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ASGE Journal Scan | Pancreas

Might Biliary Radiofrequency Ablation Be Less Effective Than We Thought?

Most inoperable malignant biliary strictures are best treated with self-expanding metal stents (SEMS); however, a significant portion of patients develop stent occlusion from neoplastic or

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ASGE Journal Scan | Pancreas

Empiric Prophylactic Plastic Stenting for Disconnected Pancreatic Duct After Necrosectomy Is Not Uniformly Beneficial

Pancreatic necrosis often results in main pancreatic duct injury and eventual discontinuity, or so-called disconnected pancreatic duct syndrome (DPDS), with recurrent symptoms from duct obstruction

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ASGE Journal Scan | Pancreas

ASGE Guideline on Screening for Pancreatic Cancer in High-Risk Cohorts

Pancreatic ductal adenocarcinoma (PDAC) continues to have a dismal prognosis at the time of presentation. Survival is improved with diagnosis at an early stage, but

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ASGE Journal Scan | Pancreas

Examining Cost-Utility Data for Interventions to Prevent Infection Transmission by Duodenoscopes

Transmission of multidrug-resistant organisms between patients undergoing ERCP prompted the U.S. Food and Drug Administration to issue guidance for endoscopy departments to adopt intensified reprocessing

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ASGE Journal Scan | Pancreas

Electrohydraulic Lithotripsy Safe and Effective for Clearing Obstructive Pancreatic Stones Near the Duodenum

Electrohydraulic lithotripsy (EHL) and laser lithotripsy are both well-established methods for the treatment of biliary and genitourinary stones. Several retrospective series have described successful pancreatoscopy-guided

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ASGE Journal Scan | Pancreas

Cholecystectomy Optimally Performed Within 8 Weeks for Necrotizing Biliary Pancreatitis

Cholecystectomy before hospital dismissal is advised for most cases of acute biliary pancreatitis (ABP). Surgery is often delayed in the setting of pancreatic necrosis to

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ASGE Journal Scan | Pancreas

Further Validation for a Motorized Endoscopic Necrosectomy Device

Many patients with walled-off pancreatic necrosis (WON) require debridement following minimally invasive drainage. This often entails serial procedures with cumulative expense and risk. These authors

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ASGE Journal Scan | Pancreas

Surveillance Rather Than Immediate Resection Appears Advisable for Most Familial Adenomatous Polyposis-Related Ampullary Adenomas

Ampullary, periampullary, and duodenal adenomas commonly occur in familial adenomatous polyposis (FAP). Their detection and management are fraught with challenges related to balancing the risk

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ASGE Journal Scan | Pancreas

Incision Improves Success and Safety for Difficult Biliary Access Compared With Wire- or Stent-Guided Entry

A variety of techniques have been described for achieving deep biliary cannulation, a necessary prelude to most endoscopic retrograde cholangiographic (ERCP) procedures. The rate of

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ASGE Journal Scan | Pancreas

On Balance, Benefit of Sphincterotomy for Biliary Stenting Appears to Outweigh the Risk

Limited reports have suggested that endoscopic biliary sphincterotomy (ES) at the time of transpapillary biliary stent placement may reduce the risk of post-ERCP pancreatitis (PEP).

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ASGE Journal Scan | Pancreas

Are There Signs or Symptoms That Predate the Diagnosis of Pancreatic Cancer?

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer mortality since most cancers are advanced at diagnosis. Early identification of these cancers is

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ASGE Journal Scan | Pancreas

DNA Methylation Studies of Biliary Brush Cytology Samples Likely to Aid in Diagnosis of Cholangiocarcinoma

Establishing a firm diagnosis for indeterminate biliary strictures is often challenging. The current standard of practice is fluoroscopic and cholangioscopic characterization with brush and biopsy

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ASGE Journal Scan | Pancreas

BILE Criteria to Assess ERCP Need in Cholangitis May Be More Sensitive, Less Cumbersome Than Others

Biliary obstruction with associated cholangitis usually is managed with the use of endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction or stent decompression of the bile

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ASGE Journal Scan | Pancreas

Covered Metal Stents Equal to Multiple Plastic Stents for Treatment of Biliary Strictures From Chronic Pancreatitis but Require Fewer Procedures

Compression of the distal bile duct within a fibrotic pancreas is one complication of chronic pancreatitis (CP), which can lead to chronic cholestasis, cholangitis, and

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ASGE Journal Scan | Pancreas

Transpapillary Gallbladder Stent Placement Usually Successful as Destination Therapy

