{
  "version": "https://jsonfeed.org/version/1.1",
  "title": "GI Signals - Endoscopy",
  "home_page_url": "https://siftingsignal.com/gisignals/",
  "feed_url": "https://siftingsignal.com/gisignals/feed/endoscopy.json",
  "description": "Endoscopy papers worth knowing in GI this week. A SiftingSignal publication.",
  "items": [
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42611155",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42611155",
      "title": "Hemostatic Efficacy and Safety of the Hybrid Injector ClearCoajet in Endoscopic Mucosal Resection of Large Colorectal Polyps: A Multicenter Randomized Trial.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "Digestive diseases and sciences. For hemostasis of intraprocedural bleeding during large polyp EMR, snare-tip hemostasis remains the standard approach; ClearCoajet offers a potential alternative if available, but this underpowered trial does not demonstrate clear superiority. No change in current hemostasis practice is required based on this evidence."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42617651",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42617651",
      "title": "Influence of artificial intelligence on the performance of endosonographers in detection of solid pancreatic tumors: a tandem randomized video study.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "Endoscopy. No direct bedside action yet: this video-based performance study does not establish real-world EUS workflow, patient-level diagnostic confirmation, or clinical consequences of improved detection. Clinical translation requires evaluation in live EUS procedures to assess specificity, false-positive impact, and whether improved accuracy changes patient management."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42624299",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42624299",
      "title": "Antibiotic Prophylaxis for Peroral Cholangioscopy: A Systematic Review and Meta-analysis.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "Gastrointestinal endoscopy. The evidence is too weak to change current practice in either direction. The confidence interval is wide and crosses near-equivalence, sensitivity analyses were unstable, and the authors explicitly call for prospective studies before recommendations shift. Whether you currently use prophylaxis or not, this evidence does not argue for a change. Individualize based on local practice patterns until stronger evidence emerges."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42624393",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42624393",
      "title": "Standardized Assessment of Complete Colorectal Polyp Resection for Polyps <20 mm (SCOPE): a Delphi Consensus.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. Adopt standardized resection assessment protocols in your practice: use HD white-light inspection as the primary assessment method (supplement with image-enhanced inspection for 10-19 mm polyps), document post-resection photographs for 10-19 mm polyps, ensure histopathological margin assessment for all non-fragmented and en bloc resections, and monitor your personal incomplete resection rate (IRR) for 10-19 mm polyps as a quality assurance metric."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42626824",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42626824",
      "title": "Self-Directed Mikoto Simulator Training for Colonoscopy in Gastroenterology Trainees: An International Multicenter Randomized Trial.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "Journal of gastroenterology and hepatology. Simulator training shows promise as a feasible adjunct to standard colonoscopy training. Although the trial was small (n=12 total) and did not achieve statistical significance for the between-group comparison, the simulator group demonstrated significant within-group improvement in cecal intubation rate from 60.0% to 80.0% (p=0.003) and reduction in procedure time. These findings support using simulation as an educational adjunct in training programs, though larger trials are needed to confirm the magnitude of benefit."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42627207",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42627207",
      "title": "Clinical and endoscopic features of checkpoint inhibitor-induced colitis and their association with selective immunosuppressive therapy use.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "Inflammatory bowel diseases. In ICI colitis, escalation to immunosuppressive therapy is primarily determined by ICI type and clinical progression, not mucosal endoscopic appearance. Do not use IMCES (AUC 0.57) or endoscopic features (erythema, exudate) to predict escalation. Monitor for clinical worsening-progressive diarrhea especially bloody, fever, severe abdominal pain, or laboratory decline (rising CRP, falling albumin)-as signals for escalation need. ICI type carries dominant risk; ipilimumab and aCTLA-4-based therapies warrant particular vigilance. Base escalation decisions on symptom trajectory and known ICI immunobiology, not endoscopic severity scoring."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42627604",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42627604",
      "title": "Forward- vs. Oblique-Viewing Endoscope for Duodenal Papillectomy: A Comparative Study on Efficacy and Safety.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "Digestive diseases and sciences. For adenoma papillectomy, oblique-viewing endoscopy achieved higher en bloc resection rates (80% vs. 61.5%) at the cost of longer procedure time (39 vs. 21 min). However, follow-up outcomes did not differ between approaches; the clinical benefit of higher en bloc rates remains unproven. Technique (particularly avoiding submucosal injection when feasible) may influence outcomes as much as endoscope choice."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42633947",
      "url": "https://siftingsignal.com/gisignals/2026-W35/#card-pmid-42633947",
      "title": "AI-assisted second forward-view examination of the right colon significantly improves the adenoma detection rate: a multicenter randomized controlled trial.",
      "date_published": "2026-08-24T19:12:09Z",
      "content_text": "The American journal of gastroenterology. Implement AI-assisted second forward-view examination of the right colon during colonoscopy to improve adenoma detection, particularly for small, flat, and hard-to-reach lesions. This combined strategy was effective across all levels of endoscopist experience."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42314698",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42314698",
