Identification of robust associations between admission microbiome profiles and complications of acute pancreatitis.

Objective: Patients with acute pancreatitis show reduced gut microbiome diversity and high abundance of pathogenic bacteria compared with healthy subjects. Admission microbiome profiles are increasingly linked to severity, but methodology and study quality hamper interpretation. Our aim was to investigate whether admission microbiome analysis provides robust and reproducible associations with severity and complications of acute pancreatitis.

Proteomic identification of PA2146 as a biofilm marker of on endoscope channel material.

Study Background And Aims: can persistently contaminate endoscopes by forming biofilms within internal channels, complicating both detection and eradication. Current microbiological surveillance methods have limited efficacy and may yield false-negative results. This study aimed to identify proteomic markers of biofilms on endoscope channel material.

A pilot study showcasing the difficulties in endoscopic biliary drainage using uncovered self-expanding metal stents for resectable perihilar cholangiocarcinoma.

Background: Endoscopic retrograde cholangio-pancreatography (ERCP) with plastic stent placement is the standard pertaining preoperative biliary drainage for resectable perihilar cholangiocarcinoma (pCCA). Uncovered self-expanding metal stents (ucSEMS) have shown better outcomes in palliative settings. This pilot study aimed to assess the feasibility and safety of direct ucSEMS placement ERCP for resectable pCCA.

The {010} form of polar brushite (CaHPO·2HO) deposits as an epi-growing crystal on a non-polar {010} substrate of gypsum (CaSO·2HO).

The mechanisms of crystal growth from solution are more complicated than those from vapor or melt growth. These mechanisms are important in bio-mineralization (bones, teeth, shells) and in the characterization of optically non-linear crystals, perfectly crystallized proteins, nucleic acids and complex viruses. This motivated studies on new basic phenomena, including the crystal interfaces of biological macromolecules and those of low-solubility inorganic salts.

Patients' Attitude toward Less Frequent Surveillance of Low-Risk Pancreatic Cysts: A Multicenter European Cohort Study.

BackgroundRecent studies show that low-risk pancreatic cysts may require less frequent monitoring. Future guidelines will likely adapt their recommendations accordingly. Our goal was to explore the willingness of individuals with a low-risk pancreatic cyst to undergo less frequent surveillance and to identify associated characteristics with such willingness.

The Brescia International Multidisciplinary Consensus Guidelines on the Optimal Pathology Assessment and Multidisciplinary Pathways of Non-Pancreatic Neoplasms in and Around the Ampulla of Vater (PERIPAN).

Importance: The lack of multidisciplinary workflow guidelines and clear definitions and classifications for neoplasms in and around the ampulla of Vater results in inconsistencies affecting patient care and research.

Objective: The PERIPAN international multidisciplinary consensus group aimed to standardize the multidisciplinary diagnostic workflow and achieve consensus on definitions and classifications in order to ensure proper classification and optimal diagnostic assessment and consequently to improve patient care and future research.

Design: An international team of 43 experts (pathologists, surgeons, radiologists, gastroenterologists, oncologists) from 12 countries identified knowledge gaps, reviewed 37061 articles, and proposed recommendations using the Scottish Intercollegiate Guidelines Network methodology (SIGN), including the Delphi methodology and the AGREEII tool for quality assessment and external validation.

Endoscopic ultrasound-guided portosystemic pressure gradient measurement transjugular balloon occlusion measurement in patients with cirrhosis (ENCOUNTER): A bicentric EU study.

Background & Aims: Patients with cirrhosis and portal hypertension are at increased risk of hepatic decompensation and liver-related mortality. While the hepatic venous pressure gradient (HVPG) is the accepted method for quantifying portal hypertension, its measurement and limited availability pose challenges. Endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) provides a direct alternative.

Endoscopic papillectomy for laterally spreading lesions of the papilla - a propensity score matched analysis.

Background And Aims: Endoscopic papillectomy (EP) is a standard treatment for ampullary lesions (AL), typically small and confined to the papillary mound. Laterally spreading lesions (LSL) of the papilla Vateri are a rare AL subtype involving extensive duodenal mucosa. Data on EP outcomes for LSL are limited.

Small and Stable Pancreatic Cysts Are Reassuring During Surveillance: Results From the PACYFIC Trial.

Background: Pancreatic cysts are increasingly discovered on imaging studies performed for unrelated conditions. Currently, surveillance of these lesions poses a substantial burden on patients, and health care recourses. We hypothesized that individuals with small and stable cysts have a diminutive risk of progressing to high-grade dysplasia (HGD) or pancreatic cancer (PC) that is similar to that in the general population.

Multi-center evaluation of radiomics and deep learning to stratify malignancy risk of IPMNs.

Distinguishing high-risk intraductal papillary mucinous neoplasms (IPMNs), pancreatic cysts requiring surgery, from low-risk lesions remains a clinical challenge, often resulting in unnecessary procedures due to limited specificity of current methods. While radiomics and deep learning (DL) have been explored for pancreatic cancer, cyst-level malignancy risk stratification of IPMNs remains untapped. We conducted a multi-institutional study (seven centers, 359 T2W MRI images) to assess the feasibility of AI for predicting IPMN dysplasia grade using cyst-level image features.

Long-Term Efficacy and Safety of Digital-Single-Operator-Video-Pancreatoscopy Guided Lithotripsy for Pancreatic Duct Stones.

Introduction: Ductal decompression has become the main approach for treating patients with symptomatic chronic calcifying pancreatitis and signs of ductal hypertension. Digital single operator video pancreatoscopy (dSOVP) has shown high success rates when compared with more established techniques such as extracorporeal shock wave lithotripsy. However, there is still limited evidence on long-term clinical success and quality of life.

