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Gastroenterology Commons

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Articles 1 - 11 of 11

Full-Text Articles in Gastroenterology

Inpatient Palliative Care Is Less Utilized In Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective, Zahra Mojtahedi, Ji Won Yoo, Karen Callahan, Neeraj Bhandari, Donghui Lou, Katayoon Ghodsi, Jay J. Shen Sep 2021

Inpatient Palliative Care Is Less Utilized In Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective, Zahra Mojtahedi, Ji Won Yoo, Karen Callahan, Neeraj Bhandari, Donghui Lou, Katayoon Ghodsi, Jay J. Shen

School of Medicine Faculty Research

Background—Extrahepatic cholangiocarcinoma (ECC) is a rare, morbid, fatal cancer with distressing symptoms. Maintaining a high quality of life while reducing hospital charges and length of stay (LOS) for the end-of-life period remains a major challenge for the healthcare system. Palliative care utilization has been shown to address these challenges; moreover, its use has increased in recent years among cancer patients. However, the utilization of palliative care in rare cancers, such as ECC, has not yet been explored. Objectives—To investigate palliative care utilization among ECC patients admitted to US hospitals between 2007 and 2016 and its association with patient demographics, clinical …


Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization Of The Gastroduodenal Artery For A Previously Bleeding Duodenal Ulcer, Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning Apr 2021

Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization Of The Gastroduodenal Artery For A Previously Bleeding Duodenal Ulcer, Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning

School of Medicine Faculty Research

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 significant rebleeding. In our case, a patient presented with a life-threatening duodenal ulcer hemorrhage, likely precipitated by intraluminal endovascular coil migration after a recent gastro-duodenal artery embolization. He was successfully managed without endoscopic coil removal and had no additional gastrointestinal bleeding. It is important for endoscopists to be aware of this complication and weigh the risks and benefits of coil removal.


Eus-Guided Pelvic Drainage: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Yassin Naga, Syed Mohsin Saghir, Amaninder Dhaliwal, Daryl Ramai, Chad Cross, Shailender Singh, Ishfaq Bhat, Douglas G. Adler Jan 2021

Eus-Guided Pelvic Drainage: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Yassin Naga, Syed Mohsin Saghir, Amaninder Dhaliwal, Daryl Ramai, Chad Cross, Shailender Singh, Ishfaq Bhat, Douglas G. Adler

School of Medicine Faculty Research

Background and Objectives: EUS-guided pelvic abscess drainage (EUS-PAD) is a procedure that utilizes an echoendoscope to visualize an area of interest for needle insertion and placement of a stent, catheter, or both for drainage of the target abscess. The aim of this study was to perform a systematic review and meta-analysis for the safety and efficacy of EUS-PAD. Materials and Methods: We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to February 2020). The primary outcomes for this study were the technical and clinical …


Efficacy Of Transoral Outlet Reduction In Roux-En-Y Gastric Bypass Patients To Promote Weight Loss: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Syed Mohsin Saghir, Yassin Naga, Amaninder Dhaliwal, Dayl Ramai, Chad Cross, Shailender Singh, Ishfaq Bhat, Douglas G. Andler Sep 2020

Efficacy Of Transoral Outlet Reduction In Roux-En-Y Gastric Bypass Patients To Promote Weight Loss: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Syed Mohsin Saghir, Yassin Naga, Amaninder Dhaliwal, Dayl Ramai, Chad Cross, Shailender Singh, Ishfaq Bhat, Douglas G. Andler

School of Medicine Faculty Research

Background and study aims Transoral outlet reduction (TORe) is an endoscopic procedure used in patients with weight gain post Roux-en-Y gastric bypass (RYGB). We performed a systematic review and meta-analysis to evaluate the efficacy and safety of TORe with a full-thickness suturing device for treating patients with weight regain after RYGB. Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to March 2020). The primary outcomes assessed were technical success, absolute weight loss (AWL) and percent of total weight loss (% TWL) …


Utility Of Inflammatory Markers To Predict Adverse Outcome In Acute Pancreatitis: A Retrospective Study In A Single Academic Center, Mohamad Mubder, Banreet Dhindsa, Danny Nguyen, Syed Saghir, Chad Cross, Ranjit Makar, Gordon Ohning Jul 2020

Utility Of Inflammatory Markers To Predict Adverse Outcome In Acute Pancreatitis: A Retrospective Study In A Single Academic Center, Mohamad Mubder, Banreet Dhindsa, Danny Nguyen, Syed Saghir, Chad Cross, Ranjit Makar, Gordon Ohning

School of Medicine Faculty Research

Background/Aim: Acute pancreatitis (AP) is a commonly encountered emergency where early identification of complicated cases is important. Inflammatory markers like lymphocyte to monocyte ratio (LMR) and neutrophil to lymphocyte ratio (NLR) are simple and readily available markers. In this study, we evaluated the utility of these markers in the early identification of patients with complicated AP. Patients and Methods: All patients with a diagnosis of AP admitted to the University Medical Center in Las Vegas/Nevada between August 2015 and September 2018 were identified using ICD-10 codes. Medical records were reviewed retrospectively. Epidemiological measures and their associated confidence intervals were calculated …


Edge In Roux-En-Y Gastric Bypass: How Does It Compare To Laparoscopy-Assisted And Balloon Enteroscopy Ercp: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Amaninder Dhaliwal, Babu P. Mohan, Harmeet Singh Mashiana, Mohit Girotra, Gordon Ohning, Ishfaq Bhat, Douglas G. Adler Jan 2020

