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.

Are All Cysts Created Equal?
Pancreatic cystic lesions (PCLs) have become more prevalent over time, particularly in asymptomatic individuals. Current screening guidelines for incidental PCLs offer a unified approach to surveillance and management, predicated on “worrisome features.” Although PCLs are common in the general population, their prevalence may be higher in high-risk individuals (HRI, unaffected patients with specific familial and/or genetic risk factors). As more PCLs are diagnosed and more HRI identified, it is important to promote research that bridges data gaps and introduces nuance to risk assessment tools, ensuring tailoring of gui...
Source: Gastrointestinal Endoscopy Clinics of North America - April 4, 2023 Category: Gastroenterology Authors: Ido Haimi, Shenin Dettwyler, Jessica Everett, Diane M. Simeone Source Type: research

Innovation in the Surgical Management of Pancreatic Cystic Neoplasms
Historically, the management of pancreatic cystic neoplasms (PCN) has been operative. Early intervention for premalignant lesions, including intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN), offers an opportunity to prevent pancreatic cancer —with potential decrement to patients’ short-term and long-term health. The operations performed have remained fundamentally the same, with most patients undergoing pancreatoduodenectomy or distal pancreatectomy using oncologic principles. The role of parenchymal-sparing resection and total panc reatectomy remains controversial. We review innovati...
Source: Gastrointestinal Endoscopy Clinics of North America - April 4, 2023 Category: Gastroenterology Authors: Lauren E. Schleimer, John A. Chabot, Michael D. Kluger Source Type: research

The Evolution of Sedation for Pediatric Gastrointestinal Endoscopy
Sedation for pediatric endoscopy has evolved from an endoscopist-administered component of procedures to an almost entirely anesthesiologist-supported endeavor. Nevertheless, there are no ideal endoscopist or anesthesiologist-administered sedation protocols, and wide practice variation exists in both models. Furthermore, sedation for pediatric endoscopy, whether administered by endoscopists or anesthesiologists, remains the highest risk to patient safety. This underscores the importance of both specialties identifying best sedation practices together that can safeguard patients while maximizing procedural efficiency and mi...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Lisa B. Mahoney, Jenifer R. Lightdale Source Type: research

Advances in Endoscopy for Pediatric Inflammatory Bowel Disease
Endoscopic characterization of pediatric inflammatory bowel disease (IBD) has developed in accordance with advances in treatment and improved understanding of disease progression and complications. Reliable and consistent endoscopic reporting practices and tools continue to evolve. The roles of endoscopic ultrasonography, capsule endoscopy, and deep enteroscopy in the care of children and adolescents with IBD are beginning to be clarified. Opportunities for therapeutic intervention with endoscopy in pediatric IBD, including endoscopic balloon dilation and electroincision therapy, require further study. This review discusse...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Nicholas Carman, Joseph A. Picoraro Source Type: research

Endoscopy in Pediatric Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is a chronic allergen-mediated clinicopathologic condition that currently requires esophagogastroduodenoscopy with biopsies and histologic evaluation to diagnose and monitor its progress. This state-of-the art review outlines the pathophysiology of EoE, reviews the application of endoscopy as a diagnostic and therapeutic tool, and discusses potential complications related to therapeutic endoscopic interventions. It also introduces recent innovations that can enhance the endoscopist ’s ability to diagnose and monitor EoE with minimally invasive procedures and perform therapeutic maneuvers mo...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Ramy Sabe, Girish Hiremath, Kenneth Ng Source Type: research

Pediatric Neurogastroenterology and Motility Disorders
Although pediatric neurogastroenterology and motility (PNGM) disorders are prevalent, often debilitating, and remain challenging to diagnose and treat, this field has made remarkable progress in the last decade. Diagnostic and therapeutic gastrointestinal endoscopy emerged as a valuable tool in the management of PNGM disorders. Novel modalities such as functional lumen imaging probe, per-oral endoscopic myotomy, gastric-POEM, and electrocautery incisional therapy have changed the diagnostic and therapeutic landscape of PNGM. In this review, the authors highlight the emerging role of therapeutic and diagnostic endoscopy in ...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Julie Khlevner, Dhiren Patel, Leonel Rodriguez Source Type: research

Pediatric Unsedated Transnasal Endoscopy
Unsedated transnasal endoscopy (TNE) is a feasible, safe, and cost-effective procedure for pediatric patients. TNE provides direct visualization of the esophagus and enables acquisition of biopsy samples while eliminating the risks associated with sedation and anesthesia. TNE should be considered in the evaluation and monitoring of disorders of the upper gastrointestinal tract, particularly in diseases such as eosinophilic esophagitis that often require repeated endoscopy. Setting up a TNE program requires a thorough business plan as well as training of staff and endoscopists. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Rajitha D. Venkatesh, Kristina Leinwand, Nathalie Nguyen Source Type: research

