Vous êtes ici : Accueil > Espace Médecin > La revue de Presse > Gastrointestinal endoscopy

Mise à jour le : 27-02-2017




Les derniers abstracts de la revue Gastrointestinal Endoscopy :


    Date de mise en ligne : Jeudi 23 février 2017
    Riccardo Solimando, Alessandro Pezzoli, Viviana Cifalà, Lucio Trevisani, Paolo Pazzi
    Unexpected Finding After Gastroduodenal Artery Embolization


    Date de mise en ligne : Jeudi 23 février 2017
    Silvia Carrara, Milena Di Leo, Alessandro Repici
    Not only biliary, but also ureteral stones can be detected by EUS


    Date de mise en ligne : Jeudi 23 février 2017
    R. Gaspar, P. Moutinho-Ribeiro, G. Macedo
    Bullous pemphigoid: extensive esophageal involvement


    Date de mise en ligne : Jeudi 23 février 2017
    Ervin Alibegovic, Admir Kurtcehajic, Ahmed Hujdurovic, Adnan Zeco, Dzenita Kurtcehajic
    Acute submucosal hematoma: an adverse event of the routine colonoscopy


    Date de mise en ligne : Jeudi 23 février 2017
    Xiaoyu Tang, Yuyong Tan, Deliang Liu
    Angiolipoma: a rare esophageal submucosal tumor


    Date de mise en ligne : Mardi 21 février 2017
    Daniela G. Vinsard, Wei-Chung Chen, Victoria Gómez
    Endoscopic band ligation in diverticular bleeding: a stepwise approach for successful treatment


    Date de mise en ligne : Mardi 21 février 2017
    Sindhu Barola, Yen-I. Chen, Saowanee Ngamruengphong, Anthony N. Kalloo, Mouen A. Khashab, Vivek Kumbhari
    Technical aspects of endoscopic sleeve gastroplasty


    Date de mise en ligne : Mardi 21 février 2017
    Takao Nishikawa, Shinichiro Okabe, Toshio Tsuyuguchi, Soichiro Kiyono, Shuichi Saito
    Endoscopic recovery of multiple migrated plastic stents during EUS-guided transmural drainage of pancreatic fluid collections


    Date de mise en ligne : Mardi 21 février 2017
    Yen-I. Chen, Haruhiro Inoue, Michael Ujiki, Peter V. Draganov, Paul Colavita, Francois Mion, John Romanelli, Philip Chiu, Valerio Balassone, Lava Patel, Ali Abbas, Dennis Yang, Christy Dunst, Mathieu Pioche, Sabine Roman, Jérôme Rivory, Thierry Ponchon, David Desilets, Roberta Maselli, Manabu Onimaru, Jun Nakamura, Yoshitaka Hata, Gulara Hajiyeva, Amr Ismail, Saowanee Ngamruengphong, Majidah Bukhari, Yamile Haito Chavez, Vivek Kumbhari, Alessandro Repici, Mouen A. Khashab
    An international multicenter study evaluating the clinical efficacy and safety of per-oral endoscopic myotomy in octogenarians
    Per-oral endoscopic myotomy (POEM) for achalasia is particularly appealing in the elderly due to its minimally invasiveness; however, data in patients age ≥ 80 years are scarce. The aim of this study was to assess the clinical outcome of POEM in octogenarians.


    Date de mise en ligne : Mardi 21 février 2017
    Fariha H. Ramay, Qingping Cui, Bruce D. Greenwald
    Outcomes after liquid nitrogen spray cryotherapy in Barrett's esophagus-associated high-grade dysplasia and intramucosal adenocarcinoma: 5-year follow-up
    Liquid nitrogen spray cryotherapy (LNSCT) has been shown to be a safe, well-tolerated, and effective therapy for Barrett’s esophagus (BE)-associated high grade dysplasia (BE-HGD) and intramucosal adenocarcinoma (IMC). Long-term follow-up is lacking.


    Date de mise en ligne : Lundi 20 février 2017
    Tejas Kirtane, Bharat Bhandari, Larry D. Scott, Shashideep Singhal
    Overtube-assisted pneumatic dilation for achalasia in Megaesophagus


    Date de mise en ligne : Vendredi 10 février 2017
    Takuto Suzuki, Taro Hara, Yoshiyasu Kitagawa, Hideyuki Takashiro, Rino Nankinzan, Osamu Sugita, Taketo Yamaguchi
    Linked-color imaging improves endoscopic visibility of colorectal nongranular flat lesions
    As a newly developed image-enhanced endoscopy (IEE) technique, linked-color imaging (LCI) provides very bright images with enhanced color tones. With the objective of improving the detection rate of colorectal flat tumor lesions, which are difficult to detect, we examined the usefulness of LCI from the viewpoint of visibility.


    Date de mise en ligne : Mercredi 08 février 2017
    Shishira Bharadwaj, Bo Shen
    Medical, endoscopic, and surgical management of ileal pouch strictures (with video)
    The construction of ileal pouch-anal anastomosis (IPAA) is the procedure of choice for patients with ulcerative colitis or familial adenomatous polyposis, who require colectomy. Furthermore, IPAA has the advantage of preserving the natural route of defecation unlike the Brooke’s ileostomy or continent ileostomies. On the other hand, the natural history of patients with the ileal pouch can be complicated by various surgical-procedure–associated mechanical adverse events as well as inflammatory and functional disorders.


    Date de mise en ligne : Mardi 07 février 2017
    Wouter F.W. Kappelle, Ronald L.A.W. Bleys, Albert J.M. van Wijck, Peter D. Siersema, Frank P. Vleggaar
    EUS-guided celiac ganglia neurolysis: a clinical and human cadaver study (with video)
    There is little evidence that structures targeted during EUS-guided celiac ganglia neurolysis (EUS-CGN) are celiac ganglia and that selective ethanol injection into ganglia is feasible. We aimed to visualize celiac ganglia, confirm that these structures are ganglia, and visualize ethanol spread after EUS-CGN and EUS-guided celiac plexus neurolysis (EUS-CPN).


    Date de mise en ligne : Mardi 07 février 2017
    Ankie Reumkens, Ad A.M. Masclee, Bjorn Winkens, Cees T. van Deursen, Silvia Sanduleanu, C. Minke Bakker
    Prevalence of hypokalemia before and after bowel preparation for colonoscopy in high-risk patients
    Bowel preparation for colonoscopy should not cause significant shifts in systemic electrolyte concentrations. We recently encountered 2 cases of severe postcolonoscopy hypokalemia with fatal consequences, prompting us to conduct a study to explore the magnitude of and risk factors for hypokalemia associated with bowel preparation. We paid specific attention to higher risk subgroups, in particular diuretic users, hospitalized patients and patients estimated at to be high risk by the gastroenterologist.


    Date de mise en ligne : Mardi 07 février 2017
    Chai Ning-Li, Feng Jia, Guo Yu-Hang, Li Hui-Kai, Ning Bo Wang, Xiangdong Wang, Wang Ying, Wang Yong-hua, Zhai Ya-qi, Linghu En-Qiang
    A preliminary study of single operator cholangioscopy for diagnosing pancreatic cystic lesions
    Advances in imaging technology have improved the annual detection rate of pancreatic cystic lesions, but the preoperative diagnosis of pancreatic cystic lesions remains unclear. Thus, the usefulness of single operator cholangioscopy (SOC) as a diagnostic imaging tool for pancreatic cystic lesions is worth investigating. We performed an intracystic visual examination of pancreatic cystic lesions using SOC to determine the diagnostic value of SOC for pancreatic cystic lesions.


    Date de mise en ligne : Samedi 04 février 2017
    Huiqin He, Chenfei Tan, Jiaguo Wu, Ning Dai, Weiling Hu, Yawen Zhang, Loren Laine, James Scheiman, John J. Kim
    Accuracy of ASGE High-Risk Criteria in Evaluation of Patients with Suspected Common Bile Duct Stones
    Endoscopic retrograde cholangiopancreatography (ERCP) is recommended for patients considered high-risk for choledocholithiasis after biochemical testing and abdominal ultrasound. Our aim was to determine whether American Society for Gastrointestinal Endoscopy (ASGE) guidelines accurately select patients where the risk of ERCP is justified.


    Date de mise en ligne : Samedi 04 février 2017
    Shozo Osera, Hiroaki Ikematsu, Satoshi Fujii, Keisuke Hori, Yasuhiro Oono, Tomonori Yano, Kazuhiro Kaneko
    Endoscopic Treatment Outcomes of Laterally Spreading Tumors with a Skirt (with video)
    A “skirt” is a slightly elevated flat lesion with wide pits occasionally observed at the margin of laterally spreading tumors (LSTs). However, the endoscopic treatment outcomes of LSTs with skirts have not been clarified. The aim of this study was to evaluate the endoscopic treatment outcomes of LSTs with skirts.


    Date de mise en ligne : Samedi 04 février 2017
    Tannaz Guivatchian, Erika S. Koeppe, Jason R. Baker, Cristina Moisa, Matthew Demerath, Caitlin Foor-Pessin, William D. Chey, Shanti L. Eswaran, Joseph C. Kolars, Stacy B. Menees, Michael Rajala, Michael D. Rice, Rafat Rizk, Joel H. Rubenstein, Pratima Sharma, Andrea Todisco, Elena M. Stoffel
    Family History in Colonoscopy Patients: Feasibility and Performance of Electronic and Paper-based Surveys for Colorectal Cancer Risk Assessment in the Outpatient Setting
    Family history is crucial in stratifying patients’ risk for colorectal cancer (CRC). Previous risk assessment tools developed for use in clinic or endoscopy settings have demonstrated suboptimal specificity for identifying patients with hereditary cancer syndromes. Our aim was to test the feasibility and performance of 2 family history surveys (paper and electronic) in individuals presenting for outpatient colonoscopy.


    Date de mise en ligne : Samedi 04 février 2017
    Abdul M. Kouanda, Ma Somsouk, Justin L. Sewell, Lukejohn W. Day
    Urgent colonoscopy in patients with lower gastrointestinal bleeding: A systematic review and meta-analysis
    Lower GI bleeding is a common cause of morbidity and mortality. Colonoscopy is indicated in all hospitalized patients with lower gastrointestinal bleeding, yet the time frame for performing colonoscopy remains unclear. Prior studies of outcomes in urgent versus elective colonoscopy have yielded conflicting results and were often underpowered. Our study objective was to compare several outcomes between urgent and elective colonoscopy in patients hospitalized for lower GI bleeding.


    Date de mise en ligne : Vendredi 03 février 2017
    Hsiang-Chieh Lee, Osman O. Ahsen, Kaicheng Liang, Zhao Wang, Marisa Figueiredo, Michael G. Giacomelli, Benjamin Potsaid, Qin Huang, Hiroshi Mashimo, James G. Fujimoto
    Endoscopic optical coherence tomography angiography microvascular features associated with dysplasia in Barrett's esophagus: a pilot study (with video)
    Angiogenesis is associated with neoplastic progression of Barrett’s esophagus (BE). Volumetric optical coherence tomography angiography (OCTA) visualizes subsurface microvasculature without exogenous contrast agents. We investigated the association of OCTA microvascular features with low-grade dysplasia (LGD) and high-grade dysplasia (HGD).


    Date de mise en ligne : Vendredi 03 février 2017
    Árpád Patai, Norbert Solymosi, László Mohácsi, Árpád V. Patai
    Indomethacin and diclofenac in the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis of prospective controlled trials
    Diclofenac and indomethacin are the most studied drugs for preventing post-ERCP pancreatitis (PEP). However, there are no prospective, randomized multicenter trials with sufficient number of patients for the correct evaluation of their efficacy. Our aim was to evaluate of all trials published in full text and studied efficacy of diclofenac or indomethacin prospective controlled with placebo or non-treatment for the prevention of PEP in adult patients undergoing ERCP.


    Date de mise en ligne : Mercredi 01 février 2017
    Sunil Dacha, Parit Mekaroonkamol, Lianyong Li, Nikrad Shahnavaz, Sonali Sakaria, Steven Keilin, Field Willingham, Jennifer Christie, Qiang Cai
    Outcomes and quality-of-life assessment after gastric per-oral endoscopic pyloromyotomy (with video)
    Gastric per-oral endoscopic pyloromyotomy (GPOEM) is emerging as a promising option for the treatment of gastroparesis. This study assessed outcomes and quality-of-life after GPOEM for gastroparesis, performed in an endoscopy unit at a major tertiary referral center.


    Date de mise en ligne : Mercredi 01 février 2017
    A. Swager, A.J. de Groof, S.L. Meijer, B.L. Weusten, W.L. Curvers, J.J. Bergman
    Feasibility of laser marking in Barrett’s esophagus with Volumetric laser endomicroscopy First-in-man pilot study
    Volumetric laser endomicroscopy (VLE) provides a circumferential scan of the esophageal wall layers, and has potential to improve neoplasia detection in Barrett’s esophagus (BE). The novel VLE laser marking system enables direct in vivo marking of suspicious areas as identified on VLE. These laser marked areas can subsequently be targeted for biopsies. The aim was to evaluate the visibility and positional accuracy of laser marks in different esophageal tissue types on white-light endoscopy (WLE) and VLE.


    Date de mise en ligne : Mercredi 01 février 2017
    Alessandro Repici, Roberta Maselli, Silvia Carrara, Andrea Anderloni, Markus Enderle, Cesare Hassan
    Standard needle versus needleless injection modality: animal study on different fluids for submucosal elevation
    Submucosal injection is currently used in GI endoscopy to reduce resection risks and to perform submucosal dissection; it is usually performed via an injection needle or via a needleless device. The aim of the study was to compare 2 submucosal injection modalities (needle-assisted vs needleless) by using substances with different viscosities


    Date de mise en ligne : Mardi 31 janvier 2017
    Hamita Sachar, Nipaporn Pichetshote, Kavitha Nandigam, Keta Vaidya, Loren Laine
    Continued midazolam versus diphenhydramine in difficult-to-sedate patients: a randomized double-blind trial
    Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine to continued midazolam in such patients.


    Date de mise en ligne : Mardi 31 janvier 2017
    Sharmila Subramaniam, Fergus Chedgy, Gaius Longcroft Wheaton, Kesavan Kandiah, Roberta Maselli, Stefan Seewald, Alessandro Repici, Pradeep Bhandari
    Complex early Barrett’s neoplasia at 3 Western centers: European Barrett’s Endoscopic Submucosal Dissection Trial (E-BEST)
    Endoscopic submucosal dissection (ESD) is an effective technique to resect early Barrett’s neoplasia and has advantages over conventional endoscopic mucosal resection (EMR) as it enables en bloc resection and accurate histopathological analysis of cancer resection margins. However, its long learning curve and higher adverse event rate has tempered its uptake in the West. We aimed to analyze the safety and efficacy of ESD when used to resect complex Barrett’s neoplasia. The primary endpoint was the en bloc and R0 resection rate.


    Date de mise en ligne : Mardi 31 janvier 2017
    Bo Shen
    Exploring endoscopic therapy for the treatment of Crohn’s disease-related fistula and abscess
    Fistula and abscess represents penetrating disease phenotype of Crohn’s disease (CD), and they can develop in patients with or without prior history of CD-related surgery. Although CD fistula and abscess have been traditionally treated with medical and surgical therapy, the role of endoscopic therapy in this particularly phenotype of CD is expanding recently, thanks to advanced endoscopic techniques and our better understanding of pathogenesis and natural history of the disease and principle of treatment.


    Date de mise en ligne : Mardi 31 janvier 2017
    Takeshi Mizushima, Shunsuke Ohnishi, Hidetaka Hosono, Kenichi Yamahara, Momoko Tsuda, Yuichi Shimizu, Mototsugu Kato, Masahiro Asaka, Naoya Sakamoto
    Oral administration of conditioned medium obtained from mesenchymal stem cell culture prevents subsequent stricture formation after esophageal submucosal dissection in pigs
    Endoscopic submucosal dissection (ESD) for esophageal cancer often causes postoperative stricture when more than three-quarters of the circumference of the esophagus is dissected. Mesenchymal stem cells are a valuable cell source in regenerative medicine, and conditioned medium (CM) obtained from mesenchymal stem cells reportedly inhibits inflammation. In this study, we evaluated whether CM could prevent esophageal stricture after ESD.


