Clinical Endoscopy

Most-cited are based on citations from 2023 ~ 2025.

Review

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

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.

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
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; 69(11): 4014. 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
Establishing a nomogram for predicting the risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal tumors
FuCheng Bian, KunShi Li, GuangYu Bian, XiuMei Li
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Endoscopic submucosal dissection for superficial ultra-low rectal tumors: outcomes and predictive factors for procedure difficulty
Yinxin Wu
American Journal of Cancer Research.2024; 14(12): 5784. CrossRef

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Original Articles

Clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling of pancreatic cancer: Nozomi Okuno, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Yasuhiro Kuraishi, Daiki Fumihara, Takafumi Yanaidani; Clin Endosc 2023;56(2):221-228. Published online March 7, 2023; DOI: https://doi.org/10.5946/ce.2022.086

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting.
Methods
CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively.
Results
The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375).
Conclusions
To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.

Citations

Citations to this article as recorded by

Updated techniques and evidence for endoscopic ultrasound‐guided tissue acquisition from solid pancreatic lesions
Masahiro Itonaga, Reiko Ashida, Masayuki Kitano
DEN Open.2025;[Epub] CrossRef
Tissue acquisition for comprehensive genomic profiling of gallbladder cancer using a forward-viewing echoendoscope in a patient who underwent Roux-en-Y reconstruction
Michihiro Ono, Shutaro Oiwa, Atsushi Uesugi, Seiya Saito, Ryota Yokoyama, Makoto Usami, Tomoyuki Abe, Miri Fujita, Kohichi Takada, Masahiro Maeda
Clinical Journal of Gastroenterology.2024; 17(1): 164. CrossRef
Endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling
Nozomi Okuno, Kazuo Hara
Journal of Medical Ultrasonics.2024; 51(2): 253. CrossRef
Oil blotting paper for formalin fixation increases endoscopic ultrasound‐guided tissue acquisition‐collected sample volumes on glass slides
Takuo Yamai, Kenji Ikezawa, Yusuke Seiki, Ko Watsuji, Yasuharu Kawamoto, Takeru Hirao, Kazuma Daiku, Shingo Maeda, Makiko Urabe, Yugo Kai, Ryoji Takada, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Sayoko Tsuzaki, Ayumi Ryu, Satoshi Tanada, Shigenori Na
Cancer Medicine.2024;[Epub] CrossRef
Utility of Transpapillary Biopsy and Endoscopic Ultrasound-Guided Tissue Acquisition for Comprehensive Genome Profiling of Unresectable Biliary Tract Cancer
Soma Fukuda, Susumu Hijioka, Yoshikuni Nagashio, Daiki Yamashige, Daiki Agarie, Yuya Hagiwara, Kohei Okamoto, Shin Yagi, Yasuhiro Komori, Masaru Kuwada, Yuta Maruki, Chigusa Morizane, Hideki Ueno, Nobuyoshi Hiraoka, Kiichiro Tsuchiya, Takuji Okusaka
Cancers.2024; 16(16): 2819. CrossRef
Mcl-1 expression is a predictive marker of response to gemcitabine plus nab-paclitaxel for metastatic pancreatic cancer
Makiko Urabe, Kenji Ikezawa, Yusuke Seiki, Ko Watsuji, Yasuharu Kawamoto, Takeru Hirao, Yugo Kai, Ryoji Takada, Takuo Yamai, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Shigenori Nagata, Kazuyoshi Ohkawa
Scientific Reports.2024;[Epub] CrossRef
Endoscopic Ultrasound-Guided Pancreatic Tissue Sampling: Lesion Assessment, Needles, and Techniques
Jahnvi Dhar, Jayanta Samanta, Zaheer Nabi, Manik Aggarwal, Maria Cristina Conti Bellocchi, Antonio Facciorusso, Luca Frulloni, Stefano Francesco Crinò
Medicina.2024; 60(12): 2021. CrossRef
Adequacy of EUS–guided fine-needle aspiration and fine-needle biopsy for next-generation sequencing in pancreatic malignancies: A systematic review and meta-analysis
Yundi Pan, Taojing Ran, Xianda Zhang, Xianzheng Qin, Yao Zhang, Chunhua Zhou, Duowu Zou
Endoscopic Ultrasound.2024; 13(6): 366. CrossRef
Feasibility and clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling in pancreatic cancer: A systematic review and meta-analysis
Sung Woo Ko, Ik Hyun Jo, Seung Bae Yoon
Pancreatology.2024;[Epub] CrossRef
Endoscopic ultrasound-guided tissue acquisition for personalized treatment in pancreatic adenocarcinoma
Sang Myung Woo
Clinical Endoscopy.2023; 56(2): 183. CrossRef
Comparison of the novel Franseen needle versus the fine‐needle aspiration needle in endoscopic ultrasound‐guided tissue acquisition for cancer gene panel testing: A propensity score‐matching analysis
Tomotaka Mori, Eisuke Ozawa, Akane Shimakura, Kosuke Takahashi, Satoshi Matsuo, Kazuaki Tajima, Yasuhiko Nakao, Masanori Fukushima, Ryu Sasaki, Satoshi Miuma, Hisamitsu Miyaaki, Shinji Okano, Kazuhiko Nakao
JGH Open.2023; 7(9): 652. CrossRef
Editorial: Endoscopic ultrasound‐guided tissue acquisition in the era of precision medicine
Tiing Leong Ang, James Weiquan Li, Lai Mun Wang
Journal of Gastroenterology and Hepatology.2023; 38(10): 1677. CrossRef

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Endoscopic ultrasound-guided coiling and glue is safe and superior to endoscopic glue injection in gastric varices with severe liver disease: a retrospective case control study: Kapil D. Jamwal, Rajesh K. Padhan, Atul Sharma, Manoj K. Sharma; Clin Endosc 2023;56(1):65-74. Published online January 3, 2023; DOI: https://doi.org/10.5946/ce.2021.119

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Gastric varices (GV) are present in 25% of cirrhotic patients with high rates of rebleeding and mortality. Data on endoscopic ultrasound (EUS)-guided treatment in severe liver disease (model for end stage liver disease sodium [MELD-Na] >18 and Child-Turcotte-Pugh [CTP] C with GV) are scarce. Thus, we performed a retrospective comparison of endoscopic glue injection with EUS-guided therapy in cirrhotic patients with large GV.
Methods
A retrospective study was performed in the tertiary hospitals of India. A total of 80 patients were recruited. The inclusion criteria were gastroesophageal varices type 2, isolated gastric varices type 1, bleeding within 6 weeks, size of GV >10 mm, and a MELD-Na >18. Treatment outcomes and complications of endoscopic glue injection and EUS-guided GV therapy were compared.
Results
In this study, the patients’ age, sex, liver disease severity (CTP, MELD-Na) and clinical parameters were comparable. The median number of procedures, injected glue volume, complications, and GV obturation were better in the EUS group, respectively. On subgroup analysis of the EUS method (e.g., direct gastric fundus vs. paragastric collateral [PGC] coil placement), PGC coil placement showed decreased coil requirement, less injected glue volume, decreased luminal coil extrusion, and increased successful GV obturation.
Conclusions
EUS-guided treatment is more efficient and safer, and requires a smaller number of treatment sessions, as compared to endoscopic treatment in severe liver disease patients with large GV. Furthermore, PGC coil placement increases the complete obliteration of GV.

