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| 1 | Biliary complications following liver transplantation显示文摘Biliary tract complications are the most common complications after liver transplantation.These complications are encountered more commonly as a result of increased number of liver transplantations and the prolonged survival of transplant patients.Biliary complications remain a major source of morbidity in liver transplant patients,with an incidence of 5%-32%.Post liver transplantation biliary complications include strictures(anastomotic and non-anastomotic),leaks,stones,sphincter of Oddi dysfunction,and recurrence of primary biliary disease such as primary sclerosing cholangitis and primary biliary cirrhosis.The risk of occurrence of a specific biliary complication is related to the type of biliary reconstruction performed at the time of liver transplantation.In this article we seek to review the major biliary complications and their relation to the type of biliary reconstruction performed at the time of liver tranplantation. | Gursimran Kochhar Jose Mari Parungao Ibrahim A Hanouneh Mansour A Parsi | 2013 | World Journal of Gastroenterology2013，19，19： | 41 |
| 2 | 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 |
| 3 | NSAIDs for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography:Ready for prime time?显示文摘Acute pancreatitis is the most common and the most fearful complication of endoscopic retrograde cholangiopancreatography (ERCP).Prevention of post-ERCP pancreatitis has therefore been of great interest to endoscopists performing ERCP procedures.So far,only pancreatic duct stenting during ERCP and rectal administration of a non-steroidal anti-inflammatory drug (NSAID) prior to or immediately after ERCP have been consistently shown to be effective for prevention of post-ERCP pancreatitis.This commentary focuses on a short discussion about the rates,mechanisms,and risk factors for post-ERCP pancreatitis,and effective means for its prevention with emphasis on the use of NSAIDs including a recent clinical trial published in The New England Journal of Medicine by Elmunzer et al. | Mansour A Parsi | 2012 | World Journal of Gastroenterology2012，18，30： | 22 |
| 4 | Aflatoxins,hepatocellular carcinoma and public health显示文摘Hepatocellular carcinoma(HCC) is one of the leading causes of cancer deaths worldwide,primarily affecting populations in the developing countries.Aflatoxin,a food contaminant produced by the fungi Aspergillus flavus and Aspergillus parasiticus,is a known human carcinogen that has been shown to be a causative agent in the pathogenesis of HCC.Aflatoxin can affect a wide range of food commodities including corns,oilseeds,spices,and tree nuts as well as milk,meat,and dried fruit.Many factors affect the growth of Aspergillus fungi and the level of aflatoxin contamination in food.Drought stress is one of the factors that increase susceptibility of plants to Aspergillus and thus aflatoxin contamination.A recent drought is thought to be responsible for finding of trace amounts of aflatoxin in some of the corn harvested in the United States.Although it's too soon to know whether aflatoxin will be a significant problem,since United States is the world's largest corn producer and exporter,this has raised alarm bells.Strict regulations and testing of finished foods and feeds in the United States should prevent a major health scare,and prevent human exposure to deleterious levels of aflatoxin.Unfortunately,such regulations and testing are not in place in many countries.The purpose of this editorial is to summarize the current knowledge on association of aflatoxin and HCC,encourage future research and draw attention to this global public health issue. | Arvin Magnussen Mansour A Parsi | 2013 | World Journal of Gastroenterology2013，19，10： | 16 |
| 5 | 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 |
| 6 | Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures显示文摘Endoscopic submucosal dissection(ESD) is a wellestablished, minimally invasive treatment for superficial neoplasms of the gastrointestinal tract. The universal adoption of ESD has been limited by its slow learning curve, long procedure times, and high risk of complications. One technical challenge is the lack of a second hand that can provide traction, as in conventional surgery. Reliable tissue retraction that exposes the submucosal plane of dissection would allow for safer and more efficient dissection. Magnetic anchor guided endoscopic submucosal dissection(MAGESD) has potential benefits compared to other current traction methods. MAG-ESD offers