Browsing by Author "Buxbaum, James L."

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    ASGE Guideline on role of endoscopy in the diagnosis of malignancy in biliary strictures of undetermined etiology: Methodology and Review of Evidence
    (Elsevier, 2023) Fujii-Lau, Larissa L.; Thosani, Nirav C.; Al-Haddad, Mohammad; Acoba, Jared; Wray, Curtis J.; Zvavanjanja, Rodrick; Amateau, Stuart K.; Buxbaum, James L.; Wani, Sachin; Calderwood, Audrey H.; Chalhoub, Jean M.; Coelho-Prabhu, Nayantara; Desai, Madhav; Elhanafi, Sherif E.; Fishman, Douglas S.; Forbes, Nauzer; Jamil, Laith H.; Jue, Terry L.; Kohli, Divyanshoo R.; Kwon, Richard S.; Law, Joanna K.; Lee, Jeffrey K.; Machicado, Jorge D.; Marya, Neil B.; Pawa, Swati; Ruan, Wenly; Sawhney, Mandeep S.; Sheth, Sunil G.; Storm, Andrew; Thiruvengadam, Nikhil R.; Qumseya, Bashar J.; Medicine, School of Medicine
    Biliary strictures of undetermined etiology pose a diagnostic challenge for endoscopists. Despite advances in technology, diagnosing malignancy in biliary strictures often requires multiple procedures. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rigorously review and synthesize the available literature on strategies used to diagnose undetermined biliary strictures. Using a systematic review and meta-analysis of each diagnostic modality, including fluoroscopic-guided biopsies, brush cytology, cholangioscopy, and endoscopic ultrasound fine needle aspiration or biopsy, the American Society of Gastrointestinal Endoscopy (ASGE) Standards of Practice committee provides this guideline on modalities used to diagnose biliary strictures of undetermined etiology. This document summarizes the methods used in the GRADE analysis to make recommendations, while the "Summary and Recommendations" document contains a concise summary of our findings and final recommendations.
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    ASGE Guideline on the role of endoscopy in the diagnosis of malignancy in biliary strictures of undetermined etiology: Summary and Recommendations
    (Elsevier, 2023) Fujii-Lau, Larissa L.; Thosani, Nirav C.; Al-Haddad, Mohammad; Acoba, Jared; Wray, Curtis J.; Zvavanjanja, Rodrick; Amateau, Stuart K.; Buxbaum, James L.; Calderwood, Audrey H.; Chalhoub, Jean M.; Coelho-Prabhu, Nayantara; Desai, Madhav; Elhanafi, Sherif E.; Fishman, Douglas S.; Forbes, Nauzer; Jamil, Laith H.; Jue, Terry L.; Kohli, Divyanshoo R.; Kwon, Richard S.; Law, Joanna K.; Lee, Jeffrey K.; Machicado, Jorge D.; Marya, Neil B.; Pawa, Swati; Ruan, Wenly; Sawhney, Mandeep S.; Sheth, Sunil G.; Storm, Andrew; Thiruvengadam, Nikhil R.; Qumseya, Bashar J.; Medicine, School of Medicine
    This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for the diagnosis of malignancy in patients with biliary strictures of undetermined etiology. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and addresses the role of fluoroscopic-guided biopsies, brush cytology, cholangioscopy, and endoscopic ultrasound (EUS) in the diagnosis of malignancy in patients with biliary strictures. In the endoscopic work-up of these patients, we suggest the use of fluoroscopic-guided biopsies in addition to brush cytology over brush cytology alone, especially for hilar strictures. Especially for patients with, non-diagnostic sampling we suggest the use of cholangioscopic and EUS-guided biopsies; the former for non-distal and the latter for distal strictures or those with suspected spread to surrounding lymph nodes and other structures.
