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Palliation of jaundice improves the general health of the patient and, therefore, surgical outcomes. Because of the complexity and location of strictures, especially proximally, drainage has been accompanied by increased morbidity due to sepsis. Another concern is the provocation of an inflammatory and fibrotic reaction around the area of stent placement. Preoperative biliary drainage with self-expanding metallic stent (SEMS) insertion can be achieved via a percutaneous method or through endoscopic retrograde cholangiopancreatography. A recently published multicenter randomized Dutch study has shown increased morbidity with preoperative biliary drainage. A Cochrane meta-analysis has also shown a significantly increased complication rate with preoperative drainage. However, few of these studies have used a SEMS, which allows better biliary drainage. No randomized controlled trials have compared preoperative deployment of SEMS versus conventional plastic stents. The outcomes of biliary drainage also depend on the location of the obstruction, namely the difficulty with proximal compared to distal strictures. Pathophysiologically, palliation of jaundice will benefit all patients awaiting surgery. However, preoperative drainage often results in increased morbidity because of procedure-related sepsis. The use of SEMS may change the outcome of preoperative biliary drainage dramatically.

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Biliopancreatic malignancies such as cholangiocarcinoma (CCA) has notoriously been diagnosed late. As such most therapy have been palliative in nature. Cholangioscopy allows for an earlier diagnosis to be made. Brachytherapy with the insertion of catheter with iridium-132 seeds, percutaneously or through endoscopic retrograde cholangiopancreatography (ERCP) was the earliest ablative techniques used. It has been shown to have a beneficial effect only in prolonging survival. Photodynamic therapy (PDT) has also been used for several years. stenting with PDT versus stenting alone for unresectable CCA showed a marked survival benefit with the addition of PDT. However the most exciting endoscopic ablative modality appears to be intraductal radiofrequency ablation using the Habib catheter and device. Several case series have shown the effectiveness of this technique in ablating tumors. This technique is evolving and coupled with early diagnosis of CCA through cholangioscopy will allow for a curative therapy. The crux to the effective treatment of early cancerous lesions in the bile or pancreatic duct is the early diagnosis of such lesions. Effective endoscopic ablative therapy is now available with the advent of radiofrequency ablation probes that can be passed through the duodenoscope via ERCP.

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The precut sphincterotomy is used to facilitate selective biliary access in cases of difficult biliary cannulation. Needle-knife precut papillotomy is the standard of care but is associated with a high rate of complications such as pancreatitis, duodenal perforation, bleeding, etc. Sometimes during bowing of the sphincterotome/cannula and the use of guide wire to facilitate biliary cannulation, inadvertent formation of a false passage occurs in the 10 to 11 o'clock direction. Use of this step to access the bile duct by the intramucosal incision technique was first described by Burdick et al., and since then two more studies have also substantiated the safety and efficacy of this non-needle type of precut sphincterotomy. In this review, we discuss this non-needle technique of precut sphincterotomy and also share our experience using this "Burdick's technique."

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Since it was first described nearly three decades ago, endoscopic papillectomy (EP) has been utilized as a less invasive, alternative therapy for adenoma of the major duodenal papilla. In this article, we review the recent advances in EP, especially those pertaining to endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS), and pancreatic stent placement for the prevention of postpapillectomy pancreatitis. Because EUS and IDUS have similar diagnostic accuracies, either modality can be used for the preprocedural evaluation of ampullary tumors. Nevertheless, further technical refinements are required for a more precise evaluation. Given the paucity of data on the usefulness of EUS and/or IDUS during follow-up after EP, a well-designed study is warranted. Furthermore, pancreatic stent placement appears to have a protective effect against postpapillectomy pancreatitis; however, a prospective, randomized, controlled study with a larger number of patients is needed to assess this finding. Moreover, since pancreatic stent placement after EP is not always successful, various novel techniques have been developed to ensure reliable stent placement. Despite the recent advances in EP, further technical refinements and studies are needed to confirm their efficacy.

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Pancreatic cysts represent a small proportion of pancreatic diseases, but their incidence has been recently increasing. Most pancreatic cysts are identified incidentally, causing a dilemma for both clinicians and patients. In contrast to ductal adenocarcinoma, neoplastic pancreatic cysts may be cured by resection. In general, pancreatic cysts are classified as neoplastic or non-neoplastic cysts. The predominant types of neoplastic cysts include intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystic neoplasms, and solid pseudopapillary neoplasms. With the exception of serous type, neoplastic cysts, have malignant potential, and in most cases requires resection. Non-neoplastic cysts include pseudocyst, retention cyst, benign epithelial cysts, lymphoepithelial cysts, squamous lined cysts (dermoid cyst and epidermal cyst in intrapancreatic accessory spleen), mucinous nonneoplastic cysts, and lymphangiomas. The incidence of nonneoplastic, noninflammatory cysts is about 6.3% of all pancreatic cysts. Despite the use of high-resolution imaging technologies and cytologic tissue acquisition with endosonography, distinguishing nonneoplastic from neoplastic cysts remains difficult with most differentiations made postoperatively. Nonetheless, the definitive distinction between non-neoplastic and neoplastic cysts is crucial as unnecessary surgery could be avoided with proper diagnosis. Therefore, consideration of these rare disease entities should be entertained before deciding on surgery.

