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  1. Article ; Online: Urgent upper gastrointestinal endoscopy referrals cancelled due to the COVID-19 pandemic.

    Phull, Perminder S

    Clinical medicine (London, England)

    2020  Volume 20, Issue 6, Page(s) e278

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Endoscopy, Gastrointestinal ; Humans ; Pandemics ; Pneumonia, Viral ; Referral and Consultation ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-11-13
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.7861/clinmed.Let.20.6.1
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    Zs.A 5439: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Treatment of

    Dutta, Amit Kumar / Phull, Perminder Singh

    World journal of gastroenterology

    2021  Volume 27, Issue 44, Page(s) 7661–7668

    Abstract: ... Therapy ... ...

    Abstract Therapy of
    MeSH term(s) Amoxicillin/adverse effects ; Anti-Bacterial Agents/adverse effects ; Bismuth/therapeutic use ; Drug Hypersensitivity ; Drug Therapy, Combination ; Helicobacter Infections/diagnosis ; Helicobacter Infections/drug therapy ; Helicobacter pylori ; Humans ; Metronidazole/therapeutic use ; Penicillins/adverse effects ; Proton Pump Inhibitors/therapeutic use ; Retrospective Studies ; Treatment Outcome
    Chemical Substances Anti-Bacterial Agents ; Penicillins ; Proton Pump Inhibitors ; Metronidazole (140QMO216E) ; Amoxicillin (804826J2HU) ; Bismuth (U015TT5I8H)
    Language English
    Publishing date 2021-06-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v27.i44.7661
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    Zs.A 6039: Show issues Location:
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  4. Article ; Online: Clinically significant findings in patients with focal incidental colorectal abnormalities on positron emission tomography-CT scans.

    Dutta, Amit K / Mitchell-Hay, Rosalind / Baio, Gabriella / Phull, Perminder S

    Journal of medical imaging and radiation oncology

    2021  Volume 66, Issue 6, Page(s) 749–754

    Abstract: Introduction: The aim of this study was to determine the clinical significance of focal incidentally detected colorectal abnormalities on : Methods: Retrospective audit of PET-CT scans performed at our institution between 2009 and 2014. Demographic ... ...

    Abstract Introduction: The aim of this study was to determine the clinical significance of focal incidentally detected colorectal abnormalities on
    Methods: Retrospective audit of PET-CT scans performed at our institution between 2009 and 2014. Demographic and clinical details were retrieved from electronic patient records. An advanced adenoma was defined as: ≥1 cm in size, tubullo-villous histology, or displaying high grade dysplasia. A high-risk lesion (HRL) was defined as an advanced adenoma or colorectal cancer (CRC).
    Results: Of the 1911 PET-CT eligible scans, focal incidental colorectal FDG uptake was detected in 99 (5.2%) patients. Colonoscopy was undertaken in 43 (43.4%) patients and 45 FDG-avid sites were evaluated. The commonest site of abnormal FDG uptake was the rectosigmoid region, with 34 (75.6%) of the 45 foci being located in this area. Overall, 23 (53.5%) of these patients had clinically significant pathology. Of the 45 focal PET-CT abnormalities evaluated, 17 (37.8%) were adenomas, of which 11 (24.4%) were advanced adenomas, and six (13.3%) were cancers, with a total of 17 (37.8%) HRLs. Five of the six patients with CRC underwent surgical resection, whilst one had endoscopic resection. The overall survival for the entire cohort was 18 months (range 1-72 months) with those that underwent colonoscopy having higher overall survival compared to those that did not (38 vs. 13.5 months).
    Conclusion: Incidental colorectal abnormalities on PET-CT scans are often clinically significant. However, careful selection for colonoscopy is important due to the poor survival in these patients related to the underlying primary malignancy.
    MeSH term(s) Adenoma/surgery ; Colorectal Neoplasms/diagnostic imaging ; Colorectal Neoplasms/pathology ; Fluorodeoxyglucose F18 ; Humans ; Incidental Findings ; Positron Emission Tomography Computed Tomography ; Positron-Emission Tomography ; Radiopharmaceuticals ; Retrospective Studies
    Chemical Substances Radiopharmaceuticals ; Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2021-10-05
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2389687-5
    ISSN 1754-9485 ; 1440-1673 ; 1754-9477 ; 0004-8461
    ISSN (online) 1754-9485 ; 1440-1673
    ISSN 1754-9477 ; 0004-8461
    DOI 10.1111/1754-9485.13338
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    Zs.B 66: Show issues Location:
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  5. Article ; Online: National adoption of an esophageal cell collection device for Barrett's esophagus surveillance: impact on delay to investigation and pathological findings.

