Physicians

Department / Division
Medicine / Medicine - Gastroenterology

Address
DUMC 3662
Durham, NC 27710

Appointment Telephone
919-684-6437

Office Telephone
919-684-3787

Fax Telephone
919-479-2664

Training

• MB ChB, University of Cape Town Medical School (South Africa), 1983

Residency

• Internal Medicine, Albert Einstein Medical Center (Pennsylvania), 1986-1989

Fellowship

• Gastroenterology, Duke University Medical Center, 1989-1991

Clinical Interests
Therapeutic ERCP; diagnosis and staging of gastrointestinal and pancreatic malignancies; endoscopic ultrasound (EUS) including EUS-guided fine-needle aspiration; therapeutic endoscopy including endoscopic mucosal resection, endoscopic pseudocyst drainage and enteral stents; management of pancreatitis and biliary and pancreatic stones and strictures

Research Interests
My primary research interest is gastrointestinal endoscopy. Areas of specific investigation relate to endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS) pancreaticobiliary disorders, and competence and training in endoscopic procedures.

Most of my research is clinical. I am participating in the following clinical trials. PI in a study to evaluate whether secretin can prevent post ERCP pancreatitis. I was PI in a study recently completed comparing endoscopic ultrasoune to CT guided fine needle aspiration in the diagnosis of pancreatic masses.

I am actively involved in several studies designed to correlate findings on endoscopic ultrasound with chronic pancreatitis on pancreatic biopsy, compare different types of FNA needles for pancreas masses, and evaluate the efficacy of celiac plexus block for patients with various types of abdominal pain

I have participated as an investigator in studies evaluating the relationship between abnormalities in the CFTR gene and patients with idiopathic pancreatitis.

Special areas of expertise are in endoscopic training and competence, therapeutic ERCP, and endoscopic ultrasound.

Key words: endoscopy training, endoscopy competence, ERCP, pancreatitis, quality improvement, complications, endoscopic ultrasound.

Industry Relationships and Collaborations (What's this?)

This faculty member (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.

• ChiRhoClin, Inc.
• Cook Medical
• Pentax Corp.

Representative Publications
Gerke, H; Jaffe, TA; Mitchell, RM; Byrne, MF; Stiffler, HL; Branch, MS; Baillie, J; Jowell, PS. Endoscopic ultrasound and computer tomography are inaccurate methods of classifying cystic pancreatic lesions. Digestive and Liver Disease. 2006;38:39-44. (2006) Abstract

Cohn, JA; Mitchell, RM; Jowell, PS. The impact of cystic fibrosis and PSTI/SPINK1 gene mutations on susceptibility to chronic pancreatitis. Clinics in Laboratory Medicine. 2005;25:79-100. (2005) Abstract

DeWitt, J; Jowell, P; Leblanc, J; McHenry, L; McGreevy, K; Cramer, H; Volmar, K; Sherman, S; Gress, F. EUS-guided FNA of pancreatic metastases: a multicenter experience. Gastrointestinal Endoscopy. 2005;61:689-696. (2005) Abstract

Green, BT; Rockey, DC; Portwood, G; Tarnasky, PR; Guarisco, S; Branch, MS; Leung, J; Jowell, P. Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. American Journal of Gastroenterology. 2005;100:2395-2402. (2005) Abstract

Volmar, KE; Vollmer, RT; Jowell, PS; Nelson, RC; Xie, HB. Pancreatic FNA in 1000 cases: a comparison of imaging modalities. Gastrointestinal Endoscopy. 2005;61:854-861. (2005) Abstract

Byrne, MF; Gerke, H; Mitchell, RM; Stiffler, HL; McGrath, K; Branch, MS; Baillie, J; Jowell, PS. Yield of endoscopic ultrasound-guided fine-needle aspiration of bile duct lesions. Endoscopy. 2004;36:715-719. (2004) Abstract

Byrne, MF; Mitchell, RM; Gerke, H; Goller, S; Stiffler, HL; Golioto, M; Branch, MS; Jowell, PS; Baillie, J. The need for caution with topical anesthesia during endoscopic procedures, as liberal use may result in methemoglobinemia. Journal of Clinical Gastroenterology. 2004;38:225-229. (2004) Abstract