dynamic tissue retraction independent of the endoscope mimicking a surgeon's 'second hand'. Two types of magnets can be used: electromagnets and permanent magnets. In this article we review the MAG-ESD technology, published work and studies of magnets in ESD. We also review the use of magnetic anchor guidance systems in natural orifice transluminal endoscopic surgery and the idea of magnetic non-contact retraction using surface ferromagentization. We discuss the current limitations, the future potential of MAG-ESD and the developments needed for adoption of this technology. | Mohamed Mortagy Neal Mehta Mansour A Parsi Seiichiro Abe Tyler Stevens John J Vargo Yutaka Saito Amit Bhatt | 2017 | World Journal of Gastroenterology2017，23，16： | 12 |
| 7 | Peroral cholangioscopy in the new millennium显示文摘Peroral cholangioscopy was first described in 1970s and has recently gained popularity.Peroral cholangioscopy is appealing to therapeutic endoscopists because a direct intraluminal view of the biliary duct system offers possibilities for diagnosis and interventions beyond that which other imaging or endoscopic modalities can provide.As the image quality of cholangioscopies improves,so too does their diagnostic capability,and as their durability and maneuverability increases,so too does their potential use for therapeutic applications.This editorial is intended to provide a brief review of recent developments in peroral cholangioscopy and current indications for its use. | Mansour A Parsi | 2011 | World Journal of Gastroenterology2011，17，1： | 8 |
| 8 | Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon显示文摘AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy(DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study.The patients underwent DPOC using an intraductal anchoring balloon,which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope.The device was later voluntarily withdrawn from the market by the manufacturer.RESULTS:Fourteen patients underwent DPOC using the anchoring balloon.Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients.In 12(86%) patients,ductal access required sphincteroplasty with a 10-mm dilating balloon.Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients(93%).Therapeutic interventions by DPOC were successfully completed in all five attempted cases(intraductal biopsy in one and DPOC guided laser lithotripsy in four).Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon.This required hospitalization and antibiotics.Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma.CONCLUSION:Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation. | Mansour A Parsi Tyler Stevens John J Vargo | 2012 | World Journal of Gastroenterology2012，18，30： | 8 |
| 9 | 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 |
| 10 | Update on endoscopic pancreatic function testing显示文摘Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the 'Dreiling tube' secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis.This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditional fluid analysis. | Tyler Stevens Mansour A Parsi | 2011 | World Journal of Gastroenterology2011，17，35： | 5 |
| 11 | Endoscopic ultrasound for the diagnosis of chronic pancreatitis显示文摘Endoscopic ultrasound(EUS) has become a well accepted test for the diagnosis of chronic pancreatitis.Advantages include its ability to detect subtle and severe changes of the pancreatic duct and parenchyma,and its relative safety compared with endoscopic retrograde cholangiopancreatography.Limitations include inter-and intraobserver variability,operator dependence,and an incomplete understanding of its true accuracy.The Rosemont classif ication has recently been proposed as a weighted,standardized method that may improve EUS chronic pancreatitis scoring.This paper reviews the published evidence regarding the accuracy of EUS in chronic pancreatitis diagnosis,and enumerates the emerging technologies that have been recently studied which may ultimately improve endosonographic imaging of the pancreas. | Tyler Stevens Mansour A Parsi | 2010 | World Journal of Gastroenterology2010，16，23： | 5 |
