Endoscopy International Open最新文献

{"title":"Real-life data about obesity management.","authors":"Jacques Deviere","doi":"10.1055/a-2515-1487","DOIUrl":"10.1055/a-2515-1487","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25151487"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499736","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 grading of gastric intestinal metaplasia using blue light imaging in a low-risk population: Multicenter cross-sectional validation study.","authors":"Marta Rodriguez-Carrasco, Gianluca Esposito, Emanuele Dilaghi, Guido Manfredi, Saverio Alicante, Elisabetta Buscarini, Bruno Annibale, Mário Dinis-Ribeiro","doi":"10.1055/a-2500-3748","DOIUrl":"10.1055/a-2500-3748","url":null,"abstract":"<p><strong>Background study aims: </strong>Detecting gastric intestinal metaplasia (GIM) with white light endoscopy (WLE) remains a challenge and virtual chromoendoscopy methods have been shown to increase accuracy. We aimed to externally validate the Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) using blue light imaging (BLI).</p><p><strong>Methods: </strong>First, the reliability of BLI and the EGGIM score was evaluated through assessment of 90 images divided into three sets of 30. A multicenter cross-sectional study was conducted at two Italian centers involving 102 patients (510 biopsies). Both per-biopsy and per-patient analyses were performed to ascertain accuracy of BLI in detecting and staging GIM (vs. histology).</p><p><strong>Results: </strong>BLI significantly enhanced interobserver agreement of endoscopic diagnosis of GIM, with a Fleiss Kappa of 0.4 (95% confidence interval [CI] 0.3-0.5), compared to 0.2 (95% CI 0.2-0.3) with WLE. Concordance was particularly strong in applying the EGGIM score (weighted Kappa 0.7; 95% CI 0.5-0.9). BLI showed significant improvements in sensitivity over WLE, with an increase observed in both per-biopsy analysis (82%; 95%CI 73.7-89.0 vs. 50%;95% CI 40.6-60.3) and per-patient analysis (96%; 95% CI 84.5-99.4 vs. 68%;95% CI 52.4-81.4). The area under the curve of EGGIM in diagnosing OLGIM III/IV was 0.9 (95% CI 0.8-1.0), confirming EGGIM > 4 being the optimal threshold (sensitivity of 80%, specificity of 88%).</p><p><strong>Conclusions: </strong>Our study validates BLI integrated with the EGGIM system as an effective strategy, highlighting its precision in identifying advanced GIM stages. BLI's notable sensitivity enhances its use as a complementary tool to WLE, significantly improving gastric cancer risk assessment.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25003748"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432451","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":"Digestive endoscopic removal of cocaine pellets: Safety evaluation.","authors":"Alolia Aboikoni, Marion Wallyn, Timothée Bonifay, Piseth Chhorn, Balandougou Sylla, Marthe Alogo A Nwatsok, Alix Becar, Paul Ngock Dime, Thi Thu Nga Nguyen, Alexis Fremery, Lorenzo Garzelli, Houari Aissaoui, Magaly Zappa, Dominique Louvel","doi":"10.1055/a-2507-7812","DOIUrl":"10.1055/a-2507-7812","url":null,"abstract":"<p><strong>Background and study aims: </strong>Removal of cocaine pellets by endoscopy is the subject of much debate, due to the supposed risk of rupture. This study aimed to evaluate the safety of digestive endoscopic removal of cocaine pellets.</p><p><strong>Patients and methods: </strong>This was a single-center, observational, retrospective study conducted at the Cayenne Hospital in French Guiana from July 2015 to May 2023. We included patients in whom digestive endoscopy was performed for delayed evacuation despite conservative treatment defined by persistence of pellets on imaging from the third day of hospitalization. Endoscopy was performed only if the pellets present were at low risk of rupture (type 4 according to the classification by Pidoto in 2002). We collected demographic, imaging, endoscopic and follow-up data.</p><p><strong>Results: </strong>We included 111 patients, 75% of whom were male. Median age was 25 years (range, 20-33). Imaging was performed in 99% of cases. On imaging prior to endoscopy, pellets were found mainly in the stomach (28%), right colon (28%), left colon (30%), and sigmoid (31%). Median time to endoscopy was 3 days (range, 2.5-4). Median number of pellets extracted endoscopically was one (range, 1-4). The material used was mainly endoscopic baskets (60%). No patient presented any per or post-endoscopic complications. No pellets ruptured during extraction. There was no sign of cocaine intoxication during or after endoscopy. The success rate for pellet removal was 92% during the first endoscopy and 100% during the second endoscopy.