Cohn, JA; Mitchell, RM; Jowell, PS. The role of cystic fibrosis gene mutations in determining susceptibility to chronic pancreatitis. Gastroenterology Clinics of North America. 2004;33:817-vii. (2004) Abstract

Gerke, H; Byrne, MF; Stiffler, HL; Obando, JV; Mitchell, RM; Jowell, PS; Branch, MS; Baillie, J. Outcome of endoscopic minor papillotomy in patients with symptomatic pancreas divisum. Journal of the Pancreas. 2004;5:122-131. (2004) Abstract

Kalady, MF; Peterson, B; Baillie, J; Onaitis, MW; Abdul-Wahab, OI; Howden, JK; Jowell, PS; Branch, MS; Clary, BM; Pappas, TN; Tyler, DS. Pancreatic duct strictures: identifying risk of malignancy. Annals of Surgical Oncology. 2004;11:581-588. (2004) Abstract

Byrne, MF; Suhocki, P; Mitchell, RM; Pappas, TN; Stiffler, HL; Jowell, PS; Branch, MS; Baillie, J. Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. Journal of the American College of Surgeons. 2003;197:206-211. (2003) Abstract

Cotton, PB; Connor, P; McGee, D; Jowell, P; Nickl, N; Schutz, S; Leung, J; Lee, J; Libby, E. Colonoscopy: practice variation among 69 hospital-based endoscopists. Gastrointestinal Endoscopy. 2003;57:352-357. (2003) Abstract

Devereaux, BM; Fein, S; Purich, E; Trout, JR; Lehman, GA; Fogel, EL; Phillips, S; Etemad, R; Jowell, P; Toskes, PP; Sherman, S. A new synthetic porcine secretin for facilitation of cannulation of the dorsal pancreatic duct at ERCP in patients with pancreas divisum: a multicenter, randomized, double-blind comparative study. Gastrointestinal Endoscopy. 2003;57:643-647. (2003) Abstract

Micames, C; Jowell, PS; White, R; Paulson, E; Nelson, R; Morse, M; Hurwitz, H; Pappas, T; Tyler, D; McGrath, K. Lower frequency of peritoneal carcinomatosis in patients with pancreatic cancer diagnosed by EUS-guided FNA vs. percutaneous FNA. Gastrointestinal Endoscopy. 2003;58:690-695. (2003) Abstract

Bergin, D; Ho, LM; Jowell, PS; Pappas, TN; Paulson, EK. Simple pancreatic cysts: CT and endosonographic appearances. American Journal of Roentgenology. 2002;178:837-840. (2002) Abstract

Byrne, MF; Jowell, PS. Gastrointestinal imaging: endoscopic ultrasound. Gastroenterology. 2002;122:1631-1648. (2002) Abstract

Cohn, JA; Noone, PG; Jowell, PS. Idiopathic pancreatitis related to CFTR: complex inheritance and identification of a modifier gene. Journal of Investigative Medicine. 2002;50:247S-255S. (2002) Abstract

Enns, R; Eloubeidi, MA; Mergener, K; Jowell, PS; Branch, MS; Pappas, TM; Baillie, J. ERCP-related perforations: risk factors and management. Endoscopy. 2002;34:293-298. (2002) Abstract

Mulcahy, HE; Patel, RS; Postic, G; Eloubeidi, MA; Vaughan, JA; Wallace, M; Barkun, A; Jowell, PS; Leung, J; Libby, E; Nickl, N; Schutz, S; Cotton, PB. Yield of colonoscopy in patients with nonacute rectal bleeding: a multicenter database study of 1766 patients. American Journal of Gastroenterology. 2002;97:328-333. (2002) Abstract

tenBerge, J; Hoffman, BJ; Hawes, RH; Van Enckevort, C; Giovannini, M; Erickson, RA; Catalano, MF; Fogel, R; Mallery, S; Faigel, DO; Ferrari, AP; Waxman, I; Palazzo, L; Ben-Menachem, T; Jowell, PS; McGrath, KM; Kowalski, TE; Nguyen, CC; Wassef, WY; Yamao, K; Chak, A; Greenwald, BD; Woodward, TA; Vilmann, P; Sabbagh, L; Wallace, MB. EUS-guided fine needle aspiration of the liver: indications, yield, and safety based on an international survey of 167 cases. Gastrointestinal Endoscopy. 2002;55:859-862. (2002) Abstract

