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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

World Journal of Gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh saurabh chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States Department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy Department of Gastroenterology and Endoscopy Catholic UniversityRoma 00168Italy Department of Gastroenterology University of Michigan HealthAnn ArborMI 48107United States Department of Endoscopy University of VeronaVerona 37121VenetoItaly Gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

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Role of endoscopic ultrasound-guided biliary drainage for palliation of malignant biliary obstruction

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2369-2373页

作者： Sahib Singh saurabh chandan Antonio Facciorusso Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Center for Interventional Endoscopy(CIE) Advent HealthOrlandoFL 32803United States Gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Endoscopic ultrasound-guided biliary drainage(EUS-BD)directs bile flow into the digestive tract and has been mostly used in patients with malignant biliary obstruction(MBO)where endoscopic retrograde cholangiopancreatography-guided biliary drainage was unsuccessful or was not *** apposing metal stents(LAMS)are deployed during EUS-BD,with the newer electrocautery-enhanced LAMS reducing procedure time and complication rates due to the inbuilt cautery at the catheter ***-BD with electrocautery-enhanced LAMS has high technical and clinical success rates for palliation of MBO,with bleeding,cholangitis,and stent occlusion being the most common adverse *** studies have even suggested comparable efficacy between EUS-BD and endosc-opic retrograde cholangiopancreatography as the primary approach for distal *** this editorial,we commented on the article by Peng et al published in the recent issue of the World Journal of Gastrointestinal Surgery in 2024.

关键词： Endoscopic ultrasound Endoscopic ultrasound guided biliary drainage Cancer Pancreas Bile duct Endoscopy

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Comprehensive approach to esophageal variceal bleeding:From prevention to treatment

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World Journal of Gastroenterology 2024年第43期30卷 4602-4608页

作者： Sahib Singh saurabh chandan Rakesh Vinayek Ganesh Aswath Antonio Facciorusso Marcello Maida Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Center for Interventional Endoscopy Advent HealthOrlandoFL 32803United States Department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States Division of Gastroenterology and Hepatology State University of New York Upstate Medical UniversitySyracuseNY 13210United States Gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy Department of Medicine and Surgery University of Enna‘Kore’Enna 94100SiciliaItaly

Esophageal variceal bleeding is a severe complication often associated with portal hypertension,commonly due to liver *** and treatment of this condition are critical for patient *** strategies focus on reducing portal hypertension to prevent varices from developing or *** prophylaxis involves the use of non-selective beta-blockers,such as propranolol or nadolol,which lower portal pressure by decreasing cardiac output and thereby reducing blood flow to the *** variceal ligation(EVL)may also be employed as primary prophylaxis to prevent initial bleeding *** bleeding occurs,immediate treatment is *** management includes hemodynamic stabilization followed by pharmacological therapy with vasoactive drugs such as octreotide or terlipressin to control *** intervention is the cornerstone of treatment,with techniques such as EVL or sclerotherapy applied to directly manage the bleeding *** cases where bleeding is refractory to endoscopic treatment,transjugular intrahepatic portosystemic shunt may be considered to effectively reduce portal ***-term management after an acute bleeding episode involves secondary prophylaxis using betablockers and repeated EVL sessions to prevent rebleeding,complemented by monitoring and managing liver function to address the underlying *** light of new scientific evidence,including the findings of the study by Peng et al,this editorial aims to review available strategies for the prevention and treatment of esophageal varices.

关键词： Esophageal varices Portal hypertension Cirrhosis Bleeding Prevention Treatment

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Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques

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World Journal of Gastroenterology 2021年第40期27卷 6874-6887页

作者： Rupinder Mann Hemant Goyal Abhilash Perisetti saurabh chandan Sumant Inamdar Benjamin Tharian Department of Internal Medicine Saint Agnes Medical CenterFresnoCA 93730United States Department of Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18503United States Department of Gastroenterology and Hepatology The University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68107United States Department of Internal Medicine Gastroenterology and Hepatology DivisionUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States

Endoscopic ultrasound(EUS)is one of the significant breakthroughs in the field of advanced *** the last two decades,EUS has evolved from a diagnostic tool to a real-time therapeutic *** luminal gastrointestinal(GI)tract provides a unique opportunity to access multiple vascular structures,especially in the mediastinum and abdomen,thus permitting a variety of EUS-guided vascular *** addition of the doppler and contrast-enhanced capability to EUS has further helped provide real-time visualization of blood flow in vessels through the GI ***-guided vascular interventions rely on standard endoscopic accessories and interventional tools such as fine-needle aspiration needles and fine-needle *** allows the visualization of various structures in real-time by differentiating tissue densities and vascularity,thus,avoiding radiation ***-guided techniques also allow real-time microscopic examination after target ***,many necessary interventions can be done during the same procedure after *** article provides an overview of EUS-guided vascular interventions such as variceal,non-variceal bleeding interventions,EUSguided portal vein(PV)access with the formation of an intrahepatic portosystemic shunt,and techniques related to diagnosis of GI ***,we discuss current insights and future outlook of therapeutic modalities like PV embolization,PV sampling,angiography,drug administration,and portal pressure measurement.

