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Original Article
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
Received April 12, 2024  Accepted May 31, 2024  Published online August 26, 2024  
DOI: https://doi.org/10.5946/ce.2024.089    [Epub ahead of print]
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.
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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
Received September 29, 2023  Accepted January 14, 2024  Published online May 24, 2024  
DOI: https://doi.org/10.5946/ce.2023.253    [Epub ahead of print]
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.
  • 1,898 View
  • 185 Download
  • 1 Web of Science
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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.

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  • 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
  • 2,462 View
  • 127 Download
  • 1 Web of Science
  • 1 Crossref
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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

Citations to this article as recorded by  
  • 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
  • 3,208 View
  • 190 Download
  • 1 Crossref
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Reviews
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

Citations to this article as recorded by  
  • 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
  • 2,912 View
  • 192 Download
  • 3 Web of Science
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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.

Citations

Citations to this article as recorded by  
  • Use of artificial intelligence in the management of T1 colorectal cancer: a new tool in the arsenal or is deep learning out of its depth?
    James Weiquan Li, Lai Mun Wang, Katsuro Ichimasa, Kenneth Weicong Lin, James Chi-Yong Ngu, Tiing Leong Ang
    Clinical Endoscopy.2024; 57(1): 24.     CrossRef
  • Computer‐aided diagnosis in real‐time endoscopy for all stages of gastric carcinogenesis: Development and validation study
    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
    United European Gastroenterology Journal.2024; 12(4): 487.     CrossRef
  • Assessing Endoscopic Response in Locally Advanced Rectal Cancer Treated with Total Neoadjuvant Therapy: Development and Validation of a Highly Accurate Convolutional Neural Network
    Hannah Williams, Hannah M. Thompson, Christina Lee, Aneesh Rangnekar, Jorge T. Gomez, Maria Widmar, Iris H. Wei, Emmanouil P. Pappou, Garrett M. Nash, Martin R. Weiser, Philip B. Paty, J. Joshua Smith, Harini Veeraraghavan, Julio Garcia-Aguilar
    Annals of Surgical Oncology.2024;[Epub]     CrossRef
  • As how artificial intelligence is revolutionizing endoscopy
    Jean-Francois Rey
    Clinical Endoscopy.2024; 57(3): 302.     CrossRef
  • Next-Generation Endoscopy in Inflammatory Bowel Disease
    Irene Zammarchi, Giovanni Santacroce, Marietta Iacucci
    Diagnostics.2023; 13(15): 2547.     CrossRef
  • Public Imaging Datasets of Gastrointestinal Endoscopy for Artificial Intelligence: a Review
    Shiqi Zhu, Jingwen Gao, Lu Liu, Minyue Yin, Jiaxi Lin, Chang Xu, Chunfang Xu, Jinzhou Zhu
    Journal of Digital Imaging.2023; 36(6): 2578.     CrossRef
  • AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     CrossRef
  • Impact of the Volume and Distribution of Training Datasets in the Development of Deep-Learning Models for the Diagnosis of Colorectal Polyps in Endoscopy Images
    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Young Joo Yang, Gwang Ho Baik
    Journal of Personalized Medicine.2022; 12(9): 1361.     CrossRef
  • 3,780 View
  • 255 Download
  • 8 Web of Science
  • 8 Crossref
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Original Articles
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.

Citations

Citations to this article as recorded by  
  • 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
  • 4,269 View
  • 253 Download
  • 1 Web of Science
  • 2 Crossref
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A Nationwide Survey on the Facilities and Personnel for Endoscopic Sedation: Results from 50 Qualified Endoscopy Units of Teaching Hospitals Accredited by the Korean Society of Gastrointestinal Endoscopy (KSGE)
Seon-Young Park, Jun Kyu Lee, Jung-Wook Kim, Tae Hee Lee, Chang-Hwan Park, Jae-Yong Jang, Byung-Wook Kim, Byung Ik Jang, the Quality management and Endoscopic sedation committee of Korean Society of Gastrointestinal Endoscopy (KSGE)
Clin Endosc 2021;54(6):843-850.   Published online July 14, 2021
DOI: https://doi.org/10.5946/ce.2021.014
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aimed to determine the current status of facilities, equipment, and personnel for endoscopic sedation from endoscopy units of representative hospitals in South Korea.
Methods
A questionnaire survey was conducted on 50 qualified endoscopy units accredited by the Korean Society of Gastrointestinal Endoscopy.
Results
All included endoscopy units had regulations and educational programs regarding sedation training for endoscopists and nursing personnel. There present one assisting nurse during endoscopy in 35 units (70%) and at least two nurses in 12 units (24.0%). All endoscopy units had examination rooms equipped with oxygen supply and suction systems. Endoscopist-directed sedation was performed in 48 units (96.0%). Propofol-based sedation was the most used sedation method. All units had a separate recovery bay. The daily number of patients per bed was greater than 10 in 17 units (34.0%). In 26 (52.0%) units, a single nurse cared for ≥10 patients per day. All the units fulfilled the discharge criteria.
Conclusions
This study presents data regarding endoscopic sedation clinical practice in 50 endoscopy units in South Korea. This study presents the current status of endoscopic sedation clinical practice in 50 qualified endoscopy units accredited by the KSGE, which provide excellent quality management.

