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Review
Role of endoscopy in gastroesophageal reflux disease
Daniel Martin Simadibrata, Elvira Lesmana, Ronnie Fass
Clin Endosc 2023;56(6):681-692.   Published online October 12, 2023
DOI: https://doi.org/10.5946/ce.2023.182
AbstractAbstract PDFPubReaderePub
In general, gastroesophageal reflux disease (GERD) is diagnosed clinically based on typical symptoms and/or response to proton pump inhibitor treatment. Upper gastrointestinal endoscopy is reserved for patients presenting with alarm symptoms, such as dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, or anorexia; those who meet the criteria for Barrett’s esophagus screening; those who report a lack or partial response to proton pump inhibitor treatment; and those with prior endoscopic or surgical anti-reflux interventions. Newer endoscopic techniques are primarily used to increase diagnostic yield and provide an alternative to medical or surgical treatment for GERD. The available endoscopic modalities for the diagnosis of GERD include conventional endoscopy with white-light imaging, high-resolution and high-magnification endoscopy, chromoendoscopy, image-enhanced endoscopy (narrow-band imaging, I- SCAN, flexible spectral imaging color enhancement, blue laser imaging, and linked color imaging), and confocal laser endomicroscopy. Endoscopic techniques for treating GERD include esophageal radiofrequency energy delivery/Stretta procedure, transoral incisionless fundoplication, and endoscopic full-thickness plication. Other novel techniques include anti-reflux mucosectomy, peroral endoscopic cardiac constriction, endoscopic submucosal dissection, and endoscopic band ligation. Currently, many of the new endoscopic techniques are not widely available, and their use is limited to centers of excellence.

Citations

Citations to this article as recorded by  
  • Long-term efficacy of endoscopic radiofrequency Stretta therapy for patients with refractory gastroesophageal reflux disease
    Sung Eun Kim
    Clinical Endoscopy.2024; 57(1): 48.     CrossRef
  • The role of ghrelin and leptin in the formation of morphological changes esophagus of patients with gastro-esophageal reflux disease against type 2 diabetes
    Olha Bondar-Keleberda
    EUREKA: Health Sciences.2023; (4): 24.     CrossRef
  • 3,580 View
  • 340 Download
  • 1 Web of Science
  • 2 Crossref
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Original Article
Endoscopic radiofrequency Stretta therapy reduces proton pump inhibitor dependency and the need for anti-reflux surgery for refractory gastroesophageal reflux disease
Abraham Joel, Alakh Konjengbam, Yirupaiahgari Viswanath, Georgios Kourounis, Emily Hammond, Helen Frank, Shivani Kuttuva, Simon Mbarushimana, Hena Hidayat, Srivishnu Thulasiraman
Clin Endosc 2024;57(1):58-64.   Published online May 2, 2023
DOI: https://doi.org/10.5946/ce.2023.026
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Radiofrequency treatment of the gastroesophageal junction using the Stretta procedure for treating gastroesophageal reflux disease (GERD) is observed to improve the symptoms and proton pump inhibitor (PPI) dependence and reduce the need for anti-reflux operations. As one of the largest studies in Europe, we evaluated the clinical outcomes of Stretta in patients with medically refractory GERD.
Methods
A tertiary UK center evaluated all patients with refractory GERD who underwent Stretta between 2014 and 2022. Patients and primary care professionals were contacted to obtain information regarding the initiation of PPI and reintervention after Stretta.
Results
Of the 195 patients (median age, 55 years; 116 women [59.5%]) who underwent Stretta, PPI-free period (PFP) data were available for 144 (73.8%) patients. Overall, 66 patients (45.8%) did not receive PPI after a median follow-up of 55 months. Six patients (3.1%) underwent further interventions. The median PFP after Stretta was 41 months. There was a significant negative correlation between PFP and age (p=0.007), with no differences between sexes (p=0.96). Patients younger than 55 years of age had a longer PFP than their older counterparts (p=0.005). Younger males had a significantly longer PFP than older males (p=0.021). However, this was not observed in the female cohort (p=0.09) or between the younger men and women (p=0.66).
Conclusions
Our findings suggest that Stretta is a safe and feasible option for treating refractory GERD, especially in younger patients. It prevents further anti-reflux interventions in most patients and increases the lead-time to surgery in patients with refractory GERD.

Citations

Citations to this article as recorded by  
  • Clinicians should be aware of proton pump inhibitor–related changes in the gastric mucosa
    Gwang Ha Kim
    Clinical Endoscopy.2024; 57(1): 51.     CrossRef
  • Long-term efficacy of endoscopic radiofrequency Stretta therapy for patients with refractory gastroesophageal reflux disease
    Sung Eun Kim
    Clinical Endoscopy.2024; 57(1): 48.     CrossRef
  • Chronic cough and refractory chronic cough: An important distinction
    Peter V. Dicpinigaitis
    Journal of Precision Respiratory Medicine.2023; 6(1): 10.     CrossRef
  • 2,270 View
  • 183 Download
  • 1 Web of Science
  • 3 Crossref
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Review
Comparing palliative treatment options for cholangiocarcinoma: photodynamic therapy vs. radiofrequency ablation
Tayyaba Mohammad, Michel Kahaleh
Clin Endosc 2022;55(3):347-354.   Published online May 17, 2022
DOI: https://doi.org/10.5946/ce.2021.274
AbstractAbstract PDFPubReaderePub
Referral to an endoscopist is often done once curative resection is no longer an option for cholangiocarcinoma management. In such cases, palliation has become the main objective of the treatment. Photodynamic therapy and radiofrequency ablation can be performed to achieve palliation, with both procedures associated with improved stent patency and survival. Despite the greatly increased cost and association with photosensitivity, photodynamic therapy allows transmission to the entire biliary tree. In contrast, radiofrequency ablation is cheaper and faster to apply but requires intraductal contact. This paper reviews both modalities and compares their efficacy and safety for bile duct cancer palliation.

Citations

Citations to this article as recorded by  
  • Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma
    Maryam Makki, Malak Bentaleb, Mohammed Abdulrahman, Amal Abdulla Suhool, Salem Al Harthi, Marcelo AF Ribeiro Jr
    World Journal of Clinical Oncology.2024; 15(3): 381.     CrossRef
  • Endoskopisch gesteuerte Diagnostik und Therapie von Cholangiokarzinomen
    Ulrike Denzer, Alexander Dechêne
    Die Gastroenterologie.2023; 18(1): 16.     CrossRef
  • Recent Updates on Local Ablative Therapy Combined with Chemotherapy for Extrahepatic Cholangiocarcinoma: Photodynamic Therapy and Radiofrequency Ablation
    Tadahisa Inoue, Masashi Yoneda
    Current Oncology.2023; 30(2): 2159.     CrossRef
  • Role of radiofrequency ablation in advanced malignant hilar biliary obstruction
    Mamoru Takenaka, Tae Hoon Lee
    Clinical Endoscopy.2023; 56(2): 155.     CrossRef
  • Impact of endobiliary radiofrequency ablation on survival of patients with unresectable cholangiocarcinoma: a narrative review
    Elena Di Girolamo, Andrea Belli, Alessandro Ottaiano, Vincenza Granata, Valentina Borzillo, Luca Tarotto, Fabiana Tatangelo, Raffaele Palaia, Corrado Civiletti, Mauro Piccirillo, Valentina D’Angelo, Francesco Fiore, Pietro Marone, Guglielmo Nasti, Frances
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Thermal ablative therapies in the gastrointestinal tract
    Hendrik Manner
    Current Opinion in Gastroenterology.2023; 39(5): 370.     CrossRef
  • Photodynamic Therapy: From the Basics to the Current Progress of N-Heterocyclic-Bearing Dyes as Effective Photosensitizers
    Eurico Lima, Lucinda V. Reis
    Molecules.2023; 28(13): 5092.     CrossRef
  • Balloon‐assisted laser application for endoscopic treatment of biliary stricture
    Seonghee Lim, Van Gia Truong, Seok Jeong, Jiho Lee, Byeong‐il Lee, Hyun Wook Kang
    Lasers in Surgery and Medicine.2023; 55(10): 912.     CrossRef
  • Emerging Systemic Therapies in Advanced Unresectable Biliary Tract Cancer: Review and Canadian Perspective
    Vincent C. Tam, Ravi Ramjeesingh, Ronald Burkes, Eric M. Yoshida, Sarah Doucette, Howard J. Lim
    Current Oncology.2022; 29(10): 7072.     CrossRef
  • 3,551 View
  • 220 Download
  • 9 Web of Science
  • 9 Crossref
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Original Article
Efficacy and Safety of Endoscopic Submucosal Dissection for Superficial Gastric Neoplasms: A Latin American Cohort Study
Fernando Palacios-Salas, Harold Benites-Goñi, Luis Marin-Calderón, Paulo Bardalez-Cruz, Jorge Vásquez-Quiroga, Edgar Alva-Alva, Bryan Medina-Morales, Jairo Asencios-Cusihuallpa
Clin Endosc 2022;55(2):248-255.   Published online November 12, 2021
DOI: https://doi.org/10.5946/ce.2021.192
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic submucosal dissection (ESD) is the preferred technique for treating early gastric cancer (EGC). However, very few studies have been conducted in South America. This study aimed to assess the efficacy and safety of ESD for EGC.
Methods
We analyzed data from a prospective cohort from 2013 to 2020. A total of 152 superficial gastric neoplasms that fulfilled the absolute or expanded criteria for ESD were included. Outcomes were en bloc, R0, and curative resection rates, incidence of adverse events, and length of procedure.
Results
The age of the enrolled patients was 68.4±11.3 years. The number of included patients based on the absolute and expanded indications was 150 and 2, respectively. En bloc, R0, and curative resections were achieved in 98.0%, 96.1%, and 89.5% of the cases, respectively. Bleeding and perforation were reported in 5.9% and 6.6% of the cases, respectively. Histopathological examination revealed lowgrade dysplasia, high-grade dysplasia, well-differentiated adenocarcinoma, and poorly differentiated adenocarcinoma in 13, 20, 117, and 2 cases, respectively.
Conclusions
Our study shows that ESD performed by properly trained endoscopists in reference centers is safe and effective, with comparable therapeutic outcomes to those reported in the Eastern series.

