Clinical Endoscopy

Original Articles

A prospective study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures: Bhavik Bharat Shah, Gajanan Ashokrao Rodge, Usha Goenka, Shivaraj Afzalpurkar, Mahesh Kumar Goenka; Clin Endosc 2022;55(6):793-800. Published online April 4, 2022; DOI: https://doi.org/10.5946/ce.2021.211

Background
/Aims: Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety of FCSEMSs in this patient group.
Methods
This prospective single-center study included patients who underwent endoscopic retrograde pancreatography with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain score of >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreatic strictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events.
Results
Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was 86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The mean visual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were asymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancreatitis (2.8%) were the most common adverse events.
Conclusions
FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractory main pancreatic duct strictures.

Citations

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Self-expanding metallic stent for refractory pancreatic duct stricture in chronic pancreatitis: A prospective follow-up study
Praveer Rai, Pankaj Kumar, Ashok Kumar, Sana Asari, Kartik Agarwal, Mayank, Ravi V. Krishna Kishore, Prabhaker Mishra
Indian Journal of Gastroenterology.2025; 44(6): 854. CrossRef
A review on pancreatic duct stents: materials and emerging trends
Huijuan Fan, Nan Li, Xingguang Zhang, Wei Xu, Wencheng Zhang, Yangjuan Ding, Lingjian Li, Taotao Liu, Shihai Xia
Biomedical Materials.2025; 20(3): 032004. CrossRef
Updates in endoscopic management of pain in chronic pancreatitis
Anthony M. Rainho, Owen C. Battel, Vanessa M. Shami
Current Opinion in Gastroenterology.2025; 41(5): 290. CrossRef
Role of fully covered metal stents in the management of chronic pancreatitis
Younghun Jeon, Hoonsub So, Sung Jo Bang
Clinical Endoscopy.2025; 58(5): 646. CrossRef
Citric Acid Loaded Hydrogel-Coated Stent for Dissolving Pancreatic Duct Calculi
Jing Li, Yanwei Lv, Zheng Chen, Jiulong Zhao, Shige Wang
Gels.2024; 10(2): 125. CrossRef
Fully Covered Self-expandable Metallic Stents for Refractory Benign Pancreatic Duct Strictures: A Systematic Review and Meta-analysis
Gajanan Rodge, Suprabhat Giri, Kailash Kolhe, Shivaraj Afzalpurkar, Sidharth Harindranath, Sridhar Sundaram, Aditya Kale
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(5): 529. CrossRef
Quality of life after endoscopic procedures for chronic pancreatitis: A multicentre study
Mikael Parhiala, Camilla Nøjgaard, Andreas Bartholdy, Anne Waage, Povilas Ignatavičius, Trond Engjom, Georg Dimcevski, Ingrid Kvåle Nordaas, Evangelos Kalaitzakis, Asbjørn M. Drewes, Amer Hadi, Søren S. Olesen, Jakob L. Poulsen, Johanna Laukkarinen
United European Gastroenterology Journal.2023; 11(9): 884. CrossRef
Pancreatic duct stents
Jin Hui Yi, Zhao Shen Li, Liang Hao Hu
Journal of Digestive Diseases.2022; 23(12): 675. CrossRef

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8 Crossref

Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System: Mahesh Kumar Goenka, Bhavik Bharat Shah, Vijay Kumar Rai, Surabhi Jajodia, Usha Goenka; Clin Endosc 2018;51(6):563-569. Published online October 5, 2018; DOI: https://doi.org/10.5946/ce.2018.041

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Background
/Aims: To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system.
Methods
Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined.
Results
Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement.
Conclusions
The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.

Citations

Citations to this article as recorded by

Capsule endoscopy for small bowel bleed: Current update
Uday C. Ghoshal, Akash Roy, Mahesh K. Goenka
Indian Journal of Gastroenterology.2024; 43(5): 896. CrossRef
Diagnosis and management of ectopic varices in portal hypertension
Thomas H Tranah, Jeremy S Nayagam, Stephen Gregory, Sarah Hughes, David Patch, Dhiraj Tripathi, Debbie L Shawcross, Deepak Joshi
The Lancet Gastroenterology & Hepatology.2023; 8(11): 1046. CrossRef
The Role of Video Capsule Endoscopy in Liver Disease
Alexander Ross Robertson, Anastasios Koulaouzidis, Emanuele Rondonotti, Mauro Bruno, Marco Pennazio
Gastrointestinal Endoscopy Clinics of North America.2021; 31(2): 363. CrossRef
Role of Video Capsule in Small Bowel Bleeding
Richard M. Wu, Laurel R. Fisher
Gastrointestinal Endoscopy Clinics of North America.2021; 31(2): 277. CrossRef
The Usefulness of New-Generation Capsule Endoscopy in Patients with Portal Hypertensive Enteropathy
Seung-Joo Nam, Ji Hyun Kim, Sung Chul Park
Clinical Endoscopy.2018; 51(6): 505. CrossRef

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Pancreatic Necrosectomy through Sinus Tract Endoscopy: Mahesh Kumar Goenka, Usha Goenka, Md.Yasin Mujoo, Indrajit Kumar Tiwary, Sanjay Mahawar, Vijay Kumar Rai; Clin Endosc 2018;51(3):279-284. Published online January 4, 2018; DOI: https://doi.org/10.5946/ce.2017.066

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Background
/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walled-off necrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. We evaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON.
Methods
Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WON requiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adult gastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain.
Results
Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean time of 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergo surgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, or recurrence during follow-up.
Conclusions
Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details of the technique and end-points of STE require further evaluation.