</p><p><strong>Conclusions: </strong>Endoscopic removal of micro-industrially-produced cocaine pellets seems to be a safe and effective method. Therefore, endoscopy has a place in management of these patients.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25077812"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432516","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 and safety of conservative treatment for colonic diverticular bleeding: Prospective study.","authors":"Hirosato Doi, Masanori Takahashi, Keita Sasajima, Takehiro Yoshii, Ryo Chinzei","doi":"10.1055/a-2509-7426","DOIUrl":"10.1055/a-2509-7426","url":null,"abstract":"<p><strong>Background and study aims: </strong>This prospective study aimed to establish the efficacy and safety of conservative treatment for non-severe cases of colonic diverticular bleeding and to verify whether early colonoscopy is necessary only in limited cases.</p><p><strong>Patients and methods: </strong>Patients who were urgently hospitalized due to hematochezia and were diagnosed with colonic diverticular bleeding were included. During hospitalization, early colonoscopy within 24 hours after admission was performed only when both systolic blood pressure < 90 mm Hg and extravasation on contrast-enhanced computed tomography were observed. However, in patients who failed to recover from hemorrhagic shock, interventional radiology was performed. In other cases, patients received conservative treatment.</p><p><strong>Results: </strong>Of the 172 patients, 15 (8.7%) met the criteria for undergoing early colonoscopy; 12 and three attained successful hemostasis via early colonoscopy and interventional radiology, respectively. Meanwhile, 157 patients received conservative treatment, resulting in spontaneous hemostasis in 148 patients (94.3%). The remaining nine patients required hemostatic intervention. No patient died from bleeding. Between the conservative treatment and the urgent hemostasis groups, the early rebleeding rate within 30 days (14.6% vs. 33.3%, <i>P</i> = 0.0733) and the overall 1-year cumulative rebleeding rate after 30 days of hospitalization (9.2% vs. 23.1%, <i>P</i> = 0.2271) were not significant. In multivariate analyses, only systolic blood pressure and extravasation were associated with a requirement for hemostatic intervention in 24 patients. Moreover, multivariate analyses showed that a history of diverticular bleeding, undergoing hemodialysis, or use of oral thienopyridine were significantly associated with late rebleeding.</p><p><strong>Conclusions: </strong>Conservative treatment for non-severe colonic diverticular bleeding is appropriate and efficient.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097426"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499752","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 hemostasis with a self-expandable metal stent as bridge therapy for hemobilia.","authors":"Junyeol Kim, Jin Ho Choi, Tae Seung Lee, Myeong Hwan Lee, In Rae Cho, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim, Sang Hyub Lee","doi":"10.1055/a-2480-7065","DOIUrl":"10.1055/a-2480-7065","url":null,"abstract":"<p><strong>Background and study aims: </strong>Management of hemobilia is often challenging. Recently, endoscopic hemostasis with a self-expandable metal stent (SEMS) has shown promising efficacy for controlling bleeding at the endoscopic sphincterotomy site. This study aimed to assess efficacy and feasibility of endoscopic hemostasis as bridge therapy for hemobilia.</p><p><strong>Patients and methods: </strong>Patients with hemobilia between 2008 and 2023 were retrospectively reviewed. We compared efficacy of hemostasis between the initial endoscopic hemostasis group (ENDO group) and the initial angiographic embolization group (EMBO group). The primary outcome was initial hemostasis success rate and the secondary outcomes were delayed bleeding rate, subsequent embolization rate, 28-day mortality, transfusion amount, time to first hemostasis, total hemobilia time, and incidence of hypovolemic shock.