UEG's content platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Re-live UEG Week 2026 on Gutflix Gut Guide online What's new on Gutflix

Trending on Gutflix

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

CROSSTALK BETWEEN MICRORNAS AND OXIDATIVE STRESS IN COELIAC DISEASE: A PILOT STUDY

Filippo Pelizzaro 1,2, Romilda Cardin 1, Giulia Sarasini 1, Milena Minotto 1, Chiara Carlotto 1, Matteo Fassan 1,3, Michela Palo 1, Fabio Farinati 1,2, Fabiana Zingone 1,2

Affiliations

1 University of Padova, Padova, Italy

2 Azienda Ospedale Università Padova, Padova, Italy

3 Veneto Institute of Oncology IOV, IRCCS, Padova, Italy

Summary

AI Generated

A pilot study of 51 subjects found differential expression of specific microRNAs and elevated oxidative stress markers in adult coeliac disease patients, with evidence of correlations between blood oxidative stress levels and certain microRNAs during follow-up and in complicated disease.

Among eight microRNAs evaluated in plasma, miR-451, miR-146, and miR-155 were differentially expressed between coeliac disease patients at diagnosis, patients on gluten-free diet for at least one year, and healthy controls.
Blood levels of the oxidative stress marker 8-OHdG were significantly higher in coeliac disease patients at diagnosis and on follow-up compared to control patients (p=0.05 and p=0.001, respectively).
Blood 8-OHdG levels correlated positively with miR-155 in complicated coeliac disease (r=0.9, p=0.04) and with miR-200 in follow-up patients (r=0.68, p=0.02), while correlating negatively with miR-1226 in follow-up patients (r=-0.62, p=0.04).
No correlations were found between tissue 8-OHdG levels and microRNAs, suggesting the crosstalk between oxidative stress and microRNAs may be detectable in blood but not duodenal tissue.
This retrospective pilot study in adults suggests a potential interplay between oxidative stress and microRNA regulation in coeliac disease pathogenesis that warrants investigation in larger prospective studies.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Many studies, mostly conducted on pediatric patients, suggested that oxidative stress as well as several micro-RNAs (miRNAs) may play an important role in coeliac disease (CeD) pathogenesis. However, the interplay between oxidative stress and miRNAs regulatory functions in CeD remains to be clarified.

Aims & Methods

This pilot study was conducted to evaluate the role of miRNAs and oxidative stress in adult CeD patients and to analyze their potential interactions.
A total of 51 subjects were retrospectively included in the study: n=12 CeD patients at the time of diagnostic upper GI endoscopy (CeD-dia); n=18 CeD patients after at least one year on a gluten-free diet (CeD-fu); n=5 patients with complicated CeD (CeD-compl); n=10 control patients undergoing upper GI endoscopy for other diseases (CP); n=6 healthy controls (HC). In these subjects, a blood sample and duodenal biopsies were collected. Based on a literature search, several miRNAs involved in the pathogenesis of CeD and with a known relationship with oxidative stress (miR-155, miR-200, miR-125, miR-192, miR-21, miR-451, miR-146 and miR-1226) were quantified with qRT-PCR in plasma. Oxidative stress was evaluated through the measurement of the levels of 8-OHdG adduct in the DNA extracted from the duodenal tissue and from peripheral blood using High Performance Liquid Chromatography with Electrochemical Detection (HPLC-EC).

Results

Among the evaluated miRNAs, miR-451, miR-146 and miR-155 were differentially expressed between groups. In particular, compared to HC, CeD-dia and CeD-fu groups have significantly lower levels of miR-451 (p=0.01 and p=0.006, respectively). The expression of miR-146 in CeD-dia was significantly higher compared to CeD-fu patients (p=0.03), while HC demonstrated lower levels compared to both CeD-dia and CeD-fu (p=0.03 and p=0.01, respectively). A trend toward lower levels of miR-155 was shown in HC compared to CeD-dia (p=0.05) and CeD-fu (p=0.06). The blood level of 8-OHdG were significantly higher in CeD-dia and CeD-fu patients compared to CP (p=0.05 and p=0.001, respectively). No correlations were demonstrated between tissue 8-OHdG levels and miRNAs. By contrast, blood 8-OHdG levels were positively correlated with miR-155 in CeD-compl (r=0.9, p=0.04) and with miR-200 in CeD-fu (r=0.68, p=0.02), while negatively correlated with miR-1226 in CeD-fu (r=-0.62, p=0.04).

