PAULO SAKAI

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Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina

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  • conferenceObject
    Traditional forward view versus wide view technology: polyp and adenoma detection rate in colonoscopy
    (2016) ROCHA, Rodrigo S.; KORKISCHKO, Nadia; SILVA, Gustavo L.; AQUINO, Julio Cesar M.; MORITA, Flavio H.; MOURA, Eduardo T. de; MOURA, Diogo T. de; OLIVEIRA, Joel; MENDONCA, Ernesto Q.; BRAVO, Jose G.; BARACAT, Felipe I.; SAKAI, Paulo; MOURA, Eduardo G. de
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    Reduced Transcobalamin I Gene Expression Following Roux-en-Y Gastric Bypass Surgery Can Contribute to B12 Deficiency
    (2015) SALA, Priscila; MACHADO, Natasha; BELARMINO, Giliane; ISHIDA, Robson; GUARDA, Ismael; GIANNELLA-NETO, Daniel; SANTO, Marco Aurelio; MOURA, Eduardo; SAKAI, Paulo; SILVA, Ismael; YE, Jianping; HEYMSFIELD, Steven; WAITZBERG, Dan
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    Results of Endoscopic Cyanoacrylate Injection for the Treatment of Esophageal Variceal Hemorrhage in Child-Pugh C Patients
    (2012) RIBEIRO, Joao Paulo A.; MALUF-FILHO, Fauze; MATUGUMA, Swrgio E.; HERMAN, Paulo; SAKAI, Paulo; D'ALBUQUERQUE, Luiz Augusto C.
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    EFTR, STER AND LAPAROSCOPIC ASSISTED RESECTION OF SUBMUCOSAL LESIONS OF THE UPPER GI TRACT: WHAT HAVE WE LEARNED ?
    (2019) KAHALEH, Michel; BHAGAT, Vicky; DELLATORE, Peter; TYBERG, Amy; SARKAR, Avik; SHAHID, Haroon M.; ANDALIB, Iman; ALKHIARI, Resheed; GAIDHANE, Monica; KEDIA, Prashant; NIETO, Jose; KUMTA, Nikhil A.; DIXON, Rebekah E.; SALAMEH, Habeeb; MAVROGENIS, Georgios; ABE, Seiichiro; MORITA, Flavio H.; SAKAI, Paulo; MOURA, Eduardo G. de
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    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, Paulo
    Common 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.
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    PREDICTORS OF GASTROESOPHAGEAL REFLUX AFTER POEM FOR ACHALASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
    (2019) MOTA, Raquel Cristina L.; MOURA, Eduardo G. de; MOURA, Diogo T. de; MOURA, Eduardo T.; FARIAS, Galileu F.; BRUNALDI, Vitor O.; BERNARDO, Wanderlei M.; SAKAI, Paulo; THOMPSON, Christopher C.
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    Balloon Assisted Enteroscopy Is Advised in the Long Term Follow-Up of Patients With On-Going Obscure Gastrointestinal Bleeding
    (2012) SAFATLE-RIBEIRO, Adriana V.; ARRAES, Livia R.; RIBEIRO, Ulysses; REIMAO, Silvia M.; MEDRADO, Bruno F.; SANTOS, Thiago N.; KAWAGUTI, Fabio S.; MOURA, Eduardo G. De; SAKAI, Paulo; CECCONELLO, Ivan
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    GASTRIC PERORAL ENDOSCOPIC MYOTOMY (G-POEM) IN THE TREATMENT OF REFRACTORY GASTROPARESIS: CASE SERIES AND LITERATURE REVIEW
    (2019) PONTE, Alberto M. da; SAGAE, Vitor M.; MORITA, Flavio H.; MATSUBAYASHI, Carolina O.; MINATA, Mauricio K.; MOURA, Eduardo T.; SAKAI, Paulo; MOURA, Eduardo G. de; CHAVES, Dalton
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    Biliary Stenosis Extreme Endoscopy Treatment - Very Large Balloon Dilation: Case Series (EBD)
    (2016) MOURA, Eduardo T. de; SILVA, Gustavo L.; PASSOS, Marina Lordello; AQUINO, Julio Cesar M.; CASTRO, Vinicius L.; MOURA, Diogo T. de; FRANZINI, Tomazo; SAKAI, Paulo
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    Evaluation of the Small Intestine by Video Capsule Endoscopy in Patients Candidates for Liver Transplantation
    (2012) FYLYK, Sonia N.; TOBARU, Andre; MESTIERI, Luiz H.; FARIAS, Alberto Q.; CARRILHO, Flair J.; D'ALBUQUERQUE, Luiz Augusto C.; MOURA, Eduardo G. De; SAKAI, Paulo
    Introduction: Recent studies suggest that in cirrhotic patients the small intestine can be affected by the consequences of a system of portal hypertension (PTH). This segment of the gastrointestinal tract, however, is hardly accessible for study. The video capsule endoscopy (VCE) is considered the gold standard exam for the investigation of small bowel diseases, especially vascular diseases of the intestinal mucosa. Objective: Evaluation of the findings of PTH in the mucosa of the small bowel of cirrhotic patients, candidates for liver transplantation (LT). Patients and Methods: Prospective, single-center, controlled study. All patients signed informed consent and the study was approved by the ethics committee. 21 patients were submitted to VCE and esophagogastroduodenoscopy (14 patients with liver cirrhosis candidates to LT and 7 control cases, with normal liver function and no evidence of PTH). Inclusion criteria: - Patients with liver cirrhosis of viral and/or alcoholic etiology and with indication for LT (Child-Pugh score A, B or C and MELD < 20). Patients submitted or not to endoscopic treatment of esophagogastric varices or GAVE. - Patients over 18 years. - Patients who agree to participate in the study. Exclusion criteria: - Patients with history of abdominal surgery and intestinal transit abnormalities. - Intestinal sub-occlusion or suspected gastroparesis. - Patients with congestive heart disease. - Patients with potentially hemorrhagic lesions that can contribute to anemia (ulcers, polyps) and not related to PTH. Results: The mucosal lesions of the small intestine secondary to portal hypertension were more common in cirrhotic patients than in control patients: 13/14 (92.8%) vs. 1/7 (14.2%). The reticular pattern of the mucosa (hypertensive enteropathy) was the most important finding of the cases (10/14 -71.4%), followed by vascular ectasia-like and varices of the jejunum and ileum (7/14 - 50%). Conclusion: This group of patients has significant changes in the mucosa of the small intestine secondary to PTH and this segment of the gastrointestinal tract may represent a site of bleeding, often classified as obscure. The VCE is an important tool for the identification of these lesions, contributing to a more accurate etiologic diagnosis.