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| 1 | Endoscopic management of difficult common bile duct stones显示文摘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.Ductal clearance can be safely achieved with peroral cholangioscopy guided laser or electrohydraulic lithotripsy in most cases where other endoscopic treatment modalities have failed.Biliary stenting may be an alternative treatment option for frail and elderly patients or those with serious co morbidities. | Guru Trikudanathan Udayakumar Navaneethan Mansour A Parsi | 2013 | World Journal of Gastroenterology2013，19，2： | 24 |
| 2 | Early precut sphincterotomy and the risk of endoscopic retrograde cholangiopancreatography related complications: An updated meta-analysis显示文摘AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and postendoscopic retrograde cholangiopancreatography(ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials(RCT) studies whichmet our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCPrelated bleeding, perforation and cannulation success rates. RESULTS: Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group(OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis(PEP) was not different between the two groups(3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation(6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION: This meta-analysis suggests that precut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications. | Udayakumar Navaneethan Rajesh Konjeti Preethi GK Venkatesh Madhusudhan R Sanaka Mansour A Parsi | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，5： | 12 |
| 3 | Clostridium difficile infection and inflammatory bowel disease:Understanding the evolving relationship显示文摘Clostridium difficile(C.difficile)infection(CDI)is the leading identifiable cause of antibiotic-associated diarrhea.While there is an alarming trend of increasing incidence and severity of CDI in the United States and Europe,superimposed CDI in patients with inflammatory bowel disease(IBD)has drawn considerable attention in the gastrointestinal community.The majority of IBD patients appear to contract CDI as outpatients.C.difficile affects disease course of IBD in several ways,including triggering disease flares,sustaining activity,and in some cases,acting as an'innocent'bystander.Despite its wide spectrum of presentations,CDI has been reported to be associated with a longer duration of hospitalization and a higher mortality in IBD patients.IBD patients with restorative proctocolectomy or with diverting ileostomy are not immune to CDI of the small bowel or ileal pouch.Whether immunomodulator or corticosteroid therapy for IBD should be continued in patients with superimposed CDI is controversial.It appears that more adverse outcomes was observed among patients treated by a combination of immunomodulators and antibiotics than those treated by antibiotics alone.The use of biologic agents does not appear to increase the risk of acquisition of CDI.For CDI in the setting of underlying IBD,vancomycin appears to be more efficacious than metronidazole.Randomized controlled trials are required to clearly define the appropriate management for CDI in patients with IBD. | Udayakumar Navaneethan Preethi GK Venkatesh Bo Shen | 2010 | World Journal of Gastroenterology2010，16，39： | 12 |