Noone, PG; Zhou, Z; Silverman, LM; Jowell, PS; Knowles, MR; Cohn, JA. Cystic fibrosis gene mutations and pancreatitis risk: relation to epithelial ion transport and trypsin inhibitor gene mutations. Gastroenterology. 2001;121:1310-1319. (2001) Abstract

Wallace, MB; Durkalski, VL; Vaughan, J; Palesch, YY; Libby, ED; Jowell, PS; Nickl, NJ; Schutz, SM; Leung, JW; Cotton, PB. Age and alarm symptoms do not predict endoscopic findings among patients with dyspepsia: a multicentre database study. Gut. 2001;49:29-34. (2001) Abstract

White, RR; Paulson, EK; Freed, KS; Keogan, MT; Hurwitz, HI; Lee, C; Morse, MA; Gottfried, MR; Baillie, J; Branch, MS; Jowell, PS; McGrath, KM; Clary, BM; Pappas, TN; Tyler, DS. Staging of pancreatic cancer before and after neoadjuvant chemoradiation. Journal of Gastrointestinal Surgery. 2001;5:626-633. (2001) Abstract

Anscher, MS; Lee, C; Hurwitz, H; Tyler, D; Prosnitz, LR; Jowell, P; Rosner, G; Samulski, T; Dewhirst, MW. A pilot study of preoperative continuous infusion 5-fluorouracil, external microwave hyperthermia, and external beam radiotherapy for treatment of locally advanced, unresectable, or recurrent rectal cancer. International Journal of Radiation: Oncology - Biology - Physics. 2000;47:719-724. (2000) Abstract

Cohn, JA; Bornstein, JD; Jowell, PS. Cystic fibrosis mutations and genetic predisposition to idiopathic chronic pancreatitis. Medical Clinics of North America. 2000;84:621-ix. (2000) Abstract

Jowell, PS; Robuck-Mangum, G; Mergener, K; Branch, MS; Purich, ED; Fein, SH. A double-blind, randomized, dose response study testing the pharmacological efficacy of synthetic porcine secretin. Alimentary Pharmacology and Therapeutics. 2000;14:1679-1684. (2000) Abstract

McGrath, KM; Jowell, PS. Endoscopic ultrasound. State of the art. North Carolina Medical Journal. 2000;61:408-412. (2000) Abstract

Cohn, JA; Jowell, PS. Are mutations in the cystic fibrosis gene important in chronic pancreatitis?. Surgical Clinics of North America. 1999;79:723-viii. (1999) Abstract

Cohn, JA; Friedman, KJ; Noone, PG; Knowles, MR; Silverman, LM; Jowell, PS. Relation between mutations of the cystic fibrosis gene and idiopathic pancreatitis. New England Journal of Medicine. 1998;339:653-658. (1998) Abstract

Jowell, PS; Baillie, J; Branch, MS; Affronti, J; Browning, CL; Bute, BP. Quantitative assessment of procedural competence. A prospective study of training in endoscopic retrograde cholangiopancreatography. Annals of Internal Medicine. 1996;125:983-989. (1996) Abstract

Jowell, PS; Eisen, G; Onken, J; Bute, BP; Ginsberg, B. Patient-controlled analgesia for conscious sedation during endoscopic retrograde cholangiopancreatography: a randomized controlled trial. Gastrointestinal Endoscopy. 1996;43:490-494. (1996) Abstract

Jowell, PS; Epstein, S; Ismail, F; Hollis, B; Schwartz, IR. Alteration in osteoblast activity and nutritional vitamin-D deficiency in non-hypercalcemic malignancy. Calcified Tissue International. 1988;42:18-22. (1988) Abstract

Jowell, PS; Epstein, S; Fallon, MD; Reinhardt, TA; Ismail, F. 1,25-Dihydroxyvitamin D3 modulates glucocorticoid-induced alteration in serum bone Gla protein and bone histomorphometry. Endocrinology. 1987;120:531-536. (1987) Abstract