Jacob Mark

University of Colorado Denver

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Taylor Montminy

Children's Hospital Colorado

Jaime Belkind‐Gerson

University of Colorado Denver

Alexandra Kilgore

University of Colorado Denver

Brianne Shuler

University of Colorado Anschutz Medical Campus

Robert Krämer

University of Colorado Denver

Maisam Abu‐El‐Haija

University of Cincinnati Medical Center

Gretchen A. Cress

University of Iowa Stead Family Children’s Hospital

Paul Tran

Phoenix Children's Hospital

Mark E. Lowe

Washington University in St. Louis

Aliye Uç

University of Iowa

Cooperative Institutions

University of Colorado Denver

Children's Hospital Colorado

University of Colorado Anschutz Medical Campus

The Medical Center of Aurora

Johns Hopkins University

Nationwide Children's Hospital

Baylor College of Medicine

Cincinnati Children's Hospital Medical Center

The Ohio State University

The University of Texas MD Anderson Cancer Center

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ENDOSCOPIC ULTRASOUND GUIDED ANAL BOTOX

Gastrointestinal Endoscopy (2023)

Brianne Shuler Jaime Belkind‐Gerson Taylor Montminy Paul Tran Alexandra Kilgore

Phoenix

10.1016/j.gie.2023.04.1721

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ENDOSCOPIC ULTRASOUND GUIDED ANAL BOTOX

Gastrointestinal Endoscopy (2023)

Brianne Shuler Jaime Belkind‐Gerson Taylor Montminy Paul Tran Alexandra Kilgore

Phoenix

Endoscopic Ultrasound

10.1016/j.gie.2023.04.1797

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Comparative Analysis of Adverse Events After Esophageal Balloon and Bougie Dilations in Children

Journal of Pediatric Gastroenterology and Nutrition (2018)

Jacob Mark Bradley T. Anderson Zhaoxing Pan Calies Menard‐Katcher Robert Krämer

Pneumatic balloon and bougie dilation are widely used methods for pediatric esophageal dilation. There are no studies directly comparing the safety of these techniques in pediatric patients. This study compared adverse events (AEs) of balloon and bougie dilation in children at a single institution.AEs were identified by means of a prospective clinical registry of all procedure related AEs from 2012 to 2015 at a single institution. Identified AEs underwent retrospective review of procedural and clinical details. The category of each AE was recorded and severity was assigned using a 5-point scoring system. AEs were compared between balloon and bougie dilation for different severities.There were 105 patients who underwent 246 dilation sessions. Balloon dilation was performed more commonly (n = 190, 77%) as compared to Maloney dilators (n = 56, 23%). Patients with balloon dilation were younger (3.0 vs 14.5 years, P = 0.0001) and more likely to have strictures from caustic ingestion (42% vs 2%, P < 0.0001) or surgical anastomoses (34% vs 5% P < 0.0001). Bougie dilation was used more commonly in patients with eosinophilic esophagitis (77% vs 7%, P < 0.0001)). In multivariate analysis, each year of increasing age was associated with a 12% increase in any AEs (P = 0.015), but no difference in clinically significant AEs (grade 2 or higher) was identified between dilation methods.Bougie and balloon dilation did not have significant differences in AE rates, but the patient populations differed between the 2 methods. The dilation method should depend on stricture characteristics and endoscopist expertise with each method.

Balloon dilation

Dilation (metric space)

Eosinophilic Esophagitis

10.1097/mpg.0000000000002237

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Outcomes of pediatric endoscopic ultrasound‐guided celiac plexus block: A single center pilot study

Journal of Pediatric Gastroenterology and Nutrition (2024)

Michael P. Joseph Edwin Liu Jacob Mark

Abstract Celiac plexus blocks (CPBs) using endoscopic ultrasound (EUS) guidance provide significant pain relief in adults with chronic pancreatitis. We present on EUS‐guided CPB for pediatric patients with abdominal pain from chronic pancreatitis or severe functional dyspepsia necessitating clinically assisted nutrition and hydration. Patients who underwent EUS‐CPB were included and followed prospectively at 2‐, 4‐, and 8‐weeks postprocedure about pain, enteral tolerance, and school/activity attendance. Thirteen patients underwent EUS‐guided CPB with a total of 21 procedures. In the pancreatitis cohort, mean pain relief was 11.7 weeks for those who responded. In the functional dyspepsia cohort, mean improvement (in either pain or enteral tolerance) was 4.8 weeks. Symptom improvement varied between the two cohorts. Acute recurrent/chronic pancreatitis patients demonstrated more sustained relief than the functional dyspepsia cohort. This study adds to the limited data investigating the utility of EUS‐CPB as part of a multimodal treatment plan in pediatrics.

Endoscopic Ultrasound

Celiac plexus

Enteral administration

Single Center

10.1002/jpn3.12348

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A National Survey of the Training and Practice Patterns of Practicing Pediatric Advanced Endoscopists in the United States

Journal of Pediatric Gastroenterology and Nutrition (2023)

Christopher Chu Paul Tran Christopher Moreau Jacob Mark Robert Krämer

Pediatric advanced endoscopy consists primarily of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) and is becoming more common in pediatrics. This study aims to characterize the current landscape of pediatric advanced endoscopy training and practice by directly surveying independently practicing pediatric advanced endoscopists (PAEs). We also aim to ascertain expert opinion on competency in pediatric ERCP and EUS.A 66-question REDCap survey and a 73-question Qualtrics survey were distributed to members of the ERCP Special Interest Group of North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Respondents currently performing ERCP or EUS independently in children were included. Statistical analysis was performed using Mann-Whitney U test.Of 41 PAEs surveyed, 38 (92.7%) responded and 27 independent practitioners were included. Thirteen respondents performed EUS. PAEs who completed an advanced endoscopy fellowship (AEF) were more comfortable performing American Society for Gastrointestinal Endoscopy grade 3 or grade 4 ERCPs ( P < 0.0008) and felt more prepared to practice EUS independently than other trainees. Expert opinion of PAEs felt a threshold of 200 procedures was needed to attain competency in either ERCP or EUS. Pediatric duodenoscope exposure improved comfort in performing ERCP in children <10 kg ( P = 0.009).Training of pediatric gastroenterologists in ERCP and EUS are highly variable, though the skills attained are similar. AEF-trained specialists reported greater training volumes and felt more prepared to practice independently than those who did not. Competency thresholds determined by expert PAEs for ERCP and EUS agree with American Society for Gastrointestinal Endoscopy guidelines for adult advanced endoscopy trainees.

Pediatric gastroenterology

10.1097/mpg.0000000000003864

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Citations (1)

ID: 3521190 CHARACTERIZATION OF THE CURRENT TRAINING AND PRACTICE ENVIRONMENT FOR PEDIATRIC ADVANCED ENDOSCOPISTS IN THE UNITED STATES

Gastrointestinal Endoscopy (2021)

Paul Tran Christopher Chu Christopher Moreau Jacob Mark Travis L. Piester

Endoscopic Ultrasound

10.1016/j.gie.2021.03.774

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ENDOSCOPIC ULTRASOUND GUIDED ANAL BOTOX