James Y W Lau

James Y W Lau
Chinese University of Hong Kong | CUHK · Institute of Digestive Disease

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183
Publications
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12,208
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Publications

Publications (183)
Article
Background The latest magnet‐controlled capsule endoscopy (MCCE) system can examine the water‐distended stomach, duodenum, and the small bowel. We assessed the use of MCCE as the first diagnostic tool in patients with acute upper gastrointestinal bleeding (AUGIB). Methods This was a prospective cohort study that enrolled patients admitted with AUG...
Article
Background: Current endoscopic methods in the control of acute nonvariceal bleeding have a small but clinically significant failure rate. The role of over-the-scope clips (OTSCs) as the first treatment has not been defined. Objective: To compare OTSCs with standard endoscopic hemostatic treatments in the control of bleeding from nonvariceal uppe...
Article
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Background The recommendation of second look endoscopy (SLOGD) in selected patients at high risk for rebleeding has been inconclusive. This study aimed to evaluate the benefit of SLOGD in selected patients predicted at high risk of recurrent bleeding. Methods From a cohort of 939 patients with bleeding peptic ulcers who underwent endoscopic hemost...
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italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Objective: Colorectal cancer (CRC) patients respond differently to treatments and are sub-classified by different approaches. We evaluated a deep learning model, which adopted endoscopic knowledge learnt from AI-doscopist, to characterise CRC patients...
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Background: Artificial intelligence (AI)-assisted colonoscopy improves polyp detection and characterization in colonoscopy. However, data from large scale multicenter randomized controlled trials (RCT) in an asymptomatic population are lacking. Methods: This multicenter RCT aimed to compare AI-assisted colonoscopy (AI) to conventional colonoscop...
Article
Background Adequate bowel preparation is an important colonoscopy quality indicator. Reinforced education is effective in improving bowel preparation quality of colonoscopy with mixed indications. However, it remains unclear whether such improvement can be consistently observed in pre- and post-irrigation during colonoscopy in screening population....
Article
Background: The effectiveness of the hemostatic powder TC-325 as a single endoscopic treatment for acute nonvariceal upper gastrointestinal bleeding is uncertain. Objective: To compare TC-325 with standard endoscopic hemostatic treatments in the control of active bleeding from nonvariceal upper gastrointestinal causes. Design: One-sided, nonin...
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Objective While it is recommended that patients presenting with acute upper gastrointestinal bleeding (AUGIB) should receive endoscopic intervention within 24 hours, the optimal timing is still uncertain. We aimed to assess whether endoscopy timing postadmission would affect outcomes. Design We conducted a retrospective, territory-wide, cohort stu...
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Background Acute gastrointestinal bleeding (GIB) remains a common cause of hospitalisation. However, interpretation and comparisons of published studies in GIB have been hampered by disparate study methodology. Aims To make recommendations about outcome measures to be used in future randomised controlled trials (RCTs) of patients with acute bleedi...
Article
Background and Aim Secondary prophylaxis (SP) of variceal rebleeding was reported to improve outcomes of hepatocellular carcinoma (HCC) patients, but the optimal endoscopic approach is not well defined. We compared outcomes in HCC patients who underwent SP by EUS‐guided cyanoacrylate obturation (EUS‐CYA) vs no SP. Methods Between 2014‐2018, 30 con...
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We have designed a deep-learning model, an “Artificial Intelligent Endoscopist (a.k.a. AI-doscopist)”, to localise colonic neoplasia during colonoscopy. This study aims to evaluate the agreement between endoscopists and AI-doscopist for colorectal neoplasm localisation. AI-doscopist was pre-trained by 1.2 million non-medical images and fine-tuned b...
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Background It is recommended that patients with acute upper gastrointestinal bleeding undergo endoscopy within 24 hours after gastroenterologic consultation. The role of endoscopy performed within time frames shorter than 24 hours has not been adequately defined. Methods To evaluate whether urgent endoscopy improves outcomes in patients predicted...
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In this study, we observe that the ischemic tissues of type-2 diabetic (T2D) patients and mice have significantly more CD8⁺ T-cells than that of their normoglycemic counterparts, respectively. However, the role of CD8⁺ T-cells in the pathogenesis of diabetic vascular complication has been less studied. Methods: We employed loss-of-function studies...
