Endoscopy International Open最新文献

{"title":"Perioperative low molecular weight heparin bridging in aortic mechanical heart valve patients undergoing endoscopic procedures.","authors":"Tegvir Singh Grewal, Alejandro Daniel Godoy, Vinai Bhagirath, Ana I Casanegra, Alfonso Tafur, Amelia McNiven Fontani, Atefeh Ghorbanzadeh, Damon E Houghton, Jameel Abdulrehman, Jean-Philippe Galanaud, Luigi D Sordo, Mouza Alnuaimi, Paul R Daniels, Stephanie Carlin, Yama Sadozai, Alan Barkun, James Douketis","doi":"10.1055/a-2840-7302","DOIUrl":"https://doi.org/10.1055/a-2840-7302","url":null,"abstract":"<p><strong>Background and study aims: </strong>Optimal management of anticoagulation for patients with aortic mechanical heart valves (MHVs) receiving vitamin K antagonists (VKAs) undergoing gastrointestinal endoscopic procedures is clinically challenging. Risk of bleeding from an unanticipated polypectomy or biopsy further complicates this issue. Current guidelines on use of bridging with low-molecular-weight heparin (LMWH) for these procedures are based on low-quality evidence.</p><p><strong>Patients and methods: </strong>We conducted a subanalysis of a retrospective, multicenter observational study of adult patients with aortic MHVs receiving VKAs who underwent elective gastrointestinal endoscopies (colonoscopy or upper endoscopy). We included patients who underwent the procedure between July 1, 2020, and July 1, 2023, at five centers in Canada and the United States Patients with procedures performed on separate days within a 30-day period were excluded. Efficacy and safety outcomes included thromboembolic events, major bleeding (MB), and clinically relevant non-major bleeding (CRNMB) in the 30 days post procedure.</p><p><strong>Results: </strong>A total of 192 endoscopic procedures were analyzed. Median (interquartile range [IQR]) patient age was 66 years (58.2-72.8) and 22% were female. Warfarin was interrupted for 185 procedures (96%). Among these, 119 (64%) received LMWH bridging: 33 (17%) pre-procedure only, 10 (5%) post-procedure only, and 76 (40%) both pre- and post-procedure. Post-procedure LMWH was initiated a median (IQR) of 1 day (1-1) and discontinued 5 days post-procedure (3-8). MB occurred in two patients (1%), CRNMB in two patients (1%), and one death (0.5%) was identified; no thromboembolic events occurred. Prior to propensity score matching (PSM), post-procedure LMWH with or without pre procedure LMWH was associated with the composite outcome of MB and CRNMB (P = 0.034), although not with MB or CRNMB individually. After stepwise regression and PSM analyses, no significant differences in bleeding outcomes were observed between patients who received LMWH bridging and those who did not.</p><p><strong>Conclusions: </strong>Our findings indicate that although adverse thrombotic events were rare and use of post-procedure LMWH bridging was significantly associated with a small absolute increased risk of bleeding, it was not significant after PSM. Larger prospective studies are needed to better inform antithrombotic management guidelines for patients with aortic MHVs undergoing gastrointestinal endoscopy.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28407302"},"PeriodicalIF":2.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766049","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":"Exploratory evaluation of magnetic capsule endoscopy with detachable-string for detecting esophageal lesions including early squamous cell carcinoma.","authors":"Haowen Dai, Xinyan Liu, Xi Sun, Xin Wang, Mingjie Zhang, Linghui Duan, Jing Liu, Xin Fan, Hui Su, Shiping Xu, Peng Jin, Jianqiu Sheng","doi":"10.1055/a-2823-7782","DOIUrl":"https://doi.org/10.1055/a-2823-7782","url":null,"abstract":"<p><strong>Background and study aims: </strong>Research regarding utilization of capsule endoscopy for detecting early esophageal squamous cell carcinoma (ESCC) is limited. This study was designed to preliminarily explore diagnostic performance of magnetically controlled capsule endoscopy with a detachable string (DS-MCCE) for detecting early ESCC.</p><p><strong>Patients and methods: </strong>In this retrospective cross-sectional diagnostic study, 496 asymptomatic individuals with high-risk lesions suspicious for early ESCC in esophagus, suspected neoplastic gastric and duodenal lesions, and all ulcers in the upper gastrointestinal tract first underwent DS-MCCE followed by esophagogastroduodenoscopy (EGD) and biopsy within 1 week. Outcomes included diagnostic performance of DS-MCCE for esophageal mucosal lesions and early ESCC, examination time, patient comfort and preference, and safety.