Journals and Research

Research and education are foundational to the mission of Orlando Health and our Digestive Health Institute. As frequent contributors to leading publications on gastroenterology and endoscopy, our physicians share their research and clinical insights with a national and international community of colleagues.


RSS Feed

Author(s) Title Description Publish Date
Bo Shen, Gursimran S Kochhar, David T Rubin, Sunanda V Kane, Udayakumar Navaneethan, Charles N Bernstein, Raymond K Cross, Akira Sugita, Jason Schairer, Ravi P Kiran, Philip Fleshner, James T McCormick, André D'Hoore, Samir A Shah, Francis A Farraye, Revital Kariv, Xiuli Liu, Joel Rosh, Shannon Chang, Ellen Scherl, David A Schwartz, Paulo Gustavo Kotze, David H Bruining, Jessica Philpott, Bincy Abraham, Jonathan Segal, Rocio Sedano, Maia Kayal, Stuart Bentley-Hibbert, Dino Tarabar, Sandra El-Hachem, Priya Sehgal, Joseph A Picoraro, Séverine Vermeire, William J Sandborn, Mark S Silverberg, Darrell S Pardi Treatment of pouchitis, Crohn's disease, cuffitis, and other inflammatory disorders of the pouch: consensus guidelines from the International Ileal Pouch Consortium Pouchitis, Crohn's disease of the pouch, cuffitis, polyps, and extraintestinal manifestations of inflammatory bowel disease are common inflammatory disorders of the ileal pouch. Acute pouchitis is treated with oral antibiotics and chronic pouchitis often requires anti-inflammatory therapy, including... 11/14/2021
Ji Young Bang, Robert Hawes, Shyam Varadarajulu Endoscopic biliary drainage for malignant distal biliary obstruction: which is better - ERCP or EUS? Presently, following endoscopic ultrasound (EUS)-guided biopsy, an endoscopic retrograde cholangiopancreatography (ERCP) with trans-papillary stenting is performed for palliation of malignant distal biliary obstruction (MDBO). However, technical failure and post-procedure pancreatitis are limitation... 11/8/2021
Bo Shen, Gursimran S Kochhar, Revital Kariv, Xiuli Liu, Udayakumar Navaneethan, David T Rubin, Raymond K Cross, Akira Sugita, André D'Hoore, Jason Schairer, Francis A Farraye, Ravi P Kiran, Philip Fleshner, Joel Rosh, Samir A Shah, Shannon Chang, Ellen Scherl, Darrell S Pardi, David A Schwartz, Paulo G Kotze, David H Bruining, Sunanda V Kane, Jessica Philpott, Bincy Abraham, Jonathan Segal, Rocio Sedano, Maia Kayal, Stuart Bentley-Hibbert, Dino Tarabar, Sandra El-Hachem, Priya Sehgal, James T McCormick, Joseph A Picoraro, Mark S Silverberg, Charles N Bernstein, William J Sandborn, Séverine Vermeire Diagnosis and classification of ileal pouch disorders: consensus guidelines from the International Ileal Pouch Consortium Restorative proctocolectomy with ileal pouch-anal anastomosis is an option for most patients with ulcerative colitis or familial adenomatous polyposis who require colectomy. Although the construction of an ileal pouch substantially improves patients' health-related quality of life, the surgery is, d... 8/20/2021
Bo Shen, Martin Bortlik, David H Bruining, Nayantara Coelho-Prabhu, Sandra El-Hachem, Francis A Farraye, Marietta Iacucci, Taku Kobayashi, Gursimran S Kochhar, Paulo Gustavo Kotze, Yago González Lama, Alexander N Levy, Xiuli Liu, Ren Mao, Udayakumar Navaneethan, David A Schwartz, Amandeep Shergill, Ajit Sood, Begoña Gonzalez Suárez Endoscopic evaluation after surgery in inflammatory bowel disease - Authors' reply No abstract 8/15/2021
Ji Young Bang, C Mel Wilcox, Juan Pablo Arnoletti, Shajan Peter, John Christein, Udayakumar Navaneethan, Robert Hawes, Shyam Varadarajulu Validation of the Orlando Protocol for endoscopic management of pancreatic fluid collections in the era of lumen-apposing metal stents CONCLUSIONS: A structured approach integrating LAMS with selective use of plastic stents improved treatment success in patients with PFCs compared to an approach using only plastic stents. 7/31/2021
Pietro Fusaroli, Mohamad Eloubeidi, Claudio Calvanese, Christoph Dietrich, Christian Jenssen, Adrian Saftoiu, Claudio De Angelis, Shyam Varadarajulu, Bertrand Napoleon, Andrea Lisotti, QUOREUS study group Quality of reporting in endoscopic ultrasound: Results of an international multicenter survey (the QUOREUS study) Background and study aims The endoscopic report has a key role in quality improvement for gastrointestinal endoscopy. High quality standards have been set by the endoscopic societies in this field. Unlike other digestive endoscopy procedures, the quality of reporting in endoscopic ultrasound (EUS) ... 7/5/2021
Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization of the Gastroduodenal Artery for a Previously Bleeding Duodenal Ulcer Transarterial angiographic embolization is a highly effective, safe treatment for non-variceal upper gastrointestinal bleeding refractory to endoscopic intervention. However, intraluminal coil migration is a possible complication. Coil migration, while usually a self-limiting process, can lead to si... 5/27/2021
Shajan Peter, Ji Young Bang, Shyam Varadarajulu Single-use duodenoscopes: where are we and where are we going? PURPOSE OF REVIEW: Given the growing concerns about infection transmission from use of contaminated reusable duodenoscopes, technological advancements have been made that vary from modifications of existing designs to development of single-use devices. 5/19/2021
Jagpal S Klair, Yousaf Zafar, Munish Ashat, Shivanand Bomman, Arvind R Murali, Mahendran Jayaraj, Joanna Law, Michael Larsen, Dhruv P Singh, Tarun Rustagi, Shayan Irani, Andrew Ross, Richard Kozarek, Rajesh Krishnamoorthi Effectiveness and Safety of EUS Rendezvous After Failed Biliary Cannulation With ERCP: A Systematic Review and Proportion Meta-analysis CONCLUSIONS: EUS-RV-assisted ERCP appears to be effective and safe in patients who failed biliary cannulation with conventional ERCP. Given the risk of adverse events, it should be performed in centers with expertise in therapeutic endoscopic ultrasound. 5/19/2021
Ji Young Bang, Robert Hawes, Shyam Varadarajulu Response to the letter to the editor No abstract 5/8/2021
Jeska A Fritzsche, Paul Fockens, Marc Barthet, Marco J Bruno, David L Carr-Locke, Guido Costamagna, Gregory A Coté, Pierre H Deprez, Marc Giovannini, Gregory B Haber, Robert H Hawes, Jong Jin Hyun, Takao Itoi, Eisuke Iwasaki, Leena Kylänpaä, Horst Neuhaus, Jeong Youp Park, D Nageshwar Reddy, Arata Sakai, Michael J Bourke, Rogier P Voermans Expert consensus on endoscopic papillectomy using a Delphi process CONCLUSIONS: This is the first step in developing an international consensus-based algorithm for endoscopic management of papillary adenomas. Surprisingly, in many areas consensus could not be achieved. These aspects should be the focus of future studies. 4/22/2021
Bo Shen, Gursimran S Kochhar, Udayakumar Navaneethan, Raymond K Cross, Francis A Farraye, Marietta Iacucci, David A Schwartz, Yago Gonzalez-Lama, Jason Schairer, Ravi P Kiran, Paulo Gustavo Kotze, Taku Kobayashi, Martin Bortlik, Xiuli Liu, Alexander N Levy, Begoña González Suárez, Shou-Jiang Tang, Nayantara Coelho-Prabhu, Martin Lukas, David H Bruining, Sandra El-Hachem, Roger J Charles, Yan Chen, Ajit Sood, Ren Mao, Carme Loras, Parambir S Dulai, Joseph A Picoraro, Michael Chiorean, Milan Lukas, Amandeep Shergill, Mark S Silverberg, William J Sandborn, Charles N Bernstein Endoscopic evaluation of surgically altered bowel in inflammatory bowel disease: a consensus guideline from the Global Interventional Inflammatory Bowel Disease Group The majority of patients with Crohn's disease and a proportion of patients with ulcerative colitis will ultimately require surgical treatment despite advances in diagnosis, therapy, and endoscopic interventions. The surgical procedures that are most commonly done include bowel resection with anastom... 4/19/2021
Ji Young Bang, Konrad Krall, Shyam Varadarajulu Single-operator cholangioscopy-guided biopsy of indeterminate bile duct strictures: Work in progress No abstract 4/8/2021
Saeed Ali, Neelam Khetpal, Evgeny Idrisov, Asad Ur Rahman, Sameen Khalid, Yuan Du, Udayakumar Navaneethan, Shyam Varadarajulu, Robert Hawes, Muhammad Khalid Hasan Endoscopic Mucosal Resection for Colonic Mucosal Neoplasia and Evaluation of Long-Term Recurrence: A Single-Center Experience of 500 Cases CONCLUSIONS: EMR is an effective, minimally invasive technique for the treatment of large laterally spreading lesions. Although recurrence is a concern, its risk is low (21.8% on SC1 and 9.8% on SC2) and was managed endoscopically in 96.3% cases on follow-up endoscopy. 3/31/2021
Brian Bressler, Andres Yarur, Mark S Silverberg, Marielle Bassel, Emanuelle Bellaguarda, Chris Fourment, Anthie Gatopoulou, Pantelis Karatzas, Uri Kopylov, George Michalopoulos, Spyridon Michopoulos, Udayakumar Navaneethan, David T Rubin, Jesse Siffledeen, Andrew Singh, Konstantinos Soufleris, Dara Stein, Dirk Demuth, Gerassimos J Mantzaris Vedolizumab and Anti-Tumour Necrosis Factor α Real-World Outcomes in Biologic-Naïve Inflammatory Bowel Disease Patients: Results from the EVOLVE Study CONCLUSION: In this real-world setting, first-line biologic therapy in biologic-naïve patients with UC and CD demonstrated that vedolizumab and anti-TNFα treatments were equally effective at controlling disease symptoms, but vedolizumab has a more favourable safety profile. 3/31/2021
Ji Young Bang, Thomas J Ward, Shady Guirguis, Konrad Krall, Francisco Contreras, Nirag Jhala, Udayakumar Navaneethan, Robert H Hawes, Shyam Varadarajulu Radiology-guided percutaneous approach is superior to EUS for performing liver biopsies No abstract 3/26/2021
Gregory A Coté, Haley Nitchie, B Joseph Elmunzer, Richard S Kwon, Field F Willingham, Sachin Wani, Daniel Mullady, Amitabh Chak, Vikesh Singh, Adam Slivka, Shyam Varadarajulu, Martin Freeman, Srinivas Gaddam, Priya Jamidar, Paul Tarnasky, Lydia Foster, Peter B Cotton Characteristics of Patients Undergoing Endoscopic Retrograde Cholangiopancreatography for Sphincter of Oddi Disorders The concept that sphincter of Oddi dysfunction (SOD) can cause attacks of biliary-type pain in postcholecystectomy patients and those with unexplained recurrent acute pancreatitis, and that endoscopic sphincterotomy can ameliorate symptoms, remains unproven. The Evaluating Predictors and Interventio... 3/15/2021
Jagpal Singh Klair, Yousaf Zafar, Navroop Nagra, Arvind R Murali, Mahendran Jayaraj, Dhruv Singh, Tarun Rustagi, Rajesh Krishnamoorthi Outcomes of Radiofrequency Ablation versus Endoscopic Surveillance for Barrett's Esophagus with Low-Grade Dysplasia: A Systematic Review and Meta-Analysis CONCLUSIONS: Based on our meta-analysis, there was a significant reduction in the risk of progression to HGD or EAC among patients with BE-LGD treated with RFA compared with those undergoing endoscopic surveillance. Endoscopic eradication therapy with RFA should be the preferred management approach ... 1/27/2021
Ji Young Bang, Robert Hawes, Shyam Varadarajulu Clinical, financial and academic implications of COVID-19 on a tertiary care interventional endoscopy programme No abstract 12/15/2020
Kumar Krishnan, Manoop S Bhutani, Harry R Aslanian, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Mansour A Parsi, Allison R Schulman, Amrita Sethi, Shelby Sullivan, Guru Trikudanathan, Arvind J Trindade, Rabindra R Watson, John T Maple, (ASGE Technology Committee Chair, 2016-2019), David R Lichtenstein, (ASGE Technology Committee Chair) Enhanced EUS imaging (with videos) CONCLUSIONS: Elastography and CE-EUS may improve the real-time evaluation of intra- and extraluminal lesions as an adjunct to standard B-mode and Doppler imaging. They are not a replacement for EUS-guided tissue sampling but provide adjunctive diagnostic information in specific clinical situations. ... 11/1/2020
Ji Young Bang, Thomas Rösch, Hyungjin Myra Kim, Shyam Thakkar, Ernesto Robalino Gonzaga, Benjamin Tharian, Sumant Inamdar, Linda S Lee, Patrick Yachimski, Priya Jamidar, Thiruvengadam Muniraj, Christopher DiMaio, Nikhil Kumta, Amrita Sethi, Peter Draganov, Dennis Yang, Talal Seoud, Abhilash Perisetti, Gayatri Bondi, Sachin Kirtane, Robert Hawes, C Mel Wilcox, Richard Kozarek, D Nageshwar Reddy, Shyam Varadarajulu Prospective evaluation of an assessment tool for technical performance of duodenoscopes CONCLUSIONS: The newly developed assessment tool appears reliable and valid for evaluating the technical performance of duodenoscopes. Registration: ClinicalTrials.gov Identifier: NCT04004533. 10/2/2020
Ji Young Bang, Robert Hawes, Shyam Varadarajulu Equivalent performance of single-use and reusable duodenoscopes in a randomised trial CONCLUSION: Given the overall safety profile and similar technical performance, single-use duodenoscopes represent an alternative to reusable duodenoscopes for performing low-complexity ERCP procedures in experienced hands. 9/8/2020
Udayakumar Navaneethan, Chad Spencer, Xiang Zhu, John J Vargo, David Grove, Raed A Dweik Volatile organic compounds in bile can distinguish pancreatic cancer from chronic pancreatitis: a prospective observational study CONCLUSION: The measurement of VOCs in bile helped to accurately distinguish pancreatic cancer from chronic pancreatitis. 9/7/2020
Ji Young Bang, Shyam Varadarajulu The promise of EUS-guided hepaticogastrostomy: miles to go before we sleep, and miles to go before we sleep No abstract 8/26/2020
B Joseph Elmunzer, Catharine M Walsh, Gretchen Guiton, Jose Serrano, Amitabh Chak, Steven Edmundowicz, Richard S Kwon, Daniel Mullady, Georgios I Papachristou, Grace Elta, Todd H Baron, Patrick Yachimski, Evan L Fogel, Peter V Draganov, Jason R Taylor, James Scheiman, Vikesh K Singh, Shyam Varadarajulu, Field F Willingham, Gregory A Cote, Peter B Cotton, Violette Simon, Rebecca Spitzer, Rajesh Keswani, Sachin Wani, SVI study group and the U.S. Cooperative for Outcomes Research in Endoscopy Development and initial validation of an instrument for video-based assessment of technical skill in ERCP CONCLUSIONS: Video-based assessment of ERCP skill appears to be feasible with a novel instrument that demonstrates favorable validity evidence. Future steps include determining whether the tool can discriminate between endoscopists of varying experience levels and predict important outcomes in clini... 8/3/2020
Udayakumar Navaneethan Stent placement through anastomotic strictures in Crohn's disease: a new beginning No abstract 7/25/2020
Ji Young Bang, C Mel Wilcox, Juan Pablo Arnoletti, Shyam Varadarajulu Importance of Disconnected Pancreatic Duct Syndrome in Recurrence of Pancreatic Fluid Collections Initially Drained Using Lumen-Apposing Metal Stents CONCLUSIONS: In treatment of PFCs with LAMS in patients with DPDS, it is important to replace the LAMS with indwelling plastic stents to minimize PFC recurrence and reduce morbidity. Clinicaltrials.gov no: NCT02422095. 7/20/2020
Udayakumar Navaneethan, Dennisdhilak Lourdusamy, Vanessa LehnerNoguera, Bo Shen Safety of Endoscopy in Patients With Inflammatory Bowel Disease During the COVID-19 Pandemic No abstract 7/18/2020
Ji Young Bang, Charles Mel Wilcox, Robert Hawes, Shyam Varadarajulu Outcomes of a Structured, Stepwise Approach to Endoscopic Necrosectomy CONCLUSIONS: By decreasing the number of necrosectomy sessions, a structured, stepwise approach to endoscopic necrosectomy seems to improve procedural efficiency. 7/14/2020
Ji Young Bang, Konrad Krall, Nirag Jhala, Charanjeet Singh, Mohamedtaki Tejani, Juan Pablo Arnoletti, Udayakumar Navaneethan, Robert Hawes, Shyam Varadarajulu Comparing Needles and Methods of Endoscopic Ultrasound-Guided Fine-Needle Biopsy to Optimize Specimen Quality and Diagnostic Accuracy for Patients With Pancreatic Masses in a Randomized Trial CONCLUSIONS: In patients with suspected pancreatic cancer, samples with the highest degree of cellularity in a single biopsy, resulting in a diagnostic accuracy of 90% of higher, were collected by fine-needle biopsy using the franseen or fork-tip needle. Clinicaltrials.gov no: NCT04085055. 7/12/2020
C Mel Wilcox, Thomas Gress, Marja Boermeester, Atsushi Masamune, Philippe Lévy, Takao Itoi, Shyam Varadarajulu, Atsushi Irisawa, Michael Levy, Masayuki Kitano, Pramod Garg, Shuiji Isaji, Tooru Shimosegawa, Andrea R G Sheel, David C Whitcomb, John P Neoptolemos, International (IAP-APA-JPS-EPC) Consensus Guidelines for Chronic Pancreatitis International consensus guidelines on the role of diagnostic endoscopic ultrasound in the management of chronic pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and European Pancreatic Club CONCLUSIONS: The presence of 5 or more and 2 or less EUS criteria strongly suggests or refutes the diagnosis of CP, respectively. Intra-observer variability still limits the role of EUS in diagnosing CP especially early stage disease. 7/8/2020
Babu P Mohan, Shahab R Khan, Saurabh Chandan, Lena L Kassab, Suresh Ponnada, Ravishankar Asokkumar, Bo Shen, Marietta Iacucci, Udayakumar Navaneethan Endoscopic resection of colon dysplasia in patients with inflammatory bowel disease: a systematic review and meta-analysis CONCLUSIONS: Risk of CRC after dysplasia resection in IBD patients appears to be low, supporting the current strategy of resection and surveillance. 6/28/2020
Mahendran Jayaraj, Ranjit Makar, Gordon Ohning Evaluation and Management of Suspected Early Chronic Pancreatitis (ECP) PURPOSE OF REVIEW: Chronic pancreatitis in the advanced stages leads to significant health care utilization because of the associated complications. Early-stage diagnosis could prevent the development of these complications by appropriate management. In this article, we reviewed the recent evidence ... 6/28/2020
Udayakumar Navaneethan, Vanessa LehnerNoguera Prolonged Duration of SARS-CoV-2 Viral Positivity in a Crohn's Disease Patient No abstract 6/25/2020
Udayakumar Navaneethan Endoscopic Stricturotomy for Refractory Anal Strictures in Crohn's Disease No abstract 6/10/2020
B Joseph Elmunzer, Jose Serrano, Amitabh Chak, Steven A Edmundowicz, Georgios I Papachristou, James M Scheiman, Vikesh K Singh, Shyam Varadarajulu, John J Vargo, Field F Willingham, Todd H Baron, Gregory A Coté, Joseph Romagnuolo, April Wood-Williams, Emily K Depue, Rebecca L Spitzer, Cathie Spino, Lydia D Foster, Valerie Durkalski, SVI study group and the United States Cooperative for Outcomes Research in Endoscopy (USCORE) Correction to: Rectal indomethacin alone versus indomethacin and prophylactic pancreatic stent placement for preventing pancreatitis after ERCP: study protocol for a randomized controlled trial An amendment to this paper has been published and can be accessed via the original article. 6/5/2020
Jagpal Singh Klair, Mahendran Jayaraj, Viveksandeep Thoguluva Chandrasekar, Harshith Priyan, Joanna Law, Arvind R Murali, Dhruv Singh, Michael Larsen, Shayan Irani, Richard Kozarek, Andrew Ross, Rajesh Krishnamoorthi ERCP with overtube-assisted enteroscopy in patients with Roux-en-Y gastric bypass anatomy: a systematic review and meta-analysis CONCLUSIONS: OAE-ERCP appears to be effective and safe in post-RYGB patients. Among the currently available techniques, OAE-ERCP is the least invasive approach in this challenging group of patients. Future studies comparing the effectiveness and safety of alternative novel techniques, such as endoso... 6/4/2020
Yan Chen, Qiao Yu, Francis A Farraye, Gursimran S Kochhar, Charles N Bernstein, Udayakumar Navaneethan, Kaicun Wu, Jie Zhong, David A Schwartz, Hao Wu, Jing-Jing Zheng, Marietta Iacucci, Ravi P Kiran, Bo Shen Patterns of endoscopy during COVID-19 pandemic: a global survey of interventional inflammatory bowel disease practice CONCLUSIONS: Cancellation of elective and emergent endoscopy in IBD care during the pandemic was common. Few respondents reported that their patients' disease conditions worsened due to the cancellation of the endoscopy procedure. Most respondents voiced the need for proper PPE during the procedure ... 6/1/2020
Mandeep S Sawhney, Mohammad Bilal, Heiko Pohl, Vladimir M Kushnir, Mouen A Khashab, Allison R Schulman, Tyler M Berzin, Prabhleen Chahal, V Raman Muthusamy, Shyam Varadarajulu, Subhas Banerjee, Gregory G Ginsberg, Gottumukkala S Raju, Joseph D Feuerstein Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method CONCLUSIONS: By using a Modified Delphi method that prioritized patient-important outcomes, we developed consensus recommendations on procedural timing for common indications for advanced endoscopy. These recommendations and the structured decision framework provided by our study can inform decision... 5/20/2020
Banreet Singh Dhindsa, Harmeet Singh Mashiana, Amaninder Dhaliwal, Babu P Mohan, Mahendran Jayaraj, Harlan Sayles, Shailender Singh, Gordon Ohning, Ishfaq Bhat, Douglas G Adler EUS-guided biliary drainage: A systematic review and meta-analysis ERCP is the current procedure of choice for patients with jaundice caused by biliary obstruction. EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to ERCP in patients requiring biliary drainage. The aim of the study was to conduct a systematic review and meta-analysis to report the... 4/17/2020
Babu P Mohan, Ravishankar Asokkumar, Shahab R Khan, Rajesh Kotagiri, Gurusravanan Kutti Sridharan, Saurabh Chandan, Naveen Pg Ravikumar, Suresh Ponnada, Mahendran Jayaraj, Douglas G Adler Outcomes of endoscopic sleeve gastroplasty; how does it compare to laparoscopic sleeve gastrectomy? A systematic review and meta-analysis No abstract 4/8/2020
Ji Young Bang, Matthew Hough, Robert H Hawes, Shyam Varadarajulu Use of Artificial Intelligence to Reduce Radiation Exposure at Fluoroscopy-Guided Endoscopic Procedures OBJECTIVES: Exposure to ionizing radiation remains a hazard for patients and healthcare providers. We evaluated the utility of an artificial intelligence (AI)-enabled fluoroscopy system to minimize radiation exposure during image-guided endoscopic procedures. 3/21/2020
Rajesh Krishnamoorthi, Chandra S Dasari, Viveksandeep Thoguluva Chandrasekar, Harshith Priyan, Mahendran Jayaraj, Joanna Law, Michael Larsen, Richard Kozarek, Andrew Ross, Shayan Irani Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis CONCLUSION: CDD using LAMS/EC-LAMS is an effective and safe technique for biliary decompression in patients who failed ERCP. Further studies are needed to assess CDD using LAMS as primary treatment modality for biliary obstruction. 3/7/2020
Udayakumar Navaneethan You cannot go wrong: choosing digital single-operator cholangioscopy for the diagnosis of biliary strictures No abstract 2/26/2020
Ji Young Bang, Robert H Hawes, Shyam Varadarajulu Lumen-apposing metal stent placement for drainage of pancreatic fluid collections: predictors of adverse events No abstract 2/19/2020
Ji Young Bang, Bryce Sutton, Udayakumar Navaneethan, Robert Hawes, Shyam Varadarajulu Efficacy of Single-Operator Cholangioscopy-Guided Lithotripsy Compared With Large Balloon Sphincteroplasty in Management of Difficult Bile Duct Stones in a Randomized Trial CONCLUSIONS: In a randomized trial of patients with difficult bile stones that cannot be cleared by standard maneuvers, SOC-guided lithotripsy leads to duct clearance in a significantly higher proportion of patients than LBS-particularly when stone size exceeds the diameter of the extrahepatic bile ... 2/15/2020
Rajesh Krishnamoorthi, Mahendran Jayaraj, Viveksandeep Thoguluva Chandrasekar, Dhruv Singh, Joanna Law, Michael Larsen, Andrew Ross, Richard Kozarek, Shayan Irani EUS-guided versus endoscopic transpapillary gallbladder drainage in high-risk surgical patients with acute cholecystitis: a systematic review and meta-analysis CONCLUSION: EUS-GBD has higher rate of technical and clinical success compared to ET-GBD. While the rates of overall adverse events are statistically similar, EUS-GBD has lower rate of recurrent cholecystitis. Hence, EUS-GBD is preferable to ET-GBD for endoscopic management of acute cholecystitis in... 2/13/2020
Bo Shen, Gursimran Kochhar, Udayakumar Navaneethan, Francis A Farraye, David A Schwartz, Marietta Iacucci, Charles N Bernstein, Gerald Dryden, Raymond Cross, David H Bruining, Taku Kobayashi, Martin Lukas, Amandeep Shergill, Martin Bortlik, Nan Lan, Milan Lukas, Shou-Jiang Tang, Paulo Gustavo Kotze, Ravi P Kiran, Parambir S Dulai, Sandra El-Hachem, Nayantara Coelho-Prabhu, Shyam Thakkar, Ren Mao, Guodong Chen, Shengyu Zhang, Begoña González Suárez, Yago Gonzalez Lama, Mark S Silverberg, William J Sandborn Practical guidelines on endoscopic treatment for Crohn's disease strictures: a consensus statement from the Global Interventional Inflammatory Bowel Disease Group Stricture formation is a common complication of Crohn's disease, resulting from the disease process, surgery, or drugs. Endoscopic balloon dilation has an important role in the management of strictures, with emerging techniques, such as endoscopic electroincision and stenting, showing promising resu... 1/20/2020
Basile Njei, Thomas R McCarty, Thiruvengadam Muniraj, Prabin Sharma, Priya A Jamidar, Harry R Aslanian, Shyam Varadarajulu, Udayakumar Navaneethan Comparative effectiveness of pharmacologic and endoscopic interventions for prevention of post-ERCP pancreatitis: a network meta-analysis Background and study aims While several interventions may decrease risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, it remains unclear whether one strategy is superior to others. The purpose of this study was to compare the effectiveness of pharmacologic and endoscopi... 1/11/2020
Annie S Hong, Wen Yuan Yu, Jenny M Hong, Chad L Cross, Mohamed Azab, Gordon Ohning, Mahendran Jayaraj Proton pump inhibitor in upper gastrointestinal fecal microbiota transplant: A systematic review and analysis CONCLUSIONS: We did not find evidence supporting a clinically significant benefit from routine use of PPIs in FMT protocol. It is possible that the theoretical benefit from improved survival of transplanted microbiota is offset by negative effects on the microbiome. We suggest that routine use of PP... 12/13/2019
Ji Young Bang, Shyam Varadarajulu Equal efficacy of FNA and fine-needle biopsy needles for EUS-guided tissue acquisition: Really? No abstract 11/25/2019
Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L Volk Safety of endoscopic retrograde cholangiopancreatography (ERCP) in pregnancy: A systematic review and meta-analysis CONCLUSIONS: ERCP done by experienced endoscopists is a safe procedure during pregnancy. Radiation-free techniques appear to reduce the rates of nonpregnancy-related complications, but not of fetal and pregnancy-related complications. 11/21/2019
Babu P Mohan, Shahab R Khan, Sushruth Trakroo, Suresh Ponnada, Mahendran Jayaraj, Ravishankar Asokkumar, Douglas G Adler Endoscopic ultrasound-guided gallbladder drainage, transpapillary drainage, or percutaneous drainage in high risk acute cholecystitis patients: a systematic review and comparative meta-analysis CONCLUSION: EUSGBD demonstrated better clinical success than ETGBD and PCGBD in the management of acute cholecystitis patients at high surgical risk. 10/24/2019
Sebron Harrison, Manasi Kakade, Shyam Varadarajulu, Justin Parden, Desiree Morgan, John Christein Correction to: Characteristics and Outcomes of Patients Undergoing Debridement of Pancreatic Necrosis There is an author's name misspelled in the published paper, Shyam Varadarajula should be Shyam Varadarajulu. 10/18/2019
Babu P Mohan, Veeraraghavan Meyyur Aravamudan, Shahab R Khan, Saurabh Chandan, Suresh Ponnada, Ravishankar Asokkumar, Udayakumar Navaneethan, Douglas G Adler Prevalence of colorectal cancer in cryptogenic pyogenic liver abscess patients. Do they need screening colonoscopy? A systematic review and meta-analysis CONCLUSION: Our study, albeit limited by heterogeneity, demonstrates that patients with cryptogenic PLA are at a 7-fold risk of having CRC. A screening colonoscopy may be considered in population with cryptogenic PLA, especially if positive for K. pneumoniae. Well-conducted studies are needed to ans... 10/12/2019
Haruhiro Inoue, Hironari Shiwaku, Yasutoshi Kobayashi, Philip W Y Chiu, Robert H Hawes, Horst Neuhaus, Guido Costamagna, Stavros N Stavropoulos, Norio Fukami, Stefan Seewald, Manabu Onimaru, Hitomi Minami, Shinwa Tanaka, Yuto Shimamura, Esperanza Grace Santi, Kevin Grimes, Hisao Tajiri Statement for gastroesophageal reflux disease after peroral endoscopic myotomy from an international multicenter experience It has been 10 years since peroral endoscopic myotomy (POEM) was reported for the first time, and POEM has currently become the standard treatment for achalasia and related disorders globally because it is less invasive and has a higher curative effect than conventional therapeutic methods. However,... 9/28/2019
Mohamad Mubder, Mohamed Azab, Mahendran Jayaraj, Chad Cross, Daisy Lankarani, Banreet Dhindsa, Jen-Jung Pan, Gordon Ohning Autoimmune hepatitis in patients with human immunodeficiency virus infection: A systematic review of the published literature CONCLUSION: Although rare, but AIH can develop in patients with HIV and physicians should consider it in the differential diagnosis for HIV patients presented with abnormal liver function tests, especially after excluding hepatitis C virus and drug-induced liver injury.Patients with immune deficienc... 9/14/2019
