Focused Review Series: Past, present and future of gastrointestinal stents
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Past, Present, and Future of Gastrointestinal Stents: New Endoscopic Ultrasonography-Guided Metal Stents and Future Developments
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Hee Seung Lee, Moon Jae Chung
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Clin Endosc 2016;49(2):131-138. Published online March 22, 2016
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DOI: https://doi.org/10.5946/ce.2016.044
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- Innovations in stent technology and technological advances in endoscopic ultrasonography have led to rapid expansion of their use in the field of gastrointestinal diseases. In particular, endoscopic ultrasonography-guided metal stent insertion has been used for the management of pancreatic fluid collection, bile duct drainage, gallbladder decompression, and gastric bypass. Endoscopic ultrasonography-guided drainage of intra-abdominal fluid collections using a plastic or metal stent is well established. Because of the various limitations—such as stent migration, injury and bleeding in the lumen—recently developed, fully covered self-expanding metal stents or lumen-apposing metal stents have been introduced for those fluids management. This article reviews the recent literature on newly developed endoscopic ultrasonography-guided metal stents and the efficacy thereof.
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PLOS ONE.2019; 14(9): e0221812. CrossRef - Lumen-Apposing Metal Stents
Matthew W. Stier, Irving Waxman
Gastrointestinal Endoscopy Clinics of North America.2018; 28(2): 207. CrossRef - A Newly Designed, Fully Covered, Metal Stent with Wide Flanges for EUS-Guided Drainage and Access
Tae Yoon Lee, Young Koog Cheon, Chan Sup Shim
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Case Report
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Multicentric Type 3 Gastric Neuroendocrine Tumors
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Sang Hoon Lee, Dochang Moon, Hee Seung Lee, Choong-kun Lee, Yong Duk Jeon, Ji Hye Park, Hyunki Kim, Sang Kil Lee
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Clin Endosc 2015;48(5):431-435. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.431
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Abstract
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A 50-year-old woman with incidentally detected multiple gastric polyps and biopsy-proven neuroendocrine tumor (NET) was referred to our hospital. More than 10 polypoid lesions (less than 15 mm) with normal gastric mucosa were detected from the gastric body to the fundus. The serum level of gastrin was within the normal limits. There was no evidence of atrophic changes on endoscopy and serologic marker as pepsinogen I/II ratio. Computed tomography of the abdomen and pelvis revealed no evidence of metastatic lesions. She refused surgery, and we performed endoscopic polypectomy for almost all the gastric polyps that were greater than 5 mm. Although the histological examination revealed that all the removed polys were diagnosed as NET G1, three of them extended to the lateral or vertical resection margins, while two exhibited lymphovascular invasion. A follow-up upper endoscopy that was performed 6 months after the diagnosis showed multiple remnant gastric polyps that were suggestive of remnant gastric NET.
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- Endoscopic Management of Gastro-Entero-Pancreatic Neuroendocrine Tumours: An Overview of Proposed Resection and Ablation Techniques
Rocio Chacchi-Cahuin, Edward J. Despott, Nikolaos Lazaridis, Alessandro Rimondi, Giuseppe Kito Fusai, Dalvinder Mandair, Andrea Anderloni, Valentina Sciola, Martyn Caplin, Christos Toumpanakis, Alberto Murino
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Tian Ming Xu, Chun Sai'er Wang, Cong Wei Jia, Jia Ming Qian, Jing Nan Li
Journal of Digestive Diseases.2016; 17(3): 162. CrossRef - A 15-year experience with gastric neuroendocrine tumors: Does type make a difference?
Lauren M. Postlewait, Gillian G. Baptiste, Cecilia G. Ethun, Nina Le, Kenneth Cardona, Maria C. Russell, Field F. Willingham, David A. Kooby, Charles A. Staley, Shishir K. Maithel
Journal of Surgical Oncology.2016; 114(5): 576. CrossRef
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Original Articles
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Efficacy and Safety of Endoscopic Papillary Balloon Dilation Using Cap-Fitted Forward-Viewing Endoscope in Patients Who Underwent Billroth II Gastrectomy
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Jong Soon Jang, Seungho Lee, Hee Seung Lee, Myeong Ho Yeon, Joung-Ho Han, Soon Man Yoon, Hee Bok Chae, Sei Jin Youn, Seon Mee Park
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Clin Endosc 2015;48(5):421-427. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.421
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- Background/Aims
Endoscopic exploration of the common bile duct (CBD) is difficult and dangerous in patients with Billroth II gastrectomy (B-II). Endoscopic papillary balloon dilation (EPBD) via a cap-fitted forward-viewing endoscope has been reported to be an effective and safe procedure. We analyzed the technical success and complications of EPBD in patients who underwent B-II.
