Use of rapid reading software to reduce capsule endoscopy reading times while maintaining accuracy.

Backgrounds And Aims: A typical capsule endoscopy (CE) case generates tens of thousands of images, with abnormalities often confined to a just few frames. Omni Mode is a novel EndoCapsule software algorithm (Olympus, Tokyo, Japan) that proposes to intelligently remove duplicate images while maintaining accuracy in lesion detection.

Methods: This prospective multicenter study took place across 9 European centers.

International core curriculum for capsule endoscopy training courses.

Capsule endoscopy (CE) has become a first-line noninvasive tool for visualisation of the small bowel (SB) and is being increasingly used for investigation of the colon. The European Society of Gastrointestinal Endoscopy (ESGE) guidelines have specified requirements for the clinical applications of CE. However, there are no standardized recommendations yet for CE training courses in Europe.

Malignant gastroduodenal obstruction: retrospective comparison of endoscopic and surgical palliative therapy.

Introduction: Endoscopic stenting (ES) is a minimally invasive alternative to surgical gastroenterostomy (GE) for palliation of malignant gastroduodenal obstructions. This consecutive, retrospective analysis compares the clinical outcome of all patients undergoing ES or GE in the same period.

Methods: ES was performed at the Endoscopy Department, University Hospital Mannheim or at the Interdisciplinary Endoscopy Department, University Hospital Hamburg-Eppendorf.

Combined alpha-methylacyl coenzyme A racemase/p53 analysis to identify dysplasia in inflammatory bowel disease.

Identification of dysplasia in inflammatory bowel disease represents a major challenge for both clinicians and pathologists. Clear diagnosis of dysplasia in inflammatory bowel disease is sometimes not possible with biopsies remaining "indefinite for dysplasia." Recent studies have identified molecular alterations in colitis-associated cancers, including increased protein levels of alpha-methylacyl coenzyme A racemase, p53, p16 and bcl-2.

A standardized injection technique and regimen ensures success and safety of N-butyl-2-cyanoacrylate injection for the treatment of gastric fundal varices (with videos).

Background: N-butyl-2-cyanoacrylate has been successfully used for the treatment of bleeding from gastric fundal varices (FV). However, significant rebleeding rates and serious complications including embolism have been reported.

Objective: Our purpose was to analyze the safety and efficacy of N-butyl-2-cyanoacrylate for FV bleeding by using a standardized injection technique and regimen.

Chromoendoscopy and narrow-band imaging compared with high-resolution magnification endoscopy in Barrett's esophagus.

Background & Aims: The aim of this study was to compare magnified still images obtained with high-resolution white light endoscopy, indigo carmine chromoendoscopy, acetic acid chromoendoscopy, and narrow-band imaging to determine the best technique for use in Barrett's esophagus.

Methods: We obtained magnified images from 22 areas with the 4 aforementioned techniques. Seven endoscopists with no specific expertise in Barrett's esophagus or advanced imaging techniques and 5 international experts in this field evaluated these 22 areas for overall image quality, mucosal image quality, and vascular image quality.

Evaluation of a resistance-based model for the quantification of pulmonary arterial hypertension using MR flow measurements.

Purpose: To establish an estimate for the mean pulmonary arterial pressure (mPAP) derived from noninvasive data acquired with magnetic resonance (MR) velocity-encoded sequences.

Materials And Methods: In seven sedated pigs synchronous catheter-based invasive pressure measurements (IPM) and noninvasive MR were acquired in the main pulmonary artery (MPA) at different severities of pulmonary arterial hypertension (PAH) that were caused by infusion of thromboxane A2 (TxA2). The invasively measured mPAP was correlated with the noninvasive MR velocity data and linear combination equations (LCE) were computed.

Biliary stent clogging solved by nanotechnology? In vitro study of inorganic-organic sol-gel coatings for teflon stents.

Background & Aims: The major drawback of plastic stents for biliary drainage is the occlusion by sludge. Sludge is accrued because the stent surface allows for the adherence of proteins, glycoproteins, or bacteria and the bile flow is insufficient to clean the surface. In this study, experience from nanotechnology to achieve a clean surface by improved soil-release characteristics is used to optimize biliary stent surface.

One-step, simultaneous double-wire technique facilitates pancreatic pseudocyst and abscess drainage (with videos).

Background: EUS-guided pancreatic pseudocyst and abscess drainage ideally requires the insertion of both a transmural stent and nasocystic catheter to ensure continuous irrigation and effective drainage. Sequential stent and nasocystic catheter insertion may be time consuming because of the difficulty in recannulating the pseudocyst after the initial stent placement.

