ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy

8 Shen_Interventional IBD

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In a State of the Art Lecture, Dr. Bo Shen discussed the role of endoscopy in the management of inflammatory bowel disease (IBD). He outlined various interventions for the treatment of IBD, including balloon dilation, stricturotomy/strictureplasty, stenting, fistulotomy, and incision and drainage. The management of different types of strictures, such as intrinsic and extrinsic strictures, was also discussed. Dr. Shen emphasized the importance of differentiating between inflammatory and fibrotic strictures in guiding the selection of appropriate interventions.<br /><br />The lecture highlighted the use of balloon dilation for strictures and provided recommendations for the size and duration of balloon insufflation. The efficacy and safety of stricturotomy and strictureplasty were also discussed, with studies showing their effectiveness in both primary and anastomotic strictures. Stenting was recommended for refractory strictures and showed promising results in terms of immediate and long-term efficacy.<br /><br />The lecture also covered the endoscopic treatment of fistulas, abscesses, bezoars, foreign bodies, and luminal lesions. Techniques such as fistulotomy, stenting, and incision and drainage were discussed, along with their indications and outcomes.<br /><br />Dr. Shen addressed the management of IBD surgery-associated complications, including leaks, bleeding, clips, sinusotomy, and bleeding control. The lecture also touched upon the endoscopic treatment of colitis-associated neoplasia, with methods such as polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection discussed.<br /><br />Throughout the lecture, Dr. Shen emphasized the need for standardization and further research in interventional IBD. He highlighted current areas of focus, such as the nature of strictures, anorectal strictures and fistulas, artificial intelligence, new stents, deep scope, drug-eluting interventions, cell therapy, oncological outcomes of endoscopic resections, and training.<br /><br />In summary, Dr. Shen's State of the Art Lecture provided a comprehensive overview of the role of endoscopy in the management of inflammatory bowel disease. The lecture covered various interventions for strictures, fistulas, abscesses, and neoplasia, emphasizing the need for standardization and further research in interventional IBD.

Keywords

endoscopy

inflammatory bowel disease

management

balloon dilation

stricturotomy

stenting

fistulotomy

incision and drainage

standardization

research