Citations

Citations to this article as recorded by  
  • Awareness of Endoscopy Nurses About Anesthesia Management in the Pediatric Gastrointestinal Endoscopy Unit; A Survey Study
    Feyza SEVER, Şamil HIZLI
    Turkish Journal of Pediatric Disease.2023; : 412.     CrossRef
  • Drugs used for sedation in gastrointestinal endoscopy
    Jun Kyu Lee
    Journal of the Korean Medical Association.2022; 65(11): 735.     CrossRef
  • 3,696 View
  • 117 Download
  • 2 Web of Science
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Focused Review Series: Image-Enhanced Endoscopy: Update on Clinical Practice
Clinical Efficacy of Endocytoscopy for Gastrointestinal Endoscopy
Masashi Misawa, Shin-ei Kudo, Yuki Takashina, Yoshika Akimoto, Yasuharu Maeda, Yuichi Mori, Toyoki Kudo, Kunihiko Wakamura, Hideyuki Miyachi, Fumio Ishida, Haruhiro Inoue
Clin Endosc 2021;54(4):455-463.   Published online July 7, 2021
DOI: https://doi.org/10.5946/ce.2021.165
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Endocytoscopy (EC) is a contact-type optical endoscope that allows in vivo cellular observation during gastrointestinal endoscopy and is now commercially available not only in Japan but also in Asian, European Union, and Middle Eastern countries. EC helps conduct a highly accurate pathological prediction without biopsy. Initially, EC was reported to be effective for esophageal diseases. Subsequently, its efficacy for stomach and colorectal diseases has been reported. In this narrative review, we searched for clinical studies that investigated the efficacy of EC. EC seems to accurately diagnose gastrointestinal diseases without biopsy. Most of the studies aimed to clarify the relationship between endocytoscopic findings of gastrointestinal neoplasia and pathological diagnosis. Some studies have investigated non-epithelial lesions or diseases, such as inflammatory bowel disease or infectious diseases. However, there are few high-level pieces of evidence, such as randomized trials; thus, further studies are needed.

Citations

Citations to this article as recorded by  
  • Endocitoscopia de la muscular propia en acalasia de rápida evolución y recidiva de acalasia post-Heller
    Hugo Uchima, Raquel Muñoz-González, Íngrid Marín, Noemí Caballero, Claudia Cepero, Ignacio Iborra, Juan Colán-Hernández, Edgar Castillo, Vicente Moreno
    Gastroenterología y Hepatología.2024; 47(7): 761.     CrossRef
  • Endocytoscopy of muscularis propria in rapidly evolving achalasia and recurrence of post-Heller achalasia
    Hugo Uchima, Raquel Muñoz-González, Íngrid Marín, Noemí Caballero, Claudia Cepero, Ignacio Iborra, Juan Colán-Hernández, Edgar Castillo, Vicente Moreno
    Gastroenterología y Hepatología (English Edition).2024; 47(7): 761.     CrossRef
  • Advanced Endoscopic Imaging for Assessing Mucosal Healing and Histologic Remission in Inflammatory Bowel Diseases
    Tommaso Pessarelli, Gian Eugenio Tontini, Helmut Neumann
    Gastrointestinal Endoscopy Clinics of North America.2024;[Epub]     CrossRef
  • Automated Endoscopic Diagnosis in IBD
    Yasuharu Maeda, Shin-ei Kudo, Takanori Kuroki, Marietta Iacucci
    Gastrointestinal Endoscopy Clinics of North America.2024;[Epub]     CrossRef
  • The diagnostic utility of endocytoscopy for the detection of gastric cancer: a systematic review and meta-analysis
    Andrew CANAKIS, Shivanand BOMMAN, Benjamin TWERY, Nevin VARGHESE, Byung JI, Justin CANAKIS, Eric M. GOLDBERG
    Minerva Gastroenterology.2024;[Epub]     CrossRef
  • The diagnostic utility of endocytoscopy for the detection of esophageal lesions: A systematic review and meta-analysis
    Lu Wang, Bofu Tang, Feifei Liu, Zhenyu Jiang, Xianmei Meng
    Gastroenterology & Endoscopy.2023; 1(1): 12.     CrossRef
  • A Review of Colonoscopy in Intestinal Diseases
    Seung Hong, Dong Baek
    Diagnostics.2023; 13(7): 1262.     CrossRef
  • Endoscopic Imaging for the Diagnosis of Neoplastic and Pre-Neoplastic Conditions of the Stomach
    Bruno Costa Martins, Renata Nobre Moura, Angelo So Taa Kum, Carolina Ogawa Matsubayashi, Sergio Barbosa Marques, Adriana Vaz Safatle-Ribeiro
    Cancers.2023; 15(9): 2445.     CrossRef
  • A comparative study of magnifying endoscopy with narrow-band image and endocytoscopy in the diagnosis of gastric neoplasm: a pilot study
    In Kyung Yoo, Jun Chul Park, Hyuk Lee, Abdullah Ozgur Yeniova, Jeong Hoon Lee, Dong Keon Yon, Joo Young Cho, Wan-Sik Lee
    European Journal of Gastroenterology & Hepatology.2023; 35(5): 530.     CrossRef
  • Advances and challenges in gastrointestinal endoscopy: a comprehensive review
    Sun Gyo Lim
    Journal of Innovative Medical Technology.2023; 1(1): 10.     CrossRef
  • The development and clinical application of microscopic endoscopy for in vivo optical biopsies: Endocytoscopy and confocal laser endomicroscopy
    Huahui Zhang, Zhongyu He, Ziyi Jin, Qinglai Yan, Peng Wang, Xuesong Ye
    Photodiagnosis and Photodynamic Therapy.2022; 38: 102826.     CrossRef
  • Risk factors for early gastric cancer: focus on Helicobacter pylori gastritis
    Hee Seok Moon
    Journal of the Korean Medical Association.2022; 65(5): 259.     CrossRef
  • 5,486 View
  • 166 Download
  • 7 Web of Science
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Review
Recent Developments in Devices Used for Gastrointestinal Endoscopy Sedation
Basavana Goudra, Gowri Gouda, Preet Mohinder Singh
Clin Endosc 2021;54(2):182-192.   Published online March 18, 2021
DOI: https://doi.org/10.5946/ce.2020.057
AbstractAbstract PDFPubReaderePub
Hypoxemia is a frequent and potentially fatal complication occurring in patients during gastrointestinal endoscopy. The administration of propofol sedation increases the risk of most complications, especially hypoxemia. Nevertheless, propofol has been increasingly used in the United States, and the trend is likely to increase in the years to come. Patient satisfaction and endoscopist satisfaction along with rapid turnover are some of the touted reasons for this trend. However, propofol sedation generally implies deep sedation or general anesthesia. As a result, hypopnea and apnea frequently occur. Inadequate sedation and presence of irritable airway often cause coughing and laryngospasm, both leading to hypoxemia and potential cardiac arrest. Hence, prevention of hypoxemia is of paramount importance. Traditionally, standard nasal cannula is used to administer supplement oxygen. However, it cannot sufficiently provide continuous positive airway pressure (CPAP) or positive pressure ventilation. Device manufacturers have stepped in to fill this void and created many types of cannulas that provide apneic insufflation of oxygen and CPAP and eliminate dead space. Such measures decrease the incidence of hypoxemia. This review aimed to provide essential information of some of these devices.

