Endoscopy International Open最新文献

{"title":"Safety of surveillance endoscopy and EUS of the esophagus after neoadjuvant chemoradiotherapy: Results from the (pre)SANO trial.","authors":"Sanjiv S G Gangaram Panday, Low Kuan Yean, Tanya M Bisseling, Wouter L Curvers, Jolanda M van Dieren, Rutger Quispel, Liekele E Oostenbrug, Andries van der Linden, Sietske Corporaal, Lieke Hol, Eva Kouw, Jolein van der Kraan, Wouter L Hazen, Judith Honing, J Jan B van Lanschot, Bianca Mostert, Joost J Nuyttens, Pieter C van der Sluis, Bas P L Wijnhoven, Manon C W Spaander, Sjoerd M Lagarde","doi":"10.1055/a-2645-7637","DOIUrl":"10.1055/a-2645-7637","url":null,"abstract":"<p><strong>Background and study aims: </strong>Active surveillance has been proposed for patients with esophageal cancer and a clinical complete response after neoadjuvant chemoradiotherapy (nCRT). This strategy involves repeated esophagogastroduodenoscopy (EGD) with bite-on-bite biopsies and endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) to detect tumor regrowth or residual disease. The aim of this study was to assess safety of endoscopic procedures during active surveillance.</p><p><strong>Patients and methods: </strong>A prospective multicenter cohort including patients who were treated with nCRT for esophageal cancer and who underwent EGD with bite-on-bite biopsies and/or EUS (with fine-needle aspiration) was retrospectively analyzed. The primary outcome was the difference in number of serious adverse events (SAEs) in endoscopic procedures performed within vs. more than 3 months after nCRT. The secondary outcome was mechanical injury.</p><p><strong>Results: </strong>In 920 patients, 2291 endoscopic procedures were performed (57% EGD combined with EUS, 39% EGD only and 4% EUS only). Of these procedures, 819 (36%) were performed more than 3 months after nCRT in 186 patients. Two gastrointestinal bleedings were reported during endoscopic procedures performed within 3 months after nCRT. One gastrointestinal bleeding and two infections were reported after 3 months following nCRT. Frequency of SAEs before and after 3 months following completion of nCRT was not significantly different (2 vs. 3, odds ratio 2.7, 95% confidence interval 0.3-32.4, <i>P</i> = 0.36).</p><p><strong>Conclusions: </strong>EGD with bite-on-bite biopsies and EUS with FNA seem to be safe during an active surveillance strategy in esophageal cancer patients after nCRT.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26457637"},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947287","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":"Single-center, prospective study evaluating safety and efficacy of a new endoscopic hemostat system in non-variceal upper gastrointestinal bleeding.","authors":"Hardik Rughwani, Rajat Garg, Mohammed Faisal Habeeb, Nitin Jagtap, Zaheer Nabi, Pradev Inavolu, Shreevyshnavi Aachi, Mohan Ramchandani, Darisetty Santosh, Gauri Nayak, Sundeep Lakhtakia, Nageshwar Reddy","doi":"10.1055/a-2650-2692","DOIUrl":"10.1055/a-2650-2692","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic spray therapy has been shown to be effective and safe in managing upper gastrointestinal bleeding (UGIB). We aimed to evaluate safety and efficacy of the novel powder-based Resolv Endoscopic Hemostat System in managing UGIB.</p><p><strong>Patients and methods: </strong>This was a single-center, prospective, single-arm study conducted from July 2022 to February 2023. It aimed to evaluate safety and efficacy of a novel plant-based polysaccharide, the Resolv Endoscopic Hemostat System, in achieving hemostasis in adult patients diagnosed with non-variceal upper gastrointestinal bleeding (UGIB) (Forest 1b/oozing bleeding). Participants in this study underwent endoscopy and received monotherapy treatment using the Resolv Endoscopic Hemostat System. Outcomes of interest were adverse events (AEs) related to the device within 72 hours and 30 days, immediate hemostasis, and rebleeding rates within 72 hours of the index procedure.</p><p><strong>Results: </strong>A total of 59 patients (71.2% men) with mean age of 55.3 ± 14.2 years were included in the study. Causes of bleeding included post-polypectomy (n = 35, 59.3%), gastric ulcers (n = 13, 22%), malignant tumor (n = 4, 6.8%), post-biopsy-related needing hemostasis (n = 3, 5.1%), congestive gastropathy (n = 2, 3.4%), duodenal ulcer (n = 1, 1.7%), and portal hypertensive duodenopathy-related (n = 1, 1.7%). Resolv achieved a 100% success rate for immediate hemostasis with a 72-hour rebleeding rate of 5.1%. There were no AEs related to the device or mortality.