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Review
Endoscopic stenting for malignant gastric outlet obstruction: focusing on comparison of endoscopic stenting and surgical gastrojejunostomy
Sun Gyo Lim, Chan Gyoo Kim
Clin Endosc 2024;57(5):571-580.   Published online February 23, 2024
DOI: https://doi.org/10.5946/ce.2023.160
Funded: National Cancer Center
AbstractAbstract PDFPubReaderePub
Malignant gastric outlet obstruction (GOO) is a condition characterized by blockage or narrowing where the stomach empties its contents into the small intestine due to primary malignant tumors or metastatic diseases. This condition leads to various symptoms such as nausea, vomiting, abdominal pain, and weight loss. To manage malignant GOO, different treatment options have been employed, including surgical gastrojejunostomy (SGJ), gastroduodenal stenting (GDS) using self-expandable metallic stent (SEMS), and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ). This review focuses on comparing the clinical outcomes of endoscopic stenting (GDS and EUS-GJ) with SGJ for malignant GOO. Studies have shown that GDS with SEMS provides comparable clinical outcomes and safety for the palliation of obstructive symptoms. The choice between covered and uncovered SEMS remains controversial, as different studies have reported varying results. EUS-GJ, performed via endoscopic ultrasound guidance, has shown promising efficacy and safety in managing malignant GOO, but further studies are needed to establish it as the primary treatment option. Comparative analyses suggest that GDS has higher recurrence and reintervention rates compared to EUS-GJ and SGJ, with similar overall procedural complications. However, bleeding rates were lower with GDS than with SGJ. Randomized controlled trials are required to determine the optimal treatment approach for malignant GOO.
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Original Articles
Current status and clinical outcome of endoscopic hemostatic powder in gastrointestinal bleeding: a retrospective multicenter study
Zie Hae Lim, Seung In Seo, Dae-Seong Myung, Seung Han Kim, Han Hee Lee, Selen Kim, Bo-In Lee
Clin Endosc 2024;57(5):620-627.   Published online March 8, 2024
DOI: https://doi.org/10.5946/ce.2023.179
Funded: Korean Gastrointestinal Endoscopy Research Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Few multicenter studies have investigated the efficacy of hemostatic powders in gastrointestinal (GI) bleeding. We aimed to investigate the clinical outcomes of hemostatic powder therapy and the independent factors affecting rebleeding rates.
Methods
We retrospectively recruited patients who underwent a new hemostatic adhesive powder (UI-EWD; Next-Biomedical) treatment for upper and lower GI bleeding between January 1, 2020 and March 1, 2023. We collected patients’ medical records and bleeding lesions. The primary outcomes were clinical and technical success rates, and the secondary outcomes were early, delayed, and refractory bleeding, mortality, and factors affecting early rebleeding rates.
Results
This study enrolled 135 patients (age: 67.7±13.6 years, male: 74.1%) from five hospitals. Indications for UI-EWD were peptic ulcers (51.1%), post-procedure-related bleeding (23.0%), and tumor bleeding (19.3%). The clinical and technical success rates were both 97%. The early, delayed, and refractory rebleeding rates were 19.3%, 11.1%, and 12.8%, respectively. Initially elevated blood urea nitrogen (BUN) levels (p=0.014) and Forrest classification IA or IB compared with IIA or IIB (p=0.036) were factors affecting early rebleeding.
Conclusions
UI-EWD showed high clinical and technical success rates; however, rebleeding after UI-EWD therapy in patients with initially high BUN levels and active bleeding, according to the Forrest classification, should be considered.