Citations

Citations to this article as recorded by  
  • 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
    Clinical Endoscopy.2024; 57(2): 196.     CrossRef
  • Noninvasive respiratory support with high-flow nasal cannula in endoscopic surgery in a patient with Legionella Pneumophila pneumonia: a case report
    Vincenzo Pota, Francesco Coppolino, Annamaria Auricchio, Francesca Cardella, Maurizio Del Prete, Antonio Scalvenzi, Pasquale Sansone, Maria Beatrice Passavanti, Maria Caterina Pace
    Perioperative Medicine.2024;[Epub]     CrossRef
  • 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
  • Should We Use High-Flow Nasal Cannula in Patients Receiving Gastrointestinal Endoscopies? Critical Appraisals through Updated Meta-Analyses with Multiple Methodologies and Depiction of Certainty of Evidence
    Chi Chan Lee, Teressa Reanne Ju, Pei Chun Lai, Hsin-Ti Lin, Yen Ta Huang
    Journal of Clinical Medicine.2022; 11(13): 3860.     CrossRef
  • An intravenous anesthetic drug-propofol, influences the biological characteristics of malignant tumors and reshapes the tumor microenvironment: A narrative literature review
    Xueliang Zhou, Yanfei Shao, Shuchun Li, Sen Zhang, Chengsheng Ding, Lei Zhuang, Jing Sun
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Endo-anesthesia: a primer
    Fateh Bazerbachi, Rodger M White, Nauzer Forbes, Basavana Goudra, Barham K Abu Dayyeh, Vinay Chandrasekhara, BobbieJean Sweitzer
    Gastroenterology Report.2022;[Epub]     CrossRef
  • High-flow oxygen via oxygenating mouthguard in short upper gastrointestinal endoscopy: A randomised controlled trial
    Kim Hay Be, Leonardo Zorron Cheng Tao Pu, Brett Pearce, Matthew Lee, Luke Fletcher, Rebecca Cogan, Philip Peyton, Rhys Vaughan, Marios Efthymiou, Sujievvan Chandran
    World Journal of Gastrointestinal Endoscopy.2022; 14(12): 777.     CrossRef
  • 9,624 View
  • 268 Download
  • 6 Web of Science
  • 7 Crossref
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Original Article
Clinical Gastroenterology and Gastrointestinal Endoscopy Practices during the Coronavirus Disease 2019 Pandemic in Indonesia: An Online Nationwide Survey
Ahmad Fariz Malvi Zamzam Zein, Rabbinu Rangga Pribadi, Uswatun Khasanah, Muhammad Begawan Bestari, Ari Fahrial Syam
Clin Endosc 2021;54(3):348-355.   Published online February 18, 2021
DOI: https://doi.org/10.5946/ce.2020.216
AbstractAbstract PDFPubReaderePub
Background
/Aims: The coronavirus disease 2019 (COVID-19) pandemic has necessitated modifications to allow the safe practice of clinical gastroenterology and gastrointestinal endoscopy. This study aimed to investigate the characteristics of clinical gastroenterology and gastrointestinal endoscopy practices during the COVID-19 pandemic in Indonesia.
Methods
This cross-sectional study enrolled physician members of the Indonesian Society for Digestive Endoscopy. We used an online self-administered questionnaire disseminated via social media. The 32-item survey determined the baseline characteristics of the participants, characteristics of clinical gastroenterology and gastrointestinal endoscopy practices, involvement of the physicians in the management of COVID-19, and overall impact of the pandemic on practice. All collected data were analyzed using descriptive statistics.
Results
The 200 participants in this study had a median age of 50 (34–76) years. Modifications in clinical gastroenterology practice were frequently reported in the outpatient (95.5%) and inpatient (100%) settings. All participants reported changes in the gastrointestinal endoscopy practice patterns. Of the participants, 86.0% were working in high-risk zones, and several of them reported inadequate protective personal equipment (34.0%). The median overall impact score of the pandemic on practice was 9 (2–10).
Conclusions
Physicians practicing clinical gastroenterology and gastrointestinal endoscopy in Indonesia work in high-risk settings. Modifications in clinical gastroenterology and gastrointestinal endoscopy practices are prevalent during the COVID-19 pandemic.

Citations

Citations to this article as recorded by  
  • Impact of the COVID-19 pandemic on digestive endoscopists: an Ibero-American study
    Robin German Prieto-Ortiz, Camilo de Jesús Blanco-Avellaneda, Ricardo Cepeda-Vásquez, Diana Yanira Chimbi Rojas, Jhon Edison Prieto-Ortiz, Leticia Moreira-Ruiz, Lázaro Antonio Arango-Molano
    Revista Española de Enfermedades Digestivas.2022;[Epub]     CrossRef
  • Clinical Practice of Gastrointestinal Endoscopy in COVID-19 Patients: An Experience from Indonesia
    Rabbinu Rangga Pribadi, Amanda Pitarini Utari, Virly Nanda Muzellina, Saskia Aziza Nursyirwan, Hasan Maulahela, Kaka Renaldi, Ari Fahrial Syam
    Clinical Endoscopy.2022; 55(1): 156.     CrossRef
  • 4,325 View
  • 105 Download
  • 2 Web of Science
  • 2 Crossref
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Reviews
Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
Clin Endosc 2017;50(4):345-356.   Published online July 31, 2017
DOI: https://doi.org/10.5946/ce.2017.106
AbstractAbstract PDFPubReaderePub
The Korean Society of Gastrointestinal Endoscopy (KSGE) developed a gastrointestinal (GI) endoscopy board in 1995 and related regulations. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. During GI fellowship training, obtaining sufficient exposure to some types of endoscopic procedures is difficult. Fellows should acquire endoscopic skills through supervised endoscopic procedures during GI fellowship training. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform independent endoscopic procedures without supervision. This document is intended to provide principles that the Committee of Education and Training of the KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. The KSGE will improve the quality of GI endoscopy by providing guidelines for fellowships and supervisors.

