Clinical Endoscopy

Volume 49(6); November 2016

Commentarys

The Importance of an Endoscopic Quality Assessment Program Reflecting Real Practice: In Kyung Yoo, Yoon Tae Jeen; Clin Endosc 2016;49(6):495-497. Published online November 15, 2016; DOI: https://doi.org/10.5946/ce.2016.137

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Is Endoscopic Ultrasonography Adequate for the Diagnosis of Gastric Schwannomas?: Eun Jeong Gong, Kee Don Choi; Clin Endosc 2016;49(6):498-499. Published online November 17, 2016; DOI: https://doi.org/10.5946/ce.2016.134

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Citations

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Gastric granular cell tumor: A case report and literature review
Huixi Li, Miao Zhang, Youyou Zheng, Hong Zhang
Oncology Letters.2024;[Epub] CrossRef

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What Is the Mean Procedure Time to Optimize Colonoscopy?: Taehyun Kim, Beom Jae Lee; Clin Endosc 2016;49(6):500-501. Published online November 29, 2016; DOI: https://doi.org/10.5946/ce.2016.142

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Focused Review Series: Pancreatobiliary endoscopys in altered gastointestinal anatomy

Challenges of Endoscopic Management of Pancreaticobiliary Complications in Surgically Altered Gastrointestinal Anatomy: Tin Moe Wai, Eun Young Kim; Clin Endosc 2016;49(6):502-505. Published online November 29, 2016; DOI: https://doi.org/10.5946/ce.2016.146

Abstract PDF PubReader ePub: Pancreaticobiliary complications following various surgical procedures, including liver transplantation, are not uncommon and are important causes of morbidity and mortality. Therapeutic endoscopy plays a substantial role in these patients and can help to avoid the need for reoperation. However, the endoscopic approach in patients with surgically altered gastrointestinal (GI) anatomy is technically challenging because of the difficulty in entering the enteral limb to reach the target orifice to manage pancreaticobiliary complications. Additional procedural complexity is due to the need of special devices and accessories to obtain successful cannulation and absence of an elevator in forward-viewing endoscopes, which is frequently used in this situation. Once bilioenteric anastomosis is reached, the technical success rates achieved in expert hands approach those of patients with intact GI anatomy. The success of endoscopic therapy in patients with surgically altered GI anatomy depends on multiple factors, including the expertise of the endoscopist, understanding of postoperative anatomic changes, and the availability of suitable scopes and accessories for endoscopic management. In this issue of Clinical Endoscopy, the focused review series deals with pancreatobiliary endoscopy in altered GI anatomy such as bilioenteric anastomosis and post-gastrectomy.

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Endoscopic Retrograde Cholangiopancreatography in Post Gastrectomy Patients: Chang-Hwan Park; Clin Endosc 2016;49(6):506-509. Published online November 29, 2016; DOI: https://doi.org/10.5946/ce.2016.124

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Endoscopic retrograde cholangiopancreatography (ERCP) in post-gastrectomy patients with Billroth II (BII) reconstruction and Roux-en-Y (RY) reconstruction presents a challenge to therapeutic endoscopists. Major difficulties, including intubation to the ampulla of Vater, selective cannulation, and ampullary intervention, must be overcome in these patients. Recent data have shown that device-assisted ERCP allows for high success rates in these patients because various devices are useful for overcoming major difficulties. Therefore, good knowledge of postoperative anatomy and various devices is mandatory before performing ERCP procedures for post-gastrectomy patients.

Citations

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Optimal choice of stapler and digestive tract reconstruction method after distal gastrectomy for gastric cancer: A prospective case–control study
Zhen Wu, Zhi-Gang Zhou, Ling-Yu Li, Wen-Jing Gao, Ting Yu
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Experience of endoscopic retrograde cholangiopancreatography with side-viewing duodenoscope in patients with previous gastric surgery
Mehmet Emin Gürbüz, Dursun Özgür Karakaş
Turkish Journal of Surgery.2022; 38(2): 149. CrossRef
Efficacy and safety of the rotatable sphincterotome during ERCP in patients with prior Billroth II gastrectomy (with videos)
Feng Zhu, Yaping Guan, Jing Wang
Surgical Endoscopy.2021; 35(8): 4849. CrossRef
Single Balloon Enteroscopy-Guided Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy: Long vs. Short Type
Chang-Hwan Park
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The feasibility of cap‐assisted routine adult colonoscope for therapeutic endoscopic retrograde cholangiopancreatography in patients with Roux‐en‐Y reconstruction after total gastrectomy
Jian Bo Ni, Mei Ying Zhu, Kai Li, Wei Ming Dai, Lun Gen Lu, Xin Jian Wan, Rong Wan, Xiao Bo Cai
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Challenges in ERCP post-Billroth II gastrectomy: Is it the scope, tools or technique?
IhabI El Hajj, Mohammad Al-Haddad
Saudi Journal of Gastroenterology.2019;[Epub] CrossRef
Challenges of endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrointestinal anatomy: A review article
Rabbinu Rangga Pribadi, Abdul Aziz Rani, Murdani Abdullah
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Endoscopic retrograde cholangiopancreatography in Billroth II gastrectomy patients: Outcomes and potential factors affecting technical failure
Jia-Su Li, Duo-Wu Zou, Zhen-Dong Jin, Jie Chen, Xin-Gang Shi, Zhao-Shen Li, Feng Liu
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Endoscopic Retrograde Cholangiopancreatography in Bilioenteric Anastomosis: Eun Taek Park; Clin Endosc 2016;49(6):510-514. Published online November 14, 2016; DOI: https://doi.org/10.5946/ce.2016.138

