CEACAM5 and TROP2 define metaplastic and dysplastic transitions in human antral gastric precancerous lesions and tumors.

Background: Mucosal gastric atrophy and intestinal metaplasia (IM) increase the risk for the development of gastric cancer (GC) as they represent a field for development of dysplasia and intestinal-type gastric adenocarcinoma.

Methods: We have investigated the expression of two dysplasia markers, CEACAM5 and TROP2, in human antral IM and gastric tumors to assess their potential as molecular markers.

Results: In the normal antral mucosa, weak CEACAM5 and TROP2 expression was only observed in the foveolar epithelium, while inflamed antrum exhibited increased expression of both markers.

International prospective observational study of upper gastrointestinal haemorrhage: Does weekend admission affect outcome?

Introduction: Out of hours admissions have higher mortality for many conditions but upper gastrointestinal haemorrhage studies have produced variable outcomes.

Methods: Prospective study of 12 months consecutive admissions of upper gastrointestinal haemorrhage from four international high volume centres. Admission period (weekdays, weeknights or weekends), demographics, haemodynamic parameters, laboratory results, endoscopy findings, further procedures and 30-day mortality were recorded.

Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms.

Background & Aims: In patients with gastroesophageal reflux disease (GERD) and excessive belching, most belches are supragastric, and can induce reflux episodes and worsen GERD. Supragastric belching (SGB) might be reduced with diaphragmatic breathing exercises. We investigated whether diaphragmatic breathing therapy is effective in reducing belching and proton pump inhibitor (PPI)-refractory gastroesophageal reflux symptoms.

Endoscopic Submucosal Dissection Outcomes for Gastroesophageal Tumors in Low Volume Units: A Multicenter Survey.

Endoscopic submucosal dissection (ESD) outcomes have traditionally been reported from high volume centers in East Asia. Data from low volume centers in other parts of Asia remain sparse. A retrospective survey with a structured questionnaire of 5 tertiary centers in 3 countries in South East Asia was conducted.

WEO position statement on hygiene in digestive endoscopy: Focus on endoscopy units in Asia and the Middle East.

The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures). These minimum requirements are mandatory for patient safety.

Evaluation of the Fukuoka Consensus Guidelines for intraductal papillary mucinous neoplasms of the pancreas: Results from a systematic review of 1,382 surgically resected patients.

Background: International consensus guidelines to guide management of intraductal papillary mucinous neoplasms (IPMN) were revised in Fukuoka and published in 2012. However, despite widespread acceptance of the Fukuoka Consensus Guidelines (FCG), the utility of these guidelines have not been well-validated. This systematic review was performed to evaluate the clinical utility of the FCG.

Diagnosis and treatment of Helicobacter pylori for peptic ulcer bleeding in clinical practice - factors associated with non-diagnosis and non-treatment, and diagnostic yield in various settings.

Background/aims: To study the practice of clinicians in the diagnosis and treatment of H. pylori for peptic ulcer bleeding, and the diagnostic yield of H. pylori tests in various situations.

Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma.

Hilar cholangiocarcinoma (HCCA) is one of the most common types of hepatobiliary cancers reported in the world including Asia-Pacific region. Early HCCA may be completely asymptomatic. When significant hilar obstruction develops, the patient presents with jaundice, pale stools, dark urine, pruritus, abdominal pain, and sometimes fever.

Factors determining diagnostic yield of endoscopic ultrasound guided fine-needle aspiration for pancreatic cystic lesions: a multicentre Asian study.

Background And Aim: The purpose of this study was to determine (1) the diagnostic yield for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in patients with pancreatic cystic lesions, (2) additional value of EUS-FNA over EUS alone in the diagnosis of pancreatic cysts, and (3) diagnostic sensitivity and specificity of EUS and EUS-FNA in the subset of patients where histopathology of surgical specimens were available.

Methods: All patients who underwent EUS examination for the evaluation of pancreatic cystic lesions in six Asian centres were included in the study.

Results: Of 298 patients with pancreatic cysts who underwent EUS, 132 (44.

Management of benign strictures of the extrahepatic bile duct due to chronic pancreatitis and surgical intervention.

In the Endoscopic Forum Japan 2011 (EFJ 2011), we focused on the management of biliary strictures derived from chronic pancreatitis and surgical intervention. We concluded that regardless of causes of strictures, a large bore single plastic stent is better as a first choice of stenting. As a next step, multiple plastic stents may be preferable compared to a covered self-expandable metallic stent in case of unexpected adverse events and cost of stent.

Outcome of endoscopic retrograde cholangiopancreatography during live endoscopy demonstrations.

Background: A number of factors may result in lower than expected success rates for endoscopic retrograde cholangiopancreatography (ERCP) performed by overseas experts during live demonstrations (LDs). Stratifying the degree of ERCP difficulty may help in the assessment of procedure outcomes, but no prior reports have done so. This study aimed to compare the success rate and complications of ERCP between procedures performed in live demonstrations and for matched control subjects.

Current status of diagnostic endoscopic ultrasonography in the evaluation of pancreatic mass lesions.

Endoscopic ultrasonography (EUS) is currently well established as a diagnostic method for the evaluation of pancreatic mass lesions. Diagnostic EUS might be divided into two broad categories; it is an imaging method, and also a device for obtaining cytopathology and histopathology. EUS as an imaging method has seen the introduction of newer intravenous contrast agents that enable the characterization of the pancreatic masses.

Experienced versus inexperienced confocal endoscopists in the diagnosis of gastric adenocarcinoma and intestinal metaplasia on confocal images.

Background: Confocal laser endomicroscopy (CLE) may be used to diagnose gastric cancer and intestinal metaplasia, but the impact of CLE experience on the accuracy of confocal diagnosis of gastric cancer and intestinal metaplasia is not clear.

Objective: To establish the sensitivity, specificity, and intragroup interobserver agreement of CLE image interpretation by 3 experienced (group 1) and 3 inexperienced (group 2) CLE endoscopists for diagnosing gastric intestinal metaplasia (GIM) and adenocarcinoma.

Design: Blinded review of CLE images for the diagnosis of gastric cancer or intestinal metaplasia.

First endoscopic procedure for diagnosis and staging of mediastinal lymphadenopathy.

Aim: To compare a first diagnostic procedure of transbronchial needle aspiration (TBNA) with selection of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or TBNA for mediastinal lymphadenopathy.

Methods: Sixty-eight consecutive patients with mediastinal lymphadenopathy on computed tomography (CT), who required cytopathological diagnosis, were recruited. The first 34 underwent a sequential approach in which TBNA was performed first, followed by EUS-FNA if TBNA was unrevealing.

Changing trends in the proportion of adenocarcinoma of the esophagogastric junction in a large tertiary referral center in Japan.

Introduction: A dramatic increase in incidence of adenocarcinoma of the esophagogastric junction (EGJ) over the past two decades has been reported in the West. However, epidemiological data from Asian countries have not shown a similar trend. The aim of this study was to determine the incidence of adenocarcinoma of the EGJ in a cohort of consecutive patients operated on for gastric adenocarcinoma at a major cancer referral center in Japan.