Clinical Endoscopy

Quality indicators in esophagogastroduodenoscopy: Sang Yoon Kim, Jae Myung Park; Clin Endosc 2022;55(3):319-331. Published online May 16, 2022; DOI: https://doi.org/10.5946/ce.2022.094

Esophagogastroduodenoscopy (EGD) has been used to diagnose a wide variety of upper gastrointestinal diseases. In particular, EGD is used to screen high-risk subjects of gastric cancer. Quality control of EGD is important because the diagnostic rate is examiner-dependent. However, there is still no representative quality indicator that can be uniformly applied in EGD. There has been growing awareness of the importance of quality control in improving EGD performance. Therefore, we aimed to review the available and emerging quality indicators for diagnostic EGD.

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The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis
Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
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Optimal number of images and 2-year interval affect cancer detection in screening esophagogastroduodenoscopy: An observational study
Kazuhiro Ksahiwagi, Toshifumi Yoshida, Kayoko Fukuhara, Rieko Bessho, Hitoshi Ichikawa, Nagamu Inoue, Hiromasa Takaishi, Yasushi Iwao, Takanori Kanai
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Sistema de auditoría automática para la exploración endoscópica del estómago con Inteligencia Artificial – Gastro UNAL: Gastroendoscopy UNit for Automatic Labeling
Martín Alonso Gómez Zuleta, Diego Fernando Bravo Higuera, Josué Andre Ruano Balseca, María Jaramillo González, Fabio Augusto González Osorio, Edgar Eduardo Romero Castro
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Endoscopic Imaging for the Diagnosis of Neoplastic and Pre-Neoplastic Conditions of the Stomach
Bruno Costa Martins, Renata Nobre Moura, Angelo So Taa Kum, Carolina Ogawa Matsubayashi, Sergio Barbosa Marques, Adriana Vaz Safatle-Ribeiro
Cancers.2023; 15(9): 2445. CrossRef
The effect of short-term training about depth predicting score on the diagnostic ability of invasion depth for differentiated early gastric Cancer among non-expert endoscopists
Hui Li, Hui Hu, Ping Geng, Panhui Guo, Yuanrong Zhu, Lulu Zeng, Jun Liu, Xiangpeng Hu
BMC Medical Education.2023;[Epub] CrossRef
Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists
Daisuke Murakami, Masayuki Yamato, Yuji Amano, Takayoshi Nishino, Makoto Arai
BMJ Open Gastroenterology.2023; 10(1): e001143. CrossRef
Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
Jae Myung Park
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Simethicone and N-acetyl cysteine in improving mucosal visibility: Towards a “clearer view” during endoscopy
Akash Roy, Mahesh K. Goenka
Indian Journal of Gastroenterology.2023;[Epub] CrossRef
Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
Caesar Ferrari, Micheal Tadros
Gastroenterology Insights.2023; 15(1): 1. CrossRef
Antispasmodic Agent Administration Improves Gastric Neoplasm Detection Rates during Esophagogastroduodenoscopy
Sang Yoon Kim, Jae Myung Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(3): 246. CrossRef
Clinical features of gastric adenoma detected within 3 years after negative screening endoscopy in Korea
Hyun Young Kim
Gastroenterology Report.2022;[Epub] CrossRef

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Quality indicators in colonoscopy: the chasm between ideal and reality: Su Bee Park, Jae Myung Cha; Clin Endosc 2022;55(3):332-338. Published online April 4, 2022; DOI: https://doi.org/10.5946/ce.2022.037

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Continuous measurement of quality indicators (QIs) should be a routine part of colonoscopy, as a wide variation still exists in the performance and quality levels of colonoscopy in Korea. Among the many QIs of colonoscopy, the adenoma detection rate, average withdrawal time, bowel preparation adequacy, and cecal intubation rate should be monitored in daily clinical practice to improve the quality of the procedure. The adenoma detection rate is the best indicator of the quality of colonoscopy; however, it has many limitations for universal use in daily practice. With the development of natural language processing, the adenoma detection rate is expected to become more effective and useful. It is important that colonoscopists do not strictly and mechanically maintain an average withdrawal time of 6 minutes but instead perform careful colonoscopy to maximally expose the colonic mucosa with a withdrawal time of at least 6 minutes. To achieve adequate bowel preparation, documentation of bowel preparation with the Boston Bowel Preparation Scale (BBPS) should be a routine part of colonoscopy. When colonoscopists routinely followed the bowel preparation protocols, ≥85% of outpatient screening colonoscopies had a BBPS score of ≥6. In addition, the cecal intubation rate should be ≥95% of all screening colonoscopies. The first step in improving colonoscopy quality in Korea is to apply these key performance measurements in clinical practice.

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What are the priority quality indicators for colonoscopy in real‐world clinical practice?
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Digestive Endoscopy.2024; 36(1): 30. CrossRef
Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
A Systematic Review of Exercise Therapy for Bowel Preparation
Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
Gastroenterology Nursing.2023;[Epub] CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef

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Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment: Giuseppe Galloro, Angelo Zullo, Gaetano Luglio, Alessia Chini, Donato Alessandro Telesca, Rosa Maione, Matteo Pollastro, Giovanni Domenico De Palma, Raffaele Manta; Clin Endosc 2022;55(3):339-346. Published online April 28, 2022; DOI: https://doi.org/10.5946/ce.2021.249

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Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.

