J. Sebastián P. A.

💡Important luminal landmarks in POEM. a=spine b=aortic arch c=trachea d=left main bronchus e=GEJ in retroflexion f=GEJ in forward view. 📗@NatRevGastroHep @RobertBechara

“Mis propios hijos me dejaron en un asilo… y se llevaron todo. Así que decidí empezar de nuevo. Pero esta vez, sin ellos.” Vinieron un domingo, sonriendo con palabras suaves y cajas que no llevaban nada. Me dijeron que me merecía descansar. Me dejaron frente a un hogar de

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Diagnostic algorithm for suspected eCCA. ERCP + brush cytology & endobiliary forceps biopsy is suggested as the 1ry tool. Overall sensitivity of brush is: 43% Combined with forceps: 66% 👉Cholangioscopy-directed biopsies is suggested when: i) previous ERCP sampling was negative

Transoral Outlet Reduction (TORe): Indications and Contraindications

Type I: duodenal wall injury from scope angulation or forceful withdrawal during stone extraction Type II: perforation from large balloon sphincteroplasty or deep sphincterotomy Type III: bile duct injury from wire/basket, seen after contrast injection Stapfer M, Ann Surg 2000

Several landmarks are currently used to identify the correct localization of the cardia during POEM transillumination POEM auxiliary technique with a second ultra-slim gastro scope inserted transnasally, advanced into the stomach and retroflexed. by Francisco Baldaque-Silva

I rated The Guilty (2021) 6/10 #IMDb imdb.com/title/tt9421570

I rated Lahn Mah (2024) 10/10 #IMDb imdb.com/title/tt313926…

💡Preoperative biliary drainage in Pancreatic Cancer 🟨bilirubin level is >14mg/dL 💉jaundice pts planned to receive neoadjuvant treatment 🔪surgery will be delayed for longer than 2 weeks 🦠cholangitis

CA 19-9 🔑 Facts ~10% of people don’t produce (Lewis antigen -) →<2U/mL ⅓ pancr cancer pts have normal levels (≤37 U/mL) Uses: Detect occult metastases; Assess risk; treatment response Not specific! Can be elevated in benign conditions (e.g., biliary obstruction, pancreatitis)

🐳Whale tail sign 💡The division of the celiac artery into the splenic and hepatic artery