Clinical Endoscopy

Original Articles

Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in Japan: Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto; Clin Endosc 2025;58(4):561-568. Published online March 12, 2025; DOI: https://doi.org/10.5946/ce.2024.181

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Background
/Aims: Underwater endoscopic mucosal resection (UEMR) is the standard resection method for superficial non-ampullary duodenal tumors (SNADETs). We developed a novel UEMR technique that creates an anchor by protruding the distal fold with a saline injection (UEMR-A). The aim of this study was to clarify the usefulness of UEMR-A compared to conventional UEMR (UEMR-C).
Methods
This retrospective observational study included patients who underwent UEMR for SNADETs.
Results
A total of 141 patients were included and divided into UEMR-A (n=54) and UEMR-C (n=87) groups. Lesion resection was performed significantly more frequently by an expert endoscopist in the UEMR-C group compared to the UEMR-A group (p<0.001). The procedure time for UEMR-A was significantly shorter than that for UEMR-C (p=0.018), despite the additional time required for submucosal injection. The R0 resection rate was significantly higher in the UEMR-A group than in the UEMR-C group (p=0.004). The horizontal margins were significantly clearer in the UEMR-A group than in the UEMR-C group (p=0.018). Multivariate analysis revealed that the use of UEMR-A was the only significant positive factor for R0 resection.
Conclusions
The UEMR-A technique for SNADETs appears to improve R0 resection rates and reduce procedure times compared to the UEMR-C technique.

Citations

Citations to this article as recorded by

Advancement of endoscopic treatment in GI tract
Yoshimasa Miura
Journal of Nihon University Medical Association.2025; 84(3): 119. CrossRef
Evaluation of a modified underwater endoscopic mucosal resection technique for duodenal neoplasms: clinical implications and future directions
Ji Yong Ahn
Clinical Endoscopy.2025; 58(4): 544. CrossRef
Reply to the comments on ‘Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in Japan'
Hironori Yamamoto, Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa
Clinical Endoscopy.2025; 58(6): 953. CrossRef
A reformative underwater endoscopic mucosal resection technique for superficial non-ampullary duodenal tumors
Yiheng Yao, Guolei Shi, Xingjie Shen, Liang Liu
Clinical Endoscopy.2025; 58(6): 951. CrossRef

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Single-Stage Endoscopic Stone Extraction and Cholecystectomy during the Same Hospitalization: Toshiaki Terauchi, Hiroharu Shinozaki, Satoshi Shinozaki, Yuichi Sasakura, Masaru Kimata, Junji Furukawa, Alan Kawarai Lefor, Yoshiro Ogata, Kenji Kobayashi; Clin Endosc 2019;52(1):59-64. Published online October 5, 2018; DOI: https://doi.org/10.5946/ce.2018.107

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Background
/Aims: The clinical impact of single-stage endoscopic stone extraction by endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy during the same hospitalization remains elusive. This study aimed to determine the efficacy and safety of single-stage ERCP and cholecystectomy during the same hospitalization in patients with cholangitis.
Methods
We retrospectively reviewed the medical records of 166 patients who underwent ERCP for mild to moderate cholangitis due to choledocholithiasis secondary to cholecystolithiasis from 2012 to 2016.
Results
Complete stone extraction was accomplished in 92% of patients (152/166) at the first ERCP. Among 152 patients who underwent complete stone extraction, cholecystectomy was scheduled for 119 patients (78%). Cholecystectomy was performed during the same hospitalization in 89% of patients (106/119). We compared two groups of patients: those who underwent cholecystectomy during the same hospitalization (n=106) and those who underwent cholecystectomy during a subsequent hospitalization (n=13). In the delayed group, cholecystectomy was performed about three months after the first ERCP. There were no significant differences between the groups in terms of operative time, rate of postoperative complications, and interval from cholecystectomy to discharge.
Conclusions
Single-stage endoscopic stone extraction is recommended in patients with mild to moderate acute cholangitis due to choledocholithiasis. The combination of endoscopic stone extraction and cholecystectomy during the same hospitalization is safe and feasible.

Citations

Citations to this article as recorded by

Safety and efficacy of single-stage endoscopic stone removal and the timing of ERCP for acute cholangitis: a multicenter study
Zhi An, Jiawei Chen, Zi Yan, Chaoqun Han, Jun Fang, Qiu Zhao
BMC Gastroenterology.2026;[Epub] CrossRef
RECURRENT BILIARY EVENTS IN PATIENTS, WHO UNDERWENT ENDOSCOPIC LITHOEXTRACTION DUE TO OBSTRUCTIVE JAUNDICE
S. V. Dolzhkovyi
World of Medicine and Biology.2022; 18(79): 59. CrossRef
Destiny for Rendezvous: Is Cholecysto/Choledocholithiasis Better Treated with Dual- or Single-Step Procedures?
S. Vaccari, M. Minghetti, A. Lauro, M. I. Bellini, A. Ussia, S. Khouzam, I. R. Marino, M. Cervellera, V. D’Andrea, V. Tonini
Digestive Diseases and Sciences.2022; 67(4): 1116. CrossRef
Application of ERCP Procedures in Choledocholithiasis with Duodenal Stenosis Patients
Yuyan Shi, Jinghon Zhong, Jianbo Zhou, Qifeng Song, Zhaoqi Dong
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Choledocholithiasis without cholecystolithiasis, after endoscopic retrograde cholangiopancreatography follow-up without cholecystectomy
Bahtiyar MUHAMMEDOĞLU, Eyüp PİRCANOĞLU, Serkan TORUN
Konuralp Tıp Dergisi.2021; 13(1): 68. CrossRef
Comparison of the safety and efficacy of single-stage endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy versus two-stage ERCP followed by laparoscopic cholecystectomy six-to-eight weeks later: A randomized controlled trial
Bahtiyar Muhammedoğlu, Ilhami Taner Kale
International Journal of Surgery.2020; 76: 37. CrossRef
Single-Stage Endoscopic Stone Extraction and Cholecystectomy during the Same Hospitalization: What is the Optimal Strategy for Patients with Choledocholithiasis and Cholelithiasis?
Tae Yoon Lee
Clinical Endoscopy.2019; 52(1): 5. CrossRef

8,538 View
163 Download
7 Web of Science
7 Crossref

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