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Quality indicators in colonoscopy: the chasm between ideal and reality
Su Bee Park, Jae Myung Cha
Clin Endosc 2022;55(3):332-338.   Published online April 4, 2022
DOI: https://doi.org/10.5946/ce.2022.037
AbstractAbstract PDFPubReaderePub
Continuous measurement of quality indicators (QIs) should be a routine part of colonoscopy, as a wide variation still exists in the performance and quality levels of colonoscopy in Korea. Among the many QIs of colonoscopy, the adenoma detection rate, average withdrawal time, bowel preparation adequacy, and cecal intubation rate should be monitored in daily clinical practice to improve the quality of the procedure. The adenoma detection rate is the best indicator of the quality of colonoscopy; however, it has many limitations for universal use in daily practice. With the development of natural language processing, the adenoma detection rate is expected to become more effective and useful. It is important that colonoscopists do not strictly and mechanically maintain an average withdrawal time of 6 minutes but instead perform careful colonoscopy to maximally expose the colonic mucosa with a withdrawal time of at least 6 minutes. To achieve adequate bowel preparation, documentation of bowel preparation with the Boston Bowel Preparation Scale (BBPS) should be a routine part of colonoscopy. When colonoscopists routinely followed the bowel preparation protocols, ≥85% of outpatient screening colonoscopies had a BBPS score of ≥6. In addition, the cecal intubation rate should be ≥95% of all screening colonoscopies. The first step in improving colonoscopy quality in Korea is to apply these key performance measurements in clinical practice.

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Citations to this article as recorded by  
  • What are the priority quality indicators for colonoscopy in real‐world clinical practice?
    Kasenee Tiankanon, Satimai Aniwan
    Digestive Endoscopy.2024; 36(1): 30.     CrossRef
  • Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
    Joo Hye Song, Eun Ran Kim
    The Korean Journal of Internal Medicine.2024; 39(4): 547.     CrossRef
  • Novel regimen for colonoscopy bowel preparation with oral lactulose: a prospective comparative study
    Josué Aliaga Ramos, Danilo Carvalho, Vitor N. Arantes
    Clinical Endoscopy.2024; 57(6): 775.     CrossRef
  • Bowel Preparation Agents: Balancing Efficacy for Colon Cleansing and Safety for Stomach Safety
    Gwang Ha Kim
    The Korean Journal of Gastroenterology.2024; 84(6): 293.     CrossRef
  • A Systematic Review of Exercise Therapy for Bowel Preparation
    Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
    Gastroenterology Nursing.2023; 46(5): 393.     CrossRef
  • Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
    Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
    Clinical Endoscopy.2023; 56(5): 553.     CrossRef
  • AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     CrossRef
  • 4,151 View
  • 266 Download
  • 8 Web of Science
  • 7 Crossref
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Quality indicators in esophagogastroduodenoscopy
Sang Yoon Kim, Jae Myung Park
Clin Endosc 2022;55(3):319-331.   Published online May 16, 2022
DOI: https://doi.org/10.5946/ce.2022.094
AbstractAbstract PDFPubReaderePub
Esophagogastroduodenoscopy (EGD) has been used to diagnose a wide variety of upper gastrointestinal diseases. In particular, EGD is used to screen high-risk subjects of gastric cancer. Quality control of EGD is important because the diagnostic rate is examiner-dependent. However, there is still no representative quality indicator that can be uniformly applied in EGD. There has been growing awareness of the importance of quality control in improving EGD performance. Therefore, we aimed to review the available and emerging quality indicators for diagnostic EGD.

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  • Endoscopic Submucosal Dissection of Gastric High-Grade Foveolar Dysplasia With Normal Background Mucosa
    Gonzalo Latorre, Alberto Espino, Christine E. Orr, Robert Bechara
    Gastro Hep Advances.2025; 4(2): 100565.     CrossRef
  • Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence
    Lihui Zhang, Liwen Yao, Zihua Lu, Honggang Yu
    Digestive Endoscopy.2024; 36(1): 5.     CrossRef
  • Simethicone and N-acetyl cysteine in improving mucosal visibility: Towards a “clearer view” during endoscopy
    Akash Roy, Mahesh K. Goenka
    Indian Journal of Gastroenterology.2024; 43(5): 863.     CrossRef
  • Relationship between observation time and detection rate of focal lesions in Esophagogastroduodenoscopy: a single-center, retrospective study
    Li Dong, Xiaodan Zhang, Yuting Xuan, Peiling Xiong, Yumei Ning, Bing Zhang, Fan Wang, Qiu Zhao, Jun Fang
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • The Effect of Esophagogastroduodenoscopy on Intraocular Pressure
    Maddalena De Bernardo, Antonella Santonicola, Marco Gioia, Livio Vitiello, Ferdinando Cione, Sergio Pagliarulo, Paola Iovino, Nicola Rosa
    Journal of Clinical Medicine.2024; 13(5): 1224.     CrossRef
  • The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis
    Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
    Gut and Liver.2024; 18(3): 444.     CrossRef
  • Optimal number of images and 2-year interval affect cancer detection in screening esophagogastroduodenoscopy: An observational study
    Kazuhiro Ksahiwagi, Toshifumi Yoshida, Kayoko Fukuhara, Rieko Bessho, Hitoshi Ichikawa, Nagamu Inoue, Hiromasa Takaishi, Yasushi Iwao, Takanori Kanai
    Medicine.2024; 103(26): e38774.     CrossRef
  • Sistema de auditoría automática para la exploración endoscópica del estómago con Inteligencia Artificial – Gastro UNAL: Gastroendoscopy UNit for Automatic Labeling
    Martín Alonso Gómez Zuleta, Diego Fernando Bravo Higuera, Josué Andre Ruano Balseca, María Jaramillo González, Fabio Augusto González Osorio, Edgar Eduardo Romero Castro
    Revista colombiana de Gastroenterología.2024; 39(2): 133.     CrossRef
  • Optimal Surveillance of Metachronous Gastric Lesion after Endoscopic Resection of Early Gastric Cancer
    Dong Chan Joo, Gwang Ha Kim
    Gut and Liver.2024; 18(5): 781.     CrossRef
  • Chronic Atrophic Gastritis and Intestinal Metaplasia: A Latin American Perspective
    Arnoldo Riquelme, Felipe Silva, Diego Reyes, Gonzalo Latorre
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2024; 24(3): 218.     CrossRef
  • Esophagogastroduodenoscopy Quality Improvement and the Role of Topical Antiperistaltic Agents: A Systematic Review and Meta-Analysis
    Eoghan Burke, Patricia Harkins, Mayilone Arumugasamy
    Cureus.2024;[Epub]     CrossRef
  • Endoscopic Imaging for the Diagnosis of Neoplastic and Pre-Neoplastic Conditions of the Stomach
    Bruno Costa Martins, Renata Nobre Moura, Angelo So Taa Kum, Carolina Ogawa Matsubayashi, Sergio Barbosa Marques, Adriana Vaz Safatle-Ribeiro
    Cancers.2023; 15(9): 2445.     CrossRef
  • The effect of short-term training about depth predicting score on the diagnostic ability of invasion depth for differentiated early gastric Cancer among non-expert endoscopists
    Hui Li, Hui Hu, Ping Geng, Panhui Guo, Yuanrong Zhu, Lulu Zeng, Jun Liu, Xiangpeng Hu
    BMC Medical Education.2023;[Epub]     CrossRef
  • Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists
    Daisuke Murakami, Masayuki Yamato, Yuji Amano, Takayoshi Nishino, Makoto Arai
    BMJ Open Gastroenterology.2023; 10(1): e001143.     CrossRef
  • Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
    Jae Myung Park
    Clinical Endoscopy.2023; 56(4): 453.     CrossRef
  • Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
    Caesar Ferrari, Micheal Tadros
    Gastroenterology Insights.2023; 15(1): 1.     CrossRef
  • Antispasmodic Agent Administration Improves Gastric Neoplasm Detection Rates during Esophagogastroduodenoscopy
    Sang Yoon Kim, Jae Myung Park
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(3): 246.     CrossRef
  • Clinical features of gastric adenoma detected within 3 years after negative screening endoscopy in Korea
    Hyun Young Kim
    Gastroenterology Report.2022;[Epub]     CrossRef
  • 12,457 View
  • 657 Download
  • 14 Web of Science
  • 18 Crossref
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Single Use (Disposable) Duodenoscope: Recent Development and Future
Kihyun Ryu, Sunguk Jang
Clin Endosc 2022;55(2):191-196.   Published online June 22, 2021
DOI: https://doi.org/10.5946/ce.2021.075
AbstractAbstract PDFPubReaderePub
Unlike simple forward-viewing endoscopes such as gastroscope or colonoscope, duodenoscope houses much more complex design to fulfil its function. This design differences leave duodenoscopes more prone to contamination from inadequate disinfection process and potential dissemination of pathogens. Recent reports on dissemination of infection through the duodenoscope mandated an overhaul of duodenoscope utilization including development of a disposable duodenoscope. This article reviews the current state of disposable duodenoscope development, including reported early efficacy as well as its future direction and utilization.

