A new pre-closure technique for endoscopic papillectomy significantly lowers delayed bleeding risk in duodenal papilla adenoma patients. Delayed bleeding rate was 0% with pre-closure vs. 17.95% without (p = 0.017). Immediate bleeding rate decreased from 66.67% to 37.93% (p = 0.027). This approach also shortens hospital stays: 6 days vs. 7 days (p = 0.048). […]
Category: Surgical Endoscopy
EUS-Guided Drainage for Symptomatic Gallstones Works
EUS-Guided Gallbladder Drainage shows strong promise for non-surgical patients with symptomatic cholelithiasis without cholecystitis. 100% technical success, with complete stone clearance achieved in all 23 patients. 87% achieved clearance in just one treatment; no procedure-related complications reported. Improving patient selection and outcomes may lead to broader acceptance of this technique in practice. Journal Article by […]
Cholecystectomy Beats ERCP for Gallstone-Related Pancreatitis
Same-admission cholecystectomy lowers recurrence of acute pancreatitis compared to ERCP or no intervention. Recurrence rates post-discharge: 3.4% (cholecystectomy), 4.9% (ERCP), and 17.5% (no intervention). Other gallstone complications: 1.6% in the cholecystectomy group versus 19.9% (ERCP) and 16.3% (no intervention). Prioritizing immediate cholecystectomy can improve long-term outcomes in suitable patients. Risk of recurrence surged 8 to […]
Real-world outcomes of duodenal endoscopic techniques
Endoscopic submucosal dissection and full-thickness resection are effective for select duodenal lesions but carry significant risks. Technical success rate was 98.2%, with R0 resection rates at 93.3% for epithelial and 90.4% for subepithelial lesions. Intraprocedural bleeding occurred in 16.5%; perforation rate was 5.5%, all manageable endoscopically. Consider severe fibrosis a key predictor for adverse events, […]
Upfront Endoscopic Necrosectomy Shows No Advantage Over Step-Up Approach
A systematic review finds no significant difference in outcomes between upfront endoscopic necrosectomy (UEN) and step-up endoscopic necrosectomy (SUEN) for walled-off pancreatic necrosis, influencing surgical decision-making. Clinical success rates were similar: RR 1.04 (95% CI, 0.98-1.11). Safety outcomes, including postprocedural bleeding and infection, also showed no significant differences. Surgeons should consider individual patient factors when […]
Laparoscopic Bile Duct Exploration Matches ERCP for Stones
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 […]
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 […]