Current status and further directions of endoscopic ultrasound-directed transgastric ERCP and endoscopic ultrasound-directed transenteric ERCP in the management of pancreaticobiliary diseases in surgically altered anatomy: a comprehensive review.

Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) and endoscopic ultrasound-directed transenteric endoscopic retrograde cholangiopancreatography (EDEE) are innovative endoscopic techniques developed to overcome the challenges of biliary access in patients with surgically altered gastrointestinal anatomy. EDGE facilitates the creation of a gastro-gastric anastomosis, enabling endoscopic access to the excluded stomach and subsequent duodenum for endoscopic retrograde cholangiopancreatography (ERCP) procedures. Similarly, EDEE involves creating a gastro-jejunal anastomosis, allowing endoscopic access to the jejunum and hepaticojejunostomy for ERCP.

Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Prediction of Aggressiveness and Treatment Response in Patients with Pancreatic Lesions.

Endoscopic ultrasonography represents a crucial aspect of the diagnosis of pancreatic lesions. The echo-endoscopic features of pancreatic lesions, particularly their contrast behavior with the advent of Contrast-Enhanced EUS (CE-EUS) and Contrast Enhanced Harmonic-EUS (CH-EUS), can predict a lesion's aggressiveness, depending on its nature. According to this, CH-EUS could be applied to structure an even more dedicated approach to patient care, for example, to ascertain eligibility for surgical intervention of a pancreatic ductal adenocarcinoma (PDAC) or the response to neoadjuvant chemotherapy in cases deemed borderline resectable.

Efficacy and Safety of 1 L PEG-ASC Preparation for Colonoscopy in Patients with Inflammatory Bowel Diseases: A Multicenter Observational Study.

: The effectiveness of 1 L PEG-ASC preparation in inflammatory bowel disease (IBD) patients is still unclear. The aim of this study was to determine the efficacy and safety of 1 L PEG-ASC in a series of IBD patients. : Data from a study conducted on a series of 284 patients collected in three centers between 2020 and 2025 were analyzed.

Endoscopic ultrasound-guided gallbladder versus bile duct drainage for first-line therapy of malignant biliary obstruction: international multicenter trial.

Background:  Endoscopic ultrasound (EUS)-guided gallbladder drainage (GBD) and EUS-guided choledochoduodenostomy (CDS) with lumen-apposing metal stents are alternative approaches to endoscopic retrograde cholangiopancreatography. We compared EUS-GBD and EUS-CDS as first-line therapies in the management of distal malignant biliary obstruction (MBO).

Methods:  This was an international, multicenter, retrospective, observational study at 28 tertiary care centers from April 2017 to August 2024.

Correction: Green endoscopy, one step toward a sustainable future: Literature review.

[This corrects the article DOI: 10.1055/a-2303-8621.].

The Role of Vitamin D in Inflammatory Bowel Diseases: From Deficiency to Targeted Therapeutics and Precise Nutrition Strategies.

Background: Vitamin D plays a crucial role in immune modulation, gut barrier integrity, and inflammation regulation, making it highly relevant in inflammatory bowel disease (IBD). IBD patients often exhibit vitamin D deficiency, which has been linked to increased disease activity, impaired mucosal healing, and a higher risk of complications, including infections and osteoporosis.

Methods: This review examines the biological functions of vitamin D in maintaining intestinal homeostasis, particularly in the context of IBD.

Devices and techniques for bariatric and metabolic endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review.

Endoscopic bariatric and metabolic therapies (EBMTs) are increasingly recognized as valuable tools for managing obesity and related metabolic disorders. As the prevalence of obesity continues to rise globally, there is a growing demand for effective, safe, and less invasive treatment options. This review provides a comprehensive summary of the available EBMTs, including both stomach-targeted and small-bowel-targeted devices.

Lenvatinib Is Highly Effective in Patients with Hepatocellular Carcinoma Related to Both Metabolic Dysfunction-Associated Steatohepatitis and Alcoholic Etiology: A Propensity Score Analysis.

Metabolic dysfunction-associated steatotic liver disease (MASLD)-related hepatocellular carcinoma (HCC) may have distinct biological characteristics influencing systemic treatment response. However, the prognostic impact of MASLD vs. alcohol-related HCC in patients receiving lenvatinib remains unclear.

Impact of Non-Anesthesiologist-Administered Propofol Sedation for Outpatient Endoscopy in the Healthcare System.

Introduction: Non-anesthesiologist-administered propofol (NAAP) sedation for outpatient endoscopy has proven to be safe. However, implementing NAAP in Western countries faces challenges, and propofol-based sedation is still largely administered by anesthetists. For low-risk patients, anesthesiologist-administered propofol (AAP) could represent an avoidable waste of healthcare resources.

