Endoscopy最新文献

{"title":"Predictors of clinical success in endoscopic ultrasound-guided drainage of postoperative pancreatic fluid collections.","authors":"Hanne Hellinckx, Michiel Bronswijk, Gitte Aabye Olsen, Giuseppe Vanella, Hanna Peeters, Marie-Anne Noreillie, Francesco Frigo, Roberto Leone, Hannah van Malenstein, Wim Laleman, Rogier Voermans, Paolo Giorgio Arcidiacono, Halit Topal, Baki Topal, Roy L J van Wanrooij, Schalk Van der Merwe","doi":"10.1055/a-2975-4821","DOIUrl":"https://doi.org/10.1055/a-2975-4821","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic ultrasound (EUS)-guided drainage is increasingly used for the management of postoperative pancreatic fluid collections (POPFC). We aimed to identify factors associated with clinical success, and to perform exploratory analyses of outcomes stratified by surgery type and stent type.</p><p><strong>Patients and methods: </strong>We performed a retrospective multicenter cohort study including patients who underwent EUS-guided drainage of POPFC following pancreatic surgery between 2014 and August 2024 at three academic centers. The primary outcome was clinical success, defined as combined radiological and clinical resolution without the need for percutaneous or surgical step-up intervention.</p><p><strong>Results: </strong>A total of 265 patients were included (mean age 64±14 years; 57% male; 52% underwent drainage ≤14 days after surgery, necrotic component in 51%). Clinical success was achieved in 194 patients (73%; 95% CI 67.5-78.1%), including 160 (60%; 95% CI 54.5-66.3%) after a single procedure and 34 after additional endoscopic reinterventions, while 20 patients (7.6%; 95% CI 4.4-10.7%) required percutaneous or surgical step-up. Distal pancreatectomy, compared with pancreaticoduodenectomy, was associated with a higher rate of reintervention (32% vs. 20%, p=0.02) and independently associated with lower odds of clinical success (odds ratio 0.53, 95% confidence interval 0.29-0.98; p=0.04).</p><p><strong>Conclusions: </strong>EUS-guided drainage for POPFC appears effective, with an acceptable safety profile in expert centers, achieving clinical resolution in the majority of patients. Distal pancreatectomy was associated with a more complex treatment course. These findings support the use of EUS-guided drainage as a central component in the management of POPFC.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid versus slow puncture in endoscopic ultrasound-guided liver biopsy: a multicenter randomized crossover trial.","authors":"Ying Wu, Ying Qu, Wen Wen, Ni Xie, Guanhao Su, Kai Xu, Jianbo Ni, Kui Peng, Lungen Lu, Xin Zeng, Hongtan Chen, Baiwen Li","doi":"10.1055/a-2957-0455","DOIUrl":"https://doi.org/10.1055/a-2957-0455","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound-guided liver biopsy (EUS-LB) is increasingly used for hepatic histologic assessment; however, optimal technical approaches remain undefined. This prospective, multicenter clinical study aimed to compare tissue acquisition and safety between the rapid and slow puncture techniques for EUS-LB.</p><p><strong>Methods: </strong>This was a multicenter randomized crossover study. Patients undergoing EUS-LB were randomized to receive both rapid puncture and slow puncture techniques in alternating sequence during the same session. The primary outcomes were the number of complete portal tracts (CPTs) and total specimen length (TSL). The secondary outcomes were diagnostic adequacy and adverse events. Linear mixed models and generalized linear mixed models were used to evaluate the technical performance.</p><p><strong>Results: </strong>A total of 62 specimens were analyzed. Compared with the conventional slow puncture technique, rapid puncture significantly increased CPTs (mean difference 2.39; 95%CI 1.50-3.27), as well as TSL (mean difference 15.19 mm; 95%CI 9.65-20.74), with corresponding improvements in diagnostic adequacy (odds ratio 16.27, 95%CI 2.41-109.97). Time period and center were not statistically significantly associated with the outcomes. No severe adverse events were reported.