Conclusion

miRNAs and the oxidative stress have a role in the pathogenesis of CeD. In this pilot study, we showed that a crosstalk between these two may exist, in particular during follow-up and in complicated CeD. Whether oxidative stress is able to up- or downregulate some miRNAs or, conversely, whether miRNAs expression is capable to modulate the response to oxidative stress in CeD patients should be evaluated in future larger studies.

Conference

UEG Week Copenhagen 2023

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

PP 03 Small intestinal (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

More Like This:

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Roos E. Pouw

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

Colorectal cancer metastasis: What did we learn from TransMet?

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

Hiroyuki Ono

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Vincent Bos 1, Sanne van Munster 1, Bas L.A.M. Weusten 2,3, Lorenza Alvarez Herrero 2, Erik Jan Schoon 4, Wouter L. Curvers 4, Wouter B. Nagengast 5, Alaa Alkhalaf 6, Arjun D. Koch 7, Pieter Jan de Jonge 7, Jessie Westerhof 5, Martin Houben 8, Jacques J. Bergman 1, Roos E. Pouw 3

Affiliations

1 Amsterdam UMC, Amsterdam, Netherlands

2 St Antonius Hospital, Nieuwegein, Netherlands

3 UMC Utrecht, Utrecht, Netherlands

4 Catharina Hospital, Eindhoven, Netherlands

5 University Medical Center Groningen, Groningen, Netherlands

6 Isala, Zwolle, Netherlands

7 Erasmus MC - University Medical center, Rotterdam, Netherlands

8 Haga Teaching Hospital, The Hague, Netherlands

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Endoscopic eradication therapy (EET) with radiofrequency ablation (RFA) ± endoscopic resection (ER) is recommended for Barrett’s esophagus (BE) with early neoplasia¹. After successful EET, the advised endoscopic follow-up (FU) duration is 5 years for low-grade dysplasia (LGD) and 10 years for high-grade dysplasia (HGD)/T1 esophageal adenocarcinoma (EAC)¹. These recommendations are mostly based on expert opinion, as high-quality long-term FU data is scarce.

Aims & Methods

We aimed to evaluate long-term outcomes and identify predictors of recurrent advanced EAC in a nationwide BE treatment cohort. We included all patients with successful EET between 2008-2018 in the Netherlands, in line with our previous publication², with additional FU data collected until September 2025. Endoscopic FU was defined as time from last treatment to last FU endoscopy. Vital FU was defined as time from last treatment to vital status assessment or death. Primary outcome was recurrent dysplasia/EAC. A Cox proportional hazards regression was performed to identify independent predictors of advanced EAC, defined as EAC exceeding boundaries of curative endoscopic treatment. Variables were selected based on clinical plausibility and included parameters available at baseline assessment, treatment, and FU.