Citations

Citations to this article as recorded by  
  • Endoscopic hemostatic powder as a salvage treatment for acute gastrointestinal bleeding
    Duc Trong Quach
    Clinical Endoscopy.2024; 57(5): 606.     CrossRef
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Puncture angle on an endoscopic ultrasound image is independently associated with unsuccessful guidewire manipulation of endoscopic ultrasound-guided hepaticogastrostomy: a retrospective study in Japan
Akihisa Ohno, Nao Fujimori, Toyoma Kaku, Kazuhide Matsumoto, Masatoshi Murakami, Katsuhito Teramatsu, Keijiro Ueda, Masayuki Hijioka, Akira Aso, Yoshihiro Ogawa
Clin Endosc 2024;57(5):656-665.   Published online July 26, 2024
DOI: https://doi.org/10.5946/ce.2023.244
Funded: JSPS KAKENHI, The Clinical Research Promotion Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Although endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is performed globally, the procedure remains challenging. Guidewire manipulation is the most difficult step, and there are few reports on the factors associated with unsuccessful guidewire manipulation. This study aimed to assess the significance of the puncture angle on EUS images and identify the most effective guidewire rescue method for patients with unsuccessful guidewire manipulation.
Methods
We retrospectively enrolled 115 patients who underwent EUS-HGS between May 2016 and April 2022 at two centers. The puncture angle between the needle and the intrahepatic bile duct was measured through EUS movie records.
Results
Guidewire manipulation was unsuccessful in 28 patients. Receiver operating characteristic (ROC) curves identified an optimal puncture angle cutoff value of 85° (cutoff value, 85°; area under the ROC curve, 0.826; sensitivity, 85.7%; specificity, 81.6%). Multivariate analysis demonstrated that a puncture angle <85° was a significant risk factor for unsuccessful guidewire manipulation (odds ratio, 19.8; 95% confidence interval, 6.42–61.5; p<0.001). Among the 28 unsuccessful cases, 24 patients (85.7%) achieved successful guidewire manipulation using various rescue methods.
Conclusions
The puncture angle observed on EUS is crucial for guidewire manipulation. A puncture angle of <85° was associated with unsuccessful guidewire manipulation.
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Review
Painless colonoscopy: fact or fiction?
Pieter Sinonquel, Alexander Jans, Raf Bisschops
Clin Endosc 2024;57(5):581-587.   Published online June 27, 2024
DOI: https://doi.org/10.5946/ce.2024.001
Funded: Research Foundation Flanders, Bijzonder Onderzoeksfonds-Fonds Klinisch Onderzoek
AbstractAbstract PDFPubReaderePub
Although colonoscopy is a routinely performed procedure, it is not devoid of challenges, such as the potential for perforation and considerable patient discomfort, leading to patients postponing the procedure with several healthcare risks. This review delves into preprocedural and procedural solutions, and emerging technologies aimed at addressing the drawbacks of colonoscopies. Insufflation and sedation techniques, together with various other methods, have been explored to increase patient satisfaction, and thereby, the quality of endoscopy. Recent advances in this field include the prevention of loop formation, encompassing the use of variable-stiffness endoscopes, computer-guided scopes, magnetic endoscopic imaging, robotics, and capsule endoscopy. An autonomous endoscope that relies on self-propulsion to completely avoid looping is a potentially groundbreaking technology for the next generation of endoscopes. Nevertheless, critical techniques need to be refined to ensure the development of effective and efficient endoscopes.
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Case Report
A rare case of esophageal mucoepidermoid carcinoma successfully treated via endoscopic submucosal dissection
So Eun Jeun, Kyung Bin Kim, Bong Eun Lee, Gwang Ha Kim, Moon Won Lee, Dong Chan Joo
Clin Endosc 2024;57(5):683-687.   Published online June 18, 2024
DOI: https://doi.org/10.5946/ce.2024.051
Funded: Pusan National University Hospital
AbstractAbstract PDFPubReaderePub
Esophageal mucoepidermoid carcinoma (EMEC) is a special subtype of esophageal malignancy, accounting for less than 1% of all cases of primary esophageal carcinoma. Pathologically, it consists of a mixture of adenocarcinoma and squamous cell carcinoma with mucin-secreting cells. Special staining for mucicarmine helps to diagnose EMEC. We present a rare case of EMEC successfully treated via endoscopic submucosal dissection (ESD). A 63-year-old man was referred to our tertiary hospital. On esophagogastroduodenoscopy, a 6-mm-sized subtle reddish depressed lesion was identified in the mid-esophagus. Diagnostic ESD was performed with a high suspicion of carcinoma. Histopathologic findings were consistent with EMEC which was confined to the lamina propria without lymphatic invasion. We plan to do a careful follow-up without administering adjuvant chemotherapy or radiotherapy. Due to the small volume of the lesion, establishing a diagnosis was difficult through forceps biopsy alone. However, by using ESD, we could confirm and successfully treat a rare case of early-stage EMEC.
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Original Article
Evaluation of cryoablation using a prototype cryoablation needle in swine liver
Hyunjoon Son, Jonghyun Lee, Sung Yong Han, Tae In Kim, Dong Uk Kim, Daejin Kim, Gun-Ho Kim
Clin Endosc 2024;57(5):675-682.   Published online July 29, 2024
DOI: https://doi.org/10.5946/ce.2024.024
Funded: Korean Gastrointestinal Endoscopy Research Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Pancreatic cancer poses significant challenges due to its tendency for late-stage diagnosis and high mortality rates. Cryoablation, a technique used to treat various types of cancer, has shown potential in enhancing the prognosis of pancreatic cancer when combined with other therapies. However, its implementation is often limited by the need for lengthy procedures and specialized equipment. This study aims to develop a cryoablation needle optimized for endoscopic ultrasonography to simplify its application in treating pancreatic cancer.
Methods
The study involved conducting cryoablation experiments on swine liver tissue. It utilized cryo-needles to evaluate the extent of cell death across various temperatures and durations of cryoablation.
Results
The cryoablation system, which employed liquid carbon dioxide, achieved rapid cooling, reaching temperatures below –60 °C within 30 seconds and maintained the cryoablation process for 200 seconds. These conditions resulted in necrosis of the liver tissue. Notable cellular changes were observed up to 15 mm away from the cryoablation needle.
Conclusions
This experimental study successfully demonstrated the efficacy of using a cryo-needle for cryoablation in swine liver tissue. Further trials involving pancreatic tissue are expected to verify its effectiveness, underscoring the importance of continued research to establish its role as a complementary therapy in pancreatic cancer treatment.
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Editorial
Never judge a book by its cover: the role of timed barium esophagography in patients with complete symptom relief after peroral endoscopic myotomy
Tae Hee Lee
Clin Endosc 2024;57(5):604-605.   Published online August 20, 2024
DOI: https://doi.org/10.5946/ce.2024.111
Funded: Soonchunhyang University Research Fund
PDFPubReaderePub
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Original Articles
Prevalence and natural course of incidental gastric subepithelial tumors
Dae-Hyuk Heo, Min A Yang, Jae Sun Song, Won Dong Lee, Jin Woong Cho
Clin Endosc 2024;57(4):495-500.   Published online March 29, 2024
DOI: https://doi.org/10.5946/ce.2023.124
Funded: Presbyterian Medical Center
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Gastric subepithelial tumors (SETs) are often encountered during the upper gastrointestinal endoscopic screening. We assessed the prevalence of gastric SETs and the risk factors for their progression.
Methods
We reviewed the electronic medical records of 30,754 patients who underwent upper gastrointestinal endoscopic screening at our medical center between January 2013 and December 2016.
Results
Among the 30,754 patients examined, 599 (1.94%) had gastric SETs. The prevalence increased with age and was 9.56% in patients aged ≥70 years. In total, 262 patients underwent serial endoscopy for more than 6 months. The median age was 68 years (interquartile range [IQR], 61–74), and the number of females was 167 (63.7%). During a median follow-up of 58 months (IQR, 38–75), 22 patients (8.4%) showed significant changes in tumor size. An irregular border (odds ratio, 4.623; 95% confidence interval, 1.093–19.558; p=0.037) was a significant risk factor for progression. Seven patients underwent surgical or endoscopic resections. The pathologies of gastric SETs included leiomyomas (n=3), gastrointestinal stromal tumors (n=2), and lipomas (n=2).
Conclusions
The prevalence of gastric SETs increases with age. Most gastric SETs do not progress during long-term endoscopic examinations, and the risk of an increase in size is low in asymptomatic small SETs without irregular borders.

