Center for Endoscopic Research & Therapeutics (CERT) Annual Report 2019

CENTER FOR

ENDOSCOPIC RESEARCH + THERAPEUTICS

TABLE OF CONTENTS

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Advancing Leading Innovating Collaborating Educating Discovering

Welcome To The Forefront At the University of Chicago Medicine Center for Endoscopic Research and Therapeutics (CERT), our experts annually perform thousands of specialized therapeutic endoscopy procedures. Our interventional endoscopy program attracts both patients and physicians from around the country and internationally due to our expertise, innovation, patient focus and strong partnerships.

We use innovative endoscopic techniques to provide minimally invasive solutions for a range of gastrointestinal problems.

Our physicians developed or perfected many of the techniques we use, and we strive to push the boundaries of endoscopic technology for the benefit of patient care and outcomes.

As we continue to innovate and strive to provide the best care for patients, we also commit to expanding and strengthening our relationships with our referring physicians.

We are grateful for your continued collaboration and invite you to learn more about our distinguished program.

Irving Waxman, MD, FASGE Sara and Harold Lincoln Thompson Professor of Medicine and Surgery Director, Center for Endoscopic Research and Therapeutics

Advancing Patient Care CERT at UChicago Medicine was created to be a one-of-a-kind program with a single focus: advancing patient care through endoscopic discovery and innovation.

We know that you want the best care for your patients who have challenging gastrointestinal conditions. Our dedicated, multidisciplinary team performs more than 3,000 highly specialized interventional endoscopy procedures each year, making our program one of the largest and most experienced in the region.

These procedures include leading-edge treatments available at only a handful of other hospitals nationwide.

We value your partnership. When you refer a patient to us, we will collaborate with you to develop a personalized treatment plan and keep you informed about your patient’s care.

Along with our team’s extensive experience, state-of-the-art technology and robust research portfolio, we offer you and your patients the collaborative expertise of our UChicago Medicine colleagues in a wide variety of specialties, including medical and surgical oncology.

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How to Refer a Patient: Referral Form (PDF) 773.702.1459 773.834.8891 uchicagomedicine.org/cert

UChicago Medicine 5700 S. Maryland Avenue | MC8043 Chicago, IL 60637

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Sara and Harold Lincoln Thompson Professor, Medicine and Surgery Director, Center for Endoscopic Research and Therapeutics

Dr. Waxman is an international authority in endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic resection techniques, such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). He is one of the most experienced physicians in the nation at performing endoscopic resection of premalignant and malignant lesions involving the colon, duodenum and Barrett’s esophagus. Dr. Waxman’s work focuses on state-of-the-art endoscopic procedures, and he is currently performing peroral endoscopic myotomy (POEM) for the treatment of achalasia. Dr. Waxman is a leading author of numerous publications and his clinical research interests include minimally invasive therapy for esophageal and colon cancers and therapeutic applications of endosonography.

WITH EXTENSIVE EXPERIENCE AND COMMITMENT TO INNOVATION

IRVING WAXMAN MD, FASGE 5 Center for Endoscopic Research + Therapeutics

UZMA D. SIDDIQUI MD, FASGE

Associate Professor of Medicine Associate Director, Center for Endoscopic Research and Therapeutics Director, Endoscopic Ultrasound and Advanced Endoscopy Training

Dr. Siddiqui is an expert therapeutic endoscopist who specializes in EUS and ERCP for pancreaticobiliary diseases, including pseudocyst drainage, diagnosing pancreatic and biliary cancers, stenting and using advanced cholangioscopy techniques for large bile duct stones and biliary strictures. Dr. Siddiqui initiated Chicago’s first photodynamic therapy (PDT) program for the endoscopic treatment of cholangiocarinoma. She also performs endoscopic resection techniques (EMR, ESD) for lesions in the GI tract, including nodules in Barrett’s esophagus, complex colon polyps and duodenal adenomas. Dr. Siddiqui is a dedicated educator and thought leader who plays an active role in multiple national GI societies and directs the University of Chicago’s Advanced Endoscopy Training Program.