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Adverse Events of Endoscopic Clip Placement
Daryl Ramai, Smit S. Deliwala, Daniel Mozell, Antonio Facciorusso, Saurabh Chandan, Alana Persaud, Kelita Singh, Andrea Anderloni, Monique T. Barakat
Journal of Clinical Gastroenterology.2024; 58(1): 76. CrossRef
Right tool for the right bleeder
Ding Ek Toh, Sheng Wei Lo, Andrew Tsoi, Jonathan P Segal, Joshua Butt
Gut.2024; 73(1): 206. CrossRef
Could a bleeding-sensor device be established as a new paradigm for detecting upper gastrointestinal bleeding before performing endoscopy?
Sun Gyo Lim
Clinical Endoscopy.2024; 57(2): 191. CrossRef
Usage of Padlock Over-the-Scope-Clip in Difficult-to-Control Recurrent Gastrointestinal Bleeding Due to a Gastric Dieulafoy Lesion
John Joyce, Vishnu Kumar, Dayana Nasr, Ganesh Aswath, Hafiz M. Khan, Savio John
Journal of Investigative Medicine High Impact Case Reports.2024;[Epub] CrossRef
Comparison of mechanical and thermal therapy in upper gastrointestinal bleeding: an analysis of efficacy outcomes
Rahul Karna, Bandhul Hans, Thayer Nasereddin, Dhruv Chaudhary, Manish Dhawan
Baylor University Medical Center Proceedings.2024; 37(5): 734. CrossRef
Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
Meng-Hsuan Lu, Hsueh-Chien Chiang
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Sustained Hemostasis With the Padlock™ Over-the-scope Clip for Gastric Fundus Dieulafoy’s Lesion in the Setting of Anticoagulation Following Hemorrhagic Shock From Two Dieulafoy’s Lesions
Jonathan J Cho, Chelsea M Forbes, Benjamin D Fiore, Joshua D McCarron, Leybelis Padilla
Military Medicine.2023; 188(9-10): e3265. CrossRef
Management of complications related to colorectal endoscopic submucosal dissection
Tae-Geun Gweon, Dong-Hoon Yang
Clinical Endoscopy.2023; 56(4): 423. CrossRef
Novel removable endoscopic clip: Usefulness in failure of traction method during endoscopic submucosal dissection
Nobukazu Agatsuma, Takahiro Utsumi, Hirokazu Higuchi, Takahiro Inoue, Yukari Tanaka, Yuki Nakanishi, Hiroshi Seno
Endoscopy.2023; 55(S 01): E1031. CrossRef

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Comparing palliative treatment options for cholangiocarcinoma: photodynamic therapy vs. radiofrequency ablation: Tayyaba Mohammad, Michel Kahaleh; Clin Endosc 2022;55(3):347-354. Published online May 17, 2022; DOI: https://doi.org/10.5946/ce.2021.274

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Referral to an endoscopist is often done once curative resection is no longer an option for cholangiocarcinoma management. In such cases, palliation has become the main objective of the treatment. Photodynamic therapy and radiofrequency ablation can be performed to achieve palliation, with both procedures associated with improved stent patency and survival. Despite the greatly increased cost and association with photosensitivity, photodynamic therapy allows transmission to the entire biliary tree. In contrast, radiofrequency ablation is cheaper and faster to apply but requires intraductal contact. This paper reviews both modalities and compares their efficacy and safety for bile duct cancer palliation.

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Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma
Maryam Makki, Malak Bentaleb, Mohammed Abdulrahman, Amal Abdulla Suhool, Salem Al Harthi, Marcelo AF Ribeiro Jr
World Journal of Clinical Oncology.2024; 15(3): 381. CrossRef
Endoskopisch gesteuerte Diagnostik und Therapie von Cholangiokarzinomen
Ulrike Denzer, Alexander Dechêne
Die Gastroenterologie.2023; 18(1): 16. CrossRef
Recent Updates on Local Ablative Therapy Combined with Chemotherapy for Extrahepatic Cholangiocarcinoma: Photodynamic Therapy and Radiofrequency Ablation
Tadahisa Inoue, Masashi Yoneda
Current Oncology.2023; 30(2): 2159. CrossRef
Role of radiofrequency ablation in advanced malignant hilar biliary obstruction
Mamoru Takenaka, Tae Hoon Lee
Clinical Endoscopy.2023; 56(2): 155. CrossRef
Impact of endobiliary radiofrequency ablation on survival of patients with unresectable cholangiocarcinoma: a narrative review
Elena Di Girolamo, Andrea Belli, Alessandro Ottaiano, Vincenza Granata, Valentina Borzillo, Luca Tarotto, Fabiana Tatangelo, Raffaele Palaia, Corrado Civiletti, Mauro Piccirillo, Valentina D’Angelo, Francesco Fiore, Pietro Marone, Guglielmo Nasti, Frances
Frontiers in Oncology.2023;[Epub] CrossRef
Thermal ablative therapies in the gastrointestinal tract
Hendrik Manner
Current Opinion in Gastroenterology.2023; 39(5): 370. CrossRef
Photodynamic Therapy: From the Basics to the Current Progress of N-Heterocyclic-Bearing Dyes as Effective Photosensitizers
Eurico Lima, Lucinda V. Reis
Molecules.2023; 28(13): 5092. CrossRef
Balloon‐assisted laser application for endoscopic treatment of biliary stricture
Seonghee Lim, Van Gia Truong, Seok Jeong, Jiho Lee, Byeong‐il Lee, Hyun Wook Kang
Lasers in Surgery and Medicine.2023; 55(10): 912. CrossRef
Emerging Systemic Therapies in Advanced Unresectable Biliary Tract Cancer: Review and Canadian Perspective
Vincent C. Tam, Ravi Ramjeesingh, Ronald Burkes, Eric M. Yoshida, Sarah Doucette, Howard J. Lim
Current Oncology.2022; 29(10): 7072. CrossRef

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Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis: Arun Sivananthan, Scarlet Nazarian, Lakshmana Ayaru, Kinesh Patel, Hutan Ashrafian, Ara Darzi, Nisha Patel; Clin Endosc 2022;55(3):355-364. Published online May 12, 2022; DOI: https://doi.org/10.5946/ce.2021.228

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Background
/Aims: Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions.
Methods
A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized by morphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportions and their differences were calculated using DerSimonian and Laird random-effects modeling.
Results
Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assisted colonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared with conventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09–0.18); it also demonstrated a 91.7% increase in the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02–0.07).
Conclusions
CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although this method is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.