Results

We included 1269 patients (1038 male, median age 66 years, median BE C2M4) with baseline LGD in 27%, and HGD/low-risk EAC in 73%. The overall median endoscopic FU was 65 months (IQR 42-93) since the last treatment with a median 5 endoscopies (IQR 3-7), and median 78 months (54-107) since baseline. In 145/1269 patients (11%), endoscopic FU was ≥ 10 years and 454/1269 (36%) started endoscopic FU in a non-BEC a median 16 months (6-30) since last treatment. Endoscopic FU was stopped in 58% following guideline recommendation to stop (20%), limited life expectancy (18%), unrelated death (14%), or lost to FU (4%).
Recurrence of dysplasia/EAC was detected in 91/1269 (7%; annual risk 1.3% [95% CI 1.1-1.6]). Seventy-three endoscopies were needed to find one recurrence. Overall, 76/91 (84%) recurrences were amenable for endoscopic treatment (LGD n=38; HGD/T1 EAC n = 38). The remaining 15/91 ((16%, 1% of total cohort (n=15/1269)) progressed to advanced EAC. Of these, 8/15 underwent treatment with curative intent, 1/15 was referred for treatment, and 6/15 were ineligible or declined curative treatment. EAC-related death occurred in 11/1269 (0.9%). Median FU from last normal endoscopy until advanced EAC was 16 months (IQR 7-38).
Most recurrences were detected during routine FU endoscopy (90%; n=82/91), while 10% (9/91) was diagnosed in an extra endoscopy performed due to symptoms. In 6/1269 (0.5%) patients, recurrent HGD/EAC, including 4 advanced EAC, were diagnosed a median 12 months (IQR 6-61) after the guideline-recommended time point at which FU could have been stopped. However, endoscopic FU had actually been stopped in only 1/6 of these patients. Overall, during a median vital FU of 101 months (IQR 80-136), 319/1269 (25%) patients had unrelated death.
For advanced EAC recurrence, an increasing number of ER sessions and longer BE length were independently associated with an increased risk.

All patients N=1269	FU time, months / FU endoscopies, n, median (IQR)	LGD in normal GEJ w/o BE, n (% [95%CI])	FU until LGD in normal GEJ w/o BE, months, median (IQR; annual risk)	Dysplasia/EAC in recurrent BE, n (% [95%CI])	FU until Dysplasia/EAC in recurrent BE, months, median (IQR; annual risk)	Advanced EAC, n (% [95%CI])	FU until Advanced EAC, months, median (IQR; annual risk)	EAC-related death, n (% [95%CI])	Non-EAC-related death, n (% [95%CI])
Baseline LGD (n=347)	65 (47-83) / 5 (4-6)	5 (5% [1-3])	31 (19-51; 0.2%)	11 (3% [2-6])	43 (30-56; 0.4%)	3 (1% [0-3])	85 (N/A; 0.1%)	2 (1% [0-2])	47 (14% [10-18])
Baseline HGD/EAC (n=922)	65 (40-99) / 5 (3-7)	13 (1% [0-2])	28 (17-46; 0.2%)	47 (5% [4-7])	34 (24-54; 0.6%)	12 (1% [0-2])	34 (17-90; 0.2%)	9 (1% [0-1])	272 (30% [27-33])
BE: Barrett’s esophagus; EAC: esophageal adenocarcinoma; FU: follow-up; HGD: high-grade dysplasia; IQR: interquartile range; LGD: low-grade dysplasia;

Conclusion

This largest cohort to date with long-term endoscopic FU after EET in an expert setting shows low recurrence risk, with EAC-related mortality (<1%), and unrelated mortality of 25%.

References

1. Weusten BLAM, Bisschops R, Dinis-Ribeiro M, et al. Diagnosis and management of Barrett esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2023;55(12):1124-1146. doi:10.1055/a-2176-24
2. Van Munster S, Nieuwenhuis E, Weusten BLAM, et al. Long-term outcomes after endoscopic treatment for Barrett's neoplasia with radiofrequency ablation ± endoscopic resection: results from the national Dutch database in a 10-year period. Gut. 2022;71(2):265-276. doi:10.1136/gutjnl-2020-322615

Event

UEG Week Barcelona 2026

Topics

Oesophagus Histopathology Endoscopy Digestive Oncology

Submission format

Abstract

Session

Interventional endoscopy: What's new and cool!

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Roos E. Pouw

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

Colorectal cancer metastasis: What did we learn from TransMet?

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

Hiroyuki Ono

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Education of endoscopy nurses in Europe – 30 years and still not standardised

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff 1

Affiliations

1 ESGENA Scientific Secretary, Ulm, Germany

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Barcelona 2026

Topics

Nurses

Session

Education of patients and staff

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Roos E. Pouw

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

Colorectal cancer metastasis: What did we learn from TransMet?

