Elkholy, S., K. Esaam, M. Wahba, and M. ElSherbiny, Endoscopic techniques to detect gastroesophageal junction in peroral endoscopic myotomy, , 2021.
Elkholy, S., K. Essam, D. abd el kereem, and M. ElSherbiny, Art in Endoscopy: Tunnel “delivery” of a large esophageal leiomyoma, , 2021.
Elkholy, S., M. El-Sherbiny, R. - D. Alonso, and J. J. - H. de Esquivel, Peroral endoscopic myotomy as treatment for Zenker’s diverticulum (Z-POEM): a multi-center international study, , 2021.
Elkholy, S., M. El-Sherbiny, M. Wahba, and K. Essam, "Gastric peroral endoscopic myotomy for refractory gastroparesis", Video GIE, 2021.
Salman, M. A., H. M. S. Mikhail, A. Abdelsalam, A. Abdallah, H. E. Elshafey, T. E. Abouelregal, M. G. Omar, H. Elkassar, R. A. Ahmed, M. Atallah, et al., "Acceleration of Gastric Emptying and Improvement of GERD Outcome After Laparoscopic Sleeve Gastrectomy in Non-diabetic Obese Patients.", Obesity surgery, 2020. Abstract

PURPOSE: Obesity has become a pandemic nowadays. Bariatric surgery is increasingly performed to manage obesity. Currently, laparoscopic sleeve gastrectomy (LSG) is a widely accepted procedure given its feasibility and efficacy. Previous studies revealed conflicting results regarding the change of gastric emptying following sleeve gastrectomy. The primary aim of the present study is to assess gastric motor function by gastric emptying scintigraphy in a cohort of non-diabetic patients undergoing laparoscopic sleeve gastrectomy (LSG) for treatment of severe obesity.

METHODS: This prospective observational study included 100 obese, non-diabetic patients attending the surgery clinic at Cairo University Hospitals and Al Azhar University Hospitals. LSG was performed following a standardized protocol, with no complications observed. All patients had gastric emptying scintigraphy done through a standard semisolid meal (250 kcal), marked with 0.5 mCiTc 99, pre-operatively and 3 months after LSG.

RESULTS: The mean age was 38.71 years (9.2) and males comprised 57% of the cohort. The body mass index, low-density lipoproteins, and glycated hemoglobin declined significantly at 3-month postsurgery. The scintigraphy study revealed a significantly reduced percent retention at equivalent time points 3 months after LSG. In addition, the percent of patients suffering from GERD decreased significantly after LSG.

CONCLUSION: Gastric emptying becomes faster after LSG in morbidly obese non-diabetic patients. GERD symptoms improve after surgery.

Elkholy, S., K. Essam, and M. El-Sherbiny, "Z-POEM (Per Oral Endoscopic Myotomy) for the management of large Zenker's diverticulum.", Acta gastro-enterologica Belgica, vol. 83, issue 1, pp. 90-91, 2020. z_poem_acta_belgica.pdf
Elkholy, S., K. Essam, and M. El-Sherbiny, "Endoscopic Submucosal Dissection (ESD) of Recurrent Tubulovillous Adenoma Twice after Trans-anal Endoscopic Microsurgery (TEMS)", Ann Clin Case Rep. , vol. 4, pp. 1724, 2019.
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Okasha, H., M. E. behiry, N. Ramadan, R. Ezzat, A. Yamany, S. El-Kholi, and G. Ahmed, "Endoscopic ultrasound-guided fine needle aspiration in diagnosis of cystic pancreatic lesions.", Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology, vol. 20, issue 2, pp. 86-90, 2019. Abstract

BACKGROUND AND STUDY AIMS: pancreatic cysts are commonly found lesions and proper diagnosis is very important for planning further management. The study aims to evaluate the role of cyst fluid amylase and tumour markers as cancer antigen (CA 19-9) and carcinoembryonic antigen (CEA) in addition to mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign lesions.

PATIENTS AND METHODS: This prospective study was conducted on 184 patients diagnosed to have pancreatic cystic lesions from January 2013 to January 2018. Fluid analysis for CA 19-9, CEA, amylase, mucin stain and cytopathology were done. We compared these data with the final diagnosis based on histopathology after surgical resection, positive cytopathology and long period of follow up of the patients for at least 18 months.

RESULTS: The highest AUC was that of cystic CEA with cut-off value of 160 ng/ml; it had a sensitivity of 60.4% and a specificity of 85%. The best cut-off value for cystic CA 19-9 was 1318 U/ml with a sensitivity of 64.1% and a specificity of 68.1%. The cut-off value of cyst amylase level was 5500 U/L, with 84.2% sensitivity and 37.1% specificity. The sensitivity of mucin stain in detecting mucinous cystic neoplasm was 85.45%, specificity was 86.05% with accuracy 85.87%.

CONCLUSION: Cyst fluid analysis by investigating amylase, mucin, CA 19-9, CEA and EUS examination improves the diagnosis of different pancreatic cysts.

Elkholy, S., D. A. Mansour, S. A. El-Hamid, U. M. Al-Jarhi, S. M. El-Nahaas, and S. Mogawer, "Risk index for early infections following living donor liver transplantation.", Archives of medical science : AMS, vol. 15, issue 3, pp. 656-665, 2019. Abstract

Introduction: Post-operative infections in patients undergoing living donor liver transplantation (LDLT) are a major cause of morbidity and mortality. This study aims to develop a practical and efficient prognostic index for early identification and possible prediction of post-transplant infections using risk factors identified by multivariate analysis.

Material and methods: One hundred patients with post-hepatitic cirrhosis, HCV positive, genotype 4, Child B/C or MELD score 13-25 undergoing LDLT were included. All potential predictors of infection were analyzed by backward logistic regression. Cut-off values were obtained from ROC curve analysis. Significant predictors were combined into a risk index, which was further tested and compared by ROC curve analysis.

Results: Post-operative infection was associated with a significantly higher mortality (50.7% vs. 33.3%). Total leucocyte count, total bilirubin, early biliary complications, fever and C-reactive protein were found to be independent predictors of early infectious complications after LDLT. The risk index predicted infection with the highest sensitivity and specificity as compared with each predictor on its own (AUC = 0.91, 95% CI: 0.830-0.955, < 0.0001).

Conclusions: The use of a combined risk index for early diagnosis of post-operative infections can efficiently identify high risk patients.

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