Rajesh Krishnamoorthi, Babu P Mohan, Mahendran Jayaraj, Kenneth K Wang, David A Katzka, Andrew Ross, Douglas G Adler, Prasad G Iyer Risk of progression in Barrett's esophagus indefinite for dysplasia: a systematic review and meta-analysis CONCLUSION: The estimated incidence of HGD and/or EAC and EAC alone in BE-IND is similar to the previously reported progression risk in BE-LGD. Based on these risk estimates, patients with BE-IND should be placed on active endoscopic surveillance. 8/18/2019
ASGE Technology Committee, Harry R Aslanian, Amrita Sethi, Manoop S Bhutani, Adam J Goodman, Kumar Krishnan, David R Lichtenstein, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Mansour A Parsi, Allison R Schulman, Shelby A Sullivan, Nirav Thosani, Guru Trikudanathan, Arvind J Trindade, Rabindra R Watson, John T Maple ASGE guideline for endoscopic full-thickness resection and submucosal tunnel endoscopic resection With the development of reliable endoscopic closure techniques and tools, endoscopic full-thickness resection (EFTR) is emerging as a therapeutic option for the treatment of subepithelial tumors and epithelial neoplasia with significant fibrosis. EFTR may be categorized as "exposed" and "nonexposed.... 8/8/2019
Eun Young Kim, Robert H Hawes Endoscopic Ultrasound-Guided Drainage of Peripancreatic Fluid Collections No abstract 8/3/2019
Muhammad K Hasan, Kambiz Kadkhodayan, Evgeny Idrisov, Saeed Ali, Ehsan Rafiq, Dana Ben-Ami Shor, Ala Abdel-Jalil, Uday Navaneethan, Ji Bang, Shyam Varadarajulu, Robert Hawes, Peter Pernicone Endoscopic ultrasound-guided liver biopsy using a 22-G fine needle biopsy needle: a prospective study CONCLUSIONS: EUS-LB using a 22-G FNB needle is a safe and viable alternative to the use of larger gauge needles, yielding adequate tissue for evaluation of parenchymal disease in 100 % of the patients. 8/1/2019
Ji Young Bang, Udayakumar Navaneethan, Muhammad Hasan, Bryce Sutton, Robert Hawes, Shyam Varadarajulu Optimizing Outcomes of Single-Operator Cholangioscopy-Guided Biopsies Based on a Randomized Trial CONCLUSIONS: In a prospective comparative study, we found that centers without onsite cytopathology support that analyze 3 single-operator cholangioscopy-guided biopsies of a biliary stricture and process the specimens offsite make the correct diagnosis for 90% of cases. ClinicalTrials.gov, Number: ... 7/28/2019
ASGE technology committee, Mansour A Parsi, Allison R Schulman, Harry R Aslanian, Manoop S Bhutani, Kuman Krishnan, David R Lichtenstein, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Amrita Sethi, Guru Trikudanathan, Arvind J Trindade, Rabindra R Watson, John T Maple, ASGE Technology Committee Chair Devices for endoscopic hemostasis of nonvariceal GI bleeding (with videos) CONCLUSIONS: Endoscopic evaluation and treatment remains a cornerstone in the management of nonvariceal upper- and lower-GI bleeding. A variety of devices is available for hemostasis of bleeding lesions in the GI tract. Other than injection therapy, which should not be used as monotherapy, there are... 7/24/2019
Mahendran Jayaraj, Babu P Mohan, Harmeet Mashiana, Rajesh Krishnamoorthi, Douglas G Adler Safety and efficacy of combined antegrade and retrograde endoscopic dilation for complete esophageal obstruction: a systematic review and meta-analysis CONCLUSIONS: The CARD procedure for CEO has a high technical success rate, but also a high rate of repeat dilations. Given its complexity and associated adverse events, this procedure should be restricted to centers with a high level of expertise. 7/3/2019
Ji Young Bang, Shyam Varadarajulu Reply No abstract 7/2/2019
Babu P Mohan, Mohammed Shakhatreh, Rajat Garg, Ravishankar Asokkumar, Mahendran Jayaraj, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler Comparison of Franseen and fork-tip needles for EUS-guided fine-needle biopsy of solid mass lesions: A systematic review and meta-analysis Franseen-tip and Fork-tip needles have been widely used in EUS guided fine-needle biopsy (FNB) of solid organs. There is conflicting data on the performance of these needles and unanswered questions on the ideal number of needle-passes and the requirement of an onsite cytopathologist (ROSE). We cond... 6/29/2019
Ji Young Bang, Charles Melbern Wilcox, Juan Pablo Arnoletti, Shyam Varadarajulu Superiority of endoscopic interventions over minimally invasive surgery for infected necrotizing pancreatitis: meta-analysis of randomized trials CONCLUSIONS: An endoscopy-based treatment approach, as compared to minimally invasive surgery, significantly reduces complications in patients with infected necrotizing pancreatitis. 6/21/2019
Udayakumar Navaneethan, Xiang Zhu, Mansour A Parsi, Shyam Varadarajulu Pre-operative biliary drainage is associated with shortened survival time in patients with cholangiocarcinoma CONCLUSIONS: PBD appears negative impact on long-term survival in patients with potentially resectable CCA and should be avoided if possible. 6/21/2019
Elaina Vivian, Leslie Cler, Darwin Conwell, Gregory A Coté, Richard Dickerman, Martin Freeman, Timothy B Gardner, Robert H Hawes, Prashant Kedia, Rajesh Krishnamoorthi, Hellen Oduor, Stephen J Pandol, Georgios I Papachristou, Andrew Ross, Amrita Sethi, Shyam Varadarajulu, Santhi Swaroop Vege, Wahid Wassef, C Mel Wilcox, David C Whitcomb, Bechien U Wu, Dhiraj Yadav, Ashton Ellison, Samar Habash, Sheila Rastegari, Rathan Reddy, Timothy Yen, Mary Rachel Brooks, Paul Tarnasky Acute Pancreatitis Task Force on Quality: Development of Quality Indicators for Acute Pancreatitis Management INTRODUCTION: Detailed recommendations and guidelines for acute pancreatitis (AP) management currently exist. However, quality indicators (QIs) are required to measure performance in health care. The goal of the Acute Pancreatitis Task Force on Quality was to formally develop QIs for the management ... 6/18/2019
ASGE Technology Committee, Adam J Goodman, Joshua Melson, Harry R Aslanian, Manoop S Bhutani, Kumar Krishnan, David R Lichtenstein, Udayakumar Navaneethan, Rahul Pannala, Mansour A Parsi, Allison R Schulman, Amrita Sethi, Shelby A Sullivan, Nirav Thosani, Guru Trikudanathan, Arvind J Trindade, Rabindra R Watson, John T Maple Endoscopic simulators CONCLUSIONS: Simulation training is a promising modality that may aid in endoscopic education. However, for widespread incorporation of simulators into gastroenterology training programs to occur, simulators must show a sustained advantage over traditional mentored teaching in a cost-effective manne... 5/25/2019
Babu P Mohan, Ravishankar Asokkumar, Mohammed Shakhatreh, Rajat Garg, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler Adverse events with lumen-apposing metal stents in endoscopic gallbladder drainage: A systematic review and meta-analysis CONCLUSION: We report an overall AE rate of 13% with LAMS in EUS-GBD. Early AE risk appears to be 6.5% and delayed AE risk appears to be 8%. Our results are analyzed out of good-quality studies, with minimal to zero heterogeneity. 5/23/2019
ASGE Technology Committee, Arvind J Trindade, Udayakumar Navaneethan, Harry R Aslanian, Manoop S Bhutani, Kumar Krishnan, David R Lichtenstein, Joshua Melson, Rahul Pannala, Mansour A Parsi, Allison R Schulman, Amrita Sethi, Guru Trikudanathan, Rabindra R Watson, John T Maple Advances in the diagnosis and surveillance of Barrett's esophagus (with videos) CONCLUSION: Several technologies discussed in this document may improve dysplasia detection in BE in a wide-field manner. Moreover, the addition of different biomarkers may aid in enhanced risk stratification to optimize approaches to surveillance or treatment for patients with BE. 5/23/2019
Ramprasad Jegadeesan, Muhammad Aziz, Madhav Desai, Tharani Sundararajan, Venkata Subhash Gorrepati, Viveksandeep Thogulva Chandrasekar, Mahendran Jayaraj, Pratiksha Singh, Ahmed Saeed, Tarun Rai, Abhishek Choudhary, Alessandro Repici, Cesare Hassan, Lorenzo Fuccio, Prateek Sharma Hot snare vs. cold snare polypectomy for endoscopic removal of 4 - 10 mm colorectal polyps during colonoscopy: a systematic review and meta-analysis of randomized controlled studies Introduction In recent years, cold snare polypectomy (CSP) has increasingly been used over hot snare polypectomy (HSP) for the removal of colorectal polyps (4 - 10 mm in size). However, the optimal technique (CSP vs. HSP), in terms of complete polyp resection and complications, is uncertain. Our aim... 5/11/2019
Ji Young Bang, Shyam Varadarajulu Lumen-apposing metal stents for endoscopic ultrasonography-guided interventions Lumen-apposing metal stents (LAMS) are integrated in a single-step delivery platform and can be deployed under endoscopic ultrasound-guidance for the drainage of intra-abdominal fluid collections, decompression of obstructed ductal systems, establishment of anastomosis or creation of fistulous tract... 5/4/2019
Benjamin Tharian, Konrad Krall, Xiang Zhu, Nayana George, Michael Chambers, Shyam Varadarajulu, Shantel Hebert-Magee Endosonographer-driven dynamic telecytopathology of pancreatic lesions-a pilot study CONCLUSION: An endosonographer with limited training can examine for specimen adequacy, transmit images, and demonstrate representative cell groups. Larger studies are required though preliminary results are encouraging. 5/3/2019
Shyam Varadarajulu Endoscopic Ultrasound-Guided Biliary Drainage for Palliation of Malignant Obstructive Jaundice No abstract 4/24/2019
Babu P Mohan, Mahendran Jayaraj, Ravishankar Asokkumar, Mohammed Shakhatreh, Parul Pahal, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler Lumen apposing metal stents in drainage of pancreatic walled-off necrosis, are they any better than plastic stents? A systematic review and meta-analysis of studies published since the revised Atlanta classification of pancreatic fluid collections Lumen-apposing metal stents (LAMS) are increasingly being used in the drainage of pancreatic walled-off necrosis (WON). Best choice of stent is subject to argument, and studies are varied in the reported outcomes between LAMS and plastic stents (PS) to this end. We conducted a comprehensive search o... 4/23/2019
Sameen Khalid, Aamer Abbass, Neelam Khetpal, Bo Shen, Udayakumar Navaneethan Endoscopic detection and resection of dysplasia in inflammatory bowel disease-techniques with videos CONCLUSIONS: In this review, we discuss the various techniques for endoscopic resection of dysplasia in patients with inflammatory bowel disease. Further research is required to determine the optimal approach to diagnosis and management of dysplasia in patients with inflammatory bowel disease. 3/12/2019
Udayakumar Navaneethan Chromoendoscopy: Coloring the Colon to Predict Submucosal Invasive Colon Cancer No abstract 3/8/2019
Ji Young Bang, Bryce Sutton, Robert Hawes, Shyam Varadarajulu Concept of disposable duodenoscope: at what cost? No abstract 2/18/2019
Shyam Varadarajulu Let's Start Looking at the Entire Patient Before Poking at Pancreatic Cysts No abstract 2/12/2019
Udayakumar Navaneethan, Jong Ho Moon, Takao Itoi Biliary interventions using single-operator cholangioscopy Cholangioscopy provides an opportunity to directly visualize the bile duct for diagnosing biliary lesions and for therapeutic interventions. Although there are different cholangioscopy techniques available, single-operator cholangioscopy has gained widespread acceptance as the standard technique for... 1/29/2019
Babu P Mohan, Mohammed Shakhatreh, Rajat Garg, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler Efficacy and Safety of Endoscopic Ultrasound-guided Choledochoduodenostomy: A Systematic Review and Meta-Analysis CONCLUSIONS: On the basis of our analysis EUS-CDD has an adverse event risk of 13.4%, which is lowest reported in literature so far. Reported adverse rates appeared to be lower with the use of lumen-apposing metal stent, except for perforation. 1/26/2019
Ji Young Bang, Shyam Varadarajulu Response No abstract 12/21/2018
Udayakumar Navaneethan, Francis A Farraye Expanding the horizons in interventional inflammatory bowel disease: endoscopic sinusotomy for the treatment of chronic pouch anastomotic sinus No abstract 12/21/2018
Ji Young Bang, Juan Pablo Arnoletti, Bronte A Holt, Bryce Sutton, Muhammad K Hasan, Udayakumar Navaneethan, Nicholas Feranec, C Mel Wilcox, Benjamin Tharian, Robert H Hawes, Shyam Varadarajulu An Endoscopic Transluminal Approach, Compared With Minimally Invasive Surgery, Reduces Complications and Costs for Patients With Necrotizing Pancreatitis CONCLUSIONS: In a randomized trial of 66 patients, an endoscopic transluminal approach for infected necrotizing pancreatitis, compared with minimally invasive surgery, significantly reduced major complications, lowered costs, and increased quality of life. Clinicaltrials.gov no: NCT02084537. 11/20/2018
Ji Young Bang, Shyam Varadarajulu Authors reply: treatment strategy for necrotising pancreatitis No abstract 11/19/2018
Udayakumar Navaneethan, Xiang Zhu, Dennisdhilak Lourdusamy, Vennisvasanth Lourdusamy, Bo Shen, Ravi Kiran Colorectal cancer resection rates in patients with inflammatory bowel disease: a population-based study CONCLUSIONS: CRC resection rates among IBD patients have continued to decrease annually from 1995 to 2012. There is a population-level decrease in resection of both proximal and distal CRC reflecting a decreasing incidence of IBD-related CRC incidence in the USA. 11/16/2018
Harmeet Singh Mashiana, Mahendran Jayaraj, Babu Pappu Mohan, Gordon Ohning, Douglas G Adler Comparison of outcomes for supine vs. prone position ERCP: a systematic review and meta-analysis Background While endoscopic retrograde cholangiopancreatography (ERCP) is usually performed in the prone position, some studies have advocated for ERCP in the supine position. Studies comparing the technical success and safety outcomes have shown variable results. We performed a systematic review an... 11/10/2018
ASGE Technology Committee, Rabindra R Watson, Mansour A Parsi, Harry R Aslanian, Adam J Goodman, David R Lichtenstein, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Amrita Sethi, Shelby A Sullivan, Nirav C Thosani, Guru Trikudanathan, Arvind J Trindade, John T Maple Biliary and pancreatic lithotripsy devices CONCLUSIONS: Several lithotripsy techniques have been described that vary with respect to ease of use, generalizability, and cost. Overall, lithotripsy is a safe and effective treatment for difficult biliary and pancreatic duct stones. 11/8/2018
Bo Shen, Gursimran Kochhar, Udayakumar Navaneethan, Xiuli Liu, Francis A Farraye, Yago Gonzalez-Lama, David Bruining, Darrell S Pardi, Martin Lukas, Martin Bortlik, Kaicun Wu, Ajit Sood, David A Schwartz, William J Sandborn, Global Interventional Inflammatory Bowel Disease Group Role of interventional inflammatory bowel disease in the era of biologic therapy: a position statement from the Global Interventional IBD Group Interventional (or therapeutic) inflammatory bowel disease (IBD) endoscopy has an expanding role in the treatment of disease and surgical adverse events. Endoscopic therapy has been explored and used in the management of strictures, fistulas/abscesses, colitis-associated neoplasia, postsurgical acut... 10/27/2018
Mahendran Jayaraj, Babu P Mohan, Banreet S Dhindsa, Harmeet S Mashiana, Gowri Radhakrishnan, Vinay Dhir, Arvind J Trindade, Douglas G Adler Periampullary Diverticula and ERCP Outcomes: A Systematic Review and Meta-Analysis CONCLUSION: ERCP is technically feasible and increasingly successful when performed by experts in the presence of PAD. The risk of complications such as PEP, bleeding, perforation and cholangitis does not differ between ERCP done in patients with and without PAD. 10/8/2018
Ji Young Bang, Sachin Kirtane, Konrad Krall, Udayakumar Navaneethan, Muhammad Hasan, Robert Hawes, Shyam Varadarajulu In memoriam: Fine-needle aspiration, birth: Fine-needle biopsy: The changing trend in endoscopic ultrasound-guided tissue acquisition CONCLUSION: Given these promising findings, in the future, EUS-guided FNB will likely be the preferred technique for sampling of solid mass lesions. 9/27/2018
Ji Young Bang, Michael J Bourke Selection of EMR and ESD for Laterally Spreading Lesions of the Colon INTRODUCTION: Colonic laterally spreading lesions (LSL) are increasingly managed using endoscopic methods that comprise two main techniques: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). 9/23/2018
Saeed Ali, Robert H Hawes, Kambiz Kadkhodayan, Ehsan Rafiq, Udayakumar Navaneethan, Ji Y Bang, Shyam Varadarajulu, Muhammad K Hasan Utility of rapid onsite evaluation of touch imprint cytology from endoscopic and cholangioscopic forceps biopsy sampling (with video) CONCLUSIONS: By establishing a rapid onsite diagnosis, ROSE-TIC expedites decision-making on patient management. Prospective studies are needed to confirm these preliminary findings. 9/9/2018
Ji Young Bang, Bryce Sutton, Robert H Hawes, Shyam Varadarajulu EUS-guided celiac ganglion radiofrequency ablation versus celiac plexus neurolysis for palliation of pain in pancreatic cancer: a randomized controlled trial (with videos) CONCLUSIONS: Compared with EUS-CPN, EUS-RFA provided more pain relief and improved the quality of life for patients with pancreatic cancer. (Clinical trials registration number: NCT03152487.). 8/19/2018
Ji Young Bang, Shyam Varadarajulu Response No abstract 8/18/2018
Ji Young Bang, Shyam Varadarajulu Response No abstract 8/18/2018
Ji Young Bang, Shyam Varadarajulu Reply No abstract 7/24/2018
ASGE Technology Committee, Udayakumar Navaneethan, Nirav Thosani, Adam Goodman, Michael Manfredi, Rahul Pannala, Mansour A Parsi, Zachary L Smith, Shelby A Sullivan, Subhas Banerjee, John T Maple Radiofrequency ablation devices No abstract 6/16/2018
ASGE Training Committee, Richard S Kwon, Raquel E Davila, Daniel K Mullady, Mohammad A Al-Haddad, Ji Young Bang, Juliane Bingener-Casey, Brian P Bosworth, Jennifer A Christie, Gregory A Cote, Sarah Diamond, Jennifer Jorgensen, Thomas E Kowalski, Nisa Kubiliun, Joanna K Law, Keith L Obstein, Waqar A Qureshi, Francisco C Ramirez, Robert E Sedlack, Franklin Tsai, Shivakumar Vignesh, Mihir S Wagh, Daniel Zanchetti, Walter J Coyle, Jonathan Cohen EGD core curriculum No abstract 6/16/2018
ASGE Technology Committee, Joo Ha Hwang, Harry R Aslanian, Nirav Thosani, Adam Goodman, Michael Manfredi, Udayakumar Navaneethan, Rahul Pannala, Mansour A Parsi, Zachary L Smith, Shelby A Sullivan, Subhas Banerjee, John T Maple Devices for use with EUS No abstract 6/16/2018
ASGE Technology Committee, Mansour A Parsi, Arvind J Trindade, Manoop S Bhutani, Joshua Melson, Udayakumar Navaneethan, Nirav Thosani, Guru Trikudanathan, Rabindra R Watson, John T Maple Cryotherapy in gastrointestinal endoscopy No abstract 6/16/2018
Hossein Movahed, Mohamed Magdy Abdelfatah, Sumyra Kachru, Amit Raina Successful management of a very large common hepatic duct stone in a patient with pancreaticoduodenectomy by use of cholangioscopy and electrohydraulic lithotripsy No abstract 6/16/2018
Nalini M Guda, Venkata Muddana, David C Whitcomb, Philippe Levy, Pramod Garg, Gregory Cote, Aliye Uc, Shyam Varadarajulu, Santhi S Vege, Suresh T Chari, Chris E Forsmark, Dhiraj Yadav, D Nageshwar Reddy, Scott Tenner, Colin D Johnson, Fatih Akisik, Ashok K Saluja, Markus M Lerch, J Shawn Mallery, Martin L Freeman Recurrent Acute Pancreatitis: International State-of-the-Science Conference With Recommendations Recurrent acute pancreatitis (RAP) is a clinically significant problem globally. The etiology remains unclear in approximately 10% to 15% of patients despite a thorough workup. Data on natural history and efficacy of treatments are limited. We aimed to establish criteria for diagnosis, evaluate the ... 6/13/2018
Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Bryce Sutton, Robert Hawes, Shyam Varadarajulu Non-superiority of lumen-apposing metal stents over plastic stents for drainage of walled-off necrosis in a randomised trial CONCLUSION: Except for procedure duration, there was no significant difference in treatment outcomes between LAMS and plastic stents. To minimise adverse events with LAMS, patients should undergo follow-up imaging and stent removal at 3 weeks if WON has resolved. 6/3/2018
Ji Young Bang, Udayakumar Navaneethan, Muhammad Hasan, Robert Hawes, Shyam Varadarajulu Stent placement by EUS or ERCP for primary biliary decompression in pancreatic cancer: a randomized trial (with videos) CONCLUSIONS: Given the similar rates of adverse events and treatment outcomes in this randomized trial, EUS-BD is a practical alternative to ERCP for primary biliary decompression in pancreatic cancer. (Clinical trial registration number: NCT03054987.). 3/26/2018
Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Robert Hawes, Shyam Varadarajulu Endoscopic Ultrasound-guided Specimen Collection and Evaluation Techniques Affect Diagnostic Accuracy CONCLUSION: In a randomized trial of patients undergoing EUS-FNA for pancreatic masses, samples collected with 22-gauge vs 25-gauge needles performed equally well for offsite specimen evaluation. Use of suction appears to increase number of passes needed and specimen bloodiness. Specimen collection ... 3/15/2018
Ji Young Bang, Shyam Varadarajulu How the Experts Do It: Step-by-Step Guide Lumen-apposing metal stents are integrated in a single-step delivery system for draining intra-abdominal fluid collections. The theoretic advantage of lumen-apposing stents is the ability to approximate the wall of the drained cavity or organ to the gastrointestinal tract lumen. The use of lumen-app... 3/10/2018
Anthony Y B Teoh, Vinay Dhir, Mitsuhiro Kida, Ichiro Yasuda, Zhen Dong Jin, Dong Wan Seo, Majid Almadi, Tiing Leong Ang, Kazuo Hara, Ida Hilmi, Takao Itoi, Sundeep Lakhtakia, Koji Matsuda, Nonthalee Pausawasdi, Rajesh Puri, Raymond S Tang, Hsiu-Po Wang, Ai Ming Yang, Robert Hawes, Shyam Varadarajulu, Kenjiro Yasuda, Lawrence Khek Yu Ho Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel CONCLUSIONS: The current guidelines on interventional EUS procedures are the first published by an endoscopic society. These guidelines provide an in-depth review of the current evidence and standardise the management of the procedures. 2/22/2018
ASGE Technology Committee, Arvind J Trindade, David R Lichtenstein, Harry R Aslanian, Manoop S Bhutani, Adam Goodman, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Mansour A Parsi, Amrita Sethi, Shelby Sullivan, Nirav Thosani, Guru Trikudanathan, Rabindra R Watson, John T Maple Devices and methods to improve colonoscopy completion (with videos) No abstract 2/19/2018
Ji Young Bang, Shyam Varadarajulu Stent Tracker app: Novel method to track patients with indwelling lumen-apposing metal stents No abstract 2/17/2018
Ji Young Bang, Shantel Hebert-Magee, Udayakumar Navaneethan, Muhammad K Hasan, Robert Hawes, Shyam Varadarajulu Randomized trial comparing the Franseen and Fork-tip needles for EUS-guided fine-needle biopsy sampling of solid pancreatic mass lesions CONCLUSIONS: There was no significant difference between Franseen and Fork-tip needles in yielding histologic tissue. Given their ability to yield diagnostic cell block in greater than 90% of patients, the new-generation fine-needle biopsy needles may obviate the need for ROSE. (Clinical trial regis... 1/7/2018
Joseph A Reza, Shani Fruchter, Shyam Varadarajulu, J Pablo Arnoletti A Large Intussuscepting Gastric Lipoma Lipomas of the lower foregut are exceptionally rare. Presenting symptoms often include bleeding, weight loss, and obstructive symptoms. Surgical resection remains the standard treatment. We report a case of a large intussuscepting gastric lipoma. 12/20/2017
Douglas K Rex, Marnie Sieber, Glen A Lehman, Douglas Webb, Bryan Schmitt, Amy Beth Kressel, Ji Young Bang, Jeffery Easler, Lee McHenry, Ihab El-Hajj, Evan Fogel, James Watkins, Stuart Sherman A double-reprocessing high-level disinfection protocol does not eliminate positive cultures from the elevators of duodenoscopes CONCLUSIONS: DHLD resulted in a low rate of positive cultures for known pathogens and for organisms of low pathogenic potential, but did not eliminate these, from duodenoscope elevators. Additional improvements in HLD protocols and/or duodenoscope design are needed. 12/14/2017
Robert H Hawes, Jacques Devière How I cannulate the bile duct No abstract 11/23/2017
Robert H Hawes, Jacques Devière How I cannulate the bile duct No abstract 11/22/2017
Nitin Kumar, Barham K Abu Dayyeh, Gontrand Lopez-Nava Breviere, Manoel P Galvao Neto, Nicole P Sahdala, Sohail N Shaikh, Robert H Hawes, Christopher J Gostout, Mahesh K Goenka, Jorge R Orillac, Alonso Alvarado, Pichamol Jirapinyo, Natan Zundel, Christopher C Thompson Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique CONCLUSIONS: Following a methodical procedure development phase, ESG demonstrated safety and short-term efficacy in this trial. The procedure also achieved meaningful weight loss during the follow-up period. 10/28/2017
Kambiz Kadkhodayan, Ehsan Rafiq, Robert H Hawes Endoscopic Evaluation and Management of Gastric Stromal Tumors Purpose of Review Gastrointestinal stromal tumors (GISTs) are both relatively common. Management of these lesions has been challenging with emerging interest in the endoscopic approach for both diagnostic and therapeutic interventions. Recent Findings Although these can be visualized on CT scan, end... 10/28/2017
ASGE Technology Committee, Nirav Thosani, Adam Goodman, Michael Manfredi, Udayakumar Navaneethan, Mansour A Parsi, Zachary L Smith, Shelby A Sullivan, Subhas Banerjee, John T Maple Endoscopic anti-reflux devices (with videos) No abstract 10/22/2017
Ji Young Bang, Shantel Hebert-Magee, Udayakumar Navaneethan, Muhammad K Hasan, Robert Hawes, Shyam Varadarajulu EUS-guided fine needle biopsy of pancreatic masses can yield true histology No abstract 10/9/2017
Patrick Yachimski, Shyam Varadarajulu Endoscopic Ultrasound-Guided Pancreatic Cyst Ablation: More Peril Than Promise? No abstract 10/9/2017
Ashil J Gosalia, Paul Martin, Patricia D Jones Advances and Future Directions in the Treatment of Hepatocellular Carcinoma Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths worldwide. Liver transplant is considered the gold standard for curative therapy for HCC when patients are not candidates for surgical resection or ablation. Because a subset of patients with HCC have a survival rate... 9/5/2017
Udayakumar Navaneethan, Dennisdhilak Lourdusamy, Norma G Gutierrez, Xiang Zhu, John J Vargo, Mansour A Parsi New approach to decrease post-ERCP adverse events in patients with primary sclerosing cholangitis CONCLUSION : Biliary aspiration and avoidance of stenting approach after dilation of strictures during ERCP in PSC patients appears to be associated with decreased risk of cholangitis and overall AEs. Future prospective randomized controlled trials are needed to validate our observation. 8/10/2017
Rajesh Krishnamoorthi, Mahendran Jayaraj, Richard Kozarek Endoscopic Stents for the Biliary Tree and Pancreas OPINION STATEMENT: PURPOSE OF REVIEW: To review the recently published literature on biliary and pancreatic stents. 7/21/2017
Saeed Ali, None Asad Ur Rahman, Udayakumar Navaneethan An Unusual Cause of Recurrent Gastrointestinal Bleeding After Whipple's Surgery No abstract 7/4/2017
Altaf Dawood, Syed Abdul Basit, Mahendran Jayaraj, Robert G Gish Drugs in Development for Hepatitis B With high morbidity and mortality worldwide, there is great interest in effective therapies for chronic hepatitis B (CHB) virus. There are currently several dozen investigational agents being developed for treatment of CHB. They can be broadly divided into two categories: (1) direct-acting antiviral... 6/30/2017
Ann Roy, Micheline Kim, Robert Hawes, Shyam Varadarajulu The clinical and cost implications of failed endoscopic hemostasis in gastroduodenal ulcer bleeding CONCLUSIONS: Failure to achieve hemostasis at the index endoscopy has significant clinical and cost implications. When feasible, a repeat endoscopy must be attempted followed by IRH. Surgery should preferably be reserved as a last resort for patients who fail other treatment measures. 5/17/2017
Udayakumar Navaneethan, Basile Njei, Xiang Zhu, Kiran Kommaraju, Mansour A Parsi, Shyam Varadarajulu Safety of ERCP in patients with liver cirrhosis: a national database study Background and aims Given the limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis, we attempted to evaluate this question using a large national database. Methods We conducted a matched case - control study using the 2010 National Inpa... 4/11/2017
