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ds2-5-body-sm-bold ds2-5-body-link" href="https://chavez-ucla.academia.edu/GiuliaSissa">Giulia Sissa</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Ucla</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://ufms.academia.edu/EdisBeliniJunior"><img class="profile-avatar u-positionAbsolute" alt="Edis Belini Junior" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/307160/78906/17669431/s200_edis.belini_junior.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://ufms.academia.edu/EdisBeliniJunior">Edis Belini Junior</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">UFMS - Universidade Federal de Mato Grosso do Sul</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://ferkauf.academia.edu/LidianeTorres"><img class="profile-avatar u-positionAbsolute" alt="Lidiane S Torres" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/320117/78948/25971317/s200_lidiane.de_souza_torres.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://ferkauf.academia.edu/LidianeTorres">Lidiane S Torres</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Albert Einstein College of Medicine</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a 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href="https://unipa.academia.edu/AntonioSimoneLagan%C3%A0">Antonio Simone Laganà</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Università degli Studi di Palermo</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://ui.academia.edu/NiaKurniati"><img class="profile-avatar u-positionAbsolute" alt="Nia Kurniati" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/23927933/6458103/11330777/s200_nia.kurniati.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://ui.academia.edu/NiaKurniati">Nia Kurniati</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">University of Indonesia</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://unza-zm.academia.edu/AudreyKalindi"><img class="profile-avatar u-positionAbsolute" alt="Audrey Kalindi" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/25004692/10311998/11507140/s200_audrey.kalindi.jpg_oh_993b75ee62420c33897c1089e92ee9de_oe_569c8832" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://unza-zm.academia.edu/AudreyKalindi">Audrey Kalindi</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">University of Zambia</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://ulb.academia.edu/YvonEnglert"><img class="profile-avatar u-positionAbsolute" alt="Yvon Englert" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/36079766/10625679/11860925/s200_yvon.englert.jpeg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://ulb.academia.edu/YvonEnglert">Yvon Englert</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Université libre de Bruxelles</p></div></div></ul></div><div class="ri-section"><div class="ri-section-header"><span>Interests</span></div><div class="ri-tags-container"><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="38200980" href="https://www.academia.edu/Documents/in/Sickle_Cell_Disease"><div id="js-react-on-rails-context" style="display:none" 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data-dom-id="Pill-react-component-52eaf551-cb77-47b3-a3ee-9e96927d44f1"></div> <div id="Pill-react-component-52eaf551-cb77-47b3-a3ee-9e96927d44f1"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="38200980" href="https://www.academia.edu/Documents/in/Pediatric"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Pediatric"]}" data-trace="false" data-dom-id="Pill-react-component-11c4c61c-9e0b-4dec-a2bb-68c1b56a29cb"></div> <div id="Pill-react-component-11c4c61c-9e0b-4dec-a2bb-68c1b56a29cb"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="38200980" href="https://www.academia.edu/Documents/in/Obstetrics_and_gynecology"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Obstetrics and gynecology"]}" data-trace="false" data-dom-id="Pill-react-component-f97eb0fa-abef-4211-aaab-645de0190136"></div> <div id="Pill-react-component-f97eb0fa-abef-4211-aaab-645de0190136"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="38200980" href="https://www.academia.edu/Documents/in/Sickle_Cell_Anemia"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Sickle Cell Anemia"]}" data-trace="false" data-dom-id="Pill-react-component-7f507890-cf74-4ee0-8d44-df64af51977f"></div> <div id="Pill-react-component-7f507890-cf74-4ee0-8d44-df64af51977f"></div> </a></div></div></div></div><div class="right-panel-container"><div class="user-content-wrapper"><div class="uploads-container" id="social-redesign-work-container"><div class="upload-header"><h2 class="ds2-5-heading-sans-serif-xs">Uploads</h2></div><div class="documents-container backbone-social-profile-documents" style="width: 100%;"><div class="u-taCenter"></div><div class="profile--tab_content_container js-tab-pane tab-pane active" id="all"><div class="profile--tab_heading_container js-section-heading" data-section="Papers" id="Papers"><h3 class="profile--tab_heading_container">Papers by Richard Kozarek</h3></div><div class="js-work-strip profile--work_container" data-work-id="126979518"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/126979518/New_Generation_of_Esophageal_Stents_Early_North_American_Experience_Managing_Obstructing_Esophageal_Cancers_Esophageal_Perforations_and_Tracheoesophageal_Fistula"><img alt="Research paper thumbnail of New Generation of Esophageal Stents: Early North American Experience Managing Obstructing Esophageal Cancers, Esophageal Perforations and Tracheoesophageal Fistula" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/126979518/New_Generation_of_Esophageal_Stents_Early_North_American_Experience_Managing_Obstructing_Esophageal_Cancers_Esophageal_Perforations_and_Tracheoesophageal_Fistula">New Generation of Esophageal Stents: Early North American Experience Managing Obstructing Esophageal Cancers, Esophageal Perforations and Tracheoesophageal Fistula</a></div><div class="wp-workCard_item"><span>The American Journal of Gastroenterology</span><span>, Oct 1, 2010</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper 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WowProfile.WorkStripView({ el: this, workJSON: {"id":126979518,"title":"New Generation of Esophageal Stents: Early North American Experience Managing Obstructing Esophageal Cancers, Esophageal Perforations and Tracheoesophageal Fistula","internal_url":"https://www.academia.edu/126979518/New_Generation_of_Esophageal_Stents_Early_North_American_Experience_Managing_Obstructing_Esophageal_Cancers_Esophageal_Perforations_and_Tracheoesophageal_Fistula","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433521"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433521/Primary_and_metastatic_melanoma_of_the_GI_tract_clinical_presentation_endoscopic_findings_and_patient_outcomes"><img alt="Research paper thumbnail of Primary and metastatic melanoma of the GI tract: clinical presentation, endoscopic findings, and patient outcomes" class="work-thumbnail" src="https://attachments.academia-assets.com/118659665/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433521/Primary_and_metastatic_melanoma_of_the_GI_tract_clinical_presentation_endoscopic_findings_and_patient_outcomes">Primary and metastatic melanoma of the GI tract: clinical presentation, endoscopic findings, and patient outcomes</a></div><div class="wp-workCard_item"><span>Surgical Endoscopy and Other Interventional Techniques</span><span>, Oct 28, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background and aims Melanoma incidence has increased worldwide with a concurrent rise in both pri...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background and aims Melanoma incidence has increased worldwide with a concurrent rise in both primary and metastatic melanomas of the gastrointestinal tract. Materials and methods This retrospective single-center case series includes patients with histopathology-confirmed primary or metastatic melanoma of the GI tract between 1998 and 2018. Results Thirty-four patients were identified for inclusion, of whom 7 were primary and 27 were metastatic cases of gastrointestinal melanoma. For both primary and metastatic cases, the majority of patients presented with frank or occult GI bleeding (57.1% and 70.4%). Primary and metastatic lesions were predominantly diagnosed endoscopically (100% and 63.0%), with 71.4% of primary lesions found at the anorectal junction and 51.9% of metastatic lesions in the small bowel. Endoscopically diagnosed lesions were either polypoid (50%) or a luminal mass (37.5%) in the majority of cases. Common features included: amelanotic (83%), ulcerated (50%), and friable (33.3%). All primary patients were treated with surgical excision or resection. Of the metastatic patients, 56% were resected. The median interval between initial primary and gastrointestinal metastases was 65 months (ranging from 1 month to 24 years). At the time of data analysis, 85.7% of primary and 29.6% of metastatic patients remained alive. Conclusions The majority of patients in this series were diagnosed endoscopically while investigating a source of gastrointestinal blood loss. Heightened clinical suspicion and recognition of the endoscopic features of gastrointestinal melanoma during evaluation of GI symptoms in a patient with a personal history of primary melanoma are advised.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a98a18c9d38b6747bc84751f48cc849d" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659665,"asset_id":124433521,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659665/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433521"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433521"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433521; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433520"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433520/Impact_of_endoscopic_assessment_and_treatment_on_operative_and_non_operative_management_of_acute_oesophageal_perforation"><img alt="Research paper thumbnail of Impact of endoscopic assessment and treatment on operative and non-operative management of acute oesophageal perforation" class="work-thumbnail" src="https://attachments.academia-assets.com/118659660/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433520/Impact_of_endoscopic_assessment_and_treatment_on_operative_and_non_operative_management_of_acute_oesophageal_perforation">Impact of endoscopic assessment and treatment on operative and non-operative management of acute oesophageal perforation</a></div><div class="wp-workCard_item"><span>British Journal of Surgery</span><span>, Mar 29, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Surgeons have not typically utilized an endoscopic approach for diagnosis and managem...