Objective: Our purpose was to describe a novel one-step simultaneous double-wire technique that facilitates effective pancreatic pseudocyst and abscess drainage.

Use of modified multiband ligator facilitates circumferential EMR in Barrett's esophagus (with video).

Background: Various techniques are available for EMR in the upper- and lower-GI tract. For early cancers of the esophagus, the "suck and cut" technique, which uses a transparent cap or variceal band ligator, is the most commonly practiced method. To facilitate multiple or circumferential EMR, a modified multiband variceal ligator (MBL) is introduced, which allows sequential banding and snare resection without the need to withdraw the endoscope.

Endoscopic resection of benign tumors of the duodenal papilla without and with intraductal growth.

Background: Endoscopic papillectomy of benign papillary tumor is still not widely practiced. Intraductal growth has been considered a contraindication for endoscopic therapy. This prospective study evaluates endoscopic papillectomy for treatment of benign papillary tumors without and with intraductal growth.

Capsule endoscopy versus standard tests in influencing management of obscure digestive bleeding: results from a German multicenter trial.

Background: Capsule endoscopy (CE) is a new modality for obscure digestive bleeding (OBD), but little is known about its influence on management and outcome.

Patients And Methods: Fifty-six patients (male/female 26/30; mean age 63 yr) with ODB, and negative upper and lower gastrointestinal (GI) endoscopy were included in this multicenter study. The diagnostic yield of CE was compared to three other tests (OT: push enteroscopy, enteroclysis, angiography), and patients were followed up for at least 6 months.

Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos).

Background: Pancreatic necrosis and pancreatic abscess are severe complications of acute pancreatitis. Surgery is associated with significant morbidity and mortality in these critically ill patients. Endoscopic therapy has the potential to offer a safer and more effective alternative treatment modality.

Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate.

Background: The treatment of pancreatic fistula can be difficult. A novel endoscopic approach to sealing pancreatic fistulas by using N-butyl-2-cyanoacrylate is described.

Methods: Twelve patients with pancreatic fistulas underwent endoscopic injection of N-butyl-2-cyanoacrylate into the fistulous tract, in addition to endoscopic drainage.

Endoscopy: current state and future trends in tumor diagnosis.

Gastrointestinal endoscopy has been significantly improved during the last decade. Tumors of less than 5 mm in diameter can now be detected by using high-resolution videoendoscopes. Additional in vivo staining allows better delineation and more precise identification of the lateral spreading of lesions.

Circumferential EMR and complete removal of Barrett's epithelium: a new approach to management of Barrett's esophagus containing high-grade intraepithelial neoplasia and intramucosal carcinoma.

Background: There is no study of circumferential EMR in patients with Barrett's esophagus containing early stage malignant lesions. This study investigated the effectiveness and safety of circumferential EMR by using a simple snare technique without cap.

Method: Patients with Barrett's esophagus containing multifocal high-grade intraepithelial neoplasia or intramucosal cancer, and patients with endoscopically nonidentifiable early stage malignant mucosal changes incidentally detected in random biopsy specimens were included in the study.

Advances in interventional gastrointestinal endoscopy in colon and rectum.

Background: Instrumental and procedural advances particularly in the therapeutic field have been achieved.

Review: Endoscopes with larger working channel, additional jet-channel, or variable stiffness allow more sophisticated interventional procedures. Higher resolution in endoscopic image quality helps to identify early lesions that can be treated endoscopically at this stage.

Endoscopic treatment of biliary leakage with n-butyl-2 cyanoacrylate.

Background: Biliary leakage is a problematic complication of hepatobiliary surgery. A novel alternative method is described that can obviate the need for reoperation for refractory biliary fistula.

Methods: Nine patients with large biliary leaks unresponsive to endoscopic drainage underwent N-butyl-2-cyanoacrylate glue occlusion at ERCP.

A new radial mechanical puncture echoendoscope: prospective comparison with standard linear and radial echoendoscopes in assessment of focal pancreatic lesions.

Background: A new mechanical puncture-echoendoscope was evaluated by comparing it with conventional linear and radial echoendoscopes. The new instrument has a 300 degrees image field parallel to the axis of the echoendoscope, which could potentially improve accuracy and facilitate assessment of suspected pancreatic lesions before needle puncture.

Methods: Twenty consecutive patients with suspected pancreatic lesions were evaluated endosonographically, including fine needle aspiration (FNA).