    Date de mise en ligne : Lundi 30 janvier 2017
    Joseph C. Anderson, Lynn F. Butterly, Julia E. Weiss, Christina M. Robinson
    Providing Data for Serrated Polyp Detection Rate Benchmarks: An Analysis of the New Hampshire Colonoscopy Registry
    Similar to achieving adenoma detection rate (ADR) benchmarks to prevent colorectal cancer (CRC), achieving adequate serrated polyp detection rates (SDR) may be essential to the prevention of CRC associated with the serrated pathway. Previous studies have been based on data from high-volume endoscopists at single academic centers. Based on a hypothesis that ADR is correlated with SDR, we stratified a large, diverse group of endoscopists (n=77 practicing at 28 centers) into high and low performers based on ADR, to provide data for corresponding target SDR benchmarks.


    Date de mise en ligne : Lundi 30 janvier 2017
    Zibing Woodward, Zaida Rodriguez, Janice Jou, Kian Keyashian, Yiyi Chen, Charles R. Thomas, Grace H. Elta, Sharlene L. D’Souza
    Gender Disparities in Gastroenterology Fellowship Director Positions in the United States
    Despite a paucity of women occupying leadership positions in academic medicine, studies have shown a higher ratio of female representation in the program director position compared with division chief in multiple specialties. This study aims to determine whether this trend exists in 3-year gastroenterology fellowships in the United States and to evaluate for any factors that may affect these differences.


    Date de mise en ligne : Dimanche 29 janvier 2017
    Hiroaki Ikematsu, Taku Sakamoto, Kazutomo Togashi, Naohisa Yoshida, Takashi Hisabe, Shinsuke Kiriyama, Koji Matsuda, Yoshikazu Hayashi, Takahisa Matsuda, Shozo Osera, Kazuhiro Kaneko, Kenichi Utano, Yuji Naito, Hiroshi Ishihara, Masayuki Kato, Kenichi Yoshimura, Hideki Ishikawa, Hironori Yamamoto, Yutaka Saito
    Detectability of colorectal neoplastic lesions using a novel endoscopic system with blue laser imaging: a multicenter randomized controlled trial
    Most studies have not reported an improvement in the detection of adenoma with the use of image-enhanced colonoscopy methods, possibly due to the darkness of the images. To overcome this limitation, a new-generation endoscopic system has been developed. This system has 2 blue-laser imaging (BLI) observation modes. The BLI observation was set to BLI-bright mode to detect lesions. We aimed to evaluate the efficacy of BLI in detecting lesions.


    Date de mise en ligne : Dimanche 29 janvier 2017
    Fabio S. Kawaguti, Adriana R. de Andrade, Stephanie Wodak, Bruno Costa Martins, Fauze Maluf-Filho
    Complete therapeutic response of a large tubulovillous adenoma after chemotherapy
    We describe the case of a woman who underwent urgent right hemicolectomy for obstructive advanced neoplasia. Histopathologic examination revealed poorly differentiated mucinous adenocarcinoma with invasion to the subserosa without vascular or perineural invasion. Seven of 28 resected regional lymph nodes were metastatic (pT3pN2M0). Immunohistochemical study showed microsatellite instability. Adjuvant chemotherapy with oxaliplatin, 5-fluorouracil, leucovorin, and folinic acid was initiated. Colonoscopy revealed a 40-mm sessile polyp in the sigmoid colon with a noninvasive aspect at magnification.


    Date de mise en ligne : Samedi 28 janvier 2017
    Iyad Khamaysi, Yoram Kluger
    The water-lily sign
    A 23-year-old healthy woman presented with epigastric pain. The result of gastroscopy was normal. CT showed 2 adjacent cysts in the lesser sac: a unilocular cyst (A, black arrow) and a septated cyst (A, white arrow). EUS demonstrated 2 cystic lesions: the first cyst was anechoic unilocular, with a thick calcified wall, and the second lesion contained floating laminated membranes within a dense fibrous cystic wall—a finding termed the water-lily sign (B). A hydatid cyst was suspected. Puncture was not performed.


    Date de mise en ligne : Vendredi 27 janvier 2017
    Eun Jung Jun, Jung-Hoon Park, Jiaywei Tsauo, Su-Geun Yang, Dae-Kee Kim, Kun Yung Kim, Min Tae Kim, Sung Hwan Yoon, Young Je Lim, Ho-Young Song
    EW-7197, a Activin-like Kinase 5 inhibitor, Suppresses Granulation Tissue after Stent Placement in Rat Esophagus
    Self-expanding metallic stent (SEMS) placement is a well-established method for treating malignant esophageal strictures; however, this procedure has not gained widespread acceptance for treating benign esophageal strictures because of the granulation tissue formation. The aim of the present study was to investigate if EW-7197, a novel per-oral transforming growth factor-β type I receptor kinase inhibitor, suppressed granulation tissue formation after SEMS placement in the rat esophagus.


    Date de mise en ligne : Vendredi 27 janvier 2017
    Timo Rath, Christian Bojarski, Markus F. Neurath, Raja Atreya
    Molecular imaging of mucosal α4β7 integrin expression with the fluorescent anti-adhesion antibody vedolizumab in Crohn’s disease
    Molecular imaging is based on the use of fluorescent probes with specificity toward defined molecular targets and their visualization by endoscopic devices such as confocal laser endomicroscopy (CLE). Herein, we describe successful molecular imaging of the α4β7 integrin through CLE in Crohn’s disease (CD). Five patients with CD refractory to anti-tumor necrosis factor (TNF) therapy and with active mucosal inflammation, as shown by high-definition endoscopy, were studied (A). Before induction therapy with the anti-α4β7 antibody vedolizumab (VDZ), molecular imaging of α4β7 with fluorescein isothiocyanate (FITC)–labeled VDZ allowed specific identification of α4β7 expressing mucosal cells with clear discrimination against FITC-IgG1 isotype control in 2 patients with CD responding to subsequent VDZ therapy (B).


    Date de mise en ligne : Vendredi 27 janvier 2017
    Tomonori Yano, Yusuke Yoda, Shogo Nomura, Kayo Toyosaki, Hiromi Hasegawa, Hiroyuki Ono, Masaki Tanaka, Hiroyuki Morimoto, Takahiro Horimatsu, Satoru Nonaka, Kazuhiro Kaneko, Akihiro Sato
    Prospective trial of biodegradable stents for refractory benign esophageal strictures after curative treatment of esophageal cancer
    Biodegradable stents are reportedly effective for refractory benign esophageal stricture, however little is known for patients with refractory stricture after endoscopic submucosal dissection (ESD) or chemoradiotherapy (CRT) for esophageal cancer. This study aimed to evaluate the effectiveness of biodegradable stents for these patients.


    Date de mise en ligne : Mercredi 25 janvier 2017
    Abdul Hamid El Chafic, David Loren, Ali Siddiqui, Rawad Mounzer, Natalie Cosgrove, Thomas Kowalski
    Comparison of fine-needle aspiration and fine-needle biopsy for EUS-guided sampling of suspected GI stromal tumors
    Subepithelial lesions (SEL) are found in about 1% of all esophagogastroduodenoscopy (EGD) procedures, and GI stromal tumors (GISTs) are a type of SEL commonly encountered. Although the majority of SELs are benign, GISTs have malignant potential, making a definitive diagnosis important. Currently, the criterion standard for the diagnosis of GISTs is EUS-directed fine-needle aspiration (EUS-FNA). The definitive diagnosis of GISTs relies upon immunohistochemical (IHC) staining, which depends on enough tissue being submitted to the pathologist.


    Date de mise en ligne : Mercredi 25 janvier 2017
    Guilherme Piovezani Ramos, Korosh Sharain, Karthik Ravi
    Juvenile polyposis and hereditary hemorrhagic telangiectasia overlap syndrome
    A 67-year-old woman with a history of ulcerative colitis, status postproctocolectomy with end ileostomy, presented with persistent iron-deficiency anemia. Her family history was significant for a daughter with gastric cancer and intracranial aneurysms. Physical examination showed multiple cherry angiomas and superficial telangiectasias on her upper back. An extended upper endoscopy revealed several large nonbleeding angioectasias throughout the stomach and the duodenum (A). Additionally, multiple 2-mm to 12-mm pedunculated and sessile polyps with no bleeding were found throughout the duodenum (B).


    Date de mise en ligne : Vendredi 20 janvier 2017
    ASGE Technology Committee, John T. Maple, Rahul Pannala, Barham K. Abu Dayyeh, Harry R. Aslanian, Brintha K. Enestvedt, Adam Goodman, Sri Komanduri, Michael Manfredi, Udayakumar Navaneethan, Mansour A. Parsi, Zachary L. Smith, Nirav Thosani, Shelby A. Sullivan, Subhas Banerjee
    Interventional EUS (with videos)
    The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration [FDA] Center for Devices and Radiological Health) database search to identify the reported adverse events of a given technology.


    Date de mise en ligne : Mercredi 18 janvier 2017
    Swathi Eluri, Nicholas J. Shaheen
    Barrett's Esophagus: Diagnosis and Management


    Date de mise en ligne : Lundi 09 janvier 2017
    Giovanni D. De Palma, Mariano C. Giglio, Dario Bruzzese, Nicola Gennarelli, Francesco Maione, Saverio Siciliano, Benedetta Manzo, Gianluca Cassese, Gaetano Luglio
    Cap cuff–assisted colonoscopy versus standard colonoscopy for adenoma detection: a randomized back-to-back study
    EndoCuff is a disposable device applied to standard colonoscopes to improve mucosal visualization. Randomized parallel trials have shown that EndoCuff increases the adenoma detection rate (ADR). The primary aim of this study was to compare the ADR between EndoCuff-assisted colonoscopies (EAC) and standard colonoscopies within a randomized back-to-back trial.


    Date de mise en ligne : Lundi 09 janvier 2017
    Loai Mansour, Ferial El-Kalla, Hanan El-Bassat, Sherief Abd-Elsalam, Mohamed El-Bedewy, Abdelrahman Kobtan, Rehab Badawi, Mohamed Elhendawy
    Randomized controlled trial of scleroligation versus band ligation alone for eradication of gastroesophageal varices
    Gastric varices develop in 5% to 33% of patients with portal hypertension. Their most common form is concomitant gastroesophageal varices. Scleroligation (combined sclerotherapy and band ligation) has been used successfully in management of esophageal varices but has not been evaluated previously in the management of gastroesophageal varices. The aim of this work was evaluation of a new scleroligation technique for management of bleeding gastroesophageal varices regarding efficacy, adverse events, variceal recurrence, and survival.


    Date de mise en ligne : Vendredi 06 janvier 2017
    Eelco C. Brand, Vincent K. Dik, Martijn G.H. van Oijen, Peter D. Siersema
    Missed adenomas with behind-folds visualizing colonoscopy technologies compared with standard colonoscopy: a pooled analysis of 3 randomized back-to-back tandem colonoscopy studies
    The Third Eye Retroscope, Full Spectrum Endoscope (FUSE), and EndoRings devices have been shown to reduce overall adenoma miss rates. We evaluated the characteristics of adenomas and patient subgroups for which these behind-folds visualizing technologies mostly reduce adenoma miss rates.


    Date de mise en ligne : Vendredi 06 janvier 2017
    Mona Rezapour, Chidi Amadi, Lauren Gerson
    Retention associated with video capsule endoscopy: systematic review and meta-analysis
    Video capsule endoscopy (VCE) has become a major diagnostic tool for small-bowel evaluation. However, retention of the video capsule endoscope remains a major concern.


    Date de mise en ligne : Mercredi 04 janvier 2017
    Reem Z. Sharaiha, Muhammad Ali Khan, Faisal Kamal, Amy Tyberg, Claudio R. Tombazzi, Bilal Ali, Claudio Tombazzi, Michel Kahaleh
    Efficacy and safety of EUS-guided biliary drainage in comparison with percutaneous biliary drainage when ERCP fails: a systematic review and meta-analysis
    EUS-guided biliary drainage (EUS-BD) is increasingly used as an alternate therapeutic modality to percutaneous transhepatic biliary drainage (PTBD) for biliary obstruction in patients who fail ERCP. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 procedures.


    Date de mise en ligne : Mardi 03 janvier 2017
    Robert J. Huang, Nirav C. Thosani, Monique T. Barakat, Abhishek Choudhary, Alka Mithal, Gurkirpal Singh, Saurabh Sethi, Subhas Banerjee
    Evolution in the utilization of biliary interventions in the United States: results of a nationwide longitudinal study from 1998 to 2013
    Bile duct surgery (BDS), percutaneous transhepatic cholangiography (PTC), and ERCP are alternative interventions used to treat biliary disease. Our aim was to describe trends in ERCP, BDS, and PTC on a nationwide level in the United States.


    Date de mise en ligne : Mardi 03 janvier 2017
    Zhen-Hua Zhao, Liang-Hao Hu, Hong-Bo Ren, An-Jing Zhao, Yang-Yang Qian, Xiao-Tian Sun, Song Su, Shu-Guang Zhu, Jin Yu, Wen-Bin Zou, Xiao-Rong Guo, Lei Wang, Zhao-Shen Li, Zhuan Liao
    Incidence and risk factors for post-ERCP pancreatitis in chronic pancreatitis
    Almost all studies on post-ERCP pancreatitis (PEP) have mainly involved patients with biliary diseases rather than chronic pancreatitis (CP), and the concept that CP seems to be a protective factor associated with PEP has not been studied in detail. The aim of this study was to determine the incidence of PEP in patients with CP at different clinical stages and to identify the predictive and protective factors of PEP in a large cohort.


    Date de mise en ligne : Vendredi 23 décembre 2016
    Vitor Sousa Medeiros, Bruno Costa Martins, Luciano Lenz, Maria Sylvia Ierardi Ribeiro, Gustavo Andrade de Paulo, Marcelo Simas Lima, Adriana Vaz Safatle-Ribeiro, Fabio Shighuehissa Kawaguti, Caterina Pennacchi, Sebastian N. Geiger, Victor R. Bastos, Ulysses Ribeiro-Junior, Rubens A. Sallum, Fauze Maluf-Filho
    Adverse events of self-expandable esophageal metallic stents in patients with long-term survival from advanced malignant disease
    Self-expandable metallic stents are considered the best palliative treatment of dysphagia for patients with advanced esophageal cancer. Adverse events (AEs) are a major concern, especially in patients with better prognosis and longer survival. The present study aimed to evaluate the AEs of patients who survived longer than 6 months with esophageal stents in place.


    Date de mise en ligne : Vendredi 23 décembre 2016
    Jasper L.A. Vleugels, Yark Hazewinkel, Paul Fockens, Evelien Dekker
    Natural history of diminutive and small colorectal polyps: a systematic literature review
    Diminutive (1-5 mm) and small (6-9 mm) polyps comprise 90% of detected lesions during colonoscopy and rarely contain advanced histology or colorectal cancer (CRC). Routine removal of these lesions results in a significant burden to colonoscopy programs. At the same time, the risk for progression of these polyps to CRC is unclear. We performed a systematic review to explore the natural history of diminutive and small colorectal polyps.


    Date de mise en ligne : Jeudi 22 décembre 2016
    Lyndon V. Hernandez
    How robust is our peer-review system? A review of emerging models
    Peer review is an enduring institution for ensuring quality and integrity of research. Every year dedicated editors and reviewers carefully sift through thousands of manuscripts and videos from behind the scenes. This scholarly cycle of sorting, correcting, purging, and publishing is almost routine and was taken for granted, until something unthinkable happened that alarmed the scientific world. A submitting author systematically recommended names of potential reviewers to scientific journals and then hacked into their electronic editorial systems to provide fictitious e-mail addresses, enabling him to create favorable reviews that led to his manuscripts being accepted and published.


    Date de mise en ligne : Jeudi 22 décembre 2016
    Rintaro Hashimoto, Dai Hirasawa, Akimichi Chonan, Hajime Yamaoka, Masato Nakahori
    “Small white sign” in Barrett’s esophageal cancer under the squamous epithelium
    A 74-year-old man visited our hospital because of epigastric discomfort. EGD revealed a subtle reddish, flat, elevated lesion 40 mm in diameter in the right anterior wall of the esophagogastric junction (A). Examination of a biopsy specimen revealed a well-differentiated adenocarcinoma. Irregular meshlike vessels were observed within the lesion using magnifying narrow-band imaging (NBI) endoscopy (B). Acetic acid spraying revealed multiple small white spots on the neighboring squamous epithelium (C, arrows).