</p><p><strong>Conclusions: </strong>Resolv Endoscopic Hemostat System is a safe and effective device for achieving immediate hemostasis in patients with non-variceal upper gastrointestinal bleeding. Future studies are required to examine its widespread adoption and applicability.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26502692"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947361","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":"Single-use versus reusable endoscopes in gastroenterology: Systematic review of full and partial economic evaluations.","authors":"Mandana Zanganeh, Yufei Jiang, Norman Waugh, Anna Brown, Yen-Fu Chen, Ramesh P Arasaradnam, Lazaros Andronis","doi":"10.1055/a-2645-1463","DOIUrl":"10.1055/a-2645-1463","url":null,"abstract":"<p><strong>Background and study aims: </strong>Future decision making on health care will need to consider broader environmental and sustainability issues. One example is adoption of single-use endoscopes instead of reusable endoscopes in gastroenterology, largely due to their perceived benefit of reducing cross-infection. Besides considerations related to technical performance, there are differences not only in the cost to healthcare but also in the impact they have on the environment. The primary aim of this systematic review was to synthesize evidence on the costs and consequences of using single-use gastrointestinal endoscopes vs. reusable ones adopting various reprocessing methods. The secondary aim was to review and discuss the way in which environmental impact is costed and reported by the studies included in this review.</p><p><strong>Methods: </strong>We searched multiple databases and the internet to September 2024. We included and quality-assessed partial and full economic evaluations according to predetermined criteria.</p><p><strong>Results: </strong>Seven studies (2 cost analyses and 5 cost-utility analyses [CUA]) were included. All focused on duodenoscopes for endoscopic retrograde cholangiopancreatography. Five studies compared single-use with reusable duodenoscopes whereas two studies compared different reprocessing methods for reusable duodenoscopes. The most common outcomes were infection risk (n = 6) and quality-adjusted life years (n = 5). Environmental impact was considered in only two studies. All studies stated that the per-procedure cost was higher using single-use endoscopes but three CUAs indicated that single-use endoscopes were more cost-effective. Several studies used doubtful assumptions, reducing their credibility.</p><p><strong>Conclusions: </strong>Future economic evaluations of single-use vs. reusable endoscopes require more robust comparative evidence and should include costs and consequences beyond health, especially environmental impact.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26451463"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947290","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":"Diagnostic and therapeutic value of appendoscope-assisted endoscopic retrograde appendicitis therapy.","authors":"Pengcheng Liu, Liqiong Wu, Pengju Li, Yu Li, Dianzuo Sun","doi":"10.1055/a-2650-2623","DOIUrl":"10.1055/a-2650-2623","url":null,"abstract":"<p><strong>Background and study aims: </strong>The appendoscope, derived from the peroral digital single-operator cholangioscope, is an endoscopic device enabling direct visualization of the appendix lumen for diagnostic or therapeutic purposes. This study aimed to investigate diagnostic and therapeutic efficacy of appendoscope-assisted endoscopic retrograde appendicitis therapy (ERAT) in patients with appendicitis.</p><p><strong>Patents and methods: </strong>A total of 131 patients were enrolled in the study, with 125 included in the final analysis. Patient demographics, procedure success, abdominal pain resolution, appendoscope manifestations, treatment strategies, procedure time, duration of antibiotic use, postoperative hospital stay, and comorbidities were recorded. Complications and recurrences were followed up. These variables were subsequently analyzed to evaluate efficacy of appendoscope-assisted ERAT.