Thursday 19 September
08:30

Thursday 19 September

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EUS19-1
08:30 - 10:15

Live Demo
Session 1

Moderators: David BERNARDINI (Toulon, FRANCE), Ch. BOUSTIÈRE (Aubagne, FRANCE), Laurent HEYRIES (Marseille, FRANCE), Mahmoud OMAR (KUWAIT)
Experts: Marc BARTHET (Marseille, FRANCE), Erwan BORIES (Marseille, FRANCE), Guido COSTAMAGNA (ITALY), Jacques DEVIERE (BELGIUM), Marc GIOVANNINI (Marseille, FRANCE), Mostafa IBRAHIM (EGYPT), Horst NEUHAUS (GERMANY), D. SEO (KOREA)
Amphithéatre
10:45

Thursday 19 September

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EUS19-2
10:45 - 12:45

Live Demo
Session 2

Moderators: David BERNARDINI (Toulon, FRANCE), Ch. BOUSTIÈRE (Aubagne, FRANCE), Laurent HEYRIES (Marseille, FRANCE), Mahmoud OMAR (KUWAIT)
Experts: Marc BARTHET (Marseille, FRANCE), Erwan BORIES (Marseille, FRANCE), Guido COSTAMAGNA (ITALY), Jacques DEVIERE (BELGIUM), Marc GIOVANNINI (Marseille, FRANCE), Mostafa IBRAHIM (EGYPT), Horst NEUHAUS (GERMANY), D. SEO (KOREA)
Amphithéatre
13:45

Thursday 19 September

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EUS19-3
13:45 - 15:45

Live Demo
Session 3

Moderators: David BERNARDINI (Toulon, FRANCE), Ch. BOUSTIÈRE (Aubagne, FRANCE), Laurent HEYRIES (Marseille, FRANCE), Mahmoud OMAR (KUWAIT)
Experts: Marc BARTHET (Marseille, FRANCE), Erwan BORIES (Marseille, FRANCE), Guido COSTAMAGNA (ITALY), Jacques DEVIERE (BELGIUM), Marc GIOVANNINI (Marseille, FRANCE), Mostafa IBRAHIM (EGYPT), Horst NEUHAUS (GERMANY), D. SEO (KOREA)
Amphithéatre
16:15

Thursday 19 September

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EUS19-4
16:15 - 17:15

Live Demo
Session 4

Moderators: David BERNARDINI (Toulon, FRANCE), Ch. BOUSTIÈRE (Aubagne, FRANCE), Laurent HEYRIES (Marseille, FRANCE), Mahmoud OMAR (KUWAIT)
Experts: Marc BARTHET (Marseille, FRANCE), Erwan BORIES (Marseille, FRANCE), Guido COSTAMAGNA (ITALY), Jacques DEVIERE (BELGIUM), Marc GIOVANNINI (Marseille, FRANCE), Mostafa IBRAHIM (EGYPT), Horst NEUHAUS (GERMANY), D. SEO (KOREA)
Amphithéatre
17:15

Thursday 19 September

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EUS19-5
17:15 - 18:30

Free paper Session

Moderators: Ch. BOUSTIÈRE (Aubagne, FRANCE), Mahmoud OMAR (KUWAIT)
17:15 - 17:30 #19639 - CO01 Trend towards less aggressive endoscopic ultrasound (EUS) surveillance for pancreatic cystic neoplasms (PCN): Results of 8-year single-center experience.
CO01 Trend towards less aggressive endoscopic ultrasound (EUS) surveillance for pancreatic cystic neoplasms (PCN): Results of 8-year single-center experience.

Background: While there are a few published guidelines on the management of PCNs, the optimal surveillance algorithm for PCNs is still a point of contention. EUS is a more sensitive modality for pancreatic imaging and fine needle aspiration (FNA) with molecular analysis provides additional information to better characterize PCNs. No prior study reports longitudinal results from serial surveillance by EUS with FNA results. We now report long-term data of pancreatic cysts followed by endoscopic ultrasound with FNA.