    Chien, Siobhan / Glen, Paul / Penman, Ian / Bryce, Gavin / Cruickshank, Neil / Miller, Michael / Crumley, Andrew / Fletcher, Jonathan / Phull, Perminder / Gunjaca, Ivan / Robertson, Kevin / Apollos, Jeyakumar / Fullarton, Grant

    Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

    2024  Volume 37, Issue 5

    Abstract: High quality Barrett's esophagus surveillance is crucial to detect early neoplastic changes. An esophageal cell collection device (OCCD) was introduced as a triage tool for Barrett's surveillance. This study aims to evaluate whether the Scottish OCCD ... ...

    Abstract High quality Barrett's esophagus surveillance is crucial to detect early neoplastic changes. An esophageal cell collection device (OCCD) was introduced as a triage tool for Barrett's surveillance. This study aims to evaluate whether the Scottish OCCD program (CytoSCOT) has reduced delays to Barrett's surveillance, and whether delayed surveillance negatively impacts endoscopic pathology. All patients undergoing OCCD testing for Barrett's surveillance across 11 Scottish health boards between 14/9/2020 and 13/9/2022 were identified. Patients were dichotomised into two groups (Year 1 vs. Year 2), with individual records interrogated to record demographics, recommended surveillance interval, time from last endoscopy to OCCD test, and OCCD result. Patients were deemed high-risk if the OCCD demonstrated atypia and/or p53 positivity. Further analysis was performed on patients who underwent endoscopy within 12 months of OCCD testing. A total of 3223 OCCD tests were included in the analysis (1478 in Year 1; 1745 in Year 2). In Year 1 versus Year 2, there was a longer median delay to surveillance (9 vs. 5 months; P < 0.001), increased proportion of patients with delayed surveillance (72.6% vs. 57.0%; P < 0.001), and more high-risk patients (12.0% vs. 5.3%; P < 0.001). 425/3223 patients (13.2%) were further investigated with upper gastrointestinal endoscopy, 57.9% of which were high-risk. As surveillance delay increased beyond 24 months, high-risk patients were significantly more likely to develop dysplasia or malignancy (P = 0.004). Delayed Barrett's esophagus surveillance beyond 24 months is associated with increased risk of pre-cancerous pathology. The CytoSCOT program has reduced delays in surveillance, promoting earlier detection of dysplasia and reducing burden on endoscopy services.
    MeSH term(s) Barrett Esophagus/pathology ; Humans ; Male ; Female ; Middle Aged ; Aged ; Esophageal Neoplasms/pathology ; Esophagoscopy/methods ; Esophagoscopy/statistics & numerical data ; Scotland/epidemiology ; Time Factors ; Early Detection of Cancer/methods ; Esophagus/pathology ; Delayed Diagnosis/statistics & numerical data ; Precancerous Conditions/pathology ; Adenocarcinoma/pathology
    Language English
    Publishing date 2024-01-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639470-x
    ISSN 1442-2050 ; 1120-8694
    ISSN (online) 1442-2050
    ISSN 1120-8694
    DOI 10.1093/dote/doae002
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    Zs.A 2378: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Oesophageal cell collection device and biomarker testing to identify high-risk Barrett's patients requiring endoscopic investigation.

    Chien, Siobhan / Glen, Paul / Penman, Ian / Cruickshank, Neil / Bryce, Gavin / Crumley, Andrew / Phull, Perminder / Miller, Michael / Fletcher, Jonathan / Gunjaca, Ivan / Apollos, Jeyakumar / Robertson, Kevin / Fullarton, Grant

    The British journal of surgery

    2024  Volume 111, Issue 5

    Abstract: Background: Barrett's oesophagus surveillance places significant burden on endoscopy services yet is vital to detect early cancerous change. Oesophageal cell collection device (OCCD) testing was introduced across Scotland for Barrett's surveillance in ... ...