Citations

Citations to this article as recorded by  
  • Short-Term and Long-Term Outcomes of Liver Cirrhosis in Gastric Neoplasm Patients Undergoing Endoscopic Submucosal Dissection
    Xu-Rui Liu, Lian-Shuo Li, Fei Liu, Zi-Wei Li, Xiao-Yu Liu, Wei Zhang, Dong Peng
    Journal of Laparoendoscopic & Advanced Surgical Techniques.2023; 33(7): 640.     CrossRef
  • Endoscopic submucosal dissection for early gastric cancer: It is time to consider the quality of its outcomes
    Gwang Ha Kim
    World Journal of Gastroenterology.2023; 29(43): 5800.     CrossRef
  • Endoscopic diagnosis of early gastric cancer
    Dong Chan Joo, Gwang Ha Kim
    Journal of the Korean Medical Association.2022; 65(5): 267.     CrossRef
  • Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
    Eun Jeong Gong, Chang Seok Bang
    Journal of the Korean Medical Association.2022; 65(5): 284.     CrossRef
  • 4,056 View
  • 220 Download
  • 5 Web of Science
  • 4 Crossref
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Focused Review Series: Future Perspectives of Fecal Microbiota Transplatation
Fecal Microbiota Transplantation beyond Clostridioides Difficile Infection
Chang Mo Moon, Sung Noh Hong
Clin Endosc 2021;54(2):149-151.   Published online March 26, 2021
DOI: https://doi.org/10.5946/ce.2021.068
AbstractAbstract PDFPubReaderePub
With advancing analytical methods for gut microbes, many studies have been conducted, revealing that gut microbes cause various diseases, including gastrointestinal and non-gastrointestinal diseases. Accordingly, studies have been actively conducted to analyze the effects on the prevention and treatment of these diseases through changes in intestinal microbes and control of dysbiosis. Fecal microbiota transplantation (FMT) is an effort and is currently being applied to Clostridioides difficile treatment in Korea. Many studies have demonstrated the application of FMT in inflammatory bowel disease, irritable bowel syndrome, non-alcoholic fatty liver disease, metabolic syndrome, obesity, and diabetes. With further studies and accumulation of evidence, FMT could help treat presently untreatable diseases in clinical practice.
  • 3,776 View
  • 110 Download
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Focused Review Series: Endoscopic Ultrasound-Guided Therapeutic Intervention: Focus on Technique and Practical Tips
Endoscopic Ultrasound-Guided Local Therapy for Pancreatic Neoplasms
Jun Seong Hwang, Hyun Don Joo, Tae Jun Song
Clin Endosc 2020;53(5):535-540.   Published online September 29, 2020
DOI: https://doi.org/10.5946/ce.2020.181
AbstractAbstract PDFPubReaderePub
Surgical resection is considered the only treatment option for pancreatic cancer and other pancreatic neoplasms with malignant potential, such as neuroendocrine tumors, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms. However, only 10%–20% of all patients with pancreatic cancer present with resectable forms of the disease as the symptoms are rarely manifested during the early stages, and the disease tends to progress rapidly. Furthermore, pancreatic surgery is associated with high rates of morbidity and mortality. The development of linear-array endoscopic ultrasound (EUS) techniques has increased the indications of EUS-guided local therapy for pancreatic neoplasms. We assessed the studies that investigated various treatment modalities, such as fine-needle injection, radiofrequency ablation, irreversible electroporation, and radiotherapy, under EUS guidance to better understand the usefulness of these techniques with respect to the efficacy and associated complications.

Citations

Citations to this article as recorded by  
  • Anticancer effect of a pyrrole‐imidazole polyamide‐triphenylphosphonium conjugate selectively targeting a common mitochondrial DNA cancer risk variant in cervical cancer cells
    Jihang Yao, Keizo Takenaga, Nobuko Koshikawa, Yuki Kida, Jason Lin, Takayoshi Watanabe, Yoshiaki Maru, Yoshitaka Hippo, Seigi Yamamoto, Yuyan Zhu, Hiroki Nagase
    International Journal of Cancer.2023; 152(5): 962.     CrossRef
  • Endoscopic Ultrasound-Guided Local Ablative Therapies for the Treatment of Pancreatic Neuroendocrine Tumors and Cystic Lesions: A Review of the Current Literature
    Alexander M. Prete, Tamas A. Gonda
    Journal of Clinical Medicine.2023; 12(9): 3325.     CrossRef
  • Response of Locally Advanced Pancreatic Cancer to Intratumoral Injection of Large Surface Area Microparticle Paclitaxel
    Neil R. Sharma, Simon K. Lo, Andrew Hendifar, Mohamed O. Othman, Kalpesh Patel, Antonio Mendoza-Ladd, Shelagh Verco, Holly A. Maulhardt, James Verco, Alison Wendt, Alyson Marin, Christian Max Schmidt, Gere diZerega
    Pancreas.2023; 52(3): e179.     CrossRef
  • Multisite Is Superior to Single-Site Intratumoral Chemotherapy to Retard the Outcomes of Pancreatic Ductal Adenocarcinoma in a Murine Model
    Janette Lazarovits, Ron Epelbaum, Jesse Lachter, Yaron Amikam, Jacob Ben Arie
    Cancers.2023; 15(24): 5801.     CrossRef
  • Endoscopic ultrasound-guided injectable therapy for pancreatic cancer: A systematic review
    Jyotroop Kaur, Veeravich Jaruvongvanich, Vinay Chandrasekhara
    World Journal of Gastroenterology.2022; 28(21): 2383.     CrossRef
  • 4,348 View
  • 151 Download
  • 5 Web of Science
  • 5 Crossref
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Review
Photodynamic Therapy for Esophageal Cancer
Takahiro Inoue, Ryu Ishihara
Clin Endosc 2021;54(4):494-498.   Published online May 19, 2020
DOI: https://doi.org/10.5946/ce.2020.073
AbstractAbstract PDFPubReaderePub
Photodynamic therapy, a curative local treatment for esophageal squamous cell carcinoma, involves a photosensitizing drug (photosensitizer) with affinity for tumors and a photodynamic reaction triggered by laser light. Previously, photodynamic therapy was used to treat superficial esophageal squamous cell carcinoma judged to be difficult to undergo endoscopic resection. Recently, photodynamic therapy has mainly been performed for local failure after chemoradiotherapy. Although surgery is the most promising treatment for local failure after chemoradiotherapy, its morbidity and mortality rates are high. Endoscopic resection is feasible for local failure after chemoradiotherapy but requires advanced skills, and its indication is limited to within the submucosal layer by depth. Photodynamic therapy is less invasive than surgery and has a wider indication than endoscopic resection. Porfimer sodium (a first-generation photosensitizer) causes a high frequency of side effects related to photosensitivity and requires the long-term sunshade period. Talaporfin (a second-generation photosensitizer) requires a much shorter sun-shade period than porfimer sodium. Photodynamic therapy will profoundly change treatment strategies for local failure after chemoradiotherapy.

