Oscar Cahyadi

691 posts

Oscar Cahyadi

Oscar Cahyadi

@Endo_OC

Gastroenterologist, aspirant interventional endoscopist, esp. towards 3rd space endoscopy and complex EUS interventions. Views are of my own.

Katılım Nisan 2022
482 Takip Edilen432 Takipçiler
Salih Tokmak
Salih Tokmak@DrSalihTokmak·
🚨🚨 We did it!!! 🚨🚨 🥳🥳💫💫🏆🏆 Our study about the PA-EMR, a novel technique in patients with difficult biliary cannulation is published in the famous @endoscopyjrnl @DouglasAdlerMD @MendozaLadd @AntonioFaccior6 @HilarHolzy @japariciot2 @stevenbollipo @tberzin @MetabolicEndo @Endo_OC @drkeithsiau @DrHasan_Orlando @DrLakhtakia @SahajRathi @DarylRamai @docdhir @GWebster_endo @flaubert_sena @Srisha_Hebbar @helpatologist @NEndoscopy @Samanta_JayPGI @JoanB_Gornals @LumirKunovsky @KMonkemuller @EUSandEndoscopy @SultanMahmoodMD @NeilBhogalMD @ChahalPrabhleen
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Partha Pal
Partha Pal@ibd_pal·
Endoscopic stricturotomy video chosen as honorable mention and for publication in @ASGE GI leap competing in Endoscopy Video World Cup @DDW showcasing minimally invasive Mx of Crohn’s disease complications #interventionalIBD
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Nadeem Tehami
Nadeem Tehami@helpatologist·
Well-attended Wessex HPB Network meeting 🙏to all the colleagues who joined! 👌 talks by Joe Coad on biodegradable stents, @JamesMFranklin on advances in EUS tissue acquisition, & @Marktheliverdoc on benefits & challenges of network collaboration gave us plenty to reflect on!
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Sajjad Mahmood
Sajjad Mahmood@smkahlon·
#SPHINX trial PEP 17% & 21 % in this cohort! This is worryingly high! Any thoughts? @NEndoscopy @helpatologist @rpsturgess @manuknayar @pawanlekharaju @drkeithsiau @bekkali_N We have seen fantastic data and very low PEP rates (below 2%) from @DrHasan_Orlando & @Srisha_Hebbar
Gut Journal@Gut_BMJ

Read the #GUTOnline paper by Onnekink et al on "Endoscopic sphincterotomy to prevent post-ERCP pancreatitis after self-expandable metal stent placement for distal malignant biliary obstruction (SPHINX): a multicentre, randomised controlled trial" via bit.ly/3BKouJa #Pancreatitis #ERCP

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Oscar Cahyadi
Oscar Cahyadi@Endo_OC·
@DrSalihTokmak @SahajRathi Wow that is very McGiver, like the idea. But can you recognize the duct lumen if you are outside the bile duct? Interesting proposal.
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Salih Tokmak
Salih Tokmak@DrSalihTokmak·
@Endo_OC @SahajRathi 1-You can just let it be and forsake the right posterior segments (6 and 7) 2-Use the GW backwards, get the GW in to peritoneum, CRE balloon at the level of clips to dislocate them and than use Spy to get in to peritoneum and try to negotiate with posterior intrahepatic duct.
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Sahaj Rathi MD, DM, MRCP
Sahaj Rathi MD, DM, MRCP@SahajRathi·
Thank you everyone for the inputs🙏 EUS/Perc biliary access would likely work, but for thin periph ducts, we chose #CholangioPeritoenoscopy FCSEMS across collection- Leak stopped. Plus gives a wide scaffold for bridging duct b/w CHD and CBD to form Pt well😮‍💨 #ERCP #GITwitter
Sahaj Rathi MD, DM, MRCP tweet mediaSahaj Rathi MD, DM, MRCP tweet media
Sahaj Rathi MD, DM, MRCP@SahajRathi

🙍‍♀️30s Lap CCx➡️CBD injury➡️Open repair 2 wks on, drain output ~400ml/d Pt toxic #ERCP 👉Wire keeps going into collection, cannot negotiate into intrahepatic ducts 👉Contrast - same ??CBD ligated #EUS RZV🙅‍♂️: Periph ducts decompressed+pneumobilia Options #GITwitter #Surgery?