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Assistant Professor of Medicine Director, Bariatric and Metabolic Endoscopy

As a skilled gastroenterologist, Dr. Chapman utilizes his expertise in interventional endoscopy and minimally invasive endoscopic techniques to treat gastrointestinal disorders. He is a boardcertified specialist in obesity medicine and has a special interest in endoscopic bariatric therapies.

Dr. Chapman offers patients a wide array of endoscopic weight loss procedures, including intragastric balloon placement, endoscopic sleeve gastroplasty (ESG), endoscopic bariatric surgery revision and aspiration therapy. He is one of the most experienced physicians in the Midwest at performing ESG. Combined with a multi-disciplinary weight management team, these procedures offer patients minimally invasive and reversible weight loss options. Additional procedures performed by Dr. Chapman include EUS, ERCP, EMR and ablation for Barrett’s esophagus.

CHRISTOPHER G. CHAPMAN, MD

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Our Team Our dedicated team of physicians, advanced practice nurses and administrative support staff have a single focus: providing you and your patients with the best possible outcomes and the highest standards of care, communication, comfort and convenience.

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REALIZING THE PROMISE OF ENDOSCOPIC TECHNOLOGIES

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Our CERT team uses the most innovative endoscopic techniques to provide minimally invasive solutions for a range of gastrointestinal problems. Many of the advanced techniques we use were developed or perfected by our physicians, who strive constantly to push the boundaries of endoscopic technology for the benefit of patients.

Our international reputation is based on consistent excellence at the leading edge of endoscopic practice: • Advanced imaging techniques to identify precancerous conditions, sometimes even before they can be found with standard endoscopy. • Endoscopic treatment of malignancies and obstruction of the GI tract and other complicated conditions, sparing patients from the risk of surgery. • Precise endoscopic diagnosis and staging of cancer, enabling referring physicians to plan the most appropriate and effective surgical and oncological care.

Many of the procedures we offer are available at only a select few institutions. These major differentiating procedures include peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), photodynamic therapy (PDT) and endoscopic sleeve gastroplasty (ESG).

Peroral Endoscopic Myotomy Peroral endoscopic myotomy (POEM) is a minimally invasive procedure that uses endoscopic technology to treat digestive and swallowing disorders. This incisionless technique offers quick recovery and treats rare digestive disorders such as achalasia, a disorder of the esophagus that makes it difficult to consume food.

During the procedure, an endoscope is inserted into the mouth and moved through the throat, creating a tunnel between layers of the esophagus. When the endoscope reaches the lower esophageal sphincter, an incision is made in the muscle, permanently opening the valve.

CERT is one of the few centers in Illinois offering peroral endoscopic myotomy to patients for the treatment of digestive and swallowing disorders.

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Endoscopic Submucosal Dissection Endoscopic submucosal dissection (ESD) can be considered minimally invasive intraluminal endoscopic surgery. ESD was developed in Japan as an alternative to standard surgical procedures to obtain en bloc removal of gastrointestinal neoplasias. En bloc resection is vital because it allows detailed histopathological evaluation of the entire resected neoplasm and is associated with lower recurrence rates when compared to the loop-snare piecemeal technique, including traditional endoscopic mucosal resection.

The ESD technique utilizes an electrosurgical knife to mark the margins of the lesion, mucosally incise around it, and cut through the submucosal layer underneath the lesion.

Due to the increased technical difficulty, ESD is available only at a few selected quaternary care centers in the United States.

Endoluminal resection is one of our main areas of research focus at CERT. We were one of the first groups in the nation to perform endoscopic mucosal resection (EMR).

Our experience performing EMR spans 15 years and thousands of cases. As a result, it is the natural evolution for us to now perform ESD. Indications for ESD include: • Superficial esophageal cancer (both squamous or adenocarcinoma) • Early gastric cancer • Early colorectal cancer (limited to the superficial submucosa) • Non-lifting colorectal lesions

Photodynamic Therapy for Cholangiocarcinoma Cholangiocarcinoma is a relatively rare cancer of the bile ducts with approximately 5,000 cases annually in the United States. Five-year survival rates average five to 10 percent.

For more than 80 percent of patients, the disease is unresectable. Traditionally, therapy options have been limited to chemotherapy and palliative bile duct stenting to relieve jaundice.

