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Background: Lumen-apposing metal stents (LAMS) have displaced double-pigtail plastic stents (DPS) as the standard treatment for walled-off necrosis (WON),β but evidence for exclusively using LAMS is limited. We aimed to assess whether the theoretical benefit of LAMS was superior to DPS. Methods: This multicenter, open-label, randomized trial was carried out in 9 tertiary hospitals. Between June 2017, and Oct 2020, we screened 99 patients with symptomatic WON, of whom 64 were enrolled and randomly assigned to the DPS group (n = 31) or the LAMS group (n = 33). The primary outcome was short-term (4-weeks) clinical success determined by the reduction of collection. Secondary endpoints included long-term clinical success, hospitalization, procedure duration, recurrence, safety, and costs. Analyses were by intention-to-treat. ClinicalTrials.gov, NCT03100578. Results: A similar clinical success rate in the short term (RR, 1.41; 95% CI 0.88–2.25; p = 0.218) and in the long term (RR, 1.2; 95% CI 0.92–1.58; p = 0.291) was observed between both groups. Procedure duration was significantly shorter in the LAMS group (35 vs. 45-min, p = 0.003). The hospital admission after the index procedure (median difference, − 10 [95% CI − 17.5, − 1]; p = 0.077) and global hospitalization (median difference − 4 [95% CI − 33, 25.51]; p = 0.82) were similar between both groups. Reported stent-related adverse events were similar for the two groups (36 vs.45% in LAMS vs. DPS), except for de novo fever, which was significantly 26% lower in LAMS (RR, 0.26 [0.08–0.83], p = 0.015). Conclusions: The clinical superiority of LAMS over DPS for WON therapy was not proved, with similar clinical success, hospital stay and similar safety profile between both groups, yet a significant reduction in procedure time was observed. Trial registration number: ClinicalTrials.gov, NCT03100578. [ABSTRACT FROM AUTHOR]

1 a Balloon dilation of a lumen-apposing metal stent (LAMS) to allow scope passage; b, c jejunal loop seen through the misplaced LAMS; d suctioning of small bowel into the transgastric LAMS before cutting with a needle-knife. Under endoscopic/fluoroscopic guidance, deploy a second coaxial rescue stent within the misplaced stent to create a bridge between the small bowel and the stomach. [Extracted from the article]

Background: It seems that lumen-apposing metal stents (LAMS) are displacing plastic stents in the therapy of pancreatic-fluid collection in walled-off necrosis (WON). To date, there is no quality of evidence to recommend LAMS as the standard treatment in the management of WON. The theoretical benefit of LAMS over plastic stents needs to be proven.Methods/design: This is a randomized controlled, multicenter, prospective clinical trial with two parallel groups, without masking. One-hundred and fourteen patients with WON will undergo endoscopic ultrasound (EUS)-guided transmural draining in nine tertiary hospitals in Spain and will be randomized to the LAMS or plastic-stent group. The primary endpoint is the short-term (4 weeks) clinical success determined by the reduction of the collection (to < 50% or < 5 cm in size), along with clinical improvement. Secondary endpoints: long-term (4 months) clinical success (total resolution or 5 cm), procedure duration, level of difficulty, safety, and recurrences.Discussion: The PROMETHEUS trial has been designed to determine whether LAMS are superior to plastic stents in EUS-guided transmural drainage of WON.Trial Registration: ClinicalTrials.gov, ID: NCT03100578. Registered on 4 April 2017. https://clinicaltrials.gov/ct2/home. [ABSTRACT FROM AUTHOR]

However, LAMS are more expensive and their safety is controversial, with a significantly higher rate of adverse events such as bleeding and "buried stent syndrome" compared with plastic stents. Returning to the basic question of which stent is best, LAMS are really displacing plastic stents. To date, there are two comparative prospective studies of self-expandable LAMS-type metal stents versus plastic stents in the endoscopic treatment of WON, from China (NCT03027895) and Spain (NCT03100578) [7][8]. [Extracted from the article]

The article presents a case of a 64-year-old male with neck pancreatic mass who was diagnosed with pancreatic tumor and underwent oncological treatment.

The article presents a case study of a 44-year-old man with chronic pancreatitis, in which it discusses the endoscopic treatment of pancreatic duct strictures by using pancreaticogastrostomy drainage through lumen-apposing metal stent (LAMS).