      "title": "Colonoscopy complications and associated costs and mortality in a Swedish colorectal cancer screening program.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Endoscopy. Continue recommending colonoscopy as the preferred screening modality, as real-world data confirm complications occur in <1% of screening procedures with no increase in mortality and minimal program costs."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42595629",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42595629",
      "title": "Pragmatic real-world evaluation of computer-aided detection in colonoscopy: A within-endoscopist comparative study.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. Consider adopting computer-aided detection systems in routine colonoscopy as an adjunctive tool. CADe remains independently associated with improved adenoma detection (aOR 1.31, 95% CI 1.11-1.55, p=0.002) after adjustment for endoscopist variation, confirming incremental benefit beyond endoscopy technique alone."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42596026",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42596026",
      "title": "Review Article: Immune Effector Cell-Mediated Enterocolitis Following CAR-T Cell Therapy-Clinical Features, Pathophysiology and Management.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Alimentary pharmacology & therapeutics. If a patient presents with gastrointestinal symptoms after CAR-T therapy, suspect immune effector cell-mediated enterocolitis. Pursue early diagnosis via endoscopy and biopsy. Implement multidisciplinary care with supportive measures, infection assessment, and step-up pharmacotherapy using inflammatory bowel disease agents (biologics and small molecules). Early recognition and multidisciplinary treatment may improve patient outcomes."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42598992",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42598992",
      "title": "Transformer-Based Deep Learning Framework for Automated Lesion Detection in Capsule Endoscopy: A Comparative Study With CNN Architectures.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Journal of clinical gastroenterology. No clinical action yet: this is algorithm benchmarking on public datasets with acknowledged frame-level data leakage. Clinical implementation requires external validation on patient-stratified data, demonstration of improved detection in clinical workflows, and assessment of patient-level outcomes."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42601260",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42601260",
      "title": "An artificial intelligence-based endoscopic ultrasonography risk assessment and stratification for gastric stromal tumors.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. No clinical action yet: this model is tested on retrospective EUS images without prospective validation or head-to-head comparison to current GIST risk stratification (Miettinen criteria from pathology). Implementation would require prospective clinical validation demonstrating improved prediction of clinically relevant outcomes."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42603214",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42603214",
      "title": "Upper Versus Lower Gastrointestinal Bleeding in Percutaneous Coronary Intervention Hospitalizations: A National Analysis, 2016-2022.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Digestive diseases and sciences. Upper GI bleeding occurred in 83% of GI complications during PCI hospitalizations with 12.4% in-hospital mortality versus 6.1% for lower GI bleeding (adjusted odds ratio 1.74, 95% CI 1.36-2.23), while UGIB incidence rose from 0.90% to 1.13% over 2016-2022."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42604636",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42604636",
      "title": "Oropharyngeal airway integrated with capnography and oxygenation for sedated gastrointestinal endoscopy in obese patients: a randomised trial.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Endoscopy. Use the COMBO device during sedated endoscopy in obese patients (BMI ≥28) to substantially reduce hypoxia risk compared to standard nasal cannula. The device maintains airway patency and enables continuous capnography monitoring, providing an effective strategy for high-risk patients."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42607265",
      "url": "https://siftingsignal.com/gisignals/2026-W34/#card-pmid-42607265",
      "title": "Management Strategies and Outcomes for Type 1 Gastric Neuroendocrine Tumors Measuring More Than 1 cm.",
      "date_published": "2026-08-20T18:40:03Z",
      "content_text": "Clinical and translational gastroenterology. For T1g-NETs >1cm, prefer ESD or modified EMR when feasible to achieve better progression-free survival; recognize lesions ≥24mm as at higher risk for recurrence, potentially warranting surgical consideration if endoscopic resection not feasible."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42314698",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42314698",
      "title": "Colonoscopy complications and associated costs and mortality in a Swedish colorectal cancer screening program.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Endoscopy. Continue recommending colonoscopy as the preferred screening modality, as real-world data confirm complications occur in <1% of screening procedures with no increase in mortality and minimal program costs."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42565678",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42565678",
      "title": "Sarcopenia as a prognostic marker in inflammatory bowel disease: Implications for endoscopic outcomes and loss of response to biologic therapy-A systematic review with narrative synthesis.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Inflammatory bowel diseases. Do not implement routine sarcopenia assessment for IBD risk stratification or treatment decisions. The evidence is observational and heterogeneous with inconsistent findings; sarcopenia may reflect disease severity, malnutrition, or inflammatory burden rather than independently predict outcomes."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42567461",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42567461",
      "title": "Use of Artificial Intelligence for Duodenal Biopsy for Celiac Disease: Developing a Prediction Model for Histopathology Diagnosis.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. No direct clinical action yet. This is a retrospective proof-of-concept study demonstrating an AI model can classify archived biopsies, but prospective validation in real clinical practice and comparison to standard pathologist review would be required before clinical deployment. The next step is validating the tool on prospectively collected biopsies."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42568228",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42568228",
