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PPI for critically ill ICU patients – no benefit?

PPIs have become routine in ICU units to prevent bleeding in critically ill patients – but are they justified?

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Literature

Polypectomy of Small Polyps – ESGE Guideline Recommends Cold Snare Polypectomy (CSP)

Since 2017, ESGE guidelines require that a standard snare should no longer be used for the removal of small polyps, and especially diminutive polyps. The

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Literature

Case Report: Unchanged Radiation-induced Ulcer after Selective Internal Radiation Therapy (SIRT)

We present a case of a 46-year-old patient with an HCV-associated, multilocular hepatocellular carcinoma. Therapy with Sorafenib was discontinued as a result of serious side

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Classifications | Literature

Endosonographic Criteria Chronic Pancreatitis

This article provides an overview of the scoring systems commonly used for diagnosing chronic pancreatitis by means of endoscopic ultrasonography (EUS), and for classifying the

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Literature

PPI, Aspirin and Prevention of Barrett’s Neoplasia – How Do We Treat Our Barrett Patients Now?

Almost everybody prescribes at least low-dose PPI to their Barrett patients even if they complete asymptomatic – is this warranted?

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Literature | Liver and biliary tract

Plastic or metal stent for benign biliary stricture?

Until only a few years ago, endoscopic therapy for benign biliary stricture involved implantation of one or multiple plastic stents, exchanged every 3 months, for

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Literature | Lower GI tract

Cold Snare on the Rise?

Cold snare resection has been established in diminutive polyps (up to 5 mm) as being at least as safe and partially more effective than biopsy

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Literature | Lower GI tract

Artificial Intelligence and Polyp Differentiation

Polyp differential diagnosis by endoscopy has become a hot topic in the frame of the DISCARD discussion, stating that histologic analysis of small/diminutive (< 5

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Literature | Lower GI tract

Fecal Transplantation in Active Ulcerative Colitis?

Disturbances of the intestinal microbiota have been linked to the pathogenesis of ulcerative colitis (UC). In active UC microbiota differs from that in healthy subjects

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Literature | Lower GI tract

Full-thickness Resection in the Colon – Finally ?

For clinical cases, endoscopic full-thickness resection (EFTR) was developed and first described by Suzuki and Ikeda in 2001. It was performed in three Japanese patients

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Literature | Lower GI tract

Optimizing the adenoma detection rate – a never-ending story? Or does the outcome quality depend on the follow-up?

The adenoma detection rate (ADR) is the holy grail of quality assurance in colonoscopy. It is the main parameter for outcome quality — or more

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Literature | Pancreas

Metal stents for pancreatic cyst drainage – equivalent success, more complications?

Endosonographic drainage of pancreatic cysts is currently regarded as the standard throughout the world, in comparison with other treatments (such as percutaneous drainage or surgery).

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Literature | Lower GI tract | Pancreas | Upper GI tract

News from DDW

The latest developments in the field of gastroenterology and endoscopy are presented every year at Digestive Diseases Week (DDW) in Chicago — although in recent

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Literature | Upper GI tract

Endoscopic Doppler examination and hemostasis in nonvariceal upper gastrointestinal hemorrhage: paradigm shift, or old wine in new bottles?

During hemostasis in patients with nonvariceal upper gastrointestinal hemorrhage, the Forrest classification is recommended for risk stratification, as it correlates best with the risk of

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Literature | Lower GI tract

The New American Guideline for Capsule Endoscopy – Too Much and Reaching Too Far?

This guidelines on capsule endoscopy was put together by 7 Canadian experts and published in a high-ranking journal. It is limited to capsule endoscopy in

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ERCP | Literature

Sedation in endoscopy: better administered by the anesthetist than the gastroenterologist?

In the German-speaking countries (and also in Scandinavia), the majority of endoscopic procedures (usually diagnostic) that were carried out in the 1960s and 1970s were

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Literature | Lower GI tract

Proctology, part 2 — treatment of acute anal pain

The most frequent causes of a pain-related presentation to the proctologist are anal venous thrombosis and anal fissure. Both of these conditions typically result from

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Colonoscopy | Literature | Lower GI tract

Colonoscopic adenoma detection – new super wide-angle scopes versus new caps

Adenoma detection rate (ADR) has become the holy grail of colonoscopy outcome quality measurement and efforts to increase ADR are ongoing.