Citations

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Percutaneous Endoscopic Necrosectomy of Walled-Off Pancreatic and Peripancreatic Necrosis
Mateusz Jagielski, Agata Chwarścianek, Damian Dudek, Jacek Piątkowski, Marek Jackowski
Journal of Clinical Medicine.2026; 15(2): 470. CrossRef
Management of pancreatic fluid collections: A concise review
Saroj Kanta Sahu, Bipadabhanjan Mallick, Preetam Nath, Dibyalochan Praharaj, Suprabhat Giri, Sarat Chandra Panigrahi, Anil Chandra Anand
Journal of Integrative Medicine and Research.2025; 3(1): 4. CrossRef
Percutaneous retroperitoneal necrectomy for infected forms of acute necrotizing pancreatitis
V.N. Ektov, A.V. Fedorov, M.A. Khodorkovsky, A.V. Kurkin
Pirogov Russian Journal of Surgery.2025; (3): 149. CrossRef
Pancreatic necrosis: a scoping review
Anthony RAINHO, Mira SRIDHARAN, Daniel S. STRAND
Minerva Gastroenterology.2025;[Epub] CrossRef
A New Step-Up Dual Endoscopic Approach for Large-Size Infected Pancreatic Necrosis: Percutaneous Endoscopic Necrosectomy Followed by Transluminal Endoscopic Drainage/Necrosectomy
Santi Mangiafico, Helga Bertani, Flavia Pigò, Salvatore Russo, Marinella Lupo, Silvia Cocca, Giuseppe Grande, Ugo Germani, Raffaele Manta, Rita Conigliaro
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(2): 156. CrossRef
Metal stent and percutaneous endoscopic necrosectomy as dual approach for the management of complex walled-off pancreatic necrosis
Cecilia BINDA, Barbara PERINI, Chiara COLUCCIO, Paolo GIUFFRIDA, Stefano FABBRI, Giulia GIBIINO, Antonio VIZZUSO, Emanuela GIAMPALMA, Carlo FABBRI
Minerva Surgery.2024;[Epub] CrossRef
Necrosis pancreática extensa, manejo exitoso con necrosectomía endoscópica percutánea
Daniela Giraldo Campillo, Juliana Lucía Molina Valencia, Juan Camilo Ricaurte Ciro, Carlos Andrés Delgado López
Revista colombiana de Gastroenterología.2024; 39(2): 194. CrossRef
Management of Pancreatic Fluid Collections
Sohini Sameera, Tayyaba Mohammad, Kelvin Liao, Haroon Shahid, Avik Sarkar, Amy Tyberg, Michel Kahaleh
Journal of Clinical Gastroenterology.2023; 57(4): 346. CrossRef
Placement of Plastic Stents after Direct Endoscopic Necrosectomy through a Novel Lumen-Apposing Metal Stent for Effective Treatment of Laterally Extended Walled-Off Necrosis: A Pilot Study
Kyong Joo Lee, Se Woo Park, Da Hae Park, Jung Hee Kim, Jang Han Jung, Dong Hee Koh, Jin Lee, Mi Gang Kim
Journal of Clinical Medicine.2023; 12(3): 1125. CrossRef
Percutaneous endoscopic necrosectomy (PEN) for treatment of necrotizing pancreatitis: a systematic review and meta-analysis
Mihajlo Gjeorgjievski, Abishek Bhurwal, Abhishek A. Chouthai, Abdelhai Abdelqader, Monica Gaidhane, Haroon Shahid, Amy Tyberg, Avik Sarkar, Michel Kahaleh
Endoscopy International Open.2023; 11(03): E258. CrossRef
Percutaneous Endoscopic Necrosectomy
Soumya Jagannath Mahapatra, Pramod Kumar Garg
Gastrointestinal Endoscopy Clinics of North America.2023; 33(4): 737. CrossRef
Controversies in EUS-guided treatment of walled-off necrosis
Michael Hocke, Sean Burmeister, Barbara Braden, Christian Jenssen, Paolo Giorgio Arcidiacono, Julio Iglesias-Garcia, André Ignee, Alberto Larghi, Kathleen Möller, Mihai Rimbas, Sun Siyu, Giuseppe Vanella, Christoph F. Dietrich
Endoscopic Ultrasound.2022; 11(6): 442. CrossRef
Interventional strategies in infected necrotizing pancreatitis: Indications, timing, and outcomes
Birte Purschke, Louisa Bolm, Max Nikolaus Meyer, Hiroki Sato
World Journal of Gastroenterology.2022; 28(27): 3383. CrossRef
Percutaneous direct endoscopic pancreatic necrosectomy
Manoj A Vyawahare, Sushant Gulghane, Rajkumar Titarmare, Tushar Bawankar, Prashant Mudaliar, Rahul Naikwade, Jayesh M Timane
World Journal of Gastrointestinal Surgery.2022; 14(8): 731. CrossRef
EUS-guided drainage using lumen apposing metal stent and percutaneous endoscopic necrosectomy as dual approach for the management of complex walled-off necrosis: a case report and a review of the literature
Cecilia Binda, Monica Sbrancia, Marina La Marca, Dora Colussi, Antonio Vizzuso, Matteo Tomasoni, Vanni Agnoletti, Emanuela Giampalma, Luca Ansaloni, Carlo Fabbri
World Journal of Emergency Surgery.2021;[Epub] CrossRef
Technical aspects of minimally invasive percutaneous approach for local complications of acute pancreatitis
S. V. Novikov, M. L. Rogal, R. A. Yartsev, Yu. S. Teterin
Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2021; 26(3): 60. CrossRef
Endoscopic transmural drainage and necrosectomy in acute necrotizing pancreatitis: A review
Linlin Feng, Jintao Guo, Sheng Wang, Xiang Liu, Nan Ge, Guoxin Wang, Siyu Sun
Journal of Translational Internal Medicine.2021; 9(3): 168. CrossRef
Percutaneous endoscopic necrosectomy in a patient with emphysematous pancreatitis
Shin Hee Lee, Kyu-hyun Paik, Ji Chang Kim, Won Suk Park
Medicine.2021; 100(46): e27905. CrossRef
Optimal Therapeutic Options for Complex Walled-Off Necrosis: Endoscopic and Percutaneous Drainage
Hoonsub So, Seokjung Jo, Tae Jun Song
The Korean Journal of Pancreas and Biliary Tract.2019; 24(1): 6. CrossRef