In photodynamic therapy (PDT), the patient receives an IV porphyrin sensitizer 48 hours prior to endoscopic application of light to the tumor with the purpose of causing cell death.

The light is delivered via a flexible fiber during endoscopic retrograde cholangiopancreatography at the time of biliary stent placement or exchange.

Although data on the use of PDT in cholangiocarcinoma is limited, initial studies in patients with unresectable disease have suggested the treatment not only aids biliary decompression, but also improves survival through actual tumor destruction. The main side effect of this therapy is severe photosensitivity for 30 days, for which the patient must be counseled.

CERT is the only center in Chicago to offer PDT for therapy of unresectable cholangiocarcinoma.

Aspiration Therapy Aspiration therapy is a nonsurgical, reversible, outpatient weight loss solution. During the procedure, a small tube is placed through the skin and into the inside of the stomach. The tube is connected to a small, discrete button that rests on the outside of the abdomen. Approximately 30 minutes after eating a meal, the patient connects a small handheld device to the button and empties the contents of the stomach. Up to 30 percent of calories are drained/diverted using this device, which results in significant sustained and durable weight loss. Patients can be expected to lose 15 to 20 percent of their total body weight at one year.

Although different from other “standard approaches,” aspiration therapy can provide substantial weight loss in a safe, reversible manner. It is differentiated from other bariatric procedures in that it allows an individual to eat and socialize normally (e.g., can eat “regular” meals) and control their own weight loss trajectory. Furthermore, it is the only available endoscopic therapy with an FDA indication up to a body mass index (BMI) of 55 kg/m2.

Weight Loss Balloons

Endoscopic Sleeve Gastric Outlet Revision Gastroplasty

Weight loss balloons are soft, fluid or gas-filled devices placed into the stomach with the aid of an endoscope as part of a nonsurgical, outpatient procedure. During this procedure, the weight loss balloon, or intragastric balloon, is inserted through the mouth, down the esophagus and into the stomach. Once in the appropriate location, it is filled with fluid to achieve the approximate size of a grapefruit and released. The balloon effectively reduces the amount of food and drink eaten at a meal and increases the feeling of being full after eating small sized meals. The weight loss balloon remains in place for six to eight months to support healthy weight loss.

The endoscopic sleeve gastroplasty (ESG) is a minimally invasive, endoscopic procedure that reduces the size and volume of the stomach to aid in weight loss. The procedure is designed for patients with a BMI between 30 and 40 who have struggled to lose weight with diet and exercise alone. When used together with lifestyle changes, this nonsurgical weight loss procedure can help patients lose nearly 20 percent of their total body weight.

Designed for patients who are obese, having a BMI of greater than 30, treatment can help candidates lose weight without invasive surgery. The procedure takes 20 to 30 minutes, and patients are typically discharged home after two hours of recovery. With active participation in our medically supervised weight loss program, patients can expect a total body weight loss of approximately 10 to 15 percent.

UChicago Medicine is currently the only hospital in Chicago offering this outpatient procedure.

During the ESG, an endoscope is inserted through the mouth, down the esophagus and into the stomach. The physician places and tightens sutures, decreasing the size and volume of the stomach. The procedure is performed orally without requiring any abdominal incisions or scars.

Advantages of the endoscopic sleeve gastroplasty procedure include: • Quick recovery time • Reduced risk of complications

Bariatric surgeries are effective methods for weight management and treatment of weight-related co-morbidities, but after long periods of time, patients may be prone to regaining the weight and its associated health problems. The weight regain may be due to a dilation of the gastric pouch, sleeve or connection site (anastomosis).

Transoral gastric outlet reduction is a minimally invasive, endoscopic procedure that repairs the gastric outlet by reducing the size of the anastomosis. If dilated, the stomach pouch or sleeve can also be reduced in size at the same time. During this outpatient procedure, sutures are inserted to tighten the stomach or the surgical connection site where it has stretched.

This procedure supports weight loss, restores the feeling of fullness and encourages patients to eat smaller meals again. Patients who undergo transoral gastric outlet reduction or revision of their laparoscopic sleeve gastrectomy lose 25 to 35 pounds on average.

