Mihajlo, Gaidhane, Monica, Muniraj, Thiruvengadam, Jamidar, Priya A., Aslanian, Harry R., Abraham, Mathew, Lajin, Michael, Kedia, Prashant, Nieto, Jose, Parsa, Nasim, Andalib, Iman, Bashir, Muhammad, Kowalski, Thomas E., Loren, David E., Kumar, Anand, Schlachterman, Alexander, Chiang, Austin, Holmes, Ian, Mendoza Ladd, Antonio H., Oleas, Roberto, Zolotarevsky, Eugene, Robles-Medranda, Carlos, and Barthet, Marc

Published
2024
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2. Colonic-enteric lumen-apposing metal stents: a promising and safe alternative for endoscopic management of small-bowel obstruction.

Author

Mitsuhashi, Shuji, Kamal, Faisal, Shinn, Brianna J., Chalikonda, Divya, Tyberg, Amy, Shahid, Haroon, Sarkar, Avik, Kahaleh, Michel, Chiang, Austin, Kumar, Anand, Schlachterman, Alex, Loren, David, and Kowalski, Thomas

Abstract

Lumen-apposing metal stents (LAMSs) have revolutionized the treatment of various gastroenterologic conditions that previously required surgery. The use of LAMSs for the management of small-bowel obstruction (SBO) involves EUS-guided coloenterostomy (EUS-CE) between the colon and a dilated loop of the small intestine proximal to the point of obstruction. This procedure is potentially beneficial for patients with malignant SBO who are poor surgical candidates. A retrospective cohort study was conducted at 2 tertiary care hospitals. Patients who underwent EUS-CE for SBO were identified, and data regarding patient demographics, indication for the procedure, location of the obstruction, procedural details, and adverse events were collected. The primary outcome was technical success of the procedure. Secondary outcomes were clinical success, resolution of symptoms, ability to tolerate enteral nutrition, and adverse events. Twenty-six patients who underwent the EUS-CE procedure were included. Technical success was achieved in all 26 patients, clinical success (resolution of obstructive symptoms) was achieved in 92.3% of patients (24/26), and the ability to resume enteral nutrition in 84.6% (22/26). Adverse events occurred in 4 patients (15.4%) and included bleeding (1/26), diarrhea (2/26), and postprocedure sepsis (1/26). Patients were followed for a mean of 54.8 days (range, 2-190). This study highlights that EUS-CE with LAMSs can be performed with high technical and clinical success for the management of SBO, particularly in patients with malignant obstructions who are not suitable candidates for surgical interventions. Further research with larger sample sizes will be essential to substantiate its efficacy and safety. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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3. The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope: A multicenter retrospective international study

Author

Fugazza, Alessandro, Colombo, Matteo, Kahaleh, Michel, Muthusamy, V. Raman, Benjamin, Bick, Laleman, Wim, Barbera, Carmelo, Fabbri, Carlo, Nieto, Jose, Al-Lehibi, Abed, Ramchandani, Mohan, Tyberg, Amy, Shahid, Haroon, Sarkar, Avik, Ehrlich, Dean, Sherman, Stuart, Binda, Cecilia, Spadaccini, Marco, Iannone, Andrea, Khalaf, Kareem, Reddy, Nageshwar, Anderloni, Andrea, and Repici, Alessandro

Abstract

Duodenoscope-related multidrug-resistant organism (MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography (ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy.

Published
2024
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4. Peroral Endoscopic Myotomy for the Management of Esophageal Diverticula: Tunneling Forward