| 12 | Obesity and cholangiocarcinoma显示文摘It is estimated that about half of the population in developed countries are either overweight or obese.In some developing nations obesity rates have increased to surpass those seen in Western countries.This rate increase in obesity has many implications as obesity has been associated with numerous negative health effects including increased risks of hypertension,diabetes,cardiovascular disease,stroke,liver disease,apnea,and some cancer types.Obesity is now considered to be one of the major public health concerns facing the society.Cholangiocarcinomas(bile duct cancers) are malignant tumors arising from cholangiocytes inside or outside of the liver.Although cholangiocarcinomas are relatively rare,they are highly lethal.The low survival rate associated with cholangiocarcinoma is due to the advanced stage of the disease at the time of diagnosis.Prevention is therefore especially important in this cancer type.Some data suggest that the incidence of cholangiocarcinoma in the western world is on the rise.Increasing rate of obesity may be one of the factors responsible for this increase.Determining whether obesity is a risk factor for cholangiocarcinoma has significant clinical and societal implications as obesity is both prevalent and modifiable.This paper seeks to provide a summary of the current knowledge linking obesity and cholangiocarcinoma,and encourage further research on this topic. | Mansour A Parsi | 2013 | World Journal of Gastroenterology2013，19，4： | 4 |
| 13 | Common controversies in management of biliary strictures显示文摘Biliary strictures are caused by a heterogeneous group of benign and malignant conditions, each requiring a specific treatment approach. Management of biliary strictures often involves endoscopy either for definite treatment, as a bridge to surgery or for palliative purposes. Endoscopic treatment of various types of biliary strictures is not standardized and there are multiple areas of controversy regarding the best treatment options. These controversies are mainly due to lack of well-designed comparative studies to support a specific therapy. This paper reviews three common areas of controversy in the endoscopic management of biliary strictures. The areas discussed in this editorial include the role of biliary drainage in resectable malignant strictures and whether such drainage should be performed routinely prior to surgery, the best endoscopic palliation for unresectable hilar strictures and whether unilateral or bilateral stenting should be attempted, and the optimal endoscopic management for dominant strictures in patients with primary sclerosing cholangitis. The goal of this editorial is twofold. The first is to review the current literature on management of the aforementioned strictures and offer recommendations based on available evidence. The second goal is to highlight the gaps in our knowledge which in turn can encourage future research on these topics. | Mansour A Parsi | 2017 | World Journal of Gastroenterology2017，23，7： | 2 |
| 14 | Transcatheter closure of interatrial communications for secondary prevention of paradoxical embolism: single-center experience显示文摘 | Bruch L Parsi A Grad MO | 2002 | Circulation2002，105，24： | 2 |
| 15 | Peroral cholangioscopy-assisted guidewire placement for removal of impacted stones in the cystic duct remnant显示文摘It is well known that impacted biliary stones are difficult to remove endoscopically.Among the many factors associated with failure of endoscopic therapy for removal of bile duct stones,impaction ranks high.One of the reasons behind failure of endoscopic therapy in such cases is that the impacted stone often does not allow passage of a guidewire.Recent introduction of a novel single-operator cholangioscopy system has made it possible for a single endoscopist to use cholangioscopy for evaluation and treatment of a wide variety of biliary disorders.This cholangioscopy system was used for placement of a guidewire in the cystic duct remnant with subsequent removal of an impacted stone which had prevented passage of a guidewire by conventional means. | Mansour A Parsi | 2009 | World Journal of Gastrointestinal Surgery2009，1，1： | 2 |
| 16 | Spontaneous bacterial peritonitis:recentdata on incidence and treatment of spontaneous bacterial peritonitis显示文摘 | Parsi MA Atreja A ZeinNN | 2004 | Cleve Clin J Med2004，71，7： | 1 |
| 17 | Protective effect of selenium on cisplatin induced nephrotoxicity:a double-blind controlled randomized clinical trial显示文摘 | Ghorbani A Omidvar B Parsi A | 2013 | J Nephropathol2013，2，2： | 1 |
| 18 | Acute pancreatits:problems in adher- ense to gnidelin显示文摘 | Stevens T Parsi MA Walsh RM | 2009 | Cleve Clin J Med2009，76，12： | 1 |
| 19 | Catheter-directed sclerotherapy 显示文摘 | Parsi K | 2009 | Phlebology2009，24，3： | 1 |
| 20 | DNA methylation alterations in en- doscopic retrograde cholangiopancreatography brush samples of pa- tients with suspected pancreaticobiliary disease 显示文摘 | Parsi M A Li A Li C P | 2008 | Clin Gastroen- terol Hepatol2008，6，11： | 1 |
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