MethodsThirty-six consecutive patients with B-II were enrolled from among 2,378 patients who had undergone endoscopic retrograde cholangiopancreatography in a single institute in the last 4 years. The EPBD procedure was carried out using a cap-fitted forward-viewing endoscope with 8-mm balloon catheters for 60 seconds. We analyzed the rates of CBD exploration, technical success, and complications.
ResultsAfferent loop intubation was performed in all patients and selective cannulation of the bile duct was performed in 32 patients (88.9%). Complications such as transient hypoxia were observed in two patients (5.6%) and perforation, in three patients (9.7%). The perforation sites were ductal injury in two patients and one patient showed retroperitoneal air alone without symptoms. Three patients manifested different clinical courses of severe acute pancreatitis and peritonitis, transient abdominal pain, and retroperitoneal air alone. The condition of one patient improved with surgery and that of the other two patients, with conservative management.
ConclusionsPatients with perforation during EPBD in B-II showed different clinical courses. Tailored treatment strategies are necessary for improving the clinical outcomes.
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- Endoscopic biliary drainage in patients with surgically altered anatomy: the Street multicenter study
Aurelio Mauro, Giuseppe Vanella, Vincenzo Giorgio Mirante, Alessandro Fugazza, Cecilia Binda, Luca Elli, Edoardo Forti, Roberto Di Mitri, Debora Berretti, Helga Bertani, Mariangela Delliponti, Federico Desideri, Virginia Ferretti, Roberto Grassia, Roberto
Gastrointestinal Endoscopy.2025;[Epub] CrossRef - A “One Accessory and One Guidewire-in-One Channel” Technique in a Patient with Billroth II Anastomosis
Kook Hyun Kim, Sung Bum Kim, Tae Nyeun Kim
Clinical Endoscopy.2021; 54(1): 139. CrossRef - Which scope is appropriate for endoscopic retrograde cholangiopancreatography after Billroth II reconstruction: An esophagogastroduodenoscope or a colonoscope?
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Takuto Hikichi, Hiromasa Ohira
World Journal of Gastrointestinal Endoscopy.2020; 12(8): 220. CrossRef - Recent advances in endoscopic retrograde cholangiopancreatography in Billroth II gastrectomy patients: A systematic review
Tae Young Park, Tae Jun Song
World Journal of Gastroenterology.2019; 25(24): 3091. CrossRef - Challenges of endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrointestinal anatomy: A review article
Rabbinu Rangga Pribadi, Abdul Aziz Rani, Murdani Abdullah
Journal of Digestive Diseases.2019; 20(12): 631. CrossRef - Endoscopic retrograde cholangiopancreatography in Billroth II gastrectomy patients: Outcomes and potential factors affecting technical failure
Jia-Su Li, Duo-Wu Zou, Zhen-Dong Jin, Jie Chen, Xin-Gang Shi, Zhao-Shen Li, Feng Liu
Saudi Journal of Gastroenterology.2019; 25(6): 355. CrossRef - Endoscopic Management of Difficult Bile Duct Stones
Murad Aburajab, Kulwinder Dua
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Tae Young Park, Chang Seok Bang, Sang Hyeon Choi, Young Joo Yang, Suk Pyo Shin, Ki Tae Suk, Gwang Ho Baik, Dong Joon Kim, Jai Hoon Yoon
Surgical Endoscopy.2018; 32(11): 4598. CrossRef - Self-expandable metal stents for choledocholithiasis in Billroth II gastrectomy patients
Min-Gui Han, Eunae Cho, Chang-Hwan Park, Chung-Hwan Jun, Seon-Young Park
Hepatobiliary & Pancreatic Diseases International.2018; 17(6): 546. CrossRef - Recent Advanced Endoscopic Management of Endoscopic Retrograde Cholangiopancreatography Related Duodenal Perforations
Seon Mee Park
Clinical Endoscopy.2016; 49(4): 376. CrossRef
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Diagnostic Accuracy of the Initial Endoscopy for Ampullary Tumors
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Hee Seung Lee, Jong Soon Jang, Seungho Lee, Myeong Ho Yeon, Ki Bae Kim, Jae Geun Park, Joo Young Lee, Mi Jin Kim, Joung-Ho Han, Rohyun Sung, Seon Mee Park
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Clin Endosc 2015;48(3):239-246. Published online May 29, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.3.239
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- Background/Aims
Ampullary tumors come in a wide variety of malignant forms. We evaluated the diagnostic accuracy of endoscopy for ampullary tumors, and analyzed the causes of misdiagnosis.
