Priya A. Jamidar's research while affiliated with Yale University and other places
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Publications (83)
Background:
Endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) is a minimally invasive therapy for patients with gastric outlet obstruction without the risks of surgical bypass and the limited long-term efficacy of enteral self-expanding metal stent placement. However, due to its novelty, there is a lack of significant data comparing lo...
The 9-member Editorial Board of the American Society for Gastrointestinal Endoscopy (ASGE) performed a systematic literature search of original articles published during 2021 in Gastrointestinal Endoscopy (GIE) and 10 other high-impact medical and gastroenterology journals on endoscopy-related topics. Votes from each Editorial Board member were tal...
Background
Juxta-papillary duodenal diverticulum (JPDD) has been associated with obstructive jaundice and ascending cholangitis. Potential mechanisms include periampullary colonization of pathogenic bacteria and mechanical obstruction. However, the relation of JPDD with pyogenic liver abscess (PLA) has not been reported. Moreover, approximately one...
Background
Despite literature and guidelines recommending same admission cholecystectomy (CCY) after endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute gallstone pancreatitis, clinical practice remains variable. The aim of this study was to investigate the role of clinical and socio-demographic factors in the management o...
Background and Aims
Digital single-operator cholangioscopy (DSOC) allows direct visualization of the biliary tree for evaluation of biliary strictures. Our objective was to assess the interobserver agreement (IOA) of DSOC interpretation for indeterminate biliary strictures using newly refined criteria.
Methods
Fourteen endoscopists were asked to r...
The American Society for Gastrointestinal Endoscopy’s Gastrointestinal Endoscopy Editorial Board reviewed a systematic literature search of original endoscopy-related articles published during 2020 in GIE and 10 other high-impact medical and gastroenterology journals. Votes from each individual board member were tallied to identify a consensus list...
Background:
Recurrent acute pancreatitis (RAP) may be a presenting feature of and an indication for resection of pancreatic cysts, including intra-ductal papillary mucinous neoplasm (IPMN). Few data are available regarding the prevalence of malignancy and post-operative RAP in this population.
Aim:
To study the role of resection to help prevent...
Background & Aims
The Charlson Comorbidity Index (CACI) has been suggested as a tool to determine comorbidity burden and guide management for patients with mucinous pancreatic cysts (Intrapapillary Mucinous Neoplasms and Mucinous Cystic Neoplasms), but has not been studied well among “low-risk” mucinous pancreatic cysts i.e. without worrisome featu...
INTRODUCTION:
Presumed mucinous cystic lesions are at increased (albeit low) risk of malignant transformation and require regular imaging for ongoing surveillance. A cost-effective evaluation of imaging resource utilization (IRU) is understudied due to a paucity of actual clinical utilization data and lack of consensus among current guidelines. We...
Background and study aims While several interventions may decrease risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, it remains unclear whether one strategy is superior to others. The purpose of this study was to compare the effectiveness of pharmacologic and endoscopic interventions to prevent post-ERCP pancreatitis...
Pancreatic fluid collections (PFCs) may develop due to inflammation secondary to acute and/or chronic pancreatitis, trauma, surgery, or obstruction from solid or cystic neoplasms. PFCs can be drained percutaneously, surgically, or endoscopically with endoscopic ultrasound-guided cyst gastrostomy and/or transpapillary drainage through endoscopic ret...
Background
Endoscopic retrograde cholangiography (ERCP) is a challenging
procedure with considerable risk. Computerized simulators are valuable in training for flexible endoscopy, but little data exist for their use in ERCP training.
Aim
To determine a simulator’s ability to assess the level of ERCP skill and its responsiveness over time to increas...
Background and study aim: Pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) is a significant and potentially life-threatening adverse event and is common in patients with suspected sphincter of Oddi dysfunction (SOD). Here we aimed to identify predictors of the risk in this population. Patients and methods: The Evaluating...
Endoscopic retrograde cholangiopancreatography (ERCP) is associated with radiation exposure to the endoscopist and staff that may be significant in high-volume centers. We investigated whether a radiation-attenuating drape over the fluoroscopy image intensifier reduces radiation exposure during ERCP.
We performed a prospective, randomized, double-b...
Endoscopic retrograde cholangiopancreatography (ERCP) represents a monumental advance in the management of patients with pancreaticobiliary diseases, but is a complex and technically demanding procedure with the highest inherent risk of adverse events of all routine endoscopic procedures. Overall adverse event rates for ERCP are typically reported...
Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), and not uncommonly is the reason behind ERCP-related lawsuits. Patients at high risk for PEP include young women with abdominal pain, normal liver tests, and unremarkable imaging. Procedure...
Benign biliary strictures are a common indication for endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic management has evolved over the last 2 decades as the current standard of care. The most common etiologies of strictures encountered are following surgery and those related to chronic pancreatitis. High-quality cross-sectional ima...
Endoscopic stenting is a widely accepted strategy for providing effective drainage in both extrahepatic and intrahepatic malignant strictures. In patients with extrahepatic malignancies, uncovered self-expanding metal stents (SEMS) provide excellent palliation. Hilar malignancies are probably best palliated by placement of uncovered SEMS although s...
Self-expandable metal stents (SEMS) are the current standard of care for the palliative management of malignant biliary strictures. Recently, endoscopic ablative techniques with direct affect to local tumor have been developed to improve SEMS patency. Several reports have demonstrated the technical feasibility and safety of intraductal radiofrequen...
Biliopancreatic-type postcholecystectomy pain, without significant abnormalities on imaging and laboratory test results, has been categorized as "suspected" sphincter of Oddi dysfunction (SOD) type III. Clinical predictors of "manometric" SOD are important to avoid unnecessary ERCP, but are unknown.
To assess which clinical factors are associated w...
Objectives:
Patients with several painful functional gastrointestinal disorders (FGIDs) are reported to have a high prevalence of psychosocial disturbance. These aspects have not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD).
Methods:
A total of 214 patients with post-cholecystectomy pain and suspected S...
Biliary stenting has evolved dramatically since endoscopic placement of the first stent in 1980. Endoscopic stenting has largely supplanted surgical bypass for palliation of malignant biliary obstruction. Plastic stents were traditionally used due their low cost and removability, with albeit limited duration of patency. The development of self-expa...
To determine whether a second observer during colonoscopy increases adenoma detection.
Consecutive patients undergoing screening colonoscopy were prospectively randomized to routine colonoscopy or physician and nurse observation during withdrawal.
Of 502 patients, 249 were randomized to routine colonoscopy, and 253 to physician plus nurse observati...
Background:
Malignant ampullary lesions can be difficult to classify by endoscopy alone. Probe-based confocal laser endomicroscopy (pCLE) permits in vivo assessment of mucosal structures in the gastrointestinal tracts in the real time.
Aim:
The objective of this pilot multicenter study was to assess the interobserver agreement and variance in in...
Background
Probe-based confocal laser endomicroscopy (pCLE) has enabled in vivo histopathology by obtaining high resolution images of the mucosal layers of the gastrointestinal tract. For indeterminate bile duct strictures, biopsy, cytologic brushing and needle aspiration have low levels of diagnostic accuracy.
Aim
The objective of this multi-cente...
Probe-based confocal laser endomicroscopy (pCLE) of the common bile duct (CBD) is a new procedure that can be used for assessing indeterminate billiary strictures. The CBD has been examined using the CholangioFlex miniprobe (Mauna Kea Technologies, Paris, France), which has a lateral resolution of 3.5 μm and diameter of <1.0 mm. However, larger-dia...
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are complementary procedures in the evaluation of obstructive jaundice.
To determine the feasibility, accuracy, and safety of the combined performance of EUS-guided fine needle aspiration (FNA) and ERCP with biliary stenting in patients with obstructive jaundice....
The incidence of gallstones during pregnancy is estimated to be between 3% and 12%. About one-third of pregnant patients with cholelithiasis become symptomatic and may require surgical intervention. Choledocholithiasis during pregnancy although infrequent usually requires therapeutic intervention. Abdominal ultrasonography is insensitive for the de...
Adenoma detection rate (ADR) is increasingly used as a quality indicator for screening/surveillance colonoscopy. Recent investigations to identify factors that affect ADR have focused on the technical aspects of the procedure or the equipment.
To assess whether gastroenterology (GI) fellow participation during colonoscopy affects ADR.
This is a ret...
There is no widely adopted, easily applied method for distinguishing between adenomatous and nonadenomatous polyps during real-time colonoscopy.
To compare white light (WL) with narrow-band imaging (NBI) for the differentiation of colorectal polyps in vivo and to assess for a learning curve.
A prospective polyp series.
A total of 302 patients refer...
Endoscopic access to the proximal gastrointestinal tract may prove difficult for a variety of anatomic reasons. Under laparoscopic visualization, trocars can be placed into the stomach with the subsequent introduction of a flexible endoscope directly into the body of the stomach. The purpose of this study was to describe this technique and demonstr...