ASGE Technology Committee, Guru Trikudanathan, Rahul Pannala, Manoop S Bhutani, Joshua Melson, Udayakumar Navaneethan, Mansour A Parsi, Nirav Thosani, Arvind J Trindade, Rabindra R Watson, John T Maple EUS-guided portal vein interventions No abstract 3/22/2017
Udayakumar Navaneethan, Timothy Edminister, Xiang Zhu, Kiran Kommaraju, Sarah Glover Vedolizumab Is Safe and Effective in Elderly Patients with Inflammatory Bowel Disease No abstract 3/16/2017
Vikram Bhatia, Shyam Varadarajulu Endoscopic ultrasonography-guided tissue acquisition: How to achieve excellence Endoscopic ultrasound (EUS)-guided tissue acquisition is a basic forte of an endosonographer. The multiple skills required to accomplish successful results include not only the puncture itself, but also proper lesion identification, correct puncture sequence, collaboration with the pathologist onsit... 2/1/2017
ASGE Technology Committee, John T Maple, Rahul Pannala, Barham K Abu Dayyeh, Harry R Aslanian, Brintha K Enestvedt, Adam Goodman, Sri Komanduri, Michael Manfredi, Udayakumar Navaneethan, Mansour A Parsi, Zachary L Smith, Nirav Thosani, Shelby A Sullivan, Subhas Banerjee Interventional EUS (with videos) No abstract 1/25/2017
Ji Young Bang, Shyam Varadarajulu Response to letter to the editor No abstract 1/14/2017
Shyam Varadarajulu, Sundeep Lakhtakia Moving away from the tumor zone: A work in progress No abstract 1/10/2017
Yunlu Feng, Udayakumar Navaneethan, Xiang Zhu, Shyam Varadarajulu, Ingrid Schwartz, Robert Hawes, Muhammad Hasan, Aiming Yang Prophylactic rectal indomethacin may be ineffective for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis in general patients: A meta-analysis CONCLUSION: In a contemporary meta-analysis of available randomized controlled trials of consecutive patients undergoing ERCP, rectal indomethacin did not show significant prevention effect of post-ERCP pancreatitis. 12/4/2016
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea CONCLUSION: Risk for OSA is extremely common in a population presenting for a routine colonoscopy, and screening at the time of a colonoscopy offers an excellent opportunity to identify these patients. 12/3/2016
Ji Young Bang, Shyam Varadarajulu Reply to letter to the editor of <em>Gut</em> No abstract 12/1/2016
Ji Young Bang, Shantel Hebert-Magee, Muhammad K Hasan, Udayakumar Navaneethan, Robert Hawes, Shyam Varadarajulu Endoscopic ultrasonography-guided biopsy using a Franseen needle design: Initial assessment CONCLUSION: Preliminary data suggest that the Franseen needle yields diagnostic material for ROSE and histology in >95% of patients. 11/24/2016
Ji Young Bang, Charles Melbern Wilcox, Udayakumar Navaneethan, Muhammad K Hasan, Shajan Peter, John Christein, Robert Hawes, Shyam Varadarajulu Impact of Disconnected Pancreatic Duct Syndrome on the Endoscopic Management of Pancreatic Fluid Collections CONCLUSIONS: DPDS has a significant effect on endoscopic management of PFCs as more patients required hybrid treatment, reinterventions, and rescue surgery for achieving optimal clinical outcomes. 11/17/2016
ASGE Technology Committee, Mansour A Parsi, Shelby A Sullivan, Adam Goodman, Michael Manfredi, Udayakumar Navaneethan, Rahul Pannala, Zachary L Smith, Nirav Thosani, Subhas Banerjee, John T Maple Automated endoscope reprocessors No abstract 10/22/2016
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee Airway observations during upper endoscopy predicting obstructive sleep apnea CONCLUSIONS: The results of our pilot study represent preliminary data regarding the use of upper endoscopy as a potential tool to evaluate patients for obstructive sleep apnea. 10/7/2016
Ji Young Bang, Shyam Varadarajulu Response No abstract 9/17/2016
Madhusudhan R Sanaka, Ramprasad Jegadeesan, Prashanthi N Thota, Udayakumar Navaneethan, Rocio Lopez, Sudish C Murthy, Siva Raja Two-Person Technique of Peroral Endoscopic Myotomy for Achalasia with an Advanced Endoscopist and a Thoracic Surgeon: Initial Experience Background and Aims. We initiated peroral endoscopic myotomy (POEM) utilizing a two-person technique with combination of an advanced endoscopist and a thoracic surgeon with complementary skills. Our aim was to determine the feasibility and outcomes in initial 20 patients. Methods. In this observatio... 9/16/2016
Basile Njei, Thomas R McCarty, Shyam Varadarajulu, Udayakumar Navaneethan Cost utility of ERCP-based modalities for the diagnosis of cholangiocarcinoma in primary sclerosing cholangitis CONCLUSIONS: SOC with biopsy sampling is the most cost-effective diagnostic modality for CCA in PSC strictures. 9/4/2016
Ji Young Bang, Muhammad Hasan, Udayakumar Navaneethan, Robert Hawes, Shyam Varadarajulu Lumen-apposing metal stents (LAMS) for pancreatic fluid collection (PFC) drainage: may not be business as usual No abstract 9/2/2016
Udayakumar Navaneethan, Muhammad K Hasan, Vennisvasanth Lourdusamy, Xiang Zhu, Robert H Hawes, Shyam Varadarajulu Efficacy and safety of endoscopic mucosal resection of non-ampullary duodenal polyps: a systematic review CONCLUSION: EMR appears to be a safe and effective therapeutic option for management of sporadic non-ampullary duodenal polyps. Long-term endoscopic surveillance is required to manage and treat recurrent disease. 8/25/2016
Ji Young Bang, Shyam Varadarajulu Endoscopic Treatment of Walled-off Necrosis in Children: Clinical Experience and Treatment Outcomes CONCLUSIONS: Endoscopic treatment is effective, safe, and when available should be the first-line modality for the management of WON in children. 8/23/2016
Ramprasad Jegadeesan, Udayakumar Navaneethan, Norma G Gutierrez, Preethi G K Venkatesh, Jeffrey P Hammel, Madhusudhan R Sanaka, Bo Shen Pattern of Inflammation on Surveillance Colonoscopy Does Not Predict Development of Colitis-associated Neoplasia CONCLUSIONS: In patients with UC, colonoscopic features especially on standard-definition white-light colonoscopy did not appear to reliably predict the development of colitis-associated neoplasia. This will leave room for image-enhanced endoscopy technology and molecular markers for the early and a... 8/20/2016
Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Robert H Hawes, Shyam Varadarajulu EUS correlates of disconnected pancreatic duct syndrome in walled-off necrosis CONCLUSIONS: We report EUS findings indicating the presence of DPDS. These findings may have significant clinical implications for the management of patients with WON. 8/20/2016
Piyush Somani, Udayakumar Navaneethan Role of ERCP in Patients With Idiopathic Recurrent Acute Pancreatitis Recurrent acute pancreatitis (RAP) is defined based on the occurrence of two or more episodes of acute pancreatitis. RAP is differentiated from chronic pancreatitis based on the presence of a normal morphological appearance of the pancreas between episodes. RAP can be due to a variety of etiologies ... 7/3/2016
Fnu Asad-Ur-Rahman, Aamer Abbass, Umair Majeed, Udayakumar Navaneethan Melanoma Metastasizing to the Small Intestine: A Case Report Illustrating Symptomatic and Asymptomatic Involvement Symptomatic gastrointestinal (GI) involvement of melanoma is rare, however, it is a frequent autopsy finding in patients with primary cutaneous melanoma. We present a case of metastatic cutaneous melanoma with initial asymptomatic jejunal involvement as found on a positron emission tomography (PET) ... 6/23/2016
C Mel Wilcox, Toni Seay, Hwasoon Kim, Shyam Varadarajulu Prospective Endoscopic Ultrasound-Based Approach to the Evaluation of Idiopathic Pancreatitis: Causes, Response to Therapy, and Long-term Outcome CONCLUSIONS: Following a single idiopathic attack of pancreatitis and a negative EUS examination, relapse was infrequent. Despite endoscopic therapy, patients with multiple attacks, especially those attributed to pancreas divisum and SOD, had high rates of recurrence. EUS may be a useful, minimally ... 6/22/2016
Joshua P Smith, J Pablo Arnoletti, Shyam Varadarajulu, Desiree E Morgan Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections... 6/16/2016
ASGE Technology Committee, Sri Komanduri, Nirav Thosani, Barham K Abu Dayyeh, Harry R Aslanian, Brintha K Enestvedt, Michael Manfredi, John T Maple, Udayakumar Navaneethan, Rahul Pannala, Mansour A Parsi, Zachary L Smith, Shelby A Sullivan, Subhas Banerjee Cholangiopancreatoscopy No abstract 5/30/2016
Ji Young Bang, Muhammad K Hasan, Udayakumar Navaneethan, Bryce Sutton, Wesam Frandah, Sameer Siddique, Robert H Hawes, Shyam Varadarajulu Lumen-apposing metal stents for drainage of pancreatic fluid collections: When and for whom? CONCLUSIONS: Although there is no difference in clinical outcomes, treating pseudocysts using plastic stents is less expensive. It is also possible that the short procedural duration is a surrogate marker for procedural complexity and this may drive the use of LAMS in sicker patients. 5/21/2016
Ji Young Bang, Nirag Jhala Optimizing the diagnostic yield in endoscopic ultrasound-guided fine-needle aspiration: Is there an alternative to rapid onsite evaluation? No abstract 5/15/2016
Udayakumar Navaneethan, Vennisvasanth Lourdusamy, Basile Njei, Bo Shen Endoscopic balloon dilation in the management of strictures in Crohn's disease: a systematic review and meta-analysis of non-randomized trials CONCLUSIONS: EBD appears to be a safe alternative for surgery in the management of Crohn's strictures. Stricture length <4 cm treated with EBD is associated with a significantly decreased risk of surgical intervention. 4/30/2016
Ji Young Bang, Shyam Varadarajulu Management of Hemorrhagic Walled-Off Necrosis Using the Multiple Transluminal Gateway Technique No abstract 4/30/2016
Udayakumar Navaneethan Diagnosis of cholangiocarcinoma in primary sclerosing cholangitis: finding a needle in a haystack No abstract 4/27/2016
Ji Young Bang, Shyam Varadarajulu Transmural drainage versus transpapillary stenting and transmural drainage: not an open and shut case…yet No abstract 4/23/2016
Mouen A Khashab, Schalk Van der Merwe, Rastislav Kunda, Mohamad H El Zein, Anthony Y Teoh, Fernando P Marson, Carlo Fabbri, Ilaria Tarantino, Shyam Varadarajulu, Rani J Modayil, Stavros N Stavropoulos, Irene Peñas, Saowanee Ngamruengphong, Vivek Kumbhari, Joseph Romagnuolo, Raj Shah, Anthony N Kalloo, Manuel Perez-Miranda, Everson L Artifon Prospective international multicenter study on endoscopic ultrasound-guided biliary drainage for patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography CONCLUSION: This study on EUS-BD demonstrates excellent efficacy and safety of EUS-BD when performed by experts. 4/20/2016
Ji Young Bang, Muhammad K Hasan, Bryce Sutton, Bronte A Holt, Udayakumar Navaneethan, Robert Hawes, Shyam Varadarajulu Intraprocedural increase in heart rate during EUS-guided celiac plexus neurolysis: Clinically relevant or just a physiologic change? CONCLUSIONS: Because patients with an increase in intraprocedural heart rate experienced significant improvement in pain and quality of life components, this observation must be further explored in order to improve the technique and outcomes of EUS-CPN. 4/7/2016
Shyam Varadarajulu, Ji Young Bang, Muhammad K Hasan, Udayakumar Navaneethan, Robert Hawes, Shantel Hebert-Magee Improving the diagnostic yield of single-operator cholangioscopy-guided biopsy of indeterminate biliary strictures: ROSE to the rescue? (with video) CONCLUSIONS: Preliminary data suggest that the diagnostic outcomes of SOC-guided biopsies in IDBSs can be significantly improved by using ROSE-TIC. This technique also may benefit centers that rely mainly on fluoroscopy-guided intraductal biopsies. 4/7/2016
Robert H Hawes Lessons Learned from Traditional NOTES: A Historical Perspective The idea of natural orifice surgery was conceived by Kantsevoy and Kalloo in the late 1990s. A group of surgeons formed the Apollo Group in 1997. Their vision and mission were to impact the practice of therapeutic endoscopy through innovation in techniques and technologies. The concept of natural or... 4/3/2016
ASGE Technology Committee, Rahul Pannala, Barham K Abu Dayyeh, Harry R Aslanian, Brintha K Enestvedt, Sri Komanduri, Michael Manfredi, John T Maple, Udayakumar Navaneethan, Mansour A Parsi, Zachary L Smith, Shelby A Sullivan, Nirav Thosani, Subhas Banerjee Per-oral endoscopic myotomy (with video) No abstract 4/2/2016
Shyam Varadarajulu, Ji Young Bang Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Clinical Assessment of Pancreatic Neoplasms Accurate diagnosis and staging of pancreatic neoplasms is essential for surgical planning and identification of locally advanced and metastatic disease that is incurable by surgery. The ability to position the endoscopic ultrasonography (EUS) transducer close to the pancreas combined with the use of... 3/26/2016
Ji Young Bang, Jayapal Ramesh, Muhammad Hasan, Udayakumar Navaneethan, Bronte A Holt, Robert Hawes, Shyam Varadarajulu Endoscopic ultrasonography is not required for staging malignant esophageal strictures that preclude the passage of a diagnostic gastroscope CONCLUSION: Routine EUS examination may not be required in all patients with ECA as the inability to advance a diagnostic gastroscope past a malignant stricture correlates 100% with locally advanced disease on EUS. 3/23/2016
Udayakumar Navaneethan, Muhammad K Hasan, Kiran Kommaraju, Xiang Zhu, Shantel Hebert-Magee, Robert H Hawes, John J Vargo, Shyam Varadarajulu, Mansour A Parsi Digital, single-operator cholangiopancreatoscopy in the diagnosis and management of pancreatobiliary disorders: a multicenter clinical experience (with video) CONCLUSIONS: SOC has become an integral part of the ERCP armamentarium and has high accuracy in the evaluation of indeterminate biliary strictures. Complete stone clearance was achieved in all but 1 patient with challenging biliary or pancreatic duct stones. ( 3/21/2016
Ramprasad Jegadeesan, Udayakumar Navaneethan, Shishira Bharadwaj, Jeffrey Hammel, Madhusudhan R Sanaka, Bo Shen Impact of Concurrent Non-IBD Immunological Diseases on the Outcome of Primary Sclerosing Cholangitis CONCLUSIONS: The association of NID in patients with PSC did not seem to affect the need for liver transplantation or transplantation-free survival. The findings suggest that the increased load of autoimmunity, including the presence of IBD or NID, has a minimum impact on the disease outcome of PSC. 3/8/2016
B Joseph Elmunzer, Jose Serrano, Amitabh Chak, Steven A Edmundowicz, Georgios I Papachristou, James M Scheiman, Vikesh K Singh, Shyam Varadarajulu, John J Vargo, Field F Willingham, Todd H Baron, Gregory A Coté, Joseph Romagnuolo, April Wood-Williams, Emily K Depue, Rebecca L Spitzer, Cathie Spino, Lydia D Foster, Valerie Durkalski, SVI study group and the United States Cooperative for Outcomes Research in Endoscopy (USCORE) Rectal indomethacin alone versus indomethacin and prophylactic pancreatic stent placement for preventing pancreatitis after ERCP: study protocol for a randomized controlled trial BACKGROUND: The combination of prophylactic pancreatic stent placement (PSP) - a temporary plastic stent placed in the pancreatic duct - and rectal non-steroidal anti-inflammatory drugs (NSAIDs) is recommended for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PE... 3/5/2016
Wesam Frandah, Sameer Siddiqui, Udayakumar Navaneethan, Abdelkader Chaar, Robert H Hawes, Shyam Varadarajulu, Muhammad K Hasan Unusual cause of hemobilia No abstract 3/2/2016
ASGE Technology Committee, Nirav Thosani, Barham K Abu Dayyeh, Prateek Sharma, Harry R Aslanian, Brintha K Enestvedt, Sri Komanduri, Michael Manfredi, Udayakumar Navaneethan, John T Maple, Rahul Pannala, Mansour A Parsi, Zachary L Smith, Shelby A Sullivan, Subhas Banerjee ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett's esophagus CONCLUSIONS: Our meta-analysis indicates that targeted biopsies with acetic acid chromoendoscopy, electronic chromoendoscopy by using narrow-band imaging, and endoscope-based CLE meet the thresholds set by the ASGE PIVI, at least when performed by endoscopists with expertise in advanced imaging tech... 2/15/2016
Benjamin Tharian, Nayana George, Udayakumar Navaneethan Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease The role of endoscopy in inflammatory bowel disease (IBD) has grown over the last decade in both diagnostic and therapeutic realms. It aids in the initial diagnosis of the disease and also in the assessment of the extent and severity of disease. IBD is associated with development of multiple complic... 12/31/2015
Udayakumar Navaneethan Gut Inflammation in Primary Sclerosing Cholangitis and Autoimmune Sclerosing Cholangitis-Contrasting Pattern of Liver-gut Cross Talk No abstract 12/3/2015
Udayakumar Navaneethan, Basile Njeim Response No abstract 11/29/2015
Ji Young Bang, Shyam Varadarajulu Management of acute hemorrhagic pancreatitis after EUS-guided FNA of a pancreatic cyst No abstract 11/19/2015
Ji Young Bang, Robert Hawes, Shyam Varadarajulu A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition CONCLUSIONS: Current data do not demonstrate a significant difference between the ProCore and standard FNA needles for sample adequacy, diagnostic accuracy or acquisition of a core specimen. However, the ProCore needle establishes the diagnosis with fewer passes. 11/13/2015
Bronte A Holt, Shyam Varadarajulu Perforation Risk Associated With Percutaneous Endoscopic Gastrostomy-Jejunal Tube Feeding in Pancreatic Walled Off Necrosis No abstract 11/4/2015
C Mel Wilcox, Hwasoon Kim, Toni Seay, Shyam Varadarajulu Choice of plastic or metal stent for patients with jaundice with pancreaticobiliary malignancy using simple clinical tools: a prospective evaluation CONCLUSIONS: The decision whether to place a plastic stent or SEMS for patients with distal malignant obstructive jaundice may be based on simple clinical tools resulting in low rates of reintervention. 10/14/2015
Ji Young Bang, Shyam Varadarajulu Management of walled-off necrosis using the multiple transluminal gateway technique with the Hot AXIOS System No abstract 10/13/2015
Benjamin Tharian, Shyam Varadarajulu, Robert Hawes Drainage of obstructed gallbladder with use of lumen-apposing metal stent No abstract 8/18/2015
Ann Roy, Micheline Kim, Robert Hawes, Shyam Varadarajulu Changing trends in tissue acquisition in malignant pancreatic neoplasms CONCLUSIONS: Although EUS-FNA is increasingly performed and is less costly, and the rate of surgical biopsies has declined precipitously, the utilization of percutaneous techniques remains prevalent. Training and education are required to disseminate the use of EUS-FNA outside major teaching institu... 8/8/2015
Bronte A Holt, Robert Hawes, Muhammad Hasan, Ashley Canipe, Benjamin Tharian, Udayakumar Navaneethan, Shyam Varadarajulu Biliary drainage: role of EUS guidance CONCLUSIONS: In a tertiary-care center, use of advanced ERCP techniques results in a high technical success rate. EUS-guided biliary drainage was required in only 0.6% of native papilla ERCPs, and although a number of excellent indications exist, it should not replace good ERCP technique. 7/29/2015
Benjamin Tharian, Ashley Canipe, Udhaykumar Navaneethan, Shyam Varadarajulu, Robert Hawes, Muhammad Hasan Successful removal of a foreign body from a gallbladder remnant by using a new single-operator digital cholangioscope No abstract 7/29/2015
David L Diehl, Amitpal S Johal, Harshit S Khara, Stavros N Stavropoulos, Mohammed Al-Haddad, Jayapal Ramesh, Shyam Varadarajulu, Harry Aslanian, Stuart R Gordon, Frederick K Shieh, Jonh J Pineda-Bonilla, Theresa Dunkelberger, Dibson D Gondim, Eric Z Chen Endoscopic ultrasound-guided liver biopsy: a multicenter experience CONCLUSIONS: EUS-guided LB was a safe technique that yields tissue adequate for diagnosis among 98 % of patients evaluated. 7/15/2015
Mohammad Yaghoobi, Qi Pauls, Valerie Durkalski, Joseph Romagnuolo, Evan L Fogel, Paul R Tarnasky, Giuseppe Aliperti, Martin L Freeman, Richard A Kozarek, Priya A Jamidar, Charles M Wilcox, Grace H Elta, Robert H Hawes, April Wood-Williams, Peter B Cotton Incidence and predictors of post-ERCP pancreatitis in patients with suspected sphincter of Oddi dysfunction undergoing biliary or dual sphincterotomy: results from the EPISOD prospective multicenter randomized sham-controlled study CONCLUSION: The performance of biliary or dual sphincterotomy does not increase the risk of PEP in patients suspected of SOD. However, the high rate of PEP in patients with suspected SOD, despite pancreatic stenting in expert centers, is confirmed in this prospective study. The combined effect of du... 7/14/2015
Ji Young Bang, Shyam Varadarajulu Endoscopic ultrasonography-guided drainage of postoperative abdominal fluid collections: What should we do to improve outcomes? No abstract 7/9/2015
Ji Young Bang, Shyam Varadarajulu Improving the results of pancreatic endoscopic ultrasound-guided fine needle aspiration in daily practice: keep it simple No abstract 7/3/2015
Anthony Yuen Bun Teoh, Lawrence Khek Yu Ho, Vinay Kumar Dhir, Zhen Dong Jin, Mitsuhiro Kida, Dong Wan Seo, Hsui Po Wang, Ai Ming Yang, Kenneth Frank Binmoeller, Shyam Varadarajulu A multi-institutional survey on the practice of endoscopic ultrasound (EUS) guided pseudocyst drainage in the Asian EUS group CONCLUSION: This was the first Asia wide survey in the practice of pseudocyst drainage. There were wide variations in practice and randomized studies are urgently needed to establish the best approach for management of this condition. There is also a pressing need for establishment of a consensus fo... 7/3/2015
Udayakumar Navaneethan, John J Vargo, K V Narayanan Menon, Madhusudhan R Sanaka, Chung-Jyi Tsai Impact of balloon-assisted enteroscopy on the diagnosis and management of suspected and established small-bowel Crohn's disease CONCLUSIONS: The use of BAE may help improve management in patients with suspected and established small-bowel CD. 7/3/2015
Muhammad Hasan, Ashley Canipe, Benjamin Tharian, Udhaykumar Navaneethan, Shyam Varadarajulu, Robert Hawes Digital cholangioscopy-directed removal of a surgical staple from a strictured bile duct No abstract 6/29/2015
Shyam Varadarajulu, Ji Young Bang Digestive Disease Week (DDW) 2015: Pancreaticobiliary update This update critiques the key abstracts relevant to endoscopic evaluation or interventions in pancreatic and biliary diseases that were presented at Digestive Disease Week (DDW) 2015. We selected 20 abstracts based on their clinical significance, relevance to endoscopic practice and impact on patien... 6/17/2015
Udayakumar Navaneethan, Muhammad K Hasan, Vennisvasanth Lourdusamy, Basile Njei, Shyam Varadarajulu, Robert H Hawes Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures: a systematic review CONCLUSIONS: Our study suggests that SpyGlass cholangioscopy with SpyBite biopsies has moderate sensitivity for the diagnosis of malignant biliary strictures. 6/14/2015
Ji Young Bang, Shantel Hebert-Magee, Shyam Varadarajulu Objective assessment of reasons for needle change during endoscopic ultrasound-guided fine-needle aspiration No abstract 6/5/2015
Bronte A Holt, Gareth Hearn, Robert Hawes, Benjamin Tharian, Shyam Varadarajulu Development and evaluation of a 3D printed endoscopic ampullectomy training model (with video) CONCLUSION: Although further studies are necessary for validation, this novel prototype appears useful for endoscopic ampullectomy training. 5/20/2015
Udayakumar Navaneethan, Steve Eubanks Approach to patients with esophageal Dysphagia Patients frequently present to a physician with complaints of difficulty swallowing. The approach to systematically evaluating these problems can be challenging for those who do not manage this type of patient regularly. The potential for life-threatening malignancies is present and makes this evalu... 5/13/2015
Zubin Arora, Xianrui Wu, Udayakumar Navaneethan, Bo Shen Non-surgical porto-mesenteric vein thrombosis is associated with worse long-term outcomes in inflammatory bowel diseases CONCLUSIONS: IBD patients who were inpatients or receiving corticosteroid therapy had an increased risk of the development of PMVT. The presence of PMVT was associated with poor clinical outcomes in IBD. 4/30/2015
Kunjam Modha, Udayakumar Navaneethan Diagnosis and management of primary sclerosing cholangitis-perspectives from a therapeutic endoscopist Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver condition characterized by inflammation, fibrosis, and destruction of the intra- and extrahepatic bile ducts. The therapeutic endoscopist plays a key role in the diagnosis and management of PSC. In patients presenting with a choles... 4/28/2015
Vennisvasanth Lourdusamy, Benjamin Tharian, Udayakumar Navaneethan Biomarkers in bile-complementing advanced endoscopic imaging in the diagnosis of indeterminate biliary strictures Biliary strictures present a diagnostic challenge and a conundrum, particularly when an initial work up including abdominal imaging and endoscopic retrograde cholangiopancreatography based sampling are non-diagnostic. Advances in endoscopic imaging have helped us diagnose these strictures better. Ho... 4/23/2015
Ji Young Bang, Robert H Hawes, Shyam Varadarajulu EUS-guided tissue acquisition: things are not always what they seem No abstract 4/14/2015
Ji Young Bang, Robert Hawes, Paul Fockens, Shyam Varadarajulu Development of an endosonography app: a smart device for continuous education No abstract 4/14/2015
Ji Young Bang, Robert H Hawes, Shyam Varadarajulu Do fluoroscopy systems influence the level of scatter radiation exposure during endoscopic procedures? No abstract 4/2/2015
Benjamin Tharian, Ashley L Canipe, Konrad Krall, Robert H Hawes, Shantel Hébert-Magee Ring around the ROSE: pancreatic acinar cell carcinoma diagnosed on site by EUS-FNA No abstract 3/26/2015
Bronte A Holt, Shyam Varadarajulu The endoscopic management of pancreatic pseudocysts (with videos) No abstract 3/26/2015
Udayakumar Navaneethan, Tarun Rai, Preethi Gk Venkatesh, Ravi P Kiran Primary sclerosing cholangitis and the risk of colon neoplasia in patients with Crohn's colitis CONCLUSIONS: CC patients with PSC appear not to be at increased risk of developing colon neoplasia. Among patients in our cohort with colon neoplasia and concurrent PSC, the neoplasia occurred in the proximal colon in all cases. 3/1/2015
Udayakumar Navaneethan, Mansour A Parsi, Dennisdhilak Lourdusamy, David Grove, Madhusudhan R Sanaka, Jeffrey P Hammel, John J Vargo, Raed A Dweik Volatile Organic Compounds in Urine for Noninvasive Diagnosis of Malignant Biliary Strictures: A Pilot Study CONCLUSIONS: Measurement of VOCs in urine may diagnose malignant biliary strictures noninvasively. 2/25/2015
Tarun Rai, Udayakumar Navaneethan, Tushar Gohel, Amareshwar Podugu, Prashanthi N Thota, Ravi P Kiran, Rocio Lopez, Madhusudhan R Sanaka Effect of quality of bowel preparation on quality indicators of adenoma detection rates and colonoscopy completion rates CONCLUSIONS: Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good preparation. However, there was no difference in ADR between the different grades of preparation. 2/15/2015
Gursimran Singh Kochhar, Udayakumar Navaneethan, Jason Hartman, Jose Mari Parungao, Rocio Lopez, Ranjan Gupta, Baljendra Kapoor, Paresh Mehta, Madhu Sanaka Comparative study of endoscopy vs. transjugular intrahepatic portosystemic shunt in the management of gastric variceal bleeding CONCLUSION: These findings suggest that both treatments are equally effective. Cyanoacrylate offers a safe, effective alternative to TIPS for gastric varices, and physician may choose the best therapy for each patient, factoring in the availability of TIPS or cyanoacrylate, the individual patient's ... 2/13/2015
Sudha Kodali, Klaus Mönkemüller, Hwasoon Kim, Jayapal Ramesh, Jessica Trevino, Shyam Varadarajulu, C Mel Wilcox ERCP-related perforations in the new millennium: A large tertiary referral center 10-year experience CONCLUSIONS: In our study, leaks were much more common than perforations and the majority of patients were successfully managed with conservative therapy alone. We report a very low perforation rate and most perforations can be managed conservatively with a good outcome. 2/6/2015
Myrna Huixian Wang, Frederick Dy, Van Khien Vu, Lee Guan Lim, Ghias Un Nabi Tayyab, Thawee Ratanachu-ek, Dharmabandhu N Samarasekera, Vinay Dhir, Zheng-Dong Jin, Mitsuhiro Kida, Dong Wang Seo, Hsiu-Po Wang, Anthony Teoh, Robert Hawes, Shyam Varadarajulu, Ken Yasuda, Khek Yu Ho Structured endoscopic ultrasonography (EUS) training program improved knowledge and skills of trainees: Results from the Asian EUS Group CONCLUSION: Following a structured training program, trainees' knowledge and skills in EUS improved significantly. Structured training courses appear to be an effective way of imparting EUS knowledge and skills to aspiring endosonographers in the Asian region. 2/6/2015
