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  1. Article ; Online: In the era of duodenoscopes with single-use endcaps, what is the role for single-use duodenoscopes?

    Barakat, Monique T

    Gastrointestinal endoscopy

    2023  Volume 98, Issue 1, Page(s) 119–121

    MeSH term(s) Humans ; Duodenoscopes ; Disinfection ; Cross Infection ; Equipment Contamination
    Language English
    Publishing date 2023-03-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2023.03.025
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  2. Article ; Online: Top tips for electrohydraulic lithotripsy (with video).

    Barakat, Monique T

    Gastrointestinal endoscopy

    2021  Volume 95, Issue 3, Page(s) 565–567

    MeSH term(s) Gallstones/therapy ; Humans ; Lithotripsy
    Language English
    Publishing date 2021-11-12
    Publishing country United States
    Document type Journal Article ; Video-Audio Media
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2021.11.005
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  3. Article ; Online: Anesthetic Considerations for Patients with Locked-In Syndrome Undergoing Endoscopic Procedures.

    Barakat, Monique T / Banerjee, Subhas / Angelotti, Timothy

    The American journal of case reports

    2024  Volume 25, Page(s) e942906

    Abstract: BACKGROUND Delivering safe anesthetic care to a patient unable to communicate easily and effectively with the anesthesia team presents many unique challenges. Communication may be limited by language, which can be resolved with translation services, or ... ...

    Abstract BACKGROUND Delivering safe anesthetic care to a patient unable to communicate easily and effectively with the anesthesia team presents many unique challenges. Communication may be limited by language, which can be resolved with translation services, or neurological conditions, such as stroke or traumatic brain injury, which are not easily remedied. In such patients, the inability to communicate effectively can lead to anxiety and negatively impact the patient-anesthesiologist relationship, especially when higher cognitive functions are preserved. CASE REPORT We present a case of a patient with locked-in syndrome (LIS), who presented to our endoscopy unit for a routine colonoscopy. The patient could only communicate with eye movements and blinking, thus limiting our ability to assess their pain or other needs in the perioperative period; however, she was otherwise cognitively intact. By utilizing the patient's home healthcare team and quickly adapting their unique communication methods during the perioperative period, we were able to provide an appropriate, safe anesthetic for this patient with LIS. CONCLUSIONS Many patients requiring an anesthetic are unable to effectively communicate due to language issues, hearing loss/mutism, neurological injury/stroke (aphasia), or developmental disabilities. The unique communication needs of this patient with LIS went beyond utilizing a translator and required the healthcare team to quickly learn a new communication method. We also discuss forms of intraoperative monitoring that can be used to differentiate consciousness from the anesthetized state in LIS patients, as well as making recommendations for future care of such patients.
    MeSH term(s) Female ; Humans ; Locked-In Syndrome ; Quadriplegia ; Endoscopy ; Anesthetics ; Stroke
    Chemical Substances Anesthetics
    Language English
    Publishing date 2024-02-15
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.942906
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  4. Article ; Online: Pediatric ERCP: Evolving into an Outpatient Procedure.

    Barakat, Monique T / Liman, Andrew Yong-Jueen / Gugig, Roberto

    Digestive diseases and sciences

    2024  

    Abstract: Background: While most adult ERCPs are performed on an outpatient basis, pediatric ERCPs are typically performed on an inpatient basis, or with ERCP followed by at least one night inpatient admission. We have begun performing a substantial proportion of ...