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Surgeons have not typically utilized an endoscopic approach for diagnosis and management of acute oesophageal perforation, mainly due to fears of increased mediastinal contamination. This study assessed the evolution of endoscopic approaches and their effect on outcomes over time in acute oesophageal perforation. Methods: All patients with documented acute oesophageal perforation between 1990 and 2009 were enrolled prospectively in an Institutional Review Board-approved database. Results: Of 81 patients who presented during the study period, 52 had upper gastrointestinal endoscopy for diagnosis alone (12 patients; 23 per cent) or as a component of acute management (40 patients; 77 per cent). Use of endoscopy increased from four of 13 patients in the first 5 years of the study to 20 of 24 patients in the final 5 years. Endoscopy was used in conjunction with surgery in 28 patients, of whom 21 underwent primary repair, three had resection, and one a diversion; 12 patients in this group had hybrid operations (combination of surgical and endoscopic management). Primary endoscopic treatment was used in 15 patients (29 per cent), most commonly involving stent placement (7). Of those having endoscopy, complication rates improved (from 3 of 4 to 8 of 20 patients), as did mean length of stay (from 21•8 to 13•4 days) between the initial and final 5 years of the study. There were two deaths (4 per cent). Of 21 patients who had both endoscopic assessment and management in the operating room, endoscopy identified additional pathology in ten, leading to a change in management plan in five patients. Conclusion: Endoscopy is a safe and important component of the management of acute oesophageal perforation. It provides additional information that modifies treatment, and its wider use should result in improved outcomes.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="65ac8c7880a3a4e3722baf0679c17cc3" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659660,"asset_id":124433520,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659660/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433520"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433520"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433520; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433520]").text(description); $(".js-view-count[data-work-id=124433520]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433520; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433520']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "65ac8c7880a3a4e3722baf0679c17cc3" } } $('.js-work-strip[data-work-id=124433520]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433520,"title":"Impact of endoscopic assessment and treatment on operative and non-operative management of acute oesophageal perforation","internal_url":"https://www.academia.edu/124433520/Impact_of_endoscopic_assessment_and_treatment_on_operative_and_non_operative_management_of_acute_oesophageal_perforation","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[{"id":118659660,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/118659660/thumbnails/1.jpg","file_name":"bjs7437.pdf","download_url":"https://www.academia.edu/attachments/118659660/download_file","bulk_download_file_name":"Impact_of_endoscopic_assessment_and_trea.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/118659660/bjs7437-libre.pdf?1728107582=\u0026response-content-disposition=attachment%3B+filename%3DImpact_of_endoscopic_assessment_and_trea.pdf\u0026Expires=1740158030\u0026Signature=JxATi4r1dEYfSWUHfVSfo4l0tnoURALkyB-zTTYphzTFMWk2-t6uLkwqjbJYY87ddVXzQ~~YKzto~Q~usMXHyOnMGS-tFFmz8ZUpf8ix0nk1VzvDcHq3pxV~3sDs4a-JYRYkxfBLnJXQmREC0KzmF1MKgHg-WvgxEPgcOF-4~B83piHwJi0FjNvsB7NqGYE0rh4UZ92QyZ9osdY-96ihp5YAv7lfZQ7jLcl5M3qPQhhzVY0s7mjTPTdZojQ~JwJVmQR8zfJmuYoa0I46Bjgmx27rzoLxBe6Xkh-Q~8YNZiD6w6eAEdHlL1tqDD6nMG-gX4RNBCK-OPYJajSS4S-TQQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433519"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433519/Effectiveness_and_safety_of_EUS_guided_choledochoduodenostomy_using_lumen_apposing_metal_stents_LAMS_a_systematic_review_and_meta_analysis"><img alt="Research paper thumbnail of Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis" class="work-thumbnail" src="https://attachments.academia-assets.com/118659663/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433519/Effectiveness_and_safety_of_EUS_guided_choledochoduodenostomy_using_lumen_apposing_metal_stents_LAMS_a_systematic_review_and_meta_analysis">Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis</a></div><div class="wp-workCard_item"><span>Surgical Endoscopy and Other Interventional Techniques</span><span>, Mar 5, 2020</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background Endoscopic ultrasound-guided choledochoduodenostomy (CDD) is emerging as an alternativ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background Endoscopic ultrasound-guided choledochoduodenostomy (CDD) is emerging as an alternative technique for biliary drainage in patients who fail conventional endoscopic retrograde cholangiopancreatography (ERCP). The lumenapposing metal stents (LAMS) are being increasingly used for CDD. We performed a systematic review and meta-analysis to evaluate the effectiveness and safety of CDD using LAMS. Methods We performed a systematic search of multiple databases through May 2019 to identify studies on CDD using covered self-expanding metal stents. Pooled rates of technical success, clinical success, adverse events, and recurrent jaundice associated with CDD using LAMS were estimated. A subgroup analysis was performed based on use of LAMS with electrocautery-enhanced delivery system (EC-LAMS). Results Seven studies on CDD using LAMS (with 284 patients) were included in the meta-analysis. Pooled rates of technical and clinical success (per-protocol analysis) were 95.7% (95% CI 93.2-98.1) and 95.9% (95% CI 92.8-98.9), respectively. Pooled rate of post-procedure adverse events was 5.2% (95% CI 2.6-7.9). Pooled rate of recurrent jaundice was 8.7% (95% CI 4.5-12.8). On subgroup analysis of CDD using EC-LAMS (5 studies with 201 patients), the pooled rates of technical and clinical success (per-protocol analysis) were 93.8% (95% CI 90.4-97.1) and 95.9% (95% CI 91.9-99.9), respectively. Pooled rate of post-procedure adverse events was 5.6% (95% CI 1.7-9.5). Pooled rate of recurrent jaundice was 11.3% (95% CI 6.9-15.7). Heterogeneity (I 2) was low to moderate in the analyses. Conclusion CDD using LAMS/EC-LAMS is an effective and safe technique for biliary decompression in patients who failed ERCP. Further studies are needed to assess CDD using LAMS as primary treatment modality for biliary obstruction. Keywords LAMS-lumen-apposing metal stents • EC-LAMS-electro-cautery-enhanced LAMS • Malignant biliary obstruction • Technical and clinical success • Adverse events In patients with malignant biliary obstruction, endoscopic retrograde cholangiopancreatography (ERCP) is the first line management to restore biliary drainage [1]. When biliary cannulation fails with conventional ERCP, percutaneous transhepatic biliary drainage (PTBD) performed by and Other Interventional Techniques Rajesh Krishnamoorthi and Chandra S. Dasari shares co-first authorship Electronic supplementary material The online version of this article (</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="4ada324cf615392542eb8d78c6f25ebf" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659663,"asset_id":124433519,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659663/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433519"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433519"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433519; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433515"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433515/Effectiveness_and_Safety_of_EUS_Rendezvous_After_Failed_Biliary_Cannulation_With_ERCP"><img alt="Research paper thumbnail of Effectiveness and Safety of EUS Rendezvous After Failed Biliary Cannulation With ERCP" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433515/Effectiveness_and_Safety_of_EUS_Rendezvous_After_Failed_Biliary_Cannulation_With_ERCP">Effectiveness and Safety of EUS Rendezvous After Failed Biliary Cannulation With ERCP</a></div><div class="wp-workCard_item"><span>Journal of Clinical Gastroenterology</span><span>, Apr 9, 2021</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Endoscopic ultrasound–guided rendezvous (EUS-RV) endoscopic retrograde cholangiopancr...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Endoscopic ultrasound–guided rendezvous (EUS-RV) endoscopic retrograde cholangiopancreatography (ERCP) is an alternative to interventional radiology–guided rendezvous ERCP in patients who failed biliary cannulation with conventional ERCP. However, there is significant variation in reported rates of success and adverse events associated with EUS-RV-assisted ERCP. We performed a systematic review and a proportion meta-analysis to reliably assess the effectiveness and safety of the EUS-RV-assisted ERCP. Materials and Methods: We conducted a comprehensive search of multiple electronic databases and conference proceedings (from inception through August 2020) to identify studies reporting EUS-RV-assisted ERCP in patients who failed biliary cannulation with conventional ERCP techniques. Using the random-effects model described by DerSimonian and Laird, we calculated the pooled rates of technical success, clinical success, and adverse events of EUS-RV-assisted ERCP. Results: Twelve studies reporting a total of 342 patients were included in the meta-analysis. The pooled rate of technical success (12 studies reporting a total of 342 patients) was 86.1% [95% confidence interval (CI): 78.4-91.3]. The pooled rate of clinical success (4 studies reporting a total of 94 patients) was 80.8% (95% CI: 64.1-90.8). The pooled rate of overall adverse events (12 studies; 42 events in 342 patients) was 14% (95% CI: 10.5-18.4). Low to moderate heterogeneity was noted in the analyses. Conclusions: EUS-RV-assisted ERCP appears to be effective and safe in patients who failed biliary cannulation with conventional ERCP. Given the risk of adverse events, it should be performed in centers with expertise in therapeutic endoscopic ultrasound.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433515"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433515"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433515; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433515]").text(description); 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dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=124433512]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433512,"title":"Cholangitis","internal_url":"https://www.academia.edu/124433512/Cholangitis","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433511"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433511/Mo1149_DIFFERENCES_IN_LOWER_GASTROINTESTINAL_BLEEDING_MANAGEMENT_AND_OUTCOMES_OVER_A_10_YEAR_SPAN"><img alt="Research paper thumbnail of Mo1149 DIFFERENCES IN LOWER GASTROINTESTINAL BLEEDING MANAGEMENT AND OUTCOMES OVER A 10 YEAR SPAN" class="work-thumbnail" src="https://attachments.academia-assets.com/118659661/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433511/Mo1149_DIFFERENCES_IN_LOWER_GASTROINTESTINAL_BLEEDING_MANAGEMENT_AND_OUTCOMES_OVER_A_10_YEAR_SPAN">Mo1149 DIFFERENCES IN LOWER GASTROINTESTINAL BLEEDING MANAGEMENT AND OUTCOMES OVER A 10 YEAR SPAN</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Jun 1, 2018</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Introduction: Gastrointestinal (GI) hemorrhage is a common complication in patients with cerebrov...