</p><p><strong>Results: </strong>The technical success rate of appendoscope-assisted ERAT was 98.5%, and the clinical success rate was 100%. Appendoscope visual manifestations included appendicolith (76.8%, n = 96), stenosis (16.8%, n = 21), foreign body (6.4%, n = 8), mucosal inflammation (13.6%, n = 17), and perforation (3.2%, n = 4), with these findings occurring individually or in combination. Abdominal pain disappeared within 12 hours post-procedure in 79% of patients (n = 99). Average procedure time was 50.3 ± 18.9 minutes. Antibiotic therapy duration was less than 2 days in 39% of patients (n = 49), whereas 19% (n = 24) received no antibiotics. Average postoperative hospital stay was 1.9 ± 1.4 days. Concomitant intestinal lesions were identified in 16 patients (12.8%). Recurrence occurred in 4.8% of patients (n = 6) during a 4- to 16-month follow-up. No complications were recorded.</p><p><strong>Conclusions: </strong>Appendoscope-assisted ERAT is a feasible, accurate, safe, and effective alternative for diagnosis and treatment of appendicitis.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26502623"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947115","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 serial pancreatic juice aspiration cytological examination for focal pancreatic duct stenosis: Multicenter, retrospective, cohort study.","authors":"Yosuke Ohashi, Takuji Iwashita, Shota Iwata, Akihiko Senju, Shinya Uemura, Keisuke Iwata, Akinori Maruta, Junji Kawaguchi, Naoki Mita, Masatoshi Mabuchi, Yasuhiro Oshima, Masahito Shimizu","doi":"10.1055/a-2655-6348","DOIUrl":"10.1055/a-2655-6348","url":null,"abstract":"<p><strong>Background and study aims: </strong>Early diagnosis of pancreatic cancer is crucial for improving patient prognosis. However, diagnosing pancreatic cancer in the absence of a distinct mass is challenging due to limitations of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Recent studies have suggested that serial pancreatic juice aspiration cytological examination (SPACE) for focal pancreatic duct stenosis may improve diagnostic yield in cases of pancreatic cancer without obvious mass. The aim of this study was to evaluate efficacy of SPACE in diagnosis of focal pancreatic duct stenosis.</p><p><strong>Patients and methods: </strong>A retrospective analysis of data from patients who underwent SPACE for pancreatic ductal stenosis between January 2017 and January 2023 was performed. Primary outcomes included diagnostic capability (sensitivity, specificity, and accuracy) and safety of SPACE.</p><p><strong>Results: </strong>SPACE was performed on 46 patients with focal pancreatic duct stenosis. Initial cytology demonstrated sensitivity of 45.0%, specificity of 84.6%, and accuracy of 67.3%. In contrast, SPACE yielded a significantly improved sensitivity of 90.0% ( <i>P</i> = 0.006) and an accuracy of 89.1% ( <i>P</i> = 0.045). Sensitivity of SPACE increased with the number of cytological examinations: 45% for one submission; 70% for two; 80% for three; 85% for four; and plateaued at 90% for five or more 5. Adverse events occurred in 19.6% of patients, including pancreatitis (mild in 7, moderate in 1) and one case of guidewire penetration of the pancreatic duct.</p><p><strong>Conclusions: </strong>SPACE was a valuable method for obtaining pathological specimens of focal pancreatic duct stenosis. It yielded improved diagnostic sensitivity and accuracy compared with initial cytology alone.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26556348"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947210","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":"Barnacle-like lesions in the gastric mucosa: Clinicopathological study of a novel endoscopic finding.","authors":"Aya Sunago, Takahisa Murao, Ken Haruma, Maki Ayaki, Noriaki Manabe, Minoru Fujita, Takashi Akiyama, Mitsuhiko Suehiro, Hirofumi Kawamoto, Kazuhiko Inoue, Katsuhiro Mabe, Eiichiro Kanda, Tomoari Kamada","doi":"10.1055/a-2645-7506","DOIUrl":"10.1055/a-2645-7506","url":null,"abstract":"<p><strong>Background and study aims: </strong>Map-like redness is a known gastric mucosal finding observed after <i>Helicobacter pylori</i> eradication. Recently, we identified gastric lesions resembling barnacles and observed that they appear more commonly in cases of post- <i>H. pylori</i> infection. This study aimed to investigate clinicopathological characteristics of these barnacle-like lesions.</p><p><strong>Patients and methods: </strong>We analyzed clinical characteristics in 436 consecutive patients examined at Kawasaki Medical School General Medical Center. Histopathological examination was conducted in 43 patients, with 65 biopsies taken from barnacle-like lesions and 17 from the surrounding mucosa. The 43 patients comprised 20 patients biopsied at General Medical Center and 23 patients at Junpukai.