MethodsWe compared endoscopic imaging and biopsy results to final diagnoses. Types of endoscope, numbers of biopsy specimens taken, and final diagnoses were evaluated as possible factors influencing diagnostic accuracy.
ResultsFinal diagnoses were 19 adenocarcinomas, 18 normal or papillitis, 11 adenomas, two adenomyomas, one paraganglioma, and one neuroendocrine tumor. The diagnostic accuracy of endoscopic imaging or the initial biopsy was identical (67.3%). At least one test was concordant with the final diagnosis in all except two cases. Compared with the final diagnosis, endoscopic imaging tended to show more advanced tumors, whereas the initial biopsy revealed less advanced lesions. The diagnostic accuracy of the initial biopsy was influenced by the type of endoscope used and the final diagnosis, but not by the number of biopsies taken.
ConclusionsEndoscopy has limited accuracy in the diagnosis of ampullary tumors. However, most cases with concordant endoscopic imaging and biopsy results are identical to the final diagnosis. Therefore, in cases where both of these tests disagree, re-evaluation with a side-viewing endoscope after resolution of papillitis is required.
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Citations to this article as recorded by

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Minh Thu T. Nguyen, Ruchir Paladiya, Dushyant Singh Dahiya, Murali Dharan
Journal of Clinical Medicine.2025; 14(10): 3532. CrossRef - Outcomes of endoscopic papillectomy of ampullary carcinoma and factors affecting additional surgery
Yoshihisa Takada, Takuya Ishikawa, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Noriaki Gibo, Eizaburo Ohno, Hiroki Kawashima
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Guizani Rami, Mseddi Mohamed Ali, Hsairi Meriem, Saad Sarra, Zehani Alia, Ben Slima Mohamed
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Francisco Ramos-Muñoz, Luis Carlos Hinojosa-Arco, Jorge Francisco Roldán-de la Rúa, Ana Isabel García-Salguero, Miguel Ángel Suárez-Muñoz
Gastroenterología y Hepatología.2022; 45: 69. CrossRef - Adenomatous neoplasia in the papilla of Vater endoscopic and/or surgical resection?
Erik Haraldsson, Asif Halimi, Elena Rangelova, Roberto Valente, J. Matthias Löhr, Urban Arnelo
Surgical Endoscopy.2022; 36(4): 2401. CrossRef - Endoscopic Papillectomy
Sara Teles de Campos, Marco J. Bruno
Gastrointestinal Endoscopy Clinics of North America.2022; 32(3): 545. CrossRef - Efficacy and Safety of Exploring Deeper Sections of the Infrapapillary Area of the Duodenum by Using Sedative Esophagogastroduodenoscopy
Ming-Tse Hsu, Chi-Yi Chen, Kai-Sheng Liao, Wei-Sheng Chung, Tatsuya Toyokawa
Gastroenterology Research and Practice.2022; 2022: 1. CrossRef - Ampullary Adenocarcinoma: a Mini-Review and a Case Report of a Clinically Stable Disease Patient Treated with Herbal Supplements
Khin Maung Lwin, Ye Htut Linn, Yamin Kyaw Swar Dee
Journal of Gastrointestinal Cancer.2021; 52(2): 750. CrossRef - Proposed nomogram predicting neoplastic ampullary obstruction in patients with a suspected ampulla of Vater lesion on CT
Soo Young Jang, Jin Sil Kim, Seung Yon Baek, Hye Ah Lee, Jeong Kyong Lee
Abdominal Radiology.2021; 46(7): 3128. CrossRef - Long‐term outcomes of endoscopic papillectomy for early‐stage cancer in duodenal ampullary adenoma: Comparison to surgical treatment
Jun Seong Hwang, Hoonsub So, Dongwook Oh, Tae Jun Song, Do Hyun Park, Dong‐Wan Seo, Sung Koo Lee, Myung‐Hwan Kim, Seung‐Mo Hong, Jungho Yang, Sang Soo Lee
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Geoffroy Vanbiervliet, Marin Strijker, Marianna Arvanitakis, Arthur Aelvoet, Urban Arnelo, Torsten Beyna, Olivier Busch, Pierre H. Deprez, Lumir Kunovsky, Alberto Larghi, Gianpiero Manes, Alan Moss, Bertrand Napoleon, Manu Nayar, Enrique Pérez-Cuadrado-Ro
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Kosuke Takahashi, Eisuke Ozawa, Ichiro Yasuda, Naohiro Komatsu, Hisamitsu Miyaaki, Ken Ohnita, Takuji Yamao, Kazuo Oba, Tatsuki Ichikawa, Kazuhiko Nakao
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Darren L Scroggie, Vasileios K Mavroeidis
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I.Y. Nedoluzhko, E.I. Khon, K.V. Shishin, L.V. Shumkina, N.A. Kurushkina
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Chisaki Ikeda, Naohiko Makino, Akiko Matsuda, Yasuharu Kakizaki, Tetsuya Ishizawa, Toshikazu Kobayashi, Shinpei Sugahara, Mayo Nishiduka, Michihiko Tsunoda, Junichiroh Haga, Rikiya Tsunoda, Yoshiyuki Ueno