| 4 | Factors predicting adverse short-term outcomes in patients with acute cholangitis undergoing ERCP: A single center experience显示文摘AIM: To identify potential factors that can predict adverse short-term outcomes in patients with acute cholangitis undergoing endoscopic retrograde cholangiopancreatography(ERCP). METHODS: Retrospective analysis of consecutive patients admitted to our center for acute cholangitis and underwent ERCP from 2001 to 2012. Involvement of two or more organ systems was termed as organ failure(OF). Cardiovascular failure was defined based on a systolic blood pressure of < 90 mmHg despite fluid replacement and/or requiring vasopressor treatment; respiratory failure if the Pa02 /Fi02 ratio was < 300 mmHg and/or required mechanical ventilation; coagulopathy if the platelet count was < 80; and renal insufficiency if serum creatinine was > 1.9 mg/dL. Variables associated with short term adverse clinical outcomes defined as persistent OF and/or 30-d mortality was determined. RESULTS: A total of 172 patients(median age 62 years, 56.4% female) were included. The median door to ERCP time was 17 h. Bile duct stones were the most common etiology(n = 67, 39.2%). In multivariate analysis, factors that were independently associated with persistent OF and/or 30-d mortality included American Society of Anesthesiology(ASA) physical classification score > 3(OR = 7.70; 95%CI: 2.73-24.40), presence of systemic inflammatory response syndrome(OR = 3.67; 95%CI: 1.34-10.3) and door to ERCP time greater than 72 h(OR = 3.36; 95%CI: 1.12-10.20). Door to ERCP time greater than 72 h was also associated with 70% increase in the mean length of stay(P < 0.001). Every one point increase in the ASA physical classification and every 1 mg/dL increase in the preERCP bilirubin level was associated with a 34% and 2% increase in the mean length of hospital stay, respectively. Transfer status did not impact clinical outcomes. CONCLUSION: Higher ASA physical classification and delays in ERCP are associated with adverse clinical outcomes and prolonged length of hospital stay in patients with acute cholangitis undergoing ERCP. | Udayakumar Navaneethan Norma G Gutierrez Ramprasad Jegadeesan Preethi GK Venkatesh Madhusudhan R Sanaka John J Vargo Mansour A Parsi | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，3： | 7 |
| 5 | Comparative study of endoscopy vs.transjugular intrahepatic portosystemic shunt in the management of gastric variceal bleeding显示文摘Background and Aim:Gastric varices are associated with high mortality.There have been conflicting reports on whether endoscopic treatment with cyanoacrylate or the placement of a transjugular intrahepatic portosystemic shunt(TIPS)is more effective in the treatment of gastric varices.We compared the outcomes of patients treated with cyanoacrylate glue or TIPS for the management of acute gastric variceal bleeding.Methods:The study was designed as a retrospective cohort analysis of patients undergoing either TIPS or endoscopic treatment with cyanoacrylate for acute gastric variceal bleeding at our institution from 2001 to 2011.Primary compared to studied between the two treatment modalities were the short-term treatment outcomes,including re-bleeding within 30 days,length of hospital stay and in-hospital mortality.Kaplan-Meier survival analysis was performed to assess factors associated with in-hospital mortality.Results:A total of 169 patients were included in the analysis.The TIPS arm contained 140 patients and the cyanoacrylate arm contained 29 patients.There was no evidence to suggest any significant differences in demographics or disease severity.There were no differences between the TIPS arm and the cyanoacrylate armtwo groups in treatment outcomes including re-bleeding within 30 days(17.4%vs.17.2%;P=0.98),median length of stay in the hospital(4.5 days vs.6.0 days;P紏0.35)or in-hospital mortality(9.0%vs.11.1%;P=0.74).In-hospital mortality was evaluated for 149 patients and lower albumin(P=0.015),higher MELD score(P<0.001),higher CTP score(P=0.005)and bleeding(P=0.008)were all significantly associated with in-hospital death.Conclusion:These findings suggest that both treatments are equally effective.Cyanoacrylate offers a safe,effective alternative to TIPS for gastric varices,and physician may choose the best therapy for each patient,factoring in the availability of TIPS or cyanoacrylate,the individual patient’s presentation,and cost. | Gursimran Singh Kochhar Udayakumar Navaneethan Jason Hartman Jose Mari Parungao Rocio Lopez Ranjan Gupta Baljendra Kapoor Paresh Mehta Madhu Sanaka | 2015 | Gastroenterology Report2015，3，1： | 2 |
