Recent Research

Diagnosis of cystic and solid neoplasms of the pancreas and bile duct malignancies.

Cystic neoplasm of the pancreas such as mucinous cysts and side-branch intraductal papillary mucinous neoplasms are a major challenge regarding diagnosis and management since they have malignant potential.  In the past CEA and amylase levels in cyst aspirates obtained by endosonography (EUS) guided fine needle aspirations were used to differentiate cystic neoplasms of the pancreas from benign serous cysts.  However, there are many cysts that are indeterminate.  The determination of KRAS, GNAS and allelic imbalances of tumor suppressor genes in cyst aspirates in addition to the endosonography features allowed us to predict the benign biological behavior of the cysts avoiding high risk surgeries.

Endosonography guided fine needle aspirations of solid pancreatic neoplasms often (up to 30%) yield inconclusive results showing on pathology only atypical cells which could be seen in inflammatory conditions but also in neoplasms.   We were among the first groups to show that immuno-histochemical analyses significantly increase the diagnostic yield EUS-guided fine needle aspirations (FNA) of pancreatic masses. We further showed that the diagnostic yield of pancreatic EUS-FNA is markedly improved by performing FISH analysis for chromosomal abnormalities and KRAS mutational profiling.

Improving the diagnostic yield of endoscopic sampling techniques is a major issue also in biliary diseases, as the early and efficient malignancy diagnosis, circumventing the need for repeat procedures, is critical for patients’ care and, ultimately, survival. We were among the first groups to show that immunohistochemical analyses significantly increase the diagnostic yield of biliary strictures.

1. Kung JS, Lopez OA, McCoy EE, Reicher S, Eysselein VE. Fluid genetic analyses predict the biological behavior of pancreatic cysts: three-year experience. JOP. 2014;15(5):427-32.
2. Jahng AW, Reicher S, Chung DS, Varela D, Chhablani R, Dev A, Pham B, Nieto J, Venegas RJ, French SW, Stabile BE, Eysselein VE. Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy. World J Gastrointest Endosc. 2010;2:362-368.
3. Jahng AW, Chung DS, Pham B, Reicher S, Yee B, Abramyan L, Venegas R, French SW, Eysselein VE. Staining for intracytoplasmic lumina and CAM5.2 increases the detection rate of bile duct cancers. 2009;41:965-70.
4. Reicher, S., F.Z. Boyar, M. Albitar, V. Sulcova, S. Agersborg, V. Nga, Y. Zhou, G. Li, R. Venegas, S.W. French, D. Chung, B.E. Stabile, E. Eysselein and A. Anguiano. Fluorescence in situ hybridization and K-ras analyses improve diagnostic yield of endoscopic ultrasound guided fine-needle aspiration of solid pancreatic masses. Pancreas 40: 1057-1062, 2011.
5. Kung JS, O.A. Lopez, E.E. McCoy, S. Reicher, E. Eysselein. Fluid genetic analyses predict the biological behavior of pancreatic cysts: three-year experience. JOP. 15(5):427-32, 2014.
6. Yoo T, Epistola R, Epistola J, Ku L, Fleischman MW, Reicher S, Eysselein VE, Hou LA. Evaluating the risk of adverse events with interventional endoscopic retrograde cholangiopancreatography and endoscopic Ultrasound Procedures in Cirrhotic Patients. World J GastrointestEndosc. 11(11):523-30, 2019.
7. Ku, L., M.A. Shahshahan, L.A. Hou, E. Eysselein, S. Reicher. Improved diagnostic yield of endoscopic ultrasound-fine needle biopsy with histology specimen processing. World Journal of Gastrointestinal Endoscopy 12(8): 212-219, 2020.

Endoscopic treatment of gastroesophageal reflux disease and Barrett’s esophagus.

Acid reflux into the esophagus causes Barrett’s esophagus which can lead dysplasia and finally to esophageal carcinoma.  We could show that dysplasia in Barrett’s esophagus could be successfully eradicated by radiofrequency ablation with or without additional endoscopic mucosal resection avoiding high risk surgeries.

Severe gastroesophageal reflux disease causing regurgitation can be treated by surgery (Nissen fundoplication) if antisecretory treatments fail.  Nissen fundoplication can however have in up to 20% severe side effects such as new onset of dysphagia and the inability to belch.  Endoscopic fundoplication without incision (Transoral Incisionless Fundoplication, TIF) does not have these side effects.  We have performed successfully without complications over 120 TIF procedures with or without laparoscopic hernia repair (a surgical procedure which does not cause dysphagia or inability to belch).  The data are very promising and have been published.

1. Hernandez JC, Reicher S, Chung D, Pham BV, Tsai F, Disibio G, French S, Eysselein VE. Pilot series of radiofrequency ablation of Barrett’s esophagus with and without neoplasia. Endoscopy. 2008;40(5):388-92.
2. Ganz, R.A., B.F. Overholt, V.K. Sharma, D.E. Fleischer, N.J. Shaheen, C.J. Lightdale, S.R. Freeman, R.E. Pruitt, S.M. Urayama, F. Gress, D.A. Pavey, M.S. Branch, T.J. Savides, K.J. Chang, V.R. Bohorfoush, S.C. Pace, S.R. DeMeester, E. Eysselein, M. Panjehpour, G. Triadafilopoulos: Circumferential ablation of Barrett’s esophagus that contains high-grade dysplasia: a U.S. Multicenter Registry.  Gastrointest. Endoscopy 68(1): 35-40, 2008.
3. Gisi C, Wang K, Khan F, Reicher S, Hou L, Fuller C, Sattler J, Eysselein VE (2021). Efficacy and patient satisfaction of single-session transoral incisionless fundoplication and laparoscopic hernia repair. Surg Endosc 2021; 35(2):921-927.

