EVERSON LUIZ DE ALMEIDA ARTIFON
Projetos de Pesquisa
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LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
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conferenceObject EUS-FNA OF PANCREATIC SOLID MASSES: A PROSPECTIVE RANDOMIZED TRIAL COMPARING SUCTION WITH SLOW PULL(2018) CHENG, Spencer; DANIELLE, Chacon A.; ARTIFON, Everson L.; MATUGUMA, Sergio E.; SANTOS, Marcos E. dos; SAKAI, Christiano M.; CHAVES, Dalton; MOURA, Diogo T. De; MOURA, Eduardo T.conferenceObject Endoscopic Papillary Large Balloon Dilation Associated With Sphincterotomy for Extraction of Large Bile Duct Stones(2012) LUZ, Gustavo O.; MOURA, Eduardo G. De; MEINE, Gilmara C.; CARNEIRO, Fred O.; MEDRADO, Bruno F.; ALMEIDA, Maira R.; MALUF-FILHO, Fauze; LERA, Marcos; IDE, Edson; FURUYA, Carlos K.; CHAVES, Dalton M.; CHENG, Spencer; MATUGUMA, Sergio E.; TOMISHIGE, Toshiro; HONDO, Fabio Y.; BARACAT, Renato; ARTIFON, Everson L.; FRANZINI, Tomazo; SAKAI, PauloCommon bile duct stones larger than 15mm are related to a higher rate of failure of endoscopic ductal clearance and need for mechanical lithotripsy. Recently, endoscopic papillary large balloon dilation (EPLBD) associated with endoscopic sphyncterotomy (ES) has been advocated for the management of difficult bile duct stones. Objective: Evaluate the efficacy and safety of EPLBD associated with ES for removal of large bile duct stones. Patients and methods: retrospective review of prospectively collected data in an academic tertiary referral center, from November 2009 to August 2011. Ampullary dilation was performed with a wire guided hydrostatic balloon (CRE/Boston Scientific) which size ranged from 12 to 20mm. The stone size and the duct diameter directed the choice of the balloon diameter. Balloon was inflated with diluted contrast medium under endoscopic and fluoroscopic control until waist disappearance and/or maximal balloon pressure. After dilation stones were extracted with the aid of standard accessories and techniques. Outcomes and adverse events were recorded. Results: A total of 730 patients with common bile duct stones were admitted for ERCP in our institution. 123 (16,8%) patients were submitted to EPLBD after sphincterotomy. The mean age was 56 years (22-98) and 77 were female (63%). The size of the stones ranged from 13 to 30mm. Initial procedure success rate without mechanical lithitripsy was 83% (102/123). In further 4 patients (3,2%) mechanical lithotripsy was used with 75% success rate (3/4). For the remaining 17 patients, mechanical litotripsy was not available and a 10Fr biliary stent was introduced to prevent obstruction and cholangitis. The total adverse events rate was 3,2%. There were 2 cases of perforation with 20mm balloon (1,6%), both treated conservatively, and two cases of mild acute pancreatitis (1,6%). None of the patients presented bleeding that required transfusion or hospitalization. Conclusion: EPLBD after sphincterotomy is a safe and effective technique for the management of large bile duct stones and it avoids mechanical lithotripsy in the majority of cases.conferenceObject A CORE CURRICULUM FOR BASIC EUS SKILLS - AN INTERNATIONAL CONSENSUS USING THE DELPHI METHODOLOGY(2021) KARSTENSEN, John Gasdal; NAYAHANGAN, Leizl Joy; SAFTOIU, Adrian; EPSHTEIN, Aleksei; SAHAI, Anand; WANG, Andrew Y.; TEOH, Anthony Y.; BURMESTER, Elke; GONEN, Can; DIETRICH, Christoph F.; JENSSEN, Christian; VAZQUEZ-SEQUEIROS, Enrique; HEIJDEN, Erik H. van der; BORIES, Erwan; SANTO, Erwin; KALAITZAKIS, Evangelos; ARTIFON, Everson; MALUF-FILHO, Fauze; MISHRA, Girish; ASLANIAN, Harry R.; SCHEIMAN, James; POLEY, Jan-Werner; HOOFT, Jeanin E. van; DEWITT, John M.; IGLESIAS-GARCIA, Julio; Khanh Do-Cong Pham; AABAKKEN, Lars; BRINK, Lene; SOSA-VALENCIA, Leonardo; LEE, Linda S.; BHUTANI, Manoop S.; PEREZ-MIRANDA, Manuel; LAHAV, Maor; PETRONE, Maria; JINGA, Mariana; TOPAZIAN, Mark; KIMMEY, Michael B.; MORTENSEN, Michael B.; LARSEN, Michael Hareskov; HOCKE, Michael; LEVY, Michael J.; AL-HADDAD, Mohammad A.; PALAZZO, Laurent; PALAZZO, Maxime; ARCIDIACONO, Paolo G.; FOCKENS, Paul; CLEMENTSEN, Paul Frost; DEPREZ, Pierre H.; FUSAROLI, Pietro; GARG, Pramod; WATSON, Rabindra; KESWANI, Rajesh N.; SADIK, Riadh; HAVRE, Roald F.; KILINCALP, Serta; TANG, Shou-Jiang; SUN, Siyu; HOLLERBACH, Stephan; PEREIRA, Stephen