iGIE最新文献

{"title":"Outcomes of subsequent endoscopic resection for rectal neuroendocrine tumors with positive/indeterminate vertical margins","authors":"Mitsunori Kusuhara MD,&nbsp;Masau Sekiguchi MD, PhD,&nbsp;Naoya Toyoshima MD, PhD,&nbsp;Hiroyuki Takamaru MD, PhD,&nbsp;Masayoshi Yamada MD, PhD,&nbsp;Nozomu Kobayashi MD, PhD,&nbsp;Taiki Hashimoto MD, PhD,&nbsp;Tadakazu Hisamatsu MD, PhD,&nbsp;Yutaka Saito MD, PhD","doi":"10.1016/j.igie.2025.10.002","DOIUrl":"10.1016/j.igie.2025.10.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Management of rectal neuroendocrine tumors (NETs) with positive/indeterminate vertical margins (VM1/VMX) after endoscopic resection (ER) remains unestablished. We aimed to evaluate the outcomes of subsequent ER for rectal NETs after initial ER with VM1/VMX.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of rectal NET cases undergoing subsequent ER at a high-volume center, where such cases were frequently referred and subsequent ER was the principal management strategy, except when the risk of metastasis was considered especially high. We assessed the presence of a residual tumor based on lesion characteristics as well as initial ER techniques and outcomes. Additionally, we assessed subsequent ER outcomes, including en bloc and R0 (en bloc with negative cut margins) resection and adverse events. For patients with follow-up longer than 1 year, we examined recurrence.</div></div><div><h3>Results</h3><div>Among 54 lesions in 51 patients undergoing subsequent ER, a residual tumor was found histologically in 20.4%, despite no endoscopic evidence of residual on the initial resection site. Subsequent ER, mainly endoscopic submucosal resection with a ligation device and endoscopic submucosal dissection, achieved en bloc resection in all and R0 resection in 10 of 11 residual cases without any adverse events. No recurrences were observed during a median follow-up period of 40 months.</div></div><div><h3>Conclusions</h3><div>A residual tumor was present in a nonnegligible proportion of rectal NETs undergoing subsequent ER after initial ER with VM1/VMX. ER of residual rectal NET in patients with VM1/VMX was successful with no recurrence. Our findings suggest the potential usefulness of subsequent ER for these rectal NET cases.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 145-150.e1"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378616","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 role of quantitative contrast-enhanced endoscopic ultrasound in the differential diagnosis of pancreatic solid neoplasms: a proof-of-concept prospective study shifting from subjective to objective","authors":"Matteo Tacelli MD,&nbsp;Niccolò Bina MD,&nbsp;Maria Chiara Petrone MD,&nbsp;Piera Zaccari MD,&nbsp;Gabriele Capurso MD,&nbsp;Gemma Rossi MD,&nbsp;Paolo Giorgio Arcidiacono MD","doi":"10.1016/j.igie.2025.10.013","DOIUrl":"10.1016/j.igie.2025.10.013","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Accurate differentiation of pancreatic solid tumors, including pancreatic neuroendocrine neoplasms (pNENs) and pancreatic ductal adenocarcinomas (PDACs), is crucial because of their distinct prognoses and treatments. Contrast-enhanced endoscopic ultrasound (CE-EUS) assesses vascularization differences but is limited by subjective interpretation and low interobserver agreement. The aim of this article is to evaluate the role of quantitative CE-EUS in differentiating pNENs from PDACs.</div></div><div><h3>Methods</h3><div>This observational study included patients with a cytological diagnosis of PDACs or pNENs undergoing CE-EUS from January to June 2024. CE-EUS videos were analyzed using software for objective contrast quantification. Vascular parameters were compared between tumor types using Mann-Whitney <em>U</em> tests and receiver operating characteristic analysis.</div></div><div><h3>Results</h3><div>Among 73 patients (51 with PDACs/22 with pNENs), pNENs had significantly greater contrast intensity, peak enhancement, and wash-in area under the curve. Receiver operating characteristic curves identified wash-in perfusion index and wash-in rate as the most discriminative parameters, achieving an area under the curve of 96.1% when combined.</div></div><div><h3>Conclusions</h3><div>Quantitative CE-EUS appears to enhance pancreatic tumor differentiation by eliminating subjectivity and improving diagnostic accuracy.