The article presents a case study of a 56-year old woman with pancreatic cancer causing obstructive jaundice and anorexia, who was referred for tissue diagnosis and biliary drainage. It states that a solid tumor of pancreatic head and dilatation of common bile duct was detected in Endoscopic ultrasound (EUS). It discusses the performance of EUS-guided fine-needle aspiration (FNA) and EUS-guided biliary drainage, and choledochoduodenostomy with placement of a biliary lumen-apposing metal stent.

Background and Aim: This study aimed to determine safety and risk factors for adverse events (AEs) of endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) with long‐term indwell of lumen‐apposing metal stents (LAMS). Methods: This study is a multicenter prospective observational study on consecutive high surgical‐risk patients requiring gallbladder drainage who underwent EUS‐GBD with LAMS over 12 months. Centralized telephone follow‐up interviews were conducted every 3 months for 1 year. Patients were censored at LAMS removal, cholecystectomy, or death. AE‐free survival was determined using log–rank tests. Cumulative risks were estimated using life‐table analysis. Results: Eighty‐two patients were included (53.7% male, median [interquartile range] age of 84.6 [76.5–89.8] years, and 85.4% with acute cholecystitis). Technical success was achieved in 79 (96.3%), and clinical success in 73 (89%). No patient was lost to follow‐up; 45 patients (54.9%) completed 1‐year follow‐up with in situ LAMS. Median (interquartile range) LAMS indwell time was 364 (47–367) days. Overall, 12 (14.6%) patients presented 14 AEs, including 5 (6.1%) recurrent biliary events (3 acute cholangitis, 1 mild acute pancreatitis, and 1 acute cholecystitis). Patients with pancreatobiliary malignancy had an increased risk of recurrent biliary events (33% vs 1.5%, P = 0.001). The overall 1‐year cumulative risk of recurrent biliary events was 9.7% (4.1–21.8%). The 1‐year risk of AEs and of severe AEs was 18.8% (11–31.2%) and 7.9% (3.3–18.2%), respectively. Pancreatobiliary malignancy was the single risk factor for recurrent biliary events; LAMS misdeployment was the strongest risk factor for AEs. Conclusions: Long‐term LAMS indwell does not increase the risk of delayed AEs following EUS‐GBD. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 54-year-old patient with a pancreatic cyst lesion resulting to a massive pneumoperitoneum. The patient was directed to the hospital's emergency unit to underwent endoscopic ultrasound (EUS)-guided transmural drainage. Details on the step-by-step medical procedure to prevent the leakage of fluids to peritoneal cavity is explored. The article also examines the use for endoscopic management therapy for pancreatic fluid collections.

The article presents case study of a 62-year-old woman having squamous cell esophageal carcinoma. It also discusses a method for managing esophageal obstruction by using endoscopic ultrasound (EUS)-guided puncture. It also discusses the whole procedure conducted on the women patient to treat the condition. Several photographs depicting images of the esophageal total stricture are also presented.

This case is recruited in a randomized trial (Multicenter study of lumen-apposing metal stents with or without pigtail in endoscopic ultrasound-guided biliary drainage for malignant obstruction-BAMPI TRIAL: an open-label, randomized controlled trial protocol). The DPS was removed and a specifically designed hepaticogastrostomy stent (8 × 80-mm, Niti-S Giobor biliary stent; TaeWoong Medical, Seoul, Korea) was inserted through the LAMS (Fig. 2 a Placement of a specialized hepaticogastrostomy stent through the biliary lumen-apposing metal stent. b Cholangiogram showing patent lumen with newly inserted stent. c Endoscopic image of the hepaticogastrostomy stent in place. [Extracted from the article]

The article presents a case study of a patient with unresectable pancreatic cancer causing obstructive jaundice was admitted to a hospital. The patient underwent for an endoscopic ultrasonography (EUS)-guided biliary drainage after a failed endoscopic retrograde cholangiopancreatography (ERCP) using Hot AXIOS system. The article also cites the use of Serum saline physiological (SSF) irrigation and cleaning of the stent.

The article discusses the use of strangulation technique with a mechanical lithotriptor for endoscopic removal of eroded gastric band as a minimally invasive procedure. Topics include the case study of a 52-year-old woman with morbid obesity who undergone an adjustable gastric band placement in 1996, the use of argon plasma coagulation to remove the band, and the mechanical lithotriptor.