    Date de mise en ligne : Jeudi 22 décembre 2016
    Bryan Rea, Dale Frank
    An uncommon manifestation of acute leukemia
    A 49-year-old man with no significant medical history presented with melena and persistent hematochezia. Colonoscopy revealed a 2.0-cm erythematous polyp in the distal sigmoid colon (A), which was removed by hot snare polypectomy. Hematoxylin and eosin–stained sections showed adenomatous colonic epithelium. The lamina propria was expanded by an infiltrate of large mitotically active cells with irregular nuclei, fine chromatin, and prominent nucleoli (B). Immunohistochemical stains confirmed that they were CD4+ CD15+ CD68+ (C) CD117+ lysozyme+ MPO+ (D) CD34− blasts.


    Date de mise en ligne : Mercredi 21 décembre 2016
    Yuga Komaki, Fukiko Komaki, Dejan Micic, Akio Ido, Atsushi Sakuraba
    Risk of colorectal cancer in chronic liver diseases: a systematic review and meta-analysis
    The risk of colorectal cancer (CRC) in various chronic liver diseases compared with the general population remains unclear. We performed a systematic review and meta-analysis to assess the risk of CRC in patients with chronic liver diseases before and after liver transplantation.


    Date de mise en ligne : Mercredi 21 décembre 2016
    Umar Hayat, Peter J. Lee, Hamid Ullah, Shashank Sarvepalli, Rocio Lopez, John J. Vargo
    Association of prophylactic endotracheal intubation in critically ill patients with upper GI bleeding and cardiopulmonary unplanned events
    Prophylactic endotracheal intubation (PEI) is often advocated to mitigate the risk of cardiopulmonary adverse events in patients presenting with brisk upper GI bleeding (UGIB). However, the benefit of such a measure remains controversial. Our study aimed to compare the incidence of cardiopulmonary unplanned events between critically ill patients with brisk UGIB who underwent endotracheal intubation versus those who did not.


    Date de mise en ligne : Dimanche 18 décembre 2016
    Satoshi Kinoshita, Toshihiro Nishizawa, Yasutoshi Ochiai, Toshio Uraoka, Teppei Akimoto, Ai Fujimoto, Tadateru Maehata, Osamu Goto, Takanori Kanai, Naohisa Yahagi
    Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma
    Endoscopic biopsy sampling for the diagnosis of duodenal adenocarcinoma is not perfect. We investigated the accuracy of biopsy specimen diagnoses of superficial nonampullary duodenal epithelial tumors (NADETs).


    Date de mise en ligne : Jeudi 15 décembre 2016
    David S. Zimmon, Fred B. Smith, Forrest Manheimer, Cathy Fan, Chantel Njiwaji, Sergei Aksenov, Premtesh Chattoo
    Endoscopic multiple biopsy and rapid diagnosis by in situ fixation and histopathologic processing
    Endoscopic forceps biopsy and fixation are laborious and prolong the procedure and anesthesia. Multiple biopsy overcomes these shortcomings with a single endoscope pass that cuts, like a needle biopsy, up to 25 biopsy samples of uniform size and depth during endoscope withdrawal. Biopsy specimens are collected in acquisition order and stored in a perforated plastic storage chamber within the perforated metal tip. The tip is cut off, immersed in fixative, and sent to pathology. A formatted log identifies each biopsy specimen by site and position.


    Date de mise en ligne : Mercredi 14 décembre 2016
    Yu-Hsi Hsieh, Chih-Wei Tseng, Chi-Tan Hu, Malcolm Koo, Felix W. Leung
    Prospective multicenter randomized controlled trial comparing adenoma detection rate in colonoscopy using water exchange, water immersion, and air insufflation
    Adenoma detection rate (ADR), defined as the proportion of patients with at least one adenoma of any size, is a quality indicator. We tested the hypothesis that water exchange (WE) improves ADR but water immersion (WI) has no adverse effect on ADR compared with air insufflation (AI).


    Date de mise en ligne : Vendredi 09 décembre 2016
    K. Nadine Phoa, Wilda D. Rosmolen, Bas L.A.M. Weusten, Raf Bisschops, Erik J. Schoon, Shefali Das, Krish Ragunath, G. Fullarton, Massimiliano DiPietro, Narayanasamy Ravi, Jan G.P. Tijssen, Marcel G.W. Dijkgraaf, Jacques J.G.H.M. Bergman, SURF investigators
    The cost-effectiveness of radiofrequency ablation for Barrett's esophagus with low-grade dysplasia: results from a randomized controlled trial (SURF trial)
    The Surveillance versus Radiofrequency Ablation (SURF) trial randomized 136 patients with Barrett's esophagus (BE) containing low-grade dysplasia (LGD), to receive radiofrequency ablation (ablation, n = 68) or endoscopic surveillance (control, n = 68). Ablation reduced the risk of neoplastic progression to high-grade dysplasia and esophageal adenocarcinoma (EAC) by 25% over 3 years (1.5% for ablation vs 26.5% for control). We performed a cost-effectiveness analysis from a provider perspective alongside this trial.


    Date de mise en ligne : Jeudi 08 décembre 2016
    Harathi Yandrapu, Madhav Desai, Sameer Siddique, Prashanth Vennalganti, Sreekar Vennalaganti, Sravanthi Parasa, Tarun Rai, Vijay Kanakadandi, Ajay Bansal, Mohammad Titi, Alessandro Repici, Matthew L. Bechtold, Prateek Sharma, Abhishek Choudhary
    Normal saline solution versus other viscous solutions for submucosal injection during endoscopic mucosal resection: a systematic review and meta-analysis
    EMR is being increasingly practiced for the removal of large colorectal polyps. A variety of solutions such as normal saline solution (NS) and other viscous and hypertonic solutions (VS) have been used as submucosal injections for EMR. A systematic review and meta-analysis is presented comparing the efficacy and adverse events of EMR performed using NS versus VS.


    Date de mise en ligne : Mardi 06 décembre 2016
    Takemasa Hayashi, Shin-ei Kudo, Hideyuki Miyachi, Tatsuya Sakurai, Tomoyuki Ishigaki, Yusuke Yagawa, Naoya Toyoshima, Yuichi Mori, Masashi Misawa, Toyoki Kudo, Kunihiko Wakamura, Atushi Katagiri, Toshiyuki Baba, Fumio Ishida
    Management and risk factor of stenosis after endoscopic submucosal dissection for colorectal neoplasms
    Although endoscopic submucosal dissection (ESD) enables en bloc removal of large colorectal neoplasms, the incidence of stenosis after ESD and its risk factors have not been well described. This study aimed to determine the risk factors of stenosis and verify the surveillance and treatment of stenosis.


    Date de mise en ligne : Lundi 05 décembre 2016
    Shinichiro Sakata, Antonio H.S. Lee, Ammar O. Kheir, Nicholas J. Tutticci, Sanjeev Naidu, Andrew R.L. Stevenson, David G. Hewett
    Patient acceptance of the optical diagnosis and misdiagnosis of diminutive colorectal polyps
    Optical diagnosis allows for real-time endoscopic assessment of colorectal polyp histology and consists of the resect and discard and diagnose and leave paradigms. This survey assessed patient acceptance of optical diagnosis and their responses to a hypothetical doomsday scenario.


    Date de mise en ligne : Lundi 05 décembre 2016
    Sheila Kumar, Nirav Thosani, Uri Ladabaum, Shai Friedland, Ann M. Chen, Rajan Kochar, Subhas Banerjee
    Adenoma miss rates associated with a 3-minute versus 6-minute colonoscopy withdrawal time: a prospective, randomized trial
    The 6-minute withdrawal time for colonoscopy, widely considered the standard of care, is controversial. The skill and technique of endoscopists may be as important as, or more important than, withdrawal time for adenoma detection. It is unclear whether a shorter withdrawal time with good technique yields an acceptable lesion detection rate. Our objective was to evaluate a 3-minute versus a 6-minute withdrawal time by using segmental tandem colonoscopy.


    Date de mise en ligne : Lundi 28 novembre 2016
    David J. Tate, Lobke Desomer, Amir Klein, Gregor Brown, Luke F. Hourigan, Eric Y.T. Lee, Alan Moss, Donald Ormonde, Spiro Raftopoulos, Rajvinder Singh, Stephen J. Williams, Simon Zanati, Karen Byth, Michael J. Bourke
    Adenoma recurrence after piecemeal colonic EMR is predictable: the Sydney EMR recurrence tool
    EMR is the primary treatment of large laterally spreading lesions (LSLs) in the colon. Residual or recurrent adenoma (RRA) is a major limitation. We aimed to identify a robust method to stratify the risk of RRA.


    Date de mise en ligne : Lundi 28 novembre 2016
    Shuntaro Mukai, Takayoshi Tsuchiya, Takao Itoi, Shujiro Tsuji, Reina Tanaka, Ryosuke Tonozuka, Yuichi Nagakawa, Kazuhiko Kasuya, Masaaki Shimatani, Atsushi Sofuni
    Prospective evaluation of a new biflanged metal stent for the treatment of pancreatic fluid collections (with videos)
    EUS-guided transluminal drainage (EUS-TD) and sequential direct endoscopic necrosectomy (DEN) for pancreatic fluid collections (PFCs) by using a dedicated biflanged metal stent (BFMS) has been reported as a useful alternative to using plastic stents or a conventional metal stent. However, current dedicated BFMSs have limitations. Recently, a new BFMS with solidly constructed biflanges and various stent lengths matched to the PFC condition has been developed. Herein, we prospectively evaluated this new BFMS for the treatment of PFCs.


    Date de mise en ligne : Samedi 26 novembre 2016
    Arvind J. Trindade, Sumant Inamdar, Michael S. Smith, Kenneth J. Chang, Cadman L. Leggett, Charles J. Lightdale, Douglas K. Pleskow, Divyesh V. Sejpal, Guillermo J. Tearney, Rebecca M. Thomas, Michael B. Wallace
    Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users
    Targeting neoplasia in Barrett’s esophagus (BE) is challenging. Volumetric laser endomicroscopy (VLE) is a new imaging technique that allows for real time cross-sectional microstructure imaging that can detect BE neoplasia. The interobserver agreement among users in practice is unknown.


    Date de mise en ligne : Samedi 26 novembre 2016
    Qing-yuan Li, Yan Meng, Yu-yuan Xu, Qiang Zhang, Jian-qun Cai, Hao-xuan Zheng, Hai-tao Qing, Si-lin Huang, Ze-long Han, Ai-min Li, Ying Huang, Ya-li Zhang, Fa-chao Zhi, Rui-jun Cai, Yue Li, Wei Gong, Si-de Liu
    Comparison of endoscopic submucosal tunneling dissection and thoracoscopic enucleation for the treatment of esophageal submucosal tumors
    Endoscopic submucosal tunneling dissection (ESTD) has been proved to be safe and effective for removal of esophageal submucosal tumors (SMTs) and can maintain the mucosal integrity compared with other endoscopic methods. The aim of the study was to estimate the safety and efficacy of ESTD as well as compare its efficacy with thoracoscopic enucleation for esophageal SMTs, which is used increasingly as a minimally invasive approach.


    Date de mise en ligne : Samedi 26 novembre 2016
    Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim, Hyun Kyun Ki
    A randomized controlled trial of prophylactic antibiotics in the prevention of electrocoagulation syndrome after colorectal endoscopic submucosal dissection
    Endoscopic submucosal dissection (ESD) is currently commonly performed, but colorectal ESD has a substantial risk of adverse events, including post-ESD electrocoagulation syndrome (PEECS). We investigated whether the use of prophylactic antibiotics can reduce the occurrence of PEECS.


    Date de mise en ligne : Vendredi 25 novembre 2016
    Rawad Mounzer, Gregory L. Austin, Sachin Wani, Brian C. Brauer, Norio Fukami, Raj J. Shah
    Per-oral video cholangiopancreatoscopy with narrow-band imaging for the evaluation of indeterminate pancreaticobiliary disease
    Cholangiopancreatoscopy for evaluating pancreaticobiliary pathology is currently limited by suboptimal optics. The aim of this study was to characterize the operating characteristics of per-oral video cholangiopancreatoscopy with narrow-band imaging (POVCP) findings in indeterminate pancreaticobiliary disease and to describe their association with neoplasia.


    Date de mise en ligne : Vendredi 25 novembre 2016
    Dep K. Huynh, Leanne Toscano, Vinh-An Phan, Tsai-Wing Ow, Mark Schoeman, Nam Q. Nguyen
    Ultrathin disposable gastroscope for screening and surveillance of gastroesophageal varices in patients with liver cirrhosis: a prospective comparative study
    This study aims to evaluate the role of unsedated, ultrathin disposable gastroscopy (TDG) against conventional gastroscopy (CG) in the screening and surveillance of gastroesophageal varices (GEVs) in patients with liver cirrhosis.


    Date de mise en ligne : Jeudi 24 novembre 2016
    John M. DeWitt, S. Krishna Murthy, Ramesh Ardhanari, G. Aaron DuVall, Grzegorz Wallner, Paul Litka, Claire Daugherty, Kirk Fowers
    EUS-guided paclitaxel injection as an adjunctive therapy to systemic chemotherapy and concurrent external beam radiation before surgery for localized or locoregional esophageal cancer: a multicenter prospective randomized trial
    OncoGel (Protherics Salt Lake City, Inc, Salt Lake City, UT) is paclitaxel (PTX) formulated in a thermosensitive, biodegradable copolymer for focused cytotoxicity and radiosensitization. A phase 2a study suggested that EUS-guided PTX injection into esophageal tumors subsequently receiving radiotherapy was safe.


    Date de mise en ligne : Mercredi 23 novembre 2016
    Yosuke Toya, Masaki Endo, Shotaro Nakamura, Risaburo Akasaka, Takashi Kosaka, Shunichi Yanai, Keisuke Kawasaki, Keisuke Koeda, Tamotsu Sugai, Takayuki Matsumoto
    Clinical outcomes of non-curative endoscopic submucosal dissection with negative resected margins for gastric cancer
    There has been little information about the long-term outcomes of patients with early gastric cancer (EGC) treated by non-curative endoscopic submucosal dissection (ESD) with negative resected margins (R0 resection). We aimed to compare the clinical outcomes of non-curative ESD with R0 resection between patients who underwent additional gastrectomy and those who did not.


    Date de mise en ligne : Mercredi 23 novembre 2016
    Su Young Kim, Jun-Won Chung, Dong Kyun Park, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Jung Ho Kim
    Comparison of carbon dioxide and air insufflation during consecutive EGD and colonoscopy in moderate-sedation patients: a prospective, double-blind, randomized controlled trial
    Endoscopy is performed with air insufflation and is usually associated with abdominal pain. It is well recognized that carbon dioxide (CO2) is absorbed more quickly into the body than air; however, to date, few studies have investigated the use of CO2 insufflation during consecutive EGD and colonoscopy (CEC). Thus, this study evaluated the efficacy of CO2 insufflation compared with air insufflation in CEC.


    Date de mise en ligne : Mercredi 23 novembre 2016
    Jennifer Nayor, John R. Saltzman, Emily J. Campbell, Molly L. Perencevich, Kunal Jajoo, James M. Richter
    Impact of physician compliance with colonoscopy surveillance guidelines on interval colorectal cancer
    Interval colorectal cancer (iCRC) incidence is the criterion standard benchmark for measuring the effectiveness of colonoscopy. Colonoscopy surveillance guidelines are designed to minimize iCRC cases. Our aims were to describe characteristics of iCRC patients and to assess whether development of iCRC is related to colonoscopy surveillance guideline intervals.


    Date de mise en ligne : Mercredi 23 novembre 2016
    Michael J. Bartel, Timothy M. Wallace, Rene D. Gomez-Esquivel, Massimo Raimondo, Herbert C. Wolfsen, Timothy A. Woodward, Michael B. Wallace
    Role of EUS in patients with suspected Barrett’s esophagus with high-grade dysplasia or early esophageal adenocarcinoma: impact on endoscopic therapy
    Endoscopic therapy is the standard treatment for high-grade dysplasia and some cases of T1a esophageal adenocarcinoma (EAC), but it is not appropriate for deeply invasive disease. Data on the value of EUS for patient selection for endoscopic or surgical resection are conflicting. We investigated the outcome of esophageal EUS for the staging and treatment selection of patients with treatment-naive, premalignant Barrett’s esophagus (BE) and suspected superficial EAC.