| 6 | Progressive Primary Sclerosing Cholangitis Requiring Liver Transplantation Is Associated With Reduced Need for Colectomy in Patients With Ulcerative Colitis显示文摘 | Udayakumar Navaneethan Preethi G.K. Venkatesh Saurabh Mukewar Bret A. Lashner Feza H. Remzi Arthur J. McCullough Ravi P. Kiran Bo Shen John J. Fung | 2012 | Clinical Gastroenterology and Hepatology2012，，5： | 2 |
| 7 | Clostridium difficile infection is associated with worse long term outcome in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Saurabh Mukewar Preethi GK Venkatesh Rocio Lopez Bo Shen | 2011 | Journal of Crohn’s and Colitis2011，，3： | 2 |
| 8 | Impact of Clostridium difficile infection in patients with ulcerative colitis显示文摘 | Revital Kariv Udayakumar Navaneethan Preethi G.K. Venkatesh Rocio Lopez Bo Shen | 2010 | Journal of Crohn’s and Colitis2010，，1： | 2 |
| 9 | Diagnosis and management of primary sclerosing cholangitis-perspectives from a therapeutic endoscopist显示文摘Primary sclerosing cholangitis(PSC) is a chronic,cholestatic liver condition characterized by inflammation,fibrosis,and destruction of the intra-and extrahepatic bile ducts.The therapeutic endoscopist plays a key role in the diagnosis and management of PSC.In patients presenting with a cholestatic profile,endoscopic retrograde cholangiopancreatography(ERCP) is warranted for a definite diagnosis of PSC.Dominant strictures of the bile duct occur in 36%-57% of PSC patients.Endoscopic balloon dilatation with or without stenting have been employed in the management of dominant strictures.In addition,PSC patients are at increased risk of developing cholangiocarcinoma with a 20% lifetime risk.Brush cytology obtained during ERCP and use of fluorescence in situ hybridization forms the initial diagnostic step in the investigation of patients with dominant biliary strictures.Our review aims to summarize the current evidence supporting the role of a therapeutic endoscopist in the management of PSC patients. | Kunjam Modha Udayakumar Navaneethan | 2015 | World Journal of Hepatology2015，7，5： | 2 |
| 10 | Hepatitis E and pregnancy:understanding the pathogen-esis显示文摘 | Udayakumar Navaneethan Mayar Al Mohajer Mohamed TShata | 2008 | Liver international:official journal of the InternationalAssociation for the Study of the Liver2008，28，9： | 1 |
| 11 | 肠道准备质量对腺瘤检出率和结肠镜完成率的影响显示文摘背景和目的:充分的肠道准备对于安全有效的结肠镜检查是非常重要的。结肠镜检查的质量指标应达到至少95%的肠镜完成率和至少25%(50岁以上男性)或15%(50岁以上女性)的腺瘤检出率。本研究旨在探讨肠道准备对腺瘤检出率和肠镜完成率的影响。方法:回顾性纳入2008年1月至2009年12月间接受结肠镜检查的病例。主要结局指标是腺瘤检出率和肠镜完成率(抵达盲肠)。结果:共2519例患者纳入研究,其中1030例(41.0%)肠道准备评价为优,1145例(45.5%)评价为良,240例(9.5%)中等,104例(4.1%)评价为差。肠道准备中、差者肠镜完成率分别为75.4%和72.1%,明显低于肠道准备优、良者(分别为99.9%和99.7%,P<0.001),且前者肠镜完成率质量达标(95%)的比例也明显低于后者(P<0.001)。全组患者中肠镜准备优、良、中、差者腺瘤检出率分别为24.2%、26.8%、32.1%和22.1%,差异无统计学意义(P=0.06),各组腺瘤检出率均质量达标(男性25%,女性15%)。其中女性肠道准备优、良者腺瘤检出率相对更高,男性肠道准备优、良、中者腺瘤检出率相对更高(P<0.001)。多因素分析显示,男性患者腺瘤检出率明显增高,但肠道准备质量对腺瘤检出率并无影响。结论:肠道准备中、差者肠镜完成率明显低于肠道准备优、良者,但肠道准备质量对腺瘤检出率并无影响。 | Tarun Rai Udayakumar Navaneethan Tushar Gohel Amareshwar Podugu Prashanthi N.Thota Ravi P.Kiran Rocio Lopez Madhusudhan R.Sanaka | 2016 | Gastroenterology Report2016，4，2： | 1 |
| 12 | Hepatitis E and Pregnancy-Understanding the pathogenesis显示文摘 | Udayakumar Navaneethan Mayar Al Mohajer Mohamed T Shata | 2008 | Liver Int2008，28，9： | 1 |