</p><p><strong>Conclusion: </strong>The modified rapid puncture technique was associated with improved specimen quality in EUS-LB. These findings support its potential utility in clinical practice; however, further validation in larger and more diverse populations is warranted.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-endoscopy upper gastrointestinal cancer in a United States multicenter cohort: site- and risk-stratified trends and survival.","authors":"Butros Fakhoury, Vinay Jahagirdar, Sachin Srinivasan, Leandro Sierra, Pojsakorn Danpanichkul, Krishan S Patel, Cesare Hassan, Leo Alexandre, Nirav Thosani, Nigel Trudgill, Prateek Sharma, Madhav Desai","doi":"10.1055/a-2948-3126","DOIUrl":"10.1055/a-2948-3126","url":null,"abstract":"<p><strong>Background: </strong>Post-endoscopy upper gastrointestinal cancer (PEUGIC) is an emerging quality metric, but varying definitions complicate benchmarking. We characterized PEUGIC rates and outcomes by anatomic site and coded high-risk condition (HRC) status in a large US cohort.</p><p><strong>Methods: </strong>This was a retrospective cancer-first cohort study of 14 814 patients with upper gastrointestinal cancer (UGIC) from a multicenter database (2016-2024). Index endoscopy-detected UGIC was diagnosed within 6 months of esophagogastroduodenoscopy. PEUGIC was defined as UGIC diagnosed 6-36 months after a nondiagnostic esophagogastroduodenoscopy. The primary outcome was PEUGIC rate by cancer type and HRC status. Secondary outcomes included 3-year overall survival.</p><p><strong>Results: </strong>The overall PEUGIC rate was 9.4% (esophageal cancer 9.6%, gastric cancer 8.6%, duodenal cancer 10.7%). Rates were higher with HRC (18.2%) than without HRC (5.0%; P < 0.001). PEUGIC rate without HRC plateaued (4.0%-5.1% in 2022-2024), while PEUGIC rate with HRC for esophageal cancer (16.8%) and gastric cancer (14.4%) decreased over time. In exploratory analysis, PEUGIC was associated with better survival vs. index endoscopy-detected UGIC for esophageal cancer (adjusted hazard ratio [aHR] 0.82, 95%CI 0.67-0.99) and gastric cancer (aHR 0.77, 0.62-0.96), and PEUGIC with HRC was associated with lower mortality vs. PEUGIC without HRC for esophageal cancer (aHR 0.51, 0.36-0.74) and gastric cancer (aHR 0.50, 0.34-0.73).</p><p><strong>Conclusions: </strong>1 in 10 UGIC patients had a prior nondiagnostic endoscopy within 3 years. PEUGIC rates varied by anatomic site and HRC status, suggesting site- and HRC-stratified benchmarks may better capture endoscopic performance than aggregate metrics.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of different computer-aided detection products in colonoscopy: a network meta-analysis of randomized controlled trials.","authors":"Marcello Maida, Giulio Calabrese, Louis H S Lau, Zhouyao Qian, Alessandro Vitello, Giovanni Marasco, Luigi Colecchia, Sandro Sferrazza, Antonio Facciorusso, Cesare Hassan","doi":"10.1055/a-2936-2838","DOIUrl":"10.1055/a-2936-2838","url":null,"abstract":"<p><strong>Background: </strong>Multiple computer-aided detection (CADe) systems have been developed to improve adenoma detection during colonoscopy, but their comparative efficacy and consistency of effect remain uncertain. This network meta-analysis aimed to compare the efficacy of different CADe systems across multiple detection outcomes.</p><p><strong>Methods: </strong>MEDLINE, Embase, Scopus, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing CADe-assisted colonoscopy versus colonoscopy without CADe or other CADe systems. The primary outcome was the adenoma detection rate (ADR). Secondary outcomes were adenomas per colonoscopy (APC) and the adenoma miss rate (AMR). A random-effects network meta-analysis was performed to synthesize direct and indirect evidence.</p><p><strong>Results: </strong>41 RCTs (31 789 patients; 14 CADe systems) were included. In the exploratory complete-network analysis, 10/14 systems significantly improved ADR (risk ratio [RR] 1.14-1.76), nine increased APC, and three reduced the AMR. In the FDA-cleared systems analysis, 3/6 improved ADR (RR 1.14-1.25), whereas three did not. Several systems retained a significant benefit in studies meeting the control-arm ADR thresholds recommended by ESGE (≥25%) and ASGE/ACG (≥35%), although effects varied across platforms and attenuation at higher baseline ADR was not uniform. Baseline ADR was not associated with treatment effects on meta-regression.