Citations

Citations to this article as recorded by

Efficacy of clip-assisted endoscopic cyanoacrylate injection therapy for gastric varices: A Meta-analysis
Yong-Cai Lv, Yan-Hua Yao, Jing-Jing Lei
World Chinese Journal of Digestology.2024; 32(2): 158. CrossRef
Advances in the endoscopic management of gastric varices
Xin‐Tong Chi, Ting‐Ting Lian, Ze‐Hao Zhuang
Digestive Endoscopy.2024; 36(8): 884. CrossRef
EUS-Guided Vascular Interventions: Recent Advances
Sahib Singh, Saurabh Chandan, Sumant Inamdar, Kambiz S. Kadkhodayan, Jahnvi Dhar, Jayanta Samanta, Antonio Facciorusso
Journal of Clinical Medicine.2024; 13(16): 4835. CrossRef
Trends in endovascular treatment and prevention of portal bleeding
S.V. Mikhin, P.V. Mozgovoy, A.V. Kitaeva, D.E. Gorbunov, I.V. Mikhin
Khirurgiya. Zhurnal im. N.I. Pirogova.2024; (3): 38. CrossRef
In an era of EUS-guided interventions, direct glue injection remains relevant in management algorithm for bleeding isolated gastric varices -1
P. Krishna Bharadwaj, Santhosh E. Kumar, Sudipta Dhar Chowdhury, Ebby George Simon, Shyamkumar Nidugala Keshava, A. J. Joseph, Reuben Thomas Kurien, Uday George Zachariah, Ashish Goel
Indian Journal of Gastroenterology.2024;[Epub] CrossRef
EUS-Guided Coil Placement for Secondary Prophylaxis in Large Gastric Varices - A Pediatric Case Report Authors
Guillermo Costaguta, Alejandro Costaguta
SSRN Electronic Journal.2024;[Epub] CrossRef
Endoscopic ultrasound-guided therapies in the treatment of gastric varices: An in-depth examination of associated adverse events
Anastasios Manolakis, Kyriaki Tsagkidou, Konstantinos Eleftherios Koumarelas
World Journal of Gastrointestinal Endoscopy.2024; 16(12): 640. CrossRef
Safety and Efficacy of Novel Cost-Effective EUS Coiling and Glue Technique for the Management of Large Gastric Varices: A Long-Term Follow-up Study
Shivam Khare, Anil Arora, Jijo Varghese, Vikas Singla, Asif Rahman, Ashish Kumar, Piyush Ranjan, Mandhir Kumar, Praveen Sharma, Naresh Bansal, Shrihari Anikhindi, Munish Sachdeva, Asheish Khandelwal, Mayank Gupta, Suprabhat Giri
Journal of Digestive Endoscopy.2024; 15(04): 222. CrossRef
EUS-guided coiling plus glue injection compared with endoscopic glue injection alone in endoscopic treatment for gastric varices: a systematic review and meta-analysis
Cynthia Florencio de Mesquita, Vanio L.J. Antunes, Natalia Junkes Milioli, Matheus Vanzin Fernandes, Tulio L. Correa, Otavio Cosendey Martins, Radhika Chavan, Stefano Baraldo
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Role of endoscopic ultrasound in the secondary prevention of gastric varices
Joung-Ho Han
Clinical Endoscopy.2023; 56(1): 50. CrossRef
Management of Gastric Varices: GI Perspective
Catherine Vozzo, Vibhu Chittajallu, Brooke Glessing, Ashley Faulx, Amitabh Chak, Richard C.K. Wong
Digestive Disease Interventions.2023; 07(04): 266. CrossRef

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Reviews

Gastrointestinal endoscopy’s carbon footprint: Su Bee Park, Jae Myung Cha; Clin Endosc 2023;56(3):263-267. Published online March 31, 2023; DOI: https://doi.org/10.5946/ce.2023.003

Abstract PDF PubReader ePub

Climate change is a global emergency. Consequently, current global targets to combat the climate crisis include reaching net-zero carbon emissions by 2050 and keeping global temperature increases below 1.5 ˚C. In 2014, the healthcare carbon footprint was 5.5% of the total national footprint. Gastrointestinal endoscopy (GIE) has a large carbon footprint compared to other procedures performed in healthcare facilities. GIE was identified as the third largest generator of medical waste in healthcare facilities for the following reasons: (1) GIE is associated with high case volumes, (2) GIE patients and relatives travel frequently, (3) GIE involves the use of many nonrenewable wastes, (4) single-use devices are used during GIE, and (5) GIE is frequently reprocessed. Immediate actions to reduce the environmental impact of GIE include: (1) adhering to guidelines, (2) implementing audit strategies to determine the appropriateness of GIE, (3) avoiding unnecessary procedures, (4) using medication rationally, (4) digitalization, (5) telemedicine, (6) critical pathways, (7) outpatient procedures, (8) adequate waste management, and (9) minimizing single-use devices. In addition, sustainable infrastructure for endoscopy units, using renewable energy, and 3R (reduce, reuse, and recycle) programs are necessary to reduce the impact of GIE on the climate crisis. Consequently, healthcare providers need to work together to achieve a more sustainable future. Therefore, strategies must be implemented to achieve net-zero carbon emissions in the healthcare field, especially from GIE, by 2050.

Citations

Citations to this article as recorded by

Single‐use accessories and endoscopes in the era of sustainability and climate change—A balancing act
Zaheer Nabi, Raymond S. Y. Tang, Sridhar Sundaram, Sundeep Lakhtakia, D. Nageshwar Reddy
Journal of Gastroenterology and Hepatology.2024; 39(1): 7. CrossRef
Impact of power consumption and power saving for GI endoscopy (power on study) on reducing CO2emissions
Anna Fichtl, Veronika Tacheva, Niklas Sturm, Karim Hamesch, Doerte Wichmann, Benjamin Mayer, Martin Müller, Martin Wagner, Thomas Seufferlein, Benjamin M Walter
Gut.2024; 73(6): 892. CrossRef
Green Endoscopy
Vivek Kaul
American Journal of Gastroenterology.2024; 119(9): 1714. CrossRef
Ecogastroenterology: cultivating sustainable clinical excellence in an environmentally conscious landscape
Kassem Sharif, Enrique Rodriguez de Santiago, Paula David, Arnon Afek, Ian M Gralnek, Shomron Ben-Horin, Adi Lahat
The Lancet Gastroenterology & Hepatology.2024; 9(6): 550. CrossRef
Longitudinal impact of screening colonoscopy on greenhouse gas emissions
Hasiya Yusuf, Vinita Gupta, Ikponmwosa Osaghae, Abhishek Kumar, Alejandro Piscoya
PLOS ONE.2024; 19(7): e0307133. CrossRef
Practical steps to green your endoscopy unit: appropriate management of endoscopic waste
Rabia de Latour, Seth D. Crockett, Sonali Palchaudhuri, Kevin S. Skole, Deepak Agrawal, Lyndon V. Hernandez, Daniel von Renteln, Rahul A. Shimpi, James Collins, Heiko Pohl
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Decarbonizing surgical care: a qualitative systematic review guided by the Congruence Model
Leonard Kloevekorn, Oskar Roemeling, Amal Fakha, Eveline Hage, Edin Smailhodzic
BMC Health Services Research.2024;[Epub] CrossRef
Awareness of green endoscopy is low among healthcare professionals performing gastrointestinal endoscopy
Tae Joo Jeon, Jae Myung Cha
Clinical Endoscopy.2024; 57(6): 836. CrossRef
Colon capsule endoscopy: Can it contribute to green endoscopy?
Konosuke Nakaji
World Journal of Gastrointestinal Endoscopy.2024; 16(12): 627. CrossRef
Can Gastric Juice Analysis with EndoFaster® Reduce the Environmental Impact of Upper Endoscopy?
Angelo Zullo, Federica Chiovelli, Enrica Esposito, Cesare Hassan, Beatrice Casini
Healthcare.2023; 11(24): 3186. CrossRef

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Simulator-based training method in gastrointestinal endoscopy training and currently available simulators: Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung; Clin Endosc 2023;56(1):1-13. Published online January 6, 2023; DOI: https://doi.org/10.5946/ce.2022.191