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    ASGE Guideline on the Role of Ergonomics for Prevention of Endoscopy-related Injury (ERI): Summary and Recommendations
    (ASGE, 2023-10) Pawa, Swati; Kwon, Richard S.; Fishman, Douglas S.; Thosani, Nirav C.; Shergill, Amandeep; Grover , Samir C.; Al-Haddad, Mohammad; Amateau, Stuart K.; Buxbaum, James L.; Calderwood , Audrey H.; Chalhoub, Jean M.; Coelho-Prabhu, Nayantara; Desai, Madhav; Elhanafi, Sherif E.; Forbes , Nauzer; Fujii-Lau, Larissa L.; Kohli , Divyanshoo R.; Machicado, Jorge D.; Marya, Neil B.; Ruan, Wenly; Sheth, Sunil G.; Storm, Andrew C.; Thiruvengadam, Nikhil R.; Qumseya, Bashar J.; Medicine, School of Medicine
    This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach to strategies to prevent endoscopy-related injury (ERI) in GI endoscopists. It is accompanied by the article subtitled “Methodology and Review of Evidence,” which provides a detailed account of the methodology used for the evidence review. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline estimates the rates, sites, and predictors of ERI. Additionally, it addresses the role of ergonomics training, microbreaks and macrobreaks, monitor and table positions, antifatigue mats, and use of ancillary devices in decreasing the risk of ERI. We recommend formal ergonomics education and neutral posture during the performance of endoscopy, achieved through adjustable monitor and optimal procedure table position, to reduce the risk of ERI. We suggest taking microbreaks and scheduled macrobreaks and using antifatigue mats during procedures to prevent ERI. We suggest the use of ancillary devices in those with risk factors predisposing them to ERI.
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    Dynamic changes in the pancreatitis activity scoring system during hospital course in a multicenter, prospective cohort
    (Wiley, 2021) Paragomi, Pedram; Tuft, Marie; Pothoulakis, loannis; Singh, Vikesh K.; Stevens, Tyler; Nawaz, Haq; Easler, Jeffrey J.; Thakkar, Shyam; Cote, Gregory A.; Lee, Peter J.; Akshintala, Venkata; Kamal, Ayesha; Gougol, Amir; Evans Phillips, Anna; Machicado, Jorge D.; Whitcomb, David C.; Greer, Phil J.; Buxbaum, James L.; Hart, Phil; Conwell, Darwin; Tang, Gong; Wu, Bechien U.; Papachristou, Georgios I.; Medicine, School of Medicine
    Background and aim: The primary aim was to validate the Pancreatitis Activity Scoring System (PASS) in a multicenter prospectively ascertained acute pancreatitis (AP) cohort. Second, we investigated the association of early PASS trajectories with disease severity and length of hospital stay (LOS). Methods: Data were prospectively collected through the APPRENTICE consortium (2015-2018). AP severity was categorized based on revised Atlanta classification. Delta PASS (ΔPASS) was calculated by subtracting activity score from baseline value. PASS trajectories were compared between severity subsets. Subsequently, the cohort was subdivided into three LOS subgroups as short (S-LOS): 2-3 days; intermediate (I-LOS): 3-7 days; and long (L-LOS): ≥7 days. The generalized estimating equations model was implemented to compare PASS trajectories. Results: There were 434 subjects analyzed including 322 (74%) mild, 86 (20%) moderately severe, and 26 (6%) severe AP. Severe AP subjects had the highest activity levels and the slowest rate of decline in activity (P = 0.039). Focusing on mild AP, L-LOS subjects (34%) had 28 points per day slower decline; whereas, S-LOS group (13%) showed 34 points per day sharper decrease compared with I-LOS (53%; P < 0.001). We noticed an outlier subset with a median admission-PASS of 466 compared with 140 in the rest. Morphine equivalent dose constituted 80% of the total PASS in the outliers (median morphine equivalent dose score = 392), compared with only 25% in normal-range subjects (score = 33, P value < 0.001). Conclusions: This study highlighted that PASS can quantify AP activity. Significant differences in PASS trajectories were found both in revised Atlanta classification severity and LOS groups, which can be harnessed in AP monitoring/management (ClincialTrials.gov number, NCT03075618).
