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Category Archives: Hepatology
Please join us on Thursday, May 28th at 5 pm for the next virtual installment of GI Journal Club when we will discus the following articles:
Claire Dorsey, MD will present:
Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding
James Y.W. Lau et al. N Engl J Med 2020; 382:1299-1308
There has been conflicting evidence on whether urgent endoscopic evaluation of acute upper GI bleed improves patient outcomes. The authors present a large randomized control trial evaluating outcomes in upper GI bleed patients who undergo urgent endoscopy within 6 hours versus early endoscopy within 6-24 hours.
PDF: Timing of Endoscopy for Acute Upper GI Bleeding
Farah Hussain, MD will present:
Endoscopic ultrasonography-guided deployment of embolization coils and cyanoacrylate injection in gastric varices versus coiling alone: a randomized trial
Robles-Medranda Carlos et al. Endoscopy 2020; 52: 268–275
This is a single center randomized trial looking at managing gastric varices using EUS- guided coil embolization plus cyanoacrylate injection versus coiling alone in terms of outcomes.
PDF: EUS coil + cyanoacrylate glue vs EUS coil alone for gastric varices
Howie Lee, MD will present:
Endoscopic ultrasound-guided gallbladder drainage, transpapillary drainage, or percutaneous drainage in high risk acute cholecystitis patients: a systematic review and comparative meta-analysis
Mohan Babu P et al. Endoscopy 2020; 52: 96–106
This is a systemic review and meta-analysis comparing EUS guided GB drainage to transpapillary and percutaneous drainage for patients with acute cholecystitis who are high risk for surgery. EUS GBD demonstrated better clinical success than ETGBD and PCGBD in the management of acute cholecystitis patients at high surgical risk.
PDF: EUS-guided GB drainage, TP drainage or PC drainage for AC in high risk patients
Please join us for the next Journal Club scheduled for Thursday, January 23rd. The following articles will be presented:
- Nikhil Kapila, MD, will present the Transplant Hepatology Article:
- MELD-GRAIL-Na: Glomerular filtration rate and mortality on Liver-Transplant Waiting List
- The authors of this study evaluated the effect on waitlist (WL) mortality of replacing serum creatinine with estimated glomerular filtration rate (eGFR) in the MELD-NA score among patients with cirrhosis awaiting liver transplantation. Incorporation of MELD-GRAIL-Na instead of MELD-Na may impact outcomes for 12-17% awaiting transplant and affect organ allocation.
- Nelson Airewele, MD, will present the Hepatology Article:
- Thromboelastography-Guided Blood Component Use in Patients With Cirrhosis With Nonvariceal Bleeding: A Randomized Controlled Trial
- Thromboelastography (TEG) provides a more comprehensive global coagulation assessment than routine blood tests and its use may avoid unnecessary blood component transfusion in patients with advanced cirrhosis and significant coagulopathy who have nonvariceal upper gastrointestinal (GI) bleeding. The authors of this study investigated differences in the use of blood components in non-variceal bleeding between a TEG-guided transfusion protocol and transfusions guided by INR and PLT count.
- Claire Dorsey, MD, will present the “Hot Topic” Article:
- Yield and Practice Patterns of Surveillance Colonoscopy Among Older Adults: An Analysis of the GI Quality Improvement Consortium
- There is little guidance regarding when to stop surveillance colonoscopy in individuals with a history of adenomas or colorectal cancer (CRC). The authors of this study evaluated both yield and recommendations for follow-up colonoscopy in a large cohort of older individuals undergoing colonoscopy, using the GI Quality
Improvement Consortium registry.