A prospective comparative trial to determine the optimal number of EUS-guided fineneedle passes for successful organoid creation in pancreatic ductal adenocarcinoma.

Introduction: EUS-guided fine-needle organoid creation (EUS-FNO) from pancreatic cancer (PC) has been increasingly important for precision medicine. The cost for pancreatic organoid creation is substantial and close to 2000 USD/specimen in our institution, and the specimen has to be processed immediately after tissue acquisition so the more passes and specimens, the higher cost of organoid creation will incur. To date, no prospective comparison trial has answered how many needle passes of EUS-FNO needed for a successful organoid creation.

Ergonomic wedge pillow to reduce neck pain after prone ERCP; a randomized, controlled study.

Background: Prone positioning during endoscopic retrograde cholangiopancreatography (ERCP) can lead to post-procedure neck pain due to increased cervical spine stress and prolonged muscle stretching. This study aimed to evaluate the efficacy and satisfaction of an ergonomic wedge pillow for patients undergoing prone ERCP.

Methods: Patients indicated for ERCP were randomized 1:1 to a study group (with the pillow) or a control group.

Contamination of Disposable Distal Cap Duodenoscopes and Detachable Elevator Duodenoscopes After Reprocessing: A Randomized Trial.

Background And Aim: To reduce bacterial contamination after reprocessing, various new designs of duodenoscopes have been developed to better expose the elevator complex for cleaning. We compared the rates of bacterial contamination and organic residue in disposable distal cap duodenoscopes and detachable elevator duodenoscopes after manual cleaning and high-level disinfection (HLD), as well as their cost-effectiveness.

Methods: A total of 162 duodenoscopes were randomly assigned to either Group A (disposable distal caps; n = 81) or Group B (detachable elevator; n = 81).

Endoscopic Gallbladder Stenting to Prevent Recurrent Cholecystitis in Deferred Cholecystectomy: A Randomized Trial.

Background & Aims: Endoscopic transpapillary gallbladder stenting (ETGS) has been proposed as one of the adjunctive treatments, apart from antibiotics, before surgery in patients with acute cholecystitis whose cholecystectomy could not be performed or was deferred. Currently, there are no comparative data on the outcomes of ETGS in those who receive and do not receive ETGS. We aimed to compare the rates of recurrent cholecystitis at 3 and 6 months in these 2 groups.

Lumen-apposing metal stents for the treatment of pancreatic and peripancreatic fluid collections and bleeding risk: a propensity matched study.

Introduction:  Endoscopic ultrasound (EUS)-guided drainage of symptomatic pancreatic fluid collections (PFCs) using the Hot-Axios device has recently been associated with a significant risk of bleeding. This adverse event (AE) seems to occur less frequently with the use of a different device, the Spaxus stent. The aim of the current study was to compare the rates of bleeding between the two stents.

US-guided adiofrequency blation plus chemotherapy chemotherapy alone for ancreatic cancer (ERAP): An observational open-label pilot study.

Background: No study has compared EUS-guided radiofrequency ablation (EUS-RFA) plus systemic chemotherapy (CMT) with CMT alone for unresectable pancreatic ductal adenocarcinoma.

Methods: This study compared the results of treatment in patients receiving EUS-RFA plus concomitant CMT (group A; = 14) with those receiving CMT (group B; = 14) as a pilot study.

Results: From July 2017 to August 2018, 4 and 2 patients from groups A and B, respectively, withdrew from the study because of progression of the disease.

Efficacy of multi-hole self-expandable metal stent compared to fully covered and uncovered self-expandable metal stents in patients with unresectable malignant distal biliary obstruction: a propensity analysis.

Background And Aims: Self-expandable metal stent (SEMS) insertion is the standard palliative treatment for unresectable malignant extrahepatic biliary obstruction (MBO). Drawbacks of conventional fully covered SEMS (FCSEMS) and uncovered SEMS (USEMS) include stent migration and tumor ingrowth, respectively. This study aimed to compare stent patency in MBO with the newly design multi-hole SEMS (MHSEMS), which has multiple small side holes in the stent membrane, with conventional FCSEMS and UCSEMS.

Curcumin and proton pump inhibitors for functional dyspepsia: a randomised, double blind controlled trial.

Objective: To compare the efficacy of curcumin versus omeprazole in improving patient reported outcomes in people with dyspepsia.

Design: Randomised, double blind controlled trial, with central randomisation.

Setting: Thai traditional medicine hospital, district hospital, and university hospitals in Thailand.

EUS-Guided Choledocho-duodenostomy Using Lumen Apposing Stent Versus ERCP With Covered Metallic Stents in Patients With Unresectable Malignant Distal Biliary Obstruction: A Multicenter Randomized Controlled Trial (DRA-MBO Trial).