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  • Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use
    Rubén Martín-Cabezuelo, Guillermo Vilariño-Feltrer, Alberto J. Campillo-Fernández, Vicente Lorenzo-Zúñiga, Vicente Pons, Pedro López-Muñoz, Isabel Tort-Ausina
    ACS Environmental Au.2024; 4(1): 42.     CrossRef
  • The Evolution of Spinal Endoscopy: Design and Image Analysis of a Single-Use Digital Endoscope Versus Traditional Optic Endoscope
    Shih-Hao Cheng, Yen-Tsung Lin, Hsin-Tzu Lu, Yu-Chuan Tsuei, William Chu, Woei-Chyn Chu
    Bioengineering.2024; 11(1): 99.     CrossRef
  • Cost-effectiveness Analysis of Single-Use Duodenoscope Applied to Endoscopic Retrograde Cholangiopancreatography
    David Nicolás-Pérez, Antonio Zebenzuy Gimeno-García, Rafael Joaquín Romero-García, Iván Castilla-Rodríguez, Manuel Hernandez-Guerra
    Pancreas.2024; 53(4): e357.     CrossRef
  • ERCP with single-use disposable duodenoscopes in four different set-ups
    Ronja Lagström, Svend Knuhtsen, Trine Stigaard, Mustafa Bulut
    BMJ Case Reports.2023; 16(2): e251514.     CrossRef
  • Good Practices on Endoscope Reprocessing in Italy: Findings of a Nationwide Survey
    Michela Scarpaci, Tommaso Cosci, Benedetta Tuvo, Alessandra Guarini, Teresa Iannone, Angelo Zullo, Beatrice Casini
    International Journal of Environmental Research and Public Health.2022; 19(19): 12082.     CrossRef
  • 4,733 View
  • 515 Download
  • 6 Web of Science
  • 5 Crossref
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Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art
Alessia Chini, Michele Manigrasso, Grazia Cantore, Rosa Maione, Marco Milone, Francesco Maione, Giovanni Domenico De Palma
Clin Endosc 2022;55(2):183-190.   Published online February 24, 2022
DOI: https://doi.org/10.5946/ce.2021.254
AbstractAbstract PDFPubReaderePub
Colorectal cancer is an important cause of morbidity and mortality worldwide. Optical colonoscopy (OC) is widely accepted as the reference standard for the screening of colorectal polyps and cancers, and computed tomography colonography (CTC) is a valid alternative to OC. The purpose of this review was to assess the diagnostic accuracy of OC and CTC for colorectal lesions. A literature search was performed in PubMed, Embase, and Cochrane Library, and 18 articles were included. CTC has emerged in recent years as a potential screening examination with high accuracy for the detection of colorectal lesions. However, the clinical application of CTC as a screening technique is limited because it is highly dependent on the size of the lesions and has poor performance in detecting individual lesions <5 mm or flat lesions, which, although rarely, can have a malignant potential.

Citations

Citations to this article as recorded by  
  • Multi-view orientational attention network combining point-based affinity for polyp segmentation
    Yan Liu, Yan Yang, Yongquan Jiang, Zhuyang Xie
    Expert Systems with Applications.2024; 249: 123663.     CrossRef
  • The Influence of Mechanical Bowel Preparation on Volatile Organic Compounds for the Detection of Gastrointestinal Disease—A Systematic Review
    Ashwin Krishnamoorthy, Subashini Chandrapalan, Sofie Bosch, Ayman Bannaga, Nanne K.H. De Boer, Tim G.J. De Meij, Marcis Leja, George B. Hanna, Nicoletta De Vietro, Donato Altomare, Ramesh P. Arasaradnam
    Sensors.2023; 23(3): 1377.     CrossRef
  • The Detection of Colorectal Cancer through Machine Learning-Based Breath Sensor Analysis
    Inese Poļaka, Linda Mežmale, Linda Anarkulova, Elīna Kononova, Ilona Vilkoite, Viktors Veliks, Anna Marija Ļeščinska, Ilmārs Stonāns, Andrejs Pčolkins, Ivars Tolmanis, Gidi Shani, Hossam Haick, Jan Mitrovics, Johannes Glöckler, Boris Mizaikoff, Mārcis Lej
    Diagnostics.2023; 13(21): 3355.     CrossRef
  • 4,629 View
  • 257 Download
  • 4 Web of Science
  • 3 Crossref
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2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation
Hong Jun Park, Byung-Wook Kim, Jun Kyu Lee, Yehyun Park, Jin Myung Park, Jun Yong Bae, Seung Young Seo, Jae Min Lee, Jee Hyun Lee, Hyung Ku Chon, Jun-Won Chung, Hyun Ho Choi, Myung Ha Kim, Dong Ah Park, Jae Hung Jung, Joo Young Cho, Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2022;55(2):167-182.   Published online February 22, 2022
DOI: https://doi.org/10.5946/ce.2021.282
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

Citations

Citations to this article as recorded by  
  • Using Clinical-based Discharge Criteria to Discharge Patients After Endoscopy Procedures Under Drug-induced Intravenous Sedation in the Outpatient Care Unit: An Observational Study
    Liangyu Fang, Lina Chen, Bingbing Wu, Yinchuan Xu, Laijuan Chen
    Journal of PeriAnesthesia Nursing.2024; 39(5): 859.     CrossRef
  • Development and Effectiveness Evaluation of 360-Degree Virtual Reality-Based Educational Intervention for Adult Patients Undergoing Colonoscopy
    Minju Gwag, Jaeyong Yoo
    Healthcare.2024; 12(14): 1448.     CrossRef
  • Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
    Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee
    Clinical Endoscopy.2024; 57(4): 476.     CrossRef
  • Comparison of Synergistic Sedation with Midazolam and Propofol Versus Midazolam and Pethidine in Colonoscopies: A Prospective, Randomized Controlled Study
    Jae Woong Lim, Min Jae Kim, Gang Han Lee, Dae Sol Kim, Sang Hyuk Jung, Yu Yeon Kim, Jin Won Kim, Yohan Lee, Hyun Soo Kim, Seon Young Park, Dong Hyun Kim
    Chonnam Medical Journal.2024; 60(3): 192.     CrossRef
  • Nasal mask versus conventional oxygen supply for endoscopy under intravenous sedation: protocol for a systematic review and meta-analysis
    Wentao Ji, Yu Deng, Min Zheng, Xiaoting Zhang, Jun Lu, Jinhai Liu, Bo Li, Lulong Bo
    BMJ Open.2024; 14(12): e092868.     CrossRef
  • Experience of organizing outpatient anesthetic care at Endoscopy centre of Multidisciplinary city clinic
    O. V. Makarov, S. A. Osipov, E. P. Rodionov, A. A. Malyshev, I. Yu. Korzheva, L. M. Avramenko, Z. Z. Loseva, I. V. Balykov, L. A. Baichorova, E. I. Alikhanova, A. V. Vlasenko, E. A. Evdokimov, V. I. Makovey, V. V. Erofeev
    Medical alphabet.2023; (6): 50.     CrossRef
  • Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study
    Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef
    Clinical Endoscopy.2023; 56(5): 658.     CrossRef
  • Current status of the gastric cancer screening program in Korea
    Young-Il Kim, Il Ju Choi
    Journal of the Korean Medical Association.2022; 65(5): 250.     CrossRef
  • In pursuit of the right plan for airway management in gastrointestinal endoscopic procedures…the battle half won?
    Upender Gowd, Sukhminder Jit Singh Bajwa, Madhuri Kurdi, Gaurav Sindwani
    Indian Journal of Anaesthesia.2022; 66(10): 683.     CrossRef
  • Drugs used for sedation in gastrointestinal endoscopy
    Jun Kyu Lee
    Journal of the Korean Medical Association.2022; 65(11): 735.     CrossRef
  • 6,852 View
  • 610 Download
  • 8 Web of Science
  • 10 Crossref
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Current Treatment Strategy for Superficial Nonampullary Duodenal Epithelial Tumors
Tetsuya Suwa, Kohei Takizawa, Noboru Kawata, Masao Yoshida, Yohei Yabuuchi, Yoichi Yamamoto, Hiroyuki Ono
Clin Endosc 2022;55(1):15-21.   Published online September 29, 2021
DOI: https://doi.org/10.5946/ce.2021.141
AbstractAbstract PDFPubReaderePub
Endoscopic submucosal dissection (ESD) is the standard treatment method for esophageal, gastric, and colorectal cancers. However, it has not been standardized for duodenal lesions because of its high complication rates. Recently, minimally invasive and simple methods such as cold snare polypectomy and underwater endoscopic mucosal resection have been utilized more for superficial nonampullary duodenal epithelial tumors (SNADETs). Although the rate of complications associated with duodenal ESD has been gradually decreasing because of technical advancements, performing ESD for all SNADETs is unnecessary. As such, the appropriate treatment plan for SNADETs should be chosen according to the lesion type, patient condition, and endoscopist’s skill.