      "title": "Diagnostic and Clinical Performance of Single-Use Versus Reusable Gastrointestinal Endoscopes: A Systematic Review and Meta-Analyses.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Journal of gastroenterology and hepatology. Maintain current practice with reusable endoscopes and rigorous reprocessing protocols. Single-use devices offer no diagnostic or technical advantage, and documented infection risk from reusable endoscopes is low. For ERCP specifically, single-use duodenoscopes (EXALT Model D) required conversion to reusable in 7% of procedures, limiting their utility as a standalone option."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42572882",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42572882",
      "title": "Advanced cannulation techniques vs early EUS-BD in case of difficult biliary cannulation in patients with DMBO: an international propensity score-matched analysis.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "The American journal of gastroenterology. When standard biliary cannulation fails at ERCP in a patient with malignant obstruction and dilated common bile duct (>12 mm), consider early EUS-guided drainage as the preferred alternative to advanced cannulation techniques if EUS expertise is available. The lower adverse event rate (particularly post-procedural pancreatitis at 12% with advanced ERCP) and higher technical success with EUS-BD support its use as a safer, more technically effective option for failed biliary access."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42573940",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42573940",
      "title": "Confounding by Indication in Real-World Indomethacin Use for Post-ERCP Pancreatitis: Implications for Severity and Cost.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Digestive diseases and sciences. This observational study cannot reliably determine indomethacin's protective effect due to confounding by indication (drug use associated with procedural difficulty rather than independent risk reduction). While severe pancreatitis occurred only in the non-indomethacin group (underpowered), confounding precludes attributing this to the drug. RCT-based guidelines recommending indomethacin should continue to direct practice."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42575378",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42575378",
      "title": "Endoscopic Management of Cystic Duct Remnant Stones Causing Post-Cholecystectomy Syndrome: A Multi-Center Experience.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Gastrointestinal endoscopy. For symptomatic cystic duct remnant stones causing post-cholecystectomy syndrome, ERCP is a less-invasive alternative to surgical excision. Anticipate escalation to cholangioscopy in approximately 43% of cases, with EHL required in most cholangioscopy cases (89%). Counsel patients on a 10% risk of mild post-ERCP pancreatitis."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42575379",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42575379",
      "title": "Clinical impact of disposable elevator-cap duodenoscopes on post-ERCP cholangitis: a prospective cohort study.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Gastrointestinal endoscopy. DEC duodenoscopes do not reduce post-ERCP cholangitis in routine practice. Although surveillance cultures showed superior sterilization, this study does not support institutional adoption of DEC equipment specifically to prevent post-ERCP cholangitis."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42575497",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42575497",
      "title": "Long-term risk of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric cancer.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Endoscopy. Extend endoscopic surveillance beyond 5 years after curative ESD for early gastric cancer, particularly in patients with family history of gastric cancer or extensive intestinal metaplasia. All detected metachronous neoplasms were early-stage (stage I) with no gastric cancer-related deaths."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42580638",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42580638",
      "title": "EUS-guided biopsy using 19-gauge Franseen needle versus percutaneous ultrasound-guided biopsy using 18-gauge full-core cutting needle for parenchymal liver disease: A randomized controlled, non-inferiority trial.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Gastrointestinal endoscopy. EUS-guided liver biopsy with 19-gauge Franseen needle achieved specimen adequacy (length ≥15 mm and ≥8 complete portal tracts) in 97.8% versus 64.4% with percutaneous 18-gauge biopsy; median specimen lengths were 6.9 cm versus 2.0 cm and median complete portal tracts 42 versus 9."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42580755",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42580755",
      "title": "Cost-effectiveness and environmental impact of artificial intelligence-assisted colonoscopy with the resect-and-discard strategy: a microsimulation study.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Endoscopy. This is a modeling study comparing strategy costs and outcomes, not a clinical trial of patient outcomes. It suggests that computer-aided detection improved adenoma detection without improving health outcomes compared to non-AI resect-and-discard; adding diagnostic AI (CADx) increased costs without clinical benefit. The findings suggest improved adenoma detection alone may not justify added costs and environmental impact if baseline health outcomes remain unchanged. However, these are model-based conclusions dependent on input assumptions about adenoma progression, detection accuracy, and mortality rates. Real-world adoption decisions about AI tools should consider actual performance, costs, and environmental impact in your setting. Individual gastroenterologists should not change current resect-and-discard practice based on this model."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42580757",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42580757",
      "title": "Endoscopic submucosal dissection versus transanal endoscopic surgery in rectal neoplasms: Meta-analysis of randomized controlled trials and trial sequential analysis.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Endoscopy. Both ESD and TES remain acceptable organ-preserving options for selected rectal neoplasms with no significant differences in resection and oncologic outcomes; however, certainty of evidence is very low for these outcomes. TES was faster by 21.93 minutes. Safety outcomes were also not significantly different but remain inconclusive (trial sequential analysis). Choose technique based on lesion characteristics, local expertise, and existing proficiency rather than evidence of superiority from this comparison."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42595629",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42595629",