UChicago Medicine is one of few hospitals in the state of Illinois to routinely perform these endoscopic bariatric revision procedures.

• Can be repeated

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Procedures The full range of advanced interventional endoscopy procedures we offer include the following: • Endoscopic ultrasound (EUS) with fine needle aspiration (FNA)

• Ampullectomy

• Celiac plexus neurolysis

• Endoscopic submucosal dissection (ESD)

• Endoscopic retrograde cholangiopancreatography (ERCP)

• Complex polypectomy in the colon and duodenum

• Cholangioscopy

• Radiofrequency ablation and cryotherapy

• Photodynamic therapy (PDT) ablation of cholangiocarcinoma

• Pancreatic pseudocyst drainage and necrosectomy

• Lithotripsy of large biliary and pancreatic duct stones

• Palliative stenting of GI tract and pancreaticobiliary malignancies

• Endoscopic mucosal resection (EMR)

• Extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones • Bariatric endoscopy • Endoscopic sleeve gastroplasty (ESG) • Intragastric balloon • Aspiration therapy with AspireAssist • Transoral gastric outlet reduction • Peroral endoscopic myotomy (POEM) • Zenker’s diverticulotomy/myotomy

Conditions We Diagnose & Treat • Achalasia

• Difficulty swallowing (dysphagia)

• Pancreatic cystic neoplasms

• Large colon polyps (adenomas)

• Early cancers of the gastrointestinal tract

• Pancreatic pseudocyst

• Ampullary polyps (adenomas)

• Malignant and benign obstruction of the GI tract, including esophagus, stomach, duodenum and colon

• Walled-off pancreatic necrosis

• Large bile duct stone (choledocholithiasis) • Infection of the bile ducts (cholangitis) • Bile duct strictures (malignant and benign) • Bile duct leaks following cholecystectomy • GI tract cancers, including cancers of the colon, stomach and esophagus

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• Complications of bariatric surgery • Gastrointestinal bleeding • Gastric cancer • Gastric carcinoid tumors

• Pancreatitis (acute and chronic) • Autoimmune pancreatitis • Hereditary pancreatic diseases • Post-operative strictures in the GI tract • Obesity and metabolic syndrome

A PARTNERSHIP THAT YOU CAN COUNT ON

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Access We know how hard it is for patients and doctors to wait. That’s why our consultation or procedure turnaround time is fast — 24 to 36 hours.

We collaborate with other physicians to provide a team approach to care. Working with oncologists, surgical oncologists, bariatric surgeons, minimally invasive specialists, radiologists and cardiothoracic specialists allows us to form a multidisciplinary team capable of providing the highest level of specialized care.

Additionally, to facilitate ease of access for as many patients as possible, the CERT team works in close collaboration with surrounding referring physicians to offer a range of services through several locations across the entire state of Illinois.

Communication As partners in your patient’s health, we keep you informed of your patient’s status at every point in the process.

Navigation Our nurse coordinators are dedicated to helping your patients navigate their care at UChicago Medicine, whether that care is a simple, one-time procedure or requires ongoing treatment.

Eating Again After Achalasia Tacos. Pizza. A steak, medium well, with a loaded baked potato.

“And a crisp apple,” Dorian Brantley added. “I was eating applesauce, but there’s no comparison.”

These were the top items on Brantley’s list of whatto-have-first after surgery for achalasia — a rare digestive disease that makes it hard to eat or drink.

Following a successful endoscopic procedure, Brantley, 35, has happily completed her to-eat list.

In the spring of 2017, Brantley, a nurse at UChicago Medicine, noticed that it seemed to be taking a long time for food to move down her esophagus. At first, she thought maybe her portions were too large or she was eating too quickly.

But the condition became more and more uncomfortable, and soon both eating solids and drinking liquids caused pain.

“If my patients told me this, I’d be very concerned,” she thought.

Brantley tried a soft diet, but it didn’t help.

A barium swallow test at UChicago Medicine showed that her esophagus wasn’t functioning properly.

Gastroenterologist and interventional endoscopist Irving Waxman, MD, suspected achalasia.

