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Volume 56(5); September 2023
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Reviews
Role of endoscopy in patients with achalasia
So Young Han, Young Hoon Youn
Clin Endosc 2023;56(5):537-545.   Published online June 2, 2023
DOI: https://doi.org/10.5946/ce.2023.001
AbstractAbstract PDFPubReaderePub
Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and peristalsis of the esophageal body. With the increasing prevalence of achalasia, interest in the role of endoscopy in its diagnosis, treatment, and monitoring is also growing. The major diagnostic modalities for achalasia include high-resolution manometry, esophagogastroduodenoscopy, and barium esophagography. Endoscopic assessment is important for early diagnosis to rule out diseases that mimic achalasia symptoms, such as pseudo-achalasia, esophageal cancer, esophageal webs, and eosinophilic esophagitis. The major endoscopic characteristics suggestive of achalasia include a widened esophageal lumen and food residue in the esophagus. Once diagnosed, achalasia can be treated either endoscopically or surgically. The preference for endoscopic treatment is increasing owing to its minimal invasiveness. Botulinum toxins, pneumatic balloon dilation, and peroral endoscopic myotomy (POEM) are important endoscopic treatments. Previous studies have demonstrated excellent treatment outcomes for POEM, with >95% improvement in dysphagia, making POEM the mainstay treatment option for achalasia. Several studies have reported an increased risk of esophageal cancer in patients with achalasia. However, routine endoscopic surveillance remains controversial owing to the lack of sufficient data. Further studies on surveillance methods and duration are warranted to establish concordant guidelines for the endoscopic surveillance of achalasia.

Citations

Citations to this article as recorded by  
  • The role of cap-assisted endoscopy and its future implications
    Sol Kim, Bo-In Lee
    Clinical Endoscopy.2024; 57(3): 293.     CrossRef
  • Case of Concomitant Endoscopic Treatment of Achalasia with Superficial Esophageal Cancer
    Myung-Hun Lee, Kyoungwon Jung, Jae Hyun Kim, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
    The Korean Journal of Gastroenterology.2023; 82(5): 248.     CrossRef
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Role of linked color imaging for upper gastrointestinal disease: present and future
Sang Pyo Lee
Clin Endosc 2023;56(5):546-552.   Published online June 9, 2023
DOI: https://doi.org/10.5946/ce.2023.015
AbstractAbstract PDFPubReaderePub
Techniques for upper gastrointestinal endoscopy are advancing to facilitate lesion detection and improve prognosis. However, most early tumors in the upper gastrointestinal tract exhibit subtle color changes or morphological features that are difficult to detect using white light imaging. Linked color imaging (LCI) has been developed to overcome these shortcomings; it expands or reduces color information to clarify color differences, thereby facilitating the detection and observation of lesions. This article summarizes the characteristics of LCI and advances in LCI-related research in the upper gastrointestinal tract field.

Citations

Citations to this article as recorded by  
  • Upper gastrointestinal signs and symptoms: assessment, management and referral pathways
    Hasan Alsararatee
    Gastrointestinal Nursing.2024; 22(4): 192.     CrossRef
  • Endoscopic submucosal dissection for early gastric cancer: It is time to consider the quality of its outcomes
    Gwang Ha Kim
    World Journal of Gastroenterology.2023; 29(43): 5800.     CrossRef
  • 2,258 View
  • 198 Download
  • 1 Web of Science
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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
Clin Endosc 2023;56(5):553-562.   Published online July 26, 2023
DOI: https://doi.org/10.5946/ce.2023.055
AbstractAbstract PDFPubReaderePub
Colonoscopy plays an important role in reducing the incidence and mortality of colorectal cancer by detecting adenomas and other precancerous lesions. Image-enhanced endoscopy (IEE) increases lesion visibility by enhancing the microstructure, blood vessels, and mucosal surface color, resulting in the detection of colorectal lesions. In recent years, various IEE techniques have been used in clinical practice, each with its unique characteristics. Numerous studies have reported the effectiveness of IEE in the detection of colorectal lesions. IEEs can be divided into two broad categories according to the nature of the image: images constructed using narrowband wavelength light, such as narrowband imaging and blue laser imaging/blue light imaging, or color images based on white light, such as linked color imaging, texture and color enhancement imaging, and i-scan. Conversely, artificial intelligence (AI) systems, such as computer-aided diagnosis systems, have recently been developed to assist endoscopists in detecting colorectal lesions during colonoscopy. To better understand the features of each IEE, this review presents the effectiveness of each type of IEE and their combination with AI for colorectal lesion detection by referencing the latest research data.

