Publications by authors named "Andrew Canakis"

Background: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a minimally invasive technique for treating gastric outlet obstruction (GOO). The aim of this study was to assess the outcomes of EUS-GE in managing benign GOO caused by duodenal stenosis in patients with acute pancreatitis.

Methods: This international retrospective study analyzed patients treated with EUS-GE for GOO caused by acute pancreatitis until December 2023, evaluating technical and clinical success, adverse events, and reintervention.

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Background And Aims: Fully covered self-expandable metal stents (FCSEMSs) are widely used in benign upper gastrointestinal (GI) conditions, but stent migration remains a limitation. An over-the-scope clip (OTSC) device (Stentfix {SF], Ovesco Endoscopy) for stent anchoring has recently been developed. The aim of this study was to evaluate the effect of OTSC fixation on FCSEMS migration rate.

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Purpose: Rising obesity and type 2 diabetes mellitus (T2DM) rates can be mitigated by various strategies, with a 10% total body weight loss (TBWL) threshold often required for T2DM remission. T2DM remission rates after bariatric surgery like Roux-en-Y gastric bypass (RYGB) are well established; endoscopic sleeve gastroplasty (ESG) is a less invasive option that averages 15% TBWL and allows for T2DM remission. This study explores the DiaRem (Diabetes Remission post-RYGB) score's ability to predict T2DM remission 1-year post-ESG.

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Article Synopsis
  • A systematic review and meta-analysis were conducted to evaluate the effectiveness of prophylactic pancreatic duct stenting (PPDS) in reducing post-ampullectomy pancreatitis (PAP) and overall complications during endoscopic ampullectomy (EA).
  • The analysis included 34 studies with nearly 1,900 patients, revealing no significant difference in PAP rates between patients who received PPDS (11.9%) and those who did not (16.6%).
  • The overall findings suggest that PPDS does not significantly protect against PAP, with variations in study methods and patient factors possibly influencing the higher PAP rates observed without PPDS.
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Article Synopsis
  • - Groove pancreatitis (GP) is a rare type of chronic pancreatitis primarily affecting middle-aged men, with risk factors including excessive alcohol use, smoking, and pancreatic issues, leading to symptoms like severe abdominal pain and jaundice.
  • - Diagnosing GP is difficult due to its symptoms overlapping with other conditions, which can result in delayed treatment and increased health risks.
  • - The potential use of artificial intelligence in diagnostic imaging could help differentiate GP from pancreatic cancers, improving diagnosis and patient outcomes, as discussed in a comprehensive review of GP's causes, symptoms, and treatment options.
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Background: I-scan is an image enhancing technology that utilizes contrast, surface, and tone enhancement to examine the microvascular and microsurface structures of mucosa. Its ability to diagnosis GC is of growing interest due to its ability to make an optical diagnosis; however, only a handful of studies have explored its role in this setting. We aimed to investigate the diagnostic capability of i-scan for GC detection.

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Article Synopsis
  • Acute appendicitis has a lifetime risk of 7-8%, with treatment options including non-operative management (NOM) using antibiotics and surgery, depending on the patient's health.
  • Interval appendectomy (IA) involves delayed surgery and is useful for patients with contained perforations, as it can help identify the nature of the condition and lower recurrence risks.
  • Post-surgery, careful closure of the appendiceal stump is crucial and can be done with various methods, while debates continue regarding the management, complications, and the potential of endoscopic appendectomy.
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Introduction: The objective of this study is to determine the difference in rates of new-onset type 2 diabetes (T2D) for individuals who have had metabolic and bariatric surgery (MBS) and similar individuals who did not have MBS, and to determine whether differences in new-onset T2D differ depending on whether the individual had prediabetes at baseline.

Methods: This study used data from a large United States employer-based retrospective claims database from 2016 to 2021 (analysis completed in 2023). Individuals who did and did not have MBS were matched 1:1 on index year, sex, age, health plan type, region, body mass index, baseline healthcare costs, other obesity-related comorbidities, prediabetes diagnosis, and inpatient admissions in the year before the index date.

