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Original Article
Effect of antithrombotic therapies on small bowel bleeding: an European multicenter retrospective study
Lucia Scaramella, Stefania Chetcuti Zammit, Reena Sidhu, Maurizio Vecchi, Gian Eugenio Tontini, Nicoletta Nandi, Matilde Topa, Luca Elli
Clin Endosc 2025;58(1):102-111.   Published online December 2, 2024
DOI: https://doi.org/10.5946/ce.2024.073
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Small bowel bleeding (SBB) is the main indication for videocapsule endoscopy (VCE); the diagnostic yield (DY) could be influenced by antithrombotic therapies. We explored the effects of these therapies on SBB.
Methods
Consecutive patients from two centers (Milan, Italy and Sheffield, UK) who underwent VCE between March 2001 and July 2020 were considered. Demographic data, clinical parameters, drug therapy, and technical characteristics of the procedure were collected. VCE findings and DY were evaluated.
Results
In total, 957 patients (1,052 VCEs) underwent VCE for SBB (DY 50.6%, no retention); 27 patients (27 VCEs) received direct oral anticoagulants, 87 (88 VCEs) received other anticoagulants, 115 (135 VCEs) received antiplatelet therapy, 198 (218 VCEs) received monotherapy, and 31 (32 VCEs) received combined therapy. There were no differences in the completion rate, findings, and DYs between each subgroup or between monotherapy and combined therapy. The overt bleeding rate was similar in all groups, even when comparing antithrombotic users versus those not on therapy (p=0.59) or monotherapy versus combined therapy (p=0.34).
Conclusions
VCE is safe and has a high clinical impact on SBB. Antithrombotic therapies did not affect DY or overt bleeding rate and, consequently, can be considered safe in terms of SBB risk.

Citations

Citations to this article as recorded by  
  • Do all antithrombotic agents have a similar impact on small bowel bleeding?
    Chung Hyun Tae, Ki-Nam Shim
    Clinical Endoscopy.2025; 58(1): 80.     CrossRef
  • 983 View
  • 118 Download
  • 1 Crossref
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Reviews
Endoscopic vacuum therapy for gastrointestinal transmural defects: a literature review
Tan Minh Le, Van Huy Tran, Kyu Sung Chung, Seong Woo Jeon
Clin Endosc 2025;58(2):181-190.   Published online November 8, 2024
DOI: https://doi.org/10.5946/ce.2024.150
AbstractAbstract PDFPubReaderePub
Endoscopic vacuum therapy (EVT) has emerged as a transformative approach for managing gastrointestinal (GI) transmural defects, offering a less invasive and more promising alternative to surgery. Initially developed to address anastomotic leaks after rectal surgery, the application of EVT has expanded to include other locations within the GI tract. This review investigated the principles, indications, procedures, outcomes, challenges, and future perspectives of EVT for the management of GI transmural defects. In conclusion, EVT has demonstrated favorable outcomes in GI defect closure, with reduced complications, shortened hospital stay, and decreased morbidity rates as compared with conventional treatments. Although EVT faces challenges in some specific anatomical locations and in managing severe complications such as major bleeding, ongoing advancements in technology and standardization efforts offer promise for broader indications and better outcomes. Future perspectives include exploring novel EVT devices, refining patient selection criteria and pre-emptive applications, and standardizing procedural protocols.
  • 1,715 View
  • 296 Download
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Image-enhanced endoscopy in upper gastrointestinal disease: focusing on texture and color enhancement imaging and red dichromatic imaging
Jae Yong Park
Clin Endosc 2025;58(2):163-180.   Published online November 6, 2024
DOI: https://doi.org/10.5946/ce.2024.159
AbstractAbstract PDFPubReaderePub
Endoscopic examination plays a crucial role in the diagnosis of upper gastrointestinal (UGI) tract diseases. Despite advancements in endoscopic imaging, the detection of subtle early cancers and premalignant lesions using white-light imaging alone remains challenging. This review discusses two novel image-enhanced endoscopy (IEE) techniques–texture and color enhancement imaging (TXI) and red dichromatic imaging (RDI)–and their potential applications in UGI diseases. TXI enhances texture, brightness, and color tone, which improves the visibility of mucosal irregularities and facilitates earlier detection of neoplastic lesions. Studies have suggested that TXI enhances the color differences between lesions and the surrounding mucosa and improves the visibility of the lesion. TXI aids in the diagnosis of various UGI diseases, including early gastric cancer, esophageal cancer, premalignant conditions such as atrophic gastritis and Barrett’s esophagus, and duodenal tumors. RDI utilizes specific wavelengths to enhance the visualization of deep blood vessels or bleeding points, aiding in the rapid and accurate identification of bleeding sources during endoscopic procedures. Although promising, TXI and RDI require further large-scale studies across diverse populations to establish their clinical utility, diagnostic performance, and cost-effectiveness before integration into the guidelines. Standardized training is also required for effective utilization. Overall, these IEE techniques has the potential to improve the diagnosis and management of UGI.
  • 2,623 View
  • 325 Download
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Original Article
Microbiological surveillance result of endoscopes after INTERCEPT Foam Spray: a quasi-experimental pilot study in Singapore
Caihong Wang, Rong Zhang, Ruhui Fan, Jiewen Low, Ruochen Du, Xueyun Ma, Congcong Cai
Clin Endosc 2024;57(6):821-831.   Published online November 4, 2024
DOI: https://doi.org/10.5946/ce.2024.030
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aimed to assess the impact of INTERCEPT Foam Spray (IFS) application on delayed endoscope reprocessing through microbiological surveillance culture (MSC).
Methods
A quasi-experimental, matched-comparison pilot study was conducted using gastrointestinal endoscopy. IFS was applied to the endoscopes after precleaning and before reprocessing the next day. An equal number of endoscopes, matched by endoscope type, were subjected to routine reprocessing. The MSC were subjected to high-level disinfection to detect any contamination. Data were analyzed using the chi-square test or Fisher exact test (categorical data) and Student t-test (continuous data).
Results
In total, 150 MSCs were collected from 42 endoscopes. Positive MSCs were observed in 4.0% (4/75) of the sprayed group and 1.3% (1/75) of the control group (95% confidence interval, 30.34–0.31; p>0.05), all of which were contributed by colonoscopes. Colonoscope were more prone to positive MSC (mean difference in percentage, p<0.05). Mean spraying hours were not associated with detected growth (11.7% vs. 13.6%; 95% confidence interval, 1.43 to –5.27; p>0.05), with environmental and skin flora being the primary contaminants.
Conclusions
IFS may be applied when delayed endoscope processing is necessary, but with caution when applied to colonoscopes. However, further research is warranted to verify the result.

Citations

Citations to this article as recorded by  
  • Efficacy of spray flushing in the reprocessing of flexible endoscopes
    Harendra Kumar, Arkadeep Dhali, Rick Maity, Jyotirmoy Biswas
    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
  • Endoscope processing effectiveness: A reality check and call to action for infection preventionists and clinicians
    Cori L. Ofstead, Abigail G. Smart, Lydia L. Hurst, Larry A. Lamb
    American Journal of Infection Control.2025;[Epub]     CrossRef
  • 1,239 View
  • 107 Download
  • 1 Web of Science
  • 2 Crossref
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Review
Endoscopic findings of immune checkpoint inhibitor-related gastrointestinal adverse events
Min Kyu Kim, Sung Wook Hwang
Clin Endosc 2024;57(6):725-734.   Published online August 29, 2024
DOI: https://doi.org/10.5946/ce.2024.003
AbstractAbstract PDFPubReaderePub
The use of immune checkpoint inhibitors (ICIs) for the treatment of various malignancies is increasing. Immune-related adverse events can occur after ICI administration, with gastrointestinal adverse events constituting a significant proportion of these events. When ICI-related diarrhea/colitis is suspected, endoscopic evaluation is recommended to differentiate it from other etiologies and assess the severity of colitis. The distribution of intestinal inflammation in ICI-related colitis demonstrates a high frequency of extensive colitis (23–86%). However, isolated right-sided colitis (3–8%) and ileitis (2–16%) are less prevalent. Endoscopic findings vary and predominantly encompass features indicative of inflammatory bowel disease, including aphthae, ulcers, diffuse or patchy erythema, mucosal edema, loss of vascular pattern, and friability. The presence of ulcers and extensive intestinal inflammation are associated with a reduced response to treatment. Microscopic inflammation can be observed even in endoscopically normal mucosa, underscoring the need for biopsies of seemingly normal mucosa. Histological findings present with acute/chronic inflammation and occasionally exhibit characteristics observed in inflammatory bowel disease, microscopic colitis, or ischemic colitis. The first-line therapeutic choice for ICI-related diarrhea/colitis with a common terminology criteria for adverse events grade of 2 or above is corticosteroids, whereas infliximab and vedolizumab are recommended for refractory cases.