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 116-122.e2"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379118","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":"An endoscopic presentation of metastasis to the gastrointestinal tract: the volcano lesion","authors":"Ashwariya Ohri MBBS,&nbsp;Davekaran Buttar MBBS,&nbsp;Mayank Goyal MBBS,&nbsp;Preeyati Chopra MBBS,&nbsp;Raseen Tariq MD,&nbsp;Andrew C. Storm MD","doi":"10.1016/j.igie.2025.09.011","DOIUrl":"10.1016/j.igie.2025.09.011","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 182-183"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379293","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":"Submucosal tunneling endoscopic resection in challenging esophageal subepithelial lesions: a minimally invasive approach","authors":"Shaimaa Elkholy MD,&nbsp;Hussein Okasha MD,&nbsp;Abeer Awad MD,&nbsp;Hany Haggag MD,&nbsp;Karim Essam MD,&nbsp;Kerolis Yousef MD,&nbsp;Mohamed Abdel Zaher MBBCh,&nbsp;Mohamed El Sherbiny MD","doi":"10.1016/j.igie.2025.10.006","DOIUrl":"10.1016/j.igie.2025.10.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Submucosal tunneling endoscopic resection (STER) is a minimally invasive procedure for resecting esophageal subepithelial lesions (SELs), particularly those arising from the muscularis propria layer. This article presents 2 challenging cases of esophageal SELs successfully managed with STER.</div></div><div><h3>Methods</h3><div>Two esophageal SELs were managed with STER, which involved creating a submucosal tunnel for en bloc resection, followed by closure with hemostatic clips. Challenges related to lesion location, size, and patient comorbidities were addressed during the procedures.</div></div><div><h3>Results</h3><div>Both patients underwent successful en bloc resection of the SELs without adverse events. One presented with progressive dysphagia for 2 years, and the other with dysphagia and intermittent chest pain. Both experienced significant clinical improvement postoperatively.</div></div><div><h3>Conclusions</h3><div>STER offers an effective, minimally invasive alternative to surgery in challenging cases of esophageal SELs, demonstrating excellent results with reduced morbidity when performed with careful planning and multidisciplinary collaboration.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 219-223"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379064","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 forgotten duo: narrow-band imaging plus Lugol iodine chromoendoscopy in the early detection of esophageal squamous cell carcinoma","authors":"Diego Cadena-Aguirre MD,&nbsp;Mimi Tan MD, MPH,&nbsp;Igor Valdeir Gomes de Sousa MD,&nbsp;Evandro Sobroza de Mello MD, PhD,&nbsp;Sérgio Barbosa Marques MD, PhD,&nbsp;Fauze Maluf-Filho MD, PhD","doi":"10.1016/j.igie.2025.11.008","DOIUrl":"10.1016/j.igie.2025.11.008","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 195-197"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379078","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":"Double-balloon enteroscopy for luminal evaluation of the excluded stomach: a retrospective multicenter analysis","authors":"Peter Albares MD,&nbsp;F. Otis Stephen MD,&nbsp;Lauren Pioppo-Phelan MD,&nbsp;Catherine Hudson MD, MPH,&nbsp;Alice Parish MSPH,&nbsp;Iris Vance MD,&nbsp;Jason Stibbe MD,&nbsp;Donna Niedzwiecki PhD,&nbsp;Daniel Wild MD","doi":"10.1016/j.igie.2025.12.012","DOIUrl":"10.1016/j.igie.2025.12.012","url":null,"abstract":"<div><h3>Background and Aims</h3><div>After Roux-en-Y gastric bypass (RYGB), accessing the excluded or remnant stomach (RS) is difficult using standard endoscopy, and double-balloon enteroscopy (DBE) is often used when pathology is suspected. Data on the use of DBE for this purpose are limited. We investigated the success rate, technical factors, and findings when using DBE to access the RS after RYGB.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of adult patients with RYGB who underwent DBE to access the RS between January 2018 and July 2023 across 3 academic medical centers. Primary aims were identifying the technical success rate of accessing the RS and associated endoscopic findings. Secondary aims were identifying patient characteristics, procedure indications, factors behind technical failures, studies preceding DBE, endoscopic therapies performed, and procedural adverse events.</div></div><div><h3>Results</h3><div>Eighty-nine patients underwent DBE to access the RS after RYGB for anemia/bleeding (56.2%), abdominal pain (32.6%), and abnormal imaging (44.9%). The RS was successfully accessed in 71.9% of cases. The most common reasons the RS was not accessed were proximal pathology (40%), anastomotic angulation (32%), and limb length (16%). Many (40.4%) examination results were normal. The most common findings were inflammatory (30.3%) or vascular (15.7%), 6.7% had polyps, and 5.6% had malignant neoplasm. Biopsy (50.6%) and hemostatic maneuvers (20.2%) were commonly performed. Accessing the RS was not associated with patient age, procedural indication, or time from RYGB. DBE served as definitive management in 29.2% of cases, and no procedural adverse events occurred.