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Sunil Amin 3 Articles
No difference in outcomes with 15 mm vs. 20 mm lumen-apposing metal stents for endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction: a meta-analysis
Shyam Vedantam, Rahil Shah, Sean Bhalla, Shria Kumar, Sunil Amin
Clin Endosc 2023;56(3):298-307.   Published online May 22, 2023
AbstractAbstract PDFSupplementary MaterialPubReaderePub
/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.
Databases were queried for studies that used LAMS for EUS-GE to relieve gastric outlet obstruction, and a proportional meta-analysis was performed.
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).
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.


Citations to this article as recorded by  
  • Endoscopic gastrointestinal bypass anastomosis using deformable self-assembled magnetic anastomosis rings (DSAMARs) in a pig model
    Miaomiao Zhang, Jianqi Mao, Jia Ma, Shuqin Xu, Yi Lyu, Xiaopeng Yan
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • Revealing Insights: A Comprehensive Overview of Gastric Outlet Obstruction Management, with Special Emphasis on EUS-Guided Gastroenterostomy
    Dimitrios Ziogas, Thomas Vasilakis, Christina Kapizioni, Eleni Koukoulioti, Georgios Tziatzios, Paraskevas Gkolfakis, Antonio Facciorusso, Ioannis S. Papanikolaou
    Medical Sciences.2024; 12(1): 9.     CrossRef
  • Lumen-apposing metal stents: A primer on indications and technical tips
    Sridhar Sundaram, Suprabhat Giri, Kenneth Binmoeller
    Indian Journal of Gastroenterology.2024;[Epub]     CrossRef
  • The Role of Luminal Apposing Metal Stents on the Treatment of Malignant and Benign Gastric Outlet Obstruction
    Mihai Rimbaș, Kar Wai Lau, Giulia Tripodi, Gianenrico Rizzatti, Alberto Larghi
    Diagnostics.2023; 13(21): 3308.     CrossRef
  • 2,539 View
  • 119 Download
  • 4 Web of Science
  • 4 Crossref
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Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?
Shyam Vedantam, Sunil Amin, Ben Maher, Saqib Ahmad, Shanil Kadir, Saad Khalid Niaz, Mark Wright, Nadeem Tehami
Clin Endosc 2022;55(3):426-433.   Published online February 4, 2022
AbstractAbstract PDFSupplementary MaterialPubReaderePub
/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.
One hundred fifty ERCPists were surveyed to appropriately interpret ERCP cholangiographic findings. There were three groups of 50 participants each: “Trainees,” “Consultants group 1” (performed >75 ERCPs per year), and “Consultants group 2” (performed >100 ERCPs per year).
Trainees was inferior to Consultants groups 1 and 2 in identifying all findings except choledocholithiasis outside the intrahepatic duct on the initial or completion/occlusion cholangiogram. Consultants group 1 was inferior to Consultants group 2 in identifying Strasberg 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).
This investigation supports the notion that cholangiogram interpretation improves with increased annual ERCP case volumes. Thus, a higher annual volume of procedures performed may improve the ability to correctly interpret particularly difficult findings. Cholangiogram interpretation, in addition to bile duct cannulation, could be considered as another KPI of ERCP training.


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  • UK ERCP sedation practices, patient comfort and endoscopist characteristics: National Endoscopy Database (NED) analysis on behalf of the JAG and BSG
    David Beaton, Matt Rutter, Linda Sharp, Kofi W Oppong, Bidour Awadelkarim, Simon M Everett, Vikramjit Mitra
    Frontline Gastroenterology.2023; 14(5): 384.     CrossRef
  • 3,683 View
  • 243 Download
  • 1 Web of Science
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There Is No Advantage to Transpapillary Pancreatic Duct Stenting for the Transmural Endoscopic Drainage of Pancreatic Fluid Collections: A Meta-Analysis
Sunil Amin, Dennis J. Yang, Aimee L. Lucas, Susana Gonzalez, Christopher J. DiMaio
Clin Endosc 2017;50(4):388-394.   Published online April 17, 2017
AbstractAbstract PDFPubReaderePub
/Aims: Options for the endoscopic management of symptomatic pancreatic fluid collections (PFCs) include transmural drainage (TM) alone, transpapillary drainage (TP) alone, or a combination of both drainage method (CD). There have been conflicting reports about the best method. This study performed a meta-analysis to determine whether CD presents an added clinical benefit over TM.
The included studies compared TM with CD and reported clinical success for both methods. A random-effects model was used to determine the pooled odds ratios (ORs) and the 95% confidence intervals (CIs) for the following outcomes: technical success, clinical success, complications, and recurrence.
Nine studies involving a combined total of 604 drainage procedures—373 TMs (62%) and 231 CDs (38%)—were included. CD showed no additional benefit over TM in terms of technical success (OR, 1.12; 95% CI, 0.37–3.37; p=0.85), clinical success (OR, 1.11; 95% CI, 0.65–1.89; p=0.70), recurrence (OR, 1.49; 95% CI, 0.53–4.21; p=0.45), or complications (OR, 1.15; 95% CI, 0.61–2.18; p=0.67).
