Shyam Thakkar

West Virginia University | WVU · Division of Gastroenterology

Objectives: Quantify the risk of drug-induced pancreatitis (DIP) from angiotensin-converting enzyme inhibitors (ACEis) and 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (statins). Methods: Retrospective cohort analysis using IBM Explorys (1999-2019), a pooled, deidentified clinical database of more than 63 million patients across the Unit...

In summary, we report on the testing of a new digital tool designed to support physicians caring for patients with AP using the APPRENTICE cohort

Background Persistent organ failure (POF) is the strongest determinant of mortality in acute pancreatitis (AP). There is a paucity of data regarding the impact of different POF attributes on mortality and the role of different characteristics of systemic inflammatory response syndrome (SIRS) in the risk of developing POF. Objective We aimed to ass...

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 throu...

Background and aims: Endoscopic resection of lesions involving the appendiceal orifice (AO) remains a challenge. We aim to report the outcomes of full-thickness resection device (FTRD) for the resection of appendiceal lesions and identify factors associated with the occurrence of appendicitis. Methods: This is a retrospective study at 18 tertiar...

Objective: While single-use and detachable-tip duodenoscopes have been recently developed to overcome risks of infection transmission, there are no reliable tools to objectively assess their technical performance. We evaluated the reliability and validity of a newly developed tool to assess the technical performance of reusable duodenoscopes. Met...

Background: Inability to advance to an oral diet, or oral feeding intolerance, is a common complication in patients with acute pancreatitis associated with worse clinical outcomes. The factors related to oral feeding intolerance are not well studied. Objective: We aimed to determine the incidence and risk factors of oral feeding intolerance in a...

Purpose Despite advances in various treatment modalities, surgical resection for pancreatic ductal adenocarcinoma (PDA) remains the only curative treatment. Data remains limited regarding survival rates for resectable PDA when managed by a multidisciplinary pancreas conference (MDPC). The aim of this study is to assess survival rates, identify sign...

Objectives: The aim of this study was to evaluate depression in pancreatic cancer (PC) patients before and after a cancer diagnosis using a US-based healthcare database. We also sought to study the impact of treatment of depression in PC patients on all-cause mortality. Methods: Pancreatic cancer patients with comorbid depression in Explorys (19...

Background and study aims Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) (EDGE) is a novel technique for managing pancreaticobiliary diseases in patients with a history of Roux-en-Y Gastric Bypass (RYGB). It has shown to have high technical success rates and fewer adverse events as compared to lapa...

Background: Endoscopic resection of lesions involving the appendix remains a challenge. The full-thickness resection device (FTRD) has emerged as a novel device for FTR of difficult colonic lesions, including those involving the appendix. Data on its use for appendiceal lesions are scarce and risk of appendicitis remains a concern. Aims: To study t...

Background and Aims Artificial intelligence (AI), specifically deep learning, offers the potential to enhance the field of gastrointestinal endoscopy in areas ranging from lesion detection and classification, to quality metrics and documentation. Progress in this field will be measured by whether AI implementation can lead to improved patient outco...

Background and Aims GI angiodysplasia is the most common cause of small-bowel bleeding. Argon plasma coagulation (APC) is preferred for ablation because of its availability, ease of use, and perceived safety, but it has limitations. An instrument capable of repeated use through the enteroscope, which covers more area of intestinal mucosa per treatm...

Background: The clinical features and outcomes of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) are not well-established. Objective: To evaluate the clinical characteristics of HTG-AP in an international, multicenter prospective cohort. Methods: Data collection was conducted prospectively through APPRENTICE between 2015 and 2018. HT...

Stricture formation is a common complication of Crohn's disease, resulting from the disease process, surgery, or drugs. Endoscopic balloon dilation has an important role in the management of strictures, with emerging techniques, such as endoscopic electroincision and stenting, showing promising results. The underlying disease process, altered bowel...

Esophageal cancer has increased in incidence over the last several decades and is now the sixth leading cause of all cancer deaths, with more than 500,000 deaths in 2018. The 2 most common types of esophageal cancer, squamous cell cancer and esophageal adenocarcinoma, make up nearly 95% of diagnoses. Based on the global distribution of these histol...

Background: The only potentially curative approach for pancreatic cancer is surgical resection, but this technically challenging procedure carries risks for postoperative morbidities and mortality. This study of a large, contemporary national database illustrates incidences of, and risk factors for, post-procedural mortality, prolonged hospital st...

Background: Colorectal cancer (CRC) is the second leading cause of all cancer related deaths in the United States and Europe. Although the incidence has been decreasing for individuals' ≥ 50, it has been on the rise for individuals < 50. Aim: To identify potential risk factors for early-onset CRC. Methods: A population-based cohort analysis us...

