Two leading treatments for choledocholithiasis—laparoscopic bile duct exploration (lbeps) and ERCP with laparoscopic cholecystectomy—show similar effectiveness, but surgeons can leverage their distinct recovery profiles. Both methods achieved 100% stone clearance with no conversions to open surgery, but lbeps showed quicker postoperative recovery of liver function tests. Patients receiving lbeps faced less acute cholangitis and had […]
Category: Surgical Endoscopy
New Endoscope Enhances Efficiency in Minimally Invasive Surgery
A novel distal-flexible endoscope offers improved maneuverability, benefiting surgeons performing complex procedures. The prototype reduced operative time by 18% in simulated tasks (5.8 vs. 4.6 min, p=0.042) and by 21% in vivo (40.2 vs. 51.0 min, p=0.046). Fewer endoscope repositionings were needed—4.8 vs. 12.8 (p=0.004). This system’s intuitive design reduces surgeon workload while ensuring patient […]
Ultra-early endoscopy cuts anastomotic leak risk post-MIE
Ultra-early postoperative endoscopy within 24 hours significantly reduces anastomotic leaks after minimally invasive esophagectomy (MIE). Anastomotic leak rates dropped from 20.07% to 11.31% with ultra-early endoscopy (p=0.007). Hypoproteinemia rates fell from 21.90% to 9.49% (p<0.001), and median hospital stay decreased (p=0.01). This approach safely enables earlier risk detection and promotes faster enteral nutrition, improving patient […]
Pocket-Creation Method Non-Inferior in Gastric ESD
The pocket-creation method for gastric tumors matches conventional techniques in safety and effectiveness, with fewer subsequent surgeries. Adverse event rates: 14.3% for pocket-creation vs. 12.9% for conventional. Significantly lower need for further surgery in pocket-creation group (2.9% vs. 12.9%, p=0.028). Consider using the pocket-creation method to reduce follow-up interventions while achieving comparable resection rates. Procedure […]
Comparing ERCP Techniques in Billroth II Gastrectomy
Forward-viewing endoscopy with a cap shows similar efficacy to side-viewing duodenoscopy for ERCP in Billroth II patients. No significant differences in biliary cannulation or clinical success rates between the two techniques. Adverse event rates were comparable; however, post-ERCP pancreatitis rates were higher with the forward-viewing approach (14.5% vs 6.7%). Surgeons should interpret these findings cautiously […]
Plastic and Metal Stents Show No Survival Difference in Pancreatic Cancer
Stent choice for preoperative biliary drainage in pancreatic cancer does not affect long-term survival. Among 6,429 patients, overall and recurrence-free survival were similar for plastic (PS) and metal stents (MS) after pancreaticoduodenectomy, even in those receiving neoadjuvant therapy. No significant difference in postoperative complications between PS and MS. Choose stents based on drainage duration and […]
New Peptide Strategy Outperforms Balloon for Post-ERCP Bleeding
A self-assembling peptide-first approach significantly enhances hemostasis for immediate post-sphincterotomy bleeding during ERCP. Successful initial hemostasis was achieved in 92.3% of the peptide group versus 76.9% in the balloon group (15.4% risk difference, p=0.027). The mean procedure time was shorter for the peptide strategy, and rescue devices were needed less often (7.7% vs 23.1%, p=0.033). […]
EUS-guided RFA shows promise for managing IPMNs
Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) offers a safe, minimally invasive option for patients with branch-duct IPMNs who cannot undergo surgery. Technical success reached 100% across 62 procedures, with local control in 98% of lesions. Adverse events occurred in 27% of cases, mainly mild abdominal pain; no procedure-related deaths were reported. This approach maintains pancreas-wide disease […]
Negligible benefit of terminal ileal intubation in asymptomatic colonoscopy
Routine terminal ileal intubation in asymptomatic patients undergoing colon cancer screening shows minimal diagnostic value. Overall diagnostic yield for any ileal finding is just 1.74%. Yield for clinically significant pathology is only 0.28%, with Crohn’s disease detection at 0.1%. Surgeons should reconsider routine TII during screening and surveillance colonoscopies due to negligible benefit. Review by […]
New risk scoring for achalasia post-POEM reveals critical patterns.
The JAMS POEM score effectively predicts short-term clinical failure (AUROC 0.71) but loses accuracy long-term (AUROC 0.54). A three-tiered risk stratification identifies an intermediate-risk group with a 10-year failure rate of 35.8%, suggesting different follow-up strategies. Surgeons should consider long-term outcomes when applying the JAMS POEM score for better patient surveillance. In the low-risk group, […]