Experts established 21 key steps for safe and effective endoscopic sleeve gastroplasty (ESG) through a modified Delphi method. Consensus was reached on the importance of full-thickness bites and the use of a helix device in tissue swirling, although opinions varied on minor details like fundus inclusion. This standardized protocol will enhance ESG training and adoption […]
Category: Surgical Endoscopy
Direct Percutaneous Endoscopic Jejunostomy Tube Placement: A Safer Alternative
Direct percutaneous endoscopic jejunostomy (DPEJ) is a safe and effective alternative to surgical jejunostomy, with lower rates of adverse events at 90 days. Procedural success rates were similar among DPEJ, laparoscopic jejunostomy, and open jejunostomy, but DPEJ had significantly lower rates of tube dysfunction. DPEJ may offer a cost-effective and less invasive option for enteral […]
Over-the-Scope Clips Show Higher Success Rates for Bariatric Surgery Leaks
A meta-analysis of five studies found that the pooled proportion of successful closure with over-the-scope clips (OTSC) for leaks and fistulae following bariatric surgery was 81.1% (95% CI 67.3 to 91.7). Observational reports suggest that patients managed with OTSC had higher rates of defect healing compared to those treated with endoscopic suturing. Larger controlled studies […]
Significant Variability in Managing Malignant Gastric Outlet Obstruction in Pancreatic Cancer, with Rising Use of EUS-Gastrojejunostomy
Survey of 290 pancreatologists revealed significant differences in managing malignant gastric outlet obstruction (MGOO) due to pancreatic cancer. Endoscopic stenting (ES) was most common, but EUS-Gastrojejunostomy (EUS-GJ) adoption is increasing. Decision drivers include life expectancy and patient frailty, with lack of standardized algorithms. Availability of EUS-GJ remains suboptimal, attributed to the steep learning curve. Journal […]
Magnetic Compression Anastomosis: A Sutureless Alternative for Superior Gastrointestinal Outcomes
Magnetic compression anastomosis (MCA) offers sutureless passage construction for tubular organs, showing promise due to low recurrence rates and improved clinical outcomes compared to conventional treatments. The review highlights MCA’s use in various gastrointestinal diseases, showcasing superior anastomotic results compared to surgical sutures. Although initial studies demonstrate safety and feasibility, larger prospective studies are needed […]
Endoscopic bariatric and metabolic therapies for obesity: ASGE-ESGE guideline
The joint American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy (ASGE-ESGE) guideline provides evidence-based recommendations for endoscopic bariatric and metabolic therapies (EBMTs) in treating obesity. Using the GRADE framework, the guideline evaluates the efficacy and safety of EBMT devices and procedures with CE Mark or FDA clearance/approval. It recommends EBMTs plus lifestyle modification for […]
Over-the-Scope Clips Show Higher Success Rates for Bariatric Surgery Leaks
A meta-analysis of five studies found that the pooled proportion of successful closure with over-the-scope clips (OTSC) for leaks and fistulae following bariatric surgery was 81.1% (95% CI 67.3 to 91.7). Observational reports suggest that patients managed with OTSC had higher rates of defect healing compared to those treated with endoscopic suturing. Larger controlled studies […]
G-Master Training Model Enhances Gastric ESD Skills
A novel gastric endoscopic submucosal dissection (ESD) training model, the G-Master, significantly improved procedural speed for trainees compared to traditional methods. Trainees using the G-Master showed faster skill development, lower perforation rates, and reduced need for expert intervention, highlighting its effectiveness in enhancing ESD skills. The study underscores the value of innovative training models in […]
Role of High-Resolution Manometry in Antireflux Surgery: The Padova Consensus
High-resolution manometry (HRM) plays a crucial role in the diagnostic assessment of foregut symptoms before and after antireflux surgery (ARS). A collaborative initiative by surgeons and gastroenterologists developed a postoperative classification for interpreting HRM findings, providing key insights into patient management post-ARS. Journal Article by Salvador R, Pandolfino JE (…) Yadlapati R et 13 al. […]
Higher Rates of Late ERCP Post-Cholecystectomy Associated with Adverse Outcomes
Despite an increase in non-invasive biliary imaging, the rate of late-ERCP post-cholecystectomy has significantly risen, with high rates of adverse events including pancreatitis, hospitalization, and new chronic opioid use. Factors linked to late-ERCP included gut-brain interaction disorders, liver disease, and use of specific medications. Late-ERCPs are associated with disproportionately worse outcomes, suggesting the need for […]