Abstract PDF PubReader ePub

The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM’s advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator’s validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Citations

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Faisal Wasim Ismail, Azam Afzal, Rafia Durrani, Rayyan Qureshi, Safia Awan, Michelle R Brown
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Riccardo Vasapolli, Jörg Schirra, Christian Schulz
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D. Roser, S. Nagl, A. Ebigbo
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Adrián Lugilde-López, Manuel Caeiro-Rodríguez, Fernando A. Mikic-Fonte, Martín Llamas-Nistal
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Hyundam Gu, Suyoung Lee, Sol Kim, Hye-Lim Jang, Da-Woon Choi, Kyu Seok Kim, Yu Ri Shin, Dae Young Cheung, Bo-In Lee, Jin Il Kim, Han Hee Lee
Clinical Endoscopy.2024; 57(6): 790. CrossRef
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Selma J. Lekkerkerker, Rogier P. Voermans
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Seong Woo Jeon
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Caesar Ferrari, Micheal Tadros
Gastroenterology Insights.2023; 15(1): 1. CrossRef

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Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management: Clement Chun Ho Wu, Samuel Jun Ming Lim, Christopher Jen Lock Khor; Clin Endosc 2023;56(4):433-445. Published online July 17, 2023; DOI: https://doi.org/10.5946/ce.2023.013

Abstract PDF Supplementary Material PubReader ePub

Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient’s clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

Citations

Citations to this article as recorded by

Prevention of post-ERCP complications
Lotfi Triki, Andrea Tringali, Marianna Arvanitakis, Tommaso Schepis
Best Practice & Research Clinical Gastroenterology.2024; 69: 101906. 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
Clinical Endoscopy.2024; 57(2): 141. CrossRef
Double-guidewire technique for selective biliary cannulation does not increase the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with naïve papilla
Han Taek Jeong, June Hwa Bae, Ho Gak Kim, Jimin Han
Clinical Endoscopy.2024; 57(2): 226. CrossRef
Computed tomography-based prediction of pancreatitis following biliary metal stent placement with the convolutional neural network
Tsuyoshi Hamada, Koichiro Yasaka, Yousuke Nakai, Rintaro Fukuda, Ryunosuke Hakuta, Kazunaga Ishigaki, Sachiko Kanai, Kensaku Noguchi, Hiroki Oyama, Tomotaka Saito, Tatsuya Sato, Tatsunori Suzuki, Naminatsu Takahara, Hiroyuki Isayama, Osamu Abe, Mitsuhiro
Endoscopy International Open.2024; 12(06): E772. 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
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
Risk factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography: a retrospective single-center study
I.М. Mamontov, D.D. Rjabushhenko, Т.І. Tamm, К.О. Kramarenko, V.V. Nepomniashchyi, A.T. Ustinov
Український радіологічний та онкологічний журнал.2024; 32(3): 287. CrossRef
Comparison of the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with and without diabetes: a meta-analysis
Fang Jia, Fujing Lv, Shutian Zhang
Surgical Endoscopy.2024;[Epub] CrossRef
Could assessment of genetic susceptibility be an effective solution to prevent pancreatitis from occurring after endoscopic retrograde cholangiopancreatography?
Jae Min Lee
The Korean Journal of Internal Medicine.2023; 38(6): 783. CrossRef

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Original Articles

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

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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.

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Jiaywei Tsauo, Yan Fu, Yue Liu, Xiaowu Zhang, He Zhao, Xiao Li
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Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer
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Physical and Engineering Sciences in Medicine.2024; 47(4): 1323. CrossRef
Radial force and wire structure determine the onset of covered self‐expandable metal stent migration in endoscopic ultrasound‐guided hepaticogastrostomy: Measurement of sliding‐resistance force using a porcine model
Takehiko Koga, Hiroshi Yamada, Yusuke Ishida, Naoaki Tsuchiya, Takanori Kitaguchi, Keisuke Matsumoto, Makoto Fukuyama, Norihiro Kojima, Fumihito Hirai
Journal of Hepato-Biliary-Pancreatic Sciences.2024; 31(11): 840. CrossRef
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Yuechuan Li, Kunshan Yuan, Chengchen Deng, Hui Tang, Jinxuan Wang, Xiaozhen Dai, Bing Zhang, Ziru Sun, Guiying Ren, Haijun Zhang, Guixue Wang
Bioactive Materials.2024; 42: 587. CrossRef
Manufacturing, Processing, and Characterization of Self-Expanding Metallic Stents: A Comprehensive Review
Saeedeh Vanaei, Mahdi Hashemi, Atefeh Solouk, Mohsen Asghari Ilani, Omid Amili, Mohamed Samir Hefzy, Yuan Tang, Mohammad Elahinia
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Kwang Bum Cho
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Covered self-expandable metallic stents versus plastic stents for endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction: Taro Shibuki, Kei Okumura, Masanari Sekine, Ikuhiro Kobori, Aki Miyagaki, Yoshihiro Sasaki, Yuichi Takano, Yusuke Hashimoto; Clin Endosc 2023;56(6):802-811. Published online April 5, 2023; DOI: https://doi.org/10.5946/ce.2022.211

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Background
/Aims: Covered self-expandable metallic stents (cSEMS) have become popular for endoscopic ultrasound-guided hepaticogastrostomy with transmural stenting (EUS-HGS). We compared the time to recurrent biliary obstruction (TRBO), complications, and reintervention rates between EUS-HGS using plastic stent (PS) and cSEMS in patients with unresectable malignancies at multicenter institutions in Japan.
Methods
Patients with unresectable malignant biliary obstruction who underwent EUS-HGS between April 2015 and July 2020 at any of the six participating facilities were enrolled. Primary endpoint: TRBO; secondary endpoints: rate of complications other than recurrent biliary obstruction and technical success rate of reintervention were evaluated.
Results
PS and cSEMS were used for EUS-HGS in 109 and 43 patients, respectively. The TRBO was significantly longer in the cSEMS group than in the PS group (646 vs. 202 days). Multivariate analysis identified two independent factors associated with a favorable TRBO: combined EUS-guided antegrade stenting with EUS-HGS and the use of cSEMS. No significant difference was observed in the rate of complications other than recurrent biliary obstruction between the two groups. The technical success rate of reintervention was 85.7% for PS and 100% for cSEMS (p=0.309).
Conclusions
cSEMS might be a better option for EUS-HGS in patients with unresectable malignancies, given the longer TRBO.

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Kotaro Takeshita, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Akihiro Ohba, Yuki Kawasaki, Tetsuro Takasaki, Shin Yagi, Daiki Agarie, Hidenobu Hara, Yuya Hagiwara, Daiki Yamashige, Kohei Okamoto, Soma Fukuda, Masaru Kuwada, Mark Chatto, Shunsuke Kond
Endoscopy International Open.2024; 12(07): E875. CrossRef
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Dong Kee Jang, Dong Wook Lee, Seong-Hun Kim, Kwang Bum Cho, Sundeep Lakhtakia
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Endoscopy International Open.2024; 12(09): E1065. CrossRef
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Daiki Yamashige, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Yasuhiro Komori, Masaru Kuwada, Soma Fukuda, Shin Yagi, Kohei Okamoto, Daiki Agarie, Mark Chatto, Chigusa Morizane, Hideki Ueno, Shunsuke Sugawara, Miyuki Sone, Yutaka Saito, Takuji Okusaka
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Hyung Ku Chon, Shayan Irani, Tae Hyeon Kim
Clinical Endoscopy.2023; 56(6): 741. CrossRef
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Samuel Han, Georgios I. Papachristou
Cancers.2023; 16(1): 29. CrossRef

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Reviews

Role of artificial intelligence in diagnosing Barrett’s esophagus-related neoplasia: Michael Meinikheim, Helmut Messmann, Alanna Ebigbo; Clin Endosc 2023;56(1):14-22. Published online January 17, 2023; DOI: https://doi.org/10.5946/ce.2022.247

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Barrett’s esophagus is associated with an increased risk of adenocarcinoma. Thorough screening during endoscopic surveillance is crucial to improve patient prognosis. Detecting and characterizing dysplastic or neoplastic Barrett’s esophagus during routine endoscopy are challenging, even for expert endoscopists. Artificial intelligence-based clinical decision support systems have been developed to provide additional assistance to physicians performing diagnostic and therapeutic gastrointestinal endoscopy. In this article, we review the current role of artificial intelligence in the management of Barrett’s esophagus and elaborate on potential artificial intelligence in the future.

