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Guru Trikudanathan

Guru Trikudanathan, Shawn J Mallery, Stuart K Amateau
Surgical resection is considered the standard of care in the management of symptomatic insulinoma. In this video, we describe the successful management of a symptomatic insulinoma by using linear array endoscopic ultrasound (EUS)-guided ethanol ablation in a poor surgical candidate. EUS-guided ethanol ablation of insulinoma offers a safer, effective, and less invasive alternative to surgery.
July 2016: Clinical Endoscopy
Guru Trikudanathan, Jose Vega-Peralta, Ahmad Malli, Satish Munigala, Yusheng Han, Melena Bellin, Usman Barlass, Srinath Chinnakotla, Ty Dunn, Timothy Pruett, Gregory Beilman, Mustafa Arain, Stuart K Amateau, Shawn Mallery, Martin L Freeman, Rajeev Attam
OBJECTIVES: Studies correlating endoscopic ultrasound (EUS) with histopathology for chronic pancreatitis (CP) are limited by small sample size, and/or inclusion of many patients without CP, limiting applicability to patients with painful CP. The aim of this study was to assess correlation of standard EUS features for CP with surgical histopathology in a large cohort of patients with non-calcific CP (NCCP). METHODS: Adult patients undergoing total pancreatectomy and islet autotransplantation (TPIAT) for NCCP, between 2008 and 2013, with EUS <1 year before surgery...
April 2016: American Journal of Gastroenterology
Imad I Ahmad, Guru Trikudanathan, Richard Feinn, Joseph C Anderson, Marie Nicholson, Samantha Lowe, Joel B Levine
AIMS: To examine the association between low 25-OH Vitamin D levels and prevalence of advanced adenomas (AAs) in screening/surveillance colonoscopy patients. RATIONALE: Low serum 25-OH Vitamin D has been associated with an increased risk for colon cancer. In the Adenoma-Carcinoma pathway, a subset of colon polyps (AA) have been regarded as high-risk precursor lesions. We used a retrospective case-control design to examine the association between Vitamin D deficiency and the prevalence of AA in a high-risk population...
September 2016: Journal of Clinical Gastroenterology
Michael C Young, Jake R Theis, James S Hodges, Ty B Dunn, Timothy L Pruett, Srinath Chinnakotla, Sidney P Walker, Martin L Freeman, Guru Trikudanathan, Mustafa Arain, Paul R Robertson, Joshua J Wilhelm, Sarah J Schwarzenberg, Barbara Bland, Gregory J Beilman, Melena D Bellin
OBJECTIVES: Approximately two thirds of patients will remain on insulin therapy after total pancreatectomy with islet autotransplant (TPIAT) for chronic pancreatitis. We investigated the relationship between measured pancreas volume on computerized tomography or magnetic resonance imaging and features of chronic pancreatitis on imaging, with subsequent islet isolation and diabetes outcomes. METHODS: Computerized tomography or magnetic resonance imaging was reviewed for pancreas volume (Vitrea software) and presence or absence of calcifications, atrophy, and dilated pancreatic duct in 97 patients undergoing TPIAT...
August 2016: Pancreas
Guru Trikudanathan, Martin L Freeman
No abstract text is available yet for this article.
June 2016: Gastrointestinal Endoscopy
Guru Trikudanathan, Sidney P Walker, Satish Munigala, Ben Spilseth, Ahmad Malli, Yusheng Han, Melena Bellin, Srinath Chinnakotla, Ty Dunn, Timothy L Pruett, Gregory J Beilman, Jose Vega Peralta, Mustafa A Arain, Stuart K Amateau, Sarah J Schwarzenberg, Shawn Mallery, Rajeev Attam, Martin L Freeman
OBJECTIVES: Diagnosis of non-calcific chronic pancreatitis (NCCP) in patients presenting with chronic abdominal pain is challenging and controversial. Contrast-enhanced magnetic resonance imaging (MRI) with secretin-stimulated MRCP (sMRCP) offers a safe and noninvasive modality to diagnose mild CP, but its findings have not been correlated with histopathology. We aimed to assess the correlation of a spectrum of MRI/sMRCP findings with surgical histopathology in a cohort of NCCP patients undergoing total pancreatectomy with islet autotransplantation (TPIAT)...
November 2015: American Journal of Gastroenterology
Guru Trikudanathan, Khalil Farah, Mustafa Tiewala
No abstract text is available yet for this article.
April 2015: ACG Case Reports Journal
Guru Trikudanathan, Aasma Shaukat, Yan Bakman
No abstract text is available yet for this article.
November 2015: Clinical Gastroenterology and Hepatology
Rajeev Attam, Mustafa A Arain, Stephen J Bloechl, Guru Trikudanathan, Satish Munigala, Yan Bakman, Maharaj Singh, Timothy Wallace, Joseph B Henderson, Marc F Catalano, Nalini M Guda
BACKGROUND: Contemporary EUS-guided FNA techniques involve the use of a needle, with an air column within the lumen, with or without suction. We describe a novel technique with an aim to improve the quality of the aspirate. OBJECTIVE: To compare a novel "wet suction" technique (WEST) with the conventional FNA technique (CFNAT) of EUS-guided FNA using a 22-gauge FNA needle. DESIGN: Prospective, single-blind, and randomized trial. SETTING: Two large tertiary-care hospitals...
2015: Gastrointestinal Endoscopy
Rajeev Attam, Mustafa Arain, Guru Trikudanathan, Martin L Freeman
No abstract text is available yet for this article.