      "title": "Pragmatic real-world evaluation of computer-aided detection in colonoscopy: A within-endoscopist comparative study.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. Consider adopting computer-aided detection systems in routine colonoscopy as an adjunctive tool. CADe remains independently associated with improved adenoma detection (aOR 1.31, 95% CI 1.11-1.55, p=0.002) after adjustment for endoscopist variation, confirming incremental benefit beyond endoscopy technique alone."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42596026",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42596026",
      "title": "Review Article: Immune Effector Cell-Mediated Enterocolitis Following CAR-T Cell Therapy-Clinical Features, Pathophysiology and Management.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Alimentary pharmacology & therapeutics. If a patient presents with gastrointestinal symptoms after CAR-T therapy, suspect immune effector cell-mediated enterocolitis. Pursue early diagnosis via endoscopy and biopsy. Implement multidisciplinary care with supportive measures, infection assessment, and step-up pharmacotherapy using inflammatory bowel disease agents (biologics and small molecules). Early recognition and multidisciplinary treatment may improve patient outcomes."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42601260",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42601260",
      "title": "An artificial intelligence-based endoscopic ultrasonography risk assessment and stratification for gastric stromal tumors.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. No clinical action yet: this model is tested on retrospective EUS images without prospective validation or head-to-head comparison to current GIST risk stratification (Miettinen criteria from pathology). Implementation would require prospective clinical validation demonstrating improved prediction of clinically relevant outcomes."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42603214",
      "url": "https://siftingsignal.com/gisignals/2026-W33/#card-pmid-42603214",
      "title": "Upper Versus Lower Gastrointestinal Bleeding in Percutaneous Coronary Intervention Hospitalizations: A National Analysis, 2016-2022.",
      "date_published": "2026-08-20T21:35:47Z",
      "content_text": "Digestive diseases and sciences. Upper GI bleeding occurred in 83% of GI complications during PCI hospitalizations with 12.4% in-hospital mortality versus 6.1% for lower GI bleeding (adjusted odds ratio 1.74, 95% CI 1.36-2.23), while UGIB incidence rose from 0.90% to 1.13% over 2016-2022."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-41668341",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-41668341",
      "title": "Intrapancreatic Fat Deposition and Risk of Post-ERCP Pancreatitis: A Systematic Review and Meta-Analysis.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Pancreas. consider intrapancreatic fat deposition when assessing post-ERCP pancreatitis risk and severity."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-41734104",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-41734104",
      "title": "Optimal Management of Conventional Adenomas in 2026: Current and Evolving Recommendations and Ongoing Controversies.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Journal of clinical gastroenterology. No clinical action yet: a guideline review synthesizing existing recommendations and controversies without new human evidence."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42240446",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42240446",
      "title": "Rectal Nonsteroidal Anti-Inflammatory Drugs, Aggressive Hydration With Lactated Ringer's Solution, Somatostatin or Combinations for Prophylaxis Post-ERCP Acute Pancreatitis: A Network Meta-Analysis.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Pancreas. Consider combining rectal indomethacin and somatostatin for high-risk ERCP patients to prevent pancreatitis and hyperamylasemia, given its superior efficacy and safety profile compared to placebo, but note that direct RCT evidence is limited."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42493409",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42493409",
      "title": "World Endoscopy Organization Position Statements for the Role of Endoscopy on the Diagnosis and Treatment of Superficial Non-Ampullary Duodenal Epithelial Tumors.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. Consider endoscopic resection for SNADETs in elective cases with routine complete wound closure to mitigate complications; prioritize high-definition endoscopy and image-enhanced endoscopy (IEE) for diagnosis and characterization. Defer ER in high thromboembolic risk patients."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42522924",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42522924",
      "title": "Endoscopic Papillectomy for Ampullary Tumors in Older Patients: Balancing Oncologic Benefit and Geriatric Risk.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. Consider integrated assessment of oncologic and geriatric factors (comorbidity burden, life expectancy) rather than chronological age alone when selecting older patients (≥75 years) for EP or surveillance of ampullary tumors. Use standardized geriatric assessment tools (specific tools not detailed in abstract) to aid decision-making."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42524792",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42524792",
      "title": "Improving follow-up of abnormal stool test results used for colorectal cancer screening.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Gastrointestinal endoscopy. Implement coordinated strategies such as patient navigation, digital tools, and open access colonoscopy to improve follow-up colonoscopy rates after abnormal stool tests."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42526878",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42526878",
      "title": "Spiral basket geometry improves procedural efficiency and reduces device escalation in small bile duct stones: a multicenter randomized controlled trial (ESCAPE trial).",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Endoscopy. Consider spiral-configured baskets for first-line ERCP extraction of small (≤8 mm) bile duct stones where available (currently primarily in Japan), given higher efficiency and lower cost without added risk."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42527225",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42527225",
      "title": "A multimodal artificial intelligence method for accurate diagnosis of autoimmune gastritis.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. No clinical action yet: a diagnostic AI tool not yet validated in real-world practice."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42543468",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42543468",
