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Early vs late cholecystectomy in mild gall stone pancreatitis: Anupdated meta-analysis and review of literature

World Journal of Clinical Cases 2021年第13期9卷 3038-3047页

作者： Saqib Walayat Muhammad Baig srinivas r puli Department of Internal Medicine OSF Saint Francis Medical CenterUniversity of Illinois Peoria CampusPeoriaIL 61637United States Department of Gastroenterology University of IllinoisPeoriaIL 61637United States Department of Medicine University of Illinois-PeoriaPeoriaIL 61604United States

BACKGrOUND Gallstone pancreatitis is one of the most common causes of acute *** remains the definitive treatment of choice to prevent *** rate of early cholecystectomies during index admission remains low due toperceived increased risk of *** compare outcomes including length of stay, duration of surgery, biliarycomplications, conversion to open cholecystectomy, intra-operative, and postoperativecomplications between patients who undergo cholecystectomy duringindex admission as compared to those who undergo cholecystectomy *** Method: Pooled proportions were calculated using both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (randomeffects model).rESULTSInitial search identified 163 reference articles, of which 45 were selected andreviewed. Eighteen studies (n = 2651) that met the inclusion criteria were includedin this analysis. Median age of patients in the late group was 43.8 years while thatin the early group was 43.6. Pooled analysis showed late laparoscopiccholecystectomy group was associated with an increased length of stay by 88.96 h(95%CI: 86.31 to 91.62) as compared to early cholecystectomy group. Pooled riskdifference for biliary complications was higher by 10.76% (95%CI: 8.51 to 13.01) in the late cholecystectomy group as compared to the early cholecystectomy *** analysis showed no risk difference in intraoperative complications [riskdifference: 0.41%, (95%CI: -1.58 to 0.75)], postoperative complications [riskdifference: 0.60%, (95%CI: -2.21 to 1.00)], or conversion to open cholecystectomy[risk difference: 1.42%, (95%CI: -0.35 to 3.21)] between early and latecholecystectomy groups. Pooled analysis showed the duration of surgery to beprolonged by 39.11 min (95%CI: 37.44 to 40.77) in the late cholecystectomy groupas compared to the early *** patients with mild gallstone pancreatitis early cholecystectomy leads to shorterhospital

关键词： Cholecystectomy Gallstone pancreatitis Acute pancreatitis Laparoscopic cholecystectomy Biliary colic Open cholecystectomy

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Effect of music on patients undergoing outpatient colonoscopy

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World Journal of Gastroenterology 2006年第45期12卷 7309-7312页

作者： Matthew L Bechtold rodney A Perez srinivas r puli John B Marshall Division of Gastroenterology University of Missouri School of Medicine Columbia Missouri United States

AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist. METHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played. rESULTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time, endoscopist assessment of scope insertion difficulty, endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure. The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales. CONCLUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.

关键词： Colonoscopy Gastrointestinal endoscopy Music Music therapy relaxation music

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Staging accuracy of esophageal cancer by endoscopic ultrasound:A meta-analysis and systematic review

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World Journal of Gastroenterology 2008年第10期14卷 1479-1490页

作者： srinivas r puli Jyotsna BK reddy Matthew L Bechtold Daphne Antillon Jamal A Ibdah Mainor r Antillon Division of Gastroenterology and Hepatology University of Missouri-Columbia Columbia Missouri 65212 United States