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ERCP | Literature | Pancreas

NSAIDs against post-ERCP pancreatitis – any doubts ?

The application of non-steroidal anti-inflammatory drugs (NSAIDs) such as indometacin or diclofenac to prevent post-ERCP pancreatitis (PEP) has been examined in several randomized trials throughout

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Literature | Lower GI tract

First Results from the NordICC randomized trial on screening colonoscopy

Screening colonoscopy is well established in a few Western countries as primary method of colorectal cancer (CRC) screening; however, most Western countries use conventional (FOBT)

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Literature | Upper GI tract

ESD probably no better than EMR in Barrett’s neoplasia

Considerable debate is currently taking place among therapeutic endoscopists regarding the best method of resecting early carcinomas, particularly in the upper gastrointestinal tract — whereas

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Literature | Lower GI tract

Are difficult colon polyps still being operated on?

The current standard is that when polyps or adenomas are identified on (screening) colonoscopies, they should be either directly removed or, if not, patients should

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Literature | Lower GI tract

Proctology — part 1: diagnosis

As a therapeutic discipline, proctology belongs primarily to the field of visceral surgery. However, the diagnosis of proctologic diseases is relevant to all physicians working

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Literature | Lower GI tract

Laparoscopic surgery for rectal carcinoma — slash back?

Since the early 2000s, meta-analyses based on smaller studies have shown that open and laparoscopic surgery for rectal carcinoma produce similar results.

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Literature | Upper GI tract

Risk stratification in Barrett’s esophagus — the emperor’s new clothes?

The efficacy of surveillance for Barrett’s patients is a matter of controversy, and it is probably due to the low long-term risk of carcinoma developing

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Literature | Pancreas

Serous cystadenoma in the pancreas — still harmless?

Cystic pancreatic tumors are increasingly being detected at the asymptomatic stage, thanks to improved imaging, and “screening” imaging in particular. This often then leads to

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Literature | Upper GI tract

Low-grade dysplasia in Barrett’s esophagus — a second opinion is important, but then treatment is needed

Low-grade dysplasia (low-grade intraepithelial neoplasia, LGIN) is difficult to distinguish from inflammation histopathologically. The interobserver variance rates usually show kappa values below 0.4, representing a

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Literature | Upper GI tract

Does Barrett’s esophagus grow during monitoring?

The risk of progression of nonneoplastic Barrett’s esophagus to high-grade intraepithelial neoplasia or adenocarcinoma is extremely low and has been reported in recent studies to

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Literature | Upper GI tract

Achalasia — place of endoscopic therapy in the light of the first long-term data for POEM

Achalasia is a rare neuromuscular disease of unclear etiology that probably has a genetic background. The precise etiopathogenesis of achalasia is still unclear. Above all,

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Literature | Lower GI tract

Surveillance and treatment for dysplasia in chronic inflammatory bowel diseases

Patients with chronic inflammatory bowel disease (IBD) are at increased risk for the development of colorectal carcinomas and the corresponding precursor lesions. This applies both

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Literature | Lower GI tract

Fecal DNA testing — a new threat to screening colonoscopy?

Fecal tests have increasingly moved on from the classic fecal occult blood test (FOBT) to fecal immunologic testing (FIT), particularly in countries with newly introduced

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Literature | Lower GI tract

New wide-angle colonoscope — far more adenomas?

A new wide-angle colonoscope now provides a viewing angle of 330°, at least on one level, which represents practically a doubling in comparison with previous

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Literature | Lower GI tract

Adenoma rate confirmed as most important quality parameter in screening colonoscopy

There has been increasing discussion regarding quality indicators in colonoscopy, and on the ways in which what parameters should be assessed and compared using benchmarking.

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Literature | Lower GI tract

Duodenoscopes with problem bacteria — only in the USA?

It has long been known that bacterial infection can be transmitted via endoscopes. Review studies have shown that infections are still occurring and are usually

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Literature | Lower GI tract

How dangerous are serrated adenomas?

Sessile serrated adenomas (SSAs) are the latest fashion in gastroenterological endoscopy. Individual histopathological examinations have shown that there is a separate pathway to carcinoma, apparently

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