Citations

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  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • 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
  • A method of “Noninjecting Resection using Bipolar Soft coagulation mode; NIRBS” for superficial non-ampullary duodenal epithelial tumor: a pilot study
    Mitsuo Tokuhara, Yasushi Sano, Yoshifumi Watanabe, Hidetoshi Nakata, Hiroko Nakahira, Shingo Furukawa, Takuya Ohtsu, Naohiro Nakamura, Takashi Ito, Ikuko Torii, Takeshi Yamashina, Masaaki Shimatani, Makoto Naganuma
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • Underwater Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Superficial Non-ampullary Duodenal Epithelial Tumors ≤20 mm
    Zhikun Yin, Ji Li, Weilin Yang, Weifeng Huang, Dong Xu, Xiaoyi Lei, Jinyan Zhang
    Journal of Clinical Gastroenterology.2023; 57(9): 928.     CrossRef
  • Long-term outcomes of endoscopic resection for duodenal neuroendocrine tumors
    Kiyoun Yi, Gwang Ha Kim, Su Jin Kim, Cheol Woong Choi, Moon Won Lee, Bong Eun Lee, Geun Am Song
    Scientific Reports.2023;[Epub]     CrossRef
  • Endoscopic management of NADTs
    Enrique Pérez-Cuadrado-Robles, Pierre H. Deprez
    Endoscopy International Open.2022; 10(06): E733.     CrossRef
  • Duodenaladenome und -karzinome: chirurgische Therapiekonzepte
    Michael Ghadimi, Jochen Gaedcke
    Allgemein- und Viszeralchirurgie up2date.2022; 16(03): 257.     CrossRef
  • Issues and Prospects of Current Endoscopic Treatment Strategy for Superficial Non-Ampullary Duodenal Epithelial Tumors
    Tetsuya Suwa, Masao Yoshida, Hiroyuki Ono
    Current Oncology.2022; 29(10): 6816.     CrossRef
  • Duodenaladenome und -karzinome: chirurgische Therapiekonzepte
    Michael Ghadimi, Jochen Gaedcke
    Onkologie up2date.2022; 4(04): 325.     CrossRef
  • 5,912 View
  • 376 Download
  • 7 Web of Science
  • 10 Crossref
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Radiation Proctitis and Management Strategies
Dushyant Singh Dahiya, Asim Kichloo, Faiz Tuma, Michael Albosta, Farah Wani
Clin Endosc 2022;55(1):22-32.   Published online November 18, 2021
DOI: https://doi.org/10.5946/ce.2020.288
AbstractAbstract PDFPubReaderePub
Radiotherapy (RT) is a treatment modality that uses high-energy rays or radioactive agents to generate ionizing radiation against rapidly dividing cells. The main objective of using radiation in cancer therapy is to impair or halt the division of the tumor cells. Over the past few decades, advancements in technology, the introduction of newer methods of RT, and a better understanding of the pathophysiology of cancers have enabled physicians to deliver doses of radiation that match the exact dimensions of the tumor for greater efficacy, with minimal exposure of the surrounding tissues. However, RT has numerous complications, the most common being radiation proctitis (RP). It is characterized by damage to the rectal epithelium by secondary ionizing radiation. Based on the onset of signs and symptoms, post-radiotherapy RP can be classified as acute or chronic, each with varying levels of severity and complication rates. The treatment options available for RP are limited, with most of the data on treatment available from case reports or small studies. Here, we describe the types of RT used in modern-day medicine and radiation-mediated tissue injury. We have primarily focused on the classification, epidemiology, pathogenesis, clinical features, treatment strategies, complications, and prognosis of RP.

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  • Management of gastrointestinal bleed in the intensive care setting, an updated literature review
    Vignesh K Nagesh, Sai Priyanka Pulipaka, Ruchi Bhuju, Emelyn Martinez, Shruthi Badam, Gomathy Aarthy Nageswaran, Hadrian Hoang-Vu Tran, Daniel Elias, Charlene Mansour, Jaber Musalli, Sanket Bhattarai, Lokeash Subramani Shobana, Tannishtha Sethi, Ritvik Se
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    Tahmineh Tahouri, Sahand Hedayati Omami, Maryam Hosseini, Ehsanollah Rahimi-Movaghar
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    Robert Klimkowski, Jakub Krzyzkowiak, Nastazja Dagny Pilonis, Krzysztof Bujko, Michal F. Kaminski
    Best Practice & Research Clinical Gastroenterology.2024; 68: 101896.     CrossRef
  • Radiation injuries of organs and tissues: mechanisms of occurrence, methods of prevention and treatment: A review
    Daiana A. Balaeva, Denis S. Romanov, Oxana P. Trofimova, Zarina Z. Gadzhibabaeva, Yury Yu. Gorchak, Garia A. Gariaev
    Journal of Modern Oncology.2024; 25(4): 504.     CrossRef
  • Interventions for Managing Late Gastrointestinal Symptoms Following Pelvic Radiotherapy: a Systematic Review and Meta-analysis
    H. Berntsson, A. Thien, D. Hind, L. Stewart, M. Mahzabin, W.S. Tung, M. Bradburn, M. Kurien
    Clinical Oncology.2024; 36(5): 318.     CrossRef
  • Intestinal microecological transplantation for a patient with chronic radiation enteritis: A case report
    Lin Wang, Yan Li, Yu-Jing Zhang, Li-Hua Peng
    World Journal of Gastroenterology.2024; 30(19): 2603.     CrossRef
  • Intrarectal formalin treatment for haemorrhagic radiation‐induced proctopathy: efficacy and safety
    Darina Kohoutova, Ana Wilson, Caroline Gee, Ramy Elhusseiny, Linda Wanders, David Cunningham
    Colorectal Disease.2024; 26(5): 932.     CrossRef
  • Emodin ameliorates acute radiation proctitis in mice by regulating AKT/MAPK/NF-κB/VEGF pathways
    Jinsheng Gao, Yousong Li, Jiaohua Chen, Wen Feng, Jianchen Bu, Zixuan Lu, Jiandong Wang
    International Immunopharmacology.2024; 132: 111945.     CrossRef
  • Protocolo diagnóstico de la rectitis (proctitis)
    C. Iniesta Cavero, L. Menchén-Viso
    Medicine - Programa de Formación Médica Continuada Acreditado.2024; 14(8): 468.     CrossRef
  • Feel the Burn: RFA for Chronic Radiation Proctitis
    Gabriele De Sena, Federico Maria Mongardini, Danilo Porpora, Maria Mauro, Davide Bentivoglio, Davide Centore, Luigi Brusciano, Claudio Gambardella, Augusto Lauro, Ludovico Docimo, Vincenzo Napolitano
    Digestive Diseases and Sciences.2024; 69(9): 3147.     CrossRef
  • Pelvic Radiation Therapy Increases Risk of Pouch Failure in Patients with Inflammatory Bowel Disease and Ileal Pouch
    Karthik Gnanapandithan, Laura G. Stuessel, Bo Shen, Fadi H. Mourad, Zhongwei Peng, Francis A. Farraye, Jana G. Hashash
    Digestive Diseases and Sciences.2024; 69(9): 3392.     CrossRef
  • Acute toxicity patterns and their management after moderate and ultra- hypofractionated radiotherapy for prostate cancer: A prospective cohort study
    F. Sinzabakira, L. Incrocci, K. de Vries, M.E.M.C. Christianen, M. Franckena, F.E. Froklage, H. Westerveld, W.D. Heemsbergen
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    Karin Steidl
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    Saboor E. Randhawa, Laura Tenner
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    António Moreira Monteiro, Diogo Alpuim Costa, Virgínia Mareco, Carla Espiney Amaro
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  • 10,139 View
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Anesthesia for Advanced Endoscopic Procedures
Basavana Goudra, Monica Saumoy
Clin Endosc 2022;55(1):1-7.   Published online January 3, 2022
DOI: https://doi.org/10.5946/ce.2021.236
AbstractAbstract PDFPubReaderePub
The gastrointestinal endoscopy paradigm is rapidly changing, and technological advancements are largely responsible. In tandem, anesthesia providers are adapting to the changing needs and demands. The challenges are unique. Complications arising from the procedures are both routine, such as aspiration and hypoxia, and procedure specific, such as bleeding, pneumothorax, pneumopericardium, and pneumoperitoneum. It is crucial for the anesthesia provider to have a good understanding of the techniques employed by the endoscopist. A higher index of suspicion is also essential to diagnose and appropriately manage many of the complications. In this review, an effort is made to discuss both procedural aspects and anesthesia challenges. We hope that both endoscopists and anesthesia providers will benefit from this review.

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    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
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    Le Xu, Yanhong Li, Hong Zheng, Rurong Wang
    Anesthesiology and Perioperative Science.2024;[Epub]     CrossRef
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    Ghazala Maryam, Rashk E-Hinna, Saman Sardar, Jahangir Khan, Javaria Isram, Fayyaz Hassan
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  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
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  • Case of Concomitant Endoscopic Treatment of Achalasia with Superficial Esophageal Cancer
    Myung-Hun Lee, Kyoungwon Jung, Jae Hyun Kim, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
    The Korean Journal of Gastroenterology.2023; 82(5): 248.     CrossRef
  • 5,664 View
  • 367 Download
  • 4 Web of Science
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When to Discharge a Patient After Endoscopy: A Narrative Review
Swapnil Sahebrao Walke, Shamshersingh Chauhan, Vikas Pandey, Rahul Jadhav, Vipul Chaudhari, Deepti Vishwanathan, Kailash Kolhe, Meghraj Ingle
Clin Endosc 2022;55(1):8-14.   Published online January 27, 2022
DOI: https://doi.org/10.5946/ce.2021.110
AbstractAbstract PDFPubReaderePub
Video endoscopy is an important modality for the diagnosis and treatment of various gastrointestinal diseases. Most endoscopic procedures are performed as outpatient basis, sometimes requiring sedation and deeper levels of anesthesia. Moreover, advances in endoscopic techniques have allowed invasion into the third space and the performance of technically difficult procedures that require the utmost precision. Hence, formulating strategies for the discharge of patients requiring endoscopy is clinically and legally challenging. In this review, we have discussed the various criteria and scores for the discharge of patients who have undergone endoscopic procedures with and without anesthesia.

