Publications by authors named "Khaled Elfert"

Background And Aims: Pancreatitis is the most common serious adverse event associated with endoscopic retrograde cholangiopancreatography (ERCP). This meta-analysis aimed to precisely assess the risk factors for post-ERCP pancreatitis (PEP).

Methods: We searched electronic databases for studies that assessed risk factors for PEP after adjusting for ≥3 risk factors, including at least one pre-specified patient-related and one procedure-related risk factor, and reported the data as adjusted odds ratios (OR) with 95% confidence intervals.

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  • * An analysis of over 93,000 CA procedures revealed that patients with LC had a similar in-hospital mortality rate as those without LC but experienced higher overall complications and incurred greater costs.
  • * While the length of hospital stay was comparable, the study suggests that further long-term research is necessary to thoroughly evaluate the safety of CA for patients with liver cirrhosis.
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Background: Endoscopic submucosal dissection (ESD) has revolutionized the treatment of early stage gastrointestinal cancers. However, ESD can be associated with increased postprocedural pain and higher complication rates. This systematic review and meta-analysis evaluated the efficacy and safety of local anesthesia.

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Background/aims: Nonagenarians will purportedly account for 10% of the United States population by 2050. However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group.

Methods: The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD).

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The increasing prevalence of bariatric surgery, particularly Roux-en-Y gastric bypass, has necessitated innovative approaches for endoscopic retrograde cholangiopancreatography (ERCP) due to the altered anatomy. Laparoscopy-assisted ERCP offers high success rates but leads to extended hospital stays and an increased risk of adverse events. Enteroscopy-assisted ERCP encounters technical challenges, resulting in lower success rates.

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  • - Non-alcoholic fatty liver disease (NAFLD) includes a range of liver conditions without heavy alcohol use and can lead to serious issues like cirrhosis; the study aimed to explore its connection to carotid intimal media thickness (C-IMT), a marker for heart disease.
  • - A comprehensive review of existing studies indicated no significant C-IMT differences for mild to moderate NAFLD when compared to controls, but severe NAFLD did show a notable difference, particularly in those with or without metabolic syndrome.
  • - The findings highlight a significant link between NAFLD and increased C-IMT, suggesting the need for C-IMT assessments in NAFLD patients to gauge their cardiovascular
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  • A gastrointestinal variant of Lemierre's syndrome (LS), linked to Fusobacterium species, can lead to serious complications like pylephlebitis and liver abscesses, which are becoming increasingly recognized in medical literature.
  • A systematic review of 36 patients showed that the majority were middle-aged men with symptoms like fever and abdominal pain, and common findings included portal vein thrombosis and liver abscesses.
  • Effective treatment often involves antibiotics, abscess drainage, and long-term anticoagulation, with no reported deaths in the studied cases, emphasizing the importance of timely diagnosis and management.
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  • Autoimmune pancreatitis (AIP) is a complex disease that has received more attention recently, particularly concerning the role of serum immunoglobulin G4 (IgG4) levels in its diagnosis and treatment.
  • A study found that patients with elevated IgG4 levels had a more active immune response and higher likelihood of relapses, indicating that both IgG4 and IgA levels, along with patient age, are important for assessing relapse risk and tailoring treatments.
  • Despite these insights, the study faced limitations, such as the lack of correlation between IgA and IgG4 levels, missing information on key AIP cases, and insufficient exploration of genetic factors, highlighting the need for better diagnostic tools for patients with low or absent
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Background: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a medical emergency that has significant morbidity and mortality. The available data about the impact of COVID-19 infection on mortality in patients with NVUGIB is limited.

Methods: We identified all hospitalizations with a principal diagnosis of NVUGIB in 2020.

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Introduction: Whether dye spray chromoendoscopy (DCE) adds value in surveillance colonoscopy with high-definition (HD) scopes remains controversial. This updated meta-analysis compares dysplasia detection using DCE and high-definition white light endoscopy (HD-WLE) in patients with inflammatory bowel disease (IBD) undergoing surveillance colonoscopy.

Methods: A comprehensive search was performed for randomized controlled trials (RCT) comparing HD-WLE and DCE in patients with IBD.

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Background: Primary sclerosing cholangitis (PSC) is a chronic progressive disease that primarily affects the medium and large biliary ducts.

Methods: This study investigated the baseline characteristics and predictors of clinical outcomes among hospitalized patients with PSC in the US. Using the National Inpatient Sample database from 2018 to 2020, we included adults with a principal diagnosis of PSC.

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Background: infection (CDI) is a significant healthcare-associated infection with implications for patient morbidity, mortality, and healthcare costs. However, the connection between CDI and coronavirus disease 2019 (COVID-19) infection and its influence on patient outcomes remain uncertain. This study aimed to examine the association between CDI and COVID-19, specifically investigating whether CDI worsens outcomes in patients with COVID-19.

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Background/aims: The pancreatic pseudocyst (PP) is a type of fluid collection that typically develops as a delayed complication of acute pancreatitis. Drainage is indicated for symptomatic patients and/or associated complications, such as infection and bleeding. Drainage modalities include percutaneous, endoscopic, laparoscopic, and open drainage.

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Electrolyte imbalances are common problems among hospitalized patients, and they can have severe consequences. Although rare, severe hyponatremia or low sodium (Na) levels have been associated with the occurrence of rhabdomyolysis. This is a case of a 45-year-old man who presented with confusion and lethargy and was found to have severe hyponatremia with an elevated creatine phosphokinase (CPK) level of 45,440 IU/L.

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Background: Extreme transaminase elevation > 1000 international units per liter (IU/L) is typically caused by hepatocellular injury due to ischemia, drugs, or viral infection. Acute choledocholithiasis can also present with marked transaminase elevation mimicking severe hepatocellular injury, contrary to the presumed cholestatic pattern.

Methods: We searched PubMed/Medline, EMBASE, Cochrane Library, and Google Scholar for studies reporting the proportion of marked elevation of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 1000 IU/L in patients with common bile duct (CBD) stones.

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Background: The role of variceal embolization (VE) during transjugular intrahepatic portosystemic shunt (TIPS) creation for preventing gastroesophageal variceal rebleeding remains controversial. Therefore, we performed a meta-analysis to compare the incidence of variceal rebleeding, shunt dysfunction, encephalopathy, and death between patients treated with TIPS alone and those treated with TIPS in combination with VE.

Methods: We performed a literature search using PubMed, EMBASE, Scopus, and Cochrane databases for all studies comparing the incidence of complications between TIPS alone and TIPS with VE.

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Background: Lumen-apposing metal stents (LAMSs) are often used to drain pancreatic fluid collections (PFCs). However, adverse events, such as stent obstruction, infection, or bleeding, have been reported. Concurrent double-pigtail plastic stent (DPPS) deployment has been suggested to prevent these adverse events.

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EUS-guided therapeutic procedures have emerged in the recent years as a minimally invasive option for the management of complex hepatobiliary disorders. Gastrointestinal surgeries, e.g.

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