Video recording in GI endoscopy.

The current approach to procedure reporting in endoscopy aims to capture essential findings and interventions but inherently sacrifices the rich detail and nuance of the entire endoscopic experience. Endoscopic video recording (EVR) provides a complete archive of the procedure, extending the utility of the encounter beyond diagnosis and intervention, and potentially adding significant value to the care of the patient and the field in general. This white paper outlines the potential of EVR in clinical care, quality improvement, education, and artificial intelligence-driven innovation, and addresses critical considerations surrounding technology, regulation, ethics, and privacy.

Bodyweight-Adjusted Nonsteroidal Anti-inflammatory Drugs Dose in the Prevention of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis.

Objectives: Although rectal nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the incidence of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP), their optimal dosage is unknown. Given possible interindividual variability in the pharmacodynamics of NSAIDs, we hypothesized that the dose required to achieve adequate PEP prophylaxis varies with body weight.

Materials And Methods: We conducted an analysis using single-center, prospective, observational cohort study data.

Evaluation of a novel contrast-enhanced fluoroscopy protocol for endoscopic retrograde cholangiopancreatography in a phantom model (with video).

Objectives: This study evaluated a novel contrast-enhanced (CE) fluoroscopy protocol for endoscopic retrograde cholangiopancreatography, which optimizes image processing to enhance contrast of devices and contrast media. We compared the CE protocol with the conventional standard protocol to assess its potential for reducing radiation exposure while improving image visibility.

Methods: The study utilized a multidirectional fluoroscopy unit and phantoms to evaluate the new CE protocol against the conventional protocol.

Capnographic monitoring using a novel mainstream system during endoscopic ultrasound and endoscopic retrograde cholangiopancreatography: A prospective randomized controlled trial.

Background/purpose: Insufficient studies exist on capnography efficacy during endoscopic ultrasound or endoscopic retrograde cholangiopancreatography, and no definitive conclusions have been drawn. To evaluate the feasibility and efficacy of a novel mainstream capnography using an over-the-biteblock end-tidal CO (EtCO) detector in decreasing the risk of hypoxemia during endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP).

Methods: Patients undergoing EUS or ERCP with conscious sedation at a single Japanese center were randomized to a control or a novel capnography monitored (intervention) group in a 1:1 ratio.

Endobariatric systems: Strategic integration of endoscopic therapies in the management of obesity.

The escalating obesity pandemic and its comorbidities necessitate adaptable and versatile treatment strategies. Endobariatric and metabolic therapies (EBMTs) can be strategically employed in a multipronged approach to obesity management, analogous to the way chess systems are employed to seize opportunities and thwart threats. In this review, we explore the spectrum of established and developing EBMTs, examining their efficacy in weight loss and metabolic improvement and their importance for a tailored, patient-centric approach.

Normal saline versus Ringer's solution and critical-illness mortality in acute pancreatitis: a nationwide inpatient database study.

Background: Fluid resuscitation is fundamental in acute pancreatitis (AP) treatment. However, the optimal choice between normal saline (NS) and Ringer's solution (RS), and its impact on mortality in critically ill patients, remains controversial. This retrospective cohort study, utilizing a national Japanese inpatient database, investigates this question.

The multidisciplinary pancreatic cyst clinic: A collaborative approach to streamlined management.

Background: Pancreatic cysts are often incidentally detected on routine imaging studies. Of these, mucinous cysts have a malignant potential. Several guidelines propose different management strategies, and implementation in patient care is inconsistent in the absence of dedicated infrastructure.

Celiac artery mesenteric fat measurement with endosonography (CAMEUS) reliably correlates with obesity and related comorbidities.

Background: Visceral fat represents a metabolically active entity linked to adverse metabolic sequelae of obesity. We aimed to determine if celiac artery mesenteric fat thickness can be reliably measured during endoscopic ultrasound (EUS), and if these measurements correlate with metabolic disease burden.

Methods: This was a retrospective analysis of patients who underwent celiac artery mesenteric fat measurement with endosonography (CAMEUS) measurement at a tertiary referral center, and a validation prospective trial of patients with obesity and nonalcoholic steatohepatitis who received paired EUS exams with CAMEUS measurement before and after six months of treatment with an intragastric balloon.

Non-interventional Management of Asymptomatic Diminutive Choledocholithiasis Versus Endoscopic Extraction in Consecutive Patients.

Background: Current guidelines recommend treating choledocholithiasis, regardless of symptoms or stone size, with endoscopic retrograde cholangiopancreatography (ERCP). However, asymptomatic choledocholithiasis, discovered incidentally on imaging, may carry a higher risk of ERCP-related adverse events, and some asymptomatic and diminutive stones may not cause biliary adverse events during extended follow-up. Therefore, we aimed to clarify the best treatment strategies for asymptomatic choledocholithiasis based on stone size.

Turnkey algorithmic approach for the evaluation of gastroesophageal reflux disease after bariatric surgery.

Bariatric surgeries are often complicated by de-novo gastroesophageal reflux disease (GERD) or worsening of pre-existing GERD. The growing rates of obesity and bariatric surgeries worldwide are paralleled by an increase in the number of patients requiring post-surgical GERD evaluation. However, there is currently no standardized approach for the assessment of GERD in these patients.