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Background And Aims: Factors predicting the need for step-up procedures after EUS-guided drainage (EUS-FCD) of peripancreatic fluid collections (PFCs) were explored in retrospective studies restricted to Walled-Off Necrosis (WON) and Lumen Apposing Metal Stents (LAMS).

Methods: All consecutive candidates for EUS-FCD between 2020-2024 were included in a Prospective Registry of Therapeutic EUS (PROTECT, NCT04813055), with prospective monthly follow-up evaluating clinical success, adverse events and recurrences. Prospectively assessed baseline clinical and morphological factors, including the Quadrant-Necrosis-Infection (QNI) classification, were included in a stepwise logistic regression model to predict the need for step-up.

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Endoscopic Ultrasound-Guided Pancreatic Tissue Sampling: Lesion Assessment, Needles, and Techniques.

Medicina (Kaunas)

December 2024

Department of Medicine, Diagnostic and Interventional Endoscopy of the Pancreas, The Pancreas Institute, University Hospital of Verona, 37134 Verona, Italy.

Endoscopic ultrasound (EUS)-guided tissue sampling includes the techniques of fine needle aspiration (FNA) and fine needle biopsy (FNB), and both procedures have revolutionized specimen collection from the gastrointestinal tract, especially from remote/inaccessible organs. EUS-FNB has replaced FNA as the procedure of choice for tissue acquisition in solid pancreatic lesions (SPLs) across various society guidelines. FNB specimens provide a larger histological tissue core (preserving tissue architecture) with fewer needle passes, and this is extremely relevant in today's era of precision and personalized molecular medicine.

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Esophageal variceal (EV) diameter is a critical, independent risk factor for hemorrhage, and plays a key role in guiding choices of endoscopic treatment techniques. We developed a novel tool, the virtual ruler (VR), which offers increased precision and expediency in EV diameter (EVD) measurements. This study investigates the clinical value of VR for assessing EVD during the endoscopic treatment of cirrhotic EVs.

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Background: Colonoscopy is widely used for screening and treatment of early colonic lesions and is critical for the early diagnosis of colorectal cancer. However, due to its invasive nature, colonoscopy can cause pain and discomfort for patients and is often associated with prolonged insertion times or failed attempts. Difficult colonoscopy is characterised by a caecal insertion time greater than 10 min, multiple insertion attempts or failed insertion, with an incidence rate of approximately 25%.

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Role of macroscopic on-site evaluation of endoscopic ultrasound-guided fine-needle aspiration/biopsy: Results of a multicentric prospective study.

World J Gastrointest Endosc

November 2024

Department of Gastroenterology and Endoscopy Center, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health, Casablanca 82403, Casablanca-Settat, Morocco.

Article Synopsis
  • The study evaluates the effectiveness of macroscopic on-site evaluation (MOSE) during endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) in diagnosing solid lesions, particularly focusing on histological core sample adequacy.
  • Conducted across 16 medical centers in Egypt, Iraq, and Morocco, the study involved over 1000 patients and revealed that a significant majority of biopsied samples were adequate for histological evaluation, demonstrating a high diagnostic yield.
  • Results indicated that FNB needles performed best in terms of sensitivity and sample quality, highlighting the potential of MOSE as a valuable alternative to traditional rapid on-site evaluation methods.
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