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Advances in Endoscopic Techniques and Technology: Old Problems, New Frontiers
Phillip S. Ge & Linda S. Lee
doi : 10.1007/s10620-022-07435-6
Volume 67, issue 5, May 2022
Hemostasis Techniques for Non-variceal Upper GI Hemorrhage: Beyond Injection and Cautery
B. Nulsen & D. M. Jensen
Variceal Bleeding: Beyond Banding
Lolwa N. Al-Obaid, Ahmad Najdat Bazarbashi & Marvin Ryou
doi : 10.1007/s10620-022-07425-8
Despite advances in the management of complications of portal hypertension, variceal bleeding continues to be associated with significant morbidity and mortality. While endoscopic variceal band ligation remains first line therapy for treating bleeding and high-risk non-bleeding esophageal varices, alternate therapies have been explored, particularly in cases of refractory bleeding. The therapies being explored include stent placement, hemostatic powder use, over-the-scope clips and others. For gastric variceal bleeding, endoscopic ultrasound-guided therapies have recently emerged as promising interventions for hemostasis. The aim of this article is to highlight these alternative therapies and their potential role in the management of gastric and esophageal variceal bleeding.
Endoscopic Management of GERD
David P. Lee & Kenneth J. Chang
doi : 10.1007/s10620-022-07390-2
Gastroesophageal reflux disease (GERD) has consistently been the most frequently diagnosed gastrointestinal malady in the USA. The mainstay of therapy has traditionally been medical management, including lifestyle and dietary modifications as well as antacid medications. In those patients found to be refractory to medical management or with a contraindication to medications, the next step up has been surgical anti-reflux procedures. Recently, though innovative advancements in therapeutic endoscopy have created numerous options for the endoscopic management of GERD, in this review, we discuss the various endoscopic therapy options, as well as suggested strategies we use to recommend the most appropriate therapy for patients.
Endoscopic Management of Barrett's Esophagus
Jennifer M. Kolb & Sachin Wani
Endoscopic Management of Luminal Strictures: Beyond Dilation
Nader D. Daoud, Hassan Ghoz, Obaie Mzaik, Himesh B. Zaver, Micah McKinney, Bhaumik Brahmbhatt & Timothy Woodward
doi : 10.1007/s10620-022-07396-w
Luminal strictures can occur as part of many different gastrointestinal (GI) disorders anywhere along the GI tract and affect all age groups. The end goal of managing any stricture is to re-establish an adequate and durable luminal patency that is sufficient to resolve the presenting clinical symptoms. Treatment options can be generally categorized into medical, endoscopic, and surgical. However, within each of these categories, multiple different options are available. Therefore, choosing the best treatment modality is often challenging and depends on multiple factors including the type, location, and complexity of the stricture, as well as the preference of the treating physician. In this article, we will review the most current literature regarding foregut strictures, particularly esophageal and gastric, beyond dilation.
POEM, GPOEM, and ZPOEM
Nasim Parsa, David Friedel & Stavros N. Stavropoulos
doi : 10.1007/s10620-022-07398-8
Our tripartite narrative review discusses Peroral Endoscopic Myotomy (POEM), gastric POEM (GPOEM) and POEM for Zenker’s diverticula (ZPOEM). POEM is the prototypical procedure that launched the novel “3rd space endoscopy� field of advanced endoscopy. It revolutionized achalasia therapy by offering a much less invasive version of the prior gold standard, the laparoscopic Heller myotomy (HM). We review in detail indications, outcomes, technique variations and comparative data between POEM and HM particularly with regard to the hotly debated issue of GERD. We then proceed to discuss two less illustrious but nevertheless important offshoots of the iconic POEM procedure: GPOEM for gastroparesis and ZPOEM for the treatment of hypopharyngeal diverticula. For GPOEM, we discuss the rationale of pylorus-directed therapies, briefly touch on GPOEM technique variations and then focus on the importance of proper patient selection and emerging data in this area. On the third and final part of our review, we discuss ZPOEM and expound on technique variations including our “ultra-short tunnel technique�. Our review emphasizes that, despite the superiority of endoscopy over surgery for the treatment of hypopharyngeal diverticula, there is no clear evidence yet of the superiority of the newfangled ZPOEM technique compared to the conventional endoscopic myotomy technique practiced for over two decades prior to the advent of ZPOEM.
