CT findings of gross perforation and peritonitis are significant factors associated with surgery in delayed perforation after endoscopic tumor resection. These factors can guide patients towards an appropriate treatment plan, with a low rate of 0.50% experiencing delayed perforation. Clinical factors and pneumoperitoneum amount were not significant predictors for surgery, emphasizing the importance of imaging […]
Category: Surgical Endoscopy
Endoscopic Submucosal Dissection Outperforms Mucosal Resection for Barrett’s Neoplasia
Endoscopic submucosal dissection (ESD) yields superior en bloc resection, higher R0 resection, and curative resection rates compared to endoscopic mucosal resection (EMR) for Barrett’s neoplasia and esophageal adenocarcinoma. ESD also shows lower local recurrence rates. Adverse events between the two techniques were similar. These findings suggest that ESD may be a more effective approach in […]
Improved Visualization and Diagnostic Accuracy in Biliary Strictures with Virtual Indigo Carmine Chromoendoscopy
Virtual Indigo Carmine Chromoendoscopy (VICI) converted from peroral cholangioscopy images using artificial intelligence technology demonstrated superior visualization of surface structures and lesion margins compared to white light imaging and narrow-band imaging. VICI, in combination with white light imaging, significantly improved diagnostic accuracy for biliary strictures, showing potential as a supportive modality for peroral cholangioscopy. Journal […]
Endoscopic Resection Clinical Algorithm
Malignancies in the upper gastrointestinal tract can be effectively treated through endoscopic resection at an early stage. Key factors influencing successful resection include thorough pre-resection assessment, precise delineation of margins, and selection of appropriate resection techniques. This review outlines clinical algorithms for the endoscopic resection of esophageal squamous cell carcinoma, Barrett’s neoplasia, and gastric neoplasia, […]
Feasibility of Laparoscopic Common Bile Duct Exploration in Gastric Bypass Patients
Study shows laparoscopic exploration with a disposable bronchoscope is safe and effective for removing common bile duct stones in gastric bypass patients, achieving 100% stone clearance without conversions to open surgery. This cost-effective approach offers a practical alternative to traditional methods, demonstrating feasibility and safety in this population. Journal Article by Jazi AHD, Mahjoubi M […]
Long-Term Outcomes of Additional Surgery for T1 Colorectal Cancer
Study comparing long-term outcomes of patients treated with additional surgery after endoscopic resection versus primary surgery for T1 colorectal cancer found no adverse effects on overall survival rates. The 5-year survival rates were 97.1% in the additional surgery group and 96.0% in the primary surgery group, indicating non-inferiority. Additionally, recurrence rates showed no significant difference […]
Endoscopic Ultrasonography for Residual Rectal Neuroendocrine Tumor Diagnosis
Endoscopic ultrasonography (EUS) is a sensitive method for identifying residual rectal neuroendocrine tumors (NETs) post-resection. EUS detection, with a high sensitivity of 94%, is superior to visual detection. Salvage endoscopic treatment, incorporating EUS, is safe and effective in managing incompletely resected NETs, with no recurrence observed in patients during follow-up. EUS shows promise in accurately […]
Pre-operative Biliary Drainage Increases Complications in Resectable Periampullary Lesions
Pre-operative biliary drainage significantly raised complication rates in periampullary lesion patients, as shown by a meta-analysis including 35 studies and 2 randomized trials with 12,641 patients. Results revealed higher overall complication rates, increased delayed gastric emptying post-surgery, and a significant rise in wound infections post-operatively in the drainage group. These findings caution against routine pre-operative […]
Establishment of a patient-specific organoid model for timely pancreatic cancer treatment
Patient-derived organoids (PDOs) from EUS-guided biopsies show high success rate in establishing models for pancreatic ductal adenocarcinoma (PDAC). PDAC PDOs accurately reflect genetic alterations in the original tumors and predict drug sensitivity, including resistance to nab-paclitaxel. This innovative model enables rapid testing of multiple therapeutic drugs, offering a personalized “patient avatar” for timely clinical decision-making […]
French Intergrup Clinical Practice Guidelines for Ampullary Tumors
French intergroup guidelines provide recommendations for accurate diagnosis, treatment, and follow-up of ampullary tumors based on expert opinions and recent literature review. Emphasizing multidisciplinary approach, guidelines suggest endoscopic papillectomy or surgical papillectomy for adenoma, and pancreaticoduodenectomy for carcinoma. Adjuvant monochemotherapy or polychemotherapy is recommended for aggressive tumors. Long-term follow-up is crucial for 5 years. Guidelines […]