Clinical Endoscopy

Harish Darak

2 Articles

Outcomes of thin versus thick-wire snares for cold snare polypectomy: a systematic review and meta-analysis: Suprabhat Giri, Vaneet Jearth, Harish Darak, Sridhar Sundaram; Clin Endosc 2022;55(6):742-750. Published online November 9, 2022; DOI: https://doi.org/10.5946/ce.2022.141

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Background
/Aims: Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regarding the influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety of thin- and thick-wire snares for CSP.
Methods
A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for comparative studies evaluating the outcomes of thin- versus thick-wire snares for CSP.
Results
Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wire snare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97–1.09), overall bleeding (RR, 0.98; 95% CI, 0.40–2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97–1.04), and involvement of submucosa in the resection specimen (RR, 1.28; 95% CI, 0.72–2.28). There was no publication bias and a small study effect, and the relative effects remained the same in the sensitivity analysis.
Conclusions
CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors other than snare design may play a role in improving CSP outcomes.

Citations

Citations to this article as recorded by

Endoscopic Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors
Hye Kyung Jeon, Gwang Ha Kim
Gut and Liver.2025; 19(1): 19. CrossRef
Factors determining the resection ability of snares in cold snare polypectomy: Construction of an ex vivo model for accurately evaluating resection ability
Ryohei Hirose, Takuma Yoshida, Naohisa Yoshida, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Hiroshi Ikegaya, Takaaki Nakaya, Yoshito Itoh
Digestive Endoscopy.2024; 36(5): 573. CrossRef
Effectiveness and safety of thin vs. thick cold snare polypectomy of small colorectal polyps: Systematic review and meta-analysis
Rishad Khan, Sunil Samnani, Marcus Vaska, Samir C Grover, Catharine M Walsh, Jeffrey Mosko, Michael J Bourke, Steven J Heitman, Nauzer Forbes
Endoscopy International Open.2024; 12(01): E99. CrossRef
International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Clinical Endoscopy.2024; 57(2): 141. CrossRef
IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
The Korean Journal of Gastroenterology.2024; 83(6): 217. CrossRef
High‐Performance Dedicated Snares with Tip Attachments can Overcome Current Disadvantages in Cold Snare Polypectomy
Ryohei Hirose, Naohisa Yoshida, Takuma Yoshida, Hiroki Mukai, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Osamu Dohi, Yoshikazu Inagaki, Yutaka Inada, Takaaki Murakami, Akio Yanagisawa, Hiroshi Ikegaya, Takaaki Nakaya, Yoshi
Advanced Materials Technologies.2024;[Epub] CrossRef
International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Gut and Liver.2024; 18(5): 764. CrossRef
Advances in Endoscopic Resection
Mitsuru Esaki, Sonmoon Mohapatra, Norio Fukami
Gastroenterology Clinics of North America.2024; 53(4): 709. CrossRef
Comparative meta-analysis of cold snare polypectomy and endoscopic mucosal resection for colorectal polyps: assessing efficacy and safety
Shouqi Wang, Qi Zhang, Li Rong Meng, Ying Wu, Pedro Fong, Weixia Zhou
PeerJ.2024; 12: e18757. CrossRef
Does the wire diameter really determine the outcomes in cold snare polypectomy?
S Giri, S Sundaram
Journal of Gastroenterology and Hepatology.2023; 38(4): 665. CrossRef
Cold resection for colorectal polyps: where we are and where we are going?
Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef

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Outcomes of Endoscopic Management among Patients with Bile Leak of Various Etiologies at a Tertiary Care Center: Suprabhat Giri, Sridhar Sundaram, Harish Darak, Sanjay Kumar, Shobna Bhatia; Clin Endosc 2020;53(6):727-734. Published online August 21, 2020; DOI: https://doi.org/10.5946/ce.2020.017

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Background
/Aims: Bile leak is a common complication of cholecystectomy, and it is also observed in other conditions such as ruptured liver abscess, hydatid cyst, and trauma. Endoscopic retrograde cholangiopancreatography (ERCP) is the first-line management for such conditions. However, studies on the outcomes of endoscopic management for bile leaks with etiologies other than post-cholecystectomy injury are extremely limited.
Methods
We conducted a retrospective review of patients with symptomatic bile leak who were referred to a tertiary care center and who underwent ERCP between April 2016 and April 2019. The primary outcome was complete symptomatic resolution without extravasation of the contrast medium during the second ERCP conducted after 6 weeks.
Results
In total, 71 patients presented with symptomatic bile leak. The etiologies of bile leak were post-cholecystectomy injury in 34 (47.8%), liver abscess in 20 (28.1%), and post-hydatid cyst surgery in 11 (15.4%) patients. All patients were managed with ERCP, sphincterotomy, and stent placement for 6 weeks, except for one who underwent surgery. The primary outcome was achieved in 65 (91.5%) of 71 patients. There was no significant difference in terms of outcome in relation to the interval between the diagnosis of bile leak and ERCP.
Conclusions
Most patients with bile leak can be successfully managed with ERCP even when performed on an elective basis.

Citations

Citations to this article as recorded by

A critical appraisal of the ISGLS definition of biliary leakage after liver resection
Svenja Sliwinski, Jan Heil, Josephine Franz, Hanan El Youzouri, Michael Heise, Wolf O. Bechstein, Andreas A. Schnitzbauer
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Progress in ERCP Treatment of Biliary Complications in Patients with Hepatic Echinococcosis
燕泽林
Advances in Clinical Medicine.2023; 13(03): 4013. CrossRef
Diagnosis and Management of Bile Leaks after Severe Liver Injury: A Trauma Association of Canada (TAC) Multicenter Study
Morgan Schellenberg, Chad G. Ball, Natthida Owattanapanich, Brent Emigh, Patrick B. Murphy, Bradley Moffat, Brett Mador, Andrew Beckett, Jennie Lee, Emilie Joos, Samuel Minor, Matt Strickland, Kenji Inaba
Journal of Trauma and Acute Care Surgery.2022;[Epub] CrossRef
Postoperative bile leakage caused by intrahepatic duct injury during right hemicolectomy
Jaram Lee, Ook Song, Hyeong-Min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
Medicine.2021; 100(46): e27877. CrossRef
The Need for a Better-Designed Study of the Outcomes of Endoscopic Management of Bile Leak
Hyung Ku Chon, Eun Ji Shin, Seong-Hun Kim
Clinical Endoscopy.2020; 53(6): 633. CrossRef

5,260 View
144 Download
4 Web of Science
5 Crossref

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