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Pancreatic Neoplasms: HELP
Articles by Todd H. Baron
Based on 23 articles published since 2010
(Why 23 articles?)
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Between 2010 and 2020, T. Baron wrote the following 23 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Editorial Preoperative biliary stents in pancreatic cancer--proceed with caution. 2010

Baron, Todd H / Kozarek, Richard A. · ·N Engl J Med · Pubmed #20071708.

ABSTRACT: -- No abstract --

2 Review Outcome of stenting in biliary and pancreatic benign and malignant diseases: A comprehensive review. 2015

Mangiavillano, Benedetto / Pagano, Nico / Baron, Todd H / Luigiano, Carmelo. ·Benedetto Mangiavillano, Unit of Gastroenterology and Digestive Endoscopy, General Hospital of Sanremo, 18038 Sanremo, Italy. ·World J Gastroenterol · Pubmed #26290631.

ABSTRACT: Endoscopic stenting has become a widely method for the management of various malignant and benign pancreatico-biliary disorders. Biliary and pancreatic stents are devices made of plastic or metal used primarily to establish patency of an obstructed bile or pancreatic duct and may also be used to treat biliary or pancreatic leaks, pancreatic fluid collections and to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis. In this review, relevant literature search and expert opinions have been used to evaluate the outcome of stenting in biliary and pancreatic benign and malignant diseases.

3 Review Preoperative biliary stents in pancreatic cancer. 2011

Bonin, Eduardo A / Baron, Todd H. ·Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. ·J Hepatobiliary Pancreat Sci · Pubmed #21667055.

ABSTRACT: BACKGROUND: Pancreatic cancer is a common digestive cancer with high mortality, and surgical resection is the only potential curative treatment option. Pancreatic head cancer is usually accompanied by biliary obstruction, which potentially increases surgical complications following pancreaticoduodenectomy. Thus, preoperative biliary drainage has long been advocated. METHODS: A review of the literature using Medline, Embase and Cochrane databases was undertaken. RESULTS: Endoscopic or percutaneous biliary stent placement is technically successful in most patients. The use of routine preoperative biliary drainage in the setting of pancreatic cancer with biliary obstruction is controversial. Prospective studies have shown that complications related to preoperative biliary drainage using endoscopic placement of traditional plastic endoprostheses increase the overall morbidity compared to pancreaticoduodenectomy alone. Placement of self-expandable metal stents could reduce stent-related complication rates such as early occlusion because of prolonged patency, especially when surgery is delayed. CONCLUSION: Pancreatic cancer patients with deep jaundice and expected delay prior to curative intent surgery are potential candidates for temporary biliary drainage. Cholangitis remains a formal indication for early, urgent preoperative biliary decompression for patients with pancreatic cancer.

4 Clinical Trial Endoscopic retrograde pancreatography criteria to diagnose autoimmune pancreatitis: an international multicentre study. 2011

Sugumar, Aravind / Levy, Michael J / Kamisawa, Terumi / Webster, G J / Kim, Myung-Hwan / Enders, Felicity / Amin, Zahir / Baron, Todd H / Chapman, Mike H / Church, Nicholas I / Clain, Jonathan E / Egawa, Naoto / Johnson, Gavin J / Okazaki, Kazuichi / Pearson, Randall K / Pereira, Stephen P / Petersen, Bret T / Read, Samantha / Sah, Raghuwansh P / Sandanayake, Neomal S / Takahashi, Naoki / Topazian, Mark D / Uchida, Kazushige / Vege, Santhi Swaroop / Chari, Suresh T. ·Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. ·Gut · Pubmed #21131631.