关键词： Endoscopic ultrasound Vascular intervention Esophageal varices Gastric varices Portal vein Therapeutic endoscopy

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Sarcopenia in hepatocellular carcinoma:Current knowledge and future directions

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World Journal of Gastroenterology 2022年第4期28卷 432-448页

作者： Abhilash Perisetti Hemant Goyal Rachana Yendala saurabh chandan Benjamin Tharian Ragesh BabuThandassery Department of Internal Medicine Gastroenterology and Hepatology DivisionUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Interventional Oncology and Surgical Endoscopy Parkview HealthFort WayneIN 46825United States Department of Internal Medicine The Wright Center for Graduate Medical EducationThe Wright Center for Graduate Medical EducationScrantonPA 18501United States Department of Hematology and Oncology Conway Regional Medical CenterConwayAR 72034United States Department of Internal Medicine Gastroenterology and Hepatology DivisionCHI Creighton University Medical CenterOmahaNE 68107United States Department of Medicine Central Arkansas Veterans Healthcare SystemLittle RockAR 72205United States

Liver cancer is the second most occurring cancer worldwide and is one of the leading causes of cancer-related *** carcinoma(HCC)is the most common(80%-90%)type among malignant liver *** occurs very early in HCC and can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant *** prognostic stating systems have been developed in HCC,such as Barcelona Clinic Liver Cancer,Child-Pugh score and Albumin-Bilirubin ***,the evaluation of patients’performance status is a major limitation of these scoring *** this review,we aim to summarize the current knowledge and recent advances about the role of sarcopenia in cirrhosis in general,while focusing specifically on ***,the role of sarcopenia in predicting clinical outcomes and prognostication in HCC patients undergoing loco-regional therapies,liver resection,liver transplantation and systematic therapy has been discussed.A literature review was performed using databases PubMed/MEDLINE,EMBASE,Cochrane,Web of Science,and CINAHL on April 1,2021,to identify published reports on sarcopenia in *** can independently predict HCC-related mortality especially in patients undergoing treatments such as loco-regional,surgical liver transplantation and systemic *** research is focused on evaluating a balance of anabolic and catabolic pathways responsible for muscle *** clinical studies have shown promising results in methods to improve sarcopenia in HCC which can potentially increase prognosis in these *** sarcopenia occurs very early in HCC,it can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant ***,sarcopenia measurement can obviate the confounding caused by the abdominal ascites in these *** use of sarcopenia can

关键词： Sarcopenia Skeletal muscle Hepatocellular carcinoma Cirrhosis Outcomes Liver cancer

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Impact of utilization of hepatitis C positive organs in liver transplant:Analysis of united network for organ sharing database

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World Journal of Hepatology 2022年第5期14卷 984-991页

作者： Amaninder Dhaliwal Banreet Dhindsa Daryl Ramai Harlan Sayles saurabh chandan Rajani Rangray Department of Gastroenterology and Hepatology Moffitt Cancer CenterTampaFL 33612United States Department of Gastroenterology and Hepatology University of Nebraska Medical CenterOmahaNE 68198United States Department of Internal Medicine The Brooklyn Hospital CenterBrooklynNY 11201United States Department of Biostatistics University of Nebraska Medical CenterOmahaNE 68198United States Department of Gastroenterology and Hepatology Creighton University Medical CenterOmahaNE 68124United States

BACKGROUND The utility of hepatitis C virus(HCV)organs has increased after the Food and Drug Administration approval of direct acting anti-viral(DAA)medications for the HCV *** efficacy of DAA in treating HCV is nearly 100%.AIM To analyze the United Network for Organ Sharing(UNOS)database to compare the survival rates between the hepatitis C positive donors and negative recipients and hepatitis C negative donors and *** We analyzed the adult patients in UNOS database who underwent deceased donor liver transplant from January 2014 to December *** primary endpoint was to compare the survival rates among the four groups with different hepatitis C donor and recipient status:(Group 1)Both donor and recipient negative for HCV(Group 2)Negative donor and positive recipient for HCV(Group 3)Positive donor and negative recipient for HCV(Group 4)Both positive donor and recipient for *** 9.4 software was used for the data *** Meier log rank test was used to analyze the estimated survival rates among the four *** A total of 24512 patients were included:Group 1:16436,Group 2:6174,Group 3:253 and Group 4:*** 1-year(Group 1:91.8%,Group 2:92.12%,Group 3:87%,Group 4:92.8%),2-year(Group 1:88.4%,Group 2:88.1%,Group 3:84.3%,Group 4:87.5%),3-year(Group 1:84.9%,Group 2:84.3%,Group 3:75.9%,Group 4:83.2%)survival rates showed no statistical significance among the four *** Meier log rank test did not show any statistical significance difference in the estimated survival rates between Group 3 vs all the other *** The survival rates in hepatitis C positive donors and negative recipients are similar as compared to both hepatitis C negative donors and *** could be due to the use of DAA therapy with cure rates of nearly 100%.This study supports the use of hepatitis C positive organs in the selected group of recipients with and without HCV *** long-term studies are needed to further valid

