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Gastroenterology Report 2022年第1期10卷 207-216页

作者： Fateh Bazerbachi Rodger M.White Nauzer Forbes Basavana Goudra barham k.abu dayyeh Vinay Chandrasekhara BobbieJean Sweitzer CentraCare Interventional Endoscopy ProgramSt.Cloud HospitalSt CloudMNUSA Department of Anesthesia Massachusetts General HospitalBostonMAUSA Department of Medicine Division of Gastroenterology and HepatologyUniversity of CalgaryCalgaryAlbertaCanada Department of Anesthesiology and Critical Care Medicine Hospital of the University of PennsylvaniaPhiladelphiaPAUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Systems Director University of VirginiaPreoperative MedicineInovaHealthFalls ChurchVAUSA

Gastrointestinal(GI)endoscopy has witnessed a Cambrian explosion of techniques,indications,and expanding target *** endoscopy encompasses traditional domains that include preventive measures,palliation,as alternative therapies in patients with prohibitive risks of more invasive procedures,and indicated primary ***,it has expanded to include therapeutic and diagnostic interventional endosonography,luminal endoscopic resection,third space endotherapy,endohepatology,and *** lines between surgery and endoscopy are blurred on many occasions within this ***,patients with high degrees of co-morbidity and complex physiology require more nuanced peri-endoscopic *** rising demand for endoscopy services has resulted in the development of endoscopy referral centers that offer these invasive procedures as directly booked referrals for regional and rural *** further necessitates specialized programs to ensure appropriate evaluation,risk stratification,and optimization for safe sedation and general anesthesia if *** landscape is conducive to the organic evolution of endo-anesthesia to meet the needs of these focused and evolving *** this primer,we delineate important aspects of endo-anesthesia care and provide relevant clinical and logistical considerations pertaining to the breadth of procedures.

关键词： endoscopic procedures endoscopy anesthesia

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Turnkey algorithmic approach for the evaluation of gastroesophageal reflux disease after bariatric surgery

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Gastroenterology Report 2023年第1期11卷 123-130页

作者： Omar M.Ghanem Rabih Ghazi Farah Abdul Razzak Fateh Bazerbachi karthik Ravi Leena khaitan Shanu N.kothari barham k.abu dayyeh Department of Surgery Mayo ClinicRochesterMNUSA Department of Medicine Mayo ClinicRochesterMNUSA CentraCare Interventional Endoscopy ProgramSt Cloud HospitalSt CloudMNUSA Department of Surgery CaseWestern Reserve UniversityClevelandOHUSA Department of Surgery Prisma HealthGreenvilleSCUSA

Bariatric surgeries are often complicated by de-novo gastroesophageal reflux disease(GERD)or worsening of pre-existing *** growing rates of obesity and bariatric surgeries worldwide are paralleled by an increase in the number of patients requiring post-surgical GERD ***,there is currently no standardized approach for the assessment of GERD in these *** this review,we delineate the relationship between GERD and the most common bariatric surgeries:sleeve gastrectomy(SG)and Roux-en-Y gastric bypass(RYGB),with a focus on pathophysiology,objective assessment,and underlying anatomical and motility *** suggest a stepwise algorithm to help diagnose GERD after SG and RYGB,determine the underlying cause,and guide the management and treatment.

关键词： RYGB sleeve gastrectomy bariatric surgery gastroesophageal reflux disease GERD

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Acute pancreatitis associated with intravenous administration of propofol:evaluation of causality in a systematic review of the literature

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Gastroenterology Report 2019年第1期7卷 13-23,I0001页

作者： Samir Haffar Ravinder Jeet kaur Sushil kumar Garg Joseph A.Hyder M.Hassan Murad barham k.abu dayyeh Fateh Bazerbachi Digestive Center for Diagnosis&Treatment 29 Ayar StreetDamascusSyrian Arab Republic Division of Gastroenterology and Hepatology Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Anesthesiology and Perioperative Medicine Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Health Care Policy and Research Mayo Clinic200 First Street SWRochesterMN 55905USA

Acute pancreatitis(AP)associated with intravenous administration of propofol has been described with unknown causal *** therefore assessed this causality in a systematic *** databases were searched on 16 August 2017;studies were appraised and selected by two reviewers based on a priori *** causality was evaluated with the Naranjo scale and Badalov *** identified 18 studies from 11 countries with a total of 21 patients,and the majority had adequate methodological *** median age was 35 years(range,4–77)and 10(48%)were ***,propofol was administrated in 8 patients as sedative along with induction/maintenance of anesthesia in 13 patients;median dose was 200 mg,with intermediate latency(1–30 days)in 14(67%).Serum triglycerides were>1000 mg/dL in four *** AP was observed in four patients(19%).AP recurrence occurred in one out of two patients who underwent *** related to AP was 3/21(14%).Propofol was the probable cause of AP according to the Naranjo scale in 19 patients(89%).Propofol-induced AP has a probable causal relation and evidence supports Badalov class *** is not the only mechanism by which propofol illicit ***-induced AP was severe in 19%of patients with a mortality rate related to AP of 14%.Future research is needed to delineate whether this risk is higher if combined with other procedures that portend inherent risk of pancreatitis such as endoscopic retrograde cholangiopancreatography.

