30-Second Takeaway
- AGA update urges risk-stratified, biomarker-based HCC surveillance beyond ultrasound plus AFP, especially in nonviral liver disease.
- Linked color imaging with CADe significantly reduces right-colon adenoma and polyp miss rates compared with white light colonoscopy.
- Early enteral feeding after pancreatoduodenectomy lowers overall 90-day complication burden in nutritionally at-risk patients.
- Biologic-era ileocolic resection for Crohn’s disease has relatively low 5- and 10-year surgical recurrence rates without clear clinical predictors.
- Achalasia substantially increases esophageal squamous cancer risk independent of smoking and alcohol, supporting long-term malignancy risk counseling.
Week ending April 25, 2026
Targeted surveillance, smarter endoscopy, and optimized support care are redefining GI cancer and procedural risk
AGA best practice update shifts HCC surveillance toward risk-stratified, biomarker-enhanced strategies
This AGA Clinical Practice Update notes that fewer than one-quarter of cirrhotic patients currently receive hepatocellular carcinoma surveillance. It highlights suboptimal sensitivity of semiannual ultrasound plus α-fetoprotein and implementation barriers for CT and MRI surveillance strategies. The document emphasizes rapidly rising HCC burden in nonviral liver diseases, where incidence is lower than in historical viral hepatitis cohorts. It recommends integrating better biomarkers and risk-stratification tools to prioritize surveillance in patients with sufficiently high anticipated HCC incidence.
LCI plus CADe significantly lowers right-colon adenoma miss rates versus white light
This randomized tandem trial compared right-colon colonoscopy using linked color imaging with computer-aided detection against conventional white-light imaging. Among 209 analyzed patients, the adenoma miss rate was substantially lower with LCI/CADe versus white light (20% vs 39%; P=0.001). Polyp and diminutive adenoma miss rates were also significantly reduced with LCI/CADe, particularly among expert endoscopists. Sessile serrated, advanced, and flat lesion miss rates favored LCI/CADe numerically but did not reach statistical significance.
Early enteral nutrition reduces 90-day complication burden after pancreatoduodenectomy in high-risk patients
This multicenter randomized trial assigned pancreatoduodenectomy patients with nutritional risk screening score ≥3 to early enteral or oral-only postoperative nutrition. Enteral nutrition via intraoperatively placed nasojejunal tube lowered the mean 90-day comprehensive complication index compared with oral nutrition alone (25.5 vs 35.8; P=.02). Overall morbidity rates and specific complications, including delayed gastric emptying and pancreatic fistula, were similar between groups. Nasojejunal tubes required replacement in 14 patients because of inadvertent removal, highlighting device-management issues.
References
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Additional Reads
Optional additional studies from this edition.