Citations

Citations to this article as recorded by  
  • Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
    Yong Soo Kwon, Su Young Kim
    Journal of the Korean Medical Association.2023; 66(11): 652.     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
  • 2,467 View
  • 205 Download
  • 4 Web of Science
  • 2 Crossref
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Current status of image-enhanced endoscopy in inflammatory bowel disease
Young Joo Yang
Clin Endosc 2023;56(5):563-577.   Published online September 26, 2023
DOI: https://doi.org/10.5946/ce.2023.070
AbstractAbstract PDFPubReaderePub
In inflammatory bowel disease (IBD), chronic inflammation leads to unfavorable clinical outcomes and increases the risk of developing colorectal neoplasm (CRN); thereby highlighting the importance of endoscopically evaluating disease activity as well as detecting and characterizing CRN in patients with IBD. With recent advances in image-enhanced endoscopic (IEE) technologies, especially virtual chromoendoscopy (VCE) platforms, this review discusses state-of-the-art IEE techniques and their applicability in assessing disease activity and surveillance colonoscopy in patients with IBD. Among various IEE, VCE demonstrated the capacity to identify quiescent disease activity. And endoscopic remission defined by the new scoring system using VCE platform better predicted clinical outcomes, which may benefit the tailoring of therapeutic strategies in patients with IBD. High-definition dye-chromoendoscopy (HD-DCE) is numerically superior to high-definition white light endoscopy (HD-WLE) in detecting CRN in IBD; however, discrepancy is observed in the statistical significance. VCE showed comparable performance in detecting dysplasia to HD-WLE or DCE and potential for optical diagnosis to differentiate neoplastic from nonneoplastic lesions during surveillance colonoscopy. Applying these novel advanced IEE technologies would provide opportunities for personalized medicine in IBD and optimal treatment of CRN in patients with IBD.
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Systematic Review and Meta-analysis
Safety of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhosis compared to non-cirrhosis and effect of Child-Pugh score on post-ERCP complications: a systematic review and meta-analysis
Zahid Ijaz Tarar, Umer Farooq, Mustafa Gandhi, Saad Saleem, Ebubekir Daglilar
Clin Endosc 2023;56(5):578-589.   Published online May 2, 2023
DOI: https://doi.org/10.5946/ce.2023.027
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis.
Methods
We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis.
Results
Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%–19.2%; I2=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%–7.2%; I2=91.5%), bleeding 3.6% (95% CI, 2.8%–4.5%; I2=67.5%), cholangitis 2.9% (95% CI, 1.9%–3.8%; I2=83.4%), and perforation 0.3% (95% CI, 0.1%–0.5%; I2=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16–1.71; I2=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06–1.48; I2=24.8%), bleeding (RR, 1.94; 95% CI, 1.59–2.37; I2=0%), cholangitis (RR, 1.15; 95% CI, 0.77–1.70; I2=12%), and perforation (RR, 1.20; 95% CI, 0.59–2.43; I2=0%).
Conclusions
Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.

