Endoscopy International Open最新文献

{"title":"Novel submucosal injection material comprising fully synthetic and self-assembling peptide solution in endoscopic submucosal dissection: A pilot study.","authors":"Kengo Kasuga, Keigo Sato, Ko Nakata, Hirohito Tanaka, Hiroko Hosaka, Shiko Kuribayashi, Yoji Takeuchi, Toshio Uraoka","doi":"10.1055/a-2487-2823","DOIUrl":"10.1055/a-2487-2823","url":null,"abstract":"<p><p>Endoscopic submucosal dissection (ESD) requires an injection solution to create a submucosal cushion for safe endoscopic resection. This study evaluated the safety and feasibility of a new injection solution (PuraLift) in ESD for early-stage gastrointestinal tumors. This prospective, single-arm, single-center pilot study included 11 patients with gastrointestinal neoplasms of the stomach (n = 5) or colorectum (n = 6) who underwent ESD. All patients underwent outpatient follow-up at week 4 to confirm presence or absence of adverse events (AEs). All underwent protocol treatment and post-treatment follow-up. None of the AEs were judged to have a cause-and-effect relationship with the study. Questionnaires to the operators who performed the protocol treatment and assistants who performed submucosal injections were evaluated in comparison with saline, and maintenance of mucosal lifting was long, comparable, and short (9/2/0). En bloc and R0 resections were achieved in all patients without intraprocedural AEs. Median size of the specimens was 40 mm (range, 20-70). Median excision time was 52 minutes (range, 22-130). Median volume of PuraLift was 32 mL (range, 22-130). No postoperative bleeding or delayed perforation was observed in any patient. The novel injectable material, PuraLift, can potentially ensure safe and feasible ESD.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24872823"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432510","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 closure using a dedicated device following gastric endoscopic submucosal dissection: Multicenter, prospective, observational pilot study.","authors":"Kazuo Shiotsuki, Kohei Takizawa, Yohei Nose, Yuki Kondo, Hitoshi Homma, Taisuke Inada, Mao Daikaku, Kosuke Maehara, Shin-Ichiro Fukuda, Hironori Aoki, Yorinobu Sumida, Hirotada Akiho, Jiro Watari, Kiyokazu Nakajima","doi":"10.1055/a-2503-1684","DOIUrl":"10.1055/a-2503-1684","url":null,"abstract":"<p><strong>Background and study aims: </strong>Development of a simple, optimized closure method for mucosal defects left by gastric endoscopic submucosal dissection (ESD) is warranted. Herein, we developed a novel and dedicated closure device called FLEXLOOP and aimed to assess feasibility and safety of the closure using FLEXLOOP following gastric ESD.</p><p><strong>Patients and methods: </strong>This multicenter, prospective, observational study enrolled patients clinically diagnosed with gastric neoplasms < 30 mm in size. Following gastric ESD, closure of the mucosal defect was performed using a FLEXLOOP with standard clips. The primary outcome was the complete closure rate. The secondary outcomes were procedure time, number of clips, sustained closure rate on second-look endoscopy on postoperative days (PODs) 5 to 7, and rate of post-ESD bleeding.</p><p><strong>Results: </strong>Overall, 35 patients were included in this study. The median specimen size was 32 mm. The mucosal defect was completely closed in 31 patients (89%; 95% confidence interval, 73%-99%) and incompletely closed in four patients (11%). Median closure time was 11 minutes and median number of clips was 10. Second-look endoscopy performed on PODs 5 to 7 demonstrated sustained, partially sustained, and unsustained closures in seven (20%), 22 (63%), and six patients (17%), respectively. Post-ESD bleeding and complications related to FLEXLOOP were not observed.</p><p><strong>Conclusions: </strong>Closure using FLEXLOOP is feasible and safe. Our technique using this new device can be an attractive option for more easily closing mucosal defects. However, further clinical research is warranted to confirm that this technique can prevent delayed complications.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25031684"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432521","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":"Glasgow-Blatchford and Rockall score utility in predicting findings on video capsule endoscopy in patients admitted with overt small bowel bleeding.","authors":"Raquel Ballester, James O'Connell, Conor Costigan, Shreyashee Sengupta, Thilagaraj Manoharan, Monserrat Martinez, Deirdre Mc Namara","doi":"10.1055/a-2452-1219","DOIUrl":"10.1055/a-2452-1219","url":null,"abstract":"<p><strong>Background and study aims: </strong>Glasgow-Blachford (GBS) and Rockall scores are recognized tools to prioritize patients with upper gastrointestinal bleeding. Their utility in predicting findings on capsule endoscopy (CE) in patients with overt small bowel bleeding (OSBB) remains unclear. The aim was to assess use of these scores in predicting relevant findings on CE and outcome among patients with suspected OSBB.