A bidirectional Mendelian randomization study integrating genome-wide association studies, expression quantitative trait locus, and methylation quantitative trait locus data revealed causal relationship between heavy cigarette dependence and Barrett’s eso Zhou An, Meichun Zeng, Xianhua Wang SAGE Open Medicine.2025;[Epub] CrossRef
Michel Kahaleh, Amy Tyberg, Supriya Suresh, Arnon Lambroza, Fernando Rodriguez Casas, Mario Rey, Jose Nieto, Guadalupe Ma Martínez, Felipe Zamarripa, Vitor Arantes, Maria G Porfilio, Monica Gaidhane, Pietro Familiari, Juan Carlos Carames, Romulo Vargas-Rubio, Raul Canadas, Albis Hani, Guillermo Munoz, Bismarck Castillo, Eduardo T Moura, Farias F Galileu, Hannah P Lukashok, Carlos Robles-Medranda, Eduardo G de Moura
Clin Endosc 2021;54(5):701-705. Published online June 3, 2021
Background /Aims: Peroral endoscopic myotomy (POEM) has been increasingly used for achalasia in Latin America, where Chagas disease is prevalent, and this makes POEM more challenging. The aim of this study was to determine the learning curve for POEM in Latin America.
Methods Patients undergoing POEM in Latin America with a single operator were included from a prospective registry over 4 years. Non-linear regression and cumulative sum control chart (CUSUM) analyses were conducted for the learning curve.
Results A total of 125 patients were included (52% male; mean age, 59 years), of which 80 had type II achalasia (64%), and 38 had Chagas disease (30%). The average pre-procedure and post-procedure Eckardt scores were 6.79 and 1.87, respectively. Technical success was achieved in 93.5% of patients, and clinical success was achieved in 88.8%. Adverse events occurred in 27 patients (22%) and included bleeding (4 patients), pneumothorax (4 patients), mucosal perforation (13 patients), mediastinitis (2 patients), and leakage (4 patients).
The CUSUM chart showed a median procedure time of 97 min (range, 45-196 min), which was achieved at the 61st procedure. Procedure duration progressively decreased, with the last 10 procedures under 50 min approaching a plateau (p-value <0.01).
Conclusions Mastering POEM in Latin America requires approximately 61 procedures for both POEM efficiency and to accomplish the procedure within 97 minutes.
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Miotomía endoscópica por vía oral (POEM) como tratamiento para la acalasia pediátrica: estudio multicéntrico y primeros resultados Carlos Leganés Villanueva, Eduardo Albéniz Arbizu, Ilaria Goruppi, Nuria Brun Lozano, Federica Bianchi, Alberto Pérez Martínez, Sheyla Montori Pina, Ada Yessenia Molina Caballero, Marianette Murzi, Federico Betroletti, Fermin Estremera, Susana Boronat Gue Gastroenterología y Hepatología.2025; 48(4): 502262. CrossRef
Peroral endoscopic myotomy (POEM) as a treatment for pediatric achalasia: Multicenter study and first results Carlos Leganés Villanueva, Eduardo Albéniz Arbizu, Ilaria Goruppi, Nuria Brun Lozano, Federica Bianchi, Alberto Pérez Martínez, Sheyla Montori Pina, Ada Yessenia Molina Caballero, Marianette Murzi, Federico Betroletti, Fermin Estremera, Susana Boronat Gue Gastroenterología y Hepatología (English Edition).2025; : 502262. CrossRef
Experiencia en miotomía endoscópica peroral en un centro de Bogotá, Colombia, entre 2018 y 2022 Tatiana P Barragan Briceño, Paola Stephany Gonzalez Ausique, Carlos Fernando Fuentes Díaz, Jesús Antonio Rodríguez Fajardo, Maria Camila Gomez Ayala Revista colombiana de Gastroenterología.2024; 39(2): 146. CrossRef
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Background /Aims: Endoscopic ultrasonography (EUS)-guided drainage is the preferred approach for infected or symptomatic pancreatic fluid collections (PFCs). Here, we developed an algorithm for the management of pancreatitis complicated by PFCs and report on its effcacy and safety.
Methods Between September 2011 and October 2017, patients were prospectively managed according to the algorithm. PFCs were classified as poorly organized fluid collections (POFCs), pancreatic pseudocysts (PPs), or walled-off pancreatic necrosis (WOPN). Clinical success was defined as a decrease in PFC size by ≥50% of the maximal diameter or to ≤2 cm.
Results A total of 108 patients (62% male; mean age, 53 years) were included: 13 had POFCs, 43 had PPs, and 52 had WOPN. Seventytwo patients (66%) required a pancreatic duct (PD) stent, whereas 65 (60%) received enteral feeding. A total of 103 (95%) patients achieved clinical success. Eight patients experienced complications including bleeding (n=6) and surgical intervention (n=2). Patients with enteral feeding were 3.4 times more likely to achieve resolution within 60 days (p=0.0421), whereas those with PD stenting was five times more likely to achieve resolution within 90 days (p=0.0069).
Conclusions A high PFC resolution rate can be achieved when a dedicated algorithm encompassing EUS-guided drainage, PD stenting, and early enteral feeding is adopted.
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Superior mesenteric artery syndrome (SMAS) causes compression and partial or complete obstruction of the duodenum, resulting in abdominal pain, nausea, vomiting, and weight loss. If conservative therapy fails, the patient is typically referred for enteral feeding or laparoscopic gastrojejunostomy.
The last few years have seen increasing use of endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) for gastric obstruction indications. EUS-GJ involves the creation of a gastric bypass via an echoendoscope in cases in which the small intestine can be punctured under ultrasonographic visualization, resulting in an incision-free, efficient, and safe procedure.
In this case report, we present the first case of SMAS treated using a reverse EUS-GJ, and describe the steps and advantages of the procedure in this particular case.
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Background /Aims: Performing endoscopic retrograde cholangiopancreatography (ERCP) in patients who have undergone Rouxen-Y gastric bypass (RYGB) is challenging. Standard ERCP and enteroscopy-assisted ERCP are associated with limited success rates. Laparoscopy- or laparotomy-assisted ERCP yields improved efficacy rates, but with higher complication rates and costs. We present the first multicenter experience regarding the efficacy and safety of endoscopic ultrasound (EUS)-directed transgastric ERCP (EDGE) or EUS.
Methods All patients who underwent EDGE at two academic centers were included. Clinical success was defined as successful ERCP and/or EUS through the use of lumen-apposing metal stents (LAMS). Adverse events related to EDGE were separated from ERCP- or EUS-related complications and were defined as bleeding, stent migration, perforation, and infection.
Results Sixteen patients were included in the study. Technical success was 100%. Clinical success was 90% (n=10); five patients were awaiting maturation of the fistula tract prior to ERCP or EUS, and one patient had an aborted ERCP due to perforation. One perforation occurred, which was managed endoscopically. Three patients experienced stent dislodgement; all stents were successfully repositioned or bridged with a second stent. Ten patients (62.5%) had their LAMS removed. The average weight change from LAMS insertion to removal was negative 2.85 kg.
Conclusions EDGE is an effective, minimally invasive, single-team solution to the difficulties associated with ERCP in patients with RYGB.
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