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  1. Article ; Online: Percutaneous endoscopic jejunostomy: when, how, and when to avoid it.

    Gkolfakis, Paraskevas / Arvanitakis, Marianna

    Current opinion in gastroenterology

    2022  Volume 38, Issue 3, Page(s) 285–291

    Abstract: Purpose of review: The current review summarizes current evidence regarding the indications, contraindications, and technical aspects of placing a direct percutaneous endoscopic jejunostomy (DPEJ), as well as procedure-related and patient-related ... ...

    Abstract Purpose of review: The current review summarizes current evidence regarding the indications, contraindications, and technical aspects of placing a direct percutaneous endoscopic jejunostomy (DPEJ), as well as procedure-related and patient-related outcomes.
    Recent findings: DPEJ is indicated for patients who require long-term (>4 weeks) jejunal nutrition due to existing altered foregut anatomy (e.g., previous gastrectomy) or because the gastric route is not an option (e.g., due to high risk of aspiration, intolerance, gastroparesis). DPEJ may also offer decompression of the gastrointestinal tract in cases of small bowel obstruction (e.g., peritoneal carcinomatosis). Absolute contraindications include active peritonitis, uncorrectable coagulopathy, and ongoing bowel ischemia. Technically, the 'pull' technique using a paediatric colonoscope will be sufficient for most cases. Recent publications demonstrate high rates of technical success (>85%), while patient outcomes do not differ among patients undergoing percutaneous endoscopic gastrostomy (PEG) and those undergoing DPEJ. Obesity is a risk factor for technical failure, while age more than 80 years, diabetes mellitus, and ongoing inflammatory status may be considered risk factors for DPEJ-associated mortality.
    Summary: DPEJ is a safe and efficacious modality for long-term jejunal nutrition with an acceptable risk of mild complications. Careful patient selection and respect of preprocedural, periprocedural, and postprocedural precautions are of the utmost importance to ensuring a favourable outcome.
    MeSH term(s) Aged, 80 and over ; Child ; Gastrectomy ; Humans ; Intestinal Obstruction/etiology ; Intestine, Small ; Jejunostomy/adverse effects ; Jejunostomy/methods ; Nutritional Status
    Language English
    Publishing date 2022-03-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632571-3
    ISSN 1531-7056 ; 0267-1379
    ISSN (online) 1531-7056
    ISSN 0267-1379
    DOI 10.1097/MOG.0000000000000828
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2072: Show issues Location:
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  2. Article ; Online: Ensuring Quality in Patients Receiving Enteral Nutrition Catheters.

    Gkolfakis, Paraskevas / Arvanitakis, Marianna

    Joint Commission journal on quality and patient safety

    2022  Volume 48, Issue 6-7, Page(s) 307–308

    MeSH term(s) Catheters ; Enteral Nutrition ; Humans
    Language English
    Publishing date 2022-04-29
    Publishing country Netherlands
    Document type Editorial ; Comment
    ZDB-ID 1189890-2
    ISSN 1938-131X ; 1549-425X ; 1553-7250 ; 1070-3241 ; 1549-3741
    ISSN (online) 1938-131X ; 1549-425X
    ISSN 1553-7250 ; 1070-3241 ; 1549-3741
    DOI 10.1016/j.jcjq.2022.04.009
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  3. Article: Recent Developments in the Field of Endoscopic Ultrasound for Diagnosis, Staging, and Treatment of Pancreatic Lesions.

    Poiraud, Marie / Gkolfakis, Paraskevas / Arvanitakis, Marianna

    Cancers

    2023  Volume 15, Issue 9

    Abstract: Endoscopic ultrasound (EUS) plays a crucial role in the diagnosis of both solid and cystic pancreatic lesions and in the staging of patients with pancreatic cancer through its use for tissue and fluid sampling. Additionally, in cases of precancerous ... ...

