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| 1 | Endoscopic ultrasound guided radiofrequency ablation,for pancreatic cystic neoplasms and neuroendocrine tumors显示文摘AIM: To outline the feasibility, safety, adverse events and early results of endoscopic ultrasound(EUS)-radiofrequency ablation(RFA) in pancreatic neoplasms using a novel probe. METHODS: This is a multi-center, pilot safety feasibility study. The intervention described was radiofrequency ablation(RF) which was applied with an innovative monopolar RF probe(1.2 mm Habib EUS-RFA catheter) placed through a 19 or 22 gauge fine needle aspiration(FNA) needle once FNA was performed in patients with a tumor in the head of the pancreas. The HabibTM EUSRFA is a 1 Fr wire(0.33 mm, 0.013') with a working length of 190 cm, which can be inserted through the biopsy channel of an echoendoscope. RF power is applied to the electrode at the end of the wire to coagulate tissue in the liver and pancreas.RESULTS: Eight patients [median age of 65(range 27-82) years; 7 female and 1 male] were recruited in a prospective multicenter trial. Six had a pancreatic cysticneoplasm(four a mucinous cyst, one had intraductal papillary mucinous neoplasm and one a microcystic adenoma) and two had a neuroendocrine tumors(NET) in the head of pancreas. The mean size of the cystic neoplasm and NET were 36.5 mm(SD ± 17.9 mm) and 27.5 mm(SD ± 17.7 mm) respectively. The EUSRFA was successfully completed in all cases. Among the 6 patients with a cystic neoplasm, post procedure imaging in 3-6 mo showed complete resolution of the cysts in 2 cases, whilst in three more there was a 48.4% reduction [mean pre RF 38.8 mm(SD ± 21.7 mm) vs mean post RF 20 mm(SD ± 17.1 mm)] in size. In regards to the NET patients, there was a change in vascularity and central necrosis after EUS-RFA. No major complications were observed within 48 h of the procedure. Two patients had mild abdominal pain that resolved within 3 d. CONCLUSION: EUS-RFA of pancreatic neoplasms with a novel monopolar RF probe was well tolerated in all cases. Our preliminary data suggest that the procedure is straightforward and safe. The response ranged from complete resolution to a 50% reduction in size. | Madhava Pai Nagy Habib Hakan Senturk Sundeep Lakhtakia Nageshwar Reddy Vito R Cicinnati Iyad Kaba Susanne Beckebaum Panagiotis Drymousis Michel Kahaleh William Brugge | 2015 | World Journal of Gastrointestinal Surgery2015，7，4： | 23 |
| 2 | Endoscopic ultrasonography guided biliary drainage: Summary of consortium meeting, May 7^(th) , 2011, Chicago显示文摘Endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred procedure for biliary or pancreatic drainage in various pancreatico-biliary disorders. With a success rate of more than 90%, ERCP may not achieve biliary or pancreatic drainage in cases with altered anatomy or with tumors obstructing access to the duodenum. In the past those failures were typically managed exclusively by percutaneous approaches by interventional radiologists or surgical intervention. The morbidity associated was significant especially in those patients with advanced malignancy, seeking minimally invasive interventions and improved quality of life. With the advent of biliary drainage via endoscopic ultrasound (EUS) guidance, EUS guided biliary drainage has been used more frequently within the last decade in different countries. As with any novel advanced endoscopic procedure that encompasses various approaches, advanced endoscopists all over the world have innovated and adopted diverse EUS guided biliary and pancreatic drainage techniques. This diversity has resulted in variations and improvements in EUS Guided biliary and pancreatic drainage; and over the years has led to an extensive nomenclature. The diversity of techniques, nomenclature and recent progress in our intrumentation has led to a dedicated meeting on May 7 th , 2011 during Digestive Disease Week 2011. More than 40 advanced endoscopists from United States, Brazil, Mexico, Venezuela, Colombia, Italy, France, Austria, Germany, Spain, Japan, China, South Korea and India attended this pivotal meeting. The meeting covered improved EUS guided biliary access and drainage procedures, terminology, nomenclature, training and credentialing; as well as emerging devices for EUS guided biliary drainage. This paper summarizes the meeting's agenda and the conclusions generated by the creation of this consortium group. | Michel Kahaleh Everson LA Artifon Manuel Perez-Miranda Kapil Gupta Takao Itoi Kenneth F Binmoeller California Pacific Medical Center San Francisco CA 94115 United States Marc Giovannini | 2013 | World Journal of Gastroenterology2013，19，9： | 15 |
