Interventional Endoscopy Program

Yale's Interventional Endoscopy Program is a tertiary referral system focusing on diseases of the pancreas, biliary tree, and the gastrointestinal tract. Patients with a variety of symptoms and diseases are evaluated, including those with pancreatitis, biliary strictures and stones, post-cholecystectomy complications, unexplained abdominal pain, and suspected gastrointestinal malignancies. The majority of referred patients require advanced endoscopic procedures, including therapeutic ERCP (endoscopic retrograde cholangiopancreatography) and EUS (endoscopic ultrasound). Many patients are sent to Yale for these procedures which are either not performed elsewhere or may have been unsuccessful.

Our interventional gastroenterologists have extensive experience in complex ERCP procedures. Therapeutic ERCP capabilities include sphincter of Oddi manometry, endoscopic sphincterotomy of both biliary and pancreatic ducts, biliary and pancreatic stent insertion, stricture dilation, pseuodocyst drainage, and complex bile duct stone extractions. Techniques requiring specialized equipment are also performed and include choledochoscopy with mother-daughter scopes, electrohydraulic lithotripsy, and extracorporeal wave lithotripsy, used for fragmentation and extraction of large common bile duct and pancreatic duct stones.

Physicians also have a great deal of expertise in performing EUS with fine needle aspiration (FNA) of masses, cysts, and lymph nodes located within and adjacent to the digestive tract. This highly sophisticated technique is utilized for the staging of malignancies of the esophagus, rectum, and pancreas. Furthermore, detailed imaging can be obtained with EUS and targeted FNA can then be performed on lesions as small as five millimeters in size. FNA can be performed on mediastinal lymph nodes, pancreatic masses or cysts, and gastrointestinal stromal tumors. EUS-guided celiac plexus nerve block (neurolysis) for palliation of pain associated with pancreatic cancer is also performed.

The members of the Interventional Endoscopy team work closely with referring physicians to promptly perform procedures, consultations, and discuss management options. A multidisciplinary approach to complex patients also involves discussions with pathologists, cytologists, surgeons, oncologists and radiologists.

	Aslanian, Harry Robert, MD	Associate Professor of Medicine (Digestive Diseases); Associate Director, Endoscopy; Director, Yale Advanced Endoscopy Fellowship; Director of Gastroenterology, Yale Health Plan	(203) 200-5083 Appts (203) 200-2235 Fax
	Farrell, James J, MD		(203) 200-5458 Appts (203) 200-2235 Fax
	Jamidar, Priya Arvind, MBChB, FACG, FASGE	Professor of Medicine (Digestive Diseases); Director, Endoscopy	(203) 200-5083 Appts (203) 200-2235 Fax

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