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  • Strukturelle, prozedurale und personelle Voraussetzungen für eine sektorenübergreifende Erbringung endoskopischer gastroenterologischer Leistungen
    Ludger Leifeld, Ulrike Denzer, Thomas Frieling, Ralf Jakobs, Siegbert Faiss, Henrike Lenzen, Petra Lynen, Julia Mayerle, Johann Ockenga, Ulrich Tappe, Birgit Terjung, Heiner Wedemeyer, Jörg Albert
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  • Promoting Research that Supports High-Quality Gastrointestinal Endoscopy in Children
    Lisa B. Mahoney, Catharine M. Walsh, Jenifer R. Lightdale
    Current Gastroenterology Reports.2023; 25(11): 333.     CrossRef
  • 4,813 View
  • 237 Download
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The Role of Endoscopy in Small Bowel Neuroendocrine Tumors
Ji Yoon Yoon, Nikhil A. Kumta, Michelle Kang Kim
Clin Endosc 2021;54(6):818-824.   Published online April 1, 2021
DOI: https://doi.org/10.5946/ce.2020.296
AbstractAbstract PDFPubReaderePub
Small bowel neuroendocrine tumors (NETs) represent approximately one-third of NETs of the gastrointestinal tract, and their incidence is increasing. When determining if endoscopic resection is appropriate, endoscopic ultrasound is used to assess the lesion size and depth of invasion for duodenal NETs. A number of techniques, including endoscopic mucosal resection (EMR), band-assisted EMR (band-EMR), endoscopic submucosal dissection (ESD), and over-the-scope clip-assisted endoscopic full-thickness resection (EFTR), have been studied; however, the best technique for endoscopic resection remains unclear. The vast majority of currently available data are retrospective, and prospective studies with longer follow-up times are required. For jejunal and ileal NETs, endoscopic techniques such as video capsule endoscopy (VCE) and balloon enteroscopy (BE) assist in diagnosis. This includes localization of the primary NET in metastatic disease where initial workup has been negative, and the identification of multifocal disease, which may change management and prognostication.

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    Sai Swarupa Vulasala, Mayur Virarkar, Dheeraj Gopireddy, Rebecca Waters, Ahmad Alkhasawneh, Ziad Awad, Jessica Maxwell, Nisha Ramani, Sindhu Kumar, Nirmal Onteddu, Ajaykumar C. Morani
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    Derek Tang, Ramona Lim, Louis Korman, Joanne Forbes, Kristen Ellsbury, Sungyoung Auh, Apurva Trivedi, Clara C. Chen, Marybeth Hughes, Stephen Wank
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    Sara Massironi, Marianna Franchina, Davide Ippolito, Federica Elisei, Olga Falco, Cesare Maino, Fabio Pagni, Alessandra Elvevi, Luca Guerra, Pietro Invernizzi
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    Kaden R. Narayani, Raj I. Narayani
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    Patrick J. Navin, Eric C. Ehman, Jason B. Liu, Thorvardur R. Halfdanarson, Akshya Gupta, Andrea Laghi, Don C. Yoo, Laura R. Carucci, Wolfgang Schima, Shannon P. Sheedy
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    Sarah Dwyer, Shaffer Mok
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    Apostolis Papaefthymiou, Faidon-Marios Laskaratos, Apostolos Koffas, Anastasios Manolakis, Paraskevas Gkolfakis, Sergio Coda, Mikael Sodergren, Noriko Suzuki, Christos Toumpanakis
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    Conrad J. Fernandes, Galen Leung, Jennifer R. Eads, Bryson W. Katona
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Endoscopic Evaluation of Biliary Strictures: Current and Emerging Techniques
Roy Huynh, Corinne Owers, Christopher Pinto, Thuy-My Nguyen, Titus Kwok
Clin Endosc 2021;54(6):825-832.   Published online May 27, 2021
DOI: https://doi.org/10.5946/ce.2021.048
AbstractAbstract PDFPubReaderePub
The diagnosis of biliary strictures in clinical practice can be challenging. Discriminating between benign and malignant biliary strictures is important to prevent the morbidity and mortality associated with incorrect diagnoses. Missing a malignant biliary stricture may delay surgery, resulting in poor prognostic outcomes. Conversely, it has been demonstrated that approximately 20% of patients who undergo surgery for suspected biliary malignancies have a benign etiology on histopathology. Traditional tissue sampling using endoscopic retrograde cholangiography does not always produce a definitive diagnosis, with a considerable proportion of cases remaining as indeterminate biliary strictures. Recent advances in endoscopic techniques have the potential to improve the diagnostic and prognostic accuracy of biliary strictures.

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    Meng-Qi Zhuang, Cheng Zheng, Wei-Wei Xie, Lin Xu, Jia-Li Wu, Dao-Quan Zhang, Yuan-Gan Chen, Sen-Sen Niu, Xiang Zhan, Yu-Bao Zhou
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Cracking Difficult Biliary Stones
Phonthep Angsuwatcharakon, Rungsun Rerknimitr
Clin Endosc 2021;54(5):660-668.   Published online March 16, 2021
DOI: https://doi.org/10.5946/ce.2020.256-IDEN
AbstractAbstract PDFPubReaderePub
Apart from difficult biliary cannulation, biliary stone removal is considered one of the hurdles in endoscopic retrograde cholangiopancreatography. Generally, simple common bile duct (CBD) stones can be removed either with an extraction balloon or a basket. However, there are difficult stones that cannot be removed using these standard methods. The most difficult stones are large CBD stones and impacted stones in a tapering CBD. A few decades ago, mechanical lithotripsy was usually required to manage these stones. At present, endoscopic papillary large balloon dilation (EPLBD) of the biliary orifice has become the gold standard for large CBD stones up to 1.5 cm. EPLBD can reduce the procedural time by shortening the stone removal process. It can also save the cost of the devices, especially multiple baskets, used in mechanical lithotripsy. Unfortunately, very large CBD stones, stones impacted in a tapering CBD, and some intrahepatic duct stones still require lithotripsy. Peroral cholangioscopy provides direct visualization of the stone, which helps the endoscopist perform a probe-based lithotripsy either with an electrohydraulic probe or a laser probe. This technique can facilitate the management of difficult CBD stones with a high success rate and save procedural time without significant technical complications.

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    Chukwunonso Ezeani, Samuel O. Igbinedion, Kwabena Asafo-Agyei, Erik A. Holzwanger, Sultan Mahmood, Mandeep S. Sawhney, Tyler M. Berzin, Moamen Gabr, Douglas K. Pleskow
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    Antonio Facciorusso, Paraskevas Gkolfakis, Daryl Ramai, Georgios Tziatzios, Janice Lester, Stefano Francesco Crinò, Leonardo Frazzoni, Ioannis S. Papanikolaou, Marianna Arvanitakis, Daniel Blero, Arnaud Lemmers, Pierre Eisendrath, Lorenzo Fuccio, Konstant
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    A. K. Uribe Rivera, B. Seeliger, C. A. Saldivar, E. Houghton, F. Rodríguez, P. Acquafresca, M. Palermo, M. E. Giménez
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    Ruchi Sharma, Vikram Sharma, Umang Singhal, Madhusudhan Sanaka
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Technical Review of Developments in Endoscopic Ultrasound-Guided Hepaticogastrostomy
Takeshi Ogura, Kazuhide Higuchi
Clin Endosc 2021;54(5):651-659.   Published online April 26, 2021
DOI: https://doi.org/10.5946/ce.2021.020-KDDW
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasound-guided biliary drainage has been developed as an alternative method for biliary drainage. EUS-guided hepaticogastrostomy (EUS-HGS) can be attempted via the trans-gastric route. These procedures are technically complex for two reasons. First, puncture of the intrahepatic bile duct via the trans-gastric route can be more difficult than that by other approaches because of the small diameter of the target site, and guidewire insertion or manipulation is challenging during EUS-HGS. Second, critical adverse events, such as stent migration into the abdominal cavity, could occur because of the greater mobility of the stomach compared to the duodenum. Therefore, endoscopists should be cautious when performing EUS-HGS. An advantage of EUS-HGS is that it can be performed in patients with complications such as duodenal bulb obstruction or surgically altered anatomy. Recent advances in technique and improvements in devices and stents for EUS-HGS have shown promise for improving the technical success rate of EUS-HGS and reducing the rate of adverse events. However, endoscopists should remain aware of the possibility of critical adverse events such as stent migration.

