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Start Over Author "Frank G. Gress" Publisher georg thieme verlag kg
4 results on '"Frank G. Gress"'

1. Confocal endomicroscopy for evaluation of pancreatic cystic lesions: a systematic review and international Delphi consensus report

Author

Bertrand Napoleon, Somashekar G. Krishna, Bruno Marco, David Carr-Locke, Kenneth J. Chang, Àngels Ginès, Frank G. Gress, Alberto Larghi, Kofi W. Oppong, Laurent Palazzo, Pradermchai Kongkam, Carlos Robles-Medranda, Divyesh Sejpal, Damien Tan, and William R. Brugge

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background and study aims The aim of thi systematic review and consensus report is to standardize the practice of endoscopic ultrasound (EUS-guided needle-based confocal laser endomicroscopy (nCLE) for pancreatic cystic lesion (PCL) evaluation. Methods We performed an international, systematic, evidence-based review of the applications, outcomes, procedural processes, indications, training, and credentialing of EUS-nCLE in management of PCLs. Based on available clinical evidence, preliminary nCLE consensus statements (nCLE-CS) were developed by an international panel of 15 experts in pancreatic diseases. These statements were then voted and edited by using a modified Delphi approach. An a priori threshold of 80 % agreement was used to establish consensus for each statement. Results Sixteen nCLE-CS were discussed. Thirteen (81 %) nCLE-CS reached consensus addressing indications (non-communication PCL meeting criteria for EUS-FNA or with prior non-diagnostic EUS-FNA), diagnostic outcomes (improved accuracy for mucinous PCLs and serous cystadenomas with substantial interobserver agreement of image patterns), low incidence of adverse events (fluorescein-associated and pancreatitis), procedural processes (nCLE duration, manipulation of needle with probe), and training (physician knowledge and competence). Conclusion Based on a high level of agreement pertaining to expert consensus statements, this report standardizes the practice of EUS-nCLE. EUS-nCLE should be systematically considered when EUS-FNA is indicated for PCL evaluation.

Published
2020
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2. Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American multicenter study

Author

Christopher J. DiMaio, Jennifer M. Kolb, Petros C. Benias, Hiral Shah, Shashin Shah, Oleh Haluszka, Jennifer Maranki, Kaveh Sharzehi, Eric Lam, Stuart R. Gordon, Sarah M. Hyder, Pavlos Z. Kaimakliotis, Satya B. Allaparthi, Frank G. Gress, Amrita Sethi, Ashish R. Shah, Jose Nieto, Vivek Kaul, Shivangi Kothari, Truptesh H. Kothari, Sammy Ho, Manhal J. Izzy, Neil R. Sharma, Rabindra R. Watson, V. Raman Muthusamy, Douglas K. Pleskow, Tyler M. Berzin, Mandeep Sawhney, Emad Aljahdi, Marvin Ryou, Clarence K. Wong, Parantap Gupta, Dennis Yang, Susana Gonzalez, and Douglas G. Adler

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background and aims: The ability to safely and effectively obtain sufficient tissue for pathologic evaluation by using endoscopic ultrasound (EUS) guidance remains a challenge. Novel designs in EUS needles may provide for improved ability to obtain such core biopsies. The aim of this study was to evaluate the diagnostic yield of core biopsy specimens obtained using a novel EUS needle specifically designed to obtain core biopsies. Patients and methods: Multicenter retrospective review of all EUS-guided fine-needle biopsies obtained using a novel biopsy needle (SharkCore FNB needle, Medtronic, Dublin, Ireland). Data regarding patient demographics, lesion type/location, technical parameters, and diagnostic yield was obtained. Results: A total of 250 lesions were biopsied in 226 patients (Median age 66 years; 113 (50 %) male). Median size of all lesions (mm): 26 (2 – 150). Overall, a cytologic diagnosis was rendered in 81 % specimens with a median number of 3 passes. When rapid onsite cytologic evaluation (ROSE) was used, cytologic diagnostic yield was 126/149 (85 %) with a median number of 3 passes; without ROSE, cytologic diagnostic yield was 31/45 (69 %, P = 0.03) with a median number of 3 passes. Overall, a pathologic diagnosis was rendered in 130/147 (88 %) specimens with a median number of 2 passes. Pathologic diagnostic yield for specific lesion types: pancreas 70/81 (86 %), subepithelial lesion 13/15 (87 %), lymph node 26/28 (93 %). Ten patients (10/226, 4 %) experienced adverse events: 4 acute pancreatitis, 5 pain, 1 fever/cholangitis. Conclusions: Initial experience with a novel EUS core biopsy needle demonstrates excellent pathologic diagnostic yield with a minimum number of passes.

