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Evolving scr.ening and sur.eillance techniques for.Bar.ett's esophagus

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Wor.d Jour.al of Gastr.enter.logy 2019年第17期25卷 2045-2057页

作者： David Steele kondal kyanam kabir baig Shajan Peter Basil Hir.chowitz Endoscopic Centr. of Endoscopic Excellence Division of Gastroenterology and HepatologyUniversity of Alabama at Birmingham

Bar.ett's esophagus(BE) is a change in the esophageal lining and is known to be the major.pr.cur.or.lesion for.most cases of esophageal adenocar.inoma(EAC).Despite an under.tanding of its association with BE for.many year. and the falling incidence r.tes of squamous cell car.inoma of the esophagus, the incidence for.EAC continues to r.se exponentially. In association with this r.sing incidence, if the delay in diagnosis of EAC occur. after.the onset of symptoms,then the mor.ality at 5 year. is gr.ater.than 80%. Appr.pr.ate diagnosis and sur.eillance str.tegies ar. ther.for. vital for.BE. Multiple novel optical technologies and other.advanced appr.aches ar. being utilized to assist in making scr.ening and sur.eillance mor. cost effective. We r.view the cur.ent guidelines and evolving techniques that ar. cur.ently being evaluated.

关键词： Bar.ett’s esophagus Scr.ening Sur.eillance New techniques Endoscopy Imaging r.diofr.quency ablation Nar.ow band imaging

Clinical appr.ach to indeter.inate biliar. str.ctur.s:Clinical pr.sentation,diagnosis,and wor.up

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Wor.d Jour.al of Gastr.enter.logy 2023年第36期29卷 5198-5210页

作者： Sujani Yadlapati r.mzi Mulki Ser.io A Sánchez-Luna Ali M Ahmed kondal r.o kyanam kabir baig Shajan Peter Depar.ment of Gastr.enter.logy and Hepatology Indiana University HospitalIndianapolisIN 46202USA Depar.ment of Gastr.enter.logy and Hepatology University of Alabama at BirminghamBirminghamAL 35294USA

Despite advances in cr.ss-sectional imaging and endoscopic technology,bile duct str.ctur.s r.main a challenging clinical *** is cr.cial to make an ear.y deter.ination of benign or.malignant natur. of biliar. *** diagnosis not only helps with fur.her.management but also minimizes mor.ality and mor.idity associated with delayed *** imaging and endoscopic techniques,par.icular.y endoscopic r.tr.gr.de cholangiopancr.atogr.phy(Er.P)and tissue sampling techniques play a key in establishing a *** biliar. str.ctur.s(IDBSs)have no definite mass on imaging or.absolute histopathological diagnosis and often war.ant utilization of multiple diagnostics to ascer.ain an *** this r.view,we discuss possible etiologies,clinical pr.sentation,diagnosis,and management of *** on available data and exper. opinion,we depict an evidence based diagnostic algor.thm for.management of *** of focus include use of tr.ditional tissue sampling techniques such as Er.P with br.sh cytology,intr.ductal biopsies,fluor.scence in situ hybr.dization and flow *** also descr.be the r.le of endoscopic ultr.sound(EUS)-guided fine needle aspir.tion and biopsies,cholangioscopy,confocal laser.endomicr.scopy,and intr.ductal EUS in management of IDBSs.

关键词： Biliar. str.ctur.s Indeter.inate str.ctur.s Biliar. sampling Cholangioscopy Benign str.ctur.s Malignant str.ctur.s Indeter.inate biliar. str.ctur.s

r.le of balloon enter.scopy for.obscur. gastr.intestinal bleeding in those with sur.ically alter.d anatomy: A systematic r.view

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Wor.d Jour.al of Gastr.intestinal Endoscopy 2022年第7期14卷 434-442页

作者： Mahmoud Ar.an Tyler.Colvin Ali M Ahmed kondal r.o kyanam kabir baig Shajan Peter Depar.ment of Inter.al Medicine University of Alabama at BirminghamBirminghamAL 35294United States Depar.ment of Gastr.enter.logy and Hepatology University of Alabama at BirminghamBirminghamAL 35294United States

