Usefulness of endoscopic ultrasound for perianal fistula in Crohn's disease.

Objective: to determine the role of endoscopic ultrasonography (EU) in comparison with nuclear magnetic resonance imaging (MRI) and examination under anesthesia (EUA) in the management of patients with perianal fistulizing Crohn's disease.

Methods: we conducted a cross-sectional, observational study with patients with perianal Crohn's disease evaluated at a tertiary center in Curitiba, Paraná, Brazil, from February 2016 to March 2017. All patients underwent EU, MRI and EUA.

Detection of peritoneal carcinomatosis by EUS fine-needle aspiration: impact on staging and resectability (with videos).

Background: Peritoneal carcinomatosis (PC) greatly affects cancer staging and resectability.

Objective: To compare the PC detection rate by using EUS and noninvasive imaging and to determine the impact on staging and resectability.

Design: Retrospective study.

Survival among pancreaticoduodenectomy patients treated for pancreatic head cancer <1 or 2 cm.

Background: Size of primary tumor has implications for staging, imaging, and treatment of pancreatic head carcinomas. Limited data suggest that small tumor size is associated with better survival. The objective of this population study is to analyze characteristics and survival of patients with resected pancreatic head ductal carcinomas sized <1 and 2 cm.

Success and complications associated with placement of fully covered removable self-expandable metal stents for benign esophageal diseases (with videos).

Background: Fully covered esophageal self-expandable metal stents (FCSEMSs) are thought to induce less mucosal hyperplasia and are potentially removable. They may constitute an attractive alternative for the treatment of benign esophageal diseases.

Objective: To evaluate the efficacy and safety of FCSEMSs in the treatment of benign esophageal diseases.

Endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anatomy.

Introduction: Roux-en-Y gastric bypass is increasingly performed in the United States. In addition, liver transplantation and other complex hepatobiliary surgeries are increasingly performed with creation of a Roux-en-Y hepaticojejunostomy. Consequently, endoscopists more frequently need to carry out endoscopic procedures in patients with Roux-en-Y anatomy.

Endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anatomy.

Bariatric surgery has been increasingly performed in response to the obesity pandemic. During the last decade, Roux-en-Y gastric bypass (RYGB) has become the preferred surgical approach. It is also commonly performed after pylorus preserving pancreaticoduodenectomy and other biliary tract surgeries.

Nitinol biliary stent versus surgery for palliation of distal malignant biliary obstruction.

Background: Curative resection of pancreatic and biliary malignancies is rare. Most tumors are inoperable at presentation, and palliation of jaundice often is the goal. Biliary decompression can be achieved by surgical diversion or endoscopic biliary stents.

Laparoscopy-assisted ERCP: experience of a high-volume bariatric surgery center (with video).

Background: Laparoscopy-assisted ERCP (LAERCP) allows the diagnosis and treatment of biliopancreatic conditions in patients with Roux-en-Y anatomy (RY). However, experience with this technique is limited.

Objectives: To report on the experience with LAERCP in consecutive patients from a high-volume bariatric surgery center and to evaluate success rates of ERCP with the laparoscopy-assisted approach.

Laparoscopy-assisted transjejunal ERCP in a patient with Roux-en-Y reconstruction following partial gastrectomy.

In this article, we report a patient with a history of partial gastrectomy and Roux-en-Y reconstruction who presented with abdominal pain due to sphincter of Oddi dysfunction. After failed endoscopic retrograde cholangiopancreatography (ERCP) through the anatomic route, the procedure was successfully performed with laparoscopy assistance through an enterotomy into the biliopancreatic limb. An internal hernia was diagnosed incidentally and treated appropriately.

A randomized trial comparing endoscopic stenting to a sham procedure for chronic pancreatitis.

Background: A number of studies support the use of endoscopically placed pancreatic duct (PD) stents to decrease pain in chronic pancreatitis (CP). Nevertheless, flaws in study design have prevented experts from reaching a consensus.

Purpose: (1) Evaluate the efficacy of PD stenting to ameliorate abdominal pain in patients with CP and ductal strictures; (2) evaluate the placebo response rate from sham endoscopic therapy; (3) compare pain medication usage, healthcare utilization, psychological distress, and quality of life before and after endoscopic stenting; (4) prospectively evaluate the durability of the response.

Novel removable internally fully covered self-expanding metal esophageal stent: feasibility, technique of removal, and tissue response in humans.

Objectives: Internally fully covered self-expandable metal stents (FCSEMSs) have recently become available offering the possibility of removal. However, to our knowledge, the feasibility, techniques for endoscopic removal, and tissue reaction to FCSEMS have not been reported in humans. Our aims are (1) to report reasons for and success of FCSEMS removal in consecutive patients, (2) to describe methods of esophageal stent retrieval, and (3) to describe stent reactions induced by FCSEMS in humans.

Cervical esophageal perforations at the time of endoscopic ultrasound: a prospective evaluation of frequency, outcomes, and patient management.

Objectives: With the exception of one retrospective survey, there are currently no prospectively published data about the frequency of cervical esophageal perforation at the time of endoscopic ultrasound (CEP-EUS). We prospectively investigated the frequency of CEP-EUS and the outcomes and management of patients sustaining CEP-EUS.

Methods: All patients that underwent upper EUS by a single experienced endosonographer over a 7-year period were enrolled.

EUS versus surgical cyst-gastrostomy for management of pancreatic pseudocysts.

Background: Although EUS-guided cyst-gastrostomy is increasingly being performed, there are no studies that compare the clinical outcomes and cost-effectiveness with surgical cyst-gastrostomy.

Objectives: To compare the clinical outcomes of EUS-guided cyst-gastrostomy with surgical cyst-gastrostomy for the management of patients with uncomplicated pancreatic pseudocysts and to perform a cost analysis of each treatment modality.

Design: A retrospective case-controlled study.