Citations

Citations to this article as recorded by  
  • Aluminium phthalocyanine-mediated photodynamic therapy induces ATM-related DNA damage response and apoptosis in human oesophageal cancer cells
    Onyisi Christiana Didamson, Rahul Chandran, Heidi Abrahamse
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • An Ailment with Which I Will Contend: A Narrative Review of 5000 Years of Esophagogastric Cancers and Their Treatments, with Special Emphasis on Recent Advances in Immunotherapeutics
    C. Beau Hilton, Steven Lander, Michael K. Gibson
    Cancers.2024; 16(3): 618.     CrossRef
  • Western outcomes of circumferential endoscopic submucosal dissection for early esophageal squamous cell carcinoma
    Enrique Rodríguez de Santiago, Laurelle van Tilburg, Pierre H. Deprez, Mathieu Pioche, Roos E. Pouw, Michael J. Bourke, Stefan Seewald, Bas L.A.M. Weusten, Jeremie Jacques, Sara Leblanc, Pedro Barreiro, Arnaud Lemmers, Adolfo Parra-Blanco, Ricardo Küttner
    Gastrointestinal Endoscopy.2024; 99(4): 511.     CrossRef
  • Interventional gastroenterology in oncology
    Vaibhav Wadhwa, Nicole Patel, Dheera Grover, Faisal S. Ali, Nirav Thosani
    CA: A Cancer Journal for Clinicians.2023; 73(3): 286.     CrossRef
  • Utilizing 4D Printing to Design Smart Gastroretentive, Esophageal, and Intravesical Drug Delivery Systems
    Dina B. Mahmoud, Michaela Schulz‐Siegmund
    Advanced Healthcare Materials.2023;[Epub]     CrossRef
  • Recent Advances in Green Metallic Nanoparticles for Enhanced Drug Delivery in Photodynamic Therapy: A Therapeutic Approach
    Alexander Chota, Blassan P. George, Heidi Abrahamse
    International Journal of Molecular Sciences.2023; 24(5): 4808.     CrossRef
  • Amino Acid Derivatives of Chlorin-e6—A Review
    Maria da Graça H. Vicente, Kevin M. Smith
    Molecules.2023; 28(8): 3479.     CrossRef
  • Stimuli-responsive heparin-drug conjugates co-assembled into stable nanomedicines for cancer therapy
    Zaixiang Fang, Ling Lin, Zhiqian Li, Lei Gu, Dayi Pan, Yunkun Li, Jie Chen, Haitao Ding, Xiaohe Tian, Qiyong Gong, Kui Luo
    Acta Biomaterialia.2023;[Epub]     CrossRef
  • Idarubicin and IR780 co-loaded PEG-b-PTMC nanoparticle for non-Hodgkin’s lymphoma therapy by photothermal/photodynamic strategy
    Shanshan Weng, Luqi Pan, Dawei Jiang, Wenxia Xie, Zhiyuan Zhang, Changcan Shi, Bin Liang, Shenghao Wu
    Materials & Design.2023; 230: 112008.     CrossRef
  • Protein Photodamaging Activity and Photocytotoxic Effect of an Axial-Connecting Phosphorus(V)porphyrin Trimer
    Kazutaka Hirakawa, Naoki Kishimoto, Yoshinobu Nishimura, Yuko Ibuki, Masaaki Fuki, Shigetoshi Okazaki
    Chemical Research in Toxicology.2023;[Epub]     CrossRef
  • Nanomedicine in Clinical Photodynamic Therapy for the Treatment of Brain Tumors
    Hyung Shik Kim, Dong Yun Lee
    Biomedicines.2022; 10(1): 96.     CrossRef
  • Poly(styrene-co-maleic acid) Micelle of Photosensitizers for Targeted Photodynamic Therapy, Exhibits Prolonged Singlet Oxygen Generating Capacity and Superior Intracellular Uptake
    Gahininath Yadavrao Bharate, Haibo Qin, Jun Fang
    Journal of Personalized Medicine.2022; 12(3): 493.     CrossRef
  • Deep-Learning for the Diagnosis of Esophageal Cancers and Precursor Lesions in Endoscopic Images: A Model Establishment and Nationwide Multicenter Performance Verification Study
    Eun Jeong Gong, Chang Seok Bang, Kyoungwon Jung, Su Jin Kim, Jong Wook Kim, Seung In Seo, Uhmyung Lee, You Bin Maeng, Ye Ji Lee, Jae Ick Lee, Gwang Ho Baik, Jae Jun Lee
    Journal of Personalized Medicine.2022; 12(7): 1052.     CrossRef
  • Palliation of Malignant Dysphagia: Dilation, Stents, Cryoablation or PDT: The GI Perspective
    Daniel J. Ellis, Nisa M. Kubiliun, Anna Tavakkoli
    Foregut: The Journal of the American Foregut Society.2022; 2(2): 186.     CrossRef
  • Palliation of Malignant Dysphagia: Dilation, Stents, Cryoablation or Photodynamic Therapy—A Surgical Perspective
    Uzma Rahman, Olugbenga T. Okusanya
    Foregut: The Journal of the American Foregut Society.2022; 2(2): 180.     CrossRef
  • Endoscopic Treatment for Disease Persistence/Recurrence after Definitive Chemoradiotherapy for Esophageal Cancer
    Prabin Sharma, Rani Modayil, Stavros N. Stavropoulos
    Foregut: The Journal of the American Foregut Society.2022; 2(2): 132.     CrossRef
  • Targeted chemo-photodynamic therapy toward esophageal cancer by GSH-sensitive theranostic nanoplatform
    Guodong Ren, ZiCheng Wang, Yafei Tian, Jinyao Li, Yingyu Ma, Liang Zhou, Chengwu Zhang, Lixia Guo, Haipeng Diao, Lihong Li, Li Lu, Sufang Ma, Zhifang Wu, Lili Yan, Wen Liu
    Biomedicine & Pharmacotherapy.2022; 153: 113506.     CrossRef
  • Therapeutic effects of in-vivo radiodynamic therapy (RDT) for lung cancer treatment: a combination of 15MV photons and 5-aminolevulinic acid (5-ALA)
    Dae-Myoung Yang, Dusica Cvetkovic, Lili Chen, C-M Charlie Ma
    Biomedical Physics & Engineering Express.2022; 8(6): 065031.     CrossRef
  • Laser induced thermotherapy of multiple actinic keratosis
    Tatiana Evgenievna Sukhova, Yulia Vladimirovna Molochkova, Anna Igorevna Pronina
    Russian Journal of Skin and Venereal Diseases.2022; 25(3): 181.     CrossRef
  • Novel sulfonamide porphyrin TBPoS-2OH used in photodynamic therapy for malignant melanoma
    Zhaohai Pan, Jiaojiao Fan, Qi Xie, Xin Zhang, Wen Zhang, Qing Ren, Minjing Li, Qiusheng Zheng, Jun Lu, Defang Li
    Biomedicine & Pharmacotherapy.2021; 133: 111042.     CrossRef
  • Photodynamic Therapy—An Up-to-Date Review
    Adelina-Gabriela Niculescu, Alexandru Mihai Grumezescu
    Applied Sciences.2021; 11(8): 3626.     CrossRef
  • Targeted Photodynamic Diagnosis and Therapy for Esophageal Cancer: Potential Role of Functionalized Nanomedicine
    Onyisi Christiana Didamson, Heidi Abrahamse
    Pharmaceutics.2021; 13(11): 1943.     CrossRef
  • 7,285 View
  • 254 Download
  • 15 Web of Science
  • 22 Crossref
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Original Article
Efficacy and Safety of Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract
Cicilia Marcella, Shakeel Sarwar, Hui Ye, Rui Hua Shi
Clin Endosc 2020;53(4):458-465.   Published online March 17, 2020
DOI: https://doi.org/10.5946/ce.2019.121
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic treatment (ET) has been applied for decades to treat subepithelial tumors, including gastrointestinal stromal tumors (GISTs). However, the efficacy of ET remains debatable. In this study, we evaluated the efficacy and safety of ET for GISTs in the upper gastrointestinal tract.
Methods
This retrospective single-center study included 97 patients who underwent ET. All patients were enrolled from July 2014 to July 2018. Parameters such as demographics, size, resection margin, complications, pathological features, procedure time, total cost, and follow-up were investigated and analyzed.
Results
Our study achieved 100% en bloc resection and 77.4% (72/93) R0 resection. The most common location was the fundus with a mean tumor size of 2.1±1.43 cm. The mean age, procedure time, hospital stay, and cost were 59.7±11.29 years, 64.7±35.23 minutes, 6.8 days, and 5,337 dollars, respectively. According to National Institutes of Health classification, 63 (64.9%), 26 (26.8%), 5 (5.2%), and 3 (3.1%) patients belonged to the very low, low, intermediate, and high risk classification, respectively. Immunohistochemistry results showed a 100% positive rate of CD34, DOG-1, CD117, and Ki67. A mean follow-up of 21.3±13.0 months showed no recurrence or metastasis.
Conclusions
ET is effective and safe for curative removal of GISTs in the upper gastrointestinal tract, and it can be a treatment of choice for patients with no metastasis.