Endoscopic ultrasound with tissue acquisition of lymph nodes in patients with resectable distal cholangiocarcinoma.

Background: Lymph node (LN) involvement is a negative prognostic factor for patients with distal cholangiocarcinoma (dCCA). Therefore, preoperative assessment of the LN status could potentially aid therapy decision making. Endoscopic ultrasound (EUS) is often used to obtain a tissue diagnosis of the primary tumor, but can also be used to sample suspicious LN.

Development and validation of the SDLD score: a simplified tool to predict successful endoscopic papillectomy in ampullary lesions.

Background And Aims: Endoscopic papillectomy (EP) is the standard treatment for noninvasive ampullary lesions (ALs), whereas advanced cases require surgery. Managing ALs is challenging and may lead to over- or undertreatment. We developed a score to identify the best candidates for endoscopic or surgical treatment.

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.

The value of cholangioscopy-guided bite-on-bite (-on bite) biopsies in indeterminate biliary duct strictures.

Background:  Digital single-operator cholangioscopy (dSOC) has improved the diagnostic accuracy of indeterminate biliary duct strictures (IBDS) through targeted intraductal biopsy sampling. However, the optimal biopsy technique remains uncertain.

Methods:  This international, multicenter, prospective interventional study (November 2020-August 2022) included patients with IBDS undergoing dSOC.

Interobserver variability in lymph node evaluation with endoscopic ultrasonography in cholangiocarcinoma.

Background And Study Aims: Accurate preoperative lymph node (LN) assessment is crucial for patients with intrahepatic cholangiocarcinoma (iCCA) and perihilar cholangiocarcinoma (pCCA) because presence of LN metastases significantly reduces survival rates and can contraindicate surgical resection. Endoscopic ultrasound (EUS) provides a reliable method for LN assessment with the advantage of enabling tissue acquisition for pathological confirmation. This study aimed to assess interobserver agreement among endosonographers in evaluating LN characteristics in patients with iCCA and pCCA.

Surgery for chronic pancreatitis across Europe (ESCOPA): prospective multicentre study.

Background: Randomized trials have demonstrated the superiority of surgery over endoscopy in patients with symptomatic chronic pancreatitis. However, large international studies quantifying the impact of surgery on chronic pancreatitis are lacking. The aim of this study was to evaluate current practice across Europe regarding indications, surgical techniques, and outcomes of surgery for chronic pancreatitis.

Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction.

Percutaneous transhepatic biliary drainage (PTBD) and endoscopic ultrasound-guided biliary drainage (EUS-BD), including choledochoduodenostomy (EUS-CDS), are alternative methods for biliary drainage in patients with distal malignant biliary obstruction (MBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). Data on long-term outcomes, adverse events (AEs), and quality of life (QoL) after EUS-CDS and PTBD are limited. Therefore, we created a registry to evaluate the outcomes of both drainage procedures.

Endoscopic Sustainability PrimAry Reporting Essentials (E-SPARE): European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

A growing number of studies aim to evaluate gastrointestinal (GI) endoscopy services from the perspective of their environmental impact. However, there are currently no guidelines or frameworks which provide specifically for the reporting of endoscopy sustainability studies, and a variety of metrics and assessment tools have been employed in the literature. To improve the clarity, transparency, and quality of reporting, the European Society of Gastrointestinal Endoscopy (ESGE) has developed a reporting framework for the community of researchers interested in conducting studies on sustainable GI endoscopy.

Novel water-based automated endoscope cleaning process vs conventional manual cleaning for reducing duodenoscope contamination.

Background And Study Aims: Duodenoscope contamination remains a persistent problem, exposing patients to infection risks. Automation in reprocessing may limit human error, reduce workload, and increase uniformity and traceability. However, its effectiveness should be evaluated before implementation.

Use of an electrospun bioveil is safe and does not decrease skin graft take on burn wounds: A randomised, controlled clinical trial.

Introduction: Split-thickness skin autografts are the gold standard for surgical treatment of burns. In preclinical studies, the use of SKINHEALTEX PLGA, an electrospun poly(lactic-co-glycolide) acid (PLGA) bioveil, placed between autografts and their bed has shown potential to stimulate dermal regeneration, increase graft take and improve scar quality. These properties have not yet been evaluated in human clinical trials.

Bio-Inspired Interlocking Micro-Patterning for Tunable, Switchable and Selective Adhesion in Wet and Dusty Environments.

Achieving adhesion under unfavorable conditions, such as when van der Waals interaction is not available or in dust environments, is crucial in applications ranging from surgical sutures to wound-healing tapes, underwater adhesives, robotic grippers, and space grasping. Interestingly, plants, animals, and microorganisms living in such environmental conditions show surface morphological traits optimized to achieve mechanical interlocking. Thus, they achieve an effective work of adhesion thanks to the interplay of friction and interfacially-storable elastic energy, which otherwise typically suppress adhesion.

Carbon footprinting and environmental impact of gastrointestinal endoscopy procedures at a tertiary care institution: a prospective multi-dimensional assessment.

Background: Given the imperative to combat climate change, reducing the healthcare sector's implications on the environment is crucial.

Objective: This study aims to offer a comprehensive assessment of the environmental impact of gastrointestinal endoscopy (GIE) procedures, specifically focusing on greenhouse gas (GHG) emissions and waste generation.

Design: A prospective study was conducted at the Asian Institute of Gastroenterology (AIG Hospitals), Hyderabad, India, from 29 May to 10 June 2023, including all consecutive GIE procedures.