Citations

Citations to this article as recorded by  
  • 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
    Journal of Clinical Medicine.2024; 13(13): 3725.     CrossRef
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Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee
Clin Endosc 2024;57(4):476-485.   Published online April 12, 2024
DOI: https://doi.org/10.5946/ce.2023.198
Funded: Korean Gastrointestinal Endoscopy Research Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation.
Methods
This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm.
Results
Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79–0.86) and displayed a moderate discriminatory power.
Conclusions
High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy.
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A novel fully covered metal stent for unresectable malignant distal biliary obstruction: results of a multicenter prospective study
Arata Sakai, Atsuhiro Masuda, Takaaki Eguchi, Keisuke Furumatsu, Takao Iemoto, Shiei Yoshida, Yoshihiro Okabe, Kodai Yamanaka, Ikuya Miki, Saori Kakuyama, Yosuke Yagi, Daisuke Shirasaka, Shinya Kohashi, Takashi Kobayashi, Hideyuki Shiomi, Yuzo Kodama
Clin Endosc 2024;57(3):375-383.   Published online July 10, 2023
DOI: https://doi.org/10.5946/ce.2023.035
Funded: JSPS KAKENHI
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO.
Methods
This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events.
Results
A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration.
Conclusions
The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.

Citations

Citations to this article as recorded by  
  • Endeavors to prevent stent malfunction: new insights into the risk factors for recurrent biliary obstruction
    Sung-Jo Bang
    Clinical Endoscopy.2024; 57(1): 56.     CrossRef
  • Understanding mechanical properties of biliary metal stents for wise stent selection
    Seok Jeong
    Clinical Endoscopy.2023; 56(5): 592.     CrossRef
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Novel upper gastrointestinal bleeding sensor capsule: a first human feasibility and safety trial
Lukas Bajer, Marvin Ryou, Christopher C. Thompson, Pavel Drastich
Clin Endosc 2024;57(2):203-208.   Published online January 17, 2024
DOI: https://doi.org/10.5946/ce.2023.111
Funded: European Union’s Horizon 2020 research and innovation programme
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Upper gastrointestinal bleeding (UGIB) is the most common GI condition requiring hospitalization, and can be diagnosed by direct visualization. The present study aimed to evaluate the safety and feasibility of using the PillSense system (EnteraSense Ltd.), a novel diagnostic tool designed for the rapid in vivo detection of UGIB, in human volunteers.
Methods
In the present study, 10 volunteers swallowed a PillSense capsule, followed by 2 servings of an autologous blood preparation. Participants were monitored for capsule passage, overall tolerability of the procedure, and adverse events.
Results
The procedure was completed per the protocol established in the present study in 9/10 cases. In 9 of the subjects, after capsule ingestion, the device indicated the absence of blood with sensor output values of 1. After the ingestion of the first blood mixture, the sensor outputs of all devices increased from 2.8 to 4, indicating that each camera detected blood. The sensor output remained within that range after the ingestion of the second mixture; however, in one case, the baseline capsule signal was positive, because of a preexisting condition. The passage of the capsule was verified in all patients, and no adverse events were reported.
Conclusions
The first trial of the PillSense system in human subjects demonstrated the feasibility, safety, and tolerability of utilizing this product as a novel, noninvasive, and easy-to-use triage tool for the diagnosis of patients suspected of having UGIB.