| 3 | Management of pancreatic fluid collections: A comprehensive review of the literature显示文摘Pancreatic fluid collections(PFCs) are a frequent complication of pancreatitis. It is important to classify PFCs to guide management. The revised Atlanta criteria classifies PFCs as acute or chronic, with chronic fluid collections subdivided into pseudocysts and walled-off pancreatic necrosis(WOPN). Establishing adequate nutritional support is an essential step in the management of PFCs. Early attempts at oral feeding can be trialed in patients with mild pancreatitis. Enteral feeding should be implemented in patients with moderate to severe pancreatitis. Jejunal feeding remains the preferred route of enteral nutrition. Symptomatic PFCs require drainage; options include surgical, percutaneous, or endoscopic approaches. With the advent of newer and more advanced endoscopic tools and expertise, and an associated reduction in health care costs, minimally invasive endoscopic drainage has become the preferable approach. An endoscopic ultrasonography-guided approach using a seldinger technique is the preferred endoscopic approach. Both plastic stents and metal stents are efficacious and safe; however, metal stents may offer an advantage, especially in infected pseudocysts and in WOPN. Direct endoscopic necrosectomy is often required in WOPN. Lumen apposing metal stents that allow for direct endoscopic necrosectomy and debridement through the stent lumen are preferred in these patients. Endoscopic retrograde cholangio pancreatography with pancreatic duct(PD) exploration should be performed concurrent to PFC drainage. PD disruption is associated with an increased severity of pancreatitis, an increased risk of recurrent attacks of pancreatitis and long-term complications, and a decreased rate of PFC resolution after drainage. Any pancreatic ductal disruption should be bridged with endoscopic stenting. | Amy Tyberg Kunal Karia Moamen Gabr Amit Desai Rushabh Doshi Monica Gaidhane Reem Z Sharaiha Michel Kahaleh | 2016 | World Journal of Gastroenterology2016，22，7： | 15 |
| 4 | Safety of endoscopic retrograde cholangiopancreatography in pregnancy: Fluoroscopy time and fetal exposure, does it matter?显示文摘AIM: To estimate the fetal radiation exposure using thermoluminescent dosimeters (TLD's) in pregnant patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and assess its relevance. METHODS: Data on thirty-five therapeutic ERCPs conducted in pregnant patients from 2001 to 2009 were retrieved from a prospective database. Techniques to minimize fluoroscopy time were implemented and the fluoroscopy times captured. TLD's were placed on the mother to estimate the fetal radiation exposure and the results were compared to the maximum allowed dose of radiation to the fetus [0.005 gray (Gy)]. Obstetrics consultations were obtained and the fetus was monitored before and after the ERCP. Fluoroscopy wasperformed at 75 kVp. ERCP was performed with the patients supine by dedicated biliary endoscopists performing more than 500 cases a year. RESULTS: A total of 35 pregnant patients underwent ERCP and biliary sphincterotomy (14 in first trimester, 11 in second trimester, and 10 in third trimester). Mean maternal age was 25 years (range 16-37 years) and mean gestational age was 18.9 wk (range 4-35 wk). Mean fluoroscopy time was 0.15 min (range 0-1 min). For 23 women, the estimated fetal radiation exposure was almost negligible (< 0.0001 Gy) while for 8 women, it was within the 0.0001-0.0002 Gy range. Three women had an estimated fetal radiation exposure between 0.0002 and 0.0005 Gy and 1 woman had an estimated fetal radiation exposure greater than 0.0005 Gy. Complications included 2 post-sphincterotomy bleeds, 2 post-ERCP pancreatitis, and 1 fatal acute respiratory distress syndrome. One patient developed cholecystitis 2 d after ERCP. CONCLUSION: ERCP with modified techniques is safe during pregnancy, and estimating the fetal radiation exposure from the fluoroscopy time or measuring it via TLD's is unnecessary. | Ioana Smith Monica Gaidhane Allen Goode Michel Kahaleh | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，4： | 12 |