Citations

Citations to this article as recorded by  
  • Who is at risk for immune checkpoint inhibitor-induced colitis among Korean patients?
    Ji Hyun Kim, Sung Chul Park
    The Korean Journal of Internal Medicine.2025; 40(1): 3.     CrossRef
  • A Case Report of Metastatic Melanoma in the Transverse Colon
    Sophia Bee Ting Tan, Michael Lamparelli
    Cureus.2025;[Epub]     CrossRef
  • CD8+ cell dominance in immune checkpoint inhibitor-induced colitis and its heterogeneity across endoscopic features
    Min Kyu Kim, Hye-Nam Son, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Shinkyo Yoon, Sung Wook Hwang
    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
  • 3,108 View
  • 391 Download
  • 2 Web of Science
  • 3 Crossref
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Original Articles
Safety and efficacy of trans-afferent loop endoscopic ultrasound-guided pancreaticojejunostomy for post pancreaticoduodenectomy anastomotic stricture using the forward-viewing echoendoscope: a retrospective study from Japan
Ahmed Sadek, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto, Kenneth Tachi
Clin Endosc 2025;58(2):311-319.   Published online August 26, 2024
DOI: https://doi.org/10.5946/ce.2024.089
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic ultrasound (EUS)-guided pancreatic duct drainage is a well-established procedure for managing pancreaticojejunostomy anastomotic strictures (PJAS) post-Whipple surgery. In this study, we examined the effectiveness and safety of EUS-guided pancreaticojejunostomy (EUS-PJS).
Methods
This retrospective, single-arm study was performed at Aichi Cancer Center Hospital on 10 patients who underwent EUS-guided pancreaticojejunostomy through the afferent jejunal loop using a forward-viewing echoendoscope when endoscopic retrograde pancreatography failed. Our primary endpoint was technical success rate, defined as successful stent insertion. The secondary endpoints were early and late adverse events.
Results
A total of 10 patients underwent EUS-PJS between February 2019 and October 2023. The technical success rate was 100%. The median procedure time was 23.5 minutes. No remarkable early or late adverse events related to the procedure, except for fever, occurred in two patients. The median follow-up duration was 9.5 months, and the median number of stent exchanges was two. A stent-free state was achieved in three patients.
Conclusions
EUS-PJS for PJAS management after pancreaticoduodenectomy appears to be an effective and safe procedure with the potential advantages of fewer reinterventions and the creation of a permanent drainage fistula.

Citations

Citations to this article as recorded by  
  • Transanastomotic Forward-Viewing EUS-Guided Pancreatic Duct Drainage via Afferent Loop for Pancreaticojejunostomy Anastomotic Stricture After Pancreaticoduodenectomy
    Tadahisa Inoue, Rena Kitano, Tomoya Kitada, Kazumasa Sakamoto, Satoshi Kimoto, Jun Arai, Kiyoaki Ito
    Digestive Diseases and Sciences.2025; 70(1): 413.     CrossRef
  • Management of Pancreaticojejunostomy Strictures: A New Perspective with Forward-Viewing EUS
    Radhika Chavan
    Digestive Diseases and Sciences.2025;[Epub]     CrossRef
  • Transforming endoscopic approaches to post-pancreaticoduodenectomy anastomotic strictures: beyond the surface
    Yu-Ting Kuo
    Clinical Endoscopy.2025; 58(2): 259.     CrossRef
  • 1,996 View
  • 308 Download
  • 1 Web of Science
  • 3 Crossref
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Efficacy of hemostasis by gastroduodenal covered metal stent placement for hemorrhagic duodenal stenosis due to pancreatobiliary cancer invasion: a retrospective study
Yasunari Sakamoto, Taku Sakamoto, Akihiro Ohba, Mitsuhito Sasaki, Shunsuke Kondo, Chigusa Morizane, Hideki Ueno, Yutaka Saito, Yasuaki Arai, Takuji Okusaka
Clin Endosc 2024;57(5):628-636.   Published online June 14, 2024
DOI: https://doi.org/10.5946/ce.2023.155
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Advanced pancreatic and biliary tract cancers can invade the duodenum and cause duodenal hemorrhagic stenosis. This study aimed to evaluate the efficacy of covered self-expandable metal stents in the treatment of cancer-related duodenal hemorrhage with stenosis.
Methods
Between January 2014 and December 2016, metal stents were placed in 51 patients with duodenal stenosis. Among these patients, a self-expandable covered metal stent was endoscopically placed in 10 patients with hemorrhagic duodenal stenosis caused by pancreatobiliary cancer progression. We retrospectively analyzed the therapeutic efficacy of the stents by evaluating the technical and clinical success rates based on successful stent placement, degree of oral intake, hemostasis, stent patency, and overall survival.
Results
The technical and clinical success rates were 100%. All 10 patients achieved a gastric outlet obstruction scoring system score of three within two weeks after the procedure and had no recurrence of melena. The median stent patency duration and overall survival after stent placement were 52 days (range, 20–220 days) and 66.5 days (range, 31–220 days), respectively.
Conclusions
Endoscopic placement of a covered metal stent for hemorrhagic duodenal stenosis associated with pancreatic or biliary tract cancer resulted in duodenal hemostasis, recanalization, and improved quality of life.

Citations

Citations to this article as recorded by  
  • Clinical significance of peritoneal lavage cytology in duodenal cancer
    Yuya Miura, Katsuhisa Ohgi, Ryo Ashida, Yoshiyasu Kato, Shimpei Otsuka, Hideyuki Dei, Katsuhiko Uesaka, Teiichi Sugiura
    Surgery.2025; 181: 109256.     CrossRef
  • Clinical effect of percutaneous hepatic puncture biliary drainage combined with metal stent implantation in the treatment of malignant obstructive jaundice
    Shoulin Zhang, Shaopeng Huang, Zheng Xing, Youwen Song, Fujian Yuan
    BMC Surgery.2025;[Epub]     CrossRef
  • 2,942 View
  • 265 Download
  • 2 Web of Science
  • 2 Crossref
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Safety and efficacy of endoscopic ultrasound-guided pancreatic duct drainage using a drill dilator: a retrospective study in Japan
Ahmed Sadek, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto, Kenneth Tachi
Clin Endosc 2024;57(5):666-674.   Published online June 5, 2024
DOI: https://doi.org/10.5946/ce.2023.272
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Dilation of the tract before stent deployment is a challenging step in endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD). In this study, we examined the effectiveness and safety of a novel spiral dilator, Tornus ES (Asahi Intec), for EUS-PDD.
Methods
This was a retrospective, single-arm, observational study at Aichi Cancer Center Hospital. The punctured tract was dilated using a Tornus ES dilator in all EUS-PDD cases. Our primary endpoint was the technical success rate of initial tract dilation. Technical success was defined as successful fistula dilation using a Tornus ES followed by successful stent insertion. Secondary endpoints were procedure times and early adverse events.
Results
A total of 12 patients were included between December 2021 and March 2023. EUS-PDD was performed in 11 patients for post-pancreaticoduodenectomy anastomotic strictures and one patient with pancreatitis with duodenal perforation. The technical success rates of stent insertion and fistula dilation using a Tornus ES dilator was 100%. The median procedure time was 24 minutes. No remarkable adverse events related to the procedure were observed, apart from fever, which occurred in 2 patients.
Conclusions
Tract dilation in EUS-PDD using a Tornus ES is effective and safe.