    Date de mise en ligne : Mercredi 23 novembre 2016
    Michael J. Levy, Steven R. Alberts, William R. Bamlet, Patrick A. Burch, Michael B. Farnell, Ferga C. Gleeson, Michael G. Haddock, Michael L. Kendrick, Ann L. Oberg, Gloria M. Petersen, Naoki Takahashi, Suresh T. Chari
    EUS-guided fine-needle injection of gemcitabine for locally advanced and metastatic pancreatic cancer
    Among the greatest hurdles to pancreatic cancer (PC) therapy is the limited tissue penetration of systemic chemotherapy because of tumor desmoplasia. The primary study aim was to determine the toxicity profile of EUS-guided fine-needle injection (EUS-FNI) with gemcitabine. Secondary endpoints included the ability to disease downstage leading to an R0 resection and overall survival (OS) at 6 months, 12 months, and 5 years after therapy.


    Date de mise en ligne : Mercredi 23 novembre 2016
    Seung Hun Kang, Yoon Tae Jeen, Jae Hyung Lee, In Kyung Yoo, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Hong Sik Lee, Hoon Jai Chun, Chang Duck Kim
    Comparison of a split-dose bowel preparation with 2L polyethylene glycol plus ascorbic acid and 1L polyethylene glycol plus ascorbic acid and bisacodyl before colonoscopy
    Recently a low-volume polyethylene glycol containing ascorbic acid (PEG-Asc) formulation has proven as safe and effective as traditional 4L PEG solutions for colonoscopy preparation. However, currently available aqueous purgative formulations are poorly tolerated. The aim of this study was to compare a split-dose 2L PEG-Asc and a 1L PEG-Asc with bisacodyl (10 mg) formulation to determine the quality of bowel cleansing and patient tolerability.


    Date de mise en ligne : Mardi 22 novembre 2016
    James W. Walter, William Klump, Francis Spitz, Adam Elfant, Henry C. Ho
    A large degenerated GI stromal tumor presenting as a peripancreatic cyst
    A 21-year-old man presented to the hospital with progressive abdominal distension. On examination, there was a palpable midline mass. CT demonstrated a well-circumscribed, septated, cystic mass in the left upper quadrant, measuring approximately 18 cm (A). EUS demonstrated a normal pancreas with a distinct septated mass (B). FNA yielded 30 mL of amber fluid that demonstrated a paucicellular specimen with proteinaceous debris and rare glandular cells. Fluid chemistry determinations showed carcinoembryonic antigen 0.9 ng/mL and amylase 15 U/L.


    Date de mise en ligne : Lundi 21 novembre 2016
    Shinya Sugimoto, Makoto Naganuma, Yasushi Iwao, Katsuyoshi Matsuoka, Masayuki Shimoda, Shuji Mikami, Shinta Mizuno, Yoshihiro Nakazato, Kosaku Nanki, Nagamu Inoue, Haruhiko Ogata, Takanori Kanai
    Endoscopic morphologic features of ulcerative colitis–associated dysplasia classified according to the SCENIC consensus statement
    Recent advances in endoscopic equipment and diagnostic techniques have made possible the detection of early dysplasia in the inflamed mucosa of ulcerative colitis (UC). The SCENIC consensus statement recommends the use of unified terminology for the morphology of dysplasia. In this study, we investigated the endoscopic features of high-grade dysplasia (HGD) in a clinical setting.


    Date de mise en ligne : Lundi 21 novembre 2016
    David H. Johnson, John B. Kisiel, Kelli N. Burger, Douglas W. Mahoney, Mary E. Devens, David A. Ahlquist, Seth Sweetser
    Multitarget stool DNA test: clinical performance and impact on yield and quality of colonoscopy for colorectal cancer screening
    Multitarget stool DNA (MT-sDNA) testing is now approved by the U.S. Food and Drug Administration for average-risk colorectal cancer screening. Trials leading to its approval used blinded colonoscopy as the reference standard. In the postapproval screen setting, the clinical performance and impact of MT-sDNA testing on unblinded colonoscopy has not been described. We measured the impact that knowledge of a positive MT-sDNA test result has on colonoscopy yield and quality.


    Date de mise en ligne : Samedi 19 novembre 2016
    Huiyun Zhu, Yuanhang Dong, Pei Xie, Zhendong Jin, Yiqi Du
    Cumbersome removal of a lumen-apposing metal stent in a case of refractory pancreatic pseudocyst
    A 32-year-old man with previous severe pancreatitis received a diagnosis of pancreatic pseudocyst and was treated by 3 different methods of drainage. There was no communication between the pseudocyst and the pancreatic duct. The pseudocyst was first discovered 3 years previously (A) and was treated by percutaneous drainage. One year later, in August 2014, the patient presented with abdominal pain and distension again, and EUS showed a huge pseudocyst (15 cm × 15 cm) in the body of the pancreas. We placed a biliary metal stent under the guidance of EUS and removed it 4 months later, but the pseudocyst recurred afterward.


    Date de mise en ligne : Samedi 19 novembre 2016
    Roberto Grassia, Elena Iiritano, Katerina Vjero, Fabrizio Cereatti, Pietro Capone, Federico Buffoli
    Severe acute diverticular bleeding: successful treatment with hemostatic powder
    A 50-year-old man was admitted to the intensive coronary care unit for acute myocardial infarction and was treated by coronary artery stenting and dual antiplatelet therapy. On postprocedure day 5, the patient presented with massive hematochezia, anemia (hemoglobin 10.4 g/dL), and hypovolemic shock. After hemodynamic stabilization, a mesenteric angiogram revealed a left-sided colonic hemorrhage highly suggestive of diverticular bleeding (A, white arrow). Selective embolization was ruled out because of the risk of bowel infarction.


    Date de mise en ligne : Samedi 19 novembre 2016
    Toyoki Kudo, Shin-ei Kudo, Yuichi Mori, Kunihiko Wakamura, Masashi Misawa, Takemasa Hayashi, Hideyuki Miyachi, Atsushi Katagiri, Fumio Ishida, Haruhiro Inoue
    Classification of nuclear morphology in endocytoscopy of colorectal neoplasms
    We investigated endocytoscopy (EC) findings that were considered risk factors for colorectal neoplasms and determined whether they could be used as new indices to identify carcinomas with massive submucosal invasion (SM-m) or worse outcomes.


    Date de mise en ligne : Jeudi 17 novembre 2016
    Tarun Rustagi, Shayan Irani, D. Nageshwar Reddy, Barham K. Abu Dayyeh, Todd H. Baron, Christopher J. Gostout, Michael J. Levy, John Martin, Bret T. Petersen, Andrew Ross, Mark D. Topazian
    Radiofrequency ablation for intraductal extension of ampullary neoplasms
    Extension of ampullary adenomas into the common bile duct (CBD) or pancreatic duct (PD) may be difficult to treat endoscopically. We evaluated the feasibility, safety, and efficacy of endoscopic radiofrequency ablation (RFA) in the management of ampullary neoplasms with intraductal extension.


    Date de mise en ligne : Vendredi 11 novembre 2016
    Sundeep Lakhtakia, Jahangeer Basha, Rupjyoti Talukdar, Rajesh Gupta, Zaheer Nabi, Mohan Ramchandani, B.V.N. Kumar, Partha Pal, Rakesh Kalpala, P. Manohar Reddy, R. Pradeep, Jagadish R. Singh, G.V. Rao, D. Nageshwar Reddy
    Endoscopic “step-up approach” using a dedicated biflanged metal stent reduces the need for direct necrosectomy in walled-off necrosis (with videos)
    EUS-guided drainage using plastic stents may be inadequate for treatment of walled-off necrosis (WON). Recent studies report variable outcomes even when using covered metal stents. The aim of this study was to evaluate the efficacy of a dedicated covered biflanged metal stent (BFMS) when adopting an endoscopic “step-up approach” for drainage of symptomatic WON.


    Date de mise en ligne : Jeudi 03 novembre 2016
    Saurabh Sethi, Robert J. Huang, Monique T. Barakat, Niaz Banaei, Shai Friedland, Subhas Banerjee
    Adenosine triphosphate bioluminescence for bacteriologic surveillance and reprocessing strategies for minimizing risk of infection transmission by duodenoscopes
    Recent outbreaks of duodenoscope-transmitted infections underscore the importance of adequate endoscope reprocessing. Adenosine triphosphate (ATP) bioluminescence testing allows rapid evaluation of endoscopes for bacteriologic/biologic residue. In this prospective study we evaluate the utility of ATP in bacteriologic surveillance and the effects of endoscopy staff education and dual cycles of cleaning and high-level disinfection (HLD) on endoscope reprocessing.


    Date de mise en ligne : Mercredi 02 novembre 2016
    Ralf Kiesslich, Markus F. Neurath
    Advanced endoscopy imaging in inflammatory bowel diseases
    Rapid assessment of mucosal inflammation is of crucial importance for the initial diagnosis and the assessment of mucosal healing in inflammatory bowel disease (IBD). Moreover, the identification of intraepithelial neoplasias in IBD is of key relevance for clinical management. Here, we systematically analyzed the utility of advanced endoscopic imaging techniques for optimized diagnosis in IBD.


    Date de mise en ligne : Mercredi 02 novembre 2016
    Shaffer R.S. Mok, Henry C. Ho, Paurush Shah, Milan Patel, John P. Gaughan, Adam B. Elfant
    Lactated Ringer's solution in combination with rectal indomethacin for prevention of post-ERCP pancreatitis and readmission: a prospective randomized, double-blinded, placebo-controlled trial
    Prospective data have shown the benefit of rectal indomethacin (IND) for preventing post-ERCP pancreatitis (PEP). A recent pilot study demonstrated a lower incidence of PEP after an 8-hour lactated Ringer’s solution (LR) infusion. The aim of this study was to evaluate the efficacy of IND with or without bolus LR in patients at high-risk for PEP.


    Date de mise en ligne : Mardi 01 novembre 2016
    Vladimir Milivojevic, Ivan Rankovic, Ljiljana Milic, Vasilije Jeremic, Ivan Jovanovic
    Mobile phone in the stomach: call the emergency endoscopist!
    A 39-year-old man presented to the emergency department with profuse melena accompanied by lightheadedness and vertigo. He reported having had 4 black, tarry stools during the past day and acknowledged having taken nonsteroidal anti-inflammatory drugs (NSAIDs) for the past 2 months for abdominal pain. In his personal history, cerebral palsy was present. Clinical and laboratory investigations yielded a Glasgow-Blatchford score of 8. Emergency endoscopy verified large amounts of hematin in his stomach; thus, the patient was referred to the surgical intensive care unit, where he received supportive and pharmacotherapeutic measures.


    Date de mise en ligne : Mardi 01 novembre 2016
    Layth Al-Jashaami, Rashmi Kumar, Rakesh Nanda
    A ribbon in the esophagus
    A 96-year-old man with a history of hypertension and inguinal hernia presented with a “sore throat” of 6 months’ duration, progressively getting worse, associated with a productive yellowish cough and occasional nausea and vomiting, mainly occurring in the evening after eating dinner. He was very active; he walked 4 to 5 miles daily when playing golf 5 days a week and did not use a golf cart! He had quit smoking at age 50 and abstained from alcohol. The results of his physical examination were unremarkable, and laboratory tests showed normal results.


    Date de mise en ligne : Lundi 31 octobre 2016
    Apostolos V. Tsolakis, Paul D. James, Gilaad G. Kaplan, Robert P. Myers, James Hubbard, Todd Wilson, Scott Zimmer, Rachid Mohamed, Martin Cole, Sydney Bass, Mark G. Swain, Steven J. Heitman
    Clinical prediction rule to determine the need for repeat ERCP after endoscopic treatment of postsurgical bile leaks
    In patients who have undergone ERCP with biliary stenting for postsurgical bile leaks, the optimal method (ERCP or gastroscopy) and timing of stent removal is controversial. We developed a clinical prediction rule to identify cases in which a repeat ERCP is unnecessary.


    Date de mise en ligne : Jeudi 20 octobre 2016
    Tarun Rustagi, Ferga C. Gleeson, Suresh T. Chari, Barham K. Abu Dayyeh, Michael B. Farnell, Prasad G. Iyer, Michael L. Kendrick, Randall K. Pearson, Bret T. Petersen, Elizabeth Rajan, Mark D. Topazian, Mark J. Truty, Santhi S. Vege, Kenneth K. Wang, Michael J. Levy
    Remote malignant intravascular thrombi: EUS-guided FNA diagnosis and impact on cancer staging
    Malignant vascular invasion usually results from gross direct infiltration from a primary tumor and impacts cancer staging, prognosis, and therapy. However, patients may also develop a remote malignant thrombi (RMT), defined as a malignant intravascular thrombus located remote and noncontiguous to the primary tumor. Our aim was to compare EUS, CT, and magnetic resonance imaging (MRI) findings of RMT and to explore the potential impact on cancer staging.


    Date de mise en ligne : Mercredi 19 octobre 2016
    Prasanna Ponugoti, Jingmei Lin, Robert Odze, Dale Snover, Charles Kahi, Douglas K. Rex
    Prevalence of sessile serrated adenoma/polyp in hyperplastic-appearing diminutive rectosigmoid polyps
    The American Society for Gastrointestinal Endoscopy recommends that distal colon hyperplastic lesions can be left in place without resection if adenomatous histology can be excluded with >90% negative predictive value. However, some lesions could be sessile serrated adenomas/polyps (SSA/Ps), which is also precancerous. The aim of this study was to describe the prevalence of SSA/Ps in hyperplastic-appearing diminutive rectosigmoid polyps.


    Date de mise en ligne : Samedi 15 octobre 2016
    Eun Hye Kim, Jun Chul Park, In Ji Song, Yeong Jin Kim, Dong Hoo Joh, Kyu Yeon Hahn, Yong Kang Lee, Ha Yan Kim, Hyunsoo Chung, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
    Prediction model for non-curative resection of endoscopic submucosal dissection in patients with early gastric cancer
    Endoscopic submucosal dissection (ESD) is a useful method for complete resection of early gastric cancer (EGC). However, there are still some patients who undergo additional gastrectomy after ESD because of non-curative resection. There is no model that can accurately predict non-curative resection of ESD. We aimed to create a model for predicting non-curative resection of ESD in patients with EGC.


    Date de mise en ligne : Samedi 15 octobre 2016
    Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
    Pancreatic juice cytology with immunohistochemistry to detect malignancy and histologic subtypes in patients with branch duct type intraductal papillary mucinous neoplasms of the pancreas
    The aim of this study was to elucidate the efficacy of pancreatic juice cytology with the cell-block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN).


    Date de mise en ligne : Samedi 15 octobre 2016
    Amy Tyberg, Stefan Seewald, Reem Z. Sharaiha, Guadalupe Martinez, Amit P. Desai, Nikhil A. Kumta, Arnon Lambroza, Amrita Sethi, Kevin M. Reavis, Ketisha DeRoche, Monica Gaidhane, Michael Talbot, Payal Saxena, Felipe Zamarripa, Maximilien Barret, Nicholas Eleftheriadis, Valerio Balassone, Haruhiro Inoue, Michel Kahaleh
    A multicenter international registry of redo per-oral endoscopic myotomy (POEM) after failed POEM
    Per-oral endoscopic myotomy (POEM) has become an accepted treatment for patients with achalasia. Despite its excellent efficacy rate of greater than 80%, a small percentage of patients remain symptomatic after the procedure. Limited data exist as to the best management for recurrence of symptoms after POEM. We present the first international, multicenter experience on the efficacy and safety of a repeat POEM in the management of achalasia.


    Date de mise en ligne : Samedi 15 octobre 2016
    Shannon Melissa Chan, Anthony Yuen Bun Teoh, Hon Chi Yip, Vivien Wai Yin Wong, Philip Wai Yan Chiu, Enders Kwok Wai Ng
    Feasibility of per-oral cholecystoscopy and advanced gallbladder interventions after EUS-guided gallbladder stenting (with video)
    The recent development of EUS-guided gallbladder drainage (EGBD) with a lumen-apposing stent has made endoscopic assessment and advanced gallbladder interventions via the stent possible. The aim of this study was to assess the feasibility and safety of per-oral cholecystoscopy and the types of gallbladder interventions that can be performed.