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    Rationale and Design for the Diabetes RElated to Acute Pancreatitis and Its Mechanisms (DREAM) Study: A Prospective Cohort Study From the Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC)
    (Wolters Kluwer, 2022) Hart, Phil A.; Papachristou, Georgios I.; Park, Walter G.; Dyer, Anne-Marie; Chinchilli, Vernon M.; Afghani, Elham; Akshintala, Venkata S.; Andersen, Dana K.; Buxbaum, James L.; Conwell, Darwin L.; Dungan, Kathleen M.; Easler, Jeffrey J.; Fogel, Evan L.; Greenbaum, Carla J.; Kalyani, Rita R.; Korc, Murray; Kozarek, Richard; Laughlin, Maren R.; Lee, Peter J.; Maranki, Jennifer L.; Pandol, Stephen J.; Evans Phillips, Anna; Serrano, Jose; Singh, Vikesh K.; Speake, Cate; Tirkes, Temel; Toledo, Frederico G. S.; Trikudanathan, Guru; Vege, Santhi Swaroop; Wang, Ming; Yazici, Cemal; Zaheer, Atif; Forsmark, Christopher E.; Bellin, Melena D.; Yadav, Dhiraj; Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC); Medicine, School of Medicine
    Acute pancreatitis (AP) is a disease characterized by an acute inflammatory phase followed by a convalescent phase. Diabetes mellitus (DM) was historically felt to be a transient phenomenon related to acute inflammation; however, it is increasingly recognized as an important late and chronic complication. There are several challenges that have prevented precisely determining the incidence rate of DM after AP and understanding the underlying mechanisms. The DREAM (Diabetes RElated to Acute Pancreatitis and its Mechanisms) Study is a prospective cohort study designed to address these and other knowledge gaps to provide the evidence needed to screen for, prevent, and treat DM after AP. In the following article, we summarize literature regarding the epidemiology of DM after AP and provide the rationale and an overview of the DREAM study.
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    SpHincterotomy for Acute Recurrent Pancreatitis Randomized Trial: Rationale, Methodology, and Potential Implications
    (Wolters Kluwer, 2019-09-01) Coté, Gregory A.; Durkalski-Mauldin, Valerie L.; Serrano, Jose; Klintworth, Erin; Williams, April W.; Cruz-Monserrate, Zobeida; Arain, Mustafa; Buxbaum, James L.; Conwell, Darwin L.; Fogel, Evan L.; Freeman, Martin L.; Gardner, Timothy B.; van Geenen, Erwin; Groce, J. Royce; Jonnalagadda, Sreenivasa S.; Keswani, Rajesh N.; Menon, Shyam; Moffatt, Dana C.; Papachristou, Georgios I.; Ross, Andrew; Tarnasky, Paul R.; Wang, Andrew Y.; Wilcox, C. Mel; Hamilton, Frank; Yadav, Dhiraj; Consortium for the SHARP; Medicine, School of Medicine
    Objectives: In patients with acute recurrent pancreatitis (ARP), pancreas divisum, and no other etiologic factors, endoscopic retrograde cholangiopancreatography (ERCP) with minor papilla endoscopic sphincterotomy (miES) is often performed to enlarge the minor papillary orifice, based on limited data. The aims of this study are to describe the rationale and methodology of a sham-controlled clinical trial designed to test the hypothesis that miES reduces the risk of acute pancreatitis. Methods: The SpHincterotomy for Acute Recurrent Pancreatitis (SHARP) trial is a multicenter, international, sham-controlled, randomized trial comparing endoscopic ultrasound + ERCP with miES vs. endoscopic ultrasound + sham for the management of ARP. A total of 234 consented patients having two or more discrete episodes of acute pancreatitis, pancreas divisum confirmed by magnetic resonance cholangiopancreatography, and no other clear etiology for acute pancreatitis will be randomized. Both cohorts will be followed for a minimum of 6 months and maximum of 48 months. Results: The trial is powered to detect a 33% risk reduction of acute pancreatitis frequency. Conclusions: The SHARP trial will determine whether ERCP with miES benefits patients with idiopathic ARP and pancreas divisum. Trial planning has informed the importance of blinded outcome assessors and long-term follow-up.