Citations

Citations to this article as recorded by  
  • Feasibility of endoscopic ultrasound‐guided hepaticogastrostomy using a novel long balloon catheter
    Yuichi Takano, Naoki Tamai, Masataka Yamawaki, Jun Noda, Tetsushi Azami, Fumitaka Niiya, Naotaka Maruoka, Tatsuya Yamagami, Masatsugu Nagahama
    DEN Open.2025;[Epub]     CrossRef
  • A novel spiral dilator for pancreatic duct drainage: catching two birds with one stone
    Han Taek Jeong, Jimin Han
    Clinical Endoscopy.2024; 57(5): 608.     CrossRef
  • Technical outcomes between a drill dilator and ultra-tapered mechanical dilator during EUS-guided pancreaticogastrostomy: Comparative study
    Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Hiroki Nishikawa
    Endoscopy International Open.2024;[Epub]     CrossRef
  • 3,924 View
  • 320 Download
  • 3 Web of Science
  • 3 Crossref
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Review
The evolution and current state of bariatric endoscopy in Western countries
Maria Valeria Matteo, Vincenzo Bove, Valerio Pontecorvi, Loredana Gualtieri, Giorgio Carlino, Cristiano Spada, Ivo Boškoski
Clin Endosc 2024;57(6):711-724.   Published online May 24, 2024
DOI: https://doi.org/10.5946/ce.2023.253
AbstractAbstract PDFPubReaderePub
With the alarmingly increasing prevalence of obesity in the Western world, it has become necessary to provide more acceptable treatment options for patients with obesity. Minimally invasive endoscopic techniques are continuously evolving. Currently, metabolic and bariatric endoscopies encompass several different techniques that can offer significant weight loss and improvement in comorbidities with a favorable safety profile. Restrictive bariatric procedures include the use of intragastric balloons and gastric remodeling techniques with different suturing devices. Several studies have demonstrated the efficacy and safety of these techniques that are widely used in clinical practice. Small intestine-targeted metabolic endoscopy is an intriguing and rapidly evolving field of research, although it is not widespread in routine practice. These techniques include duodenal-jejunal bypass liners, duodenal mucosal resurfacing, and incisionless anastomoses. The aim of this review article is to provide a detailed update on the currently available bariatric endoscopy techniques in Western countries.

Citations

Citations to this article as recorded by  
  • Duodenal mucosa resurfacing: the endoscopic silver bullet against metabolic disorders?
    Amedeo Lonardo, Ashwani K. Singal
    Metabolism and Target Organ Damage.2025;[Epub]     CrossRef
  • Intragastric Balloon as a Bridge Before Metabolic and Bariatric Surgery: A Systematic Review and Meta-analysis
    Mohammad Kermansaravi, Ali Esparham, Chetan Parmar, Farah A. Husain, Ali Solouki, Mohammad Mahjoubi, Amir Hossein Davarpanah Jazi, Shahab Shahabi Shahmiri
    Obesity Surgery.2025;[Epub]     CrossRef
  • 4,452 View
  • 460 Download
  • 2 Web of Science
  • 2 Crossref
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Original Articles
Prevalence and natural course of incidental gastric subepithelial tumors
Dae-Hyuk Heo, Min A Yang, Jae Sun Song, Won Dong Lee, Jin Woong Cho
Clin Endosc 2024;57(4):495-500.   Published online March 29, 2024
DOI: https://doi.org/10.5946/ce.2023.124
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Gastric subepithelial tumors (SETs) are often encountered during the upper gastrointestinal endoscopic screening. We assessed the prevalence of gastric SETs and the risk factors for their progression.
Methods
We reviewed the electronic medical records of 30,754 patients who underwent upper gastrointestinal endoscopic screening at our medical center between January 2013 and December 2016.
Results
Among the 30,754 patients examined, 599 (1.94%) had gastric SETs. The prevalence increased with age and was 9.56% in patients aged ≥70 years. In total, 262 patients underwent serial endoscopy for more than 6 months. The median age was 68 years (interquartile range [IQR], 61–74), and the number of females was 167 (63.7%). During a median follow-up of 58 months (IQR, 38–75), 22 patients (8.4%) showed significant changes in tumor size. An irregular border (odds ratio, 4.623; 95% confidence interval, 1.093–19.558; p=0.037) was a significant risk factor for progression. Seven patients underwent surgical or endoscopic resections. The pathologies of gastric SETs included leiomyomas (n=3), gastrointestinal stromal tumors (n=2), and lipomas (n=2).
Conclusions
The prevalence of gastric SETs increases with age. Most gastric SETs do not progress during long-term endoscopic examinations, and the risk of an increase in size is low in asymptomatic small SETs without irregular borders.

Citations

Citations to this article as recorded by  
  • Advancements in Endoscopic Treatment for Gastric Subepithelial Tumors
    Osamu Goto, Kazutoshi Higuchi, Eriko Koizumi, Katsuhiko Iwakiri
    Gut and Liver.2025; 19(2): 151.     CrossRef
  • Advancements in endoscopic resection of subepithelial tumors: toward safer, recurrence-free techniques
    Won Shik Kim, Moon Kyung Joo
    Clinical Endoscopy.2025; 58(2): 256.     CrossRef
  • Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis
    Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
    Journal of Clinical Medicine.2024; 13(13): 3725.     CrossRef
  • 3,930 View
  • 245 Download
  • 3 Web of Science
  • 3 Crossref
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Current status and clinical outcome of endoscopic hemostatic powder in gastrointestinal bleeding: a retrospective multicenter study
Zie Hae Lim, Seung In Seo, Dae-Seong Myung, Seung Han Kim, Han Hee Lee, Selen Kim, Bo-In Lee
Clin Endosc 2024;57(5):620-627.   Published online March 8, 2024
DOI: https://doi.org/10.5946/ce.2023.179
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Few multicenter studies have investigated the efficacy of hemostatic powders in gastrointestinal (GI) bleeding. We aimed to investigate the clinical outcomes of hemostatic powder therapy and the independent factors affecting rebleeding rates.
Methods
We retrospectively recruited patients who underwent a new hemostatic adhesive powder (UI-EWD; Next-Biomedical) treatment for upper and lower GI bleeding between January 1, 2020 and March 1, 2023. We collected patients’ medical records and bleeding lesions. The primary outcomes were clinical and technical success rates, and the secondary outcomes were early, delayed, and refractory bleeding, mortality, and factors affecting early rebleeding rates.
Results
This study enrolled 135 patients (age: 67.7±13.6 years, male: 74.1%) from five hospitals. Indications for UI-EWD were peptic ulcers (51.1%), post-procedure-related bleeding (23.0%), and tumor bleeding (19.3%). The clinical and technical success rates were both 97%. The early, delayed, and refractory rebleeding rates were 19.3%, 11.1%, and 12.8%, respectively. Initially elevated blood urea nitrogen (BUN) levels (p=0.014) and Forrest classification IA or IB compared with IIA or IIB (p=0.036) were factors affecting early rebleeding.
Conclusions
UI-EWD showed high clinical and technical success rates; however, rebleeding after UI-EWD therapy in patients with initially high BUN levels and active bleeding, according to the Forrest classification, should be considered.

Citations

Citations to this article as recorded by  
  • Endoscopic hemostatic powder as a salvage treatment for acute gastrointestinal bleeding
    Duc Trong Quach
    Clinical Endoscopy.2024; 57(5): 606.     CrossRef
  • 4,726 View
  • 337 Download
  • 1 Web of Science
  • 1 Crossref
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Review
Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control
Willian Ferreira Igi, Victor Lira de Oliveira, Ayah Matar, Diogo Turiani Hourneaux de Moura
Clin Endosc 2024;57(3):309-316.   Published online February 15, 2024
DOI: https://doi.org/10.5946/ce.2023.217
AbstractAbstract PDFPubReaderePub
The treatment of obesity and its comorbidities ranges from clinical management involving lifestyle changes and medications to bariat­ric and metabolic surgery. Various endoscopic bariatric and metabolic therapies recently emerged to address an important therapeutic gap by offering a less invasive alternative to surgery that is more effective than conservative therapies. This article compre­hensively reviews the technical aspects, mechanism of action, outcomes, and future perspectives of one of the most promising endoscopic bariatric and metabolic therapies, named duodenojejunal bypass liner. The duodenojejunal bypass liner mimics the mechanism of Roux-en-Y gastric bypass by preventing food contact with the duodenum and proximal jejunum, thereby initiating a series of hormonal changes that lead to delayed gastric emptying and malabsorptive effects. These physiological changes result in significant weight loss and improved metabolic control, leading to better glycemic levels, preventing dyslipidemia and non-alcoholic fatty liver disease, and mitigating cardiovascular risk. However, concern ex­ists regarding the safety profile of this device due to the reported high rates of severe adverse events, particularly liver abscesses. Ongo­ing technical changes aiming to reduce adverse events are being evaluated in clinical trials and may provide more reliable data to sup­port its routine use in clinical practice.