Shajan Peter, Leona Council, Ji Young Bang, Helmut Neumann, Klaus Mönkemüller, Shyam Varadarajulu, Charles Melbern Wilcox Poor agreement between endoscopists and gastrointestinal pathologists for the interpretation of probe-based confocal laser endomicroscopy findings CONCLUSION: There is a wide discrepancy in the interpretation of pCLE findings between endoscopists and pathologist, particularly for benign and malignant pancreaticobiliary lesions. Further studies are needed to identify the cause of this poor agreement. 12/31/2014
Gursimran Kochhar, Udayakumar Navaneethan, Jose Mari Parungao, Jason Hartman, Ranjan Gupta, Rocio Lopez, Arthur J McCullough, Baljiendra Kapoor, Bo Shen Impact of transjugular intrahepatic portosystemic shunt on post-colectomy complications in patients with ulcerative colitis and primary sclerosing cholangitis CONCLUSION: Patients with PSC and UC who underwent TIPS prior to colectomy had higher rates of complications; however, this was probably due to the greater severity of cirrhosis and PSC in this population. 12/19/2014
Ji Young Bang, Robert Hawes, Albert Bartolucci, Shyam Varadarajulu Efficacy of metal and plastic stents for transmural drainage of pancreatic fluid collections: a systematic review CONCLUSIONS: Current evidence does not support routine placement of metal stents for transmural drainage of PFC. Randomized trials are needed to justify the use of metal stents for PFC drainage. 12/18/2014
Udayakumar Navaneethan, Norma G Gutierrez, Ramprasad Jegadeesan, Preethi Gk Venkatesh, Earl Poptic, Madhusudhan R Sanaka, John J Vargo, Mansour A Parsi IgG4 Levels in Bile for Distinguishing IgG4-Associated Cholangiopathy from Other Biliary Disorders: A Single Blinded Pilot Study CONCLUSIONS: The results of this pilot study suggest that measurement of biliary IgG4 levels may have clinical value in distinguishing patients with IAC from biliary disorders that can mimic IAC. 12/16/2014
Bronte A Holt, Shyam Varadarajulu, Konrad Krall, Shantel Hébert-Magee Unusual case of a stage I thymoma of the posterior mediastinum: endoscopic ultrasound-guided fine needle aspiration alone clinches the diagnosis No abstract 12/16/2014
Udayakumar Navaneethan, Mansour A Parsi, Vennisvasanth Lourdusamy, Amit Bhatt, Norma G Gutierrez, David Grove, Madhusudhan R Sanaka, Jeffrey P Hammel, Tyler Stevens, John J Vargo, Raed A Dweik Volatile organic compounds in bile for early diagnosis of cholangiocarcinoma in patients with primary sclerosing cholangitis: a pilot study CONCLUSION: The measurement of VOCs in biliary fluid may be useful to diagnose CCA in patients with PSC. A larger study with a longitudinal study design is required to confirm our pilot observations to diagnose CCA early in patients with PSC. ( 12/16/2014
Vinay Dhir, Takao Itoi, Mouen A Khashab, Do Hyun Park, Anthony Yuen Bun Teoh, Rajeev Attam, Ahmed Messallam, Shyam Varadarajulu, Amit Maydeo Multicenter comparative evaluation of endoscopic placement of expandable metal stents for malignant distal common bile duct obstruction by ERCP or EUS-guided approach CONCLUSIONS: In patients with malignant distal CBD obstruction requiring SEMS placement, the short-term outcome of EUS-BD is comparable to that of ERCP. 12/9/2014
Harpal S Dhaliwal, Shyam Varadarajulu, Muhammad K Hasan A case of painless jaundice No abstract 12/3/2014
Udayakumar Navaneethan, Basile Njei, Vennisvasanth Lourdusamy, Rajesh Konjeti, John J Vargo, Mansour A Parsi Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis CONCLUSION: Our study suggests that both brushings and biopsy are comparable and have limited sensitivity for the diagnosis of malignant biliary strictures. A combination of both only modestly increases the sensitivity. 12/3/2014
Udayakumar Navaneethan, Rajesh Konjeti, Vennisvasanth Lourdusamy, Dennisdhilak Lourdusamy, Dhruv Mehta, Madhusudhan R Sanaka, John J Vargo, Mansour A Parsi Precut sphincterotomy: efficacy for ductal access and the risk of adverse events CONCLUSIONS: Precut sphincterotomy is effective in achieving ductal access when standard cannulation techniques fail. A successful precut sphincterotomy is not associated with an increased risk of adverse events. 12/3/2014
Bronte Holt, Shyam Varadarajulu Endoscopic ultrasound-guided fine needle aspiration or fine needle biopsy: the beauty is in the eye of the beholder No abstract 11/28/2014
Udayakumar Navaneethan, Preethi Gk Venkatesh, Ramprasad Jegadeesan, Vennisvasanth Lourdusamy, Jeffrey P Hammel, Ravi P Kiran, Bo Shen Comparison of outcomes for patients with primary sclerosing cholangitis associated with ulcerative colitis and Crohn's disease CONCLUSIONS: PSC patients with CD appear to be associated with a lower risk of colon neoplasia and colectomy than PSC patients with UC. 10/31/2014
Udayakumar Navaneethan, Vennisvasanth Lourdusamy, Earl Poptic, Jeffrey P Hammel, Madhusudhan R Sanaka, Mansour A Parsi Comparative effectiveness of pyruvate kinase M2 in bile, serum carbohydrate antigen 19-9, and biliary brushings in diagnosing malignant biliary strictures CONCLUSIONS: As a stand-alone factor, none of the markers were able to distinguish benign from malignant biliary strictures with a high sensitivity. However, a combination was highly sensitive in diagnosing malignant biliary strictures. 10/26/2014
Ji Young Bang, Shyam Varadarajulu Endoscopic ultrasound-guided management of pancreatic pseudocysts and walled-off necrosis The outcome of endoscopic management of pancreatic fluid collections is dependent on the type of collection being treated. While pseudocysts have an excellent treatment response, the outcomes are modest for walled-off pancreatic necrosis. Recent advances in cross-sectional body imaging have enabled ... 10/18/2014
Ji Young Bang, Shyam Varadarajulu Neoplasia in chronic pancreatitis: how to maximize the yield of endoscopic ultrasound-guided fine needle aspiration When performing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), identifying neoplasia in the setting of chronic pancreatitis can be technically challenging. The morphology of an ill-defined mass on sonography, presence of calcifications or intervening collaterals, reverberation from a... 10/18/2014
Udayakumar Navaneethan, Vennisvasanth Lourdusamy, Preethi Gk Venkatesh, Belinda Willard, Madhusudhan R Sanaka, Mansour A Parsi Bile proteomics for differentiation of malignant from benign biliary strictures: a pilot study CONCLUSIONS: Protein biomarkers in bile may differentiate malignant from benign biliary strictures. Larger studies are warranted to validate these observations. 10/12/2014
Bronte A Holt, Shyam Varadarajulu EUS-guided drainage: beware of the pancreatic fluid collection (with videos) No abstract 10/5/2014
Jayapal Ramesh, Ji Young Bang, Shantel Hebert-Magee, Jessica Trevino, Isam Eltoum, Andra Frost, Muhammad K Hasan, Amy Logue, Robert Hawes, Shyam Varadarajulu Randomized Trial Comparing the Flexible 19G and 25G Needles for Endoscopic Ultrasound-Guided Fine Needle Aspiration of Solid Pancreatic Mass Lesions CONCLUSIONS: As there is no significant difference in the performance of flexible 19G and 25G needles, needle choice for sampling pancreatic masses should be based on endoscopist preference and need for histology. 9/19/2014
Udayakumar Navaneethan, Basile Njei, Preethi Gk Venkatesh, Vennisvasanth Lourdusamy, Madhusudhan R Sanaka Endoscopic ultrasound in the diagnosis of cholangiocarcinoma as the etiology of biliary strictures: a systematic review and meta-analysis CONCLUSIONS: Our study suggests that EUS-FNA is useful in the evaluation of CCA as the etiology of biliary strictures. EUS-FNA may improve the diagnosis of CCA in patients with negative cytology and no mass on cross-sectional imaging. 8/30/2014
Bronte Holt, Shyam Varadarajulu Endoscopic ultrasound-guided pelvic abscess drainage (with video) Pelvic abscesses present a serious and challenging management problem. Endoscopic ultrasound (EUS)-guided drainage provides a safe and effective minimally invasive treatment option. The likelihood of a successful outcome is dependent on appropriate patient selection, drainage technique and postopera... 8/28/2014
Shyam Varadarajulu, Bronte A Holt, Ji Young Bang, Muhammad K Hasan, Amy Logue, Ashutosh Tamhane, Robert H Hawes, Shantel Hebert-Magee Training endosonographers in cytopathology: improving the results of EUS-guided FNA CONCLUSIONS: An intensive 2-day program was effective in training endosonographers in the basics of EUS-related cytopathology. Incorporating basic cytopathology in EUS fellowship curriculum will likely improve diagnostic performance of tissue acquisition procedures. 8/16/2014
Arun Kannan, Chithra Poongkunran, Mahendran Jayaraj, Rajesh Janardhanan Role of strain imaging in right heart disease: a comprehensive review Advances in the imaging techniques of the heart have fueled the interest in understanding of right heart pathology. Recently, speckle tracking echocardiography has shown to aid in understanding various right heart diseases and better management. Its role is well established in diagnosing right heart... 8/12/2014
Jayapal Ramesh, Nipun Reddy, Hwasoon Kim, Klaus Mönkemüller, Shyam Varadarajulu, Brendan McGuire, Derek DuBay, Devin Eckhoff, C Mel Wilcox Safety and yield of diagnostic ERCP in liver transplant patients with abnormal liver function tests Background. Abnormal liver enzymes postorthotopic liver transplant (OLT) may indicate significant biliary pathology or organ rejection. There is very little known in the literature regarding the current role of diagnostic ERCP in this scenario. Aim. To review the utility of diagnostic ERCP in patien... 8/12/2014
Udayakumar Navaneethan, Ramprasad Jegadeesan, Shishira Nayak, Vennisvasanth Lourdusamy, Madhusudhan R Sanaka, John J Vargo, Mansour A Parsi ERCP-related adverse events in patients with primary sclerosing cholangitis CONCLUSION: Cholangitis appears to be the most common adverse event despite intraprocedural antibiotic use. There was a low risk of adverse events in patients with PSC undergoing ERCP. 8/3/2014
Shantel Hébert-Magee, Shyam Varadarajulu, Andra R Frost, Jayapal Ramesh Primary pancreatic leiomyosarcoma: a rare diagnosis obtained by EUS-FNA cytology No abstract 7/19/2014
Udayakumar Navaneethan, Vennisvasanth Lourdusamy, Sudhir Duvuru, Dennisdhilak Lourdusamy, Dhruv Mehta, Siva Raja, Sudhish Murthy, Madhusudhan R Sanaka Timing of esophageal stent placement and outcomes in patients with esophageal perforation: a single-center experience CONCLUSIONS: Endoscopic stent placement is safe and effective for treating esophageal perforations. However, the timing of stent placement on outcomes remains unclear. 7/19/2014
Shyam Varadarajulu, Ji Young Bang, Bronte A Holt, Muhammad K Hasan, Amy Logue, Robert H Hawes, Shantel Hebert-Magee The 25-gauge EUS-FNA needle: Good for on-site but poor for off-site evaluation? Results of a randomized trial CONCLUSIONS: The 25-gauge FNA needle yielded a diagnostic cell block in only 81% of patients, irrespective of whether 2 or 4 FNA passes were performed. These findings have important implications for centers without on-site cytopathology services. (Clinical trial registration number NCT01809028.). 6/29/2014
Bronte A Holt, Shyam Varadarajulu, Shantel Hébert-Magee High-quality endoscopic ultrasound-guided fine needle aspiration tissue acquisition Endoscopic ultrasound-guided fine needle aspiration is a multistep procedure that involves proper clinical indication, correct selection of needles, adapting evidence-based techniques such as the fanning maneuver and not routinely using suction or the stylet for tissue sampling, and establishing rel... 6/25/2014
Udayakumar Navaneethan Hepatobiliary manifestations of ulcerative colitis: an example of gut-liver crosstalk The interaction between inflammatory bowel disease (IBD) and hepatobiliary manifestations represents a classic example of liver-gut crosstalk. The importance of liver-gut crosstalk in IBD is demonstrated in the pathogenesis and outcome of primary sclerosing cholangitis (PSC) in IBD patients. Immunog... 6/22/2014
Udayakumar Navaneethan, Mansour A Parsi, Norma G Gutierrez, Amit Bhatt, Preethi G K Venkatesh, Dennisdhilak Lourdusamy, David Grove, Jeffrey P Hammel, Sunguk Jang, Madhusudhan R Sanaka, Tyler Stevens, John J Vargo, Raed A Dweik Volatile organic compounds in bile can diagnose malignant biliary strictures in the setting of pancreatic cancer: a preliminary observation CONCLUSIONS: The measurement of biliary fluid VOCs may help to distinguish malignant from benign biliary strictures. Further studies are warranted to validate these observations. (Clinical Trial Registration Number NCT01565460.). 6/16/2014
Preethi G K Venkatesh, Basile Njei, Madhusudhan R Sanaka, Udayakumar Navaneethan Risk of comorbidities and outcomes in patients with lower gastrointestinal bleeding - a nationwide study CONCLUSIONS: Comorbidities were associated with increased the risk of mortality and health care utilization in patients with LGIB. Identification of comorbidities and development of risk-adjustment tools may improve the outcome of patients with LGIB. 6/11/2014
Yamile Haito-Chavez, Joanna K Law, Thomas Kratt, Alberto Arezzo, Mauro Verra, Mario Morino, Reem Z Sharaiha, Jan-Werner Poley, Michel Kahaleh, Christopher C Thompson, Michele B Ryan, Neel Choksi, B Joseph Elmunzer, Sonia Gosain, Eric M Goldberg, Rani J Modayil, Stavros N Stavropoulos, Drew B Schembre, Christopher J DiMaio, Vinay Chandrasekhara, Muhammad K Hasan, Shyam Varadarajulu, Robert Hawes, Victoria Gomez, Timothy A Woodward, Sergio Rubel-Cohen, Fernando Fluxa, Frank P Vleggaar, Venkata S Akshintala, Gottumukkala S Raju, Mouen A Khashab International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video) CONCLUSION: OTSC is safe and effective therapy for closure of GI defects. Clinical success is best achieved in patients undergoing closure of perforations or leaks when OTSC is used for primary or rescue therapy. Type of defect is the best predictor of successful long-term closure. 6/9/2014
Charles Mel Wilcox, Hwasoon Kim, Jessica Trevino, Jayapal Ramesh, Klaus Monkemuller, Shyam Varadarajulu Prevalence of normal liver tests in patients with choledocholithiasis undergoing endoscopic retrograde cholangiopancreatography CONCLUSIONS: Although rare, liver tests can be normal in patients with CBD stones. Patients most likely to have normal liver tests included older patients and those with abdominal pain. 6/7/2014
Udayakumar Navaneethan, Rajesh Konjeti, Preethi Gk Venkatesh, Madhusudhan R Sanaka, Mansour A Parsi Early precut sphincterotomy and the risk of endoscopic retrograde cholangiopancreatography related complications: An updated meta-analysis CONCLUSION: This meta-analysis suggests that pre-cut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications. 6/4/2014
Ji Young Bang, C Mel Wilcox, Jessica M Trevino, Jayapal Ramesh, Muhammad Hasan, Robert H Hawes, Shyam Varadarajulu Relationship between stent characteristics and treatment outcomes in endoscopic transmural drainage of uncomplicated pancreatic pseudocysts CONCLUSIONS: There appears to be no relationship between the number of interventions required for treatment success and stent characteristics in patients undergoing endoscopic transmural drainage of uncomplicated pancreatic pseudocysts. 5/3/2014
Raymond S Y Tang, D Nageshwar Reddy, Anthony Y B Teoh, Kelvin L Y Lam, Robert H Hawes In vivo diagnosis of clonorchiasis during cholangioscopy for workup of suspected cholangiocarcinoma (with video) No abstract 4/16/2014
Udayakumar Navaneethan, Norma G Gutierrez, Preethi Gk Venkatesh, Ramprasad Jegadeesan, Renilang Zhang, Sunguk Jang, Madhusudhan R Sanaka, John J Vargo, Mansour A Parsi, Ariel E Feldstein, Tyler Stevens Lipidomic profiling of bile in distinguishing benign from malignant biliary strictures: a single-blinded pilot study CONCLUSIONS: The measurement of specific oxPL products may help to distinguish CCA from other biliary strictures. Measurement of these products in bile may enhance the endoscopic diagnosis of indeterminate biliary strictures. 4/9/2014
Kunjam Modha, Udayakumar Navaneethan Advanced therapeutic endoscopist and inflammatory bowel disease: dawn of a new role Endoscopy plays a key role in the diagnosis and treatment of patients with inflammatory bowel disease (IBD). Colonoscopy has been traditionally used in the diagnosis of IBD and helps in determination of an important end point in patient management, "mucosal healing". However, the involvement of an a... 4/8/2014
Udayakumar Navaneethan, Dennisdhilak Lourdusamy, Dhruv Mehta, Vennisvasanth Lourdusamy, Preethi G K Venkatesh, Madhusudhan R Sanaka Endoscopic resection of large sporadic non-ampullary duodenal polyps: efficacy and long-term recurrence CONCLUSIONS: Endoscopic resection is effective for treating large duodenal adenomas. Adenomas with villous features are more likely to recur. Almost all recurrences can be managed endoscopically. 4/4/2014
Bronte A Holt, Robert Hawes, Shyam Varadarajulu Hemosuccus pancreaticus caused by superior mesenteric artery fistula presenting as pancreatic panniculitis and anemia No abstract 4/1/2014
Udayakumar Navaneethan, Mansour A Parsi Langerhans cell histiocytosis and choledocholithiasis: is there an association? No abstract 3/28/2014
Udayakumar Navaneethan, Norma G Gutierrez, Ramprasad Jegadeesan, Preethi Gk Venkatesh, Madhusudhan R Sanaka, John J Vargo, Mansour A Parsi Factors predicting adverse short-term outcomes in patients with acute cholangitis undergoing ERCP: A single center experience CONCLUSION: Higher ASA physical classification and delays in ERCP are associated with adverse clinical outcomes and prolonged length of hospital stay in patients with acute cholangitis undergoing ERCP. 3/18/2014
Jayapal Ramesh, Hwasoon Kim, Kartika Reddy, Shyam Varadarajulu, C Mel Wilcox Impact of pancreatic stent caliber on post-endoscopic retrograde cholangiopancreatogram pancreatitis rates in patients with confirmed sphincter of Oddi dysfunction CONCLUSIONS: There appears to be no relationship between stent characteristics and the risk or severity of PEP in patients with manometrically proven SOD. 3/13/2014
Udayakumar Navaneethan, Tavankit Singh, Norma G Gutierrez, Ramprasad Jegadeesan, Preethi G Venkatesh, Jennifer Brainard, John J Vargo, Mansour A Parsi Predictors for detection of cancer in patients with indeterminate biliary stricture and atypical cells on endoscopic retrograde brush cytology CONCLUSION: Elevated CA19-9 level, the presence of clinical jaundice and current alcohol consumption are associated with increased detection of cancer in patients with indeterminate biliary stricture and atypical cells on ERBC. 3/12/2014
Jayapal Ramesh, Shantel Hebert-Magee, Hwasoon Kim, Jessica Trevino, Shyam Varadarajulu Frequency of occurrence and characteristics of primary pancreatic lymphoma during endoscopic ultrasound guided fine needle aspiration: a retrospective study CONCLUSIONS: Primary pancreatic lymphoma is encountered in 0.5% of patients undergoing endoscopic ultrasound guided fine needle aspiration. A large heterogeneous mass, in the absence of chronic pancreatitis or pancreatic duct dilation that reveals atypical lymphocytes on fine needle aspiration is su... 2/25/2014
Muhammad Khalid Hasan, Ji Young Bang, Shyam Varadarajulu Diagnostic value of priming the endoscopic ultrasound-guided fine-needle aspiration needle with heparin to improve specimen quality No abstract 2/18/2014
Udayakumar Navaneethan, Jeffrey P Hammel, Mansour A Parsi Response No abstract 1/18/2014
Udayakumar Navaneethan, Basile Njei, Preethi G K Venkatesh, John J Vargo, Mansour A Parsi Fluorescence in situ hybridization for diagnosis of cholangiocarcinoma in primary sclerosing cholangitis: a systematic review and meta-analysis CONCLUSION: Our study suggests that FISH polysomy is highly specific; however, limited sensitivity of FISH highlights that better markers are required for early detection of CCA in PSC. 12/24/2013
Shyam Varadarajulu, Ji Young Bang, C Mel Wilcox Reply: To PMID 23732774 No abstract 11/28/2013
Udayakumar Navaneethan, Sudhir Duvuru, Ramprasad Jegadeesan, Preethi G K Venkatesh, Norma G Gutierrez, Jeffrey Hammel, Ravi P Kiran, Madhusudhan R Sanaka Factors associated with 30-day readmission and long-term efficacy of enteral stent placement for malignancy CONCLUSIONS: Early complications following stent placement increase the risk of 30-day readmission. SEMS is efficacious long-term for palliation of malignant gastrointestinal obstruction. 11/16/2013
Shyam Varadarajulu, Robert H Hawes Preface: EUS-guided tissue acquisition No abstract 11/13/2013
Shyam Varadarajulu, Robert H Hawes The changing paradigm in EUS-guided tissue acquisition The diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration is strongly dependent on the availability of an onsite cytopathologist. The diagnosis of some rare tumors may require ancillary testing for which a histologic core biopsy is required. There is increasing interest in ev... 11/13/2013
Anthony Yuen Bun Teoh, Enders Kwok Wai Ng, Alana Chock, Lee Swanstrom, Shyam Varadarajulu, Philip Wai Yan Chiu Asian-Chinese patient perceptions of natural orifice transluminal endoscopic surgery cholecystectomy CONCLUSIONS: Asian-Chinese preferred NOTES mainly for cosmetic reasons. However, the transvaginal route was less acceptable to females. Significant differences in patient perception on NOTES were observed between Asian-Chinese and Western patients. 11/9/2013
Ji Young Bang, Shyam Varadarajulu Procore and flexible 19 gauge needle can replace trucut biopsy needle? Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is routinely performed for establishing tissue diagnosis in patients with gastrointestinal tumors. The concept of delivering chemotherapy based on molecular markers and the ability to establish a reliable diagnosis in lieu of an onsite cy... 10/22/2013
Ji Young Bang, Shyam Varadarajulu Metal versus Plastic Stent for Transmural Drainage of Pancreatic Fluid Collections The conventional management of pancreatic fluid collections (PFCs) involves surgery or percutaneous drainage. While surgery is associated with significant complications and mortality, percutaneous drainage is associated with prolonged hospitalization and oftentimes the need for other adjunctive trea... 10/22/2013
Guru Trikudanathan, Udayakumar Navaneethan, Basile Njei, John J Vargo, Mansour A Parsi Diagnostic yield of bile duct brushings for cholangiocarcinoma in primary sclerosing cholangitis: a systematic review and meta-analysis CONCLUSION: Our study suggests that bile duct brushing is a simple and highly specific technique for detection of CCA in patients with PSC. However, the modest sensitivity from bile duct brushing precludes its utility as a diagnostic tool for early detection of CCA in patients with PSC. 10/22/2013
Shyam Varadarajulu, Robert H Hawes EUS-guided biliary drainage: taxing and not ready No abstract 10/15/2013
Preethi G K Venkatesh, Sravanthi Parasa, Basile Njei, Madhusudhan R Sanaka, Udayakumar Navaneethan Increased mortality with peptic ulcer bleeding in patients with both compensated and decompensated cirrhosis CONCLUSION: Both decompensated and compensated cirrhosis are associated with increased mortality in patients with PUB. 10/15/2013
Shyam Varadarajulu, Surinder S Rana, Deepak K Bhasin Endoscopic therapy for pancreatic duct leaks and disruptions Pancreatitis, whether acute or chronic, can lead to a plethora of complications, such as fluid collections, pseudocysts, fistulas, and necrosis, all of which are secondary to leakage of secretions from the pancreatic ductal system. Partial and side branch duct disruptions can be managed successfully... 10/2/2013
Udayakumar Navaneethan, Basile Njei, Preethi G K Venkatesh, Madhusudhan R Sanaka Timing of colonoscopy and outcomes in patients with lower GI bleeding: a nationwide population-based study CONCLUSIONS: Early colonoscopy within 24 hours is associated with decreased length of hospital stay and hospitalization costs in patients with LGIB. 9/25/2013
Shyam Varadarajulu, Muhammad K Hasan, Ji Young Bang, Shantel Hebert-Magee, Robert H Hawes Endoscopic ultrasound-guided tissue acquisition Endoscopic ultrasound (EUS) is an indispensable tool for tissue acquisition in patients with gastrointestinal tumors. While fine-needle aspiration (FNA) has been routinely carried out for establishing tissue diagnosis, the emerging concept of tailoring chemotherapeutic agents based on molecular mark... 9/17/2013
Robert H Hawes Endoscopic innovations No abstract 8/31/2013
Muhammad K Hasan, Robert Hawes, Shyam Varadarajulu Gastric heterotopic pancreas abscess leading to gastric outlet obstruction No abstract 8/17/2013
Robert H Hawes Endoscopic innovations No abstract 8/17/2013
Shantel Hébert-Magee, Robert H Hawes, Shyam Varadarajulu Is it time to take a pass on the increased number of passes in EUS-FNA? No abstract 8/9/2013
Udayakumar Navaneethan, Ramprasad Jegadeesan, Norma G Gutierrez, Preethi G K Venkatesh, Jeffrey P Hammel, Bo Shen, Ravi P Kiran Progression of low-grade dysplasia to advanced neoplasia based on the location and morphology of dysplasia in ulcerative colitis patients with extensive colitis under colonoscopic surveillance CONCLUSIONS: The frequency of progression of LGD to AN is low. Flat dysplasia located in the distal colon is associated with a greater risk of progression to AN. 8/7/2013
Ji Young Bang, Robert H Hawes, Shyam Varadarajulu Objective evaluation of a new endoscopic ultrasound processor No abstract 7/30/2013
Ramprasad Jegadeesan, Xiuli Liu, Mangesh R Pagadala, Norma Gutierrez, Mujtaba Butt, Udayakumar Navaneethan Microscopic colitis: is it a spectrum of inflammatory bowel disease? Lymphocytic and collagenous colitis are forms of microscopic colitis which typically presents in elderly patients as chronic watery diarrhea. The association between microscopic colitis and inflammatory bowel disease is weak and unclear. Lymphocytic colitis progressing to ulcerative colitis has been... 7/19/2013
Ji Young Bang, C Mel Wilcox, Jessica Trevino, Jayapal Ramesh, Shajan Peter, Muhammad Hasan, Robert H Hawes, Shyam Varadarajulu Factors impacting treatment outcomes in the endoscopic management of walled-off pancreatic necrosis CONCLUSIONS: Creating multiple gateways for drainage of necrotic debris improves treatment success, and not removing the transmural stents decreases PFC recurrence in patients undergoing endoscopic drainage of WOPN. 7/9/2013
Udayakumar Navaneethan, Norma G Gutierrez, Ramprasad Jegadeesan, Preethi G K Venkatesh, Earl Poptic, Xiuli Liu, Madhusudhan R Sanaka, Sunguk Jang, John J Vargo, Mansour A Parsi Vascular endothelial growth factor levels in bile distinguishes pancreatic cancer from other etiologies of biliary stricture: a pilot study CONCLUSIONS: This study suggests that measurement of biliary VEGF-1 levels distinguishes patients with pancreatic cancer from other etiologies of biliary stricture. This may be particularly relevant in approaching patients with indeterminate biliary stricture. 7/6/2013
Steven D Schwaitzberg, Robert H Hawes, David W Rattner, Michael L Kochman Novel challenges of multi-society investigator-initiated studies: a paradigm shift for technique and technology evaluation The introduction of innovative techniques and novel technologies into clinical practice is a challenge that confronts all aspects of healthcare delivery. Upheaval from shrinking research funding and declining healthcare reimbursements now forces patients, doctors, hospitals, payers, regulators, and ... 6/12/2013
Shyam Varadarajulu A hybrid endoscopic technique for the treatment of walled-off pancreatic necrosis No abstract 6/6/2013
Shyam Varadarajulu, Ji Young Bang, Bryce S Sutton, Jessica M Trevino, John D Christein, C Mel Wilcox Equal efficacy of endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial CONCLUSIONS: In a randomized trial comparing endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage, none of the patients in the endoscopy group had pseudocyst recurrence during the follow-up period, therefore there is no evidence that surgical cystogastrostomy is superior. Howe... 6/5/2013
Sansrita Nepal, Udayakumar Navaneethan, Ana E Bennett, Bo Shen De novo inflammatory bowel disease and its mimics after organ transplantation Diarrhea is a common symptom after solid organ transplantation or hematopoietic stem cell transplantation, with a reported prevalence up to 72%. One of the uncommon causes for diarrhea in the posttransplant setting is development of de novo inflammatory bowel disease (IBD). The incidence of posttran... 5/10/2013
Ji Young Bang, Shantel Hebert-Magee, Shyam Varadarajulu Response to Schembre No abstract 4/16/2013
Muhammad K Hasan, Takao Itoi, Shyam Varadarajulu Endoscopic management of acute cholecystitis Acute cholecystitis is a commonly encountered medical emergency that is managed surgically with excellent results. Recent experiences with endoscopic cystic duct stent placement and cholecystectomy using the NOTES (Natural Orifice Transluminal Endoscopic Surgery) approach have inspired endoscopists ... 4/2/2013