Citations

Citations to this article as recorded by  
  • The Impact of Frailty on ERCP-Related Adverse Events: Findings From a National Cohort
    Umer Farooq, Zahid Ijaz Tarar, Abdallah El Alayli, Faisal Kamal, Alexander Schlachterman, Anand Kumar, David E. Loren, Thomas E. Kowalski
    Techniques and Innovations in Gastrointestinal Endoscopy.2024; 26(2): 138.     CrossRef
  • Applicability of Child-Turcotte-Pugh Score in Anticipating Post-ERCP Adverse Events in Patients With Cirrhosis
    Saqr Alsakarneh, Fouad Jaber, Willie Mohammed, Mohammad Almeqdadi, Abdallah Al-Ani, Yassine Kilani, Saeed Abughazaleh, Laith Momani, Muhammad Shah Miran, Hassan Ghoz, John Helzberg, Wendell Clarkston, Mohamed Othman
    Journal of Clinical Gastroenterology.2024; 58(6): 554.     CrossRef
  • ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY FOR THE MANAGEMENT OF CHOLEDOCHOLITHIASIS IN OLDER PATIENTS
    Júlia Gardenyes, Pere Roura, Helena Vallverdú-Cartie, Judit Hermoso-Bosch, Cl�udia Roca, Mariona Espaulella, Antoni Casals, Héctor Ivo Marani, Joan Saló, Martín Galdín, Marta Gallach, Carles Leal
    Revista Española de Enfermedades Digestivas.2023;[Epub]     CrossRef
  • 2,382 View
  • 130 Download
  • 2 Web of Science
  • 3 Crossref
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Editorials
There is no royal road: a shortcut for endoscopic submucosal dissection training
Seong Woo Jeon
Clin Endosc 2023;56(5):590-591.   Published online August 16, 2023
DOI: https://doi.org/10.5946/ce.2023.127
PDFPubReaderePub
  • 1,150 View
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Understanding mechanical properties of biliary metal stents for wise stent selection
Seok Jeong
Clin Endosc 2023;56(5):592-593.   Published online September 12, 2023
DOI: https://doi.org/10.5946/ce.2023.206
PDFPubReaderePub
  • 1,120 View
  • 67 Download
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Original Articles
Necessity of pharyngeal anesthesia during transoral gastrointestinal endoscopy: a randomized clinical trial
Tomoyuki Hayashi, Yoshiro Asahina, Yasuhito Takeda, Masaki Miyazawa, Hajime Takatori, Hidenori Kido, Jun Seishima, Noriho Iida, Kazuya Kitamura, Takeshi Terashima, Sakae Miyagi, Tadashi Toyama, Eishiro Mizukoshi, Taro Yamashita
Clin Endosc 2023;56(5):594-603.   Published online April 12, 2023
DOI: https://doi.org/10.5946/ce.2022.182
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimed to compare the observation ability with and without pharyngeal anesthesia under midazolam sedation.
Methods
This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinal endoscopy under intravenous midazolam sedation. Patients were randomly allocated to pharyngeal anesthesia: PA+ or PA– groups (250 patients/group). The endoscopists obtained 10 images of the oropharynx and hypopharynx. The primary outcome was the non-inferiority of the PA– group in terms of the pharyngeal observation success rate.
Results
The pharyngeal observation success rates in the pharyngeal anesthesia with and without (PA+ and PA–) groups were 84.0% and 72.0%, respectively. The PA– group was inferior (p=0.707, non-inferiority) to the PA+ group in terms of observable parts (8.33 vs. 8.86, p=0.006), time (67.2 vs. 58.2 seconds, p=0.001), and pain (1.21±2.37 vs. 0.68±1.78, p=0.004, 0–10 point visual analog scale). Suitable quality images of the posterior wall of the oropharynx, vocal fold, and pyriform sinus were inferior in the PA– group. Subgroup analysis showed a higher sedation level (Ramsay score ≥5) with almost no differences in the pharyngeal observation success rate between the groups.
Conclusions
Non-pharyngeal anesthesia showed no non-inferiority in pharyngeal observation ability. Pharyngeal anesthesia may improve pharyngeal observation ability in the hypopharynx and reduce pain. However, deeper anesthesia may reduce this difference.
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Usefulness of a new polyvinyl alcohol hydrogel (PVA-H)-based simulator for endoscopic submucosal dissection training: a pilot study
Dong Seok Lee, Gin Hyug Lee, Sang Gyun Kim, Kook Lae Lee, Ji Won Kim, Ji Bong Jeong, Yong Jin Jung, Hyoun Woo Kang
Clin Endosc 2023;56(5):604-612.   Published online May 18, 2023
DOI: https://doi.org/10.5946/ce.2022.163
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: We developed a new endoscopic submucosal dissection (ESD) simulator and evaluated its efficacy and realism for use training endoscopists.
Methods
An ESD simulator was constructed using polyvinyl alcohol hydrogel sheets and compared to a previous ESD simulator. Between March 1, 2020, and December 30, 2021, eight expert endoscopists from three different centers analyzed the procedure-related factors of the simulator. Five trainees performed gastric ESD exercises under the guidance of these experts.
Results
Although the two ESD simulators provided overall favorable outcomes in terms of ESD-related factors, the new simulator had several benefits, including better marking of the target lesion’s limits (p<0.001) and overall handling (p<0.001). Trainees tested the usefulness of the new ESD simulator. The complete resection rate improved after 3 ESD training sessions (9 procedures), and the perforation rate decreased after 4 sessions (12 procedures).
Conclusions
We have developed a new ESD simulator that can help beginners achieve a high level of technical experience before performing real-time ESD procedures in patients.