Citations

Citations to this article as recorded by  
  • Comparison of endoscopic full-thickness resection and cap-assisted endoscopic full-thickness resection in the treatment of small (≤1.5 cm) gastric GI stromal tumors
    Jinping Yang, Muhan Ni, Jingwei Jiang, Ximei Ren, Tingting Zhu, Shouli Cao, Shahzeb Hassan, Ying Lv, Xiaoqi Zhang, Yongyue Wei, Lei Wang, Guifang Xu
    Gastrointestinal Endoscopy.2022; 95(4): 660.     CrossRef
  • The necessarity of treatment for small gastric subepithelial tumors (1–2 cm) originating from muscularis propria: an analysis of 972 tumors
    Jinlong Hu, Xinzhu Sun, Nan Ge, Sheng Wang, Jintao Guo, Xiang Liu, Guoxin Wang, Siyu Sun
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Natural History of Asymptomatic Esophageal Subepithelial Tumors of 30 mm or Less in Size
    Seokin Kang, Do Hoon Kim, Yuri Kim, Dongsub Jeon, Hee Kyong Na, Jeong Hoon Lee, Ji Yong Ahn, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Massive Digestive Hemorrhagia Revealing a Gastro-Intestinal Stromal Tumor of the Jejunum
    Yasmine Cherouaqi, Fatima zahra Belabbes, Hanane Delsa, Anass Nadi, Fedoua Rouibaa
    Cureus.2021;[Epub]     CrossRef
  • Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract
    In Kyung Yoo, Joo Young Cho
    Clinical Endoscopy.2020; 53(4): 383.     CrossRef
  • Recent advances in the management of gastrointestinal stromal tumor
    Monjur Ahmed
    World Journal of Clinical Cases.2020; 8(15): 3142.     CrossRef
  • 4,705 View
  • 151 Download
  • 6 Web of Science
  • 6 Crossref
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Focused Review Series: Expanding the Indication with Safety Issue of Endoscopic Ultrasound
Future Perspectives on Endoscopic Ultrasonography-Guided Therapy for Pancreatic Neoplasm
Woo Hyun Paik, Sang Hyub Lee, Sunguk Jang
Clin Endosc 2018;51(3):229-234.   Published online May 18, 2018
DOI: https://doi.org/10.5946/ce.2018.063
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasonography (EUS)-guided therapy with ethanol injection or catheter-based radiofrequency ablation for pancreatic neoplasm has been conducted as a potential alternate treatment modality for patients who are not eligible for surgery. On the basis of the limited number of studies available, EUS-guided ablation therapy with the aforementioned methods for small pancreatic neoplasms has demonstrated promising technical feasibility and safety profiles. To be considered as a legitimate alternative option to surgery, however, EUS-guided ablation therapy must provide a long-term efficacy profile along with the consensus among experts regarding its treatment parameter. This review focuses on the clinical issues and future perspectives of EUS-guided therapy for pancreatic neoplasm.

Citations

Citations to this article as recorded by  
  • An updated review on ablative treatment of pancreatic cystic lesions
    Andrew Canakis, Ryan Law, Todd Baron
    Gastrointestinal Endoscopy.2020; 91(3): 520.     CrossRef
  • Endosonography-guided Radiofrequency Ablation in Pancreatic Diseases
    Giuseppe Vanella, Gabriele Capurso, Paolo G. Arcidiacono
    Journal of Clinical Gastroenterology.2020; 54(7): 591.     CrossRef
  • 5,604 View
  • 134 Download
  • 3 Web of Science
  • 2 Crossref
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Case Report
Combined Endoscopic and Surgical Treatment of Severe Gastrointestinal Bleeding in a Patient with Heart Assist Device under Therapeutic Anticoagulation
Edris Wedi, Mohamed Bounnah, Riccardo Memeo, Carlo Jung
Clin Endosc 2017;50(6):598-601.   Published online June 1, 2017
DOI: https://doi.org/10.5946/ce.2017.024
AbstractAbstract PDFPubReaderePub
Gastrointestinal (GI) bleeding is a common complication after heart assist device placement. Reasons for bleeding are multifactorial. Endoscopic therapy is the treatment of choice, whereas invasive procedures are avoided in these critically ill patients. We present the case of a 65-year-old male patient experiencing severe GI bleeding after left ventricular assist device (LVAD) and right ventricular assist device (RVAD) placement with therapeutic anticoagulation. Endoscopically, multiple gastric bleeding sources were found but could not be treated effectively due to a large blood clot. A combined endoscopic and surgical treatment was initiated, including gastrotomy for blood clot removal, surgical transgastric suturing, endoscopic over-the-scope clip (OTSC) placement and hemospray application. Postoperative endoscopic visualization showed effective bleeding control. The patient unfortunately died due to causes unrelated to the treatment. This case shows that a minimal invasive combination of endoscopic and surgical techniques can be an alternative treatment for severe upper GI bleeding in critically ill and anticoagulated patients.
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Original Articles
Clinical Outcomes of Endoscopic Submucosal Dissection for Superficial Esophageal Squamous Neoplasms
Jung Soo Park, Young Hoon Youn, Jae Jun Park, Jie-Hyun Kim, Hyojin Park
Clin Endosc 2016;49(2):168-175.   Published online February 12, 2016
DOI: https://doi.org/10.5946/ce.2015.080
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic treatment has been broadly applied to superficial esophageal neoplasms. Endoscopic submucosal dissection (ESD) allows for high rates of en bloc resection, precise histological assessment, and low rates of local recurrence. The aim of this study was to evaluate the outcomes of ESD for superficial esophageal neoplasms.
Methods
We retrospectively reviewed 36 esophageal ESDs for superficial squamous neoplasms in 32 patients between March 2009 and August 2014 at Gangnam Severance Hospital.
Results
The median patient age was 64 years, and 30 men were included. The indications were early squamous cell carcinoma in 26 lesions, adenoma with high-grade dysplasia in five lesions, and low-grade dysplasia in five lesions. The en bloc resection and R0 resection rates were 97.2% (35 of 36) and 91.7% (33 of 36), respectively. Microperforation and post-ESD bleeding occurred in 5.6% (2 of 36) and 5.6% (2 of 36), respectively. Post-ESD esophageal strictures developed in five patients (13.9%). Five patients (15.6%) had an additional treatment after ESD (concurrent chemoradiation therapy in three, radiation therapy in one, and surgery in one patient). There was no disease-specific mortality during the median follow-up of 31 months.
Conclusions
Favorable clinical outcomes were observed in ESD for superficial esophageal squamous neoplasms. Esophageal ESD could be a good treatment option in terms of efficacy and safety.

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Risk Factors for Dieulafoy Lesions in the Upper Gastrointestinal Tract
Hae Jin Shin, Jong Seok Ju, Ki Dae Kim, Seok Won Kim, Sung Hoon Kang, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong
Clin Endosc 2015;48(3):228-233.   Published online May 29, 2015
DOI: https://doi.org/10.5946/ce.2015.48.3.228
AbstractAbstract PDFPubReaderePub
Background/Aims

The purpose of this study is to verify the risk factors associated with Dieulafoy lesion formation in the upper gastrointestinal tract.

Methods

A case-control study was performed by reviewing the electronic medical records of 42 patients who were admitted to a tertiary medical center in the Daejeon region for Dieulafoy lesions from September 2008 to October 2013, and the records of 132 patients who were admitted during the same period and who underwent endoscopic examination for reasons other than bleeding. We analyzed clinical and endoscopic findings retrospectively, and searched for risk factors associated with Dieulafoy lesion formation.

Results

All 42 patients diagnosed with Dieulafoy lesion had accompanying bleeding, and the location of the bleeding was proximal in 25 patients (59.5%), the middle portion in seven patients (16.7%), and distal in 10 patients (23.8%). Antiplatelet agents (p=0.022) and alcohol (p=0.001) use showed statistically significant differences between the two groups. The odds ratios (95% confidence intervals) of the two factors were 2.802 (1.263 to 6.217) and 3.938 (1.629 to 9.521), respectively.