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For diagnosis and treatment of pancreatobiliary diseases, endoscopic retrograde cholangiopancreatography (ERCP) is useful method nowadays and its technically success rate is usually in about 90%-95% of patients with normal gastric and pancreaticobiliary anatomy. Recently ERCP is significantly challenging after intestinal reconstruction, particularly in patients who have undergone pancreaticoduodenectomy (PD, classic Whipple’s operation) or pylorus-preserving pancreatoduodenectomy (PPPD) with reconstruction. PD and PPPD relate to numerous techniques have been presented for reconstruction of the digestive tract and pancreaticobiliary tree during the resection bilioenteric stricture commonly occurs later in the postoperative course and developed in 5-year cumulative probability of biliary stricture rate of 8.2% and pancreaticoenteric stricture of 4.6%. This complication was no difference in incidence between patients with benign or malignant disease. In PD or PPPD with reconstruction, short pancreatobiliary limb with biliojejunal anastomosis site is made usually, modestly success rate of intubation to blind loop and cannulation with conventional endoscope. However, in combined Reux-en-Y anastomosis, longer pancreatobiliary limb and additional Reux limb are obstacle to success intubation and cannulation by using conventional endoscope. In this situation, new designed enetroscope with dedicated accessories is efficient.

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Jun Shu, Hu Yang, Jun Yang, Hong-Qiang Bian, Xin Wang
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Use of modified therapeutic upper endoscope for ERCP in patients post pancreaticoduodenectomy
Nicholas M. McDonald, Mohamed Abdallah, Dharma Sunjaya, Mohammad Bilal
Endoscopy International Open.2022; 10(06): E905. CrossRef
Experience of endoscopic retrograde cholangiopancreatography with side-viewing duodenoscope in patients with previous gastric surgery
Mehmet Emin Gürbüz, Dursun Özgür Karakaş
Turkish Journal of Surgery.2022; 38(2): 149. CrossRef
EUS-Guided Pancreatic Duct Puncture for Difficult Cannulation of Stenosed Pancreaticojejunostomy
Eugenia N. Uche-Anya, Christopher D. Packey, Ali S. Khan, Amrita Sethi
Digestive Diseases and Sciences.2018; 63(1): 268. CrossRef

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Endoscopic Ultrasound-Guided Pancreatobiliary Endoscopy in Surgically Altered Anatomy: Pichamol Jirapinyo, Linda S. Lee; Clin Endosc 2016;49(6):515-529. Published online November 29, 2016; DOI: https://doi.org/10.5946/ce.2016.144

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Endoscopic retrograde cholangiopancreatography (ERCP) has become the mainstay of therapy for pancreatobiliary diseases. While ERCP is safe and highly effective in the general population, the procedure remains challenging or impossible in patients with surgically altered anatomy (SAA). Endoscopic ultrasound (EUS) allows transmural access to the bile or pancreatic duct (PD) prior to ductal drainage using ERCP-based techniques. Also known as endosonography-guided cholangiopancreatography (ESCP), the procedure provides multiple advantages over overtube-assisted enteroscopy ERCP or percutaneous or surgical approaches. However, the procedure should only be performed by endoscopists experienced in both EUS and ERCP and with the proper tools. In this review, various EUS-guided diagnostic and therapeutic drainage techniques in patients with SAA are examined. Detailed step-by-step procedural descriptions, technical tips, feasibility, and safety data are also discussed.

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ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP): ANALYSIS OF THE EFFECTIVENESS AND SAFETY OF THE PROCEDURE IN THE PATIENT WITH ROUX-EN-Y GASTRIC BYPASS
Flávio Heuta IVANO, Bruno Jeronimo PONTE, Thais Caroline DUBIK, Victor Kenzo IVANO, Vitória Luiza Locatelli WINKELER, Antônio Katsumi KAY
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Catheter probe extraductal ultrasound (EDUS) exploration of the common bile duct is safe in elderly patients with suspicion of choledocholithiasis after distal gastrectomy
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Gastrointestinal Endoscopy.2018; 87(5): 1241. CrossRef
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Lalin Navaratne, Jasim Al-Musawi, Asuncion Acosta Mérida, Jaime Vilaça, Alberto Martinez Isla
Langenbeck's Archives of Surgery.2018; 403(6): 777. CrossRef
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Tom G. Moreels
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Endoscopic ultrasound–guided biliary and pancreatic duct access and intervention
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Techniques in Gastrointestinal Endoscopy.2017; 19(4): 207. CrossRef

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Percutaneous Transhepatic Cholangioscopy in Bilioenteric Anastomosis Stricture: Hyoung-Chul Oh; Clin Endosc 2016;49(6):530-532. Published online September 19, 2016; DOI: https://doi.org/10.5946/ce.2016.125

Abstract PDF PubReader ePub

Bilioenteric anastomosis strictures are a serious complication of biliary surgery, and often result in recurrent cholangitis, choledocholithiasis, biliary cirrhosis, and hepatic failure. Bilioenteric reconstructive surgery is the standard treatment of choice for such complications. However, percutaneous transhepatic cholangioscopy (PTCS), also known as per-oral endoscopic-guided intervention, is a less invasive procedure that is becoming an increasingly popular alternative. This review describes the PTCS procedure (including the preparation process), as well as the diagnostic and therapeutic role of PTCS in bilioenteric anastomosis strictures.