Background & Aims: Several studies have compared primary endoscopic ultrasound (EUS)-guided biliary drainage to endoscopic retrograde cholangiopancreatography (ERCP) with insertion of metal stents in unresectable malignant distal biliary obstruction (MDBO) and the results were conflicting. The aim of the current study was to compare the outcomes of the procedures in a large-scale study.

Methods: This was a multicenter international randomized controlled study.

Morphology of the major duodenal papilla for the selection of advanced cannulation techniques in difficult biliary cannulation.

Background: Morphology of the major duodenal papilla (MDP) influences the outcome of standard biliary cannulation. However, those data on advanced cannulation techniques are scarce. We aimed to study the impact of MDP morphology on the outcome of both standard and advanced cannulation methods.

Deep-Learning-Enabled Computer-Aided Diagnosis in the Classification of Pancreatic Cystic Lesions on Confocal Laser Endomicroscopy.

Accurate classification of pancreatic cystic lesions (PCLs) is important to facilitate proper treatment and to improve patient outcomes. We utilized the convolutional neural network (CNN) of VGG19 to develop a computer-aided diagnosis (CAD) system in the classification of subtypes of PCLs in endoscopic ultrasound-guided needle-based confocal laser endomicroscopy (nCLE). From a retrospectively collected 22,424 nCLE video frames (50 videos) as the training/validation set and 11,047 nCLE video frames (18 videos) as the test set, we developed and compared the diagnostic performance of three CNNs with distinct methods of designating the region of interest.

Three-year evaluation of a novel, nonfluoroscopic, all-artificial model for EUS-guided biliary drainage training for the impact to practice: A prospective observational study (with videos).

Background And Objectives: EUS-guided biliary drainage (EUS-BD) required a dedicated training. We developed and evaluated a nonfluoroscopic, all-artificial training model known as Thai Association for Gastrointestinal Endoscopy Model 2 (TAGE-2) for the training of EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided choledochoduodenostomy (EUS-CDS). We hypothesize that trainers and trainees would appreciate the ease of the nonfluoroscopy model and increase their confidence to start their real procedures in humans.

Drainage of Complex Walled-Off Pancreatic Fluid Collections in LAMS Era: A Multicenter Study.

Background: The lumen-apposing metal stent (LAMS) has been increasingly used for EUS-guided drainage of symptomatic walled-off pancreatic fluid collection (WOPFC) in recent years. Nevertheless, some WOPFCs may require additional drainage methods including another LAMS as a result of complexity of the lesions. This current study aimed to compare clinical parameters of patients with complex WOPFC requiring LAMS with additional methods (complex WOPFC: group A) versus single LAMS alone (noncomplex WOPFC; group B).

Intermediate- to long-term outcomes of endoscopic transpapillary gallbladder stenting in patients with gallstone-related disease: a 10-year single-center experience.

Background: Endoscopic transpapillary gallbladder stenting (ETGS) can be a bridging therapy to elective cholecystectomy or a permanent gallbladder drainage method in patients with symptomatic gallbladder disease who are awaiting cholecystectomy or are unfit for surgery, respectively. We evaluated the intermediate- to long-term outcomes of ETGS in these groups.

Methods: We retrospectively reviewed 234 patients (acute cholecystitis = 147), who were unfit for surgery (n = 50) or had deferred cholecystectomy (n = 184) and who underwent ETGS between 2012 and 2021.

Bacterial contamination and organic residue after reprocessing in duodenoscopes with disposable distal caps compared with duodenoscopes with fixed distal caps: a randomized trial.

Background And Aims: Newly designed duodenoscopes with disposable distal caps have been developed for better cleaning and preprocessing to reduce the risk of bacterial contamination (BC). We compared BC and organic residue of duodenoscopes with disposable distal caps and duodenoscopes with fixed distal caps after manual cleaning and high-level disinfection (HLD).

Methods: Four hundred duodenoscopes were randomized into group A (fixed distal caps, n = 200) and group B (disposable distal caps, n = 200).

Evaluation of the porcine simulator on EUS-guided cystogastrostomy using lumen-apposing metal stent training.

Bckground And Objectives: EUS-guided cystogastrostomy is a well-established advanced endoscopic technique with a steep-learning curve which necessitates an ex-vivo simulator that would allow for adequate training. The aim of this study is to evaluate the feasibility of the model in allowing training for EUS-guided cystogastrostomy using lumen-apposing metal stent (LAMS).

Subjects And Methods: The model was created by ROEYA Training Center, Egypt, using native porcine tissue to create fluid collections simulating both cystic and solid lesions.