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Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD
Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD@Taalamri·
🔴Wow this talk is awesome; Ampullary adenoma approach by @DrHasan_Orlando ; the legend; Thank you for sharing us your valuable experience especially your technique with ampullectomy especially your tips to (be patient; may need 3-4 cautery cycle) and role of 50-50... @AlmuhaidbAymen #Training @helpatologist @NEndoscopy @Endoscopist4 @ChahalPrabhleen @neilRsharmaMD @MendozaLadd @HilarHolzy @JovaniManol @DrSalihTokmak @MouenKhashab @shailsingh @BilalMohammadMD @sachdevmd @GIscope_updates @drkeithsiau @Taalamri @tberzin @TomTielleman @ahmad_madkour @WasseemSkefMD @drkeithsiau @Taalamri @tberzin @TomTielleman @ahmad_madkour @WasseemSkefMD @DeMadaria @DrMohdZein @DeMadaria @Endo_OC @Endoscopist4 @Ferreira_gastro @Ferreira_gastro @bris_endoscopy @doctorboletoh @shailsingh @shanilkadir @neilRsharmaMD @drdalbir @drkeithsiau @RodriguezParra_ @Endo_OC @yeni_mtl @NCosgroveMD @AGA_TIGE
Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet media
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Oscar Cahyadi
Oscar Cahyadi@Endo_OC·
@GVanell5 Even though it is still very difficult to predict this. Normally it is the large 10-15 cm necrosis. Do you do multi gate drainage for large wons?
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Giuseppe Vanella
Giuseppe Vanella@GVanell5·
@Endo_OC That's my way to go ! On one side, there is no need for necrosectomy if a patient is improving by drainage alone. On the other side, we can ameliorate predicting from the beginning who will need that step-up !
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Giuseppe Vanella
Giuseppe Vanella@GVanell5·
Wonderful case-based talk ! - Drain #WOPN only if needed (& optimal medical goal-directed management to reduce need for drainage) - Assess the necrotic contetnt with #EUS - Stratify with #QNI to optimize stent choice and step-up
Sara Nikolić@SN_gastro

@DeMadaria has an acute pancreatitis because @lelecapurso makes a 😈 carbonara 🍝😋: 💊 Opioids for the pain @CSKnoph right? 💧moderate fluid 1.5 ml per hour 🦠 Antibiotics NO if PCT is normal 🍲 Food early 🔭 Don't drain necrosis early, only if infected,@GVanell5?

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Mohamed Othman
Mohamed Othman@EndoscopyOthman·
EUS examination of the liver should be incorporated in every EUS performed for FNB of pancreatic mass. Every once and while you might find a liver lesion like this one in the picture below and you can do FNB of liver lesion for appropriate staging of pancreatic mass by ruling out liver mets. Remeber CT scan occasionally overlook these lesions. (weekend oncall teaching @bcm_gihep and @StLukesHealthTX )
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Srisha Hebbar
Srisha Hebbar@Srisha_Hebbar·
Remote mentoring "Needle knife fistulotomy". Telementoring is useful to upskill experienced individuals. Our article on Telementoring worldgastroenterology.org/publications/e… #GITwitter @helpatologist @DrLakhtakia @docdhir @drkeithsiau @ChahalPrabhleen @NEndoscopy @MouenKhashab @WorldGastroOrg
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Sheffield Gastro@shefgastro

Is the future here? Can we use #remote #mentoring in #endoscopy ? Time to get the trail blazer @Srisha_Hebbar 's thoughts! @JAG_Endoscopy @BritSocGastro @BSGTrainees

