Guide Wire Selection (Straight vs. Angled) in Endoscopic Retrograde Cholangiopancreatography Using a Normal Contrast Catheter Performed by a Trainee: A Single-Center Prospective Randomized Controlled Cross-Over Study.

Introduction: Wire-guided cannulation (WGC) during endoscopic retrograde cholangiopancreatography (ERCP) is a selective biliary cannulation technique aimed at improving the successful selective biliary cannulation rate and reducing the rate of post-ERCP pancreatitis (PEP) incidence. This study aimed to evaluate the effectiveness of angled-tip guidewires (AGW) vs. straight-tip guidewires (SGW) for biliary cannulation via WGC by a trainee.

Metagenomic Identification of Microbial Signatures Predicting Pancreatic Cancer From a Multinational Study.

Background & Aims: To identify gut and oral metagenomic signatures that accurately predict pancreatic ductal carcinoma (PDAC) and to validate these signatures in independent cohorts.

Methods: We conducted a multinational study and performed shotgun metagenomic analysis of fecal and salivary samples collected from patients with treatment-naïve PDAC and non-PDAC controls in Japan, Spain, and Germany. Taxonomic and functional profiles of the microbiomes were characterized, and metagenomic classifiers to predict PDAC were constructed and validated in external datasets.

Effect of antiplatelet agent number, types, and pre-endoscopic management on post-polypectomy bleeding: validation of endoscopy guidelines.

Background: It remains unclear whether type of antiplatelet (AP) therapy, AP combination therapy, and AP continuing or switching strategy affect the risk of post-polypectomy bleeding (PPB). In this study, we sought to elucidate this risk.

Methods: We analyzed 1050 patients who underwent colonoscopic polypectomy: 525 AP users and 525 controls matched for age, sex, comorbidities, concomitant non-steroidal anti-inflammatory drugs use, and polyp characteristics who did not receive antithrombotics.

Efficacy of Vonoprazan, a Novel Potassium-Competitive Acid Blocker, in Patients with Proton Pump Inhibitor-Refractory Acid Reflux.

Background/aim: We evaluated the efficacy of vonoprazan (VPZ), a novel potassium-competitive acid blocker, in patients with proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD), exhibiting continued pathological esophageal acid exposure (EAE).

Methods: Despite ≥8 weeks of appropriate PPI therapy, patients with -persistent reflux symptoms and pathological EAE times (EAETs ≥4%) were invited to switch to VPZ treatment. After an 8-week-course of once-daily VPZ (20 mg), multichannel intraluminal impedance-pH (MII-pH) monitoring was repeated to compare gastric acid exposure times (GAETs), EAETs, and other reflux parameters relative to the baseline values.

Effects of bowel preparation on the human gut microbiome and metabolome.

Large bowel preparation may cause a substantial change in the gut microbiota and metabolites. Here, we included a bowel prep group and a no-procedure control group and evaluated the effects of bowel prep on the stability of the gut microbiome and metabolome as well as on recovery. Gut microbiota and metabolome compositions were analyzed by 16S rRNA sequencing and capillary electrophoresis time-of-flight mass spectrometry, respectively.

Validation of the American Gastroenterological Association guidelines on management of intraductal papillary mucinous neoplasms: more than 5 years of follow-up.

Objectives: Recent guidelines suggest that imaging surveillance be conducted for 5 years for patients with at most one high-risk feature. If there were no significant changes, surveillance is stopped. We sought to validate this follow-up strategy.

Validation of a realistic, simple, and inexpensive EUS-FNA training model using isolated porcine stomach.

Background And Study Aims: Trainees are required to learn EUS-FNA using a model before working with a patient. The aim of the current study was to validate a new training model developed for EUS-FNA.

Patients And Methods: Several fresh chicken tenderloins were embedded as target lesions in the submucosal layer of an isolated porcine stomach.

Recurrence and prognosis of patients emergently hospitalized for acute esophageal variceal bleeding: A long-term cohort study.

Aim: To elucidate the rates of recurrence and mortality in acute esophageal variceal bleeding and the associated risk factors.

Methods: A cohort of 174 patients emergently hospitalized for esophageal variceal bleeding was analyzed. All patients underwent endoscopic variceal ligation within 3 h of arrival.

An experimental study to assess the best maneuver when using a reverse side-bevel histology needle for EUS-guided fine-needle biopsy.

Background And Study Aims: Recently, ProCore™ was developed as an endoscopy ultrasound (EUS)-guided histology needle designed to address several current limitations of EUS-guided fine-needle aspiration (FNA). Nevertheless, tissue yield with the ProCore™ is not consistent. No standard technique has been established.

Clinical effects of eosinophilic esophagitis observed using endoscopic ultrasound.

A 50-year-old woman was referred to our hospital for dysphagia and several episodes of esophageal food impaction during the prior three months. Complete blood count and basic biochemical tests were normal. No eosinophilia was found.

Development of Pancreatic Cancer, Disease-specific Mortality, and All-Cause Mortality in Patients with Nonresected IPMNs: A Long-term Cohort Study.

Purpose: To determine the cumulative incidence, disease-specific mortality, and all-cause mortality of pancreatic cancer (PC) in patients with intraductal papillary mucinous neoplasms (IPMNs) and to identify imaging findings that are associated with these outcomes.

Materials And Methods: This retrospective study had institutional review board approval, and the need to obtain patient consent was waived. Data from an electronic database were analyzed and supplemented by chart reviews for 285 patients with nonresected IPMNs who were periodically followed up with imaging (1273 multidetector computed tomography and 750 magnetic resonance cholangiopancreatography examinations).

Usefulness of endoscopic ultrasound-guided fine-needle aspiration with a forward-viewing and curved linear-array echoendoscope for small gastrointestinal subepithelial lesions.

Background And Study Aims: It is difficult to perform endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of small gastrointestinal (GI) subepithelial lesions (SELs) approximately 10 mm in diameter. This study was undertaken to evaluate the feasibility, safety, and diagnostic ability of EUS-FNA with a forward-viewing and curved linear-array echoendoscope (FVCLA-ES) that has a cap for small SELs.

Patients And Methods: The study enrolled 8 patients who had small upper GI SELs approximately 10 mm in diameter.

Idiopathic granulomatous gastritis diagnosed with endoscopic ultrasound-guided fine-needle aspiration: report of a case.

A 71-year-old man in whom a gastric submucosal lesion was found incidentally was referred to our hospital for detailed examination. Esophagastroduodenoscopy showed a submucosal lesion in the body of the stomach. Endoscopic ultrasound revealed a 15-mm hypoechoic round mass with calcifications arising from the muscular layer.

Abdominal visceral fat accumulation measured by computed tomography associated with an increased risk of gallstone disease.

Background And Aim: Visceral adiposity is a strong determinant of insulin resistance, which decreases cholecystokinin response sensitivity, and increases cholesterol saturation in the gallbladder bile; thus, it potentially relates to gallstone disease development. We aimed to investigate whether visceral fat measured by computed tomography (CT) is a risk factor for gallstone disease.

Methods: A cohort of 717 participants undergoing CT and ultrasonography was analyzed.

Predictive findings for Helicobacter pylori-uninfected, -infected and -eradicated gastric mucosa: validation study.

Aim: To validate the usefulness of screening endoscopy findings for predicting Helicobacter pylori (H. pylori) infection status.

Methods: H.