Pancreatic duct (PD) stenting provides no additional clinical benefit for the TM of PFCs (particularly pseudocysts). Patients undergoing the TM of symptomatic pseudocysts may not require endoscopic retrograde pancreatography (ERP).


Citations to this article as recorded by  
  • Endoscopic management of pancreatic collections. Endoscopic Ultrasound Group from the Spanish Society of Digestive Endoscopy (GSEED-USE) Clinical Guidelines
    Mariano González-Haba Ruiz, María Teresa Betés Ibáñez, Belén Martínez Moreno , Alejandro Repiso Ortega, Carlos de la Serna Higuera, Julio Iglesias García, Oriol Sendino García, María Moris Felgueroso, Belén Agudo Castillo, José Miguel Esteban Lóp
    Revista Española de Enfermedades Digestivas.2024;[Epub]     CrossRef
  • Endoscopic management of pancreatic fluid collections with disconnected pancreatic duct syndrome
    Zhi-Jie Wang, Yi-Hang Song, Shi-Yu Li, Zi-Xuan He, Zhao-Shen Li, Shu-Ling Wang, Yu Bai
    Endoscopic Ultrasound.2023; 12(1): 29.     CrossRef
  • A release from WONderland: endoscopic ultrasonography-guided reconnection of disconnected pancreatic ducts across a walled-off necrosis cavity
    Tatsuya Sato, Tomotaka Saito, Tsuyoshi Hamada, Yousuke Nakai, Mitsuhiro Fujishiro
    Endoscopy.2023; 55(S 01): E82.     CrossRef
  • Stenting of the main pancreatic duct as a prevention of the acute post-manipulation pancreatitis development during endoscopic surgery in patients with benign diseases of the bilio-pancreatoduodenal area. Literature review
    E. Y. Sadovnikova, A. E. Klimov, V. A. Ivanov, M. Y. Persov, D. T. Nazarov
    Hirurg (Surgeon).2023; (1): 6.     CrossRef
  • Management of Disconnected Pancreatic Duct
    Jahangeer Basha, Sundeep Lakhtakia
    Gastrointestinal Endoscopy Clinics of North America.2023; 33(4): 753.     CrossRef
  • Disconnected pancreatic duct syndrome and outcomes of endoscopic ultrasound‐guided treatment of pancreatic fluid collections: Systematic review and meta‐analysis
    Tsuyoshi Hamada, Takuji Iwashita, Tomotaka Saito, Hideyuki Shiomi, Mamoru Takenaka, Hiroyuki Isayama, Ichiro Yasuda, Yousuke Nakai
    Digestive Endoscopy.2022; 34(4): 676.     CrossRef
  • Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections
    Chi Hyuk Oh, Tae Jun Song, Jun Kyu Lee, Jin-Seok Park, Jae Min Lee, Jun Hyuk Son, Dong Kee Jang, Miyoung Choi, Jeong-Sik Byeon, In Seok Lee, Soo Teik Lee, Ho Soon Choi, Ho Gak Kim, Hoon Jai Chun, Chan Guk Park, Joo Young Cho
    The Korean Journal of Pancreas and Biliary Tract.2022; 27(2): 61.     CrossRef
  • Disconnected pancreatic duct syndrome in acute pancreatitis
    A.V. Fedorov, V.N. Ektov, M.A. Khodorkovsky
    Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (8): 83.     CrossRef
  • Disconnected pancreatic duct syndrome
    S. M. Chooklin, S. S. Chuklin, R. V. Barylyak
    Klinicheskaia khirurgiia.2022; 88(11-12): 80.     CrossRef
  • Interventional Endoscopic Ultrasound: Current Status and Future Directions
    John M. DeWitt, Mustafa Arain, Kenneth J. Chang, Reem Sharaiha, Sri Komanduri, V. Raman Muthusamy, Joo Ha Hwang
    Clinical Gastroenterology and Hepatology.2021; 19(1): 24.     CrossRef
  • Endoscopic Management of Pancreatic Fluid Collections: Guidelines of Society of Gastrointestinal Endoscopy of India and Indian EUS Club
    Rahul Shah, Jahangeer Basha, Surinder Rana, Soumya Jagannath, Praveer Rai, Sudipta Dhar Chowdhury, Zubin Dev Sharma, Deepak Gunjan, Saurabh Patle, A Chalapathi Rao, Prakash Zacharia, Rajesh Sanjeevi, Manoj Sahu, Matthew Philip, Pramod Garg, Rajesh Puri, D
    Journal of Digestive Endoscopy.2021; 12(01): 003.     CrossRef
  • Current status of treatments of pancreatic and peripancreatic collections of acute pancreatitis
    Nian-Jun Xiao, Ting-Ting Cui, Fang Liu, Wen Li
    World Journal of Gastrointestinal Surgery.2021; 13(7): 633.     CrossRef
  • Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections
    Chi Hyuk Oh, Jun Kyu Lee, Tae Jun Song, Jin-Seok Park, Jae Min Lee, Jun Hyuk Son, Dong Kee Jang, Miyoung Choi, Jeong-Sik Byeon, In Seok Lee, Soo Teik Lee, Ho Soon Choi, Ho Gak Kim, Hoon Jai Chun, Chan Guk Park, Joo Young Cho
