Among 12 EUS experts who evaluated 50 video clips of PFCs, there was poor-to-moderate agreement for the determination of PFC type and morphological features such as the percentage solid component and signs of infection. On therapeutic decisions, such as type of stent to use and the need for and timing of direct necrosectomy, there was moderate-to-substantial agreement. These findings indicate the need for standardization of the morphological criteria for EUS assessment of PFCs.

Superficial gastrointestinal lesions are being detected and diagnosed more commonly, and endoscopic resection is a mainstay treatment for them. In this updated ESGE Guideline on ESD for such lesions, recommendations are made for evaluation, treatment, and post-resection management, with special emphasis on the ESD technique. The Guideline addresses major issues, including evaluation before ESD, comparison with other therapeutic strategies (namely endoscopic mucosal resection [EMR] and surgery), and management after ESD, to inform and underpin the use of this fundamental technique for the treatment of superficial GI lesions.