Advanced Endoscopic Resection Techniques: Endoscopic Submucosal Dissection and Endoscopic Full-Thickness Resection
Phillip S. Ge & Hiroyuki Aihara
doi : 10.1007/s10620-022-07392-0
Endoscopic resection is first-line therapy in the management of superficial neoplasms throughout the gastrointestinal tract, as well as an increasingly viable therapeutic alternative in the resection of selected small deep lesions throughout the upper and lower gastrointestinal tract. The mainstay of therapy has traditionally been endoscopic snare polypectomy and endoscopic mucosal resection. However, recent innovative advancements in therapeutic endoscopy have provided for the ability to resect large superficial lesions and selected subepithelial lesions in en bloc and margin-negative fashion. In this review, we discuss the current state of the art in advanced endoscopic resection techniques including endoscopic submucosal dissection and endoscopic full-thickness resection.
Video Capsule Endoscopy and Device-Assisted Enteroscopy
Mark Hanscom, Courtney Stead, Harris Feldman, Neil B. Marya & David Cave
Artificial Intelligence in Endoscopy
Yutaka Okagawa, Seiichiro Abe, Masayoshi Yamada, Ichiro Oda & Yutaka Saito
doi : 10.1007/s10620-021-07086-z
Artificial intelligence (AI) is rapidly developing in various medical fields, and there is an increase in research performed in the field of gastrointestinal (GI) endoscopy. In particular, the advent of convolutional neural network, which is a class of deep learning method, has the potential to revolutionize the field of GI endoscopy, including esophagogastroduodenoscopy (EGD), capsule endoscopy (CE), and colonoscopy. A total of 149 original articles pertaining to AI (27 articles in esophagus, 30 articles in stomach, 29 articles in CE, and 63 articles in colon) were identified in this review. The main focuses of AI in EGD are cancer detection, identifying the depth of cancer invasion, prediction of pathological diagnosis, and prediction of Helicobacter pylori infection. In the field of CE, automated detection of bleeding sites, ulcers, tumors, and various small bowel diseases is being investigated. AI in colonoscopy has advanced with several patient-based prospective studies being conducted on the automated detection and classification of colon polyps. Furthermore, research on inflammatory bowel disease has also been recently reported. Most studies of AI in the field of GI endoscopy are still in the preclinical stages because of the retrospective design using still images. Video-based prospective studies are needed to advance the field. However, AI will continue to develop and be used in daily clinical practice in the near future. In this review, we have highlighted the published literature along with providing current status and insights into the future of AI in GI endoscopy.
State-of-the-Art Update of Pancreatic Cysts
Andrew Canakis & Linda S. Lee
Advanced EUS Imaging Techniques
Irina M. Cazacu, Adrian Saftoiu & Manoop S. Bhutani
Advanced Imaging of the Biliary System and Pancreas
Selena Zhou & James Buxbaum
doi : 10.1007/s10620-022-07389-9
Despite advances in noninvasive techniques for imaging the pancreaticobiliary system, several disease processes including indeterminate biliary strictures as well as neuroendocrine tumors, inflammatory pseudotumors, and complex cysts of the pancreas remain difficult to characterize. New endoscopic imaging technologies have emerged to address these challenges. Cholangioscopy and intraductal ultrasound (IDUS) are powerful tools to characterize subtle biliary concretions and strictures. Confocal Laser Endomicroscopy (CLE) and Optical Coherence Tomography (OCT) are emerging approaches for the most difficult biliary lesions. Contrast harmonic endoscopic ultrasound (CH-EUS), elastography, and 3D-EUS are improving the approach to subtle pancreatic lesions, particularly in the context of indeterminate tissue sampling. Pancreatoscopy, pancreatic IDUS, and intracystic CLE hold promise to further improve the assessment of pancreatic cysts. We aim to comprehensively review the emerging clinical evidence for these innovative endoscopic imaging techniques.
