iGIE最新文献

{"title":"Refractory gastrojejunal anastomotic variceal bleeding successfully treated using endoscopic coil and hemostatic matrix therapy","authors":"Abdulrahman Qatomah MBBS, Saeed Soleymanjahi MD, MPH, Daryl Ramai MD, MSc, MPH, Kunal Jajoo MD, Marvin Ryou MD","doi":"10.1016/j.igie.2026.01.010","DOIUrl":"10.1016/j.igie.2026.01.010","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 378-380"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unrestricted drinking before procedural sedation using fasting cards: a prospective observational quality improvement study","authors":"Anne Rüggeberg MD, MPH,&nbsp;Eike A. Nickel MD, MaHM","doi":"10.1016/j.igie.2025.11.007","DOIUrl":"10.1016/j.igie.2025.11.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>International guidelines recommend clear-liquid fasting for 2 hours before procedural sedation—but in practice, this fasting time is usually exceeded, often significantly. We aimed to align actual liquid fasting times with these guidelines by implementing ‟unrestricted drinking using fasting cards” for patients undergoing procedural sedation.</div></div><div><h3>Methods</h3><div>In a prospective, observational, quality improvement study, we implemented ‟unrestricted drinking before procedural sedation using fasting cards” in 2 ‟Plan-Do-Study-Act” cycles. Our patient population included those scheduled for elective procedures with sedation in gastroenterology, pulmonary, and cardiology.</div></div><div><h3>Results</h3><div>The introduction of ‟drink until called” and subsequent education, including fasting cards, increased the proportion of patients who were aware they could drink before sedation to 81%. The awareness about permission to drink before procedural sedation correlated with significantly shorter median (interquartile range) clear-liquid fasting times of 1.2 (0.7-2.5) hours than those who were not informed (11.3 [4.1-12.7] hours; <em>P</em> &lt; .00001) and a greater median cumulative preoperative drinking volume on the day of sedation (300 [200-500] mL vs 50 [50-100] mL; <em>P</em> &lt; .00001). In addition, patients informed about their drinking permission experienced less thirst (71.6% vs 42.1%; <em>P</em> &lt; .05) and were more likely to take morning medication (72.8% vs 52.6%; <em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Our results demonstrate the importance of aligning clinical practice with established guidelines to improve patient safety and comfort. Future efforts should focus on overcoming institutional and cultural barriers to enable widespread adoption of such quality improvement measures.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 298-305"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic band ligation for weight loss: a case report with 6-month follow-up","authors":"Mohamed Abeid MD, MSc","doi":"10.1016/j.igie.2025.10.003","DOIUrl":"10.1016/j.igie.2025.10.003","url":null,"abstract":"<div><div>Endoscopic band ligation (EBL) is an established treatment for variceal bleeding and gastric antral vascular ectasia. We report its novel application for weight loss in a 47-year-old woman with morbid obesity (body mass index 55 kg/m², weight 140 kg) who had declined surgery and pharmacotherapy. The patient underwent EBL under propofol sedation with 15 bands placed in the gastric antrum using a standard multiband ligator. The procedure lasted 12 minutes. Early satiety and appetite suppression were reported. At 6 months, weight decreased to 90 kg (body mass index 35), with 36% total weight loss and 67% excess weight loss. Endoscopy confirmed healing of postprocedure ulcers and marginal antral narrowing. No adverse events occurred. EBL appears to be a promising, safe, and cost-effective endoscopic technique for weight loss. Further studies are needed to validate its efficacy and explore underlying mechanisms.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 393-395"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thinking outside the box: leveraging endoscopic ultrasound–guided portal pressure gradient for comprehensive risk stratification in liver transplantation candidates","authors":"Abdulmalik Saleem MD,&nbsp;Ammad Chaudhary MD,&nbsp;Kevin Harris MD,&nbsp;Yara Dababneh MD,&nbsp;Yervant Ichkhanian MD,&nbsp;Reena Salgia MD,&nbsp;Andrew Watson MD","doi":"10.1016/j.igie.2026.02.008","DOIUrl":"10.1016/j.igie.2026.02.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Coronary artery disease (CAD) is common in liver transplantation (LT) candidates and may require coronary artery bypass grafting (CABG). Risk stratification is challenging in cirrhosis because histology alone does not reliably predict clinically significant portal hypertension (CSPH). Endoscopic ultrasound–guided portal pressure gradient (EUS-PPG) provides minimally invasive, real-time hemodynamic assessment. The aim of this study was to evaluate the role of EUS-PPG in perioperative risk stratification among LT candidates requiring CABG.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 3 LT candidates with hepatocellular carcinoma (HCC) as the indication for transplant (2021-2023). All had obstructive multivessel CAD not amenable to percutaneous coronary intervention and were evaluated for CABG using EUS-PPG when feasible.