      "title": "Management of Gastric Leaks After Bariatric Surgery: Proposed Endoscopic Treatment Algorithm Based on 10-Year Experience.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Digestive diseases and sciences. Consider an algorithmic approach to endoscopic treatment of post-bariatric leaks, selecting modalities based on clinical condition, timing, and fistula characteristics. Be aware of procedure-related complications (19.7%) and prioritize early intervention for leaks without self-limited cavities, as these were associated with failure (p=0.009)."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42544755",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42544755",
      "title": "Endoscopic Ultrasonography for Diagnosing Common Bile Duct Stones With Negative Initial Imaging: A Multicenter Prospective Exploratory Study.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Journal of hepato-biliary-pancreatic sciences. Consider EUS to confirm or exclude CBDS in high-likelihood patients (per ASGE criteria) with negative initial imaging before proceeding to ERCP."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42544922",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42544922",
      "title": "Suspected Small Bowel Bleeding: A Single-Center Retrospective Study on Long-Term Prognosis and Predictive Factors.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Journal of clinical gastroenterology. Monitor hemoglobin closely in SSBB patients with levels <8.0 g/dL and consider targeted interventions for anemia management, given its association with mortality."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42544942",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42544942",
      "title": "Cold snare polypectomy for 5-9mm small-bowel polyps in patients with Peutz-Jeghers syndrome by double-balloon enteroscopy: a prospective clinical trial.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "The American journal of gastroenterology. Consider CSP for 5-9mm stubby/wide pedicle or sessile small-bowel polyps in PJS patients aged 8-60 years during double-balloon enteroscopy, as it is feasible and safe with low bleeding risk, though larger polyps (8mm) carry higher bleeding risk."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42545305",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42545305",
      "title": "AGA Clinical Practice Update on Surveillance of Metaplastic and Premalignant Conditions of the Esophagus and Colorectum in Older Adults: Expert Review.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. Use comorbidity assessment and life expectancy tools to guide decisions on endoscopic surveillance in older adults ≥65, particularly for Barrett's esophagus and colorectal cancer, balancing potential benefits and harms."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42546167",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42546167",
      "title": "Artificial Intelligence Automated Assessment of Colonoscopy Quality Metrics.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "The American journal of gastroenterology. No clinical action yet: a validation study showing AI can measure colonoscopy quality metrics from videos, but not yet proven to improve outcomes."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42546781",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42546781",
      "title": "Clinical Efficacy of Endoscopic Ultrasound-Guided Gastroenterostomy, Enteral Stenting, and Surgical Gastrojejunostomy for Malignant Gastric Outlet Obstruction: A Network Meta-Analysis.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Gastrointestinal endoscopy. Consider EUS-GE as a preferred intervention for malignant gastric outlet obstruction in expert centers, given its lower re-intervention rates, higher clinical success, and shorter hospitalization compared to enteral stenting and surgical gastrojejunostomy, pending further studies in non-expert settings."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42546782",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42546782",
      "title": "Effect of a single dose antibiotic prophylaxis in scheduled bile duct interventions in Primary Sclerosing Cholangitis.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Gastrointestinal endoscopy. Consider single-dose antibiotic prophylaxis for scheduled ERCP in PSC patients as a potential alternative to multi-day regimens, balancing reduced antibiotic exposure against the risk of increased cholangitis severity."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42547360",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42547360",
      "title": "Modified endoscopic mucosal resection versus endoscopic submucosal dissection for rectal neuroendocrine tumors ≤10 mm: a systematic review and meta-analysis of randomized controlled trials.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. Consider m-EMR as a reasonable first-line option for rectal NETs ≤10 mm, given comparable histologic efficacy to ESD, shorter procedure time, and lower cost, but confirm alignment with ENETS guidance."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42549805",
      "url": "https://siftingsignal.com/gisignals/2026-W32/#card-pmid-42549805",
      "title": "Thirty-day Mortality Among Jehovah's Witness Patients with Gastrointestinal Bleeding Who Decline Blood Transfusion: A Retrospective Cohort Study.",
      "date_published": "2026-08-06T18:00:11Z",
      "content_text": "The American journal of gastroenterology. Consider bloodless management strategies (e.g., anemia-directed therapy, bloodless medicine consultation) for JW patients with GIB, as outcomes were similar despite lower discharge hemoglobin levels (median nadir 6.6 g/dL in both groups). No change in transfusion thresholds is supported by this study."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42114823",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42114823",
      "title": "Neoplastic recurrence after colorectal endoscopic submucosal dissection at scheduled endoscopic surveillance: a systematic review and meta-analysis.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Endoscopy. Consider extending surveillance intervals up to 5 years for low-risk patients (R0 resection, favorable histology), as recurrence is rare and mostly due to metachronous lesions."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42494284",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42494284",
      "title": "Visceral Adipose Tissue as an Independent Predictor of Severe Post-ERCP Pancreatitis: A Multicenter Retrospective Cohort Study.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Journal of hepato-biliary-pancreatic sciences. Acknowledge VAT >95 cm2 as a risk factor for severe PEP in patients undergoing ERCP; however, no specific clinical action is recommended based on this observational finding."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497978",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497978",
