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.

Macrocycle Side Chain Crowding Enables Tunable Curvature from Planar to Wrinkled and Wavy Hydrogen-Bonded Sheets.

We report a side chain-crowding strategy to direct the self-assembly of hydrogen-bonded semicarbazone macrocycles into porous organic frameworks with tunable curvatures and exceptional acetone uptake and selectivity. Three triangular macrocycles bearing isopropyl, isobutyl, and isopentyl side chains were synthesized and self-assembled through hydrogen-bonding arrays into planar, wrinkled, and square-octagonal wavy sheets, driven by steric congestion. After activation, the distorted frameworks retain permanent porosity and exhibit record-high acetone vapor uptake (up to 617 cm/g STP at 298 K) with high acetone/methanol selectivity (up to 7.

Role of MRI and abbreviated MRI in the evaluation and management of acute pancreatitis: a comprehensive review.

Acute pancreatitis (AP) is one of the most common gastrointestinal emergencies, with pancreatic fluid collection (PFC) representing a frequent complication requiring precise evaluation for optimal management. While computed tomography (CT) remains the most widely utilized radiological investigation, it has limitations in correctly identifying and quantifying solid debris within PFCs and evaluating main pancreatic duct (MPD) integrity. Endoscopic ultrasound (EUS) offers improved visualization but is invasive and operator-dependent.

Surgery versus endoscopy with digital single-operator cholangioscopy-guided therapy for Mirizzi syndrome: the SEIZE study.

Background:  The management of Mirizzi syndrome has been primarily surgical, but there are no comparisons between surgical and digital single-operator cholangioscopy (dSOC)-guided treatment. The objective of this study was to compare the safety and other outcomes of the two approaches.

Methods:  A large multicenter international retrospective analysis was conducted comparing dSOC and surgery in patients with type II-IV Mirizzi syndrome between January 2005 and June 2023.

Genomic insights into novel predatory myxobacteria isolated from human feces.

Myxobacteria are Gram-negative, spore-forming predatory bacteria isolated from diverse environmental samples that feed on other microbes for their survival and growth. However, no reports of cultured representatives from the human gut have been published to date, although previous investigations have revealed the presence of myxobacterial operational taxonomic units (OTUs) in skin and fecal samples. In this study, three myxobacterial strains designated as O35, O15, and Y35 were isolated and purified from fecal samples of two inflammatory bowel disease (IBD) patients.

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).

Copper (II) Triflate/ Vitamin-C Promoted Modified Morita-Baylis-Hillman Annulation: A Facile Route to Fluorescent Cyclopentene Derivatives.

Herein we report a rapid and efficient method for the synthesis of fused cyclopentenoids via Intramolecular Morita-Baylis-Hillman (IMBH) annulation. In this approach, copper triflate (Cu(OTf)) serves as the promoter, favoring cyclization and aromatization over the conventional MBH addition product. A characteristic feature among most of the cyclized product contain two non-separable isomeric mixture of cyclopentene derivatives which has been readily interconverted via 1,5-H shift.

Endoscopic ultrasound guided liver biopsy and portal pressure gradient: when, why and how? Can it become the standard of care in endo-hepatology?

Introduction: The armamentarium of 'Endo-hepatology' is proliferating with the advancements in techniques and availability of new devices in the field of endoscopic ultrasound (EUS). This has resulted in the merger of multitude of diagnostic and therapeutic interventions, such as EUS-liver biopsy (LB), EUS-angioembolization of gastric varices, EUS-portal pressure gradient (PPG) measurement, and others into a 'one-stop-shop' for efficient patient management. Lack of standardization of these techniques forms a major hinderance in their widespread adoption.

Diagnostic Approach to Biliary Strictures.

Biliary strictures represent a narrowing of the bile ducts, leading to obstruction that may result from benign or malignant etiologies. Accurate diagnosis is crucial but challenging due to overlapping features between benign and malignant strictures. This review presents a comprehensive diagnostic approach that integrates biochemical markers, imaging modalities, and advanced endoscopic techniques to distinguish between these causes.

Timing of Surgery and Postoperative Outcomes in Esophagectomy for Squamous Cell Carcinoma: A Prospective Study in North India.

Purpose: Neoadjuvant chemotherapy followed by esophagectomy is the usual approach to manage esophageal squamous cell carcinoma (ESCC). The optimal interval to operate after completion of neoadjuvant chemoradiotherapy (NACRT) still remains controversial.

Methods: A prospective study was conducted to observe and compare postoperative complications and pathological outcomes in patients with squamous cell carcinoma of the esophagus who underwent NACRT followed by surgery within 8 weeks or after 8 weeks of NACRT completion.

Endoscopic techniques for the diagnosis of pancreatic cystic lesions.

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans, with few patients presenting with abdominal pain or other symptoms. The accurate diagnosis of cysts is important as management depends on the type (neoplastic or non-neoplastic). Cross-sectional imaging is fast being replaced with endoscopic ultrasound (EUS) and various techniques based on that such as EUS-guided fine needle aspiration, EUS-guided needle confocal laser endomicroscopy, EUS-through-the-needle biopsy, and contrast-enhanced EUS.