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Introduction: Gastrointestinal (GI) hemorrhage is a common complication in patients with cerebrovascular accidents. Reported incidence has ranged from 1% to 8% in several published studies. We studied a national inpatient database to assess the effects of GI endoscopy on mortality and length of hospital stay among patients with acute stroke. Methods: We analyzed the National Inpatient Sample (NIS) database from 2008-2012. Patients with primary or secondary diagnosis of cerebrovascular accident (CVA) were identified via ICD-9 diagnosis code and the database was further subdivided into cases with discharge diagnosis of concurrent gastrointestinal bleeding. Outcomes of the patients who underwent upper GI endoscopy or colonoscopy were compared to the ones who did not receive either procedure by utilizing bivariate analysis via Chi-square test and multivariate logistic regression. Statistical analysis was performed by SPSS Statistical software v25.0 (IBM Corp, Chicago, Illinois). Results: 804,302 patients with primary or secondary discharge diagnosis of stroke were identified, out of which 10,269 (1.3%) had concurrent gastrointestinal hemorrhage. Among these patients, 3219 (31.3%) underwent endoscopic evaluation via either upper GI endoscopy or colonoscopy. Patients who underwent endoscopic evaluation experienced lower in-hospital mortality compared to patients who did not undergo endoscopic evaluation (Adjusted Odds Ratio: 0.397 95% CI: 0.342-0.459, p<0.001) when controlling for the cofounding effects of age, gender, race, number of chronic conditions, length of hospital stay, presence of critical illness requiring mechanical ventilation and admission type. Conclusion: Approximately one third of the patients admitted with cerebrovascular stroke with concurrent gastrointestinal bleed underwent endoscopy during their hospitalization. Patients undergoing endoscopy had a relatively low mortality rate. This association persisted even after controlling for possible cofounding factors. Further research is needed to understand the benefits of endoscopy in patients with CVA and concurrent GI bleed. Reference:</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="ce02ffedb2cb159b5bbcfef5f7e556aa" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659661,"asset_id":124433511,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659661/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433511"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433511"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433511; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433511]").text(description); $(".js-view-count[data-work-id=124433511]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433511; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433511']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "ce02ffedb2cb159b5bbcfef5f7e556aa" } } $('.js-work-strip[data-work-id=124433511]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433511,"title":"Mo1149 DIFFERENCES IN LOWER GASTROINTESTINAL BLEEDING MANAGEMENT AND OUTCOMES OVER A 10 YEAR SPAN","internal_url":"https://www.academia.edu/124433511/Mo1149_DIFFERENCES_IN_LOWER_GASTROINTESTINAL_BLEEDING_MANAGEMENT_AND_OUTCOMES_OVER_A_10_YEAR_SPAN","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[{"id":118659661,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/118659661/thumbnails/1.jpg","file_name":"j.gie.2018.04.191020241005-1-82pfx7.pdf","download_url":"https://www.academia.edu/attachments/118659661/download_file","bulk_download_file_name":"Mo1149_DIFFERENCES_IN_LOWER_GASTROINTEST.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/118659661/j.gie.2018.04.191020241005-1-82pfx7-libre.pdf?1728107583=\u0026response-content-disposition=attachment%3B+filename%3DMo1149_DIFFERENCES_IN_LOWER_GASTROINTEST.pdf\u0026Expires=1740158031\u0026Signature=OkDWBq1ofx-fcIamFVdpd8ilXG9HlYLyeqzTkw4R8y1Onj74mjwaYVkU8iNfYYy4oUGYkRJLa9j9CZkq4B4jDXpwIA4eccpHIA0ZsXNdqDe4Il1aOgNsARffEv9NHU9gCPBNVdEZL8tEcPzyfI17tw~a9dLpVuErc2pINGk8IBqf3Q5Btlc8KgeaLjIMWr4mzVJ~xbAJR36DSykenZ2JU8F0lDkAUQ36Vqx1k8tTQ6P1yshoIijwizmVOaaq62K0wJmNQgACzSObUCO~aMqTih~FTUh2gPmnFHa7rnQF3BxzraXPC--7~bkPjSKITzWCqD8RLt73vagO2JpA8B-9ug__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433509"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433509/Melanoma_Involving_the_Gastrointestinal_GI_Tract_Single_Center_Large_Case_Series"><img alt="Research paper thumbnail of Melanoma Involving the Gastrointestinal (GI) Tract: Single Center Large Case Series" class="work-thumbnail" src="https://attachments.academia-assets.com/118659657/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433509/Melanoma_Involving_the_Gastrointestinal_GI_Tract_Single_Center_Large_Case_Series">Melanoma Involving the Gastrointestinal (GI) Tract: Single Center Large Case Series</a></div><div class="wp-workCard_item"><span>Gastroenterology</span><span>, Apr 1, 2017</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">had a new diagnosis of colorectal neoplasia. Microbiology reports advised of the association betw...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">had a new diagnosis of colorectal neoplasia. Microbiology reports advised of the association between S. bovis and colorectal neoplasia in 61% (23) of cases. Conclusions: Colorectal neoplasia was frequent in this population of patients with S. bovis bacteraemia, consistent with other studied cohorts. A large proportion (10 of 12 cases) of disease found was either invasive malignancy, or adenomatous polyps with a high risk of malignant transformation based on size (>10mm). We suggest that any patient with S. bovis bacteraemia who is well enough, should be assessed by colonoscopy as the gold standard investigation to detect colorectal neoplasia, and that microbiology reports should systematically report on this association, to ensure that patients are offered timely investigations to detect often asymptomatic colorectal neoplasia.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="8c8cfd164bb966fbbc01368630fdbffb" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659657,"asset_id":124433509,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659657/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433509"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433509"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433509; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433508"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433508/Sa1469_ERCP_WITH_OVERTUBE_ASSISTED_ENTEROSCOPY_IN_PATIENTS_WITH_ROUX_EN_Y_GASTRIC_BYPASS_ANATOMY_A_SYSTEMATIC_REVIEW_AND_META_ANALYSIS"><img alt="Research paper thumbnail of Sa1469 ERCP WITH OVERTUBE-ASSISTED ENTEROSCOPY IN PATIENTS WITH ROUX-EN-Y GASTRIC BYPASS ANATOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS" class="work-thumbnail" src="https://attachments.academia-assets.com/118659656/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433508/Sa1469_ERCP_WITH_OVERTUBE_ASSISTED_ENTEROSCOPY_IN_PATIENTS_WITH_ROUX_EN_Y_GASTRIC_BYPASS_ANATOMY_A_SYSTEMATIC_REVIEW_AND_META_ANALYSIS">Sa1469 ERCP WITH OVERTUBE-ASSISTED ENTEROSCOPY IN PATIENTS WITH ROUX-EN-Y GASTRIC BYPASS ANATOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Jun 1, 2019</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="b33ebae68876e7828c6488c500f80b30" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659656,"asset_id":124433508,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659656/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433508"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433508"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433508; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433507"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433507/Mo1680_SPRAY_COAGULATION_TO_MANAGE_REMNANT_POLYP_DURING_EMR_OF_DIFFICULT_COLORECTAL_POLYPS"><img alt="Research paper thumbnail of Mo1680 SPRAY COAGULATION TO MANAGE REMNANT POLYP DURING EMR OF DIFFICULT COLORECTAL POLYPS" class="work-thumbnail" src="https://attachments.academia-assets.com/118659658/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433507/Mo1680_SPRAY_COAGULATION_TO_MANAGE_REMNANT_POLYP_DURING_EMR_OF_DIFFICULT_COLORECTAL_POLYPS">Mo1680 SPRAY COAGULATION TO MANAGE REMNANT POLYP DURING EMR OF DIFFICULT COLORECTAL POLYPS</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Jun 1, 2020</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">duration of time between index and surveillance exams, diabetes, smoking history, and body mass i...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">duration of time between index and surveillance exams, diabetes, smoking history, and body mass index. Conclusion: The majority of participants with LRAs at baseline did not develop HRAs between colonoscopies, supporting a longer surveillance interval. No participants developed colon cancer. Although the current recommended interval is 5-10 years, <10% had a surveillance recommendation of 10 years. Many were told to follow up before 5 years. The findings support the current guidelines of performing a surveillance exam after 5-10 years and suggest that there is low risk in waiting to perform a surveillance exam until closer to the 10 year mark.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="eb30094ee0437f47ded00908a7282a40" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659658,"asset_id":124433507,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659658/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433507"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433507"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433507; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433506"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433506/875_Efficacy_and_Safety_of_Endoscopic_Ultrasound_EUS_Guided_Gastroenterostomy_GE_A_Systematic_Review_and_Meta_Analysis"><img alt="Research paper thumbnail of 875 Efficacy and Safety of Endoscopic Ultrasound (EUS) Guided Gastroenterostomy (GE): A Systematic Review and Meta-Analysis" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433506/875_Efficacy_and_Safety_of_Endoscopic_Ultrasound_EUS_Guided_Gastroenterostomy_GE_A_Systematic_Review_and_Meta_Analysis">875 Efficacy and Safety of Endoscopic Ultrasound (EUS) Guided Gastroenterostomy (GE): A Systematic Review and Meta-Analysis</a></div><div class="wp-workCard_item"><span>The American Journal of Gastroenterology</span><span>, Oct 1, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">INTRODUCTION: Endoscopic ultrasound (EUS) guided gastroenterostomy (GE) is emerging as an alterna...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">INTRODUCTION: Endoscopic ultrasound (EUS) guided gastroenterostomy (GE) is emerging as an alternative to enteral stenting and surgical GE for management of malignant gastric outlet obstruction (GOO). With advances in EUS technology and availability of dedicated devices/stents for EUS scopes, the use of EUS-GE is expected to increase in the future. We performed a systematic review and meta-analysis to estimate the success rate and adverse events associated with EUS-GE. METHODS: We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (from inception through May 2019) to identify studies that reported success rate and adverse events of EUS-GE. The primary outcome was to estimate the pooled rates of technical and clinical success of EUS-GE. The secondary outcome was to estimate the rate of adverse events. RESULTS: 9 studies with a total of 268 patients were included. The pooled rate of technical success of EUS-GE was 91.7 % (95% CI 87.5 – 94.5; I2 = 0). The pooled rate of clinical success of EUS-GJ was 87.8% (95% CI 83.1 – 91.3; I2 = 0). The pooled rate of overall adverse events was 12.6% (95% CI 9.0- 17.6; I2 = 0). The pooled rate of individual adverse events – perforation, bleeding, peritonitis and stent migration / misdeployment were 2% (95% CI 0.7 – 5.1), 3.2% (95% CI 1.5 – 6.5), 2.6% (95% CI 1.1-6.1) and 8.9 % (95% CI 4.3-17.5) respectively.The rate of surgical intervention for adverse events was 2%. CONCLUSION: While the rates of technical success (92%) and clinical success (88%) of EUS-GJ is promising, the risk of adverse events is considerable at 12.6%, with stent misdeployment (9%) being the most common adverse event. Hence, EUS-GJ should be performed at tertiary referral centers in a multidisciplinary (surgery, oncology, gastroenterology) team-based approach.