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Use of artificial intelligence in the management of T1 colorectal cancer: a new tool in the arsenal or is deep learning out of its depth?
James Weiquan Li, Lai Mun Wang, Katsuro Ichimasa, Kenneth Weicong Lin, James Chi-Yong Ngu, Tiing Leong Ang
Clinical Endoscopy.2024; 57(1): 24. CrossRef
As how artificial intelligence is revolutionizing endoscopy
Jean-Francois Rey
Clinical Endoscopy.2024; 57(3): 302. CrossRef
Eye tracking technology in endoscopy: Looking to the future
Arun Sivananthan, Jabed Ahmed, Alexandros Kogkas, George Mylonas, Ara Darzi, Nisha Patel
Digestive Endoscopy.2023; 35(3): 314. CrossRef
Artificial intelligence and the push for small adenomas: all we need?
Katharina Zimmermann-Fraedrich, Thomas Rösch
Endoscopy.2023; 55(04): 320. CrossRef
Recent advances in devices and technologies that might prove revolutionary for colonoscopy procedures
Jonathan S. Galati, Kevin Lin, Seth A. Gross
Expert Review of Medical Devices.2023; 20(12): 1087. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
KI-Werkzeuge als smarte Helfer in Klinik und Forschung

Zeitschrift für Gastroenterologie.2023; 61(11): 1544. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef
The Role of Artificial Intelligence in Colorectal Cancer Screening: Lesion Detection and Lesion Characterization
Edward Young, Louisa Edwards, Rajvinder Singh
Cancers.2023; 15(21): 5126. CrossRef
Artificial intelligence for colorectal neoplasia detection during colonoscopy: a systematic review and meta-analysis of randomized clinical trials
Shenghan Lou, Fenqi Du, Wenjie Song, Yixiu Xia, Xinyu Yue, Da Yang, Binbin Cui, Yanlong Liu, Peng Han
eClinicalMedicine.2023; 66: 102341. CrossRef
Pouring some water into the wine—Poor performance of endoscopists in artificial intelligence studies
Jochen Weigt
United European Gastroenterology Journal.2022; 10(8): 793. CrossRef

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Lessons learned in clinical epidemiology of esophageal adenocarcinoma: Hye Kyung Jung; Clin Endosc 2022;55(3):365-366. Published online May 16, 2022; DOI: https://doi.org/10.5946/ce.2022.109

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A new band ligation device to treat colonic diverticular bleeding: Yunho Jung; Clin Endosc 2022;55(3):367-368. Published online May 2, 2022; DOI: https://doi.org/10.5946/ce.2022.125

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2,152 View
115 Download

Covered self-expandable metal stents for distal biliary obstruction from pancreatic carcinoma: what type of stent is preferred?: Hideyuki Shiomi, Ryota Nakano, Shogo Ota; Clin Endosc 2022;55(3):369-371. Published online May 11, 2022; DOI: https://doi.org/10.5946/ce.2022.122

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A case of delayed pancreatic fistula after covered self-expandable metallic stent deployment for pancreatic head cancer
Shogo Ota, Hideyuki Shiomi, Ryota Nakano, Takashi Nishimura, Hirayuki Enomoto, Hiroko Iijima
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Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study
K.M. Ragab, M Abdel-Hameed, M Gouda, H Katamish, A Madkour, H Atalla, H Hamed, G.E. Shiha, O Abdallah, R.H. Agwa, E Ghoneem
Acta Gastro Enterologica Belgica.2023; 86(1): 26. CrossRef

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Epidemiology of early esophageal adenocarcinoma: Thuy-Van P. Hang, Zachary Spiritos, Anthony M. Gamboa, Zhengjia Chen, Seth Force, Vaishali Patel, Saurabh Chawla, Steven Keilin, Nabil F. Saba, Bassel El-Rayes, Qiang Cai, Field F. Willingham; Clin Endosc 2022;55(3):372-380. Published online February 11, 2022; DOI: https://doi.org/10.5946/ce.2021.152

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Background
/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined.
Methods
Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available.
Results
The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%–5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%.
Conclusions
There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.