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Management of anastomotic biliary stricture through utilizing percutaneous transhepatic cholangioscopy
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Reviews

Endocuff-Assisted Colonoscopy—A Novel Accessory in Improving Adenoma Detection Rate: A Review of the Literature: Rashmee Patil, Mel A. Ona, Emmanuel Ofori, Madhavi Reddy; Clin Endosc 2016;49(6):533-538. Published online May 2, 2016; DOI: https://doi.org/10.5946/ce.2016.032

Abstract PDF PubReader ePub

Endocuff (Arc Medical Design) is a U.S. Food and Drug Administration-approved device that is attached like a cap to the distal tip of the colonoscope; it is used to improve adenoma detection rates during colonoscopy. The aim of this review was to summarize and evaluate the clinical and technical efficacy of Endocuff in improving adenoma detection rate. A comprehensive literature review was performed to identify studies describing this technique. In this review article, we have summarized case series and reports describing Endocuff use and results. The reported indications, results, limitations, and complications are discussed.

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Rossella Palma, Gianluca Andrisani, Gianfranco Fanello, Augusto Lauro, Cristina Panetta, Chiara Eberspacher, Francesco Di Matteo, Samuele Vaccari, Noemi Zorzetti, Vito D’Andrea, Stefano Pontone
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Endocuff-assisted push enteroscopy increases the detection of proximal small-bowel gastrointestinal angiodysplasias
Christian S. Jackson, Chandrasekhar Kesavan, Anjali Das, Erick Imbertson, Richard M. Strong
Indian Journal of Gastroenterology.2022; 41(3): 300. CrossRef
Técnicas colonoscópicas para la detección de pólipos: un estudio egipcio
M. Abdelbary, S. Hamdy, H. Shehab, N. ElGarhy, M. Menesy, R. Marzaban
Revista de Gastroenterología de México.2021; 86(1): 36. CrossRef
Colonoscopic techniques in polyp detection: An Egyptian study
M. Abdelbary, S. Hamdy, H. Shehab, N. ElGarhy, M. Menesy, R. Marzaban
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The Use of Attachment Devices to Aid in Adenoma Detection
Zoe Lawrence, Seth A. Gross
Current Treatment Options in Gastroenterology.2020; 18(1): 137. CrossRef
Number of significant polyps detected per six-minute withdrawal time at colonoscopy (SP6): a new measure of colonoscopy efficiency and quality
Rajaratnam Rameshshanker, Brian P Saunders
Frontline Gastroenterology.2020; 11(6): 491. CrossRef
EndoCuff‐assisted colonoscopy could improve adenoma detection rate: A meta‐analysis of randomized controlled trials
Hai Xu Jian, Bing Cheng Feng, Yan Zhang, Jun Yan Qu, Yue Yue Li, Xiu Li Zuo
Journal of Digestive Diseases.2019; 20(11): 578. CrossRef
Sessile Serrated Adenomas: How to Detect, Characterize and Resect
Michael X. Ma, Michael J. Bourke
Gut and Liver.2017; 11(6): 747. CrossRef
En este número
Enrique Murcio Pérez
Endoscopia.2016; 28(4): 135. CrossRef

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Diagnosis of Obscure Gastrointestinal Bleeding: Satoshi Tanabe; Clin Endosc 2016;49(6):539-541. Published online February 11, 2016; DOI: https://doi.org/10.5946/ce.2016.004

Abstract PDF PubReader ePub

Obscure gastrointestinal bleeding (OGIB) is defined as gastrointestinal bleeding from a source that cannot be identified on upper or lower gastrointestinal endoscopy. OGIB is considered an important indication for capsule endoscopy (CE). CE is particularly useful for the detection of vascular and small ulcerative lesions, conditions frequently associated with OGIB, particularly in Western countries. On the other hand, balloon enteroscopy (BE) can facilitate the diagnosis of lesions presenting with minimal changes of the mucosal surface, such as submucosal tumors, and can be used not only for diagnosis, but also for treatment, including endoscopic hemostasis. In other words, the complementary use of both CE and BE enables OGIB to be more efficiently diagnosed and treated. However, rebleeding can occur even in patients with negative results of CE, and such patients require repeat CE or BE. It is essential to effectively use both CE and BE based on a thorough understanding of the strong points and weak points of these procedures. Further advances and developments in virtual endoscopy incorporating computed tomography and magnetic resonance imaging are expected in the future.