    Date de mise en ligne : Vendredi 14 octobre 2016
    Masau Sekiguchi, Ichiro Oda, Haruhisa Suzuki, Seiichiro Abe, Satoru Nonaka, Shigetaka Yoshinaga, Hirokazu Taniguchi, Shigeki Sekine, Yutaka Saito
    Clinical outcomes and prognostic factors in gastric cancer patients aged ≥85 years undergoing endoscopic submucosal dissection
    Although the number of gastric cancer patients aged ≥85 years indicated for endoscopic submucosal dissection (ESD) has increased, little is known about the outcomes and prognostic factors. This study aimed to investigate the clinical outcomes and prognostic factors for overall survival (OS) of patients aged ≥85 years who underwent ESD for gastric cancer.


    Date de mise en ligne : Vendredi 14 octobre 2016
    Shigehisa Aoki, Yasuhisa Sakata, Ryo Shimoda, Toshiaki Takezawa, Ayumi Oshikata-Miyazaki, Hiromi Kimura, Mihoko Yamamoto, Ryuichi Iwakiri, Kazuma Fujimoto, Shuji Toda
    High-density collagen patch prevents stricture after endoscopic circumferential submucosal dissection of the esophagus: a porcine model
    Extensive excision of the esophageal mucosa by endoscopic submucosal dissection (ESD) frequently evokes a luminal stricture. This study aimed to determine the efficacy of a high-density collagen patch for the prevention of esophageal stricture in extensive ESD.


    Date de mise en ligne : Vendredi 14 octobre 2016
    Douglas K. Rex, Prasanna Ponugoti, Charles Kahi
    The “valley sign” in small and diminutive adenomas: prevalence, interobserver agreement, and validation as an adenoma marker
    Classification schemes for differentiation of conventional colorectal adenomas from serrated lesions rely on patterns of blood vessels and pits. Morphologic features have not been validated as predictors of histology. The aim of this study was to describe the prevalence of the “valley sign” and validate it as a marker of conventional adenomas.


    Date de mise en ligne : Jeudi 06 octobre 2016
    Seifeldin Hakim, Tusar Desai, Mitchell S. Cappell
    Esophageal hemangiomatosis with chest CT revealing a fine, curvilinear, calcified thrombus within the esophagus simulating acute esophageal fishbone impaction: first reported endoscopic photograph of GI manifestations in Maffucci syndrome
    A 70-year-old-man with known Maffucci syndrome (confirmed by pathologic analysis of biopsy specimens of enchondromas and hemangiomas), who had undergone resection/amputation of left thumb chondrosarcoma 15 years earlier, without known angina or cardiac disease, presented with sudden onset of substernal chest pain, without dysphagia or vomiting, commencing 1 hour after he had eaten a cooked, whole catfish with bones. Physical examination revealed normal vital signs; normal oropharyngeal, cardiac, and abdominal examination results; and numerous 8-mm to 30-mm-wide nodules, mostly on the left arm and leg, with rare right-sided nodules, consisting of 2 tumor populations: indurated pale enchondromas and soft compressible bluish hemangiomas (A, B, numerous enchondromas and hemangiomas on the [A] dorsal and [B] volar surfaces of the left hand).


    Date de mise en ligne : Jeudi 06 octobre 2016
    Vincent Ganapini, Maryconi Jaurigue, Mitual Amin, Gehad Ghaith, Mitchell S. Cappell
    ERCP for diagnosis and extraction of choledochal phytobezoar causing right upper quadrant abdominal pain and cholestasis in a patient without prior sphincterotomy or biliary instrumentation
    A 72-year-old white man with diabetes mellitus and gastroesophageal reflux, with no history of liver disease, hepatobiliary instrumentation, sphincterotomy, or abdominal trauma, presented with acute right upper quadrant abdominal pain and diaphoresis that had started 1 hour earlier. Physical examination revealed a soft and nontender abdomen. The initial serum liver function test results were all within normal limits but rose acutely to a serum alkaline phosphatase of 224 U/L, aspartate aminotransferase of 355 U/L, alanine aminotransferase of 531 U/L, and total bilirubin of 2.4 mg/dL after 48 hours.


    Date de mise en ligne : Mardi 04 octobre 2016
    Douglas G. Adler
    Esophageal placement of a lumen-apposing metal stent in a patient with a chronic anastomotic stricture
    In 2010, a 59-year-old man experienced adenocarcinoma of the distal esophagus, which involved the periesophageal and mediastinal nodes. He received cisplatin and paclitaxel with radiation. He subsequently underwent transhiatal esophagectomy and has been without evidence of cancer since then. Postoperatively, he experienced a chronic anastomotic stricture with dysphagia and several chronic tracheoesophageal fistulas treated with esophageal and airway stents. In the intervening years, the patient has undergone multiple rounds of esophageal stenting for dysphagia with fully covered stents, but these were removed because he was experiencing coughing, discomfort, and mucous production.


    Date de mise en ligne : Lundi 03 octobre 2016
    Linda Zhang, Paul Edwards, Milan Bassan
    Thoracic osteomyelitis: an unusual adverse event of esophageal stenting
    A 51-year-old man presented with a 3-week history of interscapular pain and night sweats. He had been treated with chemoradiotherapy 15 months earlier for a locally advanced esophageal squamous cell carcinoma 25 cm aboral with complete response on subsequent restaging. A tracheoesophageal fistula (TEF) developed 3 months after chemoradiotherapy 30 cm aboral, initially managed with placement of a 23 mm × 105 mm fully covered esophageal self-expandable metal stent (SEMS) and placement of an overlapping 23 mm × 155 mm fully covered SEMS 6 months later because of stent migration and recurrent aspiration.


    Date de mise en ligne : Samedi 01 octobre 2016
    Alexander Lee, Christopher D. Jensen, Amy R. Marks, Wei K. Zhao, Chyke A. Doubeni, Ann G. Zauber, Virginia P. Quinn, Theodore R. Levin, Douglas A. Corley
    Endoscopist fatigue estimates and colonoscopic adenoma detection in a large community-based setting
    Endoscopist fatigue may impact colonoscopy quality, but prior studies conflict, and minimal data exist from community-based practices where most colonoscopies are performed.


    Date de mise en ligne : Vendredi 30 septembre 2016
    Adriana Vaz Safatle-Ribeiro, Elisa Ryoka Baba, Sheila Friedrich Faraj, Juliana Trazzi Rios, Marcelo Simas de Lima, Bruno Costa Martins, Sebastian Naschold Geiger, Caterina Pennacchi, Carla Gusman, Fábio Shiguehissa Kawaguti, Ricardo Sato Uemura, Evandro Sobroza de Melo, Ulysses Ribeiro, Fauze Maluf-Filho
    Diagnostic accuracy of probe-based confocal laser endomicroscopy in Lugol-unstained esophageal superficial lesions of patients with head and neck cancer
    Surveillance programs of patients with head and neck cancer (HNC) detect synchronous or metachronous esophageal squamous cell carcinoma (ESCC) in up to 15% of patients. Noninvasive, probe-based confocal laser endomicroscopy (pCLE) technique may improve the diagnosis allowing acquisition of high-resolution in vivo images at the cellular and microvascular levels. The aim of this study was to evaluate the accuracy of pCLE for the differential diagnosis of nonneoplastic and neoplastic Lugol-unstained esophageal lesions in patients with HNC.


    Date de mise en ligne : Jeudi 29 septembre 2016
    Navin L. Kumar, Aaron J. Cohen, Jennifer Nayor, Brian L. Claggett, John R. Saltzman
    Timing of upper endoscopy influences outcomes in patients with acute nonvariceal upper GI bleeding
    Current guidelines advise that upper endoscopy be performed within 24 hours of presentation in patients with acute nonvariceal upper GI bleeding (UGIB). However, the role of urgent endoscopy (<12 hours) is controversial. Our aim was to assess whether patients admitted with acute nonvariceal UGIB with lower-risk versus high-risk bleeding have different outcomes with urgent compared with nonurgent endoscopy.


    Date de mise en ligne : Jeudi 29 septembre 2016
    Selma J. Lekkerkerker, Marc G. Besselink, Olivier R. Busch, Joanne Verheij, Marc R. Engelbrecht, Erik A. Rauws, Paul Fockens, Jeanin E. van Hooft
    Comparing 3 guidelines on the management of surgically removed pancreatic cysts with regard to pathological outcome
    Currently, 3 guidelines are available for the management of pancreatic cysts. These guidelines vary in their indication for resection of high-risk cysts. We retrospectively compared the final pathologic outcome of surgically removed pancreatic cysts with the indications for resection according to 3 different guidelines.


    Date de mise en ligne : Jeudi 29 septembre 2016
    Jason Y. Huang, Jason B. Samarasena, Takeshi Tsujino, John Lee, Ke-Qin Hu, Christine E. McLaren, Wen-Pin Chen, Kenneth J. Chang
    EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study
    Portal hypertension (PH) is a serious adverse event of liver cirrhosis. The hepatic venous pressure gradient or portal pressure gradient (PPG) accurately reflects the degree of PH and is the single best prognostic indicator in liver disease. This is usually obtained by interventional radiology (IR), although it is not routinely performed. Recently, we developed a simple novel technique for EUS-guided PPG measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and IR-PPGM.


    Date de mise en ligne : Lundi 26 septembre 2016
    Dennis Yang, Roxana M. Coman, Michel Kahaleh, Irving Waxman, Andrew Y. Wang, Amrita Sethi, Ashish R. Shah, Peter V. Draganov
    Endoscopic submucosal dissection for Barrett’s early neoplasia: a multicenter study in the United States
    The role of endoscopic submucosal dissection (ESD) in Barrett’s early neoplasia is not well defined, with most studies originating from Asia and Europe. We aimed to assess the efficacy, safety, and results of ESD in Barrett’s esophagus (BE) with high-grade dysplasia (HGD) and early adenocarcinoma (EAC) across centers in the United States.


    Date de mise en ligne : Vendredi 23 septembre 2016
    Madhav Desai, Shreyas Saligram, Neil Gupta, Prashanth Vennalaganti, Ajay Bansal, Abhishek Choudhary, Sreekar Vennelaganti, Jianghua He, Mohammad Titi, Roberta Maselli, Bashar Qumseya, Mojtaba Olyaee, Irwing Waxman, Alessandro Repici, Cesare Hassan, Prateek Sharma
    Efficacy and safety outcomes of multimodal endoscopic eradication therapy in Barrett’s esophagus-related neoplasia: a systematic review and pooled analysis
    Focal EMR followed by radiofrequency ablation (f-EMR + RFA) and stepwise or complete EMR (s-EMR) are established strategies for eradication of Barrett's esophagus (BE)-related high-grade dysplasia (HGD) and/or esophageal adenocarcinoma (EAC)/intramucosal carcinoma (IMC). The objective of this study was to derive pooled rates of efficacy and safety of individual methods in a large cohort of patients with BE and to indirectly compare the 2 methods.


    Date de mise en ligne : Mardi 20 septembre 2016
    Takashi Murakami, Naoto Sakamoto, Hideaki Ritsuno, Tomoyoshi Shibuya, Taro Osada, Hiroyuki Mitomi, Takashi Yao, Sumio Watanabe
    Distinct endoscopic characteristics of sessile serrated adenoma/polyp with and without dysplasia/carcinoma
    Sessile serrated adenoma/polyp (SSA/P) is a colorectal polyp that has malignant potential. However, the dysplastic components within an SSA/P can be difficult to detect. This study aimed to clarify the endoscopic characteristics of SSA/P with advanced histology.


    Date de mise en ligne : Mardi 20 septembre 2016
    Saowanee Ngamruengphong, Haruhiro Inoue, Philip Wai-Yan Chiu, Hon Chi Yip, Amol Bapaye, Michael Ujiki, Lava Patel, Pankaj N. Desai, Bu Hayee, Amyn Haji, Vivien Wai-yin Wong, Silvana Perretta, Shivangi Dorwat, Mathieu Pioche, Sabine Roman, Jérôme Rivory, François Mion, Thierry Ponchon, Aurélien Garros, Jun Nakamura, Yoshitaka Hata, Valerio Balassone, Manabu Onimaru, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Majidah Bukhari, Yamile Haito-Chavez, Vivek Kumbhari, Roberta Maselli, Alessandro Repici, Mouen A. Khashab
    Long-term outcomes of per-oral endoscopic myotomy in patients with achalasia with a minimum follow-up of 2 years: an international multicenter study
    Per-oral endoscopic myotomy (POEM) has shown promising safety and efficacy in short-term studies. However, long-term follow-up data are very limited. The aims of this study were to assess (1) clinical outcome of patients with a minimum post-POEM follow-up of 2 years and (2) factors associated with long-term clinical failure after POEM.


    Date de mise en ligne : Mardi 20 septembre 2016
    Cetin Karaca, Ebubekir S. Daglilar, Ozlem Mutluay Soyer, Mine Gulluoglu, William R. Brugge
    Endoscopic submucosal resection of gastric subepithelial lesions smaller than 20 mm: a comparison of saline solution–assisted snare and cap band mucosectomy techniques
    Application of endoscopic submucosal resection (ESMR) in the management of gastric subepithelial lesions (GSLs) less than 20 mm is gradually increasing because it allows diagnosis and treatment at the same operative session. In this study, we compare and evaluate the benefits of ESMR with an endoscopic cap band mucosectomy technique or saline solution–assisted snare technique in GSLs smaller than 20 mm.


    Date de mise en ligne : Lundi 19 septembre 2016
    Anne-Fré Swager, Guillermo J. Tearney, Cadman L. Leggett, Martijn G.H. van Oijen, Sybren L. Meijer, Bas L. Weusten, Wouter L. Curvers, Jacques J.G.H.M. Bergman
    Identification of volumetric laser endomicroscopy features predictive for early neoplasia in Barrett’s esophagus using high-quality histological correlation
    Volumetric laser endomicroscopy (VLE) provides a circumferential scan that enables visualization of the subsurface layers of the esophageal wall at 7 μm resolution. The aims of this study were to identify VLE features of Barrett's esophagus (BE) neoplasia and to develop a VLE prediction score.


    Date de mise en ligne : Samedi 17 septembre 2016
    Kook Hyun Kim, Kathleen McGreevy, Kristin La Fortune, Harvey Cramer, John DeWitt
    Sonographic and cyst fluid cytologic changes after EUS-guided pancreatic cyst ablation
    The effect of EUS-guided pancreatic cyst ablation (PCA) on sonographic morphology and cyst fluid cytology is unknown. The aim of this study was to evaluate morphologic, cytologic, and change in cyst fluid DNA after PCA.


    Date de mise en ligne : Samedi 17 septembre 2016
    Dong Hui Cho, Sang Soo Lee, Dongwook Oh, Tae Jun Song, Do Hyun Park, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim
    Long-term outcomes of a newly developed hybrid metal stent for EUS-guided biliary drainage (with videos)
    Although fully covered self-expandable metal stents (FCSEMSs) have been commonly used for EUS-guided biliary drainage (EUS-BD), FCSEMS migration is a main limitation of this procedure. In the present study we evaluated the technical and clinical success rates, adverse events, and long-term outcomes of a newly developed hybrid stent that has been customized for EUS-BD.


    Date de mise en ligne : Lundi 12 septembre 2016
    Manu K. Nayar, Bharat Paranandi, Muhammad F. Dawwas, John S. Leeds, Antony Darne, Beate Haugk, Debasis Majumdar, Muna M. Ahmed, Kofi W. Oppong
    Comparison of the diagnostic performance of 2 core biopsy needles for EUS-guided tissue acquisition from solid pancreatic lesions
    A new core biopsy needle with a novel tip, opposing bevel, and sheath design has recently been introduced for EUS-guided fine-needle biopsy (FNB). The diagnostic utility of this needle for differentiating solid pancreatic masses is currently unknown. The aim of this study was to compare the diagnostic performance and yield for tissue acquisition from solid pancreatic lesions of the opposing bevel needle with those of a reverse bevel EUS-FNB needle.


