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      • KCI등재

        A Guidewire May Save the Day

        ( Rajat Garg ),( Mohammed Barawi ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.2

        Endoscopic gallbladder drainage (EGBD) has been used to treat acute cholecystitis or to relieve malignant biliary obstruction as an alternative to percutaneous gallbladder drainage and patient's are poor surgical candidates. This is currently being performed by placement of lumen apposing metallic stent (LAMS) with electrocautery mounted tip delivery system also called as "hot" technique. We had reported a case of self-expanding metallic stent (SEMS) within LAMS after stent migration during EGBD using "hot" technique and propose routine use of guidewire in patients undergoing the procedure. (Korean J Gastroenterol 2018;72:83-85)

      • KCI등재

        Effcacy and Safety of Lumen-Apposing Stents for Management of Pancreatic Fluid Collections in a Community Hospital Setting

        Rajat Garg,Abdelkader Chaar,Susan Szpunar,Babu P. Mohan,Mohammed Barawi 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.4

        Background/Aims: Endoscopic ultrasound-guided transmural drainage and necrosectomy employing lumen-apposing metal stent(LAMS) are used for treating pancreatic fluid collections (PFCs) with excellent results from academic centers. Herein, we report theeffcacy and safety of LAMS in the treatment of PFCs at a community hospital. Methods: We retrospectively reviewed the etiology of pancreatitis, type and size of PFCs, length of procedure, technical success,clinical success, adverse events, and stent removal. The primary outcome was the rate of clinical success, and secondary outcomes weretechnical success and adverse events. Results: Twenty-seven patients with a mean age of 54.1±6.5 years were included, 44% of which were men. The mean size of the PFCswas 9.7±5.0 cm (range, 3–21). The most common etiology of pancreatitis was alcohol (44%) followed by idiopathic causes (30%) andpresence of gallstones (22%). The diagnosis was pseudocyst in 44.4% (12/27) and walled off necrosis in 55.6% (15/27) of patients. Therewas 100% technical success without any complications. Clinical success was achieved in 22 of 27 patients (81.5%) who underwent stentremoval. Conclusions: Our study is the first to report that endoscopic therapy of PFCs using LAMS is safe and effective even in a communityhospital setting with limited resources and support compared to large academic centers.

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