Author

Pelton, Matt, Kahaleh, Michel, and Tyberg, Amy

Abstract

Diverticular peroral endoscopic myotomy (D-POEM) has emerged as a minimally invasive, safe, and effective option for Zenker's diverticula (ZDs) and several other types of esophageal diverticula. D-POEM involves submucosal dissection to create tunnels on the luminal and diverticular aspects of the diverticular septum, allowing for precise visualization of the septum. The operator then performs a myotomy, releasing the diverticula and reconnecting the diverticular and esophageal lumens. Approaches for D-POEM vary on the basis of the location of the initial incision for the submucosal dissection; in the long D-POEM approach, operators begin submucosal dissection 1-2 cm above the septum, whereas in the ultra-short D-POEM approach, operators begin submucosal dissection directly on the septum. Observational studies and systematic reviews demonstrate consistent technical success (93.4%-100%), high clinical success (87.1%-94.1%), few adverse events (4.6%-16.9%), and low recurrence rates (0.9%-4.4%). Meta-analyses of observational studies comparing D-POEM with surgical approaches (flexible endoscopic septotomy and rigid endoscopic septotomy) have found that D-POEM may have higher rates of clinical success (RR 1.13, CI 1.05-1.22 and RR 1.11, CI 1.03-1.18) with comparable technical success, adverse event, and recurrence rates. However, further rigorous prospective and randomized trials are warranted. Early comparisons of the ultra-short and long approaches to D-POEM have not found significant differences in efficacy. Outside of ZD, D-POEM should be further investigated for Killian-Jamieson, epiphrenic, and Rokitansky diverticula

Published
2024
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5. Comparing the Safety and Efficacy of Two Commercially Available Single-Use Duodenoscopes

Author

Shahid, Haroon M., Bareket, Romy, Tyberg, Amy, Sarkar, Avik, Simon, Alexa, Gurram, Krishna, Gress, Frank G., Bhenswala, Prashant, Chalikonda, Divya, Loren, David E., Kowalski, Thomas E., Kumar, Anand, Vareedayah, Ashley A., Abhyankar, Priya R., Parker, Kasey, Gabr, Moamen M., Nieto, Jose, De Latour, Rabia, Zolotarevsky, Mitchelle, Barber, Jeremy, Zolotarevsky, Eugene, Vazquez-Sequeiros, Enrique, Gaidhane, Monica, Andalib, Iman, and Kahaleh, Michel

Published
2023
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6. Drainage Approach for Malignant Biliary Obstruction

Author

Eisenberg, Ian, Gaidhane, Monica, Kahaleh, Michel, and Tyberg, Amy

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the standard of care in the management of unresectable malignant biliary obstruction. However, endoscopic ultrasound (EUS)-guided biliary drainage has become widely accepted over the past several years for complicated biliary drainage in cases when ERCP is unsuccessful or not feasible. Recent emerging evidence suggests EUS-guided hepaticogastrostomy and EUS-guided choledochoduodenostomy are noninferior, and possibly even superior to conventional ERCP for primary palliation of malignant biliary obstruction. This article reviews the procedural techniques and considerations of the different techniques as well as comparative literature on safety and efficacy between techniques.

Published
2023
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10. DOWNSTREAM REVENUE OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ECHOENDOSCOPY IN NORTH AMERICA: SHOW ME THE MONEY.

Author

Shah, Neal, Andalib, Iman, Kowalski, Thomas, Shahid, Haroon, Sarkar, Avik, Tyberg, Amy, Srivastava, Pranay, Gress, Frank, KAMAL, FAISAL, Schlachterman, Alexander, Kumar, Anand, Advani, Rashmi, Robles, Marcel, Yang, Angela, Gervase, Julietta, O'Malley, Blaise, Miller, Dillon, Puga-Tejada, Miguel, Egas-Izquierdo, Maria, and Gaidhane, Monica

Published
2024
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11. Endoscopic Submucosal Dissection (ESD) Offers a Safer and More Cost-effective Alternative to Transanal Endoscopic Microsurgery (TEM)

Author

Kim, Marina, Bareket, Romy, Eleftheriadis, Nikolas P., Kedia, Prashant, Seewald, Stefan, Groth, Stefan, Nieto, Jose, Kumta, Nikhil A., Deshmukh, Ameya A., Katz, Jordan, Suresh, Supriya, Zamarripa, Felipe, Martínez, Ma Guadalupe, Liu-Burdowski, Jennifer, Gaidhane, Monica, Sarkar, Avik, Shahid, Haroon M., Tyberg, Amy, and Kahaleh, Michel