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    Endoscopy International Open.2023; 11(02): E193.     CrossRef
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    Hasan Maulahela, Nagita G Annisa, Marcellus Simadibrata, Ari F Syam, Ardi Findyartini, Wresti Indriatmi, Roy Soetikno
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  • The First Systematic Gastroscopy Training Program for Surgeons in Korea
    Ho Seok Seo, So Jung Kim, Chul Hyo Jeon, Kyo Young Song, Han Hong Lee
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Implementation effect of institutional policy of EGD observation time on neoplasm detection
    Jae Myung Park, Sang Yoon Kim, Ga-Yeong Shin, Younghee Choe, Hyun Sun Cho, Chul-Hyun Lim, Yu Kyung Cho, Myung-Gyu Choi
    Gastrointestinal Endoscopy.2021; 93(5): 1152.     CrossRef
  • Training in endoscopic retrograde cholangio-pancreatography: a critical assessment of the broad scenario of training programs and models
    Camilla Gallo, Ivo Boškoski, Maria Valeria Matteo, Beatrice Orlandini, Guido Costamagna
    Expert Review of Gastroenterology & Hepatology.2021; 15(6): 675.     CrossRef
  • Colonoscopy quality in community hospitals and nonhospital facilities in Korea
    Jae Gon Lee, Dong Soo Han, Young-Eun Joo, Dae-Seong Myung, Dong Il Park, Seul Ki Kim, Yunho Jung, Won Hyun Lee, Eun Soo Kim, Joon Seok Yoon, Chang Soo Eun
    The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S35.     CrossRef
  • Guidelines for accreditation of endoscopy units: quality measures from the Korean Society of Coloproctology
    Rumi Shin, Seongdae Lee, Kyung-Su Han, Dae Kyung Sohn, Sang Hui Moon, Dong Hyun Choi, Bong-Hyeon Kye, Hae-Jung Son, Sun Il Lee, Sumin Si, Won-Kyung Kang
    Annals of Surgical Treatment and Research.2021; 100(3): 154.     CrossRef
  • Why Should We Implement a System of Endoscopic Retrograde Cholangiopancreatography Certification?
    Kwang Bum Cho
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  • Process and Renewal of Pancreatobiliary Cerification System
    Dong Wook Lee, Byoung Kwan Son
    The Korean Journal of Pancreas and Biliary Tract.2020; 25(1): 1.     CrossRef
  • Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study
    Hyun Jik Lee, Chang Min Cho, Jun Heo, Min Kyu Jung, Tae Nyeun Kim, Kook Hyun Kim, Hyunsoo Kim, Kwang Bum Cho, Ho Gak Kim, Jimin Han, Dong Wook Lee, Yoon Suk Lee
    Gut and Liver.2020; 14(2): 257.     CrossRef
  • Quality indicators in diagnostic upper gastrointestinal endoscopy
    Wladyslaw Januszewicz, Michal F. Kaminski
    Therapeutic Advances in Gastroenterology.2020; 13: 175628482091669.     CrossRef
  • Optimized diagnosis ofHelicobacter pyloriand tailored eradication therapy for preventing gastric cancer: a proposal for SHAKE strategy
    Jun-Hyung Cho, So-Young Jin
    Expert Review of Gastroenterology & Hepatology.2020; 14(7): 553.     CrossRef
  • Endoscopy training in Korea
    Joon Sung Kim, Byung-Wook Kim
    The Korean Journal of Internal Medicine.2019; 34(2): 237.     CrossRef
  • Current Korean Medical Specialty and Subspecialty System for Preparation of Privileging and Credentialing of ERCP Subspecialty
    Eun Kwang Choi
    The Korean Journal of Pancreas and Biliary Tract.2019; 24(2): 47.     CrossRef
  • Accredited Endoscopy Unit Program of Korea: Overview and Qualification
    Jung-Wook Kim, Yu Kyung Cho, Jin-Oh Kim, Jae-Young Jang
    Clinical Endoscopy.2019; 52(5): 426.     CrossRef
  • ERCP practice beyond the training period – bridging the gap between guidelines and real-life practice: a single operator experience of 679 procedures
    Theodor Voiosu, Andrei Voiosu, Andreea Benguş, Bogdan Mateescu
    Romanian Journal of Internal Medicine.2019; 57(2): 151.     CrossRef
  • Basic training in digestive endoscopy for resident physicians in gastroenterology. Recommendations by the Sociedad Española de Endoscopia Digestiva (SEED)
    Álvaro Brotons, Angels Vilella, Cristina Sánchez-Montes, Catalina Garau, Albert Vila, Vicente Pons Beltrán, Carlos Dolz Abadía
    Revista Española de Enfermedades Digestivas.2018;[Epub]     CrossRef
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Clinical Endoscopy as One of Leading Journals in Gastrointestinal Endoscopy
Kwang An Kwon, Il Ju Choi, Ji Kon Ryu, Eun Young Kim, Ki Baik Hahm
Clin Endosc 2015;48(4):312-316.   Published online July 24, 2015
DOI: https://doi.org/10.5946/ce.2015.48.4.312
AbstractAbstract PDFPubReaderePub

Clinical Endoscopy (CE) is an official open access journal published bimonthly by the Korean Society of Gastrointestinal Endoscopy (KSGE, http://www.gie.or.kr) and is listed on PMC, PubMed and SCOPUS. The KSGE was established on August 14, 1976, and the journal of the KSGE was published in Korean for the first time in November 1981. The journal was then titled the "Korean Journal of Gastrointestinal Endoscopy" and was published in Korean untill the July 2011 issue. The journal was published in English from the September 2011 issue under the official title of CE. In this review, the past and present of CE are discussed and future perspectives are introduced. In addition, the efforts to progress to a "first come, first served journal" in the field of gastrointestinal endoscopy and to be indexed in Science Citation Index will be described.

