About

Wilson Kwong is an Associate Clinical Professor of Medicine at UC San Diego School of Medicine. He holds a Bachelor of Science and a Master of Science in Biological Sciences from Stanford University, and an MD from the University of Texas Southwestern Medical School. His postgraduate training includes a residency in Internal Medicine at UC San Diego School of Medicine and fellowships in Gastroenterology and Advanced Endoscopy at Mayo Clinic, as well as Pancreatology. His research focuses on various aspects of gastroenterology, including esophageal anatomy and physiology, pancreatic cyst features, achalasia management, and endoscopic techniques. He has contributed to numerous publications in these fields, utilizing tools such as endoscopic ultrasound, manometry, and other diagnostic methods to improve treatment algorithms and patient outcomes. His work often involves the study of pancreatic cysts, esophageal disorders, and minimally invasive endoscopic procedures.

Research topics

• Medicine
• Internal medicine
• Gastroenterology
• Surgery
• Radiology
• General surgery
• Nuclear medicine

Selected publications

• 579 TRIAGING INTEVENTIONAL GI REFERRALS: IMPROVING QUALITY OF CARE AND RESOURCE UTILIZATION

  Gastroenterology · 2026-05-01

  article
  PublisherDOI

• 579 TRIAGING INTEVENTIONAL GI REFERRALS: IMPROVING QUALITY OF CARE AND RESOURCE UTILIZATION

  Gastrointestinal Endoscopy · 2026-05-01

  article
  PublisherDOI

• S3016 Physician Time Spent Triaging Interventional GI Patient Referrals

  The American Journal of Gastroenterology · 2025-10-01

  article

  Introduction: Triaging interventional gastroenterology (GI) referrals improves care efficiency but is associated with large amount of uncompensated work done outside of normal work hours. The purpose of this study was to assess the physician time spent triaging interventional GI procedure and clinic referrals. Methods: Prospective observational study from March 2024 to March 2025 involving an academic medical center with 7 interventional GI endoscopists who share triage referral responsibilities each week they are on call. Physicians performed additional daily triage of referrals directly referred to them. To systematically capture triage work performed by interventional endoscopists, an electronic medical record “smart phrase” was created to track the following variables: Diagnosis/Reason for Triage, Triaging Physician, Triage Disposition, Procedure Ordered, Type of Anesthesia, Time Frame, Requested Provider, Triage Comments. Time spent performing triage work was calculated from the EMR’s user access log. Results: 3009 triages were captured, averaging 57 triages per week (range 14-87). Physicians spent an average of 4.2 minutes in each triage note. The physicians varied in time spent per triage from 2.5 minutes to 5.3 minutes. The on-call attending of the week performed 44% triages. Sixty-nine percent of referrals were triaged directly to procedures, 23% to clinic, and 8% to other (e.g. oncology or surgery or to get more information). Thirty-eight percent of patients were triaged to have urgent (<4 weeks) procedures/visits (5% within 1 week, 12% within 2 weeks, 21% within 4 weeks). The mean amount of time per week spent by the on-call physician doing triage was 98 minutes. The mean amount of time per week spent by the other 6 non-on-call physicians doing triage was 29 minutes. Forty-eight percent of triages were done after hours (5 pm to 7 am) or on weekends/holidays. Conclusion: Half of all referrals triaging by interventional GI endoscopy physicians takes place on night/weekends/holidays. There were 57 triages per week which took an average of 4.2 minutes per triage. The on-call physician spent 98 minutes per week doing triages, while the not on-call physicians each spent 29 minutes doing triages. Although physician triaging referrals improves clinical operations efficiency and patient care by getting the right patient to the right care at the right time, it may decrease physician wellness and compensation.

