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Free for all myUEG account holders. Your access level is set automatically based on your occupation. Medical professionals get full access to all content. If you are a non-medical user, you can only access UEG Week content from congresses you attended.

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Introduction

The adherence of doctors and patients to published colorectal post-polypectomy surveillance guidelines varies greatly, and patient follow-up is critical but time-consuming.

Aims & Methods

Aims: We aimed to develop an automatic surveillance (AS) system to accurately identify post-polypectomy patients, assign surveillance intervals for different risks of patients and proactively follow up with patients on time.
Methods: The endoscopic and pathological reports from 47,544 patients from three hospitals were used to develop AS system based on natural language processing. The performance of AS system was fully evaluated in internal and external tests according to five different guidelines worldwide and compared with that of doctors. Furthermore, a multi-reader-multi-case (MRMC) trial was conducted to evaluate the effect of AS system on improving doctors’ guideline adherence and efficiency, and a prospective trial was performed to evaluate the success rate for automatically informing patients and its effect on reducing the burden of nurses.

Results

In internal, external 1, and external 2 tests, the system reached an overall accuracy of 99.73%, 99.54%, and 99.77% for identifying different types of patients, respectively; and achieved an overall accuracy of ≥99.45%, ≥98.89%, and ≥98.56% for stratifying patients' risk levels and assigning surveillance intervals according to five guidelines. The system greatly increased the accuracy of doctors (98.67% vs. 78.10%, p=0.043) in MRMC trial. In a prospective trial, AS system successfully informed 93·18% of patients, and significantly reduced the follow-up time cost (127.4s vs. 14.02s per patient).

Conclusion

This system has great potential to improve doctors' adherence to guidelines while relieving the workload of doctors and nurses.

Disclosure

The authors declare no conflict of interest.

THE DEVELOPMENT AND CLINICAL EVALUATION OF A NATURAL LANGUAGE PROCESSING-BASED AUTOMATIC SURVEILLANCE SYSTEM FOR COLORECTAL POST-POLYPECTOMY PATIENTS

CONGHUI SHI 1, Lianlian Wu 1, Jia Li 1, Honggang Yu 1

1 Renmin Hospital of Wuhan University, Wuhan, China

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Gastro-oesophageal reflux disease diagnosis and how to avoid them

Sabine Roman 1

1 Hôpital Edouard Herriot, Lyon, France

Event

UEG Week Berlin 2025

Topics

Endoscopy Nurses Small Intestine & Nutrition Oesophagus Surgery

Session

Mistakes in…: Upper GI

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Early onset life-long impact: Caustic injury/atresia (Complete Session)

Event

UEG Week Berlin 2025

Topics

Oesophagus Paediatrics

Session

Early onset life-long impact: Caustic injury/atresia

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Standards and Guidelines

Position Paper

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Abstract

Objectives

Jejunal tube feeding (JTF) is increasingly becoming the standard of care for children in whom gastric tube feeding is insufficient to achieve caloric needs. Given a lack of a systematic approach to the care of JTF in paediatric patients, the aim of this position paper is to provide expert guidance regarding the indications for its use and practical considerations to optimize its utility and safety.

Methods

A group of members of the Gastroenterology and Nutrition Committees of the European Society of Paediatric Gastroenterology Hepatology and Nutrition and of invited experts in the field was formed in September 2016 to produce this clinical guide. Seventeen clinical questions treating indications and contraindications, investigations before placement, techniques of placement, suitable feeds and feeding regimen, weaning from JTF, complications, long-term care, and ethical considerations were addressed.

A systematic literature search was performed from 1982 to November 2018 using PubMed, the MEDLINE, and Cochrane Database of Systematic Reviews. Grading of Recommendations, Assessment, Development, and Evaluation was applied to evaluate the outcomes.

During a consensus meeting, all recommendations were discussed and finalized. In the absence of evidence from randomized controlled trials, recommendations reflect the expert opinion of the authors.

Results

A total of 33 recommendations were voted on using the nominal voting technique.

Conclusions

JTF is a safe and effective means of enteral feeding when gastric feeding is insufficient to meet caloric needs or is not possible. The decision to place a jejunal tube has to be made by close cooperation of a multidisciplinary team providing active follow-up and care.

The Use of Jejunal Tube Feeding in Children

Ilse Broekaert

Publisher

European Society for Paediatric Gastroenterology, Hepatology and Nutrition

Guideline

Position Paper

Topics

Paediatrics Small Intestine & Nutrition

Citation

Journal of Pediatric Gastroenterology and Nutrition, 69: 239-258

Published

2019

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Project at a university hospital to reduce the CO2 footprint

Nils Andersen 1

1 UKE Hamburg-Eppendorf Abt. Endoskopie, Hamburg, Germany

Event

UEG Week Berlin 2025

Topics

Nurses

Session

Green endoscopy: What makes sense?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Presentation

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MANAGEMENT OF SEVERE EROSIVE GASTROESOPHAGEAL REFLUX DISEASE (EGERD) WITH HIGH-DOSE PROTON PUMP INHIBITORS: INTERIM RESULTS FROM A REAL-WORLD OBSERVATIONAL STUDY (POWER 3.0)

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Introduction

Treatment response in patients with severe erosive gastroesophageal reflux disease (eGERD) is often inadequate using regular doses of proton pump inhibitors (PPIs), thus necessitating escalation of dosing. High-dose PPIs improve compliance in such patients, leading to better outcomes. However, comparative data on effectiveness of high-dose PPIs is limited.