关键词： Acute pancreatitis drug-induced pancreatitis propofol systematic review

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Endoscopic pancreatic duct stenting for pain palliation in selected pancreatic cancer patients:a systematic review and meta-analysis

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Gastroenterology Report 2021年第2期9卷 105-114,I0001页

作者： Pradeep k.Siddappa Fadi Hawa Larry J.Prokop MHassan Murad barham k.abu dayyeh Vinay Chandrasekhara Mark D.Topazian Fateh Bazerbachi Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCAUSA Department of Internal Medicine St.Joseph Mercy Ann Arbor HospitalYpsilantiMIUSA Library Public Services Mayo ClinicRochesterMNUSA Robert D and Patricia E kern Center for the Science of Health Care Delivery Mayo ClinicRochesterMNUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Division of Gastroenterology Massachusetts General Hospital and Harvard Medical SchoolBostonMAUSA

Background Abdominal pain is a debilitating symptom affecting-80%of pancreatic cancer(PC)*** duct(PD)decompression has been reported to alleviate this pain,although this practice has not been widely *** aimed to evaluate the role,efficacy,and safety of endoscopic PD decompression for palliation of PC post-prandial obstructive-type *** A systematic review until 7 October 2020 was *** independent reviewers selected studies,extracted data,and assessed the methodological *** We identified 12 publications with a total of 192 patients with PC presenting with abdominal pain,in whom PD decompression was attempted,and was successful in 167 patients(mean age 62.5 years,58.7%males).The use of plastic stents was reported in 159 patients(95.2%).All included studies reported partial or complete improvement in pain levels after PD stenting,with an improvement rate of 93%(95%confidence interval,79%-100%).The mean duration of pain improvement was 94616 *** retrograde cholangiopancreatography(ERCP)-related adverse events(AEs)were postsphincterotomy bleeding(1.8%),post-ERCP pancreatitis(0.6%),and hemosuccus pancreaticus(0.6%).AEs were not reported in two patients who underwent endoscopic ultrasound-guided PD *** the 167 patients with technical success,the stent-migration and stent-occlusion rates were 3.6%and 3.0%,*** AE-related mortality was *** methodological quality assessment showed the majority of the studies having low or unclear *** In this exploratory analysis,endoscopic PD drainage may be an effective and safe option in selected patients for the management of obstructive-type PC ***,a randomized–controlled trial is needed to delineate the role of this invasive practice.

关键词： cancer-associated pain Endoscopic retrograde cholangiopancreatography palliative therapy pancreas cancer systematic review meta-analysis

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Effects on physiologic measures of appetite from intragastric balloon and endoscopic sleeve gastroplasty: results of a prospective study

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Chinese Medical Journal 2022年第10期135卷 1234-1241页

作者： Babusai Rapaka Daniel B.Maselli Gontrand Lopez-Nava Inmaculada Bautista-Castano Reem Matar Veeravich Jaruvongvanich Eric J.Vargas Andrew C.Storm Andres Acosta barham k.abu dayyeh Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55905USA Madrid Sanchinarro University Hospital MadridSpain

Background: Endoscopic bariatric therapies can help address widening management gaps in obesity. Their ability to facilitate weight loss is largely tied to influences on appetite through perturbations of gastric emptying and accommodation. As these tools gain traction in obesity therapy, their physiologic underpinnings require exploration, which may enhance efficacy, tolerance, and patient-tailored ***: We prospectively assessed consecutive subjects with fluid-filled intragastric balloons (IGBs) (n = 18) placed between October 2016 and June 2017 or underwent endoscopic sleeve gastroplasty (ESG) (n = 23) from March 2018 to June 2018. Patients underwent physiologic appraisal at 3 months with13C-spirulina-based gastric emptying breath test to determine time to half emptying (T50), as well as maximum tolerated volume (MTV) of a standard nutrient drink test. Changes in T50 and MTV at 3 months were compared with percent total body weight loss (%TBWL) at 3 and 6 months using best-fit linear ***: The change in T50 at 3 months correlated with %TBWL at 3 months for IGB (P = 0.01) and ESG (P = 0.01) but with greater impact on %TBWL in IGB compared to ESG (R2 = 0.42vs. 0.26). Change in T50 at 3 months was predictive of weight loss at 6 months for IGB (P = 0.01) but not ESG (P = 0.11). ESG was associated with greater decrease in MTV compared to IGB (340.25 ± 297.97 mLvs. 183.00 ± 217.13 mL,P = 0.08), indicting an enhanced effect on satiation through decreased gastric accommodation. Changes in MTV at 3 months did not correlate with %TBWL for either IGB (P = 0.26) or ESG (P = 0.49) but trended toward significance for predicting %TBWL at 6 months for ESG (P = 0.06) but not IGB (P = 0.19).Conclusion: IGB and ESG both induce weight loss but likely through distinct gastric motor function phenotypes, and gastric emptying may predict future weight loss in patients with IGB.