Published
2023
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12. Management of Pancreatic Fluid Collections

Author

Sameera, Sohini, Mohammad, Tayyaba, Liao, Kelvin, Shahid, Haroon, Sarkar, Avik, Tyberg, Amy, and Kahaleh, Michel

Abstract

Managing pancreatic fluid collections (PFCs) remains a challenge for many clinicians. Recently, significant progress has been made in the therapy of PFCs, including improvements in technology and devices, as well as in the development of minimally invasive endoscopic techniques, many of which are proven less traumatic when compared with surgical options and more efficacious when compared with percutaneous techniques. This review will explore latest developments in the management of PFCs and how they incorporate into the current treatment algorithm.

Published
2023
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13. Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD)

Author

Slater, Bethany J., Collings, Amelia, Dirks, Rebecca, Gould, Jon C., Qureshi, Alia P., Juza, Ryan, Rodríguez-Luna, María Rita, Wunker, Claire, Kohn, Geoffrey P., Kothari, Shanu, Carslon, Elizabeth, Worrell, Stephanie, Abou-Setta, Ahmed M., Ansari, Mohammed T., Athanasiadis, Dimitrios I., Daly, Shaun, Dimou, Francesca, Haskins, Ivy N., Hong, Julie, Krishnan, Kumar, Lidor, Anne, Litle, Virginia, Low, Donald, Petrick, Anthony, Soriano, Ian S., Thosani, Nirav, Tyberg, Amy, Velanovich, Vic, Vilallonga, Ramon, and Marks, Jeffrey M.

Abstract

Background: Gastroesophageal reflux disease (GERD) is one of the most common diseases in North America and globally. The aim of this guideline is to provide evidence-based recommendations regarding the most utilized and available endoscopic and surgical treatments for GERD. Methods: Systematic literature reviews were conducted for 4 key questions regarding the surgical and endoscopic treatments for GERD in adults: preoperative evaluation, endoscopic vs surgical or medical treatment, complete vs partial fundoplication, and treatment for obesity (body mass index [BMI] ≥ 35 kg/m2) and concomitant GERD. Evidence-based recommendations were formulated using the GRADE methodology by subject experts. Recommendations for future research were also proposed. Results: The consensus provided 13 recommendations. Through the development of these evidence-based recommendations, an algorithm was proposed for aid in the treatment of GERD. Patients with typical symptoms should undergo upper endoscopy, manometry, and pH-testing; additional testing may be required for patients with atypical or extra-esophageal symptoms. Patients with normal or abnormal findings on manometry should consider undergoing partial fundoplication. Magnetic sphincter augmentation or fundoplication are appropriate surgical procedures for adults with GERD. For patients who wish to avoid surgery, the Stretta procedure and transoral incisionless fundoplication (TIF 2.0) were found to have better outcomes than proton pump inhibitors alone. Patients with concomitant obesity were recommended to undergo either gastric bypass or fundoplication, although patients with severe comorbid disease or BMI > 50 should undergo Roux-en-Y gastric bypass for the additional benefits that follow weight loss. Conclusion: Using the recommendations an algorithm was developed by this panel, so that physicians may better counsel their patients with GERD. There are certain patient factors that have been excluded from included studies/trials, and so these recommendations should not replace surgeon–patient decision making. Engaging in the identified research areas may improve future care for GERD patients.

Published
2023
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14. SAME DAY DISCHARGE FOR THIRD SPACE ENDOSCOPY PROCEDURES : AN INTERNATIONAL MULTICENTER ANALYSIS.

Author

Andalib, Iman, Khan, Mahnoor, Schlachterman, Alexander, Kumar, Anand, Sarkar, Avik, Shahid, Haroon, Kedia, Prashant, KAMAL, FAISAL, Tyberg, Amy, Liao, Kelvin, Kowalski, Thomas, Robles, Marcel, Yang, Angela, Havranek, Brandon, Song, Caleb, O'Malley, Blaise, Gervase, Julietta, Puga-Tejada, Miguel, Baquerizo-Burgos, Jorge, and Alcívar-Vásquez, Juan

Published
2024
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21. DOES LUMEN APPOSING METAL STENT (LAMS) DILATION IMPACT EFFICACY AND OUTCOMES OF ENDOSCOPIC ULTRASOUND GUIDED GASTROENTEROSTOMY (EUS-GE)?