Citations

Citations to this article as recorded by  
  • Bacteroides and NAFLD: pathophysiology and therapy
    Jun Zhang, Jing Zhou, Zheyun He, Hongshan Li
    Frontiers in Microbiology.2024;[Epub]     CrossRef
  • 4,739 View
  • 164 Download
  • 2 Web of Science
  • 1 Crossref
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Original Articles
Endoscopic resection of gastric gastrointestinal stromal tumor using clip-and-cut endoscopic full-thickness resection: a single-center, retrospective cohort in Korea
Yuri Kim, Ji Yong Ahn, Hwoon-Yong Jung, Seokin Kang, Ho June Song, Kee Don Choi, Do Hoon Kim, Jeong Hoon Lee, Hee Kyong Na, Young Soo Park
Clin Endosc 2024;57(3):350-363.   Published online February 15, 2024
DOI: https://doi.org/10.5946/ce.2023.144
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: To overcome the technical limitations of classic endoscopic resection for gastric gastrointestinal stromal tumors (GISTs), various methods have been developed. In this study, we examined the role and feasibility of clip-and-cut procedures (clip-and-cut endoscopic full-thickness resection [cc-EFTR]) for gastric GISTs.
Methods
Medical records of 83 patients diagnosed with GISTs after endoscopic resection between 2005 and 2021 were retrospectively reviewed. Moreover, clinical characteristics and outcomes were analyzed.
Results
Endoscopic submucosal dissection (ESD) and cc-EFTR were performed in 51 and 32 patients, respectively. The GISTs were detected in the upper third of the stomach for ESD (52.9%) and cc-EFTR (90.6%). Within the cc-EFTR group, a majority of GISTs were located in the deep muscularis propria or serosal layer, accounting for 96.9%, as opposed to those in the ESD group (45.1%). The R0 resection rates were 51.0% and 84.4% in the ESD and cc-EFTR groups, respectively. Seven (8.4%) patients required surgical treatment (six patients underwent ESD and one underwent cc-EFTR,) due to residual tumor (n=5) and post-procedure adverse events (n=2). Patients undergoing R0 or R1 resection did not experience recurrence during a median 14-month follow-up period, except for one patient in the ESD group.
Conclusions
cc-EFTR displayed a high R0 resection rate; therefore, it is a safe and effective therapeutic option for small gastric GISTs.

Citations

Citations to this article as recorded by  
  • Advancements in Endoscopic Treatment for Gastric Subepithelial Tumors
    Osamu Goto, Kazutoshi Higuchi, Eriko Koizumi, Katsuhiko Iwakiri
    Gut and Liver.2025; 19(2): 151.     CrossRef
  • Endoscopic resection penetrating the muscularis propria for gastric gastrointestinal stromal tumors: advances and challenges
    Jin Woong Cho
    Clinical Endoscopy.2024; 57(3): 329.     CrossRef
  • 6,099 View
  • 170 Download
  • 2 Web of Science
  • 2 Crossref
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Clinical outcomes of nonvariceal upper gastrointestinal bleeding in nonagenarians and octogenarians: a comparative nationwide analysis
Khaled Elfert, James Love, Esraa Elromisy, Fouad Jaber, Suresh Nayudu, Sammy Ho, Michel Kahaleh
Clin Endosc 2024;57(3):342-349.   Published online February 7, 2024
DOI: https://doi.org/10.5946/ce.2023.130
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Nonagenarians will purportedly account for 10% of the United States population by 2050. However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group.
Methods
The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD).
Results
Nonagenarians had higher in-hospital mortality than that of octogenarians (4% vs. 3%, p<0.001). EGD utilization (30% vs. 48%, p<0.001) and blood transfusion (27% vs. 40%, p<0.001) was significantly lower in nonagenarians. Multivariate logistic regression analysis revealed that nonagenarians with NVUGIB had higher odds of mortality (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3–1.7) and lower odds of EGD utilization (OR, 0.86; 95% CI, 0.83–0.89) than those of octogenarians.
Conclusions
Nonagenarians admitted with NVUGIB have a higher mortality risk than that of octogenarians. EGD is used significantly in managing NVUGIB among nonagenarians; however, its utilization is comparatively lower than in octogenarians. More studies are needed to assess predictors of poor outcomes and the indications of EGD in this growing population.
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Novel upper gastrointestinal bleeding sensor capsule: a first human feasibility and safety trial
Lukas Bajer, Marvin Ryou, Christopher C. Thompson, Pavel Drastich
Clin Endosc 2024;57(2):203-208.   Published online January 17, 2024
DOI: https://doi.org/10.5946/ce.2023.111
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Upper gastrointestinal bleeding (UGIB) is the most common GI condition requiring hospitalization, and can be diagnosed by direct visualization. The present study aimed to evaluate the safety and feasibility of using the PillSense system (EnteraSense Ltd.), a novel diagnostic tool designed for the rapid in vivo detection of UGIB, in human volunteers.
Methods
In the present study, 10 volunteers swallowed a PillSense capsule, followed by 2 servings of an autologous blood preparation. Participants were monitored for capsule passage, overall tolerability of the procedure, and adverse events.
Results
The procedure was completed per the protocol established in the present study in 9/10 cases. In 9 of the subjects, after capsule ingestion, the device indicated the absence of blood with sensor output values of 1. After the ingestion of the first blood mixture, the sensor outputs of all devices increased from 2.8 to 4, indicating that each camera detected blood. The sensor output remained within that range after the ingestion of the second mixture; however, in one case, the baseline capsule signal was positive, because of a preexisting condition. The passage of the capsule was verified in all patients, and no adverse events were reported.
Conclusions
The first trial of the PillSense system in human subjects demonstrated the feasibility, safety, and tolerability of utilizing this product as a novel, noninvasive, and easy-to-use triage tool for the diagnosis of patients suspected of having UGIB.

Citations

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  • Advances in implantable capsule robots for monitoring and treatment of gastrointestinal diseases
    Xiaofeng Wang, Hao Xu, Yanlong Ren, Ying Yuan, Fei Deng, Wei Gao, Zheng Lou, Xian-Tao Song, Hao Guo, Wei Han, Lili Wang
    Materials Science and Engineering: R: Reports.2025; 163: 100943.     CrossRef
  • Could a bleeding-sensor device be established as a new paradigm for detecting upper gastrointestinal bleeding before performing endoscopy?
    Sun Gyo Lim
    Clinical Endoscopy.2024; 57(2): 191.     CrossRef
  • Approaches of wearable and implantable biosensor towards of developing in precision medicine
    Elham Ghazizadeh, Zahra Naseri, Hans-Peter Deigner, Hossein Rahimi, Zeynep Altintas
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • 3,631 View
  • 183 Download
  • 2 Web of Science
  • 3 Crossref
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Reviews
Endoscopic management of postoperative bleeding
Sung Hyeok Ryou, Ki Bae Bang
Clin Endosc 2023;56(6):706-715.   Published online November 2, 2023
DOI: https://doi.org/10.5946/ce.2023.028
AbstractAbstract PDFPubReaderePub
Postoperative gastrointestinal bleeding is a rare but serious complication that can lead to prolonged hospitalization and significant morbidity and mortality. It can be managed by reoperation, endoscopy, or radiological intervention. Although reoperation carries risks, particularly in critically ill postoperative patients, minimally invasive interventions, such as endoscopy or radiological intervention, confer advantages. Endoscopy allows localization of the bleeding focus and hemostatic management at the same time. Although there have been concerns regarding the potential risk of creating an anastomotic disruption or perforation during early postoperative endoscopy, endoscopic management has become more popular over time. However, there is currently no consensus on the best endoscopic management for postoperative gastrointestinal bleeding because most practices are based on retrospective case series. Furthermore, there is a wide range of individual complexities in anatomical and clinical settings after surgery. This review focused on the safety and effectiveness of endoscopic management in various surgical settings.