Management of Difficult Choledocholithiasis
Alexander Podboy, Srinivas Gaddam, Kenneth Park, Kapil Gupta, Quin Liu & Simon K. Lo
doi : 10.1007/s10620-022-07424-9
Over 30% of all endoscopic retrograde cholangiography procedures in the US are associated with biliary stone extraction, and over 10–15% of these cases are noted to be complex or difficult. The aim of this review is to define the characteristics of difficult common bile duct stones and provide an algorithmic therapeutic approach to these difficult cases. We describe additional special clinical circumstances in which difficult biliary stones are identified and provide additional management strategies to aid endoscopic stone extraction efforts.
Endoscopic Management of Complications in Chronic Pancreatitis
Ahmed Dirweesh, Guru Trikudanathan & Martin L. Freeman
doi : 10.1007/s10620-022-07391-1
Management of complications in patients with chronic pancreatitis is often suboptimal. This review discusses detailed endoscopic approaches for managing complications in CP.
Endoscopic Management of Pancreatobiliary Malignancies
Dong Wook Lee & Eun Young Kim
doi : 10.1007/s10620-022-07394-y
Pancreatobiliary malignancies have poor prognosis, and many patients are inoperable at the time of diagnosis. When surgical resection is impossible, systemic chemotherapy or radiotherapy is traditionally conducted with trial of immunotherapy or gene therapy lately. With the rapid development of endoscopic instruments and accessories in recent years, not only endoscopic early detection, characterization, and staging but also endoscopic palliative management of the pancreatobiliary malignancies is expanding the horizons. Endoscopic management is often preferred due to similar efficacy to surgical management with less morbidity. Here, we review the methodology and treatment outcome of various endoscopic management strategies in pancreatobiliary malignancies including endoscopic complication management, local palliative therapy, endoscopy-assisted therapy, and pain control utilizing endoscopic retrograde cholangiopancreatography or endoscopic ultrasound.
When ERCP Fails: EUS-Guided Access to Biliary and Pancreatic Ducts
Abdelhai Abdelqader & Michel Kahaleh
doi : 10.1007/s10620-022-07423-w
Pancreaticobiliary (PB) endotherapy continues to progress in the era of therapeutic endosonography. Endoscopic retrograde cholangiopancreatography (ERCP) remains the primary method for PB access in native and altered anatomy. In altered anatomy, PB access can be obtained via enteroscopy-assisted ERCP (e-ERCP) or laparoscopy-assisted ERCP; however, both approaches have significant limitations. Endoscopic ultrasound-guided biliary and pancreatic duct drainage (EUS-BPD) are increasingly becoming the preferred alternative when ERCP fails, with advantages over percutaneous drainage. EUS-BPD continues to evolve with better feasibility, safety and efficacy as dedicated procedural equipment continues to improve. In this article, we discuss the role of endoscopic ultrasound (EUS) when ERCP fails and their indications, technique, and outcomes.
Lumen Apposition: A Changing Landscape in Therapeutic Endoscopy
Thomas R. McCarty & Christopher C. Thompson
doi : 10.1007/s10620-022-07426-7
The concept of endoscopic lumen apposition has seen a dramatic shift in the last several decades. Early natural orifice trans-luminal endoscopic surgery (NOTES) concepts have transformed into specialized lumen-apposing metal stents (LAMSs) and delivery devices, which provide endoscopists a minimally invasive alternative to surgical intervention. These LAMSs have become the bedrock of therapeutic endoscopy and provide treatment for a wide spectrum of gastrointestinal disorders. In this review, we summarize the changing landscape of therapeutic endoscopy by highlighting the use of LAMS and future directions as well as alternative devices to achieve lumen apposition.