Methods: We performed a single-center, retrospective analysis of 727 patients (252M/475F, mean age 67, age range 21-94) who had pancreatic cysts on EUS from Jan-2010 to Dec-2017. Follow-up EUS was performed on 342 of these patients. Follow-up FNA with molecular analysis was available for analysis in 159 of these patients. Significant growth rate was defined as >2mm size increase.

Results: Of the 342 patients who had follow-up EUS, 121 (35%) patients had an increase in cyst size, while remaining 221 (65%) patients showed no change or a decrease in cyst size. Twenty-eight (8%) patients showed a growth rate >30%/year. The mean growth rate for all 342 patients was -0.26mm/year.  Prior to 2015, the mean EUS follow-up interval was 11.6 months. After 2015, the mean EUS follow-up interval increased to 19.3 months. Of the 159 patients with FNA follow-up, 73 had repeat molecular analysis performed. 

Figure 1: Change in molecular analysis results in 73/159 patients with follow-up FNA

Benign to Benign - 36

Benign to Statistically Indolent - 9

Benign to Statistically Higher Risk - 3

Statistically Indolent to Benign - 15

Statistically Indolent to Statistically Indolent - 8

Statistically Indolent to Statistically Higher Risk - 1

Statistically Higher Risk to Statistically Higher Risk -1

Discussion: There was a trend toward less frequent EUS surveillance of pancreatic cysts in this study. With close follow-up on serial EUS with FNA and molecular analyses, PCNs infrequently demonstrated progression. Coupled with the data obtained from our series of patients who had surveillance by EUS, where the mean growth rate of pancreatic cysts was low, we suggest that the recent decrease in surveillance is warranted.

Timothy NGUYEN (Newport Coast, USA), Spencer KIEU, Paul KORC, Robert SELBY, Phuong NGUYEN
17:30 - 17:45 #19625 - CO02 The macrodilatation of the sphincter of Oddi or Sphincteroplasty in the treatment of large stones of the main bile duct about 48 cases in a Moroccan Department.
CO02 The macrodilatation of the sphincter of Oddi or Sphincteroplasty in the treatment of large stones of the main bile duct about 48 cases in a Moroccan Department.

Macrodilatation of the sphincter of Oddi (MDSO) consists of a large dilatation of the papilla which completes an endoscopic sphincterotomy in cases of gross choledochal calculus. The aim of this work is to evaluate the results and complications of sphincteroplasty and associated factors. Patients and Methods: Retrospective study conducted at the Department of Hepatology and Gastroenterology II of Military Hospital between, in a period of 9 years, between January 2010 and March 2019, including 48 patients diagnosed with big stones of the main bile duct. Defined by a diameter ≥ 15 mm and whose treatment required the use of sphincteroplasty. The success of the gesture was defined by the absence of residual calculation at the end of the procedure. Results: Mean age of the patients was 63.5 ± 12 years (40 years to 83 years). The sex ratio was 0.7 (28 women, 20 men). 11.3% of the patients included in the studies had a history of cholecystectomy, 6.8% of the patients had gallbladder stones, 57.9% of the patients had multiple stones (≥2), 29.6% had 13.6% of patients had an associated endoscopic sphincterotomy, and in 11.3% there was a difference in caliber between the calculation and the diameter of the bile duct downstream. The clinical presentation of the patients was as follows: cholangitis was found in 7 patients; dissociated biliary symptoms suggestive of lithiasis migration in 28 patients while 13 patients showed no symptoms. The average number of stones found was 1.86 ± 0.8 per patient with extremes ranging from 1 to 10. The average diameter of the bile duct was 18 ± 4 mm that of the stones was 18 ± mm, and that of Macrodilating balloon was 16.9 ± 1.5 mm with extremes ranging from 14 to 20 mm. The success rate of sphincteroplasty was 91.6% (44 patients). Extraction was not possible in 4 patients with macrocalculations with an average diameter of 19 ± 2 mm. Two of these patients had undergone a plastic biliary prosthesis; the other two were surgically treated. The complication rate was 6.8% in the form of minimal bleeding from the margins curbed by pneumatic compression. Conclusion: Macrodilatation of the sphincter of Oddi is an effective method at the cost of a low morbidity for the endoscopic extraction of big stones of the main bile duct. The success rate is 91.6% and immediate complications are rare. No factors studied seem to be associated with the failure or success of this technique.

