Christopher C. Thompson

Brigham and Women's Hospital | BWH · Division of Gastroenterology, Hepatology and Endoscopy

Background and aims: Goals of therapy for patients with nonalcoholic fatty liver disease (NAFLD) and compensated advanced chronic liver disease (cACLD) include weight loss and reduction of the portosystemic pressure gradient (PPG) to decrease the risk of hepatic decompensation. Endoscopic gastric plication (EGP) is an effective endoscopic weight l...

Background and aims: Endoscopic suturing is a complex skill with broad applications. This study aims to develop and validate a novel endoscopic suturing simulator and scoring system for the pursestring suture pattern. Methods: This was a prospective study of an endoscopic suturing simulator, which consists of a circular opening representing a di...

Purpose of review: Gastroesophageal reflux disease (GERD) is the most common chronic condition with increasing prevalence in the Western world. Despite medical therapy, a considerable proportion of patients continue to experience symptoms, thus fueling the demand for minimally invasive GERD treatment options. This review will assess the currently...

Purpose Weight regain after Roux-en-Y gastric bypass (RYGB) is associated with worsening of liver outcomes. However, the effect of transoral outlet reduction (TORe) on liver fibrosis in RYGB patients with weight regain and possible advanced fibrosis remains unknown. Materials and Methods This was a retrospective analysis of prospectively collected...

Background/aims: Upper gastrointestinal bleeding (UGIB) is a life-threatening condition that necessitates early identification and intervention and is associated with substantial morbidity, mortality, and socioeconomic burden. However, several diagnostic challenges remain regarding risk stratification and the optimal timing of endoscopy. The PillS...

Background and aims: Transoral outlet reduction (TORe) and anti-obesity medication (AOM) are effective treatments for weight regain following Roux-en-Y gastric bypass (RYGB). This study aims to 1) assess the efficacy of combination therapy (TORe + AOM) for treating weight regain and 2) compare the safety and efficacy of combination therapy to AOM...

Bariatric surgery is the most effective therapy to address moderate to severe cases of obesity. Although mortality rates are minimal, non-fatal complications are substantially more common. Leaks/fistulas, strictures, and erosion or migration of adjunct medical devices (adjustable bands/sylastic rings) compose the most relevant bariatric adverse eve...

Video 1Demonstration of the steps of gastroplasty with endoscopic myotomy for the treatment of obesity.

Surgical endoscopy has evolved rapidly in the last four decades with innovative platforms and technology that continue to push the boundaries of minimally invasive gastroenterology and gastrointestinal surgery. In this chapter, we discuss the history of surgical endoscopy and review multiple operating platforms. Traditional endoscope-assisted visua...

Background and aims: Per-oral endoscopic myotomy (POEM), Laparoscopic Heller Myotomy (LHM), and Pneumatic Dilation (PD) are the most common modalities for management of achalasia. Our study aimed to directly compare their short-term outcomes and safety profile in the hospitalized cohort in the United States. Methods: National Readmission Databas...

Background and aims: Fibrosis stage is the strongest predictor of mortality in patients with nonalcoholic fatty liver disease (NAFLD). There is currently no approved therapy that specifically targets fibrosis. This study aims to assess the effect of endoscopic gastric plication on hepatic fibrosis in patients with underlying NAFLD. Methods: This...

Fecal microbiota transplantation (FMT) is a promising therapeutic modality for the treatment and prevention of metabolic disease. We previously conducted a double-blind, randomized, placebo-controlled pilot trial of FMT in obese metabolically healthy patients in which we found that FMT enhanced gut bacterial bile acid metabolism and delayed the dev...

Background Gastrogastric fistulae (GGF) occur in 1.3-6% of RYGB patients and can be associated with abdominal pain, reflux, weight regain and onset of diabetes. Endoscopic and surgical treatments are available without prior comparisons. The study aim is to compare endoscopic and surgical treatment methods in RYGB patients with GGF. Methods Retrosp...

Background & Aims Transoral Incisionless Fundoplication (TIF) using EsophyX device is a minimally invasive endoscopic fundoplication technique. Our study aimed to assess the efficacy of TIF for atypical GERD symptoms in patients with chronic or refractory GERD. Methods A systematic search of 4 major databases was performed. All original studies as...

Malignant gastric outlet obstruction (mGOO) is a late complication of pancreatic malignancy and presents a therapeutic challenge for the gastroenterologist and oncologist. Traditionally mGOO was treated with surgical gastroenterostomy. Serial advancements in endoscopy have provided minimally invasive alternatives including enteral stent placement a...

Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel technique developed to manage gastric outlet obstruction (GOO). It involves creating a fistula between the stomach and the proximal small bowel using an electric cautery-enhanced lumen-apposing metal stent (ECE-LAMS) with EUS guidance. We aimed to publish o...

Background and Aims Endoscopic submucosal dissection (ESD) has become a standard therapeutic approach for superficial GI tract neoplasia. However, it requires refined endoscopic skills and procedural expertise, and it remains limited to a few endoscopists. Traction strategy can improve procedural efficacy and allow lower-experience endoscopists to...

Background and study aims Given the sizable number of patients with symptomatic gastroesophageal reflux disease (GERD) despite proton pump inhibitor (PPI) therapy, non-pharmacologic treatment has become increasingly utilized. The aim of this study was to analyze the cost-effectiveness of medical, endoscopic, and surgical treatment of GERD. Patients...

Background Endoscopic sleeve gastroplasty (ESG) is an endolumenal, organ-sparing therapy for obesity, with wide global adoption. We aimed to explore the efficacy and safety of ESG with lifestyle modifications compared with lifestyle modifications alone. Methods We conducted a randomised clinical trial at nine US centres, enrolling individuals aged...