</p><p><strong>Results: </strong>In total, 413 patients (208 women) were included in the analysis after excluding 23 patients based on exclusion criteria. Barnacle-like lesions were identified in 66 patients (16.0%), most frequently around the gastric angle, and were significantly more common in patients with mild atrophy of the fundic mucosa. Of the 66 patients with barnacle-like lesions, 65 were considered to have a post- <i>H. pylori</i> infection status and one was currently infected. Histopathological examination revealed intestinal metaplasia in 54 (83.1%) of the 65 biopsies from barnacle-like lesions. By contrast, all 17 biopsies from surrounding mucosa showed normal fundic mucosa without inflammation or atrophy.</p><p><strong>Conclusions: </strong>Barnacle-like lesions are a characteristic endoscopic finding of gastric mucosa post-infected with <i>H. pylori</i> and are histopathologically consistent with intestinal metaplasia.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26457506"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946704","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 for distal malignant biliary obstruction: How we can evaluate clinical success.","authors":"Sun-Chuan Dai","doi":"10.1055/a-2644-4867","DOIUrl":"10.1055/a-2644-4867","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26444867"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947199","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":"Outcomes of endoscopic submucosal dissection for treatment of superficial anal squamous cell carcinoma: Multicenter international experience.","authors":"Miguel Fraile-López, Mathieu Pioche, Jérôme Rivory, Anastassios Manolakis, Yoji Takeuchi, Shiko Kuribayashi, Keigo Sato, Alberto Herreros de Tejada, Diego de Frutos Rosa, Takashi Kanesaka, Mayo Tanabe, Amyn Haji, João Santos-Antunes, Rui Morais, Zacharias Tsiamoulos, Hugo Uchima, Adolfo Parra-Blanco, Maria Luisa Cagigal, Alvaro Terán, Enrique Rodriguez de Santiago","doi":"10.1055/a-2641-5597","DOIUrl":"10.1055/a-2641-5597","url":null,"abstract":"<p><strong>Background and study aims: </strong>Data on feasibility of endoscopic submucosal dissection (ESD) for treatment of superficial anal squamous cell carcinoma are limited. This study aimed to evaluate outcomes of ESD in this anatomical location.</p><p><strong>Patients and methods: </strong>This was a multicenter retrospective study including patients who underwent ESD for treatment of superficial ASCC.</p><p><strong>Results: </strong>Twenty-three patients with superficial ASCC were included. Median lesion size was 24 mm (range, 9-65 mm) and median procedure time was 62 minutes (range, 26-210 minutes). Accuracy of optical diagnosis using Japanese Endoscopic Society Intrapapillary capillary loops (IPCLs) classification to predict final histology was 63.6%. En bloc and R0 resection were achieved in 22 (95.6%) and 18 patients (78.3%), respectively. The curative resection rate was 73.9% (17/23). Three patients received additional complementary treatment. Delayed bleeding was observed in four patients (17.4%), two of whom required endoscopic hemostasis. Anal pain was reported in nine patients (39.1%) and was effectively managed with analgesics. Fecal incontinence and anal stenosis both occurred in one patient during the perioperative period. During median follow-up of 10.1 months (range, 0-69.6 months), no recurrences were observed.</p><p><strong>Conclusions: </strong>ESD is a feasible and effective treatment for superficial ASCC. Adverse events were successfully managed with medical or endoscopic therapy. ESD should be considered as first-line resection technique to prevent recurrence while preserving anal sphincter function.