Udayakumar Navaneethan, Norma G Gutierrez, Ramprasad Jegadeesan, Preethi G K Venkatesh, Mujtaba Butt, Madhusudhan R Sanaka, John J Vargo, Mansour A Parsi Delay in performing ERCP and adverse events increase the 30-day readmission risk in patients with acute cholangitis CONCLUSION: Delays in performing ERCP during the index admission, development of after-ERCP adverse events, and etiology of cholangitis not related to stones increased the risk of 30-day readmissions. 3/27/2013
Udayakumar Navaneethan, Paresh P Mehta, Madhusudhan R Sanaka Colonoscopies by nurse practitioners: too premature to support their role No abstract 3/26/2013
Udayakumar Navaneethan, Gursimran Kochhar, Preethi G K Venkatesh, Ana E Bennett, Maged Rizk, Bo Shen, Ravi P Kiran Random biopsies during surveillance colonoscopy increase dysplasia detection in patients with primary sclerosing cholangitis and ulcerative colitis CONCLUSIONS: Random biopsies significantly increase the yield of dysplasia in patients with PSC and UC even in the absence of endoscopic features of prior inflammation and significantly impact clinical outcomes. 3/26/2013
C Mel Wilcox, Hwasoon Kim, Jayapal Ramesh, Jessica Trevino, Shyam Varadarajulu Biliary sphincterotomy is not required for bile duct stent placement CONCLUSION: Single bile duct stents, both plastic and metal, can be deployed without EBS. 3/23/2013
Pradermchai Kongkam, Tiing Leong Ang, Charles K F Vu, Frederick T Dy, Kenjiro Yasuda, Rungsun Rerknimitr, Shyam Varadarajulu, Vinay Dhir, Vui Heng Chong, Dong Jin Zhen, Jennie Y Y Wong, Khek-Yu Ho, Asian Consortium of EUS Current status on the diagnosis and evaluation of pancreatic tumor in Asia with particular emphasis on the role of endoscopic ultrasound In Asia, the incidence of pancreatic cancer in some countries has been increasing. Owing to most cases being diagnosed late, prognosis for pancreatic cancer remains dismal. It is clear that the future for pancreatic cancer lies in early detection. While the possible presence of pancreatic masses is ... 3/16/2013
Shajan Peter, Ji Young Bang, Klaus Mönkemuller, Shyam Varardarajulu, C Mel Wilcox Endomicroscopy of the pancreaticobiliary system It is often difficult to accurately differentiate between benign and malignant pancreaticobiliary strictures, and some are interpreted as indeterminate despite ERCP, EUS, or radiological imaging techniques, thereby making it difficult for the clinician to make appropriate management decisions. Probe... 3/12/2013
Preethi G K Venkatesh, Ramprasad Jegadeesan, Norma G Gutierrez, Madhusudhan R Sanaka, Udayakumar Navaneethan Natural history of low grade dysplasia in patients with primary sclerosing cholangitis and ulcerative colitis CONCLUSIONS: One-third of patients with LGD progressed to HGD/CRC in PSC-UC. Most patients progress within the first year of diagnosis of LGD supporting early colectomy in PSC-UC patients with LGD. 2/26/2013
Udayakumar Navaneethan, Bret A Lashner Effects of immunosuppression and liver transplantation on inflammatory bowel disease in patients with primary sclerosing cholangitis No abstract 2/5/2013
Udayakumar Navaneethan, Ramprasad Jegadeesan, Norma G Gutierrez, Preethi G K Venkatesh, Andrea V Arrossi, Ana E Bennett, Tarun Rai, Feza H Remzi, Bo Shen, Ravi P Kiran Backwash ileitis and the risk of colon neoplasia in ulcerative colitis patients undergoing restorative proctocolectomy CONCLUSIONS: The presence of BWI with extensive colitis was associated with the risk of identifying colon neoplasia but not cancer alone in the proctocolectomy specimen. 2/2/2013
Ji Young Bang, Jayapal Ramesh, Jessica Trevino, Mohamad A Eloubeidi, Shyam Varadarajulu Objective assessment of an algorithmic approach to EUS-guided FNA and interventions CONCLUSION: An algorithmic approach to EUS-FNA/interventions yielded better technical outcomes and cost savings without compromising diagnostic adequacy. 2/2/2013
Ji Young Bang, Shajan Peter Obscure gastrointestinal bleeding and Turner syndrome Gastrointestinal bleeding in individuals with Turner syndrome is relatively rare and there have been only a handful of reported cases in the literature. Here, we present two patients with Turner syndrome who were evaluated for obscure gastrointestinal bleeding. Our first patient presented with iron ... 2/2/2013
Stephen T Amann, Dhiraj Yadav, M Micheal Barmada, Michael O'Connell, Elizabeth D Kennard, Michelle Anderson, John Baillie, Stuart Sherman, Joseph Romagnuolo, Robert H Hawes, Samer Alkaade, Randall E Brand, Michele D Lewis, Timothy B Gardner, Andres Gelrud, Mary E Money, Peter A Banks, Adam Slivka, David C Whitcomb Physical and mental quality of life in chronic pancreatitis: a case-control study from the North American Pancreatitis Study 2 cohort CONCLUSIONS: The impact of CP on QOL appears substantial. The QOL in CP subjects appears to be worse or similar to the QOL of many other chronic conditions. 1/30/2013
Sravanthi Parasa, Udayakumar Navaneethan, Arun Raghav Mahankali Sridhar, Preethi G K Venkatesh, Kevin Olden End-stage renal disease is associated with worse outcomes in hospitalized patients with peptic ulcer bleeding CONCLUSIONS: ESRD is associated with a significant health care burden in hospitalized patients with PUB. The presence of ESRD contributes to a higher mortality rate, longer hospital stay, and increased need for surgery. 1/30/2013
Guru Trikudanathan, Udayakumar Navaneethan, Mansour A Parsi Endoscopic management of difficult common bile duct stones Endoscopy is widely accepted as the first treatment option in the management of bile duct stones. In this review we focus on the alternative endoscopic modalities for the management of difficult common bile duct stones. Most biliary stones can be removed with an extraction balloon, extraction basket... 1/25/2013
Lee Guan Lim, Sandeep Lakhtakia, Tiing Leong Ang, Charles K F Vu, Frederick Dy, Vui Heng Chong, Christopher J L Khor, Wee Chian Lim, Bhavesh Kishor Doshi, Shyam Varadarajulu, Kenjiro Yasuda, Jennie Y Y Wong, Yiong Huak Chan, Min En Nga, Khek Yu Ho, Asian EUS Consortium Factors determining diagnostic yield of endoscopic ultrasound guided fine-needle aspiration for pancreatic cystic lesions: a multicentre Asian study CONCLUSION: The cytologic yield of EUS-FNA was 47 %. When a solid component was present in the cyst, doing more than one pass during EUS-FNA increased its diagnostic yield. 1/15/2013
Jayapal Ramesh, John Christein, Shyam Varadarajulu The concept of laparoscopy-assisted pancreatobiliary EUS (LAP-EUS) INTRODUCTION: While laparoscopy-assisted endoscopic retrograde cholangiopancreatography can be performed for the diagnosis and management of pancreaticobiliary diseases in patients with Roux-en-Y (RY) anatomy; the technical feasibility of performing laparoscopy-assisted endoscopic ultrasound (EUS) i... 1/9/2013
Madhusudhan R Sanaka, Udayakumar Navaneethan, Bennie R Upchurch, Rocio Lopez, Sabrina Vannoy, Milan Dodig, Janice M Santisi, John J Vargo Diagnostic and therapeutic yield is not influenced by the timing of small-bowel enteroscopy: morning versus afternoon CONCLUSIONS: The timing of procedure, morning versus afternoon, did not affect the diagnostic and therapeutic efficacy of BE in patients with suspected small-bowel disease. 12/25/2012
Jayapal Ramesh, Ji Young Bang, Jessica Trevino, Shyam Varadarajulu Comparison of outcomes between endoscopic ultrasound-guided transcolonic and transrectal drainage of abdominopelvic abscesses CONCLUSION: Except for patients with diverticular etiology, treatment of abdominopelvic abscess under EUS guidance is highly effective and safe for both routes. 12/11/2012
Chris Reilly, Scott Zenoni, Muhammad K Hasan, Shyam Varadarajulu, Tien-Anh Tran, Sebastian G de la Fuente, Juan P Arnoletti Primary pancreatic Ewing's sarcoma with portal vein tumor thrombosis BACKGROUND: Extraosseous Ewing's sarcoma (EES) is a mesenchyme-derived small blue cell tumor, which is distinguished by its rarity, aggressiveness, dismal prognosis, and distinct pathogenesis. Occurring almost exclusively among children and young adults, EES can arise from a variety of organs and po... 11/30/2012
Guru Trikudanathan, Preethi G K Venkatesh, Udayakumar Navaneethan Diagnosis and therapeutic management of extra-intestinal manifestations of inflammatory bowel disease Extra-intestinal manifestations (EIMs) are reported frequently in patients with inflammatory bowel disease (IBD) and may be diagnosed before, concurrently or after the diagnosis of IBD. EIMs in IBD may be classified based on their association with IBD disease activity. The first group has a direct r... 11/28/2012
Eric M Nelsen, Robert H Hawes, Prasad G Iyer Diagnosis and management of Barrett's esophagus Barrett esophagus is characterized by the replacement of squamous mucosa in the esophagus by specialized intestinal metaplasia. Its clinical significance lies in it being the strongest risk factor for and known precursor for esophageal adenocarcinoma. Diagnosis requires endoscopic confirmation of co... 10/3/2012
Preethi G K Venkatesh, Udayakumar Navaneethan, Bo Shen, Arthur J McCullough Increased serum levels of carbohydrate antigen 19-9 and outcomes in primary sclerosing cholangitis patients without cholangiocarcinoma CONCLUSIONS: Thirty-two percent of patients with PSC had elevated serum CA 19-9 in the absence of CCA. There was a trend towards shorter OLT-free survival in PSC patients with elevated CA-19-9. 9/26/2012
Udayakumar Navaneethan, Sravanthi Parasa, Preethi G K Venkatesh, Thimmaiah T Ganapathi, Ravi P Kiran, Bo Shen Impact of inflammatory bowel disease on post-cholecystectomy complications and hospitalization costs: a Nationwide Inpatient Sample study CONCLUSIONS: CD patients undergoing cholecystectomy were shown to have a significantly increased risk for postoperative complications, have a longer stay in the hospital, and incur higher hospitalization costs. 9/11/2012
Mouen A Khashab, Shyam Varadarajulu Endoscopic ultrasonography as a therapeutic modality PURPOSE OF REVIEW: Endoscopic ultrasonography (EUS) has taken on more of a therapeutic role in recent years. This review will focus on the therapeutic applications of EUS. 8/14/2012
Jayapal Ramesh, Shyam Varadarajulu How can we get the best results with endoscopic ultrasound-guided fine needle aspiration? Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has evolved to become an indispensable tool for tissue acquisition. While the overall diagnostic accuracy of EUS-FNA is greater than 90% for lung cancer staging, it is lower for pancreatic mass lesions. Several factors such as location of... 8/7/2012
Robert H Hawes, James Clancy, Muhammad K Hasan Endoscopic ultrasound-guided fine needle aspiration in cystic pancreatic lesions Incidental pancreatic cysts are being increasingly recognized recently with incremented concern about health and frequent health check-up. Endoscopic ultrasound (EUS) has emerged as the principal modality for imaging pancreas for various pancreatic diseases including pancreatic cyst. But imaging alo... 8/7/2012
Shyam Varadarajulu, Nirag C Jhala Cytopathology: a dying art or something that a gastroenterologist should know? No abstract 7/24/2012
Shyam Varadarajulu, Ji Young Bang, Shantel Hebert-Magee Assessment of the technical performance of the flexible 19-gauge EUS-FNA needle CONCLUSIONS: Preliminary data suggest that the flexible 19-G needle can be used for procuring cytologic aspirates and histologic specimens and to undertake therapeutic interventions even by the transduodenal route. Confirmatory studies are required in a larger cohort of patients with varied patholog... 7/24/2012
Jonathan Cohen, Brian P Bosworth, Amitabh Chak, Brian J Dunkin, Dayna S Early, Lauren B Gerson, Robert H Hawes, Adam V Haycock, Juergen H Hochberger, Joo Ha Hwang, John A Martin, Peter R McNally, Robert E Sedlack, Melina C Vassiliou Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) on the use of endoscopy simulators for training and assessing skill No abstract 7/20/2012
Robert H Hawes, Steve Eubanks Robotic endoscopy: a small case series, a giant step for endoscopy No abstract 7/17/2012
Emmanuel C Obusez, Lei Lian, Zhuo Shao, Udayakumar Navaneethan, Robert O'Shea, Ravi P Kiran, Bo Shen Impact of ileal pouch-anal anastomosis on the surgical outcome of orthotopic liver transplantation for primary sclerosing cholangitis CONCLUSIONS: The presence of the IPAA in OLT for PSC patients appears not to have a negative impact on patient and graft survivals and post-operative complications. 7/14/2012
Jayapal Ramesh, Ji Y Bang, Jessica Trevino, Shyam Varadarajulu Endoscopic ultrasound-guided drainage of pancreatic fluid collections in children CONCLUSIONS: Single-step EUS-guided drainage of PFC in children is technically feasible, safe, clinically effective, and when available, should be the first-line treatment modality. 7/13/2012
Guru Trikudanathan, Udayakumar Navaneethan, Santhi Swaroop Vege Current controversies in fluid resuscitation in acute pancreatitis: a systematic review Acute pancreatitis (AP) is a common inflammatory disorder of the pancreas resulting in considerable morbidity and mortality. Aggressive intravenous fluid resuscitation generally is recommended in all patients with AP and remains the cornerstone of management of these patients. However, the optimal r... 7/12/2012
James L Buxbaum, Mohamad A Eloubeidi, Christianne J Lane, Shyam Varadarajulu, Ami Linder, Amanda E Crowe, Darshana Jhala, Nirag C Jhala, David R Crowe, Isam A Eltoum Dynamic telecytology compares favorably to rapid onsite evaluation of endoscopic ultrasound fine needle aspirates CONCLUSION: Dynamic telecytology compares favorably to ROSE in the assessment of EUS acquired fine needle aspirates. If confirmed by larger trials, this system might obviate the need for onsite interpretation of EUS-FNA specimens. 6/26/2012
Nathaniel Ranney, Milind Phadnis, Jessica Trevino, Jayapal Ramesh, C Mel Wilcox, Shyam Varadarajulu Impact of biliary stents on EUS-guided FNA of pancreatic mass lesions CONCLUSIONS: The presence or absence of a biliary stent, whether plastic or metal, does not have an impact on the diagnostic yield or technical difficulty of EUS-FNA. 6/26/2012
Narendra B Vadlamudi, Udayakumar Navaneethan, Kirk A Thame, David R Kelly, Reed A Dimmitt, William T Harris Crohn's disease with pulmonary manifestations in children: 2 case reports and review of the literature Crohn's disease (CD) is a chronic granulomatous disease of unknown etiology that affects primarily the gastrointestinal system but can be associated with extraintestinal manifestations. Latent pulmonary involvement in children with CD has been described, but symptomatic pulmonary disease has rarely ... 6/19/2012
Ji Young Bang, Shantel Hebert-Magee, Jessica Trevino, Jayapal Ramesh, Shyam Varadarajulu Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions CONCLUSION: Diagnostic sufficiency, technical performance, and safety profiles of FNA and FNB needles are comparable. There was no significant difference in yield or quality of the histologic core between the 2 needle types. 6/5/2012
Ganapathy A Prasad, Shyam Varadarajulu Endoscopic ultrasound-guided abscess drainage Abdominal and pelvic abscesses have traditionally been drained by percutaneous techniques or surgery. While surgical drainage is associated with considerable morbidity and mortality, percutaneous techniques are associated with the need for multiple interventions, increased length of hospital stay, a... 5/29/2012
Muhammad K Hasan, Robert H Hawes EUS-guided FNA of solid pancreas tumors Although endoscopic ultrasonography (EUS) is considered superior to MRI and CT in detecting pancreatic masses, it is the ability to target and place a needle into suspicious lesions that has made EUS indispensible in the evaluation of patients with solid pancreatic tumors. Endoscopic ultrasound-guid... 5/29/2012
Ji Young Bang, Shyam Varadarajulu Endoscopic ultrasound-guided transrectal drainage of a pelvic abscess following total abdominal hysterectomy No abstract 5/26/2012
Madhusudhan R Sanaka, Udayakumar Navaneethan, Bhanu Kosuru, Himabindu Yerneni, Rocio Lopez, John J Vargo Antegrade is more effective than retrograde enteroscopy for evaluation and management of suspected small-bowel disease CONCLUSIONS: Antegrade enteroscopy appears to provide a higher diagnostic and therapeutic yield than retrograde enteroscopy in patients with suspected small-bowel disease. 5/22/2012
Udayakumar Navaneethan, Preethi G K Venkatesh, Maria Choudhary, Bo Shen, Ravi P Kiran Elevated immunoglobulin G4 level is associated with reduced colectomy-free survival in patients with primary sclerosing cholangitis and ulcerative colitis CONCLUSIONS: Elevated IgG4 was seen in a small number of PSC patients. Most of these patients had associated UC, were younger at the time of PSC diagnosis, more likely to have backwash ileitis and had reduced colectomy-free survival than patients with normal IgG4. 5/5/2012
Ann Roy, Micheline Kim, John Christein, Shyam Varadarajulu Stenting versus gastrojejunostomy for management of malignant gastric outlet obstruction: comparison of clinical outcomes and costs CONCLUSIONS: While the technical and clinical outcomes of surgical GJ and endoscopic stenting appear comparable, stent placement is less costly and is associated with shorter length of hospital stay. Dissemination of endoscopic stenting beyond teaching, academic hospitals located in urban areas as a... 5/3/2012
Ji Young Bang, Shyam Varadarajulu Diagnosis of a metastatic neuroendocrine tumor of the pancreas by transaortic endoscopic ultrasound-guided fine-needle aspiration No abstract 4/25/2012
Ji Young Bang, Ghasem Yadegarfar, Michael Soljak, Azeem Majeed Primary care factors associated with cervical screening coverage in England CONCLUSIONS: Cervical screening coverage was significantly lower in PCTs and practices serving higher percentages of younger-aged women, non-Caucasian individuals and those living in socioeconomic deprivation. It is therefore important to adopt strategies to improve cervical screening coverage in th... 4/21/2012
Shyam Varadarajulu, Paul Fockens, Robert H Hawes Best practices in endoscopic ultrasound-guided fine-needle aspiration Over the past 2 decades, endoscopic ultrasound-guided fine-needle aspiration has evolved to become an indispensable tool for tissue acquisition in patients with gastrointestinal tumors. The technique is useful for biopsy of mucosal and submucosal lesions in which prior endoscopic biopsies have been ... 4/6/2012
Linda Y Tang, Hui Cai, Udayakumar Navaneethan, James H Boone, Sarah J Rhodes, Lauren Moore, Hyunjin Rho, Carol de La Motte, Elaine Queener, Bo Shen Utility of fecal and serum anti-Saccharomyces cerevisiae antibodies in the diagnosis of Crohn's disease-like condition of the pouch CONCLUSIONS: Fecal ASCA appears to be better than serum ASCA in differentiating CDL from other pouch disorders, although this distinction may be of limited clinical utility. 3/21/2012
Udayakumar Navaneethan, Gursimran Kochhar, Preethi G K Venkatesh, Brian Lewis, Bret A Lashner, Feza H Remzi, Bo Shen, Ravi P Kiran Duration and severity of primary sclerosing cholangitis is not associated with risk of neoplastic changes in the colon in patients with ulcerative colitis CONCLUSION: In this study, the severity of PSC was not significantly associated with the risk of colon neoplasia. Patients with PSC and UC have a high risk of colon neoplasia soon after the coexistence of the two diseases is discovered. Older age at PSC diagnosis increases this risk. 3/13/2012
Udayakumar Navaneethan, Saurabh Mukewar, Preethi G K Venkatesh, Rocio Lopez, Bo Shen Clostridium difficile infection is associated with worse long term outcome in patients with ulcerative colitis CONCLUSIONS: CDI appears to be associated with escalation of medical therapy in the year following infection. CDI and severe disease on endoscopy appear to be associated with an increased risk for subsequent colectomy on long-term follow up. 3/13/2012
Udayakumar Navaneethan, Preethi G K Venkatesh, Bret A Lashner, Rocio Lopez, Ravi P Kiran, Bo Shen Severity of primary sclerosing cholangitis and its impact on the clinical outcome of Crohn's disease CONCLUSIONS: In contrast to UC, severe PSC requiring OLT does not appear to impact the clinical outcome of CD. 3/9/2012
Udayakumar Navaneethan, Preethi G K Venkatesh, Bret A Lashner, Feza H Remzi, Bo Shen, Ravi P Kiran Temporal trends in colon neoplasms in patients with primary sclerosing cholangitis and ulcerative colitis CONCLUSIONS: With annual colonoscopic surveillance, dysplasia and cancer in patients with a combined diagnosis of PSC//UC is being diagnosed in patients with a shorter duration of these conditions. The nature and the location of neoplasia have, however, not changed. 3/9/2012
Udayakumar Navaneethan, Gursimran Kochhar, Hardeep Phull, Preethi G K Venkatesh, Feza H Remzi, Ravi P Kiran, Bo Shen Severe disease on endoscopy and steroid use increase the risk for bowel perforation during colonoscopy in inflammatory bowel disease patients CONCLUSIONS: There appears to be a higher risk of colonoscopy-associated perforation in IBD patients with active disease and on steroids. 3/9/2012
Udayakumar Navaneethan, Preethi G K Venkatesh, Ana E Bennett, Viral Patel, Jeffrey Hammel, Ravi P Kiran, Arthur J McCullough, Bo Shen Impact of budesonide on liver function tests and gut inflammation in patients with primary sclerosing cholangitis and ileal pouch anal anastomosis CONCLUSIONS: Oral budesonide appears to have no impact on liver function tests in pouch patients with PSC. However it significantly improved afferent limb and pouch inflammation in IPAA patients. 3/9/2012
Guru Trikudanathan, Udayakumar Navaneethan, Santhi Swaroop Vege Modern treatment of patients with chronic pancreatitis CP remains a challenging disease. Endoscopic and surgical management, along with antioxidants, have helped in reducing chronic pain. Management of exocrine and endocrine insufficiency forms the cornerstone for improving nutrition in these patients. Newer therapeutic targets that will transcend the m... 2/21/2012
Udayakumar Navaneethan, Preethi G K Venkatesh, Erinn Downs-Kelly, Bo Shen Isospora belli superinfection in a patient with eosinophilic gastroenteritis--a diagnostic challenge Isospora belli infection, characterized by peripheral blood eosinophilia, is often seen as an opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS). It is also reported in patients with underlying lymphoproliferative disorders including lymphoma and leukemia. Eosinophil-... 2/14/2012
Prateek Sharma, Robert H Hawes, Ajay Bansal, Neil Gupta, Wouter Curvers, Amit Rastogi, Mandeep Singh, Matt Hall, Sharad C Mathur, Sachin B Wani, Brenda Hoffman, Srinivas Gaddam, Paul Fockens, Jacques J Bergman Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barrett's oesophagus: a prospective, international, randomised controlled trial CONCLUSIONS: NBI targeted biopsies can have the same IM detection rate as an HD-WLE examination with the Seattle protocol while requiring fewer biopsies. In addition, NBI targeted biopsies can detect more areas with dysplasia. Regular appearing NBI surface patterns did not harbour high-grade dysplas... 2/9/2012
Udayakumar Navaneethan, Preethi G K Venkatesh, Ravi P Kiran Immunoglobulin E level and its significance in patients with primary sclerosing cholangitis No abstract 2/1/2012
Shyam Varadarajulu, C Mel Wilcox, Sahibzada Latif, Milind Phadnis, John D Christein Management of pancreatic fluid collections: a changing of the guard from surgery to endoscopy The aim of this study was to assess for any trend in management of pancreatic fluid collections (PFCs) and identify impacting factors. The endoscopy and surgical databases were queried for PFC patients. PFCs were categorized as pseudocysts (PP) or complex collections (CC) that included abscess/necro... 1/26/2012
Udayakumar Navaneethan, Preethi G K Venkatesh, Saurabh Mukewar, Bret A Lashner, Feza H Remzi, Arthur J McCullough, Ravi P Kiran, Bo Shen, John J Fung Progressive primary sclerosing cholangitis requiring liver transplantation is associated with reduced need for colectomy in patients with ulcerative colitis CONCLUSIONS: Severe progressive PSC that requires liver transplantation appears to reduce the disease activity of UC and the need for colectomy. 1/17/2012
Udayakumar Navaneethan, Sravanthi Parasa, Preethi G K Venkatesh, Bo Shen Prevalence and risk factors for colonic perforation during colonoscopy in hospitalized end-stage renal disease patients on hemodialysis CONCLUSIONS: There appeared no increased risk of colonic perforation during colonoscopy among inpatients who received HD in our study. Increasing age and female patients appeared to be associated with procedure-related colonic perforation. 12/30/2011
Udayakumar Navaneethan, Bo Shen Pros and cons of medical management of ulcerative colitis Ulcerative colitis (UC) is a chronic inflammatory disease characterized by diffuse mucosal inflammation limited to the colon and rectum. Although a complete medical cure may not be possible, UC can be treated with medications that induce and maintain remission. The medical management of this disease... 12/2/2011
Udayakumar Navaneethan, Ana E Bennett, Preethi G K Venkatesh, Lei Lian, Jeffrey Hammel, Viral Patel, Ravi P Kiran, Feza H Remzi, Bo Shen Tissue infiltration of IgG4+ plasma cells in symptomatic patients with ileal pouch-anal anastomosis CONCLUSIONS: Increased IgG4+ plasma cells were found in 1/4 of IPAA patients with persistent symptoms. The presence of tissue infiltration of IgG4+ plasma cells appeared to be associated with chronic pouch inflammation and concurrent autoimmune disorders. 11/26/2011
Udayakumar Navaneethan, Anuja Choure, Preethi G K Venkatesh, Jeffrey Hammel, Jingmei Lin, John R Goldblum, Elena Manilich, Ravi P Kiran, Feza H Remzi, Bo Shen Presence of concomitant inflammatory bowel disease is associated with an increased risk of postcholecystectomy complications CONCLUSIONS: IBD patients undergoing cholecystectomy have a significantly increased risk of postoperative complications. Although further studies are warranted to clarify the reason for these differences, caution should be taken to determine the need and timing of cholecystectomy in IBD patients. 11/10/2011
Roshan Patel, Shyam Varadarajulu, C Mel Wilcox Endoscopic ampullectomy: techniques and outcomes Advances in endoscopic ampullectomy continue to mitigate concerns regarding incomplete removal of ampullary neoplasias, postprocedure complications, and insufficient treatment of tumors with undetected malignant foci or intraductal invasion. Advanced T staging of these lesions with endoscopic ultras... 11/9/2011
Patrick R Pfau, Subhas Banerjee, Bradley A Barth, David J Desilets, Vivek Kaul, Sripathi R Kethu, Marcos C Pedrosa, Douglas K Pleskow, Jeffrey Tokar, Shyam Varadarajulu, Amy Wang, Louis-Michel Wong Kee Song, Sarah A Rodriguez Sphincter of Oddi manometry No abstract 10/29/2011
Shyam Varadarajulu, C Mel Wilcox Endoscopic placement of permanent indwelling transmural stents in disconnected pancreatic duct syndrome: does benefit outweigh the risks? No abstract 10/11/2011
Ji Young Bang, Shantel Hebert-Magee, Shyam Varadarajulu Diagnosis of bilateral adrenal metastases secondary to malignant melanoma by EUS-guided FNA No abstract 10/8/2011
ASGE Technology Committee, Jeffrey L Tokar, Subhas Banerjee, Bradley A Barth, David J Desilets, Vivek Kaul, Sripathi R Kethi, Marcos C Pedrosa, Patrick R Pfau, Douglas K Pleskow, Shyam Varadarajulu, Amy Wang, Louis-Michel Wong Kee Song, Sarah A Rodriguez Drug-eluting/biodegradable stents No abstract 9/28/2011
Udayakumar Navaneethan, Xiuli Liu, Ana E Bennett, R Matthew Walsh, Preethi G K Venkatesh, Bo Shen IgG4-associated ampullitis and cholangiopathy in Crohn's disease Inflammatory bowel disease (IBD) is reported to be associated with autoimmune pancreatitis and IgG4-related sclerosing disease. We report a case of a 28 year old African American male with a long history of upper gastrointestinal tract Crohn's disease (CD) with multiple surgeries who developed medic... 9/24/2011
Udayakumar Navaneethan, Ling Shen, Preethi G K Venkatesh, Jeffrey Hammel, Viral Patel, Feza H Remzi, Ravi P Kiran Influence of ileal pouch anal anastomosis on bone loss in ulcerative colitis patients CONCLUSIONS: Low BMD is common in patients with UC. The risk appears to persist even after colectomy and IPAA surgery suggesting that these patients need to be monitored for bone loss. 9/24/2011
Udayakumar Navaneethan, Preethi G K Venkatesh, Mayar Al Mohajer, Andres Gelrud Successful diagnosis and management of biliary cast syndrome in a liver transplant patient using single operator cholangioscopy CONCLUSION: Single operator cholangioscopy provides a safe means of diagnosing and treating patients with biliary cast syndrome. 9/10/2011