Background Dumping syndrome is a known complication of Roux-en-Y gastric bypass (RYGB). Recently, endoscopic gastrojejunal anastomosis (GJA) revision has been employed as a treatment option. The primary aim of this study was to perform a systematic review and meta-analysis for the role of endoscopic GJA revision in patients with RYGB for the treatm...

Since its inception, endoscopy has evolved from being a solely diagnostic procedure to an expanding therapeutic field within gastroenterology. The incorporation of robotics in gastroenterology initially aimed to address shortcomings of flexible endoscopes in natural orifice transluminal endoscopy. Developing therapeutic endoscopic robotic platforms...

Obesity is pandemic. It is estimated that by 2030, half of the U.S. population will have obesity. Current treatment options for obesity includes lifestyle modification, pharmacotherapy, endoscopic bariatric and metabolic therapy (EBMT) and bariatric surgery. Over the past decades, an increasing number of EBMTs have been developed and become availab...

The concept of endoscopic lumen apposition has seen a dramatic shift in the last several decades. Early natural orifice trans-luminal endoscopic surgery (NOTES) concepts have transformed into specialized lumen-apposing metal stents (LAMSs) and delivery devices, which provide endoscopists a minimally invasive alternative to surgical intervention. Th...

Background and Aims Distal primary obesity surgery endolumenal (POSE) procedures involve plication of the gastric body, sparing the fundus. We aim to assess the efficacy of distal POSE and to compare plication techniques (single-helix vs double-helix approaches). Methods This is a prospective registry study of patients who underwent distal POSE us...

Video 1The endoscopic submucosal dissection of the gastric duplication cyst with ductotomy of an incidental communicating duct.

Background and Aims Direct endoscopic necrosectomy (DEN) with lumen-apposing metal stents (LAMS) is increasingly used in the management of pancreatic walled-off necrosis (WON). However, it still remains unknown which patients will fail to respond to DEN with LAMS and require additional surgical intervention. Therefore, the aim of our study was to e...

Background and Aims Gastric Plication involves inverting the stomach with tissue anchor placement to achieve serosa to serosa apposition. One potential application of gastric plication is the treatment of weight regain following Roux-en-Y gastric bypass (RYGB), a procedure also known as plication transoral outlet reduction (P-TORe). This study aims...

Background Current standard of care for creation of small bowel anastomoses after a loop ileostomy reversal includes the use of stapler devices and sutures. Compression anastomosis devices have been used for decades, aimed toward improved outcomes with a “staple free” & “suture free” anastomosis. The self-forming magnet (SFM) device is a type of co...

Background Gastric outlet obstruction (GOO) with peritoneal carcinomatosis presents a technical challenge. Surgical gastrojejunostomy (SGJ) or enteral stenting have been the standard of care; however, endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a favorable alternative. Few data exist that compare these techniques in the s...

Increasing interest and innovation within the field of gastroenterology and endoscopy, combined with the proven mechanisms of weight loss associated with bariatric surgery, has allowed for the development of several endoscopic weight loss therapies. This chapter provides a detailed review of the field of bariatric endoscopy, highlights indications...

Bariatric endoscopy is an emerging subspecialty for gastroenterologists and surgeons encompassing a broad array of procedures including treatment of post‐bariatric surgery complications, primary endoscopy bariatric and metabolic therapies, and revisional procedures for weight regain. This chapter addresses the process of incorporating bariatric tra...

Background Despite literature and guidelines recommending same admission cholecystectomy (CCY) after endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute gallstone pancreatitis, clinical practice remains variable. The aim of this study was to investigate the role of clinical and socio-demographic factors in the management o...

Background Primary obesity surgery endoluminal (POSE) utilizes an incision-less operating platform system to create full-thickness plications in the gastric fundus and body (original POSE). Many studies have demonstrated the safety and efficacy of original POSE for the treatment of obesity.Objective We aimed to conduct a systematic review and meta-...

There is an increasing prevalence of both gastroesophageal reflux disease (GERD) and obesity. For patients who fail medical therapy for GERD, surgical fundoplication, such as laparoscopic Nissen fundoplication, is traditionally offered. Nevertheless, the efficacy of laparoscopic Nissen fundoplication appears limited in patients with obesity. Tradit...

Background: While endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is considered a preferred technique for tissue sampling for solid lesions, fine needle biopsy (FNB) has recently been developed. Aim: To compare the accuracy of FNB vs FNA in determining the diagnosis of solid lesions. Methods: A retrospective, multi-center study...

Background and aimThere is wide variation in choice of sedation and airway management for endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to perform a systematic review and meta-analysis to investigate safety outcomes of deep sedation with monitored anesthesia care (MAC) versus general endotracheal anesthesia (GETA)...

Background Intragastric balloons are anatomy-preserving, minimally invasive obesity therapies. Enhanced tolerance and durability could help broaden clinical adoption. We investigated the safety and efficacy of an adjustable intragastric balloon (aIGB) in adults with obesity. Methods In this prospective, multicentre, open-label, randomised clinical...

Background and Aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as an option for managing malignant gastric outlet obstruction (GOO). However, there is currently no standardized technique and outcomes are variable with inconsistencies both within and across centers. The present study aims to develop and assess outcomes of a...

Video 1Endoscopic gastric plication (EGP) to treat obesity and nonalcoholic steatohepatitis (NASH) in a patient with compensated cirrhosis, as well as the application of EUS-guided portal pressure gradient (EUS-PPG) measurement to monitor changes in PPG after EGP.

Background and aims: Endoscopic full-thickness resection (EFTR) is a novel endoscopic technique for the resection of gastrointestinal lesions not amenable to standard endoscopic therapy. The primary aim of this study is to perform a systematic review and meta-analysis to evaluate EFTR for the resection of colorectal lesions. Methods: Individuali...