A5032600330- Pancreatic and Hepatic Oncology Research
- Gallbladder and Bile Duct Disorders
- Pediatric Hepatobiliary Diseases and Treatments
- Pancreatitis Pathology and Treatment
- Gastrointestinal disorders and treatments
- Gastrointestinal Bleeding Diagnosis and Treatment
- Liver Disease Diagnosis and Treatment
- Liver Disease and Transplantation
- Gastric Cancer Management and Outcomes
- Helicobacter pylori-related gastroenterology studies
- Gastrointestinal Tumor Research and Treatment
- Gastroesophageal reflux and treatments
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Biliary and Gastrointestinal Fistulas
- Colorectal Cancer Screening and Detection
- Esophageal and GI Pathology
- Colorectal Cancer Surgical Treatments
- Gastrointestinal motility and disorders
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Esophageal Cancer Research and Treatment
- Hepatitis C virus research
- Hepatitis B Virus Studies
- Diagnosis and treatment of tuberculosis
- Hemostasis and retained surgical items
- Optimism, Hope, and Well-being
Changi General Hospital
2016-2025
SingHealth Duke-NUS Academic Medical Centre
2021-2024
SingHealth
2021-2022
National University of Singapore
2019-2022
Duke-NUS Medical School
2022
Nanyang Technological University
2022
Creative Research Enterprises (United States)
2016
University Gastroenterology
2013
Singapore General Hospital
2004
Objective Narrow band imaging (NBI) is generally considered to be useful for lesion characterization, but not enhanced detection of gastric lesions, because the dark endoscopic view. We tested whether new generation NBI (190-NBI or 290-NBI), which twice as bright previous version, would improve premalignant lesions compared with high-definition white light endoscopy (HD-WLE). Patients and methods This was a multicenter prospective randomized study involving five tertiary institutions in...
Endoscopic ultrasound-guided drainage of walled-off pancreatic fluid collections (PFCs) (pseudocyst [PC]; necrosis [WON]) utilizes double pigtail plastic stents (PS) and the newer large diameter fully covered self-expandable (FCSEMS) customized for PFC drainage. This study examined impact type stent on clinical outcomes costs.Retrospective two-center study. Outcome variables were technical success, need repeat procedures, direct endoscopic necrosectomy (DEN), procedure-related costs.A total...
Proton pump inhibitors (PPIs) are widely prescribed, often without clear indications. There conflicting data on its association with mortality risk and hepatic decompensation in cirrhotic patients. Furthermore, PPI users exposure some studies have been poorly defined many confounding factors.To examine if use increases the impact of cumulative dose exposure.Data from patients decompensated liver cirrhosis were extracted a hospital database between 2013 to 2017. as daily (cDDD) ≥ 28 within...
Abstract Background The use of macroscopic on-site evaluation (MOSE) to estimate the adequacy a specimen for histological diagnosis during endoscopic ultrasound (EUS)-guided fine-needle tissue acquisition (FNTA) has recently been advocated. This study aimed evaluate diagnostic yield MOSE compared with conventional EUS-FNTA without rapid (ROSE). Methods was an international, multicenter, prospective, randomized controlled study. After providing informed consent, consecutive adult patients...
Background: The effectiveness of the hemostatic powder TC-325 as a single endoscopic treatment for acute nonvariceal upper gastrointestinal bleeding is uncertain. Objective: To compare with standard treatments in control active from causes. Design: One-sided, noninferiority, randomized, controlled trial. (ClinicalTrials.gov: NCT02534571) Setting: University teaching hospitals Asia-Pacific region. Patients: 224 adult patients cause on endoscopy. Intervention: (n = 111) or 113). Measurements:...
Telemedicine can improve care delivery through reducing clinic wait-time, improving accessibility to specialist care, minimising cross-infection risk at patient’s convenience. Despite these benefits, telemedicine uptake remained low within our gastroenterology department, with only four teleconsultations conducted in 6 months prior this project’s conceptualisation. This quality improvement (QI) project aimed utilisation department by 20% over a 3-month period. Surveys during the planning...
Abstract Background and Aim Clarithromycin‐based triple therapy ( TT ) is the first‐line treatment for H elicobacter pylori infection in S ingapore. There awareness that may no longer be effective due to increased clarithromycin resistance rates. Sequential ST concomitant CT are alternative regimens. This study aimed compare efficacy of 10‐day , as . infection. Methods A randomized conducted a teaching hospital. Patients aged 21 years older with newly diagnosed were or Treatment outcome was...
OBJECTIVE Preliminary studies on a new topical hemostatic agent, TC‐325, have shown its safety and effectiveness in treating active upper gastrointestinal (GI) bleeding. However, to date there been no randomized trials comparing TC‐325 with the conventional combined technique (CCT). Our pilot study aimed compare efficacy of those CCT peptic ulcers bleeding or high‐risk stigmata. METHODS This was comparative patients GI who had Forrest class I, IIA IIB ulcers. RESULTS Altogether 20 mean age...