He performed an upper endoscopy to rule out stomach or esophageal cancer. Robert Kavitt, MD, MPH, then did an esophageal manometry

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study — a test that measures muscle contractions — and confirmed the achalasia diagnosis. Instead of relaxing to let food pass through, the smooth muscular valve at the lower end of Brantley’s esophagus (lower esophageal sphincter) was staying closed all the time.

The cause of achalasia is not known. “But we do know it is a progressive and irreversible disease,” Waxman said. “It can lead to serious problems in the lungs and malnutrition.” Brantley had lost 30 pounds between June and October.

Even as a nurse, Brantley had never heard of achalasia. “Dr. Waxman answered all my questions and put me at ease,” she said.

In late October 2017, Waxman performed a procedure called peroral endoscopic myotomy (POEM). Placing a flexible scope into Brantley’s esophagus through her mouth, he created a tunnel between the layers of her esophagus to reach the lower sphincter, where he cut the muscles, permanently opening the valve.

“The endoscopic approach offers patients a quick recovery, no scar and a short hospital stay,” said Waxman, director of the Center for Endoscopic Research and Therapeutics (CERT).

After the procedure, Brantley was anxious at first about going back to solid foods.

“But Dr. Waxman, his nurse, my coworkers, friends and family all encouraged me to ‘go ahead and eat again,’” Brantley said. “You know what, I did.

Everything was delicious.”

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DR. WAXMAN ANSWERED ALL MY QUESTIONS AND PUT ME AT EASE.” DORIAN BRANTLEY

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THEY BROUGHT ME BACK FROM THE DEAD.” MORRIS FOURTE

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Rare Bile Duct Bleeding Threatens Chicago Man’s Life “They brought me back from the dead,” said Morris Fourte of the life-saving care he received at UChicago Medicine.

In late 2017, Fourte was admitted to the UChicago Medicine emergency room with severe stomach pain, a low-grade fever and jaundice. Interventional gastroenterologist Uzma Siddiqui, MD, found gallstones in his bile duct and diagnosed cholangitis, or infection of the common bile duct. During treatment, Fourte’s medical team discovered a second issue that threatened his life: He had a rare connection, or fistula, between his artery and bile duct, that was causing excessive bleeding in his bile duct.

“It is extremely rare that a patient would have both conditions,” Siddiqui said. “Our team worked together every step of the way to diagnose his issues and make sure he had a good outcome, which may not have been possible at another hospital.”

Cholangitis occurs when gallstones pass from the gallbladder and then block the flow of bile, a fluid made by the liver to help digest fats. Imaging showed multiple stones in Fourte’s bile duct.

Siddiqui, an expert in the treatment of patients with complex disorders of the gastrointestinal system, removed the stones using endoscopic retrograde cholangiopancreatography (ERCP).

This procedure combines X-rays with endoscopy, where a long bendable tube with a light and camera at the end is inserted to give a view of the upper gastrointestinal system, to treat problems of the bile duct.

Siddiqui is part of the team at the UChicago Medicine Center for Endoscopic Research and Therapeutics (CERT), where highly skilled physicians routinely perform such complicated interventional endoscopic procedures.

During the ERCP, blood gushed out of Fourte’s bile duct, and Siddiqui inserted a covered metal stent, which temporarily stopped the bleeding.

After this unexpected complication, Siddiqui brought together a team of skilled experts, including surgeon Mustafa Hussain, MD, and interventional radiologist Brian Funaki, MD, who used advanced imaging to find the problem and was able to place small coils into the bleeding vessel to permanently stop the bleeding.

Siddiqui believes that Fourte’s other health issues, including end-stage kidney disease, high-blood pressure, emphysema — a disease of the lungs that makes it hard to breathe — along with chronic steroid use, may have set him up for the fistula. He is currently doing respiratory therapy at UChicago Medicine to prepare for his upcoming gallbladder surgery and credits his care team for getting him back to living his life, including spending time with his eight children and nearly 20 grandchildren.

“I have nothing but high praises for the University of Chicago Medicine team that pulled me through,” Fourte said. “Dr. Siddiqui did a wonderful job. If this happens to me again, I want her on my team.”

