iGIE最新文献

{"title":"Esophageal stent placement for acute variceal hemorrhage: a case report","authors":"Zhouwen Tang MD,&nbsp;Deepak Agrawal MD","doi":"10.1016/j.igie.2025.12.013","DOIUrl":"10.1016/j.igie.2025.12.013","url":null,"abstract":"<div><div>Esophageal stent placement as salvage therapy for acute variceal hemorrhage can serve as a bridge to definitive therapy. We discuss technical considerations of placing an esophageal stent under emergent conditions. A 47-year-old man presented with recurrent acute variceal hemorrhage. Bleeding varix was not able to be treated with band ligation because the varix could not be suctioned into the ligation device cap because of scarring from previous banding. A fully covered esophageal stent of appropriate size was selected and placed as a bridge to definitive therapy with special attention to technique to minimize ongoing bleeding, which we further describe in our case. The patient received a transjugular intrahepatic portosystemic shunt, and the esophageal stent was removed. The patient did not have any further bleeding. A fully covered esophageal stent can serve as a bridge to definitive treatment of variceal hemorrhage. Stent selection is important, and endoscopists should be prepared to place the stent under emergent conditions.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 416-419"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078702","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":"Visualization of hemostatic powder on computed tomography imaging","authors":"Noel Ravindranayagam MBBS (Hons),&nbsp;Sanjivan Mudaliar MD, BSc, FRACP,&nbsp;Rajit Gilhotra MBBS (Hons), AFRACMA, FRACP","doi":"10.1016/j.igie.2025.09.007","DOIUrl":"10.1016/j.igie.2025.09.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 365-366"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078696","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":"Promoting radiation safety in endoscopic retrograde cholangiopancreatography through dose recording and diagnostic reference level benchmarking","authors":"Tsutomu Nishida MD, PhD,&nbsp;Kengo Matsumoto MD, PhD,&nbsp;Shiro Hayashi MD","doi":"10.1016/j.igie.2026.03.007","DOIUrl":"10.1016/j.igie.2026.03.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Page 502"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078765","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":"Face validity of a new mixed-reality simulator for training endoscopic submucosal dissection: a Western pilot study","authors":"Henriette Heinrich MD,&nbsp;Pieter Dewint MD,&nbsp;Phillipe Leclercq MD,&nbsp;Jelle Haringsma MD","doi":"10.1016/j.igie.2025.10.018","DOIUrl":"10.1016/j.igie.2025.10.018","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic submucosal dissection (ESD) is an effective but technically demanding procedure with a steep learning curve. Traditional training methods, including master courses, apprenticeship, and animal models, have ethical, financial, and logistical constraints. This pilot study evaluates the face validity of a novel mixed-reality simulator designed to enhance and maintain endoscopic dexterity in ESD training.</div></div><div><h3>Methods</h3><div>In this exploratory, prospective observational cohort study, 8 ESD trainees with prior advanced endoscopy experience, but limited ESD exposure, underwent a 2-day structured training using the EndoCubot (EndoRobotics, Seoul, South Korea) simulator with artificial laminated tissue (VTT [Versatile Training Tissue], KOTOBUKI Medical, Yashio, Japan). Performance was assessed pre- and post-training through a 5-minute dexterity test simulating circular incision with 40 achievable points, and a questionnaire evaluating simulator realism, satisfaction, and training effectiveness. Paired sample <em>t</em> tests (α = 0.05) and descriptive statistics were used for analysis. Results were reported as mean with standard deviation.</div></div><div><h3>Results</h3><div>On a 40-point scale, mean postcourse scores (34.7 [4.86]) were significantly higher than precourse scores (25.50 [0.76], <em>P</em> &lt; .001), with a mean improvement of 9.25 points (95% confidence interval, 4.993-13.507, Hedges’ <em>g</em> correction = 1.613). Survey results indicated high satisfaction (mean rating: 9.125/10) and strong agreement on the simulator's realism and effectiveness.</div></div><div><h3>Conclusions</h3><div>The simulator demonstrates strong face validity and supports a realistic standardized skill acquisition in ESD. The simulator could provide a realistic and ethical alternative to current animal models and requires further study.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 291-297"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078577","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":"Successful endoscopic vacuum therapy in diffuse gastric hemorrhage secondary to acute ischemia: a case report","authors":"Marcelo Klotz Dall'Agnol MD,&nbsp;Igor Mendonça Proença MSc,&nbsp;Mateus Pereira Funari PhD,&nbsp;Diogo Turiani Hourneaux de Moura PhD,&nbsp;Fernando da Costa Ferreira Novo MD,&nbsp;Fauze Maluf-Filho PhD","doi":"10.1016/j.igie.2025.10.001","DOIUrl":"10.1016/j.igie.2025.10.001","url":null,"abstract":"<div><div>Acute gastric ischemia is rare and may lead to diffuse mucosal bleeding, often refractory to conventional endoscopic therapy. We describe the case of a 42-year-old critically ill burn patient who developed persistent upper gastrointestinal hemorrhage unresponsive to medical treatment, in whom the novel use of endoscopic vacuum therapy (EVT) was undertaken. Serial endoscopies demonstrated progressive mucosal healing, reduced necrosis, and effective bleeding control. EVT promoted granulation tissue and ulcer healing, avoiding surgical intervention. No EVT-related adverse events occurred. Despite successful hemostasis, the patient later died from a sepsis-related adverse event. In conclusion, this case illustrates EVT as a viable and effective approach for managing refractory diffuse gastric bleeding secondary to ischemia. EVT may offer a minimally invasive alternative to surgery in critically ill patients where standard therapies fail.