</div></div><div><h3>Results</h3><div>Two patients with biopsy-proven cirrhosis had PPG &lt;6 mm Hg, excluding CSPH; both underwent CABG and successful LT. In 1 patient, PPG could not be obtained because of anatomical distortion; CABG proceeded urgently, but the patient died postoperatively from stroke and aspiration pneumonia, which were unrelated to portal hypertension.</div></div><div><h3>Conclusions</h3><div>EUS-PPG may be safe and clinically informative, complementing the Model for End-Stage Liver Disease–based risk stratification and histology to refine perioperative risk assessment in LT candidates with HCC and CAD, although additional cases and further study are needed.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 445-447"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel preparation for colonoscopy in patients with surgically altered anatomy: a narrative review and institutional protocol","authors":"Fouad Jaber MD, MS,&nbsp;Mark Peicher DO,&nbsp;Juan D. Gomez Cifuentes MD,&nbsp;Maria P. Forero Rios MD,&nbsp;Robert J. Sealock MD","doi":"10.1016/j.igie.2026.05.001","DOIUrl":"10.1016/j.igie.2026.05.001","url":null,"abstract":"<div><div>Colonoscopy is a vital diagnostic and therapeutic procedure for diseases affecting the rectum, colon, and terminal ileum. In patients who have undergone colorectal surgery, postoperative colonoscopy is frequently required for purposes such as colorectal neoplasia surveillance. However, administering bowel preparation in this population poses significant challenges for patients, caregivers, and the endoscopy team, including gastroenterologists and nurses. Despite these challenges, there is limited peer-reviewed guidance on optimal bowel preparation strategies for these patients. This review summarizes the current data on bowel preparation in patients with surgically altered anatomy, identifies key challenges, addresses existing gaps in knowledge, and presents a tailored approach to bowel preparation in this population based on institutional protocol. In addition, we propose future directions for research and quality improvement to enhance outcomes in this cohort.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 479-494"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The volcano lesions may reflect a pathological phenomenon in metastatic melanoma of the gastrointestinal tract","authors":"Akira Hokama MD","doi":"10.1016/j.igie.2026.03.008","DOIUrl":"10.1016/j.igie.2026.03.008","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Page 503"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal submucosal gland duct adenoma: a rare subepithelial esophagus lesion","authors":"Gary Dezhi Zhang MD, MMed, BSc,&nbsp;Marian Priyanthi Kumarasinghe MBBS, MD,&nbsp;Spiro Raftopoulos MBBS","doi":"10.1016/j.igie.2026.01.019","DOIUrl":"10.1016/j.igie.2026.01.019","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 381-383"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a novel at-home, scope handle–based game controller on novice endoscopists","authors":"Hadi Khaled Abou Zeid MD,&nbsp;Yara Salameh MD,&nbsp;John League BS,&nbsp;Benjamin Lange MS,&nbsp;Erik Clemens MS,&nbsp;Elizabeth Rajan MD,&nbsp;Nayantara Coelho-Prabhu MBBS,&nbsp;Cadman L. Leggett MD,&nbsp;Andrew C. Storm MD","doi":"10.1016/j.igie.2025.12.011","DOIUrl":"10.1016/j.igie.2025.12.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopy training is an essential component of gastroenterology fellowship programs. Skill assessment has transitioned from a volume-based model to a competency-based framework. However, challenges such as limited supervising faculty availability, lack of standardized evaluations, and patient safety concerns hinder training. Simulation-based training has shown promise in enhancing endoscopic skills, but its adoption is restricted by cost and other practical constraints. To address these barriers, we developed ScopeQuest (Mayo Clinic, Rochester, Minn, USA), a novel, affordable, at-home, gaming-based endoscopy training device aimed at improving psychomotor skills in endoscopy trainees. This study aims to assess the feasibility and impact of the handheld ScopeQuest on endoscope manipulation skills.</div></div><div><h3>Methods</h3><div>A single-arm pretest–post-test pilot study was conducted with medical trainees with no prior endoscopy experience. Participants were trained with the ScopeQuest. Pretraining and post-training endoscopic skill assessments were conducted. Participant confidence, perceived skill improvement, and satisfaction were evaluated using post-training surveys.</div></div><div><h3>Results</h3><div>Ten participants (mean [standard deviation]) age 26 [1.25] years; 50% female) trained for an average (standard deviation) of 1080.5 (346.3) seconds. Mean (standard deviation) task completion time improved from 448.7 (218.85) to 243.6 (92.65) seconds (<em>P</em> = .509). Subjective assessments indicated increased confidence. Perceived technical skill improvement was noted by 87.5% of participants. Overall satisfaction was reported by 62.5% of participants.