Endoscopic ultrasound-guided celiac plexus block for painful chronic pancreatitis: A systematic review and meta-analysis.

Background: The efficacy of endoscopic ultrasound-guided celiac plexus block (EUS-CPB) for treatment of pain in chronic pancreatitis (CP) is unclear. Therefore, we aimed to assess this outcome using a systematic review and meta-analysis.

Methods: We conducted a comprehensive search of MEDLINE, EMBASE, and Cochrane Central for evaluating the efficacy of EUS-CPB for pain in CP.

Disproportionately rising mortality rates of alcohol-associated acute Pancreatitis: Analysis from centers for Disease Control and prevention database (2011-2020).

Background/objective: Acute pancreatitis leads to over 300,000 emergency department visits annually. Assessing its current epidemiology is crucial for developing effective preventive strategies.

Methods: The CDC WONDER database was utilized to obtain deaths and age-adjusted mortality rates of acute pancreatitis from 2011 to 2020, categorized by sex, type (alcohol- and non-alcohol-associated acute pancreatitis), race/ethnicity, and region.

Towards automating risk stratification of intraductal papillary mucinous Neoplasms: Artificial intelligence advances beyond human expertise with confocal laser endomicroscopy.

Background And Aims: Endoscopic Ultrasound (EUS)-guided needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic visualization of pancreatic cyst epithelium and can identify high-grade dysplasia/invasive adenocarcinoma (HGD/IC) in branch-duct (BD) intraductal papillary mucinous neoplasms (IPMNs). We aimed to compare the performance of experts (humans) with artificial intelligence (AI) in stratifying dysplasia in BD-IPMNs.

Methods: This post-hoc analysis involved BD-IPMNs with definitive diagnoses from prospective EUS-nCLE studies (2015-2023) enrolled at a single center.

Histologic Diagnosis of Pancreatic Cystic Lesions with Endoscopic Ultrasound Fine Needle Biopsy and Impact on Management Decisions.

Purpose: Endoscopic ultrasound with fine needle biopsy (EUS-FNB) has not been well studied in pancreatic cystic lesions (PCLs). This study evaluates the diagnostic performance of EUS-FNB for PCLs and its impact on management decisions.

Methods: We conducted a single-center, retrospective study of patients who had EUS-FNB between March 2016 and February 2024.

Spatial analysis of IPMNs defines a paradoxical KRT17-positive, low-grade epithelial population harboring malignant features.

Background & Aims: Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cysts that represent one of the few radiologically identifiable precursors to pancreatic ductal adenocarcinoma (PDAC).Though the IPMN-bearing patient population represents a unique opportunity for early detection and interception, current guidelines provide insufficient accuracy in determining which patients should undergo resection versus surveillance, resulting in a sizable fraction of resected IPMNs only harboring low-grade dysplasia, suggesting that there may be overtreatment of this clinical entity.

Methods: To investigate the transcriptional changes that occur during IPMN progression, we performed spatial transcriptomics using the Nanostring GeoMx on patient samples containing the entire spectrum of IPMN disease including low-grade dysplasia, high-grade dysplasia, and IPMN-derived carcinoma.

Effect of selective COX-2 inhibitors and non-selective non-steroidal anti-inflammatory drugs on severity of acute pancreatitis: A systematic review and meta-analysis.

Background: It's been suggested that non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the inflammatory response and severity of acute pancreatitis (AP). In this systematic review and meta-analysis, we aimed to explore the impact of selective COX-2 and non-selective NSAIDs compared to non-NSAID options on the severity of AP.

Methods: We searched MEDLINE, EMBASE, and Cochrane Central, from database inception through September 2023.

American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: methodology and review of evidence.

This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for strategies to diagnose and manage GERD. This document was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework and serves as an update to the prior ASGE guideline on the role of endoscopy in the management of GERD (2014). The updated guideline addresses the indications for endoscopy in patients with GERD, including patients who have undergone sleeve gastrectomy (SG) and peroral endoscopic myotomy (POEM).

Use of the mini-forceps traction-assisted cannulation technique when standard ERCP methods fail: Single-center retrospective study.

Background And Study Aims: There are few salvage techniques for achieving biliary cannulation when no duct can be accessed.

Patients And Methods: We retrospectively reviewed 10 consecutive cases in which the mini-forceps traction-assisted cannulation technique (MFTAC) was used after failure of any duct access during endoscopic retrograde cholangiopancreatography (ERCP). Outcomes included technical success, use of adjunct techniques; time to biliary access; and adverse events (AEs).