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  • Letter to the editor on “early postoperative endoscopy for predicting anastomotic leakage after minimally invasive esophagectomy: A large-volume retrospective study”
    Judith Sánchez-Zavaleta, Doyler Cubas-García
    Surgery.2025; 180: 108890.     CrossRef
  • Evaluating the efficacy of a novel hemostatic powder compared with traditional treatments in nonvariceal upper GI bleeding: a multicenter, randomized, noninferiority study
    Da Hyun Jung, Jun Chul Park, Joon Sung Kim, Moon Won Lee, Hyuk Lee, Gwang Ha Kim
    Gastrointestinal Endoscopy.2025; 101(4): 792.     CrossRef
  • Gastrointestinale Endoskopie im postoperativen Komplikationsmanagement
    Marcus Kantowski, Gabriel Alexander Salg
    Allgemein- und Viszeralchirurgie up2date.2025; 19(01): 53.     CrossRef
  • The impact of ERAS-based nursing interventions on postoperative complication management and prognosis in early gastrointestinal tumor endoscopic resection: a prospective randomized controlled study
    Yun Shen, Yu Xi, Li Gu Xian Ru, Huayu Liu
    Langenbeck's Archives of Surgery.2025;[Epub]     CrossRef
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Endoscopic treatment of upper gastrointestinal postsurgical leaks: a narrative review
Renato Medas, Eduardo Rodrigues-Pinto
Clin Endosc 2023;56(6):693-705.   Published online July 3, 2023
DOI: https://doi.org/10.5946/ce.2023.043
AbstractAbstract PDFPubReaderePub
Upper gastrointestinal postsurgical leaks are life-threatening conditions with high mortality rates and are one of the most feared complications of surgery. Leaks are challenging to manage and often require radiological, endoscopic, or surgical intervention. Steady advancements in interventional endoscopy in recent decades have allowed the development of new endoscopic devices and techniques that provide a more effective and minimally invasive therapeutic option compared to surgery. Since there is no consensus regarding the most appropriate therapeutic approach for managing postsurgical leaks, this review aimed to summarize the best available current data. Our discussion specifically focuses on leak diagnosis, treatment aims, comparative endoscopic technique outcomes, and combined multimodality approach efficacy.

Citations

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  • Intravaginal endoscopic vacuum therapy of a rectovaginal fistula: expanding boundaries
    Renato Medas, Guilherme Macedo, Eduardo Rodrigues-Pinto
    Endoscopy.2025; 57(S 01): E30.     CrossRef
  • Post-Surgical Leaks of the Upper Digestive Tract – The Importance of an Early Endoscopic Approach
    I Tarrio, A Andrade, A R Ribeiro, M Moreira, T Araújo, L Lopes
    Endoscopy.2025; 57(S 02): S298.     CrossRef
  • Endoscopic vacuum therapy for gastrointestinal transmural defects: a literature review
    Tan Minh Le, Van Huy Tran, Kyu Sung Chung, Seong Woo Jeon
    Clinical Endoscopy.2025; 58(2): 181.     CrossRef
  • RESULTS OF THE APPLICATION OF ENDOSURGICAL TECHNOLOGIES IN THE DIAGNOSIS AND TREATMENT OF EARLY INTRAABDOMINAL COMPLICATIONS IN POSTOPERATIVE PERIOD
    I. A. Yusubov, E. Y. Sharifov
    World of Medicine and Biology.2024; 20(89): 184.     CrossRef
  • 3,938 View
  • 358 Download
  • 3 Web of Science
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Original Article
Impact of a simple non-invasive nasal mask device on intraprocedural hypoxemia in overweight individuals undergoing upper gastrointestinal endoscopy with sedation provided by a non-anesthesiologist provider
Jan Drews, Jonas Harder, Hannah Kaiser, Miriam Soenarjo, Dorothee Spahlinger, Peter Wohlmuth, Sebastian Wirtz, Ralf Eberhardt, Florian Bornitz, Torsten Bunde, Thomas von Hahn
Clin Endosc 2024;57(2):196-202.   Published online June 27, 2023
DOI: https://doi.org/10.5946/ce.2023.010
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Hypoxemia is a common side effect of propofol sedation during endoscopy. Applying mild positive airway pressure (PAP) using a nasal mask may offer a simple way to reduce such events and optimize the conditions for diagnostic and therapeutic upper gastrointestinal endoscopies.
Methods
We compared overweight patients (body mass index >25 kg/m2) with a nasal PAP mask or standard nasal cannula undergoing upper gastrointestinal endoscopies by non-anesthesiologists who provided propofol sedation. Outcome parameters included the frequency and severity of hypoxemic episodes.
Results
We analyzed 102 procedures in 51 patients with nasal PAP masks and 51 controls. Episodes of hypoxemia (oxygen saturation [SpO2] <90% at any time during sedation) occurred in 25 (49.0%) controls compared to 8 (15.7%) patients with nasal PAP masks (p<0.001). Severe hypoxemia (SpO2 <80%) occurred in three individuals (5.9%) in both groups. The mean delta between baseline SpO2 and the lowest SpO2 recorded was significantly decreased among patients with nasal PAP mask compared to controls (3.7 and 8.2 percentage points difference, respectively). There were significantly fewer airway interventions performed in the nasal PAP mask group (15.7% vs. 41.2%, p=0.008).
Conclusions
Using a nasal PAP mask may be a simple means of increasing patient safety and ease of examination.

Citations

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  • Sedation for GI Endoscopy in the Morbidly Obese: Challenges and Possible Solutions
    Lalitha Sundararaman, Basavana Goudra
    Journal of Clinical Medicine.2024; 13(16): 4635.     CrossRef
  • 4,380 View
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Review
Role of endoscopy in patients with achalasia
So Young Han, Young Hoon Youn
Clin Endosc 2023;56(5):537-545.   Published online June 2, 2023
DOI: https://doi.org/10.5946/ce.2023.001
AbstractAbstract PDFPubReaderePub
Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and peristalsis of the esophageal body. With the increasing prevalence of achalasia, interest in the role of endoscopy in its diagnosis, treatment, and monitoring is also growing. The major diagnostic modalities for achalasia include high-resolution manometry, esophagogastroduodenoscopy, and barium esophagography. Endoscopic assessment is important for early diagnosis to rule out diseases that mimic achalasia symptoms, such as pseudo-achalasia, esophageal cancer, esophageal webs, and eosinophilic esophagitis. The major endoscopic characteristics suggestive of achalasia include a widened esophageal lumen and food residue in the esophagus. Once diagnosed, achalasia can be treated either endoscopically or surgically. The preference for endoscopic treatment is increasing owing to its minimal invasiveness. Botulinum toxins, pneumatic balloon dilation, and peroral endoscopic myotomy (POEM) are important endoscopic treatments. Previous studies have demonstrated excellent treatment outcomes for POEM, with >95% improvement in dysphagia, making POEM the mainstay treatment option for achalasia. Several studies have reported an increased risk of esophageal cancer in patients with achalasia. However, routine endoscopic surveillance remains controversial owing to the lack of sufficient data. Further studies on surveillance methods and duration are warranted to establish concordant guidelines for the endoscopic surveillance of achalasia.

Citations

Citations to this article as recorded by  
  • O papel da endoscopia no diagnóstico e tratamento de Acalasia
    Rebeca Silva Moreira da Fraga, José Joaquim de Almeida Figueiredo, Thaisa de Moraes Ribeiro Espírito Santo, Esteban Sadovsky
    Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research.2025; 26(supl_3): 107.     CrossRef
  • The role of cap-assisted endoscopy and its future implications
    Sol Kim, Bo-In Lee
    Clinical Endoscopy.2024; 57(3): 293.     CrossRef
  • Never judge a book by its cover: the role of timed barium esophagography in patients with complete symptom relief after peroral endoscopic myotomy
    Tae Hee Lee
    Clinical Endoscopy.2024; 57(5): 604.     CrossRef
  • Advanced Esophageal Endoscopy
    Kyoungwon Jung, Rebecca M. Haug, Andrew Y. Wang
    Gastroenterology Clinics of North America.2024; 53(4): 603.     CrossRef
  • 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
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  • 445 Download
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  • 5 Crossref
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Original Articles
Preclinical study of a novel ingestible bleeding sensor for upper gastrointestinal bleeding
Kimberly F. Schuster, Christopher C. Thompson, Marvin Ryou
Clin Endosc 2024;57(1):73-81.   Published online May 31, 2023
DOI: https://doi.org/10.5946/ce.2022.293
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Upper gastrointestinal bleeding (UGIB) is a life-threatening condition that necessitates early identification and intervention and is associated with substantial morbidity, mortality, and socioeconomic burden. However, several diagnostic challenges remain regarding risk stratification and the optimal timing of endoscopy. The PillSense System is a noninvasive device developed to detect blood in patients with UGIB in real time. This study aimed to assess the safety and performance characteristics of PillSense using a simulated bleeding model.
Methods
A preclinical study was performed using an in vivo porcine model (14 animals). Fourteen PillSense capsules were endoscopically placed in the stomach and blood was injected into the stomach to simulate bleeding. The safety and sensitivity of blood detection and pill excretion were also investigated.
Results
All the sensors successfully detected the presence or absence of blood. The minimum threshold was 9% blood concentration, with additional detection of increasing concentrations of up to 22.5% blood. All the sensors passed naturally through the gastrointestinal tract.
Conclusions
This study demonstrated the ability of the PillSense System sensor to detect UGIB across a wide range of blood concentrations. This ingestible device detects UGIB in real time and has the potential to be an effective tool to supplement the current standard of care. These favorable results will be further investigated in future clinical studies.

