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Radiofrequency Ablation of Pancreatic Solid Tumors
Today, endoscopic ultrasound-guided radiofrequency ablation has become increasingly accepted for the treatment of different precancerous and neoplastic lesions of the pancreas, particularly in patients who are unfit for surgery. However, thermal ablation has long been suspected to induce pancreatitis or to injure adjacent structures. Published case reports and case series on this topic are of limited size and are often based on a heterogeneous study population, reporting on functional and nonfunctional pancreatic neuroendocrine tumors. Nevertheless, the overall results are promising, with high technical success and relativ...
Source: Gastrointestinal Endoscopy Clinics of North America - June 15, 2023 Category: Gastroenterology Authors: Marc Giovannini, Mariola Marx Source Type: research

Postendoscopic Retrograde Cholangiopancreatography Pancreatitis Pathophysiology and Prevention
Endoscopic retrograde cholangiopancreatography (ERCP) is an essential procedure for the management of pancreato-biliary disorders. Pancreatitis remains the most frequent complication of the ERCP procedure, and it is, therefore, necessary to recognize the pathophysiology and risk factors contributing to the development of pancreatitis and understand the methods to prevent this complication. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - June 15, 2023 Category: Gastroenterology Authors: Venkata S. Akshintala, Vikesh K. Singh Source Type: research

Pancreatic Interventions: From the Quill to the Sonar
Pancreatic ductal interventions have come a long way since the first canulation of a dog ’s pancreatic duct using the hollow quill of a goose feather by the Dutch medical student Reignier de Graff in 1663. Even though the initial endoscopic pancreatic ductal interventions were meant for diagnostic purposes, over the years these techniques have evolved with a therapeutic intent. Develo pment of novel concepts has resulted in evolution of innovative techniques, aided by better imaging and instrumentation, and sustained by the courage of endoscopists. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - June 15, 2023 Category: Gastroenterology Authors: D. Nageshwar Reddy, Rupjyoti Talukdar Tags: Preface Source Type: research

Endoscopic Necrosectomy
The management of walled-off necrosis has evolved substantially over the past 23  years since its first description. In this article, we review its history and the evidence supporting modern treatment, which is still subject to heterogeneity across centers and among endoscopists. This allows for creativity and customization of what can be an endoscopic marathon. Our typical pra ctice is discussed with image and video guides aimed at improving procedure success. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 31, 2023 Category: Gastroenterology Authors: Andrew J. Gilman, Todd H. Baron Source Type: research

Advances in the Diagnosis and Treatment of Pancreatic Cystic Neoplasms
Pancreatic cystic lesions are increasingly recognized through broad use of cross-sectional imaging and may also be increasing in prevalence. Although the majority of these lesions are either benign or will not progress to an invasive cancer, a subset of them represents a unique opportunity to detect an early and curable precursor to pancreatic cancer. Since the recognition of these cystic precursors and the development of the early guidelines for management of pancreatic cysts, significant advances have been made in the understanding of the epidemiology, radiologic classification, endoscopic imaging, and biomarkers. (Sourc...
Source: Gastrointestinal Endoscopy Clinics of North America - May 27, 2023 Category: Gastroenterology Authors: Tamas A. Gonda Tags: Preface Source Type: research

Advances in Diagnosis and Therapy of Pancreatic Cystic Neoplasms
GASTROINTESTINAL ENDOSCOPY CLINICS OF NORTH AMERICA (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 27, 2023 Category: Gastroenterology Authors: Tamas A. Gonda Source Type: research

Copyright
ELSEVIER (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 27, 2023 Category: Gastroenterology Source Type: research

Contributors
CHARLES J. LIGHTDALE, MD (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 27, 2023 Category: Gastroenterology Source Type: research

Contents
Charles J. Lightdale (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 27, 2023 Category: Gastroenterology Source Type: research

Forthcoming Issues
Updates in Pancreatic Endotherapy (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 27, 2023 Category: Gastroenterology Source Type: research

