Editor’s Choice: RCT on top-down vs. step-up approach after EUS-guided drainage of infected walled-off necrosis
Find the article at https://t.co/U9nQuuUsB8
Sanish Ancil et al.
#Endoscopy#Gastroenterology@ESGE_news
BAMPI @AGA_CGH@AmerGastroAssn : A coaxial double-pigtail inside a biliary LAMS cut recurrent obstruction 30% → 9%. RR 0.31. n=91.
But in a cohort where median survival is around four months, is recurrent biliary obstruction the endpoint that matters most?
BAMPI answered the question it set out to answer, and answered it carefully. But RBO is something we can usually manage at the next endoscopy. The outcomes that are harder to reverse — cholecystitis (1 vs 4, two fatal) and related mortality (2% vs 11%, p=0.10) — are outside the trial's power and remain open.
https://t.co/3YYasWKBi9
#EUS #ERCP #GITwitter #PancreaticCancer
Happy to share our original article publication in @GIE_Journal Gastrointestinal Endoscopy !!!
"The Impact of Confocal Endomicroscopy Combined with Standard Diagnostics in Evaluating Large Pancreatic Cystic Lesions: An International Interobserver Study"
Led by Prof @som_krishna 🙏👍👏
⏭️ 15 EUS-CLE naive endosonographers participated in a 2 phase diagnostic study !!! 🇮🇳🇮🇹🇺🇸
💡Diagnostic accuracy before and after nCLE review was compared using histopathology as the gold standard
✅ 66 cases
✅ Accuracy increased - distinguishing mucinous vs non-mucinous cysts (90 to 96%)
✅ similar results for sub-type specific cysts as well.
✅ nCLE significantly reduced misclassification, lowering mean unnecessary benign resections from 7.2 to 4.1 (p=0.010) and missed neoplastic diagnoses from 4.4 to 0.7 (p=0.001) per observer, enhancing clinical decision-making
Thank you to all co-authors : @Samanta_JayPGI@CrinoStefano@ShubhraMishra91@drnaveenm@DachaSunil@Anand_KumarMD@SumantInamdar and others not on X !!! 😍
Have a nice read ☕️🔗
https://t.co/JN9sEjis98
#EUS #CLE #pancreaticcysts
Posting on X again after a hiatus of 1.5 years !!! 😍🙏🙏
Happy to share our Original article accepted in GIE (Gastrointestinal Endoscopy) @GIE_Journal 🥰
"Endoscopic ultrasound–guided coil and glue embolization of gastric varices targeting feeder vessel versus submucosal variceal component: a pragmatic comparative analysis (with videos)"
135 GV analysed using EUS-coil+glue combination (EUS-F = 32; EUS-SVC =103)
▶️Primary outcome: Reintervention rates at 6 months
EUS-F approach resulted in:
✅ lower requirement of coils and glue at index presentation and 6 months
✅ lower reintervention rates (3.1% vs 17.5%; P = .04)
✅ lower EUS sessions for complete obliteration (p=0.02)
⏩ For EUS-guided angioembolization of GV, targeting the feeder vessel, when feasible and discernible, over SVC (conventional method) results in significantly lower requirements of coil and glue, with significantly lower reintervention rates, which might translate to a more cost-effective strategy.
Thankyou to my co-authors: @Samanta_JayPGI@CrinoStefano and others not on X!!!
Have a nice read 📜🔗☕️ with link below
https://t.co/aExeYiv23W
Enjoy the free access link too 🙃
https://t.co/zWBtUwoPym
#EUS #gastricvarices @DouglasAdlerMD #PGIMER @pgichd
The biggest unresolved question in #pancreatology: After #EUS drainage of infected #WON — who needs necrosectomy, when should it happen, and how aggressive should you be? Three new papers address each part of that question. #GITwitter#Pancreas#Endoscopy
An 8 cm stent may not remain 8 cm after deployment!
A crucial concept in stent selection: Foreshortening
Most commonly used SEMS are braided (e.g. WallFlex).
As they expand, they shorten in length—sometimes by as much as 40%.
In contrast, laser-cut stents are fashioned from a single metal tube and exhibit minimal foreshortening.
The tradeoff? Greater axial force and often more patient discomfort.
Paciente que debutó con esta lesión en cola de páncreas. En la EUS se aprecia su componente sólido. Nótese la cercanía con la glándula suprarrenal izquierda.
The biliary "variant" framework undersells how individualized biliary anatomy actually is. Unlike vertebral count or hepatic arterial trunks, bile ducts develop via stochastic branching morphogenesis. Every cholangiogram is one of a kind.
Thank you for coming to my TED talk.
Si haces EUS-gastroenterostomía en estenosis duodenal infranqueable: ocluye el píloro con balón para distender el asa yeyunal. Facilita colocar el LAMS. Detalle técnico que marca la diferencia.
🔗 https://t.co/mf7Q1fCZuK
#EUS#Gastroenterostomía#TipEndoscopia
Dos casos de coledocolitiasis diagnosticados por ultraaonografía endoscópica , luego de resultado de resonancia negativo y persistencia de sospecha diagnóstica .