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Histology Shift in Esophageal Cancer Between Biopsies and Resections After Neoadjuvant Therapy: A Pilot Study
Tieying Hou, Zhaohai Yang, Qingzhao Zhang, Xuchen Zhang, Xiaoyan Liao, Jingmei Lin
International Journal of Surgical Pathology.2024; 32(5): 920. CrossRef
Concise Commentary: It’s All Downhill from Here—How Diagnostic and Therapeutic Advances May Decrease the Incidence Rates of Gastroesophageal Junction and Esophageal Adenocarcinoma
Anthony Gamboa, Rishi Naik
Digestive Diseases and Sciences.2024; 69(1): 254. CrossRef
Descriptive Epidemiology of Early-Onset Gastrointestinal Cancers in Iran, 2014-2018
Mohammad Sadra Gholami Chahkand, Fatemeh Esmaeilpour Moallem, Fatemeh Ghasemi-Kebria, Reza Malekzadeh, Gholamreza Roshandel, Mohammad Taher
Middle East Journal of Digestive Diseases.2024; 16(1): 28. CrossRef
Epidemiologie der Adenokarzinome des Ösophagus und des ösophagogastralen Übergangs
Sabine Luttmann, Andrea Eberle, Joachim Hübner
Die Onkologie.2023; 29(6): 470. CrossRef
Evaluation of Esophageal Dysphagia in Elderly Patients
Khanh Hoang Nicholas Le, Eric E. Low, Rena Yadlapati
Current Gastroenterology Reports.2023; 25(7): 146. CrossRef
Molecular Biology and Clinical Management of Esophageal Adenocarcinoma
Shulin Li, Sanne Johanna Maria Hoefnagel, Kausilia Krishnawatie Krishnadath
Cancers.2023; 15(22): 5410. CrossRef
Progress in Clinical Management of Esophago-Jejunal Anastomotic Fistula with Total Gastrectomy for Adenocarcinoma of the Esophagogastric Junction
天伟赖
Advances in Clinical Medicine.2023; 13(11): 17210. CrossRef
Cranberry Proanthocyanidins Mitigate Reflux-Induced Transporter Dysregulation in an Esophageal Adenocarcinoma Model
Yun Zhang, Katherine M. Weh, Bridget A. Tripp, Jennifer L. Clarke, Connor L. Howard, Shruthi Sunilkumar, Amy B. Howell, Laura A. Kresty
Pharmaceuticals.2023; 16(12): 1697. CrossRef
Lessons learned in clinical epidemiology of esophageal adenocarcinoma
Hye Kyung Jung
Clinical Endoscopy.2022; 55(3): 365. CrossRef

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Outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms in patients with liver cirrhosis: Young Kwon Choi, Jin Hee Noh, Do Hoon Kim, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung; Clin Endosc 2022;55(3):381-389. Published online April 20, 2022; DOI: https://doi.org/10.5946/ce.2021.242

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Background
/Aims: The treatment of superficial esophageal neoplasms (SENs) in cirrhotic patients is challenging and rarely investigated. We evaluated the outcomes of endoscopic submucosal dissection (ESD) to determine the efficacy and safety of treating SENs in patients with liver cirrhosis.
Methods
The baseline characteristics and treatment outcomes of patients who underwent ESD for SENs between November 2005 and December 2017 were retrospectively reviewed.
Results
ESD was performed in 437 patients with 481 SENs, including 15 cirrhotic patients with 17 SENs. En bloc resection (88.2% vs. 97.0%) and curative resection (64.7% vs. 78.9%) rates were not different between the cirrhosis and non-cirrhosis groups (p=0.105 and p=0.224, respectively). Bleeding was more common in cirrhotic patients (p=0.054), and all cases were successfully controlled endoscopically. The median procedure and hospitalization duration did not differ between the groups. Overall survival was lower in cirrhotic patients (p=0.003), while disease-specific survival did not differ between the groups (p=0.85).
Conclusions
ESD could be a safe and effective treatment option for SENs in patients with cirrhosis. Detailed preprocedural assessments are needed, including determination of liver function, esophageal varix status, and remaining life expectancy, to identify patients who will obtain the greatest benefit.

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Clinical outcomes of endoscopic submucosal dissection for esophageal squamous cell carcinoma with esophageal varices: Multicenter retrospective study
Yosuke Toya, Waku Hatta, Tomohiro Shimada, Tamotsu Matsuhashi, Takeharu Shiroki, Yu Sasaki, Tetsuya Tatsuta, Jun Nakamura, Norihiro Hanabata, Yohei Horikawa, Ko Nagino, Tomoyuki Koike, Atsushi Masamune, Yoshihiro Harada, Tetsuya Ohira, Katsunori Iijima, Y
Digestive Endoscopy.2024; 36(3): 314. CrossRef
Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasia in close proximity to esophageal varices: a multicenter international experience
Shruti Mony, Bing Hu, Abel Joseph, Hiroyuki Aihara, Lorenzo Ferri, Amit Bhatt, Amit Mehta, Peng-Sheng Ting, Alex Chen, Andrew Kalra, Jad Farha, Manabu Onimaru, Long He, Qi Luo, Andrew Y. Wang, Haruhiro Inoue, Saowanee Ngamruengphong
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Risk associated with endoscopic treatment of early upper gastrointestinal cancer in patients with liver cirrhosis and management strategies
Yu-Yong Tan, Yu-Min Qing, Jian Gong, De-Liang Liu
World Chinese Journal of Digestology.2024; 32(2): 102. CrossRef
Endoscopic submucosal dissection for early cancers or precancerous lesions of the upper GI tract in cirrhotic patients with esophagogastric varices: 10-year experience from a large tertiary center in China
Shuai Zhang, Ying-Di Liu, Ning-Li Chai, Yi Yao, Fei Gao, Bo Liu, Zhan-Di He, Lu Bai, Xin Huang, Chao Gao, En-Qiang Linghu, Lian-Yong Li
Gastrointestinal Endoscopy.2023; 97(6): 1031. CrossRef
Endoscopic Submucosal Dissection for Treatment of Early-Stage Cancer or Precancerous Lesion in the Upper Gastrointestinal Tract in Patients with Liver Cirrhosis
Yuyong Tan, Yumin Qing, Deliang Liu, Jian Gong
Journal of Clinical Medicine.2023; 12(20): 6509. CrossRef

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Real-time semantic segmentation of gastric intestinal metaplasia using a deep learning approach: Vitchaya Siripoppohn, Rapat Pittayanon, Kasenee Tiankanon, Natee Faknak, Anapat Sanpavat, Naruemon Klaikaew, Peerapon Vateekul, Rungsun Rerknimitr; Clin Endosc 2022;55(3):390-400. Published online May 9, 2022; DOI: https://doi.org/10.5946/ce.2022.005