</p><p><strong>Conclusions: </strong>The effectiveness of CADe-assisted colonoscopy is not uniform across platforms and varies according to the specific product. These findings support a system-specific rather than class-based evaluation of CADe technologies. However, comparative estimates should be interpreted cautiously given the low certainty of evidence for several outcomes and the absence of head-to-head comparisons and closed loops within the network.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic duodenal injection of autologous stromal vascular fraction in type 2 diabetes: a pilot clinical study of safety, feasibility, and preliminary metabolic effects.","authors":"Manoel Galvão Neto, Flavio Fontes Pirozzi, Marília Wellichan Mancini, Luciana Almeida-Lopes, Patricio Centurion, Luiz Gustavo de Quadros","doi":"10.1055/a-2955-8663","DOIUrl":"https://doi.org/10.1055/a-2955-8663","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of metachronous esophageal squamous cell carcinoma after endoscopic submucosal dissection in patients with multiple Lugol-voiding lesions: a long-term study.","authors":"Yosuke Kishi, Yusuke Horiuchi, Wataru Kurihara, Chika Fukuyama, Hiroyuki Yamamoto, Toshiaki Hirasawa, Akiyoshi Ishiyama, Takahisa Matsuda, Toshiyuki Yoshio","doi":"10.1055/a-2948-9340","DOIUrl":"https://doi.org/10.1055/a-2948-9340","url":null,"abstract":"<p><strong>Background: </strong>Multiple Lugol-voiding lesions (LVLs) confer a high risk of metachronous multiple esophageal squamous cell carcinomas (ESCCs) after endoscopic submucosal dissection (ESD); however, risk heterogeneity within this high-risk group remains unclear. Precise stratification could help optimize the surveillance intensity and reduce the burden of Lugol chromoendoscopy. We aimed to identify risk factors for metachronous multiple ESCCs among patients with multiple LVLs and to explore practical risk stratification.</p><p><strong>Methods: </strong>This single-center retrospective exploratory cohort study included patients who underwent initial ESD for superficial ESCC between 2014 and 2022 and had grade C LVLs, defined as ≥10 LVLs per endoscopic field of view. Grade C LVLs were subclassified by LVL counts as subgrade α (10-20), β (21-30), and γ (≥31).</p><p><strong>Results: </strong>Among 331 patients (median follow-up 57 months), 163 (49.2%) developed metachronous multiple ESCCs; the 5-year cumulative incidence was 55.2% (95%CI 48.8-61.7). In multivariable analysis, positive flushing response (hazard ratio [HR] 1.59, 95%CI 1.10-2.31) and subgrade γ (HR 5.34 vs. α, 95%CI 2.36-12.1) were independently associated with increased risk. Subgrade γ showed higher 5-year incidence than subgrade α/β among both flushing-positive (71.4% vs. 27.2%; P < 0.001) and flushing-negative (57.5% vs. 16.9%; P = 0.004) patients. No confirmed ESCC-related deaths occurred during follow-up.</p><p><strong>Conclusions: </strong>Within grade C LVLs, subgrade γ and flushing positivity were associated with an increased risk of metachronous multiple ESCCs. Combining LVL subclassification and flushing status may provide clinically relevant risk stratification and may help inform risk-adapted surveillance after ESD.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of endoscopic ultrasound in cholangiocarcinoma staging: a systematic review and meta-analysis.","authors":"Nasruddin Sabrie, Michael Youssef, Yibing Ruan, Marcus Vaska, Samir C Grover, Paul D James, Nauzer Forbes, Vinay Chandrasekhara, Lydi M J W van Driel, David M de Jong, Rishad Khan","doi":"10.1055/a-2944-4167","DOIUrl":"10.1055/a-2944-4167","url":null,"abstract":"<p><strong>Background: </strong>Accurate staging is crucial for managing cholangiocarcinoma (CCA). Endoscopic ultrasound with tissue acquisition (EUS-TA) may enhance cross-sectional imaging-based staging; however, the impact of EUS on CCA management decision-making is unclear.