</p><p><strong>Patients and methods: </strong>A retrospective analysis was performed from January 2019 to June 2022. Clinical parameters and scores were collected at presentation and at 24 hours. Univariate analysis used simple logistic regression, chi-squared test or Mann-Whitney as needed. ROC analysis was performed selecting the optimal cut-off point maximized by the Youden index.</p><p><strong>Results: </strong>Seventy-nine patients were included, 62% of whom had relevant findings. The predictor showing the highest discrimination ability was the initial GBS (area under the curve [AUC] 0.625; 95% confidence interval [CI] 0.49-0.76). The optimal cut-off point was at least 4, with sensitivity 98%, specificity 30%, and accuracy 72%. Multivariable regression analysis showed inpatient status on CE (odds ratio [OR] 117.27; 95% CI 11.32-4492.93; <i>P</i> = 0.001), shorter time to CE (OR 1.02; CI 1.01-1.04; <i>P</i> = 0.018), higher initial GBS (OR 1.22; CI 1.06-1.43; <i>P</i> = 0.009), and higher GBS within 24 hours (OR 1.19; CI 1.04-1.37; <i>P</i> = 0.013) were predictive factors for relevant findings on CE, with a model AUC 0.802, sensitivity 91.8%, and specificity 63.3%.</p><p><strong>Conclusions: </strong>GBS and Rockall scores were useful in predicting relevant findings on CE in this cohort of patients with suspected OSBB. In patients with GBS 5 or higher, early CE during the same admission is warranted.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24521219"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432244","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 features of solitary colorectal hamartomatous polyps: Solitary juvenile polyp and Peutz-Jeghers polyp.","authors":"Keisuke Kawasaki, Takehiro Torisu, Junji Umeno, Koichi Kurahara, Shinjiro Egashira, Satoshi Miyazono, Yoshiaki Taniguchi, Yumi Oshiro, Shinichiro Kawatoko, Tomohiro Nagasue, Yuichi Matsuno, Naonori Kawakubo, Kouji Nagata, Tomohiko Moriyama, Tatsuro Tajiri, Takanari Kitazono","doi":"10.1055/a-2467-9140","DOIUrl":"10.1055/a-2467-9140","url":null,"abstract":"<p><strong>Background and study aims: </strong>The aim of this study was to clarify the endoscopic characteristics of colorectal hamartomatous polyps, including solitary juvenile polyp (JP) and solitary Peutz-Jeghers polyp (PJP).</p><p><strong>Patients and methods: </strong>We reviewed the clinicopathological and endoscopic findings of 151 colorectal polyps with a diagnosis of solitary JP or solitary PJP. The clinicopathological and endoscopic findings of 119 JPs and 32 PJPs were retrospectively compared.</p><p><strong>Results: </strong>Endoscopic findings included significantly higher incidences of erosion, whitish exudates, and chicken-skin mucosa in JPs compared with PJPs. A lobular surface was more common in PJPs. Magnified narrow-band imaging endoscopic findings indicated that expanded crypt openings, sparse marginal crypt epithelia, and proliferation of capillary vessels were characteristic of JPs. Branching structures were more prevalent in PJPs. Magnifying chromoendoscopy found a predominance of star-like pit patterns and decreased pit densities in JPs, whereas tubular and branching pit patterns were more frequent in PJPs. Neither type of polyp was found to contain adenomas, dysplasia, or malignant cells. Combinations of specific characteristic endoscopic findings in the JPs and PJPs showed high diagnostic accuracy for those polyps.</p><p><strong>Conclusions: </strong>Solitary JPs and PJPs in the colorectum manifested characteristic endoscopic findings, and combinations of specific characteristic endoscopic findings may be useful for endoscopic diagnosis of solitary JPs and PJPs.