| 5 | Management of liver transplantation biliary stricture: Results from a tertiary hospital显示文摘AIM: To review results of endoscopic treatment for anastomotic biliary strictures after orthotopic liver transplantation(OLT) during an 8-year period. METHODS: This is a retrospective review of all endoscopic retrograde cholangiopancreatographys(ERCPs) performed between May 2006 and June 2014 in deceased OLT recipients with anastomotic stricture at a tertiary care hospital. Patients were divided into 2 groups, according to the type of stent used(multiple plastic or covered self-expandable metal stents), which was chose on a case-by-case basis and their characteristics. The primary outcome was anastomotic stricture resolution rate determined if there was no more than a minimum waist at cholangiography and a 10 mm balloon could easily pass through the anastomosis with no need for further intervention after final stent removal. Secondary outcomes were technical successrate, number or ERCPs required per patient, number of stents placed, stent indwelling, stricture recurrence rate and therapy for recurrent anastomotic biliary stricture(AS). Stricture recurrence was defined as clinical laboratorial and/or imaging evidence of obstruction at the anastomosis level, after it was considered completely treated, requiring subsequent interventional procedure.RESULTS: A total of 195 post-OLT patients were assessed for eligibility. One hundred and sixty-four(164) patients were diagnosed with anastomotic biliary stricture. ERCP was successfully performed in 157/164(95.7%) patients with AS, that were treated with either multiple plastic(n = 109) or metallic billiary stents(n = 48). Mean treatment duration, number of procedures and stents required were lower in the metal stent group. Acute pancreatitis was the most common procedure related complication, occurring in 17.1% in the covered self-expandable metal stents(c SEMS) and 4.1% in the multiple plastic stent(MPS) group. Migration was the most frequent stent related complication, observed in 4.3% and 5.5%(c SEMS and MPS respectively). Stricture resolution was achieved in 86.8% in the c SEMS group and in 91% in MPS group. Stricture recurrence after a median follow up of 20 mo was observed in 10(30.3%) patients in the c SEMS and 7(7.7%) in the plastic stent group, a statistically significant difference(P = 0.0017). Successful stricture resolution after secondary treatment was achieved in 66.6% and 62.5% of patients respectively in the c SEMS and plastic stents groups. CONCLUSION: Multiple plastic stents are currently the first treatment option for AS in patients with duct-toduct anastomosis. c SEMS was associated with increased pancreatitis risk and higher recurrence rate. | Fernanda Prata Martins Michel Kahaleh Angelo P Ferrari | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，7： | 10 |
| 6 | Photodynamic therapy:Palliation and endoscopic technique in cholangiocarcinoma显示文摘Cholangiocarcinoma is the primary malignancy arising from the biliary epithelium.The disease is marked by jaundice,cholestasis,and cholangitis.Over 50 percent of patients present with advanced stage disease,precluding curative surgical resection as an option of treatment.Prognosis is poor,and survival has been limited even after biliary decompression.Palliative management has become the standard of care for unresectable disease and has evolved to include an endoscopic approach. Photodynamic therapy(PDT)consists of administration of a photosensitizer followed by local irradiation with laser therapy.Several studies conducted in Europe and the United States have shown a marked improvement in the symptoms of cholestasis,survival,and quality of life.This article summarizes the published experience regarding PDT for cholangiocarcinoma and the steps required to administer this therapy safely. | James A Richter Michel Kahaleh | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，11： | 7 |
| 7 | Endoscopic ultrasonography guided drainage:Summary of consortium meeting,May 21,2012,San Diego,California显示文摘Endoscopic retrograde cholangiopancreatography(ERCP) is the preferred procedure for biliary and pancreatic drainage.While ERCP is successful in about 95% of cases,a small subset of cases are unsuccessful due to altered anatomy,peri-ampullary pathology,or malignant obstruction.Endoscopic ultrasound-guided drainage is a promising technique for biliary,pancreatic and recently gallbladder decompression,which provides multiple advantages over percutaneous or surgical biliary drainage.Multiple retrospective and some prospective studies have shown endoscopic ultrasoundguided drainage to be safe and effective.Based on the currently reported literature,regardless of the approach,the cumulative success rate is 84%-93% with an overall complication rate of 16%-35%.endoscopic ultrasoundguided drainage seems a viable therapeutic modality for failed conventional drainage when performed by highly skilled advanced endoscopists at tertiary centers with expertise in both echo-endoscopy and therapeutic | Michel Kahaleh Everson LA Artifon Manuel Perez-Miranda Monica Gaidhane Carlos Rondon Takao Itoi Marc Giovannini | 2015 | World Journal of Gastroenterology2015，21，3： | 6 |
