Background and Aims Artificial intelligence (AI) is being implemented into colonoscopy practice, but no study has investigated whether AI is cost-saving. We quantified the cost reduction from using AI as an aid in the optical diagnosis of colorectal polyps. Methods This study is an add-on analysis of a clinical trial that investigated the performance of AI for differentiating colorectal polyps (ie

Background and aims Although upper gastrointestinal bleeding (UGIB) is a significant cause of inpatient admissions, no scoring method has proven to be accurate and simple as a standard for triage purposes. Therefore, we compared a previously described 3 variable score (1 point each for: absence of daily proton pump inhibitors use in the week before the index presentation, shock index (heart rate/systolic

Background and Aims Multiband mucosectomy (MBM) is a widely used technique for the treatment of Barrett’s esophagus (BE). However, large multicenter studies enabling a generalizable estimation of the risk of serious adverse events, such as perforation and postprocedural bleeding, are lacking. The aim of this study was to estimate the rate of, and risk factors for, serious adverse events associated

Background and Aims A prior randomized study (Surveillance versus Radiofrequency Ablation study [SURF study]) demonstrated that radiofrequency ablation (RFA) of Barrett's esophagus (BE) with confirmed low-grade dysplasia (LGD) significantly reduces the risk of esophageal adenocarcinoma. Our aim was to report the long-term outcomes of this study. Methods The SURF study randomized BE patients with confirmed

Background and Aims A significant portion of patients regain weight after Roux-en-Y gastric bypass (RYGB). Both ablation with argon plasma coagulation (APC) plus endoscopic full-thickness suturing (FTS-APC) and ablation alone have been reported at treating weight regain when associated with gastrojejunostomy (GJ) dilation. However, comparative controlled data are still lacking. Methods This was a pilot

Background and Aims There are scant data describing the practice of canceling colonoscopies before colonoscope insertion for presumed inadequate bowel preparation (PIBP). We sought to better understand the ramifications of such cancellations and to characterize the nationwide practice of cancellations for PIBP. Methods We determined the frequency of colonoscopies canceled for PIBP at our institution

Background and Aims Endoscopists are at risk of developing musculoskeletal injuries, and few receive training on ergonomics. The aim of this study was to determine the impact of a simulation-based ergonomics training curriculum (ETC) on work-related musculoskeletal injury risk during clinical colonoscopy. Methods Novice endoscopists underwent a simulation-based ETC and were compared with a historical

Italy recorded its first case of confirmed acute respiratory case due to Coronavirus on February 18, 2020, soon after the initial reports in China. Since that time, Italy and nations throughout the world have adopted very stringent and severe measures to protect populations from spread of infection. Despite these measures, the number of infected people is growing exponentially with a significant number

Background and Aims Three or more stents may be needed in patients with extensive stricturing in Bismuth type IIIa/IV hilar malignant strictures. Partial stent-in-stent (PSIS) deployment has been the primary intervention for hilar malignant biliary stricture (MBS). However, simultaneous side-by-side stent placement (SBS) has become feasible with the development of the <6F diameter stent delivery system

Familial adenomatous polyposis (FAP) syndrome is a complex entity, which includes FAP, attenuated FAP, and MUTYH-associated polyposis. These patients are at significant risk for colorectal cancer and carry additional risks for extracolonic malignancies. In this guideline, we reviewed the most recent literature to formulate recommendations on the role of endoscopy in this patient population. Relevant

Background and Aims Advanced age is an important risk factor for adverse events (AEs) during propofol sedation for endoscopic procedures. This study aimed to evaluate the safety and efficacy of nonanesthesiologist-administered propofol (NAAP) sedation with a target-controlled infusion (TCI) system in elderly patients during ERCP. Methods This study retrospectively analyzed 482 patients who underwent

Background and aims Propofol-based sedations are widely used in ERCP procedures, but adverse respiratory or cardiovascular events commonly occur. Intravenous injection of lidocaine has an analgesic effect and can reduce the requirements of fentanyl and propofol during abdominal surgery. The objective of this study was to assess the efficacy and safety of intravenous lidocaine on propofol requirements

Background and Aims Duodenoscope contamination is associated with notable patient morbidity and mortality and can occur despite high-level disinfection protocols, requiring a solution that protects against contamination of the endoscope in the first place. Methods We assess a newly cleared single-use device to seal the distal end of duodenoscopes while preserving optics and other endoscope functionality

Background and Aims In recent years, the feasibility and safety of endoscopic placement of different biodegradable biliary stents has been investigated. New, helicoidally shaped, biliary and pancreatic biodegradable stents have been developed for endoscopic use. Stents are provided in different sizes and with 3 expected speeds of degradation: slow (11 weeks), medium (20 days), and fast (12 days). The

Background and Aims Endoscopic resections (ER) and radiofrequency ablation (RFA) are the established treatments for Barrett’s-associated dysplasia and early esophageal neoplasia. The UK RFA Registry collects patient outcomes from 24 centers in the United Kingdom and Ireland treating patients. Learning curves for treatment of Barrett’s dysplasia and the impact of center caseload on patient outcomes

Background and Aims The management of ampullary adenomas in familial adenomatous polyposis (FAP) is challenging due to multiple adenomas in the duodenum, history of prior major abdominal surgery, and desmoid lesions. In this study, we aim to define the optimum management for ampullary adenomas, particularly in FAP. Methods This is a retrospective study of all patients with a pathology-confirmed ampullary

Background and Aims Endoscopy guidelines recommend adhering to policies such as resect-and-discard only if optical biopsy is accurate. However, accuracy in predicting histology can vary greatly. Computer-aided diagnosis (CAD) for characterization of colorectal lesions may help with this issue. In this study, a CAD software developed at the University of Adelaide (Australia) including serrated polyp

