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Subhas Banerjee - One of the best experts on this subject based on the ideXlab platform.

  • Use of an Ultra-slim Gastroscope to Accomplish Endoscopist-Facilitated Rescue Intubation During ERCP: A Novel Approach to Enhance Patient and Staff Safety
    Digestive Diseases and Sciences, 2020
    Co-Authors: Monique T. Barakat, Timothy P. Angelotti, Subhas Banerjee
    Abstract:

    Background ERCP is often performed under monitored anesthesia care (MAC) rather than general anesthesia (GA), with patients positioned semi-prone on the fluoroscopy table. Rarely, a MAC ERCP must be converted to GA due to hypoxia or retained food in the stomach. In these circumstances, standard intubation is associated with a significant delay and potential for patient/staff injury during repositioning. We report a novel endoscopist-driven approach to intubation during ERCP using an ultra-slim, Flexible Gastroscope with an endotracheal tube backloaded onto it. Materials and Methods We identified patients who underwent ERCP from 2014 to 2019, and MAC to GA conversion events. Mode of intubation (standard vs. endoscopist-facilitated) and patient/procedure characteristics were evaluated. All endoscopist-facilitated intubations were performed under anesthesiologist supervision. Results A total of 3409 patients underwent ERCP; 1568 (46%) GA and 1841 (54%) MAC. Of these, 42 (2.3%) required intubation during ERCP and 16 underwent endoscopist-facilitated intubation due to retained food in the stomach and/or hypoxia. In 3 patients, aspirated material was suctioned from the trachea and bronchi using the ultra-slim Gastroscope. Immediate post-procedure extubation was successful in all endoscopist-facilitated intubation patients and none exhibited radiographic evidence of aspiration pneumonia. Conclusions Endoscopist-facilitated intubation using an ultra-slim Flexible Gastroscope is feasible and expeditious for MAC to GA conversion during ERCP. This technique is readily accomplished in the semi-prone position, while standard intubation requires patient transfer from fluoroscopy table to gurney, with associated delay/risks. These data suggest that further study of this approach is warranted, and this may be the most favorable approach for intubation during ERCP.

  • use of an ultra slim Gastroscope to accomplish endoscopist facilitated rescue intubation during ercp a novel approach to enhance patient and staff safety
    Digestive Diseases and Sciences, 2020
    Co-Authors: Monique T. Barakat, Timothy P. Angelotti, Subhas Banerjee
    Abstract:

    ERCP is often performed under monitored anesthesia care (MAC) rather than general anesthesia (GA), with patients positioned semi-prone on the fluoroscopy table. Rarely, a MAC ERCP must be converted to GA due to hypoxia or retained food in the stomach. In these circumstances, standard intubation is associated with a significant delay and potential for patient/staff injury during repositioning. We report a novel endoscopist-driven approach to intubation during ERCP using an ultra-slim, Flexible Gastroscope with an endotracheal tube backloaded onto it. We identified patients who underwent ERCP from 2014 to 2019, and MAC to GA conversion events. Mode of intubation (standard vs. endoscopist-facilitated) and patient/procedure characteristics were evaluated. All endoscopist-facilitated intubations were performed under anesthesiologist supervision. A total of 3409 patients underwent ERCP; 1568 (46%) GA and 1841 (54%) MAC. Of these, 42 (2.3%) required intubation during ERCP and 16 underwent endoscopist-facilitated intubation due to retained food in the stomach and/or hypoxia. In 3 patients, aspirated material was suctioned from the trachea and bronchi using the ultra-slim Gastroscope. Immediate post-procedure extubation was successful in all endoscopist-facilitated intubation patients and none exhibited radiographic evidence of aspiration pneumonia. Endoscopist-facilitated intubation using an ultra-slim Flexible Gastroscope is feasible and expeditious for MAC to GA conversion during ERCP. This technique is readily accomplished in the semi-prone position, while standard intubation requires patient transfer from fluoroscopy table to gurney, with associated delay/risks. These data suggest that further study of this approach is warranted, and this may be the most favorable approach for intubation during ERCP.