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Wirana Angthong, Kran Jiarakoop, Kaan Tangtiang
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Erratum
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Erratum: Extended Spectrum-β-Lactamase or Carbapenemase Producing Bacteria Isolated from Patients with Acute Cholangitis
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Ja Chung Goo, Mun Hyuk Seong, Young Kwang Shim, Hee Seung Lee, Jung-Ho Han, Kyeong Seob Shin, Jae-Woon Choi, Sei Jin Youn, Seon Mee Park
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Clin Endosc 2012;45(4):453-453. Published online November 30, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.4.453
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Corrects: Clin Endosc 2012;45(2):155
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Original Article
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Extended Spectrum-β-Lactamase or Carbapenemase Producing Bacteria Isolated from Patients with Acute Cholangitis
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Ja Chung Goo, Mun Hyuk Seong, Young Kwang Shim, Hee Seung Lee, Jung-Ho Han, Kyeong Seob Shin, Jae-Woon Choi, Sei Jin Youn, Seon Mee Park
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Clin Endosc 2012;45(2):155-160. Published online June 30, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.2.155
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Correction in: Clin Endosc 2012;45(4):453
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Abstract
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- Background/Aims
This study assessed the antibiotic resistance organisms isolated from the blood and bile of acute cholangitis and evaluated risk factors associated with them and their impact on clinical outcomes.
MethodsThe identities and antibiotic resistance profiles of bacteria isolated from 433 cases of acute cholangitis from 346 patients were analyzed. Risk factors and the outcomes of patients infected with them were assessed.
ResultsMicroorganisms were isolated from 266 of 419 blood cultures and 256 of 260 bile cultures. Isolates from bile and blood were identical in 71% of the cases. A total of 20 extended spectrum-β-lactamase (ESBL)-producers and 4 carbapenemase-producing organisms were isolated from blood, and 34 ESBL-producers and 13 carbapenemase-producers were isolated from bile. Sixty-four (14.8%) cases were infected with any one of these bacteria isolated from blood or bile. Risk factors associated with them in blood were nosocomial infection and prior biliary intervention. In bile, indwelling biliary device was a risk factor associated with them. Antibiotic-resistant bacteria were associated with mortality, independent of other prognostic factors.
ConclusionsESBL or carbapenemase-producing bacteria were frequently isolated in acute cholangitis patients especially with prior biliary intervention and nosocomial infection. Isolation of antibiotic-resistant bacteria was an independent risk factor of mortality.
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Infection & Chemotherapy.2022; 54(4): 812. CrossRef - Addition of anaerobic coverage for treatment of biliary tract infections: a propensity score-matched cohort study
Marina Simeonova, Nick Daneman, Philip W Lam, Marion Elligsen
JAC-Antimicrobial Resistance.2022;[Epub] CrossRef - Bacterial bile duct colonization in perihilar cholangiocarcinoma and its clinical significance
Jan Bednarsch, Zoltan Czigany, Lara Rosaline Heij, Tom Luedde, Ronald van Dam, Sven Arke Lang, Tom Florian Ulmer, Mathias Walter Hornef, Ulf Peter Neumann
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Ming Tan, Thøger Gorm Jensen, Stig Lønberg Nielsen, Ove B. Schaffalitzky de Muckadell, Stig Borbjerg Laursen
Scandinavian Journal of Gastroenterology.2021; 56(5): 578. CrossRef - Increasing burden of biliary tract infection caused by extended‐spectrum beta‐lactamase‐producing organisms in Korea: A nationwide population‐based study
Dong Kee Jang, Jungmee Kim, Wan Beom Park, Sun Young Yi, Jun Kyu Lee, Won Jae Yoon
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Tassilo Kruis, Sarah Güse-Jaschuck, Britta Siegmund, Thomas Adam, Hans-Jörg Epple
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Koki Kawanishi, Jun Kinoshita, Hiroko Abe, Tetsuhiro Kakimoto, Yuko Yasuda, Takeshi Hara, Jun Kato
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Sang-Heum Park
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