</p><p><strong>Results: </strong>DS-MCCE had a sensitivity of 95.36 % (95% confidence interval [CI] 90.32%-97.95%) and specificity of 88.99% (85.08%-91.99%) for detecting esophageal mucosal lesions, whereas for detecting early ESCC, it showed a sensitivity of 66.67% (95% CI 38.38%-88.18%) and specificity of 99.17% (95% CI 97.88%-99.77%). DS-MCCE demonstrated superiority to EGD without sedation in terms of patient comfort, and participants preferred DS-MCCE to EGD. Median examination time was 9.1 minutes. There were no adverse events associated with DS-MCCE.</p><p><strong>Conclusions: </strong>DS-MCCE has potential in detecting early ESCC, mainly for lesions that are larger in size or exhibit pronounced morphological features. These preliminary findings support a further large-sample prospective study and technical refinement.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28237782"},"PeriodicalIF":2.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766032","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":"Use of rebamipide solution as a submucosal injection material to prevent esophageal stricture after endoscopic submucosal dissection: Animal study.","authors":"Yuichiro Hirai, Ai Fujimoto, Motoki Sasaki, Masayuki Shimoda, Naohisa Yahagi","doi":"10.1055/a-2820-3721","DOIUrl":"https://doi.org/10.1055/a-2820-3721","url":null,"abstract":"<p><strong>Background and study aims: </strong>It is desirable to develop a safe, cost-effective, and easy approach to prevent strictures after esophageal endoscopic submucosal dissection (ESD). We explored use of a novel rebamipide solution, an anti-ulcer drug, as a submucosal injection material for preventing esophageal stricture after ESD.</p><p><strong>Methods: </strong>In 15 swine, two half-circumferential ESDs were performed at the proximal and distal ends of the middle thoracic esophagus using 2% rebamipide solution or saline (control) as submucosal injection material. Five swine were sacrificed on postoperative days (PODs) 7, 14, and 21, respectively. Follow-up endoscopy was performed weekly until sacrifice. ESD-related outcomes, degree of stricture, and histological characteristics were evaluated.</p><p><strong>Results: </strong>ESD-related outcomes were similar in both groups, with all post-ESD ulcers epithelialized by POD 14. Mean mucosal constriction rate in the rebamipide and control groups on PODs 14 and 21 were 19.1 ± 7.2% vs. 21.0 ± 6.4% ( <i>P</i> = 0.40) and 13.3 ± 6.8% vs. 20.8 ± 6.1% ( <i>P</i>  = 0.08), respectively. The rebamipide group peaked and showed milder constriction by POD 21, whereas the control group seemed to plateau. Histologically, mean fibrosis thickness in the rebamipide and control groups on days 14 and 21 were 807.0 ± 238.9 µm vs. 972.8 ± 395.1 µm ( <i>P</i>  = 0.40) and 782.8 ± 281.5 µm vs. 1087.0 ± 476.1 µm ( <i>P</i>  = 0.13), respectively.</p><p><strong>Conclusions: </strong>The rebamipide solution showed no statistically significant benefit in preventing post-ESD stricture. However, given the small sample size of this study, further studies are needed to clarify its potential role.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28203721"},"PeriodicalIF":2.3,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766107","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":"Quantitative mechanical profiling of 12 ERCP guidewires: Toward evidence-based device selection.","authors":"Yusuke Saimyo, Reiko Yamada, Takamitsu Tanaka, Kenji Nose, Yasuaki Shimada, Tetsuro Miwata, Minako Urata, Hayato Nakagawa","doi":"10.1055/a-2840-7390","DOIUrl":"https://doi.org/10.1055/a-2840-7390","url":null,"abstract":"<p><strong>Background and study aims: </strong>Numerous guidewires are available for endoscopic retrograde cholangiopancreatography (ERCP) and interventional endoscopic ultrasound (EUS), each with distinct mechanical characteristics. Although individual features such as tip flexibility or shaft stiffness have been studied, no prior research has comprehensively compared multiple guidewires. This study aimed to quantitatively and visually characterize mechanical properties of guidewires using a standardized bench-top evaluation framework.</p><p><strong>Methods: </strong>Twelve guidewires available in Japan were tested. Seven mechanical parameters were assessed: tip load, maximum tip load, front and rear shaft stiffness, torque performance, whip performance, and radiographic visibility. All tests were conducted under standardized conditions using dedicated equipment. Performance scores were normalized (1-10 scale), and radar charts were generated for visualization.