Drainage-only strategy on weekend for endoscopic retrograde cholangiopancreatography on the risk of procedure-related adverse events: a prospective observational study.

Background: The feasibility of performing complete endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis during weekends or holidays remains controversial due to concerns over increased risks of adverse events (AEs) in off-hour procedures.

Objectives: To evaluate whether weekend drainage-only ERCP affects the incidence of AEs compared to standard weekday ERCP, and to identify risk factors for post-ERCP pancreatitis (PEP).

Design: Prospective observational study.

Preliminary feasibility study of a novel spiral-designed plastic stent for endoscopic management of malignant hilar biliary obstruction: a multicenter prospective study (with video).

Background And Aims: Plastic stents (PSs) are widely used for palliative drainage in patients with malignant hilar obstruction (MHO); however, their clinical utility is often limited by their short duration of patency, occlusion, and the risk of migration. This study aimed to evaluate the feasibility, safety, and clinical efficacy of a newly designed Twist stent (Taewoong Medical Co, Ltd, Goyang, South Korea) PS, specifically designed to enhance anchoring and prolong patency during endoscopic MHO treatment.

Methods: This prospective study enrolled 32 patients with MHO who underwent endoscopic retrograde cholangiopancreatography with placement of an 8.

Enhancing biliary tract cancer diagnosis using AI-driven 3D optical diffraction tomography.

Biliary tract cancer is associated with distinct metabolic alterations, particularly in lipid metabolism. This study aimed to classify biliary tract cancer cells automatically based on lipid droplet (LD) characteristics using three-dimensional (3D) optical diffraction tomography (ODT) combined with convolutional neural networks (CNNs). Human biliary tract cancer cell lines (SNU1196, SNU308, and SNU478) and a normal cholangiocyte cell line (H69) were cultured to evaluate the LD volume, mass, and count.

Prospective validation and revision of predictive models for post-ERCP pancreatitis: focus on procedure-related factors and a novel risk stratification approach.

Introduction: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common serious adverse event after endoscopic retrograde cholangiopancreatography (ERCP). Although retrospective models to predict PEP have shown promise, their real-world applicability remains uncertain. Thus, we used prospectively derived cohort data to validate current prediction models.

Identification of risk factors associated with post-ERCP pancreatitis in patients with easy cannulation: a prospective multicenter observational study (with videos).

Background And Aims: Difficult biliary cannulation is an independent risk factor for post-ERCP pancreatitis (PEP); however, there is a noticeable lack of studies focusing on the incidence and risk factors of PEP among patients undergoing easy cannulation. Therefore, we systematically investigated the risk factors for PEP in patients who underwent easy cannulation.

Methods: We prospectively enrolled patients with naive major papillae who underwent diagnostic or therapeutic ERCP between June 2018 and June 2023.

Safety and efficacy of remimazolam versus propofol during EUS: a multicenter randomized controlled study.

Background And Aims: Propofol, a widely used sedative in GI endoscopic procedures, is associated with cardiorespiratory suppression. Remimazolam is a novel ultrashort-acting benzodiazepine sedative with rapid onset and minimal cardiorespiratory depression. This study compared the safety and efficacy of remimazolam and propofol during EUS procedures.

Convolutional neural network model for automatic recognition and classification of pancreatic cancer cell based on analysis of lipid droplet on unlabeled sample by 3D optical diffraction tomography.

Introduction: Pancreatic cancer cells generally accumulate large numbers of lipid droplets (LDs), which regulate lipid storage. To promote rapid diagnosis, an automatic pancreatic cancer cell recognition system based on a deep convolutional neural network was proposed in this study using quantitative images of LDs from stain-free cytologic samples by optical diffraction tomography.

Methods: We retrieved 3D refractive index tomograms and reconstructed 37 optical images of one cell.

Gallbladder perforation in acute acalculous vs. calculous cholecystitis: a retrospective comparative cohort study with 10-year single-center experience.

Background: Gallstones are a well-known risk factor for acute cholecystitis. However, their role as a risk factor for gallbladder perforation (GBP) remains unclear. Therefore, this study aimed to determine the effect of gallstones on the development of GBP.

Clinical impact of pancreatic steatosis measured by CT on the risk of post-ERCP pancreatitis: a multicenter prospective trial.

Background And Aims: Pancreatic steatosis (PS) may be a risk factor for acute pancreatitis. Whether it is also a risk factor for post-ERCP pancreatitis (PEP) has not been evaluated. This study aimed to determine the impact of PS on PEP development.

Comparison between three types of needles for endoscopic ultrasound-guided tissue acquisition of pancreatic solid masses: a multicenter observational study.

It is debatable which needle has clear superiority of diagnostic performance in endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) of solid pancreatic masses. This study aimed to compare the performance of three needles and determine the variables that affect diagnostic accuracy. From March 2014 to May 2020, 746 patients with solid pancreatic masses who underwent EUS-FNB using three types of needles (Franseen needle, Menghini-tip needle, and Reverse-bevel needle) were retrospectively reviewed.

Successful Intubation Using a Cap-Assisted Colonoscope for Endoscopic Retrograde Cholangiopancreatography in Patients Undergoing Roux-en-Y Reconstruction.

Endoscopic retrograde cholangiopancreatography (ERCP) is challenging in patients undergoing Roux-en-Y (REY) reconstruction; although balloon-assisted enteroscopy is the first-line treatment, it is not always available considering equipment and expertise. We aimed to evaluate the feasibility of using a cap-assisted colonoscope as the primary approach for ERCP in REY reconstruction. We included 47 patients with REY who underwent ERCP using a cap-assisted colonoscope between January 2017 and February 2022.

Placement of Plastic Stents after Direct Endoscopic Necrosectomy through a Novel Lumen-Apposing Metal Stent for Effective Treatment of Laterally Extended Walled-Off Necrosis: A Pilot Study.

Direct endoscopic necrosectomy (DEN) using a lumen-apposing metal stent (LAMS) is a standard therapy for the management of symptomatic walled-off necrosis (WON). Here, we demonstrated the efficacy of the routine placement of long plastic stents after a DEN session to treat laterally extended WON. Patients (n = 6) with symptomatic laterally extended WON who underwent DEN after long plastic stent placement were included.

Comparison of the long-term outcomes between proximal and distal IgG4-related sclerosing cholangitis: A multicenter cohort study.

Background And Aims: Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is considered a biliary manifestation of IgG4-related diseases. However, there has been a controversy on the clinical outcomes according to the location of the involved bile duct. We therefore compared the clinical outcomes and long-term prognosis of IgG4-SC with proximal bile duct involvement (proximal IgG4-SC) and IgG4-SC with distal bile duct involvement (distal IgG4-SC).