Endotherapy for Pancreas Divisum
Pancreas divisum (PD) is a common anatomic variant of the pancreatic duct. Causal association between PD and pancreatitis has been debated for many years. Minor papilla sphincterotomy (miES) is offered in clinical practice to patients with idiopathic acute recurrent pancreatitis (iRAP) and PD. However, available data originate mainly from observational studies with many limitations. An ongoing international, multicenter, sham-controlled trial is evaluating the efficacy of miES in iRAP and PD. Endoscopic therapy for pain relief has limited to no benefit in patients with chronic abdominal pain or chronic pancreatitis who hav...
Source: Gastrointestinal Endoscopy Clinics of North America - May 26, 2023 Category: Gastroenterology Authors: Sumant Inamdar, Gregory A. Cote, Dhiraj Yadav Source Type: research

Management of Pancreatic Duct Stones: Extracorporeal Approach
Stone clearance with extracorporeal shock wave lithotripsy is a safe and effective procedure for large pancreatic calculi not extractable by the standard endoscopic retrograde cholangiopancreatography techniques. In properly selected patients, this minimally invasive approach should be offered as the first line of therapy instead of surgery. Complete stone clearance can be achieved in three-fourths with long-term pain relief in two-thirds of patients. Re-intervention is required in less than half of the patients. Future studies should compare the extracorporeal approach with intraductal lithotripsy using the pancreatoscope...
Source: Gastrointestinal Endoscopy Clinics of North America - May 23, 2023 Category: Gastroenterology Authors: Manu Tandan, Partha Pal, Duvvuri Nageshwar Reddy Source Type: research

Management of Disconnected Pancreatic Duct
Disconnected pancreatic duct (DPD) is common after acute necrotizing pancreatitis (ANP). Its clinical implications vary according to the course of disease. In the early phase of ANP, parenchymal necrosis along with disruption of pancreatic duct cause acute necrotic collection that evolves into walled-off necrosis (WON). In the later phase, DPD becomes evident as confirmed by magnetic resonance cholangiopancreatography. Clinical manifestations of DPD can vary from being asymptomatic, recurrent pain, recurrent pancreatic fluid collection (PFC), obstructive pancreatitis, or external pancreatic fistula (EPF). Few patients deve...
Source: Gastrointestinal Endoscopy Clinics of North America - May 20, 2023 Category: Gastroenterology Authors: Jahangeer Basha, Sundeep Lakhtakia Source Type: research

Endoscopy in Gallstone Pancreatitis
The root cause for biliary pancreatitis is a transient impediment of the outflow of secretion from the pancreatic duct due to gallstones and sludge obstructing the ampulla of Vater. Based on meta-analyses and recent studies, clear recommendations can be formulated when and when not to perform an ERC in patients with biliary pancreatitis. ERC is indicated urgently in patients with biliary pancreatitis and concomitant cholangitis. Urgent ERC is not indicated in patients with predicted mild or severe biliary pancreatitis without cholangitis, even when stones or sludge are proven on EUS imaging. (Source: Gastrointestinal Endos...
Source: Gastrointestinal Endoscopy Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Marco J. Bruno Source Type: research

Endoscopic Interventions in Pancreatic Cystic Neoplasms
During the past two  decades, there has been a significant evolution in endoscopic interventions in pancreatic cystic neoplasms (PCNs), ranging from diagnostic intervention (endoscopic ultrasound-guided through-the-needle biopsy [EUS-TTNB]) to therapeutic intervention (endoscopic ultrasound-guided pancreatic cystic ab lation [EUS-PCA]). They have received attention as alternatives to conventional diagnostic and therapeutic modalities. EUS-TTNB can categorize PCN types accurately by providing histologic diagnoses that conventional diagnostic modalities cannot provide. As pancreatectomy entails high morbidities, EU S-PCA ca...
Source: Gastrointestinal Endoscopy Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Sung Hyun Cho, Dong-Wan Seo Source Type: research