Endoscopy International Open最新文献

{"title":"Peroral cholangioscopy for detecting residual stones missed by cholangiography: Systematic review and meta-analysis.","authors":"Marcelo Klotz Dall'Agnol, Mateus Bond Boghossian, André Orsini Ardengh, Ygor Rocha Fernandes, Matheus de Oliveira Veras, Evellin Souza Valentim Dos Santos, Tomazo Antonio Prince Franzini, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura","doi":"10.1055/a-2676-4062","DOIUrl":"10.1055/a-2676-4062","url":null,"abstract":"<p><strong>Background and study aims: </strong>Residual bile duct stones may persist despite negative cholangiographic findings after endoscopic retrograde cholangiopancreatography, increasing risk of recurrence and complications. This systematic review and meta-analysis aimed to determine the detection rate of residual stones identified by peroral cholangioscopy (POC), alongside stone characteristics and baseline patient features.</p><p><strong>Methods: </strong>A comprehensive search was conducted in MEDLINE, Cochrane Library, EMBASE, and LILACS through August 2024. Eligible studies included patients undergoing POC after negative occlusion cholangiography. The primary outcome was the pooled residual stone detection rate. Secondary outcomes included residual stone characteristics, adverse events (AEs), and baseline clinical parameters. Subgroup analysis was performed according to cholangioscopy technique used.</p><p><strong>Results: </strong>Nine studies comprising 485 procedures were included. The pooled residual stone detection rate was 27% (95% confidence interval 23%-31%), with higher detection using digital single-operator cholangioscopy (32%) compared with direct peroral cholangioscopy (25%) and Mother-Baby systems (24%). Residual stones had a mean size of 4.51 mm, with an average of 1.55 stones per positive procedure. Mild AEs occurred in 3% of cases, with no serious complications reported. Baseline characteristics showed an average initial stone size of 12.89 mm, a mean common bile duct diameter of 15.28 mm, and lithotripsy use in 57% of cases.</p><p><strong>Conclusions: </strong>POC identified residual stones in over one-fourth of patients following negative cholangiography. Detection rates were highest with digital systems. The procedure demonstrated a strong safety profile and may play an important role in confirming complete ductal clearance.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26764062"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039460","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":"Push enteroscopy and colonoscopy in melena patients with negative esophagogastroduodenoscopy: Prospective multicenter study.","authors":"Kotchakon Maipang, Julajak Limsrivilai, Chenchira Thongdee, Arunchai Chang, Kamonthip Sukonrut, Onuma Sattayalertyanyong, Manus Rugivarodom, Uayporn Kaosombatwattana, Nonthalee Pausawasdi, Phunchai Charatcharoenwitthaya, Supot Pongprasobchai","doi":"10.1055/a-2676-3957","DOIUrl":"10.1055/a-2676-3957","url":null,"abstract":"<p><strong>Background and study aims: </strong>Proper evaluation of patients with melena, no hematemesis, and nondiagnostic esophagogastroduodenoscopy (EGD) is poorly defined. Guidelines recommend colonoscopy, but the additional diagnostic yield is low. Owing to the high likelihood of proximal small bowel bleeding, push enteroscopy (PE) may be beneficial.</p><p><strong>Patients and methods: </strong>We conducted a prospective, multicenter cohort study from four referral centers. Consecutive patients with melena, no hematemesis, and negative EGD results underwent PE followed by colonoscopy. For patients with culprit lesions found on PE and who were at risk of undergoing colonoscopy, colonoscopy was not performed and results were presumed to be negative. Diagnostic yields of both investigations were compared.</p><p><strong>Results: </strong>Of 221 eligible patients who underwent EGD, 77 (34.8%) with nondiagnostic results were included in the analyses. Mean age of participants was 67.8 years and 51.9% were men. Culprit lesions were identified on PE in 27 of 77 patients (35.0%). Colonoscopy was performed in 59 patients and the source of bleeding was found in 10 patients (12.9%). Diagnostic yield of PE was significantly greater than that of colonoscopy ( <i>P</i> = 0.005). Combining PE and colonoscopy increased diagnostic yield to 48%, which was significantly greater than the yields of PE ( <i>P</i> = 0.002) or colonoscopy ( <i>P</i> < 0.0001) alone.</p><p><strong>Conclusions: </strong>PE is beneficial for patients with melena and nondiagnostic EGD. It should be considered before or in combination with colonoscopy for these patients.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26763957"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039487","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":"Endoscopic papillectomy of major papilla lesions: Single tertiary care center experience.","authors":"Bertrand Napoleon","doi":"10.1055/a-2684-0042","DOIUrl":"10.1055/a-2684-0042","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26840042"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039358","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":"Correction: Direct visualization endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy for management of acute uncomplicated appendicitis.","authors":"Jun-Yu Pan, Hui-Xin Zhi, Jie-Li Chen, Hao-Xin Chen, De-Feng Li, Jun Yao, Li-Sheng Wang","doi":"10.1055/a-2684-7813","DOIUrl":"10.1055/a-2684-7813","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2638-6177.].