    Abstract Background: While most adult ERCPs are performed on an outpatient basis, pediatric ERCPs are typically performed on an inpatient basis, or with ERCP followed by at least one night inpatient admission. We have begun performing a substantial proportion of our pediatric ERCPs on an outpatient basis, using our clinical judgment to guide the decision process. In the present study, we compare patient characteristics, indications, and adverse events associated with outpatient vs. inpatient ERCP.
    Methods: Using our endoscopy database, we identified patients 18 years of age and under who underwent ERCP from 2019 to 2021. Demographics, hospitalization status, indications, findings, interventions, as well as available adverse event and clinical outcomes data were analyzed.
    Results: 147 ERCP procedures were performed during the study period by one of two interventional endoscopists. A subset of 51 (34.7%) patients underwent outpatient ERCP. Comparison of the two groups (outpatient vs. inpatient ERCP) was notable for no statistically significant difference in patient age, range of indications, or proportion of index vs. subsequent ERCP. Overall rates of ERCP-associated adverse events were low and there was no statistically significant difference between adverse events in patients who underwent outpatient vs. inpatient ERCP.
    Conclusion: We analyzed outpatient and inpatient pediatric ERCP patient demographics and ERCP characteristics to identify factors that guide decision to determine whether pediatric ERCPs are performed on an outpatient vs. inpatient basis. There was no significant difference in adverse events associated with outpatient vs. inpatient pediatric ERCPs, attesting to the safety of outpatient ERCP for this subset of patients in the studied context. This is an area worthy of future prospective and multi-center study.
    Language English
    Publishing date 2024-02-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-024-08325-9
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  5. Article ; Online: Initial Experience with Duodenoscopes with Single-Use End Caps in Pediatric Endoscopic Retrograde Cholangiopancreatography: Infection Prevention Comes at a Cost.

    Barakat, Monique T / Liman, Andrew / Gugig, Roberto

    Gastrointestinal endoscopy

    2024  

    Abstract: Background and aims: Duodenoscopes with single-use end caps were introduced to minimize infection risk, but are unstudied in pediatrics.: Methods: We collected clinical data and endoscopists' evaluations of duodenoscopes with single-use end caps ... ...

    Abstract Background and aims: Duodenoscopes with single-use end caps were introduced to minimize infection risk, but are unstudied in pediatrics.
    Methods: We collected clinical data and endoscopists' evaluations of duodenoscopes with single-use end caps versus reusable duodenoscopes over 18 months.
    Results: A total of 106 ERCPs were performed for patients aged 1-18 (mean 14.2) years. Forty-six involved single-use end caps, with 9 requiring crossover to reusable duodenoscopes. ERCPs involving single-use end caps resulted in more instances of mucosal trauma (10 vs 0, p<0.05) and post-ERCP pancreatitis (4 vs 1, p<0.05), and accounted for 8 of 9 ERCPs requiring advanced cannulation techniques. No post-ERCP infections occurred. Reported challenges included single-use end cap stiffness and difficulty with their alignment for cannulation.
    Conclusions: We report difficulty with advancement, greater reliance on advanced cannulation techniques, and higher rates of PEP when using duodenoscopes with single-use end caps in pediatric ERCP. This area warrants further study.
    Language English
    Publishing date 2024-03-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2024.03.009
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  6. Article ; Online: Endoscopy and Pediatric Pancreatitis.

    Grover, Amit S / Gugig, Roberto / Barakat, Monique T

    Gastrointestinal endoscopy clinics of North America

    2023  Volume 33, Issue 2, Page(s) 363–378

    Abstract: Children and adolescents are increasingly impacted by pancreatic disease. Interventional endoscopic procedures, including endoscopic retrograde cholangiopancreatography) and endoscopic ultrasonography, are integral to the diagnosis and management of many ...

    Abstract Children and adolescents are increasingly impacted by pancreatic disease. Interventional endoscopic procedures, including endoscopic retrograde cholangiopancreatography) and endoscopic ultrasonography, are integral to the diagnosis and management of many pancreatic diseases in the adult population. In the past decade, pediatric interventional endoscopic procedures have become more widely available, with invasive surgical procedures now being replaced by safer and less disruptive endoscopic interventions.
    MeSH term(s) Adult ; Child ; Humans ; Adolescent ; Pancreas/diagnostic imaging ; Pancreatitis/diagnostic imaging ; Pancreatitis/etiology ; Endoscopy ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Pancreatic Diseases/diagnostic imaging ; Pancreatic Diseases/surgery ; Endosonography
    Language English
    Publishing date 2023-01-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1313994-0
    ISSN 1558-1950 ; 1052-5157
    ISSN (online) 1558-1950
    ISSN 1052-5157
    DOI 10.1016/j.giec.2022.11.002
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  7. Article: Incidental biliary dilation in the era of the opiate epidemic: High prevalence of biliary dilation in opiate users evaluated in the Emergency Department.

    Barakat, Monique T / Banerjee, Subhas

    World journal of hepatology

    2021  Volume 12, Issue 12, Page(s) 1289–1298

    Abstract: Background: Biliary dilation is frequently related to obstruction; however, non-obstructive factors such as age and previous cholecystectomy have also been reported. In the past two decades there has been a dramatic increase in opiate use/dependence and ...

