UEGJournal Abstracts 2021 - 209

Tuesday, October 5, 2021
Monday, October 4, 2021
Sunday, October 3, 2021
Aims & Methods: Objectives: To compare the proportion of Helicobacter
spp. in bile of patients with malignant or benign biliary obstruction. To describe
the baseline characteristics, laboratory values, and comorbidities
of these patients, as well as characteristics related to ERCP or PTC procedures
and their complications.
Methods: Cases and controls prospective study. We included 125 patients
between April 2019 and January 2021, who underwent a bile drainage
procedure by ERCP or PTC. Helicobacter spp. detection was carried out by
polymerase chain reaction. Demographic data variables, comorbidities,
hospital stay and related to drainage procedure were collected. Descriptive
statistical calculation of the variables of interest, differentiating between
the presence of malignancy or not was performed. We analyzed the
data with SPSS using Chi-square test for qualitative variables and MannWhitney
test.
Results: We studied 72 men and 53 women, who underwent PTC 12% (15),
ERCP 88% (110) due to biliary obstruction. Average age 72.5 (28-94) years.
Average time from diagnosis to admission 21 days (SD 5). Mean hospital
stay 7.7 days (SD 6.7). Cause of biliary obstruction: 50.2% (74) choledocholithiasis,
35.2% (44) malignant obstruction (40.5% (17) pancreatic cancer,
33.3% (14) cholangiocarcinoma, 7.1% (3) ampuloma, 19.1% (8) malignant
extrinsic compression of other origin), 4.8% (6) benign stenosis, 0.8%(1)
biliary fistula. Previous ERCP 20.8%(26). Previous biliary stent 13.6% (17)
and 40% (50) required biliary stent for the first time. Post-procedure complications
4%(5): 0.8% (1)pancreatitis, 2.4% (3) hemorrhage and 0.8% (1)
other complication. Global detection of Helicobacter spp. in bile samples
13.6%. Helicobacter was isolated in 17.7% (3) of the malignant lesions. No
association between Helicobacter in bile and neoplasia was found (16.9%
vs 7.1%, P=0.1). None of the PTC bile samples were positive to Helicobacter
spp.
Statistically significant association was found between neoplasia and
alcohol misuse (7.2% vs 19%, p=0.048), death during admission (2.4% vs
14.3%, p=0.01), hospital stay (5 vs 13 days, p=0.0001), absence of cholecystectomy
(65.1 vs 95.2, p = 0.0001), age (72.2 vs 71.5, p=0.0001), prothrombin
activity value (86% vs 76%, p = 0.0001) and bilirubin value( 2 vs 9.7mg/
dL, p = 0.0001).
Conclusion: No association was found between Helicobacter spp and bile
tract malignancies.
A significant percentage of Helicobacter spp was detected in ERCP bile
samples whereas none was detected in PTC bile samples, although the
small sample size could be related to this finding. Statistic association
was found between neoplasia and higher bilirrubin value, decreased prothrombin
activity, as well as being related to the absence of cholecystectomy,
alcohol misuse, death during admission and longer hospital stay.
Disclosure: Nothing to disclose.
Advanced Imaging for screening colonoscopies
10:00-11:00 / Hall 8
MP073
EFFECT OF LINKED-COLOR IMAGING ON THE DETECTION OF ADENOMAS
IN SCREENING COLONOSCOPIES
C.E. Oliveira dos Santos1
D. Malaman3, F. Onofrio4
, I.D. Arciniegas Sanmartin2
, J.C. Pereira Lima5
,
1Santa Casa Hospital Bagé, Endoscopy, Bagé, Brazil, 2
Mãe de Deus
Hospital, Gastroenterology and Endoscopy, Porto Alegre, Brazil,
3
Santa Casa de Caridade Hospital Bagé, Endoscopy, Bagé, Brazil,
4University of Toronto, Gastroenterology, Toronto, Canada, 5
Casa Hospital Porto Alegre/ UFCSPA, Porto Alegre, Brazil
Santa
Contact E-Mail Address: davidarciniegas23@gmail.com
Introduction: Endoscopic resection of colorectal adenomas reduces the
incidence of colorectal cancer (CRC) and cancer-related mortality1
. Although
colonoscopy is considered the best method for CRC screening and
prevention, it is reported a mean miss rate of 26% for adenomas and of
9% for advanced adenomas2
. Its effectiveness has been well-documented
for the prevention of left-sided CRC, but limited evidence has been reported
for CRC prevention in the right colonic segment2
.
New methods and technologies have been developed in order to increase
the adenoma detection rate (ADR) 3-7
. The use of image-enhanced endoscopy
(IEE) for increasing adenoma detection is controversial , whereas its
use for real-time lesion characterization is well established.
Linked-color imaging (LCI), a recently developed image enhancement
method, provides an increased contrast of the mucosal surface and enhances
the findings of adenomatous lesions in comparison to white light
endoscopy (WLI). These lesions are more vascularized, and so become
reddish due to color contrast of hemoglobin present in their capillary vessels,
whereas the surrounding mucosa becomes whitish.
Aims & Methods: The aim of the present study was to evaluate the potential
of LCI to detect colorectal adenomas compared with WLI and bluelaser
imaging (BLI)-bright only in patients undergoing screening colonoscopies.
Methods:
A prospective randomized study was conducted using whitelight
imaging (WLI), blue-laser imaging (BLI)-bright and LCI. The outcome
measures were adenoma detection rate (ADR), mean number of adenomas
per patient, and withdrawal time. Lesion characteristics such as size,
morphology, location, and histology were also evaluated.
Results: A total of 205 patients were randomized, and 251 adenomas were
detected. The overall ADR was 62%. The ADR was 52.9% for WLI, 62.1% for
BLI-bright, and 71% for LCI, and was significantly higher in the LCI group
than in the WLI group (p=0.04).
The mean number of adenomas per patient was 1.01, 1.03, and 1.62 for
WLI, BLI-bright, and LCI, respectively, with a significant difference (p=0.02).
Withdrawal time did not differ among the groups.
A total of 71 adenomas were detected by WLI, 68 by BLI-bright, and 112 by
LCI. There was no difference in the size and morphology of the adenomas
detected, nor in the diagnosis of sessile serrated adenomas/polyps. LCI
provided a higher rate of detection of adenomas in the right colon segment
(p=0.03).
Conclusion: This randomized study showed significant superiority of LCI
over WLI for colorectal adenoma detection and for the mean number of
adenomas detected per patient, suggesting a favorable impact of this
image-enhancement system in screening colonoscopies.
There was a significantly higher detection of adenomas in the right colon
segment with LCI, and regarding morphology, of polypoid adenomas in
the right colon segment with LCI and in the left colon segment with BLIbright.
Vol.
9 | October 2021
209
UEGJournal Abstracts 2021

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