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

Hiroyuki Ono

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

Andrea Sorge 1,2, Michele Montori 2, Maria Eva Argenziano 2, Tamás Tornai 3, Adam Monod 2, Pieter Jan Poortmans 4, Lobke Desomer 5, David James Tate 6

Affiliations

1 University of Padua, Padua, Italy

2 University Hospital Ghent, Ghent, Belgium

3 Semmelweis University, Budapest, Hungary

4 University Hospital Ghent, University Hospital Brussels, Asse, Belgium

5 Az Delta, Drongen, Belgium

6 University Hospital Ghent, Gent, Belgium

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Intraprocedural bleeding is a source of technical complexity during endoscopic submucosal dissection (ESD) and may require exchange to coagulation forceps. Spray coagulation is a non-contact, high–peak–voltage mode that combines tissue dissection with powerful coagulation. However, evidence supporting its use in ESD is limited to the stomach.

Aims & Methods

We aimed to evaluate whether spray-coagulation ESD (SP-ESD) improves intraprocedural bleeding control compared to swift ESD (SW-ESD). We analyzed consecutive esophageal, gastric, colonic, and rectal ESDs performed at a tertiary referral center over thirty-six months. SP-ESD was compared to SW-ESD. Assessment of complete procedural video was performed with event-level timestamps. SW-ESD procedures were matched 1:2 to SP-ESD procedures by propensity score on prespecified baseline covariates. The primary outcome was intraprocedural bleeding events. Secondary outcomes were total bleeding time, dissection speed, and coagulation forceps use.

Results

Of 147 eligible ESDs, 91 (60 SP-ESD, 31 SW-ESD) were matched. SP-ESD was associated with fewer bleeding events (mean 1.8 vs 4.2 per procedure; count ratio, .43; 95% CI, .26-.70; P = .001), persisting after accounting for dissection time (rate ratio, .51 per minute; 95% CI, .31-.85). Bleeding time was shorter (median .4 vs 5.5 minutes; ratio of means, .40; 95% CI, .22-.73) and dissection faster (median 16.8 vs 11.6 mm²/min; geometric mean ratio, 1.33; 95% CI, 1.03-1.70). Coagulation forceps were applied a mean of .1 versus 2.6 times per procedure, and 95.0% versus 29.0% were forceps-free (RR, 3.27; 95% CI, 1.79-5.99). R0 resection, en bloc resection, perforation, and delayed bleeding did not differ.

TABLE. Primary and secondary outcomes in the propensity score–matched cohort (n = 91)

Outcome	SW-ESD	SP-ESD	Effect (SP-ESD vs SW-ESD, 95% CI)	P value
Intraprocedural bleeds, mean (primary)	4.2	1.8	CR, .43 (.26-.70)	.001
Bleeding time, min, median	5.5	.4	Ratio of means, .40 (.22-.73)	.003
Dissection speed, mm2/min, median	11.6	16.8	GMR, 1.33 (1.03-1.70)	.027

Conclusion

SP-ESD was associated with substantially less intraprocedural bleeding and coagulation forceps use, and faster dissection without cost in resection quality or safety compared to SW-ESD. Spray coagulation mode can be selected as one of the available electrosurgical modalities to improve bleeding control during ESD.

Event

UEG Week Barcelona 2026

Topics

Primary Care Oesophagus Hepatobiliary Endoscopy Digestive Oncology Colorectal

Submission format

Late-Breaking Abstract

Session

Late-Breaking: Advances in GI-endoscopy

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Roos E. Pouw

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

Colorectal cancer metastasis: What did we learn from TransMet?

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

Hiroyuki Ono

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Colorectal cancer metastasis: What did we learn from TransMet?

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Colorectal cancer metastasis: What did we learn from TransMet?

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Barcelona 2026

Topics

Surgery Hepatobiliary Digestive Oncology Colorectal

Session

Expanding the boundaries of transplant oncology

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Roos E. Pouw

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

Colorectal cancer metastasis: What did we learn from TransMet?