    Abstract Endoscopic ultrasound (EUS) plays a crucial role in the diagnosis of both solid and cystic pancreatic lesions and in the staging of patients with pancreatic cancer through its use for tissue and fluid sampling. Additionally, in cases of precancerous lesions, EUS-guided therapy can also be provided. This review aims to describe the most recent developments regarding the role of EUS in the diagnosis and staging of pancreatic lesions. Moreover, complementary EUS imaging modalities, the role of artificial intelligence, new devices, and modalities for tissue acquisition, and techniques for EUS-guided treatment are discussed.
    Language English
    Publishing date 2023-04-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15092547
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  4. Article ; Online: Response.

    Papaefthymiou, Apostolis / Ramai, Daryl / Gkolfakis, Paraskevas

    Gastrointestinal endoscopy

    2023  Volume 98, Issue 5, Page(s) 875–876

    Language English
    Publishing date 2023-06-20
    Publishing country United States
    Document type Letter
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2023.06.006
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  5. Article ; Online: Predictive models in EUS/ERCP.

    Lattanzi, Barbara / Ramai, Daryl / Gkolfakis, Paraskevas / Facciorusso, Antonio

    Best practice & research. Clinical gastroenterology

    2023  Volume 67, Page(s) 101856

    Abstract: Predictive models (PMs) in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) have the potential to improve patient outcomes, enhance diagnostic accuracy, and guide therapeutic interventions. This review aims to ... ...

    Abstract Predictive models (PMs) in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) have the potential to improve patient outcomes, enhance diagnostic accuracy, and guide therapeutic interventions. This review aims to summarize the current state of predictive models in ERCP and EUS and their clinical implications. To be considered useful in clinical practice a PM should be accurate, easy to perform, and may consider objective variables. PMs in ERCP estimate correct indication, probability of success, and the risk of developing adverse events. These models incorporate patient-related factors and technical aspects of the procedure. In the field of EUS, these models utilize clinical and imaging data to predict the likelihood of malignancy, presence of specific lesions, or risk of complications related to therapeutic interventions. Further research, validation, and refinement are necessary to maximize the utility and impact of these models in routine clinical practice.
    MeSH term(s) Humans ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Endosonography/adverse effects ; Endosonography/methods
    Language English
    Publishing date 2023-08-02
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2048181-0
    ISSN 1532-1916 ; 1521-6918
    ISSN (online) 1532-1916
    ISSN 1521-6918
    DOI 10.1016/j.bpg.2023.101856
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  6. Article ; Online: Jejunal access for enteral nutrition: A practical guide for percutaneous endoscopic gastrostomy with jejunal extension and direct percutaneous endoscopic jejunostomy.

    Bourgeois, Amélie / Gkolfakis, Paraskevas / Fry, Lucia / Arvanitakis, Marianna

    Best practice & research. Clinical gastroenterology

    2023  Volume 64-65, Page(s) 101849

    Abstract: For patients requiring long-term (>4 weeks) jejunal nutrition, jejunal medication delivery, or decompression, a percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) or a direct percutaneous endoscopic jejunostomy (DPEJ) may be indicated. ... ...

    Abstract For patients requiring long-term (>4 weeks) jejunal nutrition, jejunal medication delivery, or decompression, a percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) or a direct percutaneous endoscopic jejunostomy (DPEJ) may be indicated. PEG-J is the preferred option if a PEG tube is already in place or if simultaneous gastric decompression and jejunal nutrition are needed. DPEJ is recommended for patients with altered anatomy due to foregut surgery, high risk of jejunal extension migration, and whenever PEG-J fails. Successful placement rates are lower for DPEJ but recent publications have reported improvements, partly due to the use of balloon-assisted enteroscopy. Both techniques are contraindicated in cases of active peritonitis, uncorrectable coagulopathy, and ongoing bowel ischaemia, and relative contraindications include, among other, peptic ulcer disease and haemodynamic or respiratory instability. In this narrative review, we present the most recent evidence on indications, contraindications, technical considerations, adverse events, and outcomes of PEG-J and DPEJ.
    MeSH term(s) Humans ; Enteral Nutrition/methods ; Jejunostomy/adverse effects ; Jejunostomy/methods ; Gastrostomy/adverse effects ; Gastrostomy/methods
    Language English
    Publishing date 2023-07-17
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2048181-0
    ISSN 1532-1916 ; 1521-6918
    ISSN (online) 1532-1916
    ISSN 1521-6918
    DOI 10.1016/j.bpg.2023.101849
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  7. Article ; Online: Percutaneous endoscopic gastrostomy and direct percutaneous endoscopic jejunostomy: 2 sides of the same coin.

