For high-risk patients with acute cholecystitis, conversion to endoscopic ultrasound-guided gallbladder drainage after percutaneous drainage achieved outcomes comparable to primary drainage. Multicenter study of 141 patients: technical success was 95.8% after conversion versus 98.3% with primary drainage. Results remained comparable after adjustment, despite more cancer and greater comorbidity in the conversion group. Clinical success, adverse […]
Category: Surgical Endoscopy
EUS-Guided Gallbladder Drainage Effective for Symptomatic Cholelithiasis
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a safe and effective option for nonoperative candidates with symptomatic cholelithiasis without cholecystitis. Complete gallstone clearance achieved in 100% of patients; 87% cleared in one treatment. All 23 patients had technical success with LAMS placement, and no procedure-related adverse events occurred. No symptom recurrence noted over a mean follow-up […]
Full-thickness myotomy shows noninferior efficacy in achalasia
Full-thickness myotomy (FTM) offers clinical outcomes similar to circular muscle myotomy (CMM) for achalasia, but carries additional safety risks. Clinical success rates: 91.2% for FTM vs. 85.7% for CMM; noninferiority demonstrated. Higher insufflation-related events with FTM at 32.35% vs. 11.43% for CMM (p = .035). Surgical teams should weigh the similar efficacy against the increased […]
EUS-Guided Gastroenterostomy Outperforms Surgical Options in MGO
EUS-guided gastroenterostomy (EUS-GE) shows superior outcomes for malignant gastric outlet obstruction (MGO) compared to traditional surgical approaches. EUS-GE has a re-intervention rate of just 17% compared to 30% for surgical gastrojejunostomy (SGJ) and significantly lower than enteral stenting. Clinical success rates are higher with EUS-GE (20% more successful than enteral stenting). EUS-GE shortens hospital stay […]
Effective Techniques for Difficult Biliary Cannulation in ERCP
Advanced techniques yield 100% final success in difficult biliary cannulation, crucial for ensuring effective ERCP outcomes. Initial cannulation success: 72% (double-guidewire), 68% (trans-pancreatic sphincterotomy), 68% (precut fistulotomy). Precut technique used less contrast dye (p<0.005). Consider individualizing the technique based on patient anatomy and operator skill for optimal outcomes. Post-ERCP pancreatitis rates were 10% (dgt), 22% […]
Novel Approach in Gastric Cancer: Clean-Net Technique Study
The Clean-Net technique shows promising long-term outcomes for select gastric cancer patients. No recurrence of gastric cancer in the 19 patients analyzed over a median follow-up of 6.2 years, with a maximum of 16.8 years. 73.7% of patients were reclassified post-surgery due to higher risk factors, underscoring the importance of careful selection. Metachronous gastric cancer […]
Endoscopic techniques for ampullary tumors yield stark differences
Endoscopic submucosal dissection (ESD) outperforms endoscopic papillectomy (EP) for ampullary tumors ≥20 mm in base size. ESD achieved 100% en bloc resection and 89.5% R0 rates compared to 71.7% and 30.2% for EP. ESD showed 0% residual disease versus 42.9% with EP during over a year of follow-up. Consider ESD for better outcomes despite its […]
Endoscopic approach shows high success for pancreatic stones
EUS-guided pancreaticogastrostomy followed by pancreatoscopy is effective for managing pancreatic head duct stones. 95% technical success rate for EUS-guided pancreaticogastrostomy in 20 patients. Complete stone clearance achieved in 89% of those treated with subsequent pancreatoscopy-guided lithotripsy. This method is safe, with only mild early adverse events and a 6% recurrence rate. No late adverse events […]
Comparison of Pocket-Creation and Conventional Methods in ESD
Pocket-creation method (PCM) is a noninferior option to conventional endoscopic submucosal dissection (ESD) for gastric tumors, with lower subsequent surgery rates. Overall post-ESD adverse event rates: 14.3% for PCM vs. 12.9% for conventional, demonstrating noninferiority with an absolute risk difference of 1.4%. Comparable resection rates: En bloc resection at 98.6% for both methods and complete […]
Stent Choice in Biliary Drainage for Pancreatic Cancer: No Survival Advantage
Surgeons need to know that plastic and metal stents show similar long-term outcomes in patients with pancreatic ductal adenocarcinoma undergoing preoperative biliary drainage. Among over 6,500 patients, overall survival and recurrence-free survival were not significantly different between plastic and metal stents. Postoperative complications also showed no significant differences between stent types. Stent selection should be […]