Sara JAMAL (Rabat, MOROCCO), Hassan SEDDIK, Sanaa BERRAG, Khaoula LOUBARIS, Reda BERRAIDA, Ilham EL KOTI, Ahmed BENKIRANE
17:45 - 18:00 #19619 - CO03 Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) in cytopathological diagnosis of subepithelial lesions of esophagus.
CO03 Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) in cytopathological diagnosis of subepithelial lesions of esophagus.

Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) in cytopathological diagnosis of subepithelial lesions of esophagus

Introduction: Subepithelial lesions of the gastrointestinal tract occur at a rate of 1/300 during endoscopy. Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is a reliable minimally invasive method in the differential diagnosis of subepithelial lesions.

Aim: The goal of this study was to investigate the EUS-FNA results according to the size and origin of the esophageal-derived subepithelial lesions (SEL) detected during upper GIS endoscopy.

Materials and Methods: The data of the patients who had esophageal SML detected between January 2010 and February 2018 in EUS Laboratory of Gastroenterology Department of Ankara University Faculty of Medicine were evaluated retrospectively.

Results: EUS procedure was performed in 200 patients due to the esophageal subepithelial lesion. 50 of them (24 males, 26 females, mean age: 49.96 (min: 20 max: 70)) received EUS-FNA. The mean lesion size was 29.02 mm (11-115 mm),  The originating layer was 72% (36) muscularis propria (4th layer origin) and 28% (14) muscularis mucosa (2nd layer origin). 4% of the SELs were located in the proximal esophagus, 42% were in the middle esophagus and 54% were in the distal esophagus.

72% (36/50) of the biopsy specimens obtained with EUS-FNA showed sufficiency for diagnostic accuracy. Cytopathology revealed mesenchymal cell tumors in 34 patients, bronchogenic cyst in 1 patient and abscess in 1 patient. The diagnosis rate was 76.9% (10/13) in lesions <2cm, 78.2% (18/23) in lesions between 2-3 cm and 64.2% (27/36) in 3-4 cm lesions. EUS FNA positivity was 75% (27/36) in muscularis propria origin and 71.4% (10/14) in muscularis mucosal origin.

Conclusion: Approximately 75 percent of the subepithelial lesions of the esophagus can be diagnosed by EUS-guided aspiration biopsy. The size of the lesion and the layer from which it originated had no effect on the EUS-FNA result.

Mesut GÜMÜŞSOY, Koray CEYHAN, Serkan DUMAN (Ankara, TURKEY), Kamani LUBNA, Aysun ÇALIŞKAN, Mübin ÖZERCAN, Ramazan ER, Ellik ZEYNEP
18:00 - 18:15 #19620 - CO04 Assessment of Solid Pancreatic Lesions with EUS Elastography.
CO04 Assessment of Solid Pancreatic Lesions with EUS Elastography.

Assessment of Solid Pancreatic Lesions with EUS Elastography

 

Aim: Evaluation of EUS-FNA cytology results with EUS-elastography color pattern and strain ratio scores in malignant solid lesions of the pancreas.

 

Methods: 132 patients who had pancreatic lesions detected with EUS in our department between January 2014 and June 2019 were included in this retrospective study. EUS elastography color pattern, strain ratio measurements and real-time EUS FNA were performed on all patients. The tissue stiffness score and coloration modes of the lesions were evaluated. We divided the lesions into five groups by their coloration modes: dark blue, blue, yellow-green,yellow-green-blue and blue-green and also into two groups by their tissue stiffness: strain ratio scores ≥4 or <4

 

Results: 132 patients with solid pancreatic lesions were included in this study. 78(59.1%) were male with an average age of 60.6, and 54(40.9%)  were female with an average age of 54.5. The mean diameter of the long and short axis were 27.1 mm and 21.5 mm, respectively. Cytopathology results revealed that 78 (59.1%) lesions were malign. The median strain ratio of all malignant lesions was 34.5 (1.5-444). Of the lesions with a value of 4 or higher, 75 (96,2%) were malignant. According to the elastography coloration mode of malignant lesions, 64 (82.1%) lesions were dark blue, 8(10.3%) were blue, 3(3.8%) were green-blue, 1 was (1.3%) blue-green-yellow, and 2 (.,6%)cwere green-yellow.