Abstract Background Antibiotic resistance is an important cause of H. pylori treatment failure. This study aimed to examine the change in antibiotic profile Singapore over course 15 years. Materials and methods The period was from 2000 2014. Gastric mucosal biopsies obtained ‐positive patients were cultured. susceptibility metronidazole, clarithromycin, levofloxacin, tetracycline, amoxicillin tested. rates time analyzed. Results A total 708 isolates There a significant increase for...
EUS-guided fine-needle biopsy (EUS-FNB) with acquisition of tissue core is possible the use 19G aspiration (FNA) and dedicated needles. Published data direct comparisons between needles are more limited compared to abundant comparing EUS-FNA EUS-FNB. We performed a retrospective study determine difference in histologic yield FNA needle EUS-FNB patients solid masses.Consecutive who underwent masses from January 2014 July 2018 were identified database. The was analyzed.A total 159 179...
Real-world data on sofosbuvir/velpatasvir with and without ribavirin (SOF/VEL ± RBV), particularly among patients genotype 3 (GT3) decompensated cirrhosis, prior treatment, coinfection, hepatocellular carcinoma (HCC), are scarce. We aimed to assess the efficacy safety of SOF/VEL RBV in a real-world setting that included both community incarcerated GT3 hepatitis C virus (HCV) patients.We all HCV treated our institution. The primary outcome measure was overall sustained virological response 12...
Background and study aims Published data on blue laser imaging (BLI) for detection differentiation of colonic polyps are limited compared to narrow band (NBI). This investigated whether BLI can increase the rate adenomas when white light (WLI), examined use NICE (NBI International Colorectal Endoscopic) JNET (Japan NBI Expert Team) classifications with BLI. Patients methods aged 50 years above referred colonoscopy were randomized or WLI withdrawal. Detected characterized using under mode...
OBJECTIVE: The use of early precut during endoscopic retrograde cholangiopancreatography (ERCP) is controversial because its association with a higher risk complications. This study examined the efficacy and safety strategy for biliary access difficult ERCP in general hospital. METHODS: Data from January 2007 to June 2009 were reviewed. Criteria performing were: (i) inadvertent guidewire cannulation pancreatic duct on three occasions; (ii) stone impacted at papilla; (iii) inability achieve...
AIMTo evaluate the efficacy of 5 mL simethicone solution in decreasing gastric foam if given at least 30 min before gastroscopy. METHODSThis was a randomized, placebo controlled, endoscopist blinded study performed Changi General Hospital.Patients were 21 years old, had no prior sur gical resection upper gastrointestinal tract, and scheduled for elective diagnostic gastroscopies.The primary outcome total mucosal visibility score (TMVS) which evaluated using McNally score.The sample size...
Intra-abdominal lymphadenopathy poses a diagnostic and management challenge in highly endemic regions for tuberculosis. Opting empirical anti-tuberculosis treatment raises the risk of wrong or delayed treatment. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is procedure choice tissue acquisition from peri-luminal lymph nodes. We studied utility EUS-FNA evaluating intra-abdominal nodes unknown etiology, setting high endemicity tuberculosis.Consecutive patients with etiology...
Endoscopic transenteric stenting is the standard treatment for pseudocysts, but it may be inadequate treating infected collections with solid debris. Surgical necrosectomy results in significant morbidity. Direct endoscopic (DEN), a minimally invasive treatment, viable option. This study examined efficacy and safety of DEN walled-off pancreatic necrosis pseudocysts debris.This was retrospective analysis data collected from prospective database patients who underwent presence or debris April...
Proximal (upstream) migration of pancreatic duct stents is a recognized complication that occurs in up to 5.2 % patients [1], and stent retrieval important prevent long-term serious ductal damage. Reported techniques remove proximally migrated include balloon extraction, direct snare or forceps grasp, wire cannulation with capture. We report novel technique using the SpyGlass Direct Visualization System (Boston Scientific, Natick, Massachusetts, USA).
Background and study aims: eUs-guided rendezvous technique for biliary access requires expert manipulation of the guidewire across downstream stricture or papilla.published literature reports usage long-wire system to prevent loss wire during scope exchange.We studied efficacy using a short hydrophilic in eUsguided rendezvous.Patients methods: This is retrospective conducted tertiary care referral centre.15 patients underwent with wire.eUs-guided transduodenal / transgastric puncture was...
<b>Background and study aims:</b> Two 22G needles with similar designs, apart from the absence (A) or presence of a side port (B), are available for endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). The was designed to increase diagnostic yield but this advantage unproven. This evaluated difference in between both pancreatic masses. <b>Patients methods:</b> prospective multicenter randomized cross-over study. Patients masses were one needle first two passes, followed by other...