Primary Bariatric Procedures
Pichamol Jirapinyo & Christopher C. Thompson
doi : 10.1007/s10620-022-07393-z
Obesity is pandemic. It is estimated that by 2030, half of the U.S. population will have obesity. Current treatment options for obesity includes lifestyle modification, pharmacotherapy, endoscopic bariatric and metabolic therapy (EBMT) and bariatric surgery. Over the past decades, an increasing number of EBMTs have been developed and become available. As a gastroenterologist, it is therefore important to become familiar with the available EBMTs as well as their safety and efficacy profiles in order to educate and expeditiously refer patients for the appropriate therapy when eligible. This chapter will review currently available and upcoming EBMTs. Details on how the procedures are performed, their mechanisms of action as well as data from pivotal studies will be summarized.
Revision Bariatric Procedures and Management of Complications from Bariatric Surgery
Thomas R. McCarty & Nitin Kumar
doi : 10.1007/s10620-022-07397-9
Bariatric surgery is effective, but may be associated with adverse events. A multi-disciplinary approach including endoscopic interventions can be effective to manage these. Endoscopists should familiarize themselves with gastrointestinal pathology which can occur after bariatric surgery, including nutritional deficiencies, acid reflux, anastomotic stenosis, gallstone disease, leaks, fistulas, and weight regain. Endoscopic interventions including anastomotic stricture dilation, control of bleeding, endoscopic ultrasound-guided approach for endoscopic retrograde cholangiopancreatography, leak or fistula closure via endoscopic suturing or stent placement, and transoral outlet reduction (TORe) or revision obesity surgery endoluminal (ROSE) to address weight regain are among the endoscopic tools which have demonstrated safety and efficacy in the management of adverse events after bariatric surgery.
No Longer Stretching Credibility: Mechanical Force Meets Inflammation in Experimental Intestinal Stenosis
Calen A. Steiner & Florian Rieder
Does Surveillance Increase Survival? Benefits of Periodic Colonoscopy in Patients with Ulcerative Colitis and Colorectal Cancer
Michael J. StewartÂ
An Overview of the GI Fellowship Interview: Part I—Tips for the Interviewee
Rashmi Advani, Nikki Duong, Mohammad Bilal, Samir C. Grover, Keith Siau, Steven Bollipo & Aline Charabaty
An Overview of the GI Fellowship Interview: Part II—Tips for Selection Committees and Interviewers
Rashmi Advani, Steven Bollipo, Aline Charabaty, Nikki Duong, Mohammad Bilal, Keith Siau & Samir C. Grover
Gastrointestinal Endoscopy-Associated Infections: Update on an Emerging Issue
Anasua Deb, Abhilash Perisetti, Hemant Goyal, Mark M. Aloysius, Sonali Sachdeva, Dushyant Dahiya, Neil Sharma & Nirav Thosani
doi : 10.1007/s10620-022-07441-8
Over 17.7 million gastrointestinal (GI) endoscopic procedures are performed annually, contributing to 68% of all endoscopic procedures in the United States. Usually, endoscopic procedures are low risk, but adverse events may occur, including cardiopulmonary complications, bleeding, perforation, pancreatitis, cholangitis, and infection. Infections after the GI endoscopies most commonly result from the patient’s endogenous gut flora. Although many studies have reported infection after GI endoscopic procedures, a true estimate of the incidence rate of post-endoscopy infection is lacking. In addition, the infection profile and causative organisms have evolved over time. In recent times, multi-drug-resistant microorganisms have emerged as a cause of outbreaks of endoscope-associated infections (EAI). In addition, lapses in endoscope reprocessing have been reported, with some but not all outbreaks in recent times. This systematic review summarizes the demographical, clinical, and management data of EAI events reported in the literature. A total of 117 articles were included in the systematic review, with the majority reported from North America and Western Europe. The composite infection rate was calculated to be 0.2% following GI endoscopic procedures, 0.8% following ERCP, 0.123% following non-ERCP upper GI endoscopic procedures, and 0.073% following lower GI endoscopic procedures. Pseudomonas aeruginosa was the most common culprit organism, followed by other Enterobacteriaceae groups of organisms and Gram-positive cocci. We have also elaborated different prevention methods such as antimicrobial prophylaxis, adequate sterilization methods for reprocessing endoscopes, periodic surveillance, and current evidence supporting their utilization. Finally, we discuss disposable endoscopes, which could be an alternative to reprocessing to minimize the chances of EAIs with their effects on the environmental and financial situation.