Author

McDonald, Nicholas, Gouda, Zane, Boortalary, Tina, Cohen, Ethan, Thakkar, Shyam, Singh, Shailendra, Krafft, Matthew, Ferrante, Nicole, Amin, Sunil, Kahaleh, Michel, Tyberg, Amy, Shahid, Haroon, Sarkar, Avik, Jamali, Taher, Zuchelli, Tobias, Piraka, Cyrus, Rizzatti, Gianenrico, Larghi, Alberto, Kumta, Nikhil, and Ladd, Antonio Mendoza

Published
2024
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24. DOWNSTREAM REVENUE OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ECHOENDOSCOPY IN NORTH AMERICA: SHOW ME THE MONEY.

Author

Shah, Neal, Andalib, Iman, Kowalski, Thomas, Shahid, Haroon, Sarkar, Avik, Tyberg, Amy, Srivastava, Pranay, Gress, Frank, KAMAL, FAISAL, Schlachterman, Alexander, Kumar, Anand, Advani, Rashmi, Robles, Marcel, Yang, Angela, Gervase, Julietta, O'Malley, Blaise, Miller, Dillon, Puga-Tejada, Miguel, Egas-Izquierdo, Maria, and Gaidhane, Monica

Published
2024
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25. SAME DAY DISCHARGE FOR THIRD SPACE ENDOSCOPY PROCEDURES : AN INTERNATIONAL MULTICENTER ANALYSIS.

Author

Andalib, Iman, Khan, Mahnoor, Schlachterman, Alexander, Kumar, Anand, Sarkar, Avik, Shahid, Haroon, Kedia, Prashant, KAMAL, FAISAL, Tyberg, Amy, Liao, Kelvin, Kowalski, Thomas, Robles, Marcel, Yang, Angela, Havranek, Brandon, Song, Caleb, O'Malley, Blaise, Gervase, Julietta, Puga-Tejada, Miguel, Baquerizo-Burgos, Jorge, and Alcívar-Vásquez, Juan

Published
2024
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26. DOWNSTREAM REVENUE OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ECHOENDOSCOPY IN NORTH AMERICA: SHOW ME THE MONEY.

Author

Shah, Neal, Andalib, Iman, Kowalski, Thomas, Shahid, Haroon, Sarkar, Avik, Tyberg, Amy, Srivastava, Pranay, Gress, Frank, KAMAL, FAISAL, Schlachterman, Alexander, Kumar, Anand, Advani, Rashmi, Robles, Marcel, Yang, Angela, Gervase, Julietta, O'Malley, Blaise, Miller, Dillon, Puga-Tejada, Miguel, Egas-Izquierdo, Maria, and Gaidhane, Monica

Published
2024
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27. Endoscopic Treatment of Reflux

Author

Duarte Chavez, Rodrigo, Marino, Daniel, Kahaleh, Michel, and Tyberg, Amy

Abstract

The last decade has seen the rise of multiple novel endoscopic techniques to treat gastroesophageal reflux disease, many of which are efficacious when compared with traditional surgical options and allow relief from long-term dependence on antacid medications. This review will explore the latest endoscopic treatment options for gastroesophageal reflux disease including a description of the technique, review of efficacy and safety, and future directions.

Published
2022
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28. Safety and efficacy of a novel resection system for direct endoscopic necrosectomy of walled-off pancreas necrosis: a prospective, international, multicenter trial.