  PublisherDOI

• PHYSICIAN TRIAGE TIME FOR INTERVENTIONAL GI PROCEDURE REFERRALS - BALANCING PRACTICE EFFICIENCY AND PHYSICIAN WELL-BEING

  Gastrointestinal Endoscopy · 2025-05-01

  article
  PublisherDOI

• Esophageal anatomy and physiology vary across spastic and non‐spastic phenotypes of disorders of esophagogastric junction outflow

  Neurogastroenterology & Motility · 2023-11-27 · 2 citations

  articleOpen access

  Abstract Background Pathophysiologic mechanisms of disorders of esophagogastric junction (EGJ) outflow are poorly understood. We aimed to compare anatomic and physiologic characteristics among patients with disorders of EGJ outflow and normal motility. Methods We retrospectively evaluated adult patients with achalasia types 1, 2, 3, EGJ outflow obstruction (EGJOO) or normal motility on high‐resolution manometry who underwent endoscopic ultrasound (EUS) from January 2019 to August 2022. Thickened circular muscle was defined as ≥1.6 mm. Characteristics from barium esophagram (BE) and functional lumen imaging probe (FLIP) were additionally assessed. Key Results Of 71 patients (mean age 56.2 years; 49% male), there were 8 (11%) normal motility, 58 (82%) had achalasia (5 (7%) type 1, 32 (45%) classic type 2, 21 (30%) type 3 [including 12 type 2 with FEPs]), and 7 (7%) had EGJOO. A significantly greater proportion of type 3 achalasia had thickened distal circular muscle (76.2%) versus normal motility (0%; p &lt; 0.001) or type 2 achalasia (25%; p &lt; 0.001). Type 1 achalasia had significantly wider mean maximum esophageal diameter on BE (57.8 mm) compared to type 2 achalasia (32.8 mm), type 3 achalasia (23.4 mm), EGJOO (15.9 mm), and normal motility (13.5 mm). 100% type 3 achalasia versus 0% type 1 achalasia/normal motility had tertiary contractions on BE. Mean EGJ distensibility index on FLIP was lower for type 3 achalasia (1.2 mmHg/mm 2 ) and EGJOO (1.2 mmHg/mm 2 ) versus type 2 (2.3 mmHg/mm 2 ) and type 1 achalasia (2.9 mmHg/mm 2 ). Conclusions Our findings suggest distinct pathologic pathways may exist: type 3 achalasia and EGJOO may represent a spastic outflow phenotype consisting of a thickened, spastic circular muscle, which is distinct from type 1 and 2 achalasia consisting of a thin caliber circular muscle layer with more prominent esophageal dilation.

  PublisherOA PDFDOI

• Pancreatic cyst features predict future development of pancreatic cancer: results of a nested case-control study

  Gastrointestinal Endoscopy · 2023-10-17 · 4 citations

  articleOpen access

  Background and AimsRisk factors for pancreatic cancer among patients with pancreatic cysts are incompletely characterized. The primary aim of this study was to evaluate risk factors for development of pancreatic cancer among patients with pancreatic cysts.MethodsWe conducted a retrospective case-control study of U.S. veterans with a suspected diagnosis of branch-duct intraductal papillary mucinous neoplasm from 1999 to 2013.ResultsAge (hazard ratio [HR], 1.03 per year; 95% confidence interval [CI], 1.00-1.06), larger cyst size at cyst diagnosis (HR, 1.03 per mm; 95% CI, 1.01-1.04), cyst growth rate (HR, 1.22 per mm/y; 95% CI, 1.14-1.31), and pancreatic duct dilation (5-9.9 mm: HR, 3.78; 95% CI, 1.90-7.51; ≥10 mm: HR, 13.57; 95% CI, 5.49-33.53) were found to be significant predictors for pancreatic cancer on multivariable analysis.ConclusionsAge, cyst size, cyst growth rate, and high-risk or worrisome features were associated with a higher risk of developing pancreatic cancer. Applying current and developing novel strategies is required to optimize early detection of pancreatic cancer after cyst diagnosis. Risk factors for pancreatic cancer among patients with pancreatic cysts are incompletely characterized. The primary aim of this study was to evaluate risk factors for development of pancreatic cancer among patients with pancreatic cysts. We conducted a retrospective case-control study of U.S. veterans with a suspected diagnosis of branch-duct intraductal papillary mucinous neoplasm from 1999 to 2013. Age (hazard ratio [HR], 1.03 per year; 95% confidence interval [CI], 1.00-1.06), larger cyst size at cyst diagnosis (HR, 1.03 per mm; 95% CI, 1.01-1.04), cyst growth rate (HR, 1.22 per mm/y; 95% CI, 1.14-1.31), and pancreatic duct dilation (5-9.9 mm: HR, 3.78; 95% CI, 1.90-7.51; ≥10 mm: HR, 13.57; 95% CI, 5.49-33.53) were found to be significant predictors for pancreatic cancer on multivariable analysis. Age, cyst size, cyst growth rate, and high-risk or worrisome features were associated with a higher risk of developing pancreatic cancer. Applying current and developing novel strategies is required to optimize early detection of pancreatic cancer after cyst diagnosis.