P.; LAKHTAKIA, Sundeep; RANA, Surinder S.; HAQUE, Saad; ITOI, Takao; WOODWARD, Timothy A.; BARON, Todd H.; SIDDIQUI, Uzma D.; SHAMI, Vanessa M.; SHARMA, Vijay; BHATIA, Vikram; DHIR, Vinay; ARANTES, Vitor N.; KONGE, Lars; VILMANN, PeterconferenceObject MID TERM EVALUATION OF EUS-GUIDED GASTROENTEROSTOMY: AN INTERNATIONAL COLLABORATIVE STUDY(2023) SHAHID, Haroon; CANAKIS, Andrew; TYBERG, Amy; MILLER, Dillon; BAREKET, Romy; CHEN, Conan; GAIDHANE, Monica; KARAGYOZOV, Petko; SARKAR, Avik; WIDMER, Jessica; ARTIFON, Everson; KEDIA, Prashant; CHOWDHURY, Salil; CHALIKONDA, Divya; DIOGUARDI, Vincent; LOREN, David; KOWALSKI, Thomas; SCHLACHTERMAN, Alexander; KUMAR, Anand; CHIANG, Austin; CUNTO, Domenica; ROBLES-MEDRANDA, Carlos; KAHALEH, MichelconferenceObject MID TERM EVALUATION OF EUS-GUIDED GASTROENTEROSTOMY: AN INTERNATIONAL COLLABORATIVE STUDY(2023) SHAHID, Haroon; CANAKIS, Andrew; TYBERG, Amy; MILLER, Dillon; BAREKET, Romy; CHEN, Conan; GAIDHANE, Monica; KARAGYOZOV, Petko; SARKAR, Avik; WIDMER, Jessica; ARTIFON, Everson; KEDIA, Prashant; CHOWDHURY, Salil; CHALIKONDA, Divya; DIOGUARDI, Vincent; LOREN, David; KOWALSKI, Thomas; SCHLACHTERMAN, Alexander; KUMAR, Anand; CHIANG, Austin; CUNTO, Domenica; ROBLES-MEDRANDA, Carlos; KAHALEH, MichelconferenceObject ERCP Versus EUS for Tissue Diagnosis of Malignant Biliary Stricture: Systematic Review and Meta-Analysis(2016) MOURA, Diogo T. de; MOURA, Eduardo T. de; BERNARDO, Wanderlei M.; BARACAT, Felipe I.; KONDO, Andre; MATUGUMA, Sergio E.; ARTIFON, Everson L.conferenceObject CONVENTIONAL CANNULATION OR PAPILLARY FISTULOTOMY: A PROSPECTIVE RANDOMIZED TRIAL(2018) FURUYA, Carlos K.; MARINHO, Fabio R.; CHENG, Spencer; SAKAI, Paulo; ARTIFON, Everson L.- WHICH TECHNIQUE IS BETTER: EUS VS ERCP GUIDED BILIARY DRAINAGE FOR DISTAL MALIGNANT BILIARY OBSTRUCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS(2019) CHANDRASEKAR, Viveksandeep Thoguluva; JEGADEESAN, Ramprasad; HASSAN, Seemeen; AZIZ, Muhammad; DUVVURI, Abhiram; DASARI, Chandra S.; PATEL, Harsh K.; RAI, Tarun; SATHYAMURTHY, Anjana; VENNALAGANTI, Prashanth; ARTIFON, Everson L.; SHARMA, Prateek; KOHLI, Divyanshoo R.
conferenceObject Results of Endoscopic Treatment of Gastrojejunal Anastomosis Strictures After Bariatric Surgery: Analyses of Risk Factors Related to Bad Prognosis(2012) MOURA, Eduardo G. H. De; MANOEL, Galvao Neto; CEREDA, Diamari C.; RAMOS, Almino C.; MOURA, Diogo T. H. De; OLIVEIRA, Suzana L. De; YAMAZAKI, Kendi; MOURA, Eduardo T. H. De; FERREIRA, Flavio C.; ARTIFON, Everson L.; SAKAI, Paulo; CAMPOS, JosembergBackground: One of the most popular techniques on bariatric surgery is gastric bypass with Roux-en-Y reconstruction which aims to create a narrow area with important restriction of stomach area thus leading to early repletion. Objective: To analyze the factors relevant to patient’s clinical response to the treatment by endoscopic dilation and the risk factors. Methods: 54 patients submitted to bariatric surgery by gastric bypass with Roux-en-Y reconstruction that developed anastomotic stricture. The parameters analyzes were age, gender, presence or not of silastic ring, extension of the gastric pouch, anastomosis diameter, number of dilation sessions, balloon diameter, association with other surgical complications, endoscopic complications and need of re-operation. Results: When silastic ring was found it was necessary to perform dilation with larger balloons (Rigiflex 30mm) (p = 0,02) and also higher post-surgical complication rates (p = 0,01). Among the analyzed factors relevant to technical success it was identified that the presence of an ischemic segment was related with higher complication rates (perforation and re-estenosis) and also technical failure. There was no significant correlation between the diameter of the anastomosis, total amount of dilation sessions, gender, age and post-surgical complications. Conclusion: Gastrojejunal anastomosis strictures after bariatric surgery are associated with a high success rate of treatment by endoscopic dilation. When performing dilation of patients with a silastic ring or an ischemic segment of the gastric pouch it is recommended to perform this procedure with extra care once this condition is associated with higher complication rates and technical failure.