Author

Stassen, Pauline M.C., de Jonge, Pieter Jan F., Bruno, Marco J., Koch, Arjun D., Trindade, Arvind J., Benias, Petros C., Sejpal, Divyesh V., Siddiqui, Uzma D., Chapman, Christopher G., Villa, Edward, Tharian, Benjamin, Inamdar, Sumant, Hwang, Joo Ha, Barakat, Monique T., Andalib, Iman, Gaidhane, Monica, Sarkar, Avik, Shahid, Haroon, Tyberg, Amy, and Binmoeller, Kenneth

Abstract

Direct endoscopic necrosectomy (DEN) of walled-off pancreatic necrosis (WOPN) lacks dedicated instruments and requires repetitive and cumbersome procedures. This study evaluated the safety and efficacy of a new powered endoscopic debridement (PED) system designed to simultaneously resect and remove solid debris within WOPN. This was a single-arm, prospective, multicenter, international device trial conducted from November 2018 to August 2019 at 10 sites. Patients with WOPN ≥6 cm and ≤22 cm and with >30% solid debris were enrolled. The primary endpoint was safety through 21 days after the last DEN procedure. Efficacy outcomes included clearance of necrosis, procedural time, adequacy of debridement, number of procedures until resolution, hospital stay duration, and quality of life. Thirty patients (mean age, 55 years; 60% men) underwent DEN with no device-related adverse events. Of 30 patients, 15 (50%) achieved complete debridement in 1 session and 20 (67%) achieved complete debridement within 2 or fewer sessions. A median of 1.5 interventions (range, 1-7) were required. Median hospital stay was 10 days (interquartile range, 22). There was an overall reduction of 91% in percent necrosis within WOPN from baseline to follow-up and 85% in collection volume. Baseline WOPN volume was positively correlated with the total number of interventions (ρ =.363, P =.049). The new PED system seems to be a safe and effective treatment tool for WOPN, resulting in fewer interventions and lower hospital duration when compared with published data on using conventional instruments. Randomized controlled trials comparing the PED system with conventional DEN are needed. (Clinical trial registration number: NCT03694210.) [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2022
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29. Digital single-operator cholangioscopy interobserver study using a new classification: the Mendoza Classification (with video).

Author

Kahaleh, Michel, Gaidhane, Monica, Shahid, Haroon M., Tyberg, Amy, Sarkar, Avik, Ardengh, Jose Celso, Kedia, Prashant, Andalib, Iman, Gress, Frank, Sethi, Amrita, Gan, S. Ian, Suresh, Supriya, Makar, Michael, Bareket, Romy, Slivka, Adam, Widmer, Jessica L., Jamidar, Priya A., Alkhiari, Resheed, Oleas, Roberto, and Kim, Dongchoon

Abstract

Digital single-operator cholangioscopy (DSOC) allows direct visualization of the biliary tree for evaluation of biliary strictures. Our objective was to assess the interobserver agreement (IOA) of DSOC interpretation for indeterminate biliary strictures using newly refined criteria. Fourteen endoscopists were asked to review an atlas of reference clips and images of 5 criteria derived from expert consensus. They then proceeded to score 50 deidentified DSOC video clips based on the visualization of tortuous and dilated vessels, irregular nodulations, raised intraductal lesions, irregular surface with or without ulcerations, and friability. The endoscopists then diagnosed the clips as neoplastic or non-neoplastic. Intraclass correlation (ICC) analysis was done to evaluate inter-rater agreement for both criteria sets and final diagnosis. Clips of 41 malignant lesions and 9 benign lesions were scored. Three of 5 revised criteria had almost perfect agreement. ICC was almost perfect for presence of tortuous and dilated vessels (.86), raised intraductal lesions (.90), and presence of friability (.83); substantial agreement for presence of irregular nodulations (.71); and moderate agreement for presence of irregular surface with or without ulcerations (.44). The diagnostic ICC was almost perfect for neoplastic (.90) and non-neoplastic (.90) diagnoses. The overall diagnostic accuracy using the revised criteria was 77%, ranging from 64% to 88%. The IOA and accuracy rate of DSOC using the new Mendoza criteria shows a significant increase of 16% and 20% compared with previous criteria. The reference atlas helps with formal training and may improve diagnostic accuracy. (Clinical trial registration number: NCT02166099.) [ABSTRACT FROM AUTHOR]

Published
2022
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30. Maximizing success in single-session EUS-directed transgastric ERCP: a retrospective cohort study to identify predictive factors of stent migration.