</p><p><strong>Results: </strong>A total of 26 patients with hemobilia were included in this study and 17 patients (65.4%) were identified as the ENDO group and nine patients (34.6%) were classified as the EMBO group. The success rate of initial hemostasis was 88.2% (15/17) in the ENDO group and 100% (9/9) in the EMBO group ( <i>P</i> = 0.529). The rate of delayed bleeding in the ENDO group was 17.6% (3/17) and 0.0% (0/9) in the EMBO group ( <i>P</i> = 0.529). Total hemobilia time was shorter in the ENDO group than in the EMBO group (mean: 281.5 ± 1022.4 minutes vs. 5002.8 ± 7982.6 minutes; <i>P</i> < 0.001) Stent insertion depth was associated with successful hemostasis without delayed bleeding. ( <i>P</i> = 0.015).</p><p><strong>Conclusions: </strong>Endoscopic hemostasis using SEMS for hemobilia appeared to be a feasible bridge therapy.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24807065"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432030","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 submucosal dissection for proximal colonic lesions: An effective therapeutic option.","authors":"Ludovico Alfarone, Roberta Maselli, Cesare Hassan, Paola Spaggiari, Marco Spadaccini, Antonio Capogreco, Davide Massimi, Roberto De Sire, Elisabetta Mastrorocco, Alessandro Repici","doi":"10.1055/a-2443-1609","DOIUrl":"10.1055/a-2443-1609","url":null,"abstract":"<p><strong>Background and study aims: </strong>Due to the greater risks of adverse events (AEs) and the lower rate of submucosal invasive cancer (SMIC), large proximal colonic polyps are frequently treated by piecemeal endoscopic mucosal resection (EMR) in the West. However, this implies the risk of surgery to radicalize non-curative endoscopic resection in case of early colorectal cancer (CRC). We evaluated procedure outcomes in patients undergoing ESD for proximal colonic lesions at risk of SMIC.</p><p><strong>Patients and methods: </strong>All consecutive patients with lesions at risk of SMIC proximal to splenic flexure referred for ESD at a tertiary center were prospectively included from 2019 to 2021. En bloc, R0, and curative resection rates were primary outcomes, while length of hospitalization, AEs, need for surgery due to AEs, and recurrence rates were secondary outcomes.</p><p><strong>Results: </strong>A total of 116 patients (mean age: 68.4±10.91 years; men: 69.8%) were included. En bloc, R0, and curative resection rates were 84.5%, 78.4%, and 72.4%, respectively. T1 adenocarcinoma was reported in 25% of lesions (29/116). Eleven patients (9.5%) underwent secondary surgery due to non-curative resections; residual disease was found in one patient. Most frequent AE was intra-procedural perforation (9.9%); no AE required surgery. Median follow-up was 36 months; three of 97 recurrences (3.1%) at 6 months and one of 85 recurrence (1.2%) at 36 months were reported, which were all endoscopically treated.</p><p><strong>Conclusions: </strong>In expert hands, ESD is effective and safe for proximal colonic lesions at risk of SMIC for the favorable balance between risk of AEs and benefit of avoiding unnecessary surgery, even for early CRC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24431609"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662690","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":"Predictive factors for long-term patency in duodenal stenting for malignant gastric outlet obstruction.","authors":"David Razzaz, Stefan Linder, Alexander Waldthaler, Marcus Holmberg, Poya Ghorbani","doi":"10.1055/a-2487-2722","DOIUrl":"10.1055/a-2487-2722","url":null,"abstract":"<p><strong>Background and study aims: </strong>Malignant gastric outlet obstruction (GOO) occurs often late during disseminated disease, requiring palliation. Placement of duodenal self-expandable metal stents (SEMS) is a common method for relieving malignant GOO but recurrent obstruction is common, warranting reintervention. The aim of the present study was to identify predictive factors for stent patency at 3 months and survival. Also, stent patency rate and adverse events after duodenal stenting were analyzed.</p><p><strong>Patients and methods: </strong>This was a retrospective observational single-center study including all patients with malignant GOO receiving duodenal SEMS for palliation (2008-2021). Logistic regression for stent patency (3 months) and Cox regression for survival were undertaken.