Lee Guan Lim, Takao Itoi, Wee Chian Lim, Steven Joseph Mesenas, Dong Wan Seo, Jonard Tan, Hsiu Po Wang, Thawatchai Akaraviputh, Sandeep Lakhtakia, Salem Omar, Thawee Rantachu, Sharmila Sachitanandan, Kenjiro Yasuda, Shyam Varadarajulu, Jennie Wong, Vinay Dhir, Khek Yu Ho, Asian Consortium of EUS Current status on the diagnosis and management of pancreatic cysts in the Asia-Pacific region: role of endoscopic ultrasound Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) play increasingly prominent roles in the diagnosis and management of pancreatic cysts. The Asian Consortium of Endoscopic Ultrasound was recently formed to conduct collaborative research in this area. This is a review of lit... 8/30/2011
Kara S Davis, Cynthia T Welsh, Robert H Hawes, M Boyd Gillespie Pathology quiz case 3. Heterotopic gastric mucosa (inlet patch) No abstract 8/17/2011
Bo Shen, Ana E Bennett, Udayakumar Navaneethan, Lei Lian, Zhuo Shao, Ravi P Kiran, Victor W Fazio, Feza H Remzi Primary sclerosing cholangitis is associated with endoscopic and histologic inflammation of the distal afferent limb in patients with ileal pouch-anal anastomosis CONCLUSIONS: Concurrent PSC appears to be associated with a significant prepouch ileitis on endoscopy and histology in patients with IPAA. Pouch patients with long segment of ileitis should be evaluated for PSC. 8/11/2011
C Mel Wilcox, Roshan Patel, Chad Burski, Shyam Varadarajulu, Meredith Kilgore Prospective assessment of out-of-pocket patient-related cost for ERCP at an urban tertiary care medical center CONCLUSIONS: Out-of-pocket ERCP costs are not insignificant from the patient's perspective and should be added to the direct costs to calculate true procedure costs. 8/6/2011
Preethi Gk Venkatesh, Udayakumar Navaneethan, Bo Shen Hepatobiliary disorders and complications of inflammatory bowel disease One of typical examples of liver-gut cross talk is the interaction and impact of inflammatory bowel disease (IBD) and hepatobiliary (HB) abnormalities on each other's disease course. There are several layers of association between IBD and HB diseases: (i) HB diseases and IBD share pathogenetic mecha... 7/28/2011
Shyam Varadarajulu, Ji Young Bang, Milind A Phadnis, John D Christein, C Mel Wilcox Endoscopic transmural drainage of peripancreatic fluid collections: outcomes and predictors of treatment success in 211 consecutive patients CONCLUSIONS: Endoscopic therapy is a highly effective technique for the management of patients with non-necrotic peripancreatic fluid collections. 7/26/2011
ASGE Technology Committee, Shyam Varadarajulu, Subhas Banerjee, Bradley Barth, David Desilets, Vivek Kaul, Sripathi Kethu, Marcos Pedrosa, Patrick Pfau, Jeffrey Tokar, Amy Wang, Louis-Michel Wong Kee Song, Sarah Rodriguez Enteral stents The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clini... 7/19/2011
Yang K Chen, Mansour A Parsi, Kenneth F Binmoeller, Robert H Hawes, Douglas K Pleskow, Adam Slivka, Oleh Haluszka, Bret T Petersen, Stuart Sherman, Jacques Devière, Søren Meisner, Peter D Stevens, Guido Costamagna, Thierry Ponchon, Joyce A Peetermans, Horst Neuhaus Single-operator cholangioscopy in patients requiring evaluation of bile duct disease or therapy of biliary stones (with videos) CONCLUSIONS: Evaluation of bile duct disease and biliary stone therapy can be safely performed with a high success rate by using the SOC system. 7/19/2011
Roshan Patel, Jonathan Davitte, Shyam Varadarajulu, C Mel Wilcox Endoscopic resection of ampullary adenomas: complications and outcomes CONCLUSIONS: Endoscopic ampullectomy is a safe and effective treatment for benign ampullary neoplasms and should become the treatment of choice rather than surgical therapy. 7/16/2011
Guru Trikudanathan, Udayakumar Navaneethan, Santhi Swaroop Vege Intra-abdominal fungal infections complicating acute pancreatitis: a review Intra-abdominal infections of pancreatic or peripancreatic necrotic tissue complicate the clinical course of severe acute pancreatitis (SAP) and are associated with significant morbidity. Fungal infection of necrotic pancreatic tissue is increasingly being reported. The incidence of intra-abdominal ... 7/7/2011
Udayakumar Navaneethan, Preethi G K Venkatesh, Sumit Kapoor, Ravi P Kiran, Feza H Remzi, Bo Shen Elevated serum IgG4 is associated with chronic antibiotic-refractory pouchitis CONCLUSIONS: Approximately 8% of pouch patients presenting with symptoms of pouch dysfunction to our clinic had elevated serum IgG4. Patients with elevated serum IgG4 were more likely to have CARP. 7/5/2011
Udayakumar Navaneethan, Preethi G K Venkatesh, Elena Manilich, Ravi P Kiran, Feza H Remzi, Bo Shen Prevalence and clinical implications of positive serum anti-microsomal antibodies in symptomatic patients with ileal pouches CONCLUSIONS: Anti-microsomal antibodies were common in pouch patients presenting with symptoms. Patients with positive anti-microsomal antibodies were much more likely to have concurrent AID and PSC. These patients were more likely to require therapy with steroids. 7/1/2011
ASGE Technology Committee, Shyam Varadarajulu, Subhas Banerjee, Bradley A Barth, David J Desilets, Vivek Kaul, Sripathi R Kethu, Marcos C Pedrosa, Patrick R Pfau, Jeffrey L Tokar, Amy Wang, Louis-Michel Wong Kee Song, Sarah A Rodriguez GI endoscopes The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. F... 6/28/2011
Udayakumar Navaneethan, Preethi G K Venkatesh, Jiang Wang Cytomegalovirus ileitis in a patient after liver transplantation-differentiating from de novo IBD Cytomegalovirus (CMV) infection of the gastrointestinal (GI) tract has been reported in immunocompromised patients and is seen following liver transplantation. Although CMV infection can affect any part of the GI tract, involvement of the terminal ileum is rarely encountered after liver transplantat... 6/21/2011
Arun Raghav Mahankali Sridhar, Sravanthi Parasa, Udayakumar Navaneethan, Michael D Crowell, Kevin Olden Comprehensive study of cardiovascular morbidity in hospitalized inflammatory bowel disease patients CONCLUSIONS: Our study substantiates the previously reported associations of mesenteric ischemia and venous thrombotic disorders with IBD. Our study also suggests that young females with IBD might have an increased risk for dysrhythmias. 6/21/2011
Shyam Varadarajulu, C Mel Wilcox, John D Christein EUS-guided therapy for management of peripancreatic fluid collections after distal pancreatectomy in 20 consecutive patients No abstract 6/18/2011
Nicholas J Shaheen, Bergein F Overholt, Richard E Sampliner, Herbert C Wolfsen, Kenneth K Wang, David E Fleischer, Virender K Sharma, Glenn M Eisen, M Brian Fennerty, John G Hunter, Mary P Bronner, John R Goldblum, Ana E Bennett, Hiroshi Mashimo, Richard I Rothstein, Stuart R Gordon, Steven A Edmundowicz, Ryan D Madanick, Anne F Peery, V Raman Muthusamy, Kenneth J Chang, Michael B Kimmey, Stuart J Spechler, Ali A Siddiqui, Rhonda F Souza, Anthony Infantolino, John A Dumot, Gary W Falk, Joseph A Galanko, Blair A Jobe, Robert H Hawes, Brenda J Hoffman, Prateek Sharma, Amitabh Chak, Charles J Lightdale Durability of radiofrequency ablation in Barrett's esophagus with dysplasia CONCLUSIONS: In subjects with dysplastic BE, RFA therapy has an acceptable safety profile, is durable, and is associated with a low rate of disease progression, for up to 3 years. 6/18/2011
Henit Yanai, Geoffrey C Nguyen, Laura Yun, Oscar Lebwohl, Udayakumar Navaneethan, Christian D Stone, Leyla Ghazi, Paul Moayyedi, Jeffrey Brooks, Charles N Bernstein, Shomron Ben-Horin Practice of gastroenterologists in treating flaring inflammatory bowel disease patients with clostridium difficile: antibiotics alone or combined antibiotics/immunomodulators? CONCLUSIONS: There is significant disagreement among gastroenterologists on whether combination AB+IM or AB alone should be given to IBD patients with CDI-associated flares. Controlled trials are needed to investigate the optimal management approach to this clinical dilemma. 6/16/2011
Shyam Varadarajulu, Milind A Phadnis, John D Christein, C Mel Wilcox Multiple transluminal gateway technique for EUS-guided drainage of symptomatic walled-off pancreatic necrosis CONCLUSION: The EUS-guided MTGT is an effective treatment option for the management of symptomatic walled-off pancreatic necrosis because it obviates the need for surgery and endoscopic necrosectomy and its attendant procedure-related morbidity. Prospective studies are required to confirm these prel... 5/27/2011
Preethi G K Venkatesh, Udayakumar Navaneethan, Santhi Swaroop Vege Intraductal papillary mucinous neoplasm and acute pancreatitis Intraductal papillary mucinous neoplasms (IPMNs) are cystic pancreatic tumors that arise from the pancreatic ducts and are increasingly reported worldwide. Both benign and malignant tumors of the pancreas are thought to contribute to recurrent pancreatitis possibly by pancreatic duct obstruction, an... 5/24/2011
Ji Young Bang, Shyam Varadarajulu, Juan Pablo Arnoletti Mucinous cystic neoplasm of the pancreas No abstract 5/21/2011
Udayakumar Navaneethan, Sravanthi Parasa, Preethi G K Venkatesh, Guru Trikudanathan, Bo Shen Prevalence and risk factors for colonic perforation during colonoscopy in hospitalized inflammatory bowel disease patients CONCLUSIONS: There appears to be a higher risk of colonoscopy-associated perforation in IBD inpatients than non-IBD controls. In addition, older age, female patients and endoscopic dilations appeared to be associated with an increased risk for perforation. 5/18/2011
Shyam Varadarajulu, John D Christein, Charles Mel Wilcox Frequency of complications during EUS-guided drainage of pancreatic fluid collections in 148 consecutive patients CONCLUSIONS: Complications are rare during EUS-guided drainage of PFC and can be managed successfully in most patients. 5/18/2011
Preethi G K Venkatesh, Udayakumar Navaneethan Azathioprine induced pancreatitis in a patient with co-existing autoimmune pancreatitis and hepatitis CONCLUSIONS: Future studies to investigate the risk of azathioprine induced pancreatitis in the presence of underlying disease of the pancreas including autoimmune pancreatitis are required to further understand the safety of azathioprine in this sub group of patients. 5/7/2011
David J Desilets, Subhas Banerjee, Bradley A Barth, Vivek Kaul, Sripathi R Kethu, Marcos C Pedrosa, Patrick R Pfau, Jeffrey L Tokar, Shyam Varadarajulu, Amy Wang, Louis-Michel Wong Kee Song, Sarah A Rodriguez, ASGE Technology Committee Endoscopic simulators No abstract 4/28/2011
Marcos C Pedrosa, Bradley A Barth, David J Desilets, Vivek Kaul, Sripathi R Kethu, Patrick R Pfau, Jeffrey L Tokar, Shyam Varadarajulu, Amy Wang, Louis-Michel Wong Kee Song, Sarah A Rodriguez, ASGE Technology Committee Enhanced ultrasound imaging No abstract 4/28/2011
Ji Young Bang, Shyam Varadarajulu Pediatrics: ERCP in children Although endoscopic retrograde cholangiopancreatography (ERCP) is a well-established technique for both the diagnosis and treatment of biliary and pancreatic disorders in adults, indications for some pediatric applications, such as idiopathic and recurrent pancreatitis, remain contentious. This News... 4/14/2011
Xiaohan Cai, Yiding Liu, Xiang Zhou, Udayakumar Navaneethan, Bo Shen, Baochuan Guo An LC-ESI-MS method for the quantitative analysis of bile acids composition in fecal materials In this work, a liquid chromatography coupled with electrospray ionization mass spectrometry (LC-ESI-MS) method was developed and validated for quantification of bile acids in fecal materials. Co-eluting matrix impurities in fecal materials have been shown to greatly suppress the ionization of analy... 4/6/2011
Udayakumar Navaneethan, Elisha Lancaster, Preethi G K Venkatesh, Jiang Wang, Guy W Neff Herpes simplex virus hepatitis - it's high time we consider empiric treatment Fulminant hepatitis is an uncommon complication of herpes simplex virus infection. Patients at risk, in particular pregnant women and immunosuppressed patients presenting with fulminant liver failure, receiving delayed acyclovir intervention may lose significant liver parenchyma prompting the need f... 4/1/2011
James L Buxbaum, Mohamad A Eloubeidi, Shyam Varadarajulu Utility of EUS-guided FNA in the management of children with idiopathic fibrosing pancreatitis No abstract 3/17/2011
Christopher Decker, John D Christein, Milind A Phadnis, C Mel Wilcox, Shyam Varadarajulu Biliary metal stents are superior to plastic stents for preoperative biliary decompression in pancreatic cancer CONCLUSIONS: SEMS are superior to plastic stents for preoperative biliary decompression in pancreatic cancer. 3/5/2011
Preethi G K Venkatesh, Udayakumar Navaneethan Mimickers of intestinal tuberculosis: could this be Crohn's disease? An unsolved enigma No abstract 3/5/2011
Mohamad A Eloubeidi, Robert James Cerfolio, Ayesha S Bryant, Shyam Varadarajulu Efficacy of endoscopic ultrasound in patients with esophageal cancer predicted to have N0 disease CONCLUSION: EUS-FNA is very accurate and sensitive when it clinically stages patients with esophageal cancer as N0. In addition, it is even accurate and sensitive when restaging patients as N0 after neo-adjuvant chemo-radiotherapy. These results, which differ from previous reports, are critical for ... 2/26/2011
Shyam Varadarajulu, Ann Roy, Tercio Lopes, Ernesto R Drelichman, Micheline Kim Endoscopic stenting versus surgical colostomy for the management of malignant colonic obstruction: comparison of hospital costs and clinical outcomes CONCLUSION: Although the technical and clinical outcomes for colostomy and stent placement appear comparable, stent placement is less costly and associated with shorter LOS and fewer complications. Dissemination of stent placement beyond large teaching hospitals located in urban areas as a treatment... 2/5/2011
Revital Kariv, Udayakumar Navaneethan, Preethi G K Venkatesh, Rocio Lopez, Bo Shen Impact of Clostridium difficile infection in patients with ulcerative colitis CONCLUSIONS: Recent antibiotic exposure was a risk factor for CDI in UC patients. Interestingly, CDI does not seem to adversely affect short-term adverse clinical outcome (colectomy). 1/29/2011
Dhiraj Yadav, Adam Slivka, Stuart Sherman, Robert H Hawes, Michelle A Anderson, Frank R Burton, Randall E Brand, Michele D Lewis, Timothy B Gardner, Andres Gelrud, James Disario, Stephen T Amann, John Baillie, Christopher Lawrence, Michael O'Connell, Albert B Lowenfels, Peter A Banks, David C Whitcomb Smoking is underrecognized as a risk factor for chronic pancreatitis CONCLUSIONS: Physicians often underrecognize smoking as a CP risk factor. Efforts are needed to raise awareness of the association between smoking and CP. and IAP. 1/19/2011
Ajaypal Singh, John D Christein, Shyam Varadarajulu Preoperative detection of malignant transformation in a choledochal cyst No abstract 1/4/2011
Udayakumar Navaneethan, Nyingi Kemmer, Guy W Neff Predicting the probable outcome of treatment in HCV patients Hepatitis C virus (HCV) is a major cause of chronic liver disease infecting more than 170 million people worldwide. HCV produces a wide gamut of manifestations varying from mild self-limiting disease to cirrhosis and hepatocellular carcinoma. A variety of viral, environmental and host genetic factor... 12/25/2010
Daniel K Mullady, Dhiraj Yadav, Stephen T Amann, Michael R O'Connell, Michael M Barmada, Grace H Elta, James M Scheiman, Erik-Jan Wamsteker, William D Chey, Meredith L Korneffel, Beth M Weinman, Adam Slivka, Stuart Sherman, Robert H Hawes, Randall E Brand, Frank R Burton, Michele D Lewis, Timothy B Gardner, Andres Gelrud, James DiSario, John Baillie, Peter A Banks, David C Whitcomb, Michelle A Anderson, NAPS2 Consortium Type of pain, pain-associated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study CONCLUSIONS: This is the largest study ever conducted of pain in CP. These findings suggest that the temporal nature of pain is a more important determinant of health-related QOL and healthcare utilisation than pain severity. In contrast to previous studies, the pain associated with CP was not found... 12/15/2010
Jessica M Trevino, Shyam Varadarajulu Endoscopic ultrasonography-guided ablation therapy Endoscopic ultrasonography (EUS) imaging has undergone extensive technological advancement since its development in the 1980s, including improvement of echoendoscopes with larger channels and accessories.These advancements enable not only tissue procurement for diagnosis but also therapeutic interve... 12/1/2010
Christopher Decker, Shyam Varadarajulu EUS-guided drainage of an intra-abdominal abscess after liver transplantation No abstract 11/30/2010
C Mel Wilcox, Shyam Varadarajulu, Desiree Morgan, John Christein Progress in the management of necrotizing pancreatitis Pancreatic necrosis, a complication of severe pancreatitis, may become infected, resulting in significant morbidity and potential mortality. Infected necrosis was heretofore considered a surgical condition, and despite aggressive operative management, the mortality remained high. With a better under... 11/27/2010
Udayakumar Navaneethan, Preethi G K Venkatesh Idiopathic hyperammonemia in a patient with total pancreatectomy and islet cell transplantation CONCLUSION: Idiopathic hyperammonemia in the setting of total pancreatectomy and islet cell transplantation has not been reported before. We propose that malnutrition following total pancreatectomy resulting in repressed urea cycle enzyme synthesis may have predisposed for this hyperammonemia. 11/12/2010
Jason A Wilson, Brenda Hoffman, Robert H Hawes, Joseph Romagnuolo EUS in patients with surgically altered upper GI anatomy CONCLUSION: EUS is generally successful and safe in patients with surgically altered anatomy in this tertiary-care setting, and a very low rate of adverse events is possible. Exceptions included imaging the HOP and CBD after Roux-en-Y surgery. After Billroth II surgery, if the afferent limb was intu... 11/2/2010
Gregory A Coté, Dhiraj Yadav, Adam Slivka, Robert H Hawes, Michelle A Anderson, Frank R Burton, Randall E Brand, Peter A Banks, Michele D Lewis, James A Disario, Timothy B Gardner, Andres Gelrud, Stephen T Amann, John Baillie, Mary E Money, Michael O'Connell, David C Whitcomb, Stuart Sherman, North American Pancreatitis Study Group Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis CONCLUSIONS: The frequency of alcohol-related CP at tertiary US referral centers is lower than expected. Idiopathic CP and nonalcohol etiologies represent a large subgroup, particularly among women. Smoking is an independent risk factor for idiopathic CP. 10/30/2010
Udayakumar Navaneethan, Preethi Gk Venkatesh, Bo Shen Clostridium difficile infection and inflammatory bowel disease: understanding the evolving relationship Clostridium difficile (C. difficile) infection (CDI) is the leading identifiable cause of antibiotic-associated diarrhea. While there is an alarming trend of increasing incidence and severity of CDI in the United States and Europe, superimposed CDI in patients with inflammatory bowel disease (IBD) h... 10/19/2010
Udayakumar Navaneethan, Bo Shen Diagnosis and management of pouchitis and ileoanal pouch dysfunction Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the surgical treatment of choice for patients with medically refractory ulcerative colitis (UC) or UC with dysplasia and for the majority of patients with familial adenomatous polyposis. However, UC patients with IPAA ar... 10/5/2010
Shyam Varadarajulu Antibiotic prophylaxis is recommended for endoscopic ultrasound-guided fiducial placements No abstract 9/22/2010
Udayakumar Navaneethan, Ralph A Giannella Infectious colitis PURPOSE OF REVIEW: The incidence of gastrointestinal infections continues to increase and infectious colitis contributes to significant morbidity and mortality worldwide. The purpose of this review is to highlight the recent advances in knowledge of pathogens causing infectious colitis. We describe ... 9/22/2010
Lindsay S Robison, Cheri L Canon, Shyam Varadarajulu, Mohamad A Eloubeidi, Selwyn Vickers, C Mel Wilcox Autoimmune pancreatitis mimicking pancreatic cancer CONCLUSIONS: Although AIP commonly presents with features suggestive of pancreatic cancer, clinical recognition of AIP with appropriate diagnostic testing including EUS with fine-needle aspiration, ERCP, IgG4 levels, and pancreatic protocol CT expedites diagnosis and can spare patients unnecessary s... 9/3/2010
Bo Shen, Ana E Bennett, Udayakumar Navaneethan IgG4-associated pouchitis No abstract 8/20/2010
Venkata Muddana, James Park, Janette Lamb, Dhiraj Yadav, Georgios I Papachristou, Robert H Hawes, Randall Brand, Adam Slivka, David C Whitcomb Are genetic variants in the platelet-derived growth factor [beta] gene associated with chronic pancreatitis? CONCLUSIONS: Known variations in the PDGF-[beta] gene do not have a significant effect on promoting or preventing fibrogenesis in pancreatitis. Further evaluation of this important pathway is warranted. 8/19/2010
Christopher Lawrence, M Faisal Siddiqi, Jonathan N Hamilton, Thomas E Keane, Joseph Romagnuolo, Robert H Hawes, Peter B Cotton Chronic calcific pancreatitis: combination ERCP and extracorporeal shock wave lithotripsy for pancreatic duct stones CONCLUSIONS: A multidisciplinary approach, combining ERCP and ESWL, to painful obstructing pancreatic duct stones provided symptomatic improvement and allowed pancreatic surgery to be avoided in the majority of patients. 8/17/2010
Robert H Hawes The evolution of endoscopic ultrasound: improved imaging, higher accuracy for fine needle aspiration and the reality of endoscopic ultrasound-guided interventions PURPOSE OF REVIEW: Endoscopic ultrasound (EUS) is one of the fastest growing areas within gastrointestinal endoscopy. Although the growth in the United States has been steady, EUS is exploding in areas of Asia and Eastern Europe. As utilization of EUS is increasing, so is the evolution of the discip... 8/13/2010
Christopher Lawrence, Joseph Romagnuolo, K Mark Payne, Robert H Hawes, Peter B Cotton Low symptomatic premature stent occlusion of multiple plastic stents for benign biliary strictures: comparing standard and prolonged stent change intervals CONCLUSION: Multiple plastic biliary stents for benign nonhilar strictures were associated with a low rate of premature symptomatic stent occlusion at more than 6 months and a longer occlusion-free survival. 7/20/2010
C Mel Wilcox, Milind Phadnis, Shyam Varadarajulu Biliary stent placement is associated with post-ERCP pancreatitis CONCLUSIONS: Bile duct stent placement is an independent predictor for pancreatitis, and pancreatitis is not related to performing sphincterotomy before stenting or to stent characteristics. 7/17/2010
Nicholas J Shaheen, Anne F Peery, Bergein F Overholt, Charles J Lightdale, Amitabh Chak, Kenneth K Wang, Robert H Hawes, David E Fleischer, John R Goldblum, AIM Dysplasia Investigators Biopsy depth after radiofrequency ablation of dysplastic Barrett's esophagus CONCLUSIONS: In both squamous and columnar tissue, endoscopic biopsy samples after RFA were as likely to demonstrate subepithelium as untreated controls. Almost 80% of all biopsy samples were adequate to evaluate for subsquamous intestinal metaplasia. The primary determinant of biopsy depth is the t... 7/6/2010
ASGE Technology Committee, Richard S Kwon, Subhas Banerjee, David Desilets, David L Diehl, Francis A Farraye, Vivek Kaul, Petar Mamula, Marcos C Pedrosa, Sarah A Rodriguez, Shyam Varadarajulu, Louis-Michel Wong Kee Song, William M Tierney Enteral nutrition access devices The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. F... 6/15/2010
Kanwar R Gill, Marwan S Ghabril, Laith H Jamil, Muhammad K Hasan, Rebecca B McNeil, Timothy A Woodward, Massimo Raimondo, Brenda J Hoffman, Robert H Hawes, Joseph Romagnuolo, Michael B Wallace Endosonographic features predictive of malignancy in mediastinal lymph nodes in patients with lung cancer CONCLUSION: Among patients with lung cancer, EUS features of round shape, sharp margins, and short axis of >8.3 mm are significant predictors of malignancy. The probability of malignancy is low when none of the features are present. 6/15/2010
ASGE Technology Committee, Marcos C Pedrosa, Francis A Farraye, Amandeep K Shergill, Subhas Banerjee, David Desilets, David L Diehl, Vivek Kaul, Richard S Kwon, Petar Mamula, Sarah A Rodriguez, Shyam Varadarajulu, Louis-Michel Wong Kee Song, William M Tierney Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, by using a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Foo... 6/12/2010
Guru Trikudanathan, Udayakumar Navaneethan Association of pancreatitis with inflammatory bowel disease No abstract 5/25/2010
ASGE Technology Committee, Sarah A Rodriguez, Subhas Banerjee, David Desilets, David L Diehl, Francis A Farraye, Vivek Kaul, Richard S Kwon, Petar Mamula, Marcos C Pedrosa, Shyam Varadarajulu, Louis-Michel Wong Kee Song, William M Tierney Ultrathin endoscopes No abstract 5/5/2010
In Sook Min, Ji Young Bang, Soon Won Seo, Cheong Ho Lee, Pil Jae Maeng Differential expression of citA gene encoding the mitochondrial citrate synthase of Aspergillus nidulans in response to developmental status and carbon sources As an extension of our previous studies on the mitochondrial citrate synthase of Aspergillus nidulans and cloning of its coding gene (citA), we analyzed differential expression of citA in response to the progress of development and change of carbon source. The cDNA consisted of 1,700 nucleotides and... 5/4/2010
Andrey Frolov, J Spencer Liles, Andrew V Kossenkov, Ching-Wei D Tzeng, Nirag Jhala, Peter Kulesza, Shyam Varadarajulu, Mohamad Eloubeidi, Martin J Heslin, J Pablo Arnoletti Epidermal growth factor receptor (EGFR) intron 1 polymorphism and clinical outcome in pancreatic adenocarcinoma CONCLUSIONS: The length of the EGFR intron 1 CA repeats does not correlate with levels of EGFR expression and cannot be used as marker of clinical prognosis in pancreatic cancer patients. 4/23/2010
Shyam Varadarajulu, Mohamad A Eloubeidi The role of endoscopic ultrasonography in the evaluation of pancreatico-biliary cancer Accurate staging of pancreatico-biliary cancer is essential for surgical planning and for identification of locally advanced and metastatic disease that is incurable by surgery. The complex regional anatomy of the pancreatico-biliary system makes histologic diagnosis of malignancy at this region dif... 4/6/2010
Jessica M Trevino, Shyam Varadarajulu Endoscopic ultrasound-guided transjejunal drainage of pancreatic pseudocyst No abstract 3/26/2010
Udayakumar Navaneethan, Bo Shen Hepatopancreatobiliary manifestations and complications associated with inflammatory bowel disease Diseases involving the hepatopancreatobiliary (HPB) system are frequently encountered in patients with inflammatory bowel disease (IBD). Hepatobiliary manifestations constitute some of the most common extraintestinal manifestations of IBD. They appear to occur with similar frequency in patients with... 3/4/2010
Hong Lu, Lei Lian, Udayakumar Navaneethan, Bo Shen Clinical utility of C-reactive protein in patients with ileal pouch anal anastomosis CONCLUSIONS: Serum CRP levels correlated with endoscopic inflammation in the pouch and afferent limb. Elevated CRP levels might be useful to monitor the degree of inflammatory activity in pouch noninvasively. However, the CRP level as a snapshot had a limited role in distinction between healthy and ... 2/27/2010
Udayakumar Navaneethan Seroprevalence of hepatitis E infection in pregnancy - more questions than answers No abstract 1/22/2010
Jessica M Trevino, Ashutosh Tamhane, Shyam Varadarajulu Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections CONCLUSIONS: Transpapillary PD stenting improves treatment outcomes in patients undergoing endoscopic transmural drainage of PFC. 1/16/2010
Shyam Varadarajulu, Ernesto R Drelichman Effectiveness of EUS in drainage of pelvic abscesses in 25 consecutive patients (with video) CONCLUSIONS: EUS is a minimally invasive, safe, and effective technique that affords long-term benefit for patients undergoing pelvic abscess drainage. 12/8/2009
Udayakumar Navaneethan, Santhi Swaroop Vege, Suresh T Chari, Todd H Baron Minimally invasive techniques in pancreatic necrosis Traditional open surgical necrosectomy for treatment of infected pancreatic necrosis is associated with high morbidity and mortality, leading to a shift toward minimally invasive endoscopic, radiologic, and laparoscopic approaches. Percutaneous drainage is useful as a temporizing method to control s... 10/27/2009
Udayakumar Navaneethan, Bo Shen Pros and cons of antibiotic therapy for pouchitis Restorative proctocolectomy with ileal pouch-anal anastomosis has become the surgical treatment of choice for patients with medically refractory ulcerative colitis or ulcerative colitis with dysplasia and for the majority of patients with familial adenomatous polyposis. However, pouchitis and other ... 10/13/2009