Conclusions

This study showed that antiplatelet agents and alcohol consumption were risk factors associated with Dieulafoy lesion formation in the upper gastrointestinal tract.

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    Daniel Felipe Barrantes Murillo, Michael Tillson, Jennifer W. Koehler, Maninder Sandey
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    Flavius F. Guglielmo, Michael L. Wells, David H. Bruining, Lisa L. Strate, Álvaro Huete, Avneesh Gupta, Jorge A. Soto, Brian C. Allen, Mark A. Anderson, Olga R. Brook, Michael S. Gee, David J. Grand, Martin L. Gunn, Ashish Khandelwal, Seong Ho Park, Vijay
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Clinical Outcomes of Argon Plasma Coagulation Therapy for Early Gastric Neoplasms
Kyu Young Kim, Seong Woo Jeon, Hea Min Yang, Yu Rim Lee, Eun Jeong Kang, Hyun Seok Lee, Sung Kook Kim
Clin Endosc 2015;48(2):147-151.   Published online March 27, 2015
DOI: https://doi.org/10.5946/ce.2015.48.2.147
AbstractAbstract PDFPubReaderePub
Background/Aims

Argon plasma coagulation (APC) has some merits in the treatment of gastric neoplasms including a shorter operative time and fewer complications compared with endoscopic mucosal resection or endoscopic submucosal dissection. However, there are few reports on the outcomes of gastric neoplasms treated using APC. The aim of this study was to evaluate APC in the treatment of early gastric neoplasms in terms of clinical efficacy, safety, and local recurrence.

Methods

We enrolled 28 patients who received APC therapy at the Kyungpook National University Hospital between May 2007 and April 2013. Clinical outcomes were analyzed.

Results

The median follow-up period was 24.8 months (range, 2 to 78). Among the 28 lesions treated using the APC procedure, tumor recurrence was encountered in seven lesions (25.0%). Recurrence was found in 50% (5/10) of single APC cases and 11% (2/18) of rescue APC cases. The mean time to recurrence was 16.1 months (range, 2 to 78). There were no serious APC-related complications such as perforation, bleeding, or infection.

Conclusions

APC therapy can be a useful treatment with a favorable safety profile for patients with early gastric neoplasms. However, further studies are necessary to determine the long-term prognosis of patients undergoing this treatment.

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Focused Review Series: Endoscopic Management of Upper Gastrointestinal Bleeding
Endoscopic Management of Dieulafoy's Lesion
Hye Kyung Jeon, Gwang Ha Kim
Clin Endosc 2015;48(2):112-120.   Published online March 27, 2015
DOI: https://doi.org/10.5946/ce.2015.48.2.112
AbstractAbstract PDFPubReaderePub

A Dieulafoy's lesion is a vascular abnormality consisting of a large caliber-persistent tortuous submucosal artery. A small mucosal defect with the eruption of this protruding vessel can cause bleeding. In fact, a Dieulafoy's lesion is a relatively rare but potentially life-threatening condition. It accounts for 1% to 2% of cases of acute gastrointestinal bleeding. Although there is no consensus on the treatment of Dieulafoy's lesions; treatment options depend on the mode of presentation, site of the lesion, and available expertise. Endoscopic therapy is usually successful in achieving primary hemostasis, with hemostasis success rates reaching 75% to 100%. Although various therapeutic endoscopic methods are used to control bleeding in Dieulafoy's lesions, the best method for endoscopic intervention is not clear. Combination endoscopic therapy is known to be superior to monotherapy because of a lower rate of recurrent bleeding. In addition, mechanical therapies including hemostatic clipping and endoscopic band ligation are more effective and successful in controlling bleeding than other endoscopic methods. Advances in endoscopic techniques have reduced mortality in patients with Dieulafoy's lesion-from 80% to 8%-and consequently, the need for surgical intervention has been reduced. Currently, surgical intervention is used for cases that fail therapeutic endoscopic or angiographic interventions.

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Review
Plastic and Biodegradable Stents for Complex and Refractory Benign Esophageal Strictures
Young Hee Ham, Gwang Ha Kim
Clin Endosc 2014;47(4):295-300.   Published online July 28, 2014
DOI: https://doi.org/10.5946/ce.2014.47.4.295
AbstractAbstract PDFPubReaderePub

Endoscopic stent placement is a well-accepted and effective alternative treatment modality for complex and refractory esophageal strictures. Among the currently available types of stents, the partially covered self-expanding metal stent (SEMS) has a firm anchoring effect, preventing stent migration and ensuring effective covering of a narrowed segment. However, hyperplastic tissue reaction driven by the uncovered mesh may prevent easy and safe stent removal. As an alternative, a fully covered SEMS decreases the recurrence of dysphagia caused by hyperplastic tissue ingrowth; however, it has a high migration rate. Likewise, although a self-expanding plastic stent (SEPS) reduces reactive hyperplasia, the long-term outcome is disappointing because of the high rate of stent migration. A biodegradable stent has the main benefit of not requiring stent removal in comparison with SEMS and SEPS. However, it still has a somewhat high rate of hyperplastic reaction, and the long-term outcome does not satisfy expectations. Up to now, the question of which type of stent should be recommended for the effective treatment of complex and refractory benign strictures has no clear answer. Therefore, the selection of stent type for endoscopic treatment should be individualized, taking into consideration the endoscopist's experience as well as patient and stricture characteristics.

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Focused Review Series: Endoscopic and Molecular Imaging of Premalignant GI Lesions, Part II
Treatment of Dysplasia in Barrett Esophagus
Javier Aranda-Hernandez, Maria Cirocco, Norman Marcon
Clin Endosc 2014;47(1):55-64.   Published online January 24, 2014
DOI: https://doi.org/10.5946/ce.2014.47.1.55
AbstractAbstract PDFPubReaderePub

Barrett esophagus is recognized as a risk factor for the development of dysplasia and adenocarcinoma of the esophagus. Cancer is usually diagnosed at an advanced stage with a 5-year survival rate of 15%. Most of these patients present de novo and are not part of a surveillance program. Endoscopic screening with improvement in recognition of early lesions may change this pattern. In the past, patients diagnosed with dysplasia and mucosal cancer were best managed by esophagectomy. Endoscopic techniques such as endoscopic mucosal resection and radiofrequency ablation have resulted in high curative rates and a shift away from esophagectomy. This pathway is supported by the literature review of esophagectomies performed for mucosal disease, as well as pathologists' interpretation of endoscopic mucosal specimens, which document the low risk of lymph node metastasis. The role of endoscopic therapy for superficial submucosal disease continues to be a challenge.

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Special Issue Article of IDEN 2013
Endoscopic Treatment for Early Foregut Neuroendocrine Tumors
Moo In Park
Clin Endosc 2013;46(5):450-455.   Published online September 30, 2013
DOI: https://doi.org/10.5946/ce.2013.46.5.450
AbstractAbstract PDFPubReaderePub

Foregut neuroendocrine tumors (NETs) include those arising in the esophagus, stomach, pancreas, and duodenum and seem to have a broad range of clinical behavior from benign to metastatic. Several factors including the advent of screening endoscopy may be related to increased incidence of gastrointestinal NETs; thus, many foregut NETs are diagnosed at an early stage. Early foregut NETs, such as those of the stomach and duodenum, can be managed with endoscopic treatment because of a low frequency of lymph node and distant metastases. However, controversy continues concerning the optimal management of early foregut NETs due to a lack of controlled prospective studies. Several issues such as indications, technical issues, and outcomes of endoscopic treatment for early foregut NETs are reviewed based on some published studies.