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Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study: Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary; Clin Endosc 2017;50(1):58-63. Published online October 31, 2016; DOI: https://doi.org/10.5946/ce.2016.028

Abstract PDF PubReader ePub

Background
/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC.
Methods
Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip.
Results
All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding.
Conclusions
In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.

Citations

Citations to this article as recorded by

Efficacy and safety of hand suturing technique application in the endoscopic treatment of gastrointestinal tract tumors: a systematic review and meta-analysis
Mohamed Mahmoud Marey, Abdelaziz A. Awad, Amany Mahmoud Genidy, Aliaa Bahaa Abdelaziz, Menna M. Aboelkhier, Mazen Negmeldin Aly Yassin, Mohamed A. Aldemerdash, Ahmed Aldemerdash, Mohamed Eldesouki, Abdelrahman Shata, Mohamed Hamed, Ahmed R. A. Abou-Shanab
European Surgery.2025;[Epub] CrossRef
Endoscopic self-expandable metal stent versus endoscopy vacuum therapy for traumatic esophageal perforations: a retrospective cohort study
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Kun He, Ke Pang, Lujing Ying, Daiyu Yang, Kai Song, Yangjin Ciren, Xiaxiao Yan, Ziqi Guo, Chengzhen Lyu, Qiang Wang, Dong Wu
Alimentary Pharmacology & Therapeutics.2024; 60(2): 112. CrossRef
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Antonio Corsello, Matthieu Antoine, Shishu Sharma, Valérie Bertrand, Salvatore Oliva, Giorgio Fava, Francesca Destro, Andrew Huang, Wei S. W. Fong, Martina Ichino, Mike Thomson, Frederic Gottrand
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Shannon Chan, Rapat Pittayanon, Hsiu-Po Wang, Jiann-Hwa Chen, Anthony YB Teoh, Yu Ting Kuo, Raymond SY Tang, Hon Chi Yip, Stephen Ka Kei Ng, Sunny Wong, Joyce Wing Yan Mak, Heyson Chan, Louis Lau, Rashid N Lui, Marc Wong, Rungsun Rerknimitr, Enders K Ng,
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Shannon Melissa Chan, Kitty Kit Ying Auyeung, Siu Fung Lam, Philip Wai Yan Chiu, Anthony Yuen Bun Teoh
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Closure of Gastrointestinal Fistulas and Leaks with the Over-the-Scope Clip: Case-Series Analysis
Abdullah Senlikci, Tahsin Dalgic, Ahmet Alyanak, Erdal Birol Bostanci
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Combination Endoscopic Therapy is Effective for Treatment of Nonbariatric Postoperative Gastroenteric Leaks
Nikhil R. Thiruvengadam, Christopher Hamerski, Andrew Nett, Yasser Bhat, Janak Shah, Jona Bernabe, Steven Kane, Kenneth Binmoeller, Rabindra R. Watson
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