| 8 | Safety and Efficacy of Radiofrequency Ablation in the Management of Unresectable Bile Duct and Pancreatic Cancer: A Novel Palliation Technique显示文摘 | Paola Figueroa-Barojas Mihir R. Bakhru Nagy A. Habib Kristi Ellen Jennifer Millman Armeen Jamal-Kabani Monica Gaidhane Michel Kahaleh Jose G. de la Mora-Levy | 2013 | Journal of Oncology2013，，： | 5 |
| 9 | Endoscopic Ultrasound-assisted Bile Duct Access and Drainage: Multicenter, Long-term Analysis of Approach, Outcomes, and Complications of a Technique in Evolution显示文摘 | Kapil Gupta Manuel Perez-Miranda Michel Kahaleh Everson L.A. Artifon Takao Itoi Martin L. Freeman Carlos de-Serna Bryan Sauer Marc Giovannini | 2014 | Journal of Clinical Gastroenterology2014，，1： | 4 |
| 10 | Evaluation of effects of a novel endoscopically applied radiofrequency ablation biliary catheter using an ex-vivo pig liver显示文摘 | Takao Itoi Hiroyuki Isayama Atsushi Sofuni Fumihide Itokawa Miho Tamura Yusuke Watanabe Fuminori Moriyasu Michel Kahaleh Nagy Habib Toshitaka Nagao Tomohisa Yokoyama Kazuhiko Kasuya Hiroshi Kawakami | 2012 | Journal of Hepato-Biliary-Pancreatic Sciences2012，，5： | 3 |
| 11 | Endoscopic palliation of malignant biliary stricture显示文摘Malignant biliary strictures often present late after the window for curative resection has elapsed. In such patients, the goal of therapy is typically focused on palliation. While historically, palliative measures were performed surgically, the advent of endoscopic intervention offers minimally invasive options to provide relief of symptoms, improve quality of life, and in some cases, increase survival of these patients. Some of these therapies, such as endoscopic biliary decompression, have become mainstays of treatment for decades, whereas newer modalities, including radiofrequency ablation, and photodynamic therapy offer additional options for patients with incurable biliary malignancies. | Sanjay M Salgado Monica Gaidhane Michel Kahaleh | 2016 | World Journal of Gastrointestinal Oncology2016，8，3： | 3 |
| 12 | Prophylaxis of post-ERCP pancreatitis: a practice survey显示文摘 | Jean-Marc Dumonceau Johanne Rigaux Michel Kahaleh Carlos Macias Gomez Alain Vandermeeren Jacques Devière | 2010 | Gastrointestinal Endoscopy2010，，6： | 3 |
| 13 | Pre‐ and post‐training session evaluation for interobserver agreement and diagnostic accuracy of probe‐based confocal laser endomicroscopy for biliary strictures显示文摘 | Jayant P. Talreja Brian G. Turner Frank G. Gress Sammy Ho Savreet Sarkaria Naveen Paddu Nikola Natov Sheila Bharmal Monica Gaidhane Amrita Sethi Michel Kahaleh | 2014 | Digestive Endoscopy2014，，4： | 2 |
| 14 | Interventional EUS-guided cholangiography: evaluation of a technique in evolution显示文摘 | Michel Kahaleh Alfredo J. Hernandez Jeffrey Tokar Reid B. Adams Vanessa M. Shami Paul Yeaton | 2006 | Gastrointestinal Endoscopy2006，，： | 2 |
| 15 | Comparison of Metal Stenting with Radiofrequency Ablation Versus Stenting Alone for Treating Malignant Biliary Strictures: Is There an Added Benefit?显示文摘 | Reem Z. Sharaiha Nikola Natov Kati S. Glockenberg Jessica Widmer Monica Gaidhane Michel Kahaleh | 2014 | Digestive Diseases and Sciences2014，，： | 2 |
| 16 | Management of Complications Associated with Partially Covered Biliary Metal Stents显示文摘 | Henry Ho Anshu Mahajan Sonia Gosain Animesh Jain Andrew Brock Michele E. Rehan Kristi Ellen Vanessa M. Shami Michel Kahaleh | 2010 | Digestive Diseases and Sciences2010，，2： | 2 |
| 17 | Meshed capillary vessels found on narrow-band imaging without optical magnification effectively identifies colorectal neoplasia: a North American validation of the Japanese experience显示文摘 | Zachary H. Henry Paul Yeaton Vanessa M. Shami Michel Kahaleh James T. Patrie Dawn G. Cox David A. Peura Fabian Emura Andrew Y. Wang | 2010 | Gastrointestinal Endoscopy2010，，1： | 2 |
| 18 | The vascular endothelium in scleroderma显示文摘 | Kahaleh MB | 1995 | Int Rev Immunol1995，12，24： | 1 |
| 19 | Prospective evaluation of pancreatic sphincterotomy as a precut technique for biliary cannu- lation 显示文摘 | Kahaleh M Tokar J Mullick T | 2004 | Clin Gastroenteml Hepatol2004，2，11： | 1 |
| 20 | The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee显示文摘 | Topp R Woolley S Hornyak 3rd J Khuder S Kahaleh B | | 0，，： | 1 |
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