Duodenal Follicular Lymphoma: Track or Treat?
M. Varanese, A. Lauro, I. Lattina, D. Tripodi, T. Daralioti, S. Khouzam, I. R. Marino, V. Stigliano, V. D’Andrea, S. Frattaroli & S. Sorrenti
doi : 10.1007/s10620-022-07498-5
Duodenal follicular lymphoma (DFL) is a rare variety of non-Hodgkin’s lymphoma of the gastrointestinal tract that usually carries a favorable course, recognized as a new entity in 2016. It is usually diagnosed at an early stage located predominantly in the second portion of the duodenum. We report the case of a 74-year-old male patient with epigastric pain in whom gastroscopy revealed white mucosal nodules that were pathologically diagnosed as grade 1–2 DFL. Staging investigations revealed secondary lesions in the spleen and at the base of the tongue together with latero-cervical adenopathy. The tumor was stage IV according to the Lugano staging system. We reviewed the recent (last five years) literature defining the importance of combination therapy in the advanced stage. The patient achieved complete remission of the disease through chemoimmunotherapy following the Rituximab–Bendamustine scheme.
Intestinal Failure in Junctional Epidermolysis Bullosa: Mild Skin Disease, Severe Diarrhea
Karen A. DeMaria, Christopher Fink, Michael Pepper, Kerri Rieger, Serena Y. Tan & Shweta S. Namjoshi
Australasian Pediatric Gastroenterologists’ Perspectives and Practices of Celiac Disease Diagnosis and Management
Shaun S. C. Ho, Sophie Hall, Jacqueline I. Keenan & Andrew S. Day
doi : 10.1007/s10620-021-06988-2
The application of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) celiac disease (CeD) guidelines by pediatric gastroenterologists in Australia and New Zealand (Australasia) is unknown. Similarly, long-term management practices for patients with CeD are also unknown in this region.
Adverse Event Fatalities Related to GI Endoscopy
Eric Swei, J. Christie Heller, Frank Scott & Augustin Attwell
doi : 10.1007/s10620-021-06981-9
Death after endoscopy is rare, under-reported, and has variable causes. This study aimed to evaluate the incidence and causes of fatal endoscopic adverse events (AEs) across two academic medical centers and to identify patient-, procedure-, and sedation-related risk factors.
Carbonic Anhydrases II, IX, and XII in Reflux Esophagitis
Minna Nortunen, Nina V?kiparta, Seppo Parkkila, Juha Saarnio, Heikki Huhta & Tuomo J. Karttunen
doi : 10.1007/s10620-021-06985-5
The pathogenesis of gastroesophageal reflux disease (GERD) has not been resolved in detail. Esophageal epithelial cells provide resistance to acidic reflux via several mechanisms, many of which involve buffering acid with bicarbonate and transporting protons. Carbonic anhydrases (CAs) are enzymes that control the acid–base balance by catalyzing the reversible hydration of carbon dioxide to produce bicarbonate and hydrogen ions.