Background Removing lumen-apposing metal stents (LAMSs) may be difficult and even harmful, but these features have seldom been analyzed. We aimed to generate a comprehensive assessment of the feasibility and safety of LAMS retrieval procedures. Methods A prospective multicenter case series including all technically successfully deployed LAMSs between January 2019 and January 2020 that underwent endoscopic stent removal. All retrieval-related data were prospectively recorded using standardized telephone questionnaires as part of centralized follow-up that ended after stent removal had been performed. Multivariable logistic regression models assessed the potential risk factors for complex removal. Results For the 407 LAMSs included, removal was attempted in 158 (38.8 %) after an indwell time of 46.5 days (interquartile range [IQR] 31–70). The median (IQR) removal time was 2 (1–4) minutes. Removal was labelled as complex in 13 procedures (8.2 %), although advanced endoscopic maneuvers were required in only two (1.3 %). Complex removal risk factors were stent embedment (relative risk [RR] 5.84, 95 %CI 2.14–15.89; P = 0.001), over-the-wire deployment (RR 4.66, 95 %CI 1.60–13.56; P = 0.01), and longer indwell times (RR 1.14, 95 %CI 1.03–1.27; P = 0.01). Partial and complete embedment were observed in 14 (8.9 %) and five cases (3.2 %), respectively. The embedment rate during the first 6 weeks was 3.1 % (2/65), reaching 15.9 % (10/63) during the following 6 weeks (P = 0.02). The adverse event rate was 5.1 %, including seven gastrointestinal bleeds (5 mild, 2 moderate). Conclusions LAMS removal is a safe procedure, mostly requiring basic endoscopic techniques attainable in conventional endoscopy rooms. Referral to advanced endoscopy units should be considered for stents with known embedment or long indwell times, which may require more technically demanding procedures. [ABSTRACT FROM AUTHOR]

The article presents the case study of 75-year-old man who developed complete stenosis of the upper esophagus after resection and radiotherapy for supraglottis carcinoma and endoscopic gastrostomy feeding. It states that a guidewire was passed and grapsed with forceps and withdrawn out of the mouth, avoiding the use of electrocautery. It adds that a new endoscopic gastrostomy tube was placed through the gastrocutaneous fistula.

The article presents information on a 65-year-old patient presented with non-specific abdominal discomfort and occult gastrointestinal bleeding. Endoscopic ultrasound showed an isoechoic tumor. Pathology study of the patient revealed that found a low grade of dysplasia without malignancy and the patient was discharged from the hospital a day after.

Background: A validated classification of endoscopic ultrasound (EUS) morphological characteristics and consequent therapeutic intervention(s) in pancreatic and peripancreatic fluid collections (PFCs) is lacking. We performed an interobserver agreement study among expert endosonographers assessing EUS-related PFC features and the therapeutic approaches used.Methods: 50 EUS videos of PFCs were independently reviewed by 12 experts and evaluated for PFC type, percentage solid component, presence of infection, recognition of and communication with the main pancreatic duct (MPD), stent choice for drainage, and direct endoscopic necrosectomy (DEN) performance and timing. The Gwet's AC1 coefficient was used to assess interobserver agreement.Results: A moderate agreement was found for lesion type (AC1, 0.59), presence of infection (AC1, 0.41), and need for DEN (AC1, 0.50), while fair or poor agreements were stated for percentage solid component (AC1, 0.15) and MPD recognition (AC1, 0.31). Substantial agreement was rated for ability to assess PFC-MPD communication (AC1, 0.69), decision between placing a plastic versus lumen-apposing metal stent (AC1, 0.62), and timing of DEN (AC1, 0.75).Conclusions: Interobserver agreement between expert endosonographers regarding morphological features of PFCs appeared suboptimal, while decisions on therapeutic approaches seemed more homogeneous. Studies to achieve standardization of the diagnostic endosonographic criteria and therapeutic approaches to PFCs are warranted. [ABSTRACT FROM AUTHOR]

The article presents a case study of an obese 63-year-old woman with clinical symptoms of periodic hypoglycemic episodes was diagnosed with an insulinoma in the pancreatic body that had not been detected by previous computed tomography and magnetic resonance imaging. It mentions identification of neuroendocrine tumor by endoscopic ultrasonography (EUS).