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

Hiroyuki Ono

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang

UEG Poster

New

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

SHUNTA NAGAMORI 1, Kingo Hirasawa 1, Hiroya Mizutani 2, Hideki Kobara 3, Takashi Kanesaka 4, Noboru Kawata 5, Takashi Ibuka 6, Toshiro Iizuka 7, Y. Morita 8, Noriko Matsuura 9, Hiroyuki Odagiri 10, Naoyuki Yamaguchi 11, Tomohiro Shinozaki 12, Yoji Takeuchi 13, Yosuke Tsuji 2, Hiroyuki Ono 5

Affiliations

1 Yokohama City University Medical Center, Yokohama, Japan

2 Graduate School of Medicine, the University of Tokyo, Tokyo, Japan

3 Kagawa University, Kagawa, Japan

4 Osaka International Cancer Institute, Osaka, Japan

5 Shizuoka Cancer Center, Shizuoka, Japan

6 Gifu University School of Medicine, Gifu, Japan

7 Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

8 Kobe University International Clinical Cancer Research Center, Hyogo, Japan

9 Keio University School of Medicine, Tokyo, Japan

10 Toranomon Hospital, Tokyo, Japan

11 Nagasaki University Hospital, Nagasaki, Japan

12 The University of Tokyo, Tokyo, Japan

13 Kindai University, Osaka, Japan

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Endoscopic submucosal dissection (ESD) is widely established as a curative treatment for gastric epithelial neoplasms in Japan. However, post-ESD bleeding remains one of the major adverse events, occurring in approximately 5% of cases. The risk is substantially higher, reported about 10-20% of patients receiving dual antiplatelet therapy (DAPT) or anticoagulants, including warfarin and direct oral anticoagulants (DOACs), and more effective preventive strategies are needed for these high-risk patients. Shielding of post-ESD ulcers with polyglycolic acid (PGA) sheets fixed with fibrin glue has recently been reported as a potential preventive method 1,2).

Aims & Methods

This multicenter prospective study aimed to evaluate the efficacy and safety of PGA sheet and fibrin glue shielding in patients undergoing gastric ESD while receiving anticoagulants or DAPT.
Between October 26, 2020 and March 5, 2025, 130 patients undergoing gastric ESD for gastric epithelial neoplasms were enrolled. After exclusion of 5 patients who discontinued the study, 125 patients were included in the analysis. In all patients, the post-ESD ulcer was endoscopically covered with a PGA sheet (Neoveil® NV-M-015G) and fibrin glue (Beriplast® P). The primary endpoint was the incidence of delayed bleeding within 28 days after ESD. Secondary endpoints included late-phase bleeding (days 7-28), bleeding rates according to antithrombotic regimen, procedure-related adverse events, and risk factors for delayed bleeding. The full analysis set (FAS) was used for the primary analysis, the per-protocol set (PPS) for supportive analysis, and the safety analysis set for safety evaluation. Based on previous reports and clinical relevance, the threshold delayed bleeding rate was set at 15%.

Results

Among the 125 patients analyzed, the mean age was 77.2 years and 96 patients (76.8%) were male. The preoperative diagnoses were gastric adenoma in 24 patients (19.2%), suspected early gastric cancer in 18 (14.4%), and early gastric cancer in 83 (66.4%). The mean tumor size was 16.4 mm. Regarding antithrombotic therapy, 7 patients (5.6%) received DAPT, 111 (88.8%) received DOACs, and 7 (5.6%) received warfarin. Among DOAC users, 47 received edoxaban, 7 dabigatran, 31 rivaroxaban, and 26 apixaban. In the FAS analysis, delayed bleeding occurred in 13 of 125 patients (10.4%; 95% confidence interval [CI], 5.7%-17.1%), with a one-sided p value of 0.0899. In the PPS analysis, delayed bleeding occurred in 12 of 123 patients (9.8%; 95% CI, 5.1%-16.4%), with a one-sided p value of 0.0608.

