7.00-7.30 am: Registration

7.25-7.30 am: Opening remarks- Banke Agarwal, MD
7.30-9.15 Session I

Multidisciplinary management of tumors of the liver and bile ducts
Moderators: David Linehan and Betsy Tuttle-Newhall

7.30-7.45   Patient with obstructive jaundice and intra-hepatic biliary dilation with normal sized CBD - Martin FreemanDownload PDF
  • ERCP: is it really needed and if yes, when to perform, by whom, and where
  • Transaxial imaging : when should it be performed and what kind of imaging is appropriate
  • Multi-disciplinary evaluation and management
  • Tissue diagnosis of cholangiocarcinoma: how to obtain tissue, what are the acceptable gold standards
  • Patients with PSC: when to suspect cancer and how to diagnose it
7.45-8.00   Hepatocellular carcinoma: when to suspect and how to diagnose: Luis Balart Download PDF
  • Role of tissue diagnosis in patients with suspected HCC
    • potential benefits
    • whom
    • how
  • Screening and surveillance for HCC
    • tumor staging
    • co-morbidities
  • Treatment considerations in patients with suspected HCC
8.00-8.15  State-of-the-art imaging for hepatic malignancy: Elliot Fishman Download PDF
  • CT vs MRCP
    • which one to choose for HCC vs. cholangioCA
    • what special protocols to use for liver tumors
  • Role of PET and Duplex US in these patients
  • Evaluating resectablity in hilar cholangioCA
  • Diagnostic accuracy of radiologic imaging for cholangioCA and HCC
8.15-8.30   Management of hilar and intrahepatic cholangiocarcinoma : Charles B. Rosen Download PDF
  • Resection vs. transplantation
  • Which patients are eligible for transplantation
  • How to determine resectability for hilar and intrahepatic cholangioCA
  • What to do if tissue diagnosis of cholangioCA cannot be established
  • Outcomes of surgery for cholangioCA
  • Malignant masquerades:  how they are dealt with surgically and their outcomes
8.30-8.45   Management of hepatocellular carcinoma:  Pierre A. Clavien Download PDF
  • Patient selection: expanding Milan criteria
  • Patients with hepatitis B vs. hepatitis C
  • Bridging therapies
    • transarterial chemo-embolization
    • percutaneous ethanol injection
  •  Patient selection for definitive therapy
  • Role in down staging HCC
  • Combination therapy
    • RFA
    • radiation
    • systemic therapy

8.45-9.15Q&A and Case discussions

9.15 – 9.30Coffee Break

9.30 – 11.00Session II
Small bowel neoplasms 
Moderators:  Sreenivasa Jonnalagadda and Steven Fern
9.30-9.50   Gastroenterologist’s perspective – Lauren Gerson Download PDF
  • What clinical presentations should prompt small bowel imaging for tumors
  • How to choose between capsule endoscopy and DBE
  • Common tumors noted in small bowel by CE and DBE
  • What if both CE and DBE are negative?  Should CT or MR enterography be performed
  • Mass lesions seen on CE: how to further manage these patients?
9.50-10.10  Radiologic Imaging for small bowel tumors-Elliot Fishman    Download PDF
  • Available radiologic imaging tests for patients suspected small bowel tumors
  • Indications for using small bowel imaging
  • Radiologic findings for the different small bowel tumors
  • Radiation risk to patients undergoing these evaluations
10.10-10.30   Surgical perspective- Robert R. Cima Download PDF
  • Common clinical presentations of small bowel tumors presenting to a surgeon
  • Appropriate pre-operative work-up in a patient with small bowel tumor noted on imaging is a tissue diagnosis necessary
  • What are the different surgical procedures for the different small bowel tumors
  • Expected outcomes in patient s with small bowel tumors
  • How to follow up these patients after surgery