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    Anna Pozza, Bruno Pauletti, Marco Scarpa, Cesare Ruffolo, Nicolò Bassi, Marco Massani
    International Journal of Colorectal Disease.2019; 34(11): 1849.     CrossRef
  • The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter
    Waku Hatta, Tomoyuki Koike, Katsunori Iijima, Kiyotaka Asanuma, Naoki Asano, Hiroaki Musha, Yoshifumi Inomata, Toshikazu Sano, Hiroyuki Endo, Atsushi Ikehata, Toru Horii, Motoki Ohyauchi, Satoshi Yokosawa, Atsuko Kasajima, Fumiyoshi Fujishima, Hironobu Sa
    Digestion.2017; 95(3): 201.     CrossRef
  • Metastatic neuroendocrine tumor of the esophagus with features of medullary thyroid carcinoma
    Raymond M Fertig, Adam Alperstein, Carlos Diaz, Kyle D Klingbeil, Sameera S. Vangara, Ryosuke Misawa, Jennifer Reed, Sudeep Gaudi
    Intractable & Rare Diseases Research.2017; 6(3): 224.     CrossRef
  • Correlation of Ki-67 indices from biopsy and resection specimens of neuroendocrine tumours
    J Barnes, SJ Johnson, JJ French
    The Annals of The Royal College of Surgeons of England.2017; 99(3): 193.     CrossRef
  • Chirurgische Therapie gastroduodenaler neuroendokriner Neoplasien
    V. Fendrich, D. K. Bartsch
    Der Chirurg.2016; 87(4): 280.     CrossRef
  • Increasing incidence of duodenal neuroendocrine tumors: Incidental discovery of indolent disease?
    Timothy L. Fitzgerald, Samuel O. Dennis, Swapnil D. Kachare, Nasreen A. Vohra, Emmanuel E. Zervos
    Surgery.2015; 158(2): 466.     CrossRef
  • Small cell neuroendocrine carcinoma of the esophagus
    Yu‐Ling Huang, Shah‐Hwa Chou, Chee‐Yin Chai, Jui‐Sheng Hsu
    The Kaohsiung Journal of Medical Sciences.2015; 31(2): 108.     CrossRef
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Case Report
Endoscopic Treatment of a Symptomatic Ileal Lipoma with Recurrent Ileocolic Intussusceptions by Using Cap-Assisted Colonoscopy
Eun Sung Lee, Kang Nyeong Lee, Kyung Soo Choi, Hang Lak Lee, Dae Won Jun, Oh Young Lee, Byung Chul Yoon, Ho Soon Choi
Clin Endosc 2013;46(4):414-417.   Published online July 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.4.414
AbstractAbstract PDFPubReaderePub

A 73-year-old woman presented with intermittent abdominal pain and weight loss of 15 kg for 2 years. Colonoscopy revealed an erythematous polypoid tumor with a long and wide stalk in the cecum, but with air inflation, it abruptly went away through the ileocecal valve (ICV). An abdominal computed tomography showed a well-demarcated pedunculated subepithelial mass of 2.6×2.7 cm size with fat attenuation in the terminal ileum. It was an intussusceptum of the ileal lipoma through the ICV. This ileal lipoma was causing her symptoms because repeated ileocolic intussusceptions resulted in intermittent intestinal obstructions. In order to avoid surgical sequelae of ileal resection, snare polypectomy using cap-assisted colonoscopy technique was performed within the ileum without complications. The histopathology report confirmed it as a subepithelial lipoma. After endoscopic resection of the ileal lipoma, the patient has been free of symptoms and was restored to the original weight.

Citations

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  • Extraction of terminal ileal lipomas to cecum can facilitate endoscopic resection: A case series with video
    Hiroshi Yamazaki, Yohei Minato, Deepak Madhu, Toshifumi Iida, Susumu Banjyoya, Tomoya Kimura, Koichi Furuta, Shinya Nagae, Yohei Itou, Nao Takeuchi, Shunya Takayanagi, Yoshiaki Kimoto, Yuki Kano, Takashi Sakuno, Kohei Ono, Ken Ohata
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    Ramprashanth MP
    Journal of Surgery Research and Practice.2024; : 1.     CrossRef
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    Siddhant Dogra, Jason Wei, Benjamin Wadowski, Virginia Devi-Chou, Leandra Krowsoski, Rajiv R Shah
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    Amy Donovan, Sandun Abeyasundara, Hajir Nabi
    ANZ Journal of Surgery.2020;[Epub]     CrossRef
  • Intususcepción íleo-cólica de lipoma ileal como causa de hemorragia digestiva baja
    Eduardo Valdivielso Cortázar, María López Álvarez, Alberto Guerrero Montañes, Loreto Yañez González-Dopeso, Jesus Ángel Yañez López, Pedro Antonio Alonso Aguirre
    Gastroenterología y Hepatología.2017; 40(7): 457.     CrossRef
  • Ileocolic intussusception of ileal lipoma as a cause of lower gastrointestinal bleeding
    Eduardo Valdivielso Cortázar, María López Álvarez, Alberto Guerrero Montañes, Loreto Yañez González-Dopeso, Jesus Ángel Yañez López, Pedro Antonio Alonso Aguirre
    Gastroenterología y Hepatología (English Edition).2017; 40(7): 457.     CrossRef
  • Unroofing Technique as an Option for the Endoscopic Treatment of Giant Gastrointestinal Lipomas
    Marcela Kopáčová, Stanislav Rejchrt, Jan Bureš
    Acta Medica (Hradec Kralove, Czech Republic).2015; 58(4): 115.     CrossRef
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Review
Endoscopic Treatment of Refractory Gastroesohageal Reflux Disease
Won Hee Kim, Pil Won Park, Ki Baik Hahm, Sung Pyo Hong
Clin Endosc 2013;46(3):230-234.   Published online May 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.3.230
AbstractAbstract PDFPubReaderePub

Though efficient acid suppression with proton pump inhibitors (PPIs) remains the mainstay of treatment of gastroesophageal reflux disease (GERD), some of the patients showed refractory response to PPIs, necessitating further intervention. After increasing dose of PPIs and other kinds of pharmacological intervention adopting prokinetics or others, variable endoscopic treatments are introduced for the treatment of these refractory cases. The detailed introduction regarding endoscopic treatment for GERD is forwarded in this review article. Implantation of reabsorbable or synthetic materials in the distal esophagus was tried in vain and is expelled from the market due to limited efficacy and serious complication. Radiofrequency energy delivery (Stretta) and transoral incisionless fundoplication (EsophyX) are actively tried currently.

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  • Refractory gastroesophageal reflux disease
    C. R. Subramanian, G. Triadafilopoulos
    Gastroenterology Report.2015; 3(1): 41.     CrossRef
  • Long-term outcomes of patients with refractory gastroesophageal reflux disease following a minimally invasive endoscopic procedure: a prospective observational study
    Wei-Tao Liang, Zhong-Gao Wang, Feng Wang, Yue Yang, Zhi-Wei Hu, Jian-Jun Liu, Guang-Chang Zhu, Chao Zhang, Ji-Min Wu
    BMC Gastroenterology.2014;[Epub]     CrossRef
  • 7,791 View
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Case Reports
Cecal Fecaloma Due to Intestinal Tuberculosis: Endoscopic Treatment
Sun Moon Kim, Ki Hyun Ryu, Young Suk Kim, Tae Hee Lee, Euyi Hyeog Im, Kyu Chan Huh, Young Woo Choi, Young Woo Kang
Clin Endosc 2012;45(2):174-176.   Published online June 30, 2012
DOI: https://doi.org/10.5946/ce.2012.45.2.174
AbstractAbstract PDFPubReaderePub

Colorectal fecaloma is a mass of accumulated feces that is much harder in consistency than a fecal impactation. The rectosigmoid area is the common site for fecalomas and the cecum is the most unusual site. Diagnosis is usually made by distinctive radiographic findings of a mobile intraluminal mass with a smooth outline and no mucosal attachment. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, endoscopic procedures or a surgical intervention may be needed. We report here that a cecal fecaloma caused by intestinal tuberculosis scar was successfully removed by endoscopic procedures.

Citations

Citations to this article as recorded by  
  • Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction
    Risa Kanai, Kengo Nakaya, Koji Fukumoto, Masaya Yamoto, Hiromu Miyake, Akiyoshi Nomura, Susumu Yamada, Akihiro Makino, Hideto Iwafuchi, Naoto Urushihara, Georg Singer
    Case Reports in Pediatrics.2021; 2021: 1.     CrossRef
  • Cecal fecaloma: A rare cause of right lower quadrant pain
    Brian T. Wang, Stefanie Y. Lee
    European Journal of Radiology Open.2019; 6: 136.     CrossRef
  • Gastrointestinal Tuberculosis
    Eric H. Choi, Walter J. Coyle, David Schlossberg
    Microbiology Spectrum.2016;[Epub]     CrossRef
  • Successful Removal of Hard Sigmoid Fecaloma Using Endoscopic Cola Injection
    Jong Jin Lee, Jeong Wook Kim
    The Korean Journal of Gastroenterology.2015; 66(1): 46.     CrossRef
  • Ileal Fecaloma Presenting with Small Bowel Obstruction
    Ha Yeong Yoo, Hye Won Park, Seong-Hwan Chang, Sun Hwan Bae
    Pediatric Gastroenterology, Hepatology & Nutrition.2015; 18(3): 193.     CrossRef
  • 10,503 View
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Endoscopic Management of Afferent Loop Syndrome after a Pylorus Preserving Pancreatoduodenecotomy Presenting with Obstructive Jaundice and Ascending Cholangitis
Jae Kyung Kim, Chan Hyuk Park, Ji Hye Huh, Jeong Youp Park, Seung Woo Park, Si Young Song, Jaebock Chung, Seungmin Bang
Clin Endosc 2011;44(1):59-64.   Published online September 30, 2011
DOI: https://doi.org/10.5946/ce.2011.44.1.59
AbstractAbstract PDFPubReaderePub

Afferent loop syndrome is a rare complication of gastrojejunostomy. Patients usually present with abdominal distention and bilious avomiting. Afferent loop syndrome in patients who have undergone a pylorus preserving pancreaticoduodenectomy can present with ascending cholangitis. This condition is related to a large volume of reflux through the biliary-enteric anastomosis and static materials with bacterial overgrowth in the afferent loop. Patients with afferent loop syndrome after pylorus preserving pancreaticoduodenectomy frequently cannot be confirmed as surgical candidates due to poor medical condition. In that situation, a non-surgical palliation should be considered. Herein, we report two patients with afferent loop syndrome presenting with obstructive jaundice and ascending cholangitis. The patients suffered from the recurrence of pancreatic cancer after pylorus preserving pancreaticoduodenectomy. The diagnosis of afferent loop syndrome was confirmed, and the patients were successfully treated by inserting an endoscopic metal stent using a colonoscopic endoscope.