</p><p><strong>Results: </strong>Guidewires showed wide variability across parameters. Tip load ranged from 0.026 ± 0.029 to 0.114 ± 0.025 N; maximum tip load from 0.180 ± 0.040 to 0.697 ± 0.059 N. Shaft stiffness ranged from 0 to 0.343 ± 0.006 N (front) and 0.057 ± 0.006 to 0.477 ± 0.006 N (rear). Torque deviation ranged from 19.6 ± 16.7° to 41.0 ± 23.8°; whip performance from 13.5 ± 0.6 to 163.4 ± 77.6 °/sec. Radiographic contrast ranged from 292.7 to 1125.4. Values are mean ± SD unless otherwise stated; radiographic contrast was measured once. Radar chart shapes were classified into four types: bowl, rightward, leftward, and upward. Radar chart visualization revealed distinct mechanical profile patterns among guidewires.</p><p><strong>Conclusions: </strong>This was the first study to provide integrated mechanical profiles of ERCP and EUS guidewires based on standardized bench-top testing. Radar chart visualization offers an intuitive framework for comparing relative mechanical tendencies and may serve as a useful reference for research and education.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28407390"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688849","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":"EUS-HGS with antegrade stenting vs. hepaticogastrostomy alone for malignant biliary drainage: Systematic review and meta-analysis.","authors":"Tawfik Khoury, Wisam Sbeit, Fabien Fumex, Pietro Fusaroli, Graziella Masciangelo, Angelo Bruni, Giovanni Barbara, Andrea Anderloni, Masayuki Kitano, Masahiro Itonaga, Takeshi Ogura, Carlos A Praticò, Rodica Gincul, Sarah Leblanc, Anthony Y B Teoh, Jeremie Jacques, Bertrand Napoleon, Andrea Lisotti","doi":"10.1055/a-2840-6762","DOIUrl":"https://doi.org/10.1055/a-2840-6762","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an effective and safe therapeutic option for biliary drainage in patients with malignant biliary obstruction (MBO). Several authors proposed use of antegrade stenting (AS) combined with EUS-HGS to improve long-term outcomes, with controversial results. We aimed to assess pooled performance of EUS-HGS+AS compared with EUS-HGS alone.</p><p><strong>Methods: </strong>Database search was performed to identify studies comparing EUS-HGS+AS to EUS-HGS alone for biliary drainage in patients with MBO. Primary outcome was recurrent biliary obstruction (RBO). Secondary outcomes were technical, clinical success, adverse events (AEs), severe AEs rate, time to RBO, and overall survival (OS). Relative risks (RRs) with 95% confidence intervals (CIs) were calculated using random-effect model.</p><p><strong>Results: </strong>Five studies involving 555 patients were retrieved. RBO was lower in patients who underwent EUS-HGS+AS (RR 0.30; [0.18-0.49]; <i>P</i> < 0.001). Pooled technical success, clinical success, AE, and severe AE rates were similar (RR 0.94 [0.85-1.05], RR 1.02 [0.94-1.11], RR 0.88 [0.50-1.55]), and 0.26 [0.03-2.22], respectively). Time to RBO was higher in EUS-HGS+AS (SMD + 4.02 [0.57-7.47]; <i>P</i> = 0.04). Mean procedure time was similar among the groups (SMD +0.38 [-0.12-0.87]; <i>P</i> = 0.13) as well as OS was similar in the two groups (SMD 0.18 [-0.20-0.52]; <i>P</i> = 0.85).</p><p><strong>Conclusions: </strong>Combining AS with EUS-HGS reduces RBO risk in patients with MBO, without impact on technical, clinical success rates, or safety profile. Randomized controlled trials are needed to confirm these observations.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28406762"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688873","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":"Reliability and utility of the Toronto Upper Gastrointestinal Cleaning Score for optimizing mucosal visualization during esophagogastroduodenoscopy.","authors":"Alfonso Fernandez-Ramirez, David Aguirre-Villarreal, Ivonne Hurtado-Diaz de Leon, Erick Jasso-Baltazar, Arturo Navarro-Sánchez, Jessica Paola Guerrero-Cabrera, Hiram Noel Tadeo-Espinoza, Guillermo Rosales-Sotomayor, Luis Carlos Chávez García, Berenice M Román-Calleja, Ricardo Ulises Macías-Rodríguez, Sergio A Sánchez-Luna, Rafael Barreto-Zuñiga","doi":"10.1055/a-2781-6570","DOIUrl":"https://doi.org/10.1055/a-2781-6570","url":null,"abstract":"<p><strong>Background and study aims: </strong>Esophagogastroduodenoscopy (EGD) is a key tool for diagnosing upper gastrointestinal lesions, but its accuracy relies on optimal mucosal visualization. Currently, there are few validated instruments to objectively assess mucosal cleanliness. This study aimed to validate the Toronto Upper Gastrointestinal Cleaning Score (TUGCS) and explore its association with lesion detection.