Clinical Endoscopy最新文献_第6页

Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in Japan. 日本一项回顾性研究：水下内镜粘膜切除术结合生理盐水注射突出锚治疗浅表非髓质十二指肠肿瘤的实用性。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-03-12 DOI: 10.5946/ce.2024.181

Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto

{"title":"Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in Japan.","authors":"Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto","doi":"10.5946/ce.2024.181","DOIUrl":"10.5946/ce.2024.181","url":null,"abstract":"Background: Underwater endoscopic mucosal resection (UEMR) is the standard resection method for superficial non-ampullary duodenal tumors (SNADETs). We developed a novel UEMR technique that creates an anchor by protruding the distal fold with a saline injection (UEMR-A). The aim of this study was to clarify the usefulness of UEMR-A compared to conventional UEMR (UEMR-C).Methods: This retrospective observational study included patients who underwent UEMR for SNADETs.Results: A total of 141 patients were included and divided into UEMR-A (n=54) and UEMR-C (n=87) groups. Lesion resection was performed significantly more frequently by an expert endoscopist in the UEMR-C group compared to the UEMR-A group (p<0.001). The procedure time for UEMR-A was significantly shorter than that for UEMR-C (p=0.018), despite the additional time required for submucosal injection. The R0 resection rate was significantly higher in the UEMR-A group than in the UEMR-C group (p=0.004). The horizontal margins were significantly clearer in the UEMR-A group than in the UEMR-C group (p=0.018). Multivariate analysis revealed that the use of UEMR-A was the only significant positive factor for R0 resection.Conclusions: The UEMR-A technique for SNADETs appears to improve R0 resection rates and reduce procedure times compared to the UEMR-C technique.","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"561-568"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604085","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}

引用次数: 0

Successful resection and diagnosis of primary gastric myxoid liposarcoma using endoscopic submucosal dissection. 内镜下粘膜夹层成功切除及诊断原发性胃粘液样脂肪肉瘤。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-03-13 DOI: 10.5946/ce.2024.330

Kimitoshi Kubo, Noriko Kimura

引用次数: 0

Endoscopic approach to indeterminate biliary strictures. 内镜入路确定胆道狭窄。

IF 2.1

Clinical Endoscopy Pub Date : 2025-07-01 DOI: 10.5946/ce.2025.052

Yousuke Nakai, Ryunosuke Hakuta, Yutaka Shimamatsu, Nao Otsuka, Yukiko Takayama

{"title":"Endoscopic approach to indeterminate biliary strictures.","authors":"Yousuke Nakai, Ryunosuke Hakuta, Yutaka Shimamatsu, Nao Otsuka, Yukiko Takayama","doi":"10.5946/ce.2025.052","DOIUrl":"https://doi.org/10.5946/ce.2025.052","url":null,"abstract":"Diagnosis of biliary strictures remains challenging because of the low sensitivity of conventional transpapillary sampling using endoscopic retrograde cholangiopancreatography. New devices and tips have been developed to increase the diagnostic yield of conventional transpapillary sampling. However, additional endoscopic procedures are often necessary for indeterminate biliary strictures. Two major approaches for indeterminate biliary strictures are endoscopic ultrasonography-guided sampling and peroral cholangioscopy (POCS)-guided biopsy. The selection of modalities should be considered based on the stricture location. Although endoscopic ultrasound is the preferred approach for distal biliary strictures, POCS is preferred for perihilar biliary strictures. Endoscopic ultrasonography-guided sampling is highly sensitive in cases with a mass, but the sensitivity of POCS-guided biopsies is unsatisfactory, and discrepancy with the visual diagnosis of POCS is common. Whether these advanced techniques should be performed as the initial procedure or as a rescue after a failed diagnosis by conventional transpapillary sampling needs to be clarified in terms of diagnostic yield and cost-effectiveness.","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526654","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}

引用次数: 0

An unusual cause of acute obstructive suppurative cholangitis. 急性梗阻性化脓性胆管炎的罕见病因。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-07-02 DOI: 10.5946/ce.2025.108

Kohei Iribe, Koji Sawada, Koji Kubo, Mikihiro Fujiya

引用次数: 0

Assessment of endoscopic ultrasound-guided hepaticogastrostomy as a feasible option for preoperative biliary drainage before pancreaticoduodenectomy. 超声内镜引导下肝胃造口术作为胰十二指肠切除术前胆道引流的可行性评估。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-07-28 DOI: 10.5946/ce.2025.177

Mamoru Takenaka, Masatoshi Kudo

引用次数: 0

Computer-aided diagnosis of colorectal polyps: assisted or autonomous? 结直肠息肉的计算机辅助诊断：辅助还是自主？