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433506"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433506"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433506; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); 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</script> <div class="js-work-strip profile--work_container" data-work-id="124433505"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433505/Risk_Stratification_for_Proximal_Colon_Neoplasia_Using_Age_Gender_Family_History_and_Distal_Colon_Findings"><img alt="Research paper thumbnail of Risk Stratification for Proximal Colon Neoplasia Using Age, Gender, Family History and Distal Colon Findings" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433505/Risk_Stratification_for_Proximal_Colon_Neoplasia_Using_Age_Gender_Family_History_and_Distal_Colon_Findings">Risk Stratification for Proximal Colon Neoplasia Using Age, Gender, Family History and Distal Colon Findings</a></div><div class="wp-workCard_item"><span>The American Journal of Gastroenterology</span><span>, Oct 1, 2004</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433505"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433505"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433505; 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</script> <div class="js-work-strip profile--work_container" data-work-id="124433504"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433504/Papillectomy_and_Ampullectomy"><img alt="Research paper thumbnail of Papillectomy and Ampullectomy" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433504/Papillectomy_and_Ampullectomy">Papillectomy and Ampullectomy</a></div><div class="wp-workCard_item"><span>Elsevier eBooks</span><span>, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Abstract Ampullary neoplasms (benign and malignant) are rare, with a reported prevalence of less ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Abstract Ampullary neoplasms (benign and malignant) are rare, with a reported prevalence of less than 0.1% in autopsy series. Other etiologies such as papillitis, gastric foveolar metaplasia, and pancreatic acinar hyperplasia can also lead to enlarged or abnormal papillae. Ampullary tumors can arise from epithelium (e.g., adenomas, adenocarcinomas, lymphomas) or the subepithelium (e.g., neuroendocrine tumors, lipomas). The incidence of ampullary adenomas is increased two- to threefold in genetic polyposis syndromes. 4 Early lesions are often asymptomatic, while larger lesions can cause obstruction, presenting with cholestasis, cholangitis, and pancreatitis. Although some authors perform endoscopic ultrasound (EUS) on all lesions, many perform EUS only for worrisome features such as weight loss, jaundice, and lesions larger than 2 cm. After performing pancreatography and cholangiography, snare excision is performed, ideally without saline injection and en bloc, if feasible. Preresection sphincterotomy and stent placement are not routinely performed, while postresection sphincterotomy is usually performed unless there is a concern it might lead to perforation. Postresection pancreatic stenting is recommended due to the high risk of post-ERCP pancreatitis, but biliary stenting is performed based on perceived poor biliary drainage after the papillectomy. The most common adverse events of papillectomy include pancreatitis and bleeding. Postpapillectomy surveillance should be performed 3 months following resection, and once confirmed to be completely removed, continued surveillance should be considered as frequently as every 6 months for the subsequent 2 years. Complete tumor eradication rates of 80% or more are reported in larger series. Surgery is usually recommended for treatment of operative patients who have lesions that harbor invasive cancer.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433504"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433504"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433504; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433504]").text(description); $(".js-view-count[data-work-id=124433504]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433504; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433504']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=124433504]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433504,"title":"Papillectomy and Ampullectomy","internal_url":"https://www.academia.edu/124433504/Papillectomy_and_Ampullectomy","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433503"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433503/Soft_self_expandable_metal_stent_to_treat_painful_pancreatic_duct_strictures_secondary_to_chronic_pancreatitis_a_prospective_multicenter_trial"><img alt="Research paper thumbnail of Soft self-expandable metal stent to treat painful pancreatic duct strictures secondary to chronic pancreatitis: a prospective multicenter trial" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433503/Soft_self_expandable_metal_stent_to_treat_painful_pancreatic_duct_strictures_secondary_to_chronic_pancreatitis_a_prospective_multicenter_trial">Soft self-expandable metal stent to treat painful pancreatic duct strictures secondary to chronic pancreatitis: a prospective multicenter trial</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Mar 1, 2023</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background and Aims:Fully covered self-expandable metal stents (FCSEMSs) may offer a treatment op...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background and Aims:Fully covered self-expandable metal stents (FCSEMSs) may offer a treatment option for pain associated with a dilated pancreatic duct (PD) in chronic pancreatitis (CP), but optimal patient selection and FCSEMS design, efficacy, and safety remain uncertain. We studied an investigational pancreatic FCSEMS for treatment of CP-associated pain.Methods:Patients with painful CP, a dominant distal PD stricture, and PD dilation upstream were enrolled in a prospective, multicenter, single-arm trial studying 6-month indwell of a 4- to 6-cm-long soft pancreatic FCSEMS. Primary efficacy and safety endpoints were pain reduction 6 months after FCSEMS indwell (performance goal ≥53%) and PD stenting–related serious adverse events (SAEs), respectively (performance goal <32%). The primary efficacy endpoint was assessed in patients with sufficiently severe and frequent pain at FCSEMS placement as a first stent or in exchange of a plastic stent.Results:Among 67 patients (mean age, 52.7 ± 12.5 years; mean time since CP diagnosis, 6.4 ± 6.4 years), 34 (50.7%) had plastic stent placement within 90 days of FCSEMS placement, and 46 patients were eligible for the primary efficacy endpoint analysis. Technical success was 97.0% (65/67). The observed primary efficacy (26.1%, 12/46) and safety endpoints (31.3%, 21/67) failed to meet the a priori study hypotheses. Study stent migration occurred in 47.7% of patients (31/65).Conclusions:Six-month treatment with an FCSEMS did not lead to an expected degree of pain reduction, and migrations and SAEs were common. Further study is needed to clarify optimal decompressive strategy, FCSEMS design, and patient selection. (Clinical trial registration number: NCT02802020.)</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433503"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433503"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433503; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433503]").text(description); $(".js-view-count[data-work-id=124433503]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433503; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433503']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=124433503]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433503,"title":"Soft self-expandable metal stent to treat painful pancreatic duct strictures secondary to chronic pancreatitis: a prospective multicenter trial","internal_url":"https://www.academia.edu/124433503/Soft_self_expandable_metal_stent_to_treat_painful_pancreatic_duct_strictures_secondary_to_chronic_pancreatitis_a_prospective_multicenter_trial","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433502"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433502/Endoscopic_suturing_of_a_large_type_I_duodenal_perforation"><img alt="Research paper thumbnail of Endoscopic suturing of a large type I duodenal perforation" class="work-thumbnail" src="https://attachments.academia-assets.com/118659655/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433502/Endoscopic_suturing_of_a_large_type_I_duodenal_perforation">Endoscopic suturing of a large type I duodenal perforation</a></div><div class="wp-workCard_item"><span>VideoGIE</span><span>, Feb 1, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">An 83-year-old man with an 18-month history of a previously assumed benign duodenal stricture and...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">An 83-year-old man with an 18-month history of a previously assumed benign duodenal stricture and relapsing pancreatitis was transferred from an outside hospital with new-onset obstructive jaundice. His medical history included heart failure, atrial fibrillation for which warfarin was prescribed, and a pacemaker. CT of the abdomen demonstrated biliary and pancreatic duct dilation, multiple peripancreatic lymph nodes, and a possible small lesion in the periampullary area (Fig. 1). EUS demonstrated thickening of the distal common bile duct without an obvious mass to biopsy when observed from the duodenal bulb (Fig. 2). Because the diameter of the duodenal stenosis at the turn from the bulb to the second portion of the duodenum was about 3 mm to 4 mm, the echoendoscope could not pass through the stricture; therefore, the echoendoscope was switched to a standard gastroscope, but that too was unable to traverse the stricture. The duodenoscope was reinserted with intention to dilate the stricture and to perform ERCP. Dilatation of the duodenal stricture to 15 mm (Fig. 3) resulted in a local perforation (Fig. 4).</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="138fd20edb10046e85148196c0a27d2e" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659655,"asset_id":124433502,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659655/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433502"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433502"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433502; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433502]").text(description); $(".js-view-count[data-work-id=124433502]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433502; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433502']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "138fd20edb10046e85148196c0a27d2e" } } $('.js-work-strip[data-work-id=124433502]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433502,"title":"Endoscopic suturing of a large type I duodenal perforation","internal_url":"https://www.academia.edu/124433502/Endoscopic_suturing_of_a_large_type_I_duodenal_perforation","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[{"id":118659655,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/118659655/thumbnails/1.jpg","file_name":"main.PMC6362276.pdf","download_url":"https://www.academia.edu/attachments/118659655/download_file","bulk_download_file_name":"Endoscopic_suturing_of_a_large_type_I_du.