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• Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences
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• Local recurrence and subsequent endoscopic treatment after endoscopic piecemeal mucosal resection with or without precutting in the colorectum
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• How to deal with large colorectal polyps
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• Endoscopic mucosal resection and endoscopic submucosal dissection for colorectal lesions: A systematic review
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• Should antibiotics be administered after endoscopic mucosalresection in patients with colon polyps?
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• Endoscopic Approach for Superficial Colorectal Neoplasms
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• Many Options to Manage Laterally Spreading Tumors
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  Clinical Endoscopy.2015; 48(1): 4.     CrossRef

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• The therapeutic effect of balloon dilatation with different duration for biliary duct calculi: A network meta-analysis
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  World Journal of Gastroenterology.2016; 22(26): 5909.     CrossRef
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  Clinical Endoscopy.2015; 48(1): 6.     CrossRef

Corrosive esophagitis is characterized by caustic injury due to the ingestion of chemical agents, mainly alkaline substances such as detergents. Esophageal bleeding, perforation, or stricture can be worsened by high-degree corrosive esophagitis. Picosulfate is a commonly used laxative frequently administered for bowel preparation before colonoscopy or colon surgery. Picosulfate powder should be completely dissolved in water before ingestion because the powder itself may cause chemical burning of the esophagus and stomach. Here, we report a case of corrosive esophagitis due to the ingestion of picosulfate powder that was not completely dissolved in water.

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• 3D printing of melatonin-loaded esophageal stents for treatment of corrosive esophagitis
  Tianyu Yuan, Dongdong Liu, Qian Li, Meng Wei, Yingbao Sun, Hua Xie, Lina Du, Bochuan Yuan, Pei Deng, Yanli Guo, Yiguang Jin
  Applied Materials Today.2024; 37: 102161.     CrossRef
• Endoscopic Grading as a Predictor to Develop Strictures in Corrosive Esophagitis in Children
  Ioana Badiu Tisa, Lia Pepelea, Alexandru Pirvan, Iulia Lupan, Gabriel Samasca, Madalina Adriana Bordea
  Journal of Clinical Medicine.2023; 12(4): 1699.     CrossRef
• Efficacy of a patient with scar constitution combined with corrosive esophageal strictures after different endoscopic therapies
  Haixia Wang, Wei Tao
  Clinical Case Reports.2023;[Epub]     CrossRef
• Esophageal Stricture Caused by the Ingestion of Undissolved Picosulfate Powder
  Daehyun Kim, Byungha Cho, Jong Wook Choi, Ki Bae Kim, Seon Mee Park
  Clinical Endoscopy.2021; 54(1): 122.     CrossRef
• The effects of ω-3 fish oil emulsion-based parenteral nutrition plus combination treatment for acute paraquat poisoning
  Zhaohua Meng, Yanling Dong, Hengbo Gao, Dongqi Yao, Yu Gong, Qingbing Meng, Tuokang Zheng, Xiaolei Cui, Xiaoyun Su, Yingping Tian
  Journal of International Medical Research.2019; 47(2): 600.     CrossRef
• Unexpected caustic esophageal injury associated with the use of a bowel preparation agent
  Yi-Ting Chou, Tien-Yu Huang, Chao-Feng Chang
  Journal of Medical Sciences.2019; 39(5): 251.     CrossRef
• Acute Abdominal Pain after Ingestion of Bowel Cleansing Agent for Colonoscopy
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• Acute Gastric Injury Caused by Undissolved Sodium Picosulfate/Magnesium Citrate Powder
  Eun Young Ze, Chang Hwan Choi, Jeong Wook Kim
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• A Case of Thermal Esophageal Injury Induced by Sodium Picosulfate with Magnesium Citrate
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  Laurino Grossi, Antonio Francesco Ciccaglione, Leonardo Marzio
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The simultaneous occurrence of achalasia and esophageal diverticula is rare. Here, we report the case of a 68-year-old man with multiple esophageal diverticula associated with achalasia who was later diagnosed with early esophageal cancer. He initially presented with dysphagia and dyspepsia, and injection of botulinum toxin to the lower esophageal sphincter relieved his symptoms. Five years later, however, the patient presented with worsening of symptoms, and esophagogastroduodenoscopy (EGD) was performed. The endoscopic findings showed multifocal lugol-voiding lesions identified as moderate dysplasia. We decided to use photodynamic therapy to treat the multifocal dysplastic lesions. At follow-up EGD 2 months after photodynamic therapy, more lugol-voiding lesions representing a squamous cell carcinoma in situ were found. The patient ultimately underwent surgery for the treatment of recurrent esophageal multifocal neoplasia. After a follow-up period of 3 years, the patient showed a good outcome without symptoms. To manage premalignant lesions such as achalasia with esophageal diverticula, clinicians should be cautious, but have an aggressive approach regarding endoscopic surveillance.