  PublisherOA PDFDOI

• Comparison of cold snare and hot snare polypectomy for the resection of sporadic nonampullary duodenal adenomas

  Gastrointestinal Endoscopy · 2022 · 18 citations

  • Medicine
  • General surgery
  • Surgery

  BACKGROUND AND AIMS: Nonampullary duodenal adenomas can undergo malignant transformation, making endoscopic resection, often by hot snare (HSP) or cold snare polypectomy (CSP), necessary. Although CSP has been shown to be safer for removal of colon polyps, data comparing these techniques for the resection of duodenal adenomas are limited. Our aim was to compare the safety and efficacy of CSP and HSP for the removal of nonampullary duodenal adenomas. METHODS: We performed a retrospective cohort study of patients referred to 2 academic medical centers with a histologically confirmed sporadic, nonampullary duodenal adenoma who underwent endoscopic snare polypectomy between January 1, 2007 and March 1, 2021. Patients with underlying polyposis syndromes were excluded. Outcomes included postprocedural adverse events and polyp recurrence. RESULTS: Of 110 total patients, 69 underwent HSP and 41 underwent CSP. Intraprocedural bleeding was similar between both groups, but 7 patients in the HSP group experienced delayed adverse events versus none in the CSP group (P = .04). Fifty-four patients had complete polyp resection and subsequent surveillance endoscopies. Multivariate analysis showed polyp size to be associated with recurrence (per mm; odds ratio, 1.11; 95% confidence interval, 1.04-1.20; P < .01). Endoscopic resection technique (HSP vs CSP) was not a predictor of recurrence (P = .18). CONCLUSIONS: HSP led to more delayed adverse events compared with CSP, whereas no significant differences on outcomes were noted, suggesting that CSP is equally effective and potentially safer for the removal of duodenal adenomas.

  PublisherOA PDFDOI

• Type<scp>II</scp>achalasia with focal elevated pressures: A distinct manometric and clinical<scp>sub‐group</scp>

  Neurogastroenterology & Motility · 2022 · 8 citations

  • Gastroenterology
  • Internal medicine
  • Medicine

  BACKGROUND: Type II achalasia (Ach2) is distinguished from other achalasia sub-types by the presence of panesophageal pressurization (PEP) of ≥30 mmHg in ≥20% swallows on high-resolution manometry (HRM). Variable manometric features in Ach2 have been observed, characterized by focal elevated pressures (FEPs) (focal/segmental pressures ≥70 mmHg within the PEP band) and/or high compression pressures (PEP ≥70 mmHg). This study aimed to examine clinical and physiologic variables among sub-groups of Ach2. METHODS: This retrospective single center study performed over 3 years (1/2019-1/2022) included adults with Ach2 on HRM who underwent endoscopic ultrasound (EUS), functional lumen imaging probe (FLIP), and/or barium esophagram (BE) prior to therapy. Patients were categorized into two overarching sub-groups: Ach2 without FEPs and Ach2 with FEPs. Demographic, clinical, and physiologic data were compared between these sub-groups utilizing unpaired univariate analyses. KEY RESULTS: /mmHg [0.9] vs 0.9 [0.4]; p = 0.0008) as well as higher distensive pressure (31.0 mmHg [9.8] vs. 55.4 [18.8]; p = 0.01) at 60 cc fill on FLIP, and higher prevalence of chest pain on Eckardt score (p = 0.03). CONCLUSIONS AND INFERENCES: We identified a distinct sub-group of type II achalasia on HRM, defined as type II achalasia with focal elevated pressures. This sub-group uniquely exhibits spastic features and may benefit from personalized treatment approaches.

