Publications by authors named "Douglas G Adler"

Primary sclerosing cholangitis (PSC) is a risk factor for cholangiocarcinoma. When a child is diagnosed with both PSC and inflammatory bowel disease (IBD), evidence-based information on counseling families and risk management of developing cholangiocarcinoma is limited. In this case series (PubMed/collaborators), we included patients with PSC-IBD who developed cholangiocarcinoma and contacted authors to determine an event curve specifying the time between the second diagnosis (IBD or PSC) and a diagnosis of cholangiocarcinoma.

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Article Synopsis
  • The study focuses on developing guidelines for the safe use of fluoroscopy in gastrointestinal endoscopy, balancing its benefits with concerns about radiation exposure to patients and healthcare workers.
  • A modified Delphi method was used, involving three rounds of surveys with 46 experts, resulting in 43 proposed statements, of which 31 achieved consensus and were prioritized across various categories such as Patient Safety and Staff Safety.
  • The final consensus statements highlight the importance of education and safety measures, with a significant majority rated as high priority, aiming to enhance safety culture in healthcare settings while utilizing fluoroscopy.
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Background/objectives: Predicting inpatient mortality for acute pancreatitis (AP) patients in the ICU is crucial for optimal treatment planning. This study aims to develop a concise risk score model for this purpose, enhancing the predictability and management of AP in ICU settings.

Methods: We included 380 patients in our training set.

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Background And Aims: Effect of underwater endoscopic submucosal dissection (UESD) on clinical outcomes as compared with conventional ESD (CESD) remains unclear. We conducted a meta-analysis of the available data.

Methods: Online databases were searched for studies comparing UESD with CESD for colorectal lesions.

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Article Synopsis
  • IgG4 pancreaticobilliary disease (IgG4-PBD) often recurs after glucocorticoid treatment, leading researchers to investigate rituximab (RTX) as a potential solution to prevent relapses.
  • A systematic review and meta-analysis assessed available studies on the efficacy and safety of RTX in treating IgG4-PBD, analyzing outcomes like remission and adverse events.
  • Results showed that RTX led to a 68% rate of complete remission and a low relapse rate of 23%, with few adverse events, indicating RTX is a promising treatment for managing recurrent IgG4-PBD, particularly for patients who can’t tolerate steroids.
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Debridement of infected walled-off pancreatic necrosis is indicated to treat and prevent sepsis-related multiorgan failure. The aim of this study was to evaluate the efficacy and safety of the EndoRotor-powered endoscopic debridement system to remove solid debris under direct endoscopic visualization. Search strategies were developed for PubMed, EMBASE, and Cochrane Library databases from inception to June 2022, in accordance with Preferred Reporting items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines.

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EUS-guided hepaticogastrostomy (EUS-HGS) is one of the preferred methods in biliary drainage where ERCP fails or is contraindicated. The clinical outcomes of EUS-HGS are not well studied because of variability in procedure technique. We conducted a search of multiple electronic databases and conference proceedings from inception through January 2023.

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Objective: Gastric antral vascular ectasia (GAVE) is characterized by vascular ectasias accounting for 4% of nonvariceal upper gastrointestinal bleeds, which can range from occult bleeds to severe acute upper gastrointestinal bleeding. In turn, GAVE can lead to severe morbidity and recurrent hospitalization. Current endoscopic treatments for GAVE include argon plasma coagulation (APC), endoscopic band ligation (EBL), and radiofrequency ablation.

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Background: Anastomotic strictures following colectomy and proctectomy are a significant cause of benign lower gastrointestinal tract (LGIT) obstruction, with a reported incidence of up to 30%. Endoscopic interventions such as balloon dilation, stricturotomy, mechanical dilation, electrocautery incision, and stent placement are utilized for management. This meta-analysis aimed to evaluate the efficacy and safety of endoscopic interventions for the management of benign LGIT anastomotic strictures.

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Background: Crohn's disease (CD) predisposes patients to intestinal obstruction (IO), a severe complication. This study examined the outcomes and healthcare utilization of patients with CD and IO using data from the National Inpatient Sample (NIS).

Methods: This retrospective analysis of NIS data from 2016-2020 compared hospitalized adult CD patients with and without IO.

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Background And Aims: Gastric peroral endoscopic myotomy (G-POEM) is an emerging treatment for refractory gastroparesis. Although its efficacy and safety have been analyzed in previous systematic reviews and meta-analyses, no studies have compared its effectiveness based on etiology. Our study aims to evaluate the efficacy and safety of G-POEM by etiologies of gastroparesis.

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Background & Aims: Sleeve gastrectomy (SG) is one of the most commonly performed bariatric procedures worldwide. Gastroesophageal reflux disease (GERD) is a major concern in patients undergoing SG and is a risk factor for Barrett's esophagus (BE). We conducted a systematic review and meta-analysis to assess the incidence of and analyze predictive factors for post-SG BE.

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Background: Microscopic colitis (MC) is an inflammatory bowel disease of autoimmune origin that causes chronic watery diarrhea. Medications, including budesonide, mesalamine, loperamide, cholestyramine, and bismuth subsalicylate, are first-line therapies. Meanwhile, azathioprine, 6-mercaptopurine, and methotrexate are indicated for refractory MC.

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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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