Monique T. Barakat - One of the best experts on this subject based on the ideXlab platform.

  • Use of an Ultra-slim Gastroscope to Accomplish Endoscopist-Facilitated Rescue Intubation During ERCP: A Novel Approach to Enhance Patient and Staff Safety
    Digestive Diseases and Sciences, 2020
    Co-Authors: Monique T. Barakat, Timothy P. Angelotti, Subhas Banerjee
    Abstract:

    Background ERCP is often performed under monitored anesthesia care (MAC) rather than general anesthesia (GA), with patients positioned semi-prone on the fluoroscopy table. Rarely, a MAC ERCP must be converted to GA due to hypoxia or retained food in the stomach. In these circumstances, standard intubation is associated with a significant delay and potential for patient/staff injury during repositioning. We report a novel endoscopist-driven approach to intubation during ERCP using an ultra-slim, Flexible Gastroscope with an endotracheal tube backloaded onto it. Materials and Methods We identified patients who underwent ERCP from 2014 to 2019, and MAC to GA conversion events. Mode of intubation (standard vs. endoscopist-facilitated) and patient/procedure characteristics were evaluated. All endoscopist-facilitated intubations were performed under anesthesiologist supervision. Results A total of 3409 patients underwent ERCP; 1568 (46%) GA and 1841 (54%) MAC. Of these, 42 (2.3%) required intubation during ERCP and 16 underwent endoscopist-facilitated intubation due to retained food in the stomach and/or hypoxia. In 3 patients, aspirated material was suctioned from the trachea and bronchi using the ultra-slim Gastroscope. Immediate post-procedure extubation was successful in all endoscopist-facilitated intubation patients and none exhibited radiographic evidence of aspiration pneumonia. Conclusions Endoscopist-facilitated intubation using an ultra-slim Flexible Gastroscope is feasible and expeditious for MAC to GA conversion during ERCP. This technique is readily accomplished in the semi-prone position, while standard intubation requires patient transfer from fluoroscopy table to gurney, with associated delay/risks. These data suggest that further study of this approach is warranted, and this may be the most favorable approach for intubation during ERCP.

  • use of an ultra slim Gastroscope to accomplish endoscopist facilitated rescue intubation during ercp a novel approach to enhance patient and staff safety
    Digestive Diseases and Sciences, 2020
    Co-Authors: Monique T. Barakat, Timothy P. Angelotti, Subhas Banerjee
    Abstract:

    ERCP is often performed under monitored anesthesia care (MAC) rather than general anesthesia (GA), with patients positioned semi-prone on the fluoroscopy table. Rarely, a MAC ERCP must be converted to GA due to hypoxia or retained food in the stomach. In these circumstances, standard intubation is associated with a significant delay and potential for patient/staff injury during repositioning. We report a novel endoscopist-driven approach to intubation during ERCP using an ultra-slim, Flexible Gastroscope with an endotracheal tube backloaded onto it. We identified patients who underwent ERCP from 2014 to 2019, and MAC to GA conversion events. Mode of intubation (standard vs. endoscopist-facilitated) and patient/procedure characteristics were evaluated. All endoscopist-facilitated intubations were performed under anesthesiologist supervision. A total of 3409 patients underwent ERCP; 1568 (46%) GA and 1841 (54%) MAC. Of these, 42 (2.3%) required intubation during ERCP and 16 underwent endoscopist-facilitated intubation due to retained food in the stomach and/or hypoxia. In 3 patients, aspirated material was suctioned from the trachea and bronchi using the ultra-slim Gastroscope. Immediate post-procedure extubation was successful in all endoscopist-facilitated intubation patients and none exhibited radiographic evidence of aspiration pneumonia. Endoscopist-facilitated intubation using an ultra-slim Flexible Gastroscope is feasible and expeditious for MAC to GA conversion during ERCP. This technique is readily accomplished in the semi-prone position, while standard intubation requires patient transfer from fluoroscopy table to gurney, with associated delay/risks. These data suggest that further study of this approach is warranted, and this may be the most favorable approach for intubation during ERCP.