关键词： Hepatitis C Liver transplant Survival United Network for Organ Sharing Direct acting antiviral

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Gastrointestinal manifestations,risk factors,and management in patients with post-transplant lymphoproliferative disorder:A systematic review

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World Journal of Transplantation 2022年第8期12卷 268-280页

作者： William Reiche Abubakar Tauseef Ahmed Sabri Mohsin Mirza David Cantu Peter Silberstein saurabh chandan Department of Medicine CHI Creighton University Medical CenterOmahaNE 68124United States Department of Pathology CHI Creighton University Medical CenterOmahaNE 68124United States Division of Hematology and Oncology Department of MedicineCHI Creighton University Medical CenterOmahaNE 68124United States Division of Gastroenterology and Hepatology Department of MedicineCHI Creighton University Medical CenterOmahaNE 68124United States

BACKGROUND Patients with a history of solid organ transplantation(SOT)or hematopoietic stem cell transplantation(HSCT)are at an increased risk of developing post-transplant lymphoproliferative disorder(PTLD).The gastrointestinal(GI)tract is commonly affected as it has an abundance of B and T *** To determine typical GI-manifestations,risk factors for developing PTLD,and *** Major databases were searched until November *** Non-case report studies that described GI manifestations of PTLD,risk factors for developing PTLD,and management of PTLD were *** articles written within the last 20 years were included in the *** articles found that patients with a history of SOT,regardless of transplanted organ,have a propensity to develop *** GI tract manifestations may be nonspecific;therefore,consideration of risk factors is crucial for identifying *** other lymphoma variants,PTLD is very aggressive making early diagnosis key to *** treatment is reduction of immunosuppression which is effective in more than 50%of cases;however,additional therapy including rituximab,chemotherapy,and surgery may also be required.

关键词： Post-transplant lymphoproliferative disorder Gastrointestinal manifestations Reduction of immunosuppression Risk factors Epstein-Barr virus

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Understanding evidence-based clinical practice guidelines for cholelithiasis 2021

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Hepatobiliary Surgery and Nutrition 2024年第2期13卷 352-355页

作者： Dushyant Singh Dahiya Antonio Facciorusso saurabh chandan Amir Humza Sohail Manesh Kumar Gangwani Gianluca Franchellucci Benedetto Mangiavillano Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKSUSA Gastroenterology Unit Department of Biomedical ScienceFoggia University HospitalFoggiaFGItaly Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNEUSA Complex Surgical Oncology Department of SurgeryUniversity of New MexicoAlbuquerqueNMUSA Department of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockARUSA Digestive Endoscopy IRCCS Humanitas Research HospitalRozzanoMIItaly Department of Biomedical Sciences Humanitas UniversityPieve EmanueleMIItaly Gastrointestinal Endoscopy Unit Humanitas-Mater DominiCastellanzaVAItaly

Cholelithiasis is characterized by impaired metabolism of bile acids,cholesterol and bilirubin resulting in deposition of gallstones within the gallbladder(1).The article by Fujita et *** the third revision of the evidence-based practice guidelines issued by the Japanese Society of Gastroenterology(JSGE)on cholelithiasis(2).For these current guidelines,52 questions were adopted through discussions among committee members,covering epidemiology,pathogenesis,diagnosis,treatments,complications,and prognostic aspects of cholelithiasis in Japan(2).The strengths of recommendations were determined by voting by committee members after assessing current available literature,patient preferences,and cost-benefit balance(2).Similar to the previous guideline(second revision),consensus among committee members was defined as the acquisition of 70%votes or over(2).