</p><p><strong>Patients and methods: </strong>In this prospective, single-center study, 175 patients undergoing diagnostic EGD were enrolled. Interobserver and intraobserver reliability of the TUGCS was assessed using intraclass correlation coefficients (ICCs) among expert and non-expert endoscopists. Secondary outcomes included detection of endoscopic lesions, which were analyzed using multivariate logistic regression adjusted for age, procedure duration, and indication. Additional analyses included Spearman's correlation and z-tests.</p><p><strong>Results: </strong>TUGCS demonstrated excellent interobserver reliability (ICC = 0.95; 95% confidence interval 0.93-0.96) and intra-observer agreement (ICC = 0.896 for non-experts, 0.924 for experts). The score correlated strongly with subjective assessments ( <i>P</i> = 0.68; <i>P</i> < 0.001). Both TUGCS as a continuous variable and TUGCS ≥ 6 were independently associated with increased detection of gastroduodenal findings as a composite outcome, when adjusted for age, sex, simethicone use, and procedure duration.</p><p><strong>Conclusions: </strong>TUGCS is a reliable and reproducible tool across varying levels of endoscopic expertise. Higher scores were associated with improved detection of gastroduodenal pathology, supporting its utility as a quality metric in EGD. Multicenter studies are warranted to validate its role in broader clinical practice.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a27816570"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688883","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":"Music in complex endoscopy: Effect of functional music on sedation requirements during endoscopic ultrasound and ERCP.","authors":"Volker Meves, Alexander Chamieh, Moustafa Mohamed, Hinrich Fehrendt, Christian Meinhardt, Alexander Arlt","doi":"10.1055/a-2840-7071","DOIUrl":"https://doi.org/10.1055/a-2840-7071","url":null,"abstract":"<p><strong>Background and study aims: </strong>Previous studies in esophagogastroduodenoscopy or colonoscopy have demonstrated positive effects of music on patient anxiety and comfort. This study prospectively evaluated the effect of functional music on sedation requirements and satisfaction during complex endoscopic procedures.</p><p><strong>Patients and methods: </strong>A total of 144 patients undergoing endoscopic ultrasound or endoscopic retrograde cholangiopancreatography were prospectively randomized to either a functional music group or a control group without music. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) before the procedure. Sedation depth was monitored with bispectral index (BIS) monitoring. The primary endpoint was the amount of propofol required in mg/kg/min. Secondary endpoints included patient and staff satisfaction.</p><p><strong>Results: </strong>Propofol requirements did not differ significantly between groups (music: 0.15 ± 0.05 mg/kg/min; control: 0.17 ± 0.08 mg/kg/min, <i>P</i> = 0.77). Mean BIS values were similar (music: 60.2 ± 8.4 vs. control: 61.0 ± 8.4, <i>P</i> = 0.74). However, patient satisfaction was markedly higher in the music group (mean value 4.6 ± 0.6 vs. 3.9 ± 0.8, <i>P</i> < 0.00001), as was staff satisfaction (4.8 ± 0.4 vs. 4.1 ± 0.7, <i>P</i> < 0.00001). No adverse events through music intervention occurred. Analysis of PSQI subgroups revealed a trend toward lower propofol use in patients with impaired sleep quality (PSQI > 5) exposed to music, suggesting a possible modulatory effect in this subset.</p><p><strong>Conclusions: </strong>Functional music during complex endoscopic procedures did not reduce propofol consumption but significantly improved satisfaction for both patients and staff. The findings justify implementation of music as a non-pharmacological adjunct to improve patient comfort in endoscopic suites.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28407071"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688832","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":"Impact of acetic acid chromoendoscopy on detection of serrated lesions in the proximal colon compared with white-light endoscopy.","authors":"Fernando José Savóia de Oliveira, Fernando Lander Mota, Eduardo Mendes Alves Pereira Junior, Jarbas Faraco Loureiro, Tomas Navarro-Rodriguez","doi":"10.1055/a-2826-9621","DOIUrl":"https://doi.org/10.1055/a-2826-9621","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colorectal cancer (CRC) screening programs demonstrated a significant reduction in distal CRC mortality. However, similar results are not observed in proximal cancer, probably due to subtle and easily overlooked serrated lesions (SLs) that account for up to 30% of cases. Acetic acid chromoendoscopy may be useful in characterization of SLs. Data on its impact on SL detection rates remain limited. The aim of this study was to assess SL detection rates using high-definition white-light endoscopy (HD-WLE) versus sequential HD-WLE followed by 2% acetic acid chromoendoscopy (AAC) in the proximal colon and to evaluate the association between proximal SL rates and risk factors.