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Introduction

Atrophic gastritis (AG) is a well-established precursor of gastric cancer, and its most frequent aetiological agent is Helicobacter pylori (H. pylori). Accurate risk stratification is essential to optimise endoscopic surveillance and resource allocation. The Operative Link on Gastritis Assessment (OLGA) system offers a histological staging tool to quantify the severity of gastric atrophy and associated cancer risk. Despite high H. pylori endemicity in Colombia, local data on the prevalence of advanced OLGA stages remains scarce. This study aimed to elucidate the distribution of OLGA stages and their correlation with age and H. pylori status in a large dyspeptic cohort.

Aims & Methods

We conducted a cross-sectional, observational study of adult patients undergoing upper gastrointestinal endoscopy for dyspepsia between January 2019 and December 2023 at a high-volume reference centre in Bogotá, Colombia. All cases followed the updated Sydney biopsy protocol, with five mapped gastric samples analysed by experienced gastrointestinal pathologists. The OLGA system was applied to stage gastric atrophy (0–IV). H. pylori detection was based on histology using Giemsa and H&E stains. Demographic variables, H. pylori status, OLGA stage, and histological features were recorded. Data were processed using SPSS v26, and statistical significance was set at p<0.05.

Results

Out of 6,746 patients (mean age: 59 years; 73.4% female), 99% exhibited low-risk OLGA stages (0–II). Only 3 patients (0.04%) presented with advanced OLGA stages (III–IV). A positive correlation was noted between increasing age and the frequency of gastric atrophy, although this did not correspond to an increase in advanced stages. H. pylori infection was confirmed in 82% of the cohort, showing an upward trend over the study period. Interestingly, no cases of H. pylori infection were observed among patients with OLGA III–IV. The majority of infections were restricted to the antrum. Gastric dysplasia and cancer were rare events, both observed in <1% of patients. The association between H. pylori and gastric cancer did not reach statistical significance (OR 0.49; 95% CI 0.23–1.04; p=0.07).

Conclusion

Despite the high prevalence of H. pylori, the frequency of advanced OLGA stages remains remarkably low in Colombian dyspeptic patients. These findings reinforce the utility of the OLGA system, coupled with Sydney protocol biopsies, as a valuable approach to risk stratification. Only 1% of patients would benefit from endoscopic surveillance under international guidelines, suggesting that widespread follow-up may be unnecessary and potentially wasteful.

References

1. Rugge M, Genta RM, Dixon MF. OLGA staging for gastritis: a tutorial. Dig Liver Dis. 2008 Oct;40(10):650–8. doi:10.1016/j.dld.2008.02.029.
2. El-Zimaity HM, Graham DY. Evaluation of gastric mucosal atrophy in clinical practice: OLGA is OK, but incomplete and in need of standardization. Am J Gastroenterol. 2011 Feb;106(2):469–70. doi:10.1038/ajg.2010.417.
3. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process—First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992 Dec 1;52(24):6735–40.
4. Herrera-Goossens A, Bravo LE, Correa P. Helicobacter pylori infection and histopathological findings in a population at high risk for gastric cancer in Colombia. Am J Gastroenterol. 2005 Nov;100(11):2314–20. doi:10.1111/j.1572-0241.2005.00226.x.

LOW PREVALENCE OF HIGH-RISK OLGA STAGES DESPITE HIGH HELICOBACTER PYLORI INFECTION: A 5-YEAR CROSS-SECTIONAL STUDY IN COLOMBIA

Juan Frias-Ordoñez 1, Hernando Marulanda 2, Jairo Alonso Rodríguez Criollo 3, Lina Otero 4, Sebastián Fernando Niño Ramirez 5, Elder Otero 6, Alejandra Villareal 7, Luis Peña 6, william Otero 2

1 Hospital Internacional de Colombia, Bucaramanga, Colombia|||National University of Colombia, Bogota, Colombia

2 National University of Colombia, Bogota, Colombia|||Centro de Gastroenterología y Endoscopia, Bogota, Colombia

3 National University of Colombia, Bogota, Colombia

4 Centro de Gastroenterología y Endoscopia, Bogota, Colombia|||National University of Colombia, Bogota, Colombia

5 Universidad CES, Medellin, Colombia

6 Centro de Gastroenterología y Endoscopia, Bogota, Colombia

7 Juan N. Corpas University, Bogota, Colombia

Conference

UEG Week Berlin 2025

Topics

Stomach & H. Pylori

Submission format

Abstract

Session

H.PYLORI (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Drug management in necrotising pancreatitis

Jacob Hamm 1

1 University Medical Center Goettingen, Goettingen, Germany

Event

UEG Week Berlin 2025

Topics

Endoscopy Pancreas

Session

Therapy update: Acute severe pancreatitis – It's all about timing!

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Panel discussion: Liver and pregnancy - Beware of dangerous liaisons

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

Hepatobiliary Paediatrics

Session

Liver and pregnancy: Beware of dangerous liaisons

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Persistent lipase and localised damage: Cause or consequence?

Peter Hegyi 1

1 University of Pecs, Pecs, Hungary

Event

UEG Week Berlin 2025

Topics

Endoscopy Pancreas

Session

Therapy update: Acute severe pancreatitis – It's all about timing!

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

There has been a shift from percutaneous drainage towards endoscopic ultrasound (EUS)-guided drainage for management of post-operative pancreatic fluid collections (POPFC). However, available series have been limited by sample size and little is known about the factors that may influence clinical success.

Aims & Methods

Our aim was to evaluate the outcomes of EUS-guided drainage of POPFC following pancreatic surgery and identify predictors of clinical success.
We performed a retrospective review of patients who underwent EUS-guided drainage of POPFC between 2014 and August 2024 at three academic centers. Primary outcome was clinical success, defined as the complete radiological regression of the collection and resolution of symptoms without the need for additional drainage procedures.