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 388-392"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078699","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":"Post–endoscopic retrograde cholangiopancreatography pancreatitis prophylaxis: a stratified assessment for evaluation of risk approach","authors":"David S. Braun MD,&nbsp;Prashant S. Kedia MD,&nbsp;Mingyang Cui MSc,&nbsp;Paul R. Tarnasky MD","doi":"10.1016/j.igie.2025.10.009","DOIUrl":"10.1016/j.igie.2025.10.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The risk of post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is influenced by patient and procedure-related factors. Strategies to decrease PEP are of great importance. This study aimed to determine if PEP prophylaxis (PEPX) could be avoided in patients in whom high-risk procedure-related factors are avoided as guided by a Stratified Assessment for Evaluation of Risk (SAFER) approach. SAFER is a dynamic process whereby procedure-related factors direct PEPX strategies.</div></div><div><h3>Methods</h3><div>A prospective database of consecutive ERCPs was analyzed. Data regarding demographics, procedure indications, previous ERCP attempts, cannulation techniques, PEPX received, and adverse events were collected. Each ERCP was classified for PEP risk pre- and post-ERCP based on patient factors, procedure indications, findings, and techniques. PEP incidence was assessed with or without PEPX after stratifying risk using a SAFER approach.</div></div><div><h3>Results</h3><div>From a cohort of 3006 procedures, PEP incidence without any PEPX in all patients with low post-ERCP risk (n = 2096) was 0.2%. Independent of PEPX, there was no significant difference in the incidence of PEP between procedures with both low pre- and post-ERCP risk and those with high pre-ERCP risk but low post-ERCP risk.</div></div><div><h3>Conclusions</h3><div>To influence PEPX decisions, procedure-related factors may be more important than patient-related PEP risk factors. A SAFER approach suggests that low-risk post-ERCP patients do not need PEPX, although further prospective studies are needed.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 312-324"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078580","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":"Identifying gaps in gastroenterology advanced practice provider onboarding: results from a national survey and early outcomes from a pilot inpatient training curriculum","authors":"Catherine Brady MPAS, PA-C","doi":"10.1016/j.igie.2026.05.013","DOIUrl":"10.1016/j.igie.2026.05.013","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Advanced practice providers (APPs) play an essential role in gastroenterology (GE), yet structured onboarding practices remain highly variable across practice settings. Limited specialty-specific training may affect provider confidence, clinical readiness, and patient care quality. This study aimed to characterize national GE APP onboarding experiences and evaluate the early outcomes of a pilot inpatient GE training curriculum designed to address identified gaps.</div></div><div><h3>Methods</h3><div>A 13-item national electronic survey was distributed through the American Gastroenterological Association (AGA) APP listserv to assess onboarding duration, confidence in managing routine GE cases, and desired training topics. Descriptive statistics, the Wilcoxon signed-rank test and McNemar test were used to analyze survey responses. On the basis of key findings, a 4-week competency-based inpatient GE curriculum was implemented at the University of Colorado (Aurora, Colorado, USA). Knowledge acquisition was measured through pretest and post-test assessments, and attending physicians evaluated APP readiness using Accreditation Council for Graduate Medical Education–aligned competency domains.</div></div><div><h3>Results</h3><div>The survey was distributed to 289 APPs via the AGA APP listserv, with 69 responses received (67 complete; 23% response rate). Before any onboarding, 46.9% reported “not at all” or “slightly confident.” After onboarding (which was &lt;3 months for &gt;80% of respondents), only 39.4% felt “very” or “extremely confident” in managing routine GE cases. In the pilot curriculum, 4 APP participants with prior outpatient GE experience improved their mean knowledge scores from 9.5 out of 13 to 12 out of 13. All participants reported increased confidence, improved team integration, and greater readiness for inpatient care. Attending evaluations reflected progression from developing competence in week 1 to meeting or exceeding expectations by week 4.