Aim. To evaluate the role of choice of endoscopic surgery in the treatment of patients with adenomas of the major duodenal papilla, using the developed endoscopic classification of adenomas based on duodenoscopy and endosonography. Material and methods. From 2000 to 2024, endoscopic removal of adenomas of the major duodenal papilla was performed in 200 patients. Endosonography was used at the diagnostic stage in 165 cases, while this diagnostic method was not used in 35 cases. Results. The technical success rate for endoscopic removal of adenomas of the major duodenal papilla was 100% in both groups. The postoperative complication rate was 16.9% in the study group, compared to 40% in the comparison group. In the long-term follow-up, adenoma recurrence rates were 6.6% in the study group and 20% in the comparison group. Conclusion. Personalized selection of the optimal surgical method for the removal of adenomas of the major duodenal papilla, depending on the classification typing of the neoplasm, allows for minimizing the risk of postoperative complications and increasing the radicality of the intervention.

There are international and Russian guidelines dedicated to the management of endoscopic interventions in patients taking anticoagulants: from the Federation of Anesthesiologists and Reanimatologists of Russia (FAR) dated 2025, the European Society of Gastrointestinal Endoscopy (ESGE) dated 2021, the American Society for Gastrointestinal Endoscopy (ASGE) dated 2016, and the Japan Gastroenterological Endoscopy Society (JGES) dated 2013 with an addendum from May 2018. These guidelines are based on various studies and have some discrepancies in certain aspects, related to regional differences. We conducted a comparative analysis of these clinical guidelines for planned endoscopic interventions based on the type of drug (acetylsalicylic acid, P2Y12 inhibitors, warfarin, direct oral anticoagulants), the bleeding risk of the planned endoscopic procedure (low/high), and the individual patient’s thrombotic risk (assessed using the CHA₂DS₂-VASc, Caprini, and other scales). This article is a valuable practical review that helps clinicians optimize patient management tactics.

Diverticular disease of the colon is the most common disease of the colon. In some cases, diverticular disease may be complicated by fistula. According to clinical guidelines resection of the bowel carrying the fistula is the method of choice. In a number of cases, surgical treatment may be contraindicated in case of pronounced somatic aggravation of the patient. The electronic databases Elibrary.ru, PubMed, Medline, Cochrane were searched for scientific studies on endoscopic treatment of patients with diverticular disease complicated by fistula formation in the period from 1993 to 2024. To date, there are no large studies on minimally invasive ways to eliminate fistulae complicating diverticular disease.

Introduction. Pancreatic signet ring cell carcinoma is a rare, aggressive tumor. To make a decision on treatment tactics, tumor verification is extremely important. Materials, methods, results. Clinical case of the verification of pancreatic signet ring cell carcinoma using EUS-FNA is presented. Conclusions. Endosonography with fine-needle aspiration allows to obtain sufficient material for morphological examination and clarify the stage of the disease.

Eosinophilic gastritis (EoG) is a form of eosinophilic gastrointestinal diseases (EGID), which has been increasing in the last decade, including in children. EoG is characterized by nonspecific symptoms of upper gastrointestinal tract lesions and eosinophilic infiltration of the gastric wall. Since EoG is a rare disease, uniform standards for diagnosis, differential diagnosis, treatment, and follow-up have not yet been developed. This article presents data on the prevalence, pathogenesis, and main clinical, endoscopic, and histological manifestations of Eo G. A clinical case of severe EoG in a child with a rare genetic disorder, Noonan-like syndrome, is presented. No association between eosinophilic gastrointestinal lesions and any gastrointestinal abnormalities in this syndrome has previously been described.

Introduction. Splenic cysts are rare benign neoplasms, occurring with an incidence of approximately 0.75 per 100,000 population per year. These neoplasms are significantly less common than cystic lesions of other organs, such as the liver, pancreas, and kidneys, and account for less than 1% of all cystic lesions of internal organs. In most cases, splenic cysts are asymptomatic and are discovered incidentally during instrumental examinations. For a long time, surgical treatment of patients with splenic cysts involved open or laparoscopic spleen resection, as well as splenectomy. However, in recent years, minimally invasive treatment approaches have become increasingly used in clinical practice, particularly ultrasound-guided cyst drainage followed by sclerotherapy and de-epithelialization of the cyst walls. Clinical observation. A 20-year-old female patient underwent surgical treatment in the Surgical Endoscopic Department of the A.V. Vishnevsky National Medical Research Center of Surgery for a nonparasitic cyst located in the hilum of the spleen, measuring over 6 cm. Results. In our clinical observation of a patient with a large splenic cyst, we successfully performed a minimally invasive procedure involving endoluminal transgastric puncture and endosonographically guided splenic cyst de-epithelialization. Conclusion. Endoscopic endoluminal transgastric puncture followed by endosonographically guided splenic cyst de-epithelialization represents an optimal minimally invasive technique and a preferred alternative to traditional surgical interventions.

This article analyzes and evaluates a key aspect of healthcare, fundamentally changing all aspects of medical practice: the digital transformation of nursing, a key component of the healthcare system. In Russia, this process has specific characteristics due to the country’s size, regional development disparities, the state of the IT infrastructure, and the level of digital competencies of nursing staff. The objective of the study is to analyze the key challenges and prospects for the digitalization of nursing in the Russian Federation and assess the system’s readiness and human resources for the integration of digital technologies. An analysis of current scientific sources in this area, regulatory documents, and industry statistics was conducted. The key challenges of digitalization for nursing staff in Russia were identified: a lack of digital competencies; the risk of increased administrative burden, which may distract from direct patient care; issues with technical equipment and unequal access to digital resources across regions; and issues of patient data confidentiality. Significant opportunities were also identified: improving the quality and safety of care through the use of telemedicine consultations, decision support systems, and electronic document management; Optimization of working hours through automation; new opportunities for remote patient monitoring (telemonitoring of chronic patients); development of continuous distance education; strengthening the analytical and research functions of nursing practice. The author concluded that the digitalization of nursing in Russia is inevitable, requiring a balanced, systematic approach. Success will depend on addressing technological, personnel, and organizational challenges. Factors facilitating these processes may include mandatory improvements not only in digital literacy but also in the digital culture of nursing staff through a system of continuing professional education; modernization of the IT infrastructure of healthcare institutions; adaptation of work processes with an emphasis on the supporting, rather than replacing, role of technology; and the development of domestic digital solutions focused on the needs of nursing personnel. The digital transformation of nursing will contribute to the growing prestige of the nursing profession and improved patient health and satisfaction.

Тhe article is dedicated to the IX Eurasian Forum UralEndo, which took place in Ufa in September 2025. A brief overview of the forum’s events summarizes the gained experience, formulates the main ideas of the forum, and identifies the immediate development objectives, focusing on modern scientific achievements and international best practices for implementing the latest endoscopic technologies in clinical practice for the benefit of patients in the field of endoscopy and related surgical specialties. Official web: www.uralendo.ru