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Background
/Aims: Previous artificial intelligence (AI) models attempting to segment gastric intestinal metaplasia (GIM) areas have failed to be deployed in real-time endoscopy due to their slow inference speeds. Here, we propose a new GIM segmentation AI model with inference speeds faster than 25 frames per second that maintains a high level of accuracy.
Methods
Investigators from Chulalongkorn University obtained 802 histological-proven GIM images for AI model training. Four strategies were proposed to improve the model accuracy. First, transfer learning was employed to the public colon datasets. Second, an image preprocessing technique contrast-limited adaptive histogram equalization was employed to produce clearer GIM areas. Third, data augmentation was applied for a more robust model. Lastly, the bilateral segmentation network model was applied to segment GIM areas in real time. The results were analyzed using different validity values.
Results
From the internal test, our AI model achieved an inference speed of 31.53 frames per second. GIM detection showed sensitivity, specificity, positive predictive, negative predictive, accuracy, and mean intersection over union in GIM segmentation values of 93%, 80%, 82%, 92%, 87%, and 57%, respectively.
Conclusions
The bilateral segmentation network combined with transfer learning, contrast-limited adaptive histogram equalization, and data augmentation can provide high sensitivity and good accuracy for GIM detection and segmentation.

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Applications of artificial intelligence in gastroscopy: a narrative review
Hu Chen, Shi-yu Liu, Si-hui Huang, Min Liu, Guang-xia Chen
Journal of International Medical Research.2024;[Epub] CrossRef
Computer‐aided diagnosis in real‐time endoscopy for all stages of gastric carcinogenesis: Development and validation study
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
United European Gastroenterology Journal.2024; 12(4): 487. CrossRef
As how artificial intelligence is revolutionizing endoscopy
Jean-Francois Rey
Clinical Endoscopy.2024; 57(3): 302. CrossRef
Accuracy of artificial intelligence-assisted endoscopy in the diagnosis of gastric intestinal metaplasia: A systematic review and meta-analysis
Na Li, Jian Yang, Xiaodong Li, Yanting Shi, Kunhong Wang, Chih-Wei Tseng
PLOS ONE.2024; 19(5): e0303421. CrossRef
Real-time gastric intestinal metaplasia segmentation using a deep neural network designed for multiple imaging modes on high-resolution images
Passin Pornvoraphat, Kasenee Tiankanon, Rapat Pittayanon, Natawut Nupairoj, Peerapon Vateekul, Rungsun Rerknimitr
Knowledge-Based Systems.2024; 300: 112213. CrossRef
A Benchmark Dataset of Endoscopic Images and Novel Deep Learning Method to Detect Intestinal Metaplasia and Gastritis Atrophy
Jie Yang, Yan Ou, Zhiqian Chen, Juan Liao, Wenjian Sun, Yang Luo, Chunbo Luo
IEEE Journal of Biomedical and Health Informatics.2023; 27(1): 7. CrossRef
Real-time gastric intestinal metaplasia diagnosis tailored for bias and noisy-labeled data with multiple endoscopic imaging
Passin Pornvoraphat, Kasenee Tiankanon, Rapat Pittayanon, Phanukorn Sunthornwetchapong, Peerapon Vateekul, Rungsun Rerknimitr
Computers in Biology and Medicine.2023; 154: 106582. CrossRef
Diagnostic value of artificial intelligence-assisted endoscopy for chronic atrophic gastritis: a systematic review and meta-analysis
Yanting Shi, Ning Wei, Kunhong Wang, Tao Tao, Feng Yu, Bing Lv
Frontiers in Medicine.2023;[Epub] CrossRef
Recent Advances in Applying Machine Learning and Deep Learning to Detect Upper Gastrointestinal Tract Lesions
Malinda Vania, Bayu Adhi Tama, Hasan Maulahela, Sunghoon Lim
IEEE Access.2023; 11: 66544. CrossRef
Colon histology slide classification with deep-learning framework using individual and fused features
Venkatesan Rajinikanth, Seifedine Kadry, Ramya Mohan, Arunmozhi Rama, Muhammad Attique Khan, Jungeun Kim
Mathematical Biosciences and Engineering.2023; 20(11): 19454. CrossRef
Clinical Decision Support System for All Stages of Gastric Carcinogenesis in Real-Time Endoscopy: Model Establishment and Validation Study
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Hae Min Jeong, Gwang Ho Baik, Jae Hoon Jeong, Sigmund Dick, Gi Hun Lee
Journal of Medical Internet Research.2023; 25: e50448. CrossRef

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Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases?: Bin Chet Toh, Jingli Chong, Baldwin PM Yeung, Chin Hong Lim, Eugene KW Lim, Weng Hoong Chan, Jeremy TH Tan; Clin Endosc 2022;55(3):401-407. Published online January 6, 2022; DOI: https://doi.org/10.5946/ce.2021.197

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Background
/Aims: Surgeons and endoscopists have started to use endoscopically inserted double pigtail stents (DPTs) in the management of upper gastrointestinal (UGI) leaks, including UGI anastomotic leaks. We investigated our own experiences in this patient population.
Methods
From March 2017 to June 2020, 12 patients had endoscopic internal drainage of a radiologically proven anastomotic leak after UGI surgery in two tertiary UGI centers. The primary outcome measure was the time to removal of the DPTs after anastomotic healing. The secondary outcome measure was early oral feeding after DPT insertion.
Results
Eight of the 12 patients (67%) required only one DPT, whereas four (33%) required two DPTs. The median duration of drainage was 42 days. Two patients required surgery due to inadequate control of sepsis. Of the remaining 10 patients, nine did not require a change in DPT before anastomotic healing. Nine patients were allowed oral fluids within the 1st week and a soft diet in the 2nd week. One patient was allowed clear oral feeds on the 8th day after DPT insertion.
Conclusions
Endoscopic internal drainage is becoming an established minimally invasive technique for controlling anastomotic leak after UGI surgery. It allows for early oral nutritional feeding and minimizes discomfort from conventional external drainage.