ABSTRACT: BACKGROUND: Characteristic pancreatic duct changes on endoscopic retrograde pancreatography (ERP) have been described in autoimmune pancreatitis (AIP). The performance characteristics of ERP to diagnose AIP were determined. METHODS: The study was done in two phases. In phase I, 21 physicians from four centres in Asia, Europe and the USA, unaware of the clinical data or diagnoses, reviewed 40 preselected ERPs of patients with AIP (n=20), chronic pancreatitis (n=10) and pancreatic cancer (n=10). Physicians noted the presence or absence of key pancreatographic features and ranked the diagnostic possibilities. For phase II, a teaching module was created based on features found most useful in the diagnosis of AIP by the four best performing physicians in phase I. After a washout period of 3 months, all physicians reviewed the teaching module and reanalysed the same set of ERPs, unaware of their performance in phase I. RESULTS: In phase I the sensitivity, specificity and interobserver agreement of ERP alone to diagnose AIP were 44, 92 and 0.23, respectively. The four key features of AIP identified in phase I were (i) long (>1/3 the length of the pancreatic duct) stricture; (ii) lack of upstream dilatation from the stricture (<5 mm); (iii) multiple strictures; and (iv) side branches arising from a strictured segment. In phase II the sensitivity (71%) of ERP significantly improved (p<0.05) without a significant decline in specificity (83%) (p>0.05); the interobserver agreement was fair (0.40). CONCLUSIONS: The ability to diagnose AIP based on ERP features alone is limited but can be improved with knowledge of some key features.

5 Article Covered versus uncovered self-expandable metal stent for palliation of primary malignant extrahepatic biliary strictures: a randomized multicenter study. 2018

Conio, Massimo / Mangiavillano, Benedetto / Caruso, Angelo / Filiberti, Rosa Angela / Baron, Todd H / De Luca, Luca / Signorelli, Sergio / Crespi, Mattia / Marini, Mario / Ravelli, Paolo / Conigliaro, Rita / De Ceglie, Antonella. ·Gastroenterology Department, General Hospital, Sanremo (IM). · Gastroenterology and Digestive Endoscopy Department, Azienda Ospedaliera Universitaria di Modena, Sant'Agostino Estense Hospital, Baggiovara (MO). · Clinical Epidemiology Unit, Ospedale Policlinico San Martino, Genova, Italy. · Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Gastroenterology and Digestive Endoscopy Unit, Ospedali Riuniti Marche Nord, Pesaro. · Gastroenterology and Gastrointestinal Endoscopy Unit, ASST, Papa Giovanni XXIII, Bergamo, Italy. · Gastroenterology and Operative Endoscopy Unit, Santa Maria Alle Scotte Hospital, Siena, Italy. ·Gastrointest Endosc · Pubmed #29653120.

ABSTRACT: BACKGROUND AND AIMS: Self-expandable metal stents (SEMSs) are used to relieve malignant biliary obstructions. We aimed to compare stent patency, the adverse events rate, and overall survival of covered versus uncovered self-conformable metal stents in patients with primary malignant extrahepatic biliary strictures, not eligible for surgery. METHODS: This is a multicenter randomized trial analyzing 158 patients with inoperable distal malignant biliary obstruction conducted in 5 Italian referral centers between December 2014 and October 2016. Seventy-eight patients were randomized to receive a fully covered SEMS (FCSEMS), and 80 patients received uncovered SEMSs (USEMSs). Data from 148 (72 FCSEMSs and 76 USEMSs) of 158 patients were analyzed. RESULTS: Median time of stent patency was lower for FCSEMSs (240 days vs 541 days for USEMSs; P = .031). Adverse events occurred with 19 FCSEMSs (26.4%) and 10 USEMSs (13.2%); P = .061. The main causes of FCSEMS dysfunction were migration (7% vs 0% in the USEMS group) and early occlusion mainly because of sludge or overgrowth; late stent occlusion because of tumor ingrowth occurred in 13.2% of patients in the USEMS group. There were no significant differences either in levels of conjugated bilirubin improvement or in overall survival between the FCSEMS and USEMS groups. Median survival was 134 days in the FCSEMS group and 112 days in the USEMS group (P = .23). CONCLUSION: The number of stent-related adverse events was higher, although not significantly, among patients in the FCSEMS group. FCSEMSs had a significantly higher rate of migration than USEMSs, and stent occlusion occurred earlier. A significant difference in the patency rate was observed in favor of the USEMS group. (Clinical trial registration number: NCT02102984.).

6 Article Cohort study comparing the diagnostic yields of 2 different EUS fine-needle biopsy needles. 2018

Abdelfatah, Mohamed M / Grimm, Ian S / Gangarosa, Lisa M / Baron, Todd H. ·Division of Gastroenterology and Hepatology, East Carolina University, Greenville, Chapel Hill North Carolina, USA. · Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, Chapel Hill North Carolina, USA. ·Gastrointest Endosc · Pubmed #28882575.

