Citations 2
US multicenter outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents for acute cholecystitis
David, Yakira , Kakked, Gaurav, Confer, Bradley , Shah, Ruchit N. , Khara, Harshit S. , Diehl, David L. , Krafft, Matthew , Shah-Khan, Sardar M. , Nasr, John , Benias, Petros C. , Muniraj, Thiruvengadam , Aslanian, Harry R., Chahal, Prabhleen , Rodriguez, John , DuBroff, Jason, Latour, Rabi De, Khanna, Lauren , Haber, Gregory , Hoerter, Nicholas A. , Pandey, Nishi , Bakhit, Mena , Kowalski, Thomas E., Loren, David E. , Chiang, Austin , Schlachterman, Alexander , Nieto, Jose , Ichkhanian, Yervant , Khashab, Mouen A. , Halabi, Maan El , Kwon, Richard S. , Hernandez-Lara, Ariosto, Poneros, John M., Sethi, Amrita, Gonda, Tamas A. , Kushnir, Vladimir , Cosgrove, Natalie , Mullady, Daniel , Al-Shahrani, Abdullah , Buscaglia, Jonathan M. , Bucobo, Juan Carlos , Rolston, Vineet S. , Kedia, Prashant , Kasmin, Franklin, Kumta, Nikhil A. , DiMaio, Christopher J. , Krafft, Matthew Richard , Trindade, Arvind J. , Adler, Douglas G. , Tzimas, Demetrios J. , Goodman, Adam J. , Nieto, José , Deshmukh, Ameya A. , Prabhu, Anoop , Storm, Andrew C. , Berzin, Tyler M. , Sethi, Amrita , D'Souza, Lionel S. , Nagula, Satish
Endoscopy International Open | January 13, 2025 | Volume: 13 | Issue: CP | Pages: No page available
AbstractEUS-guided gallbladder drainage (EUS-GBD) using lumen apposing metal stents (LAMS) has excellent technical and short-term clinical success for acute cholecystitis (AC). The goals of this study were to determine the long-term clinical outcomes and adverse events (AEs) of EUS-GBD with LAMS.A multicenter, retrospective study was conducted at 18 US tertiary care institutions. Inclusion criteria: any AC patient with attempted EUS-GBD with LAMS and minimum 30-day post-procedure follow-up. Long-term clinical success was defined as absence of recurrent acute cholecystitis (RAC) > 30 days and long-term AE was defined as occurring > 30 days from the index procedure.A total of 109 patients were included. Technical success was achieved in 108 of 109 (99.1%) and initial clinical success in 106 of 109 (97.2%). Long-term clinical success was achieved in 98 of 109 (89.9%) over a median follow-up of 140 days (range 30–1188). On multivariable analysis (MVA), acalculous cholecystitis (odds ratio [OR] 15.93, 95% confidence interval [CI] 1.22–208.52, P = 0.04) and the occurrence of a LAMS-specific AE (OR 63.60, 95% CI 5.08–799.29, P <0.01) were associated with RAC. AEs occurred in 38 of 109 patients (34.9%) at any time, and in 10 of 109 (9.17%) > 30 days from the index procedure. Most long-term AEs (7 of 109; 6.42%) were LAMS-specific. No technical or clinical factors were associated with occurrence of AEs. LAMS were removed in 24 of 109 patients (22%). There was no difference in RAC or AEs whether LAMS was removed or not.EUS-GBD with LAMS has a high rate of long-term clinical success and modest AE rates in patients with AC and is a reasonable destination therapy for high-risk surgical candidates.
A novel through-the-scope helix tack-and-suture device for mucosal defect closure following colorectal endoscopic submucosal dissection: a multicenter study
Farha, Jad , Ramberan, Hemchand, Aihara, Hiroyuki , Zhang, Linda Y. , Mehta, Amit , Hage, Camille , Schlachterman, Alexander , Kumar, Anand , Shinn, Brianna , Canakis, Andrew , Kim, Raymond E., Buscaglia, Jonathan M. , Samarasena, Jason , Chang, Kenneth J. , Friedland, Shai , Qumseya, Bashar , Jawaid, Salmaan , Othman, Mohamed O. , Hasan, Muhammad K. , Khashab, Mouen A., Ngamruengphong, Saowanee , group, ESD-Closure working, Storm, Andrew C , Othman, Mohamed O , Canakis, Andrew , D'Souza, Lionel S. , Storm, Andrew C. , Draganov, Peter V. , Yang, Dennis J. , Khashab, Mouen A. , group, ESD-Closure working
Endoscopy | November 3, 2022 | Volume: 55 | Issue: 06 | Pages: 571-577
Background Complete closure of large mucosal defects following colorectal endoscopic submucosal dissection (ESD) with through-the-scope (TTS) clips is oftentimes not possible. We aimed to report our early experience of using a novel TTS suturing system for the closure of large mucosal defects after colorectal ESD. Methods We performed a retrospective multicenter cohort study of consecutive patients who underwent attempted prophylactic defect closure using the TTS suturing system after colorectal ESD. The primary outcome was technical success in achieving complete defect closure, defined as a < 5 mm residual mucosal defect in the closure line using TTS suturing, with or without adjuvant TTS clips. Results 82 patients with a median defect size of 30 (interquartile range 25–40) mm were included. Technical success was achieved in 92.7 % (n = 76): TTS suturing only in 44 patients (53.7 %) and a combination of TTS suturing to approximate the widest segment followed by complete closure with TTS clips in 32 (39.0 %). Incomplete/partial closure, failure of appropriate TTS suture deployment, and the need for over-the-scope salvage closure methods were observed in 7.3 % (n = 6). One intraprocedural bleed, one delayed bleed, and three intraprocedural perforations were observed. There were no adverse events related to placement of the TTS suture. Conclusion The TTS suture system is an effective and safe tool for the closure of large mucosal defects after colorectal ESD and is an alternative when complete closure with TTS clips alone is not possible.