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Introduction to Starting Upper Gastrointestinal Endoscopy: Proper Insertion, Complete Observation, and Appropriate Photographing
Kyung Sik Park
Clin Endosc 2015;48(4):279-284.   Published online July 24, 2015
DOI: https://doi.org/10.5946/ce.2015.48.4.279
AbstractAbstract PDFPubReaderePub

Diagnostic upper gastrointestinal endoscopy is the most basic of endoscopy procedures and is the technique that trainee doctors first learn. Mastering the basics of endoscopy is very important because when this process is imprecise or performed incorrectly, it can severely affect a patient's health or life. Although there are several guidelines and studies that consider these basics, there are still no standard recommendations for endoscopy in Korea. In this review, basic points, including proper endoscope insertion, precise observation without blind spots, and appropriate photographing, for upper gastrointestinal endoscopy will be discussed.

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    Chih-Wei Yang, Yueng-Hsiang Chu, Hsin-Chien Chen, Wei-Chen Huang, Peng-Jen Chen, Wei-Kuo Chang
    Frontiers in Oncology.2022;[Epub]     CrossRef
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  • Prevalence of CYP2C19 polymorphism in Bogotá, Colombia: The first report of allele *17
    Azucena Arévalo-Galvis, William A. Otero-Regino, Gloria N. Ovalle-Celis, Eliana R. Rodríguez-Gómez, Alba A. Trespalacios-Rangel, Jed N. Lampe
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    Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Ki Baik Hahm
    Clinical Endoscopy.2015; 48(4): 269.     CrossRef
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International Digestive Endoscopy Network 2014: Turnpike to the Future
Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ji Kon Ryu, Ki Baik Hahm
Clin Endosc 2014;47(5):371-382.   Published online September 30, 2014
DOI: https://doi.org/10.5946/ce.2014.47.5.371
AbstractAbstract PDFSupplementary MaterialPubReaderePub

Social networks are useful in the study of relationships between individuals or entire populations, and the ties through which any given social unit connects. Those represent the convergence of the various social contacts of that unit. Consequently, the term "social networking service" (SNS) became extremely familiar. Similar to familiar SNSs, International Digestive Endoscopy Network (IDEN) 2014 was based on an international network composed of an impressive 2-day scientific program dealing with a variety of topics for gastrointestinal (GI) diseases, which connects physicians and researchers from all over the world. The scientific programs included live endoscopic demonstrations and provided cutting-edge information and practice tips as well as the latest advances concerning upper GI, lower GI, and pancreatobiliary endoscopy. IDEN 2014 featured American Society for Gastrointestinal Endoscopy-Korean Society of Gastrointestinal Endoscopy (ASGE-KSGE)-joint sessions prepared through cooperation between ASGE and KSGE. Furthermore, IDEN 2014 provided a special program for young scientists called the 'Asian Young Endoscopist Award Forum' to foster networks, with many young endoscopists from Asian countries taking an active interest and participation.

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  • Survey results from the participants of the Asian Young Endoscopist Award and International Young Endoscopist Award as part of the International Digestive Endoscopy Network
    Tae-Geun Gweon, Sang Hoon Kim, Ki Bae Bang, Seung Wook Hong, Won Jae Yoon, Sung Noh Hong, Jae Jun Park, Jimin Han, Ja Seol Koo, Oh Young Lee
    Clinical Endoscopy.2023; 56(5): 674.     CrossRef
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    Jun Huang, Hong-Liang Luo, Hua Pan, Cheng Qiu, Teng-Fei Hao, Zheng-Ming Zhu
    Biochemistry (Moscow).2018; 83(1): 69.     CrossRef
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Special Issue Article of IDEN 2013
Highlights of International Digestive Endoscopy Network 2013
Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm
Clin Endosc 2013;46(5):425-435.   Published online September 30, 2013
DOI: https://doi.org/10.5946/ce.2013.46.5.425
AbstractAbstract PDFPubReaderePub

Rapid advances in the technology of gastrointestinal endoscopy as well as the evolution of science have made it necessary for us to continue update in either various endoscopic techniques or state of art lectures relevant to endoscopy. International Digestive Endoscopy Network (IDEN) 2013 was held in conjunction with Korea-Japan Joint Symposium on Gastrointestinal Endoscopy (KJSGE) during June 8 to 9, 2013 at Seoul, Korea. Two days of impressive scientific program dealt with a wide variety of basic concerns from upper gastrointestine (GI), lower GI, pancreaticobiliary endoscopy to advanced knowledge including endoscopic submucosal dissection forum. IDEN seems to be an excellent opportunity to exchange advanced information of the latest issues on endoscopy with experts from around the world. In this special issue of Clinical Endoscopy, we prepared state of art review articles from contributing authors and the current highlights will skillfully deal with very hot spots of each KJSGE, upper GI, lower GI, and pancreaticobiliary sessions by associated editors of Clinical Endoscopy.

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Original Article
Early Gastric Cancer-Like Advanced Gastric Cancer versus Advanced Gastric Cancer-Like Early Gastric Cancer
Hyun Sik Park, Sun-Young Lee, Sung Noh Hong, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park, Chan Sup Shim, Choon Jo Jin
Clin Endosc 2013;46(2):155-160.   Published online March 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.2.155
AbstractAbstract PDFPubReaderePub
Background/Aims

Improvements in the endoscopic evaluation and management of gastric cancer have made it possible to determine the depth of invasion during endoscopic examination. The aim of this study was to elucidate the differences between early gastric cancer (EGC) that resembles advanced gastric cancer (AGC) and AGC that resembles EGC.

Methods

We retrieved cases of EGC-like AGC and AGC-like EGC from consecutive gastric cancers that had been completely resected. The endoscopic diagnoses and clinicopathological findings were analyzed.

Results

AGC-like EGCs were located mainly in the distal part of the stomach, whereas EGC-like AGCs were located mainly in the proximal part of the stomach (p<0.001). Sixty percent of AGC-like EGCs were moderately differentiated adenocarcinomas, while 64% of EGC-like AGCs were poorly differentiated adenocarcinomas (p=0.015). According to Lauren's classification, 68% of AGC-like EGCs were intestinal type, whereas 71% of EGC-like AGCs were diffuse type (p=0.020).

Conclusions

AGC-like EGCs predominate in the distal part of the stomach, while EGC-like AGCs predominate in the proximal part. When evaluating the depth of a gastric cancer, care should be taken not to underestimate measurements in proximal gastric cancers since they tend to be poorly-differentiated adenocarcinomas, in Lauren's diffuse type, and invade deeper than their endoscopic appearance might suggest.