Polyps and Polyposis Syndromes in Children
Polypectomy is the most common therapeutic endoscopic intervention in children. Management of sporadic juvenile polyps is limited to polypectomy to resolve symptoms, whereas polyposis syndromes pose a multidisciplinary challenge with broader ramifications. In preparation for polypectomy, there are key patient, polyp, endoscopy unit, and provider characteristics that factor into the likelihood of success. Younger age and multiple medical comorbidities increase the risk of adverse outcomes, classified as intraoperative, immediate postoperative, and delayed postoperative complications. Novel techniques, including cold snare p...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Thomas M. Attard, Shlomi Cohen, Carol Durno Source Type: research

Endoscopy and Pediatric Pancreatitis
Children and adolescents are increasingly impacted by pancreatic disease. Interventional endoscopic procedures, including endoscopic retrograde cholangiopancreatography) and endoscopic ultrasonography, are integral to the diagnosis and management of many pancreatic diseases in the adult population. In the past decade, pediatric interventional endoscopic procedures have become more widely available, with invasive surgical procedures now being replaced by safer and less disruptive endoscopic interventions. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Amit S. Grover, Roberto Gugig, Monique T. Barakat Source Type: research

Gastrointestinal Bleeding in Children
Upper gastrointestinal bleeding (UGIB) in children has many causes, with its prevalence varying by age. Often presenting as hematemesis or melena, the initial treatment is stabilization of the patient, including protection of the airway, fluid resuscitation, and a transfusion hemoglobin threshold of 7  g/L. Endoscopy should be performed with the goal of using combinations of therapies to treat a bleeding lesion, generally involving epinephrine injection along with either cautery, hemoclips, or hemospray. This review discusses the diagnosis and treatment of variceal and non-variceal gastrointesti nal bleeding in children w...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Inna Novak, Lee M. Bass Source Type: research

Electronic Medical Records
Quality indicators and standards for pediatric endoscopy have recently been developed by the inaugural working group of the international Pediatric Endoscopy Quality Improvement Network (PEnQuIN). Currently available electronic medical record (EMR) functionalities can enable real-time capture of quality indicators to support continuous quality measurement and improvement within pediatric endoscopy facilities. Ultimately, EMR interoperability and cross-institutional data sharing can serve to validate PEnQuIN standards of care and permit benchmarking across endoscopy services, in the pursuit of elevating the quality of endos...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Jeannie S. Huang, Catharine M. Walsh Source Type: research

Endoscopic Management of Congenital Esophageal Defects and Associated Comorbidities
The endoscopist plays a critical role in the management of patients with congenital esophageal defects. This review focuses on esophageal atresia and congenital esophageal strictures and, in particular, the endoscopic management of comorbidities related to these conditions, including anastomotic strictures, tracheoesophageal fistulas, esophageal perforations, and esophagitis surveillance. Practical aspects of endoscopic techniques for stricture management are reviewed including dilation, intralesional steroid injection, stenting, and endoscopic incisional therapy. Endoscopic surveillance for mucosal pathology is essential ...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Jessica L. Yasuda, Michael A. Manfredi Source Type: research

Upskilling Pediatric Ileocolonoscopy
Upskilling in ileocolonoscopy is an important aspect of pediatric endoscopic practice as it enables endoscopists to learn additional skills through education and training to improve outcomes. With the advent of technologies, endoscopy is continuously evolving. Many devices can be applied to improve endoscopy quality and ergonomics. In addition, techniques such as dynamic position change can be employed to increase procedural efficiency and completeness. Key to upskilling is enhancing endoscopists ’ cognitive, technical and nontechnical skills and the concept of “training the trainer” to ensure trainers have the requi...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Wenly Ruan, Priya Narula, Douglas S. Fishman Source Type: research

The Role of Endoscopy in the Diagnosis and Management of Small Bowel Pathology in Children
Small bowel evaluation has been transformed by capsule endoscopy and advances in small bowel imaging, which provide reliable and noninvasive means for assessing the mucosal surface. Device-assisted enteroscopy has been critical for histopathological confirmation and endoscopic therapy for a wide range of small bowel pathology that conventional endoscopy cannot reach. The purpose of this review is to provide a comprehensive overview of the indications, techniques, and clinical applications of capsule endoscopy; device-assisted enteroscopy; and imaging studies for small bowel evaluation in children. (Source: Gastrointestinal...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Amornluck Krasaelap, Diana G. Lerner, Salvatore Oliva Source Type: research

Artificial Intelligence in Pediatric Endoscopy
The application of artificial intelligence (AI) has great promise for improving pediatric endoscopy. The majority of preclinical studies have been undertaken in adults, with the greatest progress being made in the context of colorectal cancer screening and surveillance. This development has only been possible with advances in deep learning, like the convolutional neural network model, which has enabled real-time detection of pathology. Comparatively, the majority of deep learning systems developed in inflammatory bowel disease have focused on predicting disease severity and were developed using still images rather than vid...
Source: Gastrointestinal Endoscopy Clinics of North America - March 21, 2023 Category: Gastroenterology Authors: Jasbir Dhaliwal, Catharine M. Walsh Source Type: research