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Consultant Loses Weight with the Help of an New Outpatient Procedure Since college, Christina Brodzik, 42, struggled with her weight. “I had a genuine love for fast food and no self-control with portion sizes,” she admitted.

Additionally, the working mother of two travels for work Monday through Thursday, making exercising and eating well challenging.

Brodzik had tried every diet in the world, but nothing seemed to work — until last year, when her husband read an article about endoscopic sleeve gastroplasty (ESG), a new nonsurgical weight loss procedure offered at the UChicago Medicine Center for Endoscopic Research and Therapeutics (CERT). It’s currently the only location in the city offering this procedure.

At 5’2” and 225 pounds, the northwest Chicago suburban mom met with gastroenterologist Christopher Chapman, MD, director of bariatric and metabolic endoscopy. And on Dec. 20, 2017, a day that Brodzik calls “one of my favorite days ever,” she underwent the procedure.

“From the second I had the surgery, I felt like I got my life back,” said Brodzik, who has since lost 65 pounds and no longer suffers from sleep apnea, one common side effect of being overweight.

During the outpatient procedure, the physician places and tightens sutures, decreasing the size and volume of the stomach by about 60 percent.

People eat less, get full faster and lose weight.

It was the perfect procedure for Brodzik, who had been exploring a full gastric bypass, a more invasive surgical procedure.

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“That just wasn’t for me,” she said. “I couldn’t commit to a full year of nutritional counseling because of my job, and I was really struggling with the permanence of the procedure and being out of work for several weeks. That’s not something I could do.”

In the first week after her ESG, Brodzik lost 12 pounds. In the first month she lost 24 pounds, and since then she has lost a total of 73 pounds.

Her BMI has dropped from 41 to 27. She has maintained her weight loss — and continued to lose weight — for more than a year.

“We’re excited about ESG because we know that patients are interested in minimally invasive procedures, and our data is showing that with dedicated lifestyle changes, people can maintain this weight loss for years,” Dr. Chapman said.

In coming months, UChicago Medicine will be one of eight centers around the country taking part in a clinical trial comparing ESG with a diet and exercise program.

“We think this procedure works better than diet and exercise alone,” said Chapman, who added that patients who may not have financial means for the procedure will be able to participate in the trial.

For her part, Brodzik is thrilled with the results.

“I feel much healthier, I can order clothing online and I can shop at ‘regular’ clothing stores,” she said. “I’m much happier, and I feel proud of my appearance and the fact that I accomplished this.”

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FROM THE SECOND I HAD THE SURGERY, I FELT LIKE I GOT MY LIFE BACK.” CHRISTINA BRODZIK Before

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LIVE ENDOSCOPY COURSES TAUGHT BY INTERNATIONALLY RECOGNIZED EXPERTS

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Education Opportunities We are committed to educating colleagues on how to use advanced endoscopic imaging, and on how to incorporate these technologies into their medical practices.

CERT faculty members demonstrate their capabilities during two live endoscopy courses each year that attract attendees and faculty from around the world. Both are held in the UChicago Medicine Center for Care and Discovery.

Our annual EUS LIVE course is one of the bigger endoscopy courses focusing on endoscopic ultrasound (EUS). The course, held in the winter, recently celebrated its 20th year of successful collaboration with Massachusetts General Hospital. The schedule included 24 lectures, 16 live cases, debates, two interactive quiz sections and a hands-on workshop.

We were able to showcase not only master endoscopists from all over the world, but also our UChicago Medicine colleagues from pulmonology, surgery and pathology.

Endoscopic Advances for Clinical Practice, offered in the spring, outlines current standard practices in endoscopy and how innovations may enhance or revolutionize endoscopy practice in the future. The two-day course includes lectures from expert faculty, debates and live case demonstrations conducted by expert faculty from leading institutions.

Furthermore, CERT faculty offer additional didactic courses throughout the year, and CERT physicians routinely give lectures and perform live demonstrations at conferences around the world.

For information about upcoming CME opportunities, visit cme.uchicago.edu.

Advanced Interventional Endoscopy Fellowship The One-Year Advanced Fellowship in Interventional Endoscopy provides broad exposure to clinically advanced endoscopic procedures and techniques, as well as in-depth investigative training. During these 12 months, the trainee will receive direct and continuous contact and supervision by and with full-time faculty, along with a personal and individualized approach to the trainee’s educational, clinical and scientific development.