AIM: To evaluate the accuracy of endoscopic ultrasound (EUS) in the staging of esophageal cancer. METHODS: Only EUS studies confirmed by surgery were selected. Articles were searched in Medline and Pubmed. Two reviewers independently searched and extracted data. Meta-analysis of the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both the Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran’s Q test based upon inverse variance weights. rESULTS: Forty-nine studies (n = 2558) which met the inclusion criteria were included in this analysis. Pooled sensitivity and specificity of EUS to diagnose T1 was 81.6% (95% CI: 77.8-84.9) and 99.4% (95% CI: 99.0-99.7), respectively. To diagnose T4, EUS had a pooled sensitivity of 92.4% (95% CI: 89.2-95.0) and specificity of 97.4% (95% CI: 96.6-98.0). With Fine Needle Aspiration (FNA), sensitivity of EUS to diagnose N stage improved from 84.7% (95% CI: 82.9-86.4) to 96.7% (95% CI: 92.4-98.9). The P value for the χ2 test of heterogeneity for all pooled estimates was > 0.10. CONCLUSION: EUS has excellent sensitivity and specificity in accurately diagnosing the TN stage of esophageal cancer. EUS performs better with advanced (T4) than early (T1) disease. FNA substantially improves the sensitivity and specificity of EUS in evaluating N stage disease. EUS should be strongly considered for staging esophageal cancer.

关键词： Esophageal cancer Cancer staging Endoscopic ultrasound, TNM staging, Diagnostic accuracy

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Meta-analysis and systematic review of colorectal endoscopic mucosal resection

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World Journal of Gastroenterology 2009年第34期15卷 4273-4277页

作者： srinivas r puli Yasuo Kakugawa Takuji Gotoda Daphne Antillon Yutaka Saito Mainor r Antillon Division of Gastroenterology and Hepatology University of Missouri-Columbia Endoscopy Division National Cancer Center Hospital

AIM:To evaluate the proportion of successful complete cure en-bloc resections of large colorectal polyps achieved by endoscopic mucosal resection(EMr). METHODS:Studies using the EMr technique to resect large colorectal polyps were *** complete cure en-bloc resection was defined as one piece margin-free polyp *** were searched for in Medline,Pubmed,and the Cochrane Control Trial registry,among other sources. rESULTS:An initial search identified 2620 reference articles,from which 429 relevant articles were selected and *** was extracted from 25 studies(n =5221)which met the inclusion *** the studies used snares to perform *** proportion of en-bloc resections using a random effect model was 62.85%(95%CI:51.50-73.52).The pooled proportion for complete cure en-bloc resections using a random effect model was 58.66%(95%CI:47.14-69.71).With higher patient load(>200 patients),this complete cure en-bloc resection rate improves from 44.19%(95%CI: 24.31-65.09)to 69.17%(95%CI:51.11-84.61). CONCLUSION:EMr is an effective technique for the resection of large colorectal polyps and offers an alternative to surgery.

关键词： Meta-analysis Systematic review Polyps Endoscopic mucosal resection En-bloc resection

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Endoscopic ultrasound:It’s accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review

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World Journal of Gastroenterology 2008年第19期14卷 3028-3037页

作者： srinivas r puli Jyotsna Batapati Krishna reddy Matthew L Bechtold Jamal A Ibdah Daphne Antillon Shailender Singh Mojtaba Olyaee Mainor r Antillon Division of Gastroenterology and Hepatology University of Missouri- Columbia Division of Gastroenterology and Hepatology University of Kansas School of Medicine

AIM:To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. METHODS:Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran’s Q test based upon inverse variance weights. rESULTS:Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7% (95% CI:82.9-86.4) to 88.0% (95% CI:85.8-90.0). With FNA, the specificity of EUS improved from 84.6% (95% CI:83.2-85.9) to 96.4% (95% CI:95.3-97.4). The P forchi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. CONCLUSION:EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy.

关键词： Endoscopic ultrasound EUS-fine needleaspiration Mediastinal lymphadenopathy

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Water-jet vs traditional triangular tip knife in peroral endoscopic myotomy for esophageal dysmotility:A systemic review and metaanalysis

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World Journal of Gastrointestinal Endoscopy 2022年第10期14卷 608-615页

作者： Yuliya Belopolsky srinivas r puli Division of Gastroenterology and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States