 

Conclusions: EUS is an effective and safe method for assessing solid pancreatic lesions with fine needle aspiration. 96.2% of patients with diagnosed malignancy  showed tissue stiffness (strain ratio) ≥4 with EUS elastography. Endoscopic elastography is a non-invasive method, which can discriminate between malign and benign pancreatic solid lesions.

Mehmet BEKTAŞ (Ankara, TURKEY), Mesut GÜMÜŞSOY, Serkan DUMAN, Mübin ÖZERCAN, Ramazan ER, Koray CEYHAN
18:15 - 18:30 #19617 - CO05 New software, for the virtual 3D reality, in the use of endo-ultrasonography for rectal adenocarcinoma.
CO05 New software, for the virtual 3D reality, in the use of endo-ultrasonography for rectal adenocarcinoma.

MRI and rectal EUS are determinant for staging of rectal adenocarcinoma. EUS has been criticized for lack of precision and systematization. Images can be unclear for other specialists. We present the results of the rectal EUS in 3D and in coronal, sagittal and front sections, using an electronic spreadsheet and  a new computer program (3d.eus) . This system is independent of the ultrasonography computer. A multicenter study is scheduled, and a future development with other diseases.

 

Michel CASSAGNOU (Tourcoing)
Amphithéatre
Friday 20 September
08:30

Friday 20 September

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EUS20-1
08:30 - 10:30

Session Pancreas/Bile Ducts

Moderators: Jacques DEVIERE (BELGIUM), Marc GIOVANNINI (Marseille, FRANCE), D. SEO (KOREA)
08:30 - 08:50 What's new in the surgical management of side branch IPMN ? O TURRINI (FRANCE)
08:50 - 09:10 Cholangiocarcinoma : Biliary drainage: For whom and how? Guido COSTAMAGNA (ITALY)
09:10 - 09:30 EUS FNB for solid pancreatic mass : Is EUS-FNA still needed? Erwan BORIES (Marseille, FRANCE)
09:30 - 09:50 What's the place of cholangioscopy in 2019 ? Horst NEUHAUS (GERMANY)
09:50 - 10:30 CONFERENCE: Place of EUS guided local therapy for pancreatic tumors. D. SEO (KOREA)
Amphithéatre
11:00

Friday 20 September

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EUS20-2
11:00 - 11:30

Free paper Session

Moderators: David BERNARDINI (Toulon, FRANCE), Ch. BOUSTIÈRE (Aubagne, FRANCE), Christian PESENTI (Marseille, FRANCE)
11:00 - 11:15 #19596 - CO06 Innovation of EUS-guided Transmural Drainage using a Novel Self-Expanding Metal Stent.
CO06 Innovation of EUS-guided Transmural Drainage using a Novel Self-Expanding Metal Stent.

Backgrounds: Endoscopic ultrasonography (EUS)-guided transmural drainage has been accepted as a modality of choice in pancreatic pseudocyst and acute cholecystitis. Each type of stent, including double-pigtail plastic stents, tubular self-expandable metal stents (SEMS), and lumen-apposing metal stents, for these procedure has its own disadvantages. To overcome their disadvantages, this animal study evaluated the feasibility of a newly designed twisted fully covered metal stent with dual coiled ends.

Methods: We performed the EUS-guided GB drainage with a newly developed metal stent in eight mini pigs with surgically induced GB distension. This novel stent is a twisted fully covered SEMS with dual 360-degree coiled ends. The stent has been maintained for four to seven weeks after EUS-guided GB drainage. The primary outcome was the technical success rate, and the secondary outcomes were adverse events, stent dysfunction, stent removability, and fistula formation.