    Abstract Background: Barrett's oesophagus surveillance places significant burden on endoscopy services yet is vital to detect early cancerous change. Oesophageal cell collection device (OCCD) testing was introduced across Scotland for Barrett's surveillance in response to the COVID-19 pandemic. This national pragmatic retrospective study presents the CytoSCOT programme results and evaluates whether OCCD testing is successfully identifying high-risk Barrett's patients requiring urgent endoscopy.
    Methods: All patients undergoing OCCD testing for Barrett's surveillance across 11 Scottish health boards over a 32-month period were identified. Patients who underwent endoscopy within 12 months of OCCD test were included. Individual patient records were interrogated to record clinical information and OCCD test result to categorize patients into risk groups. Endoscopic histopathology results were analysed according to risk group and segment length. Patients were deemed high risk if the OCCD test demonstrated atypia and/or p53 positivity.
    Results: 4204 OCCD tests were performed in 3745 patients: 608 patients underwent endoscopy within 12 months and were included in this analysis. Patients with longer Barrett's segments were significantly more likely to have an abnormal OCCD test. 50/608 patients (8.2%) had high-grade dysplasia or cancer on endoscopic biopsies: this equates to 1.3% of the total group (50/3745). 46/50 patients (92.0%) were deemed high risk, triggering urgent endoscopy: this rose to 100% with insufficient tests removed. There were no cancers diagnosed within 12 months post-OCCD in the low-risk group.
    Conclusion: OCCD testing is an effective triage tool to identify high-risk patients with Barrett's oesophagus requiring further investigation with endoscopy within the real-world setting.
    MeSH term(s) Humans ; Barrett Esophagus/pathology ; Barrett Esophagus/diagnosis ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Esophagoscopy/methods ; Esophageal Neoplasms/diagnosis ; Esophageal Neoplasms/pathology ; COVID-19/diagnosis ; Scotland/epidemiology ; Biomarkers/metabolism ; Risk Assessment ; Esophagus/pathology ; Early Detection of Cancer/methods ; Adult
    Chemical Substances Biomarkers
    Language English
    Publishing date 2024-05-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znae117
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    Uk I Zs.66: Show issues Location:
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  7. Article: Initial experience of direct-to-test endoscopic ultrasonography for suspected choledocholithiasis.

    Lochhead, Paul / Phull, Perminder

    Scottish medical journal

    2015  Volume 60, Issue 2, Page(s) 85–89

    Abstract: Background and aims: Endoscopic ultrasound has become an invaluable tool in the investigation of patients with suspected pancreatobiliary disease. We set out to determine whether a "direct-to-test" endoscopic ultrasound procedure could be offered to ... ...

    Abstract Background and aims: Endoscopic ultrasound has become an invaluable tool in the investigation of patients with suspected pancreatobiliary disease. We set out to determine whether a "direct-to-test" endoscopic ultrasound procedure could be offered to selected patients with suspected choledocholithiasis.
    Methods and results: We included patients referred to our general gastroenterology service with clinical history, symptomatology and/or laboratory results compatible with choledocholithiais. Almost all patients had already had a transabdominal ultrasound performed at the request of their general practitioner. All patients underwent direct-to-test day-case endoscopic ultrasound under conscious sedation. Procedures were performed by a single practitioner using an oblique-viewing radial echoendoscope. The diagnostic yield and frequencies of discharge, onward referral and follow-up were determined. Overall diagnostic yield of direct-to-test endoscopic ultrasound was 61%. The most common diagnoses were cholelithiasis (18%) and choledocholithiasis (11%); one periampullary cancer was also detected. A definitive outcome (discharge or referral for a therapeutic procedure) occurred in 14 of 28 patients (50%). The remaining 14 patients underwent further out-patient evaluation. Eventual diagnoses in this group included autoimmune hepatitis, primary biliary cirrhosis and drug-induced hepatitis.
    Conclusions: For patients with suspected biliary disease, direct-to-test endoscopic ultrasound has a high diagnostic yield, and may be an appropriate mode of investigation.
    MeSH term(s) Abdominal Pain/etiology ; Adult ; Aged ; Aged, 80 and over ; Choledocholithiasis/complications ; Choledocholithiasis/diagnostic imaging ; Endosonography ; Female ; Humans ; Male ; Middle Aged ; Patient Selection ; Referral and Consultation ; Retrospective Studies
    Language English
    Publishing date 2015-05
    Publishing country Scotland
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 414085-0
    ISSN 2045-6441 ; 0036-9330
    ISSN (online) 2045-6441
    ISSN 0036-9330
    DOI 10.1177/0036933015572276
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  8. Article: Variation in caecal intubation rates between screening and symptomatic patients.

    Nagrath, Nalin / Phull, Perminder S

    United European gastroenterology journal

    2014  Volume 2, Issue 4, Page(s) 295–300

    Abstract: Background: The caecal intubation rate (CIR) is an important quality standard for endoscopists, as well as for national bowel cancer screening programmes; however, individuals undergoing colonoscopy for bowel screening and symptomatic patients represent ...

