Publications by authors named "Shyam Thakkar"
Introduction: Roux-en-Y gastric bypass (RYGB) related late gastro-jejunal (GJ) strictures are often resistant to endoscopic balloon dilations. Lumen-apposing metal stents (LAMSs) have been used to treat benign strictures with favorable results. However, the data remains limited to justify LAMS use for management of post-RYGB late GJ strictures.
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- - The study investigates the effectiveness of endoscopic ultrasound (EUS)-guided celiac plexus block versus a sham procedure in alleviating abdominal pain for patients suffering from chronic pancreatitis, with the aim of determining pain reduction statistics.
- - Conducted as a randomized sham-controlled trial, the research will involve multiple academic sites and focus on patients whose chronic pancreatitis is confirmed by EUS diagnostic criteria, measuring outcomes like pain reduction through specific pain assessment tools.
- - The ultimate goal is to provide a clear evaluation of celiac plexus block’s efficacy compared to a placebo treatment, which may help in managing chronic pain related to pancreatitis more effectively.
Article Synopsis
- The study investigates how an artificial intelligence (AI) tool improves the detection of colorectal polyps during colonoscopy, particularly for patients with poor bowel preparation.
- Using a case-control design and propensity score matching, researchers analyzed data from 2017 to 2023 to compare colonoscopies performed with and without AI assistance.
- Results show that AI significantly increased the detection rates of various types of polyps, especially in patients with inadequate preparation, highlighting its potential role in enhancing colonoscopy outcomes.
Background And Aims: Fully covered self-expandable metal stents are commonly used for managing GI adverse events like perforations, leaks, fistulas, and strictures. Although effective, stent length and migration can be a limitation when dealing with larger defects. Over-the-scope clips and over-the-scope suturing can be used to mitigate migration risk; however, their role is limited for stent-to-stent suturing to create longer stents.
View Article and Find Full Text PDFBackground And Aims: The American Society for Gastrointestinal Endoscopy (ASGE) AI Task Force along with experts in endoscopy, technology space, regulatory authorities, and other medical subspecialties initiated a consensus process that analyzed the current literature, highlighted potential areas, and outlined the necessary research in artificial intelligence (AI) to allow a clearer understanding of AI as it pertains to endoscopy currently.
Methods: A modified Delphi process was used to develop these consensus statements.
Results: Statement 1: Current advances in AI allow for the development of AI-based algorithms that can be applied to endoscopy to augment endoscopist performance in detection and characterization of endoscopic lesions.
Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an essential therapeutic tool for biliary and pancreatic diseases. Frail and elderly patients, especially those aged ≥ 90 years are generally considered a higher-risk population for ERCP-related complications.
Aim: To investigate outcomes of ERCP in the Non-agenarian population (≥ 90 years) concerning Frailty.
Background: Although the preferred management approach for patients with infected necrotising pancreatitis is endoscopic transluminal stenting followed by endoscopic necrosectomy as step-up treatment if there is no clinical improvement, the optimal timing of necrosectomy is unclear. Therefore, we aimed to compare outcomes between performing upfront necrosectomy at the index intervention versus as a step-up measure in patients with infected necrotising pancreatitis.
Methods: This single-blinded, multicentre, randomised trial (DESTIN) was done at six tertiary care hospitals (five hospitals in the USA and one hospital in India).
Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a safe and efficacious procedure to treat pancreaticobiliary diseases in Roux-en-Y gastric bypass (RYGB). This multicenter study aimed to determine the long-term outcomes of EDGE focusing on fistula persistence rates and post-procedure weight change. Information about patients with Roux-en-Y gastric bypass anatomy who underwent EDGE between 2015 and 2021 from 10 institutions was captured in a registry.
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- The study developed a new DNA/RNA next-generation sequencing platform called PancreaSeq Genomic Classifier to enhance the evaluation of pancreatic cysts, particularly in identifying cystic precursor neoplasms and advanced neoplasia.
- This platform features a 74-gene targeted NGS panel that assesses various genomic alterations, and it was validated in separate cohorts, demonstrating high sensitivity and specificity for diagnosing pancreatic conditions.
- The results show that PancreaSeq significantly increased the sensitivity of traditional pancreatic cyst guidelines by over 10% while maintaining high specificity, indicating its potential to improve clinical decision-making.
Introduction: Cholecystectomy (CCY) is the gold standard treatment of acute cholecystitis (AC). Nonsurgical management of AC includes percutaneous transhepatic gallbladder drainage (PT-GBD) and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD). This study aims to compare outcomes of patients who undergo CCY after having received EUS-GBD vs PT-GBD.
View Article and Find Full Text PDFObjectives: There have been conflicting reports concerning an increased risk of pancreatic cancer (PC) in new users of glucagon-like peptide-1 agonists (GLP-1As). We aimed to explore whether the use of GLP-1A is associated with an increased risk of PC.
Methods: A multicenter, retrospective cohort study was conducted using TriNetX.
Article Synopsis
- Multisystem organ failure (MSOF) is a serious condition that can occur in people with acute pancreatitis (AP), and it is a major cause of death.
- The study looked at how obesity and alcohol-related causes affect the risk of MSOF in patients with AP through a big research project involving many hospitals in different countries.
- The results showed that obese men are more likely to have MSOF, and people who drink alcohol also have a higher risk, while obesity does not seem to affect women in the same way.
Importance: Bariatric surgery (BS) is associated with significantly reduced incidence of cardiovascular diseases and mortality in patients with obesity. However, whether BS can decrease major adverse cardiovascular events in patients with nonalcoholic fatty liver disease (NAFLD) remains poorly understood.
Objective: To investigate the association of BS with the incidence of adverse cardiovascular events and all-cause mortality in patients with NAFLD and obesity.
Background: Celiac disease (CD) has been associated with gastrointestinal malignancies. However, the magnitude of the risk of pancreatic cancer (PC) associated with CD is much less clear, and risks have not been estimated from large populations.
Aim: To assess the risk of PC in CD patients.
Background: Patients with autoimmune hepatitis (AIH) require life-long immunosuppressive agents that may increase the risk of poor coronavirus disease 2019 (COVID-19) outcomes. There is a paucity of large data at the population level to assess whether patients with AIH have an increased risk of severe diseases.
Aim: To evaluate the impact of pre-existing AIH on the clinical outcomes of patients with COVID-19.
BACKGROUND : Multiple devices are available for tissue approximation. A new through-the-scope suturing (TTSS) device has recently been introduced; however, data on its scope of use and clinical effectiveness are limited. We aimed to assess the clinical course and effectiveness of this TTSS device.
View Article and Find Full Text PDFVideo 1Use of a novel endoscopic tack and suture system for the management of pancreatocolonic fistula.
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- This study aimed to prospectively evaluate the effectiveness of next-generation sequencing (NGS) on pancreatic cyst fluid in a multi-institutional setting, as previous research had mainly been retrospective or focused on single hospitals.
- In total, 1933 pancreatic cyst specimens were tested, with 98% being satisfactory for NGS analysis, and findings were correlated with current guidelines and surgical outcomes.
- Results indicated that mutations such as GNAS had high sensitivity and specificity for diagnosing mucinous cysts and that combining genomic alterations with cytopathologic evaluation significantly improved diagnostic accuracy compared to existing guidelines.