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Distal biliary strictures (DBS) are common and may be caused by both malignant and benign pathologies. While endoscopic procedures play a major role in their management, a comprehensive review of the subject is still lacking. Our consensus statements were formulated by a group of expert Asian pancreatico-biliary interventional endoscopists, followi...
Article
Background and aims: Accurate diagnosis of indeterminate biliary strictures is challenging but important for patient prognostication and further management. Biopsy under direct cholangioscopic vision might be superior to standard ERCP techniques such as brushing or biopsy. Our aim was to investigate whether digital single-operator cholangioscopy (...
Article
Background Peroral cholangioscopy (POCS) can be useful for difficult bile duct stone clearance. Large prospective multinational data on POCS-guided lithotripsy for clearing difficult bile duct stones in a single session of endoscopic retrograde cholangiopancreatography (ERCP) are missing. Methods Patients with difficult bile duct stones (defined as...
Article
Objective Patients with a history of Helicobacter pylori -negative idiopathic bleeding ulcers have a considerable risk of recurrent ulcer complications. We hypothesised that a proton pump inhibitor (lansoprazole) is superior to a histamine 2 receptor antagonist (famotidine) for the prevention of recurrent ulcer bleeding in such patients. Design In...
Article
Objective The risk associated with a family history of non-advanced adenoma (non-AA) is unknown. We determined the prevalence of colorectal neoplasms in subjects who have a first-degree relative (FDR) with non-AA compared with subjects who do not have an FDR with adenomas. Design In a blinded, cross-sectional study, consecutive subjects with newly...
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Background and study aims Image enhanced endoscopy (IEE) allows endoscopists to improve recognition and characterization of gastrointestinal neoplasia. The Asian Novel Bio-Imaging and Intervention Group (ANBIG) conducted a standardized training program in endoscopic diagnosis and treatment of early gastrointestinal cancers in Asia. We embarked on a...
Article
Many nanoparticle-based carriers to atherosclerotic plaques contain peptides, lipoproteins, and sugars, yet the application of DNA-based nanostructures for targeting plaques remains infrequent. In this work, we demonstrate that DNA-coated superparamagnetic iron oxide nanoparticles (DNA-SPIONs), prepared by attaching DNA oligonucleotides to poly(eth...
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Background This is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers. Method The Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy....
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AIM To assess the utility of modified Sano′s (MS) vs the narrow band imaging international colorectal endoscopic (NICE) classification in differentiating colorectal polyps. METHODS Patients undergoing colonoscopy between 2013 and 2015 were enrolled in this trial. Based on the MS or the NICE classifications, patients were randomised for real-time e...
Conference Paper
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Algorithms for localising colorectal polyps have been studied extensively; however, they were often trained and tested using the same database. In this study, we present a new application of a unified and real-time object detector based on You-Only-Look-Once (YOLO) convolutional neural network (CNN) for localizing polyps with bounding boxes in endo...
Article
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Objectives In the management of patients with bleeding peptic ulcers, recurrent bleeding is associated with high mortality. We investigated if added angiographic embolisation after endoscopic haemostasis to high-risk ulcers could reduce recurrent bleeding. Design After endoscopic haemostasis to their bleeding gastroduodenal ulcers, we randomised p...
Article
A computer-aided detection (CAD) tool for locating and detecting polyps can help reduce the chance of missing polyps during colonoscopy. Nevertheless, state-of-the-art algorithms were either computationally complex or suffered from low sensitivity and therefore unsuitable to be used in real clinical setting. In this paper, a novel regression-based...
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Background and aims: Wire-guided biliary cannulation has been demonstrated to improve cannulation rates and reduce post-ERCP pancreatitis (PEP), but the impact of wire caliber has not been studied. This study compares successful cannulation rates and ERCP adverse events using a 0.025-inch and 0.035-inch guidewire. Methods: A randomized, single b...
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Ambulatory blood pressure monitoring (ABPM) has become an essential tool in the diagnosis and management of hypertension. Current standard ABPM devices use an oscillometric cuff-based method which can cause physical discomfort to the patients with repeated inflations and deflations, especially during nighttime leading to sleep disturbance. The abil...
Article
Background and aims: Colorectal cancer (CRC) incidence is rising among <50 year olds. The objective of this study was to determine screening colonoscopy outcomes among 40-49 year olds, which are currently limited. Methods: Asymptomatic 40-49 year olds underwent one time CRC screening colonoscopy at The Chinese University of Hong Kong between 200...