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World Journal of Gastroenterology.2017; 23(20): 3752. CrossRef

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Original Articles

Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea: Yu Kyung Cho, Jeong Seop Moon, Dong Su Han, Yong Chan Lee, Yeol Kim, Bo Young Park, Il-Kwun Chung, Jin-Oh Kim, Jong Pil Im, Jae Myung Cha, Hyun Gun Kim, Sang Kil Lee, Hang Lak Lee, Jae Young Jang, Eun Sun Kim, Yunho Jung, Chang Mo Moon, Ethics and Quality Control Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2016;49(6):542-547. Published online March 2, 2016; DOI: https://doi.org/10.5946/ce.2015.113

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Background
/Aims: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions.
Methods
We surveyed the staff of institutional endoscopic units via e-mail.
Results
Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program.
Conclusions
Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

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Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5‐year experience in an endoscopy center
Shu‐Hui Chen, Theophile Liu, Huei‐Wen Lai, Hui‐Lan Chang, Hsu‐Heng Yen
Advances in Digestive Medicine.2022; 9(2): 103. CrossRef
A nationwide survey on the effectiveness of training on endoscope reprocessing within the national cancer screening program in Korea
Hye Young Shin, Da Hun Jang, Jae Kwan Jun
American Journal of Infection Control.2021; 49(8): 1031. CrossRef
Polyp missing rate and its associated risk factors of referring hospitals for endoscopic resection of advanced colorectal neoplasia
Jae Gyu Shin, Hyung Wook Kim, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Medicine.2017; 96(19): e6742. CrossRef
Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
Clinical Endoscopy.2017; 50(4): 345. CrossRef
How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program
Yu Kyung Cho
Clinical Endoscopy.2016; 49(4): 312. CrossRef
How Can We Propagate the National Endoscopy Quality Improvement Program and Improve the Quality of Endoscopic Screening?
Dong-Hoon Yang
Gut and Liver.2016; 10(5): 657. CrossRef
The Importance of an Endoscopic Quality Assessment Program Reflecting Real Practice
In Kyung Yoo, Yoon Tae Jeen
Clinical Endoscopy.2016; 49(6): 495. CrossRef

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7 Crossref

Endosonographic Features of Gastric Schwannoma: A Single Center Experience: Jong Min Yoon, Gwang Ha Kim, Do Youn Park, Na Ri Shin, Sangjeong Ahn, Chul Hong Park, Jin Sung Lee, Key Jo Lee, Bong Eun Lee, Geun Am Song; Clin Endosc 2016;49(6):548-554. Published online March 15, 2016; DOI: https://doi.org/10.5946/ce.2015.115

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Background
/Aims: Gastric schwannomas are rare benign mesenchymal tumors that are difficult to differentiate from other mesenchymal tumors with malignant potential, such as gastrointestinal stromal tumors. This study aimed to evaluate the characteristic findings of gastric schwannomas via endoscopic ultrasonography (EUS).
Methods
We retrospectively reviewed the EUS findings of 27 gastric schwannoma cases that underwent surgical excision at Pusan National University Hospital during 2007 to 2014.
Results
Gastric schwannomas were mainly located in the middle third of the stomach with a mean tumor size of 32 mm. All lesions exhibited hypoechoic echogenicity, and 24 lesions (88.9%) exhibited heterogeneous echogenicity. Seventeen lesions (63.0%) exhibited decreased echogenicity compared to the normal proper muscle layer. Distinct borders were observed in 24 lesions (88.9%), lobulated margins were observed in six lesions (22.2%), and marginal haloes were observed in 24 lesions (88.9%). Hyperechogenic spots were observed in 21 lesions (77.8%), calcifications were observed in one lesion (3.7%), and cystic changes were observed in two lesions (7.4%).
Conclusions
During EUS, gastric schwannomas appear as heterogeneously hypoechoic lesions with decreased echogenicity compared to the normal proper muscle layer. These features may be helpful for differentiating gastric schwannomas from other mesenchymal tumors.