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/118659655/main.PMC6362276-libre.pdf?1728107585=\u0026response-content-disposition=attachment%3B+filename%3DEndoscopic_suturing_of_a_large_type_I_du.pdf\u0026Expires=1740158031\u0026Signature=a3dA-XffnPlg0JWJ2~QwOTx6zWKKeMsCOS-vrwJH46rXqaI7uWL23oHEyVyVw2NVcXByvNSRBqY6~2DjEPJhQmjnkfRXDKl4jy~n9PSOJTzalUaWOCWW5G4-~W7~~RbXHBFEycDET9xbIsxilfmmbnqF07SAa6HuGi1-4p8AhJeAYUMcnuMC-jE4gVtDVCqTia5E4NSz9FpvfK5--1BHn5oGHO5w5~MvPZcIemjgo8HJhrkQMvSxij~0FwEXlH1jkidGIdeTZsEVNVfvG7EGdnlJCW41CMobqnBBDCA84SNeBvV0HJNXMrqEod5MD2HKPU9vjEmp8sWePcUWfChJtw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> </div><div class="profile--tab_content_container js-tab-pane tab-pane" data-section-id="4002514" id="papers"><div class="js-work-strip profile--work_container" data-work-id="126979518"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/126979518/New_Generation_of_Esophageal_Stents_Early_North_American_Experience_Managing_Obstructing_Esophageal_Cancers_Esophageal_Perforations_and_Tracheoesophageal_Fistula"><img alt="Research paper thumbnail of New Generation of Esophageal Stents: Early North American Experience Managing Obstructing Esophageal Cancers, Esophageal Perforations and Tracheoesophageal Fistula" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/126979518/New_Generation_of_Esophageal_Stents_Early_North_American_Experience_Managing_Obstructing_Esophageal_Cancers_Esophageal_Perforations_and_Tracheoesophageal_Fistula">New Generation of Esophageal Stents: Early North American Experience Managing Obstructing Esophageal Cancers, Esophageal Perforations and Tracheoesophageal Fistula</a></div><div class="wp-workCard_item"><span>The American Journal of Gastroenterology</span><span>, Oct 1, 2010</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="126979518"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="126979518"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 126979518; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=126979518]").text(description); $(".js-view-count[data-work-id=126979518]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 126979518; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='126979518']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=126979518]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":126979518,"title":"New Generation of Esophageal Stents: Early North American Experience Managing Obstructing Esophageal Cancers, Esophageal Perforations and Tracheoesophageal Fistula","internal_url":"https://www.academia.edu/126979518/New_Generation_of_Esophageal_Stents_Early_North_American_Experience_Managing_Obstructing_Esophageal_Cancers_Esophageal_Perforations_and_Tracheoesophageal_Fistula","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433521"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433521/Primary_and_metastatic_melanoma_of_the_GI_tract_clinical_presentation_endoscopic_findings_and_patient_outcomes"><img alt="Research paper thumbnail of Primary and metastatic melanoma of the GI tract: clinical presentation, endoscopic findings, and patient outcomes" class="work-thumbnail" src="https://attachments.academia-assets.com/118659665/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433521/Primary_and_metastatic_melanoma_of_the_GI_tract_clinical_presentation_endoscopic_findings_and_patient_outcomes">Primary and metastatic melanoma of the GI tract: clinical presentation, endoscopic findings, and patient outcomes</a></div><div class="wp-workCard_item"><span>Surgical Endoscopy and Other Interventional Techniques</span><span>, Oct 28, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background and aims Melanoma incidence has increased worldwide with a concurrent rise in both pri...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background and aims Melanoma incidence has increased worldwide with a concurrent rise in both primary and metastatic melanomas of the gastrointestinal tract. Materials and methods This retrospective single-center case series includes patients with histopathology-confirmed primary or metastatic melanoma of the GI tract between 1998 and 2018. Results Thirty-four patients were identified for inclusion, of whom 7 were primary and 27 were metastatic cases of gastrointestinal melanoma. For both primary and metastatic cases, the majority of patients presented with frank or occult GI bleeding (57.1% and 70.4%). Primary and metastatic lesions were predominantly diagnosed endoscopically (100% and 63.0%), with 71.4% of primary lesions found at the anorectal junction and 51.9% of metastatic lesions in the small bowel. Endoscopically diagnosed lesions were either polypoid (50%) or a luminal mass (37.5%) in the majority of cases. Common features included: amelanotic (83%), ulcerated (50%), and friable (33.3%). All primary patients were treated with surgical excision or resection. Of the metastatic patients, 56% were resected. The median interval between initial primary and gastrointestinal metastases was 65 months (ranging from 1 month to 24 years). At the time of data analysis, 85.7% of primary and 29.6% of metastatic patients remained alive. Conclusions The majority of patients in this series were diagnosed endoscopically while investigating a source of gastrointestinal blood loss. Heightened clinical suspicion and recognition of the endoscopic features of gastrointestinal melanoma during evaluation of GI symptoms in a patient with a personal history of primary melanoma are advised.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a98a18c9d38b6747bc84751f48cc849d" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659665,"asset_id":124433521,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659665/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433521"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433521"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433521; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433521]").text(description); $(".js-view-count[data-work-id=124433521]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433521; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433521']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "a98a18c9d38b6747bc84751f48cc849d" } } $('.js-work-strip[data-work-id=124433521]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433521,"title":"Primary and metastatic melanoma of the GI tract: clinical presentation, endoscopic findings, and patient outcomes","internal_url":"https://www.academia.edu/124433521/Primary_and_metastatic_melanoma_of_the_GI_tract_clinical_presentation_endoscopic_findings_and_patient_outcomes","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek","email":"WVJhOWxFalJxL2lhWTZkenBVdUR0aGhuTXdMUWp5Tk1wV3ltMldKcStESUEvNEJuNXlZcVJXWUVreGhJazR5bi0tMUlqVGhQM2htdkkzcmdIcksxUTl1UT09--8bf146e3df53032ef2b1a3547f8796def988fc69"},"attachments":[{"id":118659665,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/118659665/thumbnails/1.jpg","file_name":"s00464-019-07225-820241005-1-g7q0cs.pdf","download_url":"https://www.academia.edu/attachments/118659665/download_file","bulk_download_file_name":"Primary_and_metastatic_melanoma_of_the_G.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/118659665/s00464-019-07225-820241005-1-g7q0cs-libre.pdf?1728107580=\u0026response-content-disposition=attachment%3B+filename%3DPrimary_and_metastatic_melanoma_of_the_G.pdf\u0026Expires=1739914945\u0026Signature=EavpMWa88fErbn1HMcGOe17LngbP5ffYN6~MJqsEM3PxUL4Nw09heDJOvAz7aigrjNIfuSPq-MWU423OL-zplzteGmAaAG5ij1RcknB3MKgbbm8K9ZDbetcoAl-S6~W4bQmYmiLZtnaPX3vTsVfSfQI5a1i1uvbbzk~lQqdDuo9vTkLKp2DPduFRimHBgstJRYecIr5OOiJOwZF99atXerC-RT0nNzFwVaxRu0waqCYQVyDVREutYI8xqEzH5BjjVPGdE7xxoIPqMqsFBP60XIM7VJ4CuFybT8HKDpRUHqnvUO34X3e2ib2wgNpn7gJ5Wr3qub~0xvu3WATu4t7XsA__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433520"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433520/Impact_of_endoscopic_assessment_and_treatment_on_operative_and_non_operative_management_of_acute_oesophageal_perforation"><img alt="Research paper thumbnail of Impact of endoscopic assessment and treatment on operative and non-operative management of acute oesophageal perforation" class="work-thumbnail" src="https://attachments.academia-assets.com/118659660/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433520/Impact_of_endoscopic_assessment_and_treatment_on_operative_and_non_operative_management_of_acute_oesophageal_perforation">Impact of endoscopic assessment and treatment on operative and non-operative management of acute oesophageal perforation</a></div><div class="wp-workCard_item"><span>British Journal of Surgery</span><span>, Mar 29, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Surgeons have not typically utilized an endoscopic approach for diagnosis and managem...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Surgeons have not typically utilized an endoscopic approach for diagnosis and management of acute oesophageal perforation, mainly due to fears of increased mediastinal contamination. This study assessed the evolution of endoscopic approaches and their effect on outcomes over time in acute oesophageal perforation. Methods: All patients with documented acute oesophageal perforation between 1990 and 2009 were enrolled prospectively in an Institutional Review Board-approved database. Results: Of 81 patients who presented during the study period, 52 had upper gastrointestinal endoscopy for diagnosis alone (12 patients; 23 per cent) or as a component of acute management (40 patients; 77 per cent). Use of endoscopy increased from four of 13 patients in the first 5 years of the study to 20 of 24 patients in the final 5 years. Endoscopy was used in conjunction with surgery in 28 patients, of whom 21 underwent primary repair, three had resection, and one a diversion; 12 patients in this group had hybrid operations (combination of surgical and endoscopic management). Primary endoscopic treatment was used in 15 patients (29 per cent), most commonly involving stent placement (7). Of those having endoscopy, complication rates improved (from 3 of 4 to 8 of 20 patients), as did mean length of stay (from 21•8 to 13•4 days) between the initial and final 5 years of the study. There were two deaths (4 per cent). Of 21 patients who had both endoscopic assessment and management in the operating room, endoscopy identified additional pathology in ten, leading to a change in management plan in five patients. Conclusion: Endoscopy is a safe and important component of the management of acute oesophageal perforation. It provides additional information that modifies treatment, and its wider use should result in improved outcomes.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="65ac8c7880a3a4e3722baf0679c17cc3" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659660,"asset_id":124433520,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659660/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433520"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433520"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433520; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433520]").text(description); $(".js-view-count[data-work-id=124433520]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433520; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433520']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "65ac8c7880a3a4e3722baf0679c17cc3" } } $('.js-work-strip[data-work-id=124433520]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433520,"title":"Impact of endoscopic assessment and treatment on operative and non-operative management of acute oesophageal perforation","internal_url":"https://www.academia.edu/124433520/Impact_of_endoscopic_assessment_and_treatment_on_operative_and_non_operative_management_of_acute_oesophageal_perforation","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[{"id":118659660,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/118659660/thumbnails/1.jpg","file_name":"bjs7437.pdf","download_url":"https://www.academia.edu/attachments/118659660/download_file","bulk_download_file_name":"Impact_of_endoscopic_assessment_and_trea.