ABSTRACT: BACKGROUND AND AIMS: Two second-generation, flexible EUS fine-needle biopsy (FNB) needles have been marketed recently in the United States. Thus far, there have been no comparative studies of the diagnostic yield of these needles. The aim of this study was to compare the diagnostic yield achieved with FNB by using 1 needle during 1 time period and the other needle during a second time period. METHODS: Consecutive patients with solid lesions undergoing EUS-FNB by using 1 of two 22-gauge FNB needles (Franseen needle or fork-tip) at 2 different time intervals were included. The final diagnosis was based on positive pathology results. In cases of a negative pathology result, the final diagnosis was based on clinical and imaging follow-up. RESULTS: A total of 194 lesions (97 in each group) were sampled in 179 patients. Rapid on-site evaluation (ROSE) was used in 12% of cases. The overall diagnostic yield was lower in the Franseen needle group compared with the fork-tip needle group (61/97 [63%] vs 75/97 [77%], odds ratio (OR) 2.01, 1.07-3.8; P = .027). Similarly, subanalysis of the yield for solid pancreatic masses demonstrated a lower yield with the Franseen needle (34/53 [64%] vs 40/47 [85%], OR 3.4, 9.1-8.9; P = .017). Multivariate analysis controlling for the number of passes, site, and lesion size did not have any effect on diagnostic yield. There were no adverse events in either group. CONCLUSION: In this first, large, single-center comparative cohort study of 2 new, second-generation EUS-FNB needles of different design, the diagnostic yield when used primarily without ROSE was high in both groups but was significantly higher when a fork-tip needle was used.

7 Article Preoperative decompression and diagnosis of pancreatic head adenocarcinoma in a patient with Roux-en-Y gastric bypass by means of EUS-guided gastric pouch hepaticogastrostomy. 2017

Abdelfatah, Mohamed M / Baron, Todd H. ·Division of Gastroenterology and Hepatology, East Carolina University, Greenville, North Carolina, USA. · Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. ·Gastrointest Endosc · Pubmed #28610858.

ABSTRACT: -- No abstract --

8 Article Impact of EUS-guided fine-needle biopsy sampling with a new core needle on the need for onsite cytopathologic assessment: a preliminary study. 2016

Rodrigues-Pinto, Eduardo / Jalaj, Sujai / Grimm, Ian S / Baron, Todd H. ·Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal; Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. · Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. ·Gastrointest Endosc · Pubmed #27345131.

ABSTRACT: BACKGROUND AND AIMS: FNA is the primary method of EUS tissue acquisition. In an attempt to improve our yield of EUS-guided tissue acquisition, we compared fine-needle biopsy (FNB) sampling without rapid onsite evaluation (ROSE) with FNA with ROSE and assessed the concordance of FNA and FNB sampling. METHODS: This was a retrospective review of prospectively collected data from consecutive patients. Patients underwent FNB sampling and FNA of the same single lesion, with the same needle gauge and number of passes. FNA with ROSE was performed with a standard FNA needle. FNB sampling was performed with a new dedicated core needle. FNA samples were assessed with ROSE, and a final interpretation was provided by cytopathology staff; FNB samples were analyzed by surgical pathologists, each not made aware of the other's opinion. RESULTS: Thirty-three patients underwent 312 passes in 42 different lesions. A diagnosis of malignancy was more likely with FNB sampling than with FNA (72.7% vs 66.7%, P = .727), although statistical significance was not reached. FNA and FNB sampling had similar sensitivities, specificities, and accuracies for cancer (81.5% vs 88.9%, 100% vs 100%, and 84.8% vs 90.9%, respectively). FNB sampling provided qualitative information not reported on FNA, such as degree of differentiation in malignancy, metastatic origin, and rate of proliferation in neuroendocrine tumors. CONCLUSIONS: FNB sampling without ROSE using a dedicated core needle performed as well as FNA with ROSE in this small cohort, suggesting that FNB sampling with this new core needle may eliminate the need for an onsite cytopathologic assessment, without loss of diagnostic accuracy.

