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- 저자 : Shyam Vedantam (검색결과 2 건)
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Shyam Vedantam,Sunil Amin,Ben Maher,Saqib Ahmad,Shanil Kadir,Saad Khalid Niaz,Mark Wright,Nadeem Tehami 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3
Background/Aims: Cholangiogram interpretation is not used as a key performance indicator (KPI) of endoscopic retrograde cholangiopancreatography(ERCP) training, and national societies recommend different minimum numbers per annum to maintain competence. This study aimed to determine the relationship between correct ERCP cholangiogram interpretation and experience. Methods: One hundred fifty ERCPists were surveyed to appropriately interpret ERCP cholangiographic findings. There were threegroups of 50 participants each: “Trainees,” “Consultants group 1” (performed >75 ERCPs per year), and “Consultants group 2” (performed>100 ERCPs per year). Results: Trainees was inferior to Consultants groups 1 and 2 in identifying all findings except choledocholithiasis outside the intrahepaticduct on the initial or completion/occlusion cholangiogram. Consultants group 1 was inferior to Consultants group 2 in identifyingStrasberg type A bile leaks (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.77−0.96), Strasberg type B (OR, 0.84; 95% CI,0.74−0.95), and Bismuth type 2 hilar strictures (OR, 0.81; 95% CI, 0.69−0.95). Conclusions: This investigation supports the notion that cholangiogram interpretation improves with increased annual ERCP casevolumes. Thus, a higher annual volume of procedures performed may improve the ability to correctly interpret particularly difficultfindings. Cholangiogram interpretation, in addition to bile duct cannulation, could be considered as another KPI of ERCP training.
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Shyam Vedantam,Rahil Shah,Sean Bhalla,Shria Kumar,Sunil Amin 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.3
Background/Aims: We compared outcomes between use of 15 vs. 20 mm lumen-apposing metal stents (LAMSs) in endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for gastric outlet obstruction. Methods: Databases were queried for studies that used LAMS for EUS-GE to relieve gastric outlet obstruction, and a proportional meta-analysis was performed. Results: Thirteen studies were included. The 15 mm and 20 mm LAMS had pooled technical success rates of 93.2% (95% confidence interval [CI], 90.5%–95.2%) and 92.1% (95% CI, 68.4%–98.4%), clinical success rates of 88.6% (95% CI, 85.4%–91.1%) and 89.6% (95% CI, 79.0%–95.1%), adverse event rates of 11.4% (95% CI, 8.1%–15.9%) and 14.7% (95% CI, 4.4%–39.1%), and reintervention rates of 10.3% (95% CI, 6.7%–15.4%) and 3.5% (95% CI, 1.6%–7.6%), respectively. Subgroup analysis revealed no significant differences in technical success, clinical success, or adverse event rates. An increased need for reintervention was noted in the 15 mm stent group (pooled odds ratio, 3.59; 95% CI, 1.40–9.18; p=0.008). Conclusions: No differences were observed in the technical, clinical, or adverse event rates between 15 and 20 mm LAMS use in EUS-GE. An increased need for reintervention is possible when using a 15 mm stent compared to when using a 20 mm stent.
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