Citations

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  • Percutaneous transhepatic duodenal drainage is good option for afferent loop syndrome for obstructive colorectal cancer patient with history of Billroth's operation II: A case report of a rare postoperative complication
    Tung‐Yuan Chen, Chin‐Wen Hsu, Yee‐Phoung Chang, Min‐Tsung Wang, Yueh‐Jung Wu, Ching‐Hsien Wang, Kuan‐Yu Wang, Tian‐Huei Chu, Yung‐Kuo Lee
    Clinical Case Reports.2023;[Epub]     CrossRef
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    Mahrukh Ali, Om Parkash, Jehanzeb Shahid
    Cureus.2022;[Epub]     CrossRef
  • The Use of Palliative Endoscopic Ultrasound-guided Enterostomy to Treat Small Bowel Obstruction in Two Patients with Advanced Malignancies
    Ji Hong Oh, Seung Goun Hong
    The Korean Journal of Medicine.2022; 97(3): 191.     CrossRef
  • Endoscopic Transluminal Stent Placement for Malignant Afferent Loop Obstruction
    Chinatsu Yonekura, Takashi Sasaki, Takafumi Mie, Takeshi Okamoto, Tsuyoshi Takeda, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
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    Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
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    Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
    World Journal of Gastrointestinal Oncology.2021; 13(7): 684.     CrossRef
  • Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review
    Arata Sakai, Hideyuki Shiomi, Takao Iemoto, Ryota Nakano, Takuya Ikegawa, Takashi Kobayashi, Atsuhiro Masuda, Yuzo Kodama
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    Yuning Cao, Xiangheng Kong, Daogui Yang, Senlin Li
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    Ki Byung Song, Daegwang Yoo, Dae Wook Hwang, Jae Hoon Lee, Jaewoo Kwon, Sarang Hong, Jong Woo Lee, Woo Young Youn, Kyungyeon Hwang, Song Cheol Kim
    Journal of Hepato-Biliary-Pancreatic Sciences.2019; 26(10): 459.     CrossRef
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    Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Yoshiki Koike, Taku Yamagata, Megumi Tanaka, Tomohiro Shimada, Kei Ito
    Clinical Endoscopy.2018; 51(3): 299.     CrossRef
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    José Ruiz Pardo, Erik Llàcer-Millán, Pilar Jimeno Griñó, Juan Ángel Fernández Hernández, Pascual Parrilla Paricio
    Cirugía Española.2016; 94(2): 106.     CrossRef
  • Cholangitis Due to Afferent Loop Obstruction After Cephalic Duodenopancreatectomy
    José Ruiz Pardo, Erik Llàcer-Millán, Pilar Jimeno Griñó, Juan Ángel Fernández Hernández, Pascual Parrilla Paricio
    Cirugía Española (English Edition).2016; 94(2): 106.     CrossRef
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    Puneet Chhabra, Surinder Singh Rana, Vishal Sharma, Ravi Sharma, Rajesh Gupta, Deepak Kumar Bhasin
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    Jun Jae Kim, Young Koog Cheon, Tae Yoon Lee, Chan Sup Shim
    The Korean Journal of Medicine.2015; 89(4): 428.     CrossRef
  • Acute afferent loop syndrome in the early postoperative period following pancreaticoduodenectomy
    H Nageswaran, A Belgaumkar, R Kumar, A Riga, N Menezes, T Worthington, ND Karanjia
    The Annals of The Royal College of Surgeons of England.2015; 97(5): 349.     CrossRef
  • Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case
    Yukihiro Sanada, Naoya Yamada, Masanobu Taguchi, Kazue Morishima, Naoya Kasahara, Yuji Kaneda, Atsushi Miki, Yasunao Ishiguro, Akira Kurogochi, Kazuhiro Endo, Masaru Koizumi, Hideki Sasanuma, Takehito Fujiwara, Yasunaru Sakuma, Atsushi Shimizu, Masanobu H
    International Surgery.2014; 99(4): 426.     CrossRef
  • A Case of Gastrojejunostomy under Endoscopic Ultrasound Guidance for the Treatment of Jejunal Stenosis Induced by Cholangiocarcinoma Recurrence after Pancreaticoduodenectomy
    Chikashi WATASE, Junzo SHIMIZU, Masahiro MURAKAMI, Yong Kong KIM, Shoki MIKATA, Junichi HASEGAWA
    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2014; 75(8): 2307.     CrossRef
  • Electrohydraulic Lithotripsy of an Impacted Enterolith Causing Acute Afferent Loop Syndrome
    Young Sin Cho, Tae Hoon Lee, Soon Oh Hwang, Sunhyo Lee, Yunho Jung, Il-Kwun Chung, Sang-Heum Park, Sun-Joo Kim
    Clinical Endoscopy.2014; 47(4): 367.     CrossRef
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Original Article
Effect of Additional Ecabet Sodium on Conventional Triple Therapy for Helicobacter pylori Eradication in Korea
Ji Yeon Kim, M.D., Dong Ho Lee, M.D.*, Jun Hyuk Son, M.D., Jae Yeon Kim, M.D., Ji Eun Kwon, M.D., Young Soo Park, M.D.*, Nayoung Kim, M.D.*, Cheol Min Shin, M.D.*, Hyun Chae Jung, M.D. and In Sung Song, M.D.
Korean J Gastrointest Endosc 2011;42(6):349-355.   Published online May 25, 2011
AbstractAbstract PDF
Background/Aims: Ecabet sodium is known for its bactericidal effect against H. pylori. It was reported that a supplement of ecabet sodium to conventional triple therapy showed good results in Asia. The Aim of this study was to ascertain the efficacy of additional ecabet sodium on conventional triple therapy for eradication of H. pylori. Methods: We reviewed the cases of 111 patients (Group A) with H. pylori infection who received ecabet sodium with triple therapy (20 mg of rabeprazole, 1 g of amoxicillin, 500 mg of clarithromycin and 1 g of ecabet sodium, twice daily for 7 days). Another 186 patients (Group B) received PPI-based triple therapy (same as the above, except without the ecabet sodium). Eradication was evaluated 4 weeks later after completion of treatment by 13C-UBT. Results: Eradication rates were 74.8% (83/111) in group A and 70.4% (131/186) in group B by intention-to-treat analysis (p=0.420), and 75.2% (82/109) in group A and 70.7% (128/181) in group B by per protocol analysis (p=0.405). Conclusions: The addition of ecabet sodium to conventional triple therapy did not increase the eradication rate of H. pylori in this study. These findings imply that ecabet sodium as an additional agent cannot overcome antibiotic resistance, which is the most important cause of failure of triple therapy.
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Three Cases of Successful Treatment of Iatrogenic Duodenal Perforation
Choong Heon Ryu, M.D., Do Hyun Park, M.D., Myung-Hwan Kim, M.D., Dong Wan Seo, M.D., Sang Soo Lee, M.D., Sung Koo Lee, M.D. and Hong Jun Kim, M.D.
Korean J Gastrointest Endosc 2011;42(1):57-61.   Published online January 30, 2011
AbstractAbstract PDF
Endoscopic retrograde cholangiopancreatography has become a standard procedure for the diagnosis and treatment of pancreatobiliary disease. Like any invasive procedure, it carries a small, but significant rate of serious complications such as duodenal perforation. Primary surgical closure is the treatment of choice for the cases of duodenal perforation. However, there have been some case reports in which endoscopic metal clip closure of an iatrogenic duodenal perforation was successful. We experienced three cases of successful treatment of the iatrogenic duodenal perforation using endoscopic clipping and fibrin glue injections during a duodenoscope insertion. (Korean J Gastrointest Endosc 2011;42:57-61)
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Endoscopic Treatment of Gallstone Diseases
Byeong Moo Yoo, M.D.
Korean J Gastrointest Endosc 2010;41(5):255-265.   Published online November 30, 2010
AbstractAbstract PDF