</div></div><div><h3>Conclusions</h3><div>National data demonstrate substantial variability and gaps in GE APP onboarding, underscoring the need for structured, competency-based education. The pilot inpatient curriculum significantly improved knowledge, confidence, and observed clinical readiness, suggesting that short, focused training may be an effective model to enhance APP integration and support high-quality GE care.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 495-500"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078763","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":"Full-thickness endoscopic myotomy for management of a twisted gastric conduit postesophagectomy","authors":"Shirley Jiang MD,&nbsp;Ali Dashti MD,&nbsp;Cynthuja Thilakanathan MD,&nbsp;John Yee MD,&nbsp;Roberto Trasolini MD, MSc","doi":"10.1016/j.igie.2025.12.005","DOIUrl":"10.1016/j.igie.2025.12.005","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 370-371"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078698","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 diagnosis and management of biliary neuroendocrine tumor with prior Roux-en-Y choledochojejunostomy: a case report","authors":"Alec Hope BMed, MD, MPH,&nbsp;Hasib Ahmadzai MBBS, MS, FRACP,&nbsp;Philip Ian Craig MB, BS, PhD, FRACP","doi":"10.1016/j.igie.2026.03.017","DOIUrl":"10.1016/j.igie.2026.03.017","url":null,"abstract":"<div><div>A 74-year-old woman with a previous Roux-en-Y choledochojejunostomy presented with biliary sepsis, <em>Escherichia coli</em> bacteremia, and a left-sided intrahepatic biliary stricture. Initial management included percutaneous transhepatic cholangiography with external biliary drainage. Colonoscope-directed cholangioscopy enabled biopsies and balloon dilatation because of the colonoscope's suitable length and channel diameter. Histology revealed a poorly differentiated neuroendocrine tumor of the bile duct. Surgical resection was abandoned intraoperatively because of peritoneal metastases. Following chemotherapy, the patient re-presented with biliary sepsis. Endoscopic retrograde cholangiography using a pediatric colonoscope allowed placement of an uncovered self-expandable metal stent across the intrahepatic stricture. The patient underwent lutetium therapy and was clinically stable at 12-month follow-up. This case highlights biliary neuroendocrine tumor as a rare cause of stricture and demonstrates the utility of colonoscope-directed cholangioscopy and endoscopic retrograde cholangiography for diagnosis and management.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 428-432"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078705","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 closure technique performance for iatrogenic perforation: a systematic review and meta-analysis","authors":"Justin Buttar MD,&nbsp;Avni Jain MD,&nbsp;Shirley Jiang MD,&nbsp;Sunil Gupta MD,&nbsp;Hong Qian MSc,&nbsp;Roberto Trasolini MD,&nbsp;Sergei Vosko MD,&nbsp;Douglas Motomura MD,&nbsp;Eric Lam MD,&nbsp;Michael J. Bourke MBBS,&nbsp;Neal Shahidi MD, PhD","doi":"10.1016/j.igie.2026.01.015","DOIUrl":"10.1016/j.igie.2026.01.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Perforation is the most feared endoscopy-related adverse event. Various closure techniques are available, including through-the-scope clips (TTSCs), over-the-scope clips (OTSCs), and over-the-scope suturing (OTSS). Given the lack of comparative performance estimates, we sought to systematically appraise TTSC, OTSC, and OTSS performance for iatrogenic perforation.</div></div><div><h3>Methods</h3><div>MEDLINE and Embase were independently searched between June 1947 and January 2024 for citations evaluating TTSC, OTSC, or OTSS performance. Technical success was defined as complete apposition of the borders of the defect with visual confirmation. Clinical success was defined as technical success without further intervention. Pooled estimates using random-effects modeling were generated and stratified by closure modality, location, perforation etiology, and time.</div></div><div><h3>Results</h3><div>Thirty-seven citations assessing 795 perforations were included. Pooled technical and clinical success were 91.5% (95% confidence interval [CI], 87.9-94.1; <em>I</em>^<em>2</em> = 26%) and 86.3% (95% CI, 81.9-89.8; <em>I</em>^<em>2</em> = 39%). Technical success of TTSCs, OTSCs, and OTSS was 89.3% (95% CI, 82.6-93.6), 90.7% (95% CI, 86.0-93.9), and 94.9% (95% CI, 83.8-98.5; <em>P</em> = .53), respectively. Clinical success of TTSCs, OTSCs, and OTSS was 85.3% (95% CI, 77.9-90.6), 86.2% (95% CI, 80.4-90.5) and 94.9% (95% CI, 83.8-98.5) (<em>P</em> = .24). Clinical success was significantly higher for tissue resection–related perforations (<em>P</em> = .02) and perforations in the stomach (<em>P</em> &lt; .04); no difference in clinical success was identified when stratifying by closure modality and time (all <em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>TTSCs, OTSCs, and OTSS are effective for iatrogenic perforation management, especially in tissue resection–related perforations and perforations in the stomach. No difference in performance was identified on the basis of closure modality or time.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 457-469.e3"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078760","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}