Watch a video of this article [ABSTRACT FROM AUTHOR]

The stent-induced mural erosion technique using self-expandable plastic stents has been reported a few times [3][4][5]. 10-1055-a-1195-2191-1703evv01.mp4 Endoscopic removal of a nonadjustable bariatric band using an esophageal FCSEMS-induced gastric mural erosion technique seems to be feasible and effective, and could allow easier extraction of the band than using a plastic stent. [Extracted from the article]

Background: It is unclear whether the insertion of an axis-orienting double-pigtail plastic stent (DPS) through biliary lumen-apposing meal stent (LAMS) in EUS-guided choledochoduodenostomy (CDS) improves the stent patency. The aim of this study is to determine whether this technical variant offers a clinical benefit in EUS-guided biliary drainage (BD) for the management of distal malignant biliary obstruction. Methods/design: This is a multicenter open-label, randomized controlled trial with two parallel groups. Eighty-four patients with malignant biliary obstruction will undergo EUS-BD (CDS type) using LAMS in 7 tertiary hospitals in Spain and will be randomized to the LAMS and LAMS plus DPS groups. The primary endpoint is the rate of recurrent biliary obstruction, as a stent dysfunction parameter, detected during follow-up. Secondary endpoints: technical and clinical success (reduction in bilirubin > 50% within 14 days of stent placement), safety, and others (number of reinterventions, time to biliary obstruction, prognostic factors, survival rate). Discussion: The BAMPI trial has been designed to determine whether the addition of a coaxial axis-orienting DPS through LAMS is superior to LAMS alone to prevent stent dysfunction. Trial registration: ClinicalTrials.govNCT04595058. Registered on October 14, 2020. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether the insertion of an axis-orienting double-pigtail plastic stent (DPS) through biliary lumen-apposing meal stent (LAMS) in EUS-guided choledochoduodenostomy (CDS) improves the stent patency. The aim of this study is to determine whether this technical variant offers a clinical benefit in EUS-guided biliary drainage (BD) for the management of distal malignant biliary obstruction.Methods/design: This is a multicenter open-label, randomized controlled trial with two parallel groups. Eighty-four patients with malignant biliary obstruction will undergo EUS-BD (CDS type) using LAMS in 7 tertiary hospitals in Spain and will be randomized to the LAMS and LAMS plus DPS groups. The primary endpoint is the rate of recurrent biliary obstruction, as a stent dysfunction parameter, detected during follow-up. Secondary endpoints: technical and clinical success (reduction in bilirubin > 50% within 14 days of stent placement), safety, and others (number of reinterventions, time to biliary obstruction, prognostic factors, survival rate).Discussion: The BAMPI trial has been designed to determine whether the addition of a coaxial axis-orienting DPS through LAMS is superior to LAMS alone to prevent stent dysfunction.Trial Registration: ClinicalTrials.gov NCT04595058 . Registered on October 14, 2020. [ABSTRACT FROM AUTHOR]

The role of endoscopic ultrasound (EUS) and guided biopsies has been well established for the locoregional staging of esophageal cancers. However, their role in posttreatment surveillance is unclear. Here, we describe a case of a pancreatic mass diagnosed on the follow-up positron emission tomography scan, concerning for a metastatic lesion. EUS-guided fine-needle aspiration (FNA) helped in establishing the diagnosis of neuroendocrine tumor, which tends to have a similar sonographic appearance. Therefore, it is imperative to evaluate a suspicious mass seen on computed tomography/positron emission tomography scan. EUS and EUS-guided FNA can serve as useful modalities to confirm the diagnosis by cytopathology. [ABSTRACT FROM AUTHOR]

Endoscopic ultrasound-guided ostomy repermeabilization as a rescue technique to resolve a deeply buried lumen-apposing stent With the increasing use of lumen-apposing metal stents (LAMS), some cases of buried stents have been reported in various scenarios (ie. gastroentorostomy, pancreatic fluid collection, gallbladder), but mainly with the use of the 10 × 10-mm size and located in the gastric cavity. 2019; 111: 243 - 5. 4 Ligresti D, Cipolletta F, Amata M, Cimavilla M, Traina M, Tarantino I. Buried lumen-apposing metal stent (LAMS) following endoscopic ultrasound-guided gallbladder drainage: the LAMS-in-LAMS rescue treatment. [Extracted from the article]