Citations

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Endoscopic Intervention for Anastomotic Leakage After Gastrectomy
Ji Yoon Kim, Hyunsoo Chung
Journal of Gastric Cancer.2024; 24(1): 108. CrossRef
Endoscopic Management of Post-Sleeve Gastrectomy Complications
Muaaz Masood, Donald E. Low, Shanley B. Deal, Richard A. Kozarek
Journal of Clinical Medicine.2024; 13(7): 2011. CrossRef
Endoscopic Internal Drainage Achieving Successful Closure of Iatrogenic Pharyngoesophageal Fistula
Ahmad Rimawi, Yahia Al-Turk, Abdul Monem Swied
ACG Case Reports Journal.2023; 10(10): e01191. CrossRef

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Comparison of conventional and new endoscopic band ligation devices for colonic diverticular bleeding: Ayaka Takasu, Takashi Ikeya, Yasutoshi Shiratori; Clin Endosc 2022;55(3):408-416. Published online February 18, 2022; DOI: https://doi.org/10.5946/ce.2021.200

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Background
/Aims: Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligation device for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by Sumitomo Bakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL.
Methods
Seventy-nine patients who underwent EBL for CDB at St. Luke’s International Hospital, Japan, between 2017 and 2020 were included in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, including achieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated.
Results
Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initial hemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleeding rate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (18.2 minutes vs. 14.2 minutes, p=0.02). No adverse events were observed in either group.
Conclusions
The N-EBL device is safe and useful and may reduce EBL procedure time.

Citations

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Advances in endoscopic management of colonic diverticular bleeding
Yasutoshi Shiratori, Syed Matthew Kodilinye, Ahmed E. Salem
Current Opinion in Gastroenterology.2024; 40(5): 363. CrossRef
Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline
Neil Sengupta, Joseph D. Feuerstein, Vipul Jairath, Amandeep K. Shergill, Lisa L. Strate, Robert J. Wong, David Wan
American Journal of Gastroenterology.2023; 118(2): 208. CrossRef
Effective endoscopic band ligation for diverticular perforation with a refractory pelvic abscess
Koichi Soga, Atsushi Majima
Clinical Endoscopy.2023; 56(2): 252. CrossRef
A new band ligation device to treat colonic diverticular bleeding
Yunho Jung
Clinical Endoscopy.2022; 55(3): 367. CrossRef

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Feasibility and safety of endoscopic submucosal dissection for lesions in proximity to a colonic diverticulum: Nobuaki Ikezawa, Takashi Toyonaga, Shinwa Tanaka, Tetsuya Yoshizaki, Toshitatsu Takao, Hirofumi Abe, Hiroya Sakaguchi, Kazunori Tsuda, Satoshi Urakami, Tatsuya Nakai, Taku Harada, Kou Miura, Takahisa Yamasaki, Stuart Kostalas, Yoshinori Morita, Yuzo Kodama; Clin Endosc 2022;55(3):417-425. Published online May 12, 2022; DOI: https://doi.org/10.5946/ce.2021.245

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. The aim of this study was to evaluate the feasibility and safety of D-ESD.
Methods
D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients who underwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategy were analyzed.
Results
The en bloc resection rate was 96.2%. The rates of R0 and curative resection in strategies A and B were 80.8%, 73.1%, 84.6%, and 70.6%, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforation case required emergency surgery, but the other cases were managed conservatively.
Conclusions
D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert hands because it requires highly skilled endoscopic techniques.

Citations

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Endoscopic submucosal dissection for diverticulum using combination of countertraction and circumferential-inversion method
Hiroshi Takayama, Yoshinori Morita, Toshitatsu Takao, Douglas Motomura, Madoka Takao, Takashi Toyonaga, Yuzo Kodama
Endoscopy.2024; 56(S 01): E91. CrossRef
Traction-assisted endoscopic submucosal dissection for resection of ileocecal valve neoplasia: a French retrospective multicenter case series
Clara Yzet, Timothée Wallenhorst, Jérémie Jacques, Mariana Figueiredo Ferreira, Jérôme Rivory, Florian Rostain, Louis-Jean Masgnaux, Jean Grimaldi, Romain Legros, Pierre Lafeuille, Jérémie Albouys, Fabien Subtil, Marion Schaefer, Mathieu Pioche
Endoscopy.2024;[Epub] CrossRef
The role of cap-assisted endoscopy and its future implications
Sol Kim, Bo-In Lee
Clinical Endoscopy.2024; 57(3): 293. CrossRef
Strategies to successfully complete complex ESD in the colon
David Barquero Declara, Alex Blasco Pelicano, Claudia Berbel Comas, Alfredo Mata Bilbao
Endoscopy International Open.2024; 12(07): E914. CrossRef
Successful planned piecemeal endoscopic resection using gel immersion and an over-the-scope clip for a lesion extensively extended into the colonic diverticulum
Tomoaki Tashima, Takahiro Muramatsu, Tomonori Kawasaki, Tsubasa Ishikawa, Shomei Ryozawa
VideoGIE.2023; 8(4): 167. CrossRef
Future therapeutic implications of new molecular mechanism of colorectal cancer
Sen Lu, Cheng-You Jia, Jian-She Yang
World Journal of Gastroenterology.2023; 29(16): 2359. CrossRef
Iatrogenic colorectal perforation caused by a clip
Hirotaka Oura, Yasuki Hatayama, Erika Nomura, Harutoshi Sugiyama, Daisuke Murakami, Makoto Arai, Takayoshi Nishino
Endoscopy.2023; 55(S 01): E1091. CrossRef

