Endoscopic Transmural Necrosectomy: Timing, Indications, and Methods.
Endoscopic Transmural Necrosectomy: Timing, Indications, and Methods. Clin Endosc. 2019 Sep 18;: Authors: Rerknimitr R Abstract Walled-off necrosis is considered one of the most severe complications after an episode of severe acute pancreatitis. Traditionally, percutaneous drainage is selected as the first treatment step, while open surgery can be planned as a secondary option if necrosectomy is required. In recent years, endoscopic necrosectomy has evolved as a more favorable approach. To date, a step-up treatment strategy is recommended, particularly when a plastic stent is selected as the drainage device. Multi-gateway endoscopic therapy may be used in a step-up fashion if only one stent fails to clear debris. Over many years, there has been an evolution in stent selection, from plastic to metallic stents. Within a few years of its clinical usage, lumen-apposing stents are gaining more popularity as they offer direct endoscopic necrosectomy and only require a few sessions. PMID: 31530792 [PubMed - as supplied by publisher]
Endoscopy DOI: 10.1055/a-1011-3796 © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Full text
Since 2010, substantial progress has been made in artificial intelligence (AI) and its application to medicine. AI is explored in gastroenterology for endoscopic analysis of lesions, in detection of cancer, and to facilitate the analysis of inflammatory lesions or gastrointestinal bleeding during wireless capsule endoscopy. AI is also tested to assess liver fibrosis and to differentiate patients with pancreatic cancer from those with pancreatitis. AI might also be used to establish prognoses of patients or predict their response to treatments, based on multiple factors.
Conclusions Consistent with other published series, LA-ERCP yields excellent cannulation rates after RYGB. Successful treatment of pancreatic and Type 1 biliary SOD suggests that there is significant symptomatic benefit to treating this patient population. However, an overall complication rate of approximately 15 % with LAERCP leaves open the possibility for improvements in access techniques in post-RYGB patients. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | open access Full text
Endoscopy 2019; 51: 905-906 DOI: 10.1055/a-0994-0024 © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Full text
Endoscopy 2019; 51: 909-910 DOI: 10.1055/a-0997-3181 © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Full text
Endoscopy 2019; 51: 911-912 DOI: 10.1055/a-0997-3053 © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Full text
Objective In European Society of Gastrointestinal Endoscopy guidelines, biliary cannulation of native papilla is defined as difficult in the presence of>5 papilla contacts,>5 min cannulation time or>1 unintended pancreatic duct cannulation (5-5-2). The aim is to test 5-5-2-criteria in a single-center practice predicting the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP), and to study the efficacy of transpancreatic biliary sphincterotomy (TPBS) as an advanced method for biliary cannulation. Methods Prospectively collected data of 821 patients with native papilla were analyzed. ...
This study aimed to assess long-term outcomes in CP-associated BBSs after FCSEMS placement and removal.
Acute pancreatitis is an inflammatory process of the pancreas, which can range from a localized inflammatory process to a systemic response, resulting in sepsis and multisystem failure. Pancreatic fluid collections are a complication of pancreatitis. Treatment of these fluid collections is dependent on correct classification. The 2012 Atlanta Criteria divides fluid collections into four categories: acute peripancreatic fluid collections, pancreatic pseudocysts, acute necrotic collections, and walled-off necrosis. Endoscopic ultrasound-guided management of chronic fluid collections is currently the preferred treatment modal...
Abstract Brunner's gland hamartoma (or Brunneroma) is an uncommon tumour with an incidence of