Published
2016
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3. Retrospective analysis of the utility of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic masses, using a 22-gauge or 25-gauge needle system: a multicenter experience

Author

Frank G. Gress, Darren Pavey, H. Michael, S. Ho, and T. E. Yusuf

Subjects
Adult, Male, Endoscopic ultrasound, medicine.medical_specialty, Adolescent, Biopsy, Fine-Needle, Sensitivity and Specificity, Endosonography, Diagnosis, Differential, Young Adult, medicine, Humans, Pancreas, Ultrasonography, Interventional, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Ultrasound, Gastroenterology, Magnetic resonance imaging, Equipment Design, Gold standard (test), Middle Aged, medicine.disease, digestive system diseases, Endoscopy, Pancreatic Neoplasms, body regions, medicine.anatomical_structure, Fine-needle aspiration, Pancreatitis, Needles, Female, Radiology, business
Abstract

BACKGROUND AND STUDY AIMS Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is now performed routinely in many advanced endoscopy centers and has enhanced the ability to diagnose pancreatic masses. However, there is uncertainty about which needle size is optimal for EUS-FNA of pancreatic masses. We aimed to evaluate the performance of the 22-gauge and 25-gauge needles in obtaining cytologic diagnosis of pancreatic masses. METHODS All cases that were referred for EUS-FNA for pancreatic masses between February 2001 and June 2007 were reviewed, and patients who underwent EUS-FNA using the 22-gauge and 25-gauge needle system were identified. In patients who underwent surgery, operative histopathological findings were compared with the cytopathological findings from EUS-FNA. RESULTS A total of 842 patients with pancreatic masses detected on computed tomography (CT) and/or magnetic resonance imaging (MRI) and confirmed by EUS underwent EUS-FNA with the 22-gauge needle (n = 540) or the 25-gauge needle (n = 302). Results of EUS-FNA cytology findings were compared with the gold standard of surgical histopathological findings or long-term clinical follow-up. The sensitivity, specificity, PPV, and NPV of FNA were respectively 84%, 100%, 100%, and 73% [corrected] for the 22-gauge needle compared with 92%, 97%, 98%, and 87%, [corrected] respectively for the 25-gauge needle. No complications were noted in the 25-gauge needle group, compared with pancreatitis in 2% of the 22-gauge needle group. CONCLUSIONS This retrospective comparative study shows that EUS-FNA with a 25-gauge needle system is a safe and reliable method for tissue sampling in pancreatic masses. The system is more sensitive and has a slightly [corrected] higher NPV than the standard 22-gauge needle. Our study suggests that perhaps the smaller caliber FNA needle causes less trauma during EUS-FNA and hence less complications. Further studies including randomized trials are needed.

Published
2009
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4. Experience with a Catheter-Based Ultrasound Probe in the Bile Duct and Pancreas

Author

P. Jaffe, Stuart Sherman, S. Zaidi, Thomas J. Savides, Glen A. Lehman, M. J. Wonn, Frank G. Gress, Y. K. Chen, and Robert H. Hawes

Subjects
Adult, Male, medicine.medical_specialty, Bile Duct Diseases, Constriction, Pathologic, Catheterization, medicine, Humans, Aged, Ultrasonography, Aged, 80 and over, Pancreatic duct, Pancreas divisum, business.industry, Bile duct, Gastroenterology, Pancreatic Diseases, Endoscopy, Middle Aged, medicine.disease, Catheter, medicine.anatomical_structure, Bile Duct Neoplasms, Pancreatitis, Biliary tract, Sphincter of Oddi dysfunction, Chronic Disease, Female, Radiology, Pancreas, business, Artery
Abstract

Background and study aims Complete examination of the biliary tree and pancreatic duct may be difficult or unsuccessful using conventional imaging instruments. The purpose of this study was to evaluate the cannulation success rate, clinical utility, and safety of a new catheter-based ultrasound probe (CBUSP) used in the biliary tree and pancreas. Patients and methods The probes used in this study are manufactured by Microvasive (Watertown, MA, U.S.A.) and were 6.2 Fr in diameter, operated at 12.5 MHz. Thirty-six patients (11 with malignant bile-duct strictures, 12 with benign bile-duct strictures, two with bile duct stones, three with pancreatic duct strictures, one with a pancreatic cyst, one with pancreas divisum, three with sphincter of Oddi dysfunction, and three normal) underwent examination with a CBUSP. Results Cannulation was successful in all 36 patients. The hepatic artery and portal vein could be visualized with the probe in the proximal bile duct in 81% and 94% of the cases, respectively. The portal vein could not be adequately visualized in any patients when the probe was in the distal bile duct. The mean thickness of the normal bile duct wall was 0.17 cm, and the mean wall thicknesses proximal to a benign and malignant stricture were 0.16 and 0.17 cm, respectively. The mean thicknesses of benign and malignant biliary strictures were 0.32 cm and 0.31 cm, respectively (not significant). Eight of 12 benign biliary strictures (67%) and five of 11 malignant strictures (45%) were symmetrical. However, no obvious differences could be identified between benign and malignant biliary strictures. There were no catheter related complications. Conclusions Further catheter modifications are needed, but it appears to be feasible to assess vascular invasion in cholangiocarcinoma and to characterize biliary strictures in a way that may be able to influence therapy options in some patients. The currently available CBUSP cannot distinguish between benign and malignant strictures. However, with technical modifications, this may be possible in the future. The clinical usefulness of CBUSP in the pancreas awaits further investigation, but pancreatic imaging is feasible.

Published
1995
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