</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26847813"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947007","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":"Correction: Safety and efficacy of peroral endoscopic myotomy with endoscopic fundoplication compared with POEM alone: International multicenter cohort study.","authors":"Michel Kahaleh, Vera Hapshy, Juan A Alcívar, Jorge Baquerizo-Burgos, Hannah Lukashok, Monica R Gaidhane, Iman Andalib, Amy Tyberg, Avik Sarkar, Haroon Shahid, Abid Allehibi, Resheed Alkhiari, Magda L Rodriguez, Carmen Bautista-Altamirano, Sarbelio Rodriguez, Maria G Porfilio, Mine Carames, Juan Carlos Carames, Amol Bapaye, Carlos Robles-Medranda","doi":"10.1055/a-2685-7125","DOIUrl":"10.1055/a-2685-7125","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2655-6550.].</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26857125"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946991","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":"Evaluation of the clip anchorage technique using mucosal elevation and incision in prevention of esophageal stent migration.","authors":"Anais Darnaude, Maxime Thobois, Philippe Onana Ndong, Cécile Gomercic, James Boulant, Geoffroy Vanbiervliet","doi":"10.1055/a-2663-6533","DOIUrl":"10.1055/a-2663-6533","url":null,"abstract":"<p><strong>Background and study aims: </strong>Migration remains a frequent and challenging situation following esophageal stent placement. The aims of this study were to evaluate efficiency and safety of a new anchorage technique using through-the-scope (TTS) clips to prevent esophageal stent migration.</p><p><strong>Patients and methods: </strong>This was a retrospective case-control analysis of a prospective, monocentric database. Patients with a fully-covered esophageal stent, fixed or not for benign or malignant indications, were included. Fixation of the stent at the oral flange was achieved with TTS clips, placed for a bite in submucosal space after injection with saline and mucosal incision using the tip of a snare.</p><p><strong>Results: </strong>A total of 52 patients were included, 24 stents with anchorage (fixed group) and 28 without (control group). Fixation was more frequently performed for benign disease (75.0% fixed group vs. 39.29% for control, <i>P</i> = 0.021). Median length of stent dwell time was 41.5 days in the fixed group and 30.5 days for controls ( <i>P</i> = 0.263). The overall migration rate was comparable (45.83% in the fixed group vs. 35.71% for controls, <i>P</i> = 0.647). A higher rate of early migration was observed in the control group (60.0% vs 18.18%, <i>P</i> = 0.080). A prior history of radio-chemotherapy was predictive of migration. There was no increased complication rate at placement or at removal in the treated group.</p><p><strong>Conclusions: </strong>The new esophageal stent fixation technique appears to be simple, inexpensive, feasible, and safe. Although there is no impact on overall migration, there does seem to be a reduction in early migration.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26636533"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947224","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":"Efficacy of remimazolam with fentanyl vs midazolam with fentanyl for sedation in screening colonoscopy: Randomized controlled study.","authors":"Andrea C Armbrecht, Bojan Kovacevic, Maria Dyrehave Rasmussen, Michelle Katharina Bernth, Ann Merete Moeller, Peter Vilmann","doi":"10.1055/a-2655-1083","DOIUrl":"10.1055/a-2655-1083","url":null,"abstract":"<p><strong>Background and study aims: </strong>Remimazolam is a new ultra-short-acting benzodiazepine with a favorable safety-profile when used for sedation in endoscopy. The aim of this project was to investigate efficacy of remimazolam with fentanyl compared with midazolam with fentanyl for sedation in colonoscopy among fecal immunochemical test (FIT)-positive screening participants.</p><p><strong>Patients and methods: </strong>The study was a prospective, single-blinded, randomized controlled trial. FIT-positive participants undergoing colonoscopy were randomized to intravenous remimazolam + fentanyl (RF) or midazolam + fentanyl (MF). Primary outcome was total time from start of medication until discharge. Secondary outcomes included time to reach cecum, need for post-procedure recovery, patient-reported pain and satisfaction, need for additional medication, and procedure completion.</p><p><strong>Results: </strong>A total of 205 patients were included and randomized 1:1 (RF:103, MF:102). Mean age was 62.6 years, whereas female/male ratio was 97/108. Mean time from start of medication until discharge was 29.9 minutes (RF) versus 35.0 minutes (MF) (95% confidence interval 0.77-0.94, <i>P</i> = 0.012). Mean time to reach the cecum was 15.4 minutes (RF) compared with 20.2 minutes (MF) ( <i>P</i> = 0.001). Proportion of patients requiring postoperative observation was lower for RF 0.97% vs 9.8% for MF ( <i>P</i> = 0.022). Patients receiving remimazolam reported an average lower pain score (mean 2.25 (RF) vs 3.25 (MF) <i>P</i> = 0.012) and higher overall satisfaction score (4.65 vs 4.33, <i>P</i> = 0.012).