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-05-22 DOI: 10.5946/ce.2024.338

Yuichi Mori, Cesare Hassan

{"title":"Computer-aided diagnosis of colorectal polyps: assisted or autonomous?","authors":"Yuichi Mori, Cesare Hassan","doi":"10.5946/ce.2024.338","DOIUrl":"10.5946/ce.2024.338","url":null,"abstract":"Computer-aided diagnosis (CADx) in colonoscopy aims to improve the accuracy of diagnosing small polyps; however, its integration into clinical practice remains challenging. Human-artificial intelligence (AI) collaboration, which is expected to enhance optical diagnosis, has shown limited success in clinical trials, with studies indicating no significant improvement in human-only performance. Conversely, autonomous CADx systems that operate independently of clinicians have demonstrated superior diagnostic accuracy in some studies, suggesting their potential for efficiency, consistency, and standardization in healthcare. However, the adoption of autonomous AI raises ethical, legal, and practical concerns such as accountability for errors, loss of clinical context, and clinician or patient distrust. The decision between using CADx as an assistant or as an autonomous system may depend on the clinical scenario. Autonomous systems can standardize routine screening for low-risk patients, whereas assistive systems may complement expertise in complex cases. Regardless of the model used, robust regulatory frameworks and clinician training are essential to ensure safety and maintain trust. Balancing the strengths of AI with the critical role of human judgment is the key to optimizing outcomes and navigating the complex implications of integrating CADx technologies into colonoscopy practice.","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"514-517"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118918","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}

引用次数: 0

Primary endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage prior to pancreatoduodenectomy: a retrospective study in Japan. 在日本进行的一项回顾性研究：在胰十二指肠切除术之前，超声引导下的原发性肝胃造口术用于胆道引流。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-02-11 DOI: 10.5946/ce.2024.218

Nozomi Okuno, Kazuo Hara, Seiji Natsume, Masataka Okuno, Shin Haba, Tomonari Asano, Takamichi Kuwahara, Hiroki Koda, Yasuhiro Shimizu

{"title":"Primary endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage prior to pancreatoduodenectomy: a retrospective study in Japan.","authors":"Nozomi Okuno, Kazuo Hara, Seiji Natsume, Masataka Okuno, Shin Haba, Tomonari Asano, Takamichi Kuwahara, Hiroki Koda, Yasuhiro Shimizu","doi":"10.5946/ce.2024.218","DOIUrl":"10.5946/ce.2024.218","url":null,"abstract":"Background: Malignant lesions of the pancreatic head can cause obstructive jaundice requiring biliary drainage. However, the effect of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and metal stents on surgical resection remains controversial. This study aimed to investigate the efficacy of primary endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) performed prior to pancreatoduodenectomy, excluding patients with biliary duct cancer.Methods: We retrospectively analyzed consecutive patients who underwent pancreatoduodenectomy at our institution between January 2019 and December 2022. The patients were divided into three groups: without biliary drainage (n=130), endoscopic biliary stenting (EBS) (n=57), and primary EUS-HGS (n=20).Results: The positivity rate of the intraoperative bile juice culture was significantly higher in the EBS group (p<0.001). No significant difference was observed among the groups in terms of postoperative adverse events (Clavien-Dindo grade 3 or higher, p=0.784) or the positive rate of peritoneal lavage cytology (p=0.984). Seven patients in the EBS group (12.3%) experienced early adverse events related to biliary drainage (post-ERCP pancreatitis, n=3; acute cholecystitis, n=3; bile duct perforation, n=1), whereas none in the EUS-HGS group experienced adverse events.Conclusions: Primary EUS-HGS is technically feasible as a preoperative procedure and has no short-term postoperative disadvantages.","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"604-611"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405621","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}

引用次数: 0

Efficacy of endoscopic ultrasound-guided biliary drainage of malignant biliary obstruction: a systematic review and meta-analysis of randomized controlled trials. 内镜下超声引导胆道引流治疗恶性胆道梗阻的疗效：随机对照试验的系统回顾和荟萃分析。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-02-24 DOI: 10.5946/ce.2024.183

Yousaf Zafar, Hafsa Azam, Muhammad Abdullah Bin Azhar, Fabeeha Shaheen, Syed Sarmad Javaid, Laila Manzoor, Muaaz Masood, Rajesh Krishnamoorthi