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Die Gastroenterologie.2023; 18(3): 186. CrossRef

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Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review: Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Rie Shiomi, Takahiro Shin, Kei Sugimoto, Shomei Ryozawa; Clin Endosc 2023;56(6):716-725. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2023.023

Abstract PDF Supplementary Material PubReader ePub

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. For example, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical practice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE) with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of larger accessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the development in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the challenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as perforation, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regarding SBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated with ERCP.

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Advanced technical tips and recent insights in ERCP using balloon‐assisted endoscopy
Masaaki Shimatani, Toshiyuki Mitsuyama, Takeshi Yamashina, Masahiro Takeo, Shunsuke Horitani, Natsuko Saito, Hironao Matsumoto, Masahiro Orino, Masataka Kano, Takafumi Yuba, Takuya Takayama, Tatsuya Nakagawa, Shoji Takayama
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Yuki Tanisaka, Mamoru Takenaka, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Takahiro Shin, Kei Sugimoto, Ken Kamata, Kosuke Minaga, Shunsuke Omoto, Tomohiro Yamazaki, Shomei Ryozawa
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Ru-Yi Wang, Zhen Fan
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Original Article

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

Abstract PDF Supplementary Material PubReader ePub

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
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Thomas J. Wang, Pichamol Jirapinyo, Raj Shah, Kimberly Schuster, David J. Papke, Christopher C. Thompson, Laura Doyon, David B. Lautz, Marvin Ryou
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Reviews

Optimal endoscopic drainage strategy for unresectable malignant hilar biliary obstruction: Itaru Naitoh, Tadahisa Inoue; Clin Endosc 2023;56(2):135-142. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2022.150

Abstract PDF PubReader ePub

Endoscopic biliary drainage strategies for managing unresectable malignant hilar biliary obstruction differ in terms of stent type, drainage area, and deployment method. However, the optimal endoscopic drainage strategy remains unclear. Uncovered self-expandable metal stents (SEMS) are the preferred type because of their higher functional success rate, longer time to recurrent biliary obstruction (RBO), and fewer cases of reintervention than plastic stents (PS). Other PS subtypes and covered SEMS, which feature a longer time to RBO than PS, can be removed during reintervention for RBO. Bilateral SEMS placement is associated with a longer time to RBO and a longer survival time than unilateral SEMS placement. Unilateral drainage is acceptable if a drainage volume of greater than 50% of the total liver volume can be achieved. In terms of deployment method, no differences were observed in clinical outcomes between side-by-side (SBS) and stent-in-stent deployment. Simultaneous SBS boasts a shorter procedure time and higher technical success rate than sequential SBS. This review of previous studies aimed to clarify the optimal endoscopic biliary drainage strategy for unresectable malignant hilar biliary obstruction.

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Complications of endoscopic resection in the upper gastrointestinal tract: Takeshi Uozumi, Seiichiro Abe, Mai Ego Makiguchi, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Yutaka Saito; Clin Endosc 2023;56(4):409-422. Published online June 21, 2023; DOI: https://doi.org/10.5946/ce.2023.024

Abstract PDF PubReader ePub

Endoscopic resection (ER) is widely utilized as a minimally invasive treatment for upper gastrointestinal tumors; however, complications could occur during and after the procedure. Post-ER mucosal defect leads to delayed perforation and bleeding; therefore, endoscopic closure methods (endoscopic hand-suturing, the endoloop and endoclip closure method, and over-the-scope clip method) and tissue shielding methods (polyglycolic acid sheets and fibrin glue) are developed to prevent these complications. During duodenal ER, complete closure of the mucosal defect significantly reduces delayed bleeding and should be performed. An extensive mucosal defect that comprises three-quarters of the circumference in the esophagus, gastric antrum, or cardia is a significant risk factor for post-ER stricture. Steroid therapy is considered the first-line option for the prevention of esophageal stricture, but its efficacy for gastric stricture remains unclear. Methods for the prevention and management of ER-related complications in the esophagus, stomach, and duodenum differ according to the organ; therefore, endoscopists should be familiar with ways of preventing and managing organ-specific complications.

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Gut and Liver.2024; 18(5): 764. 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

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Systematic Review and Meta-analysis

No difference in outcomes with 15 mm vs. 20 mm lumen-apposing metal stents for endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction: a meta-analysis: Shyam Vedantam, Rahil Shah, Sean Bhalla, Shria Kumar, Sunil Amin; Clin Endosc 2023;56(3):298-307. Published online May 22, 2023; DOI: https://doi.org/10.5946/ce.2022.299

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: We compared outcomes between use of 15 vs. 20 mm lumen-apposing metal stents (LAMSs) in endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for gastric outlet obstruction.
Methods
Databases were queried for studies that used LAMS for EUS-GE to relieve gastric outlet obstruction, and a proportional meta-analysis was performed.
Results
Thirteen studies were included. The 15 mm and 20 mm LAMS had pooled technical success rates of 93.2% (95% confidence interval [CI], 90.5%–95.2%) and 92.1% (95% CI, 68.4%–98.4%), clinical success rates of 88.6% (95% CI, 85.4%–91.1%) and 89.6% (95% CI, 79.0%–95.1%), adverse event rates of 11.4% (95% CI, 8.1%–15.9%) and 14.7% (95% CI, 4.4%–39.1%), and reintervention rates of 10.3% (95% CI, 6.7%–15.4%) and 3.5% (95% CI, 1.6%–7.6%), respectively. Subgroup analysis revealed no significant differences in technical success, clinical success, or adverse event rates. An increased need for reintervention was noted in the 15 mm stent group (pooled odds ratio, 3.59; 95% CI, 1.40–9.18; p=0.008).
Conclusions
No differences were observed in the technical, clinical, or adverse event rates between 15 and 20 mm LAMS use in EUS-GE. An increased need for reintervention is possible when using a 15 mm stent compared to when using a 20 mm stent.