BACKGrOUND Peroral endoscopic myotomy is an increasingly used less invasive modality to treat esophageal ***,triangular tip knife with integrated water jet function has been introduced to mitigate multiple instrument *** To compare traditional triangular tip knife and water jet knife in terms of procedural success,duration,instrument exchanges,coagulation forceps use,and adverse *** We conducted a systemic review and meta-analysis with two authors independently in electronic databases(PubMed,Embase,and Cochrane Library)from inception through May *** addition,we conducted a relevant search by reference Citation Analysis(rCA)(https://***).A fixed-effects model was used to calculate weighted mean,odds ratio(Or),and confidence intervals(CI).rESULTS We included 7 studies involving 558 *** knife and water jet knife were similar in odds of procedural success with ratio of 4.78(95%CI=0.22-102.47)and odds of clinical success with ratio of 0.93(95%CI=0.29-2.97),*** jet knife had fewer instrument exchanges compared to triangular knife(2.21,95%CI=1.98-2.45 vs 11.9,95%CI=11.15-12.70)and usage of coagulation forceps(1.75,95%CI=1.52-1.97 vs 2.63,95%CI=2.37-2.89).Adverse events were higher in triangular knife group(Or:2.30,95%CI=1.35-3.95).CONCLUSION Peroral endoscopic myotomy using water jet knife is comparable in terms of pro cedural success to triangular tip *** jet knife also required shorter procedural duration,less instrument exchanges,coagulation devices,and overall adverse events.

关键词： Gastroenterology Endoscopy gastrointestinal Esophageal motility disorders Water jet knife Dysmotility

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Efficacy and safety of endoscopic transpapillary gallbladder drainage in acute cholecystitis:An updated meta-analysis

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World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 345-355页

作者： David M Jandura srinivas r puli Department of Gastroenterology University of Illinois College of Medicine at PeoriaPeoriaIL 61637United States Department of Gastroenterology and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61637United States

BACKGrOUND Percutaneous transhepatic gallbladder drainage has been the most frequently performed treatment for acute cholecystitis for patients who are not candidates for *** transpapillary gallbladder drainage(ETGBD)has evolved into an alternative *** have been numerous retrospective and prospective studies evaluating ETGBD for acute cholecystitis,though results have been *** To evaluate the efficacy and safety of ETGBD in the treatment of inoperable patients with acute *** We performed a systematic review of major literature databases including PubMed,OVID,Science Direct,Google Scholar(from inception to March 2021)to identify studies reporting technical and clinical success,and post procedure adverse events in *** pooled rates were then calculated using fixed effects models for technical and clinical success,and post procedure adverse events,including recurrent *** We found 21 relevant articles that were then included in the *** all 1307 patients were *** pooled technical success rate was 82.62%[95%confidence interval(CI):80.63-84.52].The pooled clinical success rate was found to be 94.87%(95%CI:93.54-96.05).The pooled overall complication rate was 8.83%(95%CI:7.42-10.34).Pooled rates of post procedure adverse events were bleeding 1.03%(95%CI:0.58-1.62),perforation 0.78%(95%CI:0.39-1.29),peritonitis/bile leak 0.45%(95%CI:0.17-0.87),and pancreatitis 1.98%(95%CI:1.33-2.76).The pooled rates of stent occlusion and migration were 0.39%(95%CI:0.13-0.78)and 1.3%(95%CI:0.75-1.99)*** pooled rate of cholecystitis recurrence following ETGBD was 1.48%(95%CI:0.92-2.16).CONCLUSION Our meta-analysis suggests that ETGBD is a feasible and efficacious treatment for inoperable patients with acute cholecystitis.

关键词： Endoscopic transpapillary gallbladder drainage Acute cholecystitis Inoperable treatment Double pigtail stent Nasobiliary drainage

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Effect of precut sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis:A systematic review and meta-analysis

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World Journal of Gastroenterology 2014年第14期20卷 4093-4101页

作者： Abhishek Choudhary Jessica Winn Sameer Siddique Murtaza Arif Zainab Arif Ghassan M Hammoud srinivas r puli Jamal A Ibdah Matthew L Bechtold Division of Gastroenterology Department of Internal MedicineUniversity of Missouri-Columbia Division of Gastroenterology and Hepatology University of IllinoisPeoria CampusOSF Saint Francis Medical CenterPeoria

AIM: To conduct a systemic review and meta-analysis to investigate the role of early precut technique. Multiple randomized controlled trails (rCTs) have reported conflicting results of the early precut sphincterotomy.