Results: The stent was placed successfully between the gallbladder and the stomach in all cases without any adverse event. We observed neither stent migration nor dysfunction during the study period, and all the stents were removed easily as scheduled. We confirmed successful cholecysto-gastric fistula formation in all cases.

Conclusion: EUS-guided transmural drainage and fistula formation using a new twisted fully covered SEMS with dual coiled ends was technically feasible without any adverse event in this animal study. 

Sang Hyub LEE (Seoul, KOREA), Gunn HUH, Jin Ho CHOI, Woo Hyun PAIK, Ji Kon RYU, Yong-Tae KIM, Seok JEONG, Don Haeng LEE
11:15 - 11:30 CO07 - Risk factors associated with adverse evets during EUS guided tissue sampling. Lee KWANG HYUCK (Korea)
Amphithéatre
11:30

Friday 20 September

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EUS20-3
11:30 - 12:15

PENTAX SYMPOSIUM

Moderators: Marc BARTHET (Marseille, FRANCE), Marc GIOVANNINI (Marseille, FRANCE)
11:30 - 12:15 Expanding EUS-guided therapy to the new level- Our experience with a true therapeutic echendocope. Geoffroy VANBIERVLIET (Nice Cedex 3, FRANCE)
11:30 - 12:15 Expanding EUS-guided therapy to the new level - Can we have better outcomes performing EUS-guided therapy? Alberto LARGHI (Rome, ITALY)
Amphithéatre
13:30

Friday 20 September

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EUS20-4
13:30 - 14:15

COOK SYMPOSIUM
Endo-hepatology: the future of EUS?

13:30 - 14:15 Endo-hepatology: the future of EUS? Schalk VAN DER MERWE (Leuven, BELGIUM)
Amphithéatre
14:15

Friday 20 September

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EUS20-5
14:15 - 16:00

Round table on therapeutic EUS

Moderators: Jacques DEVIERE (BELGIUM), Marc GIOVANNINI (Marseille, FRANCE), D. SEO (KOREA)
14:15 - 14:35 Pancreatic collection drainage: Is lams the panacea ? Jacques DEVIERE (BELGIUM)
14:35 - 14:55 EUS guided pancreatic duct drainage : Is it ready for prime time ? Nan GE (CHINA)
14:55 - 15:15 EUS guided biliary drainage in altered anatomy: Is it the first choice ? Marc BARTHET (Marseille, FRANCE)
15:15 - 15:35 EUS guided biliary drainage : What's stents to use ? Fabrice CAILLOL (Marseille, FRANCE)
14:15 - 16:00 EUS guided fiducial placement for SBRT. D. SEO (KOREA)
15:55 - 16:00 Questions/answers.
Amphithéatre
16:30

Friday 20 September

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EUS20-6
16:30 - 17:30

Free Paper Session

Moderators: Erwan BORIES (Marseille, FRANCE), Marc GIOVANNINI (Marseille, FRANCE)
16:30 - 16:42 #19624 - CO08 Is the diverticular papilla a factor in the failure of catheterization of the main bile duct in lithiasis pathology? Experience of a Moroccan Department : About 846 cases.
CO08 Is the diverticular papilla a factor in the failure of catheterization of the main bile duct in lithiasis pathology? Experience of a Moroccan Department : About 846 cases.

Introduction: The duodenal diverticula are frequent (6 to 20%), and they preferentially sit in the papillary region and are called juxta-, peri-para-papillary or valerian. The latter may be a difficulty in the catheterization of the main bile duct and are more common in cases of associated cholelithiasis. The objective of our study is to calculate the prevalence of juxta-papillary diverticula (JPD) in patients with VBP lithiasis and evaluate their influence on the success rate of main bile duct catheterization in lithiasis pathology.