Udayakumar Navaneethan Infections in flares of inflammatory bowel disease No abstract 10/7/2009
Udayakumar Navaneethan, Bo Shen Secondary pouchitis: those with identifiable etiopathogenetic or triggering factors Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for the majority of patients with medically refractory ulcerative colitis (UC) or UC with dysplasia, or familial adenomatous polyposis. Various forms of pouchitis frequently occur after surgery. ... 9/17/2009
Steven D Schwaitzberg, Michael L Kochman, Robert H Hawes, David W Rattner Natural orifice translumenal endoscopic surgery (NOTES): is it time for introduction to clinical practice? No abstract 9/12/2009
Shyam Varadarajulu, Jessica M Trevino, John D Christein EUS for the management of peripancreatic fluid collections after distal pancreatectomy CONCLUSIONS: EUS-guided drainage is a minimally invasive, safe, and highly effective technique for the management of symptomatic PFC after distal pancreatectomy. 8/8/2009
Jessica M Trevino, John D Christein, Shyam Varadarajulu EUS-guided transesophageal drainage of peripancreatic fluid collections CONCLUSIONS: In experienced hands, EUS-guided transesophageal drainage of PFCs is technically feasible and safe and is associated with favorable clinical outcomes. A long-term follow-up with larger numbers of patients is required to determine whether the procedure could be an effective alternative t... 8/4/2009
Udayakumar Navaneethan, Bo Shen Laboratory tests for patients with ileal pouch-anal anastomosis: clinical utility in predicting, diagnosing, and monitoring pouch disorders Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for patients with medically refractory ulcerative colitis (UC) or UC-associated dysplasia, and for the majority of patients with familial adenomatous polyposis. Pouchitis and other complications ... 7/16/2009
Udayakumar Navaneethan, Jijo V Cherian, Rajesh Prabhu, Jayanthi Venkataraman Distinguishing tuberculosis and Crohn's disease in developing countries: how certain can you be of the diagnosis? Distinguishing tuberculosis and Crohn's disease in patients presenting with chronic abdominal pain and diarrhea is a huge diagnostic challenge, particularly in tuberculosis endemic countries. A large number of patients with Crohn's disease are initially misclassified as having Intestinal tuberculosi... 7/2/2009
Jessica M Trevino, C Mel Wilcox, Nirag C Jhala, Shyam Varadarajulu Endoscopic resection of distal bile duct mass (with video) No abstract 6/30/2009
Shyam Varadarajulu, Nirag C Jhala, Ernesto R Drelichman EUS-guided radiofrequency ablation with a prototype electrode array system in an animal model (with video) CONCLUSIONS: In this experimental study, EUS-RFA of the liver was performed safely by using the retractable umbrella-shaped electrode array with effective coagulation necrosis of large areas. 6/30/2009
Udayakumar Navaneethan, Feza H Remzi, Benjamin Nutter, Victor W Fazio, Bo Shen Risk factors for abnormal liver function tests in patients with ileal pouch-anal anastomosis for underlying inflammatory bowel disease CONCLUSIONS: Abnormal LFTs were common in patients with IPAA in this cohort. The presence of co-existing autoimmune disorder, a family history of IBD, extensive colitis before colectomy, the presence of PSC, and a high BMI appear to be a significant risk factors for abnormal LFTs. Whether abnormal L... 6/25/2009
Dhiraj Yadav, Robert H Hawes, Randall E Brand, Michelle A Anderson, Mary E Money, Peter A Banks, Michele D Bishop, John Baillie, Stuart Sherman, James DiSario, Frank R Burton, Timothy B Gardner, Stephen T Amann, Andres Gelrud, Christopher Lawrence, Beth Elinoff, Julia B Greer, Michael O'Connell, M Michael Barmada, Adam Slivka, David C Whitcomb, North American Pancreatic Study Group Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis CONCLUSIONS: Very heavy alcohol consumption and smoking are independent risks for CP. A minority of patients with pancreatitis currently seen at US referral centers report very heavy drinking. 6/10/2009
Burr J Loew, Douglas A Howell, Michael K Sanders, David J Desilets, Paul P Kortan, Gary R May, Raj J Shah, Yang K Chen, Willis G Parsons, Robert H Hawes, Peter B Cotton, Adam A Slivka, Jawad Ahmad, Glen A Lehman, Stuart Sherman, Horst Neuhaus, Brigitte M Schumacher Comparative performance of uncoated, self-expanding metal biliary stents of different designs in 2 diameters: final results of an international multicenter, randomized, controlled trial CONCLUSIONS: SEMS occlusions were much more frequent with a 6-mm diameter SEMS and equivalent in the two 10-mm arms despite major differences in stent design, material, and expansion, suggesting that diameter is the critical feature. Malignant tumor ingrowth produced only a minority of the documente... 6/2/2009
Nicholas J Shaheen, Prateek Sharma, Bergein F Overholt, Herbert C Wolfsen, Richard E Sampliner, Kenneth K Wang, Joseph A Galanko, Mary P Bronner, John R Goldblum, Ana E Bennett, Blair A Jobe, Glenn M Eisen, M Brian Fennerty, John G Hunter, David E Fleischer, Virender K Sharma, Robert H Hawes, Brenda J Hoffman, Richard I Rothstein, Stuart R Gordon, Hiroshi Mashimo, Kenneth J Chang, V Raman Muthusamy, Steven A Edmundowicz, Stuart J Spechler, Ali A Siddiqui, Rhonda F Souza, Anthony Infantolino, Gary W Falk, Michael B Kimmey, Ryan D Madanick, Amitabh Chak, Charles J Lightdale Radiofrequency ablation in Barrett's esophagus with dysplasia CONCLUSIONS: In patients with dysplastic Barrett's esophagus, radiofrequency ablation was associated with a high rate of complete eradication of both dysplasia and intestinal metaplasia and a reduced risk of disease progression. (ClinicalTrials.gov number, NCT00282672.) 5/29/2009
Muhammad Shaalan Beg, Udayakumar Navaneethan, Muslim Atiq, Rami Komrokji, Malek Safa Outcome of esophageal carcinoma in the veteran affairs population: a comparative analysis from the Veteran Affairs Central Cancer Registry CONCLUSIONS: In nonmetastatic esophageal cancer at the VA, SCC has worse outcome as compared with AC. Blacks with AC have worse outcome than whites. Despite equal access to health care blacks are less likely to undergo surgery, which may contribute to their worse outcome. We recommend further studie... 5/13/2009
Udayakumar Navaneethan, Ralph A Giannella Thinking beyond the colon-small bowel involvement in clostridium difficile infection Small intestinal Clostridium difficile seems to be increasing in incidence. The spectrum of Clostridium difficile infection (CDI) has definitely expanded with small bowel involvement. They are more frequently reported in patients with inflammatory bowel disease (IBD) who have undergone total colecto... 4/3/2009
Wayne Tsuang, Udayakumar Navaneethan, Luis Ruiz, Joseph B Palascak, Andres Gelrud Hypertriglyceridemic pancreatitis: presentation and management Hypertriglyceridemia (HTG) is reported to cause 1-4% of acute pancreatitis (AP) episodes. HTG is also implicated in more than half of gestational pancreatitis cases. Disorders of lipoprotein metabolism are conventionally divided into primary (genetic) and secondary causes, including diabetes, hypoth... 3/19/2009
Christopher Lawrence, Joseph Romagnuolo, Peter B Cotton, K Mark Payne, Robert H Hawes Post-ERCP pancreatitis rates do not differ between needle-knife and pull-type pancreatic sphincterotomy techniques: a multiendoscopist 13-year experience CONCLUSIONS: The risk of post-ERCP pancreatitis does not differ between EPS techniques when performed at a high-volume pancreaticobiliary referral center when using routine prophylactic pancreatic duct stent placement. 2/28/2009
Jayapal Ramesh, Shyam Varadarajulu Interventional endoscopic ultrasound Endoscopic ultrasonography (EUS), since its development in the 1980s, has undergone a great deal of technological advancement in imaging, scopes with larger channels and accessories. This has given the endosonographer an immense reach in terms of accessing difficult areas with fewer complications. C... 2/4/2009
Maria Victoria Alvarez Sanchez, Shyam Varadarajulu, Bertrand Napoleon EUS contrast agents: what is available, how do they work, and are they effective? No abstract 1/31/2009
Jacques Van Dam, Shyam Varadarajulu, Zhendong Jin, EUS 2008 Working Group EUS 2008 Working Group document: evaluation of EUS-guided implantation therapy (with video) No abstract 1/31/2009
Angels Ginès, Shyam Varadarajulu, Bertrand Napoleon, EUS 2008 Working Group EUS 2008 Working Group document: evaluation of EUS-guided pancreatic-duct drainage (with video) No abstract 1/31/2009
Shyam Varadarajulu, Yuk Tong Lee, EUS 2008 Working Group EUS 2008 Working Group document: evaluation of EUS-guided drainage of pelvic-fluid collections (with video) No abstract 1/31/2009
Thomas J Savides, Shyam Varadarajulu, Laurent Palazzo, EUS 2008 Working Group EUS 2008 Working Group document: evaluation of EUS-guided hepaticogastrostomy No abstract 1/31/2009
Shyam Varadarajulu, Jessica M Trevino Review of EUS-guided pancreatic duct drainage (with video) No abstract 1/31/2009
Shyam Varadarajulu EUS followed by endoscopic pancreatic pseudocyst drainage or all-in-one procedure: a review of basic techniques (with video) No abstract 1/31/2009
Robert H Hawes, Jacques Van Dam, Shyam Varadarajulu EUS 2008 Working Group document: interventional EUS--a road map for the future No abstract 1/31/2009
Asif Khalid, Maliha Zahid, Sydney D Finkelstein, Julia K LeBlanc, Neeraj Kaushik, Nuzhat Ahmad, William R Brugge, Steven A Edmundowicz, Robert H Hawes, Kevin M McGrath Pancreatic cyst fluid DNA analysis in evaluating pancreatic cysts: a report of the PANDA study CONCLUSIONS: Elevated amounts of pancreatic cyst fluid DNA, high-amplitude mutations, and specific mutation acquisition sequences are indicators of malignancy. The presence of a k-ras mutation is also indicative of a mucinous cyst. DNA analysis should be considered when cyst cytologic examination is... 1/21/2009
Shyam Varadarajulu, Ernesto R Drelichman Natural orifice transluminal endoscopic surgery: breaching the boundaries safely No abstract 12/30/2008
Jessica M Trevino, Shyam Varadarajulu Initial experience with the prototype forward-viewing echoendoscope for therapeutic interventions other than pancreatic pseudocyst drainage (with videos) CONCLUSIONS: It was feasible to perform interventions such as drainage of an obstructive bile duct and a pelvic abscess, and placement of fiducial markers via the transduodenal and transrectal approaches by using the prototype forward-viewing echoendoscope. Further studies that include larger number... 12/23/2008
Jessica M Trevino, Ernesto R Drelichman, Shyam Varadarajulu Modified technique for EUS-guided drainage of pelvic abscess (with video) CONCLUSIONS: The combined placement of a transrectal drainage catheter and a stent under EUS guidance was a technically feasible, safe, and effective technique for management of patients with pelvic abscess. This technique minimized the possibility of accidental dislodgement of the drainage catheter... 11/26/2008
Eung-Yoon Kim, Ji Young Bang, Soo-Ik Chang, In-Cheol Kang A novel integrin alpha5beta1 antagonistic peptide, A5-1, screened by Protein Chip system as a potent angiogenesis inhibitor Integrin alpha5beta1 immobilized on a ProteoChip was used to screen new antagonistic peptides from multiple hexapeptide sub-libraries of the positional scanning synthetic peptide combinatorial library (PS-SPCL). The integrin alpha5beta1-Fibronectin interaction was demonstrated on the chip. A novel p... 11/11/2008
Udayakumar Navaneethan, Ralph A Giannella Mechanisms of infectious diarrhea Infectious diarrhea is an important public health problem worldwide. Research has provided new insights into the mechanisms of diarrhea caused by various pathogens that are classified as noninflammatory, inflammatory or invasive. These three groups of organisms cause two diarrheal syndromes--noninfl... 9/25/2008
Mohamed T Shata, Udayakumar Navaneethan The mystery of hepatitis E seroprevalence in developed countries: is there subclinical infection due to hepatitis E virus? No abstract 9/11/2008
David C Whitcomb, Dhiraj Yadav, Slivka Adam, Robert H Hawes, Randall E Brand, Michelle A Anderson, Mary E Money, Peter A Banks, Michele D Bishop, John Baillie, Stuart Sherman, James DiSario, Frank R Burton, Timothy B Gardner, Stephen T Amann, Andres Gelrud, Simon K Lo, Mark T DeMeo, William M Steinberg, Michael L Kochman, Babak Etemad, Christopher E Forsmark, Beth Elinoff, Julia B Greer, Michael O'Connell, Janette Lamb, M Michael Barmada, North American Pancreatic Study Group Multicenter approach to recurrent acute and chronic pancreatitis in the United States: the North American Pancreatitis Study 2 (NAPS2) CONCLUSION: The NAPS2 consortium has successfully completed a prospective ascertainment of 1,000 subjects with RAP and CP from the USA. These data will be useful in elucidating the environmental, metabolic and genetic conditions, and to investigate the complex interactions that underlie RAP and CP. 9/4/2008
Venkata Muddana, Janette Lamb, Julia-B Greer, Beth Elinoff, Robert H Hawes, Peter B Cotton, Michelle A Anderson, Randall E Brand, Adam Slivka, David C Whitcomb Association between calcium sensing receptor gene polymorphisms and chronic pancreatitis in a US population: role of serine protease inhibitor Kazal 1type and alcohol CONCLUSION: Our United States-based study confirmed an association of CASR and CP and for the first time demonstrated that CASR R990G is a significant risk factor for CP. We also conclude that the risk of CP with CASR R990G is increased in subjects with moderate to heavy alcohol consumption. 8/6/2008
Udayakumar Navaneethan, Mayar Al Mohajer, Mohamed T Shata Hepatitis E and pregnancy: understanding the pathogenesis Hepatitis E virus (HEV) is a single-stranded RNA virus that causes large-scale epidemics of acute viral hepatitis, particularly in developing countries. In men and non-pregnant women, the disease is usually self-limited and has a case-fatality rate of less than <0.1%. However, in pregnant women, par... 7/30/2008
Shyam Varadarajulu, John D Christein, Ashutosh Tamhane, Ernesto R Drelichman, C Mel Wilcox Prospective randomized trial comparing EUS and EGD for transmural drainage of pancreatic pseudocysts (with videos) CONCLUSIONS: When available, EUS should be considered as the first-line treatment modality for endoscopic drainage of pancreatic pseudocysts given its high technical success rate. 7/22/2008
Shyam Varadarajulu, Ashutosh Tamhane, Jeanetta Blakely Graded dilation technique for EUS-guided drainage of peripancreatic fluid collections: an assessment of outcomes and complications and technical proficiency (with video) CONCLUSIONS: In this study, EUS-guided drainage of a PFC could be performed safely by using the graded dilation technique, with a successful outcome in a majority of patients. Technical proficiency, with regard to procedural duration, improved significantly after the first 25 cases. 7/5/2008
Jessica M Trevino, C Mel Wilcox, Shyam Varadarajulu Endoscopic resection of minor papilla adenomas (with video) CONCLUSIONS: In experienced hands, endoscopic resection of the minor papilla is technically feasible, safe, and is associated with favorable clinical outcomes. 6/28/2008
Shyam Varadarajulu, Tercio L Lopes, C Mel Wilcox, Ernesto R Drelichman, Meredith L Kilgore, John D Christein EUS versus surgical cyst-gastrostomy for management of pancreatic pseudocysts CONCLUSIONS: EUS-guided cyst-gastrostomy should be considered as a first-line treatment approach for patients with uncomplicated pancreatic pseudocysts, because the procedure is cost saving and is associated with a shorter length of a postprocedure hospital stay when compared with surgical cyst-gast... 6/13/2008
Shyam Varadarajulu, Mohamad A Eloubeidi, C Mel Wilcox The concept of bedside EUS CONCLUSIONS: Bedside EUS is technically feasible, safe, facilitates both diagnosis and therapy, and enables the clinical management of patients who are critically ill. 4/22/2008
Mohamad A Eloubeidi, Shyam Varadarajulu, Shilpa Desai, C Mel Wilcox Value of repeat endoscopic ultrasound-guided fine needle aspiration for suspected pancreatic cancer CONCLUSION: Repeat EUS-FNA is warranted in patients with high clinical suspicion for pancreatic cancer despite indeterminate or negative findings at initial EUS-FNA. 4/10/2008
Robert H Hawes Transition from laboratory to clinical practice in NOTES: role of NOSCAR The way to move natural orifice translumenal endoscopic surgery (NOTES) from the laboratory to the clinical arena is to do high-quality research in the areas recommended by the NOSCAR working group representing barriers to NOTES procedures. Additionally, good experimental work needs to be done to de... 4/3/2008
Shyam Varadarajulu, Ashutosh Tamhane, Ernesto R Drelichman Patient perception of natural orifice transluminal endoscopic surgery as a technique for cholecystectomy CONCLUSIONS: Patients preferred NOTES to laparoscopy as the technique for cholecystectomy as long as the complication rates were comparable with current standards of LC. The oral orifice appeared to be the preferred approach for most patients. Given this favorable perception, further innovations in ... 3/22/2008
Coimbatore Azeez Rasheeda, Udayakumar Navaneethan, Venkataraman Jayanthi Liver disease in pregnancy and its influence on maternal and fetal mortality: a prospective study from Chennai, Southern India No abstract 3/13/2008
Neelima Reddy, C Mel Wilcox, Ashutosh Tamhane, Mohamad A Eloubeidi, Shyam Varadarajulu Protocol-based medical management of post-ERCP pancreatitis CONCLUSIONS: A protocol-based management strategy was associated with less severe pancreatitis, shorter length of hospital stay, need for fewer imaging studies, and use of antibiotics. Prospective validation of these findings is justified. 3/6/2008
Udayakumar Navaneethan, Jayanthi Venkatraman Herbal drugs in liver disease: how safe are they? A 24-year-old man presented with jaundice to our center and further evaluation revealed the presence of acute hepatitis E infection, an infection common in India. The patient's parents consulted a traditional medicine practitioner for giving him native medications for jaundice, a practice very commo... 2/28/2008
Kazuki Sumiyama, Christopher J Gostout, Elizabeth Rajan, Timothy A Bakken, Mary A Knipschield, Sydney Chung, Peter B Cotton, Robert H Hawes, Anthony N Kalloo, Sergey V Kantsevoy, Pankaj J Pasricha Pilot study of transesophageal endoscopic epicardial coagulation by submucosal endoscopy with the mucosal flap safety valve technique (with videos) CONCLUSIONS: The SEMF technique allowed endoscopic access to the upper mediastinum, the pericardium, and the epicardium via the esophagus, along with a minimal intervention on the epicardium. 2/26/2008
Shyam Varadarajulu, Juan Pablo Arnoletti Laparoscopic assistance for endoscopic resection of early stage esophageal cancer (with video) No abstract 2/19/2008
Ii Kwun Chung, Robert H Hawes Advantages and limitations of endoscopic ultrasonography in the evaluation and management of patients with gastrointestinal submucosal tumors: a review Conventional endoscopy can assess the location, mucosal appearance, and consistency of a gastrointestinal submucosal tumor but cannot provide enough information to differentiate the tumor from extraluminal compression by an external structure or from a neoplastic lesion or to determine whether the t... 1/15/2008
Shyam Varadarajulu, Ernesto R Drelichman EUS-guided therapeutic paracentesis No abstract 1/8/2008
Joy Verghese, Udayakumar Navaneethan, Jayanthi Venkatraman Clinical pattern of elderly cirrhosis: an Indian experience No abstract 12/1/2007
Shyam Varadarajulu, Mohamad A Eloubeidi, C Mel Wilcox Prospective evaluation of indeterminate ERCP findings by intraductal ultrasound CONCLUSIONS: A technically easy procedure, IDUS offers unique advantages in the evaluation of patients with indeterminate findings at ERCP. 11/23/2007
Shyam Varadarajulu, C Mel Wilcox, Ashutosh Tamhane, Mohamad A Eloubeidi, Jeanetta Blakely, Cheri L Canon Role of EUS in drainage of peripancreatic fluid collections not amenable for endoscopic transmural drainage CONCLUSIONS: Because a majority of PFCs can be drained by CTD in a shorter duration, with comparable outcomes, EUS-guided drainage should be reserved mainly for PFCs located at the pancreatic tail, because these are unlikely to cause luminal compression or are technically difficult to access. Also, ... 9/26/2007
Shyam Varadarajulu, Ernesto R Drelichman EUS-guided drainage of pelvic abscess (with video) CONCLUSIONS: EUS-guided placement of drainage catheter is a minimally invasive technique for draining pelvic abscesses that are within the reach of the echoendoscope. 7/24/2007
Shyam Varadarajulu, Isam Eltoum, Ashutosh Tamhane, Mohamad A Eloubeidi Histopathologic correlates of noncalcific chronic pancreatitis by EUS: a prospective tissue characterization study CONCLUSIONS: An excellent correlation exists between EUS and histologic findings of NCCP. 7/21/2007
Robert H Hawes Advanced endoscopy and endosurgical procedures: do we need a new subspecialty? On the horizon is a new paradigm in minimally invasive therapy called natural orifice transluminal endoscopic surgery (NOTES). This new approach will most certainly disrupt both those living in the gut lumen with flexible endoscopes as well as those living in the peritoneal cavity using laparoscopes... 7/21/2007
Shyam Varadarajulu, Ashutosh Tamhane, C Mel Wilcox Prospective evaluation of adjunctive ketamine on sphincter of Oddi motility in humans CONCLUSIONS: Ketamine at 20 mg did not significantly affect SOM parameters. Further studies are required to confirm our preliminary findings before ketamine can be added to the armamentarium of agents used for performance of sphincter of Oddi manometry. 6/27/2007
Allison Bridges, C Mel Wilcox, Shyam Varadarajulu Endoscopic management of traumatic bile leaks CONCLUSIONS: Consideration should be given to incorporate ERCP as first-line therapy in management of traumatic bile leaks, because endobiliary stent placement provides a successful outcome in a majority of cases, irrespective of the severity of injury. 5/29/2007
Kazuki Sumiyama, Christopher J Gostout, Elizabeth Rajan, Timothy A Bakken, Mary A Knipschield, Sydney Chung, Peter B Cotton, Robert H Hawes, Anthony N Kalloo, Sergey V Kantsevoy, Pankaj J Pasricha Transgastric cholecystectomy: transgastric accessibility to the gallbladder improved with the SEMF method and a novel multibending therapeutic endoscope CONCLUSIONS: Transgastric cholecystectomy is technically feasible. Transgastric access to the gallbladder may be improved by using submucosal endoscopy with an offset exit gastrotomy by means of the mucosal flap safety-valve technique and a multibending gastroscope. 5/29/2007
Donald Garrow, Scott Miller, Debajyoti Sinha, Jason Conway, Brenda J Hoffman, Robert H Hawes, Joseph Romagnuolo Endoscopic ultrasound: a meta-analysis of test performance in suspected biliary obstruction CONCLUSIONS: There is excellent overall accuracy for EUS in diagnosing choledocholithiasis, with less impressive results for malignancy (when fine-needle aspiration is not used). 5/5/2007
André Kheng Ho Chong, Robert H Hawes, Brenda J Hoffman, David B Adams, David N Lewin, Joseph Romagnuolo Diagnostic performance of EUS for chronic pancreatitis: a comparison with histopathology CONCLUSIONS: A threshold of 3 or more EUS criteria provides the best balance of sensitivity and specificity for histologic pancreatic fibrosis. Calcifications seen by EUS but missed by other imaging are common in this group of patients. 5/1/2007
Lindsay S Robison, Shyam Varadarajulu, C Mel Wilcox Safety and success of precut biliary sphincterotomy: Is it linked to experience or expertise? CONCLUSION: Despite the lack of specific training in this technique, PBS was performed with a high success rate and a complication rate similar to or less than reports from other experienced centers. These results suggest that endoscopic experience and perhaps innate endoscopic skill may play an imp... 5/1/2007
Shyam Varadarajulu, K R Palaniswamy Precut papillotomy is effective and safe only "when" clinically indicated and "in" expert hands No abstract 4/24/2007
Mohamad A Eloubeidi, Shyam Varadarajulu, Shilpa Desai, Rhett Shirley, Martin J Heslin, Mohit Mehra, Juan P Arnoletti, Isam Eltoum, Charles M Wilcox, Selwyn M Vickers A prospective evaluation of an algorithm incorporating routine preoperative endoscopic ultrasound-guided fine needle aspiration in suspected pancreatic cancer CONCLUSIONS: EUS-FNA is a safe and highly accurate method for tissue diagnosis in suspected pancreatic cancer. This approach allows for preoperative counseling of patients, minimizing surgeon's operative time in cases of unresectable disease, and avoids surgical biopsies in the majority of patients ... 4/19/2007
Shyam Varadarajulu, Mohamad A Eloubeidi Diagnosis of an aneurysm masquerading as a pancreatic-cyst lesion at EUS CONCLUSIONS: Aneurysms can masquerade as pancreatic-cystic lesions. Awareness of this entity is important because an inadvertent FNA during EUS may potentially lead to serious complications. 3/1/2007
Sergey V Kantsevoy, Bing Hu, Sanjay B Jagannath, Nina V Isakovich, Sydney S C Chung, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Pankaj J Pasricha, Yukio Nakajima, Koichi Kawashima, Anthony N Kalloo Technical feasibility of endoscopic gastric reduction: a pilot study in a porcine model CONCLUSIONS: Endoscopic gastric reduction is technically feasible on a live porcine model. 2/27/2007
Sergey V Kantsevoy, Sanjay B Jagannath, Hideaki Niiyama, Nina V Isakovich, Sydney S C Chung, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Pankaj J Pasricha, Anthony N Kalloo A novel safe approach to the peritoneal cavity for per-oral transgastric endoscopic procedures CONCLUSIONS: The PEG-like transgastric approach to the peritoneal cavity appears technically simple and safe. 2/27/2007
Jason D Conway, Robert H Hawes The expanding role of endoscopic ultrasound in pancreatic disease Since endoscopic ultrasound (EUS) was first developed in the 1980s, this technology has emerged as the principal modality for imaging the pancreas. When compared with other imaging techniques, EUS can more accurately image solid lesions of the pancreas and determine vascular involvement that might p... 1/17/2007
Kathryn Clary, Shyam Varadarajulu, Cheri Canon, Nirag Jhala, Darshana N Jhala Diagnosis of paraspinal abscess by EUS-guided FNA No abstract 12/5/2006
Kazuki Sumiyama, Christopher J Gostout, Elizabeth Rajan, Timothy A Bakken, Jodie L Deters, Mary A Knipschield, Robert H Hawes, Anthony N Kalloo, Pankaj J Pasricha, Sydney Chung, Sergey V Kantsevoy, Peter B Cotton Pilot study of the porcine uterine horn as an in vivo appendicitis model for development of endoscopic transgastric appendectomy CONCLUSIONS: This preliminary study demonstrated the technical feasibility to create a model for acute appendicitis by using the porcine uterine horn and transgastric appendectomy. 10/24/2006
Shyam Varadarajulu, C Mel Wilcox Randomized trial comparing needle-knife and pull-sphincterotome techniques for pancreatic sphincterotomy in high-risk patients CONCLUSIONS: Pancreatic sphincterotomy is safer in high-risk patients when performed with a needle knife over a pancreatic stent. 10/24/2006
Stephen B Hanauer, William J Sandborn, Nimish Vakil, Philip O Katz, Nicholas J Talley, Douglas K Rex, Robert H Hawes, Nalini M Guda, Martin L Freeman, Emmet B Keeffe, Luis A Balart Best of DDW 2006 Highlights from the 2006 Digestive Disease Week May 20-25, 2006, Los Angeles, CA. In this meeting review, many of our editorial board members report on Digestive Disease Week 2006. They highlight the most noteworthy presentations in their respective areas of expertise, including the latest treatment... 9/8/2006
Mohamad A Eloubeidi, Shyam Varadarajulu, Rizk El-Galley, Anton J Bueschen, Isam Eltoum EUS-guided FNA for the diagnosis of recurrent bladder cancer through the ileal conduit: a novel approach CONCLUSIONS: EUS-guided FNA through the ileal conduit is technically feasible, safe, and establishes diagnosis in patients suspected of tumor recurrence after complete cystectomy for bladder cancer. 8/23/2006
Peter B Cotton, Alan Barkun, Gregory Ginsberg, Robert H Hawes, Wendy Atkin, David J Bjorkman, Cathy Dykes, Grace Elta, James Farrell, David Fleischer, Robert Ganz, Tammy Glenn, Doug Janowski, David Johnson, Michael Kochman, Thomas Kowalski, Alec J Megibow, Kenneth McQuaid, Hiro Sasa, Chris C Thompson, John Vargo, Karen Woods Diagnostic endoscopy: 2020 vision No abstract 8/23/2006
Shyam Varadarajulu, Meredith L Kilgore, Charles M Wilcox, Mohamad A Eloubeidi Relationship among hospital ERCP volume, length of stay, and technical outcomes CONCLUSIONS: Inpatients who undergo ERCP at high-volume hospitals have shorter LOS and lower procedural failure rates than those undergoing ERCP at low-volume hospitals. These findings have important implications for health care policy decision making and resource utilization. 8/23/2006
