{"title":"Endoscopic ultrasound-guided hepaticogastrostomy by puncturing both B2 and B3: a single center experience.","authors":"Moaz Elshair, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Asmaa Bakr, Abdou Elshafei, Mohamed Z Abu-Amer","doi":"10.5946/ce.2022.209","DOIUrl":"10.5946/ce.2022.209","url":null,"abstract":"<p><p>Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) through ducts B2 or B3 is effective in most patients with biliary obstruction, because B2 and B3 commonly join together. However, in some patients, B2 and B3 do not join each other due to invasive hilar tumors; therefore, single-route drainage is insufficient. Here, we investigated the feasibility and efficacy of EUS-HGS through both B2 and B3 simultaneously in seven patients. We decided to perform EUS-HGS through both B2 and B3 to achieve adequate biliary drainage because these two ducts were separate from each other. Here, we report a 100% technical and overall clinical success rate. Early adverse effects were closely monitored. Minimal bleeding was reported in one patient (1/7) and mild peritonitis in one patient (1/7). None of the patients experienced stent dysfunction, fever, or bile leakage after the procedure. EUS-HGS through both B2 and B3 simultaneously is safe, feasible, and effective for biliary drainage in patients with separated ducts.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"542-546"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9785737","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":"Clinicopathological and endoscopic features of Helicobacter pylori infection-negative gastric cancer in Japan: a retrospective study.","authors":"Kentaro Imamura, Kenshi Yao, Satoshi Nimura, Takao Kanemitsu, Masaki Miyaoka, Yoichiro Ono, Toshiharu Ueki, Hiroshi Tanabe","doi":"10.5946/ce.2023.258","DOIUrl":"10.5946/ce.2023.258","url":null,"abstract":"<p><strong>Background/aims: </strong>Helicobacter pylori infection-negative gastric cancer (HPNGC) has not been systematically investigated in consecutive patients. Hence, this study aimed to investigate the clinicopathological and endoscopic features of HPNGC.</p><p><strong>Methods: </strong>This single-center retrospective study selected participants from patients with gastric cancer who were treated at the Fukuoka University Chikushi Hospital between January 2013 and December 2021. Only patients diagnosed with HPNGC were enrolled, and their clinicopathological and endoscopic features were analyzed in detail.</p><p><strong>Results: </strong>The prevalence of HPNGC in the present study was 2.6% (54/2112). The types of HPNGC observed in each gastric region were as follows: advanced gastric cancer was observed in the cardia; gastric adenocarcinoma of fundic-gland differentiation, gastric adenocarcinoma of foveolar-type presenting with whitish elevation and raspberry-like foveolar-type gastric adenocarcinoma, gastric adenocarcinoma arising in polyposis, and gastric adenocarcinoma with autoimmune gastritis were observed in the fundic gland region ranging from the gastric fornix to the gastric body; signet-ring cell carcinoma was observed in the gastric-pyloric transition region ranging from the lower gastric body to the gastric angle; and well-differentiated tubular adenocarcinoma with low-grade atypia was observed in the antrum.</p><p><strong>Conclusions: </strong>This study revealed that tumors from each gastric region exhibited distinct macroscopic and histological types in HPNGC.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"486-494"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183916","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}
Clinical EndoscopyPub Date : 2024-07-01Epub Date: 2024-01-26DOI: 10.5946/ce.2023.164
David Hoffman, Christina Cool
{"title":"Costs involved in compliance with new endoscope reprocessing guidelines.","authors":"David Hoffman, Christina Cool","doi":"10.5946/ce.2023.164","DOIUrl":"10.5946/ce.2023.164","url":null,"abstract":"<p><strong>Background/aims: </strong>In March 2022, the Association for the Advancement of Medical Instrumentation (AAMI) released the American National Standards Institute (ANSI)/AAMI ST91:2021, their latest update on comprehensive, flexible, and semirigid endoscope reprocessing. These updated standards recommend the sterilization of high-risk endoscopes when possible and provide new recommendations for the precleaning, leak testing, manual cleaning, visual inspection, automated reprocessing, drying, storage, and transport of endoscopes.</p><p><strong>Methods: </strong>ANSI/AAMI ST91:2021 was compared with ANSI/AAMI ST91:2015 for major reprocessing differences that result in either time and/or cost increases. Time estimates were captured by explicit recommendation inclusion or taken from the literature. All the costs were estimated using publicly available resources.