Fateh Bazerbachi

• Doctor of Medicine
• Director of Interventional Endoscopy at St. Cloud Hospital

BACKGROUND AND AIMS: Endoscopic transluminal drainage of symptomatic walled-off necrosis (WON) is a good management option, although the optimal choice of drainage site stent is unclear. We performed a systematic review and meta-analysis to compare metal stents (MSs) and plastic stents (PSs) in terms of WON resolution, likelihood of resolution afte...

Case reports and case series are uncontrolled study designs known for increased risk of bias but have profoundly influenced the medical literature and continue to advance our knowledge. In this guide, we present a framework for appraisal, synthesis and application of evidence derived from case reports and case series. We propose a tool to evaluate...

Background: Peribiliary cysts are usually benign, although severe complications and mortality may occur, and they may be confounded with other diseases, and no classification delineating their different characteristics exists. Design: We performed a systematic review of the frequency and clinical manifestations of peribiliary cysts. Two reviewers i...

Gastrointestinal (GI) endoscopy has witnessed a Cambrian explosion of techniques, indications, and expanding target populations. GI endoscopy encompasses traditional domains that include preventive measures, palliation, as alternative therapies in patients with prohibitive risks of more invasive procedures, and indicated primary treatments. But, it...

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...

Objectives This study evaluated a novel contrast‐enhanced (CE) fluoroscopy protocol for endoscopic retrograde cholangiopancreatography, which optimizes image processing to enhance contrast of devices and contrast media. We compared the CE protocol with the conventional standard protocol to assess its potential for reducing radiation exposure while...

Background/Purpose Insufficient studies exist on capnography efficacy during endoscopic ultrasound or endoscopic retrograde cholangiopancreatography, and no definitive conclusions have been drawn. To evaluate the feasibility and efficacy of a novel mainstream capnography using an over‐the‐biteblock end‐tidal CO 2 (EtCO 2 ) detector in decreasing th...

Objectives: Although rectal non-steroidal anti-inflammatory drugs (NSAIDs) reduce the incidence of post endoscopic retrograde cholangiopancreatography pancreatitis (PEP), their optimal dosage is unknown. Given possible inter-individual variability in the pharmacodynamics of NSAIDs, we hypothesized that the dose required to achieve adequate PEP prop...

The escalating obesity pandemic and its comorbidities necessitate adaptable and versatile treatment strategies. Endobariatric and metabolic therapies (EBMTs) can be strategically employed in a multipronged approach to obesity management, analogous to the way chess systems are employed to seize opportunities and thwart threats. In this review, we ex...

Background: Fluid resuscitation is fundamental in acute pancreatitis (AP) treatment. However, the optimal choice between normal saline (NS) and Ringer's solution (RS), and its impact on mortality in critically ill patients, remains controversial. This retrospective cohort study, utilizing a national Japanese inpatient database, investigates this q...

Background: Peroral endoscopic myotomy (Z-POEM) is an effective treatment for Zenker's diverticulum (ZD), but procedural time and safety vary based on technique. Modified Z-POEM approaches incorporating fewer submucosal tunnels may offer advantages.

Background Visceral fat represents a metabolically active entity linked to adverse metabolic sequelae of obesity. We aimed to determine if celiac artery mesenteric fat thickness can be reliably measured during endoscopic ultrasound (EUS), and if these measurements correlate with metabolic disease burden. Methods This was a retrospective analysis o...

Endoscopic resection of gastrointestinal stromal tumors of the fundus is challenging due to the need for full-thickness resection and the difficulties for defect closure. Submucosal tunneling in direct view through the esophagus can be applied for esophageal tumors and gastric tumors of the cardia near the gastroesophageal junction. However, for tu...

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Current guidelines recommend treating choledocholithiasis, regardless of symptoms or stone size, with endoscopic retrograde cholangiopancreatography (ERCP). However, asymptomatic choledocholithiasis, discovered incidentally on imaging, may carry a higher risk of ERCP-related adverse events, and some asymptomatic and diminutive stones may not cause...

Bariatric surgeries are often complicated by de-novo gastroesophageal reflux disease (GERD) or worsening of pre-existing GERD. The growing rates of obesity and bariatric surgeries worldwide are paralleled by an increase in the number of patients requiring post-surgical GERD evaluation. However, there is currently no standardized approach for the as...

Background and aims: Patients with infected or symptomatic walled-off necrosis (WON) have high morbidity and health care utilization. Despite the recent adoption of non-surgical treatment approaches, WON management remains non-algorithmic. We investigated the impact of a protocolized early necrosectomy approach compared to a non-protocolized, clin...