Citations

Citations to this article as recorded by  
  • 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
  • Approaches of wearable and implantable biosensor towards of developing in precision medicine
    Elham Ghazizadeh, Zahra Naseri, Hans-Peter Deigner, Hossein Rahimi, Zeynep Altintas
    Frontiers in Medicine.2024;[Epub]     CrossRef
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Performance comparison between two computer-aided detection colonoscopy models by trainees using different false positive thresholds: a cross-sectional study in Thailand
Kasenee Tiankanon, Julalak Karuehardsuwan, Satimai Aniwan, Parit Mekaroonkamol, Panukorn Sunthornwechapong, Huttakan Navadurong, Kittithat​ Tantitanawat, Krittaya Mekritthikrai, Salin Samutrangsi, Peerapon Vateekul, Rungsun Rerknimitr
Clin Endosc 2024;57(2):217-225.   Published online February 7, 2024
DOI: https://doi.org/10.5946/ce.2023.145
Funded: National Research Council of Thailand, Center of Excellence for Gastrointestinal and Oncology Endoscopy Unit, King Chulalongkorn Memorial Hospital
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aims to compare polyp detection performance of “Deep-GI,” a newly developed artificial intelligence (AI) model, to a previously validated AI model computer-aided polyp detection (CADe) using various false positive (FP) thresholds and determining the best threshold for each model.
Methods
Colonoscopy videos were collected prospectively and reviewed by three expert endoscopists (gold standard), trainees, CADe (CAD EYE; Fujifilm Corp.), and Deep-GI. Polyp detection sensitivity (PDS), polyp miss rates (PMR), and false-positive alarm rates (FPR) were compared among the three groups using different FP thresholds for the duration of bounding boxes appearing on the screen.
Results
In total, 170 colonoscopy videos were used in this study. Deep-GI showed the highest PDS (99.4% vs. 85.4% vs. 66.7%, p<0.01) and the lowest PMR (0.6% vs. 14.6% vs. 33.3%, p<0.01) when compared to CADe and trainees, respectively. Compared to CADe, Deep-GI demonstrated lower FPR at FP thresholds of ≥0.5 (12.1 vs. 22.4) and ≥1 second (4.4 vs. 6.8) (both p<0.05). However, when the threshold was raised to ≥1.5 seconds, the FPR became comparable (2 vs. 2.4, p=0.3), while the PMR increased from 2% to 10%.
Conclusions
Compared to CADe, Deep-GI demonstrated a higher PDS with significantly lower FPR at ≥0.5- and ≥1-second thresholds. At the ≥1.5-second threshold, both systems showed comparable FPR with increased PMR.
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Efficacy of an assistive guide tube for improved endoscopic access to gastrointestinal lesions: an in vivo study in a porcine model
Dong Seok Lee, Jeong-Sik Byeon, Sang Gyun Kim, Ji Won Kim, Kook Lae Lee, Ji Bong Jeong, Yong Jin Jung, Hyoun Woo Kang
Clin Endosc 2024;57(1):82-88.   Published online April 18, 2023
DOI: https://doi.org/10.5946/ce.2022.161
Funded: Seoul National University Boramae Medical Center, National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Guide tube-assisted endoscopy for procedures that require repeated endoscopic access is safer and more effective than conventional endoscopy. However, its effectiveness has not been confirmed in animal studies. We assessed the usefulness of guide tube-assisted endoscopic procedures in an in vivo porcine model.
Methods
Five different guide tube-assisted endoscopic procedures were performed by experienced endoscopists on a pig weighing 32 kg. To evaluate the efficacy of these procedures, we compared the endoscopic approach time when a guide tube was used to that when it was not. Additional endoscopic procedures using a guide tube were performed, including multiple foreign body extractions, multiple polypectomies, and multiple submucosal dissections. To evaluate safety, we compared the insertion force into the proximal esophagus between the guide tube and conventional overtube methods.
Results
Using the endoscopic approach with a guide tube required a shorter average approach time to reach the three target lesions than when using the endoscopic approach without a guide tube (p<0.001). Compared to the conventional overtube method, the guide tube method produced a lower average resistance during insertion into the upper esophagus (p<0.001).
Conclusions
Guide tube-assisted endoscopic procedures are effective and safe for repeated endoscopic access in an in vivo porcine model.
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Preclinical study of a novel ingestible bleeding sensor for upper gastrointestinal bleeding
Kimberly F. Schuster, Christopher C. Thompson, Marvin Ryou
Clin Endosc 2024;57(1):73-81.   Published online May 31, 2023
DOI: https://doi.org/10.5946/ce.2022.293
Funded: EnteraSense Inc
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Upper gastrointestinal bleeding (UGIB) is a life-threatening condition that necessitates early identification and intervention and is associated with substantial morbidity, mortality, and socioeconomic burden. However, several diagnostic challenges remain regarding risk stratification and the optimal timing of endoscopy. The PillSense System is a noninvasive device developed to detect blood in patients with UGIB in real time. This study aimed to assess the safety and performance characteristics of PillSense using a simulated bleeding model.
Methods
A preclinical study was performed using an in vivo porcine model (14 animals). Fourteen PillSense capsules were endoscopically placed in the stomach and blood was injected into the stomach to simulate bleeding. The safety and sensitivity of blood detection and pill excretion were also investigated.
Results
All the sensors successfully detected the presence or absence of blood. The minimum threshold was 9% blood concentration, with additional detection of increasing concentrations of up to 22.5% blood. All the sensors passed naturally through the gastrointestinal tract.
Conclusions
This study demonstrated the ability of the PillSense System sensor to detect UGIB across a wide range of blood concentrations. This ingestible device detects UGIB in real time and has the potential to be an effective tool to supplement the current standard of care. These favorable results will be further investigated in future clinical studies.

Citations

Citations to this article as recorded by  
  • Miniaturized Capsule System Toward Real‐Time Electrochemical Detection of H2S in the Gastrointestinal Tract
    Justin M. Stine, Katie L. Ruland, Luke A. Beardslee, Joshua A. Levy, Hossein Abianeh, Santiago Botasini, Pankaj J. Pasricha, Reza Ghodssi
    Advanced Healthcare Materials.2023;[Epub]     CrossRef
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  • 158 Download
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Brief Report
Side-opening cutting forceps and esophageal lamina propria yield in pediatric patients with eosinophilic esophagitis
Adam T. Cardullo, Jacob O. Robson
Clin Endosc 2024;57(1):128-130.   Published online June 28, 2023
DOI: https://doi.org/10.5946/ce.2023.008
Funded: North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
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Review
Advanced endoscopic imaging for detection of Barrett’s esophagus
Netanel Zilberstein, Michelle Godbee, Neal A. Mehta, Irving Waxman
Clin Endosc 2024;57(1):1-10.   Published online January 5, 2024
DOI: https://doi.org/10.5946/ce.2023.031
Funded: National Research Service Award
AbstractAbstract PDFPubReaderePub
Barrett’s esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), and is caused by chronic gastroesophageal reflux. BE can progress over time from metaplasia to dysplasia, and eventually to EAC. EAC is associated with a poor prognosis, often due to advanced disease at the time of diagnosis. However, if BE is diagnosed early, pharmacologic and endoscopic treatments can prevent progression to EAC. The current standard of care for BE surveillance utilizes the Seattle protocol. Unfortunately, a sizable proportion of early EAC and BE-related high-grade dysplasia (HGD) are missed due to poor adherence to the Seattle protocol and sampling errors. New modalities using artificial intelligence (AI) have been proposed to improve the detection of early EAC and BE-related HGD. This review will focus on AI technology and its application to various endoscopic modalities such as high-definition white light endoscopy, narrow-band imaging, and volumetric laser endomicroscopy.