10.30-11.00Q&A  and case discussions

11.00 -12.00Dealing with conflicts in Healthcare setting

Panel:   Andrew Schlafly, Larry Huntoon , Shaun Falvey


1.00 – 2.30Session III
Diagnosis and management of pancreatic cancer:  common dilemmas
Moderators:  Banke Agarwal and Paul Buse
1.00-1.15   Evaluation of patients with obstructive jaundice and dilated CBD without stones in CBD or gallbladder - Robert Hawes Download PDF
  • What transaxial imaging to perform prior to ERCP
  • What to do if no mass is identifiable on CT/MRI
  • Role of EUS-FNA  in these patients
  • Staging of pancreatic cancers: role of EUS
  • ERCP for biliary drainage : how to decide who would benefit
1.15-1.30   What to do and not do before seeking surgical consultation for patient with suspected pancreatic cancer – Carlos Fernandez-del-castillo Download PDF
  • Common pitfalls in management prior to surgical consultation for pancreatic cancer
  • Value of EUS-FNA in patients with obstructive jaundice
    • and mass lesion on CT scan
    • no identifiable mass lesion on CT scan
  • Non-jaundiced patient with potentially resectable mass in body of pancreas
    • should tissue diagnosis be obtained prior to surgery
  • What is appropriate staging work-up for patient with pancreatic cancer
1.30-1.45  Is R1 or R2 resection of pancreatic adenocarcinoma of any benefit or does it just increase morbidity – Robert Wolff Download PDF
  • What is comparative survival in pancreatic cancer patients with R0, R1 and R2 resection and how does it compare with patients who elect not have surgery
  • How accurate is the radiologic imaging for staging pancreatic cancer
    • do R1 and R2 resections occur only in patients with borderline resectable tumor on CT/MRI
  • Borderline resectable tumors
    • how to define them
    • should they always receive pre-operative chemoradiation
  • Unresectable pancreatic tumors in younger individuals- Is aggressive therapy worth it for the patient

1.45-2.30Q&A and case discussions

2.30-3.30Session IV
Health Care reform and future of medicine
Moderators:  Keith Naunheim and Ira Kodner

Health care reforms:  Physician’s perspective – John Matthew Inadomi, M.D.
Health care reforms: Hospital’s perspective - David Applington
Health care reforms: How it is likely to affect private practice - John Allen

Session IV - Diagnosis and management of pancreatic cancer.pdf

3.30-3.45Coffee break

3.45-5.15 pmSession V
Information you should have to make the correct treatment choice in patients with Barrett’s  esophagus
Moderators: Michael Presti and Charlene Prather
3.45-4.00   Epidemiology of Barrett’s esophagus and cancer risk - Glenn EisenDownload PDF
  • Degree of dyplasia and risk of cancer
  • Are there molecular markers that are associated with increased risk of cancer
  • Does presence of severe GE reflux increase the risk of Barrett’s associated cancer
  • Barrett’s Surveillance: is it worth the cost
  • What are optimal intervals between endoscopy for Barrett’s surveillance
  • Barrett’s with dysplasia on biopsy
    • should be biopsies always be reviewed by a second pathologist
    • what if the pathologists differ in their interpretation of dysplasia
  • Barrett’s with high grade dysplasia in the background of inflammation
    • when should the biopsies be repeated
    • what if the inflammation does not resolve on repeat biopsies
4.00-4.15   Medical treatment of Barrett’s esophagus – Kenneth WangDownload PDF
  • Role of PPIs: what is the benefit, what is the supporting data
  • Role of ASA: what is the benefit, what is the supporting data
  • Do they reduce cancer risk and by how much
  • Who should be treated
4.15-4.30   Surgical treatment for Barrett’s esophagus - Jeffrey Peters Download PDF
  • What are the current indications for surgery in patients with Barrett’s esophagus
  • What are the various kinds of esophageal surgeries performed in these patients and what are their relative advantages and disadvantages
  • What is the risk of post-operative complications
  • What is the expected quality of life after esophagectomy
4.30-4.45   Endoscopic therapy of Barrett’s esophagus - Nicholas Shaheen Download PDF
  • Indications for Radiofrequency ablation for Barrett’s esophagus
  • What are the potential complications of RFA
  • What is achieved by ablation of Barrett’s by RFA
    • does the cancer risk decrease
    • do the patients still need to be on surveillance
  • Potential role of Cryoablation for Barrett’s treatment - how does it compare with RFA

4.45-5.15Q&A and case discussions

5.15 pmConference adjourned


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