Background: It is unclear whether the insertion of an axis-orienting double-pigtail plastic stent (DPS) through biliary lumen-apposing meal stent (LAMS) in EUS-guided choledochoduodenostomy (CDS) improves the stent patency. The aim of this study is to determine whether this technical variant offers a clinical benefit in EUS-guided biliary drainage (BD) for the management of distal malignant biliary obstruction. Methods/design: This is a multicenter open-label, randomized controlled trial with two parallel groups. Eighty-four patients with malignant biliary obstruction will undergo EUS-BD (CDS type) using LAMS in 7 tertiary hospitals in Spain and will be randomized to the LAMS and LAMS plus DPS groups. The primary endpoint is the rate of recurrent biliary obstruction, as a stent dysfunction parameter, detected during follow-up. Secondary endpoints: technical and clinical success (reduction in bilirubin > 50% within 14 days of stent placement), safety, and others (number of reinterventions, time to biliary obstruction, prognostic factors, survival rate). Discussion: The BAMPI trial has been designed to determine whether the addition of a coaxial axis-orienting DPS through LAMS is superior to LAMS alone to prevent stent dysfunction. Trial registration: ClinicalTrials.govNCT04595058. Registered on October 14, 2020. [ABSTRACT FROM AUTHOR]

Background: There are uncertainties concerning the possible benefits derived from the insertion of double-pigtail plastic stents (DPS) within lumen-apposing metal stents (LAMS) in EUS-guided choledochoduodenostomy (CDS). The aim of this study was to determine whether a DPS within a biliary LAMS offers a potential benefit in EUS-guided CDS for the palliative management of malignant biliary obstruction. Methods: This was a multicentre retrospective study at three tertiary institutions. Period: May 2015 to August 2020. Two interventional strategies (LAMS alone and LAMS plus DPS) were compared. The choice was the endoscopist's discretion. Inclusion: unresectable/inoperable biliopancreatic tumours with previous failed ERCP. Clinical success: bilirubin decrease > 30% at 4 weeks. Results: Forty-one consecutive cases of EUS-CDS using biliary LAMS were treated (22 women; mean age, 72.3 years) during the study period. The procedure was technically successful in 39 (95.1%), who were managed using the two strategies (22 LAMS alone; 17 LAMS plus DPS). No differences between the groups, in terms of clinical success (77.3 vs 87.5%, p = 0.67), adverse events (AEs, 13.6 vs 11.8%, p = 0.99), recurrent biliary obstruction (RBO, 13.6 vs 23.5%, p = 0.67), or survival rate (p = 0.67) were encountered. The LAMS alone group had a shorter length of procedure (50 min vs 66 min, p = 0.102). No risk factors related to clinical success, AEs, RBO, or survival were detected. Conclusions: The technical variant of adding a coaxial DPS within LAMS in EUS-CDS seems not to be enough to prevent biliary morbidities, and it is a time-consuming strategy. Although prospective studies are needed, these results do not support its routine use. [ABSTRACT FROM AUTHOR]

We therefore contacted an expert in the biological field, Dr. Conxita Avila from the Department of Evolutionary Biology, Ecology and Environmental Sciences, and Biodiversity Research Institute (IrBIO), University of Barcelona. The image was so extraordinary that we wondered whether any similar image might exist in nature. Our image of the papilla resembles this one of the Caribbean sponge, Mycale laxissima, https://spongeguide.uncw.edu/imageinfo.php?img=319 (photographer Sven Zea; The Sponge Guide, Universidad Nacional de Colombia). [Extracted from the article]

14867984-efc44546.mp4 The Giobor stent is a dedicated biliary stent for HGS and has been reported for use in malignant diseases but not as a temporary stent [1][2][3][4][5]. The recent change in covered design (70 %:30 %) enables its use in a biliary benign scenario as a temporary stent to create a transhepatic mature fistula, allowing subsequent anterograde stenting. 3 Endoscopic transhepatic anterograde intervention. a Balloon catheter and plastic stent within the mature hepaticogastrostomy fistula. b Anterograde dilation of extrahepatic distal biliary stenosis up to 8 mm, guided by fluoroscopy. [Extracted from the article]

A 78-year-old man developed a late fistula between the gastroplasty pouch and right bronchus following Ivor Lewis esophagectomy for esophageal neoplasia (Fig. To extract the fistula from the wall, traction was applied to the mucosal flap using the clip-with-line traction technique, enabling deeper dissection of the fistula tract. [Extracted from the article]

The article presents a case study of an 86-year-old woman with cholangitis and choledocholithiasis and underwent endoscopic ultrasound-guided methylene blue injection to achieve bile duct access after endoscopic retrograde cholangipancreatography (ERCP) failed.