Citations

Citations to this article as recorded by  
  • There is no royal road: a shortcut for endoscopic submucosal dissection training
    Seong Woo Jeon
    Clinical Endoscopy.2023; 56(5): 590.     CrossRef
  • 2,088 View
  • 110 Download
  • 1 Web of Science
  • 1 Crossref
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Management of esophageal neoplasms by endoscopic submucosal dissection: experience over 100 consecutive procedures
Josué Aliaga Ramos, Yoshinori Morita, Takashi Toyonaga, Danilo Carvalho, Moises Salgado Pedrosa, Vitor N. Arantes
Clin Endosc 2023;56(5):613-622.   Published online May 17, 2023
DOI: https://doi.org/10.5946/ce.2022.245
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficial neoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience with esophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the results of the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutive cases.
Methods
This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasms between 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence, adverse events, and procedure-related mortality.
Results
Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%), and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was 64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months.
Conclusions
ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions of the esophagus in Latin America.
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Evaluation of a new method, “non-injection resection using bipolar soft coagulation mode (NIRBS)”, for colonic adenomatous lesions
Mitsuo Tokuhara, Masaaki Shimatani, Kazunari Tominaga, Hiroko Nakahira, Takuya Ohtsu, Katsuyasu Kouda, Makoto Naganuma
Clin Endosc 2023;56(5):623-632.   Published online May 18, 2023
DOI: https://doi.org/10.5946/ce.2022.200
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called “non-injection resection using bipolar soft coagulation mode (NIRBS)” method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method.
Methods
We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer.
Results
A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1–35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation.
Conclusions
NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.

Citations

Citations to this article as recorded by  
  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • 2,640 View
  • 96 Download
  • 1 Web of Science
  • 1 Crossref
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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
Clin Endosc 2023;56(5):633-649.   Published online April 10, 2023
DOI: https://doi.org/10.5946/ce.2022.201
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Mechanical properties (MPs) and axial and radial force (AF and RF) may influence the efficacy and complications of self-expandable metallic stent (SEMS) placement. We measured the MPs of various SEMSs and examined their influence on the SEMS clinical ability.
Methods
We evaluated the MPs of 29 types of 10-mm SEMSs. RF was measured using a conventional measurement device. AF was measured using the conventional and new methods, and the correlation between the methods was evaluated.
Results
A high correlation in AFs was observed, as measured by the new and conventional manual methods. AF and RF scatterplots divided the SEMSs into three subgroups according to structure: hook-and-cross-type (low AF and RF), cross-type (high AF and low RF), and laser-cut-type (intermediate AF and high RF). The hook-and-cross-type had the largest axial force zero border (>20°), followed by the laser-cut and cross types.
Conclusions
MPs were related to stent structure. Hook-and-cross-type SEMSs had a low AF and high axial force zero border and were considered safest because they caused minimal stress on the biliary wall. However, the increase in RF must be overcome.

Citations

Citations to this article as recorded by  
  • Characteristics of four commonly used self-expanding biliary stents: an in vitro study
    Jiaywei Tsauo, Yan Fu, Yue Liu, Xiaowu Zhang, He Zhao, Xiao Li
    European Radiology Experimental.2024;[Epub]     CrossRef
  • Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer
    Hiroki Nakagawa, Tsuyoshi Takeda, Takeshi Okamoto, Takafumi Mie, Akiyoshi Kasuga, Takashi Sasaki, Masato Ozaka, Takahisa Matsuda, Yoshinori Igarashi, Naoki Sasahira
    DEN Open.2024;[Epub]     CrossRef
  • Late-onset Rupture of the Intrahepatic Pseudoaneurysm Developed by Endoscopic Ultrasonography-guided Hepaticogastrostomy: A Case Report and Literature Review
    Tesshin Ban, Yoshimasa Kubota, Takuya Takahama, Shun Sasoh, Satoshi Tanida, Makoto Nakamura, Tomoaki Ando, Takashi Joh
    Internal Medicine.2024;[Epub]     CrossRef
  • Understanding mechanical properties of biliary metal stents for wise stent selection
    Seok Jeong
    Clinical Endoscopy.2023; 56(5): 592.     CrossRef
  • How to reduce fistula formation after self-expandable metallic stent insertion for treating malignant esophageal stricture?
    Kwang Bum Cho
    Clinical Endoscopy.2023; 56(6): 735.     CrossRef
  • 2,900 View
  • 198 Download
  • 4 Web of Science
  • 5 Crossref
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Clinical outcomes of permanent stenting with endoscopic ultrasound gallbladder drainage
Eisuke Suzuki, Yuji Fujita, Kunihiro Hosono, Yuji Koyama, Seitaro Tsujino, Takuma Teratani, Atsushi Nakajima, Nobuyuki Matsuhashi
Clin Endosc 2023;56(5):650-657.   Published online April 5, 2023
DOI: https://doi.org/10.5946/ce.2022.190
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD.
Methods
This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events.
Results
A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10–1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period.
Conclusions
EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.

