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Current Issue May 2016

Prospective evaluation of bacteremia rates and infectious complications among patients undergoing single-operator choledochoscopy during ERCP  (FREE ACCESS)

Nirav Thosani, Richard S. Zubarik, Rajan Kochar, Shivangi Kothari, Neeraj Sardana, Tu Nguyen, Subhas Banerjee

The question of whether antibiotic prophylaxis is indicated in patients undergoing choledochoscopy has yet to be addressed. This prospective study demonstrated a 14% rate of sustained bacteremia related to choledochoscopy, with 10% of patients requiring antibiotic treatment for infectious complications after the procedure. Antibiotic prophylaxis should be considered in patients undergoing choledochoscopy, particularly in older patients with previous stent or intraductal stone lithotripsy.

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Clinicopathological, endoscopic, and molecular characteristics of the "skirt" – a new entity of lesions at the margin of laterally spreading tumors  (FREE ACCESS) 

Shozo Osera, Satoshi Fujii, Hiroaki Ikematsu, Hideaki Miyamoto, Yasuhiro Oono, Tomonori Yano, Atsushi Ochiai, Takayuki Yoshino, Atsushi Ohtsu, Kazuhiro Kaneko

Japanese investigators describe and characterize a "new" finding at the edge of rectal laterally spreading lesions, which was termed the "skirt." Other endoscopists may have seen this endoscopic phenomenon and termed it "chicken skinning" or mucosal edema. These lesions tended to be larger compared with lesions without a skirt, were located in the rectum, and contained adenocarcinoma or high grade dysplasia. From a cohort of >1000 lesions, a skirt was seen in 3.4 %. It remains to be determined whether a skirt is part of the pathogenic pathway or more likely an epiphenomenon of advanced disease or location in the rectum.

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Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline  (FREE ACCESS)

Michael Birk, Peter Bauerfeind, Pierre H. Deprez, Michael Häfner, Dirk Hartmann, Cesare Hassan, Tomas Hucl, Gilles Lesur, Lars Aabakken, Alexander Meining

This Guideline from the European Society of Gastrointestinal Endoscopy (ESGE) summarizes currently available data on the management of adult patients after ingestion of foreign bodies. Non-endoscopic or endoscopic measures are recommended, depending on the type of ingested foreign body. Furthermore, if endoscopy is indicated, the Guideline gives advice on when the appropriate examinations should be performed and on what devices and tools can be useful.

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