Citations

Citations to this article as recorded by  
  • Gender disparities and woman-specific trends in Barrett’s esophagus in the United States: An 11-year nationwide population-based study
    Karina Fatakhova, Faisal Inayat, Hassam Ali, Pratik Patel, Attiq Ur Rehman, Arslan Afzal, Muhammad Sarfraz, Shiza Sarfraz, Gul Nawaz, Ahtshamullah Chaudhry, Rubaid Dhillon, Arthur Dilibe, Benjamin Glazebnik, Lindsey Jones, Emily Glazer
    World Journal of Methodology.2025;[Epub]     CrossRef
  • Advancements in Barrett's esophagus detection: The role of artificial intelligence and its implications
    Sara Massironi
    World Journal of Gastroenterology.2024; 30(11): 1494.     CrossRef
  • Advanced Esophageal Endoscopy
    Kyoungwon Jung, Rebecca M. Haug, Andrew Y. Wang
    Gastroenterology Clinics of North America.2024; 53(4): 603.     CrossRef
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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
Funded: National Research Foundation of Korea, Ministry of Science and ICT
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
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Original Article
Medical disputes related to advanced endoscopic procedures with endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the management of pancreas and biliary tract diseases
Yoon Suk Lee, Jae-Young Jang, Jun Yong Bae, Eun Hye Oh, Yehyun Park, Yong Hwan Kwon, Jeong Eun Shin, Jun Kyu Lee, Tae Hee Lee, Chang Nyol Paik
Clin Endosc 2023;56(4):499-509.   Published online March 28, 2023
DOI: https://doi.org/10.5946/ce.2022.208
Funded: Korean Gastrointestinal Endoscopy Research Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aimed to evaluate the characteristics of endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasonography (EUS)-related adverse events (AEs) that eventually lead to medical disputes or claims on medical professional liability.
Methods
Medical disputes for ERCP/EUS-related AEs filed in the Korea Medical Dispute Mediation and Arbitration Agency between April 2012 and August 2020 were evaluated using corresponding medical records. AEs were categorized into three sections: procedure-related, sedation-related, and safety-related AEs.
Results
Among a total of 34 cases, procedure-related AEs were 26 (76.5%; 12 duodenal perforations, 7 post-ERCP pancreatitis, 5 bleedings, 2 perforations combined with post-ERCP pancreatitis); sedation-related AEs were 5 (14.7%; 4 cardiac arrests, 1 desaturation), and safety-related AEs were 5 (8.8%; 1 follow-up loss for stent removal, 1 asphyxia, 1 fall). Regarding clinical outcomes, 20 (58.8%) were fatal and eventually succumbed to AEs. For the types of medical institutions, 21 cases (61.8%) occurred at tertiary or academic hospitals, and 13 (38.2%) occurred at community hospitals.
Conclusions
The ERCP/EUS-related AEs filed in Korea Medical Dispute Mediation and Arbitration Agency showed distinct features: duodenal perforation was the most frequent AE, and clinical outcomes were fatal, resulting in at least more than permanent physical impairment.

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  • Diagnostic Assessment of Endoscopic Ultrasonography–Fine Needle Aspiration Cytology in the Pancreas: A Comparison between Liquid-Based Preparation and Conventional Smear
    Jung-Soo Pyo, Dae Hyun Lim, Kyueng-Whan Min, Nae Yu Kim, Il Hwan Oh, Byoung Kwan Son
    Medicina.2024; 60(6): 930.     CrossRef
  • 2,371 View
  • 112 Download
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  • 1 Crossref
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Boost Your Learning with Quiz
Rare cause of granulomatous enteritis
Seung Min Hong, Byeong Kyu Park, Dong Hoon Baek
Clin Endosc 2023;56(4):534-536.   Published online May 9, 2023
DOI: https://doi.org/10.5946/ce.2023.014
Funded: Pusan National University Hospital
PDFPubReaderePub
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  • 75 Download
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Reviews
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, Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines
Clin Endosc 2023;56(4):391-408.   Published online June 23, 2023
DOI: https://doi.org/10.5946/ce.2023.062
Funded: Korean Society of Gastrointestinal Endoscopy
AbstractAbstract PDFSupplementary MaterialPubReaderePub
With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

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  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Fast-track discharge following percutaneous endoscopic gastrostomy removal in head and neck cancer patients after remission: a feasibility and safety study
    Daniel Conceição, Luís Correia Gomes, Fátima Francisco, Ivone Frade, Joana Gramacho, Sandra Faias, Isabel Claro
    Journal of Gastrointestinal Surgery.2024; 28(6): 943.     CrossRef
  • When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta‐analysis of randomized controlled trials
    Matthew L. Bechtold, Zahid Ijaz Tarar, Muhammad N. Yousaf, Ghady Moafa, Abdul M. Majzoub, Xheni Deda, Michelle L. Matteson‐Kome, Srinivas R. Puli
    Nutrition in Clinical Practice.2024; 39(5): 1191.     CrossRef
  • The Effect of Oral Diet Training in Indwelling Nasogastric Tube Patients with Prolonged Dysphagia
    Byung-chan Choi, Sook Joung Lee, Eunseok Choi, Sangjee Lee, Jungsoo Lee
    Nutrients.2024; 16(15): 2424.     CrossRef
  • The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis
    Jeffrey L. Roberson, Julia A. Gasior, Sara P. Ginzberg, Emna Bakillah, Jesse Passman, Lauren Shreve, Catherine E. Sharoky, Gregory Nadolski, Katherine R. Courtright, Elinore J. Kaufman
    Annals of Surgical Oncology.2024; 31(10): 6931.     CrossRef
  • A systematic review and quality appraisal of guidelines and recommendations for home enteral tube feeding in adults
    Andriana Korai, Isabella Thomson, Sharon Carey, Margaret Allman-Farinelli
    European Journal of Clinical Nutrition.2024;[Epub]     CrossRef
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Management of complications related to colorectal endoscopic submucosal dissection
Tae-Geun Gweon, Dong-Hoon Yang
Clin Endosc 2023;56(4):423-432.   Published online July 27, 2023
DOI: https://doi.org/10.5946/ce.2023.104
Funded: National Research Foundation of Korea, Ministry of Science and ICT
AbstractAbstract PDFPubReaderePub
Compared to endoscopic mucosal resection (EMR), colonoscopic endoscopic submucosal dissection (C-ESD) has the advantages of higher en bloc resection rates and lower recurrence rates of colorectal neoplasms. Therefore, C-ESD is considered an effective treatment method for laterally spread tumors and early colorectal cancer. However, C-ESD is technically more difficult and requires a longer procedure time than EMR. In addition to therapeutic efficacy and procedural difficulty, safety concerns should always be considered when performing C-ESD in clinical practice. Bleeding and perforation are the main adverse events associated with C-ESD and can occur during C-ESD or after the completion of the procedure. Most bleeding associated with C-ESD can be managed endoscopically, even if it occurs during or after the procedure. More recently, most perforations identified during C-ESD can also be managed endoscopically, unless the mural defect is too large to be sutured with endoscopic devices or the patient is hemodynamically unstable. Delayed perforations are quite rare, but they require surgical treatment more frequently than endoscopically identified intraprocedural perforations or radiologically identified immediate postprocedural perforations. Post-ESD coagulation syndrome is a relatively underestimated adverse event, which can mimic localized peritonitis from perforation. Here, we classify and characterize the complications associated with C-ESD and recommend management options for them.