</div></div><div><h3>Conclusions</h3><div>The RS in RYGB can be successfully and safely accessed with DBE.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 161-166.e1"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379244","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":"Usefulness of artificial intelligence in diagnosing early gastric cancer using magnifying endoscopy with narrow-band imaging","authors":"Kenshi Yao MD, PhD,&nbsp;Shunpei Nishida BEng,&nbsp;Masaki Miyaoka MD, PhD,&nbsp;Yoichiro Ono MD, PhD,&nbsp;Takao Kanemitsu MD, PhD,&nbsp;Kentaro Imamura MD, PhD,&nbsp;Satoshi Ishikawa MD,&nbsp;Rino Hasegawa MD, PhD,&nbsp;Shou Aso MD,&nbsp;Keisuke Takano MD,&nbsp;Shugo Ozono MD,&nbsp;Takayuki Hirase MD,&nbsp;Takashi Hisabe MD, PhD,&nbsp;Seiichiro Sakaguchi BEng,&nbsp;Manabu Ichikawa MEng,&nbsp;Hidetoshi Nishimura MEng","doi":"10.1016/j.igie.2025.10.005","DOIUrl":"10.1016/j.igie.2025.10.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>In this study, we developed an artificial intelligence (AI) system to support the diagnosis of early gastric cancer using magnifying endoscopy with narrow-band imaging (NBI), with the goal of improving the diagnostic accuracy of upper gastrointestinal endoscopy. This study aimed to evaluate the diagnostic performance of the AI-based system compared with endoscopists.</div></div><div><h3>Methods</h3><div>A total of 500 cases, including early gastric cancer and noncancer cases, were used to develop the diagnostic support AI system. We evaluated the AI system with models created using <em>k</em>-fold cross-validation. We determined the diagnostic performance of the AI system and 10 endoscopists (5 experts and 5 nonexperts) for detecting early gastric cancer and compared the diagnostic performance between the AI system and endoscopists. Histopathologic diagnosis was used as the reference standard for cancerous lesions, while magnifying endoscopic diagnosis with high confidence served as the reference standard for noncancerous lesions.</div></div><div><h3>Results</h3><div>The median (interquartile range [IQR]) sensitivity for the AI system and all endoscopists was 100% (100%-100%) and 76.8% (65.5%-78.9%), respectively. The sensitivity of the AI system was significantly higher than that of the endoscopists (<em>P</em> = .002). The median (IQR) specificity for the AI system and all endoscopists was 100% (99.0%-100%) and 86.0% (72.0%-91.8%), respectively. The specificity of the AI system was also significantly higher (<em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>This study demonstrates the feasibility of applying the diagnostic support AI system during magnified observation with NBI and suggests that it could enhance the diagnostic accuracy of upper gastrointestinal endoscopy for early gastric cancer.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 104-115"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379218","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":"Comparison of fully covered self-expandable metal biliary stents with or without anchoring double-pigtail plastic stents: a systematic review and meta-analysis","authors":"Samuel Tanner MD,&nbsp;Fadi Hawa MD,&nbsp;Alejandra Vargas MD,&nbsp;Priyata Dutta MD,&nbsp;Antonio Facciorusso MD, PhD,&nbsp;Janice Lester MLS,&nbsp;Jean M. Chalhoub MD,&nbsp;Jorge D. Machicado MD, MPH","doi":"10.1016/j.igie.2025.12.002","DOIUrl":"10.1016/j.igie.2025.12.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Fully covered self-expandable metal stents (FcSEMSs) have become the mainstay of treatment for a variety of biliary pathologies. However, FcSEMSs have been associated with a greater rate of stent migration than other types of stents. A technique of anchoring double-pigtail plastic stents (DPPSs) has been proposed to minimize migration of biliary FcSEMSs. Herein, we evaluated the efficacy of anchoring DPPSs among patients treated with biliary FcSEMSs.</div></div><div><h3>Methods</h3><div>We performed a systematic review using PubMed, EMBASE, and Web of Science from database inception through August 2023. Full-text articles comparing FcSEMSs with or without anchoring DPPSs were included. We evaluated the following outcomes: (1) stent migration; (2) stent occlusion; (3) duration of stent patency; (4) cholangitis; (5) unplanned reinterventions; and (6) adverse events. Meta-analysis was carried out using random-effect models and reported as odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs).</div></div><div><h3>Results</h3><div>Four studies encompassing 489 patients were included. Patients with anchoring DPPSs had a 67% reduction in FcSEMS migration compared with those without anchoring DPPSs (OR: 0.33; 95% CI, 0.19-0.57; <em>I</em>² 0%). Anchoring DPPSs increased the mean duration of FcSEMS patency by 83 days compared with FcSEMSs alone (95% CI, 46-120; <em>I</em>² 94%). No differences in other clinical end points or adverse events were observed.</div></div><div><h3>Conclusions</h3><div>Anchoring DPPSs reduced the risk of FcSEMS migration and increased the duration of FcSEMS patency without an increased risk of adverse events. Future studies are needed to corroborate these findings, determine the optimal DPPS technique, and to compare DPPS placement with other antimigratory modalities.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 234-240.e5"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379242","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":"Application of a novel 4.5F electrohydraulic lithotripsy probe for complex biliary stone fragmentation: a case series","authors":"Kanika Garg MD,&nbsp;Thomas J. Wang MD,&nbsp;Agnieszka Maniak MD,&nbsp;Christopher G. Chapman MD,&nbsp;Irving Waxman MD,&nbsp;Ajaypal Singh MD,&nbsp;Neal A. Mehta MD","doi":"10.1016/j.igie.2025.12.009","DOIUrl":"10.1016/j.igie.2025.12.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Large biliary stones (&gt;25 mm) present significant therapeutic challenges, with standard endoscopic techniques frequently failing to achieve complete ductal clearance. Conventional 3F electrohydraulic lithotripsy (EHL) probes often require multiple sessions or result in incomplete fragmentation. We present a novel approach using a 4.5F EHL probe (Walz Elektronik GmbH, Rohrdorf, Germany) for successful management of large refractory biliary stones.</div></div><div><h3>Methods</h3><div>Three female patients (aged 57, 59, and 67 years) with large biliary stones (35-45 mm) previously refractory to standard techniques underwent direct cholangioscopy with a 4.5F EHL probe fragmentation using an 11F cholangioscope (eyeMAX; Micro-Tech, Ann Arbor, Mich, USA). The 4.5F probe delivers energy up to 950 mJ with greater surface area contact than standard 3F probes.</div></div><div><h3>Results</h3><div>Complete ductal clearance was achieved in all 3 cases within a single session, with successful fragmentation where conventional techniques had failed. Procedure durations ranged from 49 to 94 minutes. No adverse events occurred in any case.</div></div><div><h3>Conclusions</h3><div>The 4.5F EHL probe represents a significant advancement for managing large refractory biliary stones, potentially reducing repeat procedures and obviating surgical intervention.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 229-233"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379281","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":"Radiation-free luminal stenting using peroral cholangioscope","authors":"Lin Liu MM,&nbsp;Hongguang Wang MBBS,&nbsp;Liying Tao MM,&nbsp;Qingmei Guo MBBS,&nbsp;Junpeng Liu MM,&nbsp;Shizhu Liu MM,&nbsp;Peng Zhan MBBS","doi":"10.1016/j.igie.2025.10.010","DOIUrl":"10.1016/j.igie.2025.10.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Traditional endoscopic self-expandable metal stent (SEMS) placement necessitates fluoroscopy guidance when treating gastrointestinal obstruction. This study was performed to report the safety and efficacy of radiation-free peroral cholangioscopy-guided SEMS placement in the treatment of 2 cases with gastrointestinal obstruction.</div></div><div><h3>Methods</h3><div>This study included 2 patients with gastrointestinal obstruction due to cholangiocarcinoma and sigmoid colon cancer. Peroral cholangioscopy was applied for radiation-free guidewire insertion and SEMS placement.</div></div><div><h3>Results</h3><div>The guidewire insertion and SEMS placement were successfully accomplished by radiation-free peroral cholangioscopy in both cases. It resulted in significant relief of gastrointestinal obstruction symptoms. In addition, no adverse events such as bleeding or perforation were observed intraoperatively and postoperatively.</div></div><div><h3>Conclusions</h3><div>Radiation-free peroral cholangioscopy may safely and effectively assist SEMS placement to relieve the symptoms of obstruction caused by gastrointestinal tumors.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 2","pages":"Pages 224-228"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378564","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}