    Gkolfakis, Paraskevas / Arvanitakis, Marianna

    Gastrointestinal endoscopy

    2021  Volume 94, Issue 1, Page(s) 57–59

    MeSH term(s) Enteral Nutrition ; Gastrostomy ; Humans ; Jejunostomy
    Language English
    Publishing date 2021-06-21
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2021.02.007
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  8. Article ; Online: Zenker Diverticulum Treatment: The New Gold Standard Still to be Defined.

    Gkolfakis, Paraskevas / Costamagna, Guido / Devière, Jacques

    Journal of clinical gastroenterology

    2022  Volume 56, Issue 6, Page(s) 552

    MeSH term(s) Diverticulum ; Esophagoscopy ; Humans ; Retrospective Studies ; Zenker Diverticulum/surgery
    Language English
    Publishing date 2022-04-11
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 448460-5
    ISSN 1539-2031 ; 0192-0790
    ISSN (online) 1539-2031
    ISSN 0192-0790
    DOI 10.1097/MCG.0000000000001703
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    Zs.A 1523: Show issues Location:
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  9. Article ; Online: Nutrition in acute pancreatitis: when, what and how.

    Fostier, Romane / Arvanitakis, Marianna / Gkolfakis, Paraskevas

    Current opinion in clinical nutrition and metabolic care

    2022  Volume 25, Issue 5, Page(s) 325–328

    Abstract: Purpose of review: This review intends to discuss recently available evidence in three topics related to nutrition in patients with acute pancreatitis, namely timing of refeeding, type of nutritional therapy and its route of administration.: Recent ... ...

    Abstract Purpose of review: This review intends to discuss recently available evidence in three topics related to nutrition in patients with acute pancreatitis, namely timing of refeeding, type of nutritional therapy and its route of administration.
    Recent findings: Recent lines of research confirm that early oral feeding leads to shorter length of stay, fewer complications and lower costs in patients with acute pancreatitis. Moreover, early (<48 h) enteral nutrition led to decreased hospital mortality in patients with mild and severe acute pancreatitis; thus, in case of intolerance to oral feeding or severe disease, nutritional therapy should be offered within 24-72 h. Furthermore, enteral nutrition should be preferred against parenteral nutrition, as it is related to shorter length of stay and less complications, while initial data bring to light the potential role of the soluble dietary fibre polydextrose as an agent that could lead to faster achievement of energy goal with concomitant lower rates of feeding intolerance. Finally, enteral nutrition can be administered through gastric or jejunal feeding, depending on digestive tolerance, whereas latest data also address the safety of percutaneous gastrostomy with a jejunal extension for enteral nutrition administration. However, more data about its real benefit are warranted.
    Summary: Accumulating evidence confirms the importance of early oral refeeding or early administration of enteral nutrition as vital parts of the armamentarium for the management of patients with acute pancreatitis.
    MeSH term(s) Acute Disease ; Enteral Nutrition/adverse effects ; Humans ; Infant, Newborn ; Pancreatitis/complications ; Pancreatitis/therapy ; Parenteral Nutrition ; Parenteral Nutrition, Total
    Language English
    Publishing date 2022-07-05
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1460178-3
    ISSN 1473-6519 ; 1363-1950
    ISSN (online) 1473-6519
    ISSN 1363-1950
    DOI 10.1097/MCO.0000000000000851
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  10. Article: Precut fistulotomy for choledocholithiasis: what about long-term efficacy?

    Gkolfakis, Paraskevas / Arvanitakis, Marianna

    Endoscopy international open

    2020  Volume 8, Issue 2, Page(s) E231–E233

    Language English
    Publishing date 2020-01-31
    Publishing country Germany
    Document type Editorial ; Comment
    ZDB-ID 2761052-4
    ISSN 2196-9736 ; 2364-3722
    ISSN (online) 2196-9736
    ISSN 2364-3722
    DOI 10.1055/a-0959-6105
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