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Endoscopic gastrointestinal bypass anastomosis using deformable self-assembled magnetic anastomosis rings (DSAMARs) in a pig model
Miaomiao Zhang, Jianqi Mao, Jia Ma, Shuqin Xu, Yi Lyu, Xiaopeng Yan
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Revealing Insights: A Comprehensive Overview of Gastric Outlet Obstruction Management, with Special Emphasis on EUS-Guided Gastroenterostomy
Dimitrios Ziogas, Thomas Vasilakis, Christina Kapizioni, Eleni Koukoulioti, Georgios Tziatzios, Paraskevas Gkolfakis, Antonio Facciorusso, Ioannis S. Papanikolaou
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III BRAZILIAN CONSENSUS STATEMENT ON ENDOSCOPIC ULTRASOUND
Ricardo Rangel de Paula PESSOA, Alexandre Moraes BESTETTI, Victor Lira de OLIVEIRA, Wladimir Campos de ARAUJO, Simone GUARALDI, Rodrigo Roda RODRIGUES SILVA, Francisco Antonio Araujo OLIVEIRA, Maria Sylvia Ierardi RIBEIRO, Fred Olavo Aragão Andrade CARNEI
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Mihai Rimbaș, Kar Wai Lau, Giulia Tripodi, Gianenrico Rizzatti, Alberto Larghi
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Reviews

A practical approach for small bowel bleeding: Sung Eun Kim, Hyun Jin Kim, Myeongseok Koh, Min Cheol Kim, Joon Sung Kim, Ji Hyung Nam, Young Kwan Cho, A Reum Choe, The Research Group for Capsule Endoscopy and Enteroscopy of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2023;56(3):283-289. Published online May 11, 2023; DOI: https://doi.org/10.5946/ce.2022.302

Abstract PDF PubReader ePub

Gastrointestinal (GI) bleeding is one of the most common conditions among patients visiting emergency departments in Korea. GI bleeding is divided into upper and lower GI bleeding, according to the bleeding site. GI bleeding is also divided into overt and occult GI bleeding based on bleeding characteristics. In addition, obscure GI bleeding refers to recurrent or persistent GI bleeding from a source that cannot be identified after esophagogastroduodenoscopy or colonoscopy. The small intestine is the largest part of the alimentary tract. It extends from the pylorus to the cecum. The small intestine is difficult to access owing to its long length. Moreover, it is not fixed to the abdominal cavity. When hemorrhage occurs in the small intestine, the source cannot be found in many cases because of the characteristics of the small intestine. In practice, small-intestinal bleeding accounts for most of the obscure GI bleeding. Therefore, in this review, we introduce and describe systemic approaches and examination methods, including video capsule endoscopy and balloon enteroscopy, that can be performed in patients with suspected small bowel bleeding in clinical practice.

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Manejo da hemorragia digestiva baixa na emergência: abordagem cirúrgica
Carla Azevedo Zaibak, Sara Monteiro Barbosa, Nathalia Machado De Lima, Jordane Lula Cruz, Angela Maria Pereira Costa, Maria Eduarda da Silva Borges, Mariana Vasconcellos De Oliveira, Danyelly Rodrigues Machado
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Case 19: A 65-Year-Old Man With Melena and Hematochezia
Hajin Lee, Younghee Choe, Jung Heo, Gwkang Hui Park, Su Young Lee, Young Wook Cho, Hyo Suk Kim
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Aortoduodenal fistula bleeding caused by an aortic stent graft
Seunghyun Hong, Gwang Ha Kim
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Diagnostic Yield and Outcomes of Small Bowel Capsule Endoscopy in Patients with Small Bowel Bleeding Receiving Antithrombotics
Nikos Viazis, Dimitris Christodoulou, Vasilis Papastergiou, Konstantinos Mousourakis, Dimitra Kozompoli, Giannis Stasinos, Konstantina Dimopoulou, Periklis Apostolopoulos, Fotios Fousekis, Christos Liatsos, Nikolaos Kyriakos, Theodoros Argyropoulos, Georg
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Jejunal Dieulafoy’s lesion resembling subepithelial mass resulting in profound gastrointestinal hemorrhage
Thanaboon Chaemsupaphan, Tanawat Geeratragool, Napat Angkathunyakul, Arissa Phothisirisakulwong, Monthira Maneerattanaporn
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Effect of Different Types of Antithrombotic Agents on Clinical Outcomes in Patients With Small Bowel Bleeding Who Underwent Balloon‐Assisted Enteroscopy: A KASID Multicenter Study
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong‐Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Journal of Gastroenterology and Hepatology.2024;[Epub] CrossRef

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Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction: Partha Pal, Sundeep Lakhtakia; Clin Endosc 2023;56(2):143-154. Published online February 17, 2023; DOI: https://doi.org/10.5946/ce.2022.198

Abstract PDF PubReader ePub

Advanced malignant hilar biliary obstruction (MHBO) with inaccessible papilla poses a significant challenge to endoscopists, as drainage of multiple liver segments may be warranted. Transpapillary drainage may not be feasible in patients with surgically altered anatomy, duodenal stenosis, prior duodenal self-expanding metal stent, and after initial transpapillary drainage, but require re-intervention for draining separated liver segments. Endoscopic ultrasound-guided biliary drainage (EUS-BD) and percutaneous trans-hepatic biliary drainage are the feasible options in this scenario. The major advantages of EUS-BD over percutaneous trans-hepatic biliary drainage include a reduction in patient discomfort and internal drainage away from the tumor, thus reducing the possibility of tissue or tumor ingrowth. With innovations, EUS-BD is helpful not only for bilateral communicating MHBO but also for non-communicating systems with bridging hilar stents or isolated right intra-hepatic duct drainage by hepatico-duodenostomy. EUS-guided multi-stent drainage with specially designed cannulas and guidewires has become a reality. A combined approach with endoscopic retrograde cholangiopancreatography for re-intervention, interventional radiology, and intraductal tumor ablative therapies has been reported. Stent migration and bile leakage can be minimized with proper stent selection and technique, and stent blocks can be managed with EUS-guided interventions in a majority of cases. Future comparative studies are required to establish the role of EUS-guided interventions in MHBO as rescue or primary therapy.

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Endoscopic Management of Malignant Biliary Obstruction
Woo Hyun Paik, Do Hyun Park
Gastrointestinal Endoscopy Clinics of North America.2024; 34(1): 127. CrossRef
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Hiroki Sato, Hidemasa Kawabata, Mikihiro Fujiya
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Comparison of stent patency between EUS-guided hepaticogastrostomy with bridging and endoscopic transpapillary biliary drainage for hilar obstruction
Kotaro Takeshita, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Akihiro Ohba, Yuki Kawasaki, Tetsuro Takasaki, Shin Yagi, Daiki Agarie, Hidenobu Hara, Yuya Hagiwara, Daiki Yamashige, Kohei Okamoto, Soma Fukuda, Masaru Kuwada, Mark Chatto, Shunsuke Kond
Endoscopy International Open.2024; 12(07): E875. CrossRef
Feasibility of Endoscopic Ultrasound-Guided Hepaticogastrostomy for Malignant Hilar Biliary Obstruction
Akihisa Ohno, Nao Fujimori, Toyoma Kaku, Yuzo Shimokawa, Tsukasa Miyagahara, Yuta Suehiro, Anthony Gerodias, Shotaro Kakehashi, Kazuhide Matsumoto, Masatoshi Murakami, Keijiro Ueda, Yoshihiro Ogawa
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Percutaneous transhepatic cholangioscopy combined with endoscopic retrograde cholangiopancreatography for bilateral biliary bridge drainage for malignant biliary obstruction
Gang Tang, Jingyi Zhang, Rui Chen, Jie Zhang, Rongxing Zhou
Endoscopy.2024; 56(S 01): E724. CrossRef
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Endoscopy.2024; 56(S 01): E943. CrossRef

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Submucosal endoscopy: the present and future: Zaheer Nabi, Duvvur Nageshwar Reddy; Clin Endosc 2023;56(1):23-37. Published online January 9, 2023; DOI: https://doi.org/10.5946/ce.2022.139

Abstract PDF PubReader ePub

Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in patients with achalasia cardia, and its use has grown exponentially since. Currently, submucosal endoscopy is widely used to resect subepithelial tumors and to manage refractory gastroparesis and Zenker’s diverticulum. While the utility of submucosal endoscopy has stood the test of time in esophageal motility disorders and subepithelial tumors, its durability remains to be established in conditions such as Zenker’s diverticulum and refractory gastroparesis. Other emerging indications for submucosal endoscopy include esophageal epiphrenic diverticulum, Hirschsprung’s disease, and esophageal strictures not amenable to conventional endoscopic treatment. The potential of submucosal endoscopy to provide easy and safe access to the mediastinum and peritoneal spaces may open doors to novel indications and rejuvenate the interest of endoscopists in natural orifice transluminal endoscopic surgery in the future. This review focuses on the current spectrum, recent updates, and future direction of submucosal endoscopy in the gastrointestinal tract.