关键词： Cholecystectomy gallbladder cholelithiasis endoscopic ultrasonography(EUS) cholecystitis cholangitis

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Efficacy of pancreatoscopy for pancreatic duct stones:A systematic review and meta-analysis

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World Journal of Gastroenterology 2020年第34期26卷 5207-5219页

作者： Syed M Saghir Harmeet S Mashiana Babu P Mohan Banreet S Dhindsa Amaninder Dhaliwal saurabh chandan Neil Bhogal Ishfaq Bhat Shailender Singh Douglas G Adler Department of Internal Medicine University of Nevada Las Vegas School of MedicineLas VegasNV 89102United States Division of Gastroenterology and Hepatology University of Nebraska School of MedicineOmahaNE 68198-2000United States Division of Gastroenterology and Hepatology University of Utah HealthSalt Lake CityUT 84132United States

BACKGROUND Pancreatic duct stones can lead to significant abdominal pain for *** oral pancreatoscopy(POP)-guided intracorporal lithotripsy is being increasingly used for the management of main pancreatic duct calculi(PDC)in chronic *** uses two techniques:Electrohydraulic lithotripsy(EHL)and laser lithotripsy(LL).Data on the safety and efficacy are limited for this *** performed a systematic review and meta-analysis with a primary aim to calculate the pooled technical and clinical success rates of *** secondary aim was to assess pooled rates of technical success,clinical success for the two individual techniques,and adverse event *** To perform a systematic review and meta-analysis of POP,EHL and LL for management of PDC in chronic *** We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed,EMBASE,Cochrane,Google Scholar and Web of Science databases(from 1999 to October 2019)to identify studies with patient age greater than 17 and any gender that reported on outcomes of POP,EHL and *** primary outcome assessed involved the pooled technical success and clinical success rate of *** secondary outcome included the pooled technical success and clinical success rate for EHL and *** also assessed the pooled rate of adverse events for POP,EHL and LL including a subgroup analysis for the rate of adverse event subtypes for POP:Hemorrhage,post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP),perforation,abdominal pain,fever and *** success was defined as the rate of clearing pancreatic duct stones and clinical success as the improvement in *** model was used for *** between study-specific estimates was calculated using the Cochran Q statistical test and I2 *** bias was ascertained,qualitatively by visual inspection of funnel plot and quantitatively by the Egger ***

关键词： Electrohydraulic shockwave lithotripsy Laser lithotripsy Chronic pancreatitis Calculi Extracorporeal shockwave lithotripsy Endoscopic retrograde cholangiopancreatography Systematic review Meta-analysis Outcome

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Spontaneous bacterial empyema in cirrhosis:A systematic review and meta-analysis

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World Journal of Hepatology 2022年第6期14卷 1258-1268页

作者： William Reiche Smit Deliwala saurabh chandan Babu P Mohan Banreet Dhindsa Daryl Ramai Abhilash Perisetti Rajani Rangray Sandeep Mukherjee Department of Internal Medicine CHI Creighton University Medical CenterOmahaNE 68124United States Department of Internal Medicine Michigan State University at Hurley Medical CenterFlintMI 48503United States Division of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68124United States Department of Gastroenterology University of UtahSalt Lake CityUT 84132United States Division of Gastroenterology and Hepatology University of Nebraska Medical CenterOmahaNE 68198United States Division of Gastroenterology Parkview HealthFort WayneIN 46845United States

BACKGROUND Spontaneous bacterial empyema(SBE)occurs when a hepatic hydrothorax becomes infected and runs a course similar to spontaneous bacterial peritonitis(SBP).It remains underdiagnosed as patients with cirrhosis do not routinely undergo diagnostic *** understanding is limited by small cohorts,while studies reporting its association with ascites/SBP are *** To explore the incidence of SBE,to determine its association with ascites,and to summarize what is known regarding treatment and outcomes for patients with *** Major databases were searched until June *** include the incidence of SBE in pleural effusions,SBP in peritoneal fluid,and SBE in patients without ascites within our cohort of patients with *** performed a meta-analysis using a randomeffects model with pooled proportions and 95%confidence intervals(CI).We assessed heterogeneity using I^(2)and classic fail-safe to determine *** Eight studies with 8899 cirrhosis patients were *** median age ranged between 41.2 to 69.7 *** majority of the patients were Child-Pugh B and *** MELD score was 18.6±8.09.A total of 1334 patients had pleural effusions and the pooled incidence of SBE was 15.6%(CI 12.6-19;I^(2)50).Amongst patients diagnosed with SBE,the most common locations included right(202),left(64),and bilateral(8).Amongst our cohort,a total of 2636 patients had ascites with a pooled incidence of SBP of 22.2%(CI 9.9-42.7;I^(2)97.8).The pooled incidence of SBE in patients with cirrhosis but without concomitant ascites was 9.5%(CI 3.6-22.8;I^(2)82.5).CONCLUSION SBE frequently occurs with concurrent ascites/SBP;our results suggest high incidence rates of SBE even in the absence of *** pleura can be an unrecognized nidus and our findings support the use of diagnostic thoracentesis in patients with decompensated cirrhosis after exclusion of other causes of pleural *** should be considered particularly in p

关键词： Spontaneous bacterial peritonitis Spontaneous bacterial peritonitis Postparacentesis circulatory dysfunction Refractory ascites Hepatic hydrothorax

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