May 2015: Gastrointestinal Endoscopy
Guru Trikudanathan, Santhi Swaroop Vege
The association of acute pancreatitis (AP) with intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) has only recently been recognized. The detrimental effects of raised intra-abdominal pressure in cardiovascular, pulmonary and renal systems have been well established. Although IAH was associated with a higher APACHE II score and multi-organ dysfunction syndrome (MODS) in severe acute pancreatitis, a causal relationship between ACS and MODS in SAP is yet to be established. It is therefore debatable whether IAH is a phenomenon causative of organ failure or an epiphenomenon seen in conjunction with other organ dysfunction...
July 2014: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Rajeev Attam, Thomas M Leventhal, Guru Trikudanathan, Mustafa A Arain, Martin L Freeman
No abstract text is available yet for this article.
April 2015: Gastrointestinal Endoscopy
Guru Trikudanathan, Rajeev Attam, Mustafa A Arain, Shawn Mallery, Martin L Freeman
Interventions for necrotizing pancreatitis have undergone a paradigm shift away from open surgical necrosectomy and toward minimally invasive techniques, with endoscopic transmural drainage (ETD) and necrosectomy emerging as principle forms of treatment. Recent multicenter studies, randomized trials, evidence-based guidelines, and consensus statements have endorsed the safety and efficacy of endoscopic and other minimally invasive techniques for the treatment of walled-off necrosis. A comprehensive review of indications, standard and novel approaches, outcomes, complications, and controversies regarding ETD and necrosectomy is presented...
July 2014: American Journal of Gastroenterology
Guru Trikudanathan, Mustafa A Arain, Rajeev Attam, Martin L Freeman
Extraction of common bile duct stones by endoscopic retrograde cholangiopancreatography generally involves biliary sphincterotomy, endoscopic papillary balloon dilation or a combination of both. Endoscopic papillary large-balloon dilation after sphincterotomy has increased the safety of large stone extraction. Cholangioscopically directed electrohydraulic and laser lithotripsy using single-operator mother-daughter systems or direct peroral cholangioscopy using ultraslim endoscopes are increasingly utilized for the management of refractory stones...
September 2014: Nature Reviews. Gastroenterology & Hepatology
Guru Trikudanathan, Mustafa Arain, Shawn Mallery, Martin Freeman, Rajeev Attam
Acute pancreatitis in children is rarely complicated by the development of necrosis. Although endoscopic transluminal necrosectomy is evolving as the standard of care in adults, its feasibility in the pediatric population has not been established. We hereby report the first case series of children with necrotizing pancreatitis successfully treated with endoscopic therapy. We believe the use of fully covered self-expanding metallic stents in the cystgastrostomy may reduce the number of transluminal necrosectomy sessions for large necrotic collections in children...
August 2014: Journal of Pediatric Gastroenterology and Nutrition
Rajeev Attam, Guru Trikudanathan, Mustafa Arain, Yukako Nemoto, Brooke Glessing, Shawn Mallery, Martin L Freeman
BACKGROUND: Interventions for necrotizing pancreatitis have undergone a recent paradigm shift toward minimally invasive techniques, including endoscopic transluminal necrosectomy (ETN). The optimal stent for endoscopic transmural drainage remains unsettled. OBJECTIVE: To evaluate a novel large-bore, fully covered metal through-the-scope (TTS) esophageal stent for cystenterostomy in large walled-off necrosis (WON). DESIGN: Retrospective case series...
August 2014: Gastrointestinal Endoscopy
Guru Trikudanathan, Basile Njei, Rajeev Attam, Mustafa Arain, Aasma Shaukat
BACKGROUND AND AIM: Accurate preoperative staging of ampullary neoplasms is of paramount importance in predicting prognosis and determining the most appropriate therapeutic approach. The aim of the present review was to evaluate the accuracy of endoscopic ultrasound (EUS) in predicting depth of ampullary tumor invasion (T-stage) and regional lymph node status (N-stage) by carrying out a meta-analysis of all relevant studies. METHODS: We systematically searched PubMed, Medline and Scopus databases for all studies published between January 1980 and December 2012...
September 2014: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Guru Trikudanathan, Udayakumar Navaneethan, Basile Njei, John J Vargo, Mansour A Parsi
BACKGROUND: The most ominous adverse event of primary sclerosing cholangitis (PSC) is development of cholangiocarcinoma (CCA). There is a wide variation in the reported diagnostic yield of bile duct brush cytology in PSC strictures. OBJECTIVE: To determine the diagnostic utility of biliary brush cytology for CCA detection in patients with PSC. DESIGN: Meta-analysis. Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to December 2012...
May 2014: Gastrointestinal Endoscopy
Guru Trikudanathan, Mustafa Arain, Rajeev Attam, Martin L Freeman
The management of necrotizing pancreatitis has undergone a paradigm shift toward minimally invasive techniques for necrosectomy, obviating the need for open necrosectomy in most cases. There is increasing evidence that minimally invasive approaches including a step-up approach that incorporates percutaneous catheter or endoscopic transluminal drainage, followed by video-assisted retroperitoneal or endoscopic debridement are associated with improved outcomes over traditional open necrosectomy for patients with infected necrosis...
July 2013: Expert Review of Gastroenterology & Hepatology
Guru Trikudanathan, Udayakumar Navaneethan, Mansour A Parsi
Endoscopy is widely accepted as the first treatment option in the management of bile duct stones. In this review we focus on the alternative endoscopic modalities for the management of difficult common bile duct stones. Most biliary stones can be removed with an extraction balloon, extraction basket or mechanical lithotripsy after endoscopic sphincterotomy. Endoscopic papillary balloon dilation with or without endoscopic sphincterotomy or mechanical lithotripsy has been shown to be effective for management of difficult to remove bile duct stones in selected patients...
January 14, 2013: World Journal of Gastroenterology: WJG
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