BACKGROUND AND AIMS We perform a meta-analysis of all published studies to determine the diagnostic accuracy of AI on histology prediction and detection of colorectal polyps. METHOD We searched Embase, PubMed, Medline, Web of Science and Cochrane library databases to identify studies using AI for colorectal polyp histology prediction and detection. The quality of the included studies was measured by

BACKGROUND AND AIMS Variceal hemorrhage can be a life-threatening adverse event of chronic liver disease. In contrast to the well described guidelines for the management of portal hypertension (PH) in adults, there is limited evidence about the optimal prophylactic management of variceal bleeding in children. The study was carried out to assess the efficacy of endoscopic variceal ligation (EVL) as

BACKGROUND AND AIMS There is an increasing number of patients undergoing gastrointestinal endoscopic procedures with active prescriptions for direct oral anticoagulants (DOACs). DOACs have been associated with a higher risk of gastrointestinal bleeding (GIB) compared with warfarin. Our aims were to compare the risk of postendoscopic gastrointestinal bleeding (GIB) and thromboembolic (TE) events among

BACKGROUND AND AIMS Roux-en-Y gastric bypass (RYGB) is refractory to lifestyle and pharmacotherapy measures requiring reversal of the patient's bariatric surgery. Reversal can lead to weight re-gain and recrudescence of their comorbidities. Our aim was to report a multicenter experience on the endoscopic management of refractory dumping syndrome with endoscopic transoral outlet revision (TORe). METHODS

BACKGROUND AND AIMS Although conventional endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has previously been considered first-line for sampling subepithelial lesions (SELs), variable accuracy has resulted in increased use of fine-needle biopsy (FNB) to improve diagnostic yield. The primary aim of this study was to compare FNA versus FNB for diagnosis of SEL. METHODS This was a multicenter

BACKGROUND AND AIMS Endoscopic resection is often feasible for submucosal invasive colorectal cancers (T1-CRCs) and usually judged as complete. If histology casts doubt on the radicality of resection margins, adjuvant surgical resection is advised, although, residual intramural cancer (RIC) is found in only 5% to 15% of patients. We assessed sensitivity of biopsies from the resection area for RIC as

BACKGROUND AND AIMS In addition to managing malignant obstruction, esophageal stents (ESs) have evolved to address various benign etiologies of dysphagia. We sought to evaluate national trends and changes in practice of ES placement for both benign and malignant etiologies in hospitalized patients with dysphagia. METHODS The National Inpatient Sample (2003-2013) was used to include all adult inpatients

Background and Aims Although colonoscopy reduces colorectal cancer (CRC) risk, interval CRCs (iCRCs) still occur. We aimed to determine iCRC incidence, assess the relationship between adenoma detection rates (ADRs) and iCRC rates, and evaluate iCRC rates over time concomitant with initiation of an institutional colonoscopy QI program. Methods We performed a retrospective cohort study of patients who

BACKGROUND AND AIMS Several ligation techniques for ulceration after endoscopic submucosal dissection (ESD) have been reported but none have been established for clinical use because of technical complexity and requirement for expensive equipment. Therefore, the technical feasibility of a new ligation using the double-loop clips (D-L clips) technique without an adhesive agent for ulceration after ESD

BACKGROUND AND AIMS Protruding lesions of the small bowel vary in wireless capsule endoscopy (WCE) images, and their automatic detection may be difficult. We aimed to develop and test a deep learning-based system to automatically detect protruding lesions of various types in WCE images. METHODS We trained a deep convolutional neural network (CNN), using 30,584 WCE images of protruding lesions from

BACKGROUND AND AIMS The importance of having quality assessment, assurance, and improvement tools in healthcare is increasingly recognized. However, the additional administration burden, which is still often associated therewith, progressively interferes with the structural implementation and adoption of such tools, especially when it concerns high-volume procedures such as colonoscopies. The development

Efforts to increase patient safety and satisfaction, a critical concern for health providers, require periodic evaluation of all factors involved in the provision of GI endoscopy services. We aimed to develop guidelines on minimum staffing requirements and scope of practice of available staff for the safe and efficient performance of GI endoscopy. The recommendations in this guideline were based on

BACKGROUND AND AIMS Endoluminal functional luminal imaging probe (EndoFLIP) is an imaging tool that measures physiological characteristics of gastrointestinal sphincters. In this study we used EndoFLIP to evaluate the association between the pyloric physiological measurements with clinical outcomes of gastric peroral endoscopic myotomy (G-POEM) in patients with refractory gastroparesis. METHODS Thirty-seven

BACKGROUND AND AIMS CT colonography (CTC) or barium enema (BE) are commonly ordered to complete colorectal imaging after an incomplete colonoscopy. We evaluated the sensitivity of radiographic studies performed for this purpose in clinical practice outside of clinical trials. METHODS Adult patients referred to an expert endoscopist for incomplete colonoscopy because of a redundant colon or a difficult

BACKGROUND AND AIMS There is currently limited evidence supporting the use of endoscopic ultrasound-guided through-the-needle biopsy for sampling pancreatic cystic lesions. The aim of this meta-analysis was to provide a pooled estimate of the diagnostic performance of through-the-needle biopsy for sampling of pancreatic cysts. METHODS A bibliographic search on the main databases was performed through

BACKGROUND AND AIMS Nonvariceal upper GI hemorrhage (NVUGIH) is a feared adverse event after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). We aimed to determine the incidence of NVUGIH after PCI for AMI and its impact on mortality, morbidity, and healthcare resource utilization over 11 months. METHODS We used the Nationwide Readmission Database 2014. Inclusion criteria