Conclusion

This prospective multicenter study evaluated PGA sheet and fibrin glue shielding in patients at high risk of post-ESD bleeding due to anticoagulant use or DAPT. Although the delayed bleeding rate was below the prespecified threshold of 15%, statistical significance was not achieved. The observed bleeding rate was numerically lower than previously reported rates in similar high-risk populations, suggesting that this shielding method may be a promising preventive strategy. Further controlled studies are warranted.

References

Tsuji, Yosuke, et al. "Polyglycolic acid sheets and fibrin glue decrease the risk of bleeding after endoscopic submucosal dissection of gastric neoplasms (with video)." Gastrointestinal endoscopy 81.4 (2015): 906-912.
Kataoka, Yosuke, et al. "Endoscopic tissue shielding to prevent bleeding after endoscopic submucosal dissection: a prospective multicenter randomized controlled trial." Endoscopy 51.07 (2019): 619-627.

Disclosure

Yosuke Tsuji, Male, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan: Study grant from GUNZE.
Others: Nothing to disclosure.

Conference

UEG Week Barcelona 2026

Topics

Oesophagus

Submission format

Abstract

Session

Stemming the red tide: Current trends in GI bleeding (Posters)

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Roos E. Pouw

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

Colorectal cancer metastasis: What did we learn from TransMet?

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

Hiroyuki Ono

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang 1, jing Yang 2

Affiliations

1 Hangzhou First People's Hospital, Hangzhou, China

2 Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, China

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Selective biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging. Successful cannulation depends not only on papillary orientation but also on the overall configuration of the endoscope. We developed an artificial intelligence (AI)-assisted guidance systemand present a three-case video demonstration to illustrate its potential value in guiding novice ERCP operators during selective biliary cannulation.

Aims & Methods

The system integrates real-time analysis of both endoscopic and fluoroscopic images. In the endoscopic view, the system automatically identifies the papillary axis and displays the predicted direction for biliary cannulation: a thin yellow line indicates the papillary axis, while a thicker orange-pink line represents the suggested cannulation path. In the fluoroscopic view, the system analyzes duodenoscope configuration, including shaft course, luminal curvature, and bending segment angle. These parameters characterize the endoscopic course within the stomach and duodenum, thereby reflecting procedural compliance and providing additional guidance for assessing case suitability for junior endoscopists.

Results

During cannulation attempts in all three cases, the system generated continuously updated real-time overlays. The endoscopic module provided visual guidance for alignment with the presumed biliary direction, while the fluoroscopic module supplemented information on scope configuration and distal bending. This integrated visualization helped interpret the relationship between local papillary orientation and global endoscope geometry during selective biliary access.

Conclusion

Real-time AI-assisted guidance during ERCP is feasible and may offers practical support for selective biliary cannulation. By combining papillary axis recognition with fluoroscopic assessment of scope configuration, this approach may improve cannulation positioning accuracy and enhance understanding of cannulation difficulty. Further prospective evaluation is needed to evaluate its impact on cannulation success rates, procedure time, and training outcomes.

References

Event

UEG Week Barcelona 2026

Topics

Endoscopy Hepatobiliary

Submission format

Video Case

Session

Lights, camera, lumen! High-impact endoscopy video cases

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LOW RECURRENCE RATES AFTER ENDOSCOPIC ERADICATION THERAPY OF BARRETT'S NEOPLASIA: LONG-TERM FOLLOW-UP RESULTS FROM THE NATIONWIDE DUTCH BARRETT'S REGISTRY

Roos E. Pouw

Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

Colorectal cancer metastasis: What did we learn from TransMet?

POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE SHIELDING FOR PREVENTION OF POST-ESD BLEEDING IN PATIENTS RECEIVING ANTICOAGULANTS OR DUAL ANTIPLATELET THERAPY: A PROSPECTIVE MULTICENTER STUDY

Hiroyuki Ono

ARTIFICIAL INTELLIGENCE FOR PROCEDURAL GUIDANCE IN ERCP: A VIDEO DEMONSTRATION STUDY

Xiaofeng Zhang