Prophylaxis of post-ERCP pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - updated June 2014.

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the prophylaxis of post-endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis. Main recommendations 1 ESGE recommends routine rectal administration of 100 mg of diclofenac or indomethacin immediately before or after ERCP in all patients without contraindication.

Endoscopy in the early postoperative setting after primary gastrointestinal anastomosis.

Introduction: Gastrointestinal anastomoses may require early evaluation and treatment via flexible endoscopic techniques when complications arise. There is reticence, however, to perform endoscopy given the applied mechanical forces. We aimed to identify the incidence of gastrointestinal anastomotic perforation or disruption resulting from endoscopy performed ≤6 weeks of anastomoses.

Endoscopic band ligation for closure of GI perforations in a porcine animal model (with video).

Background: GI perforations occur rarely during endoscopy but have life-threatening implications.

Objective: To evaluate endoscopic band ligation (EBL) for closure of acute GI perforations by using a porcine model.

Design: Investigator-initiated interventional pilot study by using an in vivo porcine model.

Resolution of walled-off pancreatic necrosis by EUS-guided drainage when using a fully covered through-the-scope self-expandable metal stent in a single procedure (with video).

Background: Walled-off pancreatic necrosis (WOPN) is effectively managed with percutaneous and endoscopic techniques such as direct endoscopic necrosectomy. However, they require repeat interventions and lengthy hospital stays.

Objective: To evaluate a new platform to manage WOPNs by using a large-bore, through-the-scope, fully covered, self-expandable metal stent (FCSEMS) to overcome the need for repeat interventions and extended hospital stays.

The use of rapid indicators for the detection of organic residues on clinically used gastrointestinal endoscopes with and without visually apparent debris.

Background: Outbreaks of multidrug-resistant organisms have been linked to endoscope reprocessing lapses. Meticulous manual cleaning before high-level disinfection (HLD) is essential in reducing residual contamination that can interfere with HLD. Current reprocessing guidelines state that visual inspection is sufficient to confirm adequate cleaning.

Best endoscopic stents for the biliary tree and pancreas.

Purpose Of Review: To determine trends in pancreaticobiliary stents over the past 12-18 months.

Recent Findings: Metal biliary stents continue to be used for palliation of malignant distal biliary obstruction with superior patency to plastic stents. The use of covered metal biliary stents is increasingly being used for the management of benign biliary disease.

Adenomas of the ampulla of Vater: a comparison of outcomes of operative and endoscopic resections.

Background: Data comparing operative and endoscopic resection of adenomas of the ampulla of Vater are limited. Our aims were to evaluate and compare the long-term results and outcomes of endoscopic and operative resections of benign tumors of the ampulla of Vater as well as to determine which features of benign periampullary neoplasms would predict recurrence or failure of endoscopic therapy and therefore need for operative treatment.

Methods: Retrospective review of all patients treated for adenomas of ampulla of Vater at our institution from 1994 to 2009.

The role of endoscopic stents in the management of chronic anastomotic and staple line leaks and chronic strictures after bariatric surgery.

Background: The use of endoluminal stents has been proposed for the management of fistulas and anastomotic strictures after bariatric surgery. The objective of our study was to determine the success of endoscopically placed, self-expandable metal stents (SEMS) in bariatric patients specifically with either chronic persistent anastomotic or staple line leaks/fistulas or chronic, persistent anastomotic strictures.

Methods: We treated 21 patients including 5 with chronic staple line leaks/fistulas (4 from the gastric sleeve after biliopancreatic diversion with duodenal switch [BPD/DS] and 1 after removal of an eroding laparoscopic adjustable gastric band) and 16 with chronic anastomotic strictures (15 at the gastrojejunostomy after Roux-en-Y gastric bypass and 1 at the duodenoileal anastomosis after BPD/DS).

Endoscopic management of biliary disorders: diagnostic and therapeutic.

The use of peroral endoscopy in the diagnosis of and therapy for biliary disorders has evolved immensely since the introduction of flexible fiberoptic endoscopes more than 50 years ago. Endoscopic retrograde cholangiopancreatography was introduced approximately a decade after flexible upper endoscopy and has evolved from a purely diagnostic procedure to almost exclusively a therapeutic procedure for managing biliary tract disorders. Endoscopic ultrasound, which continues to be a procedure of high diagnostic yield, is becoming a therapeutic modality for management of biliary diseases.

Perforation in colorectal stenting: a meta-analysis and a search for risk factors.

Background: Recent studies suggest that there is a substantial risk of perforation after colorectal stent placement.

Objective: To identify risk factors for perforation from colonic stenting.

Design: A meta-analysis of 86 studies published between 2005 and 2011.