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    Lijian He, Qiange Ye, Yanmei Zhu, Wenqi Zhong, Guifang Xu, Lei Wang, Zhangding Wang, Xiaoping Zou, Stephen Fink
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    Hyun-June Paik, Si-Hak Lee, Chang-In Choi, Dae-Hwan Kim, Tae-Yong Jeon, Dong-Heon Kim, Ung-Bae Jeon, Cheol-Woong Choi, Sun-Hwi Hwang
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Special Issue Articleses of IDEN 2012
Management of Non-Variceal Upper Gastrointestinal Bleeding
Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Sang Woo Lee
Clin Endosc 2012;45(3):220-223.   Published online August 22, 2012
DOI: https://doi.org/10.5946/ce.2012.45.3.220
AbstractAbstract PDFPubReaderePub

Upper gastrointestinal bleeding (UGIB) is a critical condition that demands a quick and effective medical management. Non-variceal UGIB, especially peptic ulcer bleeding is the most significant cause. Appropriate assessment and treatment have a major influence on the prognosis of patients with UGIB. Initial fluids resuscitation and/or transfusion of red blood cells are necessary in patients with clinical evidence of intravascular volume depletion. Endoscopy is essential for diagnosis and treatment of UGIB, and should be provided within 24 hours after presentation of UGIB. Pre-endoscopic use of intravenous proton pump inhibitor (PPI) can downstage endoscopic signs of hemorrhage. Post-endoscopic use of high-dose intravenous PPI can reduce the risk of rebleeding and further interventions such as repeated endoscopy and surgery. Eradication of Helicobacter pylori and withdrawal of non-steroidal anti-inflammatory drugs are recommended to prevent recurrent bleeding.

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    Il Ju Choi
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Sketch of International Digestive Endoscopy Network 2012 Meeting: Overview
Ho Gak Kim
Clin Endosc 2012;45(3):211-213.   Published online August 22, 2012
DOI: https://doi.org/10.5946/ce.2012.45.3.211
AbstractAbstract PDFPubReaderePub

International Digestive Endoscopy Network (IDEN) is an international meeting covering scientific subjects of diverse topics about upper gastrointestinal (GI) endoscopy, colonoscopy, endoscopic ultrasonography, and PB endoscopy. IDEN is organized by Korean Society of Gastrointestinal Endoscopy and the Korean Gastrointestinal Endoscopy Research Foundation, and took its first step in 2011 in Seoul, Korea. IDEN inaugurated a new era of diagnostic and therapeutic GI endoscopy. IDEN 2012 was designed to offer participants from all over the world with opportunities to share up-to-date knowledge about basic and clinical aspects of GI endoscopy and to engage in in-depth discussion with worldwide well-known experts. During the 2 days of meeting, there were 62 invited lectures, 28 case-based discussions, 20 video lectures, and 6 breakfast with the experts. There were a total of 598 participants registered from 12 countries, including Asian countries, Europe, and USA as well as Korea.

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  • Upper Endoscopy in International Digestive Endoscopy Network 2012: Towards Upper End of Quality
    Il Ju Choi
    Clinical Endoscopy.2012; 45(3): 217.     CrossRef
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Review
Past, Present, and Future of the Korea-Japan Joint Symposium on Gastrointestinal Endoscopy
Michio Kaminishi, Hirohumi Niwa
Clin Endosc 2011;44(1):1-5.   Published online September 30, 2011
DOI: https://doi.org/10.5946/ce.2011.44.1.1
AbstractAbstract PDFPubReaderePub

We herein discuss the history, the present situation, and the future prospects of Korean Society of Gastrointestinal Endoscopy (KSGE) and Japan Gastroenterological Endoscopy Society (JGES). Through the symposiums, endoscopy medicine in both countries has developed and matured remarkably, and Korea and Japan have taken a leadership position in this field. In the future, we continuously challenge to advance the symposium further, to hold international sessions, to develop the new KSGE journal Clinical Endoscopy and the JGES journal Digestive Endoscopy through friendly competition. Through those above, we will share useful information with the world and provide leadership in the field of endoscopy medicine.

