Gastrointestinal Endoscopy Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

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

Management of Pancreatic Duct Stones
Chronic pancreatitis (CP) is an ongoing inflammatory disease with most patients developing pancreatic calculi during their course of disease. Extracorporeal shock wave lithotripsy (ESWL) is a first-line treatment option in patients with large lumen obstructing pancreatic duct (PD) stones. In patients with CP and PD dilatation, digital single-operator pancreatoscopy (DSOP)-guided lithotripsy seems to be an appealing option to ESWL and surgery. DSOP-guided lithotripsy for the treatment of large symptomatic PD-stones has been demonstrated to be safe, technically, and clinically effective, and should be regarded as an alternat...
Source: Gastrointestinal Endoscopy Clinics of North America - May 15, 2023 Category: Gastroenterology Authors: Christian Gerges, Torsten Beyna, Horst Neuhaus Source Type: research

Endoscopic Ultrasound-Guided Pancreatic Duct Interventions
Endoscopic ultrasound (EUS)-guided pancreatic duct drainage is one of the most challenging procedures in therapeutic endoscopy. Technical success is lower than for other therapeutic EUS procedures. However, when successful in a clear clinical indication, this procedure can offer a useful therapeutic alternative and improves the overall clinical success of the endoscopic approach. Current challenges include the standardization of clinical indications and of the techniques used for accessing the pancreatic duct, the strategy for mid-term and long-term management, and definition of the scope of the training that should be off...
Source: Gastrointestinal Endoscopy Clinics of North America - May 15, 2023 Category: Gastroenterology Authors: Jacques Devi ère Source Type: research

Management of Benign Biliary Stricture in Chronic Pancreatitis
Endoscopic therapy is the first line of management for chronic pancreatitis (CP)-related benign biliary strictures. Multiple plastic stents (MPS) exchanged at regular intervals and temporary placement of fully covered self-expanding metal stents (FCSEMS) are preferred modalities of endotherapy. FCSEMS placement is non-inferior to MPS and requires fewer sessions of endoscopic retrograde cholangiopancreatography than MPS placement. The presence of head calcifications, severe CP, and length of stricture are predictors of failure or recurrence after endotherapy. Failure of endotherapy should be considered after 1  year when s...
Source: Gastrointestinal Endoscopy Clinics of North America - May 11, 2023 Category: Gastroenterology Authors: Mohan Ramchandani, Partha Pal, Guido Costamagna Source Type: research

Endoscopic Ultrasound Guided Walled-off Necrosis Drainage
Walled-off necrosis is a well-recognized complication of necrotizing pancreatitis that can cause sepsis, luminal or ductal obstruction, or persistent unwellness requiring multidisciplinary care. Recent data suggest that minimally invasive endoscopic treatment strategies are preferred over more invasive surgical approaches. Although endoscopic transmural drainage with or without necrosectomy is the primary approach for patients requiring an intervention, for collections not amenable to endoscopic approach, percutaneous drain placement followed by video-assisted retroperitoneal debridement or laparoscopic cystogastrostomy wi...
Source: Gastrointestinal Endoscopy Clinics of North America - May 8, 2023 Category: Gastroenterology Authors: Philippe Willems, Shyam Varadarajulu Source Type: research

Evolution of Pancreatic Endotherapy
This article discusses the changing landscape of pancreatic endotherapy as therapeutic ERCP and EUS were introduced and because they have evolved to treat different diseases. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 3, 2023 Category: Gastroenterology Authors: YongYan Cui, Richard A. Kozarek Source Type: research

Pancreatic Cystic Lesions
The detection of incidental pancreatic cystic lesions has increased over time. It is crucial to separate benign from potentially malignant or malignant lesions to guide management and reduce morbidity and mortality. The key imaging features used to fully characterize cystic lesions are optimally assessed by contrast-enhanced magnetic resonance imaging/magnetic resonance cholangiopancreatography, with pancreas protocol computed tomography offering a complementary role. While some imaging features have high specificity for a particular diagnosis, overlapping imaging features between diagnoses may require further investigatio...
Source: Gastrointestinal Endoscopy Clinics of North America - April 26, 2023 Category: Gastroenterology Authors: Michio Taya, Elizabeth M. Hecht, Chenchan Huang, Grace C. Lo Source Type: research

Pancreatic Cyst Fluid Analysis
Pancreatic cyst fluid analysis can help diagnose pancreatic cyst type and the risk of high-grade dysplasia and cancer. Recent evidence from molecular analysis of cyst fluid has revolutionized the field with multiple markers showing promise in accurate diagnosis and prognostication of pancreatic cysts. The availability of multi-analyte panels has great potential for more accurate prediction of cancer. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 25, 2023 Category: Gastroenterology Authors: Pradeep K. Siddappa, Walter G. Park Source Type: research