Author

Shinn, Brianna, Boortalary, Tina, Raijman, Isaac, Nieto, Jose, Khara, Harshit S., Kumar, S. Vikas, Confer, Bradley, Diehl, David L., El Halabi, Maan, Ichkhanian, Yervant, Runge, Thomas, Kumbhari, Vivek, Khashab, Mouen, Tyberg, Amy, Shahid, Haroon, Sarkar, Avik, Gaidhane, Monica, Bareket, Romy, Kahaleh, Michel, and Piraka, Cyrus

Abstract

EUS-directed transgastric ERCP (the EDGE procedure) is a simplified method of performing ERCP in Roux-en-Y gastric bypass patients. The EDGE procedure involves placement of a lumen-apposing metal stent (LAMS) into the excluded stomach to serve as a conduit for passage of the duodenoscope for pancreatobiliary intervention. Originally a multistep process, urgent indications for ERCP have led to the development of single-session EDGE (SS-EDGE) with LAMS placement and ERCP performed in the same session. The goal of this study was to identify predictive factors of intraprocedural LAMS migration in SS-EDGE. We conducted a multicenter retrospective review that included 9 tertiary medical centers across the United States. Data were collected and analyzed from 128 SS-EDGE procedures. The primary outcome was intraprocedural LAMS migration. Secondary outcomes were other procedural adverse events such as bleeding and perforation. Eleven LAMS migrations were observed in 128 procedures (8.6%). Univariate analysis of clinically relevant variables was performed, as was a binary logistic regression analysis of stent diameter and stent dilation. This revealed that use of a smaller (15 mm) diameter LAMS was an independent predictor of intraprocedural stent migration (odds ratio, 5.36; 95% confidence interval, 1.29-22.24; P =.021). Adverse events included 3 patients who required surgery and 2 who experienced intraprocedural bleeding. Use of a larger-diameter LAMS is a predictive factor for a nonmigrated stent and improved procedural success in SS-EDGE. Although larger patient cohorts are needed to adequately assess these findings, performance of LAMS dilation and fixation may also decrease risk of intraprocedural LAMS migration and improve procedural success. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2021
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32. Per Oral Endoscopic Myotomy for Zenker’s Diverticulum

Author

Kahaleh, Michel, Mahpour, Noah Y., Tyberg, Amy, Bareket, Romy, Shahid, Haroon M., Sarkar, Avik, Abdelqader, Abdelhai, Gjeorgjievski, Mihajlo, Marino, Daniel, Kats, Daniel, Gaidhane, Monica, Greenberg, Ian, Lee, David P., Bushe, Bryce, Eke, Chiemeziem, Sun, Hojin, Kedia, Prashant, Méndez, Ana L.M., Lambroza, Arnon, Barret, Maximilien, Hallit, Rachel, Eleftheriadis, Nikolas P., Nieto, Jose, Oleas, Roberto, Robles-Medranda, Carlos, and Bapaye, Amol

Published
2022
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34. LONG TERM EVALUATION OF EUS-GUIDED DRAINAGE OF THE GALLBLADDER WITH LUMEN APPOSING METAL STENTS: AN INTERNATIONAL COLLABORATIVE STUDY.

Author

Aguon, Paul Muna, Tyberg, Amy, Pimpinelli, Marcella, Mikhail, Daniella, Gupta, Kapil, Mallangada, Naveen, Pimpinelli, Sophia, Chouthai, Abhishek, Sarkar, Avik, Miller, Dillon, Shahid, Haroon, Simon, Alexa, Baig, Muhammad, Gaidhane, Monica, Kedia, Prashant, Andalib, Iman, Gress, Frank, Shah, Neal, Vanella, Giuseppe, and Arcidiacono, Paolo

Published
2023
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39. LONG TERM EVALUATION OF EUS-GUIDED DRAINAGE OF THE GALLBLADDER WITH LUMEN APPOSING METAL STENTS: AN INTERNATIONAL COLLABORATIVE STUDY.