John Wong - One of the best experts on this subject based on the ideXlab platform.

  • A prospective randomized trial comparing the use of the Flexible Gastroscope versus the bronchoscope in the management of foreign body ingestion
    Gastrointestinal endoscopy, 1998
    Co-Authors: Kent-man Chu, Hok-kwok Choi, Henry H. Tuen, Simon Law, Fj Branicki, John Wong
    Abstract:

    Abstract Background : Foreign body ingestion is a common clinical problem in Hong Kong. Some recent reports have proposed the use of Flexible nasoendoscopy for foreign body retrieval. The present study is a prospective randomized trial on the use of the Flexible Gastroscope and bronchoscope in the management of foreign body ingestion. Methods : Two hundred sixteen patients older than 11 years were prospectively randomized to Flexible endoscopic examination using either the Gastroscope (108 patients) or the bronchoscope (108 patients). The duration of the procedure was noted. Patients were asked to assess their overall tolerance to the procedure on a scale of 1 (well tolerated) to 10 (unacceptable). Results : A foreign body was retrieved in 68 patients (31.5%). There was no difference between the two groups in the foreign body retrieval rate, type of foreign body retrieved, duration of procedure, and tolerance level. In the group managed with the bronchoscope, however, three patients required the additional use of the Gastroscope for foreign body retrieval at (for one patient) or below (for two patients) the cricopharyngeus. The patient's tolerance level was related only to the duration of procedure (rho = 0.386; p Conclusion : The use of the Flexible Gastroscope is recommended because of its efficacy, safety, and tolerability. (Gastrointest Endosc 1998;47:23-7.)

  • A prospective randomized trial comparing the use of Flexible Gastroscope versus bronchoscope in the management of foreign body ingestion
    Gastrointestinal Endoscopy, 1997
    Co-Authors: Kent-man Chu, Hok-kwok Choi, Henry H. Tuen, Simon Law, Fj Branicki, John Wong
    Abstract:

    Background Foreign body ingestion is a common clinical problem in Hong Kong. Some recent reports have proposed the use of Flexible bronchoscope for foreign body retrieval. The present study is a prospective randomized trial on the use of Flexible Gastroscope and bronchoscope in the management of foreign body ingestion. Methods Between December 1995 and June 1996, 216 patients older than 11 years were prospectively randomized to Flexible endoscopic examination using either the Gastroscope (108 patients) or the bronchoscope (108 patients) under local pharyngeal anesthesia. The duration of procedure and the type of foreign body retrieved were noted. On conclusion of the endoscopie examination, patients were asked to assess their overall tolerance to the procedure on a scale of 1 (well tolerated) to 10 (unacceptable). Results There was a preponderance of female patients (M : F = 72 : 144). Mean age was 46 years (range, 12 to 85 years). A foreign body was retrieved in 68 patients (31.5%). There was no difference between the two groups in the foreign body retrieval rate, type of foreign body retrieved, duration of procedure, and tolerance level. In the group managed with the bronchoscope, however, three patients required the additional use of the Gastroscope for foreign body retrieval at (one patient) or below (two patients) the cricopharyngeus. Patient's tolerance level was related only to the duration of procedure in the GE group (rho = 0.444; p < 0.001), BE group (rho = 0.388; p < 0.001), and in the whole group (rho = 0.386; p < 0.001). Conclusion The use of the Flexible Gastroscope is recommended because of its efficacy, safety, and tolerability.link_to_subscribed_fulltextAnnual Meeting of the American Society for Gastrointestinal Endoscopy, Digestive Disease Week (DDW), Washington DC, USA 11-14 May, 1997. In Gastrointestinal Endoscopy, 1997, v. 45 n. 4, p. AB66, abstract no. 16

Kent-man Chu - One of the best experts on this subject based on the ideXlab platform.