Severe acute cholecystitis (AC) often is palliated with percutaneous or endoscopic drainage 6 to 12 weeks prior to preplanned interval cholecystectomy. Many patients with severe

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ASGE Journal Scan | Pancreas

Radiofrequency Ablation Plus Stent Placement for Extrahepatic Cholangiocarcinoma Shows Benefit Over Stenting Alone

The optimal treatment for cholangiocarcinoma (CCA) or ampullary carcinoma (AC) is surgery. When deemed unresectable and not amenable to neoadjuvant therapy followed by liver transplantation,

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ASGE Journal Scan | Pancreas

Better, but Insufficient Results From Duodenoscope Reprocessing With Double Wash and High-Level Disinfection or Liquid Chemical Sterilization

The potential for interpatient transmission of infections by contaminated duodenoscopes is a significant concern in the practice of ERCP. Pending further understanding and development of

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ASGE Journal Scan | Pancreas

Cholecystectomy Before Dismissal Confirmed as Optimal in Large Population of Veterans With Biliary Pancreatitis

Multiple guidelines recommend performing cholecystectomy (CCy) before hospital dismissal for patients with mild gallstone pancreatitis that is not complicated by infection or necrosis. In this

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ASGE Journal Scan | Pancreas

Hydrogen Peroxide, One Way or Another, Appears Beneficial During Endoscopic Necrosectomy

Management of walled-off pancreatic necrosis often benefits from direct transmural endoscopic necrosectomy. This retrospective chart review assessed the utility of hydrogen peroxide (H2O2) lavage as

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ASGE Journal Scan | Pancreas

Best Conformation for Hilar Self-Expanding Metal Stents Remains Undefined

Bilateral placement of metal stents for malignant hilar strictures (MHS) can be challenging. Two approaches have been used, each with potential benefits and challenges.  In

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ASGE Journal Scan | Pancreas

Updated Criteria for Prediction of Choledocholithiasis Add Specificity

A variety of recommendations have been proposed for predicting choledocholithiasis based upon presenting signs, symptoms, initial laboratory studies, and imaging. In this retrospective study, the

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ASGE Journal Scan | Pancreas

Further Evidence Supporting Early, Primary Use of Precut Sphincterotomy for Duct Access

Deep access to the bile duct or the pancreatic duct is required in order to complete all subsequent therapeutic ERCP maneuvers. Precut sphincterotomy (PCS) refers

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ASGE Journal Scan | Pancreas

Endoscopic Approaches to Drainage for Acute Cholecystitis Are Optimal in Nonoperative Patients

Gallbladder removal or drainage is a key component of treatment for acute cholecystitis. When the risk of urgent cholecystectomy is considered prohibitive, the optimal alternative

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ASGE Journal Scan | Pancreas

First Single-Use Duodenoscope Measures up in Direct Comparison for Low-Complexity Procedures

The development of single-use (disposable) endoscopes is one approach to eliminating infection transmission between sequential patients during endoscopy. This single-center study randomized patients undergoing endoscopic

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ASGE Journal Scan | Pancreas

Large-Caliber Dilation Without Sphincterotomy Is Efficacious and Safe for Stones >10 mm

Endoscopic biliary sphincterotomy (ES) is the standard prelude to duct stone removal; however, it carries moderate risk for both pancreatitis and bleeding and can be

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ASGE Journal Scan | Pancreas

Pancreatic Extracorporeal Shock Wave Lithotripsy: Efficient and Effective in Gastroenterologists’ Hands

Extracorporeal shock wave lithotripsy (ESWL) has become the dominant therapy for the treatment of symptomatic pancreatic duct stone obstruction in chronic calcific pancreatitis. In the

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ASGE Journal Scan | PANCREATOBILIARY | Pancreas

Video Auditing of Duodenoscope Reprocessing Contributes to High Performance in a Tertiary Care Center

Lapses in reprocessing of flexible endoscopes have been demonstrated in many environments and are thought to contribute to the transmission of infection between patients.  The

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ASGE Journal Scan | PANCREATOBILIARY | Pancreas

Urgent Early Pancreatic Drainage Is Safe and Effective

Endoscopic decompression and drainage of immature pancreatic and peripancreatic fluid collections with incomplete encapsulation by a wall of surrounding tissue have generally been avoided out

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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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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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Pancreas | Special Cases | Teaching Videos | Upper GI tract

Endoscopic therapy of pancreatic fluid collections caused by severe necrotic pancreatitis

Pancreatitis can cause various severe complications such as acute fluid collections with superinfected necrotic content requiring drainage and removal of necrotic debris. Here we demonstrate

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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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