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26415597"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947282","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":"Histology of colonic submucosal lesions reveals a high proportion of benign lesions that do not require R0 en bloc endoscopic resection.","authors":"Pierre Lafeuille, Renato Medas, Benjamin Hamel, Romain Legros, Sarah Leblanc, Maximilien Barret, Vincent Lepilliez, Juliette Leroux, Thimothee Wallenhorst, Dann Joseph Ouizeman, Clement Fortier Beaulieu, Hugo Uchima, Elena De Cristofaro, Yann Le Baleur, Antoine Debourdeau, Fabien Subtil, Tanguy Fenouil, Alexandru Lupu, Florian Rostain, Jérôme Rivory, Jeremie Jacques, João Santos-Antunes, Mathieu Pioche","doi":"10.1055/a-2641-5256","DOIUrl":"10.1055/a-2641-5256","url":null,"abstract":"<p><strong>Background and study aims: </strong>Submucosal lesions in the colon are much rarer than those in the rectum. Their nature is poorly understood, as is the best technique for their excision. Based on that of rectal lesions, it most often aims for R0 en bloc resection, but without formal proof of efficacy. The aim of this study was to evaluate histology of these lesions and determine whether submucosal lesions of the colon always require R0 en bloc endoscopic resection.</p><p><strong>Patients and methods: </strong>We conducted a retrospective international study of all colonic submucosal lesions with confirmed histology by resection or biopsy. We assessed the proportion of lesions correctly managed by endoscopy, so that the proposed resection technique offered a level of tumor resection quality appropriate to the definitive histology of the lesion.</p><p><strong>Results: </strong>One hundred patients with 105 colonic submucosal lesions from 13 European centers were included. Histology revealed 91.4% (96/105) non-malignant lesions and 8.6% (9/105) malignant lesions. Endoscopic techniques used were curative in 41.7% (5/12) of cases requiring resection, non-curative in 58.3% (7/12), and endoscopic resection was not necessary in 88.7% (93/105). There was no delayed surgery for adverse events.</p><p><strong>Conclusions: </strong>Most colonic submucosal lesions are non-malignant and do not warrant advanced endoscopic resection. A new therapeutic approach could be first-line use of a low-risk, low-cost histological diagnostic technique followed in a second phase by a more advanced technique in the event of a malignant histological result. Further studies are needed to evaluate this step-up strategy.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26415256"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947322","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":"Prospective study on outcomes of endotherapy for pancreatic divisum in patients of recurrent acute pancreatitis.","authors":"Amol Vadgaonkar, Nagesh Kamat, Ankit Dalal, Gaurav Patil, Sanil Parekh, Sehajad Vora, Amit Maydeo","doi":"10.1055/a-2641-5532","DOIUrl":"10.1055/a-2641-5532","url":null,"abstract":"<p><strong>Background and study aims: </strong>Minor papilla endotherapy success rate is highly variable for pancreatic divisum (PD) among recurrent acute pancreatitis (RAP) patients due to frequent relapses. Therefore, we assessed effectiveness and predictors of successful endotherapy.</p><p><strong>Patients and methods: </strong>This was a prospective observational study of patients with RAP who underwent minor papilla sphincterotomy and prophylactic stenting for PD. Technical success was minor papilla cannulation and successful procedure completion. Primary and secondary outcomes were improvement in recurrent episodes of pain with reduction in visual analogue scale (VAS) score > 50% from baseline and occurrence of chronic pancreatitis (CP) at 12 months, respectively. Predictors of success were assessed by logistic regression.</p><p><strong>Results: </strong>Ninety-four patients, with median age (interquartile range) 29.5 years (23.7-40.2); the majority male (62 [65.9%]), successfully underwent endotherapy. Typical clinical presentation was abdominal pain in 87 patients (92.5%). The primary outcome was achieved in 65 patients (69.1%). The average number of endoscopic retrograde cholangiopancreatography (ERCP) sessions was two; technical success was achieved in 88 patients (93.6%). Post-ERCP pancreatitis was the most common adverse event (AE) in 10 patients (10.6%). Signs of CP were seen in 11 patients (11.7%) and mean follow-up period was 12.8 ± 1.3 months. Presence of smoking (adjusted odds ratio [AOR] 0.027, <i>P</i> = 0.001) and recurrent attacks of RAP after index ERCP (AOR 0.169, <i>P</i> < 0.001) had lower odds of successful endotherapy outcomes.</p><p><strong>Conclusions: </strong>Minor papilla endotherapy for RAP significantly improved VAS scores at 12 months among 69.1% of patients with acceptable AEs. Early CP was seen in 11.7% of patients. (Unique identifier: CTRI/2019/05/019332).</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26415532"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947335","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}