9 Article Fluorescence in situ hybridization compared with conventional cytology for the diagnosis of malignant biliary tract strictures in Asian patients. 2016

Chaiteerakij, Roongruedee / Barr Fritcher, Emily G / Angsuwatcharakon, Phonthep / Ridtitid, Wiriyaporn / Chaithongrat, Supakarn / Leerapun, Apinya / Baron, Todd H / Kipp, Benjamin R / Henry, Michael R / Halling, Kevin C / Rerknimitr, Rungsun / Roberts, Lewis R. ·Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA; Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA. · Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. · Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA; Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA. ·Gastrointest Endosc · Pubmed #26684604.

ABSTRACT: BACKGROUND AND AIMS: Fluorescence in situ hybridization (FISH) has improved the diagnostic performance of cytology for the evaluation of malignant biliary strictures in the United States and Europe. The utility of FISH for the diagnosis of biliary strictures in Asia is currently unknown. We aimed to compare the sensitivity of FISH and conventional cytology for the diagnosis of malignant biliary strictures in Thai patients. METHODS: A prospective study was performed at 2 university hospitals between 2010 and 2013. Patients being evaluated for malignant-appearing biliary strictures were included (N = 99). Bile duct brushings were collected and assessed by cytology and FISH. Sensitivities with 95% confidence intervals of cytology and FISH were the main outcome measures. RESULTS: The overall sensitivities of cytology and FISH were 38% and 55%, respectively (P = .001). For those with a diagnosis of cancer based on clinical evidence without biopsy confirmation (n = 44), the sensitivities of cytology and FISH were 43% and 57%, respectively (P = .06). For the 49 patients for whom a cancer diagnosis was confirmed by pathology, FISH had a significantly higher sensitivity than cytology, with a sensitivity of 53% versus 33%, respectively (P = .008). CONCLUSIONS: FISH improves the diagnostic performance of cytology and can be used as a complementary tool to bile duct brushing and biopsy for the evaluation of malignancy in biliary strictures in Asian populations.

10 Article Relief of obstructive jaundice from pancreatic cancer: the end of the plastic stent era? 2016

Baron, Todd H / Grimm, Ian S. ·Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. ·Gut · Pubmed #26420418.

ABSTRACT: -- No abstract --

11 Article Transgastric endoscopic ultrasound with fine-needle aspiration and ERCP using percutaneous-assisted transprosthetic endoscopic therapy in a gastric bypass patient. 2015

Law, Ryan / Baron, Todd H / Topazian, Mark D. ·Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. · Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina. ·Endoscopy · Pubmed #25734805.

ABSTRACT: -- No abstract --

12 Article Natural orifice transluminal endoscopic surgery gastroenterostomy with a biflanged lumen-apposing stent: first clinical experience (with videos). 2015

Barthet, Marc / Binmoeller, Kenneth F / Vanbiervliet, Geoffroy / Gonzalez, Jean-Michel / Baron, Todd H / Berdah, Stéphane. ·Faculty of Medicine, Aix-Marseille University, Marseille, France; Gastroenterology, Public Assistance Hospitals of Marseille, Marseille, France. · Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, USA. · Faculty of Medicine, Aix-Marseille University, Marseille, France; Gastroenterology, University Hospital of Nice, Nice, France. · Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. ·Gastrointest Endosc · Pubmed #25527056.

ABSTRACT: BACKGROUND: We established feasibility and safety for natural orifice transluminal endoscopic surgery (NOTES) GI anastomosis with a lumen-apposing stent in live pigs. This approach was performed in 3 patients. OBJECTIVE: Creation of a NOTES gastroduodenal anastomosis in patients. DESIGN: Case series. SETTING: Two tertiary-care referral centers at large academic hospitals in France and in the United States. PATIENTS: Patients with refractory benign duodenal stenosis and malignant duodenal obstruction. INTERVENTION: NOTES GI anastomosis with a lumen-apposing stent. MAIN OUTCOME MEASUREMENTS: Disappearence of gastric outlet obstruction. RESULTS: All 3 procedures were technically successful and uneventful, except 1 minor adverse event. There were no instances of stent occlusion or migration during follow-up. All patients resumed a normal diet. LIMITATIONS: Small case series. CONCLUSION: NOTES gastroenteric anastomosis is feasible and safe in humans. A prospective pilot study is warranted.

13 Article Cholecystoduodenostomy and duodenal stenting for relief of biliary and gastric outlet obstruction. 2015

Law, Ryan / Grimm, Ian S / Baron, Todd H. ·Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. · Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. ·Gastrointest Endosc · Pubmed #25440674.