Citations

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  • Ingestible electrochemical sensors: Emerging tools for gastrointestinal disease detection and monitoring
    Zhaodong Wang
    International Journal of Electrochemical Science.2025; 20(3): 100952.     CrossRef
  • Miniaturized Capsule System Toward Real‐Time Electrochemical Detection of H2S in the Gastrointestinal Tract
    Justin M. Stine, Katie L. Ruland, Luke A. Beardslee, Joshua A. Levy, Hossein Abianeh, Santiago Botasini, Pankaj J. Pasricha, Reza Ghodssi
    Advanced Healthcare Materials.2024;[Epub]     CrossRef
  • 3,599 View
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Stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions
Seigo Nakatani, Kosuke Okuwaki, Masafumi Watanabe, Hiroshi Imaizumi, Tomohisa Iwai, Takaaki Matsumoto, Rikiya Hasegawa, Hironori Masutani, Takahiro Kurosu, Akihiro Tamaki, Junro Ishizaki, Ayana Ishizaki, Mitsuhiro Kida, Chika Kusano
Clin Endosc 2024;57(1):89-95.   Published online April 18, 2023
DOI: https://doi.org/10.5946/ce.2022.288
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: In stereomicroscopic sample isolation processing, the cutoff value (≥4 mm) of stereomicroscopically visible white cores indicates high diagnostic sensitivity. We aimed to evaluate endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a simplified stereomicroscopic on-site evaluation of upper gastrointestinal subepithelial lesions (SELs).
Methods
In this multicenter prospective trial, we performed EUS-TA using a 22-gauge Franseen needle in 34 participants with SELs derived from the upper gastrointestinal muscularis propria, requiring pathological diagnosis. The presence of stereomicroscopically visible white core (SVWC) in each specimen was assessed using stereomicroscopic on-site evaluation. The primary outcome was EUS-TA’s diagnostic sensitivity with stereomicroscopic on-site evaluation based on the SVWC cutoff value (≥4 mm) for malignant upper gastrointestinal SELs.
Results
The total number of punctures was 68; 61 specimens (89.7%) contained stereomicroscopically visible white cores ≥4 mm in size. The final diagnoses were gastrointestinal stromal tumor, leiomyoma, and schwannoma in 76.5%, 14.7%, and 8.8% of the cases, respectively. The sensitivity of EUS-TA with stereomicroscopic on-site evaluation based on the SVWC cutoff value for malignant SELs was 100%. The per-lesion accuracy of histological diagnosis reached the highest level (100%) at the second puncture.
Conclusions
Stereomicroscopic on-site evaluation showed high diagnostic sensitivity and could be a new method for diagnosing upper gastrointestinal SELs using EUS-TA.

Citations

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  • Adverse events of 20–22G second‐generation endoscopic ultrasound‐guided fine‐needle biopsy needles for solid lesions in the upper gastrointestinal tract and adjacent organs: Systematic review and meta‐analysis
    Cheng‐ye Pan, Shi‐min Wang, Dong‐hao Cai, Jia‐yi Ma, Shi‐yu Li, Yibin Guo, Sun Jing, Jin Zhendong, Kaixuan Wang
    Digestive Endoscopy.2025;[Epub]     CrossRef
  • Case Report: Rare duodenal schwannoma diagnosis and treatment process report
    Shan Li, Lingyu Tu, Ting Li, Xiongchuan Pei, Xijin Wang, Yanqing Shi
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Advancements in endoscopic resection of subepithelial tumors: toward safer, recurrence-free techniques
    Won Shik Kim, Moon Kyung Joo
    Clinical Endoscopy.2025; 58(2): 256.     CrossRef
  • What method can we choose if rapid on-site evaluation is not available for the endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions?
    Yu Kyung Cho
    Clinical Endoscopy.2024; 57(1): 53.     CrossRef
  • Endoscopic Ultrasound-Guided Tissue Acquisition Using Fork-Tip Needle for Subepithelial Lesions: A Single-Center Validation Study
    Masafumi Watanabe, Kosuke Okuwaki, Tomohisa Iwai, Mitsuhiro Kida, Hiroshi Imaizumi, Kai Adachi, Akihiro Tamaki, Junro Ishizaki, Taro Hanaoka, Chika Kusano
    Digestive Diseases and Sciences.2024; 69(7): 2567.     CrossRef
  • Impact of macroscopic on-site evaluation (MOSE) on accuracy of endoscopic ultrasound-guided fine-needle aspiration/biopsy of solid lesions
    Hussein Okasha, Ahmed Ebrahim, Ihab Samih, Mohammed Sayed
    International Journal of Gastrointestinal Intervention.2024; 13(3): 98.     CrossRef
  • Role of macroscopic on-site evaluation of endoscopic ultrasound-guided fine-needle aspiration/biopsy: Results of a multicentric prospective study
    Hussein H Okasha, Hiwa A Hussein, Khaled M Ragab, Omar Abdallah, Fedoua Rouibaa, Borahma Mohamed, Fahd Ghalim, Mahmoud Farouk, Mohamed Lasheen, Mohamed A Elbasiony, Ahmed E Alzamzamy, Ahmed El Deeb, Hassan Atalla, Mahmoud El-Ansary, Sahar Mohamed, Moaz El
    World Journal of Gastrointestinal Endoscopy.2024; 16(11): 595.     CrossRef
  • An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
    Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
    The Ewha Medical Journal.2023;[Epub]     CrossRef
  • 2,940 View
  • 163 Download
  • 8 Web of Science
  • 8 Crossref
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Review
Management of aerosol generation during upper gastrointestinal endoscopy
Chawisa Nampoolsuksan, Vitoon Chinswangwatanakul, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Thawatchai Akaraviputh
Clin Endosc 2022;55(5):588-593.   Published online August 24, 2022
DOI: https://doi.org/10.5946/ce.2022.062
AbstractAbstract PDFPubReaderePub
In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.

