EUS-guided FNA of the left adrenal gland in patients with thoracic or GI malignancies.

Background: The diagnostic yield and safety of trans-gastric EUS-guided FNA of the left adrenal gland are not well defined.

Methods: All patients with an enlarged left adrenal gland on abdominal imaging and known or suspected malignancy referred to two EUS centers over a 3-year period were included in this study. EUS-guided FNA was performed on an outpatient basis by one of 4 experienced endosonographers.

Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate.

Background: The treatment of pancreatic fistula can be difficult. A novel endoscopic approach to sealing pancreatic fistulas by using N-butyl-2-cyanoacrylate is described.

Methods: Twelve patients with pancreatic fistulas underwent endoscopic injection of N-butyl-2-cyanoacrylate into the fistulous tract, in addition to endoscopic drainage.

Circumferential EMR and complete removal of Barrett's epithelium: a new approach to management of Barrett's esophagus containing high-grade intraepithelial neoplasia and intramucosal carcinoma.

Background: There is no study of circumferential EMR in patients with Barrett's esophagus containing early stage malignant lesions. This study investigated the effectiveness and safety of circumferential EMR by using a simple snare technique without cap.

Method: Patients with Barrett's esophagus containing multifocal high-grade intraepithelial neoplasia or intramucosal cancer, and patients with endoscopically nonidentifiable early stage malignant mucosal changes incidentally detected in random biopsy specimens were included in the study.

Endoscopic treatment of biliary leakage with n-butyl-2 cyanoacrylate.

Background: Biliary leakage is a problematic complication of hepatobiliary surgery. A novel alternative method is described that can obviate the need for reoperation for refractory biliary fistula.

Methods: Nine patients with large biliary leaks unresponsive to endoscopic drainage underwent N-butyl-2-cyanoacrylate glue occlusion at ERCP.

Symptomatic or asymptomatic gallstone disease: is the gallbladder motility the clue?

Background/aims: Only a minority of gallstone patients develop biliary pain. Until now, the factors related to pain have been poorly described.

Methodology: In a prospective study, gallstone patients without acute cholecystitis, pancreatitis or hepatobiliary obstruction were classified into typical symptomatic (type-I, n = 44), atypical symptomatic (type-II, n = 14) and asymptomatic (type-III, n = 29) using a standardized questionnaire (8 items for typical, 3 items for unspecific complaints).

A new radial mechanical puncture echoendoscope: prospective comparison with standard linear and radial echoendoscopes in assessment of focal pancreatic lesions.

Background: A new mechanical puncture-echoendoscope was evaluated by comparing it with conventional linear and radial echoendoscopes. The new instrument has a 300 degrees image field parallel to the axis of the echoendoscope, which could potentially improve accuracy and facilitate assessment of suspected pancreatic lesions before needle puncture.

Methods: Twenty consecutive patients with suspected pancreatic lesions were evaluated endosonographically, including fine needle aspiration (FNA).