Author

Aguon, Paul Muna, Tyberg, Amy, Pimpinelli, Marcella, Mikhail, Daniella, Gupta, Kapil, Mallangada, Naveen, Pimpinelli, Sophia, Chouthai, Abhishek, Sarkar, Avik, Miller, Dillon, Shahid, Haroon, Simon, Alexa, Baig, Muhammad, Gaidhane, Monica, Kedia, Prashant, Andalib, Iman, Gress, Frank, Shah, Neal, Vanella, Giuseppe, and Arcidiacono, Paolo

Published
2023
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41. PREDICTIVE FACTORS FOR EUS-GUIDED DRAINAGE OF PANCREATIC FLUID COLLECTIONS: A MULTICENTER INTERNATIONAL COLLABORATIVE STUDY COMPARING CYSTGASTROSTOMY TO CYSTODUODENOSTOMY.

Author

Tyberg, Amy, Shahid, Haroon, Sarkar, Avik, Patel, Ankoor, Baig, Muhammad, Aguon, Paul Muna, Gaidhane, Monica, Abdelqader, Abdelhai, Gjeorgjievski, Mihajlo, Muhlgeier, Brittany, Simon, Alexa, Vanella, Giuseppe, Cunto, Domenica, Alcívar-Vásquez, Juan, Gornals, Joan, Kowalski, Thomas, Vemula, Sudheshna, Chiang, Austin, Kumar, Anand, and Bilello, Justin

Published
2023
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44. OUTCOMES OF EUS-GUIDED CHOLEDOCHODUODENOSTOMY WITH 6 MILLIMETER AND 8 MILLIMETER LUMEN-APPOSING METAL STENTS FOR TREATMENT OF DISTAL MALIGNANT BILIARY OBSTRUCTION.

Author

Chalikonda, Divya, Mitsuhashi, Shuji, Shinn, Brianna, Tyberg, Amy, Shahid, Haroon, Sarkar, Avik, Kahaleh, Michel, Thakkar, Shyam, Zitun, Mohamed, Singh, Shailendra, Shah-Khan, Sardar, Ahmed, Moiz, Kadkhodayan, Kambiz, Hasan, Muhammad, Hoerter, Nicholas, Kumta, Nikhil, Khara, Harshit, Confer, Bradley, Diehl, David, and Shrigiriwar, Apurva

Published
2023
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45. DIRECT ENDOSCOPIC NECROSECTOMY WITH A FLEXIBLE MOTORIZED ENDOSCOPIC RESECTION SYSTEM: MIDTERM RESULTS OF A MULTICENTER STUDY.

Author

Baig, Muhammad, Shahid, Haroon, Gupta, Kapil, Chouthai, Abhishek, Sarkar, Avik, Gaidhane, Monica, Tyberg, Amy, Widmer, Jessica, Loren, David, Schlachterman, Alexander, KAMAL, F.A.I.S.A.L., Kowalski, Thomas, Kumar, Anand, Patel, Akash, Chiang, Austin, Chalikonda, Divya, Kedia, Prashant, Lee, David, Obeng, George, and Shah-Khan, Sardar

Published
2023
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46. DIRECT ENDOSCOPIC NECROSECTOMY WITH A FLEXIBLE MOTORIZED ENDOSCOPIC RESECTION SYSTEM: MIDTERM RESULTS OF A MULTICENTER STUDY.