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Walled-off necrosis (WON) is a new term for encapsulated necrotic tissue after severe acute pancreatitis. Various terminologies such as pseudocyst, necroma, pancreatic abscess and infected necrosis were previously used in the literature, resulting in confusion. The current and past terminologies must be reconciled to meaningfully interpret past dat...
Article
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Walled-off necrosis (WON) is a relatively new term for encapsulated necrotic tissue after severe acute pancreatitis. Various terminologies such as pseudocyst, necroma, pancreatic abscess and infected necrosis were previously used in the literature, resulting in confusion. The current and past terminologies must be reconciled to meaningfully interpr...
Article
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The current design of capsule endoscope is limited by the inability to control the motion within gastrointestinal tract. The rising incidence of gastrointestinal cancers urged improvement in the method of screening endoscopy. This preclinical study aimed to design and develop a novel locomotive module for capsule endoscope. We investigated the feas...
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Serrated polyps of the colon comprise a heterogeneous group of lesions with distinct histological and malignant features. The presence of serrated polyps has been associated with synchronous advanced neoplasia, although the magnitude of this relationship is unclear. Using studies identified from systematic literature search up to February 2014, we...
Article
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Tendon-sheath actuation mechanism is widely used in surgical robot, especially in endoscopic surgery, due to its capable of providing remote force and action transmission through long and flexible channel. However, hysteresis, backlash, nonlinear friction are the drawbacks of this mechanism. Our surgical robot use continuum manipulator which is use...
Article
The Over-The-Scope Clip (OTSC; Ovesco, Tübingen, Germany) is a novel endoscopic clipping device designed for tissue approximation. The device has been used in the closure of fistulas and perforations. We hereby report on a series of patients in whom OTSCs were used for endoscopic control of refractory or major upper gastrointestinal bleeding from l...
Article
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Gastric submucosal tumors are often treated by laparoscopic wedge resection. This study aimed to examine the feasibility of gastric full-thickness resection through a totally endoscopic approach using the master and slave transluminal endoscopic robot (MASTER), and closure of the luminal defect with an endoscopic suturing device. The operation was...
Article
Acute upper gastrointestinal bleeding is a common medical emergency worldwide, a major cause of which are bleeding peptic ulcers. Endoscopic treatment and acid suppression with proton-pump inhibitors are cornerstones in the management of the disease, and both treatments have been shown to reduce mortality. The role of emergency surgery continues to...
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Abstract Colorectal cancer (CRC) is rapidly increasing in Asia, but screening guidelines are lacking. Through reviewing the literature and regional data, and using the modified Delphi process, the Asia Pacific Working Group on Colorectal Cancer and international experts launch consensus recommendations aiming to improve the awareness of healthcare...
Article
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The management of patients with acute upper gastrointestinal bleeding should consist of early assessment and volume resuscitation. Endoscopy should be performed in all patients within 24 hours of their presentation. The Glasgow Blatchford score requires validation in different centers. It is accurate in identifying those at low risk of requiring in...
Article
Background & aims: Colorectal cancer (CRC) is the second-most common cancer in Hong Kong. Relatives of patients with CRC have an increased risk of colorectal neoplasm. We assessed the prevalence of advanced neoplasms among asymptomatic siblings of patients with CRC. Methods: Patients with CRC were identified from the Prince of Wales Hospital CRC...
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Endoscopic treatment for non-variceal upper gastrointestinal bleeding has evolved over decades. Injection with diluted epinephrine is considered as a less than adequate treatment, and the current standard therapy should include second modality if epinephrine injection is used initially. Definitive hemostasis rate following mono-therapy with either...
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Both capsule endoscopy (CE) and angiography have been recommended as first investigation for patients with acute overt obscure gastrointestinal bleeding (OGIB). However, no studies have directly compared the two modalities in patients with overt OGIB. We compared the diagnostic yield and long-term outcomes of patients with overt OGIB randomized to...
Article
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The role of cap-assisted colonoscopy (CAC) in polyp detection and cecal intubation is unclear. We conducted a meta-analysis to compare the efficacy of CAC vs. standard colonoscopy (SC). Publications in English and non-English literatures (OVID, MEDLINE, and EMBASE) and abstracts in major international conferences were searched for controlled trials...
Chapter
IntroductionDefinitionsEtiologyPatient's evaluation and assessmentInvestigationsComparative studiesDiagnostic approach to patients with OGIBConclusions References