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Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?: Shyam Vedantam, Sunil Amin, Ben Maher, Saqib Ahmad, Shanil Kadir, Saad Khalid Niaz, Mark Wright, Nadeem Tehami; Clin Endosc 2022;55(3):426-433. Published online February 4, 2022; DOI: https://doi.org/10.5946/ce.2021.239

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Cholangiogram interpretation is not used as a key performance indicator (KPI) of endoscopic retrograde cholangiopancreatography (ERCP) training, and national societies recommend different minimum numbers per annum to maintain competence. This study aimed to determine the relationship between correct ERCP cholangiogram interpretation and experience.
Methods
One hundred fifty ERCPists were surveyed to appropriately interpret ERCP cholangiographic findings. There were three groups of 50 participants each: “Trainees,” “Consultants group 1” (performed >75 ERCPs per year), and “Consultants group 2” (performed >100 ERCPs per year).
Results
Trainees was inferior to Consultants groups 1 and 2 in identifying all findings except choledocholithiasis outside the intrahepatic duct on the initial or completion/occlusion cholangiogram. Consultants group 1 was inferior to Consultants group 2 in identifying Strasberg type A bile leaks (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.77–0.96), Strasberg type B (OR, 0.84; 95% CI, 0.74–0.95), and Bismuth type 2 hilar strictures (OR, 0.81; 95% CI, 0.69–0.95).
Conclusions
This investigation supports the notion that cholangiogram interpretation improves with increased annual ERCP case volumes. Thus, a higher annual volume of procedures performed may improve the ability to correctly interpret particularly difficult findings. Cholangiogram interpretation, in addition to bile duct cannulation, could be considered as another KPI of ERCP training.

Citations

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UK ERCP sedation practices, patient comfort and endoscopist characteristics: National Endoscopy Database (NED) analysis on behalf of the JAG and BSG
David Beaton, Matt Rutter, Linda Sharp, Kofi W Oppong, Bidour Awadelkarim, Simon M Everett, Vikramjit Mitra
Frontline Gastroenterology.2023; 14(5): 384. CrossRef

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Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study: Koh Kitagawa, Akira Mitoro, Takahiro Ozutsumi, Masanori Furukawa, Yukihisa Fujinaga, Kenichiro Seki, Norihisa Nishimura, Yasuhiko Sawada, Kosuke Kaji, Hideto Kawaratani, Hiroaki Takaya, Kei Moriya, Tadashi Namisaki, Takemi Akahane, Hitoshi Yoshiji; Clin Endosc 2022;55(3):434-442. Published online October 28, 2021; DOI: https://doi.org/10.5946/ce.2021.161

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Background
/Aims: Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs.
Methods
To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems.
Results
In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braidedtype CMSs. There were no differences in the survival duration between the groups.
Conclusions
The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cuttype. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

Citations

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Braided-type stent versus laser-cut-type stent for patients with unresectable distal malignant biliary obstruction: a randomized controlled trial
Sho Hasegawa, Takamitsu Sato, Satoru Shinoda, Yusuke Kurita, Tomoki Ogata, Shinichi Nihei, Shin Yagi, Kunihiro Hosono, Itaru Endo, Noritoshi Kobayashi, Kensuke Kubota, Atsushi Nakajima
Gastrointestinal Endoscopy.2024; 99(5): 739. CrossRef
Removal of Duckbill‐type laser‐cut anti‐reflux metal stents: Clinical evaluation and in vitro study
Yuto Yamada, Takashi Sasaki, Tsuyoshi Takeda, Takeshi Okamoto, Takafumi Mie, Chinatsu Yonekura, Takaaki Furukawa, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Takahisa Matsuda, Yoshinori Igarashi, Naoki Sasahira
DEN Open.2023;[Epub] CrossRef
Comparable Efficacy of Laser-Cut and Braided Self Expanding Metallic Biliary Stent: A Systematic Review and Meta-Analysis
Priyadarshini Loganathan, Saurabh Chandan, Babu P. Mohan, Shreyas Saligram, Douglas G. Adler
Digestive Diseases and Sciences.2023; 68(9): 3756. CrossRef
Evaluation of the mechanical properties of current biliary self-expandable metallic stents: axial and radial force, and axial force zero border
Wataru Yamagata, Toshio Fujisawa, Takashi Sasaki, Rei Ishibashi, Tomotaka Saito, Shuntaro Yoshida, Shizuka No, Kouta Inoue, Yousuke Nakai, Naoki Sasahira, Hiroyuki Isayama
Clinical Endoscopy.2023; 56(5): 633. CrossRef
Covered self-expandable metal stents for distal biliary obstruction from pancreatic carcinoma: what type of stent is preferred?
Hideyuki Shiomi, Ryota Nakano, Shogo Ota
Clinical Endoscopy.2022; 55(3): 369. CrossRef

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Endoscopic hemostasis using an over-the-scope clip for massive bleeding after percutaneous endoscopic gastrostomy removal: a case report: Sun Young Moon, Min Kyu Jung, Jun Heo; Clin Endosc 2022;55(3):443-446. Published online May 25, 2021; DOI: https://doi.org/10.5946/ce.2020.294

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Percutaneous endoscopic gastrostomy (PEG) is a common method for providing long-term enteral nutrition to patients. PEG tube placement and removal are relatively safe; generally, a PEG tube can be removed using gentle traction, and excessive bleeding is rare. The over-the-scope clip system is a new device that can be used for gastrointestinal hemostasis and for closing gastrointestinal fistulae. In the present case, a 68-year-old male patient had to remove the PEG tube because of persistent leakage around the PEG tube. Although it was gently removed using traction, incessant bleeding continued, with a Rockall score of 5 points, even after hemocoagulation was attempted. An over-the-scope clip device was used to achieve hemostasis and fistula closure.