This is one of a series of statements discussing training issues,for gastrointestinal endoscopy The Training Committee of the American Society for Gastrointestinal Endoscopy prepared this text. A previous guideline related to this topic (Gastrointest Endosc 1998:47;669-71) was publisbed in 1998. Since that time, new information has become available...
Citations
... EUS-GE had a technical success of 90% and clinical success of 100%, while no adverse effects were described. According to a recent review including fourteen studies, technical success of EUS-GE ranged from 87 to 100% and had a clinical success of 84-100%, irrespective of the technique performed [18][19][20][21]. A recent meta-analysis including twelve, mostly retrospective, studies (n = 285), conducted by Iqbal et al. [19], assessed the performance of EUS-GE in the treatment of GOO. ...
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... The presence of neovascularization was the only macroscopic feature of the suspected malignant lesions that we took into consideration, corresponding to "spider vascularizations" and "tortuous and dilated vessels" common features encountered in neoplastic lesions as described in the Carlos Robles-Medranda (CRM) et al classification [6] and in the Mendoza criteria [7], respectively. Both classification systems are detailed in ▶ Table 1. ...
... It is important to delineate that the patient has abdominal symptoms related to recurrent pancreatitis and not another cause. Resection can lead to decreased recurrent acute pancreatitis if patients are carefully selected but do not change the risk of downstream cancer [85]. ...
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... 34 Another U.S. study supports these results in concluding that Medicare payer status decreased the odds of undergoing same admission cholecystectomy after ERCP for acute gallstone pancreatitis. 35 Overall, after a complication (biliary colic, cholecystitis, or biliary pancreatitis), the likelihood of having cholecystectomy, as recommended, is lower in severely deprived patients. However, in patients previously hospitalized for gallstones treated with ERCP, the rate of early cholecystectomy (performed within 14 days after sphincterotomy) was significantly lower in populations of patients with high SES (41.3% vs. 48.4%, ...
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... Utilization of only IPMN-LGD as controls caters to a more specific question of malignant stratification of IPMNs. In clinical practice, delineation of IPMNs from lesions such as serous cystadenoma and pancreatic pseudocysts can be achieved through cyst morphology and aspirate cytology [25,26]. ...
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... Technical performance measured duodenoscope manoeuvrability, mechanical-imaging characteristics and the ability to perform therapeutic interventions based on a recently developed assessment tool (online supplemental file 1). 8 ERCP procedural complexity and adverse events were categorised based on the American Society for Gastrointestinal Endoscopy (ASGE) criteria. [9][10][11] ...
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... In approximately 4% of cases during PID, right upper quadrant abdominal pain may occur due to inflammation of the hepatic capsule and overlying peritoneum with adhesion formation (perihepatitis). This condition is known as Fitz-Hugh-Curtis syndrome, and during CT imaging, it manifests as a thickened and enhanced liver capsule, transient hepatic perfusion abnormalities in arterial phases, periportal oedema, and inflammatory stranding in the right paracolic gutter [44,45]. Bilateral tubo-ovarian abscesses in a 44-year-old woman who presented with fever, leucocytosis, and acute pelvic pain. ...
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... Lipoamele tractului gastrointestinal (TGI) reprezintă tumori de origine benignă, cu creștere lentă și compuse morfologic de țesut adipos matur cu o capsulă fibroasă subțire [1][2][3][4]. Aceste tumori mezenchimale sunt destul de rare cu o prevalență de 4 -6% în structura tumorilor benigne ale tractului gastrointestinal [5]. Cele mai comune locații din tractul gastrointestinal sunt: intestinul gros (64%), jejun și ileon (26%), mai puțin frecvente în stomac (3%) și esofag (2%) [6,7]. ...
Reference: Diagnosis and treatment of duodenal lipoma
... Six network meta-analyses were identified that compared the efficacy of single and combination therapies on PEP reduction, and they highlighted 3 therapeutic modalities: PPS, a combination of sublingual nitrate plus NSAIDs, and a combination of fluid therapy with NSAIDs [41,[70][71][72][73][74]. Table 2 gives a brief overview of their most relevant findings. ...
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... Cannabis has also been associated with increased post endoscopic retrograde cholangiopancreatography pancreatitis. [15] The endocannabinoid system consists of endogenous cannabinoids, cannabinoid receptors mediated by G protein-coupled receptors CB1, CB2, and enzymes. CBD treatment significantly reduces the level of cytokines involved in the immune response, such as interleukin (IL)-4, which inhibits T helper type 1 cells differentiation, and IL-5, which causes eosinophilic maturation. ...