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  • 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
  • Is there a best choice of equipment for colorectal endoscopic submucosal dissection?
    Francesco Cocomazzi, Sonia Carparelli, Nunzia Labarile, Antonio Capogreco, Marco Gentile, Roberta Maselli, Jahnvi Dhar, Jayanta Samanta, Alessandro Repici, Cesare Hassan, Francesco Perri, Antonio Facciorusso
    Expert Review of Medical Devices.2024; 21(7): 561.     CrossRef
  • IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    The Korean Journal of Gastroenterology.2024; 83(6): 217.     CrossRef
  • Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
    Yunho Jung
    The Korean Journal of Internal Medicine.2024; 39(4): 563.     CrossRef
  • Clinical meaning of sarcopenia in patients undergoing endoscopic treatment
    Hiroyuki Hisada, Yosuke Tsuji, Hikaru Kuribara, Ryohei Miyata, Kaori Oshio, Satoru Mizutani, Hideki Nakagawa, Rina Cho, Nobuyuki Sakuma, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Seiichi Yakabi, Yu Takahashi, Yoshiki Sakaguchi, Naomi Kakushima, Nobutake
    Clinical Endoscopy.2024; 57(4): 446.     CrossRef
  • Endoscopic approaches for the management of giant colonic polyps
    Yunho Jung
    Clinical Endoscopy.2024; 57(4): 468.     CrossRef
  • Outcome and predictive factors for perforation in orthodontic rubber band-assisted endoscopic submucosal dissection of fibrotic colorectal lesions
    Linfu Zheng, Binbin Xu, Fuqiang Wang, Longping Chen, Baoxiang Luo, Zhilin Liu, Xingjie Gao, Linxin Zhou, Rong Wang, Chuanshen Jiang, Dazhou Li, Wen Wang
    Scientific Reports.2024;[Epub]     CrossRef
  • Rhabdomyolysis following colorectal endoscopic submucosal dissection: A case report
    Ying Chen, Wenxuan Zhang, Junqiang Cai, Min Zhong
    Clinical Case Reports.2024;[Epub]     CrossRef
  • International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Gut and Liver.2024; 18(5): 764.     CrossRef
  • Knives Out: Does the Choice of Endoscopic Knife Influence the Outcome of Colorectal Endoscopic Submucosal Dissection?
    Yunho Jung
    Digestive Diseases and Sciences.2024;[Epub]     CrossRef
  • Safety and Efficacy of Endoscopic Submucosal Dissection for Rectal Neoplasms Extending to the Dentate Line
    Harishankar Gopakumar, Dushyant Singh Dahiya, Peter V. Draganov, Mohamed O. Othman, Neil R. Sharma
    Journal of Clinical Gastroenterology.2024;[Epub]     CrossRef
  • 2,494 View
  • 173 Download
  • 10 Web of Science
  • 11 Crossref
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Original Articles
Efficacy and safety of intragastric balloon for obesity in Korea
Kwang Gyun Lee, Seung-Joo Nam, Hyuk Soon Choi, Hang Lak Lee, Jai Hoon Yoon, Chan Hyuk Park, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Sung Hoon Jung, Korean Research Group for Endoscopic Management of Metabolic Disorder and Obesity
Clin Endosc 2023;56(3):333-339.   Published online December 13, 2022
DOI: https://doi.org/10.5946/ce.2022.143
Funded: Korean Gastrointestinal Endoscopy Research Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea.
Methods
We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed.
Results
In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain.
Conclusions
IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

Citations

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  • Intragastric Balloons
    D.T.H. de Moura, Sergio A. Sánchez-Luna, Adriana Fernandes Silva, Alexandre Moraes Bestetti
    Gastrointestinal Endoscopy Clinics of North America.2024; 34(4): 687.     CrossRef
  • Effectiveness and Safety of the Allurion Swallowable Intragastric Balloon for Short-term Weight Loss: A Systematic Review and Meta-analysis
    Adriana Fernandes Silva, Alexandre Moraes Bestetti, Angelo So Taa Kum, Beanie Conceição Medeiros Nunes, Matheus de Oliveira Veras, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
    Obesity Surgery.2024; 34(10): 3735.     CrossRef
  • Endoscopic treatment of obesity: A protocol of updated systematic review with network meta-analysis of randomized controlled trials
    Eun Jeong Gong, Chang Seok Bang, Gwang Ho Baik, Dong Keon Yon
    PLOS ONE.2024; 19(9): e0308410.     CrossRef
  • How effective is intragastric balloon insertion as an obesity treatment in Korea?
    Youngdae Kim
    Clinical Endoscopy.2023; 56(3): 310.     CrossRef
  • Laparoscopy-assisted trans-hiatal endoscopic removal of an intragastric balloon after placement-related esophageal perforation
    Pablo Cortegoso Valdivia, Giorgio Dalmonte, Marina Valente, Lucia Ballabeni, Federica Gaiani, Gian Luigi de' Angelis, Federico Marchesi
    Endoscopy.2023; 55(S 01): E1137.     CrossRef
  • 3,298 View
  • 232 Download
  • 4 Web of Science
  • 5 Crossref
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Accuracy of administrative claim data for gastric adenoma after endoscopic resection
Ga-Yeong Shin, Hyun Ho Choi, Jae Myung Park, Sang Yoon Kim, Jun Young Park, Donghoon Kang, Yu Kyung Cho, Sung Soo Kim, Myung-Gyu Choi
Clin Endosc 2023;56(3):325-332.   Published online March 21, 2023
DOI: https://doi.org/10.5946/ce.2022.147
Funded: National Research Foundation of Korea, Ministry of Education, Science and Technology
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Administrative databases provide valuable information for large-cohort studies. This study aimed to evaluate the diagnostic accuracy of an administrative database for resected gastric adenomas.
Methods
Data of patients who underwent endoscopic resection for benign gastric lesions were collected from three hospitals. Gastric adenoma cases were identified in the hospital database using International Classification of Diseases (ICD) 10-codes. The non-adenoma group included patients without gastric adenoma codes. The diagnostic accuracy for gastric adenoma was analyzed based on the pathological reports of the resected specimen.
Results
Among 5,095 endoscopic resections with codes for benign gastric lesions, 3,909 patients were included in the analysis. Among them, 2,831 and 1,078 patients were allocated to the adenoma and non-adenoma groups, respectively. Regarding the overall diagnosis of gastric adenoma with ICD-10 codes, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.7%, 88.5%, 95.2%, and 96.8%, respectively. There were no significant differences in these parameters between the tertiary and secondary centers.
Conclusions
Administrative codes of gastric adenoma, according to ICD-10 codes, showed good accuracy and can serve as a useful tool to study prognosis of these patients in real-world data studies in the future.