Aims & Methods

This interim analysis assessed symptomatic improvement of regurgitation in an ongoing, prospective, real-world, observational study to compare the effectiveness of rabeprazole 40mg to pantoprazole 80mg and omeprazole 40mg/esomeprazole 80mg. Adult patients with endoscopically confirmed severe eGERD were enrolled. Patients shifted from low-dose PPIs or started on high-dose PPIs were included; those with complications of GERD were excluded.

Results

A total of 260 patients (rabeprazole, 130; omeprazole/esomeprazole, 65; pantoprazole, 65) from 37 sites in India were analyzed. Although symptomatic improvement of diurnal and nocturnal regurgitation based on patient-reported severity scores was observed among the three arms after 4±1 weeks of treatment, the complete-resolution rate of diurnal regurgitation was significantly higher with rabeprazole (17.97%) compared to omeprazole/esomeprazole (5.08%; p=0.018) and higher than pantoprazole (8.20%; p=0.077). Similarly, complete resolution of nocturnal regurgitation was significantly higher with rabeprazole (14.06%) compared to omeprazole/esomeprazole (1.59%; p=0.007) and higher than pantoprazole (7.94%; p=0.221). Among patients with associated work-related stress (n=132), one-fifth in the rabeprazole arm experienced complete resolution of diurnal regurgitation compared to none in the omeprazole/esomeprazole (p=0.013) or pantoprazole (p=0.030) arms. Patients with lack of regular physical exercise (83.08%) exhibited higher rate of complete resolution of nocturnal regurgitation with rabeprazole (13.73%) compared to the other PPIs. Overall, elderly patients >60 years of age (mean±SD, 68.82±6.54 years) treated with rabeprazole showed significantly higher complete-resolution rates of diurnal regurgitation compared to pantoprazole (36.67% vs. 0%; p=0.003). For complete resolution of nocturnal regurgitation, rabeprazole proved to be significantly better when compared to omeprazole/esomeprazole (31.25% vs. 0%; p=0.015) in elderly patients (Table 1).

Conclusion

The interim results showed that rabeprazole led to significantly higher complete-resolution rates of diurnal and nocturnal regurgitation at 4±1 weeks of treatment than omeprazole/esomeprazole in adults with severe eGERD. In elderly patients, rabeprazole showed significant resolution over pantoprazole.

Disclosure

Study funded by: Dr. Reddy's Laboratories Ltd., Hyderabad, Telangana, India

MANAGEMENT OF SEVERE EROSIVE GASTROESOPHAGEAL REFLUX DISEASE (EGERD) WITH HIGH-DOSE PROTON PUMP INHIBITORS: INTERIM RESULTS FROM A REAL-WORLD OBSERVATIONAL STUDY (POWER 3.0)

Mahesh Goenka 1, Kranthi Pebbili 2, Balakrishna Namala 2

1 Apollo Gleneagles Hospitals, Kolkata, India

2 Dr Reddys Laboratories Ltd, Hyderabad, India

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Endoscopy Neurogastroenterology & Motility Oesophagus Stomach & H. Pylori

Submission format

Late-Breaking Abstract

Session

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most demanding and high-risk endoscopic procedures.
Failures and complications are more common than we realise, they lead to low satisfaction for the patient, high frustration for the endoscopist, higher risks of more instrumentalization in further re-attempts.

Keeping a meticulous updated data logging is fundamental to understand how we perform, what specific factors predict our failures, and identifying areas of improvement, mistakes or learning opportunities.

Aims & Methods

This prospective cohort study was conducted over a 3-year period (September 2020 to January 2024) at a tertiary care centre.
We defined all the adverse events as per ESGE guidelines¹ The 30- mortality was analysed and stratified based on relation to ERCP.
We also identified patients’ factors (Age, sex, frailty, NEWS>4, anticoagulation, antiplatelets, palliative) and technique (First pass cannulation, double wire, precut sphincterotomy, sphincteroplasty). Descriptive statistics, chi-square or t-tests were used to evaluate associations between clinical characteristics and outcomes.