  • A prospective randomized trial comparing the use of the Flexible Gastroscope versus the bronchoscope in the management of foreign body ingestion
    Gastrointestinal endoscopy, 1998
    Co-Authors: Kent-man Chu, Hok-kwok Choi, Henry H. Tuen, Simon Law, Fj Branicki, John Wong
    Abstract:

    Abstract Background : Foreign body ingestion is a common clinical problem in Hong Kong. Some recent reports have proposed the use of Flexible nasoendoscopy for foreign body retrieval. The present study is a prospective randomized trial on the use of the Flexible Gastroscope and bronchoscope in the management of foreign body ingestion. Methods : Two hundred sixteen patients older than 11 years were prospectively randomized to Flexible endoscopic examination using either the Gastroscope (108 patients) or the bronchoscope (108 patients). The duration of the procedure was noted. Patients were asked to assess their overall tolerance to the procedure on a scale of 1 (well tolerated) to 10 (unacceptable). Results : A foreign body was retrieved in 68 patients (31.5%). There was no difference between the two groups in the foreign body retrieval rate, type of foreign body retrieved, duration of procedure, and tolerance level. In the group managed with the bronchoscope, however, three patients required the additional use of the Gastroscope for foreign body retrieval at (for one patient) or below (for two patients) the cricopharyngeus. The patient's tolerance level was related only to the duration of procedure (rho = 0.386; p Conclusion : The use of the Flexible Gastroscope is recommended because of its efficacy, safety, and tolerability. (Gastrointest Endosc 1998;47:23-7.)

  • A prospective randomized trial comparing the use of Flexible Gastroscope versus bronchoscope in the management of foreign body ingestion
    Gastrointestinal Endoscopy, 1997
    Co-Authors: Kent-man Chu, Hok-kwok Choi, Henry H. Tuen, Simon Law, Fj Branicki, John Wong
    Abstract:

    Background Foreign body ingestion is a common clinical problem in Hong Kong. Some recent reports have proposed the use of Flexible bronchoscope for foreign body retrieval. The present study is a prospective randomized trial on the use of Flexible Gastroscope and bronchoscope in the management of foreign body ingestion. Methods Between December 1995 and June 1996, 216 patients older than 11 years were prospectively randomized to Flexible endoscopic examination using either the Gastroscope (108 patients) or the bronchoscope (108 patients) under local pharyngeal anesthesia. The duration of procedure and the type of foreign body retrieved were noted. On conclusion of the endoscopie examination, patients were asked to assess their overall tolerance to the procedure on a scale of 1 (well tolerated) to 10 (unacceptable). Results There was a preponderance of female patients (M : F = 72 : 144). Mean age was 46 years (range, 12 to 85 years). A foreign body was retrieved in 68 patients (31.5%). There was no difference between the two groups in the foreign body retrieval rate, type of foreign body retrieved, duration of procedure, and tolerance level. In the group managed with the bronchoscope, however, three patients required the additional use of the Gastroscope for foreign body retrieval at (one patient) or below (two patients) the cricopharyngeus. Patient's tolerance level was related only to the duration of procedure in the GE group (rho = 0.444; p < 0.001), BE group (rho = 0.388; p < 0.001), and in the whole group (rho = 0.386; p < 0.001). Conclusion The use of the Flexible Gastroscope is recommended because of its efficacy, safety, and tolerability.link_to_subscribed_fulltextAnnual Meeting of the American Society for Gastrointestinal Endoscopy, Digestive Disease Week (DDW), Washington DC, USA 11-14 May, 1997. In Gastrointestinal Endoscopy, 1997, v. 45 n. 4, p. AB66, abstract no. 16

Timothy P. Angelotti - One of the best experts on this subject based on the ideXlab platform.