Pancreatic Cysts
This article reviews the types of pancreatic cysts encountered in Radiologic practice. It summarizes the malignancy risk of each of the following: serous cystadenoma, mucinous cystic tumor, intraductal papillary mucinous neoplasm main duct and side branch, and some miscellaneous cysts such as neuroendocrine tumor and solid pseudopapillary epithelial neoplasm. Specific reporting recommendations are given. The choice between radiology follow-up versus endoscopic analysis is discussed. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 24, 2023 Category: Gastroenterology Authors: Alec J. Megibow Source Type: research

Blood-Based Biomarkers in the Diagnosis and Risk Stratification of Pancreatic Cysts
The use of blood-based biomarkers for the assessment of pancreatic cystic lesions is a rapidly growing field with incredible potential. CA 19-9 remains the only blood-based marker in common use, while many novel biomarkers are in early stages of development and validation. We highlight current work in the fields of proteomics, metabolomics, cell-free DNA/circulating tumor DNA, extracellular vesicles, and microRNA among others, as well as barriers to development and future directions in the work of blood-based biomarkers for pancreatic cystic lesions. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 24, 2023 Category: Gastroenterology Authors: Matthew T. Peller, Koushik K. Das Source Type: research

Surveillance of Pancreatic Cystic Neoplasms
Pancreatic cystic neoplasms (PCNs) are increasingly detected because of the widespread use of cross-sectional imaging and overall aging population. While the majority of these cysts are benign, some can progress to advanced neoplasia (defined as high-grade dysplasia and invasive cancer). As the only widely accepted treatment for PCNs with advanced neoplasia is surgical resection, accurate preoperative diagnosis, and stratification of malignant potential for deciding about surgery, surveillance or doing nothing remains a clinical challenge. Surveillance strategies for pancreatic cysts (PCNs) combine clinical evaluation and ...
Source: Gastrointestinal Endoscopy Clinics of North America - April 24, 2023 Category: Gastroenterology Authors: Ankit Chhoda, Julie Schmidt, James J. Farrell Source Type: research

Risk Models for Pancreatic Cyst Diagnosis
The overall prevalence of pancreatic cysts (PCs) is high in the general population. In clinical practice PCs are often incidentally discovered and are classified into benign, premalignant, and malignant lesions according to the World Health Organization. For this reason, in the absence of reliable biomarkers, to date clinical decision-making relies mostly on risk models based on morphological features. The aim of this narrative review is to present the current knowledge regarding PC ’s morphologic features with related estimated risk of malignancy and discuss available diagnostic tools to minimize clinically relevant dia...
Source: Gastrointestinal Endoscopy Clinics of North America - April 24, 2023 Category: Gastroenterology Authors: Alice Cattelani, Giampaolo Perri, Giovanni Marchegiani, Roberto Salvia, Stefano Francesco Crin ò Source Type: research

Incidental Pancreatic Cysts: What to Do
With the widespread use of chest and abdominal imaging using computed tomography or MRI, the incidental finding of pancreatic cysts has become commonplace. Herein lies the rub. While the great majority of these cysts are benign or indolent, a small minority may offer the chance to prevent or cure a potentially lethal pancreatic cancer. What to do? (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 24, 2023 Category: Gastroenterology Authors: Charles J. Lightdale Tags: Foreword Source Type: research

Pancreatic Cystic Lesions
Pancreatic cystic lesions are frequently identified on cross-sectional imaging. As many of these are presumed branch-duct intraductal papillary mucinous neoplasms, these lesions generate much anxiety for the patients and clinicians, often necessitating long-term follow-up imaging and even unnecessary surgical resections. However, the incidence of pancreatic cancer is overall low for patients with incidental pancreatic cystic lesions. Radiomics and deep learning are advanced tools of imaging analysis that have attracted much attention in addressing this unmet need, however, current publications on this topic show limited su...
Source: Gastrointestinal Endoscopy Clinics of North America - April 8, 2023 Category: Gastroenterology Authors: Chenchan Huang, Sumit Chopra, Candice W. Bolan, Hersh Chandarana, Nassier Harfouch, Elizabeth M. Hecht, Grace C. Lo, Alec J. Megibow Source Type: research

Burden of New Pancreatic Cyst Diagnosis
Pancreatic cysts are an increasingly identified entity with significant health care implications. Although some cysts present with concurrent symptoms that often require operative intervention, the advent of improved cross-sectional imaging has heralded an era of increased incidentally detected pancreatic cysts. Although the rate of malignant progression in pancreatic cysts remains low, the poor prognosis of pancreatic malignancy has driven recommendations for ongoing surveillance. A uniform consensus has not been reached on the management and surveillance of pancreatic cysts leading clinicians to grapple with the burden o...
Source: Gastrointestinal Endoscopy Clinics of North America - April 6, 2023 Category: Gastroenterology Authors: Stephanie Romutis, Randall Brand Source Type: research