ABSTRACT: -- No abstract --

14 Article Choledochoduodenal fistula after biliary placement of a self-expanding metallic stent for palliation of pancreatic cancer. 2013

Chaudhari, D / Saleem, A / Murthy, R / Baron, T / Young, M. ·Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA. Chaudharidhara@yahoo.com ·Endoscopy · Pubmed #23526528.

ABSTRACT: -- No abstract --

15 Article EUS-guided biliary drainage for patients with malignant biliary obstruction with an indwelling duodenal stent (with videos). 2012

Khashab, Mouen A / Fujii, Larissa L / Baron, Todd H / Canto, Marcia Irene / Gostout, Christopher J / Petersen, Bret T / Okolo, Patrick I / Topazian, Mark D / Levy, Michael J. ·Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA. ·Gastrointest Endosc · Pubmed #22726485.

ABSTRACT: -- No abstract --

16 Article Outcomes of endoscopic and percutaneous drainage of pancreatic fluid collections arising after pancreatic tail resection. 2012

Azeem, Nabeel / Baron, Todd H / Topazian, Mark D / Zhong, Ning / Fleming, Chad J / Kendrick, Michael L. ·Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. ·J Am Coll Surg · Pubmed #22634120.

ABSTRACT: BACKGROUND: Up to 15% to 30% of patients develop pancreatic fluid collections (PFCs) after pancreatic tail resection. Percutaneous and endoscopic methods have been used to drain these collections, though few data are available that compare outcomes of these modalities. STUDY DESIGN: From December 1998 to April 2011, we identified all patients who underwent pancreatic tail resection and developed PFCs requiring intervention. The primary aim was to compare overall success rates in resolution of PFCs using endoscopic and percutaneous modalities. Success rates, hospital length of stay, number of CT scans, sinograms and endoscopies performed, and days with drain(s) in place were compared. RESULTS: Forty-eight patients were identified. Percutaneous drainage was performed a median of 25 days postoperatively, compared with 85 days for endoscopic drainage (p < 0.001). Endoscopic and percutaneous methods had similar rates of technical success (100% vs 97%, p = 0.50) and treatment success (80% vs 81%, p = 0.92), respectively. Recurrence rates were 16.6% for the endoscopic group and 23% for the percutaneous group (p = 0.65), and adverse events occurred in 9.4% of those treated endoscopically vs 13.3% of those treated percutaneously (p = 0.68). Location and characteristics of PFCs did not influence success rates. Recurrences were often treated by "salvage" drainage via the other modality. Median hospital stay was longer after primary percutaneous drainage compared with primary endoscopic drainage (5.5 days vs 2 days, p = 0.046). Primary percutaneous drainage patients also had more CT scans (median 3 vs 2, p = 0.03). CONCLUSIONS: Endoscopic drainage and percutaneous drainage appear to be equally effective and complementary interventions for PFCs occurring after pancreatic tail resection. Primary endoscopic drainage may be associated with shorter hospital stay and fewer CT scans.

17 Article Side-by-side dual echoendoscope and ultrathin endoscopy to facilitate EUS-ERCP biliary rendezvous. 2012

Baron, T H / Levy, M J. ·Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA. baron.todd@mayo.edu ·Endoscopy · Pubmed #22622737.

ABSTRACT: -- No abstract --

18 Article Photodynamic therapy of intraductal papillary mucinous neoplasm. 2012

Topazian, M / Zhong, N / Baron, T H / Vege, S S / Wang, K K. ·Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. topazian.mark@mayo.edu ·Endoscopy · Pubmed #22271032.

ABSTRACT: Intraductal papillary mucinous neoplasm (IPMN) of the main pancreatic duct is usually treated by surgical excision of the affected pancreas. Nonoperative ablative therapies have not been described. We treated IPMN of the pancreatic duct with photodynamic therapy (PDT) in a patient who was a poor operative candidate. Porfimer sodium was administered intravenously, and laser light was delivered by a diffusing catheter placed in the pancreatic duct during endoscopic retrograde cholangiopancreatography (ERCP). Imaging and biopsy findings of IPMN resolved after PDT, and symptoms also resolved. Metastatic cancer was diagnosed 2 years after PDT had been initiated. Pancreatic PDT was well tolerated in this case, and may be a therapeutic option for selected patients with IPMN of the main pancreatic duct.