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Background and Aims The dissemination of endoscopic submucosal dissection (ESD) has been limited by its technical complexity and safety profile, particularly among non-experts. Various techniques and devices have facilitated the performance of ESD, but their yield and role in the path to learning ESD remain unclear. Methods We performed a systemat...

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Background: Despite post-ERCP pancreatitis (PEP) being a major focus of outcomes research in endoscopic retrograde cholangiopancreatography (ERCP), little is known regarding the frequency with which asymptomatic biochemical and/or radiologic pancreatic alterations occur in patients following ERCP. Methods: Adult inpatients undergoing ERCP were i...

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A reference interval, or an interval in which a pre-specified proportion of measurements from a healthy population are expected to fall, is used to determine whether a person's measurement is typical of a healthy individual. For a specific biomarker, multiple published studies may provide data collected from healthy participants. A reference interv...

Video 1Endoscopic submucosal dissection of a sizeable gastric polyp with a short and broad stalk assisted by a novel traction device.

The cumulative metastasis rate of esophageal squamous cell carcinoma (ESCC) pathologically invading the muscularis mucosae (pT1a-MM), based on lymphovascular invasion (LVI) evaluated by immunohistochemical (IHC) staining is unknown. This retrospective study included patients with endoscopically resected pT1a-MM ESCC. The primary endpoint was the me...

Background Lumen-apposing metal stents (LAMS) are an alternative therapeutic option for benign gastrointestinal (GI) tract strictures. Our study aimed to evaluate the safety and efficacy of LAMS for the management of benign GI strictures. Methods Consecutive patients who underwent a LAMS placement for benign luminal GI strictures at a tertiary car...

Esophageal cancer is the eighth most common malignancy worldwide with more than 600,000 new cases diagnosed annually. Although curative approaches to early-stage esophageal cancer have historically been surgical, advances in endoscopic techniques resulted in the identification of patients who may benefit from minimally invasive endoscopic therapies...

BACKGROUND The endoscopic management of benign short post-anastomotic ileocolonic stricture (PAICS) that is refractory to primary and secondary treatment modalities remains challenging. The lumen-apposing metal stent (LAMS) is a novel device recently developed for therapeutic gastrointestinal endoscopy. LAMSs have demonstrated significantly better...

A 56-year-old female developed deep jaundice months after struggling with critical illness, needing hemodialysis, and tracheostomy, due to COVID-19. Lab tests included alkaline phosphatase 1574U/L, total bilirubin 11mg/dL, ALT 88U/L, AST 101U/L. Baseline liver tests were normal before illness. ANA, IgG4 level, and viral hepatitides were negative. T...

Abstract BACKGROUND The endoscopic management of benign short post-anastomotic ileocolonic stricture (PAICS) that is refractory to primary and secondary treatment modalities remains challenging. The lumen-apposing metal stent (LAMS) is a novel device recently developed for therapeutic gastrointestinal endoscopy. LAMSs have demonstrated significantl...

BACKGROUND AND AIMS The optimal therapeutic approach for walled off necrosis (WON) is not fully understood, given the lack of validated classification system. We propose a novel and robust classification system based on radiologic and clinical factors to standardize the nomenclature, provide a framework to guide comparative effectiveness trials, an...

(1) Background: Various methods to predict the presence or absence of choledocholithiasis (CDL) have been proposed. We aimed to assess the performance characteristics of dynamic liver enzyme trends in the prediction of CDL. (2) Methods: This was a single-center retrospective cohort study. All adult in-patients undergoing endoscopy for suspected CDL...

The promotion of quality and best practices in gastroenterology and endoscopy is an ongoing effort. For upper GI endoscopy, quality indicators derived from clinical studies and expert consensus have been long established but remain variably obtained. To date, data on interventions aimed to improve these indicators are scarce. We systematically revi...

Background: Microangiopathic hemolytic anemia (MAHA) is a rare paraneoplastic syndrome that has been reported in patients with gastric signet ring cell carcinoma (SRCC). Clinical and prognostic features of MAHA in this setting have been poorly described. Materials and methods: We conducted a systematic review in 8 databases of gastric SRCC compl...

Background and study aims Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is an endoscopic procedure for treating gastric outlet obstruction (GOO). Limited data exist regarding the safety and efficacy of EUS-GJ in patients with malignant GOO with ascites. Thus, we aimed to study the outcomes and safety of EUS-GJ in GOO patients with vs. wit...

Clinicians frequently must decide whether a patient's measurement reflects that of a healthy "normal" individual. Thus, the reference range is defined as the interval in which some proportion (frequently 95%) of measurements from a healthy population is expected to fall. One can estimate it from a single study or preferably from a meta-analysis of...