</p><p><strong>Results: </strong>Overall, 198 patients were included. The most common malignancies were pancreatic adenocarcinoma (40%), gastric adenocarcinoma (18%), and cholangiocarcinoma (13%). Uncovered SEMS were used in 88% of patients and the reintervention rate was 44%. The stent patency rate was 63% in 188 patients with clinical success. Predictors of stent patency at 3 months were jaundice, semi- or fully-covered stents, and chemotherapy prior to stenting. Median survival was 81 days (interquartile range 40-241) after stenting. In Cox regression, predictors for overall survival at 6 months were absence of jaundice and stent patency at 3 months. Stent dysfunction was the most common cause of reintervention and was managed by repeated stent (76%) or dilation (11%).</p><p><strong>Conclusions: </strong>Treatment of malignant GOO with duodenal SEMS is effective but the reintervention rate is high. Predictors of stent patency were jaundice, semi- or fully-covered SEMS, and chemotherapy. Survival was impaired by jaundice and stent dysfunction.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24872722"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432632","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":"On-site ERCP availability and cholangitis outcomes: Retrospective cohort study.","authors":"Rishad Khan, Kayley-Jasmin Marchena-Romero, Marwa F Ismail, Surain B Roberts, Nikko Gimpaya, Michael A Scaffidi, Nasruddin Sabrie, Kareem Khalaf, Jeffrey Mosko, Paul James, Nauzer Forbes, Fahad Razak, Amol A Verma, Samir C Grover","doi":"10.1055/a-2494-7333","DOIUrl":"10.1055/a-2494-7333","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is important in acute cholangitis (AC) management but is not available at all hospitals. The association between on-site ERCP availability and cholangitis outcomes is unknown.</p><p><strong>Patients and methods: </strong>We included adults diagnosed with AC at 27 hospitals in Ontario through the GEMINI network. We collected data on demographics, clinical and laboratory values, and interventions. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay, intensive care unit (ICU) admission, readmission rates, and requirement for percutaneous or surgical decompression. We used multivariable regression analyses to assess the impact of on-site ERCP availability on the primary and secondary outcomes with adjustment for relevant variables.</p><p><strong>Results: </strong>Our cohort included 4492 patients with a median age of 75. Patients at ERCP sites had higher unadjusted rates of undergoing ERCP (55.7% at ERCP sites, 40.8% at non-ERCP sites). Patients at ERCP sites compared with non-ERCP sites did not have significantly different in-hospital mortality (adjusted odds ratio [aOR] = 2.19, 95% confidence interval [CI] = 0.86-5.55). Compared with non-ERCP sites, patients at ERCP sites with underlying stricturing biliary disease or pancreaticobiliary malignancy (aOR = 1.94, 95% CI = 1.14-13.58) or severe cholangitis (aOR = 2.17, 95% CI = 1.17-4.02) had higher odds of in-hospital mortality. In a post-hoc propensity score-based analysis, there was no significant difference between patients at ERCP sites compared with those at non-ERCP sites for in-hospital mortality.</p><p><strong>Conclusions: </strong>Patients at ERCP sites compared with non-ERCP sites did not have significantly different mortality. Subgroups of patients with underlying stricturing biliary disease or pancreaticobiliary malignancy and severe cholangitis, who have higher mortality at ERCP sites, warrant further study.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24947333"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432444","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":"Improved outcomes of endoscopic treatment for delayed perforation following endoscopic submucosal dissection for gastric epithelial neoplasms.","authors":"Daiki Kitagawa, Noriya Uedo, Noboru Hanaoka, Takashi Kanesaka, Yasuhiro Tani, Yuki Okubo, Yuya Asada, Tomoya Ueda, Atsuko Kizawa, Takehiro Ninomiya, Yoshiaki Ando, Gentaro Tanabe, Yuta Fujimoto, Mori Hitoshi, Minoru Kato, Shunsuke Yoshii, Satoki Shichijo, Sachiko Yamamoto, Koji Higashino, Tomoki Michida, Ryu Ishihara, Yasuhiro Fujiwara","doi":"10.1055/a-2451-7835","DOIUrl":"10.1055/a-2451-7835","url":null,"abstract":"<p><strong>Background and study aims: </strong>Emergency surgery is usually required for patients with delayed perforation after gastric endoscopic submucosal dissection (ESD); however, cases of successful endoscopic treatment recently have been reported. Here, we elucidated the usefulness of endoscopic intervention for patients with delayed perforation.