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/118659660/bjs7437-libre.pdf?1728107582=\u0026response-content-disposition=attachment%3B+filename%3DImpact_of_endoscopic_assessment_and_trea.pdf\u0026Expires=1740158030\u0026Signature=JxATi4r1dEYfSWUHfVSfo4l0tnoURALkyB-zTTYphzTFMWk2-t6uLkwqjbJYY87ddVXzQ~~YKzto~Q~usMXHyOnMGS-tFFmz8ZUpf8ix0nk1VzvDcHq3pxV~3sDs4a-JYRYkxfBLnJXQmREC0KzmF1MKgHg-WvgxEPgcOF-4~B83piHwJi0FjNvsB7NqGYE0rh4UZ92QyZ9osdY-96ihp5YAv7lfZQ7jLcl5M3qPQhhzVY0s7mjTPTdZojQ~JwJVmQR8zfJmuYoa0I46Bjgmx27rzoLxBe6Xkh-Q~8YNZiD6w6eAEdHlL1tqDD6nMG-gX4RNBCK-OPYJajSS4S-TQQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433519"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433519/Effectiveness_and_safety_of_EUS_guided_choledochoduodenostomy_using_lumen_apposing_metal_stents_LAMS_a_systematic_review_and_meta_analysis"><img alt="Research paper thumbnail of Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis" class="work-thumbnail" src="https://attachments.academia-assets.com/118659663/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433519/Effectiveness_and_safety_of_EUS_guided_choledochoduodenostomy_using_lumen_apposing_metal_stents_LAMS_a_systematic_review_and_meta_analysis">Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis</a></div><div class="wp-workCard_item"><span>Surgical Endoscopy and Other Interventional Techniques</span><span>, Mar 5, 2020</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background Endoscopic ultrasound-guided choledochoduodenostomy (CDD) is emerging as an alternativ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background Endoscopic ultrasound-guided choledochoduodenostomy (CDD) is emerging as an alternative technique for biliary drainage in patients who fail conventional endoscopic retrograde cholangiopancreatography (ERCP). The lumenapposing metal stents (LAMS) are being increasingly used for CDD. We performed a systematic review and meta-analysis to evaluate the effectiveness and safety of CDD using LAMS. Methods We performed a systematic search of multiple databases through May 2019 to identify studies on CDD using covered self-expanding metal stents. Pooled rates of technical success, clinical success, adverse events, and recurrent jaundice associated with CDD using LAMS were estimated. A subgroup analysis was performed based on use of LAMS with electrocautery-enhanced delivery system (EC-LAMS). Results Seven studies on CDD using LAMS (with 284 patients) were included in the meta-analysis. Pooled rates of technical and clinical success (per-protocol analysis) were 95.7% (95% CI 93.2-98.1) and 95.9% (95% CI 92.8-98.9), respectively. Pooled rate of post-procedure adverse events was 5.2% (95% CI 2.6-7.9). Pooled rate of recurrent jaundice was 8.7% (95% CI 4.5-12.8). On subgroup analysis of CDD using EC-LAMS (5 studies with 201 patients), the pooled rates of technical and clinical success (per-protocol analysis) were 93.8% (95% CI 90.4-97.1) and 95.9% (95% CI 91.9-99.9), respectively. Pooled rate of post-procedure adverse events was 5.6% (95% CI 1.7-9.5). Pooled rate of recurrent jaundice was 11.3% (95% CI 6.9-15.7). Heterogeneity (I 2) was low to moderate in the analyses. Conclusion CDD using LAMS/EC-LAMS is an effective and safe technique for biliary decompression in patients who failed ERCP. Further studies are needed to assess CDD using LAMS as primary treatment modality for biliary obstruction. Keywords LAMS-lumen-apposing metal stents • EC-LAMS-electro-cautery-enhanced LAMS • Malignant biliary obstruction • Technical and clinical success • Adverse events In patients with malignant biliary obstruction, endoscopic retrograde cholangiopancreatography (ERCP) is the first line management to restore biliary drainage [1]. When biliary cannulation fails with conventional ERCP, percutaneous transhepatic biliary drainage (PTBD) performed by and Other Interventional Techniques Rajesh Krishnamoorthi and Chandra S. Dasari shares co-first authorship Electronic supplementary material The online version of this article (</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="4ada324cf615392542eb8d78c6f25ebf" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659663,"asset_id":124433519,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659663/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433519"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433519"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433519; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433516"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433516/Nurse_Administered_Propofol_Continuous_Infusion_Sedation_NAPCIS_A_New_Paradigm_for_GI_Procedure_Sedation"><img alt="Research paper thumbnail of Nurse Administered Propofol Continuous Infusion Sedation (NAPCIS): A New Paradigm for GI Procedure Sedation" class="work-thumbnail" src="https://attachments.academia-assets.com/118659659/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433516/Nurse_Administered_Propofol_Continuous_Infusion_Sedation_NAPCIS_A_New_Paradigm_for_GI_Procedure_Sedation">Nurse Administered Propofol Continuous Infusion Sedation (NAPCIS): A New Paradigm for GI Procedure Sedation</a></div><div class="wp-workCard_item"><span>Gastroenterology</span><span>, Apr 1, 2017</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="270849f02af6f38742139d8581f47f3b" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659659,"asset_id":124433516,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659659/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433516"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433516"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433516; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433516]").text(description); $(".js-view-count[data-work-id=124433516]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433516; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433516']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433515"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433515/Effectiveness_and_Safety_of_EUS_Rendezvous_After_Failed_Biliary_Cannulation_With_ERCP"><img alt="Research paper thumbnail of Effectiveness and Safety of EUS Rendezvous After Failed Biliary Cannulation With ERCP" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433515/Effectiveness_and_Safety_of_EUS_Rendezvous_After_Failed_Biliary_Cannulation_With_ERCP">Effectiveness and Safety of EUS Rendezvous After Failed Biliary Cannulation With ERCP</a></div><div class="wp-workCard_item"><span>Journal of Clinical Gastroenterology</span><span>, Apr 9, 2021</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Endoscopic ultrasound–guided rendezvous (EUS-RV) endoscopic retrograde cholangiopancr...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Endoscopic ultrasound–guided rendezvous (EUS-RV) endoscopic retrograde cholangiopancreatography (ERCP) is an alternative to interventional radiology–guided rendezvous ERCP in patients who failed biliary cannulation with conventional ERCP. However, there is significant variation in reported rates of success and adverse events associated with EUS-RV-assisted ERCP. We performed a systematic review and a proportion meta-analysis to reliably assess the effectiveness and safety of the EUS-RV-assisted ERCP. Materials and Methods: We conducted a comprehensive search of multiple electronic databases and conference proceedings (from inception through August 2020) to identify studies reporting EUS-RV-assisted ERCP in patients who failed biliary cannulation with conventional ERCP techniques. Using the random-effects model described by DerSimonian and Laird, we calculated the pooled rates of technical success, clinical success, and adverse events of EUS-RV-assisted ERCP. Results: Twelve studies reporting a total of 342 patients were included in the meta-analysis. The pooled rate of technical success (12 studies reporting a total of 342 patients) was 86.1% [95% confidence interval (CI): 78.4-91.3]. The pooled rate of clinical success (4 studies reporting a total of 94 patients) was 80.8% (95% CI: 64.1-90.8). The pooled rate of overall adverse events (12 studies; 42 events in 342 patients) was 14% (95% CI: 10.5-18.4). Low to moderate heterogeneity was noted in the analyses. Conclusions: EUS-RV-assisted ERCP appears to be effective and safe in patients who failed biliary cannulation with conventional ERCP. Given the risk of adverse events, it should be performed in centers with expertise in therapeutic endoscopic ultrasound.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433515"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433515"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433515; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433515]").text(description); 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dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=124433512]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433512,"title":"Cholangitis","internal_url":"https://www.academia.edu/124433512/Cholangitis","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433511"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433511/Mo1149_DIFFERENCES_IN_LOWER_GASTROINTESTINAL_BLEEDING_MANAGEMENT_AND_OUTCOMES_OVER_A_10_YEAR_SPAN"><img alt="Research paper thumbnail of Mo1149 DIFFERENCES IN LOWER GASTROINTESTINAL BLEEDING MANAGEMENT AND OUTCOMES OVER A 10 YEAR SPAN" class="work-thumbnail" src="https://attachments.academia-assets.com/118659661/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433511/Mo1149_DIFFERENCES_IN_LOWER_GASTROINTESTINAL_BLEEDING_MANAGEMENT_AND_OUTCOMES_OVER_A_10_YEAR_SPAN">Mo1149 DIFFERENCES IN LOWER GASTROINTESTINAL BLEEDING MANAGEMENT AND OUTCOMES OVER A 10 YEAR SPAN</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Jun 1, 2018</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Introduction: Gastrointestinal (GI) hemorrhage is a common complication in patients with cerebrov...