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Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD
Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD@Taalamri·
🔴Large pancreatic stone distally; beautifully done by 🌟 @ibrahim_zh10 ; decent pancreatic sphincterotomy yield Large two Stones ...Nice work ... @IbrahimAlhafid @mismail_md @RaedAlsulaiman @alhaddad_mo @HilarHolzy @DharJahnvi @helpatologist @SyedGerdezi @AlmuhaidbAymen @Almotasembilla1 @neilRsharmaMD @ZahraAlMuslim2 @duhailebm @TAlameel #Training @helpatologist @NEndoscopy @Endoscopist4 @ChahalPrabhleen @neilRsharmaMD @MendozaLadd @HilarHolzy @JovaniManol @DrSalihTokmak @MouenKhashab @shailsingh @BilalMohammadMD @sachdevmd @GIscope_updates @drkeithsiau @Taalamri @tberzin @TomTielleman @ahmad_madkour @WasseemSkefMD @DeMadaria @DrMohdZein @DeMadaria @Endo_OC @Endoscopist4 @Ferreira_gastro @Ferreira_gastro @bris_endoscopy
Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet media
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Oscar Cahyadi
Oscar Cahyadi@Endo_OC·
@DrSalihTokmak How did you flush the blood from the core, do you have any filter or wash it first with water? This is inline with my experience with 19G Franseen also. Our problem is that fragmentation occurs during transfer of the tube to the pathology, which is not in House😮‍💨
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Salih Tokmak
Salih Tokmak@DrSalihTokmak·
🔥 Beautiful EUS-LB samples 🔥 Notice anything different ⁉️
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Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD
Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD@Taalamri·
🔴This is Nice Teaching case for the GI fellows; always be humble and ready .... ➡️You have this large Pedunculated polyp sitting in peace good position ; in such case you need to risk stratify the risk of bleeding; like large thick stalk and you have an angry head polyp ... 1️⃣Placed clip 16mm in the stalk able to accommodate and injected further the base below the clip 2️⃣Snared out with hot snare; ⚠️Here is the teaching point ; you have this spurting vessel🩸 👇 ; the simplest way is to use the gravity in your side by positioning the patient in a way that the blood will pool away from you then select your First clip carefully ... #GIfellows #Advancedtherapeutic #Basics #ScreeningColonoscopy @alhaddad_mo @HilarHolzy @DharJahnvi @helpatologist @SyedGerdezi @AlmuhaidbAymen @Almotasembilla1 @neilRsharmaMD @ZahraAlMuslim2 @duhailebm @TAlameel #Training @helpatologist @NEndoscopy @Endoscopist4 @ChahalPrabhleen @neilRsharmaMD @MendozaLadd @HilarHolzy @JovaniManol @DrSalihTokmak @MouenKhashab @shailsingh @BilalMohammadMD @sachdevmd @GIscope_updates @drkeithsiau @Taalamri @tberzin @TomTielleman @ahmad_madkour @WasseemSkefMD @DeMadaria @DrMohdZein @DeMadaria @Endo_OC @Endoscopist4 @Ferreira_gastro @Ferreira_gastro @bris_endoscopy @japariciot2 @MarijoRojasMD @AdvaniRashmiMD @DrViswanathRed1 @TheBileDoc @TudiSabban @TrieuMD @travispiester @yeni_mtl
Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet mediaTurki AlAmri |تُرْكي عبدالله الْعَمريَّ MD tweet media
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Oscar Cahyadi
Oscar Cahyadi@Endo_OC·
@KMonkemuller I prefer swabian made Hemopill from Ovesco. Also tried and tested ;) 26x7 mm. But also cost 150 Euro each. Esp. useful in high comorbid patients with acute anemia or patients, whom you not want to scope, e.g. active corona. ovesco.com/de/hemopill/
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Keşfet

@DrSalihTokmak @endoscopyjrnl @DouglasAdlerMD @MendozaLadd @AntonioFaccior6 @HilarHolzy @japariciot2 @stevenbollipo