William R. Brugge, MD, is the past director of Gastrointestinal Endoscopy at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School. He is interested in the diagnosis and treatment of early gastrointestinal malignancies.
William R. Brugge, MD is the director of the Pancreas-Biliary Center at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School. You may contact him via email: WBrugge@partners.org.
Dr. Brugge is an active clinical consultant in gastroenterology and gastrointestinal endoscopy, focusing on patients with complex pancreatic diseases. His research has focused on the early diagnosis of pancreatic cancer, developing a variety of endoscopic techniques to aspirate malignant and pre-malignant lesions of the pancreas, including mucinous cysts, intra-ductal tumors, and masses. He also performs therapeutic endoscopic procedures such as ERCP, stent placement, FNA and EMR. Currently he is currently conducting a trial of injection therapy for pancreatic cystic neoplasms.
Dr. Brugge is a Fellow of the American Society of Gastrointestinal Endoscopy, the American College of Gastroenterology and the American Gastroenterological Association. Dr. Brugge has published more than 200 manuscripts in the field of gastrointestinal endoscopy.
My clinical research program focuses on the early detection of gastrointestinal malignancy using advanced endoscopic techniques. Using endoscopic confocal microscopy, we compared the diagnostic accuracy of traditional endoscopy with mucosal resection to confocal microscopy in patients with high risk lesions arising from Barrett's esophagus. This clinical research program is conducted in the context of a national prospective multicenter trial (CEBE).
We also use advanced endoscopic techniques for the detection of early pancreatic malignancy arising from cystic lesions of the pancreas. Endoscopic ultrasound is used to guide fine needle aspiration and optical coherence tomography (OCT) imaging. Confocal needle imaging is performed using a novel catheter placed within a EUS needle and guided into a cystic lesion. A variety of cyst fluid markers are used to enhance the diagnostic accuracy of EUS imaging alone. We have examined the accuracy of CEA and cytology in the diagnosis of mucinous cystic lesions. Currently we are investigating new molecular markers such as kRAS and GNAS. For a list of current research projects, please visit Dr. Brugge's research page.
We are currently directing several clinical trials, including EUS guided Abraxane injection of pancreas cysts and a pilot study of confocal endomicroscopy of pancreatic cysts (visit the Clinical Trials website of the National Institutes of Health for more information).
1. Endoscopic evaluation of bile duct strictures. Yoon WJ, Brugge WR Gastrointest Clinics of North Am 2013 Apr;23(2):277-93.
2. Oh HC, Brugge WR.EUS-guided pancreatic cyst ablation: a critical review. Gastrointest Endosc. 2013 Jan 12.
3.Brugge WR. Curr Opin Gastroenterol. 2013 Sep;29(5):559-65.
Endoscopic approach to the diagnosis and treatment of pancreatic disease.
4.Das KK, Xiao H, Geng X, Fernandez-Del-Castillo C, Morales-Oyarvide V, Daglilar E, Forcione DG, Bounds BC, Brugge WR, Pitman MB, Mino-Kenudson M, Das KM.Gut. 2013 Nov 25.
mAb Das-1 is specific for high-risk and malignant intraductal papillary mucinous neoplasm (IPMN).
5. Brugge WR. Gastrointest Endosc. 2013 Sep;78(3):414-20.
EUS: A review of DDW abstracts
6. Controlled swine bile duct ablation with a bipolar radiofrequency catheter Daglilar ES, Yoon WJ, Brugge WR 2013 May;77(5):815-9
7. Pitman MB, Centeno BA, Daglilar ES, Brugge WR, Mino-Kenudson M.Cancer Cytopathol. 2013 Aug 12.
Cytological criteria of high-grade epithelial atypia in the cyst fluid of pancreatic intraductal papillary mucinous neoplasms.
Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is performed with a linear echoendoscope using endoscopic imaging as well as ultrasound guidance. During FNA, the needle can be seen entering the pancreas. For cystic lesions, fluid is removed. For solid lesions, cytologic material is sampled.
Cystic pancreatic lesions are being detected with increasing frequency, and pancreatic cystic neoplasms account for the majority of these lesions. Designed for medical professionals, this video illustrates the use of endoscopic ultrasound and cyst fluid analysis in differential diagnosis of cystic pancreatic lesions.
Up until the mid-1990s, physicians knew little about the relationship between pancreatic cysts and pancreatic cancer. But collaborative research conducted by gastroenterologists, surgeons, radiologists, and pathologists at the Massachusetts General Hospital Digestive Healthcare Center has led to a much greater understanding of pancreatic cystadenomas and what makes some cysts progress to cancer. These advances are opening up new therapies to target this deadly cancer early on, when it is most treatable.
Patients seeking care for pancreatic and biliary system disorders at Massachusetts General Hospital’s Digestive Healthcare Center receive the latest in diagnostic and therapeutic treatments from a collaborative team of experts, including gastroenterologists, interventional endoscopists, pathologists, medical oncologists, surgeons, radiation oncologists, and radiation therapists.
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