      "title": "Endoscopic Ultrasound and Clinical Features for Differentiating Autoimmune Pancreatitis and Pancreatic Ductal Adenocarcinoma: A Multicenter Cohort Study.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. Consider integrating these four EUS and clinical features (IgG4, CA19-9, vascular involvement, diffuse reduced echogenicity) when evaluating pancreatic masses suspicious for AIP vs. PDAC, but await prospective validation and external validation before relying solely on this model due to its retrospective design and risk of overfitting."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497979",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497979",
      "title": "Esophagogastric Junction Marking Clip Placement During Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Single-Center Retrospective Study.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. Consider placing an EGJ marking clip during EUS-HGS to reduce transesophageal puncture risk, especially for less experienced endoscopists, while monitoring for procedure-related adverse events."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497980",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497980",
      "title": "Combined prophylactic vessel coagulation and high-density complete defect closure after colorectal endoscopic submucosal dissection.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. Consider combining prophylactic vessel coagulation with high-density complete defect closure (using standard clips or advanced closure devices) after colorectal ESD to reduce delayed bleeding and adverse events, noting that cases with intraprocedural perforation, incomplete closure, or use of hemostatic gels or powders were excluded."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497981",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497981",
      "title": "Association between colonoscopy and colorectal cancer risk in adults aged 75 to 85 years: a nationwide population-based cohort study.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. For adults aged 75-79, discuss colonoscopy as an option for CRC screening during shared decision-making, weighing life expectancy and comorbidities. For those aged 80-85, particularly women, emphasize individualized decisions due to uncertain benefit and potential risks. Counsel on alcohol reduction as a modifiable CRC risk factor."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497983",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42497983",
      "title": "Diagnostic Performance and Feasibility of the CC100 Colon Capsule Endoscopy System: A Prospective Multicenter Study.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. Consider CC100 colon capsule endoscopy as a minimally invasive alternative for colorectal cancer screening in average-risk patients aged 45+ who decline or are unsuitable for conventional colonoscopy, given its high specificity for polyps ≥6 mm. No clinical action yet for routine use over colonoscopy due to lower sensitivity and incomplete visualization in 8.82%."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42498887",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42498887",
      "title": "A Practical Endoscopic Treatment Strategy for Appendiceal Orifice Lesions Using Forceps-Assisted Polypectomy (Strip Biopsy).",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Digestive diseases and sciences. Consider strip biopsy for small appendiceal orifice lesions without malignant features, as it offers faster resection with comparable safety to ESD in this study, but be aware of higher margin positivity (50% vs. 13%)."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42498927",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42498927",
      "title": "Endoscopic variceal ligation-induced ulcer bleeding: incidence by indication, real-world treatment, and outcomes.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "BMC gastroenterology. Consider early TIPS in high-risk patients (those with 5-day rebleeding or post-bleeding sepsis) and implement sepsis prevention strategies post-EVL, especially in semi-elective and emergency settings. Monitor for rebleeding and sepsis closely."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42501881",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42501881",
      "title": "Robust Performance Metrics of the Capsule-Sponge-Trefoil-Factor-3 Test for Detecting Barrett's Esophagus: A Pooled Analysis.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. Consider the capsule-sponge-trefoil-factor-3 test as a non-endoscopic screening option for Barrett's esophagus in eligible patients, particularly those unwilling or unable to undergo endoscopy, while noting potential limitations and adverse events."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42503311",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42503311",
      "title": "Immediate vs Step-up Endoscopic Transluminal Necrosectomy in Necrotizing Pancreatitis: Systematic Review and Meta-analysis of Randomized Controlled Trials.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Endoscopy. Consider immediate DEN in patients with WON who are stable and may benefit from earlier source control, balancing against potential overtreatment. Individualize timing based on clinical context."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42508426",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42508426",
      "title": "Establishment and Evaluation of a Probe-based Confocal Laser Endomicroscopy Training System for Gastric Cancerous Lesions Diagnosis: Evidence from a National Training Program.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Clinical and translational gastroenterology. Evaluate the feasibility of implementing short-term systematic pCLE training programs for novice endoscopists to enhance diagnostic proficiency for gastric cancerous lesions, considering resource requirements and trainee performance gaps versus pCLE experts."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42509099",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42509099",
      "title": "Sampling performance of EUS-Guided fine-needle biopsy in pancreatic neuroendocrine tumors: A systematic review and meta-analysis.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]. Consider using EUS-guided FNB over FNA for suspected PNETs when histological and Ki-67 assessment is needed, with preference for the Sharkcore needle if available, acknowledging moderate to high risk of bias and low certainty of evidence."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42521099",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42521099",
