EUS-guided gastroenterostomy has gained recognition as an effective alternative to surgical gastrojejunostomy and duodenal stenting for treating gastric outlet obstruction. Key advantages include reduced invasiveness, shorter hospital stays, and potentially improved patient outcomes. This comprehensive review highlights the evolved techniques and their comparative effectiveness, affirming that EUS-guided gastroenterostomy offers significant benefits without the need for […]
Category: Surgical Endoscopy
Per-Oral Endoscopic Myotomy (POEM) Offers Critical Guidelines
A clinical practice update presented vital guidance on per-oral endoscopic myotomy (POEM), emphasizing that extensive diagnostic evaluations are essential before treatment. It highlights POEM as the preferred option for type III achalasia, while also supporting laparoscopic Heller myotomy and pneumatic dilation for other types. Antibiotic prophylaxis, post-procedure monitoring for gastroesophageal reflux disease, and individualized discharge […]
Sigmoid-type achalasia shows higher risk of esophageal cancer
In a study involving 450 achalasia patients undergoing peroral endoscopic myotomy (POEM), treatment outcomes were favorable across disease types, with efficacy rates of 97.9% and 94.2% at one and two years, respectively. However, the incidence of esophageal cancer varied significantly among types: 1% in straight, 2.5% in sigmoid type 1, and 10% in sigmoid type […]
Visual endoscopic retrograde appendicitis therapy reduces recurrence risk
Findings indicate that visual endoscopic retrograde appendicitis therapy (v-erat) and antibiotic therapy have similar treatment success rates for uncomplicated acute appendicitis (93.6% vs. 90.5%). However, v-erat significantly lowers the recurrence risk during follow-up and decreases the appendectomy rate (4.3% vs. 9.5%). Additionally, patients undergoing v-erat experience a shorter initial hospitalization (3 days vs. 4 days) […]
Identified risk factors for inadequate bowel preparation in colonoscopy
A meta-analysis of 154 studies involving 358,257 participants identified 48 unique risk factors for inadequate bowel preparation (IBP) before colonoscopy. Key sociodemographic predictors included Medicaid insurance, obesity, and male sex, while comorbidities such as psychiatric disease and diabetes also played significant roles. Medication use, particularly tricyclic antidepressants and opioids, exacerbated risk. These findings aim to […]
Minimally invasive approach effectively treats appendicitis
Endoscopic retrograde appendicitis therapy (ERAT) emerges as a promising alternative for managing acute or chronic appendicitis, allowing effective elimination of obstructions through endoscopic techniques. Compared to antibiotic therapy, patients undergoing ERAT showed lower rates of recurrence and avoided the need for appendectomy. Innovations like the “mother-baby” endoscopic system and microbubble contrast agents have broadened its […]
Predictive model established for early esophageal cancer invasion
A logistic regression model developed from various risk factors effectively predicts early esophageal cancer with submucosal infiltration beyond 200 micrometers. Key predictive factors include endoscopic findings, esophageal wall thickening, pickled food intake, platelet-lymphocyte ratio, tumor size, circumferential mucosal defect percentage, and preoperative pathological type. The model demonstrated high efficacy, achieving an area under the curve […]
Minimally invasive common bile duct exploration reduces fluoroscopy time.
In a comparison of minimally invasive common bile duct exploration (MICBDE) and endoscopic retrograde cholangiopancreatography (ERCP) for treating choledocholithiasis, significant advantages were found for MICBDE. Fluoroscopy time was notably lower for MICBDE (1.54 minutes) compared to ERCP (3.1 minutes, p
Re-examining the entire colon enhances polyp detection rates.
A randomized controlled trial involving 406 patients demonstrated that re-examination of the entire colon significantly improves the detection of concealed polyps and adenomas compared to standard colonoscopic methods. While polyp detection rates were generally similar between the study and control groups, the second withdrawal significantly increased the number of detected polyps and adenomas. These findings […]
Endoscopic ultrasound effectively diagnoses unexplained bile duct dilation.
Endoscopic ultrasound (EUS) demonstrated significant diagnostic yield for patients with unexplained common bile duct (CBD) dilation, particularly among those with negative prior imaging. In a cohort of 109 patients, 41 tested positive for various conditions, including choledocholithiasis and chronic pancreatitis. Factors such as older age and symptoms like jaundice increased the likelihood of positive findings. […]