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    Shuntaro Mukai, Takao Itoi, Takayoshi Tsuchiya, Kentaro Ishii, Ryosuke Tonozuka, Yuichi Nagakawa, Shingo Kozono, Chie Takishita, Hiroaki Osakabe, Atsushi Sofuni
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    Masanari Sekine, Yusuke Hashimoto, Taro Shibuki, Kei Okumura, Ikuhiro Kobori, Aki Miyagaki, Yoshihiro Sasaki, Yuichi Takano, Keita Matsumoto, Hirosato Mashima
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    Takeshi Ogura, Yuki Uba, Hiroki Nishikawa
    Journal of Hepato-Biliary-Pancreatic Sciences.2023; 30(10): 1188.     CrossRef
  • Loop technique for guidewire manipulation during endoscopic ultrasound‐guided hepaticogastrostomy
    Haruo Miwa, Kazuya Sugimori, Yuto Matsuoka, Kazuki Endo, Ritsuko Oishi, Masaki Nishimura, Yuichiro Tozuka, Takashi Kaneko, Kazushi Numata, Shin Maeda
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    Ian Eisenberg, Monica Gaidhane, Michel Kahaleh, Amy Tyberg
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  • Guidewire malposition outside the bile duct during endoscopic ultrasound-guided hepaticogastrostomy
    Yoshimitsu Fukasawa, Mitsuharu Fukasawa, Shinichi Takano, Satoshi Kawakami, Hiroshi Hayakawa, Shota Harai, Nobuyuki Enomoto
    Endoscopy.2023; 55(S 01): E894.     CrossRef
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    Hirotsugu Maruyama, Yuki Ishikawa-Kakiya, Kojiro Tanoue, Akira Higashimori, Yasuhiro Fujiwara
    Arab Journal of Gastroenterology.2023; 24(3): 183.     CrossRef
  • Guidewires in GI endoscopy
    Samuel Han, Mohit Girotra, Venkata S. Akshintala, Dennis Chen, Yen-I Chen, Koushik K. Das, Allon Kahn, Girish Mishra, V. Raman Muthusamy, Jorge V. Obando, Frances U. Onyimba, Swati Pawa, Tarun Rustagi, Sonali Sakaria, Guru Trikudanathan, Ryan J. Law
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  • EUS–guided transhepatic metal stent deployment technique without tract dilation using a 0.018-inch guidewire (with video)
    Takeshi Ogura, Jyunichi Kawai, Kyohei Nishiguchi, Yoshitaro Yamamoto, Kazuhide Higuchi
    Endoscopic Ultrasound.2023;[Epub]     CrossRef
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    Hyung Ku Chon, Shayan Irani, Tae Hyeon Kim
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  • Rescue technique after endoscopic ultrasound-guided hepaticogastrostomy stent dislocation
    Takeshi Ogura, Taro Iwatsubo, Atsushi Okuda, Saori Ueno, Hiroki Nishikawa
    Endoscopy.2023; 55(S 01): E1236.     CrossRef
  • Simplified single-session EUS-guided transhepatic antegrade stone removal for management of choledocholithiasis in patients with surgically altered anatomy
    Tingting Yu, Suning Hou, Haiming Du, Wei Zhang, Jiao Tian, Yankun Hou, Jun Yao, Senlin Hou, Lichao Zhang
    Gastroenterology Report.2023;[Epub]     CrossRef
  • Endoscopic ultrasound-guided hepaticogastrostomy using a novel drill dilator
    Masanori Yamada, Kazuo Hara, Shin Haba, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi
    Endoscopy.2022; 54(S 02): E856.     CrossRef
  • Successful endoscopic treatment of huge infected biloma and hepatic abscess after endoscopic ultrasound-guided hepaticogastrostomy with brain abscess
    Koji Takahashi, Hiroshi Ohyama, Hiroki Nagashima, Yotaro Iino, Yuko Kusakabe, Kohichiroh Okitsu, Izumi Ohno, Yuichi Takiguchi, Naoya Kato
    Clinical Journal of Gastroenterology.2022; 15(5): 988.     CrossRef
  • Prevention of Serious Complications during Endoscopic Ultrasound-Guided Biliary Drainage: A Case-Based Technical Review
    Surinder Singh Rana, Jimil Shah, Harish Bhujade, Ujjwal Gorsi, Mandeep Kang, Rajesh Gupta
    Journal of Digestive Endoscopy.2022; 13(02): 082.     CrossRef
  • Endoscopic salvage therapy after failed biliary cannulation using advanced techniques: A concise review
    Yung-Kuan Tsou, Kuang-Tse Pan, Mu Hsien Lee, Cheng-Hui Lin
    World Journal of Gastroenterology.2022; 28(29): 3803.     CrossRef
  • Usefulness of the double-guidewire technique for endoscopic procedures in the field of biliary and pancreatic diseases
    Mamoru Takenaka, Masatoshi Kudo
    Clinical Endoscopy.2022; 55(5): 605.     CrossRef
  • New Stents for Endoscopic Ultrasound-Guided Procedures
    Gunn Huh, Tae Jun Song
    The Korean Journal of Pancreas and Biliary Tract.2021; 26(4): 248.     CrossRef
  • 6,071 View
  • 318 Download
  • 29 Web of Science
  • 31 Crossref
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Photodynamic Therapy for Esophageal Cancer
Takahiro Inoue, Ryu Ishihara
Clin Endosc 2021;54(4):494-498.   Published online May 19, 2020
DOI: https://doi.org/10.5946/ce.2020.073
AbstractAbstract PDFPubReaderePub
Photodynamic therapy, a curative local treatment for esophageal squamous cell carcinoma, involves a photosensitizing drug (photosensitizer) with affinity for tumors and a photodynamic reaction triggered by laser light. Previously, photodynamic therapy was used to treat superficial esophageal squamous cell carcinoma judged to be difficult to undergo endoscopic resection. Recently, photodynamic therapy has mainly been performed for local failure after chemoradiotherapy. Although surgery is the most promising treatment for local failure after chemoradiotherapy, its morbidity and mortality rates are high. Endoscopic resection is feasible for local failure after chemoradiotherapy but requires advanced skills, and its indication is limited to within the submucosal layer by depth. Photodynamic therapy is less invasive than surgery and has a wider indication than endoscopic resection. Porfimer sodium (a first-generation photosensitizer) causes a high frequency of side effects related to photosensitivity and requires the long-term sunshade period. Talaporfin (a second-generation photosensitizer) requires a much shorter sun-shade period than porfimer sodium. Photodynamic therapy will profoundly change treatment strategies for local failure after chemoradiotherapy.

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    Guodong Ren, ZiCheng Wang, Yafei Tian, Jinyao Li, Yingyu Ma, Liang Zhou, Chengwu Zhang, Lixia Guo, Haipeng Diao, Lihong Li, Li Lu, Sufang Ma, Zhifang Wu, Lili Yan, Wen Liu
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  • 275 Download
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  • 22 Crossref
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Current Status of Colorectal Cancer and Its Public Health Burden in Thailand
Kasenee Tiankanon, Satimai Aniwan, Rungsun Rerknimitr
Clin Endosc 2021;54(4):499-504.   Published online March 15, 2021
DOI: https://doi.org/10.5946/ce.2020.245-IDEN
AbstractAbstract PDFPubReaderePub
Colorectal cancer (CRC) accounts for approximately 10.3% of new cancer cases in Thailand and is currently the 3rd most prevalent cancer found among the Thai population. Starting in 2017, the Thai government announced the national CRC screening program as a response to this important issue. Among the 70 million people currently residing in Thailand, 14 million require screening, while there are approximately a total of 1,000 endoscopists available to perform colonoscopy. Due to the limited resources and shortage of endoscopists in Thailand, applying a population-based one-step colonoscopy program as a primary screening method is not feasible. To reduce colonoscopy workload, with the help of others, including village health volunteers, institution-based health personnel, reimbursement coders, pathologists, and patients due for CRC screening, a two-step approach of one-time fecal immunochemical test (FIT), which prioritizes and filters out subjects for colonoscopy, is chosen. Moreover, additional adjustments to the optimal FIT cutoff value and the modified Asia-Pacific Colorectal Screening risk score, including body weight, were proposed to stratify the priority of colonoscopy schedule. This article aims to give an overview of the past and current policy developmental strategies and the current status of the Thailand CRC screening program.

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    Ampornpan Theeranut, Nonglak Methakanjanasak, Sunee Lertsinudom, Pattama Surit, Nichanun Panyaek, Saisamon Leeladapattarakul, Peangtikumporn Nilpetch, Pattapong Kessomboon, Chalongchai Chalermwat, Watcharapong Rintara, Wudipong Khongtong, Pawich Paktipat,
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  • 201 Download
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  • 5 Crossref
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Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections
Chi Hyuk Oh, Jun Kyu Lee, Tae Jun Song, Jin-Seok Park, Jae Min Lee, Jun Hyuk Son, Dong Kee Jang, Miyoung Choi, Jeong-Sik Byeon, In Seok Lee, Soo Teik Lee, Ho Soon Choi, Ho Gak Kim, Hoon Jai Chun, Chan Guk Park, Joo Young Cho
Clin Endosc 2021;54(4):505-521.   Published online July 27, 2021
DOI: https://doi.org/10.5946/ce.2021.185
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to develope medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on Indications for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.

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    Judy Daboul, Shiab Mussad, Anna Cecilia Amaral, Waleed K. Hussain, Peter J. Lee, Samuel Han
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    Hemanta Kumar Nayak, Shubham Gupta, Manas Kumar Panigrahi, Abhijeet Rai, Saswati Kar, Mansi Chaudhary, Ajay Ghosh, Taraprasad Tripathy, Bramhadatta Pattnaik, Subash Chandra Samal
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    Dong Kee Jang, Dong Wook Lee, Seong-Hun Kim, Kwang Bum Cho, Sundeep Lakhtakia
    Clinical Endoscopy.2024; 57(5): 588.     CrossRef
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    Yousuke Nakai, Saburo Matsubara, Tsuyoshi Mukai, Tsuyoshi Hamada, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda
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    Hyung Ku Chon, Seong-Hun Kim
    International Journal of Gastrointestinal Intervention.2023; 12(1): 7.     CrossRef
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    Ning Xu, Longsong Li, Danqi Zhao, Zixin Wang, Xueting Wang, Runzi Wang, Yanbo Zeng, Lei Zhang, Ning Zhong, Ying Lv, Enqiang Linghu, Ningli Chai
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    A.V. Fedorov, V.N. Ektov, M.A. Khodorkovsky
    Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (8): 83.     CrossRef
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    Eunae Cho, Chang-Hwan Park, Seo Yeon Cho
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  • 6,663 View
  • 264 Download
  • 13 Web of Science
  • 11 Crossref
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Diagnosing Gastric Mesenchymal Tumors by Digital Endoscopic Ultrasonography Image Analysis
Moon Won Lee, Gwang Ha Kim
Clin Endosc 2021;54(3):324-328.   Published online June 18, 2020
DOI: https://doi.org/10.5946/ce.2020.061
AbstractAbstract PDFPubReaderePub
Gastric mesenchymal tumors (GMTs) are incidentally discovered in national gastric screening programs in Korea. Endoscopic ultrasonography (EUS) is the most useful diagnostic modality for evaluating GMTs. The differentiation of gastrointestinal stromal tumors from benign mesenchymal tumors, such as schwannomas or leiomyomas, is important to ensure appropriate clinical management. However, this is difficult and operator dependent because of the subjective interpretation of EUS images. Digital image analysis computes the distribution and spatial variation of pixels using texture analysis to extract useful data, enabling the objective analysis of EUS images and decreasing interobserver and intraobserver agreement in EUS image interpretation. This review aimed to summarize the usefulness and future of digital EUS image analysis for GMTs based on published reports and our experience.