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Gastric schwannoma: The gastrointestinal tumor simulator - case report and review of the literature
Amine Majdoubi, Anass El Achchi, Mohamed El Hammouti, Tareq Bouhout, Badr Serji
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Schwannoma gástrico. Reporte de un caso
Darío Montes N, Nixon Cevallos R, Rubén Montes N
Oncología (Ecuador).2024; 34(1): 52. CrossRef
Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis
Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
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Shwannoma of the stomach and synchronous cancer of the transverse colon: a clinical case report
A. B. Baychorov, M. A. Danilov, N. C. Karnaukhov, Z. M. Abdulatipova, A. V. Leontiev, G. G. Sahakyan
Surgery and Oncology.2023; 13(3): 38. CrossRef
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Gwang Ha Kim
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The Diagnosis of Small Gastrointestinal Subepithelial Lesions by Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy
Masanari Sekine, Takeharu Asano, Hirosato Mashima
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Clinicopathological characteristics of gastrointestinal schwannomas: A retrospective analysis of 78 cases
Hailing Peng, Liu Han, Yuyong Tan, Yi Chu, Liang Lv, Deliang Liu, Hongyi Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
What About Gastric Schwannoma? A Review Article
Sara Lauricella, Sergio Valeri, Gianluca Mascianà, Ida Francesca Gallo, Erica Mazzotta, Chiara Pagnoni, Saponaro Costanza, Lorenza Falcone, Domenico Benvenuto, Marco Caricato, Gabriella Teresa Capolupo
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Diagnosing Gastric Mesenchymal Tumors by Digital Endoscopic Ultrasonography Image Analysis
Moon Won Lee, Gwang Ha Kim
Clinical Endoscopy.2021; 54(3): 324. CrossRef
Gastric schwannoma with high accumulation on fluorodeoxyglucose-positron emission tomography resected by non-exposed endoscopic wall-inversion surgery
Tomoya Sugiyama, Masahide Ebi, Tomoko Ochiai, Shintaro Kurahashi, Takuya Saito, Kentaro Onishi, Kazuhiro Yamamoto, Satoshi Inoue, Kazunori Adachi, Takashi Yoshimine, Yoshiharu Yamaguchi, Yasuhiro Tamura, Shinya Izawa, Yasutaka Hijikata, Yasushi Funaki, Na
Clinical Journal of Gastroenterology.2020; 13(1): 50. CrossRef
Schwannoma gástrico: una rareza entre los tumores mesenquimatosos del tracto gastrointestinal
G.E. Sánchez-Morales, A.M. Trolle-Silva, P. Moctezuma-Velázquez, J.H. Rodríguez-Quintero, R.J. Alcazar-Félix
Revista de Gastroenterología de México.2020; 85(1): 102. CrossRef
Gastric schwannoma: A rarity among mesenchymal tumors of the gastrointestinal tract
G.E. Sánchez-Morales, A.M. Trolle-Silva, P. Moctezuma-Velázquez, J.H. Rodríguez-Quintero, R.J. Alcazar-Félix
Revista de Gastroenterología de México (English Edition).2020; 85(1): 102. CrossRef
Clinical Characteristics and Surgical Management of Gastrointestinal Schwannomas
Xin Wu, Binglu Li, Chaoji Zheng, Xiaodong He, Kosei Maemura
BioMed Research International.2020;[Epub] CrossRef
Periampullary duodenal schwannoma mimicking ampullary neoplasm
Marly Pierina Rubio Sierra, Aydamir Alrakawi, Ahmad Alduaij, Dana AlNuaimi, Numan Cem Balci
Radiology Case Reports.2020; 15(11): 2085. CrossRef
Gastric schwannoma: a case report and literature review
Changsheng Pu, Keming Zhang
Journal of International Medical Research.2020;[Epub] CrossRef
Application of A Convolutional Neural Network in The Diagnosis of Gastric Mesenchymal Tumors on Endoscopic Ultrasonography Images
Yoon Ho Kim, Gwang Ha Kim, Kwang Baek Kim, Moon Won Lee, Bong Eun Lee, Dong Hoon Baek, Do Hoon Kim, Jun Chul Park
Journal of Clinical Medicine.2020; 9(10): 3162. CrossRef
Glomus Tumor of the Duodenum
Tae Kyoung Ha, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Young Min Kwak, Guk Bin Park, Yong Bo Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2020; 20(4): 328. CrossRef
Simultaneous organ-sparing surgery in a patient with rare synchronous polyneoplasms of the gastrointestinal tract
D.V. Sidorov, I.V. Stepanyuk, I.A. Bakasov, M.V. Lozhkin, N.N. Volchenko, R.I. Moshurov, N.A. Grishin, E.V. Gameeva
Onkologiya. Zhurnal imeni P.A.Gertsena.2020; 9(6): 67. CrossRef
Digital image analysis-based scoring system for endoscopic ultrasonography is useful in predicting gastrointestinal stromal tumors
Moon Won Lee, Gwang Ha Kim, Kwang Baek Kim, Yoon Ho Kim, Do Youn Park, Chang In Choi, Dae Hwan Kim, Tae Yong Jeon
Gastric Cancer.2019; 22(5): 980. CrossRef
Gastric schwannoma misdiagnosed as a GIST
Roberto Peltrini, Paola Antonella Greco, Riccardo Aurelio Nasto, Alessandra D’Alessandro, Alessandro Iacobelli, Luigi Insabato, Luigi Bucci
Acta Chirurgica Belgica.2019; 119(6): 411. CrossRef
Clinical characteristics and surgical treatment of schwannomas of the esophagus and stomach: A case series and systematic review
Jesús Morales-Maza, Francisco Ulises Pastor-Sifuentes, Germán E Sánchez-Morales, Emilio Sanchez-Garcia Ramos, Oscar Santes, Uriel Clemente-Gutiérrez, Adriana Simoneta Pimienta-Ibarra, Heriberto Medina-Franco
World Journal of Gastrointestinal Oncology.2019; 11(9): 750. CrossRef
Gastric Schwannoma Mimicking Advanced Gastric Cancer
Woo Sun Rou, Ju Seok Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2019; 19(4): 282. CrossRef
Gastrointestinal schwannomas: a rare but important differential diagnosis of mesenchymal tumors of gastrointestinal tract
Alexandros Mekras, Veit Krenn, Aristotelis Perrakis, Roland S Croner, Vasileios Kalles, Cem Atamer, Robert Grützmann, Nikolaos Vassos
BMC Surgery.2018;[Epub] CrossRef
Endosonographic Findings and the Natural Course of Chronic Gastric Anisakiasis: A Single-Center Experience
Eun Young Park, Dong Hoon Baek, Gwang Ha Kim, Bong Eun Lee, So-Jeong Lee, Do Youn Park
Gastroenterology Research and Practice.2018; 2018: 1. CrossRef
A Rare Duodenal Subepithelial Tumor: Duodenal Schwannoma
Dong Hwahn Kahng, Gwang Ha Kim, Sang Gyu Park, So Jeong Lee, Do Youn Park
Clinical Endoscopy.2018; 51(6): 587. CrossRef
Endoscopic ultrasonography diagnosis of subepithelial lesions
Mitsuhiro Kida, Yusuke Kawaguchi, Eiji Miyata, Rikiya Hasegawa, Toru Kaneko, Hiroshi Yamauchi, Shuko Koizumi, Kosuke Okuwaki, Shiro Miyazawa, Tomohisa Iwai, Hidehiko Kikuchi, Maya Watanabe, Hiroshi Imaizumi, Wasaburo Koizumi
Digestive Endoscopy.2017; 29(4): 431. CrossRef
Role of endoscopic ultrasound and endoscopic resection for the treatment of gastric schwannoma
Jinlong Hu, Xiang Liu, Nan Ge, Sheng Wang, Jintao Guo, Guoxin Wang, Siyu Sun
Medicine.2017; 96(25): e7175. CrossRef
Is Endoscopic Ultrasonography Adequate for the Diagnosis of Gastric Schwannomas?
Eun Jeong Gong, Kee Don Choi
Clinical Endoscopy.2016; 49(6): 498. CrossRef