Results

A total of 438 patients underwent ERCP by the single operator during the study period. Procedural success was achieved in 389 cases (88.9%) and in 100% of cases of non-native ampulla. Success rates were lower in malignant cases (80.6%) compared to benign cases (90.05%) with an odds ratio (OR) of 2.21 (CI 1.05–4.63, p = 0.03).
Complications included: Post-ERCP pancreatitis: 12/438 (2.74%) Infections: 4/438 (0.91%) (3 cholangitis, 1 cholecystitis) Perforation: 3/438 (0.68%) and Bleeding: 2/438 (0.45%)
Mortality within 1 month was 17/438 (3.88%) mostly unrelated to the procedure in palliative and frail patients. Procedure-related mortality occurred in 4 cases (0.91%),due to pancreatitis (n=2),perforation (n=1) and sepsis secondary to cholecystitis (n=1).
Of all conscious sedation, only 204 /423 (48.2%) were deemed comfortable. 174/423 (41.1%) had mild discomfort, 32/423 (7.5%) had significant discomfort and 13/423 ( 3.07%) severe or very poor. Female patients demonstrated higher risk of poor tolerance (OR 2.09, CI 1.05–4.18 p = 0.04) but no higher procedural failure.
In difficult cannulation, double-wire succeeded in 19/36(52.8%). When combined with additional techniques after initial failure, success increased to 77.8%. Pre-cut sphincterotomy succeeded only in 13/25( 52%) lower than data published (>75%), thought to be due to learning curve and limited patient tolerance. However, pre-cut helped cannulation in most follow-up ERCPs .
Double wire associated risk of post-ERCP pancreatitis -but exclusively when prophylactic pancreatic duct stent was not placed-OR 3.96 (CI 1.02-15.3) p=0.04. None other AEs were significantly associated with any advanced cannulation techniques.

Conclusion

Overall failure rates and AEs were consistent with published literature. Statistically significant risks of failure included malignant aetiology (OR 2.21) and poor tolerance (OR 2.20). Female sex associated higher intolerance (OR 2.09). Both double-wire and pre-cut sphincterotomy showed failure rates of approximately 50%. Frailty was a significant predictor of 30-day mortality (OR 4.83).

AUDIT RESULTS	STRATEGY IMPLEMENTED
Success rates lower in malignant cases (OR 2.21)	Consent form adapted in malignant cases (cannulation rate of 80% instead of 90%)
Poor tolerance (10.57%) → higher in females (OR 2.09)	Increasing the availability of deep sedation lists. Pre-identifying cases of possible low tolerance/anxiety
Post-ERCP Pancreatitis in double wire when prophylactic pancreatic duct stent was not placed-(OR 3.96 )	Any unintentional cannulation pancreatic duct ≥2 times, early PD stent placement
Needle knife success only in 52%	Enhancing mentorship and training in needle-knife
Frailty significant predictor of 30-day mortality (OR 4.83)	Involving palliative care in early discussion with patient. Reevaluate ERCP indication in jaundice without pruritus.

References

1. Dumonceau JM, Kapral C, Aabakken L, Papanikolaou IS, Tringali A, Vanbiervliet G, Beyna T, Dinis-Ribeiro M, Hritz I, Mariani A, Paspatis G, Radaelli F, Lakhtakia S, Veitch AM, van Hooft JE. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2020 Feb;52(2):127-149.
2. Banks PA, BollenTL, Dervenis C et al. Classification of acute pancreatitis– 2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62: 102–111
3. Enochsson L., Swahn F., Arnelo U., Nilsson M., Löhr M., Persson G. Nationwide, population-based data from 11,074 ERCP procedures from the Swedish Registry for Gallstone Surgery and ERCP. Gastrointest. Endosc. 2010;72:1175–1184.
4. Spadaccini M, Binda C, Fugazza A, Repici A, Tarantino I, Fabbri C, Cugia L, Anderloni A, On Behalf Of The Interventional Endoscopy Amp Ultra Sound I-Eus Group. Informed Consent for Endoscopic Biliary Drainage: Time for a New Paradigm. Medicina (Kaunas). 2022 Feb 22;58(3):331.
5.Chen J, Wan JH, Wu DY, Shu WQ, Xia L, Lu NH. Assessing Quality of Precut Sphincterotomy in Patients With Difficult Biliary Access: An Updated Meta-analysis of Randomized Controlled Trials. J Clin Gastroenterol. 2018 Aug;52(7):573-578

MY FAILURES IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) - STRATEGIES THAT CAN BE LEARNED BY EMBRACING SETBACKS

Jose Masegosa Ataz 1, MAITE SERRANO DUEÑAS 2, Arfan Mahmood 1, Mustafa Jalal 2, Shihaz Ambalathu Veettil Hussain 3, Adriana Guerra Romero 4

1 University Hospital North Durham, Durham, United Kingdom

2 University Hospitals Dorset NHS Foundation Trust, Bournemouth, United Kingdom

3 Cairns and Hinterland Hospital and Health Service, Cairns, Australia

4 University Hospital Limerick, Limerick, Ireland

Conference

UEG Week Berlin 2025

Topics

Hepatobiliary

Submission format

Abstract

Session

Difficult biliary cannulation (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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