      "title": "Peroral Endoscopic Myotomy for Pediatric Achalasia: 36-Month Outcomes from a Single-Center Cohort Study.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. Consider POEM as a durable treatment option for children with achalasia (typically ages 8-14), though comparative efficacy vs pneumatic dilation or Heller myotomy remains unstudied in this cohort."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42521100",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42521100",
      "title": "Peroral Endoscopic Myotomy versus Flexible Endoscopic Septotomy for Zenker's Diverticulum: A Cost-Effectiveness Analysis.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. For short-term (12-month) cost-effectiveness in older patients (typically 70-year-old), prefer FES over Z-POEM in Zenker's diverticulum. For longer-term (24-month) outcomes, consider Z-POEM due to its durability and reduced reintervention needs, but weigh against higher upfront costs."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42521412",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42521412",
      "title": "Feasibility and Impact of Traction Band-Assisted Cannulation for Difficult Biliary Cannulation in Patients With Periampullary Diverticulum: A Propensity Score-Matched Analysis.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Journal of hepato-biliary-pancreatic sciences. Consider TRIAS over conventional cannulation for difficult biliary cannulation in PAD patients to reduce reliance on advanced techniques, but expect similar overall cannulation success."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42522011",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42522011",
      "title": "The diagnostic yield of endoscopic ultrasound-guided fine-needle biopsy in autoimmune pancreatitis: a systematic review and meta-analysis.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "BMC gastroenterology. Consider using a 22G Franseen or Fork-tip needle for EUS-FNB when AIP is suspected after inconclusive imaging/serology/other organ evaluation, as these yield higher diagnostic accuracy than other needle types, with a low adverse event rate."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42522103",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42522103",
      "title": "The Effect of Nexpowder in Reducing Post-ESD Coagulation Syndrome in Proximal Colon Lesions: A Retrospective Multicenter Study.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Journal of gastroenterology and hepatology. Prophylactic Nexpowder may reduce PECS risk in high-risk proximal colorectal ESD, but efficacy requires confirmation in prospective trials."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42524792",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42524792",
      "title": "Improving follow-up of abnormal stool test results used for colorectal cancer screening.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Gastrointestinal endoscopy. Implement coordinated strategies such as patient navigation, digital tools, and open access colonoscopy to improve follow-up colonoscopy rates after abnormal stool tests."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42526878",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42526878",
      "title": "Spiral basket geometry improves procedural efficiency and reduces device escalation in small bile duct stones: a multicenter randomized controlled trial (ESCAPE trial).",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Endoscopy. Consider spiral-configured baskets for first-line ERCP extraction of small (≤8 mm) bile duct stones where available (currently primarily in Japan), given higher efficiency and lower cost without added risk."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42527225",
      "url": "https://siftingsignal.com/gisignals/2026-W31/#card-pmid-42527225",
      "title": "A multimodal artificial intelligence method for accurate diagnosis of autoimmune gastritis.",
      "date_published": "2026-07-30T22:01:39Z",
      "content_text": "Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. No clinical action yet: a diagnostic AI tool not yet validated in real-world practice."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42331035",
      "url": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42331035",
      "title": "Computer-assisted versus standard colonoscopy for adenoma detection in a population-based colorectal cancer screening program: a randomized clinical trial.",
      "date_published": "2026-07-25T22:16:33Z",
      "content_text": "Endoscopy. CADe systems should not be expected to improve adenoma detection rates in screening practice. This trial found no benefit across all tested subgroups, including endoscopists with lower baseline adenoma detection and those with suboptimal bowel preparation."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42480549",
      "url": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42480549",
      "title": "Sedation for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Guideline.",
      "date_published": "2026-07-25T22:16:33Z",
      "content_text": "Endoscopy. In your endoscopy practice: (1) adopt propofol as your first-line procedural sedation unless contraindicated or unavailable; (2) use midazolam with opiates as alternative if propofol not accessible; (3) consider remimazolam specifically for elderly patients or those with significant cardiac or pulmonary disease, but exercise caution when combining with other sedatives or analgesics; if analgesia is required, carefully coordinate drug selection with your sedation team; (4) ensure a dedicated, specifically trained staff member (not dual-tasking) administers all sedation; (5) perform pre-procedure risk assessment for each patient and calibrate your sedation regimen and monitoring based on both procedure complexity and patient risk factors; include capnography monitoring for high-risk patients; (6) individualize sedation decisions for patients taking GLP-1 receptor agonists rather than using a standard approach; (7) routinely offer unsedated diagnostic colonoscopy and gastroscopy as a patient option."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42485125",
      "url": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42485125",
      "title": "Ferric carboxymaltose for iron-deficiency anemia secondary to gastrointestinal bleeding: a systematic review and meta-analysis.",
      "date_published": "2026-07-25T22:16:33Z",
      "content_text": "European journal of gastroenterology & hepatology. FCM is more effective than other iron formulations for treating anemia from gastrointestinal bleeding. This evidence applies to patients requiring IV iron due to intolerance or inadequate response to oral iron therapy. Monitor serum phosphate during therapy; hypophosphatemia occurs substantially more often and requires active surveillance and supplementation if depleted."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42492900",