    Date de mise en ligne : Lundi 12 septembre 2016
    Shayan Irani, Sujai Jalaj, Andrew Ross, Michael Larsen, Ian S. Grimm, Todd H. Baron
    Use of a lumen-apposing metal stent to treat GI strictures (with videos)
    Benign GI strictures occur typically in the esophagus and pyloric channel but can occur anywhere in the GI tract and at anastomotic sites. Such strictures can be treated with dilation, incisional therapy, steroid injection, and stents. Our aim was to describe the use of a lumen-apposing metal stent (LAMS) to treat short, benign GI strictures.


    Date de mise en ligne : Samedi 10 septembre 2016
    Folasade P. May, Mark W. Reid, Samuel Cohen, Francis Dailey, Brennan M.R. Spiegel
    Predictive overbooking and active recruitment increases uptake of endoscopy appointments among African American patients
    Use of GI endoscopy is historically lower in nonwhite ethnic and racial groups compared with whites. These disparities are multifactorial but likely contribute to differences in GI clinical outcomes. We sought to improve endoscopy uptake overall and in minorities by predictive overbooking and active recruitment in a hospital-based GI clinic.


    Date de mise en ligne : Samedi 10 septembre 2016
    Tomas DaVee, Sunil K. Geevarghese, James C. Slaughter, Patrick S. Yachimski
    Refractory anastomotic bile leaks after orthotopic liver transplantation are associated with hepatic artery disease
    Anastomotic bile leaks are common after orthotopic liver transplant (OLT), and standard treatment consists of placement of a biliary endoprosthesis. The objectives of this study were to identify risk factors for refractory anastomotic bile leaks and to determine the morbidity associated with refractory bile leaks after OLT.


    Date de mise en ligne : Samedi 10 septembre 2016
    Stig B. Laursen, Grigorios I. Leontiadis, Adrian J. Stanley, Morten H. Møller, Jane M. Hansen, Ove B. Schaffalitzky de Muckadell
    Relationship between timing of endoscopy and mortality in patients with peptic ulcer bleeding: a nationwide cohort study
    The optimal timing of endoscopy in patients with peptic ulcer bleeding (PUB) remains unclear. The aim of this study was to examine the association between timing of endoscopy and mortality in PUB.


    Date de mise en ligne : Vendredi 09 septembre 2016
    Sung Ill Jang, Kwang-Hun Lee, Hong Jin Yoon, Dong Ki Lee
    Treatment of completely obstructed benign biliary strictures with magnetic compression anastomosis: follow-up results after recanalization
    Although nonsurgical methods produce high clinical success rates in the treatment of benign biliary stricture (BBS), conventional methods are not always successful in cases of severe biliary stricture or complete obstruction. Therefore, the efficacy of magnetic compression anastomosis (MCA) for treatment of refractory BBS was evaluated in a single-center, nonrandomized study.


    Date de mise en ligne : Mardi 06 septembre 2016
    Mihir S. Wagh, Peter V. Draganov
    Per-oral endoscopic tunneling for restoration of the esophagus: a novel endoscopic submucosal dissection technique for therapy of complete esophageal obstruction
    Total aphagia from complete esophageal obstruction (CEO) can be seen in patients with head–neck or thoracic malignancies undergoing chemoradiation or surgery. Combined antegrade and retrograde endoscopy (via gastrostomy tube [G-tube] tract) is often performed for esophageal reconstruction but is limited by the length of the obstructed esophagus. We describe per-oral endoscopic tunneling for restoration of the esophagus (POETRE) for patients with longer segments of esophageal obstruction. The aim of this study was to assess the efficacy and safety of POETRE for CEO.


    Date de mise en ligne : Lundi 05 septembre 2016
    Yuki B. Werner, Daniel von Renteln, Tania Noder, Guido Schachschal, Ulrike W. Denzer, Stefan Groth, Jan F. Nast, Jan F. Kersten, Martin Petzoldt, Gerhard Adam, Oliver Mann, Alessandro Repici, Cesare Hassan, Thomas Rösch
    Early adverse events of per-oral endoscopic myotomy
    The recently developed technique of per-oral endoscopic myotomy (POEM) has been shown to be effective for the therapy of esophageal motility disorders. Limited information is available about POEM adverse events (AEs).


    Date de mise en ligne : Vendredi 02 septembre 2016
    Young Koog Cheon, Tae Yoon Lee, Soo-Nyung Kim, Chan Sup Shim
    Impact of endoscopic papillary large-balloon dilation on sphincter of Oddi function: a prospective randomized study
    Endoscopic papillary balloon dilation (≤8 mm in diameter) preserves sphincter of Oddi (SO) function. However, it is still unknown whether papillary function is preserved after endoscopic papillary large-balloon dilation (EPLBD, ≥12 mm in diameter). We investigated SO function after EPLBD with or without endoscopic sphincterotomy (EST) by endoscopic manometry, up to 1 year after the procedure.


    Date de mise en ligne : Vendredi 02 septembre 2016
    Joshua Melson, Daniel Berger, Michael Greenspan, Mohamed Bayoumi, Shriram Jakate
    Maintaining low non-neoplastic polypectomy rates in high-quality screening colonoscopy
    Non-neoplastic polypectomies (NNPs) add pathology and procedural costs but do not reduce cancer risk and should be minimized. We sought to define the minimal non-neoplastic polypectomy rate (NNPR) for those colonoscopists achieving high-quality colorectal cancer screening based on adenoma detection rates (ADRs).


    Date de mise en ligne : Mardi 30 août 2016
    Daniel von Renteln, Douglas J. Robertson, Steve Bensen, Heiko Pohl
    Prolonged cecal insertion time is associated with decreased adenoma detection
    The adenoma detection rate (ADR) is an important colonoscopy quality parameter. A longer withdrawal time is associated with increased adenoma detection; however, the effect of cecal insertion time on adenoma detection is unclear. The aim of this study was to evaluate if cecal insertion time is associated with adenoma detection.


    Date de mise en ligne : Mardi 30 août 2016
    Basile Njei, Thomas R. McCarty, Shyam Varadarajulu, Udayakumar Navaneethan
    Cost utility of ERCP-based modalities for the diagnosis of cholangiocarcinoma in primary sclerosing cholangitis
    Cholangiocarcinoma (CCA) is a leading cause of morbidity and mortality in patients with primary sclerosing cholangitis (PSC). Although several ERCP-based diagnostic modalities are available for diagnosing CCA, it is unclear whether one modality is more cost-effective than the others. The primary aim of this study was to compare the cost-effectiveness of ERCP-based techniques for diagnosing CCA in patients with PSC-induced biliary strictures.


    Date de mise en ligne : Jeudi 25 août 2016
    Badr Al-Bawardy, Elizabeth Rajan, Louis M. Wong Kee Song
    Over-the-scope clip-assisted endoscopic full-thickness resection of epithelial and subepithelial GI lesions
    Endoscopic full-thickness resection (EFTR) allows for definitive diagnosis and treatment of select subepithelial and epithelial lesions unsuitable to conventional resection techniques. Our aim was to evaluate the efficacy and safety of over-the-scope (OTS) clip-assisted EFTR for these lesions.


    Date de mise en ligne : Jeudi 25 août 2016
    Douglas G. Adler, Georgios I. Papachristou, Linda Jo Taylor, Tyler McVay, Madeleine Birch, Gloria Francis, Andrew Zabolotsky, Sobia N. Laique, Umar Hayat, Tingting Zhan, Rohit Das, Adam Slivka, Mordechai Rabinovitz, Satish Munigala, Ali A. Siddiqui
    Clinical outcomes in patients with bile leaks treated via ERCP with regard to the timing of ERCP: a large multicenter study
    Postsurgical or traumatic bile duct leaks (BDLs) can be safely and effectively managed by endoscopic therapy via ERCP. The early diagnosis of BDL is important because unrecognized leaks can lead to serious adverse events (AEs). Our aim was to evaluate the relationship between timing of endotherapy after BDL and the clinical outcomes, AEs, and long-term results of endoscopic therapy.


    Date de mise en ligne : Mercredi 24 août 2016
    Pouya Iranmanesh, Olivier Tobler, Sandra De Sousa, Jean-Louis Frossard, Philippe Morel, Christian Toso
    Prospective validation of an initial cholecystectomy strategy for patients at intermediate-risk of common bile duct stone
    Initial cholecystectomy for patients at intermediate risk of common bile duct (CBD) stones (including increased liver function tests but bilirubin <4 mg/dL and no cholangitis) showed shorter length of stay and fewer CBD investigations without increased morbidity compared with sequential CBD endoscopic assessment and subsequent cholecystectomy in a randomized controlled trial. The objectives were to prospectively validate these results in daily clinical practice and discuss current guidelines.


    Date de mise en ligne : Mardi 23 août 2016
    Ali A. Siddiqui, Thomas E. Kowalski, David E. Loren, Ammara Khalid, Ayesha Soomro, Syed M. Mazhar, Laura Isby, Michel Kahaleh, Kunal Karia, Joseph Yoo, Andrew Ofosu, Beverly Ng, Reem Z. Sharaiha
    Fully covered self-expanding metal stents versus lumen-apposing fully covered self-expanding metal stent versus plastic stents for endoscopic drainage of pancreatic walled-off necrosis: clinical outcomes and success
    Endoscopic transmural drainage/debridement of pancreatic walled-off necrosis (WON) has been performed using double-pigtail plastic (DP), fully covered self-expanding metal stents (FCSEMSs), or the novel lumen-apposing fully covered self-expanding metal stent (LAMS). Our aim was to perform a retrospective cohort study to compare the clinical outcomes and adverse events of EUS-guided drainage/debridement of WON with DP stents, FCSEMSs, and LAMSs.


    Date de mise en ligne : Mardi 23 août 2016
    Jong Jin Hyun, Tae Hoon Lee, Jin-Seok Park, Joung-Ho Han, Seok Jeong, Seon Mee Park, Hong Sik Lee, Jong Ho Moon, Sang-Heum Park
    A prospective multicenter study of submucosal injection to improve endoscopic snare papillectomy for ampullary adenoma
    Whether or not submucosal injection of a diluted epinephrine solution should be used to lift ampullary tumors during endoscopic snare papillectomy is unclear. This study aimed to investigate the clinical efficacy of a simple snaring method versus submucosal injection for papillectomy.


    Date de mise en ligne : Mardi 23 août 2016
    Erkan Parlak, Aydın Seref Koksal, Fahrettin Kucukay, Ahmet Tarık Eminler, Bilal Toka, Mustafa Ihsan Uslan
    A novel technique for the endoscopic treatment of complete biliary anastomosis obstructions after liver transplantation: through-the-scope magnetic compression anastomosis
    Magnetic compression anastomosis is a rescue technique for recanalization of complete biliary strictures. Here, we present magnetic compression anastomosis with novel through-the-scope magnets in patients with complete duct-to-duct anastomosis obstruction after liver transplantation.


    Date de mise en ligne : Mardi 23 août 2016
    Eelco C. Brand, Raouf E. Nakhleh, Michael B. Wallace
    Pseudoinvasion appearing as a deeply invasive malignant colorectal polyp
    A 50-year-old man with alcoholic liver cirrhosis and a Model for End-Stage Liver Disease score of 15 underwent colonoscopy as part of his evaluation and screening for liver transplantation. A malignant-appearing 20-mm sessile polyp with an ulcerated surface, Paris IIa/III, was seen in a tight area of the sigmoid. Owing to notable contractions, the polyp prolapsed into the lumen. The polyp surface, assessed with high-definition near-focus white-light and narrow-band imaging (CF-HQ190, Olympus Corp, Center Valley, Pa), demonstrated a Sano IIIb and Kudo Vn pattern for the ulcer and Sano II for the sharply demarcated margins, suggestive of deep submucosal invasion (A).


    Date de mise en ligne : Mardi 23 août 2016
    Vincent Huberty, Mostafa Ibrahim, Martin Hiernaux, Alexandre Chau, Sonia Dugardeyn, Jacques Deviere
    Safety and feasibility of an endoluminal-suturing device for endoscopic gastric reduction (with video)
    Obesity is a major pandemic disease. Surgical therapy is highly effective, but its availability will likely be overwhelmed by the burden of the disease. Endoscopic technologies that could reproduce some of the clinical effects of surgery may become part of the treatment armamentarium. A simple transoral restrictive procedure could play a role in first-line surgical management.


    Date de mise en ligne : Samedi 13 août 2016
    Lisa S. Cassani, Gandhi Lanke, Hsiang-Chun Chen, Xuemei Wang, Patrick Lynch, Jeffrey H. Lee
    Comparison of nonampullary duodenal adenomas in patients with familial adenomatous polyposis versus patients with sporadic adenomas
    Nonampullary duodenal adenomas are either sporadic or associated with a hereditary syndrome such as familial adenomatous polyposis (FAP). The aim of this study is to compare characteristics and outcomes of sporadic and FAP-associated duodenal adenomas.


    Date de mise en ligne : Samedi 06 août 2016
    Seohui Lee, Byeong Gwan Kim, Ji Won Kim, Kook Lae Lee, Dae Lim Koo, Hyunwoo Nam, Jong Pil Im, Joo Sung Kim, Seong-Joon Koh
    Obstructive sleep apnea is associated with an increased risk of colorectal neoplasia
    A recent meta-analysis showed that obstructive sleep apnea (OSA) is associated with a higher prevalence of cancer and cancer-related mortality; however, little information is available on the association between OSA and colorectal neoplasia.


    Date de mise en ligne : Lundi 01 août 2016
    Rintaro Hashimoto, Tomoki Matsuda, Hayato Aoki, Toru Okuzono, Masato Nakahori
    Double-balloon assisted trans-anal ERCP in a patient with Roux-en-Y choledochojejunostomy
    A 66-year-old man was referred to our hospital with fever and elevated liver enzymes. His medical history was significant for Roux-en-Y choledochojejunostomy performed because of iatrogenic bile duct injury during cholecystectomy a few years earlier. CT showed biliary tract dilatation and some small liver abscesses. Endoscopic sonography revealed mild dilatation of the common bile duct (CBD). Drip infusion cholecystocholangiography/computed tomography revealed the stenosis at the anastomosis. These results led to a diagnosis of acute cholangitis due to a postoperative CBD stricture.


    Date de mise en ligne : Lundi 01 août 2016
    Yasuyuki Tanaka, Takeharu Nakamura, Shigehiko Fujii, Toshihiro Kusaka
    Successful treatment of a perforated duodenal ulcer with polyglycolic acid sheets
    An 86-year-old woman was admitted to our hospital with severe abdominal and back pain. Abdominal CT revealed a gas-containing retroperitoneal abscess surrounded by the duodenal bulb and anterior part of the right kidney. EGD revealed an active ulcer in the duodenal bulb. Furthermore, a slit-shaped excavation of the ulcer floor (A) and retroperitoneal leakage of contrast medium (B) were detected. Therefore, a perforated duodenal ulcer with a retroperitoneal abscess was diagnosed. The perforation was managed conservatively in consideration of the patient’s poor general condition.


    Date de mise en ligne : Vendredi 29 juillet 2016
    Cregan J. Laborde, Charreau S. Bell, James Chris Slaughter, Pietro Valdastri, Keith L. Obstein
    Evaluation of a novel tablet application for improvement in colonoscopy training and mentoring (with video)
    Endoscopic training can be challenging for the trainee and preceptor. Frustration can result from ineffective communication regarding areas of interest. Our team developed a novel tablet application for real-time mirroring of the colonoscopy examination that allows preceptors to make annotations directly on the viewing monitor. The potential for improvement in team proficiency and satisfaction is unknown.


    Date de mise en ligne : Mercredi 27 juillet 2016
    Tae Jun Kim, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Kyoung-Mee Kim, Min-Ji Kim, Kyunga Kim, Poong-Lyul Rhee, Jae J. Kim
    One-dimensional and 2-dimensional tumor size measurement for prediction of lymph node metastasis in differentiated early gastric cancer with minute submucosal invasion
    Differentiated minute submucosal cancers measuring ≤3 cm that exhibit no lymphovascular invasion are considered eligible for endoscopic resection; however, the ≤3-cm criterion remains debatable. The aim of this study was to verify the optimal tumor size cutoff for endoscopic resection eligibility, and to determine whether 2-dimensional tumor size measurement would be more accurate for this purpose.