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    Darío Montes N, Nixon Cevallos R, Rubén Montes N
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    Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
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    Xian‐Da Zhang, Ling Zhang, Ting‐Ting Gong, Zhuo‐Ran Wang, Kang‐Li Guo, Jun Li, Yuan Chen, Jian‐Tao Zhang, Ben‐Gong Ye, Jin Ding, Jian‐Wei Zhu, Feng Liu, Duan‐Min Hu, JianGang Chen, Chun‐Hua Zhou, Duo‐Wu Zou
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    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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    Osamu Goto, Mitsuru Kaise, Katsuhiko Iwakiri
    Gut and Liver.2022; 16(3): 321.     CrossRef
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    M. Reyes Busta Nistal, Noelia Alcaide Suarez, Luis Fernández Salazar, Daniel Corrales Cruz
    Gastroenterología y Hepatología.2021;[Epub]     CrossRef
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    Shotaro Okanoue, Masaya Iwamuro, Takehiro Tanaka, Takuya Satomi, Kenta Hamada, Hiroyuki Sakae, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
    Medicine.2021; 100(40): e27520.     CrossRef
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  • 226 Download
  • 7 Web of Science
  • 7 Crossref
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Artificial Intelligence in Lower Gastrointestinal Endoscopy: The Current Status and Future Perspective
Sebastian Manuel Milluzzo, Paola Cesaro, Leonardo Minelli Grazioli, Nicola Olivari, Cristiano Spada
Clin Endosc 2021;54(3):329-339.   Published online January 13, 2021
DOI: https://doi.org/10.5946/ce.2020.082
AbstractAbstract PDFPubReaderePub
The present manuscript aims to review the history, recent advances, evidence, and challenges of artificial intelligence (AI) in colonoscopy. Although it is mainly focused on polyp detection and characterization, it also considers other potential applications (i.e., inflammatory bowel disease) and future perspectives. Some of the most recent algorithms show promising results that are similar to human expert performance. The integration of AI in routine clinical practice will be challenging, with significant issues to overcome (i.e., regulatory, reimbursement). Medico-legal issues will also need to be addressed. With the exception of an AI system that is already available in selected countries (GI Genius; Medtronic, Minneapolis, MN, USA), the majority of the technology is still in its infancy and has not yet been proven to reach a sufficient diagnostic performance to be adopted in the clinical practice. However, larger players will enter the arena of AI in the next few months.

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    Sebastian Baumer, Kilian Streicher, Saleh A. Alqahtani, Dominic Brookman-Amissah, Monika Brunner, Christoph Federle, Klaus Muehlenberg, Lukas Pfeifer, Andrea Salzberger, Wolfgang Schorr, Jozef Zustin, Oliver Pech
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    Donghwan Kim, Eunsun Kim
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    Uday C. Ghoshal, Saikat Chakrabarti, Mahesh K. Goenka
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    Carolin Zippelius, Saleh A. Alqahtani, Jörg Schedel, Dominic Brookman-Amissah, Klaus Muehlenberg, Christoph Federle, Andrea Salzberger, Wolfgang Schorr, Oliver Pech
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    Yuan-Yen Chang, Pai-Chi Li, Ruey-Feng Chang, Yu-Yao Chang, Siou-Ping Huang, Yang-Yuan Chen, Wen-Yen Chang, Hsu-Heng Yen
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    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Seung In Seo, Young Joo Yang, Gwang Ho Baik, Jong Wook Kim
    Journal of Personalized Medicine.2022; 12(6): 963.     CrossRef
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    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Young Joo Yang, Gwang Ho Baik
    Journal of Personalized Medicine.2022; 12(9): 1361.     CrossRef
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    Chang Bong Yang, Sang Hoon Kim, Yun Jeong Lim
    Clinical Endoscopy.2022; 55(5): 594.     CrossRef
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    Naoki Muguruma, Tetsuji Takayama
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    Antonino Guerrisi, Italia Falcone, Fabio Valenti, Marco Rao, Enzo Gallo, Sara Ungania, Maria Teresa Maccallini, Maurizio Fanciulli, Pasquale Frascione, Aldo Morrone, Mauro Caterino
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    Pablo Cortegoso Valdivia, Alfonso Elosua, Charles Houdeville, Marco Pennazio, Ignacio Fernández-Urién, Xavier Dray, Ervin Toth, Rami Eliakim, Anastasios Koulaouzidis
    European Journal of Gastroenterology & Hepatology.2021; 33(7): 949.     CrossRef
  • Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
    Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
    Diagnostics.2021; 11(11): 2123.     CrossRef
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Role of Endoscopy in Primary Sclerosing Cholangitis
Purnima Bhat, Lars Aabakken
Clin Endosc 2021;54(2):193-201.   Published online May 8, 2020
DOI: https://doi.org/10.5946/ce.2020.019-IDEN
AbstractAbstract PDFPubReaderePub
Primary sclerosing cholangitis (PSC) is a progressive disease of the bile ducts that usually results in chronic liver disease often requiring liver transplantation. Endoscopy remains crucial to the care of these patients, although magnetic resonance cholangiopancreatography has replaced endoscopic retrograde cholangiopancreatography (ERCP) as the primary imaging modality for diagnosis. For detection of dysplasia or cholangiocarcinoma, ERCP with intraductal sampling remains compulsory. Moreover, dominant strictures play an important part in the disease development, and management by balloon dilatation or stenting could contribute to long-term prognosis. In addition, endoscopy offers management for adverse events such as bile leaks and anastomotic strictures after liver transplantation. Finally, the special phenotype of inflammatory bowel disease associated with PSC as well as the frequent occurrence of portal hypertension mandates close follow-up with colonoscopy and upper endoscopy. With the emergence of novel techniques, the endoscopist remains a key member of the multidisciplinary team caring for PSC patients.

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    Eszter Bényei, Antonio Molinaro, Per Hedenström, Riadh Sadik
    Scandinavian Journal of Gastroenterology.2024; 59(8): 980.     CrossRef
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    Hamza Azam, Mohammed Affan Guliyara, Bapti Roy
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    Arvid Gustafsson, Lars Enochsson, Bobby Tingstedt, Greger Olsson
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    Roger W. Chapman
    Clinical Liver Disease.2022; 20(S1): 21.     CrossRef
  • 11,850 View
  • 313 Download
  • 5 Web of Science
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Recent Developments in Devices Used for Gastrointestinal Endoscopy Sedation
Basavana Goudra, Gowri Gouda, Preet Mohinder Singh
Clin Endosc 2021;54(2):182-192.   Published online March 18, 2021
DOI: https://doi.org/10.5946/ce.2020.057
AbstractAbstract PDFPubReaderePub
Hypoxemia is a frequent and potentially fatal complication occurring in patients during gastrointestinal endoscopy. The administration of propofol sedation increases the risk of most complications, especially hypoxemia. Nevertheless, propofol has been increasingly used in the United States, and the trend is likely to increase in the years to come. Patient satisfaction and endoscopist satisfaction along with rapid turnover are some of the touted reasons for this trend. However, propofol sedation generally implies deep sedation or general anesthesia. As a result, hypopnea and apnea frequently occur. Inadequate sedation and presence of irritable airway often cause coughing and laryngospasm, both leading to hypoxemia and potential cardiac arrest. Hence, prevention of hypoxemia is of paramount importance. Traditionally, standard nasal cannula is used to administer supplement oxygen. However, it cannot sufficiently provide continuous positive airway pressure (CPAP) or positive pressure ventilation. Device manufacturers have stepped in to fill this void and created many types of cannulas that provide apneic insufflation of oxygen and CPAP and eliminate dead space. Such measures decrease the incidence of hypoxemia. This review aimed to provide essential information of some of these devices.