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• Advanced squamous cell carcinoma in an asymptomatic, large, epiphrenic esophageal diverticulum
  Tomoaki Yoshida, Satoru Hashimoto, Ken-ichi Mizuno, Hiroshi Ichikawa, Junji Yokoyama, Hajime Umezu, Shuji Terai
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• Locally Advanced Esophageal Cancer Arising from an Epiphrenic Diverticulum Treated by Curative Esophagectomy Combined with Adjacent Organs Resection
  Aina KUNITOMO, Eiji HIGAKI, Tetsuya ABE, Takahiro HOSOI, Seiji ITO, Yasuhiro SHIMIZU
  Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2019; 80(11): 1999.     CrossRef
• Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia
  Diego Palladino, Andrea Mardighian, Marilina D’Amora, Luca Roberto, Francesco Lassandro, Claudia Rossi, Gianluca Gatta, Mariano Scaglione, Guglielmi Giuseppe
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Endometriosis is a disease characterized by the presence of endometrial tissue outside of the uterine cavity. It is common in women of childbearing age, and is most frequently located in the pelvic cavity. Approximately 10% of endometriosis cases occur outside of the pelvic cavity in locations such as the intestines, genitourinary system, kidneys, lungs, and skin. However, there have been few reports of endometriosis in the stomach. Here, we report a rare case of endometriosis that presented as a subepithelial stomach tumor.

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• Gastric Endometriosis
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• Müllerian‐type carcinosarcoma arising in gastric endometriosis: Case report and review of the literature
  Rayne Peerenboom, Sabrina Wang, Ryan Morgan, Seth Sankary, Lindsay Yassan, Katherine Kurnit, Mitchell C. Posner
  Clinical Case Reports.2024;[Epub]     CrossRef
• Transcoelomic and Lympho-Hematogenous Dissemination of Endometrioid Heterotopias – the Mechanism of Extragenital Endometriosis Formation
  R. V. Ukrainets, Yu. S. Korneva
  Journal of Anatomy and Histopathology.2021; 10(1): 85.     CrossRef
• Molecular and Cellular Changes in the Pathogenesis of Endometriosis
  K. A. Toniyan, O. I. Orlov, V. V. Boyarintsev, I. V. Ogneva
  Human Physiology.2021; 47(6): 690.     CrossRef
• Imaging of gastrointestinal endometriosis: what the radiologist should know
  Adrian Jaramillo-Cardoso, Anuradha S. Shenoy-Bhangle, Wendaline M. VanBuren, Giancarlo Schiappacasse, Christine O. Menias, Koenraad J. Mortele
  Abdominal Radiology.2020; 45(6): 1694.     CrossRef

We present the case of a woman on whom a percutaneous endoscopic gastrostomy (PEG) was performed through the sinus tract of a previous surgical gastrostomy for supraglottic obstructing malignancy. Five years after the induction of the surgical gastrostomy, she experienced a peristomal leakage, leading to severe necrotizing fasciitis, with skin irritation and inflammation. Despite extensive treatment to heal the abdominal wall close to the feeding tube, it recurred 3 months later, without any obvious cause. It was thus decided to perform a new gastrostomy in a nearby normal skin area, but, since it was totally impossible for the endoscope to be passed by mouth, due to obstruction, the sinus tract of the gastrostomy was used to facilitate endoscope insertion into the stomach for a new PEG.

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• Percutaneous endoscopic gastrostomy through a cervical esophageal fistula. An alternative, much improved technique for patient safety
  George Stavrou, Vassilios Grosomanidis, Anastasia Sarafidou, Gavriil Tsiropoulos, Stefanos Triaridis, Katerina Kotzampassi
  American Journal of Otolaryngology.2020; 41(3): 102408.     CrossRef

Lymphangioma is an uncommon malformation of the lymphatic system that involves a benign proliferation of the lymphatics, with no established treatment method. Multiple colonic lymphangioma, or colonic lymphangiomatosis, is an extremely rare condition. We report a case of colonic lymphangiomatosis that was detected during a colonoscopic examination conducted as part of a general health check-up. The lesion completely resolved after excisional biopsy.

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• Reverse Koebner's phenomenon in a case of Lymphohemangioma circumscriptum: A diagnostic clue representative of the Whimster hypothesis
  Manu Sehrawat, Kabir Sardana, Anusha Katare, Purnima Malhotra
  Journal of Cosmetic Dermatology.2020; 19(7): 1702.     CrossRef
• Lymphangiomatosis of the ileum with perforation: A case report and review of the literature
  Antonio Giuliani, Lucia Romano, Gino Coletti, Mohammad Walid A Fatayer, Giuseppe Calvisi, Francesco Maffione, Chiara Muolo, Vincenzo Vicentini, Mario Schietroma, Francesco Carlei
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• Clinical benefit of the multibending endoscope for gastric endoscopic submucosal dissection: a randomized controlled trial
  Koichi Hamada, Yoshinori Horikawa, Yoshiki Shiwa, Kae Techigawara, Takayuki Nagahashi, Daizo Fukushima, Shinya Nishida, Ryota Koyanagi, Koichiro Kawano, Noriyuki Nishino, Michitaka Honda
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• Is the Double Channel Gastroscope Useful in Endoscopic Mucosal Resection for Large Sessile Colon Polyps?
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