关键词： Intragastric balloon Endoscopic sleeve gastroplasty Gastric emptying Gastric accommodation Obesity

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Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage

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World Journal of Gastroenterology 2008年第28期14卷 4573-4575页

作者： Nicole M Martin barham k.abu dayyeh Raymond T Chung Gastrointestinal Unit Massachusetts General HospitalBostonMassachusetts 02114United States

Anabolic steroid abuse is common among athletes and is associated with a number of medical complications. We describe a case of a 27-year-old male bodybuilder with multiple hepatic adenomas induced by anabolic steroids. He initially presented with tumor hemorrhage and was treated with left lateral hepatic segmentectomy. Regression of the remaining tumors was observed with cessation of steroid use. However, 3 years and a half after his initial hepatic segmentectomy, he presented with recurrent tumor enlargement and intraperitoneal hemorrhage in the setting of steroid abuse relapse. Given his limited hepatic reserve, he was conservatively managed with embolization of the right accessory hepatic artery. This is the first reported case of hepatic adenoma re- growth with recidivistic steroid abuse, complicated by life-threatening hemorrhage. While athletes and bodybuilders are often aware of the legal and social ramifications of steroid abuse, they should continue to be counseled about its serious medical risks.

关键词： Anabolic steroids Adenoma Liver Hemorrhage

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End-stage renal disease is associated with increased post endoscopic retrograde cholangiopancreatography adverse events in hospitalized patients

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World Journal of Gastroenterology 2018年第41期24卷 4691-4697页

作者： Tarek Sawas Fateh Bazerbachi Samir Haffar Won k Cho Michael J Levy John A Martin Bret T Petersen Mark D Topazian Vinay Chandrasekhara barham k.abu dayyeh Division of Gastroenterology and Hepatology Mayo Clinic Department of Gastroenterology Digestive Center for Diagnosis and Treatment Division of Gastroenterology and Hepatology Georgetown University Medstar Washington Hospital Center

AIM To determine if end-stage renal disease (ESRD) is a risk factor for post endoscopic retrograde cholangio-pancreatography (ERCP) adverse events (AEs). METHODS We performed a retrospective cohort study using the Nationwide Inpatient Sample (NIS) 2011-2013. We identified adult patients who underwent ERCP using the International Classification of Diseases 9^(th) Revision (ICD-9-CM). Included patients were divided into three groups: ESRD, chronic kidney disease (CkD), and control. The primary outcome was post-ERCP AEs including pancreatitis, bleeding, and perforation determined based on specific ICD-9-CM codes. Secondary outcomes were length of hospital stay, in-hospital mortality, and admission cost. AEs and mortality were compared using multivariate logistic regression *** There were 492175 discharges that underwent ERCP during the 3 years. The ESRD and CkD groups contained 7347 and 39403 hospitalizations respectively, whereas the control group had 445424 hospitalizations. Post-ERCP pancreatitis (PEP) was significantly higher in the ESRD group (8.3%) compared to the control group (4.6%) with adjusted odd ratio (aOR) = 1.7 (95% CI: 1.4-2.1, ~aP k factor for post-ERCP AEs and is associated with higher hospital mortality. Careful selection and close monitoring is warranted to improve outcomes.

关键词： End-stage renal disease Nationwide Inpatient Sample Endoscopic retrograde cholangiopancreatography

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Percutaneous transluminal angioplasty balloons for endoscopic ultrasound-guided pancreatic duct interventions

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World Journal of Gastrointestinal Endoscopy 2022年第8期14卷 487-494页

作者： Jad P AbiMansour barham k.abu dayyeh Michael J Levy Andrew C Storm John A Martin Bret T Petersen Ryan J Law Mark D Topazian Vinay Chandrasekhara Department of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55905United States

BACkGROUND Endoscopic ultrasound(EUS)-guided main pancreatic duct(PD)access may be used when conventional endoscopic retrograde cholangiopancreatography(ERCP)techniques *** use of a percutaneous transluminal angioplasty balloon(PTAB),originally developed for vascular interventions,can be used to facilitate transmural(e.g.,transgastric)PD access and to dilate high-grade pancreatic *** To describe the technique,efficacy,and safety of PTABs for EUS-guided PD *** Patients who underwent EUS with use of a PTAB from March 2011 to August 2021 were retrospectively identified from a tertiary care medical center supply *** included 3-4 French angioplasty catheters with 3-4 mm balloons designed to use over a 0.018-inch *** primary outcome was technical *** outcomes included incidence of adverse events(AEs)and need for early *** A total of 23 patients were identified(48%female,mean age 55.8 years).Chronic pancreatitis was the underlying etiology in 13(56.5%)patients,surgically altered anatomy(SAA)with stricture in 7(30.4%),and SAA with post-operative leak in 3(13.0%).Technical success was achieved in 20(87%)*** AE rate was 26%(n=6).All AEs were mild and included 1 pancreatic duct leak,2 cases of post-procedure pancreatitis,and 3 admissions for post-procedural *** patients required early *** EUS-guided use of PTABs for PD access and/or stricture management is feasible with an acceptable safety profile and can be considered in patients when conventional ERCP cannulation fails.

关键词： Dilating balloon Pancreatic duct intervention Chronic pancreatitis Anastomotic stricture

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