LAUSR

It is our pleasure to introduce this special issue of Digestive Diseases and Sciences (DDS) dedicated to its former Editor-in-Chief, the late Emmet B. Keeffe. Dr. Keeffe was a giant in gastroenterology having served as both President of the American Gastroenterological Association (AGA) as well as the American Society for Gastrointestinal Endoscopy (ASGE). While he loved all things liver, his remarkable research contributions spanned from endoscopy to liver transplantation in over 700 published articles. Under the leadership of current Editor-in-Chief Jonathan Kaunitz, DDS has continued to grow its reputation as one of the leading translational journals in gastroenterology. Special issues of DDS were initiated on a recurring basis in 2015; we are delighted to edit this latest special issue entitled “Advances in Endoscopic Techniques and Technology: Old Problems, New Frontiers.” Since the development of the flexible fiberoptic endoscope by Basil Hirschowitz in 1956, endoscopy has become an integral part of the discipline of gastroenterology. Subsequent innovations such as the advent of ERCP (1968), snare polypectomy (1969), endoscopic sphincterotomy (1973), endoscopic mucosal resection (1977), band ligation (1985), and endoscopic submucosal dissection (1998) have transformed the field from a purely diagnostic into a therapeutic discipline. Today, endoscopy continues to take-off in a myriad of directions, both in diagnostics and increasingly in therapeutics where it now offers minimally-invasive alternatives to situations that have traditionally required surgical intervention. Owing to the central location of the gastrointestinal tract within the human body, it can be argued that within the field of medicine, there is no other subspecialty where creativity and imagination is as obvious, encouraged, and limitless as gastrointestinal endoscopy. While originally developed as a diagnostic procedure, ERCP today is almost entirely therapeutic. This reflects advances in diagnostic radiological imaging with magnetic resonance cholangiopancreatography as well as diagnostic endoscopic ultrasound (EUS). Intraluminal diagnostics during ERCP have been enhanced with cholangioscopy and pancreatoscopy as well as adjunctive techniques including confocal laser endomicroscopy. Difficult intraluminal stone disease may be managed with several lithotripsy techniques. Though strictures are managed with an armamentarium of stents ranging from plastic to numerous types of covered metal stents, more novel therapeutics for malignant strictures include photodynamic therapy, radiofrequency ablation, and brachytherapy. The transition of EUS from diagnostic to therapeutics has also occurred more recently although diagnosis and staging continues to be the “bread and butter” cornerstone of endosonography. Diagnostic EUS has been enhanced by new technologies including elastography, contrast harmonic EUS, and needle-based confocal laser endomicroscopy, as well as serial refinements in EUS needles and tissue diagnostics. Nevertheless, the epicenter of advancements in EUS lies squarely within therapeutics, with the advent of innovative applications that have expanded the boundaries of the field. EUS-guided fine needle injection, initially developed for celiac plexus block and neurolysis to manage chronic pancreatitis and pancreatic cancer-associated pain, has subsequently opened new possibilities including targeted therapy of pancreatic lesions with alcohol or chemotherapeutics, and ablative techniques including EUS-guided radiofrequency * Phillip S. Ge [email protected]