19 Article Diagnostic and therapeutic peroral direct cholangioscopy in patients with altered GI anatomy (with videos). 2012

Itoi, Takao / Sofuni, Atsushi / Itokawa, Fumihide / Kurihara, Toshio / Tsuchiya, Takayoshi / Ishii, Kentaro / Ikeuchi, Nobuhito / Moriyasu, Fuminori / Kasuya, Kazuhiko / Tsuchida, Akihiko / Kamisawa, Terumi / Baron, Todd H. ·Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. ·Gastrointest Endosc · Pubmed #22154415.

ABSTRACT: -- No abstract --

20 Article Meta-analysis of randomized trials comparing the patency of covered and uncovered self-expandable metal stents for palliation of distal malignant bile duct obstruction. 2011

Saleem, Atif / Leggett, Cadman L / Murad, M Hassan / Baron, Todd H. ·Department of Internal Medicine, Mayo Clinic, College of Medicine, Rochester, Minnesota, USA. ·Gastrointest Endosc · Pubmed #21683354.

ABSTRACT: BACKGROUND: Self-expandable metal stents (SEMSs) are used for palliation of malignant biliary obstruction. OBJECTIVE: We performed a meta-analysis to compare stent patency and stent survival of covered SEMSs (CSEMSs) and uncovered SEMSs (USEMSs) in patients with unresectable distal malignant biliary obstruction. DESIGN: Meta-analysis. SETTING: Tertiary-care facility. PATIENTS: A comprehensive search of several databases (from each database's earliest inclusive dates to November 2010, any language, and any population) was conducted. The search identified 337 potential abstracts and titles, of which 16 were retrieved in full text. Review of references identified 17 additional studies. We found 5 multicenter, randomized trials involving 781 patients. INTERVENTION: Placement of covered and uncovered SEMSs for treatment of distal malignant biliary obstruction. MAIN OUTCOME MEASUREMENTS: Stent patency, stent survival, patient survival, and cause for stent dysfunction (ingrowth, overgrowth, migration, and sludge formation). RESULTS: The median length of follow-up was 212 days. Compared with USEMSs, CSEMSs were associated with significantly prolonged stent patency (weighted mean difference [WMD] 60.56 days; 95% confidence interval [CI], 25.96, 95.17; I² = 0%) and longer stent survival (WMD 68.87 days; 95% CI, 25.64, 112.11; I(2) = 79%). Stent migration, tumor overgrowth, and sludge formation were significantly higher with CSEMSs (relative risk [RR] 8.11; 95% CI, 1.47, 44.76; I² = 0%), (RR 2.02; 95% CI, 1.08, 3.78; I² = 0%), (RR 2.89; 95% CI, 1.27, 6.55; I² = 0%). LIMITATIONS: Relatively low number of studies available and the fact that 2 of the 5 studies were from one institution. Also, the limited availability of some stents used in the trials may limit the applicability of these results. CONCLUSION: CSEMSs have a significantly longer duration of patency compared with USEMSs in patients with distal malignant biliary obstruction. Stent dysfunction occurs at a similar rate, although there is a trend toward later obstruction with CSEMSs.

21 Article Small diameter delivery system allows expandable metal biliary stent placement using a pediatric colonoscope in surgically altered anatomy. 2011

Saleem, A / Baron, T H. ·Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA. ·Endoscopy · Pubmed #21341188.

ABSTRACT: -- No abstract --

22 Minor Diagnosis of autoimmune pancreatitis using new, flexible EUS core biopsy needles: report of 2 cases. 2017

Runge, Thomas M / Hart, Phil A / Sasatomi, Elizaburo / Baron, Todd H. ·Division of Gastroenterology, Department of Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. · Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. · Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. ·Gastrointest Endosc · Pubmed #28522022.

ABSTRACT: -- No abstract --

23 Minor Evaluation of TNM status changes between the first two CT scans in patients with pancreatic cancer. 2014

Adler, Douglas G / Nallamothu, Geetha / Cox, Kristen / Heilbrun, Marta / Sharma, Ashish / Baron, Todd H. ·Huntsman Cancer Center, Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA. · Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah, USA. · Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. ·Am J Gastroenterol · Pubmed #25373589.

ABSTRACT: -- No abstract --