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    Jan Drews, Jonas Harder, Hannah Kaiser, Miriam Soenarjo, Dorothee Spahlinger, Peter Wohlmuth, Sebastian Wirtz, Ralf Eberhardt, Florian Bornitz, Torsten Bunde, Thomas von Hahn
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    Vincenzo Pota, Francesco Coppolino, Annamaria Auricchio, Francesca Cardella, Maurizio Del Prete, Antonio Scalvenzi, Pasquale Sansone, Maria Beatrice Passavanti, Maria Caterina Pace
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    Lalitha Sundararaman, Basavana Goudra
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    Cheng-Hui Fan, Xiao-Qin Zeng, Rui-Min Feng, Hua-Wei Yi, Rui Xia
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    Chi Chan Lee, Teressa Reanne Ju, Pei Chun Lai, Hsin-Ti Lin, Yen Ta Huang
    Journal of Clinical Medicine.2022; 11(13): 3860.     CrossRef
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    Fateh Bazerbachi, Rodger M White, Nauzer Forbes, Basavana Goudra, Barham K Abu Dayyeh, Vinay Chandrasekhara, BobbieJean Sweitzer
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    Kim Hay Be, Leonardo Zorron Cheng Tao Pu, Brett Pearce, Matthew Lee, Luke Fletcher, Rebecca Cogan, Philip Peyton, Rhys Vaughan, Marios Efthymiou, Sujievvan Chandran
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Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition of Pancreatic Solid Tumor: Korean Society of Gastrointestinal Endoscopy (KSGE)
Moon Jae Chung, Se Woo Park, Seong-Hun Kim, Chang Min Cho, Jun-Ho Choi, Eun Kwang Choi, Tae Hoon Lee, Eunae Cho, Jun Kyu Lee, Tae Jun Song, Jae Min Lee, Jun Hyuk Son, Jin Suk Park, Chi Hyuk Oh, Dong-Ah Park, Jeong-Sik Byeon, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun, Ho Soon Choi, Chan Guk Park, Joo Young Cho
Clin Endosc 2021;54(2):161-181.   Published online March 24, 2021
DOI: https://doi.org/10.5946/ce.2021.069
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition of pancreatic solid tumor. The strength of recommendation and the level of evidence for each statement were graded according to the Minds Handbook for Clinical Practice Guideline Development 2014. The committee, comprising a development panel of 16 endosonographers and an expert on guideline development methodology, developed 12 evidence-based recommendations in 8 categories intended to help physicians make evidence-based clinical judgments with regard to the diagnosis of pancreatic solid tumor. This clinical practice guideline discusses EUS-guided sampling in pancreatic solid tumor and makes recommendations on circumstances that warrant its use, technical issues related to maximizing the diagnostic yield (e.g., needle type, needle diameter, adequate number of needle passes, sample obtaining techniques, and methods of specimen processing), adverse events of EUS-guided tissue acquisition, and learning-related issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This guideline may not be applicable for all clinical situations and should be interpreted in light of specific situations and the availability of resources. It will be revised as necessary to cover progress and changes in technology and evidence from clinical practice.

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    Balaji Musunuri, Shiran Shetty
    Indian Journal of Surgical Oncology.2024; 15(S2): 269.     CrossRef
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    Julio Iglesias-García, Yessica Domínguez-Novoa, Héctor Lazare-Iglesias, Antonio González-Cantalapiedra, Ihab Abdulkader-Nallib, Óscar Varela-López, José Lariño-Noia, Enrique Domínguez-Muñoz
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    Sang Myung Woo
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    Kentaro SUDO, Emiri KITA, Akiko TSUJIMOTO, Kazuyoshi NAKAMURA, Akiko ODAKA, Makiko ITAMI, Sana YOKOI, Hiroshi ISHII
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    Irem Guvendir, Itir Ebru Zemheri, Kamil Ozdil
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    Kwang Hyuck Lee
    The Korean Journal of Pancreas and Biliary Tract.2021; 26(4): 241.     CrossRef
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  • 305 Download
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The Role of Needle-Based Confocal Laser Endomicroscopy in the Evaluation of Pancreatic Cystic Lesions: A Systematic Review
Yung Ka Chin, Clement Chun Ho Wu, Damien Meng Yew Tan
Clin Endosc 2021;54(1):38-47.   Published online March 31, 2020
DOI: https://doi.org/10.5946/ce.2019.200-IDEN
AbstractAbstract PDFPubReaderePub
The prevalence of pancreatic cystic lesions (PCLs) has increased recently due to the increased use of cross-sectional abdominal imaging and the ageing global population. Current diagnostic techniques are inadequate to distinguish between PCLs that require surgery, close surveillance, or expectant management. This has resulted in increased morbidity from both inappropriately aggressive and conservative management strategies. Needle-based confocal laser endomicroscopy (nCLE) has allowed microscopic examination and visual delineation of the surface epithelium of PCLs. Landmark studies in this decade have correlated nCLE and histological findings and identified characteristics differentiating various types of PCLs. Subsequent studies have confirmed the high diagnostic yield of nCLE and its diagnostic utility in PCLs with an equivocal diagnosis. Moreover, nCLE has been shown to improve the diagnostic yield of PCLs. This will help avoid unnecessary pancreatic surgery, which carries significant morbidity and mortality risks. The early detection of high-grade dysplasia in PCLs will provide early surgical treatment and improve outcomes for pancreatic cancer. Despite the high upfront cost of nCLE, the improved diagnostic accuracy and resultant appropriate management have resulted in improved cost effectiveness. Refining the procedure technique and limiting the procedure length have significantly improved the safety of nCLE. A structured training program and device improvements to allow more complete mapping of the pancreatic cyst epithelium will be crucial for the widespread adoption of this promising technology.

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  • Molecular Pathology of Pancreatic Cystic Lesions with a Focus on Malignant Progression
    Yan Hu, Dan Jones, Ashwini K. Esnakula, Somashekar G. Krishna, Wei Chen
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    Michele T. Yip-Schneider, Rodica Muraru, Rachel C. Kim, Howard H. Wu, Stuart Sherman, Aditya Gutta, Mohammad A. Al-Haddad, John M. Dewitt, C. Max Schmidt
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    Hyung Ku Chon, Sung Hoon Moon, Sang Wook Park, Woo Hyun Paik, Chang Nyol Paik, Byoung Kwan Son, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Jae Min Lee, Tae Joo Jeon, Chang-Hwan Park, Kwang Bum Cho, Dong Wook Lee
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    Do Han Kim, Somashekar G. Krishna, Emmanuel Coronel, Paul T. Kröner, Herbert C. Wolfsen, Michael B. Wallace, Juan E. Corral
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    Jorge D. Machicado, Bertrand Napoleon, Anne Marie Lennon, Samer El-Dika, Stephen P. Pereira, Damien Tan, Rahul Pannala, Mohit Girotra, Pradermchai Kongkam, Helga Bertani, Yunlu Feng, Hao Sijie, Ning Zhong, Vincent Valantin, Sarah Leblanc, Alice Hinton, So
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    Wei Chen, Nehaal Ahmed, Somashekar G. Krishna
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    Ralf Kiesslich
    Techniques and Innovations in Gastrointestinal Endoscopy.2021; 23(1): 57.     CrossRef
  • 6,096 View
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Trends of Colorectal Cancer Prevalence in Kazakhstan Related to Screening
Alma Zhylkaidarova, Dilyara Kaidarova, Kanat Batyrbekov, Oxana Shatkovskaya, Dinara Begimbetova
Clin Endosc 2021;54(1):32-37.   Published online May 25, 2020
DOI: https://doi.org/10.5946/ce.2019.198
AbstractAbstract PDFPubReaderePub
We carried out an analysis of the total incidence of colon cancer throughout Kazakhstan. Retrospectively, according to the regional reports on endoscopic screening, the study showed an increase in the age-related incidence of colorectal cancer (CRC) cases from 2004–2008 to 2009–2014. The peak of morbidity in both periods was noted in the age category of >70 years. The indicators of the territorial distribution of CRC incidence make it possible to divide the regions into areas with low or high rates of CRC. Specific indicators showed newly diagnosed cases of CRC stages I, II, III, and IV in 2004–2018. The incidence rates of stages I and II showed a two-fold increase (35%–67.4%) and the incidence of stage IV showed a decline from 19.3% to 13.1% and of stage III from 45.7% to 19.5% from 2004 to 2018, respectively. An analysis of CRC incidence throughout Kazakhstan showed an increase in the overall incidence. Since population-based CRC screening was introduced in 2011, the morbidity was found to increase for stages I and II.

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  • Colorectal cancer’s burden attributable to a diet high in processed meat in the Belt and Road Initiative countries
    Gu Liu, Chang-Min Li, Fei Xie, Qi-Lai Li, Liang-Yan Liao, Wen-Jun Jiang, Xiao-Pan Li, Guan-Ming Lu
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    Constantin-Dan Tâlvan, Liviuța Budișan, Elena-Teodora Tâlvan, Valentin Grecu, Oana Zănoagă, Cosmin Mihalache, Victor Cristea, Ioana Berindan-Neagoe, Călin Ilie Mohor
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    Indira Karibayeva, Botagoz Turdaliyeva, Nor Zuraida Zainal, Fatima Bagiyarova, Dinara Kussainova
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    Jandos Amankulov, Dilyara Kaidarova, Zhamilya Zholdybay, Marianna Zagurovskaya, Nurlan Baltabekov, Madina Gabdullina, Akmaral Ainakulova, Dias Toleshbayev, Alexandra Panina, Elvira Satbayeva, Zhansaya Kalieva
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    Yevgeniya Kolesnikova, Dmitriy Babenko, Irina Kadyrova, Svetlana Kolesnichenko, Lyudmila Akhmaltdinova, Ilya Korshukov, Naylya Kabildina, Valentina Sirota, Vera Zhumaliyeva, Dana Taizhanova, Dmitriy Vazenmiller, Anar Turmukhambetova
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Practical Approaches for High-Risk Surgical Patients with Acute Cholecystitis: The Percutaneous Approach versus Endoscopic Alternatives
Rungsun Rerknimitr, Khanh Cong Pham
Clin Endosc 2020;53(6):678-685.   Published online January 9, 2020
DOI: https://doi.org/10.5946/ce.2019.186
AbstractAbstract PDFPubReaderePub
In high-risk surgical patients with acute cholecystitis who are not candidates for early laparoscopic cholecystectomy, gallbladder (GB) drainage is an alternative treatment option. Percutaneous transhepatic gallbladder drainage (PTGBD) is a recommended first line intervention because of its high efficacy and feasibility in most centers. However, with the advent of endoscopic accessories and technology, endoscopic GB drainage has been chosen as a more favorable choice by endoscopists. Endoscopic transpapillary gallbladder drainage (ETGBD) can be performed under either fluoroscopic or peroral cholangioscopic guidance via endoscopic retrograde cholangiopancreatography by the transpapillary placement of a long double-pigtail stent. In a patient with common bile duct stones, this procedure is accompanied with stone removal. ETGBD is especially useful for acute cholecystitis patients who are contraindicated for PTGBD or those with severe coagulopathy, thrombocytopenia, and abnormal anatomy. Moreover, the advantage of ETGBD is its preservation of the external GB structure. Thereby it would not disturb the future cholecystectomy. Recently, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using plastic, fully covered metallic, or lumen-apposing metal stents transmurally has emerged as a modality for GB drainage with higher technical and clinical success rates. EUS-GBD can provide a more permanent GB drainage than PTGBD and ETGBD.

