Endoscopic ultrasound–guided liver biopsy: needle types and suction methods

Post written by Catherine Vozzo, DO, from the Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio. Endoscopic ultrasound-guided liver biopsy is gaining traction amongst the advanced endoscopy and hepatology community. It is safe and effective at delivering adequate liver biopsy specimens. In this tools and techniques article, we describe the variety of needles and …

Continue reading Endoscopic ultrasound–guided liver biopsy: needle types and suction methods

Effects of endoscopic gastric plication on portal pressure gradient in a patient with nonalcoholic steatohepatitis cirrhosis

Post written by Pichamol Jirapinyo, MD, MPH, from the Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts. The current treatment for nonalcoholic steatohepatitis (NASH) remains limited to weight loss via lifestyle modification. While bariatric surgery can be considered in otherwise eligible patients who suffer from obesity with concomitant NASH, less than 2% of …

Continue reading Effects of endoscopic gastric plication on portal pressure gradient in a patient with nonalcoholic steatohepatitis cirrhosis

Freestyle endoscopic submucosal dissection using a multifunctional snare

Post written by Jun Arimoto, MD, PhD, from the Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan. A novel multifunctional snare (SOUTEN; Kaneka Medics, Tokyo, Japan) was introduced to enable successful hybrid ESD procedures. Although this multifunctional snare was introduced for hybrid ESD, hybrid ESD involves partial submucosal dissection, and we have previously reported …

Continue reading Freestyle endoscopic submucosal dissection using a multifunctional snare

The use of double-pigtailed stents to relieve obstruction of a previous endoscopic gastrojejunal lumen-apposing metal stent

Post written by Corey O’Brien, MD, from the Department of Hospital Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. The case involved an elderly woman with locally advanced pancreatic adenocarcinoma. She was recently admitted for malignant gastric outlet obstruction and underwent successful placement of a gastrojejunal LAMS. She was readmitted shortly thereafter with occlusion of the …

Continue reading The use of double-pigtailed stents to relieve obstruction of a previous endoscopic gastrojejunal lumen-apposing metal stent

An effective method for removing surgical staples during endoscopic submucosal dissection for early gastric cancer on the suture line of remnant stomach

Post written by Yugo Suzuki, MD, from the Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan. This is the first report to show the utility and feasibility of removing surgical staples during endoscopic submucosal dissection (ESD) for residual gastric cancer in the remnant stomach. The surgical staples were removed using the Dual Knife, and we electrified …

Continue reading An effective method for removing surgical staples during endoscopic submucosal dissection for early gastric cancer on the suture line of remnant stomach

EUS-guided blood patch delivery during liver biopsy: nature’s gel foam

Post written by Kenneth J. Chang, MD, from the Digestive Health Institute, Chao Family Comprehensive Digestive Disease Center, University of California, Irvine. These are 2 cases of EUS-guided liver biopsy where there was active blood flow within the needle tract prior to needle withdrawal. After waiting 2-3 minutes, we saw persistent flow, raising concerns that …

Continue reading EUS-guided blood patch delivery during liver biopsy: nature’s gel foam

Switching the switch: endoscopic reversal of a biliopancreatic diversion

Post written by Manol Jovani, MD, MPH, from the Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland. Biliopancreatic diversion (also known as duodenal switch) is a complex bariatric surgery that includes a sleeve gastrectomy and long Roux-en-Y intestinal bypass. This is a very effective surgery for weight loss, but it can be complicated …

Continue reading Switching the switch: endoscopic reversal of a biliopancreatic diversion

Extracorporeal rendezvous technique combining endoscopic retrograde pancreatography with endoscopic ultrasound for main pancreatic duct disconnection arising from acute necrotizing pancreatitis

Post written by Toshiyasu Shiratori, MD, from the Department of Gastroenterology, Kameda Medical Center, Kamogawa City, Japan. This video shows an endoscopic pancreatic duct drainage technique combining ERCP with EUS using a percutaneous drainage route for main pancreatic duct disconnection that was difficult to traverse through the disconnected segment using either ERCP- or EUS-guided approaches. …

Continue reading Extracorporeal rendezvous technique combining endoscopic retrograde pancreatography with endoscopic ultrasound for main pancreatic duct disconnection arising from acute necrotizing pancreatitis

Hybrid endoscopic submucosal dissection with novel helix tacking system for defect closure

Post written by Hiroyuki Aihara, MD, PhD, FASGE, from the Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts. This case video demonstrates a hybrid endoscopic submucosal dissection (ESD) with a novel ESD knife, followed by mucosal defect closure using an innovative endoscopic helix tacking system. A 60-year-old man …

Continue reading Hybrid endoscopic submucosal dissection with novel helix tacking system for defect closure

Endoscopic hemostatic spray for uncontrolled bleeding after complicated endoscopic mucosal resection or endoscopic submucosal dissection

Post written by Kayla M. Hartz, DO, from the Department of Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania. These are 2 cases in which hemostatic spray was used as a bail-out method for hemostasis when other standard methods failed. These cases show the value in using a hemostatic spray as …

Continue reading Endoscopic hemostatic spray for uncontrolled bleeding after complicated endoscopic mucosal resection or endoscopic submucosal dissection