Publications by authors named "Sana Kenshil"
Article Synopsis
- Stent misdeployment (SMD) is a significant challenge in EUS-guided choledochoduodenostomy (EUS-CDS) for treating malignant distal biliary obstruction, with the study aiming to define its rate and outcomes, and propose a classification system.
- In a review of data from two randomized controlled trials involving 152 patients, SMD was found in 7.2% of cases, with most types being misdeployments of the distal flange (type I) and a small number causing minor adverse events.
- The analysis revealed that a smaller extrahepatic bile duct diameter (≤ 15 mm) increases the likelihood of SMD or technical failures, but most misdeployments can be successfully managed
Article Synopsis
- EUS-CDS (endoscopic ultrasound-guided choledochoduodenostomy) was compared to ERCP-M (endoscopic retrograde cholangiopancreatography with metal stenting) for treating malignant distal biliary obstruction in a randomized controlled trial involving patients with specific cancer types.
- The study found that EUS-CDS had a shorter procedure time and a high technical success rate (90.4%), comparable to ERCP-M (83.1%), with similar rates of stent dysfunction (9.6% vs 9.9%).
- The results suggest that while EUS-CDS is not superior, it is a safe and efficient alternative to ERCP-M, advocating for its broader use in clinical settings.
Article Synopsis
- - The study focuses on finding effective ways to differentiate Crohn's disease from cryptoglandular disease in patients with isolated perianal fistulas who showed no visible inflammation during traditional imaging tests like ileocolonoscopy and enterography.
- - Researchers used video capsule endoscopy to evaluate 45 adults with isolated perianal fistulas and discovered that 26% of these patients had signs of Crohn's disease, significantly higher than the 3% found in controls without perianal fistulas.
- - The study concludes that video capsule endoscopy is a promising tool for detecting small intestine inflammation in these patients, although more extensive research is necessary to confirm these findings.
Background: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the standard in the diagnosis of solid pancreatic lesions, in particular when combined with rapid onsite evaluation of cytopathology (ROSE). More recently, a fork-tip needle for core biopsy (FNB) has been shown to be associated with excellent diagnostic yield. EUS-FNB alone has however not been compared with EUS-FNA + ROSE in a large clinical trial.
View Article and Find Full Text PDFBackground & Aims: Endoscopic ultrasound guided-biliary drainage (EUS-BD) is a promising alternative to endoscopic retrograde cholangiopancreatography (ERCP); however, its growth has been limited by a lack of multicenter randomized controlled trials (RCT) and dedicated devices. A dedicated EUS-BD lumen- apposing metal stent (LAMS) has recently been developed with the potential to greatly facilitate the technique and safety of the procedure. We aim to compare a first intent approach with EUS-guided choledochoduodenostomy with a dedicated biliary LAMS vs.
View Article and Find Full Text PDFBackground And Aims: Minimum EUS and ERCP volumes that should be offered per trainee in "high quality" advanced endoscopy training programs (AETPs) are not established. We aimed to define the number of procedures required by an "average" advanced endoscopy trainee (AET) to achieve competence in technical and cognitive EUS and ERCP tasks to help structure AETPs.
Methods: American Society for Gastrointestinal Endoscopy (ASGE)-recognized AETPs were invited to participate; AETs were graded on every fifth EUS and ERCP examination using a validated tool.
Background: While most pancreatic fluid collections (PFCs) resolve spontaneously, endoscopic ultrasound-guided transluminal drainage (EUS-TD) may be necessary. EUS-TD has evolved from multiple double-pigtail plastic stents (DPPS) to fully covered self-expanding metal stents (FCSEMS) and lumen-apposing metal stents (LAMS). This study compares clinical attributes of DPPS, FCSEMS and LAMS.
View Article and Find Full Text PDFBackground & Aims: It is unclear whether participation in competency-based fellowship programs for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) results in high-quality care in independent practice. We measured quality indicator (QI) adherence during the first year of independent practice among physicians who completed endoscopic training with a systematic assessment of competence.
Methods: We performed a prospective multicenter cohort study of invited participants from 62 training programs.