Edge In Roux-En-Y Gastric Bypass: How Does It Compare To Laparoscopy-Assisted And Balloon Enteroscopy Ercp: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Amaninder Dhaliwal, Babu P. Mohan, Harmeet Singh Mashiana, Mohit Girotra, Gordon Ohning, Ishfaq Bhat, Douglas G. Adler

School of Medicine Faculty Research

Background and study aims Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a new endoscopic procedure to perform ERCP in Roux-en-y gastric bypass (RYGB) patients. The aim of this study was to conduct a systematic review and meta-analysis to evaluate technical success, clinical success and adverse effects of EDGE and compare it to laparoscopic ERCP (LA-ERCP) and balloon ERCP (BE-ERCP). Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, LILACS, SCOPUS, and Web of Science databases to identify studies reporting on EDGE, LA-ERCP, and BE-ERCP. The primary outcome was to evaluate technical and …


Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk Dec 2019

Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk

School of Medicine Faculty Research

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe postprocedure complications. Hormonal changes during pregnancy promote cholelithiasis, but there are limited clinical data available on the outcomes of ERCP in pregnant women. ERCP techniques without irradiation were recently introduced as potential alternative. We performed a systematic review and meta-analysis to assess the safety of ERCP in pregnancy and to compare outcomes of radiation versus nonradiation ERCP. Materials and Methods: A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through April 18th, 2018 using PRISMA and MOOSE guidelines identified 27 studies reporting the …


Safety And Efficacy Of Combined Antegrade And Retrograde Endoscopic Dilation For Complete Esophageal Obstruction: A Systematic Review And Meta-Analysis, Mahendran Jayaraj, Babu P. Mohan, Harneet Mashiana, Rajesh Krishnamoorthi, Douglas G. Adler Jun 2019

Safety And Efficacy Of Combined Antegrade And Retrograde Endoscopic Dilation For Complete Esophageal Obstruction: A Systematic Review And Meta-Analysis, Mahendran Jayaraj, Babu P. Mohan, Harneet Mashiana, Rajesh Krishnamoorthi, Douglas G. Adler

School of Medicine Faculty Research

Background Complete esophageal obstruction (CEO) due to occlusive proximal stricture occurs after chemoradiation for head and neck cancers. A combined antegrade and retrograde endoscopic technique with controlled recanalization and dilation (CARD) has been shown to be an effective and safe method for regaining and maintaining esophageal luminal patency in the short term. Methods We conducted a comprehensive search of multiple electronic databases and conference proceedings, including PubMed, EMBASE, and Web of Science databases (from inception through November 2018), to identify studies that reported the outcomes of CARD. The primary outcomes were the pooled rates of technical and clinical success, specifically …


Hot Snare Vs. Cold Snare Polypectomy For Endoscopic Removal Of 4-10mm Colorectal Polyps During Colonoscopy: A Systematic Review And Meta-Analysis Of Randomized Controlled Studies, Mahendran Jayaraj May 2019

Hot Snare Vs. Cold Snare Polypectomy For Endoscopic Removal Of 4-10mm Colorectal Polyps During Colonoscopy: A Systematic Review And Meta-Analysis Of Randomized Controlled Studies, Mahendran Jayaraj

School of Medicine Faculty Research

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 was to compare incomplete resection rate (IRR) of polyps and complications using CSP vs. HSP. Methods Randomized controlled studies (RCTs) comparing CSP and HSP for removal of 4 – 10 mm colorectal polyps were considered. Studies were included in the analysis if they obtained biopsy specimens from the resection margin to confirm …


Endoscopic Retrograde Cholangiopancreatography In Cirrhosis - A Systematic Review And Meta-Analysis Focused On Adverse Events, Harmeet Singh Mashiana, Banreet Dhindsa, Ji Won Yoo, Amaninder Singh Dhaliwal, Shailender Singh, Harlan Sayles, Qing Wu, Ali A. Siddiqui, Gordon Ohning, Mohit Girotra, Douglas A. Adler Nov 2018

Endoscopic Retrograde Cholangiopancreatography In Cirrhosis - A Systematic Review And Meta-Analysis Focused On Adverse Events, Harmeet Singh Mashiana, Banreet Dhindsa, Ji Won Yoo, Amaninder Singh Dhaliwal, Shailender Singh, Harlan Sayles, Qing Wu, Ali A. Siddiqui, Gordon Ohning, Mohit Girotra, Douglas A. Adler

School of Medicine Faculty Research

AIM To investigate indications and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhotics, especially adverse events. Patients with cirrhosis undergoing ERCP are believed to have increased risk. However, there is a paucity of literature describing the indications and outcomes of ERCP procedures in patients with cirrhosis, especially focusing on adverse events. METHODS We performed a systematic appraisal of major literature databases, including PubMed and EMBASE, with a manual search of literature from their inception until April 2017. RESULTS A total of 6,505 patients from 15 studies were analyzed (male ratio 59%, mean age 59 years), 11% with alcoholic and 89% …


Comparison Of Outcomes For Supine Vs. Prone Position Ercp: A Systematic Review And Meta-Analysis, Harmeet Singh Mashiana, Mahendran Jayaraj, Babu Pappu Mohan, Gordon Ohning, Douglas G. Adler Nov 2018

Comparison Of Outcomes For Supine Vs. Prone Position Ercp: A Systematic Review And Meta-Analysis, Harmeet Singh Mashiana, Mahendran Jayaraj, Babu Pappu Mohan, Gordon Ohning, Douglas G. Adler

School of Medicine Faculty Research

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 and meta-analysis of studies reporting the comparison between the two positions for ERCP outcomes. Methods We conducted a search of electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (from inception through October 2016) to identify studies that reported the comparison of technical success and safety outcomes between supine and prone ERCP. The primary outcome was …