</p><p><strong>Conclusions: </strong>This study shows clear superiority of the combination of remimazolam with fentanyl over midazolam with fentanyl for conscious sedation in screening colonoscopy, obtaining shorter procedure time, less postoperative need for observation, lower patient pain scores, and higher patient satisfaction.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26551083"},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947118","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":"Optimal endoscopic resection method based on vertical margin distance for small rectal neuroendocrine tumors: Propensity score-matched study.","authors":"Jianning Liu, Weihua Yu, Peng Liu, Hao Tian, Lihong Gan, Kaige Zhang, Hui Chen, Nian Fang","doi":"10.1055/a-2655-1320","DOIUrl":"10.1055/a-2655-1320","url":null,"abstract":"<p><strong>Background and study aims: </strong>Advanced endoscopic resection methods are recommended for removing rectal neuroendocrine tumors (NETs) < 10 mm, but there is no consensus on optimal endoscopic technique. This study aimed to determine whether endoscopic mucosal resection with ligation (EMR-L) is superior to endoscopic submucosal dissection (ESD) in terms of efficacy and safety, focusing on achieving adequate vertical margin distance.</p><p><strong>Patients and methods: </strong>This dual-center cohort study included consecutive patients with rectal NETs ≤ 10 mm. Adequate vertical margins were exploratively defined as a margin distance exceeding 115 μm, the 25th percentile threshold. Propensity score matching (PSM) was applied to compare outcomes between EMR-L and ESD.</p><p><strong>Results: </strong>The study included 204 rectal NETs from 186 patients, with 61 lesions in each group after PSM. Compared with ESD, the EMR-L group demonstrated a higher R0 resection rate (98.4% vs. 83.6%, <i>P</i> = 0.021), a greater proportion of adequate vertical margins (80.3% vs. 62.3%, <i>P</i> = 0.030), and a lower rate of positive vertical margins (1.6% vs. 13.1%, <i>P</i> = 0.041). Subgroup analysis indicated that lesions ≤ 5 mm without prior biopsy or central depression derived greater benefit from EMR-L. Furthermore, EMR-L was associated with significantly shorter procedure times (median 5.0 vs. 19 minutes) and a markedly lower overall complication rate (8.2% vs. 29.5%, <i>P</i> = 0.005), particularly perforation (3.3% vs. 16.4%, <i>P</i> = 0.028).</p><p><strong>Conclusions: </strong>EMR-L outperforms ESD for small rectal NETs by achieving higher R0 and better vertical margins in shorter times, while minimizing risk of perforation.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26551320"},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947364","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":"Endoscopic papillectomy of major papilla lesions: Single tertiary care center experience.","authors":"Gaurav Suryawanshi, Mohamed Abdallah, Guru Trikudanathan, Stuart K Amateau, Shawn Mallery, Martin Freeman, Nabeel Azeem","doi":"10.1055/a-2663-6291","DOIUrl":"10.1055/a-2663-6291","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic papillectomy (EP) is an effective endoscopic modality for managing ampullary lesions. This study aimed to evaluate predictors for recurrence and adverse events (AEs) in patients who underwent EP for major papilla lesions.</p><p><strong>Patients and methods: </strong>This was a retrospective analysis of all patients who underwent endoscopic snare papillectomy for a major papilla lesion between January 2006 and December 2021. We assessed multiple patient- and procedure-related variables to identify risk factors related to post-EP AEs and lesion recurrence using both univariate and multivariate analysis. In addition, we compared baseline characteristics and outcomes in patients with familial adenomatous polyposis (FAP) vs. sporadic ampullary lesions (SALs).</p><p><strong>Results: </strong>Fifty-one patients (11 FAP) were included in the final analysis. Recurrence was seen in 17 patients (37.0%) among those who followed up after technical success. Complete histological (R0) resection was the only factor associated with no recurrence following EP (odds ratio [OR] 5.4, 95% confidence interval [CI] 1.4-20.8, <i>P</i> = 0.014). PEP was associated with delayed bleeding (OR 7.5, 95% CI 1.2-46.1, <i>P</i> = 0.03). In FAP vs. SAL, lesion size was smaller in FAP: 10 mm (interquartile range 6-15 mm) vs. 15 mm (12-21 mm, <i>P</i> = 0.03) and the en-bloc resection rate was higher (100 vs. 67.5%, <i>P</i> = 0.01). Although the recurrence rate was higher in FAP vs. SAL (55.6 vs. 32.4%, <i>P</i> = 0.2), this was not statistically significant. Rates of AEs were similar.</p><p><strong>Conclusions: </strong>R0 resection was associated with reduced risk of recurrence whereas delayed bleeding after EP is associated with an increased risk of developing PEP. EP is safe and effective for removing ampullary lesions irrespective of lesion type.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26636291"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947249","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":"Beyond the ruler: Measuring what truly matters in endoscopic ultrasound-guided pancreatic cancer genomics.","authors":"Jinyu Wu, Wen Wang, Kuncheng Yang","doi":"10.1055/a-2677-0505","DOIUrl":"10.1055/a-2677-0505","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26770505"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946715","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}