    Clinical Endoscopy.2021; 54(4): 505.     CrossRef
  • Interventionelle endoskopische Therapie bei akuter Pankreatitis
    Marcus Hollenbach, Jürgen Feisthammel, Albrecht Hoffmeister
    Der Internist.2021; 62(10): 1055.     CrossRef
  • Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections
    Chi Hyuk Oh, Tae Jun Song, Jun Kyu Lee, Jin-Seok Park, Jae Min Lee, Jun Hyuk Son, Dong Kee Jang, Miyoung Choi, Jeong-Sik Byeon, In Seok Lee, Soo Teik Lee, Ho Soon Choi, Ho Gak Kim, Hoon Jai Chun, Chan Guk Park, Joo Young Cho
    Gut and Liver.2021; 15(5): 677.     CrossRef
  • The augmented role of pancreatic imaging in the era of endoscopic necrosectomy: an illustrative and pictorial review
    Harit Kapoor, Mohamed Issa, Michael A. Winkler, Rashmi T. Nair, Frandah Wesam, Halemane Ganesh
    Abdominal Radiology.2020; 45(5): 1534.     CrossRef
  • Disconnected pancreatic duct syndrome: Updated review on clinical implications and management
    Suhang Verma, Surinder S. Rana
    Pancreatology.2020; 20(6): 1035.     CrossRef
  • Role of pancreatography in the endoscopic management of encapsulated pancreatic collections – review and new proposed classification
    Igor Mendonça Proença, Marcos Eduardo Lera dos Santos, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Sergio Eiji Matuguma, Spencer Cheng, Thomas R McCarty, Epifanio Silvino do Monte Junior, Paulo Sakai, Eduardo Guimarães Hourneaux de Moura
    World Journal of Gastroenterology.2020; 26(45): 7104.     CrossRef
  • Comparison of three different stents for endoscopic ultrasound‐guided drainage of pancreatic fluid collection: A large retrospective study
    Zhijie Wang, Shengbing Zhao, Qianqian Meng, Shuling Wang, Yan Chen, Fuming Wang, Qiang Li, Jun Yao, Yiqi Du, Zhendong Jin, Yu Bai, Zhaoshen Li, Dong Wang
    Journal of Gastroenterology and Hepatology.2019; 34(4): 791.     CrossRef
  • Recent advances in the diagnosis and management of chronic pancreatitis
    Chang-Il Kwon, Jae Hee Cho, Sung Hoon Choi, Kwang Hyun Ko, Temel Tirkes, Mark A. Gromski, Glen A. Lehman
    The Korean Journal of Internal Medicine.2019; 34(2): 242.     CrossRef
  • Endoscopic versus surgical treatment for pancreatic pseudocysts
    Galileu F.A. Farias, Wanderley M. Bernardo, Diogo T.H. De Moura, Hugo G. Guedes, Vitor O. Brunaldi, Thiago A. de C. Visconti, Caio V.T. Gonçalves, Christiano M. Sakai, Sergio E. Matuguma, Marcos E.L. dos Santos, Paulo Sakai, Eduardo G.H. De Moura
    Medicine.2019; 98(8): e14255.     CrossRef
  • An overview of walled-off pancreatic necrosis for clinicians
    Surinder Singh Rana
    Expert Review of Gastroenterology & Hepatology.2019; 13(4): 331.     CrossRef
  • Safety and efficacy of lumen-apposing metal stents with and without simultaneous double-pigtail plastic stents for draining pancreatic pseudocyst
    Murad Aburajab, Zachary Smith, Abdul Khan, Kulwinder Dua
    Gastrointestinal Endoscopy.2018; 87(5): 1248.     CrossRef
  • Management of complications of acute pancreatitis
    Christopher J. DiMaio
    Current Opinion in Gastroenterology.2018; 34(5): 336.     CrossRef
  • Endoscopic management of complications of acute pancreatitis: an update on the field
    Ali Aghdassi, Peter Simon, Tilman Pickartz, Christoph Budde, Mariya E. Skube, Markus. M. Lerch
    Expert Review of Gastroenterology & Hepatology.2018; 12(12): 1207.     CrossRef
  • Endoscopic Drainage of Pancreatic Fluid Collections
    B. Joseph Elmunzer
    Clinical Gastroenterology and Hepatology.2018; 16(12): 1851.     CrossRef
  • Is Endoscopic Ultrasound-Guided Drainage Alone Sufficient for the Treatment of Peripancreatic Fluid Collection?
    Se Woo Park
    Clinical Endoscopy.2017; 50(4): 316.     CrossRef
  • False Reassurance Based on Non-Significant Results
    Douglas G. Altman
    Clinical Endoscopy.2017; 50(6): 617.     CrossRef
  • 6,231 View
  • 168 Download
  • 26 Web of Science
  • 28 Crossref
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