关键词： Early precut Endoscopic retrograde cholangiopancreatography cannulation Post-endoscopic retrograde cholangiopancreatography pancreatitis randomized controlled trials Meta-analysis

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Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: A systematic review and meta analysis

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World Journal of Gastroenterology 2013年第23期19卷 3678-3684页

作者： srinivas r puli Nikhil Kalva Matthew L Bechtold Smitha r Pamulaparthy Micheal D Cashman Norman C Estes richard H Pearl Fritz-Henry Volmar Sonu Dillon Michael F Shekleton David Forcione Division of Gastroenterology and Hepatology University of Illinois Peoria Campus OSF Saint Francis Medical CenterPeoria IL 61637 United States Department of Internal Medicine University of Illinois Peoria Campus OSF Saint Francis Medical CenterPeoria IL 61637 United States Division of Gastroenterology and Hepatology University of Missouri-ColumbiaColumbia MS 65212 United States Department of Surgery University of Illinois Peoria Campus OSF Saint Francis Medical CenterPeoria IL 61637 United States Interventional Endoscopy Services Gastrointestinal Unit Massachusetts General Hospital Harvard Medical SchoolBoston MA 02114 United States

AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting ***: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central register of Controlled Trials and Database of Systematic reviews. Pooling was conducted by both fixed and random effects model). rESULTS: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ2 heterogeneity for all the pooled accuracy estimates was > 0.10. CONCLUSION: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.

关键词： Endoscopic ultrasound Ultrasound Endosonography Pancreatic mass Neuroendocrine tumors Sensitivity Specificity Positive predictive value Negative predictive value

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Endoscopic ultrasound-guided fiducial marker placement in pancreatic cancer:A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2020年第8期12卷 231-240页

作者： Jaymon B Patel Vakya revanur David G Forcione Matthew L Bechtold srinivas r puli Department of Gastroenterology University of Illinois College of Medicine at PeoriaPeoriaIL 61637United States Department of Internal Medicine University of Illinois College of Medicine at PeoriaPeoriaIL 61637United States Department of Gastroenterology Massachusetts General HospitalBostonMA 02114United States Department of Gastroenterology University of MissouriColumbiaMO 65203United States

BACKGrOUND Pancreatic cancer(PC)mortality remains high despite advances in *** chemoradiotherapy offers modest survival benefit over monotherapy with *** markers serve as needed landmarks for imageguided radiotherapy(IGrT).Traditionally,these markers were placed surgically or percutaneously with limitations of *** ultrasound-guided placement overcomes these *** To evaluate the safety,efficacy,and feasibility of endoscopic ultrasound(EUS)-guided fiducial placement for PC undergoing *** Articles were searched in MEDLINE,PubMed,and Ovid *** was conducted by fixed and random effects *** was assessed using Cochran’s Q test based upon inverse variance *** Initial search identified 1024 reference articles for EUS-guided fiducial placement in *** these,261 relevant articles were *** was extracted from 11 studies(n=820)meeting inclusion *** proportion of successful placement was 96.27%(95%CI:95.35-97.81)with fiducial migration rates low at 4.33%(95%CI:2.45-6.71).Adverse event rates remained low,with overall pooled proportion of 4.85%(95%CI:3.04-7.03).CONCLUSION EUS-guided placement of fiducial markers for IGrT of PC is safe,feasible,and *** ability to target deep structures under direct visualization while remaining minimally invasive are added ***,the ability to perform fine needle aspiration or celiac plexus neurolysis add value and increase patient-care *** EUS-guided fiducial placement improves outcomes in IGrT or offers any mortality benefits over traditional placement remains unknown and future studies are needed.

关键词： Endoscopic ultrasound Pancreatic cancer Fiducial marker Image-guided radiotherapy Systematic review Meta-analysis

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