Clinical Endoscopy最新文献

{"title":"Single-session dual peroral endoscopic myotomy: near-complete esophageal myotomy for combined Zenker's diverticulum and Jackhammer esophagus in a patient with longstanding dysphagia.","authors":"Biswa Ranjan Patra, Nagesh Kamat, Sanil Parekh, Sharan Malipatil, Onkar Pensalwar, Shivdas Medabalmewar, Sehajad Vora, Amit Maydeo","doi":"10.5946/ce.2025.456","DOIUrl":"10.5946/ce.2025.456","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"859-863"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663595","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":"A simple model for a complex procedure: broadening access to endoscopic retrograde cholangiopancreatography simulation.","authors":"Kyu-Hyun Paik","doi":"10.5946/ce.2026.409","DOIUrl":"10.5946/ce.2026.409","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":"59 5","pages":"768-770"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079875","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":"More frames or better labels?: training data and computer-aided detection of sessile serrated lesions.","authors":"Min-Jae Kim","doi":"10.5946/ce.2026.439","DOIUrl":"10.5946/ce.2026.439","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":"59 5","pages":"771-773"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079893","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":"Predicting retention and rethinking removal of pancreatic duct stents with a standardized protocol: a United Statesbased retrospective study.","authors":"Divyanshoo R Kohli, Xiang Yu Gao, Wichit Srikureja, Jack Brandabur, Shih-Ting Chiu, Nishant Puri","doi":"10.5946/ce.2025.327","DOIUrl":"10.5946/ce.2025.327","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic duct (PD) stent selection impacts migration and retention. We evaluated risk factors for migration versus inappropriate retention of PD stents at a high volume center using a standardized stent management protocol.</p><p><strong>Methods: </strong>Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) with PD stenting were retrospectively categorized by stent status at 2 weeks post-ERCP. Spontaneous migration was defined as absence of a PD stent on follow-up imaging, while inappropriate retention was defined as persistence of a non-flanged PD stent within the duct. The primary endpoint was PD stent retention at 2 weeks. Secondary endpoints included predictors of inappropriate retention and the need for endoscopic stent removal.</p><p><strong>Results: </strong>A total of 482 patients underwent ERCP for biliary (n=289), pancreatic (n=181), or dual (n=12) indications. Non-flanged PD stents for biliary vs. pancreatic indications were 74.4% vs. 31.5% (p<0.001). Among 425 patients with follow-up imaging, predictors of PD stent retention included internal flanges (odds ratio [OR], 6.39; 95% confidence interval [CI], 3.29-12.67), pancreatic indication (OR, 2.23; 95%CI, 1.22-4.07), and stent length >3cm (OR, 2.5; 95% CI, 1.23-5.07). Inappropriate retention of non-flanged stents occurred in 29 patients (12.5%), with only 5 (2.2%) requiring endoscopic removal due to mechanical obstruction.</p><p><strong>Conclusions: </strong>Inappropriate retention of short, narrow caliber, non flanged PD stents is infrequent and rarely requires endoscopic removal.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"833-842"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721579","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":"Feasibility of ex vivo single-operator cholangioscopy in liver grafts.","authors":"Jimin Han","doi":"10.5946/ce.2026.205","DOIUrl":"10.5946/ce.2026.205","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"868-869"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872907","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":"Endobiliary radiofrequency ablation for malignant biliary obstruction: clinical benefits, limitations, and future directions.","authors":"Tadahisa Inoue, Huapyong Kang, Jae Hee Cho","doi":"10.5946/ce.2025.475","DOIUrl":"10.5946/ce.2025.475","url":null,"abstract":"<p><p>Endobiliary radiofrequency ablation (EB-RFA) is an adjunctive local therapy performed during endoscopic biliary drainage for malignant biliary obstruction. EB-RFA was originally introduced to reduce the intraductal tumor burden and maintain biliary drainage, and has been investigated for its potential survival benefits, especially for patients with extrahepatic cholangiocarcinoma (eCCA). However, the available evidence shows heterogeneity, and recent large trials have reported neutral results. This review summarizes the current evidence regarding the clinical benefits and limitations of EB-RFA, focusing on its effects on survival and stent patency. Existing data suggest that the survival benefit associated with EB-RFA is greater in patients with eCCA without distant metastasis than in those with metastatic disease. Evidence of its efficacy in improving stent patency is inconsistent based on the findings of randomized trials. However, observational studies, particularly those involving uncovered self-expandable metal stents, have reported its benefits. EB-RFA may also be considered for reintervention in cases involving metal stents occluded due to tumor ingrowth; however, clinical success may be suboptimal due to imperfect tissue contact and technical factors. Future studies with standardized protocols and predefined subgroup analyses are required to define optimal candidates and clinically meaningful endpoints, especially in the context of evolving systemic therapy.