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Introduction: Gastrointestinal (GI) hemorrhage is a common complication in patients with cerebrovascular accidents. Reported incidence has ranged from 1% to 8% in several published studies. We studied a national inpatient database to assess the effects of GI endoscopy on mortality and length of hospital stay among patients with acute stroke. Methods: We analyzed the National Inpatient Sample (NIS) database from 2008-2012. Patients with primary or secondary diagnosis of cerebrovascular accident (CVA) were identified via ICD-9 diagnosis code and the database was further subdivided into cases with discharge diagnosis of concurrent gastrointestinal bleeding. Outcomes of the patients who underwent upper GI endoscopy or colonoscopy were compared to the ones who did not receive either procedure by utilizing bivariate analysis via Chi-square test and multivariate logistic regression. Statistical analysis was performed by SPSS Statistical software v25.0 (IBM Corp, Chicago, Illinois). Results: 804,302 patients with primary or secondary discharge diagnosis of stroke were identified, out of which 10,269 (1.3%) had concurrent gastrointestinal hemorrhage. Among these patients, 3219 (31.3%) underwent endoscopic evaluation via either upper GI endoscopy or colonoscopy. Patients who underwent endoscopic evaluation experienced lower in-hospital mortality compared to patients who did not undergo endoscopic evaluation (Adjusted Odds Ratio: 0.397 95% CI: 0.342-0.459, p<0.001) when controlling for the cofounding effects of age, gender, race, number of chronic conditions, length of hospital stay, presence of critical illness requiring mechanical ventilation and admission type. Conclusion: Approximately one third of the patients admitted with cerebrovascular stroke with concurrent gastrointestinal bleed underwent endoscopy during their hospitalization. Patients undergoing endoscopy had a relatively low mortality rate. This association persisted even after controlling for possible cofounding factors. Further research is needed to understand the benefits of endoscopy in patients with CVA and concurrent GI bleed. Reference:</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="ce02ffedb2cb159b5bbcfef5f7e556aa" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659661,"asset_id":124433511,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659661/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433511"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433511"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433511; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433511]").text(description); $(".js-view-count[data-work-id=124433511]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433511; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433511']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433509"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433509/Melanoma_Involving_the_Gastrointestinal_GI_Tract_Single_Center_Large_Case_Series"><img alt="Research paper thumbnail of Melanoma Involving the Gastrointestinal (GI) Tract: Single Center Large Case Series" class="work-thumbnail" src="https://attachments.academia-assets.com/118659657/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433509/Melanoma_Involving_the_Gastrointestinal_GI_Tract_Single_Center_Large_Case_Series">Melanoma Involving the Gastrointestinal (GI) Tract: Single Center Large Case Series</a></div><div class="wp-workCard_item"><span>Gastroenterology</span><span>, Apr 1, 2017</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">had a new diagnosis of colorectal neoplasia. Microbiology reports advised of the association betw...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">had a new diagnosis of colorectal neoplasia. Microbiology reports advised of the association between S. bovis and colorectal neoplasia in 61% (23) of cases. Conclusions: Colorectal neoplasia was frequent in this population of patients with S. bovis bacteraemia, consistent with other studied cohorts. A large proportion (10 of 12 cases) of disease found was either invasive malignancy, or adenomatous polyps with a high risk of malignant transformation based on size (>10mm). We suggest that any patient with S. bovis bacteraemia who is well enough, should be assessed by colonoscopy as the gold standard investigation to detect colorectal neoplasia, and that microbiology reports should systematically report on this association, to ensure that patients are offered timely investigations to detect often asymptomatic colorectal neoplasia.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="8c8cfd164bb966fbbc01368630fdbffb" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659657,"asset_id":124433509,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659657/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433509"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433509"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433509; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433509]").text(description); $(".js-view-count[data-work-id=124433509]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433509; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433509']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "8c8cfd164bb966fbbc01368630fdbffb" } } $('.js-work-strip[data-work-id=124433509]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433509,"title":"Melanoma Involving the Gastrointestinal (GI) Tract: Single Center Large Case Series","internal_url":"https://www.academia.edu/124433509/Melanoma_Involving_the_Gastrointestinal_GI_Tract_Single_Center_Large_Case_Series","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[{"id":118659657,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/118659657/thumbnails/1.jpg","file_name":"s0016-508528172933020-220241005-1-v6qxal.pdf","download_url":"https://www.academia.edu/attachments/118659657/download_file","bulk_download_file_name":"Melanoma_Involving_the_Gastrointestinal.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/118659657/s0016-508528172933020-220241005-1-v6qxal-libre.pdf?1728107585=\u0026response-content-disposition=attachment%3B+filename%3DMelanoma_Involving_the_Gastrointestinal.pdf\u0026Expires=1740158031\u0026Signature=TwrIMfiGryXbrg5YHKTvkuGj97CfbrkkyI4F1avNqiNKZvzNVnWonzURj5lA8gUVc-ewtnNJSS-rJoO8UKSNQp~8YKcFWoJ2eRgCgwrw4Pon4PVL8SYr1GCt7nm4GOXuwZqOZgsG7Guh9u949nt3v~2FD-FhunHHyzW4Z6L1jX7mPEq6xv5zp5nxyqlSaxJtH9wmCz76K~CgAiXX2BsRhcnhXIBFJ8wLtej5K1qgXIQs8vq6jeBEen17hUn9X1p05y5mbvOskU7rDIRlg76g4A55fFyI7GrCbl8ObHDpCdxdByX1E23Wrfr1ZAQkKEYsPVNJRA9Y0xz4XKXIWZ5OkA__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433508"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433508/Sa1469_ERCP_WITH_OVERTUBE_ASSISTED_ENTEROSCOPY_IN_PATIENTS_WITH_ROUX_EN_Y_GASTRIC_BYPASS_ANATOMY_A_SYSTEMATIC_REVIEW_AND_META_ANALYSIS"><img alt="Research paper thumbnail of Sa1469 ERCP WITH OVERTUBE-ASSISTED ENTEROSCOPY IN PATIENTS WITH ROUX-EN-Y GASTRIC BYPASS ANATOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS" class="work-thumbnail" src="https://attachments.academia-assets.com/118659656/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433508/Sa1469_ERCP_WITH_OVERTUBE_ASSISTED_ENTEROSCOPY_IN_PATIENTS_WITH_ROUX_EN_Y_GASTRIC_BYPASS_ANATOMY_A_SYSTEMATIC_REVIEW_AND_META_ANALYSIS">Sa1469 ERCP WITH OVERTUBE-ASSISTED ENTEROSCOPY IN PATIENTS WITH ROUX-EN-Y GASTRIC BYPASS ANATOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Jun 1, 2019</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="b33ebae68876e7828c6488c500f80b30" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659656,"asset_id":124433508,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659656/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433508"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433508"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433508; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433508]").text(description); $(".js-view-count[data-work-id=124433508]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433508; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433508']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433507"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433507/Mo1680_SPRAY_COAGULATION_TO_MANAGE_REMNANT_POLYP_DURING_EMR_OF_DIFFICULT_COLORECTAL_POLYPS"><img alt="Research paper thumbnail of Mo1680 SPRAY COAGULATION TO MANAGE REMNANT POLYP DURING EMR OF DIFFICULT COLORECTAL POLYPS" class="work-thumbnail" src="https://attachments.academia-assets.com/118659658/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433507/Mo1680_SPRAY_COAGULATION_TO_MANAGE_REMNANT_POLYP_DURING_EMR_OF_DIFFICULT_COLORECTAL_POLYPS">Mo1680 SPRAY COAGULATION TO MANAGE REMNANT POLYP DURING EMR OF DIFFICULT COLORECTAL POLYPS</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Jun 1, 2020</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">duration of time between index and surveillance exams, diabetes, smoking history, and body mass i...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">duration of time between index and surveillance exams, diabetes, smoking history, and body mass index. Conclusion: The majority of participants with LRAs at baseline did not develop HRAs between colonoscopies, supporting a longer surveillance interval. No participants developed colon cancer. Although the current recommended interval is 5-10 years, <10% had a surveillance recommendation of 10 years. Many were told to follow up before 5 years. The findings support the current guidelines of performing a surveillance exam after 5-10 years and suggest that there is low risk in waiting to perform a surveillance exam until closer to the 10 year mark.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="eb30094ee0437f47ded00908a7282a40" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659658,"asset_id":124433507,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659658/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433507"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433507"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433507; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433506"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433506/875_Efficacy_and_Safety_of_Endoscopic_Ultrasound_EUS_Guided_Gastroenterostomy_GE_A_Systematic_Review_and_Meta_Analysis"><img alt="Research paper thumbnail of 875 Efficacy and Safety of Endoscopic Ultrasound (EUS) Guided Gastroenterostomy (GE): A Systematic Review and Meta-Analysis" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433506/875_Efficacy_and_Safety_of_Endoscopic_Ultrasound_EUS_Guided_Gastroenterostomy_GE_A_Systematic_Review_and_Meta_Analysis">875 Efficacy and Safety of Endoscopic Ultrasound (EUS) Guided Gastroenterostomy (GE): A Systematic Review and Meta-Analysis</a></div><div class="wp-workCard_item"><span>The American Journal of Gastroenterology</span><span>, Oct 1, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">INTRODUCTION: Endoscopic ultrasound (EUS) guided gastroenterostomy (GE) is emerging as an alterna...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">INTRODUCTION: Endoscopic ultrasound (EUS) guided gastroenterostomy (GE) is emerging as an alternative to enteral stenting and surgical GE for management of malignant gastric outlet obstruction (GOO). With advances in EUS technology and availability of dedicated devices/stents for EUS scopes, the use of EUS-GE is expected to increase in the future. We performed a systematic review and meta-analysis to estimate the success rate and adverse events associated with EUS-GE. METHODS: We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (from inception through May 2019) to identify studies that reported success rate and adverse events of EUS-GE. The primary outcome was to estimate the pooled rates of technical and clinical success of EUS-GE. The secondary outcome was to estimate the rate of adverse events. RESULTS: 9 studies with a total of 268 patients were included. The pooled rate of technical success of EUS-GE was 91.7 % (95% CI 87.5 – 94.5; I2 = 0). The pooled rate of clinical success of EUS-GJ was 87.8% (95% CI 83.1 – 91.3; I2 = 0). The pooled rate of overall adverse events was 12.6% (95% CI 9.0- 17.6; I2 = 0). The pooled rate of individual adverse events – perforation, bleeding, peritonitis and stent migration / misdeployment were 2% (95% CI 0.7 – 5.1), 3.2% (95% CI 1.5 – 6.5), 2.6% (95% CI 1.1-6.1) and 8.9 % (95% CI 4.3-17.5) respectively.The rate of surgical intervention for adverse events was 2%. CONCLUSION: While the rates of technical success (92%) and clinical success (88%) of EUS-GJ is promising, the risk of adverse events is considerable at 12.6%, with stent misdeployment (9%) being the most common adverse event. Hence, EUS-GJ should be performed at tertiary referral centers in a multidisciplinary (surgery, oncology, gastroenterology) team-based approach.