Transforming Gastrointestinal Diagnosis with Molecular Endoscopy: Challenges and Opportunities.

Molecular endoscopy represents a transformative advance in the detection, diagnosis, and management of gastrointestinal diseases, addressing the critical limitations of conventional techniques. Current diagnostic standards, such as white light endoscopy (WLE), often fail to detect early-stage lesions, particularly in high-risk populations like Barrett's esophagus or inflammatory bowel disease patients. To overcome these challenges, molecular endoscopy, using fluorescent molecular probes, may offer ultimate precision by targeting disease-specific biomarkers.

Management of Postoperative Pancreatic Fluid Collection and Role of Endoscopy: A Case Series and Review of the Literature.

Postoperative fluid collections (POFCs) after abdominal surgeries, particularly pancreatic surgeries, are associated with high morbidity and mortality rates and were historically managed with surgical re-exploration and drainage. In particular, postoperative pancreatic fluid collections (PPFCs) are the most common complications after pancreatic surgery resulting from pancreatic leaks. They occur in up to 50% of cases, and approximately 10% of them need to be drained to avoid further sequelae.

EUS-guided gallbladder drainage as a rescue in distal malignant biliary obstruction: A systematic review with meta-analysis.

Patients with distal malignant biliary obstruction (dMBO) needing biliary drainage (BD) undergo ERCP as a first approach. EUS-guided gallbladder drainage (EUS-GBD) is now accepted as a rescue alternative for the palliation of jaundice in those patients with dMBO who fail ERCP and cannot undergo EUS-BD. This is a systematic review with meta-analysis for evaluating the efficacy and safety of EUS-GBD in this scenario.

Exploring ChatGPT effectiveness in addressing direct patient queries on colorectal cancer screening.

Background And Study Aims: Recent studies showed that large language models (LLMs) could enhance understanding of colorectal cancer (CRC) screening, potentially increasing participation rates. However, a limitation of these studies is that questions posed to LLMs are generated by experts. This study aimed to investigate ChatGPT-4o effectiveness in answering CRC screening queries directly generated by patients.

Unmet Needs of Artificial Intelligence in Small Bowel Capsule Endoscopy.

Small bowel capsule endoscopy (SBCE) has emerged in the past two decades as the cornerstone for assessing small bowel disorders, and its use is supported by several guidelines. However, there are several limitations, such as the considerable time required for gastroenterologists to review these videos and reach a diagnosis. To address these limitations, researchers have explored the integration of artificial intelligence in the interpretation of these videos.

Impact of Bowel Cleansing on Polyp and Adenoma Detection Rate: Post-Hoc Analysis of a Randomized Clinical Trial.

Objectives: To assess the impact of bowel cleansing quality on polyp detection rate (PDR) and adenoma detection rate (ADR) and explore predictors of lesion detection rate in patients undergoing colonoscopy.

Methods: This is a post-hoc analysis of a multicenter randomized controlled trial (RCT) comparing 1L polyethylene glycol plus ascorbate (1L PEG+ASC) vs. 4L PEG as bowel preparation for colonoscopy.

Artificial intelligence and colorectal neoplasia detection performances in patients with positive fecal immunochemical test: Meta-analysis and systematic review.

Objectives: The combination of fecal immunochemical test (FIT) followed by colonoscopy has established itself as one of the preferred population-based screening strategies. Despite extensive exploration of various techniques and technologies, their impact on adenoma detection rate has shown inconsistency across studies in this specific setting "FIT+ population." We aimed to assess the impact of the computer-aided detection (CADe) system in all randomized trials focused on this subpopulation.

Advances in Endo-Hepatology: The Role of Endoscopic Ultrasound in the Management of Portal Hypertension.

Portal hypertension (PH) is a complication of advanced liver diseases, including cirrhosis and hepatocellular carcinoma, often leading to unfavorable outcomes. Endo-hepatology, particularly endoscopic ultrasound (EUS) has revolutionized the assessment of PH. Notably, EUS-guided portal pressure gradient (EUS-PPG) enables measurement of portal and hepatic venous pressures, offering diagnostic precision for both cirrhotic and non-cirrhotic forms of PH, including porto-sinusoidal vascular disorder (PSVD).

Optimal timing for lumen-apposing metal stent removal following endoscopic ultrasound-guided drainage of pancreatic fluid collections: a systematic review and meta-analysis.

Background:  Lumen-apposing metal stents (LAMSs) are widely used for endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs). Safety is a major concern and the timing of LAMS removal is debated owing to the risk of adverse events (AEs). Previous studies showed early stent removal was associated with a reduced risk of AEs, but data are still conflicting.