| 13 | Delay in performing ERCP and adverse events increase the 30-day readmission risk in patients with acute cholangitis显示文摘 | Udayakumar Navaneethan Norma G. Gutierrez Ramprasad Jegadeesan Preethi G.K. Venkatesh Mujtaba Butt Madhusudhan R. Sanaka John J. Vargo Mansour A. Parsi | 2013 | Gastrointestinal Endoscopy2013，，1： | 1 |
| 14 | Endoscopic ultrasound in the diagnosis of cholangiocarcinoma as the etiology of biliary strictures:a systematic review and meta-analysis显示文摘Background and aim:Extrahepatic cholangiocarcinoma(CCA)typically presents as biliary strictures.Endoscopic ultrasound(EUS)-fine needle aspiration(FNA)may contribute to the diagnosis of CCA as the etiology of extrahepatic biliary strictures.Our aim was to study the uselfulness of EUS-FNA in diagnosing CCA as the etiology of biliary strictures.Patients and methods:In this meta-analysis,PUBMED and EMBASE databases were examined to find studies published to April 2014 where diagnostic correlation of CCA was available.Studies reporting only‘‘positive for malignancy’’were included in our analysis.The main outcome measurements were sensitivity,specificity and likelihood ratio.Results:Six studies were included,covering 196 patients.The overall pooled sensitivity and negative likelihood ratio(LR-)of EUS-FNA for diagnosis of CCA were 66%[95%confidence interval(CI)57-74%]and 0.34(95%CI 0.26-0.43),respectively.In five studies(146 patients),where a mass lesion was detected during EUS,the pooled sensitivity and LR-of EUS-FNA for diagnosis of CCA were 80%[95%CI 72-87%]and 0.20(95%CI 0.13-0.28),respectively.In the 49 patients with a negative brush cytology,the pooled sensitivity and LR-of EUS-FNA for diagnosis of CCA were 59%[95%CI 44-73%]and 0.41(95%CI 0.27-0.56),respectively.Conclusions:Our study suggests that EUS-FNA is useful in the evaluation of CCA as the etiology of biliary strictures.EUS-FNA may improve the diagnosis of CCA in patients with negative cytology and no mass on cross-sectional imaging. | Udayakumar Navaneethan Basile Njei Preethi G.K Venkatesh Vennisvasanth Lourdusamy Madhusudhan R Sanaka | 2015 | Gastroenterology Report2015，3，3： | 1 |
| 15 | Progressive Primary Sclerosing Cholangitis Requiring Liver Transplantation Is Associated With Reduced Need for Colectomy in Patients With Ulcerative Colitis显示文摘 | Udayakumar Navaneethan Preethi G.K. Venkatesh Saurabh Mukewar Bret A. Lashner Feza H. Remzi Arthur J. McCullough Ravi P. Kiran Bo Shen John J. Fung | 2012 | Clinical Gastroenterology and Hepatology2012，，5： | 1 |
| 16 | Duration and severity of primary sclerosing cholangitis is not associated with risk of neoplastic changes in the colon in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Gursimran Kochhar Preethi G.K. Venkatesh Brian Lewis Bret A. Lashner Feza H. Remzi Bo Shen Ravi P. Kiran | 2012 | Gastrointestinal Endoscopy2012，，5： | 1 |
| 17 | Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis显示文摘 | Udayakumar Navaneethan Basile Njei Vennisvasanth Lourdusamy Rajesh Konjeti John J. Vargo Mansour A. Parsi | 2014 | Gastrointestinal Endoscopy2014，，： | 1 |
| 18 | Comprehensive study of cardiovascular morbidity in hospitalized inflammatory bowel disease patients显示文摘 | Arun Raghav Mahankali Sridhar Sravanthi Parasa Udayakumar Navaneethan Michael D. Crowell Kevin Olden | 2011 | Journal of Crohn’s and Colitis2011，，4： | 1 |
| 19 | Clostridium difficile infection is associated with worse long term outcome in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Saurabh Mukewar Preethi GK Venkatesh Rocio Lopez Bo Shen | 2011 | Journal of Crohn’s and Colitis2011，，3： | 1 |
| 20 | Comprehensive study of cardiovascular morbidity in hospitalized inflammatory bowel disease patients显示文摘 | Arun Raghav Mahankali Sridhar Sravanthi Parasa Udayakumar Navaneethan Michael D. Crowell Kevin Olden | 2011 | Journal of Crohn’s and Colitis2011，，4： | 1 |
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