Patients and Methods:This is a retrospective study conducted from April 2004 until April 2018. There were included 846 patients having benefited from an ERCP for lithiasis of the main bile duct. The presence or absence of a juxta-papillary diverticulum has been noted. We compared the success rate of catheterization of the main bile duct in patients with juxta-papillary diverticulum (group I) versus patients without diverticular disc (group II).

Results:The mean age of the patients was 58 ± 13 years, 515 women and 331 men (sex ratio H / F: 0.64). Patients with a diverticular disc (group I) accounted for 9.6% of the patients included (81 patients). Group II consisted of 765 patients (90.4%). The success rate of the main bile duct catheterization was 96.4% in group II versus 86.5% in group I (p: 0.007). The overall rate of early complications was 6% in group II versus 7.4% in group I (p = 0.12).

Conclusion:The presence of a PDI appears to significantly decrease the success rate of the main bile duct catheterization in lithiasis pathology without increasing the risk of early complications. Prospective studies with large series, however, remain necessary to confirm these results.

Sara JAMAL (Rabat, MOROCCO), Hassan SEDDIK, Fouad NEJJARI, Khaoula LOUBARIS, Reda BERRAIDA, Ilham EL KOTI, Ahmed BENKIRANE
16:42 - 16:54 #19621 - CO09 Endoscopic Ultrasound (EUS) Fine Needle Biopsy (FNB) and Endoscopic Submucosal Dissection (ESD) for Radical Resection of a large Gastric Gastrointestinal Stromal Tumor (GIST).
CO09 Endoscopic Ultrasound (EUS) Fine Needle Biopsy (FNB) and Endoscopic Submucosal Dissection (ESD) for Radical Resection of a large Gastric Gastrointestinal Stromal Tumor (GIST).

Introduction

We report a case of a GIST of the gastric antrum that was successfully treated after a carefull EUS in association of FNB with an Endoscopic Submucosal Dissection (ESD).

FS,a 45 yers-old female, was refferred to our third level Gastroenterological Unit in Siena because of submucosal lesion located in gastric antrum wich determined bleeding and anemia (Hb 7,5 g/dl). She had not known allergies and family history was not significant. Se did not take drugs. The patient was a smoker (20 cigarettes/day), consumed alcohol occasionally, and denied taking illicit drugs.

A CT scan showed a gastric wall thickening of about 40x38x30 mm dimension placed at the limit between gastric body and antrum with contrast enhancement.

EUS demonstrated ipoechoic lesion with a rich vascolarization, originated by submucosal layer, with ulcerated surface. It was performed fine needle biopsy (FNB) that diagnosed Gastrointestinal Stromal Tumor (GIST). Oncologic serological test were negative.

Despite the considerable size of the GIST, because of its submucosal origin and the absence of metastasis, we decided for an endoscopic approach. Patient underwent to an endoscopic submucosal dissection (ESD) with dualknife obtained an en bloc resection. No bleeding complicated the resection.

At the end of the procedure FS underwent to an abdomen and chest X-ray and then to a CT scan that showed pneumoperitoneum and pneumomediastinum without gastric perforation. Either the pneumoperitoneum and pneumomediastinum were treated conservatively through a transcutaneous small dreinage placemente then removed in a few hours.

FS was then observed, treated with antibiotics, feeded after two days and then discharged after four days.

Definitive histology confirmed GIST with low mitotic count.

In tis case a meticulous EUS study allowed to decide for a low invasive resective procedure.

Despite considerable size ESD obtained a complete resection of the gastric GIST lesion decreasing hospitalization days.

Raffaele MACCHIARELLI, Alessia SANTINI (Siena, ITALY), Silvia RENTINI, Elena GIANNI, Ivano BIVIANO
16:54 - 17:06 #19627 - CO09 Severe acute colitis: Predicting response factors to intravenous corticosteroid therapy about 81 cases in a Moroccan Department.
CO09 Severe acute colitis: Predicting response factors to intravenous corticosteroid therapy about 81 cases in a Moroccan Department.