{"title":"Efficacy of endoscopic ultrasound-guided biliary drainage of malignant biliary obstruction: a systematic review and meta-analysis of randomized controlled trials.","authors":"Yousaf Zafar, Hafsa Azam, Muhammad Abdullah Bin Azhar, Fabeeha Shaheen, Syed Sarmad Javaid, Laila Manzoor, Muaaz Masood, Rajesh Krishnamoorthi","doi":"10.5946/ce.2024.183","DOIUrl":"10.5946/ce.2024.183","url":null,"abstract":"Background: Malignant biliary obstruction is a major clinical challenge. We assessed the efficacy of endoscopic ultrasound-guided biliary drainage (EUS-BD) compared with that of endoscopic retrograde cholangiopancreatography biliary drainage (ERCP-BD) or percutaneous transhepatic biliary drainage (PTBD).Methods: We searched for randomized controlled trials comparing EUS-BD with ERCP or PTBD in treating malignant biliary obstruction. Using random-effects models, we synthesized risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs). A subgroup analysis was performed using a comparator (ERCP or PTBD).Results: EUS-BD significantly reduced the risk of stent dysfunction (RR, 0.46; 95% CI, 0.33-0.64), with consistent results in subgroup analysis for ERCP (RR, 0.54; 95% CI, 0.35-0.84) and PTBD (RR, 0.37; 95% CI, 0.22-0.61). It also lowered the risk of post-procedure pancreatitis (RR, 0.24; 95% CI, 0.07-0.83) and reduced tumor ingrowth or overgrowth risk (RR, 0.27; 95% CI, 0.11-0.65), even when compared to ERCP alone (RR, 0.28; 95% CI, 0.11-0.70). EUS-BD demonstrated a lower risk of adverse events compared to PTBD (RR, 0.37; 95% CI, 0.14-0.97) and reduced length of hospital stay (WMD, -1.03; 95% CI, -1.53 to -0.53) when compared to ERCP.Conclusions: EUS-BD outperformed ERCP-BD and PTBD in reducing stent dysfunction, postprocedural pancreatitis, and tumor ingrowth or overgrowth.","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"533-543"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514903","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}

引用次数: 0

Endoscopic ultrasound-guided transrectal drainage of deep pelvic abscesses is safe and effective in children. 超声内镜引导下经直肠引流治疗儿童盆腔深脓肿安全有效。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-04-03 DOI: 10.5946/ce.2024.262

Christopher A Bouvette, Jalal Gondal, Rachel Davis, Alessandra Landmann, Amir Rumman

引用次数: 0

Exploring lumen-apposing metal stents as a novel approach for managing walled-off necrosis in pediatric acute pancreatitis in Indian cohort: a prospective study. 在印度队列中，探索管腔旁置金属支架作为治疗小儿急性胰腺炎壁闭塞性坏死的新方法：一项前瞻性研究。

IF 2.3

Clinical Endoscopy Pub Date : 2025-07-01 Epub Date: 2025-05-29 DOI: 10.5946/ce.2024.315

Varun Mehta, Abhinav Abhinav, Yogesh Kumar Gupta, Manisha Khubber, Ajit Sood, Manjeet Kumar Goyal

{"title":"Exploring lumen-apposing metal stents as a novel approach for managing walled-off necrosis in pediatric acute pancreatitis in Indian cohort: a prospective study.","authors":"Varun Mehta, Abhinav Abhinav, Yogesh Kumar Gupta, Manisha Khubber, Ajit Sood, Manjeet Kumar Goyal","doi":"10.5946/ce.2024.315","DOIUrl":"10.5946/ce.2024.315","url":null,"abstract":"Background: Walled-off necrosis (WON) is a severe complication of acute pancreatitis in children, with limited evidence on its endoscopic management. This study evaluated the efficacy and safety of endoscopic ultrasonography (EUS)-guided lumen-apposing metal stent (LAMS) placement for WON in pediatric patients.Methods: This open-label prospective study included pediatric patients aged 5-18 years with WON secondary to acute necrotizing pancreatitis that was managed with EUS-guided LAMS at a tertiary center from January 2021 to July 2023. Clinical success, defined as symptom resolution and WON clearance at 12 weeks, was the primary outcome. Secondary outcomes included technical success, complications, and the need for additional interventions.Results: Eleven patients (mean age, 15.5±3.1 years) were included. Clinical success was achieved in 90.9% of the patients within 12 weeks, with a 100% technical success rate. Two patients experienced stent occlusions that were managed with saline irrigation; one case required video-assisted retroperitoneal debridement. The mean hospital stay was 5.4±3.3 days. No major adverse events were reported.Conclusions: EUS-guided LAMS placement is a safe and effective alternative to surgery for pediatric WON, with high clinical and technical success rates and minimal complications. Further multicenter studies are required to validate these findings.","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"595-603"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172611","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}

引用次数: 0