Background: The aim of this study was to evaluate whether the placement of a coaxial double-pigtail plastic stent (DPS) within a lumen-apposing metal stent (LAMS) may improve the safety of endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs).Methods: This was a retrospective cohort study including patients with PFCs and an indication for transmural drainage. Two strategies (LAMS alone or LAMS plus DPS) were used at the endoscopist's discretion.Results: A total of 41 patients were treated (21 LAMS alone; 20 LAMS plus DPS). The characteristics of the PFCs, and the technical and clinical success rates did not differ between groups. The LAMS alone group had a significantly higher rate of adverse events than the LAMS plus DPS group (42.9 % vs. 10.0 %; P = 0.04). Bleeding was the most frequent adverse event observed.Conclusions: The addition of a coaxial DPS to LAMS was associated with a lower rate of adverse events in EUS-guided drainage of PFCs. [ABSTRACT FROM AUTHOR]

B Video 1 b A teaching video demonstrating the technique of direct endoscopic ultrasound-guided gastroenterostomy using a feeding-tube waterjet system. To facilitate the safe and simple introduction of an endoscopic ultrasound (EUS)-guided gastroenterostomy technique, we present a step-by-step teaching video of a variant technique for direct EUS-guided gastroenterostomy using a feeding tube (Video 1). [Extracted from the article]

Background: Locally advanced esophageal carcinoma (LAEC) represents less than 30% of all diagnosed esophageal carcinoma worldwide. The standard of care for resectable tumours consists of preoperative chemoradiotherapy (CRT) followed by surgery. Despite the curative intent, the prognosis is still poor mainly due to relapse. A multidisciplinary approach is required in order to optimize the therapeutic strategy and follow-up. Differences in outcomes between the two main histological subtypes, adenocarcinoma (ADC) and squamous cell carcinoma (SCC), have been reported. Nevertheless, the heterogeneity in trials design and data available have hampered the achievement of clear conclusions. The purpose of this study is to report the outcomes from a cohort of patients with LAEC treated with a multidisciplinary approach and to remark the differences observed between the two main histologic subtypes and their clinical implications. Methods: We retrospectively reviewed 100 patients diagnosed with LAEC that were treated with preoperative CRT at our institution and integrated centres. Histopathological characteristics and toxicities during treatment were recorded. Patterns of recurrence at the first relapse were analysed. Survival curves were plotted using the Kaplan Meier method and multivariate Cox proportional hazards models were used. Results: Among the patients who received preoperative CRT, 83% underwent surgery. The median overall survival (mOS) was 31.7 months, 26.9 months for ADC and 45.5 for SCC (p-value = 0.33). In the multivariate Cox regression analysis, ypN+ was the only factor that negatively influenced in OS (OR = 4.1, p-value = 0.022). Patterns of recurrence differed according to histologic subtype. Distant relapse was more frequent in ADC (62%), whereas locoregional relapse was higher in SCC (50%) (p-value = 0.027). Second line therapeutic strategies could be offered to 50% of those patients who relapsed. Conclusions: Differences in outcomes and recurrence pattern could be observed between the two main histologic subtypes of LAEC. A better molecular characterization, adapted therapeutic regimens and follow up strategies should be adopted in order to improve survival of these patients. [ABSTRACT FROM AUTHOR]

After the bowel had been dilated up to 15 mm to allow the gastroscope to be passed across the duodenum, loops of the small bowel were distended with 1 L of saline mixed with methylene blue, using the water-jet channel. 2 Views of the enteral fully covered self-expandable metal stent deployed within the misplaced lumen-apposing stent to create a bridge between the small bowel and the stomach on: a fluoroscopy; b endoscopy. [Extracted from the article]