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Predicting Colonoscopy Time: A Quality Improvement Initiative: Deepanshu Jain, Abhinav Goyal, Stacey Zavala; Clin Endosc 2016;49(6):555-559. Published online March 2, 2016; DOI: https://doi.org/10.5946/ce.2015.110

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Background
/Aims: There is lack of consensus on the optimal time allotted for colonoscopy, which increases patient wait times. Our aim was to identify and quantify the individual pre-procedural factors that determine the total procedure time (TPT) of colonoscopy.
Methods
This retrospective study involved 4,494 subjects, undergoing outpatient colonoscopy. Effects of age, sex, body mass index, abdominal surgery history, procedure indication (screening, surveillance, or diagnostic), procedure session (morning or afternoon), and endoscopist’s experience (fellow or attending) on TPT were evaluated using multiple regression analysis. A p<0.05 was considered significant.
Results
A total of 1,239 subjects satisfied the inclusion/exclusion criteria. Women, older individuals, and those with a history of abdominal surgery were found to have a shorter TPT (p>0.05) as did afternoon session colonoscopies (p=0.004). Less experienced endoscopists had longer TPTs (p>0.05). Screening (p=0.01) and surveillance (p=0.008) colonoscopies had a longer TPT than diagnostic procedures. Overall, the F-value of the regression model was 0.0009.
Conclusions
The indication for colonoscopy and the time of day have statistically significant associations with TPT. These results will help in streamlining workflow, reduce wait time, and improve patient satisfaction.

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MorphGI: A Self-Propelling Soft Robotic Endoscope Through Morphing Shape
Julius E. Bernth, Guokai Zhang, Dionysios Malas, George Abrahams, Bu Hayee, Hongbin Liu
Soft Robotics.2024; 11(4): 670. CrossRef
A Chemical Reaction-Driven Untethered Volume Changing Robotic Capsule for Tissue Dilation
Kaan Esendag, Mark E. McAlindon, Daniela Rus, Shuhei Miyashita, Dana D. Damian
IEEE Transactions on Medical Robotics and Bionics.2024; 6(4): 1300. CrossRef
A review on model-based and model-free approaches to control soft actuators and their potentials in colonoscopy
Motahareh Asgari, Ludovic Magerand, Luigi Manfredi
Frontiers in Robotics and AI.2023;[Epub] CrossRef
Disparities in colonoscopy utilization for lower gastrointestinal bleeding in rural vs urban settings in the United States
Nagapratap Ganta, Mina Aknouk, Dina Alnabwani, Ivan Nikiforov, Veera Jayasree Latha Bommu, Vraj Patel, Pramil Cheriyath, Christopher S Hollenbeak, Alan Hamza
World Journal of Gastrointestinal Endoscopy.2022; 14(8): 474. CrossRef
Endorobots for Colonoscopy: Design Challenges and Available Technologies
Luigi Manfredi
Frontiers in Robotics and AI.2021;[Epub] CrossRef
The efficacy of music as a non-pharmacological intervention in the endoscopy setting: a literature review
Dale Ware, John Habron
Gastrointestinal Nursing.2020; 18(Sup1): S16. CrossRef
Use of rapid reading software to reduce capsule endoscopy reading times while maintaining accuracy
Sabina Beg, Ewa Wronska, Isis Araujo, Begona González Suárez, Ekaterina Ivanova, Evgeny Fedorov, Lars Aabakken, Uwe Seitz, Jean-Francois Rey, Jean-Christophe Saurin, Roberto Tari, Tim Card, Krish Ragunath
Gastrointestinal Endoscopy.2020; 91(6): 1322. CrossRef
Quality measures improving endoscopic screening of colorectal cancer: a review of the literature
Marcello Maida, Gaetano Morreale, Emanuele Sinagra, Gianluca Ianiro, Vito Margherita, Alfonso Cirrone Cipolla, Salvatore Camilleri
Expert Review of Anticancer Therapy.2019; 19(3): 223. CrossRef
Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative
Michal F Kaminski, Siwan Thomas‐Gibson, Marek Bugajski, Michael Bretthauer, Colin J Rees, Evelien Dekker, Geir Hoff, Rodrigo Jover, Stepan Suchanek, Monika Ferlitsch, John Anderson, Thomas Roesch, Rolf Hultcranz, Istvan Racz, Ernst J Kuipers, Kjetil Garbo
United European Gastroenterology Journal.2017; 5(3): 309. CrossRef
Colonoscopy Procedure Time: Does the Learning Environment Matter?
Neel Sharma
Clinical Endoscopy.2017; 50(3): 308. CrossRef
What Is the Mean Procedure Time to Optimize Colonoscopy?
Taehyun Kim, Beom Jae Lee
Clinical Endoscopy.2016; 49(6): 500. CrossRef