Results

In total, 265 cases were included (mean age 64 [SD±13.9] years, 37% pylorus-resecting pancreatoduodenectomy). Early drainage (≤14 days) was performed in 52% of cases (n=138) and DPPS were used in 209 cases (79%).
Clinical success with a single EUS drainage procedure was achieved in 160 cases (60.4%). Step-up interventions were required in 67 patients (25.3%), 37 of which required endoscopic revision only. Technical success was achieved in 90% (n=238) and adverse events occurred in 43 cases (16%).
Stent type, drainage timing, splenectomy and drainage route did not seem to significantly influence clinical success. Multivariate analysis including stent type and surgical history, showed that distal pancreatectomy was an independent risk factor for clinical failure.

Conclusion

EUS-guided drainage of POPFC was effective in the majority of cases with a single procedure, although distal pancreatectomy was suggested as an independent risk factor for clinical failure. These results further support the use of EUS-guided drainage for the management of postoperative collections.

Disclosure

HH declares no competing interests. MB received trial support from Boston Scientific and holds consultancy agreements with Dekra, Ovesco and Prion Medical. GV received lecture fees from Boston Scientific and travel grants from Pentax Medical and Euromedical. RVW holds a consultancy agreement with Boston Scientific. Schalk van der Merwe holds the Cook chair in Interventional endoscopy, has consultancy agreements with Cook, Pentax and Olympus and co-chairs the Boston-Scientific Chair in Therapeutic Biliopancreatic Endoscopy.

PREDICTORS OF CLINICAL SUCCESS IN EUS-GUIDED DRAINAGE OF POSTOPERATIVE PANCREATIC FLUID COLLECTIONS

Hanne Hellinckx 1, Michiel Bronswijk 2, Giuseppe Vanella 3, Hanna Peeters 1, Marie-Anne Noreille 1, Francesco Frigo 4, Roberto Leone 3, Hannah Van Malenstein 1, Wim Laleman 5, Rogier P. Voermans 6, Paolo Giorgio Arcidiacono 7, Roy .L.J Van Wanrooij 8, Schalk van der Merwe 1

1 UZ Leuven, Leuven, Belgium

2 Imelda Hospital Bonheiden and University Hospitals Leuven, Keerbergen, Belgium

3 Vita-Salute San Raffaele University, Milan, Italy

4 Vita-Salute San Raffaele University, Piazzola sul Brenta, Italy

5 University Hospital Gasthuisberg, Leuven, Belgium

6 Amsterdam University Medical Center, Amsterdam, Netherlands

7 Ospedale San Raffaele, Milan, Italy

8 AMC Amsterdam, Amsterdam, Netherlands

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

PANCREAS (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Endoscopic treatment: EMR/ESD

Raf Bisschops 1

1 Katholieke Universiteit Leuven, Leuven, Belgium

Event

UEG Week Berlin 2025

Topics

Endoscopy Oesophagus

Session

Barrett's oesophagus: Are we getting there?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Predicting choledocholithiasis in acute pancreatitis is challenging. Existing predictive models typically rely on the common bile duct (CBD) width, a parameter difficult to assess reliably. We aimed to develop a model based solely on easily available clinical and laboratory markers, excluding CBD width.

Aims & Methods

We conducted a retrospective cohort study of 348 patients treated for acute pancreatitis at the LMU University Hospital in Munich, Germany, between 2005 and 2021. A Random Forrest (RF) model was developed using the TensorFlow Decision Forests (TFDF) library with 14 clinical and laboratory features, excluding CBD width. Model performance was assessed using sensitivity, specificity, predictive values, and area under the receiver operating characteristic curve (AUC-ROC).

Results

Of 348 patients with acute biliary pancreatitis, 167 (48.0%) had CBD stones. Our model achieved a sensitivity of 92.3%, a negative predictive value (NPV) of 83.3%, and an AUC-ROC of 0.739. Compared to using CBD width ≥8 mm or bilirubin ≥4 mg/dl as predictors (as guidelines recommend), our model demonstrated superior sensitivity (92.3% vs. 79.5% vs. 30.8%, respectively) and NPV (83.3% vs. 74.3% vs. 54.8%, respectively). The rate of missed intraductal concrements was substantially lower with our model (4.3% vs. 41.4%). In subgroup analysis, our model performed better in predicting stones (AUC=0.8) than microlithiasis or sludge (AUC=0.623).

Conclusion

We developed the first machine learning-based score to predict choledocholithiasis in acute pancreatitis without relying on CBD width. The model's high sensitivity and NPV make it a promising tool for clinical decision-making, specifically for hospitals without the option of endosonography.

Disclosure

SS is funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - 413635475 - and the LMU Munich Clinician Scientist Program (MCSP).

PREDICTING CHOLEDOCHOLITHIASIS IN ACUTE BILIARY PANCREATITIS – A NEW SCORE INDEPENDENT OF IMAGING AND COMMON BILE DUCT WIDTH

Arlett Patricia Gloria Schäfer 1, Simon Sirtl 1, Katharina Bretthauer 1, Eric Hohmann 1, Mali Junge 1, Mahmood Ahmad 1, Jakob Vielhauer 1, Anna Hausdorf 1, Max Ole Hubert 1, Raul Velamazan Sandalinas 2, Ughur Aghamaliyev 3, Jörg Schirra 1, Christian Schulz 1, Michal Zorniak 4, Georg Beyer 1, Ujjwal Mahajan 1, Julia Mayerle 1, Hans Stubbe 1

1 LMU University Hospital Munich, Munich, Germany

2 Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain

3 LMU University Hospital, Munich, Germany

4 The Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

Acute pancreatitis: Complications and consequences (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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