</p><p><strong>Patients and methods: </strong>Patients who underwent gastric ESD from 2005 to 2022 were assessed for eligibility. Delayed perforation was defined as no intraprocedural perforation after the ESD but subsequent development of peritoneal irritation and free air on computed tomography scan. Participants were divided into early- and late-period groups based on time (October 2015) of implementation of the polyglycolic acid (PGA) sheet and the over-the-scope clip (OTSC) in clinical practice. We evaluated changes in incidence of required surgery.</p><p><strong>Results: </strong>Among the 5,048 patients who underwent gastric ESD, delayed perforation occurred in 28 patients (0.6%, 95% confidence interval [CI] 0.4%-0.8%). Incidence of delayed perforation did not differ significantly between the early- and late-period groups (0.5% vs. 0.6%). The proportion of patients who underwent surgery was significantly smaller in the late-period group than in the early-period group (54% vs. 13%, odds ratio [OR] 0.14, 95% CI 0.02-0.83; <i>P</i> = 0.042); this was confirmed by multivariate analysis (adjusted OR 0.04, 95% CI 0.002-0.9; <i>P</i> = 0.043) after adjustment for age, sex, Charlson's comorbidity index, tumor location, and size.</p><p><strong>Conclusions: </strong>Endoscopic intervention using PGA sheets and OTSC was associated with a low incidence of required surgery for delayed perforation after gastric ESD and is recommended.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24517835"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432501","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-guided gallbladder drainage vs dual stent transpapillary gallbladder drainage for management of acute cholecystitis.","authors":"Dhruval Amin, Katherine M Cooper, Prashanth Rau, Lea Sayegh, Nouran Mostafa, Ikechukwu Achebe, Zachary DeVore, Daniella Gonzalez, Stephanie Stephanie, Jaroslav Zivny, Savant Mehta, Christopher Marshall, Navine Nasser-Ghodsi, Andrew C Storm, Neil B Marya","doi":"10.1055/a-2509-7076","DOIUrl":"10.1055/a-2509-7076","url":null,"abstract":"<p><strong>Background and study aims: </strong>Cholecystectomy (CCY) is the standard treatment for acute cholecystitis. For non-surgical patients, percutaneous cholecystostomy tube (PT-GBD) is recommended but is associated with high readmission rates and poor quality of life. Endoscopic gallbladder decompression techniques, including endoscopic transpapillary gallbladder drainage (ET-GBD) and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD), are alternatives. Studies comparing ET-GBD and EUS-GBD have shown EUS-GBD to have superior outcomes. However, these studies assessed ET-GBD mostly via single transcystic stent placement (SSET-GBD). This study aimed to compare outcomes of dual transcystic stents (DSET-GBD) and EUS-GBD in non-surgical candidates with acute cholecystitis.</p><p><strong>Patients and methods: </strong>A multicenter analysis was conducted on patients who underwent ET-GBD or EUS-GBD between January 2019 and January 2023. Data were extracted from electronic medical records and outcomes including technical success, success, adverse events (AEs), and recurrence rates of cholecystitis were measured.</p><p><strong>Results: </strong>Of 129 procedures (56 EUS-GBD; 73 ET-GBD), technical success was achieved in 87.5% of EUS-GBD and 86.3% of ET-GBD attempts. Immediate clinical success was achieved in 98.1% for EUS-GBD and 100% for DSET-GBD. AE rates were similar between the groups. Recurrent cholecystitis rates were 5.3% for EUS-GBD and 8.2% for DSET-GBD ( <i>P</i> = 0.692).</p><p><strong>Conclusions: </strong>This study demonstrates that DSET-GBD has similarly low rates of recurrent acute cholecystitis compared with EUS-GBD. DSET-GBD should be considered as an alternative management strategy for management of acute cholecystitis in patients who are unable to undergo CCY.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097076"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499791","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}