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Case Reports

An Intractable Caustic Esophageal Stricture Successfully Managed with Sequential Treatment Comprising Incision with an Insulated-Tip Knife, Balloon Dilation, and an Oral Steroid: Woong Ki Lee, Byung Sun Kim, Min A Yang, So Hee Yun, Young Jae Lee, Ji Woong Kim, Jin Woong Cho; Clin Endosc 2016;49(6):560-563. Published online August 12, 2016; DOI: https://doi.org/10.5946/ce.2016.048

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Bougie or balloon dilation is a good short-term treatment for caustic esophageal strictures, although recurrence after dilation occurs in approximately 30% of these cases. Therefore, long-term treatment options are required in some cases, and endoscopic incisional therapy has been used for patients with an anastomotic stricture in the gastrointestinal tract. A 58-year-old woman presented with severe swallowing difficulty because of a caustic esophageal stricture, which was caused by accidental exposure to anhydrous acetic acid at infancy. She had undergone several previous bougie and balloon dilations but the stricture did not improve. We performed sequential treatment comprising incision with an insulated-tip knife, balloon dilation, and an oral steroid, which resulted in the patient’s symptoms markedly improving. Thus, we report this case of an intractable caustic esophageal stricture, which was successfully treated using combined endoscopic sequential treatment.

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A new simple endoscopic incision therapy for refractory benign oesophageal anastomotic stricture
Jeongmin Choi, Soo In Choi
BMJ Case Reports.2021; 14(3): e239798. CrossRef
Endoscopic incision for treatment of benign gastrointestinal strictures
Chengbai Liang, Yuyong Tan, Jiaxi Lu, Meixian Le, Deliang Liu
Expert Review of Gastroenterology & Hepatology.2020; 14(6): 445. CrossRef

8,083 View
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Multidrug-Resistant Tuberculous Mediastinal Lymphadenitis, with an Esophagomediastinal Fistula, Mimicking an Esophageal Submucosal Tumor: Dongwuk Kim, Juwon Kim, Daegeun Lee, Ha Sung Chang, Hyunsung Joh, Won-Jung Koh, Jun Haeng Lee; Clin Endosc 2016;49(6):564-569. Published online April 18, 2016; DOI: https://doi.org/10.5946/ce.2016.020

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Mediastinal tuberculous lymphadenitis rarely mimics esophageal submucosal tumor, particularly in the case of multidrug-resistant tuberculosis (MDR-TB). Herein, we report the case of a 61-year-old woman who visited a local hospital complaining of odynophagia. An initial esophagogastroduodenoscopy revealed an esophageal submucosal tumor, and subsequent chest computed tomography showed subcarinal lymphadenopathy with an esophagomediastinal fistula. The patient was then referred to Samsung Medical Center, and a second esophagogastroduodenoscopy showed deep central ulceration, as well as a suspicious fistula in the esophageal submucosal tumor-like lesion. A biopsy examination of the ulcerative lesion confirmed focal inflammation only. Next, an endobronchial, ultrasound-guided lymph node biopsy was performed, and TB was confirmed. The patient initially began a course of isoniazid, rifampicin, ethambutol, and pyrazinamide. However, after a drug sensitivity test, she was diagnosed with MDR-TB, and second-line anti-TB medications were prescribed. She recovered well subsequently.