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Emerging indications for third space endoscopy
Rahil H. Shah, Sunil Amin
Best Practice & Research Clinical Gastroenterology.2024; 71: 101911. CrossRef
Therapeutic endoscopy: Recent updates and future directions
Zaheer Nabi, D. Nageshwar Reddy
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Endoscopic full thickness resection: techniques, applications, outcomes
Zaheer Nabi, D. Nageshwar Reddy
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The role of cap-assisted endoscopy and its future implications
Sol Kim, Bo-In Lee
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Precision Endoscopy in Peroral Myotomies for Motility Disorders of the Upper Gastrointestinal Tract: Current Insights and Prospective Avenues—A Comprehensive Review
Francesco Vito Mandarino, Edoardo Vespa, Alberto Barchi, Ernesto Fasulo, Emanuele Sinagra, Francesco Azzolini, Silvio Danese
Life.2023; 13(11): 2143. CrossRef
An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study
Younghee Choe, Yu Kyung Cho, Gwang Ha Kim, Jun-Ho Choi, Eun Soo Kim, Ji Hyun Kim, Eun Kwang Choi, Tae Hyeon Kim, Seong-Hun Kim, Do Hoon Kim
Clinical Endoscopy.2023; 56(6): 744. CrossRef

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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

Abstract PDF PubReader ePub

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.

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Advanced Endoscopic Imaging for Detection of Dysplasia in Inflammatory Bowel Disease
Laura Alexandra Lucaciu, Edward John Despott
Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 141. 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
Practical utility of linked color imaging in colonoscopy: Updated literature review
Fumiaki Ishibashi, Sho Suzuki
Digestive Endoscopy.2024;[Epub] CrossRef
The Past, Present and Future of Imaging Enhanced Endoscopy in Colon Tumor
Kyueng-Whan Min, One-Zoong Kim
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Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
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Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef

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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

Abstract PDF Supplementary Material PubReader ePub

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
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Byung-chan Choi, Sook Joung Lee, Eunseok Choi, Sangjee Lee, Jungsoo Lee
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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
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Andriana Korai, Isabella Thomson, Sharon Carey, Margaret Allman-Farinelli
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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 Abstract Abstract PDF Supplementary Material PubReader ePub

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.

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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;[Epub] CrossRef
Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Hyung Ku Chon, Ki-Hyun Kim, Tae Jun Song, Dong-Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyun Chung, Jin Lee, Miyoung Choi
Gut and Liver.2024; 18(4): 564. CrossRef
Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Ki-Hyun Kim, Hyung Ku Chon, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyung Chung, Jin Lee, Miyoung Choi
The Korean Journal of Gastroenterology.2024; 84(3): 111. CrossRef
Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Ki-Hyun Kim, Hyung Ku Chon, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyung Chung, Jin Lee, Miyoung Choi
The Korean Journal of Pancreas and Biliary Tract.2024; 29(4): 144. 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

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Systematic Review and Meta-Analysis

Hybrid argon plasma coagulation in Barrett’s esophagus: a systematic review and meta-analysis: Sagar N. Shah, Nabil El Hage Chehade, Amirali Tavangar, Alyssa Choi, Marc Monachese, Kenneth J. Chang, Jason B. Samarasena; Clin Endosc 2023;56(1):38-49. Published online January 30, 2023; DOI: https://doi.org/10.5946/ce.2022.179

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Patients with Barrett’s esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC.
Methods
We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett’s esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM.
Results
Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872–0.939; I2=0%). Pooled stricture rate was 2.0% (95% CI, 0.005–0.042; I2=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007–0.055; I2=0%).
Conclusions
Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

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Hongrui Wang, Jiuzhou Zhao, Yu Zhou
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Maria Manuela Estevinho, Rolando Pinho, João Carlos Silva, João Correia, Pedro Mesquita, Teresa Freitas
Biomedicines.2023; 11(4): 1139. CrossRef
Hybrid-APC treatment for gastric vascular ectasia of atypical location after failed radiofrequency ablation
José Manuel Palma García, Raúl Honrubia López, Cristina Fernández de Castro, Carmen Comas Redondo
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Current Opinion in Gastroenterology.2023; 39(5): 370. CrossRef
Endoscopic Management of Dysplastic Barrett’s Oesophagus and Early Oesophageal Adenocarcinoma
Leonardo Henry Eusebi, Andrea Telese, Chiara Castellana, Rengin Melis Engin, Benjamin Norton, Apostolis Papaefthymiou, Rocco Maurizio Zagari, Rehan Haidry
Cancers.2023; 15(19): 4776. CrossRef
Critical Decision Making: Technical Aspects of Esophageal Ablation
Felice Schnoll-Sussman
Foregut: The Journal of the American Foregut Society.2023; 3(3): 314. 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

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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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Bariatric surgery for treatment of morbid obesity in adults
Ki Bum Park, Kyong-Hwa Jun
The Korean Journal of Internal Medicine.2025; 40(1): 24. CrossRef
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

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Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites: Tsukasa Yasuda, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Masanori Yamada, Toshitaka Fukui; Clin Endosc 2024;57(2):246-252. Published online September 7, 2023; DOI: https://doi.org/10.5946/ce.2023.075

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Background
/Aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) is useful for patients with biliary cannulation failure or inaccessible papillae. However, it can lead to serious complications such as bile peritonitis in patients with ascites; therefore, development of a safe method to perform EUS-HGS is important. Herein, we evaluated the safety of EUS-HGS with continuous ascitic fluid drainage in patients with ascites.
Methods
Patients with moderate or severe ascites who underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after the procedure at our institution between April 2015 and December 2022, were included in the study. We evaluated the technical and clinical success rates, EUS-HGS-related complications, and feasibility of re-intervention.
Results
Ten patients underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after completion of the procedure. Median duration of ascites drainage before and after EUS-HGS was 2 and 4 days, respectively. Technical success with EUS-HGS was achieved in all 10 patients (100%). Clinical success with EUS-HGS was achieved in 9 of the 10 patients (90 %). No endoscopic complications such as bile peritonitis were observed.
Conclusions
In patients with ascites, continuous ascites drainage, which is initiated before EUS-HGS and terminated after completion of the procedure, may prevent complications and allow safe performance of EUS-HGS.

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Management of iatrogenic perforations during endoscopic interventions in the hepato-pancreatico-biliary tract
Kirsten Boonstra, Rogier P. Voermans, Roy L.J. van Wanrooij
Best Practice & Research Clinical Gastroenterology.2024; 70: 101890. CrossRef
Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?—A Systematic Review and Meta-Analysis
Saqr Alsakarneh, Mahmoud Y. Madi, Dushyant Singh Dahiya, Fouad Jaber, Yassine Kilani, Mohamed Ahmed, Azizullah Beran, Mohamed Abdallah, Omar Al Ta’ani, Anika Mittal, Laith Numan, Hemant Goyal, Mohammad Bilal, Wissam Kiwan
Journal of Clinical Medicine.2024; 13(13): 3883. CrossRef
Feasibility and safety of EUS-guided biliary drainage in inexperienced centers: a multicenter study in southwest Japan
Takehiko Koga, Yusuke Ishida, Shunpei Hashigo, Yuzo Shimokawa, Hirofumi Harima, Kazuhisa Okamoto, Akihisa Ohno, Tsukasa Miyagahara, Toshihiro Fujita, Satoshi Fukuchi, Kosuke Takahashi, Hiroki Taguchi, Norimasa Araki, Yuichiro Ohtsuka, Toshiyuki Uekitani,
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Endoscopic ultrasound-guided antegrade stenting combined with closure of the puncture route using self-assembling peptide solution in a jaundiced patient with ascites
Hirotsugu Maruyama, Kojiro Tanoue, Tatsuya Kurokawa, Yoshinori Shimamoto, Yuki Ishikawa-Kakiya, Akira Higashimori, Yasuhiro Fujiwara
Endoscopy.2024; 56(S 01): E953. CrossRef
The Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios
Giuseppe Dell’Anna, Rubino Nunziata, Claudia Delogu, Petra Porta, Maria Vittoria Grassini, Jahnvi Dhar, Rukaia Barà, Sarah Bencardino, Jacopo Fanizza, Francesco Vito Mandarino, Ernesto Fasulo, Alberto Barchi, Francesco Azzolini, Guglielmo Albertini Petron
Journal of Clinical Medicine.2024; 13(24): 7731. CrossRef