Introduction : Severe acute colitis may be a revelation or occur in the course of a known chronic intestinal inflammatory disease, particularly hemorrhagic colitis. Intravenous corticosteroid therapy is the first-line medical treatment for the severe acute colitis.

The purpose of our work is to assess the predictors of response to intravenous corticosteroid therapy during severe acute colitis.

Materials and methods: This is a 5 year retrospective study, from June 2013 to December 2018, including 81 cases of severe acute colitis collected in the Department of Hepatology and Gastroenterology I of the Military Training Hospital of Rabat in Morocco. The severe acute colitis was defined by a Lichtiger score above 10. Clinical, biological, endoscopic and radiological data were collected and analyzed by SPSS20.

Results: The average age of our patients is 37.9-17.1 years with a clear female predominance (63 F/ 18 H), 16 patients (22.2%) had a known inflammatory bowel disease (IBD).  The average Lichtiger Scale was 13-1.45, 34 patients (33.3%) were naive to steroids, 31 patients (33.3%) had endoscopic gravity criteria.  In univariate analysis, the factors significantly associated with intravenous corticosteroid therapy failure were: J3-elevated CRP (45mg/l), blood presence at J3, pancolic impairment, non-naïve corticosteroid status. In multi-variance analysis and adjusting for the above factors, only CRP (c-reactive protein) was 45mg/l at J3 is significantly associated with intravenous corticosteroid therapyfailure (OR 1.3, p-0.02).

Conclusion: Our study supports the literature on the value of pCR-to-J3 dosage to assess response or failure to intravenous corticosteroid therapy in the initial management of severe acute colitis.

 

Sara JAMAL (Rabat, MOROCCO), Sanaa BERRAG, Fouad NEJJARI, Mouna TAMZAOURTE, Aziz AOURARH
17:06 - 17:18 #19618 - CO10 The role of endoscopic ultrasonography in esophageal cancer staging.
CO10 The role of endoscopic ultrasonography in esophageal cancer staging.

The role of endoscopic ultrasonography in esophageal cancer staging

Introduction:  Endoscopic ultrasonography (EUS) is an effective and reliable method for local staging of esophageal cancers and provides information about the prognosis of the disease. EUS staging is performed only after distant metastasis is excluded from CT or PET-CT.

Aim: The goal of this study is to compare EUS staging with postoperative histopathological staging, which is the gold standard in patients diagnosed with esophageal cancer without distant metastasis by CT or PET-CT after preoperative or neoadjuvant CRT and to investigate the diagnostic accuracy of EUS in tumor and lymph node staging.

Materials and Methods: Between January 2010 and November 2018, 139 patients diagnosed with esophageal cancer in the Chest Surgery Clinic of Ankara University Faculty of Medicine underwent preoperative radial type EUS device staging in the EUS laboratory of Gastroenterology Department. Histopathological and EUS stages of 74 operated out of 139 patients were compared. TNM classification was used for EUS staging.

Results: Of the 74 patients included in the study, 43 (58.1%) were male and 31 (41.9%) were female, and the mean age was 59 (28-86). The tumor was located in the distal esophagus in 54 patients, in the distal esophagus and esophagogastric junction in 8 patients, and in the middle esophagus in 9 patients. Biopsy revealed 40 patients with squamous cell carcinoma and 23 patients with adenocarcinoma. The mean tumor length was 5 cm. The mean tumor thickness in EUS was 13.6 mm. 25 (33.7%) of 74 patients who underwent preoperative staging with EUS received neoadjuvant CRT.

In 49 patients who did not receive preoperative CRT, the diagnostic accuracy rate of EUS was according to stages; T1: 66.6%, T2: 80%, T3: 65%, T4: 0%, overall: 65%; N staging rate was 92%. In 29 patients who received neoadjuvant CRT, the diagnostic accuracy rate of EUS was T1: 33%, T2: 50%, T3: 55.5%, T4: 100% and overall: 40%. All of the 7 patients who did not detect any tumor on histopathological examination after surgery the EUS stage was minimal T1 and above.