  PublisherOA PDFDOI

• A link between dishonest data reporting and xenophobia

  Public Health · 2021-01-01

  article1st authorCorresponding
  PublisherDOI

• S483 Esophageal Circular Muscle Thickness With Endoscopic Ultrasound Among Esophageal Motility Disorders

  The American Journal of Gastroenterology · 2021 · 3 citations

  • Medicine
  • Internal medicine
  • Gastroenterology

  Introduction: Esophageal motility disorders comprise heterogeneous pathologies at the lower esophageal sphincter (LES) and/or esophageal body. As endoscopic ultrasound (EUS) can accurately measure muscle thickness, this study aimed to characterize and compare LES and esophageal body muscle thickness among patients with achalasia and normal motility on high-resolution manometry (HRM). Methods: This retrospective, single center study evaluated adult patients with achalasia or normal motility on HRM (Medtronic, Minneapolis, MN; interpreted per Chicago Classification v4.0) who underwent EUS from 01/2019-05/2021. On EUS, measurements of the circular muscle thickness were taken at the LES and every cm proximal until the muscle thickness reached 1mm or less. Mean distal esophageal thickness was calculated as an average of the muscle thickness 6cm proximal to the LES. Distal esophageal thickness was categorized as thickened if ≥ 1.5mm, or not thickened if < 1.5mm. Results: Of 41 patients [mean age 57 years and 47% male], 9 (22%) had normal motility on HRM and 32 (78%) had achalasia [3 (7%) type 1, 20 (49%) type 2, 9 (22%) type 3]. Mean LES muscle was significantly thicker in achalasia vs normal (1.8mm (SD 1.2) vs 0.9 (0.4), P=0.03). Specifically, mean LES muscle thickness was 1.6 (1.2) for type 1, 1.8 (1.4) for type 2, and 1.9 (0.8) for type 3. Mean distal esophageal muscle was significantly thicker in achalasia vs normal (1.9mm (SD 1.4) vs 0.9 (0.4), P=0.05). Specifically, mean distal esophageal muscle thickness was 1.2 (0.6) for type 1, 1.8 (1.4) for type 2, and 2.3 (1.5) for type 3. A thickened distal esophageal muscle was seen in 33% type 1, 50% type 2, and 78% type 3 achalasia patients (Figure 1). Ten of 20 type 2 achalasia patients had a thickened distal esophageal muscle. Of those who underwent barium esophagram, 5/5 (100%) with thickened distal esophageal muscle had tertiary contractions compared to 3/7 (43%) with non-thickened distal esophageal muscle (P=0.08). Conclusion: On EUS, type 1 achalasia exhibits a thickened LES with normalization of circular muscle proximally whereas type 3 achalasia exhibits a thickened LES and distal esophageal muscle, supporting the current paradigm of short myotomy for type 1 and extended myotomy for type 3. Interestingly, manometric type 2 achalasia may represent 2 physiologic phenotypes, one akin to type 1 that may respond well to short myotomy, and one with distal esophageal spasticity that may respond to tailored myotomy.Figure 1:: Figure legend: (A) boxplot depiction of esophageal circular muscle thickness (measured in cm along the x-axis) measured at each cm along the distal esophagus from the lower esophageal sphincter (location 0 on the y-axis) to 6 cm proximal for each achalasia sub-type. (B) proportion of subjects with a thickened esophageal muscle layer (blue) and not thickened muscle layer (orange).Table 1.: Title: Table. Cohort Demographics; Table Key: (a) P-value of comparison between achalasia vs normal (b) P-value of comparison between achalasia type 1, 2, and 3

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Frequent coauthors

• Thomas J. Savides

  University of California, San Diego

  27 shared

• Gobind Anand

  University of California, San Diego

  21 shared

• Syed M. Abbas Fehmi

  14 shared

• Mary L. Krinsky

  University of California San Diego Medical Center

  14 shared

• Samir Gupta

  Moores Cancer Center

  13 shared

• Fady Youssef

  San Francisco VA Medical Center

  13 shared

• Ashley Earles

  11 shared

• Ranier Bustamante

  VA San Diego Healthcare System

  11 shared