Correlation of Probe-Based Confocal Laser Endomicroscopy (pCLE) and Mucosal Integrity Testing (MIT) with Epithelial Barrier Function and Presence of Gastroesophageal Reflux Disease (GERD)
Pritesh R. Mutha, Matthew Fasullo, Shijian Chu, Mitchell L. Schubert, Alvin Zfass, Patricia Cooper, Mankanchan Gill, Le Kang, Michael Vaezi, Stu Wildh
doi : 10.1007/s10620-021-06980-w
Epithelial barrier function (EBF) disruption is a key mechanism underlying gastroesophageal reflux disease (GERD). Our aim was to assess whether two novel technologies, probe-based confocal laser endomicroscopy (pCLE) and mucosal integrity testing (MIT), could assess EBF.
Experimental Intestinal Stenosis Alters Crohn’s Disease-Like Intestinal Inflammation in Ileitis-Prone Mice
Ioannis Georgopoulos, Eleftheria Mavrigiannaki, Sotiria Stasinopoulou, Georgios Renieris, Georgios Nikolakis, Giorgos Bamias, Dina Tiniakos & Ioannis
doi : 10.1007/s10620-021-07161-5
Clinical observations indicate that mechanical factors contribute to the expression or recurrence of Crohn’s disease. We investigated whether the creation of an intestinal stenosis could alter the severity of the expected Crohn-like ileitis, in a Crohn’s disease animal model, the TNFΔare/+ mouse.
MicroRNA-26b-5p Targets DAPK1 to Reduce Intestinal Ischemia/Reperfusion Injury via Inhibition of Intestinal Mucosal Cell Apoptosis
Bowei Zhou, Wenjuan Zhang, Zhengzheng Yan, Bingcheng Zhao, Jin Zhao, Weijie Feng, Xiaodong Chen, Cai Li & Ke-Xuan Liu
doi : 10.1007/s10620-021-06975-7
Emerging evidence has suggested that miRNAs are important regulators of intestinal I/R injury, but their function in this context remains elusive.
Inhibition of TLR7 and TLR9 Reduces Human Cholangiocarcinoma Cell Proliferation and Tumor Development
Fatma El Zahraa Mohamed, Rajiv Jalan, Shane Minogue, Fausto Andreola, Abeba Habtesion, Andrew Hall, Alison Winstanley, Steven Olde Damink, Massimo Mal
doi : 10.1007/s10620-021-06973-9
Toll-like receptors (TLRs) are key players in innate immunity and modulation of TLR signaling has been demonstrated to profoundly affect proliferation and growth in different types of cancer. However, the role of TLRs in human intrahepatic cholangiocarcinoma (ICC) pathogenesis remains largely unexplored.
Ranitidine Use and Gastric Cancer Among Persons with Helicobacter pylori
Shria Kumar, David S. Goldberg & David E. Kaplan
doi : 10.1007/s10620-021-06972-w
The Food and Drug Administration requested withdrawal of ranitidine formulations, due to a potentially carcinogenic contaminant, N-nitrosodimethylamine.
Gastrointestinal Computed Tomography Findings in Chronic Granulomatous Disease with Subgroup Clinicopathologic Analysis
Sumona Bhattacharya, Yilun Koethe, Alexander Ling, Natasha Kamal, Sajneet Khangura, Meghna Alimchandani, Martha M. Quezado, Christa S. Zerbe, Harry L.
doi : 10.1007/s10620-021-06978-4
Chronic granulomatous disease (CGD) is a rare primary immunodeficiency which can lead to gastrointestinal (GI) complications including inflammatory bowel disease. Radiographic findings in this cohort have not been well described.
A True Positive and a False Negative? The Dilemma of Negative Colonoscopy After a Positive Fecal Occult Blood Test
J. S. Hunt, C. Cock & E. L. Symonds
doi : 10.1007/s10620-021-06986-4
Many colonoscopies following a positive fecal immunochemical test (FIT) will not identify a probable cause for fecal blood, and missed neoplasia is a concern. The study determined whether the absence of neoplasia at a FIT positive diagnostic colonoscopy was due to a missed lesion and whether the initial FIT hemoglobin (f-Hb) concentration could predict missed lesions.