    Date de mise en ligne : Mercredi 27 juillet 2016
    Kenjiro Shigita, Shiro Oka, Shinji Tanaka, Kyoku Sumimoto, Daiki Hirano, Yuzuru Tamaru, Yuki Ninomiya, Naoki Asayama, Nana Hayashi, Fumio Shimamoto, Koji Arihiro, Kazuaki Chayama
    Long-term outcomes after endoscopic submucosal dissection for superficial colorectal tumors
    Endoscopic submucosal dissection (ESD) is an effective procedure for en bloc resection of superficial colorectal tumors regardless of tumor size or location. However, there are few reports on long-term outcomes for patients with superficial colorectal tumors after ESD. We therefore aimed to evaluate the long-term outcomes after ESD for superficial colorectal tumors.


    Date de mise en ligne : Mercredi 27 juillet 2016
    Michael B. Wallace, Julia E. Crook, Colleen S. Thomas, Estella Staggs, Laurie Parker, Douglas K. Rex
    Effect of an endoscopic quality improvement program on adenoma detection rates: a multicenter cluster-randomized controlled trial in a clinical practice setting (EQUIP-3)
    Colonoscopy is protective against colorectal cancer, but its quality and protective benefits can vary. Adenoma detection rate (ADR) is associated with quality and the degree of protection against colorectal cancer and death. In a previous, single academic center, randomized, controlled trial, we demonstrated that an endoscopic quality improvement program increased ADR (EQUIP-1) and that those increases were durable (EQUIP-2). We hypothesized that EQUIP training would increase ADR in a multicenter clinical practice setting.


    Date de mise en ligne : Mercredi 27 juillet 2016
    Ihab I. El Hajj, Brian C. Brauer, Sachin Wani, Norio Fukami, Augustin R. Attwell, Raj J. Shah
    Role of per-oral pancreatoscopy in the evaluation of suspected pancreatic duct neoplasia: a 13-year U.S. single-center experience
    The role of per-oral pancreatoscopy (POP) in the evaluation of occult pancreatic duct (PD) lesions remains limited to case series. The aim of this study was to evaluate the ability of POP to differentiate malignant from benign diseases of the PD.


    Date de mise en ligne : Dimanche 24 juillet 2016
    Satoshi Kinoshita, Toshihiro Nishizawa, Tadakazu Hisamatsu, Takanori Kanai, Naohisa Yahagi
    Polyglycolic acid sheet for closure of esophagobronchial fistula in a patient with Behçet's disease
    Esophagobronchial fistula in Behçet's disease is rare, and this condition is difficult to treat. Here we report successful closure of an esophagobronchial fistula using polyglycolic acid (PGA) sheets and fibrin glue. PGA sheets (Neovail; Gunze, Osaka, Japan) is a suture reinforcement material that is absorbed within 4 to 15 weeks. PGA promotes the formation of granulation tissue.


    Date de mise en ligne : Samedi 23 juillet 2016
    Prasanna L. Ponugoti, Douglas K. Rex
    Clip retention rates and rates of residual polyp at the base of retained clips on colorectal EMR sites
    Prophylactic endoscopic clipping may be effective in preventing delayed post-polypectomy hemorrhage after EMR of large colorectal lesions. The rate of retention of hemoclips on EMR sites has not been fully described. The aim of this study was to evaluate the adherence rates of hemoclips placed after EMR of large colorectal lesions.


    Date de mise en ligne : Samedi 23 juillet 2016
    Kyoku Sumimoto, Shinji Tanaka, Kenjiro Shigita, Daiki Hirano, Yuzuru Tamaru, Yuki Ninomiya, Naoki Asayama, Nana Hayashi, Shiro Oka, Koji Arihiro, Masaharu Yoshihara, Kazuaki Chayama
    Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team
    The Japan NBI Expert Team (JNET) was established in 2011 and has proposed a universal narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors. The aim of this study was to evaluate the clinical usefulness of the JNET classification for colorectal lesions.


    Date de mise en ligne : Lundi 18 juillet 2016
    Corlan O. Adebajo, Irving Waxman, Christopher Chapman, Carol Semrad
    Foiled by coils: upper GI bleeding from a rare delayed adverse event of transarterial embolization
    A 99-year-old woman was admitted with presyncope and her second GI bleed. One year earlier, she had experienced a major upper-GI bleed from a large cratered duodenal bulb ulcer with a spurting vessel; attempts at endoscopic hemostasis had failed. Angiography revealed a subcentimeter pseudoanuerysm of her gastroduodenal artery (GDA) just caudal to the endoscopic clips. Her GDA was embolized proximal and distal to the pseudoanuerysm with coils extending to the proximal GDA. At her current admission, she was given an intravenous proton pump inhibitor.


    Date de mise en ligne : Samedi 25 juin 2016
    Eugenia N. Uche-Anya, Ali S. Khan, Christopher D. Packey, Diana Sung, Amrita Sethi
    Gastric pancreatic heterotopia with pancreatic intraepithelial neoplasia
    A 39-year-old man reported a 2-year history of postprandial epigastric pain radiating to his back, with nausea and vomiting. Physical examination revealed mild epigastric tenderness. EGD showed a lobulated, hypoechoic 17-mm × 8-mm submucosal nodule in the gastric greater curvature with no adjacent lymph nodes (A and B). Examination of a biopsy specimen demonstrated pancreatic heterotopia (C). He underwent an endoscopic submucosal dissection, en bloc resection of the lesion, and closure with an endoscopic suture.


    Date de mise en ligne : Samedi 25 juin 2016
    Tomoyuki Ushijima, Yoshinobu Okabe, Yusuke Ishida, Masaru Fukahori, Takuji Torimura
    A case of intragastric wall abscess developing after EUS-FNA in a patient with pancreatic body cancer
    The patient, a 71-year-old man presenting with weight loss, was referred to our hospital with a 41-mm tumor of the pancreatic body as shown by CT (A) and bilateral lung nodules. EUS-FNA with a 22G needle revealed cancer cells with necrotic material, and we made a diagnosis of pancreatic cancer. Systemic chemotherapy with gemcitabine was started 14 days after the EUS-FNA; however, the patient experienced epigastric pain and a high fever. Blood examination revealed elevated levels of inflammatory reactants (white blood cell count 14,900/μL, serum C-reactive protein 16.73 mg/dL), and abdominal CT revealed multilocular cystic lesions extending from the ventral aspect of the pancreatic tumor to the gastric wall, surrounded by irregular fat tissue (B).


    Date de mise en ligne : Samedi 25 juin 2016
    Ning Li, Lizhou Dou, Yueming Zhang, Jing Jin, Guiqi Wang, Qin Xiao, Yexiong Li, Xin Wang, Hua Ren, Hui Fang, Weihu Wang, Shulian Wang, Yueping Liu, Yongwen Song
    Use of sequential endorectal US to predict the tumor response of preoperative chemoradiotherapy in rectal cancer
    Accurate prediction of the response to preoperative chemoradiotherapy (CRT) potentially assists in the individualized selection of treatment. Endorectal US (ERUS) is widely used for the pretreatment staging of rectal cancer, but its use for preoperatively predicting the effects of CRT is not well evaluated because of the inflammation, necrosis, and fibrosis induced by CRT. This study assessed the value of sequential ERUS in predicting the efficacy of preoperative CRT for locally advanced rectal cancer.


    Date de mise en ligne : Mercredi 22 juin 2016
    Lobke Desomer, Nicholas Tutticci, David J. Tate, Stephen J. Williams, Duncan McLeod, Michael J. Bourke
    A standardized imaging protocol is accurate in detecting recurrence after EMR
    EMR of large laterally spreading lesions (LSL) in the colon is a safe and effective alternative to surgery. Post-EMR scar assessment currently involves taking biopsy specimens of the scar to detect residual or recurrent adenoma (RRA). The accuracy of endoscopic imaging of the post-EMR scar is unknown. We aimed to determine the accuracy of a standardized imaging protocol in post-EMR scar assessment.


    Date de mise en ligne : Mercredi 22 juin 2016
    Masaya Iwamuro, Takehiro Tanaka, Haruo Urata, Katsuhiko Kimoto, Hiroyuki Okada
    Lanthanum phosphate deposition in the duodenum
    A 71-year-old Japanese man on hemodialysis for chronic renal failure underwent EGD screening. He had been taking lanthanum carbonate for 6 years to treat hyperphosphatemia. EGD showed diffuse deposition of white microgranules in the gastric body (A). In addition, white villi were observed in the duodenal second portion (B). Histologic examination of the duodenal biopsy specimen from the duodenal mucosa showed a fine, amorphous, eosinophilic material (C) that was also seen in the gastric mucosa. A diagnosis of lanthanum phosphate deposition in the duodenal and gastric mucosa was made after analysis by scanning electron microscopy and elemental mapping showing the colocation of lanthanum and phosphate (D).


    Date de mise en ligne : Samedi 18 juin 2016
    Imad Elkhatib, Natasha Shah, Thomas J. Savides
    Neuroma of the bile duct mimicking cholangiocarcinoma
    A 75-year-old woman presented with a history of right upper-quadrant and epigastric pain for several months. Her history was notable for cholecystectomy for gallstones and ERCP with sphincterotomy for choledocholithiasis several decades previously. MRCP revealed a 14-mm common bile duct with a 5-mm filling defect within the distal duct (A). EUS revealed a 7-mm hypoechoic well-defined nodule in the distal common bile duct, without shadowing, consistent with a soft-tissue lesion (B). The bile duct was 14-mm upstream of the lesion.


    Date de mise en ligne : Samedi 18 juin 2016
    Viviana Parra, Fanny Acero, Eligio Alvarez, Diego Mauricio Aponte, Luis Carlos Sabbagh
    A case mucinous cystic neoplasm from a gastric ectopic pancreas
    The ectopic pancreas is a relatively common phenomenon. These lesions are usually asymptomatic and discovered incidentally during endoscopy, surgery, or autopsy. Mucinous cystic neoplasm (MCN) is a mucin-producing and septated cyst-forming epithelial neoplasia of the pancreas that does not communicate with the pancreatic ductal system. MCN is a cystic neoplasm with a malignant potential. We report the first case of MCN originating from the antrum ectopic pancreas.


    Date de mise en ligne : Samedi 18 juin 2016
    Jae Hyung Lee, Hoon Jai Chun, Bora Keum, Eun Sun Kim, Yoon Tae Jeen
    A case of esophageal hemangioma treated with endoscopic injection sclerotherapy
    An 87-year-old woman presented with a 1-month history of dysphagia. She underwent an endoscopy, which showed a pale-bluish and engorged submucosal tumor obstructing the mid to lower esophagus (A). EUS showed a hypoechoic mass with numerous irregular anechoic spaces within the muscularis mucosa layer (B). Biopsy sampling was performed, and the histopathologic findings showed a vascular lumen with irregular dilatation below the muscularis mucosa, suggesting esophageal cavernous hemangioma. Immunohistochemistry (CD31 and D2-40) was performed later, which confirmed the diagnosis.


    Date de mise en ligne : Vendredi 17 juin 2016
    Jun Fang, Shu-Ling Wang, Hong-Yu Fu, Zhao-Shen Li, Yu Bai
    Impact of gum chewing on the quality of bowel preparation for colonoscopy: an endoscopist-blinded, randomized controlled trial
    Gum chewing can accelerate motility in the GI tract; clinical studies suggested gum chewing can reduce postoperative ileus. However, no trial has investigated the effect of gum chewing on bowel preparation for colonoscopy in addition to polyethylene glycol (PEG). The objective of this study was to investigate whether gum chewing before colonoscopy can increase the quality of bowel preparation.


    Date de mise en ligne : Mardi 14 juin 2016
    Takeshi Tsujino, Yuxin Lu, Kenneth J. Chang
    Treatment of post-EMR duodenal adenoma: a case of unusual recurrence and novel approach
    A 65-year-old man underwent EMR of a 3-cm duodenal polyp. Piecemeal EMR was performed, which was complicated by a perforation, but was successfully closed using the over-the-scope clip system (A). The patient remained asymptomatic and recovered uneventfully. Pathology showed tubular adenoma. Biopsy specimens from the post-EMR site at 4, 8, 12, and 24 months after the initial EMR were all negative for adenoma. EGD at 3 years after the initial EMR, however, demonstrated granulomatous growth around the clip, and biopsy specimens revealed tubulovillous adenoma with low-grade dysplasia.


    Date de mise en ligne : Samedi 11 juin 2016
    Sho Sasaki, Jun Nishikawa, Atsushi Goto, Takeshi Okamoto, Isao Sakaida
    Papillary adenocarcinoma with tentacular processes (with video)
    An 83-year-old man with diabetes mellitus and hypertension presented with a complaint of belching. EGD revealed a polypoid lesion, 10 mm in diameter (A) (Video 1, available online at www.giejournal.org), with tentacular processes on the greater curvature of the gastric body. After the introduction of water into the stomach, each process floated up and clearly separated (B). This lesion appeared just like a sea anemone undulating in the water. Magnifying endoscopy with narrow-band imaging (M-NBI) revealed that each process was lined with white marginal crypt epithelium and contained irregular microvessels that varied in caliber (C).


    Date de mise en ligne : Samedi 11 juin 2016
    Malay Sharma, Piyush Somani, Amol Patil, Avinash Kumar, Charu Shastri
    EUS of solitary rectal ulcer syndrome
    A 55-year-old woman presented with rectal bleeding and straining at stool for 5 months. Sigmoidoscopy showed a large ulceration in the anterior rectal mucosa approximately 7 cm above the anal verge (A). A biopsy specimen was taken, and linear endoscopic ultrasonography (EUS) of the rectum was performed to rule out rectal cancer. EUS showed thick, hyperechoic submucosa and thick muscularis propria in the area of ulceration. It revealed a transition zone where the first interface layer and the muscularis mucosae disappeared and the submucosa gradually became thicker (B).


    Date de mise en ligne : Mercredi 11 mai 2016
    Jun Liong Chin, Subhasish Sengupta, Martina M. Morrin, Frank E. Murray, Stephen E. Patchett
    Common bile duct duplication: double bile ducts, double trouble
    A 43-year-old woman presented with 3 episodes of intermittent severe epigastric discomfort, associated with chills and rigors, in the previous 3 weeks. An abdominal examination revealed mild tenderness in the epigastrium. Her liver blood tests showed predominant cholestasis, with raised alkaline phosphatase 201 IU/L and γ-glutamyltransferase 552 IU/L but normal bilirubin. Her C-reactive protein was raised at 74.9 mg/L. The result of her gastroscopy was normal, but abdominal US showed grossly dilated bile ducts with at least 2 stones.


    Date de mise en ligne : Mercredi 11 mai 2016
    Rintaro Hashimoto, Hidetaka Hamamoto, Yuko Omori, Tokuma Tanuma
    Early gastric cancer on submucosal heterotopic gastric glands
    A 77-year-old man came to our hospital to investigate the cause of his anemia. EGD revealed a submucosal tumor–like elevated lesion 20 mm in diameter, with a central depression in the lesser curvature of the gastric antrum, and a gastric ulcer scar on the posterior wall (A). The lesion was covered with hyperemic mucosa. With magnifying narrow-band imaging endoscopy, the central depression showed an irregular microsurface pattern (B). Biopsy and examination of the biopsy specimen revealed a well-differentiated adenocarcinoma.


    Date de mise en ligne : Mardi 10 mai 2016
    Eduardo Couchonnal, Jérôme Rivory, Sabine Roman, Thierry Ponchon, Mathieu Pioche
    EUS-guided per-oral endoscopic myotomy to treat an achalasia with relapse after Heller's myotomy
    A 76-year-old man underwent Heller’s myotomy with Dor fundoplication for achalasia 12 years ago. He was referred for a progressive recurrence (12 months' duration) of dysphagia with an Eckardt score of 9. Barium transit showed esophageal dilation and a delayed passage through the cardia. Manometry was not feasible because of an extremely sealed lower sphincter that prevented probe passage. An EUS examination was performed to assess the length and position of the previous myotomy and also to eliminate other etiologies like tumor infiltration.


    Date de mise en ligne : Jeudi 05 mai 2016
    Takashi Kanesaka, Noriya Uedo, Koji Higashino, Yoji Takeuchi, Ryu Ishihara
    Traction-assisted endoscopic submucosal dissection of a rectal adenoma located on the anastomotic suture line
    An 80-year-old woman, who had undergone surgery for rectal cancer when in her sixties, was found on colonoscopy to have a 3-cm superficial elevated tumor in her rectum (A). The lesion was located on the anastomotic suture line. Because severe fibrosis prevented EMR, the patient underwent endoscopic submucosal dissection using the clip-with-line technique. After circumferential mucosal incision with a Flushknife BT (DK2618JB15; Fujifilm Medical, Tokyo, Japan), the colonoscope was withdrawn outside the rectum.