    Abstract Background: The caecal intubation rate (CIR) is an important quality standard for endoscopists, as well as for national bowel cancer screening programmes; however, individuals undergoing colonoscopy for bowel screening and symptomatic patients represent different groups, and their characteristics may affect colonoscopy performance.
    Objective: To compare colonoscopists' performance, as assessed by the CIR, in symptomatic patients compared to individuals undergoing colonoscopy for bowel cancer screening.
    Methods: Retrospective audit of CIRs for all patients undergoing colonoscopy at our institution during the year 2008. We retrieved the data from an endoscopy reporting software database and from the local bowel cancer screening programme database. Demographic data was extracted, as well as details of known factors that may affect completion of colonoscopy, such as poor bowel preparation, presence of diverticular disease, polyps, tumour and strictures. The unadjusted CIRs for colonoscopists participating in the screening programme were compared between the bowel screening and the symptomatic patient groups.
    Results: Five screening colonoscopists performed 1056 colonoscopies, of which 488 were bowel screening procedures. The overall CIR was significantly lower in the symptomatic, compared to the screening, individuals (88.5% versus 93%, P < 0.02). No significant differences were observed between the two groups for risk factors that could impair the CIR. The CIR was <90% for two of the five colonoscopists in symptomatic patients, and just under 90% for one colonoscopist in screening individuals. Multivariate analysis revealed that non-screening colonoscopy was an independent predictor for an incomplete procedure (OR 1.8; 95% CI 1.2-2.8).
    Conclusions: The CIR, a key quality performance indicator for colonoscopy, is lower in symptomatic patients compared to individuals undergoing colorectal cancer screening. These results suggested that CIR should be monitored independently in screening and non-screening colonoscopies.
    Language English
    Publishing date 2014-04-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2728585-6
    ISSN 2050-6414 ; 2050-6406
    ISSN (online) 2050-6414
    ISSN 2050-6406
    DOI 10.1177/2050640614536898
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  9. Article ; Online: Extensive esophageal papillomatosis after chemoradiotherapy for squamous cell carcinoma.

    Siu, Wilson / Murray, Graeme I / McKinlay, Alastair / Phull, Perminder

    Gastrointestinal endoscopy

    2017  Volume 87, Issue 6, Page(s) 1581–1582

    MeSH term(s) Aged ; Carcinoma, Squamous Cell/therapy ; Chemoradiotherapy ; Deglutition Disorders/etiology ; Esophageal Neoplasms/complications ; Esophageal Neoplasms/diagnosis ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/therapy ; Esophageal Squamous Cell Carcinoma ; Esophageal Stenosis/complications ; Esophageal Stenosis/diagnostic imaging ; Female ; Humans ; Papilloma/complications ; Papilloma/diagnosis ; Papilloma/pathology
    Language English
    Publishing date 2017-12-06
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2017.12.001
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    Zs.B 283: Show issues Location:
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  10. Article: Increasing the low-risk threshold for patients with upper gastrointestinal bleeding during the COVID-19 pandemic: a prospective, multicentre feasibility study.

    Dunne, Philip / Livie, Victoria / McGowan, Aaron / Siu, Wilson / Chaudhary, Sardar / Groome, Maximillian / Phull, Perminder / Fraser, Andrew / Morris, Allan John / Penman, Ian D / Stanley, Adrian J

    Frontline gastroenterology

    2021  Volume 13, Issue 4, Page(s) 303–308

    Abstract: Objective: During the COVID-19 pandemic, we extended the low-risk threshold for patients not requiring inpatient endoscopy for upper gastrointestinal bleeding (UGIB) from Glasgow Blatchford Score (GBS) 0-1 to GBS 0-3. We studied the safety and efficacy ... ...

    Abstract Objective: During the COVID-19 pandemic, we extended the low-risk threshold for patients not requiring inpatient endoscopy for upper gastrointestinal bleeding (UGIB) from Glasgow Blatchford Score (GBS) 0-1 to GBS 0-3. We studied the safety and efficacy of this change.
    Methods: Between 1 April 2020 and 30 June 2020 we prospectively collected data on consecutive unselected patients with UGIB at five large Scottish hospitals. Primary outcomes were length of stay, 30-day mortality and rebleeding. We compared the results with prospective prepandemic descriptive data.
    Results: 397 patients were included, and 284 index endoscopies were performed. 26.4% of patients had endoscopic intervention at index endoscopy. 30-day all-cause mortality was 13.1% (53/397), and 33.3% (23/69) for pre-existing inpatients. Bleeding-related mortality was 5% (20/397). 30-day rebleeding rate was 6.3% (25/397). 84 patients had GBS 0-3, of whom 19 underwent inpatient endoscopy, 0 had rebleeding and 2 died. Compared with prepandemic data in three centres, there was a fall in mean number of UGIB presentations per week (19 vs 27.8; p=0.004), higher mean GBS (8.3 vs 6.5; p<0.001) with fewer GBS 0-3 presentations (21.5% vs 33.3%; p=0.003) and higher all-cause mortality (12.2% vs 6.8%; p=0.02). Predictors of mortality were cirrhosis, pre-existing inpatient status, age >70 and confirmed COVID-19. 14 patients were COVID-19 positive, 5 died but none from UGIB.
    Conclusion: During the pandemic when services were under severe pressure, extending the low-risk threshold for UGIB inpatient endoscopy to GBS 0-3 appears safe. The higher mortality of patients with UGIB during the pandemic is likely due to presentation of a fewer low-risk patients.
    Language English
    Publishing date 2021-08-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2521857-8
    ISSN 2041-4137
    ISSN 2041-4137
    DOI 10.1136/flgastro-2021-101851
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