Gallstone diseases include gallbladder stones, extrahepatic bile duct stones and intrahepatic duct stones. In the past, the main treatment modality was a surgical operation. With the development of endoscopic treatment, the main treatment modality is shifting towards endoscopic treatment. After the development of endoscopic sphincterotomy, endoscopic stone removal using a basket or balloon has been the major treatment modality for extrahepatic bile duct stones. For huge extrahepatic bile duct stones, mechanical or laser lithotripsy are used as ancillary equipment. Direct peroral cholangioscopic methods using a slim endoscopy or a Spyglass system now being rapidly developed instead of the "mother and baby" scope. If extrahapatic bile duct stones fail to be removed with peroral endoscopic treatment, then the stones can be treated via a percutaneous route (a percutaneous transhepatic route or a percutaneous transabdominal route). For intrahepatic duct stones, the location of stones, the site and degree of bile duct stricture and the existence of parenchymal atrophy are important factors to decide the treatment modality. The treatment modality is usually decided on according to the Tsunoda classification. Gallbladder stones usually need cholecystectomy because of recurrence. Endoscopic treatment is an indication for treating inoperable calculous cholecystitis patients. Endoscopic treatment for gallstone disesae will continue to rapidly develop in the future to the benefit of both the patients and endoscopists. (Korean J Gastrointest Endosc 2010;41:255-265)
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A Case of Fishbone-induced Esophageal Perforation Closed by Endoscopic Clipping
Joung Muk Leem, M.D., Joung-Ho Han, M.D.*, Byeong Seong Ko, M.D.*, Mi Sung Kim, M.D.*, Ji Young Park, M.D.*, Woo Hyung Choi, M.D.*, Sei Jin Youn, M.D. and Seon Mee Park, M.D.
Korean J Gastrointest Endosc 2010;41(3):151-154.   Published online September 30, 2010
AbstractAbstract PDF
Esophageal perforation continues to be associated with high mortality - 20% to 30% - despite advances in surgical techniques. Traditional surgery has been the mainstay of treatment for perforation, but recent advances in endoscopic closure devices has increased therapeutic options for selected patients. Our patient had a fishbone-induced esophageal perforation. He was treated successfully with endoscopic clipping, antibiotics and parenteral nutrition. We report this case and provide a review of the relevant literature. (Korean J Gastrointest Endosc 2010; 41:151-154)
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Gastric Wall Abscess Caused by a Fish Bone and Treated with Endoscopic Management
Won Jung Jun, M.D., Jong Sun Rew, M.D., Yong Chan Cho, M.D., Du Young Noh, M.D., Sung Kyun Kim, M.D., Hyen Soo Kim, M.D. and Sung Kyu Choi, M.D.
Korean J Gastrointest Endosc 2010;41(2):98-101.   Published online August 30, 2010
AbstractAbstract PDF
Intramural gastric abscess is a rare condition representing a localized form of suppurative gastritis. According to the extent of the disorder, suppurative gastritis is classified into diffuse and localized types. The diffuse or phlegmonous type is more common and involves the entire stomach with inflammation spreading to all layers from the submucosa. The localized form referred to as "intramural gastric abscess" accounts for 5% to 15% of cases. The pathogenic mechanism includes direct invasion by microorganisms and hematogenous spread from a distant source. Cases are usually diagnosed with a combination of imaging modalities such as ultrasound, computed tomography, endoscopic ultrasound, and esophagogastroduodenoscopy. Herein we report a case of intramural gastric abscess that developed following ingestion of a fish bone. It was successfully treated with endoscopic incision and drainage of pus. (Korean J Gastrointest Endosc 2010;41:98-101)
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A Case of Incidentally Found Primary Esophageal Bezoar in a Patient with Situs Inversus Totalis
Yong Chan Cho, M.D., Won Jung Jun, M.D., Hyung Il Kim, M.D., Sung Kyun Kim, M.D., Hyen Soo Kim, M.D., Sung Kyu Choi, M.D. and Jong Sun Rew, M.D.
Korean J Gastrointest Endosc 2010;41(1):16-20.   Published online July 31, 2010
AbstractAbstract PDF
Situs inversus totalis (SIT) is very rare autosomal recessive condition, and patients with SIT have complete mirror image reversal of the thoracic and abdominal viscera. There have been no case reports of esophageal bezoar in a patient with situs inversus totalis. Bezoars are retained concretions of indigestible foreign material, including food material, vegetable material and hair, and they are usually founded in the stomach, small intestine and rectum. Esophageal bezoars are very rare, but they are known to occur in patients with anatomical defects or esophageal motility disorders. The treatment of esophageal bezoar is usually based on endoscopic fragmentation and extraction, dissolution with papain, cellulose, pancreatic enzyme and/or Coca cola. We report here on a case of an endoscopically treated primary esophageal bezoar in a patient with situs inversus totalis, and the patient experienced no complications from the treatment. (Korean J Gastrointest Endosc 2010;41:16-20)
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Endoscopic Treatment of Chronic Pancreatitis
Hong Sik Lee, M.D., Ph.D.
Korean J Gastrointest Endosc 2010;40(5):291-296.   Published online May 30, 2010
AbstractAbstract PDF
Endoscopic treatments are being increasingly used for chronic pancreatitis. Themost common indications for endoscopic treatment are pancreatic duct stones (requiring removal) and pancreatic duct stricture (requiring stenting). Endoscopic treatment is also widely indicated for drainage of pseudocyst and ceiliac plexus block/neurolysis. In this review, I discuss techniques, efficacy and complications of various endoscopic treatments for chronic pancreatitis. (Korean J Gastrointest Endosc 2010;40:291-296)
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Non-surgical Treatment with Endoscopic Clipping in a Patient with Boerhaave's Syndrome
Yun-Kyung Kim, M.D., Chang Nyol Paik, M.D., U-Im Chang, M.D., Sung Hoon Jung, M.D., Jeong Rok Lee, M.D., Woo Chul Chung, M.D., Kang-Moon Lee, M.D. and Jin-Mo Yang, M.D.
Korean J Gastrointest Endosc 2008;37(6):409-412.   Published online December 30, 2008
AbstractAbstract PDF
Boerhaave's syndrome is difficult to diagnosis because of the esophageal rupture, which is caused by nausea and vomiting, and Boerhaave's syndrome is known to have a high mortality rate. The mortality increases with a delayed diagnosis; therefore, an early diagnosis and surgical treatment are critical for a good prognosis. Yet some recent cases have shown that non-surgical treatments are successful in some classified patient groups. These groups should be considered according to their symptoms and their laboratory and radiological findings. Sepsis and multi-organ failure should be continuously checked for to see if they occurred and/or progressed. We report here on a 51 year old woman who had Boerhaave's syndrome, and this was caused by heavy drinking, nausea and vomiting, and she improved with just non-surgical treatment such as fasting, antibiotics and endoscopic clipping. (Korean J Gastrointest Endosc 2008;37:409-412)
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Spontaneous Resolving of Cytomegalovirus Associated Gastritis after Conservative Treatment in Immunocompetent Patients: A Report of Two Cases
Jaehoon Lee, M.D., Suck Chei Choi, M.D., Chang Soo Choi, M.D. and Tae Hyeon Kim, M.D.
Korean J Gastrointest Endosc 2008;37(5):344-348.   Published online November 30, 2008
AbstractAbstract PDF
Cytomegalovirus (CMV) disease is an important cause of morbidity and mortality in an immunocompromised host. Patients with AIDS, organ transplantion and chemotherapy for malignant disease are susceptible to CMV diseases. CMV disease rarely occurs in an immunocompetent host. The gastrointestinal tract is one of target organs for CMV infection. Immunocompetent patients with gastrointestinal CMV disease frequently recover with supportive therapy. If immunosuppressive therapy is stopped, patients infected with CMV can be spontaneously cured. However, as the prognosis of CMV infection in immunocompromised patients is usually poor, the administration of an antiviral agent is recommended for treatment. We report two cases of gastric CMV in immonocompetent patients who completely recovered with supportive treatment without antiviral therapy. (Korean J Gastrointest Endosc 2008;37:344-348)
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