Video 1Over-the-wire snare-assisted exchange in ERCP.

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A 65-year-old patient was referred for endoscopic management of a complete 5-cm long radiation-induced stricture of the hypopharynx and esophagus (Fig 1, Video 1). He had a history of curative chemoradiation therapy for T2N1 squamous cell carcinoma of the larynx. His nutrition was exclusively maintained through a percutaneous gastrostomy. Recanaliz...

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 Guidelines recommend that all patients with upper gastrointestinal bleeding (UGIB) undergo endoscopy within 24 h. It is unclear whether a subgroup may benefit from an urgent intervention. We aimed to evaluate the influence of endoscopic hemostasis and urgent endoscopy on mortality in UGIB patients with high-risk stigmata (HRS). Methods...

Endoscopic therapy is a key component in the management algorithm for variceal and nonvariceal hemorrhage related to portal hypertension. Band ligation is the endoscopic treatment of choice for acute esophageal variceal bleeding, and for preventing a first episode of bleeding (primary prophylaxis) and rebleeding (secondary prophylaxis). In contrast...

Background and study aims The COVID-19 pandemic has had a profound impact on gastroenterology training programs. We aimed to objectively evaluate procedural training volume and impact of COVID-19 on gastroenterology fellowship programs in the United States. Methods This was a retrospective, multicenter study. Procedure volume data on upper and lowe...

Studies on normal (or healthy) individuals are an essential step in the process of diagnostic research. However, deciding what is normal in medicine can be difficult. In this chapter, we discuss how to adapt the concept of normality to clinical decisions, particularly in the field of liver disease. In addition, we summarize the main evidence on the...

Background Spontaneous hyperinflation is reported to the Food and Drug Administration as a complication of intragastric balloons. It is postulated that orogastric contamination of the intragastric balloon may cause this phenomenon. We sought to investigate the effects of intentional balloon contamination with gastric contents on intragastric balloo...

Purpose Staple line leak (SLL) is a serious complication after sleeve gastrectomy (SG). Common endoscopic treatment options include self-expandable metallic stent (SEMS), endoscopic internal drainage (EID), and endoscopic closure. The endoscopic negative pressure therapy (ENPT) is a promising treatment option combining temporary sealing of the defe...

Video 1Preparation and demonstration of bone wax-tipped catheter for optimized hemostatic powder delivery ex vivo and in vivo.

e16253 Background: Acinar cell carcinoma (ACC) is a very rare tumor of the exocrine pancreas, representing less than 1% of all pancreatic malignancies. The majority of data regarding ACC are limited to small case series. Methods: This is a retrospective study conducted at a large healthcare system from 1996-2019. Patients with pathologically confir...

Background Acinar cell carcinoma (ACC) is a very rare tumor of the exocrine pancreas, representing less than 1% of all pancreatic malignancies. The majority of data regarding ACC are limited to small case series. Methods This is a retrospective study conducted at a large healthcare system from 1996-2019. Patients with pathologically confirmed ACC...

Αn 80-year-old man with end-stage achalasia presented with aspiration pneumonia, weight loss and debilitation. He was not deemed a surgical candidate for palliative esophagectomy. Previous treatment with dilation was unsucessful. A posterior-like anterior peroral endoscopic myotomy was performed [1,2]. Following mucosotomy and an intial 2 cm submuc...

Background: Learning experience studies on endoscopic submucosal dissection (ESD) commonly originate from the East. Little is known about the performance of ESD in low-volume western centers. Further, it is unclear whether ESD can be self-taught without a tutored approach. Methods: We performed a retrospective analysis of consecutive ESDs, perform...

Background Spontaneous hyperinflation is reported to the Food and Drug Administration as a complication of intragastric balloons. It is postulated that orogastric contamination of the intragastric balloon may cause this phenomenon. We sought to investigate the effects of intentional balloon contamination with gastric contents on intragastric balloo...

Background /Aims Glycogenic hepatopathy (GH) in type 1 diabetes‐mellitus (T1DM) is characterized by hepatomegaly and perturbations of liver chemistries (LC) that have not been well studied. Furthermore, misdiagnosis with other hepatic complications of T1DM, such as nonalcoholic fatty liver disease, has been described. We perform a systematic review...

Background Abdominal pain is a debilitating symptom affecting ∼80% of pancreatic cancer (PC) patients. Pancreatic duct (PD) decompression has been reported to alleviate this pain, although this practice has not been widely adopted. We aimed to evaluate the role, efficacy, and safety of endoscopic PD decompression for palliation of PC post-prandial...