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Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study: Younghee Choe, Yu Kyung Cho, Gwang Ha Kim, Jun-Ho Choi, Eun Soo Kim, Ji Hyun Kim, Eun Kwang Choi, Tae Hyeon Kim, Seong-Hun Kim, Do Hoon Kim, The Research Group for Endoscopic Ultrasound in Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2023;56(6):744-753. Published online August 25, 2023; DOI: https://doi.org/10.5946/ce.2023.005

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Background
/Aims: This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the upper gastrointestinal (UGI) tract.
Methods
The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals between January and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016.
Results
UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions, 1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequently found in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients (28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The proportions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastric SELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs.
Conclusions
The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed by EUS and clinical decisions without initial pathological confirmation.

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A Case of Esophageal MALT Lymphoma Mimicking a Subepithelial Tumor
Ha Eun Lee, Gwang Ha Kim, Min Ji Kim, Kyung Bin Kim, Dong Chan Joo, Hye Kyung Jeon, Moon Won Lee, Bong Eun Lee
The Korean Journal of Gastroenterology.2024; 83(4): 157. CrossRef
Small gastric subepithelial lesions: A sand in the eye
Tanyaporn Chantarojanasiri, Nikhil Sonthalia, Rashid N. Lui
Journal of Gastroenterology and Hepatology.2024; 39(7): 1207. CrossRef
Endoscopic treatment of a large Brunner’s gland hamartoma in the duodenum
Ha Eun Lee, Gwang Ha Kim, Kyungbin Kim
Endoscopy.2024; 56(S 01): E546. CrossRef
Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis
Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
Journal of Clinical Medicine.2024; 13(13): 3725. CrossRef
An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
The Ewha Medical Journal.2023;[Epub] CrossRef

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Stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions: Seigo Nakatani, Kosuke Okuwaki, Masafumi Watanabe, Hiroshi Imaizumi, Tomohisa Iwai, Takaaki Matsumoto, Rikiya Hasegawa, Hironori Masutani, Takahiro Kurosu, Akihiro Tamaki, Junro Ishizaki, Ayana Ishizaki, Mitsuhiro Kida, Chika Kusano; Clin Endosc 2024;57(1):89-95. Published online April 18, 2023; DOI: https://doi.org/10.5946/ce.2022.288

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Background
/Aims: In stereomicroscopic sample isolation processing, the cutoff value (≥4 mm) of stereomicroscopically visible white cores indicates high diagnostic sensitivity. We aimed to evaluate endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a simplified stereomicroscopic on-site evaluation of upper gastrointestinal subepithelial lesions (SELs).
Methods
In this multicenter prospective trial, we performed EUS-TA using a 22-gauge Franseen needle in 34 participants with SELs derived from the upper gastrointestinal muscularis propria, requiring pathological diagnosis. The presence of stereomicroscopically visible white core (SVWC) in each specimen was assessed using stereomicroscopic on-site evaluation. The primary outcome was EUS-TA’s diagnostic sensitivity with stereomicroscopic on-site evaluation based on the SVWC cutoff value (≥4 mm) for malignant upper gastrointestinal SELs.
Results
The total number of punctures was 68; 61 specimens (89.7%) contained stereomicroscopically visible white cores ≥4 mm in size. The final diagnoses were gastrointestinal stromal tumor, leiomyoma, and schwannoma in 76.5%, 14.7%, and 8.8% of the cases, respectively. The sensitivity of EUS-TA with stereomicroscopic on-site evaluation based on the SVWC cutoff value for malignant SELs was 100%. The per-lesion accuracy of histological diagnosis reached the highest level (100%) at the second puncture.
Conclusions
Stereomicroscopic on-site evaluation showed high diagnostic sensitivity and could be a new method for diagnosing upper gastrointestinal SELs using EUS-TA.

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What method can we choose if rapid on-site evaluation is not available for the endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions?
Yu Kyung Cho
Clinical Endoscopy.2024; 57(1): 53. CrossRef
Endoscopic Ultrasound-Guided Tissue Acquisition Using Fork-Tip Needle for Subepithelial Lesions: A Single-Center Validation Study
Masafumi Watanabe, Kosuke Okuwaki, Tomohisa Iwai, Mitsuhiro Kida, Hiroshi Imaizumi, Kai Adachi, Akihiro Tamaki, Junro Ishizaki, Taro Hanaoka, Chika Kusano
Digestive Diseases and Sciences.2024; 69(7): 2567. CrossRef
Impact of macroscopic on-site evaluation (MOSE) on accuracy of endoscopic ultrasound-guided fine-needle aspiration/biopsy of solid lesions
Hussein Okasha, Ahmed Ebrahim, Ihab Samih, Mohammed Sayed
International Journal of Gastrointestinal Intervention.2024; 13(3): 98. CrossRef
Role of macroscopic on-site evaluation of endoscopic ultrasound-guided fine-needle aspiration/biopsy: Results of a multicentric prospective study
Hussein H Okasha, Hiwa A Hussein, Khaled M Ragab, Omar Abdallah, Fedoua Rouibaa, Borahma Mohamed, Fahd Ghalim, Mahmoud Farouk, Mohamed Lasheen, Mohamed A Elbasiony, Ahmed E Alzamzamy, Ahmed El Deeb, Hassan Atalla, Mahmoud El-Ansary, Sahar Mohamed, Moaz El
World Journal of Gastrointestinal Endoscopy.2024; 16(11): 595. CrossRef
An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
The Ewha Medical Journal.2023;[Epub] CrossRef

2,582 View
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Reviews

Potassium-competitive acid blocker-associated gastric mucosal lesions: Kimitoshi Kubo, Noriko Kimura, Mototsugu Kato; Clin Endosc 2024;57(4):417-423. Published online February 29, 2024; DOI: https://doi.org/10.5946/ce.2023.279

Abstract PDF PubReader ePub

Since the introduction of vonoprazan, a potassium-competitive acid blocker (P-CAB), it has been demonstrated to reversibly inhibit gastric acid secretion by engaging in potassium-competitive ionic binding to H+/K+-ATPase. In contrast, proton pump inhibitors (PPIs) achieve H+/K+-ATPase inhibition through covalent binding to cysteine residues of the proton pump. Reported cases have indicated an emerging trend of P-CAB-related gastropathies, similar to those associated with PPIs, as well as unique gastropathies specific to P-CAB use, such as the identification of web-like mucus. Pathologically, parietal cell profusions, which show a positively correlated with hypergastrinemia, have a higher incidence in P-CAB users compared to PPI users. Thus, this review aims to summarize the endoscopic and pathological findings reported to date concerning P-CAB-related gastric mucosal lesions. Additionally, it seeks to discuss the differences between the PPIs and P-CABs in terms of the formation and frequency of associated gastropathies. This review highlights the evident differences in the mechanism of action and potency of acid inhibition between P-CABs and PPIs, notably contributing to differences in the formation and frequency of associated gastropathies. It emphasizes the necessity to distinguish between P-CAB-related and PPI-related gastropathies in the clinical setting.