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433506"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433506"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433506; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); 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</script> <div class="js-work-strip profile--work_container" data-work-id="124433505"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433505/Risk_Stratification_for_Proximal_Colon_Neoplasia_Using_Age_Gender_Family_History_and_Distal_Colon_Findings"><img alt="Research paper thumbnail of Risk Stratification for Proximal Colon Neoplasia Using Age, Gender, Family History and Distal Colon Findings" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433505/Risk_Stratification_for_Proximal_Colon_Neoplasia_Using_Age_Gender_Family_History_and_Distal_Colon_Findings">Risk Stratification for Proximal Colon Neoplasia Using Age, Gender, Family History and Distal Colon Findings</a></div><div class="wp-workCard_item"><span>The American Journal of Gastroenterology</span><span>, Oct 1, 2004</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433505"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433505"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433505; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433505]").text(description); $(".js-view-count[data-work-id=124433505]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433505; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433505']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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</script> <div class="js-work-strip profile--work_container" data-work-id="124433504"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433504/Papillectomy_and_Ampullectomy"><img alt="Research paper thumbnail of Papillectomy and Ampullectomy" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433504/Papillectomy_and_Ampullectomy">Papillectomy and Ampullectomy</a></div><div class="wp-workCard_item"><span>Elsevier eBooks</span><span>, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Abstract Ampullary neoplasms (benign and malignant) are rare, with a reported prevalence of less ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Abstract Ampullary neoplasms (benign and malignant) are rare, with a reported prevalence of less than 0.1% in autopsy series. Other etiologies such as papillitis, gastric foveolar metaplasia, and pancreatic acinar hyperplasia can also lead to enlarged or abnormal papillae. Ampullary tumors can arise from epithelium (e.g., adenomas, adenocarcinomas, lymphomas) or the subepithelium (e.g., neuroendocrine tumors, lipomas). The incidence of ampullary adenomas is increased two- to threefold in genetic polyposis syndromes. 4 Early lesions are often asymptomatic, while larger lesions can cause obstruction, presenting with cholestasis, cholangitis, and pancreatitis. Although some authors perform endoscopic ultrasound (EUS) on all lesions, many perform EUS only for worrisome features such as weight loss, jaundice, and lesions larger than 2 cm. After performing pancreatography and cholangiography, snare excision is performed, ideally without saline injection and en bloc, if feasible. Preresection sphincterotomy and stent placement are not routinely performed, while postresection sphincterotomy is usually performed unless there is a concern it might lead to perforation. Postresection pancreatic stenting is recommended due to the high risk of post-ERCP pancreatitis, but biliary stenting is performed based on perceived poor biliary drainage after the papillectomy. The most common adverse events of papillectomy include pancreatitis and bleeding. Postpapillectomy surveillance should be performed 3 months following resection, and once confirmed to be completely removed, continued surveillance should be considered as frequently as every 6 months for the subsequent 2 years. Complete tumor eradication rates of 80% or more are reported in larger series. Surgery is usually recommended for treatment of operative patients who have lesions that harbor invasive cancer.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433504"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433504"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433504; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433504]").text(description); $(".js-view-count[data-work-id=124433504]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433504; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433504']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=124433504]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433504,"title":"Papillectomy and Ampullectomy","internal_url":"https://www.academia.edu/124433504/Papillectomy_and_Ampullectomy","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433503"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/124433503/Soft_self_expandable_metal_stent_to_treat_painful_pancreatic_duct_strictures_secondary_to_chronic_pancreatitis_a_prospective_multicenter_trial"><img alt="Research paper thumbnail of Soft self-expandable metal stent to treat painful pancreatic duct strictures secondary to chronic pancreatitis: a prospective multicenter trial" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/124433503/Soft_self_expandable_metal_stent_to_treat_painful_pancreatic_duct_strictures_secondary_to_chronic_pancreatitis_a_prospective_multicenter_trial">Soft self-expandable metal stent to treat painful pancreatic duct strictures secondary to chronic pancreatitis: a prospective multicenter trial</a></div><div class="wp-workCard_item"><span>Gastrointestinal Endoscopy</span><span>, Mar 1, 2023</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background and Aims:Fully covered self-expandable metal stents (FCSEMSs) may offer a treatment op...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background and Aims:Fully covered self-expandable metal stents (FCSEMSs) may offer a treatment option for pain associated with a dilated pancreatic duct (PD) in chronic pancreatitis (CP), but optimal patient selection and FCSEMS design, efficacy, and safety remain uncertain. We studied an investigational pancreatic FCSEMS for treatment of CP-associated pain.Methods:Patients with painful CP, a dominant distal PD stricture, and PD dilation upstream were enrolled in a prospective, multicenter, single-arm trial studying 6-month indwell of a 4- to 6-cm-long soft pancreatic FCSEMS. Primary efficacy and safety endpoints were pain reduction 6 months after FCSEMS indwell (performance goal ≥53%) and PD stenting–related serious adverse events (SAEs), respectively (performance goal <32%). The primary efficacy endpoint was assessed in patients with sufficiently severe and frequent pain at FCSEMS placement as a first stent or in exchange of a plastic stent.Results:Among 67 patients (mean age, 52.7 ± 12.5 years; mean time since CP diagnosis, 6.4 ± 6.4 years), 34 (50.7%) had plastic stent placement within 90 days of FCSEMS placement, and 46 patients were eligible for the primary efficacy endpoint analysis. Technical success was 97.0% (65/67). The observed primary efficacy (26.1%, 12/46) and safety endpoints (31.3%, 21/67) failed to meet the a priori study hypotheses. Study stent migration occurred in 47.7% of patients (31/65).Conclusions:Six-month treatment with an FCSEMS did not lead to an expected degree of pain reduction, and migrations and SAEs were common. Further study is needed to clarify optimal decompressive strategy, FCSEMS design, and patient selection. (Clinical trial registration number: NCT02802020.)</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433503"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433503"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433503; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=124433503]").text(description); $(".js-view-count[data-work-id=124433503]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 124433503; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='124433503']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=124433503]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":124433503,"title":"Soft self-expandable metal stent to treat painful pancreatic duct strictures secondary to chronic pancreatitis: a prospective multicenter trial","internal_url":"https://www.academia.edu/124433503/Soft_self_expandable_metal_stent_to_treat_painful_pancreatic_duct_strictures_secondary_to_chronic_pancreatitis_a_prospective_multicenter_trial","owner_id":38200980,"coauthors_can_edit":true,"owner":{"id":38200980,"first_name":"Richard","middle_initials":null,"last_name":"Kozarek","page_name":"RKozarek","domain_name":"independent","created_at":"2015-11-12T09:18:28.650-08:00","display_name":"Richard Kozarek","url":"https://independent.academia.edu/RKozarek"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="124433502"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/124433502/Endoscopic_suturing_of_a_large_type_I_duodenal_perforation"><img alt="Research paper thumbnail of Endoscopic suturing of a large type I duodenal perforation" class="work-thumbnail" src="https://attachments.academia-assets.com/118659655/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/124433502/Endoscopic_suturing_of_a_large_type_I_duodenal_perforation">Endoscopic suturing of a large type I duodenal perforation</a></div><div class="wp-workCard_item"><span>VideoGIE</span><span>, Feb 1, 2019</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">An 83-year-old man with an 18-month history of a previously assumed benign duodenal stricture and...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">An 83-year-old man with an 18-month history of a previously assumed benign duodenal stricture and relapsing pancreatitis was transferred from an outside hospital with new-onset obstructive jaundice. His medical history included heart failure, atrial fibrillation for which warfarin was prescribed, and a pacemaker. CT of the abdomen demonstrated biliary and pancreatic duct dilation, multiple peripancreatic lymph nodes, and a possible small lesion in the periampullary area (Fig. 1). EUS demonstrated thickening of the distal common bile duct without an obvious mass to biopsy when observed from the duodenal bulb (Fig. 2). Because the diameter of the duodenal stenosis at the turn from the bulb to the second portion of the duodenum was about 3 mm to 4 mm, the echoendoscope could not pass through the stricture; therefore, the echoendoscope was switched to a standard gastroscope, but that too was unable to traverse the stricture. The duodenoscope was reinserted with intention to dilate the stricture and to perform ERCP. Dilatation of the duodenal stricture to 15 mm (Fig. 3) resulted in a local perforation (Fig. 4).</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="138fd20edb10046e85148196c0a27d2e" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":118659655,"asset_id":124433502,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/118659655/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="124433502"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="124433502"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 124433502; 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