Conclusion: EUS is an effective and reliable method in the preoperative staging of esophageal cancers. The diagnostic accuracy rate of US in restaging after CRT is low, and in all patients with no tumor detected after surgery, the EUS stage was minimal T1 and above.

Mehmet BEKTAŞ (Ankara, TURKEY), Mübin ÖZERCAN, Serkan DUMAN, Kamani LUBNA, Aysun ÇALIŞKAN, Mesut GÜMÜŞSOY, Ellik ZEYNEP , Hakan KUTLAY
17:18 - 17:30 #19622 - CO11 The effectiveness of endoscopic dilations in benign digestive stenosis in a Moroccan population: Retrospective study about 93 cases.
CO11 The effectiveness of endoscopic dilations in benign digestive stenosis in a Moroccan population: Retrospective study about 93 cases.

Introduction: Endoscopic dilations are an interventional endoscopy technique indicated in the organic and motor stenosis of the digestive tract. The purpose of our work is to evaluate the effectiveness of this technique in the treatment of benign digestive stenosis.

Materials and methods: This is a descriptive retrospective study, in a period of 9 years, from March 2010 to March 2019. We included 93 patients having a benign digestive stenosis treated endoscopically by dilation with candles or balloon, collected at  the department of Hepato-Gastroenterology I of the Military Training Hospital Mohammed V of  Rabat in Morocco.

Results : The average age was 45.2 years with a slight female predominance. The main symptomatology was dysphagia for esophageal stenosis. The causes of these stenosis were: achalasia in 30 cases, peptic stenosis in 21 cases, anastomots in 18 cases, a Vincent Plummer Syndrom in 12 cases and caustic stenosis in 3 cases, 3 stenosis after sleeverectomy and 6 cases of colic stenosis. 54 patients received candle-dilation and 39 patients were treated with pneumatic balloon dilation. The number of dilation was on average 2 sessions (extreme: 1-4 sessions). No immediate complications were reported. The evolution of the patients was satisfactory, a case of anastomotic stenosis (oeso-jejunal anastomosis for carcinoid tumor operated 6 years ago) that was resistant to dilation several times.

Conclusion: Endoscopic dilation is an effective technique in the management of benign digestive stenoses and is an alternative to surgery, its complications are exceptional when the rules of action are respected.

Sara JAMAL (Rabat, MOROCCO), Fedoua ROUIBAA, Mouna TAMZAOURTE, Aziz AOURARH
Amphithéatre
17:30

Friday 20 September

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EUS20-7
17:30 - 17:45

Closing remarks and adjourn

Keynote Speaker: Marc GIOVANNINI (Marseille, FRANCE)
Amphithéatre
Saturday 21 September
08:30

Saturday 21 September

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HOS1
08:30 - 10:30

Hands on Session
EUS RFA Group 1

Saturday 21 September

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HOS2
08:30 - 10:30

Hands on Session
EUS-FNA - Group 1

Saturday 21 September

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HOS3
08:30 - 10:30

Hands on Session
EUS FNA - Group 2

Saturday 21 September

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HOS4
08:30 - 10:30

Hands on Session
EUS guided collection drainage - Group 1

Saturday 21 September

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HOS5
08:30 - 10:30

Hands on Session
EUS guided collection drainage - Group 2

Saturday 21 September

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HOS6
08:30 - 10:30

Hands on Session
EUS guided collection drainage - Group 3

11:00

Saturday 21 September

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HOS7
11:00 - 13:00

Hands on Session
EUS RFA - Group 1

Saturday 21 September

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HOS8
11:00 - 13:00

Hands on Session
EUS-FNA - Group 1

Saturday 21 September

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HOS9
11:00 - 13:00

Hands on Session
EUS-FNA - Group 2

Saturday 21 September

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HOS10
11:00 - 13:00

Hands on Session
EUS guided collection drainage - Group 1

Saturday 21 September

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HOS11
11:00 - 13:00

Hands on Session
EUS guided collection drainage - Group 2

Saturday 21 September

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HOS12
11:00 - 13:00

Hands on Session
EUS guided collection drainage - Group 3