Periodic Colonoscopies Are Associated with Improved Survival and Prognosis of Colorectal Cancer in Ulcerative Colitis
Neeraj Narula, Anne Hu, Geoffrey C. Nguyen, Jagadish Rangrej & John K. Marshall
doi : 10.1007/s10620-021-07151-7
This study aimed to identify whether ulcerative colitis (UC) patients who develop colorectal cancer (CRC) present at earlier stages of CRC and have improved survival if prior to their CRC diagnosis, they underwent intermittent follow-up colonoscopies compared to those who have no follow-up colonoscopies.
Increased Risk of Advanced Colonic Adenomas and Timing of Surveillance Colonoscopy Following Solid Organ Transplantation
Motaz H. Ashkar, Jacqueline Chen, Corey Shy, Jeffrey S. Crippin, Chien-Huan Chen, Gregory S. Sayuk & Nicholas O. Davidson
doi : 10.1007/s10620-021-06987-3
Detection and removal of colonic adenomatous polyps (CAP) decreases colorectal cancer (CRC) development, particularly with more or larger polyps or polyps with advanced villous/dysplastic histology. Immunosuppression following solid organ transplantation (SOT) may accelerate CAP development and progression compared to average-risk population but the benefit of earlier colonoscopic surveillance is unclear.
Risk of Delayed Bleeding after Cold Snare Polypectomy in Patients with Antithrombotic Therapy
Masato Aizawa, Kenichi Utano, Daiki Nemoto, Noriyuki Isohata, Shungo Endo, Noriko Tanaka, David G. Hewett & Kazutomo Togashi
doi : 10.1007/s10620-021-06984-6
Cold snare polypectomy is being increasingly adopted; however, there are few reports of cold snare polypectomy regarding antithrombotic therapy.
Stress Hyperglycemia Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis
Xinmin Yang, Ruwen Zhang, Tao Jin, Ping Zhu, Linbo Yao, Lan Li, Wenhao Cai, Rajarshi Mukherjee, Dan Du, Xianghui Fu, Jing Xue, Reynaldo Martina, Tingt
doi : 10.1007/s10620-021-06982-8
Stress hyperglycemia is common in critical illness but it has not been clearly studied in patients with acute pancreatitis (AP). This study aimed to investigate the specific blood glucose (BG) level that defines stress hyperglycemia and to determine the impact of stress hyperglycemia on clinical outcomes in AP patients.
Risk Factors for Perforation During Endoscopic Papillary Large Balloon Dilation and Bile Duct Stone Removal
Hiroshi Yamauchi, Tomohisa Iwai, Kosuke Okuwaki, Eiji Miyata, Yusuke Kawaguchi, Takaaki Matsumoto, Kazuho Uehara, Akihiro Tamaki, Masao Araki, Takashi
doi : 10.1007/s10620-021-06974-8
Stone removal using endoscopic papillary large balloon dilation (EPLBD) is extremely effective. However, limited research exists regarding the risk factors for perforation of the duodenal papilla and bile duct, which may be fatal.
Success and Safety of Needle Knife Papillotomy and Fistulotomy Based on Papillary Anatomy: A Prospective Controlled Trial
Qi-sheng Zhang, Jian-hua Xu, Zhi-qi Dong, Peng Gao & Yu-cui Shen
doi : 10.1007/s10620-021-06983-7
Needle knife papillotomy (NKP) and fistulotomy (NKF) are the two most commonly used rescue techniques for patients with difficult biliary cannulation (DBC). Anatomy of the major duodenal papillae (MDP) influences the optimal precut technique for biliary access. However, comparative studies of the success and safety of NKP and NKF based on the anatomy of MDP have been scarce.
Correction to: Cost‑Effectiveness of Empirical Bismuth‑Based Quadruple Therapy and Tailored Therapy After Clarithromycin Resistance Tests for Helicobacter pylori Eradication
Young Woon Chang, Ga Young Shin, Jung-Wook Kim, Jin-Chang Moon, Eun Jee Chang, Chi Hyuk Oh & Jae-Young Jang