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24679140"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432447","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":"Assessment of safety and patency of 7-mm covered metal stents for preoperative biliary drainage in pancreatic cancer: Prospective multicenter study.","authors":"Hirotoshi Ishiwatari, Yousuke Kobayashi, Shinya Kawaguchi, Takuji Iwashita, Junichi Kaneko, Jun Ito, Kazuma Ishikawa, Junya Sato, Fumitaka Niiya, Shinya Endo, Tatsunori Satoh, Shinya Uemura, Keita Mori","doi":"10.1055/a-2503-1995","DOIUrl":"10.1055/a-2503-1995","url":null,"abstract":"<p><strong>Background and study aims: </strong>For preoperative biliary drainage of pancreatic cancer (PC), a 10-mm diameter metal stent (MS) is commonly used; however, the rate of pancreatitis is high. It is hypothesized that smaller-diameter MS may reduce the rate of pancreatitis. Therefore, we conducted a multicenter prospective study to evaluate the efficacy and safety of 7-mm MS.</p><p><strong>Patients and methods: </strong>Patients requiring initial biliary drainage for obstructive jaundice caused by PC and scheduled for surgery from six facilities were included. After endoscopic retrograde cholangiography, a 7-mm MS was placed at the site of biliary obstruction. The primary endpoint was the rate of pancreatitis, and the secondary endpoints included early and late adverse events (AEs). The pancreatitis rate was assumed to be 18% and 5% with 10- and 7-mm MS, respectively; with a power of 80% and one-sided significance level of 10%, the planned enrollment was 38 patients. If pancreatitis occurred in no more than three patients, this indicates that the 7-mm MS effectively reduced incidence of pancreatitis.</p><p><strong>Results: </strong>Overall, 38 patients were enrolled, and 35 patients in whom a 7-mm MS was successfully placed were analyzed. All MS were placed after sphincterotomy. Pancreatitis occurred in four patients (11.4%) and no early AEs were observed. Surgery was performed in 24 patients and late AEs included stent occlusion in eight patients (23%) and cholecystitis in four patients (11%).</p><p><strong>Conclusions: </strong>The 7-mm MS did not reduce incidence of pancreatitis among surgical candidates for PC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25031995"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499710","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 early mortality after EUS-guided gastroenterostomy in malignant gastric outlet obstruction.","authors":"Hyuk Lee, Kenneth Hyunsoo Park, Ulysses Rosas, Mohamad Othman El Helou, Jae Min Lee, Liliana Bancila, Laith H Jamil, Quin Liu, Rabindra R Watson, Srinivas Gaddam, Simon K Lo","doi":"10.1055/a-2474-9802","DOIUrl":"10.1055/a-2474-9802","url":null,"abstract":"<p><p><b>Background and study aims</b> Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has recently emerged as a potential treatment option for malignant gastric outlet obstruction (mGOO), with a relatively long duration of patency and low rate of reintervention. Its intrinsic risk for serious adverse events and high procedure cost mandates careful patient selection beyond the common safety profiles. This study aimed to assess for predictors of early post-EUS-GE mortality. <b>Patients and methods</b> We conducted a retrospective analysis of all patients with unresectable mGOO who underwent EUS-GE. Predictive factors for postoperative 30-day mortality with crude and adjusted hazard ratios were examined using univariate and multivariate penalized likelihood Firth logistic regression analyses. <b>Results</b> Technical and clinical success was achieved in 96.7% and 93.1% of the patients, respectively. The 30-day mortality rate after the procedure was 11.7%, and no procedure complications were observed. The 30-day mortality group had a significantly low rate of initial clinical success (66.7% vs. 96.2%, <i>P</i> = 0.007). Univariate analysis identified significantly higher postoperative 30-day mortality in patients with poor baseline ECOG performance status scale (≥ 2) and ascites. Presence of grade 2 ascites was confirmed as an independent predictive factor in the multivariate analysis (adjusted hazard ratio 52.41, 95% confidence interval 1.55 to 1775.64, <i>P</i> = 0.024). <b>Conclusions</b> EUS-GE should be carefully considered for patients with ascites which was an independent predictor for early mortality after procedure in mGOO, especially those with grade 2 or higher level of ascites.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24749802"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432631","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":"GLP-1 receptor agonist use does not increase risk of respiratory complications post-endoscopy.","authors":"Jena Velji-Ibrahim, Piyush Nathani, Harsh K Patel, Prateek Sharma","doi":"10.1055/a-2487-2937","DOIUrl":"10.1055/a-2487-2937","url":null,"abstract":"<p><strong>Background and study aims: </strong>Data on respiratory complications associated with GLP-1 receptor agonist (GLP-1 RA) use before endoscopic procedures are limited.