    Abstract Background: Biliary dilation is frequently related to obstruction; however, non-obstructive factors such as age and previous cholecystectomy have also been reported. In the past two decades there has been a dramatic increase in opiate use/dependence and utilization of cross-sectional abdominal imaging, with increased detection of biliary dilation, particularly in patients who use opiates.
    Aim: To evaluate associations between opiate use, age, cholecystectomy status, ethnicity, gender, and body mass index utilizing our institution's integrated informatics platform.
    Methods: One thousand six hundred and eighty-five patients (20% sample) presenting to our Emergency Department for all causes over a 5-year period (2011-2016) who had undergone cross-sectional abdominal imaging and had normal total bilirubin were included and analyzed.
    Results: Common bile duct (CBD) diameter was significantly higher in opiate users compared to non-opiate users (8.67 mm
    Conclusion: Opiate use and a history of cholecystectomy are associated with CBD dilation in the absence of an obstructive process. Age alone is not associated with increased CBD diameter. These findings suggest that factors such as opiate use and history of cholecystectomy may underlie the previously-reported association of advancing age with increased CBD diameter. Further prospective study is warranted.
    Language English
    Publishing date 2021-01-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2573703-X
    ISSN 1948-5182
    ISSN 1948-5182
    DOI 10.4254/wjh.v12.i12.1289
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  8. Article: EUS-directed transgastric ERCP: A first-line option for ERCP following Roux-en-Y gastric bypass.

    Barakat, Monique T / Adler, Douglas G

    Endoscopic ultrasound

    2021  Volume 10, Issue 3, Page(s) 151–153

    Language English
    Publishing date 2021-06-17
    Publishing country China
    Document type Editorial
    ZDB-ID 2998317-4
    ISSN 2226-7190 ; 2303-9027
    ISSN (online) 2226-7190
    ISSN 2303-9027
    DOI 10.4103/eus.eus_148_20
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  9. Article: EUS-guided biliary drainage: A realistic perspective.

    Barakat, Monique T / Adler, Douglas G

    Endoscopic ultrasound

    2021  Volume 10, Issue 4, Page(s) 227–229

    Language English
    Publishing date 2021-08-11
    Publishing country China
    Document type Editorial
    ZDB-ID 2998317-4
    ISSN 2226-7190 ; 2303-9027
    ISSN (online) 2226-7190
    ISSN 2303-9027
    DOI 10.4103/EUS-D-21-00173
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  10. Article ; Online: Endoscopy in Patients With Surgically Altered Anatomy.

    Barakat, Monique T / Adler, Douglas G

    The American journal of gastroenterology

    2021  Volume 116, Issue 4, Page(s) 657–665

    Abstract: A comprehensive understanding of gastrointestinal anatomy is essential for performance of any endoscopic procedure. Surgical approaches to therapy have become increasingly common in the past decade, which has resulted in a substantial proportion of ... ...

    Abstract A comprehensive understanding of gastrointestinal anatomy is essential for performance of any endoscopic procedure. Surgical approaches to therapy have become increasingly common in the past decade, which has resulted in a substantial proportion of patients with surgically altered anatomy who require endoscopy. In parallel with the obesity epidemic, bariatric surgery for obesity management has been widely adopted. In response to these trends, gastroenterologists must become familiar with patient anatomy after these surgical interventions and understand the implications of this altered anatomy on the current array of available endoscopic modalities for diagnosis and therapy. This review describes the range of surgically altered anatomy commonly encountered in the upper gastrointestinal tract. For each foregut location-esophagus, stomach, and small bowel-we describe indications for and specific details of the range of common surgical approaches affecting this regional anatomy. We then provide an endoscopic roadmap through the altered anatomy resulting from these surgical interventions. Finally, we address the impact of postsurgical anatomy on performance of endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, with guidance surrounding how to successfully execute these procedures. Evolution of endoscopic approaches over time might be expected to enhance the safety and efficacy of these interventions in patients with surgically altered anatomy.
    MeSH term(s) Endoscopy, Gastrointestinal/methods ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/surgery ; Gastrointestinal Tract/anatomy & histology ; Gastrointestinal Tract/surgery ; Humans
    Language English
    Publishing date 2021-05-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000001102
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