</p><p><strong>Results: </strong>The updated standards represent a potential 24.3-minute and 52.35 to 67.57 United States dollars increase per procedure in terms of reprocessing time and spending, respectively, not including capital investments. Capital costs per procedure were highly dependent on the procedure volume of the facility.</p><p><strong>Conclusions: </strong>The new AAMI standards recommend several major changes, such as sterilization, for facilities to reprocess and manage endoscopes between uses. As more facilities increase their reprocessing methods to reflect the updated standards, they do so at a cost and introduce several delays. As the reprocessing landscape evolves, facilities should consider their true costs and alternative solutions, such as single-use endoscopes.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"534-541"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563313","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}
Clinical EndoscopyPub Date : 2024-07-01Epub Date: 2024-07-02DOI: 10.5946/ce.2024.130
Yunho Jung
{"title":"Endoscopic approaches for the management of giant colonic polyps.","authors":"Yunho Jung","doi":"10.5946/ce.2024.130","DOIUrl":"10.5946/ce.2024.130","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"468-470"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476068","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":"Closure of esophageal-pleural fistula using a cardiac occluder in a patient with systemic scleroderma.","authors":"Oleksandr Kiosov, Vladyslav Tkachov, Sergii Gulevskyi","doi":"10.5946/ce.2024.037","DOIUrl":"10.5946/ce.2024.037","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"547-548"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533773","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}
Clinical EndoscopyPub Date : 2024-07-01Epub Date: 2024-03-29DOI: 10.5946/ce.2023.124
Dae-Hyuk Heo, Min A Yang, Jae Sun Song, Won Dong Lee, Jin Woong Cho
{"title":"Prevalence and natural course of incidental gastric subepithelial tumors.","authors":"Dae-Hyuk Heo, Min A Yang, Jae Sun Song, Won Dong Lee, Jin Woong Cho","doi":"10.5946/ce.2023.124","DOIUrl":"10.5946/ce.2023.124","url":null,"abstract":"<p><strong>Background/aims: </strong>Gastric subepithelial tumors (SETs) are often encountered during the upper gastrointestinal endoscopic screening. We assessed the prevalence of gastric SETs and the risk factors for their progression.</p><p><strong>Methods: </strong>We reviewed the electronic medical records of 30,754 patients who underwent upper gastrointestinal endoscopic screening at our medical center between January 2013 and December 2016.</p><p><strong>Results: </strong>Among the 30,754 patients examined, 599 (1.94%) had gastric SETs. The prevalence increased with age and was 9.56% in patients aged ≥70 years. In total, 262 patients underwent serial endoscopy for more than 6 months. The median age was 68 years (interquartile range [IQR], 61-74), and the number of females was 167 (63.7%). During a median follow-up of 58 months (IQR, 38-75), 22 patients (8.4%) showed significant changes in tumor size. An irregular border (odds ratio, 4.623; 95% confidence interval, 1.093-19.558; p=0.037) was a significant risk factor for progression. Seven patients underwent surgical or endoscopic resections. The pathologies of gastric SETs included leiomyomas (n=3), gastrointestinal stromal tumors (n=2), and lipomas (n=2).</p><p><strong>Conclusions: </strong>The prevalence of gastric SETs increases with age. Most gastric SETs do not progress during long-term endoscopic examinations, and the risk of an increase in size is low in asymptomatic small SETs without irregular borders.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"495-500"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317917","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":"Clinical meaning of sarcopenia in patients undergoing endoscopic treatment.","authors":"Hiroyuki Hisada, Yosuke Tsuji, Hikaru Kuribara, Ryohei Miyata, Kaori Oshio, Satoru Mizutani, Hideki Nakagawa, Rina Cho, Nobuyuki Sakuma, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Seiichi Yakabi, Yu Takahashi, Yoshiki Sakaguchi, Naomi Kakushima, Nobutake Yamamichi, Mitsuhiro Fujishiro","doi":"10.5946/ce.2023.193","DOIUrl":"10.5946/ce.2023.193","url":null,"abstract":"<p><p>With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"446-453"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183915","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}
Clinical EndoscopyPub Date : 2024-07-01Epub Date: 2024-07-29DOI: 10.5946/ce.2024.158
Todd H Baron
{"title":"Migration of covered expandable metal stents after endoscopic ultrasound-guided hepaticogastrostomy: stent covering versus stent design?","authors":"Todd H Baron","doi":"10.5946/ce.2024.158","DOIUrl":"10.5946/ce.2024.158","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":"57 4","pages":"471-472"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792124","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}