</p><p><strong>Patients and methods: </strong>We conducted a retrospective cohort study using TriNetX in adults with diabetes or obesity on GLP-1 RAs within 3 months of endoscopy, comparing them with non-GLP-1 RA users. Propensity score matching and Cox proportional hazards models were used to assess outcomes.</p><p><strong>Results: </strong>Among 46,948 patients, no significant differences in post-endoscopy aspiration pneumonitis (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.54-1.56) or pneumonia (HR 1.01, 95% CI 0.83-1.24) were found between groups.</p><p><strong>Conclusions: </strong>GLP-1 RA use before endoscopy does not increase respiratory complications, supporting continued preoperative medication use.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24872937"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432250","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":"Unifying terminology, reporting, and bowel preparation standards in colon capsule endoscopy: Nyborg Consensus.","authors":"Ian Io Lei, Anastasios Koulaouzidis, Benedicte Schelde-Olesen, James Turvill, Pablo Cortegoso Valdivia, Emanuele Rondonotti, John N Plevris, Martin Keuchel, Jean-Christophe Saurin, Xavier Dray, Jacob Broder Brodersen, Mark McAlindon, Ervin Toth, Alexander Robertson, Ramesh Arasaradnam","doi":"10.1055/a-2495-5427","DOIUrl":"10.1055/a-2495-5427","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colon capsule endoscopy (CCE) is becoming increasingly popular in Europe. However, development of quality assurance and standardized terminology has not kept pace with clinical integration of this technology. As a result, there are significant variations in reporting standards, highlighting the need for a standardized terminology and framework. We used the RAND process to achieve a consensus of experts to determine the terminology in CCE, bowel cleansing assessment, and quality assurance reporting and future research priorities.</p><p><strong>Methods: </strong>A panel comprising 14 European CCE experts evaluated 45 statements during the international REFLECT symposium (Nyborg, Denmark) through three survey rounds and face-to-face and virtual discussions in the initial two rounds. Participants anonymously rated statement appropriateness.</p><p><strong>Results: </strong>Twenty-eight consensus statements were developed. Eight statements focus on consistent terminology for confirming CCE-detected polypoid and inflammatory colonic lesions with colonoscopy. To ensure standardization and quality assurance, 13 mandatory fields were recommended for inclusion in a CCE report. Three endorsed reporting methodologies were suggested, emphasizing prompt notification for suspected malignant findings, recommending a generic disclaimer regarding stomach and small bowel visualization intentions, and establishing reporting timelines at an interdepartmental level based on urgency. Four bowel preparation scale-related statements led to the recommendation to adoptithe Colon Capsule CLEansing Assessment and Reporting (CC-CLEAR) scale as the preferred scale.</p><p><strong>Conclusions: </strong>This study established a framework for terminology, reporting, and assessment of bowel cleansing for CCE. Future research should focus on optimizing bowel preparation regimens and exploring artificial intelligence applications in CCE.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24955427"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432729","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":"US multicenter outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents for acute cholecystitis.","authors":"Yakira David, Gaurav Kakked, Bradley Confer, Ruchit Shah, Harshit Khara, David L Diehl, Matthew Richard Krafft, Sardar M Shah-Khan, John Y Nasr, Petros Benias, Arvind Trindade, Thiruvengadam Muniraj, Harry Aslanian, Prabhleen Chahal, John Rodriguez, Douglas G Adler, Jason Dubroff, Rabi De Latour, Demetrios Tzimas, Lauren Khanna, Gregory Haber, Adam J Goodman, Nicholas Hoerter, Nishi Pandey, Mena Bakhit, Thomas E Kowalski, David Loren, Austin Chiang, Alexander Schlachterman, Jose Nieto, Ameya Deshmukh, Yervant Ichkhanian, Mouen A Khashab, Maan El Halabi, Richard S Kwon, Anoop Prabhu, Ariosto Hernandez-Lara, Andrew Storm, Tyler M Berzin, John Poneros, Amrita Sethi, Tamas A Gonda, Vladimir Kushnir, Natalie Cosgrove, Daniel Mullady, Abdullah Al-Shahrani, Lionel D'Souza, Jonathan Buscaglia, Juan Carlos Bucobo, Vineet Rolston, Prashant Kedia, Franklin Kasmin, Satish Nagula, Nikhil A Kumta, Christopher DiMaio","doi":"10.1055/a-2495-5542","DOIUrl":"10.1055/a-2495-5542","url":null,"abstract":"<p><strong>Background and study aims: </strong>EUS-guided gallbladder drainage (EUS-GBD) using lumen apposing metal stents (LAMS) has excellent technical and short-term clinical success for acute cholecystitis (AC). The goals of this study were to determine the long-term clinical outcomes and adverse events (AEs) of EUS-GBD with LAMS.