</div></div><div><h3>Conclusions</h3><div>An at-home, gaming-based, handheld endoscope simulator is a feasible adjunct to traditional endoscopy training. Although preliminary results suggest improvements in task efficiency and trainee confidence, larger multicenter studies are needed to confirm its effectiveness and assess skill retention and translation to real-life clinical skill development.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 306-311"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic evaluation in patients with gastrointestinal bleeding receiving anticoagulation for venous thromboembolism","authors":"Nichole E. Brunton DO,&nbsp;Waldemar E. Wysokinski MD, PhD,&nbsp;Ryan T. Moerer BS,&nbsp;David O. Hodge MS,&nbsp;Andres J. Acosta MD, PhD,&nbsp;Danielle T. Vlazny PA-CMS,&nbsp;Damon E. Houghton MD, MS,&nbsp;Ana I. Casanegra MD, MS","doi":"10.1016/j.igie.2025.12.007","DOIUrl":"10.1016/j.igie.2025.12.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastrointestinal bleeding (GIB) is a common adverse event of anticoagulation in patients undergoing treatment for venous thromboembolism (VTE) and is often assessed by endoscopic evaluation. It remains unclear whether identification of the bleeding source impacts outcomes. Our aim was to describe endoscopic evaluation strategies, management, and outcomes in patients with GIB complicating anticoagulation for VTE.</div></div><div><h3>Methods</h3><div>Patients in the Mayo Clinic VTE registry between March 2013 and October 2021 were prospectively followed. For patients with a first episode of GIB, endoscopic studies and related interventions were reviewed.</div></div><div><h3>Results</h3><div>Among the 3287 patients, 109 (3%) experienced GIB (median age = 67, 52.3% female). Endoscopic evaluation occurred in 73 patients (67%): upper endoscopy (n = 53, 49%), colonoscopy (n = 41, 38%), and capsule endoscopy (n = 2, 2%). Endoscopy identified a bleeding source in 51 cases (73%), and hemostatic intervention occurred in 19 cases (26%). A bleeding source was not identified in 26 (24%) of cases. Among the 33 (30%) patients who did not undergo endoscopic evaluation, the majority (n = 29, 88%) had an identified source by either prior endoscopy or alternative imaging modality. Anticoagulation was interrupted in 90 (82%) patients for an average of 3.5 days; this was similar regardless of whether a source was identified. During follow-up (median = 103 days), 16 (14.7%) patients experienced a recurrent GIB, and 54 (50%) patients died. Rates of recurrent bleeding, VTE, and death were similar between patients with identified and unidentified bleeding sources.</div></div><div><h3>Conclusions</h3><div>Although endoscopy has a high diagnostic yield in anticoagulated patients, anticoagulation management and clinical outcomes are similar regardless of GIB source identification. Further studies are needed to determine the net clinical benefit of endoscopy in this high-risk cohort.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 340-349"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors linked to gastric intestinal metaplasia in adults from a private clinic in the Dominican Republic","authors":"Pablo Socias-Pappaterra MD,&nbsp;Yousef S. Ebrahim Ibrahim MD,&nbsp;Vivian Ho Sang MD,&nbsp;Beatriz Moquete Grullon MD,&nbsp;Ramon Romano MD,&nbsp;Fernando Contreras MD","doi":"10.1016/j.igie.2025.12.010","DOIUrl":"10.1016/j.igie.2025.12.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric intestinal metaplasia (GIM) significantly increases the risk of developing future gastric cancer by 6-fold. This study aimed to identify the most common risk factors associated with GIM in adults who underwent EGD at a private clinic in the Dominican Republic.</div></div><div><h3>Methods</h3><div>This retrospective cohort study examined the risk factors of GIM in adults who underwent esophagogastroduodenoscopy (EGD) at a private clinic in the Dominican Republic in 2024. Indications included dyspepsia, gastroesophageal reflux disease (GERD), surveillance of premalignant lesions, combined lower and upper gastrointestinal screening, and alarm symptoms. All procedures followed the Sydney biopsy protocol, with additional biopsy specimens from areas concerning for GIM. Experienced pathologists reviewed biopsy specimens and diagnosed GIM histologically. Patient data and biopsy results were obtained from electronic medical records, and logistic regression identified independent risk factors for GIM.</div></div><div><h3>Results</h3><div>Of the 781 patients, 14.6% had GIM. Multivariate odds ratio (MultivOR) analysis indicated that current <em>Helicobacter pylori</em> (<em>H pylori</em>) infection (MultivOR, 3.51; 95% confidence interval [CI], 2.01-6.10), past <em>H pylori</em> infection (MultivOR, 2.61; 95% CI, 1.63-4.16), and age (MultivOR, 1.06; 95% CI, 1.04-1.08) were linked to an increased risk of GIM. Other factors showed no significant association.</div></div><div><h3>Conclusions</h3><div>Current and past <em>H pylori</em> infections and age increase GIM risk for both extensive and limited GIM in adults undergoing EGD at a Dominican clinic. Further studies are needed to evaluate their relevance for gastric cancer screening strategies.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 350-356"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}