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Endoscopic ultrasound (EUS) has rapidly evolved from a diagnostic to a therapeutic tool with applications for various pancreaticobiliary diseases. As part of this evolution, EUS-guided chemoablation for neoplastic pancreatic cysts is developing as a minimally invasive treatment option for appropriately selected mucinous cysts, which can spare patients major resective surgery and may reduce progression to pancreatic cancer. Chemotherapeutic cyst ablation has demonstrated encouraging complete resolution rates, while an alcohol-free chemoablation protocol has demonstrated a significant decrease in adverse events without a compromise to complete ablation rates when compared with previous alcohol-based protocols.

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Endoscopic ultrasound (EUS)-guided biliary drainage (BD) is a minimally invasive procedure that allows for biliary access when conventional endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful. The technique can be divided based on biliary access route: intrahepatic or extrahepatic, as well as on stenting approach: rendezvous approach (EUS-RV), antegrade placement, or transluminal (intra or extra hepatic) placement. There is no clear consensus on which approach is superior.

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Pancreatic cancer is one of the leading causes of cancer-related deaths worldwide. Pancreatic lesions consist of both neoplastic and non-neoplastic lesions and often pose a diagnostic and therapeutic challenge due to similar clinical and radiological features. In recent years, pancreatic lesions have been discovered more frequently as incidental findings due to the increased utilization and widespread availability of abdominal cross-sectional imaging.

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Background: Closure of gastrointestinal defects can reduce postprocedural adverse events. Over-the-scope clips and an over-the-scope suturing system are widely available, yet their use may be limited by defect size, location, operator skill level, and need to reinsert the endoscope with the device attached. The introduction of a through-the-scope helix tack suture system (TTSS) allows for closure of large irregular defects using a gastroscope or colonoscope, without the need for endoscope withdrawal.

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Background: Gastric cancer (GC) is associated with a significant global health burden and high mortality rates when diagnosed at later stages. The diagnosis often occurs at advanced stages when treatment options are limited and less effective. Early detection strategies are crucial to improving survival rates and outcomes for patients.

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Introduction: Endoscopic removal techniques for colorectal polyps include cold snare polypectomy (CSP) and hot snare polypectomy (HSP). Although HSP is recommended for pedunculated polyps (PPs) larger than 10 mm, data regarding use of CSP for PPs <10 mm continues to emerge. We aimed to investigate outcomes of these techniques in small (<10 mm) pedunculated colorectal polyps.

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Background And Aims: The application of endoscopic suturing has revolutionized defect closures. Conventional over-the-scope suturing necessitates removal of the scope, placement of the device, and reinsertion. A single channel, single sequence, through-the-scope suturing device has been developed to improve this process.

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Video 1EMR of a large colonic polyp with defect closure using Resolution 360 ULTRA Clips (Boston Scientific, Boston, Mass, USA) and the Anchor, Mobilize, and Close approach.

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Radiation proctitis (RP), a well-known complication of pelvic radiation therapy, may lead to recurrent hospitalizations. We aimed to assess readmissions of RP in the United States. We analyzed the Nationwide Readmission Database from 2016 to 2020 to identify all 30-, 60-, and 90-day readmissions of RP in the United States.

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Article Synopsis
  • Opioid-induced esophageal dysfunction (OIED), which includes spastic esophageal disorders (SEDs) and esophagogastric junction outflow obstruction (EGJOO), is the focus of a study that compares treatment outcomes of peroral endoscopic myotomy (POEM) between opioid users and nonusers.
  • The study involved a matched analysis of 128 patients (64 opioid users and 64 nonusers) who underwent POEM, ensuring that demographic and clinical characteristics were comparable.
  • Results showed that opioid users had a significantly lower clinical response to POEM (79.7% vs. 93.8%), with higher daily opioid doses linked to a greater likelihood of treatment failure.
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