    Date de mise en ligne : Jeudi 05 mai 2016
    Isis K. Araujo, Mario Pages, Cristina Romero, Antoni Castells, Begoña González-Suárez
    Twelve-year asymptomatic retention of a colon capsule endoscope
    Capsule retention is the most significant adverse event related to capsule endoscopy but it is rather infrequent. Here, we present the case of a 43-year-old man with a history of familial adenomatous polyposis who underwent a proctocolectomy with ileal J-pouch and protective ileostomy in 2000. A year later the ileostomy was reversed. In 2004, a colon capsule endoscopy was performed for a pilot study, but the patient was lost to contact during follow-up. In 2015, an abdominal CT scan showed an ileal anastomotic stricture with dilated loops and an image of a metallic foreign body suggestive of a capsule (A).


    Date de mise en ligne : Samedi 23 avril 2016
    Giuseppe Gizzi, Donatella Santini, Rita Golfieri, Lorenzo Fuccio
    Diffuse colonic metastases from primary pancreatic cancer
    Pancreatic cancer with synchronous secondary metastases infiltrating the colon is very rare. Here we present the case of a 70-year-old woman with 2-month fatigue, progressive loss of appetite, and 6-kg weight loss. Laboratory analyses revealed severe anemia (hemoglobin 7.2 g/dL) resulting from iron deficiency.


    Date de mise en ligne : Lundi 18 avril 2016
    Koichiro Kawano, Reiko Kawano, Takanori Harada, Shujiro Yazumi
    Successful endoscopic submucosal dissection of a rectal laterally spreading tumor causing intussusception
    A 76-year-old woman was admitted to our hospital for hematochezia. She had no nausea or abdominal pain. Digital rectal examination revealed a negligible amount of blood and no palpable tumor. The laboratory tests showed a normal hemoglobin value (13.5 mg/dL) and a slightly increased level of C-reactive protein (1.65 mg/dL). An abdominal contrast-enhanced CT scan (Fig. 1A) showed a multiple concentric ring sign in the rectum. There was no ischemic change or dilation of the rectosigmoid colon. Although colonoscopy (Fig. 1B) revealed a large reddish type 1 tumor over 5 cm in diameter without ulceration in the rectum, the intussusception could not be reduced by CO2 gas insufflation during colonoscopy.


    Date de mise en ligne : Lundi 18 avril 2016
    Takeshi Ogura, Wataru Takagi, Shinya Fukunishi, Kazuhide Higuchi, Yoshitaka Kurisu
    Anterior mediastinum tumor diagnosed by EUS-guided FNA from the hypopharynx
    EUS-guided FNA is an established diagnostic method. However, if a tumor is present around the anterior mediastinum, EUS-FNA may be contraindicated because the EUS endoscope is not in the esophagus. Here, we report for the first time that an anterior mediastinum tumor can be diagnosed by EUS-FNA from the hypopharynx.


    Date de mise en ligne : Vendredi 15 avril 2016
    Andrea Anderloni, Alessandro Fugazza, Milena Di Leo, Serena Battista, Alessandro Repici
    A case of cystic duct carcinoma successfully diagnosed with a novel digital colangioscope
    An 83-year-old man was admitted to our institution because of jaundice and abdominal pain. Magnetic resonance imaging demonstrated dilatation of the proximal common bile duct (CBD) and of the intrahepatic biliary ducts, with an obstacle at the insertion of the cystic duct (A). The subsequent EUS revealed a hypoechoic lesion 7 mm in diameter with irregular margins in the cystic duct (B). FNA was performed through the duodenal bulb with a 25-gauge needle. Although 3 passes were made (rapid on-site evaluation was not available) to obtain macroscopic core tissue, the results of the final cytologic examination were inconclusive.


    Date de mise en ligne : Mercredi 06 avril 2016
    Laura Calavas, Jérome Rivory, Valérie Hervieu, Jean-Christophe Saurin, Mathieu Pioche
    Macroscopically visible flat dysplasia in the fundus of 3 patients with familial adenomatous polyposis
    We report 3 patients with familial adenomatous polyposis (FAP) followed up with gastroscopy. All lesions were diagnosed with well-demarcated whitish flat areas of the fundus, within fundic gland polyposis (FGP) with dysplasia. On the edges of those lesions, FGP were partially covered by the whitish dysplastic area (A). The whitish and flat aspects of those 3 lesions clearly contrasted with the surrounding FGP mucosa (B, C). Under narrow-band imaging and dual focus, those lesions showed light blue crests (D) as described as usual intestinal metaplasia features.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Information for readers


    Date de mise en ligne : Jeudi 01 janvier 1970
    In upcoming issues...


    Date de mise en ligne : Jeudi 01 janvier 1970
    ASGE update


    Date de mise en ligne : Jeudi 01 janvier 1970
    Focus on...


    Date de mise en ligne : Jeudi 01 janvier 1970
    Editors


    Date de mise en ligne : Jeudi 01 janvier 1970
    Contents


    Date de mise en ligne : Jeudi 01 janvier 1970
    James Buxbaum, Karthik Ravi, William Ross, Brian Weston, Prasad G. Iyer, Amit Rastogi, Michael B. Wallace
    Continuing Medical Education Exam: March 2017


    Date de mise en ligne : Jeudi 01 janvier 1970
    Jenna Koliani-Pace, Douglas J. Robertson
    Looking harder, finding more: it’s positively in our DNA
    In average-risk populations, the lifetime risk of colorectal cancer (CRC) is approximately 5% to 6%, and in the United States CRC remains the second leading cause of cancer-related death.1 Importantly, CRC screening improves outcomes. For example, randomized controlled trials of both fecal occult blood tests2 and sigmoidoscopy3 suggest that screening reduces CRC mortality by about 30%. Observational studies of primary screening colonoscopy suggest an even larger CRC mortality benefit, in the range of nearly 70%.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Christopher V. Almario, Brennan M.R. Spiegel
    Does endoscopist fatigue impact adenoma detection rate? A review of the evidence to date
    Although there are several approaches to screening for colorectal cancer (CRC), colonoscopy remains the preferred screening modality; it is the only test that is both cancer-detecting and cancer-preventing through removal of adenomatous polyps—the CRC precursor. Nonetheless, colonoscopy is an imperfect test, and its results depend on a wide range of patient-level and endoscopist-level factors. To identify and remove polyps, patients must (1) receive and accept a recommendation for a colonoscopy from a healthcare provider in the first place, (2) take the time to obtain the prescribed bowel preparation at a local pharmacy, (3) adhere to dietary restrictions, (4) ingest the purgative as directed, and (5) present to the endoscopy unit for the colonoscopy.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Sumant Inamdar, Divyesh V. Sejpal, Arvind J. Trindade
    Response:
    We thank the authors1-3 of the various letters for their interest and comments on article “Rectal indomethacin is protective against post-ERCP pancreatitis in high-risk patients but not average-risk patients: a systematic review and meta-analysis.”4 This is a topic of significant debate, and we appreciate the opportunity to respond.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Maria Pellise, Liseth Rivero-Sanchez
    Retained clips: A new challenge for post-EMR surveillance?
    The first-line treatment for nonpedunculated colonic polyps, EMR, is associated with a 2.5% to 11% risk of postprocedural bleeding and a 0.5% to 4% risk of perforation.1,2 Endoscopic clipping is an effective technique to manage intraprocedural bleeding and achieve closure of deep mural injuries. However, the effectiveness of clips in preventing delayed postpolypectomy bleeding remains controversial. A retrospective analysis from a highly experienced endoscopist revealed that the rate of delayed bleeding declined significantly after prophylactic hemoclipping for large (≥2 cm) polyps was carried out.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Tae Jun Song, Sang Soo Lee
    Response:
    We thank Kawakubo and colleagues1 for their helpful comments. Unfortunately, we do not agree with their opinion that primary surgery should be performed without biliary drainage, or that biliary drainage be performed with metal stents. It is too early to jump to such conclusions. Early surgery without biliary drainage has been the trend in pancreaticobiliary surgery.2 However, if patients have severe jaundice, concomitant cholangitis, or obstructive jaundice–related symptoms, we think it is important to consider implementing biliary drainage and not to let them wait for surgery without biliary drainage.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Aatur D. Singhi, Herbert J. Zeh, Adam Slivka, Kevin McGrath
    Response:
    We appreciate the interest of Vege et al1 in our article, which raised concerns for missed cancers, if the American Gastroenterological Association (AGA) pancreatic cyst guidelines were invoked.2 They suggest that patients with neoplastic cysts harboring advanced pathologic changes would be better off not undergoing surgical resection because the outcome for resected pancreatic adenocarcinoma is poor. Is not the purpose of evaluating and surveying pancreatic cysts to discover early malignant change, which can be intervened upon for cure? As opposed to the quoted 28% 5-year survival for a resected pancreatic cancer arising in an intraductal papillary mucinous neoplasm (IPMN), which lumps all stages, the survival for resected disease ≤2.0 cm is 59%, and that of high-grade dysplasia is 100%.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Nikhil R. Thiruvengadam, Kimberly A. Forde, Vinay Chandrasekhara, Michael L. Kochman
    Lowering the risk of post-ERCP pancreatitis
    We read with interest the meta-analysis of prospective randomized control trials examining the efficacy of rectal indomethacin for prevention of post-ERCP pancreatitis (PEP) in high-risk and average-risk patients published in Gastrointestinal Endoscopy by Inamdar et al.1 They demonstrated that indomethacin reduced PEP in high-risk patients. However, they concluded that among average-risk patients the rate of PEP was similar and not statistically significant (relative risk [RR], 0.74; 95% confidence interval [CI], 0.52-1.07).


    Date de mise en ligne : Jeudi 01 janvier 1970
    Jodie A. Barkin, Enrico O. Souto, Jamie S. Barkin
    Rectal indomethacin should be used routinely in all patients for prevention of post-ERCP pancreatitis
    We read with great interest the systematic review and meta-analysis on the effect of rectal indomethacin for prevention of post-ERCP pancreatitis (PEP) by Inamdar et al.1 The benefit of rectal indomethacin in their meta-analysis was seen only in high-risk patients undergoing ERCP. This may be due to their all-inclusive criteria for defining high-risk patients to include 7 procedural and 5 patient elements, including number and extent of pancreatic duct injections. When these criteria are used, the defined “average-risk” patients are actually not average but rather are at lowest risk for PEP.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Jonathan Cohen
    The benefit of narrow-band imaging after EMR of laterally spreading lesions
    Optical enhanced imaging created much excitement when narrow-band imaging (NBI) became commercially available in Western countries in 2006. For various reasons, the adoption of this technology by practicing endoscopists has been slow. In their large prospective study appearing in this issue of Gastrointestinal Endoscopy, Desomer and colleagues1 have provided solid evidence of a practical application that may generate the needed motivation and momentum to spark wider use of this technology.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Lawrence Hookey, Jacob Louw, Michelle Wiepjes, Natalie Rubinger, Stijn Van Weyenberg, Andrew G. Day, William Paterson
    Response:
    We thank Drs Triantafyllou, Gkolfakis, and Dimitriadis1 for their interest in our study.2 We also share their interest in obtaining the best view and highest possible diagnostic yield during small-bowel capsule endoscopy, and we agree that larger studies are needed to assess the effect, if any, of bowel cleansing on this most important outcome.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Kazumichi Kawakubo, Masaki Kuwatani, Naoya Sakamoto
    Too short to choose biliary drainage?
    We read the great interest the article by Song et al,1 “Metal versus plastic stents for drainage of malignant biliary obstruction before primary surgical resection.” The authors concluded that preoperative drainage with plastic stents is preferable to metal stent placement, considering the cost-effectiveness.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Brian R. Weston, William A. Ross
    Quality metrics: beyond adenoma detection rate
    Measuring quality of care in ways related to significant patient outcomes is a widely shared goal among physicians. Gastroenterologists have such a metric in the adenoma detection rate (ADR), inasmuch as it has been tied both to interval cancer occurrence and to colon cancer mortality. Numerous articles have proposed variations on ADR or other enhancements with the goal of achieving screening colonoscopy of ever higher quality. In this issue of Gastrointestinal Endoscopy, Melson and his colleagues1 propose another metric: nonneoplastic polypectomy rate (NNPR), defined as the percentage of 1 or more nonneoplastic polypectomies, considering hyperplastic lesions as neoplastic.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Xing-kang He, Lei-min Sun
    Does rectal indomethacin prevent post-ERCP pancreatitis in average-risk patients?
    We read with great interest the recent meta-analysis by Inamdar et al1 on the utility of rectal indomethacin in the prevention of post-ERCP pancreatitis (PEP). According to their strict criteria, the authors included 8 articles. They concluded that rectal indomethacin protected high-risk patients from post-ERCP pancreatitis but not average-risk patients.1 The results of this meta-analysis were partly in contrast to a previous meta-analysis,2 which demonstrated that rectal indomethacin reduced, by approximately 50%, the risk of PEP in both low-risk and high-risk patients.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Jubeen Moaven, Vanessa M. Shami
    Predicting pathologic response: the “bottom line” in the management of locally advanced rectal cancer
    The standard of care for management of locally advanced rectal cancer (stage II/III) consists of neoadjuvant chemoradiation therapy (nCRT) and total mesorectal excision (TME), followed by adjuvant chemotherapy.1 A substantial proportion of patients achieve pathologic complete response (pCR) at the time of resection and are known to have decreased rates of tumor recurrence and improved survival.2


    Date de mise en ligne : Jeudi 01 janvier 1970
    Douglas K. Rex, C. Cesare Hassan, John M. Dewitt
    Colorectal endoscopic submucosal dissection in the United States: Why do we hear so much about it and do so little of it?
    Endoscopic submucosal dissection (ESD) was developed in Japan for the nonoperative treatment of early gastric cancer. In Japan and some other Asian countries, the indications for ESD expanded to colorectal lateral spreading tumors (LSTs).1-3 It seems reasonable to speculate that more than 99% of American endoscopists have never performed an ESD, and probably the overwhelming majority are not interested in learning and performing ESD. Anecdotally, this reluctance to embrace ESD in the United States is a source of frustration to some Japanese endoscopists, many of whom are virtuoso masters of ESD and firm believers that a subset of lesions in the colorectum should be approached only endoscopically by ESD.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Santhi Swaroop Vege, Barry Ziring, Rajeev Jain, James M. Scheiman, Joo Ha Hwang, Paul Moayyedi
    Optimal strategies for pancreatic cyst surveillance: we need better comparative data, not more case series
    We read with interest the article by Singhi et al.1 The authors set out to assess the accuracy of the recently published American Gastroenterological Association (AGA) guidelines on asymptomatic neoplastic cysts. They report a select group of 225 patients with pancreas cysts who underwent EUS and further narrowed this to an even more select group for whom the results of pathologic examination were available. Thus, the authors are presenting on 41 very highly selected patients. A relatively small subset of 13 (6% of all patients) had advanced neoplasia, so there is a high degree of uncertainty around any proportions they report.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Walter J. Coyle
    A tool for training better endoscopists
    Colonoscopy is one of the key tools for the screening, diagnosis, and treatment of colonic neoplasia in gastroenterology. Even with the new United States Preventive Services Task Force (USPSTF) Colon Cancer Screening Guidelines, colonoscopy remains a major screening tool.1 The focus on quality measures in medicine places an emphasis on adenoma detection rate (ADR) and the completion of colonoscopy to the cecum.2 Any tool that safely, efficiently, and with minimal cost improves these colon measures would be welcome.


    Date de mise en ligne : Jeudi 01 janvier 1970
    Konstantinos Triantafyllou, Paraskevas Gkolfakis, George D. Dimitriadis
    Abandon purgative bowel preparation before small-bowel capsule endoscopy? Not yet
    We congratulate Hookey et al1 for providing an objective, computerized measurement of small intestinal mucosa cleansing that correlates with the traditional, albeit subjective, ways to rate the visualization of small-bowel mucosa during capsule endoscopy (CE). Future research might benefit from this observation.