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"716-725"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663599","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":"Hybrid endoscopic submucosal dissection enhances efficiency with comparable curative outcomes: a Bayesian meta-analysis, systematic review, and Monte Carlo simulation of randomized controlled trials.","authors":"Ashesh Das, Arpitha Sirichandana Baggu, Param Darpan Sheth, Nihal Reddy Bandi, Chandana Priya Digumurthy, Urvashi Bharia, Shah Kavya Hiteshkumar, Krishna Sai Kiran Sakalabaktula, Shankar Biswas, Riyakumari Patel, Meenakshi Reddy Yathindra, Venkata Dileep Kumar Veldi","doi":"10.5946/ce.2025.439","DOIUrl":"10.5946/ce.2025.439","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal (GI) cancers accounted for 3.24 million deaths worldwide in 2022. Endoscopic submucosal dissection (ESD) enables en bloc resection of early neoplasms but is time-intensive and technically challenging. Hybrid ESD (H-ESD), which combines dissection with snare polypectomy, may improve efficiency while maintaining efficacy.This Bayesian meta-analysis of randomized controlled trials (RCTs) compares the safety and efficacy of H-ESD with conventional ESD (C-ESD).</p><p><strong>Methods: </strong>We searched the PubMed, Embase, Cochrane, Scopus databases for RCTs comparing hybrid and C-ESD for superficial GI neoplasms. Bayesian modeling in Just Another Gibbs Sampler used normal-normal hierarchies for procedure time and logRR for binary outcomes with weakly informative priors. Frequentist analyses were performed using Der-Simonian-Laird τ². Heterogeneity was assessed using I²/τ².</p><p><strong>Results: </strong>H-ESD showed comparable en bloc (RR, 0.97; 95% [CrI], 0.92-1.03; I²=22.8%) and R0 resection rates (RR, 0.97; 95% CrI, 0.90-1.04; I²=0%). Procedure time decreased significantly with H-ESD (MD, -18.05; 95% CrI, -27.77 to -8.33 minutes; I²=66.5%). Adverse events (RR, 1.08; 95% CrI, 0.44-2.63) and perforations (RR, 1.05; 95% CrI, 0.34-3.19) were similar between the two procedures.</p><p><strong>Conclusions: </strong>H-ESD matches C-ESD in curative resection while reducing the procedure time, offering a safer and more efficient alternative. Larger RCTs are needed to confirm the long-term benefits.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"754-764"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015675","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":"Real-world computer-aided detection for adenoma detection: promising but context-dependent.","authors":"Yunho Jung","doi":"10.5946/ce.2026.330","DOIUrl":"10.5946/ce.2026.330","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"870-871"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015716","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":"Evolution of lesion capture in duodenal endoscopic mucosal resection.","authors":"Su Jin Kim","doi":"10.5946/ce.2026.327","DOIUrl":"https://doi.org/10.5946/ce.2026.327","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and preliminary evaluation of a novel low-cost endoscopic retrograde cholangiopancreatography simulator with electrocautery training capability: a proof-of-concept study from India.","authors":"Avinash Tiwari, Duncan Khanikar","doi":"10.5946/ce.2025.438","DOIUrl":"10.5946/ce.2025.438","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) requires extensive training, with around 350-400 supervised cases being required for proficiency. Existing simulators face costs, limited availability, and limited realism. Therefore, we developed and preliminarily evaluated a minimal ERCP training model that incorporated electrocautery capabilities.</p><p><strong>Methods: </strong>A five-phase development process was employed, including needs assessment, iterative prototyping with material optimization, technical performance testing across 50 training sessions, comparative analysis against existing simulators, and preliminary expert evaluation by eight experienced endoscopists (mean ERCP experience: 12.3±4.2 years). The primary outcomes included verification of functional capability, cost analysis, durability assessment, and expert ratings on 5-point Likert scales for realism and educational value.</p><p><strong>Results: </strong>The simulator successfully achieved biliary cannulation in 48/50 sessions (96.0%), supported needle knife precut training with functional electrocautery, and demonstrated compatibility with C-arm fluoroscopy, providing adequate contrast visualization. The total material cost per unit was 47.32 United States dollars (USD), compared to 180,000-250,000 USD for commercial virtual reality simulators. The model withstood 50 sessions without structural failure (onion bulb replacement was required every 8.2±1.4 precut attempts). Expert ratings indicated high scores for anatomical realism (4.1±0.6), tactile feedback (3.9±0.7), and educational value (4.4±0.5).</p><p><strong>Conclusions: </strong>This novel, low-cost ERCP simulator demonstrated technical feasibility and face validity. This proof-of-concept requires formal prospective validation studies to establish construct validity, concurrent validity, and educational effectiveness through trainee learning outcomes before conclusions regarding the impact on clinical training can be drawn. The innovation addresses significant accessibility barriers but represents preliminary evidence that requires formal educational validation.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"806-820"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722228","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}