Citations

Citations to this article as recorded by  
  • Revolutionizing outcomes: endoscopic ultrasound-guided gallbladder drainage using innovative electrocautery enhanced-lumen apposing metal stents for high-risk surgical patients
    Hyung Ku Chon, Yun Chae Lee, Tae Hyeon Kim, Seung Ok Lee, Seong-Hun Kim
    Scientific Reports.2024;[Epub]     CrossRef
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  • 96 Download
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Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study
Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef
Clin Endosc 2023;56(5):658-665.   Published online July 3, 2023
DOI: https://doi.org/10.5946/ce.2023.006
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: We aimed to study the effects of sedation on endoscopic ultrasound–guided tissue acquisition.
Methods
We conducted a retrospective study evaluating the role of sedation in endoscopic ultrasound–guided tissue acquisition by comparing two groups: anesthesia care provider (ACP) sedation and endoscopist-directed conscious sedation (CS).
Results
Technical success was achieved in 219/233 (94.0%) in the ACP group and 114/136 (83.8%) in the CS group (p=0.0086). In multivariate analysis, the difference in technical success between the two groups was not significant (adjusted odds ratio [aOR], 0.5; 95% confidence interval [CI], 0.234–1.069; p=0.0738). A successful diagnostic yield was present in 146/196 (74.5%) in the ACP group and 66/106 (62.3%) in the CS group, respectively (p=0.0274). In multivariate analysis, the difference in diagnostic yield between the two groups was not significant (aOR, 0.643; 95% CI, 0.356–1.159; p=0.142). A total of 33 adverse events (AEs) were observed. The incidence of AEs was significantly lower in the CS group (5/33 CS vs. 28/33 ACP; OR, 0.281; 95% CI, 0.095–0.833; p=0.022).
Conclusions
CS provided equivalent technical success and diagnostic yield for malignancy in endoscopic ultrasound–guided tissue acquisition. Increased AEs were associated with anesthesia for the endoscopic ultrasound–guided tissue acquisition.
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Case Report
Ischemic colitis complicated by Clostridioides difficile infection treated with fecal microbiota transplantation
Seok Hyung Kang, Tae-Geun Gweon, Hyunjung Hwang, Myong Ki Baeg
Clin Endosc 2023;56(5):666-670.   Published online January 20, 2022
DOI: https://doi.org/10.5946/ce.2021.199
AbstractAbstract PDFPubReaderePub
Ischemic colitis is an inflammatory condition of the colon that results from insufficient blood supply commonly caused by enterocolitis, vessel occlusion, or shock. In contrast, pseudomembranous colitis is a clinical manifestation of Clostridioides difficile infection (CDI). Ischemic colitis caused by CDI has rarely been reported. Fecal microbiota transplantation (FMT) is an efficient treatment for refractory or fulminant CDI, and the indications for its use have recently expanded. However, performing FMT in patients with ischemic colitis is challenging because of the risk of perforation. Here, we have presented a case of ischemic colitis caused by CDI that was successfully treated with FMT via sigmoidoscopy.

Citations

Citations to this article as recorded by  
  • Case of Pseudomembranous Colitis Caused by a Clostridioides difficile Infection Concomitant with Cytomegalovirus colitis Mimicking Ischemic Colitis
    Hyo Suk Kim, Hye Min Kim, Tae-Geun Gweon
    The Korean Journal of Gastroenterology.2023; 81(3): 133.     CrossRef
  • Fecal microbiota transplantation in non-communicable diseases: Recent advances and protocols
    Sevag Hamamah, Roxana Gheorghita, Andrei Lobiuc, Ioan-Ovidiu Sirbu, Mihai Covasa
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • 3,498 View
  • 262 Download
  • 2 Web of Science
  • 2 Crossref
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Brief Reports
Warm water irrigation is useful for the identification of a bleeding colonic diverticulum
Isaac Seow-En, Francis Seow-Choen
Clin Endosc 2023;56(5):671-673.   Published online May 17, 2023
DOI: https://doi.org/10.5946/ce.2022.279
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Survey results from the participants of the Asian Young Endoscopist Award and International Young Endoscopist Award as part of the International Digestive Endoscopy Network
Tae-Geun Gweon, Sang Hoon Kim, Ki Bae Bang, Seung Wook Hong, Won Jae Yoon, Sung Noh Hong, Jae Jun Park, Jimin Han, Ja Seol Koo, Oh Young Lee, on behalf of the Public Affairs Committee of the Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2023;56(5):674-676.   Published online August 24, 2023
DOI: https://doi.org/10.5946/ce.2023.100
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Boost Your Learning with Quiz
Unusual cause of persistent chest pain
Yuri Kim, Ji Yong Ahn
Clin Endosc 2023;56(5):677-679.   Published online July 26, 2023
DOI: https://doi.org/10.5946/ce.2023.078
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