40th Anniversary of the First Endoscopic Retrograde Pancreatogram
2008 marks the 40th anniversary of endoscopic retrograde cholangiopancreatography (ERCP). In 1968, a group of physicians from the George Washington University Medical Center published the first report that documented the initial clinical application of ERCP.The successful procedure was performed by Drs. McCune, Shorb, and Moscovitz and was predicated on hours of canine research followed by… Continue Reading
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Accessing the Gastric Remnant After Roux-en-Y Gastric Bypass
INTRODUCTION: A minimally invasive method for accessing the gastric remnant to intervene on the biliary and pancreatic system after Roux-en-Y gastric bypass (RYGB) has not been well described. This is a retrospective review describing two surgeons’ complete experience with laparoscopic trans-gastric (LaTG) ERCP for biliary and pancreatic duct management.METHODS AND PROCEDURES: Twelve patients underwent LaTG-ERCP.… Continue Reading
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Contribution of Flexible Endoscopy in Trauma Reimbursement
IntroductionThe ability of a trauma surgeon to perform flexible endoscopy helps in early and accurate diagnosis of various acute injuries and adds to the bottom line in a predominantly trauma practice. With decrease in operative trauma cases, flexible endoscopy may help to generate enough revenue to sustain trauma practice. Methods: The following data was collected-1)… Continue Reading
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Dilation of Anastomotic Strictures After Transhiatal Esophagectomies
Objective: Anastomotic stricture presenting with dysphagia after transhiatal esophagectomy is a common problem. We have reviewed our experience with esophageal dilatations after transhiatal esophagectomies. Methods: We retrospectively reviewed the medical records of all patients who underwent esophageal dilatation after transhiatal esophagectomies. Demographic data, number and methods of dilatations, time between dilatations, and time between surgery… Continue Reading
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Does Preoperative Endoscopy in Bariatric Surgery Alter the Medical or Surgical Strategy?
Introduction: Controversy exists as to the need for preoperative esophago-gastro-duodenoscopy (EGD) for patients undergoing bariatric surgery. Specifically, do findings alter the medical and surgical management. The purpose of this study is to evaluate the role of preoperative EGD in the therapeutic strategy of bariatric surgery. Methods: We conducted a retrospective analysis of consecutive patients undergoing… Continue Reading
Duodenoscope Choice in Pediatric ERCP
Introduction: Although rare, some pediatric diseases may require diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The choice of duodenoscope for pediatric ERCP is not well studied. This study investigated the hypothesis that a therapeutic adult duoenoscope can be utilized safely for pediatric ERCP. Methods: All patients under the age of 18 were included in this… Continue Reading
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Efficacy and Safety in Pediatric ERCP By a Surgical Endoscopist
Introduction: Pediatric endoscopic rertograde cholagiopancreatography (ERCP) is not routinely performed by most therapeutic endoscopists. The challenges of a pediatric anatomy, pediatric physiology, rare indications, and the need for side viewing endoscope preclude this procedure from becoming popular by pediatric gastroenterologist or laparoendoscopic surgeons. This investigation studied the hypothesis that pediatric ERCP can be performed by… Continue Reading
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Endoscopic and Manometric Characteristics of the Gastroesophageal Valve in Lateral Decubitus and Upright Positions in Clinically Normal Patients
Background: The relationship between body position and the gastroesophageal junction (GEJ) has been subject to intense interest in its role in gastroesophageal reflux disease (GERD). Few studies have looked at the position related changes of the gastroesophageal valve (GEV) in asymptomatic individuals.Purpose: To define the normal physiology of the GEJ in left lateral decubitus (LLD)… Continue Reading
Endoscopic Findings in Patients with Upper Gi Symptoms After Roux-en-Y Gastric Bypass
INTRODUCTION: Upper endoscopy (UE) is essential in the diagnosis and treatment of complications after Roux-en-Y gastric bypass (RYGB). Patients who have undergone RYGB present with a variety of functional (nausea, pain, and reflux) as well as obstructive (vomiting and dysphagia) symptoms. The primary aim of this study was to correlate symptoms and endoscopic findings with… Continue Reading
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Endoscopic Tissue Fusion for Weight Regain After Gastric Bypass: Does It Help?
Background: Gastric bypass results in significant weight loss in the morbidly obese population. There is however, an incidence of weight regain associated with the procedure. One theory for the weight regain is pouch dilation. StomaphyX is a device which addresses pouch dilation by endoscopically plicating the gastric pouch, resulting in a decreased pouch size. This… Continue Reading
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Endoscopic Ultrasound-guided Gastrostomy After Roux-en-Y Gastric Bypass: A Novel Approach
Objective: Gastrostomy tube (GT) placement after Roux-en-Y gastric bypass can be challenging. Novel, minimally invasive approaches are needed to access the gastric remnant in these patients. Our objective is to present an innovative method of endoscopic ultrasound (EUS)-guided GT placement.Procedure Description: A 55 year-old morbidly obese female underwent reoperative, open retrocolic Roux-en-Y gastric bypass, and… Continue Reading
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Esophageal Dilatation for Corrosive Stricture of the Esophagus
Less was known regarding outcome of dilatation in corrosive stricture of the esophagus. The aim of this study was to report the treatment outcome of dilatation for corrosive esophageal stricture.Methods: Medical records of twenty-three patients with corrosive esophageal stricture who underwent esophagal dilatations were reviewed. All dilatations were performed under general anesthesia using Savary-Gillard dilator… Continue Reading
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Esophageal Ulcers At a Large Urban Emergency Hospital: A Seventeen Year Experience
OBJECTIVE: In this study, we report the incidence, common etiologies, endoscopic and pathologic findings and clinical outcomes of patients with esophageal ulcers (EU) in our urban population over a seventeen year period. METHODS: This is a retrospective chart review of all upper endoscopies (EGD) performed by a single surgical endoscopist at an urban emergency hospital… Continue Reading
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Feasibility of Diagnostic Peritoneoscopy Using a Flexible Endoscope Under Low Pressure Pneumoperitoneum
Objectives: Standard laparoscopy requires general anesthesia for muscle paralysis to allow for adequate pneumoperitoneum. Our goal is to determine the effectiveness of diagnostic peritoneoscopy using a flexible endoscope under low pressure pneumoperitoneum. Methods: Three 25-kg female swine were subjected to general anesthesia. Pneumoperitoneum to 8mm Hg was achieved with a veress needle. Using a laparoscopic… Continue Reading
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Feasibility of Transabdominal Diagnostic Peritoneoscopy Using a Flexible Endoscope
Objectives: Diagnostic laparoscopy is an established tool in oncologic evaluation. Standard rigid laparoscopy presents certain limitations in terms of access to various areas of the peritoneal cavity. Other authors have explored the utility of diagnostic laparoscopy with a flexible endoscope via a transgastric or transvaginal approach (NOTES). Our goal is to determine the effectiveness of… Continue Reading
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