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Current Issue July 2017

Gastroesophageal reflux after peroral endoscopic myotomy: a multicenter case–control study  (FREE ACCESS)

Vivek Kumbhari, Pietro Familiari, Niels Christian Bjerregaard et al.

In this retrospective multicenter cohort study on 282 patients with achalasia who were treated by peroral endoscopic myotomy (POEM), 58% were found to have a high DeMeester score and 23% had endoscopic esophagitis after POEM. The results importantly reflect a high incidence of gastroesophageal reflux after POEM, and further studies should be conducted to address this issue.

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Endoscopic resection of large duodenal and papillary lateral spreading lesions is clinically and economically advantageous compared with surgery  (FREE ACCESS)

Amir Klein, Golo Ahlenstiel, David J. Tate et al.

In this study, the outcomes of 102 duodenal or papillary lesions treated by endoscopic resection were compared with "hypothetical" surgery. Although the local recurrence rate after the first surveillance endoscopy was 17.7% after endoscopic resection, this approach was associated with lower morbidity and shorter hospital stay, as well as lower costs, compared with surgery. This study shows that excellent results can be achieved by endoscopic resection for the treatment of duodenal and papillary lesions if performed in an expert center.

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Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline – Updated January 2017  (FREE ACCESS)

Jean-Marc Dumonceau, Pierre H. Deprez, Christian Jenssen et al.

In this Update to the 2012 Guideline, ESGE recommends EUS-guided sampling for pancreatic solid lesions as first-line diagnostic procedure, with percutaneous sampling as an alternative in metastatic disease. EUS-guided sampling is recommended for pancreatic cysts if a precise diagnosis may change patient management, except for lesions ≤ 10mm in diameter with no high risk stigmata; if the volume of aspirate is small, carcinoembryonic antigen (CEA) level determination should be the first analysis. In esophageal cancer, EUS-guided sampling is recommended for assessment of regional lymph nodes in T1 adenocarcinoma and of lesions suspicious for metastasis such as distant nodes, left liver lobe lesions, and suspected peritoneal carcinomatosis.

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