New endoscopic interventional techniques.

Advanced endoscopy and endosonography are main areas of my clinical research.   We could show that

long term stenting using fully covered metal stents for benign bile duct strictures could relief the obstruction in the majority of patients avoiding high risk surgeries. This technique was also used with high success for recalcitrant bile duct leaks.

Fully covered metal stents could also successfully used in the palliation of malignant gastrointestinal obstructions bridging or avoiding surgery. This was also part of a Multi-Center study.

Another project focuses on the use of fully covered metal stents in management benign refractory esophageal strictures. This project was part of a multi-center trial where I was co-investigator.

1. Lalezari D, Singh IM, Reicher S, Eysselein VE. An evaluation of fully covered self-expanding metal stents in benign biliary strictures and complex bile leaks. World J Gastroenterol . 2013;5(7): 332-339.
2. Piesman, M., R.A. Kozarek, J.J. Brandabur, D.K. Pleskow, R. Chuttani, Eysselein VE, W.B. Silverman, J.J. Vargo 2nd, I. Waxman, M.F. Catalano, T.H. Baron, W.G. Parsons 3rd, A. Slivka, D.L. Carr-Locke: Improved oral intake after palliative duodenal stenting for malignant obstruction: a prospective multicenter clinical trial. Am. J. Gastroenterol. 104 (10): 2404-2411, 2009.
3. Gukovsky-Reicher S, Lin RM, Sial SH, Garrett B, Wu D, Lee T, Lee H, Arnell T, Stamos MJ, Eysselein VE. Self-expandable metal stents in palliation of malignant gastrointestinal obstruction. Review of current literature data and 5-year experience at Harbor-UCLA Medical Center. MedGenMed. 2003;5(1):16.

Consortium for the Study of Chronic Pancreatitis, 12/2015-11/2020 Diabetes and Pancreatic Cancer Clinical Centers, 1U01DK108314-01 NIH/NIDDK Co-PI for the Harbor-UCLA Medical Center site.

Positions and Employment:

1977                                  Intern, Surgery, Hospital Schweinfurt, FRG

1977                             Intern, Internal Medicine, University of ULM, FRG

1977-1979                    Army Medical Corps

1979-1981                    Resident, Internal Medicine, University of Essen, FRG

1981-1983                    Research Scholarship, University of California, Los Angeles

and Center for Ulcer Research & Education

1983-1988                    Resident/Fellow, University of Essen, FRG

1988                             Associate Professor of Medicine, University of Essen, Germany

1988-1995                    Associate Professor of Medicine, David Geffen School of Medicine, UCLA

1988-1992                    Director, Biochemistry Core, NHI funded Inflammatory Bowel Disease Center,

Harbor-UCLA Medical Center

1988-present                 Clinical Investigator LABioMed/Lundquist Institute

1991-present                 Chief, Division of Gastroenterology, Harbor-UCLA Medical Center

1995-2007                    Professor of Medicine, David Geffen School of Medicine, UCLA

2007-present                 Clinical Professor of Medicine, David Geffen School of Medicine, UCLA

Honors and Awards:

1987              Thannhauser Award (German Society for Digestive Diseases)

1989              Heisenberg Award (German Research Society)

1988-1989    Physician Scientist Award (NIH)

2003             UCLA Affiliated Fellowship Training Program in Gastroenterology
Distinguished Faculty Teaching Award.

Ongoing Research Support

Boston Scientific Corporation Project:  “A multi-site, single arm, prospective safety & effectiveness study of the WallFlex™ enteral duodenal stent for the palliative treatment of malignant gastroduodenal obstructions”.  TDC: $15,830, IDC: $4,669, TC: $20,500.  V.E. Eysselein, Co-investigator.  March 15, 2005 – March 13, 2007.

Cook Medical Corporation Project: “Clinical investigation to evaluate removal of the evolution esophageal stent – fully covered (Clarity). V.E. Eysselein,Co-PI for HUMC.

October 2013 – July 2017.

NIH/NIDDK, 1U01DK108314-01.  Consortium for the Study of Chronic Pancreatitis,
Diabetes and Pancreartic Cancer Clinical Centers.  V.E. Eysselein, Co-PI for HUMC.

December 2015 – November 2020.

Pfizer Incorporation. A multicenter, randomized, double blind, placebo-controlled, parallel group study of oral CP-690,550 as an induction therapy in subjects with moderate to severe ulcerative colitis.  V.E. Eysselein, PI. September 2014 to December 2015.

Emmaus Incorporation. A pilot/phase 1, interventional open-label, multi-center study to assess the safety and efficacy of L-Glutamine treatment in patients with diverticulosis.  2019