Impact and outcomes of research sponsored by the American Society for Gastrointestinal Endoscopy.

Background And Aims: Since 1985, the American Society for Gastrointestinal Endoscopy (ASGE) has awarded grants for endoscopic-related research. The goals of this study were to examine trends in ASGE grant funding and to assess productivity of previous recipients of the ASGE grant awards.

Methods: This was a retrospective cohort analysis of all research grants awarded by the ASGE through 2009.

The risk of post-ERCP pancreatitis and the protective effect of rectal indomethacin in cases of attempted but unsuccessful prophylactic pancreatic stent placement.

Background: It is believed, based on limited observational data, that an unsuccessful attempt to place a prophylactic pancreatic stent substantially increases the risk of post-ERCP pancreatitis (PEP).

Objective: To better understand the risk of PEP in patients with failed pancreatic stent placement (FPS) and the impact of rectal indomethacin on this risk.

Design: Secondary analysis of randomized, controlled trial data.

[Scores and stages in gastroenterology].

Staging and grading are indispensable in clinical gastroenterology in order to determine disease activity or therapeutic outcomes in a systematic and reproducible way. Adequate diagnosis, patient care and appropriate therapy will often depend on accurate staging and grading. Some of the most commonly encountered diseases in clinical gastroenterology and gastrointestinal endoscopy are gastroesophageal reflux disease, peptic ulcer disease, gastrointestinal vascular disorders such as hemorrhoids and esophageal varices as well as inflammatory bowel diseases.

Does rectal indomethacin eliminate the need for prophylactic pancreatic stent placement in patients undergoing high-risk ERCP? Post hoc efficacy and cost-benefit analyses using prospective clinical trial data.

Objectives: A recent large-scale randomized controlled trial (RCT) demonstrated that rectal indomethacin administration is effective in addition to pancreatic stent placement (PSP) for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in high-risk cases. We performed a post hoc analysis of this RCT to explore whether rectal indomethacin can replace PSP in the prevention of PEP and to estimate the potential cost savings of such an approach.

Methods: We retrospectively classified RCT subjects into four prevention groups: (1) no prophylaxis, (2) PSP alone, (3) rectal indomethacin alone, and (4) the combination of PSP and indomethacin.

Effect of endoscopic stenting of malignant bile duct obstruction on quality of life.

Background And Goals: Endoscopic stent insertion is considered the method of choice for palliation of malignant bile duct obstruction (MBDO). However, it can cause complications and requires periodic stent exchanges. Although endoscopic stenting is clearly indicated for relief of cholangitis or refractory pruritus, its role in patients with jaundice alone is less clear.

A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis.

Background: Preliminary research suggests that rectally administered nonsteroidal antiinflammatory drugs may reduce the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).

Methods: In this multicenter, randomized, placebo-controlled, double-blind clinical trial, we assigned patients at elevated risk for post-ERCP pancreatitis to receive a single dose of rectal indomethacin or placebo immediately after ERCP. Patients were determined to be at high risk on the basis of validated patient- and procedure-related risk factors.

Accuracy of magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum.

Background: Patients with pancreas divisum may develop pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for diagnosing pancreas divisum. Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive test reported to be highly accurate in diagnosing pancreas divisum.

Diagnosis and management of acute cholangitis.

Acute cholangitis is a potentially life-threatening systemic disease resulting from a combination of infection and obstruction of the biliary tree, secondary to different underlying etiologies. Common causes of cholangitis (eg, gallstones, benign and malignant biliary strictures) are well known. However, others (eg, immunoglobulin-G subclass-4-related sclerosing cholangitis) have been described only recently, are still under evaluation, and need to gain broader attention from clinicians.

Evaluation of supplemental cautery during endoluminal gastroplication for the treatment of gastroesophageal reflux disease.

Background: Endoscopic suture plications at the cardia decreased gastroesophageal reflux disease (GERD) symptoms in short-term studies. Pull-through of submucosal sutures may lead to loss of efficacy. The application of cautery on mucosal surfaces may promote tissue adherence.

Predicting pancreas divisum by inspection of the minor papilla: a prospective study.

Background: Minor papilla (MP) cannulation remains difficult in some patients despite improved cannulation devices and techniques. Therefore, noninvasive methods to predict presence of pancreas divisum (Pdiv) are desired. If Pdiv could be recognized before any cannulation is attempted, appropriate attention could be focused on MP cannulation and prolonged major papilla attempt at pancreatogram can be avoided.

Oral allopurinol does not prevent the frequency or the severity of post-ERCP pancreatitis.

Background: Pancreatitis is the most common major complication of ERCP. Efforts have been made to identify pharmacologic agents capable of reducing its incidence and severity. The aim of this trial was to determine whether prophylactic allopurinol, an inhibitor of oxygen-derived free radical production, would reduce the frequency and severity of post-ERCP pancreatitis.

Palliation of gastric outlet obstruction and proximal small bowel obstruction with self-expandable metal stents: a single center series.

Background: Self-expandable metal stents (SEMS) are being increasingly used to palliate malignant stenoses of the gastric outlet and proximal small bowel. Accordingly, we reviewed our experience in this setting.

Methods: Patients with gastric outlet or proximal small bowel stents were identified by reviewing hospital charts.