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Profound gastric mucosal changes and severe rebound acid hypersecretion after long‐term Vonoprazan use: A case report
Hiroko Suda, Sachi Eto, Koichi Sakurai
DEN Open.2025;[Epub] CrossRef
Whitish gastric mucosa on upper gastrointestinal endoscopy
Eun Jeong Gong, Chang Seok Bang
Clinical Endoscopy.2024; 57(2): 277. CrossRef
Vonoprazan-Associated Mucosal Redness: A Report of Two Cases
Masaya Iwamuro, Yoshiyasu Kono, Takehiro Tanaka, Seiji Kawano, Nobumasa Ikeda
Cureus.2024;[Epub] CrossRef
Prevalence and factors associated with web‑like mucus in the stomach after vonoprazan use
Satoshi Shinozaki, Hirotsugu Sakamoto, Hiroyuki Osawa, Tomonori Yano, Hironori Yamamoto
Biomedical Reports.2024;[Epub] CrossRef

5,848 View
516 Download
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Application of artificial intelligence for diagnosis of early gastric cancer based on magnifying endoscopy with narrow-band imaging: Yusuke Horiuchi, Toshiaki Hirasawa, Junko Fujisaki; Clin Endosc 2024;57(1):11-17. Published online January 5, 2024; DOI: https://doi.org/10.5946/ce.2023.173

Abstract PDF PubReader ePub

Although magnifying endoscopy with narrow-band imaging is the standard diagnostic test for gastric cancer, diagnosing gastric cancer using this technology requires considerable skill. Artificial intelligence has superior image recognition, and its usefulness in endoscopic image diagnosis has been reported in many cases. The diagnostic performance (accuracy, sensitivity, and specificity) of artificial intelligence using magnifying endoscopy with narrow band still images and videos for gastric cancer was higher than that of expert endoscopists, suggesting the usefulness of artificial intelligence in diagnosing gastric cancer. Histological diagnosis of gastric cancer using artificial intelligence is also promising. However, previous studies on the use of artificial intelligence to diagnose gastric cancer were small-scale; thus, large-scale studies are necessary to examine whether a high diagnostic performance can be achieved. In addition, the diagnosis of gastric cancer using artificial intelligence has not yet become widespread in clinical practice, and further research is necessary. Therefore, in the future, artificial intelligence must be further developed as an instrument, and its diagnostic performance is expected to improve with the accumulation of numerous cases nationwide.

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Combination of artificial intelligence endoscopic diagnosis and Kimura‐Takemoto classification determined by endoscopic experts may effectively evaluate the stratification of gastric atrophy in post‐eradication status
Kumiko Kirita, Seiji Futagami, Ken Nakamura, Shuhei Agawa, Nobue Ueki, Kazutoshi Higuchi, Mayu Habiro, Rie Kawawa, Yusuke Kato, Tomohiro Tada, Katsuhiko Iwakiri
DEN Open.2025;[Epub] CrossRef
Identification and validation of serum MUC17 as a non‐invasive early warning biomarker for screening of gastric intraepithelial neoplasia
Bingxue Yang, Xiaoli Xie, Xiaoxu Jin, Xiuhong Huang, Yujian He, Kaige Yin, Chenguang Ji, Li Liu, Zhijie Feng
Translational Oncology.2025; 51: 102207. CrossRef
Pitfalls in Endoscopic Submucosal Dissection for Early Gastric Cancer with Papillary Adenocarcinoma
Gwang Ha Kim
Gut and Liver.2024; 18(3): 368. CrossRef
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Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
Biomimetics.2024; 9(12): 783. CrossRef

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Role of endoscopy in gastroesophageal reflux disease: Daniel Martin Simadibrata, Elvira Lesmana, Ronnie Fass; Clin Endosc 2023;56(6):681-692. Published online October 12, 2023; DOI: https://doi.org/10.5946/ce.2023.182

Abstract PDF PubReader ePub

In general, gastroesophageal reflux disease (GERD) is diagnosed clinically based on typical symptoms and/or response to proton pump inhibitor treatment. Upper gastrointestinal endoscopy is reserved for patients presenting with alarm symptoms, such as dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, or anorexia; those who meet the criteria for Barrett’s esophagus screening; those who report a lack or partial response to proton pump inhibitor treatment; and those with prior endoscopic or surgical anti-reflux interventions. Newer endoscopic techniques are primarily used to increase diagnostic yield and provide an alternative to medical or surgical treatment for GERD. The available endoscopic modalities for the diagnosis of GERD include conventional endoscopy with white-light imaging, high-resolution and high-magnification endoscopy, chromoendoscopy, image-enhanced endoscopy (narrow-band imaging, I- SCAN, flexible spectral imaging color enhancement, blue laser imaging, and linked color imaging), and confocal laser endomicroscopy. Endoscopic techniques for treating GERD include esophageal radiofrequency energy delivery/Stretta procedure, transoral incisionless fundoplication, and endoscopic full-thickness plication. Other novel techniques include anti-reflux mucosectomy, peroral endoscopic cardiac constriction, endoscopic submucosal dissection, and endoscopic band ligation. Currently, many of the new endoscopic techniques are not widely available, and their use is limited to centers of excellence.

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Exploring esophagogastric junction morphology and contractile integral: implications for refractory gastroesophageal reflux disease pathophysiology
Sihui Lin, Zhilong Chen, Wei Jiang, Yucheng Zhu
Scandinavian Journal of Gastroenterology.2025; : 1. CrossRef
Long-term efficacy of endoscopic radiofrequency Stretta therapy for patients with refractory gastroesophageal reflux disease
Sung Eun Kim
Clinical Endoscopy.2024; 57(1): 48. CrossRef
Correlation of Endoscopic and Histopathological Diagnoses in Upper Gastrointestinal Tract Lesions: A Cross-Sectional Study
Sudhasmita Rauta, Pratima Baisakh, Aswini K Sahoo, Dhiren K Panda, Manas R Baisakh, Sushree s Dash
Cureus.2024;[Epub] CrossRef
The role of ghrelin and leptin in the formation of morphological changes esophagus of patients with gastro-esophageal reflux disease against type 2 diabetes
Olha Bondar-Keleberda
EUREKA: Health Sciences.2023; (4): 24. CrossRef

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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

Abstract PDF PubReader ePub

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.

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The role of cap-assisted endoscopy and its future implications
Sol Kim, Bo-In Lee
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Tae Hee Lee
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Kyoungwon Jung, Rebecca M. Haug, Andrew Y. Wang
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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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Original Article

Utility of narrow-band imaging with or without dual focus magnification in neoplastic prediction of small colorectal polyps: a Vietnamese experience: Tien Manh Huynh, Quang Dinh Le, Nhan Quang Le, Huy Minh Le, Duc Trong Quach; Clin Endosc 2023;56(4):479-489. Published online May 24, 2023; DOI: https://doi.org/10.5946/ce.2022.212

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Background
/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm).
Methods
This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology.
Results
There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was signiﬁcantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001).
Conclusions
NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

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Effectiveness of Dual-Focus Magnification on Confidence Levels in Optical Diagnosis of Small Colorectal Polyps
Tien M Huynh, Quang D Le, Nhan Q Le , Huy M Le , Duc T Quach
Cureus.2024;[Epub] CrossRef
Implementing narrow banding imaging with dual focus magnification for histological prediction of small rectosigmoid polyps in Vietnamese setting
Tien Manh Huynh, Quang Dinh Le, Nhan Quang Le, Huy Minh Le, Duc Trong Quach
JGH Open.2024;[Epub] CrossRef
The role of narrow-band imaging with or without dual focus in the detection of polyps smaller than 10 mm, especially diminutive polyps
Jin Hwa Park
Clinical Endoscopy.2023; 56(4): 455. CrossRef
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

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