      "url": "https://siftingsignal.com/gisignals/2026-W30/#card-pmid-42492900",
      "title": "Prophylaxis of esophageal stricture after endoscopic submucosal dissection with autologous adipose-derived stromal cells.",
      "date_published": "2026-07-25T22:16:33Z",
      "content_text": "Endoscopy. evaluate autologous stromal cell injection as a stricture prophylaxis option for high-risk esophageal ESD if efficacy is established."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42442706",
      "url": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42442706",
      "title": "Computer-aided quality assurance versus standard colonoscopy: A systematic review and meta-analysis of randomized-controlled trials.",
      "date_published": "2026-07-18T20:04:34Z",
      "content_text": "Endoscopy. Consider adopting CAQ systems for colonoscopy to improve detection of adenomas and advanced adenomas, given the significant increase in ADR and AADR."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42447876",
      "url": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42447876",
      "title": "Curriculum on management of acute upper gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.",
      "date_published": "2026-07-18T20:04:34Z",
      "content_text": "Endoscopy. GI clinicians training endoscopy fellows should implement these ESGE standards: ensure trainees meet preadoption skill benchmarks, provide simulator training, and directly supervise at least 20 UGIB cases with active bleeding. No direct clinical action for patient care: these are training guidelines."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42448239",
      "url": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42448239",
      "title": "Long term follow-up from the Barrett's esophagus screening trial 3 (BEST3) demonstrates high negative predictive value of capsule-sponge-Trefoil-factor-3 (TFF3) test for esophageal adenocarcinoma.",
      "date_published": "2026-07-18T20:04:34Z",
      "content_text": "Gastroenterology. Consider using the capsule-sponge-TFF3 test as a non-invasive screening tool to rule out esophageal adenocarcinoma in patients at risk for Barrett's esophagus (e.g., chronic GERD, male, age >50, white race), particularly when endoscopy is not feasible or preferred."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42456983",
      "url": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42456983",
      "title": "Advanced and Salvage Techniques for Difficult Biliary Cannulation in ERCP: A Randomized Trial of Outcomes and Efficacy.",
      "date_published": "2026-07-18T20:04:34Z",
      "content_text": "Gastrointestinal endoscopy. For difficult biliary cannulation (DBC), DGT, TPS, or precut fistulotomy achieve similar final success but differ in pancreatitis risk (lower with DGT) and contrast use (lower with precut). Individualize choice by weighing these tradeoffs against patient anatomy, operator expertise, and local resources."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42462747",
      "url": "https://siftingsignal.com/gisignals/2026-W29/#card-pmid-42462747",
      "title": "Artificial intelligence-assisted detection and optical differentiation of colorectal lesions in Lynch syndrome surveillance (CADLY2): a multicentre, open-label, randomised controlled superiority trial.",
      "date_published": "2026-07-18T20:04:34Z",
      "content_text": "The lancet. Gastroenterology & hepatology. Consider using AI-assisted colonoscopy (e.g., CAD EYE) for Lynch syndrome surveillance to improve adenoma detection, particularly in specialized hereditary cancer centers, acknowledging potential bias from unmasked endoscopists."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-41701117",
      "url": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-41701117",
      "title": "Dysplasia detection using high-definition scopes with dye vs virtual chromoendoscopy in IBD: A meta-analysis of randomized clinical trials.",
      "date_published": "2026-07-09T16:47:07Z",
      "content_text": "Inflammatory bowel diseases. No need to prefer dye over virtual chromoendoscopy for dysplasia detection in IBD surveillance, as both methods perform similarly. Choose based on availability, cost, or operator preference."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42365851",
      "url": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42365851",
      "title": "Computer-aided detection in surveillance colonoscopy: a population-based randomized trial.",
      "date_published": "2026-07-09T16:47:07Z",
      "content_text": "Endoscopy. Consider CADe for endoscopists with lower baseline ADR (<54.5%) in surveillance colonoscopy, as it improves detection in this subgroup. For high-performing endoscopists, CADe does not provide additional benefit."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42366841",
      "url": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42366841",
      "title": "Methodology Assessment of Endoscopic Ultrasound Radiofrequency Ablation (EUS-RFA) for Pancreatic Neoplasms: Results From an International Survey.",
      "date_published": "2026-07-09T16:47:07Z",
      "content_text": "Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. EUS-RFA for pancreatic neoplasms remains non-standardized outside insulinoma; indications, antibiotic prophylaxis, power settings, and follow-up vary widely, so it stays investigational pending consensus, with no immediate practice change."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42383968",
      "url": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42383968",
      "title": "Adverse events associated with endoscopic retrograde cholangiopancreatography (ERCP) and ERCP-related procedures.",
      "date_published": "2026-07-09T16:47:07Z",
      "content_text": "Gastrointestinal endoscopy. Apply ASGE ERCP adverse-event guidance now: routine rectal NSAID (indomethacin or diclofenac 100 mg) for post-ERCP pancreatitis prophylaxis and prophylactic pancreatic-duct stenting in high-risk cases, plus aggressive periprocedural hydration."
    },
    {
      "id": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42409294",
      "url": "https://siftingsignal.com/gisignals/2026-W26/#card-pmid-42409294",
      "title": "Single-blinded randomized controlled trial comparing the effect of underwater versus carbon dioxide insufflation during peroral endoscopic myotomy on post-procedural pain (U-POEM trial).",
      "date_published": "2026-07-09T16:47:07Z",
      "content_text": "Gastrointestinal endoscopy. Underwater immersion (U-POEM) may reduce post-procedural pain and opioid requirements vs CO2-POEM in achalasia type I/II, though larger trials are needed before protocol changes."
    }
  ]
}