COMMITTED TO LEADERSHIP IN ENDOSCOPIC RESEARCH AND INNOVATION

At CERT, our research helps healthcare professionals here and throughout the world continue learning through participation in clinical trials. We participate in studies that range from pilot and feasibility studies on novel technologies to randomized, multicenter clinical trials.

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As leaders in endoscopic research, we are pioneering new techniques and tools to advance the diagnosis and treatment of many conditions, including Barrett’s esophagus, esophageal cancer, biliary disorders, pancreatitis, pancreatic cancer and colon cancer.

Our practice is shaped by an ongoing commitment to discovery and innovation in gastrointestinal interventional endoscopy. We integrate delivery of state-of-the-art clinical care with research, which helps us continually discover new approaches to the greatest medical challenges.

Research Programs

Clinical Studies and Trials

As a leader in endoscopic research, our physician-scientists are involved in the development of laboratory research programs and clinical trials. We collaborate with our clinical partners in surgery, pathology and oncology to establish new standards of care.

We have studied the use of laser endomicroscopy, which is a tool for real-time imaging of the GI tract. This expertise gives us a detailed picture of internal organs and, in turn, allows us to better care for Barrett’s esophagus, pancreatic cysts and indeterminate strictures of the bile duct. In addition, we sample blood from the portal vein to capture circulating tumor cells. We investigate these circulating tumor cells to explore more information about pancreatic cancer and to develop better strategies for therapy.

At CERT, we commit to innovation and learning through our participation in trials, ranging from pilot and feasibility studies on novel technologies to randomized, multicenter clinical trials. Our current multi-center clinical trials include improved detection of precancerous cells in Barrett’s esophagus, optimizing resection of large colon polyps and improving drainage methods for the treatment of fluid collections.

With more ongoing clinical trials than any other hospital in Illinois, we give our patients access to novel treatments and therapies that often aren’t available elsewhere. Learn more about our currently active trials and research projects: uchicagomedicine.org/CERT-clinical-trials or do a nationwide search for clinical trials through databases such as www.clinicaltrials.gov.

Publications Our physician-scientists publish numerous peer-reviewed manuscripts in leading journals each year. View a list of publications: Dr. Waxman

Dr. Siddiqui

Dr. Chapman

Philanthropic Partners CERT’s ambitious research agenda would not be possible without our donors’ strong commitment to improving patient care and outcomes. These generous individuals and organizations provide vital support as our physician-scientists investigate ways to advance the diagnosis and treatment of gastrointestinal cancers and other diseases through endoscopic discovery and innovation.

During the past year, private philanthropy has supported Dr. Waxman’s trials investigating the use of endoscopic ultrasound rather than the current method of blood testing to identify and examine circulating tumor cells.

This research could lead to earlier detection of pancreatic cancer and a better understanding of its prognosis to help patients and physicians make more informed choices about therapies.

For supporting these and other initiatives, we wish to thank and acknowledge those who provided philanthropic support over the past year.

The Francis L. Lederer Foundation The Gerald O. Mann Charitable Foundation Harriet and Allan Wulfstat, Officers Julius Lewis and the Rhoades Foundation The Rolfe Pancreatic Cancer Foundation Mrs. Jane Woldenberg To make a gift online, visit givetomedicine.uchicago.edu/ give. Please include “Center for Endoscopic Research and Therapeutics” in the special instructions field.

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Partnering with the Center for Endoscopic Research & Therapeutics Our team at CERT partners with referring physicians to ensure every patient receives the best, most expedient care possible. When you refer a patient to us, we will collaborate with you to develop an individualized treatment plan.

To refer a patient, please call 773-702-1459.

Please fax the completed referral form (below) and all relevant documentation to 773-834-8891.

Referral Form for CERT Procedures (PDF)

How to Refer a Patient: Referral Form (PDF) 773.702.1459 773.834.8891 uchicagomedicine.org/cert

UChicago Medicine 5700 S. Maryland Avenue | MC8043 Chicago, IL 60637