Citations

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Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Gut and Liver.2024; 18(1): 10. CrossRef
Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Clinical Endoscopy.2023; 56(4): 391. CrossRef
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef

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Gastroduodenal intussusception of a gastrointestinal stromal tumor: a rare cause of acute pancreatitis: Pornpayom Numpraphrut, Sorachat Niltwat, Thammawat Parakonthun, Nonthalee Pausawasdi; Clin Endosc 2022;55(3):447-451. Published online June 22, 2021; DOI: https://doi.org/10.5946/ce.2021.073

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Patients with symptomatic gastrointestinal stromal tumor (GIST) typically present with gastrointestinal bleeding and abdominal pain. This report presents an unusual case of fundic GIST complicated by gastroduodenal intussusception, manifesting as acute pancreatitis. The patient presented with epigastric pain and pancreatic enzyme elevation; thus, he was diagnosed with acute pancreatitis. Computed tomography showed evidence of pancreatitis and a 4×4.7 cm well-defined hyperdense lesion in the 2nd part of the duodenum, compressing the pancreatic head and pancreatic duct. Esophagogastroduodenoscopy revealed invagination of the gastric folds into the duodenum, causing pyloric canal blockage consistent with gastroduodenal intussusception. Spontaneous reduction of the lesion during endoscopy revealed a 4 cm pedunculated subepithelial mass with central ulceration originating from the gastric fundus. Endoscopic ultrasound demonstrated a heterogeneous hypoechoic lesion originating from the 4th layer of the gastric wall. Laparoscopic-endoscopic intragastric wedge resection of the fundic lesion was subsequently performed, and surgical histology confirmed GIST.

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Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor in adults: a case report and literature review
Wenbing Zhang, Haifeng Chen, Lulu Zhu, Zhiyuan Kong, Tingting Wang, Weiping Li
Journal of International Medical Research.2022; 50(5): 030006052211007. CrossRef

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Development of colon cancer in a patient with longstanding colonic diffuse ganglioneuromatosis: a case report: Jin Sun Oh, Seung Wook Hong, Jin Hee Noh, Jiyoung Yoon, Hyo Jeong Kang, Young Soo Park, Dong-Hoon Yang, Jeong-Sik Byeon; Clin Endosc 2022;55(3):452-457. Published online March 4, 2021; DOI: https://doi.org/10.5946/ce.2021.013

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Colonic diffuse ganglioneuromatosis is an extremely rare disease in which multiple tumors derived from the ganglion cells, nerve fibers, and supporting cells are distributed in the colon. It is generally considered to be a benign neoplastic condition and is occasionally associated with rare hereditary conditions such as neurofibromatosis type I or multiple endocrine neoplasia type 2B. Here, we report a case of a patient in whom colon cancer developed 12 years after the initial diagnosis of colonic diffuse ganglioneuromatosis, which suggests a possible association between colonic diffuse ganglioneuromatosis and colorectal cancer.

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A Case Series of Pediatric Intestinal Ganglioneuromatosis With Novel Phenotypic and Genotypic Profile
Yuan Fang, Ye Zhang, Rui Dong, Yi-zhen Wang, Lian Chen, Gong Chen
Frontiers in Medicine.2022;[Epub] CrossRef

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Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography: Shin Haba, Kazuo Hara, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Akira Miyano, Daiki Fumihara, Moaz Elshair; Clin Endosc 2022;55(3):458-462. Published online November 30, 2021; DOI: https://doi.org/10.5946/ce.2021.114

Abstract PDF Supplementary Material PubReader ePub: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliary drainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidable risk of mispuncturing intrahepatic vessels. We report a technique for troubleshooting EUS-guided portal vein coiling to prevent bleeding from the intrahepatic portal vein after mispuncture during interventional EUS. EUS-HGS was planned for a 59-year-old male patient with unresectable pancreatic cancer. The dilated bile duct (lumen diameter, 2.8 mm) was punctured with a 19-gauge needle, and a guidewire was inserted. After bougie dilation, the guidewire was found to be inside the intrahepatic portal vein. Embolizing coils were placed to prevent bleeding. Embolization coils were successfully inserted under stabilization of the catheter using a double-lumen cannula with a guidewire. Following these procedures, the patient was asymptomatic. Computed tomography performed the next day revealed no complications.

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Metastasis of breast cancer presenting as enlarged folds in the stomach: So Eun Jeun, Gwang Ha Kim, Moon Won Lee, Sojeong Lee; Clin Endosc 2022;55(3):463-464. Published online November 6, 2020; DOI: https://doi.org/10.5946/ce.2020.239

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Underwater cold forceps polypectomy for an adenoma within a cecal diverticulum: Sho Sasaki, Jun Nishikawa, Isao Sakaida; Clin Endosc 2022;55(3):465-466. Published online May 26, 2021; DOI: https://doi.org/10.5946/ce.2021.038

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An unwonted complication of endoscopic retrograde cholangiopancreatography: Han Taek Jeong, Ho Gak Kim, Jimin Han; Clin Endosc 2022;55(3):467-469. Published online May 10, 2022; DOI: https://doi.org/10.5946/ce.2022.106

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Simple and innovative methods of minimizing risk of aerosol generation during endoscopy: Sumitro Kosasih, Adli Metussin, Norwani Basir, Vui Heng Chong; Clin Endosc 2022;55(3):470-472. Published online May 11, 2022; DOI: https://doi.org/10.5946/ce.2022.069

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