Citations

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  • Highlights of International Digestive Endoscopy Network 2013
    Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm
    Clinical Endoscopy.2013; 46(5): 425.     CrossRef
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  • 69 Download
  • 1 Crossref
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Case Report
A Bowel Perforation That Developed during the Transanal Extraction of a Large Rectal Foreign Body
Keun-Suk Yang, M.D., Joung-Ho Han, M.D.*, Sunyoung Kim, M.D., Woo Hyung Choi, M.D., Hong-Soon Jung, M.D., Eun Chung, M.D., HyenJeong Jeon, M.D.* and Seijin Youn, M.D.*
Korean J Gastrointest Endosc 2011;42(6):406-409.   Published online May 25, 2011
AbstractAbstract PDF
Rectal foreign bodies are rare clinical problem in South Korea. Although many foreign bodies can be extracted safely using endoscopic procedures, some patients require surgery. Here we describe the case of a 35-year-old male who presented with a rectosigmoid foreign body, a large carrot measuring 28×7 cm. Sigmoidoscopy revealed a carrot in the upper rectum extending to the sigmoid colon. Endoscopic removal failed. The surgeon unsuccessfully attempted to extract the carrot using various tools without spinal anesthesia. During the extraction attempt, the patient complained of sudden abdominal pain, and a simple x-ray revealed pneumoperitoneum. An emergency colotomy and removal of the foreign body was performed, followed by primary repair of the perforation and a colostomy. Three months later, the colostomy was repaired.
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Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Kee Myung Lee, M.D., Seok Reyol Choi, M.D.*, Byung Ik Jang, M.D., Seong Hwan Kim, M.D., Chang Don Kang, M.D.§, Young Dae Kim, M.D., Jeong Youp Park, M.D. and Il-Kwun Ch
Korean J Gastrointest Endosc 2011;42(4):207-214.   Published online April 28, 2011
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The Korean Society of Gastrointestinal Endoscopy (KSGE) developed regulations and a gastrointestinal endoscopy board in 1995. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. Although endoscopic examinations are supervised by a specialist during a GI fellowship, some types of GI endoscopic examinations and treatments are difficult to obtain exposure. Fellows should acquire endoscopic skills through repeated independent endoscopic examinations after a GI fellowship. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform endoscopic examinations without a supervisor. This document is intended to provide the principles that the Committee of Education and Training of KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. KSGE will contribute to improving the quality of GI endoscopy by providing guidelines for fellowships and supervisors. (Korean J Gastrointest Endosc 2011;42:207-214)
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A Deep Neck Infection Due to Esophageal Perforation That Was Caused by Upper Gastrointestinal Endoscopy
Sung Gon Shim, M.D., Hang Rak Lee, M.D., Kang Nyeong Lee, M.D., Oh Young Lee, M.D., Byung Chul Yoon, M.D., Ho Soon Choi, M.D., Joon Soo Hahm, M.D. and Kyung Tae, M.D.*
Korean J Gastrointest Endosc 2009;38(4):205-209.   Published online April 30, 2009
AbstractAbstract PDF
Diagnostic upper gastrointestinal endoscopy is a very commonly performed procedure. Physicians use it as a safe diagnostic tool to evaluate patients with a wide range of problems and complaints, but it can cause several complications in few cases. Esophageal perforation is a rare complication of upper gastrointestinal endoscopy, but it is associated with a relatively high mortality rate. Surgical management is required in most such cases. However, medical treatment can be considered for selected patients who are without a large perforation or systemic effects such as sepsis. Deep neck abscess can develop in patients who have had difficult intubations, and this may be related to retropharyngeal trauma or unapparent perforations. We experienced a case of deep neck infection due to an esophageal perforation that developed as a complication of diagnostic upper gastrointestinal endoscopy, and we successfully treated this patient with incision and drainage. (Korean J Gastrointest Endosc 2009;38:205-209)
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The Evalution of Patient Anxiety Associated with Upper Gastrointestinal Endoscopy
Jin Su Jang, M.D., Moon Kyung Joo, M.D., Jin Nam Kim, M.D., Yong Sik Kim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Hong Sik Lee, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D. and Ho Sang Ryu, M.D.
Korean J Gastrointest Endosc 2007;34(2):65-70.   Published online March 2, 2007
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Background
/Aims: Upper gastrointestinal (UGI) endoscopy is a necessary procedure for making the diagnosis of UGI diseases. However, it may evoke anxiety due to the procedural discomfort before endoscopy. There have been few detailed studies that have evaluated the anxiety of patients who undergo UGI endoscopy in Korea. The aim of this study is to evaluate the patient's anxiety associated with UGI endoscopy and to determine the methods to improve the tolerance of patients to UGI endoscopy. Methods: From May to September 2004, we assessed 38 patients who received UGI endoscopy for the first time as outpatients at Korea University, Anam Hospital. One group was examined with UGI endoscopy after being sedated. The patient's anxiety was rated at baseline and immediately before the procedure. Results: Endoscopy was associated with a significant increase in anxiety (prior to procedure, 48.53 vs. baseline, 43.58, p<0.001) but not trait anxiety (43.92 vs. 43.63, p=0.70). The procedural anxiety was not influenced by gender, age or the education level, but it was correlated with conscious sedation (without CS, 5.67±0.23 vs. with CS, 4.06±0.16, p<0.05). Conclusions: Sedating the patient during UGI endoscopy is an effective method to lower procedural anxiety.
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Two Cases of Vocal Cord Paralysis Complicated by Upper Gastrointestinal Endoscopy
Sung Won Jung, M.D.
Korean J Gastrointest Endosc 2006;33(1):32-36.   Published online July 30, 2006
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Upper Gastrointestinal endoscopy is extensively used these days and its various complications, including cardiopulmonary disease, bleeding, perforation and infection, have been reported on, but vocal cord paralysis as a complication of endoscopy has not been reported on. The pressure on the larynx by the endoscopic tip itself or the gag reflex during endoscopy could cause vocal cord paralysis as the endoscopic tip passes through the pyriform sinus, which is close to the recurrent laryngeal nerve and arytenoid cartilage. We experienced two cases of vocal cord paralysis as complications of upper Gastrointestinal endoscopy and we report on them here. (Korean J Gastrointest Endosc 2006;33:32⁣36)
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A Case of an Acute Huge Hemorrhagic Gastric Ulcer after an Endoscopic Mucosal Biopsy
So Ri Kim, M.D., Kyung Hoon Min, M.D., Sang Woo Nam, M.D., Hyun Chul Kim, M.D.,Yong Keun Cho, M.D., In Hee Kim, M.D., Soo Teik Lee, M.D. and Deuk Soo Ahn, M.D.
Korean J Gastrointest Endosc 2005;31(2):111-115.   Published online August 30, 2005
AbstractAbstract PDF
Although most diagnostic upper gastrointestinal endoscopic procedures are performed on an outpatient basis with relatively low risk, complications related with these procedures can occur. The reported complications are cardiopulmonary complications, drug side effects, perforation, hemorrhage and infection. Hemorrhage may occur from the site of biopsy or polyp removal. It is usually minimal and heals spontaneously with or without endoscopic treatment and rarely requires transfusion or surgery. Acute hemorrhagic ulceration associated with endoscopic mucosal biopsy is very rare. We report a case of a 46-year-old woman with an acute hemorrhagic gastric ulcer after an endoscopic mucosal biopsy. She has been receiving upper gastrointestinal endoscopic examinations annually for the gastric polyp detected 4 years ago. Endoscopic mucosal biopsy was performed without complications. Twelve hours later, she admitted to the emergency room because of melena. Emergent upper gastrointestinal endoscopy showed an acute huge hemorrhagic ulceration along the antrum. She was treated conservatively and discharged 5 days later. (Korean J Gastrointest Endosc 2005;31:111⁣115)