Binh V Pham, Gottumukkala S Raju, Ijaz Ahmed, Douglas Brining, Sydney Chung, Peter Cotton, Christopher J Gostout, Robert H Hawes, Anthony N Kalloo, Sergey V Kantsevoy, Pankaj Jay Pasricha Immediate endoscopic closure of colon perforation by using a prototype endoscopic suturing device: feasibility and outcome in a porcine model (with video) CONCLUSIONS: Closure of acute perforation of the colon is feasible with the Eagle Claw endoscopic suturing device in a porcine model. 7/4/2006
Shyam Varadarajulu Non-operative management of pancreatic pseudocysts: there is still a role No abstract 6/24/2006
Sergey V Kantsevoy, Hideaki Niiyama, Sanjay B Jagannath, Sydney S C Chung, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Pankaj J Pasricha, Carolyn A Magee, Cheryl A Vaughn, David Barlow, Hironobu Kawano, Hideki Shimonaka, Anthony N Kalloo The endoscopic transilluminator: an endoscopic device for identification of the proximal jejunum for transgastric endoscopic gastrojejunostomy CONCLUSIONS: The ET is a safe instrument and can be used to identify the proximal jejunum to facilitate endoscopic gastrojejunostomy. 5/31/2006
C Mel Wilcox, Shyam Varadarajulu, Mohamad Eloubeidi Role of endoscopic evaluation in idiopathic pancreatitis: a systematic review In approximately 20% of patients with acute pancreatitis, a cause is not established by history, physical examination, routine laboratory testing, and abdominal imaging. For those with a single unexplained attack, the role of invasive evaluation with endoscopic retrograde cholangiopancreatography is... 5/31/2006
Shyam Varadarajulu, C Mel Wilcox Endoscopic management of sphincter of Oddi dysfunction in children CONCLUSIONS: As in adults, pancreatic and dual sphincterotomy, in expert hands, is effective and safe in a subgroup of children with SOD. Prospective, randomized trials with larger number of patients are required to validate the efficacy of endotherapy in children with SOD. 5/19/2006
Judith L Pugh, Nirag C Jhala, Mohamad A Eloubeidi, David C Chhieng, Isam A Eltoum, D Ralph Crowe, Shyam Varadarajulu, Darshana N Jhala Diagnosis of deep-seated lymphoma and leukemia by endoscopic ultrasound-guided fine-needle aspiration biopsy We retrospectively studied the use of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) as a tool for the diagnosis of deep-seated lymphoma. An on-site assessment at the time of EUS-FNAB was performed by a cytopathologist using Diff-Quik (American Scientific Products, McGraw Park... 5/19/2006
David Rattner, Robert H Hawes NOTES: Gathering momentum No abstract 5/9/2006
David Rattner, Robert H Hawes NOTES: Gathering momentum No abstract 5/3/2006
David A Sass, Georgios I Papachristou, Janette Lamb, M Michael Barmada, Randall E Brand, Mary E Money, Robert H Hawes, Peter B Cotton, Adam Slivka, David C Whitcomb The MCP-1 -2518 A/G polymorphism is not a susceptibility factor for chronic pancreatitis CONCLUSIONS: Although the pro-inflammatory chemokine MCP-1 -2518 G allele is a severity factor for AP, it does not significantly alter susceptibility to CP. 4/26/2006
Mohamad A Eloubeidi, Ashutosh Tamhane, Shyam Varadarajulu, C Mel Wilcox Frequency of major complications after EUS-guided FNA of solid pancreatic masses: a prospective evaluation CONCLUSIONS: EUS-FNA of solid pancreatic masses infrequently leads to major complications. Our results can be used by endosonographers to counsel patients before EUS-FNA of solid pancreatic masses. 3/28/2006
Shyam Varadarajulu, Mohamad Eloubeidi Can endoscopic ultrasonography-guided fine-needle aspiration predict response to chemoradiation in non-small cell lung cancer? A pilot study CONCLUSIONS: EUS-FNA appears to qualify as an accurate, safe and minimally invasive diagnostic technique for restaging of mediastinal LN after CHEMO-XRT in NSCLC patients. Given this promising preliminary data, a prospective evaluation is justified. 3/22/2006
C Mel Wilcox, Shyam Varadarajulu Endoscopic therapy for chronic pancreatitis: an evidence-based review In the setting of chronic pancreatitis, pancreatic ductal obstruction, and ductal leak, pseudocyst formation and biliary obstruction present many challenges for endoscopists. Although chronic pancreatitis has a variety of clinical manifestations, most commonly patients present with intermittent or c... 3/15/2006
Udayakumar Navaneethan, A C Ramesh Kumar, G Ravi Multiple visceral abscess in a case of melioidosis No abstract 3/1/2006
Isam A Eltoum, Victor K Chen, David C Chhieng, Darshana Jhala, Nirag C Jhala, Ralph Crowe, Shyam Varadarajulu, Mohamad A Eloubeidi Probabilistic reporting of EUS-FNA cytology: Toward improved communication and better clinical decisions CONCLUSION: The authors demonstrated the uncertainty associated with EUS-FNA diagnostic categories and used the threshold approach to qualify quantitatively the decision to perform EUS-FNA and the decision to treat patients suspected of having malignancy. 1/31/2006
Regina S Meara, Vishnu Reddy, Juan Pablo Arnoletti, Darshana Jhala, Shyam Varadarajulu, Nirag Jhala Hairy cell leukemia: a diagnosis by endoscopic ultrasound guided fine needle aspiration CONCLUSION: This report underscores the concept that the presence of a cytopathologist in the endoscopy suite plays an important role in providing accurate diagnoses of lymphoid lesions biopsied with EUS-FNA. 1/25/2006
Peter B Cotton, Robert H Hawes, Alan Barkun, Gregory G Ginsberg, Stephan Amman, Jonathan Cohen, Jeffrey Ponsky, Douglas K Rex, Drew Schembre, C Mel Wilcox Excellence in endoscopy: toward practical metrics No abstract 1/24/2006
Shyam Varadarajulu, Ashutosh Tamhane, Mohamad A Eloubeidi Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis CONCLUSIONS: EUS-FNA has a low sensitivity for pancreatic-mass lesions in the setting of CP. This decreased sensitivity can be overcome by performing more numbers of passes at FNA, which improves diagnostic accuracy. Demographic features and clinical presentation are predictive of underlying CP in p... 10/26/2005
Ali Fazel, Koorosh Moezardalan, Shyam Varadarajulu, Peter Draganov, Mohamad A Eloubeidi The utility and the safety of EUS-guided FNA in the evaluation of duplication cysts CONCLUSIONS: Variation exists in the EUS appearance of benign mediastinal cysts. EUS-FNA of mediastinal cysts with smaller-gauge needles, and antibiotic prophylaxis appears safe and can provide a definitive diagnosis in atypical mediastinal cystic lesions. 9/28/2005
Sergey V Kantsevoy, Sanjay B Jagannath, Hideaki Niiyama, Sydney S C Chung, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Pankaj J Pasricha, Carolyn A Magee, Cheryl A Vaughn, David Barlow, Hideki Shimonaka, Anthony N Kalloo Endoscopic gastrojejunostomy with survival in a porcine model CONCLUSIONS: The endoscopic transgastric approach to create a gastrojejunostomy is technically feasible and can be performed, with survival, in a porcine model. 7/28/2005
Bing Hu, S C Sydney Chung, Lawrence C L Sun, Koichi Kawashima, Tetsuya Yamamoto, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Anthony N Kalloo, Sergey V Kantsevoy, Pankaj J Pasricha Eagle Claw II: A novel endosuture device that uses a curved needle for major arterial bleeding: a bench study CONCLUSIONS: Control of bleeding from large arteries by using endoscopic suturing is possible. Continued refinements of the device are required. 7/28/2005
Shyam Varadarajulu, C Mel Wilcox, Mohamad A Eloubeidi Impact of EUS in the evaluation of pancreaticobiliary disorders in children CONCLUSIONS: EUS and EUS-guided FNA are feasible, safe, and have significant impact that alters subsequent management in the majority of children with PB disorders. Further studies and dissemination of information is required to facilitate its increased application in children. 7/28/2005
Bing Hu, S C Sydney Chung, Lawrence C L Sun, James Y W Lau, Koichi Kawashima, Tetsuya Yamamoto, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Anthony N Kalloo, Sergey V Kantsevoy, Pankaj J Pasricha Endoscopic suturing without extracorporeal knots: a laboratory study CONCLUSIONS: The present prototype represents significant improvements in the ease of operation and the security of the suture, bringing the technique closer to clinical use for a variety of applications. 7/28/2005
Shyam Varadarajulu, Mohamad A Eloubeidi The role of endoscopic ultrasonography in the evaluation of pancreatico-biliary cancer Accurate staging of pancreatico-biliary cancer is essential for surgical planning and for identification of locally advanced and metastatic disease that is incurable by surgery. The complex regional anatomy of the pancreatico-biliary system makes histologic diagnosis of malignancy at this region dif... 7/2/2005
Shyam Varadarajulu, Mohamad A Eloubeidi, Rig S Patel, Hugh E Mulcahy, Alan Barkun, Paul Jowell, Eric Libby, Stephen Schutz, Nicholas J Nickl, Peter B Cotton The yield and the predictors of esophageal pathology when upper endoscopy is used for the initial evaluation of dysphagia CONCLUSIONS: EGD is an effective and an appropriate tool for the initial evaluation of patients presenting with dysphagia. Early EGD should be considered, particularly, in male patients aged more than 40 years old who concomitantly report heartburn, odynophagia, or weight loss. 6/4/2005
Alan C Finley, Jason R Hosey, Tara C Noone, David M Shackelford, Shyam Varadarajulu Multiple focal nodular hyperplasia syndrome: diagnosis with dynamic, gadolinium-enhanced MRI We present a rare case of multiple focal nodular hyperplasia (FNH) with greater than 20 FNH lesions and coexistent liver hemangiomata. Particular attention is paid to the MRI characteristics of this disease process and the features of "multiple FNH syndrome" are discussed. 5/3/2005
Robert H Hawes Endoscopic mucosal resection: established indications, potential indications and perspectives No abstract 4/19/2005
Shyam Varadarajulu, Tara C Noone, Radu Tutuian, Robert H Hawes, Peter B Cotton Predictors of outcome in pancreatic duct disruption managed by endoscopic transpapillary stent placement CONCLUSIONS: Successful resolution of PD disruption by transpapillary stent insertion depends on the type of disruption and the ability to bridge the disrupted duct with a stent. 4/7/2005
Sanjay B Jagannath, Sergey V Kantsevoy, Cheryl A Vaughn, Sydney S C Chung, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Pankaj J Pasricha, Diana G Scorpio, Carolyn A Magee, Laurie J Pipitone, Anthony N Kalloo Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model CONCLUSIONS: The peroral endoscopic transgastric approach to ligation of the Fallopian tubes with long-term survival is technically feasible and safe in a porcine model. The endoscopic transgastric approach to the peritoneal cavity has potential for a wide array of diagnostic and therapeutic procedu... 3/11/2005
Rafael F Perini, Rafal Sadurski, Peter B Cotton, Rig S Patel, Robert H Hawes, John T Cunningham Post-sphincterotomy bleeding after the introduction of microprocessor-controlled electrosurgery: does the new technology make the difference? CONCLUSIONS: Use of the microprocessor-controlled ERBE electrosurgical generator for endoscopic sphincterotomy was associated with a significantly lower frequency of endoscopically observed bleeding but not clinically evident bleeding. 1/27/2005
Nadeem Hussain, Robert H Hawes Principles of endosonography and imaging Accurate interpretation of ultrasound images requires knowledge of the principles of ultrasound and how it interacts with tissue. This article outlines the important principles that every endosonographer should know and provides clinical implications to make the material relevant to endosonographers... 11/24/2004
Shyam Varadarajulu, Mohamad A Eloubeidi Frequency and significance of acute intracystic hemorrhage during EUS-FNA of cystic lesions of the pancreas CONCLUSIONS: Acute intracystic hemorrhage is a rare complication of EUS-guided FNA; it has a characteristic EUS appearance. Recognition of this event is important, because it permits termination of the procedure and thereby minimizes the potential for more serious bleeding. 10/9/2004
Elizabeth Rajan, Christopher J Gostout, Arnaldo B Feitoza, Olga N Leontovich, Lori J Herman, Lawrence J Burgart, Sydney Chung, Peter B Cotton, Robert H Hawes, Anthony N Kalloo, Sergey V Kantsevoy, Pankaj J Pasricha Widespread EMR: a new technique for removal of large areas of mucosa CONCLUSIONS: Wide EMR appears to be technically feasible for removal of large areas of mucosa. Mucosal strips 5 cm long that included over 50% of the luminal circumference were resected safely. Resection was followed by complete regrowth of the mucosa. However, a second wide EMR to create a circumfe... 10/9/2004
Shyam Varadarajulu, C Mel Wilcox, Robert H Hawes, Peter B Cotton Technical outcomes and complications of ERCP in children CONCLUSIONS: When ERCP is performed in children by expert endoscopists, the success rate is high and the complication rate is low, both being comparable with those for ERCP in adult patients. 8/28/2004
Shyam Varadarajulu, Brenda J Hoffman, Robert H Hawes, Mohamad A Eloubeidi EUS-guided FNA of lung masses adjacent to or abutting the esophagus after unrevealing CT-guided biopsy or bronchoscopy CONCLUSIONS: In this study, EUS-guided FNA of lung mass was safe, and it established a diagnosis in all patients with accessible lesions. Given these preliminary data, a prospective evaluation of this new indication for EUS-guided FNA is justified. 7/28/2004
Robert H Hawes Measuring outcomes of dual sphincterotomy No abstract 6/10/2004
Stephan M Wildi, Monty H Cox, Leslie L Clark, Robert Turner, Robert H Hawes, Brenda J Hoffman, Michael B Wallace Assessment of health state utilities and quality of life in patients with malignant esophageal Dysphagia CONCLUSIONS: These results confirm the perceived poor state of health of patients with esophageal cancer and are substantially lower than previous estimates in operated patients. Cost-effectiveness models must take into account significant differences between patients' assessment of their own state ... 6/8/2004
Michael B Wallace, James Ravenel, Mark I Block, Mostafa Fraig, Gerard Silvestri, Stephan Wildi, Nathan Schmulewitz, Shyam Varadarajulu, Stacey Roberts, Brenda J Hoffman, Robert H Hawes, Carolyn E Reed Endoscopic ultrasound in lung cancer patients with a normal mediastinum on computed tomography CONCLUSIONS: Endoscopic ultrasound guided fine needle aspiration can detect advanced mediastinal disease and avoid unnecessary surgical exploration in almost one of four patients who have no evidence of mediastinal disease on CT scan. In addition to previously reported results in patients with enlar... 4/28/2004
Stephan M Wildi, Tammy F Glenn, Robert F Woolson, Wei Wang, Robert H Hawes, Michael B Wallace Is esophagoscopy alone sufficient for patients with reflux symptoms? CONCLUSIONS: Daily abdominal pain and nausea, in combination with a history of ulcer disease, are strong predictors of major gastric or duodenal disease. Patients with reflux without these predictors are highly unlikely to have a major disease involving the stomach or duodenum, and are suitable cand... 3/5/2004
Shyam Varadarajulu, Nathan Schmulewitz, Stephan M Wildi, Stacey Roberts, James Ravenel, Carolyn E Reed, Mark Block, Brenda J Hoffman, Robert H Hawes, Michael B Wallace Accuracy of EUS in staging of T4 lung cancer CONCLUSIONS: Caution is warranted when unresectability of lung cancer is based solely on tumor invasion into mediastinal soft tissue at EUS. Overstaging occurs when a tumor appears to invade the pleural layer without mediastinal organ invasion. Confirmation of unresectability by other diagnostic mod... 3/5/2004
Shyam Varadarajulu, Robert Hawes Key issues in sphincter of Oddi dysfunction SOD is a challenging condition that is difficult to diagnose and treat. The high failure rate of endoscopic and surgical treatment reflects the difficulties in establishing accurate diagnosis and the lack of specific objective criteria by which appropriate therapy could be determined. In general, sp... 2/28/2004
Shyam Varadarajulu, Michael B Wallace Applications of endoscopic ultrasonography in pancreatic cancer CONCLUSIONS: EUS in combination with FNA is a highly accurate method of preoperative staging of pancreatic cancer, especially those too small to be characterized by CT or MRI, and it has the ability to obtain cytological confirmation of pancreatic cancer. 1/30/2004
Nathan Schmulewitz, Stephan M Wildi, Shyam Varadarajulu, Stacey Roberts, Robert H Hawes, Brenda J Hoffman, Valerie Durkalski, Gerard A Silvestri, Mark I Block, Carolyn Reed, Michael B Wallace Accuracy of EUS criteria and primary tumor site for identification of mediastinal lymph node metastasis from non-small-cell lung cancer CONCLUSIONS: Although tumor location and EUS lymph nodal characteristics are associated with malignant involvement of lymph nodes, the accuracy of these predictors does not obviate the need for cytologic evaluation. EUS with FNA should be performed for all lymph nodes when an abnormal finding will a... 1/28/2004
Priyajit Prasad, Nathan Schmulewitz, Alpesh Patel, Shyam Varadarajulu, Stephan M Wildi, Stacey Roberts, Radu Tutuian, Peter King, Robert H Hawes, Brenda J Hoffman, Michael B Wallace Detection of occult liver metastases during EUS for staging of malignancies CONCLUSIONS: EUS can detect occult liver metastases in patients in whom noninvasive hepatic imaging studies are normal, although the frequency at which such lesions are detected is low. Liver surveillance during EUS is worthwhile for patients in whom there is another indication for the procedure; bu... 1/15/2004
Stephan M Wildi, Christopher Y Kim, Tammy F Glenn, Harold A Mackey, Gerry E Viator, Michael B Wallace, Robert H Hawes Tele-endoscopy: a way to provide diagnostic quality for remote populations CONCLUSIONS: Upper-GI tele-endoscopy by using telephone lines has good diagnostic quality and is highly sensitive with regard to major findings. The misinterpretation of certain findings (esophageal ring, gastric erosions) may be caused by interobserver variability. The data strongly suggest that en... 1/15/2004
Shyam Varadarajulu, Tara Noone Symptomatic lower esophageal muscular ring: response to botox No abstract 1/7/2004
Shyam Varadarajulu, Radu Tutuian, Christopher Gostout, Richard Kozarek, C Mel Wilcox, Peter B Cotton Efficacy of the Za self-expandable metal stent for palliation of malignant biliary obstruction CONCLUSIONS: The Za-metal stent provided effective palliation for patients with inoperable malignant biliary tumors. Although minor technical problems were encountered with stent deployment, the overall stent patency, efficacy, and safety profile appear satisfactory. 12/18/2003
Mahesh S Mokhashi, Stephan M Wildi, Tammy F Glenn, Michael B Wallace, Christian Jost, Bora Gumustop, Christopher Y Kim, Peter B Cotton, Robert H Hawes A prospective, blinded study of diagnostic esophagoscopy with a superthin, stand-alone, battery-powered esophagoscope CONCLUSIONS: Unsedated esophagoscopy with a 3.1-mm, battery-powered, stand-alone esophagoscope is feasible, well tolerated, and accurate in detecting esophageal pathologies. It might be an efficient and cost-effective screening tool for the detection of columnar lined esophagus. 11/26/2003
Shyam Varadarajulu, Peter B Cotton Autoimmune pancreatitis: is it relevant in the west? No abstract 11/25/2003
Shyam Varadarajulu, Tara Noone, Robert H Hawes, Peter B Cotton Pancreatic duct stent insertion for functional smoldering pancreatitis CONCLUSIONS: Smoldering pancreatitis may result from functional obstruction, possibly caused by edema or spasm, of the papillary orifice. Insertion of a stent into the pancreatic duct alleviates pain, enables early resumption of oral intake of food, and facilitates pancreatic duct drainage. It also ... 10/7/2003
Stephan M Wildi, Rana S Hoda, William Fickling, Nathan Schmulewitz, Shyam Varadarajulu, Stacey S Roberts, Brenda Ferguson, Brenda J Hoffman, Robert H Hawes, Michael B Wallace Diagnosis of benign cysts of the mediastinum: the role and risks of EUS and FNA CONCLUSIONS: EUS provides a minimally invasive approach to the diagnosis of benign mediastinal cysts and may be more accurate than CT or other imaging modalities. Aspiration of suspected cysts should be undertaken with caution, given the risk of infection. 10/7/2003
Shyam Varadarajulu, Robert H Hawes, Peter B Cotton Determination of sphincter of Oddi dysfunction in patients with prior normal manometry CONCLUSIONS: A single negative manometry study does not rule out sphincter of Oddi dysfunction. Repeat ERCP with manometry may be warranted for patients with persistent symptoms in whom the clinical suspicion for sphincter of Oddi dysfunction remains high. 10/7/2003
Robert H Hawes Endoscopic management of pseudocysts Endoscopic retrograde cholangiopancreatography (ERCP) has gained acceptance as a treatment of pancreatic pseudocysts in patients suited to this procedure. This article describes a standard approach to the technique. Evaluation prior to endoscopic drainage of pseudocysts should involve review of a hi... 9/23/2003
Shyam Varadarajulu, Robert H Hawes Is EUS the answer for dyspepsia? No abstract 7/23/2003
Shyam Varadarajulu, David Lewin Enteropathy-associated T-cell lymphoma involving the colon and extraintestinal B-cell lymphoma in celiac disease No abstract 7/23/2003
Shyam Varadarajulu, Mark H Delegge Use of a 19-gauge injection needle as a guide for direct percutaneous endoscopic jejunostomy tube placement CONCLUSIONS: A DPEJ can be performed successfully by using a 19-gauge injection needle as guide for tube placement. 5/31/2003
Ravi Madhotra, Mahesh Mokhashi, Ira Willner, Robert H Hawes, Adrian Reuben Prospective evaluation of a 3.1-mm battery-powered esophagoscope in screening for esophageal varices in cirrhotic patients CONCLUSIONS: Unsedated endoscopy with a BPE is safe and well tolerated. The diagnostic accuracy of a BPE for diagnosing EV is the same as by EGD. Esophagoscopy with a BPE is a potential alternative to EGD for EV screening. 5/10/2003
Robert H Hawes Should we stop doing ERCP on patients with abdominal pain? No abstract 4/10/2003
Michael G Sarr, Michel Murr, Thomas C Smyrk, Charles J Yeo, Carlos Fernandez-del-Castillo, Robert H Hawes, Patrick C Freeny Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions No abstract 3/26/2003
Michael B Wallace, Mark Block, Brenda J Hoffman, Robert H Hawes, Gerard Silvestri, Carolyn E Reed, Michael Mitas, James Ravenel, Mostafa Fraig, Scott Miller, Edward T Jones, Alice Boylan Detection of telomerase expression in mediastinal lymph nodes of patients with lung cancer Mediastinal lymph nodes are the most common site of tumor spread in non-small cell lung cancer (NSCLC). We hypothesized that micrometastatic disease could be detected by reverse transcription-polymerase chain reaction (RT-PCR) for expression of human telomerase reverse transcriptase (hTERT) in media... 3/5/2003
Paul J Nietert, Marc D Silverstein, Mahesh S Mokhashi, Christopher Y Kim, Tammy F Glenn, Vicki A Marsi, Robert H Hawes, Michael B Wallace Cost-effectiveness of screening a population with chronic gastroesophageal reflux CONCLUSIONS: Screening for Barrett's esophagus with ultrathin endoscopy is more cost-effective than standard endoscopy, and both strategies appear to improve quality-adjusted life-years among patients with chronic reflux at costs that are similar to those of other accepted preventive measures. 3/4/2003
Stephan M Wildi, Michael B Wallace, Tammy F Glenn, Mahesh S Mokhashi, Christopher Y Kim, Robert H Hawes Accuracy of esophagoscopy performed by a non-physician endoscopist with a 4-mm diameter battery-powered endoscope CONCLUSION: Esophagoscopy with a battery-powered 4-mm diameter endoscope by a non-physician endoscopist is feasible and accurate in detecting esophageal pathologies. It may be an efficient screening method for the detection of columnar-lined esophagus. There was a distinct underestimate of the prese... 3/4/2003
Michael Mitas, David J Cole, Loretta Hoover, Mostafa M Fraig, Kaidi Mikhitarian, Mark I Block, Brenda J Hoffman, Robert H Hawes, William E Gillanders, Michael B Wallace Real-time reverse transcription-PCR detects KS1/4 mRNA in mediastinal lymph nodes from patients with non-small cell lung cancer No abstract 2/1/2003
David A Sabol, Shyam Varadarajulu Use of stent retrieval rat tooth forceps for percutaneous endoscopic gastrostomy/jejunostomy tube placement No abstract 12/19/2002
Shyam Varadarajulu Patient compliance for endoscopic procedures No abstract 12/19/2002
Robert H Hawes Diagnostic and therapeutic uses of ERCP in pancreatic and biliary tract malignancies No abstract 11/26/2002
Michael B Wallace, Paul J Nietert, Craig Earle, Mark J Krasna, Robert H Hawes, Brenda J Hoffman, Carolyn E Reed An analysis of multiple staging management strategies for carcinoma of the esophagus: computed tomography, endoscopic ultrasound, positron emission tomography, and thoracoscopy/laparoscopy CONCLUSIONS: The combination of PET + EUS-FNA should be the recommended staging procedure for patients with esophageal cancer, unless resources are scarce or PET is unavailable. In these instances, CT + EUS-FNA can be considered the preferred strategy. 10/29/2002
Guruprasad P Aithal, Robert Y m Chen, John T Cunningham, Valerie Durkalski, Eun Y Kim, Rig S Patel, Michael B Wallace, Robert H Hawes, Brenda J Hoffman Accuracy of EUS for detection of intraductal papillary mucinous tumor of the pancreas CONCLUSIONS: EUS may be useful in the initial evaluation of patients suspected to have IPMT. Paucity of parenchymal features of chronic pancreatitis is important in differentiating IPMT from other causes of chronic pancreatitis. 10/25/2002
Shyam Varadarajulu, Santosh Reddy, Tara Noone, K Mark Payne Successful treatment of dysphagia in Paget's disease of the bone No abstract 10/2/2002
Robert H Hawes New approaches in interventional EUS No abstract 9/26/2002
Nimish Vakil, Robert H Hawes, Stephen B Hanauer, Martin L Freeman, Michael Camilleri Best of DDW 2002. Highlights from the 2002 Digestive Disease Week. May 19-22, 2002, San Francisco, CA No abstract 9/14/2002
Shyam Varadarajulu, Carol Petruff, William H Ramsey Patient preferences for gender of endoscopists CONCLUSION: Compared with male patients, female patients are more likely to have gender preferences for an endoscopist. 7/30/2002
Robert H Hawes A clinician's perspective on chronic pancreatitis--2002 The diagnosis and management of chronic pancreatitis represents a significant challenge to clinicians. Progress is being made in our understanding of this disease, especially in the area of genetics and molecular biology. Despite these advances, diagnosis of early-stage disease depends on indirect t... 7/19/2002
Robert Y M Chen, Robert H Hawes Idopathic acute pancreatitis: Is EUS worth doing? No abstract 6/6/2002
Jorgen tenBerge, Brenda J Hoffman, Robert H Hawes, Conny Van Enckevort, Marc Giovannini, Richard A Erickson, Marc F Catalano, Roberto Fogel, Shawn Mallery, Douglas O Faigel, Angelo P Ferrari, Irving Waxman, Larent Palazzo, Tamir Ben-Menachem, Paul S Jowell, Kevin M McGrath, Thomas E Kowalski, Cuong C Nguyen, Wahid Y Wassef, Keiji Yamao, Amitabh Chak, Bruce D Greenwald, Timothy A Woodward, Peter Vilmann, Luis Sabbagh, Michael B Wallace EUS-guided fine needle aspiration of the liver: indications, yield, and safety based on an international survey of 167 cases CONCLUSION: EUS-guided FNA of the liver appears to be a safe procedure with a major complication rate of approximately 1%. EUS-FNA should be considered when a liver lesion is poorly accessible to US-, or CT-guided FNA should be considered when US- or CT-guided FNA fail to make a diagnosis, when a li... 5/25/2002
Joseph Romagnuolo, John Scott, Robert H Hawes, Brenda J Hoffman, Carolyn E Reed, Guruprasad P Aithal, Niall P Breslin, Robert Y M Chen, Bora Gumustop, Winnie Hennessey, Annette Van Velse, Michael B Wallace Helical CT versus EUS with fine needle aspiration for celiac nodal assessment in patients with esophageal cancer CONCLUSIONS: Despite technological advances, helical CT still appears unreliable, mainly because of insensitivity, for the identification of inoperable T4 or metastatic involvement of celiac lymph node disease in esophageal cancer. 4/30/2002
Robert H Hawes Does virtual colonoscopy have a major role in population-based screening? In summary, technical advances in the performance of VC are occurring at a very rapid pace. These technical improvements will undoubtedly improve the polyp detection rate and reduce false-positive and false-negative examinations. The concept of VC is clearly attractive and the general public is enam... 3/28/2002