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Detection of Esophageal Tuberculosis, a Rare Cause of Abdominal Pain, on18F-FDG PET/CT
Tarun Kumar Jain, Hemant Malhotra, Subhash Nepalia, Ganesh Narayan Saxena
Journal of Nuclear Medicine Technology.2024; 52(2): 179. CrossRef
Esophagomediastinal fistula secondary to tuberculous mediastinal lymphadenopathy
Ming-Dong Zhou, Dong-Ge Han, Wei Liu
Clinics and Research in Hepatology and Gastroenterology.2023; 47(10): 102243. CrossRef
“Esophagomediastinal fistula presenting as drug resistant tuberculosis”
Chinnu Sasikumar, Ketaki Utpat, Unnati Desai, Jyotsna M. Joshi
Indian Journal of Tuberculosis.2020; 67(3): 363. CrossRef
Tuberculous esophagomediastinal fistula with concomitant mediastinal bronchial artery aneurysm-acute upper gastrointestinal bleeding: A case report
Sultan R Alharbi
World Journal of Gastroenterology.2019; 25(17): 2144. CrossRef
Combined transbronchoscopic needle aspiration (TBNA) and rapid on-site cytological evaluation (ROSE) for diagnosis of tuberculous mediastinal lymphadenitis
Xi Dai, Bin Niu, Xiao-Qiong Yang, Guo-Ping Li
Medicine.2018; 97(37): e11724. CrossRef
Mediastinal Tuberculous Lymphadenitis Diagnosed by Endosonographic Fine Needle Aspiration
Joonhwan Kim, Youngwoo Jang, Kyung Oh Kim, Yoon Jae Kim, Dong Kyun Park, Dong Hae Chung, Eun Young Kim, Jun-Won Chung
The Korean Journal of Gastroenterology.2016; 68(6): 312. CrossRef

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130 Download
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Giant Brunner’s Gland Hamartoma of the Duodenal Bulb Presenting with Upper Gastrointestinal Bleeding and Obstruction: Ju Hyoung Lee, Kyeong Min Jo, Tae Oh Kim, Jong Ha Park, Seung Hyun Park, Jae Won Jung, So Chong Hur, Sung Yeun Yang; Clin Endosc 2016;49(6):570-574. Published online October 13, 2016; DOI: https://doi.org/10.5946/ce.2016.022

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Brunner’s gland hamartomas are small benign lesions that are most commonly found in the bulb of the duodenum. They are very uncommon, and most are found incidentally during upper gastrointestinal series or esophagogastroduodenoscopy. The lesions tend to be asymptomatic, but patients may present with symptoms of duodenal obstruction or hemorrhage secondary to ulceration. Histologically, a Brunner's gland hamartoma consists of the components of Brunner's gland cells, as well as glandular, adipose and muscle cells. In this study, we report the case of a 30-year-old man who presented with upper gastrointestinal bleeding and obstructive symptoms due to a giant Brunner's gland hamartoma in the duodenal bulb. The hamartoma was successfully removed by endoscopic resection. No significant complications were observed. Microscopically, the lesion was found to be entirely composed of variable Brunner's glands and adipocytes.

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A case of primary duodenal Brunner's gland hamartoma that gradually underwent morphological changes over a period of 10 years
Yusuke Sunada, Hiromichi Yamane, Nobuaki Ochi, Hirohito Kirishi, Takako Saitou, Masafumi Miura, Hidekazu Nakanishi, Hideyo Fujiwara, Nagio Takigawa
DEN Open.2025;[Epub] CrossRef
Brunner’s gland hamartomas: Not always benign
Manar Shmais, Ahmad Mousawi, Fadi Mourad, Ala I. Sharara
Arab Journal of Gastroenterology.2024; 25(1): 70. CrossRef
The Characteristics and Treatment Outcomes of 71 Duodenal Brunner’s Gland Adenomas with Endoscopic Submucosal Dissection
Ying Xiang, Jinyan Liu, Nan ya Wang, Dehua Tang, Lei Wang, Ping xiao Zou, Guifang Xu, Qin Huang
Digestive Diseases.2023; 41(6): 852. CrossRef
Giant brunner gland hamartoma: An unusual cause of upper gastrointestinal bleed
Bershic Valantine, ManjunathB Venkatapur, Sultan Nawahirsha, SBabu Kumar
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A giant Brunner’s gland hamartoma being treated as a pedunculated polyp: a case report
Lizhi Yi, Zhengyu Cheng, Huarong Qiu, Jianjun Yang, Tao Wang, Ke Liu
BMC Gastroenterology.2019;[Epub] CrossRef

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Acute Pancreatitis Following Endoscopic Ampullary Biopsies without Attempted Cannulation of the Ampulla of Vater: Spyridon Michopoulos, Dimitra Kozompoli, Sparti Ntai, Georgios Kalantzis, Evanthia Zampeli, Kalliopi Petraki; Clin Endosc 2016;49(6):575-578. Published online July 20, 2016; DOI: https://doi.org/10.5946/ce.2016.043

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A 51-year-old man underwent diagnostic work-up for an abnormal-appearing ampulla of Vater. Three hours after biopsy of the ampulla, the patient presented with intense symptoms suggesting acute pancreatitis, which was later confirmed with laboratory and radiographic examinations. Other causes were excluded and the acute pancreatitis was considered a procedural complication. This is a rarely reported complication that must be taken into consideration when biopsies are performed in the ampulla of Vater.

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Two Cases of Severe Acute Pancreatitis Following Duodenal Papillary Biopsy
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Letter to the Editor

Fecal Microbiota Transplantation and the Brain Microbiota in Neurological Diseases: Marco Ruggiero; Clin Endosc 2016;49(6):579-579. Published online November 11, 2016; DOI: https://doi.org/10.5946/ce.2016.098

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