Radiographic, fluoroscopic, and endosonographic predictors of failed EUS-guided transgastric stent placement in patients with Roux-en-Y bypass anatomy.

Background And Study Aims: Gastric access temporary for endoscopy (GATE) via endoscopic ultrasound-guided stent placement between the gastric pouch/jejunum and remnant stomach is used in Roux-en-Y gastric bypass (RYGB) to facilitate endoscopic retrograde cholangiopancreatography or other maneuvers. This study aimed to identify radiographic predictors of GATE failure and intraprocedure reasons for aborting.

Patients And Methods: Patients undergoing GATE were matched 3:1 on procedure success.

American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: methodology and review of evidence.

This article from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used to inform the final guidance outlined in the accompanying summary and recommendations article for strategies to manage endoscopically placed gastrostomy tubes. This article was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and specifically addresses the utility of PEG versus interventional radiology-guided gastrostomy (IR-G), the need for withholding antiplatelet and anticoagulant medications, appropriate timing to initiate tube feedings, and appropriate selection of the gastrostomy technique in patients with malignant dysphagia. In patients needing enteral access, the ASGE suggests PEG as the preferred technique for initial gastrostomy over IR-G.

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.

American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: summary and recommendations.

This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for strategies to diagnose and manage GERD. This document was developed using the Grading of Recommendations Assessment, Development, and Evaluation framework and serves as an update to the 2014 ASGE guideline on the role of endoscopy in the management of GERD. This updated guideline addresses the indications for endoscopy in patients with GERD as well as in the emerging population of patients who develop GERD after sleeve gastrectomy or peroral endoscopic myotomy.

Cytokine signatures in post-endoscopic retrograde cholangiopancreatography pancreatitis: a pilot study.

Background: Following endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP pancreatitis (PEP) is the most common complication. The host's innate immune response to periprocedural pancreatic injury is the hallmark of its pathogenesis. Investigating cytokine signatures associated with PEP and its risk factors can guide understanding of PEP immunopathogenesis.

Prevalence of exocrine pancreatic insufficiency at 12 months after acute pancreatitis: a prospective, multicentre, longitudinal cohort study.

Background: Exocrine Pancreatic insufficiency (EPI) occurs following acute pancreatitis (AP) at variably reported rates and with unclear recovery timeline. The aim of this study was to establish the prevalence and predictors of EPI at 12 months after AP in a prospective cohort.

Methods: In this prospective, multicentre, longitudinal cohort study, adult participants (≥18 years) admitted to the hospital with an AP attack (defined by Revised Atlanta Classification) were enrolled in a United States multi-centre longitudinal cohort (Sites: The Ohio State University, University of Pittsburgh, and Johns Hopkins University).

American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of chronic pancreatitis: summary and recommendations.

This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for the role of endoscopy in the management of chronic pancreatitis (CP). This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline addresses effectiveness of endoscopic therapies for the management of pain in CP, including celiac plexus block, endoscopic management of pancreatic duct (PD) stones and strictures, and adverse events such as benign biliary strictures (BBSs) and pseudocysts.

American Society for Gastrointestinal Endoscopy guideline on the role of therapeutic EUS in the management of biliary tract disorders: summary and recommendations.

This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach for the role of therapeutic EUS in the management of biliary tract disorders. This guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation framework and addresses the following: 1: The role of EUS-guided biliary drainage (EUS-BD) versus percutaneous transhepatic biliary drainage (PTBD) in resolving biliary obstruction in patients after failed ERCP. 2: The role of EUS-guided hepaticogastrostomy versus EUS-guided choledochoduodenostomy in resolving distal malignant biliary obstruction after failed ERCP.

Effect of the number of passes on diagnostic performance of EUS fine-needle biopsy of solid pancreatic masses: a systematic review and meta-analysis.

Background And Aims: The optimal number of passes to maximize the diagnostic ability of EUS fine-needle biopsy (FNB) of solid pancreatic masses (SPMs) is not well known. We conducted a systematic review to evaluate the impact of the incremental number of passes on diagnostic accuracy, tissue adequacy, and diagnostic yield for EUS-FNB of SPMs.

Methods: We searched MEDLINE, Embase, Scopus, and Cochrane Central for randomized controlled trials comparing per-pass diagnostic outcomes of FNB needles in patients with SPMs.