Endoscopic ultrasonography-guided deployment of embolization coils and cyanoacrylate injection in gastric varices versus coiling alone: a randomized trial. This section has its own submission website at https://mc.manuscriptcentral.com/e-videos References 1 Rowley M. W., Suarez J. Coil migration after EUS-guided coil embolization of gastric varices. Endoscopic ultrasound-guided treatment of gastric varices with coil embolization and absorbable hemostatic gelatin sponge: a novel alternative to cyanoacrylate. [Extracted from the article]

In a few cases, endoscopic ultrasound (EUS)-guided percutaneous endoscopic gastrostomy (PEG) has been reported as a safe alternative in cases that are not suitable for conventional PEG [1][2][3]. EUS-guided percutaneous endoscopic gastrostomy for enteral feeding tube placement. [Extracted from the article]

Background: Endoscopic management of walled-off pancreatic necrosis (WOPN) is an area of great interest with many still unanswered questions, including the role of mechanical necrosectomy versus irrigation. The aim of this study was to evaluate a new method of endoscopic transmural necrosectomy.Methods: Patients with WOPN after necrotizing pancreatitis, who underwent endoscopic transmural necrosectomy using a lumen-apposing metal stent with vigorous irrigation sessions, were prospectively recruited between September 2011 and August 2014. Initial endoscopic session was performed by EUS-guided drainage and lavage sessions by flushing saline through the stent. Technical and clinical success rates, number of repeat interventions, and adverse events were analyzed.Results: Twelve patients with 13 WOPN collections (median size 12.4 ± 2.94 cm) underwent endoscopic treatment. Clinical success was achieved in 100 % of cases after a median of three sessions per patient (range 2-8). The median length of hospitalization was 15.9 days. Median procedure time of the access session was 31 ± 10.16 min. No adverse events (AE) were described during the procedures or 24 h after. There were four AE (two infections and two bleedings) between sessions, but only two were severe (16.6 %). There was no need for surgery, and no mortalities occurred. Mean time to stent retrieval was 9 ± 3.4 weeks. Mean follow-up was 13 months with only one recurrence at 12 months after stent removal.Conclusions: This new variant of irrigation endoscopic transmural necrosectomy without mechanical debridement helps to simplify the technique, is feasible, and has excellent outcomes in WOPN treatment. [ABSTRACT FROM AUTHOR]

Background and study aims: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate the efficacy and safety of this stent in a large cohort. Patients and methods: Patients with a PFC undergoing EUS-guided drainage with this novel stent were prospectively enrolled in this multicenter cohort study. Results: There were 61 patients: 46 patients (75 %) with walled-off necrosis(WON) and 15 (25 %) with a pancreatic pseudocyst. Stent placement was technically successful in 60 patients (98 %, 95%CI 95%-100%). Clinical success, defined as resolution of clinical symptoms in combination with a decrease in the PFC size to ⩽2cm on imaging, was achieved in 93% of patients with a pancreatic pseudocyst (95 %CI 77%-100%) and in 81% of patients with WON (95 %CI 69%-94%). Treatment failure occurred in nine patients (16 %, 95%CI 6%- 26%), including four patients who required surgical intervention. Stent removal was performed in 82% of patients after a median of 32 days (range 2-178) and was rated as easy in all but one patient. In 10 patients, endoscopic stent removal was not performed because of stent migration (n=3), stent dislodgement during necrosectomy (n=3), stent removal during surgery (n=2), or refusal by the patient (n=2). In total, five major complications were reported (9 %, 95%CI 2%-16 %), including PFC infection (n=4) and perforation (n=1). Conclusion: EUS-guided drainage using this novel stent is feasible and the clinical results obtained are promising with a low major complication rate. [ABSTRACT FROM AUTHOR]

Correction to: Multicenter study of lumen-apposing metal stents with or without pigtail in endoscopic ultrasound-guided biliary drainage for malignant obstruction - BAMPI TRIAL: an open-label, randomized controlled trial protocol Multicenter study of lumen-apposing metal stents with or without pigtail in endoscopic ultrasound-guided biliary drainage for malignant obstruction - BAMPI TRIAL: an open-label, randomized controlled trial protocol. B Correction to: Trials 23, 181 (2022) b B https://doi.org/10.1186/s13063-022-06106-1 b Following the publication of the original article [[1]], we were notified that the below statement needed to be added to the Acknowledgements section:'We thank CERCA Programme / Generalitat de Catalunya for institutional support'. [Extracted from the article]