Citations

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  • Gastric Cancer Incidence and Mortality After Endoscopic Resection of Gastric Adenoma: A Nationwide Cohort Study
    Jae Myung Park, Songhee Cho, Ga-Yeong Shin, Jayoun Lee, Minjee Kim, Hyeon Woo Yim
    American Journal of Gastroenterology.2023; 118(12): 2166.     CrossRef
  • 2,738 View
  • 126 Download
  • 1 Web of Science
  • 1 Crossref
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Review
Sex/gender differences in gastrointestinal endoscopy from the perspective of patients and gastroenterologists
Nayoung Kim
Clin Endosc 2023;56(3):268-282.   Published online May 3, 2023
DOI: https://doi.org/10.5946/ce.2022.270
Funded: National Research Foundation of Korea, Ministry of Science and ICT
AbstractAbstract PDFPubReaderePub
The sex/gender of gastroenterologists impact patients’ satisfaction, compliance, and clinical outcomes. For instance, female gastrointestinal (GI) endoscopist–patient gender concordance improves health-related outcomes. This finding suggests that it is important to increase the number of female GI endoscopists. While the number of women in the field of gastroenterology is increasing in the United States and Korea by over 28.3%, it is not enough to account for the gender preferences of female patients. GI endoscopists are at a high risk of endoscopy-related injuries. However, there is a different distribution of muscle and fat; male endoscopists are more affected in their back, while females are more affected in the upper extremities. Women are more susceptible to endoscopy-related injuries than men. There is a correlation between the number of colonoscopies performed and musculoskeletal pain. Job satisfaction is lower in young female gastroenterologists (30’ and 40’) than in the opposite gender and other ages. Thus, it is important to address these issues in the development of GI endoscopy.

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  • Protecting Gastroenterologists through Rehabilitation Training: An Overlooked Area of Concern
    Sun-Hye Ko, Myong Ki Baeg
    Gut and Liver.2023; 17(6): 829.     CrossRef
  • 2,581 View
  • 152 Download
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  • 1 Crossref
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Original Articles
Methylene blue chromoendoscopy is more useful in detection of intestinal metaplasia in the stomach than mucosal pit pattern or vessel evaluation and predicts advanced Operative Link on Gastric Intestinal Metaplasia stages
Justyna Wasielica-Berger, Pawel Rogalski, Anna Pryczynicz, Agnieszka Swidnicka-Siergiejko, Andrzej Dabrowski
Clin Endosc 2023;56(2):203-213.   Published online March 9, 2023
DOI: https://doi.org/10.5946/ce.2022.087
Funded: Medical University of Bialystok
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Intestinal metaplasia (IM) of the stomach is a precancerous condition that is often not visible during conventional endoscopy. Hence, we evaluated the utility of magnification endoscopy and methylene blue (MB) chromoendoscopy to detect IM.
Methods
We estimated the percentage of gastric mucosa surface staining with MB, mucosal pit pattern, and vessel visibility and correlated it with the presence of IM and the percentage of metaplastic cells in histology, similar to the Operative Link on Gastric Intestinal Metaplasia (OLGIM) stage.
Results
IM was found in 25 of 33 (75.8%) patients and in 61 of 135 biopsies (45.2%). IM correlated with positive MB staining (p<0.001) and other than dot pit patterns (p=0.015). MB staining indicated IM with better accuracy than the pit pattern or vessel evaluation (71.7% vs. 60.5% and 49.6%, respectively). At a cut-off point of 16.5% for the MB-stained gastric surface, the sensitivity, specificity, and accuracy of chromoendoscopy in the detection of advanced OLGIM stages were 88.9%, 91.7%, and 90.9%, respectively. The percentage of metaplastic cells detected on histology was the strongest predictor of positive MB staining.
Conclusions
MB chromoendoscopy can serve as a screening method for detecting advanced OLGIM stages. MB mainly stains IM areas with a high concentration of metaplastic cells.

Citations

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  • The prediction model of operative link on gastric intestinal metaplasia stage III-IV: A multicenter study
    Song Wang, Meng Qian, Min Wu, Shuo Feng, Kaiguang Zhang
    Heliyon.2023; 9(11): e21905.     CrossRef
  • 2,941 View
  • 164 Download
  • 2 Web of Science
  • 1 Crossref
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Defining the optimal technique for endoscopic ultrasound shear wave elastography: a combined benchtop and animal model study with comparison to transabdominal shear wave elastography
Thomas J. Wang, Marvin Ryou
Clin Endosc 2023;56(2):229-238.   Published online February 28, 2023
DOI: https://doi.org/10.5946/ce.2022.135
Funded: Olympus America Inc
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Shear wave elastography (SWE) is used for liver fibrosis staging based on stiffness measurements. It can be performed using endoscopic ultrasound (EUS) or a transabdominal approach. Transabdominal accuracy can be limited in patients with obesity because of the thick abdomen. Theoretically, EUS-SWE overcomes this limitation by internally assessing the liver. We aimed to define the optimal technique for EUS-SWE for future research and clinical use and compare its accuracy with that of transabdominal SWE.
Methods
Benchtop study: A standardized phantom model was used. The compared variables included the region of interest (ROI) size, depth, and orientation and transducer pressure. Porcine study: Phantom models with varying stiffness values were surgically implanted between the hepatic lobes.
Results
For EUS-SWE, a larger ROI size of 1.5 cm and a smaller ROI depth of 1 cm demonstrated a significantly higher accuracy. For transabdominal SWE, the ROI size was nonadjustable, and the optimal ROI depth ranged from 2 to 4 cm. The transducer pressure and ROI orientation did not significantly affect the accuracy. There were no significant differences in the accuracy between transabdominal SWE and EUS-SWE in the animal model. The variability among the operators was more pronounced for the higher stiffness values. Small lesion measurements were accurate only when the ROI was entirely situated within the lesion.
Conclusions
We defined the optimal viewing windows for EUS-SWE and transabdominal SWE. The accuracy was comparable in the non-obese porcine model. EUS-SWE may have a higher utility for evaluating small lesions than transabdominal SWE.

