Tube-in-tube endoscopic vacuum therapy for treatment of colorectal anastomotic leaks: A low-cost, patient-friendly, feasible and efficient technical modification of sponge-based endoscopic vacuum therapy.

Background And Aims: Colorectal endoscopic vacuum therapy (CR EVT) is usually performed using sponges passed through the anus. It may be associated with patient discomfort and displacement of the aspiration tube.

Methods: With the tube-in-tube endoscopic vacuum therapy modification (CR TT-EVT), it is possible to position the aspiration tube in the pelvic cavity through the abdominal wall.

Association between mucosal surface pattern under near focus technology and infection.

Background: Many studies evaluated magnification endoscopy (ME) to correlate changes on the gastric mucosal surface with () infection. However, few studies validated these concepts with high-definition endoscopy without ME.

Aim: To access the association between mucosal surface pattern under near focus technology and infection status in a western population.

ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY.

Background: Endoscopic aspect of fundoplication anatomy: Normal aspect of Nissen fundoplication. Upper digestive endoscopy is important for the evaluation of patients submitted to fundoplication, especially to elucidate postoperative symptoms. However, endoscopic assessment of fundoplication anatomy and its complications is poorly standardized among endoscopists, which leads to inadequate agreement.

Papillary fistulotomy conventional cannulation for endoscopic biliary access: A prospective randomized trial.

Aim: To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique catheter and guidewire standard access.

Methods: From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire (Group I) and papillary fistulotomy (Group II). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications (pancreatitis, bleeding, perforation) were recorded.

Modified technique for percutaneous endoscopic gastrojejunostomy placement.

The placement of percutaneous endoscopic gastrojejunostomy (PEG-J) provides diet delivery beyond the angle of Treitz, and it is associated with decrease of complications related to gastroparesis, such as aspiration pneumonia. There are many different techniques to perform a PEG-J described in the literature, with variable degrees of technical success. In this article, we suggest modifications to the technique of PEG-J placement in order to reduce time of procedure and minimize the risk of technical failure.

AN INNOVATIVE EX-VIVO MODEL FOR RAPID CHANGE OF THE PAPILLA FOR TEACHING ADVANCED ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PROCEDURES.

Background: Models for endoscopic retrograde cholangiopancreatography training allow practice with an expert feedback and without risks. A method to rapidly exchange the papilla can be time saving and accelerate the learning curve.

Aim: To demonstrate a newly method of rapid exchange papilla in ex-vivo models to teach retrograde cholangiopancreatography advanced procedures.

Ex vivo and simulator models teaching therapeutic ERCP and EUS: description of SOBED's first course.

Teaching models in endoscopy are important tools to minimize risks derived from endoscopic procedures, taking into account that therapeutic endoscopy, also known as surgical endoscopy, has greatly developed during the last decade. This results from the fact that minimally invasive procedures present relevant contributions and promote more comfort to patients. In this context, ex vivo teaching models and virtual simulators are important tools to the safe acquisition of abilities.

Surgical or endoscopic management for post-ERCP large transmural duodenal perforations: a randomized prospective trial.

Introduction: Duodenal perforations are an uncommon adverse event during ERCP. Patients can develop significant morbidity and mortality. Even though surgery has been used to manage duodenal complications, therapeutic endoscopy has seen significant advances.

Biliary transpapillary endoscopic balloon dilation for treating choledocholithiasis.

Objective: To evaluate the efficacy and safety of transpapillary papilloplasty in patients with choledocholithiasis.

Materials And Methods: All endoscopic retrograde cholangiopancreatography (ERCP) procedures performed at Hospital Ana Costa, in the city of Santos, Brazil, over the last five years were retrospectively evaluated using the hospital's information database. The success of the procedure and complications due to residual calculi, pancreatitis, bleeding and perforation were evaluated.

ERCP using double-balloon enteroscopy in patients with Roux-en-Y anatomy.

Double-balloon enteroscopy (DBE) is a useful method for endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anatomy. Depending on the distorted anatomy, endoscopic therapies with conventional scopes were very difficult or impossible before the advent of DBE and patients had to be submitted to a percutaneous or surgical approach. The case of 6 patients with different types of Roux-en-Y-altered anatomy in which DBE-ERCP was performed with 83.

Combination of N-acetylcysteine and metformin improves histological steatosis and fibrosis in patients with non-alcoholic steatohepatitis.

Aim: There is no proven medical therapy for the treatment of non-alcoholic steatohepatitis (NASH). Oxidative stress and insulin resistance are the mechanisms that seem to be mostly involved in its pathogenesis. The aim of our study was to evaluate the efficacy of N-acetylcysteine (NAC) in combination with metformin (MTF) in improving the aminotransferases and histological parameters (steatosis, inflammation, hepatocellular ballooning, and fibrosis) after 12 months of treatment.

Endoscopic findings in the excluded stomach after Roux-en-Y gastric bypass surgery.

Hypothesis: After gastric bypass surgery performed because of morbid obesity, the excluded stomach can rarely be endoscopically examined. With the advent of a new apparatus and technique, possible mucosal changes can be routinely accessed and monitored, thus preventing potential benign and malignant complications.

Design: Prospective observational study in a homogeneous population with nonspecific symptoms.

Effects of bariatric surgery on nonalcoholic fatty liver disease: preliminary findings after 2 years.

Background And Aim: Although nonalcoholic fatty liver disease (NAFLD) is very common among morbidly obese patients, the effect of weight loss after bariatric surgery on inflammation and fibrosis related to NAFLD is still a matter of debate. The aim of this study was to evaluate the impact of Roux-en-Y gastric bypass (RYGB) surgery on NAFLD with a follow up of 2 years.

Methods: Eighteen consecutive NAFLD patients with body mass index >40 kg/m(2) undergoing gastroplasty with RYGB were enrolled, and wedge liver biopsy was obtained at the operation.

Lipid peroxidation in bariatric candidates with nonalcoholic fatty liver disease (NAFLD) -- preliminary findings.

Background: Pathogenesis of nonalcoholic fatty liver disease (NAFLD) remains incompletely known, and oxidative stress is one of the mechanisms incriminated. The aim of this study was to evaluate the role of liver oxidative stress in NAFLD affecting morbidly obese patients.

Methods: 39 consecutive patients with BMI >40 kg/m2 submitted to Roux-en-Y gastric bypass were enrolled, and wedge liver biopsy was obtained during operation.