</p><p><strong>Patients and methods: </strong>A multicenter, retrospective study was conducted at 18 US tertiary care institutions. Inclusion criteria: any AC patient with attempted EUS-GBD with LAMS and minimum 30-day post-procedure follow-up. Long-term clinical success was defined as absence of recurrent acute cholecystitis (RAC) > 30 days and long-term AE was defined as occurring > 30 days from the index procedure.</p><p><strong>Results: </strong>A total of 109 patients were included. Technical success was achieved in 108 of 109 (99.1%) and initial clinical success in 106 of 109 (97.2%). Long-term clinical success was achieved in 98 of 109 (89.9%) over a median follow-up of 140 days (range 30-1188). On multivariable analysis (MVA), acalculous cholecystitis (odds ratio [OR] 15.93, 95% confidence interval [CI] 1.22-208.52, <i>P</i> = 0.04) and the occurrence of a LAMS-specific AE (OR 63.60, 95% CI 5.08-799.29, <i>P</i> <0.01) were associated with RAC. AEs occurred in 38 of 109 patients (34.9%) at any time, and in 10 of 109 (9.17%) > 30 days from the index procedure. Most long-term AEs (7 of 109; 6.42%) were LAMS-specific. No technical or clinical factors were associated with occurrence of AEs. LAMS were removed in 24 of 109 patients (22%). There was no difference in RAC or AEs whether LAMS was removed or not.</p><p><strong>Conclusions: </strong>EUS-GBD with LAMS has a high rate of long-term clinical success and modest AE rates in patients with AC and is a reasonable destination therapy for high-risk surgical candidates.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24955542"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432734","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":"Utility of cholangioscopy in patients with surgically altered anatomy after percutaneous transhepatic biliary drainage.","authors":"Ankit Dalal, Nagesh Kamat, Gaurav Patil, Amol Vadgaonkar, Sanil Parekh, Sehajad Vora, Amit Maydeo","doi":"10.1055/a-2487-2890","DOIUrl":"10.1055/a-2487-2890","url":null,"abstract":"<p><strong>Background and study aims: </strong>Surgical therapy that alters the biliary anatomy makes endoscopic access to the biliary system difficult. These surgeries promote cholestasis, calculi development and lead to biliary stricture. Stricture resolution and removal of intrahepatic bile duct stones remain challenging.</p><p><strong>Patients and methods: </strong>This was a retrospective analysis of prospective data from patients with altered surgical anatomy with intrahepatic bile duct stones/strictures. Percutaneous transhepatic biliary drainage (PTBD) was attempted, followed by transhepatic SpyGlass cholangioscopy for stricture or removal of intrahepatic bile duct stones. The number of sessions, stricture dilatation, and complications were noted. A cholangiogram revealing a clear duct was a technical success, and stricture resolution was considered a clinical success. Complete ductal clearance was clinical success in those with stones. Patients with follow-up of a minimum of 6 months were included.</p><p><strong>Results: </strong>Twenty-four patients, 16 of whom were male (66.7%), median age 41.5 years (interquartile range [IQR] 38.2-49) successfully underwent PTBD. The most common indication was biliary stricture in 13 (54.2%), followed by intrahepatic stones in six (25%) and stones with strictures in five patients (20.8%). Most patients had undergone Roux-en-Y hepaticojejunostomy (22; 91.7%), and the level of bile duct obstruction was hilum in 20 (83.3%). The median (IQR) total bilirubin levels reduced from 6.6 (5.1-8.3) to 1.8 mg/dL (1.2-2.8) after PTBD; <i>P</i> <0.001. The technical success was 90.9% after a median (IQR) number of two (1.7-2) SpyGlass sessions; clinical success was 88.9% after a median of three (3-4) SpyGlass sessions. Abdominal pain (8.3%) and cholangitis (12.5%) were the complications after cholangioscopy. The median (IQR) follow-up duration was 7 months (6-8).</p><p><strong>Conclusions: </strong>SpyGlass cholangioscopy, although challenging, is a safe option for intrahepatic stones and strictures with excellent short-term outcomes and minimal complications.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24872890"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432742","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}