  • Use of an Ultra-slim Gastroscope to Accomplish Endoscopist-Facilitated Rescue Intubation During ERCP: A Novel Approach to Enhance Patient and Staff Safety
    Digestive Diseases and Sciences, 2020
    Co-Authors: Monique T. Barakat, Timothy P. Angelotti, Subhas Banerjee
    Abstract:

    Background ERCP is often performed under monitored anesthesia care (MAC) rather than general anesthesia (GA), with patients positioned semi-prone on the fluoroscopy table. Rarely, a MAC ERCP must be converted to GA due to hypoxia or retained food in the stomach. In these circumstances, standard intubation is associated with a significant delay and potential for patient/staff injury during repositioning. We report a novel endoscopist-driven approach to intubation during ERCP using an ultra-slim, Flexible Gastroscope with an endotracheal tube backloaded onto it. Materials and Methods We identified patients who underwent ERCP from 2014 to 2019, and MAC to GA conversion events. Mode of intubation (standard vs. endoscopist-facilitated) and patient/procedure characteristics were evaluated. All endoscopist-facilitated intubations were performed under anesthesiologist supervision. Results A total of 3409 patients underwent ERCP; 1568 (46%) GA and 1841 (54%) MAC. Of these, 42 (2.3%) required intubation during ERCP and 16 underwent endoscopist-facilitated intubation due to retained food in the stomach and/or hypoxia. In 3 patients, aspirated material was suctioned from the trachea and bronchi using the ultra-slim Gastroscope. Immediate post-procedure extubation was successful in all endoscopist-facilitated intubation patients and none exhibited radiographic evidence of aspiration pneumonia. Conclusions Endoscopist-facilitated intubation using an ultra-slim Flexible Gastroscope is feasible and expeditious for MAC to GA conversion during ERCP. This technique is readily accomplished in the semi-prone position, while standard intubation requires patient transfer from fluoroscopy table to gurney, with associated delay/risks. These data suggest that further study of this approach is warranted, and this may be the most favorable approach for intubation during ERCP.

  • use of an ultra slim Gastroscope to accomplish endoscopist facilitated rescue intubation during ercp a novel approach to enhance patient and staff safety
    Digestive Diseases and Sciences, 2020
    Co-Authors: Monique T. Barakat, Timothy P. Angelotti, Subhas Banerjee
    Abstract:

    ERCP is often performed under monitored anesthesia care (MAC) rather than general anesthesia (GA), with patients positioned semi-prone on the fluoroscopy table. Rarely, a MAC ERCP must be converted to GA due to hypoxia or retained food in the stomach. In these circumstances, standard intubation is associated with a significant delay and potential for patient/staff injury during repositioning. We report a novel endoscopist-driven approach to intubation during ERCP using an ultra-slim, Flexible Gastroscope with an endotracheal tube backloaded onto it. We identified patients who underwent ERCP from 2014 to 2019, and MAC to GA conversion events. Mode of intubation (standard vs. endoscopist-facilitated) and patient/procedure characteristics were evaluated. All endoscopist-facilitated intubations were performed under anesthesiologist supervision. A total of 3409 patients underwent ERCP; 1568 (46%) GA and 1841 (54%) MAC. Of these, 42 (2.3%) required intubation during ERCP and 16 underwent endoscopist-facilitated intubation due to retained food in the stomach and/or hypoxia. In 3 patients, aspirated material was suctioned from the trachea and bronchi using the ultra-slim Gastroscope. Immediate post-procedure extubation was successful in all endoscopist-facilitated intubation patients and none exhibited radiographic evidence of aspiration pneumonia. Endoscopist-facilitated intubation using an ultra-slim Flexible Gastroscope is feasible and expeditious for MAC to GA conversion during ERCP. This technique is readily accomplished in the semi-prone position, while standard intubation requires patient transfer from fluoroscopy table to gurney, with associated delay/risks. These data suggest that further study of this approach is warranted, and this may be the most favorable approach for intubation during ERCP.