Citations

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  • Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial
    Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn,
    Clinical Endoscopy.2024; 57(3): 335.     CrossRef
  • Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019
    Shahnaz Sultan
    Gastroenterology Clinics of North America.2023; 52(1): 157.     CrossRef
  • Does an Extraoral Suction Device Reduce Aerosol Generation and Prevent Droplet Exposure to the Examiner during Esophagogastroduodenoscopy?
    Shintaro Fujihara, Hideki Kobara, Noriko Nishiyama, Naoya Tada, Yasuhiro Goda, Kazuhiro Kozuka, Takanori Matsui, Taiga Chiyo, Nobuya Kobayashi, Tatsuo Yachida, Tsutomu Masaki
    Journal of Clinical Medicine.2023; 12(7): 2574.     CrossRef
  • 3,593 View
  • 201 Download
  • 3 Web of Science
  • 3 Crossref
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Original Articles
Comparison of diagnostic performances of slow-pull suction and standard suction in endoscopic ultrasound-guided fine needle biopsy for gastrointestinal subepithelial tumors
Joon Seop Lee, Chang Min Cho, Yong Hwan Kwon, An Na Seo, Han Ik Bae, Man-Hoon Han
Clin Endosc 2022;55(5):637-644.   Published online August 17, 2022
DOI: https://doi.org/10.5946/ce.2021.257
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is integral to the diagnosis of gastrointestinal (GI) subepithelial tumors (SETs). The impact of different EUS-FNB tissue sampling techniques on specimen adequacy and diagnostic accuracy in SETs has not been fully evaluated. This study aimed to compare the diagnostic outcomes of slow-pull (SP) and standard suction (SS) in patients with GI SETs.
Methods
In this retrospective comparative study, 54 patients were enrolled. Medical records were reviewed for location and size of the target lesion, FNB needle type/size, technical order, specimen adequacy, diagnostic yield, and adverse events. The acquisition rate of adequate specimens and diagnostic accuracy were compared according to EUS-FNB techniques.
Results
The mean lesion size was 42.6±36.4 mm, and most patients were diagnosed with GI stromal tumor (75.9%). The overall diagnostic accuracies of the SP and SS techniques were 83.3% and 81.5%, respectively (p=0.800). The rates of obtaining adequate core tissue were 79.6% and 75.9%, respectively (p=0.799). No significant clinical factors affected the rate of obtaining adequate core tissue, including lesion location and size, FNB needle size, and final diagnosis.
Conclusions
SP and SS had comparable diagnostic accuracies and adequate core tissue acquisition for GI SETs via EUS-FNB.

Citations

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  • Advancements in endoscopic resection of subepithelial tumors: toward safer, recurrence-free techniques
    Won Shik Kim, Moon Kyung Joo
    Clinical Endoscopy.2025; 58(2): 256.     CrossRef
  • Endoscopic ultrasound-guided fine-needle aspiration for gastrointestinal subepithelial lesions
    Takuto Hikichi, Minami Hashimoto, Takumi Yanagita, Tsunetaka Kato, Jun Nakamura
    Journal of Medical Ultrasonics.2024; 51(2): 195.     CrossRef
  • What method can we choose if rapid on-site evaluation is not available for the endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions?
    Yu Kyung Cho
    Clinical Endoscopy.2024; 57(1): 53.     CrossRef
  • The Diagnostic Approach of Benign Esophageal Tumors: A Narrative Review
    Alex R. Jones, Preksha Vankawala, Tarek Sawas
    Current Treatment Options in Gastroenterology.2024; 22(2): 44.     CrossRef
  • Diagnostic yield of endoscopic and EUS-guided biopsy techniques in subepithelial lesions of the upper GI tract: a systematic review
    Cynthia A. Verloop, Jacqueline A.C. Goos, Marco J. Bruno, Rutger Quispel, Lydi M.J.W. van Driel, Lieke Hol
    Gastrointestinal Endoscopy.2024; 99(6): 895.     CrossRef
  • EUS‐guided tissue acquisition from gastric subepithelial lesions—The optimal technique still remains undecided
    Suprabhat Giri, Sridhar Sundaram
    Australasian Journal of Ultrasound in Medicine.2024; 27(4): 263.     CrossRef
  • An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
    Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
    The Ewha Medical Journal.2023;[Epub]     CrossRef
  • Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study
    Younghee Choe, Yu Kyung Cho, Gwang Ha Kim, Jun-Ho Choi, Eun Soo Kim, Ji Hyun Kim, Eun Kwang Choi, Tae Hyeon Kim, Seong-Hun Kim, Do Hoon Kim
    Clinical Endoscopy.2023; 56(6): 744.     CrossRef
  • 3,483 View
  • 139 Download
  • 6 Web of Science
  • 8 Crossref
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Efficacy of a novel channel-cleaning ball brush for endoscope reprocessing: a randomized controlled trial
Kwang Hyun Chung, Jeong Don Chae, Wonho Choe, Hyo Young Lee, Il Hwan Oh, Byoung Kwan Son
Clin Endosc 2022;55(5):674-682.   Published online August 2, 2022
DOI: https://doi.org/10.5946/ce.2021.210
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic channels are difficult to clean and can cause infection transmission. We examined the effectiveness of a newly developed channel-cleaning ball brush (BB), which is sucked into the endoscopic channel and scrapes and cleans the lumen as it passes through.
Methods
The upper and lower gastrointestinal endoscopes used for patient examinations were randomly selected as the conventional brush (CB) or BB group. After manual cleaning, the presence or absence of carbohydrates, proteins, adenosine triphosphate, and hemoglobin was assessed.
Results
Fifty-six and 58 endoscopes were cleaned with the CB and BB, respectively. Carbohydrate and protein were detected in one (1.8%) and two endoscopes (3.4%) in the CB and BB groups, respectively (p=1.000). Hemoglobin was observed in one (1.8%) and three endoscopes (5.2%) in the CB and BB groups, respectively (p=0.636). The adenosine triphosphate levels were 10.6±15.9 and 12.5±14.3 relative light units in the CB and BB groups, respectively (p=0.496). Twenty-seven (48.2%) and 19 (32.8%) endoscopes were positive for microbial cultures in the CB and BB groups, respectively (p=0.136).
Conclusions
The efficacy of BB was not significantly different from that of CB in the endoscopic channel-cleaning process.

Citations

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  • An investigation into cleaning quality of suction-type metal lumen instruments: a cross-sectional study
    Yuqi Wu, Li Li
    Scientific Reports.2025;[Epub]     CrossRef
  • A prospective, quasi-experimental study on the efficacy of a novel double-headed endoscope cleaning brush for cleaning flexible endoscopes
    Rui Shen, Yaping Wu, Jiajun Lv, Qukai Liu, Weiyan Yao, Shu Chen, Dandan Liu, Huijun Xi, Yibo Zhang
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • Simulated-use evaluation of rapid ChannelCheck™ cleaning test for optimal detection of organic residues in flexible endoscope channels
    K. Kulkarni, M. Gavette, M.J. Alfa
    Journal of Hospital Infection.2024; 152: 66.     CrossRef
  • 4,336 View
  • 189 Download
  • 3 Web of Science
  • 3 Crossref
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Reviews
Preparation of image databases for artificial intelligence algorithm development in gastrointestinal endoscopy
Chang Bong Yang, Sang Hoon Kim, Yun Jeong Lim
Clin Endosc 2022;55(5):594-604.   Published online May 31, 2022
DOI: https://doi.org/10.5946/ce.2021.229
AbstractAbstract PDFPubReaderePub
Over the past decade, technological advances in deep learning have led to the introduction of artificial intelligence (AI) in medical imaging. The most commonly used structure in image recognition is the convolutional neural network, which mimics the action of the human visual cortex. The applications of AI in gastrointestinal endoscopy are diverse. Computer-aided diagnosis has achieved remarkable outcomes with recent improvements in machine-learning techniques and advances in computer performance. Despite some hurdles, the implementation of AI-assisted clinical practice is expected to aid endoscopists in real-time decision-making. In this summary, we reviewed state-of-the-art AI in the field of gastrointestinal endoscopy and offered a practical guide for building a learning image dataset for algorithm development.

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    Jean-Francois Rey
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    Hang Viet Dao, Binh Phuc Nguyen, Tung Thanh Nguyen, Hoa Ngoc Lam, Trang Thi Huyen Nguyen, Thao Thi Dang, Long Bao Hoang, Hung Quang Le, Long Van Dao
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Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment
Giuseppe Galloro, Angelo Zullo, Gaetano Luglio, Alessia Chini, Donato Alessandro Telesca, Rosa Maione, Matteo Pollastro, Giovanni Domenico De Palma, Raffaele Manta
Clin Endosc 2022;55(3):339-346.   Published online April 28, 2022
DOI: https://doi.org/10.5946/ce.2021.249
AbstractAbstract PDFPubReaderePub
Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.