Author

Baig, Muhammad, Shahid, Haroon, Gupta, Kapil, Chouthai, Abhishek, Sarkar, Avik, Gaidhane, Monica, Tyberg, Amy, Widmer, Jessica, Loren, David, Schlachterman, Alexander, KAMAL, FAISAL, Kowalski, Thomas, Kumar, Anand, Patel, Akash, Chiang, Austin, Chalikonda, Divya, Kedia, Prashant, Lee, David, Obeng, George, and Shah-Khan, Sardar

Published
2023
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48. The safety and efficacy of a new 20-mm lumen apposing metal stent (lams) for the endoscopic treatment of pancreatic and peripancreatic fluid collections: a large international, multicenter study

Author

Anderloni, Andrea, Fabbri, Carlo, Nieto, Jose, Uwe, Will, Dollhopf, Markus, Aparicio, José Ramón, Perez-Miranda, Manuel, Tarantino, Ilaria, Arlt, Alexander, Vleggaar, Frank, Vanbiervliet, Geoffrey, Hampe, Jochen, Kahaleh, Michel, Vila, Juan J., Dayyeh, Barham K. Abu, Storm, Andrew C., Fugazza, Alessandro, Binda, Cecilia, Charachon, Antoine, Sevilla-Ribota, Sergio, Tyberg, Amy, Robert, Moran, Wani, Sachin, Repici, Alessandro, Sethi, Amrita, Khashab, Mouen A., and Kunda, Rastislav

Abstract

Background: Lumen apposing metal stent (LAMS) allows an easy access to peripancreatic fluid collections (PPFCs) and the possibility of performing direct endoscopic necrosectomy (DEN). The aim of our study was to evaluate the safety and efficacy of a new 20-mm LAMS in the management of PPFCs. This novel stent represents the largest diameter LAMS available on the market to date. Methods: This is an international, multicenter retrospective study involving 20 centers. Consecutive patients who underwent EUS-guided PPFC drainage using a 20-mm LAMS were included. Primary outcomes were technical and clinical success. Secondary outcomes were rate and the severity of adverse events. Results: A total 105 patients underwent PPFC drainage using the new 20-mm LAMS and 106 LAMS were placed. Technical success was 100% (106/106). 7/105 patients died due to causes not related to the stent. Clinical success was achieved in 92/98 patients (93.9%). Significant adverse events occurred in 8/98 patients (8.16%): 4 cases (4.08%) of bleeding, 3 cases (3.06%) of suprainfection, 1 case of gastric outlet obstruction. Conclusions: This multicenter study demonstrated acceptable rates of technical and clinical success using a new 20-mm LAMS for PPFC, including walled-off pancreatic necrosis (WOPN). The results of our study suggest that a new 20-mm LAMS is non-inferior in terms of safety, efficacy, and adverse events as compared to smaller diameter LAMS in the management of PPFCs, including pancreatic psuedocysts (PP) and WOPN. Randomized controlled studies will be needed to determine the ideal size of LAMS need to achieve the greatest clinical benefit with the minimized risk exposure for this high-risk patient population.

Published
2021
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50. Clinical Review of EUS-guided Gastroenterostomy (EUS-GE)

Author

Carbajo, Ana Y., Kahaleh, Michel, and Tyberg, Amy

Abstract

Gastric outlet obstruction (GOO) refers to mechanical obstruction of the distal stomach or proximal duodenum and it is associated with a significant decrease in quality of life. Surgical gastrojejunostomy and self-expandable metal stents were the traditional treatment for GOO. Recently, endoscopic ultrasound guided gastroenterostomy (EUS-GE) has emerged as a third therapeutic option for patients with GOO. Most EUS-GE techniques utilize the placement of a lumen-apposing metal stent under echoendoscopy but differ in the method of localizing the jejunal loop prior to EUS puncture. Data supporting EUS-GE have been promising. Case series including 10 or more cases showed the technical success rate to be approximately 90%. Clinical success is achieved in approximately 85–90% and a less than 18% risk of adverse events is reported. EUS-GE was associated with a lower recurrence of GOO and need for re-intervention when compared to enteral stenting. In addition, EUS-GE shows significantly fewer adverse events compared with surgical gastrojejunostomy. In conclusion, EUS-GE provides symptom relief without the risks of surgical intervention and the limited patency of enteral SEMS placement. EUS-GE is an exciting new option in the management of GOO. Despite the excellent results, randomized studies comparing these different modalities of treatment for GOO are needed before EUS-GE can be accepted as standard of care.

Published
2020
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