</p><p><strong>Methods: </strong>6 electronic databases were searched through to 10 July 2025 for studies on EUS-TA in staging CCA cases eligible for surgical resection or liver transplantation. The primary outcome was the pooled proportion of patients excluded from curative-intent surgery based on the EUS findings, which included newly detected findings and confirmation by EUS-TA of cross-sectional imaging findings. Secondary outcomes included the pooled incremental benefit of EUS (IBEUS) over cross-sectional imaging and EUS-specific adverse events. The IBEUS was defined as the proportion of patients with malignant lymph nodes identified by EUS-TA but not by cross-sectional imaging, relative to all patients who underwent cross-sectional imaging.</p><p><strong>Results: </strong>9 studies with 831 patients were included. The rate of exclusion from curative-intent surgery based on EUS findings was 10% overall (95%CI 6%-18%; 9 studies), 7% for perihilar CCA (pCCA; 95%CI 2%-19%; 5 studies), 10% for those planned for resection (95%CI 4%-22%; 5 studies), and 8% for those planned for transplantation (95%CI 3%-22%; 3 studies). The pooled IBEUS was 3% (95%CI 1%-10%; 5 studies) overall, 4% (95%CI 1%-17%; 3 studies) for pCCA, 1% (95%CI 0%-3%; 2 studies) in patients intended for operative resection, and 7% (95%CI 1%-26%; 2 studies) in those intended for transplantation.</p><p><strong>Conclusion: </strong>EUS may impact CCA staging and support treatment decisions.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambient green lighting during ERCP.","authors":"Daryl Ramai, David Jonason, Andrew Fuller, Abdulrahman Qatomah, Baylee Barnes, Christopher C Thompson","doi":"10.1055/a-2963-2239","DOIUrl":"https://doi.org/10.1055/a-2963-2239","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in endoscopy: a call for joint leadership between ESGE and Endoscopy.","authors":"Yuichi Mori, Cesare Hassan, Jacques J G H M Bergman","doi":"10.1055/a-2954-8396","DOIUrl":"https://doi.org/10.1055/a-2954-8396","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term risk of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric cancer.","authors":"Jong Sun Park, Eunyoung Angela Lee, Ji Hyun Park, Bumhee Park, Jong Hoon Park, Min Jae Yang, Sun Gyo Lim, Sung Jae Shin, Sung Soo Ahn, Gil Ho Lee, Choong-Kyun Noh","doi":"10.1055/a-2936-0365","DOIUrl":"10.1055/a-2936-0365","url":null,"abstract":"<p><strong>Background: </strong>There is currently no consensus on long-term risk stratification for metachronous gastric neoplasms (MGNs) occurring beyond 5 years following endoscopic submucosal dissection (ESD). This study aimed to investigate the time-dependent changes in predictive factors for MGN after curative ESD for early gastric cancer (EGC) and analyze the clinicopathological features of late MGNs.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent ESD for early gastric neoplasms between March 2005 and June 2020. MGN was defined as a new gastric neoplasm detected at a different site >12 months after ESD. Survival data were collected and analyzed using multivariable and time-split Cox hazard regression models.</p><p><strong>Results: </strong>Among 5571 patients treated with ESD, 876 were included, with a median follow-up of 58 months. The cumulative incidence of MGN was 10.8% at 5 years and continued to accumulate beyond 5 years (26.7% at 10 years). All MGNs were stage I and there was no gastric cancer-related mortality. Cox regression analysis identified family history of gastric cancer (adjusted hazard ratio [aHR] 2.12, 95%CI 1.32-3.41) and extensive intestinal metaplasia (aHR 6.50, 95%CI 3.73-11.36) as independent predictors of MGN. Histological upgrade was not associated with MGN during the first 5 years, but emerged as a significant risk factor in the late period (interaction <i>P</i> = 0.005).</p><p><strong>Conclusion: </strong>MGNs may develop even beyond 5 years following ESD with curative resection in patients with EGC. These findings highlight the long-term risk of MGN after ESD, providing a framework for clinical risk estimation.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}