Background & Aims: Few studies have compared regional differences in acute pancreatitis. We analyzed data from an international registry of patients with acute pancreatitis to evaluate geographic variations in patient characteristics, management, and outcomes. Methods: We collected data from the APPRENTICE registry of patients with acute pancreatit...

INTRODUCTION Despite its first description by Chiari in 1883, pancreatic panniculitis remains an atypical manifestation of pancreatic disease, appearing in only 0.3-2% of patients. Although the pathogenesis remains unclear, biopsy-proven subcutaneous liquefactive fat necrosis has implicated elevated lipase, amylase, and trypsin in dissemination and...

INTRODUCTION Colorectal cancer screening remains underutilized with 66–67% of adults 50–75 years old being up to date with screening. The National CRC Roundtable and the ACG aimed to increase screening rates to 80% by 2018. To achieve this goal, screening colonoscopy was provided on Saturdays to improve access and provide for patients who could not...

INTRODUCTION Our Health Network and insurance provider collaborated to focus on a Care Model for colorectal cancer (CRC) screening to address barriers to screening. This Care Model corresponds to a manner in which healthcare services are delivered while outlining best practices and services to patients as they progress through stages of colon cance...

INTRODUCTION Small bowel angioectasia (SBA) are the most common cause of small bowel GI bleeding, usually treated with argon plasma coagulation (APC). Bleeding recurs in >40%. The outcomes of patients with SBA treated with a dedicated radiofrequency ablation catheter was reported. METHODS Patients were treated using a commercially available small...

INTRODUCTION Operational flow is an important factor in relation to efficiency in an endoscopy center. There are opportunities for improvement in efficiency while keeping the standards of quality. We performed a time flow analysis in our outpatient endoscopy center to identify workflow improvement opportunities. METHODS We evaluated 616 patients w...

Objectives: The appropriate timing of chemotherapy following surgery for resectable pancreatic adenocarcinoma is controversial. Using the National Cancer Database we evaluated time to initiation of chemotherapy postresection and correlated with outcome. Methods: We identified stage I-III pancreatic adenocarcinoma treated surgically with adjuvant...

Objectives: Acute and/or chronic pancreatitis has been implicated as an important risk factor for pancreatic cancer; however, the incidence and temporal relationship of pancreatitis before pancreatic cancer diagnosis are unclear. We aim to understand the role and incidence of pancreatitis temporally with the development of pancreatic cancer. Meth...

Background: Endoscopic ultrasound (EUS) guided core needle biopsies (CNB) are increasingly being performed to diagnose solid pancreatic lesions. However, studies have been conflicting in terms of CNB improving diagnostic accuracy and procedural efficiency vs fine-needle aspiration (FNA), which this study aims to elucidate. Methods: Data were pro...

Carcinosarcoma of the pancreas is a rare type of pancreatic neoplasm, and only a few cases have been described in the literature. This tumor is characterized by distinct biphasic histopathology consisting of carcinomatous and sarcomatous component. We present a case of pancreatic carcinosarcoma in a patient who underwent successful resection but wa...

e15791 Background: Pancreatic adenocarcinoma is an aggressive malignancy with a high propensity for distant spread. To date, surgery remains the only potentially curative treatment option; which has traditionally been followed by adjuvant chemotherapy. Past research from the pancreatic literature as well as other disease sites has shown conflicting...

e15706 Background: To date, the only curative option for pancreatic cancer is surgical resection, which only 15-20% of patients are eligible for at diagnosis. The conventional operation is a pancreaticoduodenectomy which carries a mortality risk of 3-7%. We used the National Cancer Database (NCDB) to examine surgical outcomes following pancreatecto...

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns...

Radiation exposure during endoscopic retrograde cholangiopancreatography is known, however, data in relation to radiation usage is unclear. We evaluate radiation exposure using fluoroscopy dose (FD) and time (FT). A prospective analysis of 197 patients undergoing endoscopic retrograde cholangiopancreatography was completed. Univariate and multivari...

Objectives: Surgery is the curative treatment for pancreatic ductal adenocarcinoma (PDA). Guidelines recommend utilizing a multidisciplinary pancreatic cancer conference (MDPC) in treatment; however, data are limited. The objective of this study was to assess the accuracy of an MDPC. Methods: Patients with PDA presented at an MDPC were prospecti...

Zenker's diverticulum (ZD) is a relatively uncommon esophageal pathology with significant morbidity typically presenting in the elderly population. Symptoms often include dysphagia, halitosis, regurgitation, and food retention [1]. Current treatment options include open surgical cricopharyngeal myotomy/diverticulectomy and rigid or flexible endosco...

Familial Adenomatous Polyposis (FAP) is a genetic condition characterized by extensive adenoma development throughout the gastrointestinal (GI) tract. GI neoplasias have been removed via endoscopic submucosal dissection in patients with FAP after total colectomy [1]. However, treatment modalities for biliary adenomas as a complication of FAP are no...