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Ingestion of a Mouthpiece Fragment during Intravenous
Seung Ryong Lee, M.D., Byoung Sik Mun, M.D., Heok Soo Ahn, M.D. and Seung Ok Lee, M.D.
Korean J Gastrointest Endosc 2003;26(1):31-34.   Published online January 30, 2003
AbstractAbstract PDF
The demand for intravenous sedated upper gastrointestianl endoscopy is currently increasing steeply. Despite this trend, patient status complication due to this procedure is largerly neglected by most physicians. Recently, in three patients, mouthpiece fragment were left within the patients' body after intravenous sedated upper gastrointestinal endoscopy. They were transferred to our institution for the removal of the fragment. The patients complained of an uneasy sensation from within their body, around their necks and chests. After conducting therapeutic endoscopy, the fragment could be located around the distal part of their esophagus and within their stomach. The fragment were removed successfully by using snare in two patients, and by using forceps in another patient. (Korean J Gastrointest Endosc 2003; 26:31⁣34)
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수면내시경 검사에서 Midazolam 전처치와 Flumazenil 길항작용에 대한 연구 ( Effectiveness of Flumazenil against Midazolam as Premedication for Upper Gastrointestinal Endoscopy )
Korean J Gastrointest Endosc 2000;21(1):518-524.   Published online November 30, 1999
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Background
/Aims : Midazolam is utilized as a premedication for uppoer gastrointestinal endoscopy. Midazolam has a more rapid onset of reaction than that of diazepam and its duration is shorter. But the Consciousness of premedicated patients has not been regained sooner. The Purpose of this study was to examine the effectiveness of flumazenil against midazolam as premedication for upper gastrointesinal endoscopy. Methods : Sixty patients underwent upper gastrointestinal endoscopy. These patients were divided to three groups: Group I included twenty patients without premedication; Group Ⅱ Included twenty patients with premedication of midazolam and then were not given an antisedative agent excluign of normal saline; and Group Ⅲ included the others with midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam injection, compared with presedation value. Modified Steward Coma Scale showed a significant increase after flumazenil injection as an antagonist of midazolam. The assessment of the endoscopist and the comfort of patients were satisfactory. When the 40 patients were asked about their willingness to undergo the same procedure in the future, thirty-four patients responded favorably. Conclusion : Midazolam was safe and effective for sedation for upper gastrointestinal endoscopy. There was rapid regaining of consciousness with flumazenil indection after midazolam, so the use of flumazenil against midazolam injection also appeared to be effective. ( Korean J Gastrointest Endosc 2000;21:518-524)
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상부 위장관 내시경 검사 시 전처치로서의 Propofol의 효과 ( Propofol as Premedication for Upper Gastrointestinal Endoscopy )
Korean J Gastrointest Endosc 2000;20(3):165-170.   Published online November 30, 1999
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Background
/Aims: Benzodiazepine is generally used when sedation is required for endoscopy, while propofol, a phenol-derived intravenous anesthetic agent, appears to have a more suitable phamacokinetic profile. The aim of this study was to evaluate the effectiveness and safety of propofol as premedication for upper gastrointestinal endoscopy. Methods: Between July 1998 and October 1998, 44 male patients and 70 female patients were involved in this study. The relative ease of upper gastrointestinal endoscopy, patient's tolerance, and amnestic effects on 64 patients with propofol was compared with 50 patients with non-sedation. Pulse rate and arterial oxygen saturation was monitored. The endoscopist and patients replied to a questionnaire. Results: Patients receiving propofol tolerated endoscopy much more than patients with non-sedation (p<0.01). The change in pulse rate was less variable but arterial oxygen saturation showed a statistically significant decrease in patients receiving propofol (p<0.01). Propofol induced complete amnesia in 93.7% of the patients and partial anesthesia in 4.7%. Most of the patients receiving propofol accepted the same sedative methods in their next endoscopy (p<0.01). Conclusions: Propofol is highly effective, with a short recovery time and satisfaction of the patients, but careful monitoring is recommended because of its untoward effect of hypoxia. It is recommended that propofol be used as a premedication especially in patients who are apprehensive about a repeated endoscopy.
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Propofol 지속정주를 이용한 상부소화관 내시경 ( Gastrointestinal Endoscopy under Sedation with a Continuous Infusion of Propofol )
Korean J Gastrointest Endosc 1999;19(5):706-715.   Published online November 30, 1998
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Background
/Aims: Propofol is a short-acting intravenous sedative-hypnotic agent that can be used as a hypnotics for upper gastrointestinal endoscopy. A study was conducted to evaluate the effectiveness and safety of propofol as a hypnotic agent for upper gastrointestinal endoscopy. Methods: From June to October 1998, twenty eight patients undergoing upper gastrointestinal endoscopy were to receive propofol. Vital signs and peripheral oxygen saturation (SpO2) were monitored by pulse oximetry during continuous infusion of propofol. Propofol (1% solution) was initially infused by 26.7 mg/kg/hr until loss of eyelash reflex and then titrated to 6∼10 mg/kg/hr according to the patient's response and vital sign. Propofol infusion was discontinued while the endoscopic fiber was removed. Recovery time was defined from discontinuation of infusion to positive Romberg test. Evaluation was made from the endoscopists' assessment, patients' satisfaction, patients' recall of the procedure, and consciousness of the patients. Results: It was discovered that systolic, diastolic pressure and heart rate were significantly decreased, compared to control group. But clinically significant changes were not found. Apnea did not exist. And the respiration rate was significantly increased during propofol infusion. Peripheral oxygen saturation (SpO2) was transiently decreased during endoscopy. 14 patients (50%) complained of transient dizziness. Pain and redness over the infusion site was not found. The mean total dose of propofol was 133.6 mg. The mean infusion time of propofol was 6.2 minutes. Mean response and recovery time was 3.7 2.1, 20.9 5.4 minutes. Endoscopists' assessment and patients' comfort for endoscopy were satisfactory. When we asked 28 patients about willingness to undergo the same procedure in the future, 27 patients (96.4%) agreed. Degree of amnesia after examination revealed total amnesia in 27 patients (96.4%), partial amnesia in 1 patients (3.6%), and recall was not. Conclusions: Propofol has beneficial effects as hypnotic for upper gastrointestinal endoscopy without significant alteration in cardiopulmonary parameters. Patients' and endoscopists' assessment is good. This suggest that propofol may be used more frequently as a kind of premedication, especially in the cases of repeated endoscopy. (Korean J Gastrointest Endosc 19: 706∼715, 1999)
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