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  • Evaluating the efficacy of a novel hemostatic powder compared with traditional treatments in nonvariceal upper GI bleeding: a multicenter, randomized, noninferiority study
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    Daryl Ramai, Smit S. Deliwala, Daniel Mozell, Antonio Facciorusso, Saurabh Chandan, Alana Persaud, Kelita Singh, Andrea Anderloni, Monique T. Barakat
    Journal of Clinical Gastroenterology.2024; 58(1): 76.     CrossRef
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    Jonathan J Cho, Chelsea M Forbes, Benjamin D Fiore, Joshua D McCarron, Leybelis Padilla
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    Tae-Geun Gweon, Dong-Hoon Yang
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Original Articles
Comparison of conventional and new endoscopic band ligation devices for colonic diverticular bleeding
Ayaka Takasu, Takashi Ikeya, Yasutoshi Shiratori
Clin Endosc 2022;55(3):408-416.   Published online February 18, 2022
DOI: https://doi.org/10.5946/ce.2021.200
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligation device for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by Sumitomo Bakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL.
Methods
Seventy-nine patients who underwent EBL for CDB at St. Luke’s International Hospital, Japan, between 2017 and 2020 were included in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, including achieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated.
Results
Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initial hemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleeding rate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (18.2 minutes vs. 14.2 minutes, p=0.02). No adverse events were observed in either group.
Conclusions
The N-EBL device is safe and useful and may reduce EBL procedure time.

Citations

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  • Advances in endoscopic management of colonic diverticular bleeding
    Yasutoshi Shiratori, Syed Matthew Kodilinye, Ahmed E. Salem
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    Jamie Bering, Mashal J. Batheja, Neena S. Abraham
    Gastroenterology Clinics of North America.2024; 53(4): 573.     CrossRef
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    Yunho Jung
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Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System
Matheus Cavalcante Franco, Sunguk Jang, Bruno da Costa Martins, Tyler Stevens, Vipul Jairath, Rocio Lopez, John J. Vargo, Alan Barkun, Fauze Maluf-Filho
Clin Endosc 2022;55(2):240-247.   Published online January 21, 2022
DOI: https://doi.org/10.5946/ce.2021.115
AbstractAbstract PDFPubReaderePub
Background
/Aims: Few studies have measured the accuracy of prognostic scores for upper gastrointestinal bleeding (UGIB) among cancer patients. Thereby, we compared the prognostic scores for predicting major outcomes in cancer patients with UGIB. Secondarily, we developed a new model to detect patients who might require hemostatic care.
Methods
A prospective research was performed in a tertiary hospital by enrolling cancer patients admitted with UGIB. Clinical and endoscopic findings were obtained through a prospective database. Multiple logistic regression analysis was performed to gauge the power of each score.
Results
From April 2015 to May 2016, 243 patients met the inclusion criteria. The AIMS65 (area under the curve [AUC] 0.85) best predicted intensive care unit admission, while the Glasgow-Blatchford score best predicted blood transfusion (AUC 0.82) and the low-risk group (AUC 0.92). All scores failed to predict hemostatic therapy and rebleeding. The new score was superior (AUC 0.74) in predicting hemostatic therapy. The AIMS65 (AUC 0.84) best predicted in-hospital mortality.
Conclusions
The scoring systems for prognostication were validated in the group of cancer patients with UGIB. A new score was developed to predict hemostatic therapy. Following this result, future prospective research should be performed to validate the new score.

Citations

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  • Comparative diagnostic utility of Rockall and Glasgow-Blatchford scores in non-variceal upper gastrointestinal bleeding: a systematic review and meta-analysis
    Landon Kozai, Arvin Tan, Kevin Nebrejas, Yoshito Nishimura
    European Journal of Gastroenterology & Hepatology.2025; 37(2): 161.     CrossRef
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    Frances Dang, Marc Monachese
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    Cong-Biao Cheng, Na Li
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    Sergiu Marian Cazacu, Dragoș Ovidiu Alexandru, Răzvan-Cristian Statie, Sevastița Iordache, Bogdan Silviu Ungureanu, Vlad Florin Iovănescu, Petrică Popa, Victor Mihai Sacerdoțianu, Carmen Daniela Neagoe, Mirela Marinela Florescu
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    莉 王
    Advances in Clinical Medicine.2023; 13(05): 8163.     CrossRef
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    Kim Oren Gradel
    Journal of Clinical Medicine.2023; 12(19): 6132.     CrossRef
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Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases?
Bin Chet Toh, Jingli Chong, Baldwin PM Yeung, Chin Hong Lim, Eugene KW Lim, Weng Hoong Chan, Jeremy TH Tan
Clin Endosc 2022;55(3):401-407.   Published online January 6, 2022
DOI: https://doi.org/10.5946/ce.2021.197
AbstractAbstract PDFPubReaderePub
Background
/Aims: Surgeons and endoscopists have started to use endoscopically inserted double pigtail stents (DPTs) in the management of upper gastrointestinal (UGI) leaks, including UGI anastomotic leaks. We investigated our own experiences in this patient population.
Methods
From March 2017 to June 2020, 12 patients had endoscopic internal drainage of a radiologically proven anastomotic leak after UGI surgery in two tertiary UGI centers. The primary outcome measure was the time to removal of the DPTs after anastomotic healing. The secondary outcome measure was early oral feeding after DPT insertion.
Results
Eight of the 12 patients (67%) required only one DPT, whereas four (33%) required two DPTs. The median duration of drainage was 42 days. Two patients required surgery due to inadequate control of sepsis. Of the remaining 10 patients, nine did not require a change in DPT before anastomotic healing. Nine patients were allowed oral fluids within the 1st week and a soft diet in the 2nd week. One patient was allowed clear oral feeds on the 8th day after DPT insertion.
Conclusions
Endoscopic internal drainage is becoming an established minimally invasive technique for controlling anastomotic leak after UGI surgery. It allows for early oral nutritional feeding and minimizes discomfort from conventional external drainage.

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  • Managing Leaks and Fistulas After Laparoscopic Sleeve Gastrectomy: Challenges and Solutions
    Jordan Gipe, Alexandra Agathis, SQ Nguyen
    Clinical and Experimental Gastroenterology.2025; Volume 18: 1.     CrossRef
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    Ji Yoon Kim, Hyunsoo Chung
    Journal of Gastric Cancer.2024; 24(1): 108.     CrossRef
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    Muaaz Masood, Donald E. Low, Shanley B. Deal, Richard A. Kozarek
    Journal of Clinical Medicine.2024; 13(7): 2011.     CrossRef
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    Ahmad Rimawi, Yahia Al-Turk, Abdul Monem Swied
    ACG Case Reports Journal.2023; 10(10): e01191.     CrossRef
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Preclinical Efficacy and Clinical Feasibility of a Novel Aerosol-Exposure Protection Mask for Esophagogastroduodenoscopy
Mai Ego Makiguchi, Seiichiro Abe, Yutaka Okagawa, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Ichiro Oda, Okamoto Ryuta, Yutaka Saito
Clin Endosc 2022;55(2):226-233.   Published online December 15, 2021
DOI: https://doi.org/10.5946/ce.2021.178-IDEN
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aimed to assess the efficacy of a novel aerosol-exposure protection (AP) mask in preventing coronavirus disease in healthcare professionals during upper gastrointestinal endoscopy and to evaluate its clinical feasibility.
Methods
In Study 1, three healthy volunteers volitionally coughed with and without the AP mask in a cleanroom. Microparticles were visualized and counted with a specific measurement system and compared with and without the AP mask. In Study 2, 30 patients underwent endoscopic resection with the AP mask covering the face, and the SpO2 was measured throughout the procedure.
Results
In Study 1, the median number of microparticles in volunteers 1, 2, and 3 with and without the AP mask was 8.5 and 110.0, 7.0 and 51.5, and 8.0 and 95.0, respectively (p<0.01). Using the AP mask, microparticles were reduced by approximately 92%. The median distances of microparticle scattering without the AP mask were 60, 0, and 68 in volunteers 1, 2, and 3, respectively. In Study 2, the mean SpO2 was 96.3%, and desaturation occurred in three patients.
Conclusion
The AP mask could provide protection from aerosol exposure and can be safely used for endoscopy in clinical practice.

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  • Aerosol and Droplet Dispersion Control during Bronchoscopy Using a Newly Developed Oxygen Mask
    Yuki Nagamatsu, Masatoshi Kakihana, Yujin Kudo, Wakako Hamanaka, Yohei Kawaguchi, Yuki Yamada, Chiaki Kanno, Sachio Maehara, Masaru Hagiwara, Tatsuo Ohira, Norihiko Ikeda
    Respiratory Endoscopy.2024; 2(1): 25.     CrossRef
  • A Novel Aerosol-Exposure Protection Mask for Patients During Upper Endoscopy
    Soo-Jeong Cho
    Clinical Endoscopy.2022; 55(2): 208.     CrossRef
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  • 259 Download
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