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  • Endoscopic Ultrasound-based Shear Wave Elastography for Detection of Advanced Liver Disease
    Jad AbiMansour, Jerry Yung-Lun Chin, Jyotroop Kaur, Eric J. Vargas, Barham K. Abu Dayyeh, Ryan Law, Vishal Garimella, Michael J. Levy, Andrew C. Storm, Ross Dierkhising, Alina Allen, Sudhakar Venkatesh, Vinay Chandrasekhara
    Journal of Clinical Gastroenterology.2024;[Epub]     CrossRef
  • Response
    Divyanshoo R. Kohli, Mohammad Shadab Siddiqui
    Gastrointestinal Endoscopy.2024; 100(1): 161.     CrossRef
  • Advancements and challenges in gastrointestinal imaging
    Eun Jeong Gong, Chang Seok Bang
    World Journal of Clinical Cases.2024; 12(33): 6591.     CrossRef
  • The Role of Endoscopic Ultrasound-Guided Shear Wave Elastography in Pancreatic Diseases
    Yazan Abboud, Srinivas Gaddam
    Diagnostics.2024; 14(20): 2329.     CrossRef
  • EUS-based shear wave elastography of the spleen for detection of clinically significant portal hypertension
    Jad P. AbiMansour, Jerry Yung-Lun Chin, Eric J. Vargas, Jyotroop Kaur, Barham K. Abu Dayyeh, Ryan J. Law, Vishal Garimella, Michael J. Levy, Andrew C. Storm, Ross Dierkhising, Alina Allen, Vinay Chandrasekhara
    iGIE.2024;[Epub]     CrossRef
  • Standardization of endoscopic ultrasound shear wave elastography
    Julio Iglesias-García, J. Enrique Domínguez-Muñoz
    Clinical Endoscopy.2023; 56(2): 185.     CrossRef
  • 2,741 View
  • 181 Download
  • 3 Web of Science
  • 6 Crossref
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Review
Role of radiofrequency ablation in advanced malignant hilar biliary obstruction
Mamoru Takenaka, Tae Hoon Lee
Clin Endosc 2023;56(2):155-163.   Published online January 16, 2023
DOI: https://doi.org/10.5946/ce.2022.218
Funded: Soonchunhyang University Research Fund
AbstractAbstract PDFPubReaderePub
Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.

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  • Percutaneous endobiliary radiofrequency ablation with stent placement in type IV hilar cholangiocarcinoma: A prospective comparison with stent placement alone
    Kun Yung Kim, Chang Jin Yoon, Jae Hwan Lee, Chong-Ho Lee, Jin-Hyeok Hwang, Jaihwan Kim
    European Journal of Radiology.2024; 176: 111516.     CrossRef
  • Metastatic Cholangiocarcinoma Presenting as Colonic Obstruction
    Yianni Protopapadakis, Kevin Lamm, Joseph Baber
    ACG Case Reports Journal.2023; 10(12): e01238.     CrossRef
  • Is endoscopic radiofrequency ablation plus stent placement superior to stent placement alone for the treatment of malignant biliary obstruction? A systematic review and meta-analysis
    Chenming Liu, Jiaming Dong, Yuxing Liu, Siyuan Zhang, Ruanchang Chen, Haijun Tang
    Journal of International Medical Research.2023;[Epub]     CrossRef
  • 3,469 View
  • 263 Download
  • 3 Web of Science
  • 3 Crossref
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Brief Report
Trans-cavity lumen-apposing metal stent removal: an alternative safe modality
Giacomo Emanuele Maria Rizzo, Ilaria Tarantino
Clin Endosc 2023;56(1):129-131.   Published online January 18, 2023
DOI: https://doi.org/10.5946/ce.2022.105
Funded: Italian Ministry of Health
PDFSupplementary MaterialPubReaderePub
  • 1,947 View
  • 101 Download
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Editorials
Role of endoscopic ultrasound in the secondary prevention of gastric varices
Joung-Ho Han
Clin Endosc 2023;56(1):50-52.   Published online January 16, 2023
DOI: https://doi.org/10.5946/ce.2022.301
Funded: Chungbuk National University
PDFPubReaderePub

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  • Comparison of Endoscopic Ultrasound-guided Cyanoacrylate Injection and Transjugular Intrahepatic Portosystemic Shunt in the Prevention of Gastric Varices Rebleeding
    Zhuang Zeng, Zhihong Wang, Jing Jin, Fumin Zhang, Qianqian Zhang, Xuecan Mei, Derun Kong
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(5): 518.     CrossRef
  • 2,143 View
  • 143 Download
  • 1 Web of Science
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Application of double-balloon enteroscopy for small bowel tumors
Su Bum Park
Clin Endosc 2023;56(1):53-54.   Published online January 13, 2023
DOI: https://doi.org/10.5946/ce.2022.307
Funded: Pusan National University Yangsan Hospital
PDFPubReaderePub

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    Meng Kong, Weiqiang Liu, Yuexia Bai, Jinhua Jia, Chuanyang Liu, Shisong Zhang
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Bibliometrics analysis on the research status and trends of small bowel adenocarcinoma: 1923-2023
    Yao Lu, Cheng C. Pan, Xin Hu, Jing Sun
    Frontiers in Oncology.2024;[Epub]     CrossRef
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