Flaubert Sena de Medeiros

@eusmania_shun @meganerock10 👍👍👍👍

最近SNSがClaudeで溢れてるので、医師向けに書きました。「医師のためのClaude完全講座」 note公開しました。前半は無料です。 ・ChatGPTとの7つの違い ・放置メール5件を10分で全処理するプロンプト ・論文の推敲を「60点→100点」に引き上げるコンボ技 ・コピペで使えるプロンプトテンプレート たんくんとすいちゃんの掛け合いをお楽しみください note.com/pancreatobilia…

@drkeithsiau @Ary_Rodriguez_ Arterial bleeding after EMR. A relatively controlled scenario for hemostasis. Note the importance of gravity in improving visualization of the bleeding point. Hemostasis using a Coagrasper with soft coagulation.

Chaotic scenes on colonoscopy. What is the likely cause of bleeding here?

@ce_journal_blog 十二指腸ESDでは、Viscoclearは非常に重要だと考えています。私は、出血によって視野が失われるような剥離操作の場面で使用しています。

under waterもゲット！ …いつもはgel immersionですが、ゲルを使用していない施設の方が圧倒的に多いので、under waterのこともしっかりと知っておかないと

@ce_journal_blog 十二指腸ESDでは、Viscoclearは非常に重要だと考えています。私は、出血によって視野が失われるような剥離操作の場面で使用しています。

ビスコクリア高いのであまり使われませんが、やはり、under waterとは違う利点があります。 …が、コスト意識されている施設ばかりなので……。 amzn.to/4d25bM0 #PR

@Ferreira_gastro Funciona bem melhor pois estabiliza o campo

@flaubert_sena Se ve interesante . En tu experiencia ha funcionado mejor que la inmersión en agua?

Gel immersion Spy Glass lithotripsy

@SArshiaArshad @SAGES_Updates @EzraTeitelbaum @EdLinEmory @EricKnauerMD @MBosleyMD @rbarbosa91 GGT

Surgical myth worth retiring: “Normal bilirubin ≠ no indication for IOC”. Transaminases can rise before bilirubin if early choledocho or partial cbd obstruction. #gallbladder #IOC #SoMe4Surgery @SAGES_Updates @EzraTeitelbaum @EdLinEmory @EricKnauerMD @MBosleyMD @rbarbosa91

@eusmania_shun SpyGlass胆道鏡に関して、単一術者手技の技術的側面や実践的なTips & Tricksに焦点を当てた書籍や参考文献はありますでしょうか。

ercpもそうですよね、基本操作が安定しないと胆管軸や、乳頭への面作りなどに心を配るのは難しいかもしれない。 無意識に側視鏡での基本操作ができるようになってはじめて、乳頭を真剣に観察できるようになり、真の意味で乳頭と対峙できるようになるんだろう。

@bharatnandaniy2 New message in English: The stent would not fit well because the fistula is located too high.

@flaubert_sena Esophageal SEMS

@jdgemelo Unfortunately, it would not close the fistula. This is a chronic fistula measuring about 20 mm, and this tangential image does not show its true size.

@flaubert_sena If is not sign of infection you can try with burn the edge of the lesion and close with clips , but if you see some sign of infection you can put endovac first

@stefanobps Upper third. He has been free of lymphoma for 2 years.

@flaubert_sena Is it too high up in the esophagus? If that’s not the case, the Shim technique would probably be the way to go.”

@HilarHolzy @Abuhalima14 @docdhir @TrieuMD @MoamenGabrMD @BilalMohammadMD @SultanMahmoodMD @SahajRathi @Taalamri @NEndoscopy @DrSaeeeed @KMonkemuller @shifaumarMD Congratulations, great case. I prefer to use a less concentrated contrast; it makes guidewire visualization easier.

🧰EUS Guided Rendezvous ERCP 🔥Great for unusual papillas (inability to identify/cannulate) + dilated CBD 💡19g FNA 🪡, 450 guidewire (straight or angled depending) 💡Ideal position 🪡 parallel to CBD 💡Cannulate next to wire or backload wire with tome #GITwitter #MedEd @docdhir

Bepirovirsen not only suppresses HBV markers but may also enhance immune‑mediated killing of infected hepatocytes, supporting the concept of functional cure with finite therapy. See: Gane E et al. Immunomodulation by bepirovirsen J Hepatol 2025. doi: 10.1016/j.jhep.2025.09.012 #

New study shows the AI model PANDA detects pancreatic cancer on non-contrast CT scans with 92.9% sensitivity. A major step in early diagnosis Source: DOI: 10.1038/s41591-023-02640-w

@DrBloodandGuts Review CTA/MRA to identify which ductal sectors have portal inflow thrombosis in the territory you plan to drain. If portal segments are thrombosed stenting won’t help (may ↑ cholangitis). Drain only viable ducts Spy selective drainage, suprapapillary stents, avoid sphincterotom

Help: Are there any drainage options for something like this? A large centrally obliterating HCC causing jaundice and precluding chemotherapy.

Rectal ESD for adenoma. Retrovision

@Santododia1 Amém 🙏

✝️ EVANGELHO DO DIA - 26/10/2025 Lc 18,9-14 Naquele tempo, 9 Jesus contou esta parábola para alguns que confiavam na sua própria justiça e desprezavam os outros: 10 "Dois homens subiram ao Templo para rezar: um era fariseu, o outro cobrador de impostos. 11 O fariseu, de pé, rezava assim em seu íntimo: 'Ó Deus, eu te agradeço porque não sou como os outros homens, ladrões, desonestos, adúlteros, nem como este cobrador de impostos. 12 Eu jejuo duas vezes por semana, e dou o dízimo de toda a minha renda'. 13 O cobrador de impostos, porém, ficou à distância, e nem se atrevia a levantar os olhos para o céu; mas batia no peito, dizendo: 'Meu Deus, tem piedade de mim que sou pecador!' 14 Eu vos digo: este último voltou para casa justificado, o outro não. Pois quem se eleva será humilhado, e quem se humilha será elevado". — Palavra da Salvação. — Glória a Vós, Senhor. Que as palavras do Santo Evangelho perdoem os nossos pecados e nos guardem para a Vida Eterna. Amém.

Gastric peroral endoscopic myotomy (G-POEM) for post-esophagectomy gastroparesis

@joakirodriguez Este formato de pantalla con la visualización de las maniobras manuales del endoscopio es importante.

🔪 Jornada intensa en el Programa de Especialización en DSE Hoy nos pasamos el día disecando lesiones con IT knife, afinando la técnica hasta el último detalle. Con nuestros monitores y sistemas de cámara, analizamos cada movimiento para optimizar la precisión y la seguridad.

Pocket creation method in rectal adenoma