</p><p><strong>Patients and methods: </strong>This prospective study included colonoscopies performed at a tertiary care center in patients aged ≥ 18 years between January and July 2021. HD-WLE was followed by HD-WLE with 2% acetic acid chromoendoscopy (AAC). SL detection rates were analyzed using McNemar's test, and risk factors were evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>Four hundred thirty-four patients aged 18 to 82 years underwent both inspection strategies. Among proximal lesions, 60.9% were detected under HD-WLE and 39.1% after AAC ( <i>P</i> < 0.001). Proximal SL detection increased from 36.6% with HD-WLE to 63.4% after AAC ( <i>P</i> = 0.016). After adjustment, hypertension was associated with a higher likelihood of proximal SL detection (odds ratio 2.28; <i>P</i> = 0.032).</p><p><strong>Conclusions: </strong>HD-WLE with sequential application of 2% acetic acid chromoendoscopy was associated with higher proximal SL detection compared with HD-WLE alone. Hypertension was the only risk factor significantly associated with proximal SL detection, within the context of a sequential examination design.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28269621"},"PeriodicalIF":2.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671549","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":"Uncovered versus fully-covered self-expandable metal stents for nonpancreatic cancer: Propensity score-matched, multicenter study.","authors":"Fumitaka Niiya, Tatsunori Satoh, Junichi Kaneko, Kazuma Ishikawa, Naoki Tamai, Masataka Yamawaki, Jun Noda, Tetsushi Azami, Yuichi Takano, Masatsugu Nagahama","doi":"10.1055/a-2803-4179","DOIUrl":"https://doi.org/10.1055/a-2803-4179","url":null,"abstract":"<p><strong>Background and study aims: </strong>The efficacy of uncovered self-expandable metal stents (UCSEMS) compared to that of fully covered self-expandable metal stents (FCSEMS) for distal malignant biliary obstruction (dMBO) is controversial. Studies have highlighted the heterogeneity of disease conditions because pancreatic and nonpancreatic cancers exhibit different clinical courses. This is the first study to specifically compare the safety and efficacy of UCSEMS and FCSEMS for dMBO caused by nonpancreatic cancer.</p><p><strong>Patients and methods: </strong>This retrospective multicenter study included patients who underwent UCSEMS or FCSEMS placement for nonpancreatic cancer-induced dMBO at four centers between January 2010 and April 2024. Propensity score matching (PSM) (1:1) of both groups was performed. Technical and clinical success, adverse events, recurrent biliary obstruction (RBO), time to RBO (TRBO), and overall survival (OS) of these groups were compared.</p><p><strong>Results: </strong>After PSM, 24 patients were included in each group. Technical and clinical success rates and TRBO did not differ significantly between the groups (median TRBO: 311 days [UCSEMS] vs 317 days [FCSEMS]; <i>P</i> = 0.42). Similarly, OS was not significantly different (median OS: 432 days [UCSEMS] vs 190 days [FCSEMS]; <i>P</i> = 0.083). Incidence of pancreatitis after endoscopic retrograde cholangiopancreatography in the UCSEMS group was significantly lower than that in the FCSEMS group (4.2% vs. 33%; <i>P</i> = 0.023).</p><p><strong>Conclusions: </strong>UCSEMS may be safer than FCSEMS for managing dMBO caused by nonpancreatic cancer.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28034179"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671503","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":"Gravity-sensing device for measuring bending angles in digestive endoscopes: Design and clinical evaluation.","authors":"Ming-Yan Luo, Li-Qiu Liu, Zhao-Xia Lun, Chao-Yuan Huang, Xu-Chao Chen, Yuan Huang, Zhao-Li Fu, Chang-Kun Zhou, Hua Yang, Wang Zhang","doi":"10.1055/a-2816-5256","DOIUrl":"https://doi.org/10.1055/a-2816-5256","url":null,"abstract":"<p><p>We developed a novel, gravity-sensing device to measure bending angles of digestive endoscopes, addressing inefficiency and inaccuracy of traditional planar measurement cards. This single-operator tool utilizes a freely rolling ball bearing within a calibrated ring to quantify angles. A multicenter instrument comparison demonstrated that the device significantly improved measurement efficiency and consistency while reducing associated maintenance costs, offering a practical solution for endoscopy unit quality control.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28165256"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671369","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}