BACKGr.UND Obscur. gastr.intestinal(GI)bleeding is defined as per.istent bleeding despite negative evaluation with both esophagogastr.duodenoscopy and colonoscopy and can be secondar. to small intestinal *** endoscopy as well as push endoscopy can be a challenge in those with alter.d anatomy given inaccessible ar.as as well as per.or.tion *** and double balloon enter.scopy can be war.anted in this patient population in instances of obscur. GI *** To assess the safety and diagnostic efficacy of balloon enter.scopy for.obscur. GI bleeding in patients with sur.ically alter.d *** A sear.h was conducted thr.ugh PubMed,MEDLINE,Google Scholar.Scopus,and Embase with the key wor.s“enter.scopy,”“obscur. bleeding,”and“alter.d anatomy,”to identify r.levant ar.icles in English with no r.str.cted time fr.me.A sear.h within the r.fer.nce Citation Analysis database was conducted to ensur. inclusion of the latest high impact *** types included in the r.view wer. pr.spective and r.tr.spective r.views,case ser.es,and case *** r.fer.nce lists of these paper. wer. also r.viewed to find fur.her.paper. that wer. *** author. extr.cted the data fr.m the studies that fit inclusion *** of inter.st included type of study,type of pr.cedur.,and type of alter.d anatomy,as well as the number.of patients with any diagnostic or.ther.peutic *** was also r.cor.ed on pr.cedur. toler.nce and *** data was analyzed with descr.ptive *** Our.liter.tur. sear.h yielded 14 studies that wer. *** wer. 68 pr.cedur.s per.or.ed with 61 unique patients subjected to these ***-four.65%)of the pr.cedur.s wer. double balloon,21(31%)wer. single balloon,and 3(4%)wer. classified as thr.ugh the scope balloon *** most common alter.d anatomy types included Gastr.c Bypass r.ux-en-Y,Pylor.s Spar.ng Whipple,Or.hotopic Liver.Tr.nsplantation with r.ux-en-Y,and Gastr.jejunostom

关键词： Alter.d anatomy Single balloon enter.scopy Double balloon enter.scopy Obscur. Bleed Gastr.intestinal

Case ser.es on multimodal endoscopic ther.py for.gastr.c antr.l vascular.ectasia, a ter.iar. center.exper.ence

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Wor.d Jour.al of Gastr.intestinal Endoscopy 2018年第1期10卷 30-36页

作者： Tasnia Matin Mohammed Naseemuddin Mohamed Shor.ibah Peng Li kondal kyanam kabir baig Char.es Mel Wilcox Shajan Peter Inter.al Medicine UAB Hospital Division of Gastr.enter.logy University of Alabama School of Medicine Depar.ment of Gastr.enter.logy Emory Division of Gastr.enter.logy Uni-versity of Alabama at Birmingham School of Public Health University of Alabama at Birmingham

AIM To study and descr.be patients who under.ent tr.atment for.gastr.c antr.l vascular.ectasia(GAVE) with differ.nt endoscopic tr.atment *** We r.viewed patients with GAVE who under.ent tr.atment at Univer.ity of Alabama at Bir.ingham between Mar.h 1, 2012 and December.31, 2016. Included patients had an endoscopic diagnosis of GAVE with associated upper.gastr.intestinal bleeding or.ir.n deficiency *** Seven out of 15 patients had classic water.elon descr.ption for.GAVE, 1/15 with diffuse/honeycomb patter. and 6/15 with nodular.GAVE per.EGD descr.ption. Seven out of 15 patients r.quir.d multimodal tr.atment. Four.out of six of patients with endoscopically nodular.GAVE r.quir.d multimodal ther.py. Over.ll, mean pr.-and post-tr.atment hemoglobin(Hb) values wer. 8.2 ± 0.8 g/dL and 9.7 ± 1.6 g/dL, r.spectively(P ≤ 0.05). Mean number.of packed r.d blood cells tr.nsfusions befor. and after.tr.atment was 3.8 ± 4.3 and 1.2 ± 1.7(P ≤ 0.05), *** Patients with nodular.var.ant GAVE r.quir.d multimodal appr.ach mor. fr.quently than non-nodular.var.ants. Patients r.sponded well to multimodal ther.py and saw decr.ase in tr.nsfusion r.tes and incr.ase in Hb concentr.tions. Our.findings suggest a multimodal appr.ach may be beneficial in nodular.var.ant GAVE.

关键词： Gastr.c antr.l vascular ectasia Upper GI bleed r.diofr.quency ablation Endoscopic band ligation Ar.on plasma coagulation