Thomas Balanis

Gastroenterologist, Diagnostic and therapeutic endoscopy

[Thomas Balanis @ThomasBalanis]

@DrSalihTokmak @DouglasAdlerMD @DrBloodandGuts @Stentingwoman @CarlKayMD @drkeithsiau @SahajRathi @DannyIssaMD @JoanB_Gornals Me either, in the last two years only EUS-LB performed, love it

[Salih Tokmak @DrSalihTokmak]

🧲Magnetic Compression Anastomosis🧲

1️⃣ 57 y/o male, h/o chronic HBV, LDLT
2️⃣ Double anastomosis, double stricture. Can't traverse in to the posterior duct
3️⃣ Magnets to the rescue

#ercp #GITwitter #livertwitter @DouglasAdlerMD @HilarHolzy @MendozaLadd @ThomasBalanis @Stentingwoman @drkeithsiau @SahajRathi @AntonioFaccior6 @DarylRamai @JoanB_Gornals @helpatologist @NEndoscopy @Samanta_JayPGI @Taalamri

[Thomas Balanis @ThomasBalanis]

@DrSalihTokmak @DouglasAdlerMD @HilarHolzy @MendozaLadd Brilliant 🙌🤩👏🔝🔥

[Tyler Berzin MD, FASGE @tberzin]

For medical trainees in any interventional or surgical field, I'm not sure there's a more important lesson than this one.

[Thomas Balanis @ThomasBalanis]

@NEndoscopy @GVanell5 @GIE_Journal @DouglasAdlerMD Excellent 👏🙌

[Thomas Balanis @ThomasBalanis]

@DrSalihTokmak @IAUKampus @HilarHolzy You rock it, man! 🔥💪

[Prof John Leeds @NEndoscopy]

@docdhir @ThomasBalanis @JoanB_Gornals @helpatologist @DrSalihTokmak @Srisha_Hebbar @DrLakhtakia @HilarHolzy @DouglasAdlerMD @Samanta_JayPGI @AntonioFaccior6 Yes I think this is the key. For me the levels of advanced EUS has this quite high up:
Level 1 - cysts/wons
Level 2 - gallbladders (positional)
Level 3 - EDGE & GJ
Level 4 - CDD
Level 5 - HGS and AGS

[Thomas Balanis @ThomasBalanis]

@JoanB_Gornals @helpatologist @NEndoscopy @DrSalihTokmak @Srisha_Hebbar @DrLakhtakia @docdhir @HilarHolzy @DouglasAdlerMD @Samanta_JayPGI @AntonioFaccior6 @DharJahnvi @GVanell5 @MBronswijkMD @endoscopyjrnl @ESGEoffi

[Thomas Balanis @ThomasBalanis]

🚨 EUS-CDS failures can be deadly.
New multicenter data (n = 296) → 12% 30-day mortality after failed procedures.
Risk factors: small CBD, duodenal stenosis, wired technique, low operator experience.
Structured training & rescue protocols are needed https://t.co/lLWf8zrcEQ

[Thomas Balanis @ThomasBalanis]

WDYT? #GITwiter @JoanB_Gornals @helpatologist @NEndoscopy @DrSalihTokmak @Srisha_Hebbar @DrLakhtakia @docdhir @HilarHolzy @DouglasAdlerMD @Samanta_JayPGI @AntonioFaccior6

[Thomas Balanis @ThomasBalanis]

@JoanB_Gornals @AGA_CGH @SEEDendoscopia @SCDigestologia @Albertsumallag Huge congratulations! We've been eagerly awaiting this publication! 😅👏🙌🔝

[Thomas Balanis @ThomasBalanis]

@Lguilabert1 @YouppiePancreas @SN_gastro @DHgua @SanRaffaeleMI @lelecapurso @EurPancClub @GVanell5 @DeMadaria @AmmerHerrmenau @AfroPanaitescu Many congratulations!!! 🔝🔝🔥🔥🙌

[Jahnvi Dhar @DharJahnvi]

Happy to share our latest original article online in Endoscopy @endoscopyjrnl @ESGE_news 😇

"Surgery versus endoscopy with digital single-operator cholangioscopy-guided therapy for Mirizzi syndrome: The SEIZE study"

Led by @MBronswijkMD, Joachim, and Prof Schalk Merwe 🙏

✅ International multicenter study (2005 - 2023)
✅ Mirizzi syndrome (Type II-IV)
✅ dSOC n=176 vs surgery n=114
✅ Primary outcome: Adverse events

Use of dSOC @bostonsci led to (compared to surgery):
⬇️ Overall ADE (10.2% vs 41.2%)
⬇️ severe ADE (1.7% vs 15.8%)
⬇��� lower need of HJ (8.2% vs 25.4%)
⬇️ lower rates of conversion to open surgery (6% vs 22.8%)

Congratulations to all co-authors 👏🙏💪
@Samanta_JayPGI @DrLakhtakia @GVanell5 @MarcusHollenba1 @GWebster_endo and others not on X !!!

Have a nice read !!!����👇
https://t.co/h07EZcxoYH

[Thomas Balanis @ThomasBalanis]

Afferent limp syndrome after pp-Whipple for dCCA causing cholangitis treated with EUS-GE #GITwitter

[Thomas Balanis @ThomasBalanis]

@NEndoscopy @smkahlon @SharanWad @SyedGerdezi @helpatologist @MoGamil5 @Medicase1 @manuknayar To be honest, I am really impressed with DFI Mode, and don't find any differences with contrast, I used it both so far.. There are 3 Studies till now for DFI
@NEndoscopy you are right, the only very few complications that I hat with EUS FNA/FNB were only in cystic lesions 🙉😅

[Thomas Balanis @ThomasBalanis]

@Srisha_Hebbar @RakeshKalapala1 @umeshaberdeen @helpatologist @NEndoscopy @MitraVikramjit @smkahlon @drkeithsiau @pbendoscopist Absolutely true!

[Thomas Balanis @ThomasBalanis]

@docberza @EASLnews Warmest Congratulations!!! Very well deserved. Keep inspiring us know 🔝🙏🙋‍♂️

[Saqib Ahmad @Notts_DrSaqib]

Following a masterful live endoscopy demonstration in #PSG2025, an excellent overview on managing malignant hilar strictures by our HPB endoscopy champ @helpatologist

@abdullahaabbasi @SyedGerdezi @Srisha_Hebbar @jalpa_devi @drnasirjaved1 @KamaniLubna @DrNazishbutt

[Thomas Balanis @ThomasBalanis]

@drkeithsiau @AmerGastroAssn Underwater rules

[Thomas Balanis @ThomasBalanis]

@DrSalihTokmak @endoscopyjrnl @DouglasAdlerMD @MendozaLadd @AntonioFaccior6 @HilarHolzy @japariciot2 @stevenbollipo @tberzin Congratulations Salih! Keep rocking 💪🙌