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    Guido Costamagna
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Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Hyun Lim, Eun Jeong Gong, Byung-Hoon Min, Seung Joo Kang, Cheol Min Shin, Jeong-Sik Byeon, Miyoung Choi, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun
Clin Endosc 2020;53(6):663-677.   Published online November 26, 2020
DOI: https://doi.org/10.5946/ce.2020.192
AbstractAbstract PDFPubReaderePub
Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. The management of patients using antithrombotic agents and requiring gastrointestinal endoscopy is an important clinical challenge. Although clinical practice guidelines (CPGs) for the management of patients receiving antithrombotic agents and undergoing gastrointestinal endoscopy have been developed in the Unites States, Europe, and Asia Pacific region, it is uncertain whether these guidelines can be adopted in South Korea. After reviewing current CPGs, we identified unmet needs and recognized significant discrepancies in the clinical practice among regions. This is the first CPG in Korea providing information that may assist endoscopists in the management of patients on antithrombotic agents who require diagnostic or elective therapeutic endoscopy. This guideline was developed through the adaptation process as an evidence-based method, with four guidelines retrieved by systematic review. Eligible guidelines were evaluated according to the Appraisal of Guidelines for Research and Evaluation II process, and 13 statements were established using a grading system. This guideline was reviewed by external experts before an official. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

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Colon Capsule Endoscopy for Inflammatory Bowel Disease
Naoki Hosoe, Yukie Hayashi, Haruhiko Ogata
Clin Endosc 2020;53(5):550-554.   Published online January 9, 2020
DOI: https://doi.org/10.5946/ce.2019.156
AbstractAbstract PDFPubReaderePub
Colon capsule endoscopy was initially introduced in 2006. Since the results of a prospective study to evaluate first-generation colon capsule endoscopy efficacy for the detection of colonic neoplasia were unsatisfactory, second-generation colon capsule endoscopy was developed and reported in 2009. In this review article, we provide an overview of the current state of colon capsule endoscopy for evaluation of inflammatory bowel disease in a clinical setting and describe our clinical experience with this technology and its application. Among the various types of inflammatory bowel diseases, ulcerative colitis is the primary target for application of colon capsule endoscopy. Nevertheless, the initial results of studies using first-generation colon capsule endoscopy to evaluate inflammation were unclear. More recently, second-generation colon capsule endoscopy has provided higher accuracy for assessment of inflammation in patients with ulcerative colitis. Colon capsule endoscopy enables noninvasive observation (with reduced volume preparation) of mucosal inflammation severity in patients with ulcerative colitis.

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    Bruno Rosa, Patrícia Andrade, Sandra Lopes, Ana Rita Gonçalves, Juliana Serrazina, Pedro Marílio Cardoso, Andrea Silva, Vítor Macedo Silva, José Cotter, Guilherme Macedo, Pedro Narra Figueiredo, Cristina Chagas
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Endoscopic Full Thickness Resection for Gastrointestinal Tumors - Challenges and Solutions
Hung Leng Kaan, Khek Yu Ho
Clin Endosc 2020;53(5):541-549.   Published online February 17, 2020
DOI: https://doi.org/10.5946/ce.2019.161
AbstractAbstract PDFPubReaderePub
Standard polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection (ESD) are established techniques for the treatment of gastrointestinal tumors. However, resection of submucosal tumors via ESD often results in low rates of microscopically margin-negative (R0) resection and high rates of perforation. Endoscopic full thickness resection (EFTR) overcomes this adverse event and aids in the therapeutic management of complex tumors.
Multiple techniques for EFTR have been developed, each with its own advantages and disadvantages. Submucosal tunneling and nonexposed techniques are generally preferable, because the layer of overlying intact mucosa reduces the incidence of intraperitoneal contamination by the gastric fluid and dissemination of the tumor cells. However, adoption of EFTR by endoscopists in clinical practice remains low. The major challenge seems to be the technical difficulty in performing laparoscopic and/or endoscopic suturing using the currently available instruments.
We developed a novel robotic endoscopic platform with suturing capabilities to overcome the technical challenges of suturing. This platform allows easy maneuvering and triangulation of the instruments, thus facilitating endoscopic suturing using robotic arms. Our studies have demonstrated that this robotic endoscopic platform with suturing capabilities is an effective and safe method for performing EFTR with endoscopic suturing.

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Endoscopic Ultrasound-Guided Fine Needle Aspiration and Endoscopic Retrograde Cholangiopancreatography-Based Tissue Sampling in Suspected Malignant Biliary Strictures: A Meta-Analysis of Same-Session Procedures
Diogo Turiani Hourneax de Moura, Marvin Ryou, Eduardo Guimarães Hourneaux de Moura, Igor Braga Ribeiro, Wanderlei Marques Bernardo, Christopher C. Thompson
Clin Endosc 2020;53(4):417-428.   Published online November 5, 2019
DOI: https://doi.org/10.5946/ce.2019.053
AbstractAbstract PDFPubReaderePub
Background
/Aims: The diagnosis of biliary strictures can be challenging. There are no systematic reviews studying same-session endoscopic retrograde cholangiopancreatography (ERCP)-based tissue sampling and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of biliary strictures.
Methods
A systematic review was conducted on studies analyzing same-session EUS and ERCP for tissue diagnosis of suspected malignant biliary strictures. The primary outcome was the accuracy of each method individually compared to the two methods combined. The secondary outcome was the accuracy of each method in pancreatic and biliary etiologies. In the meta-analysis, we used Forest plots, summary receiver operating characteristic curves, and estimates of the area under the curve for intention-to-treat analysis.
Results
Of the 12,132 articles identified, six were included, resulting in a total of 497 patients analyzed. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and accuracy of the association between the two methods were: 86%, 98%, 12.50, 0.17, and 96.5%, respectively. For the individual analysis, the sensitivity, specificity and accuracy of EUS-FNA were 76%, 100%, and 94.5%, respectively; for ERCP-based tissue sampling, the sensitivity, specificity, and accuracy were 58%, 98%, and 78.1%, respectively. For pancreatic lesions, EUS-FNA was superior to ERCP-based tissue sampling. However, for biliary lesions, both methods had similar sensitivities.
Conclusions
Same-session EUS-FNA and ERCP-based tissue sampling is superior to either method alone in the diagnosis of suspected malignant biliary strictures. Considering these results, combination sampling should be performed when possible.

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    跃华 李
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    Diogo Turiani Hourneaux Moura, Thomas R McCarty, Pichamol Jirapinyo, Igor Braga Ribeiro, Galileu Ferreira Ayala Farias, Antonio Coutinho Madruga-Neto, Marvin Ryou, Christopher C Thompson
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Endoscopic Ultrasound-Guided Pancreatic Transmural Stenting and Transmural Intervention
Takeshi Ogura, Hideko Ohama, Kazuhide Higuchi
Clin Endosc 2020;53(4):429-435.   Published online November 27, 2019
DOI: https://doi.org/10.5946/ce.2019.130
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasound (EUS)-guided pancreatic access is an emergent method that can be divided into the two main techniques of EUS-guided rendezvous and pancreatic transmural stenting (PTS). While many reports have described EUS-guided procedures, the indications, technical tips, clinical effects, and safety of EUS-guided pancreatic duct drainage (EUS-PD) remain controversial. This review describes the current status of and problems associated with EUS-PD, particularly PTS. We reviewed clinical data derived from a total of 334 patients. Rates of technical and clinical success ranged from 63% to 100% and 76% to 100%, respectively. In contrast, the rate of procedure-related adverse events was high at 26.7% (89/334). The most frequent adverse events comprised abdominal pain (n=38), acute pancreatitis (n=15), bleeding (n=9), and issues associated with pancreatic juice leakage such as perigastric fluid, pancreatic fluid collection, or pancreatic juice leaks (n=8). In conclusion, indications for EUS-PTS are limited, as is the evidence of its viability, due to the scarcity of expert operators. Despite improvements made to various devices, EUS-PTS remains technically challenging. Therefore, a long-term, large-scale, multicenter study is required to establish this technique as a viable alternative drainage method.

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    Yousuke Nakai
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  • 6,252 View
  • 284 Download
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Atraumatic Splenic Hemorrhage as a Rare Complication of Pancreatitis: Case Report and Literature Review
Deepanshu Jain, Byeori Lee, Michael Rajala
Clin Endosc 2020;53(3):311-320.   Published online July 24, 2019
DOI: https://doi.org/10.5946/ce.2019.087
AbstractAbstract PDFPubReaderePub
Splenic hemorrhage (hematoma and rupture) is a rare complication of pancreatitis. In this article, we present a rare case of spontaneous splenic rupture as a complication of acute pancreatitis. A literature review was also completed to describe the patient characteristics, associated pancreatitis etiology, clinical presentations, risk factors, diagnostic and treatment modalities, and outcomes.

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  • 8,505 View
  • 186 Download
  • 11 Web of Science
  • 11 Crossref
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