Gastrointestinal endoscopy最新文献

{"title":"Risk of post-ERCP pancreatitis due to placement of biliary self-expandable metal stents (SEMS): a single-center retrospective study.","authors":"Mark Radetic, Michael Ladna, Steve Shen, Arvin Daneshmand, Talal Seoud, Devika Dixit, Amira Qumseya, Aleksey Novikov, Bashar Qumseya","doi":"10.1016/j.gie.2025.03.1212","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.1212","url":null,"abstract":"<p><strong>Background & aims: </strong>Post-ERCP pancreatitis (PEP) is the most common adverse event following ERCP. Placement of self-expandable metal stents (SEMS) is common during ERCP. Our aim was to investigate whether SEMS placement during ERCP increases the risk for PEP.</p><p><strong>Methods: </strong>We conducted a retrospective study on patients who underwent ERCP at our institution from 2016 to 2021. Patients were divided into those with SEMS and those without SEMS. The PEP rates were compared between the two groups. We used a multivariable logistic regression model to assess the strength of the association between the primary outcome (PEP) and its predictor (SEMS placement) while controlling for potential confounders such as procedure indication, indomethacin use, native papilla, and pancreatic duct manipulation/stenting.</p><p><strong>Results: </strong>1,718 consecutive patients were included in the study with 21% (n=358) undergoing SEMS placement. PEP was higher in the SEMS group than in the non-SEMS group (10.6% vs. 5.7%, p=0.0008) and higher than those who had plastic stent placement (10.6% vs. 6.3%, n=31/494; p=0.0299). On multivariable logistic regression analysis, SEMS placement was independently associated with a 2.3-fold increased risk of PEP (adjusted OR 2.30 [95% CI: 1.48-3.56], p=0.0002.</p><p><strong>Conclusions: </strong>At our center, SEMS placement was found to be an independent risk factor for the development of PEP.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS fine-needle biopsy of solid pancreatic masses with and without rapid on-site evaluation for commercial next generation genomic profiling.","authors":"Mohamad Dbouk, Brenton G Davis, Matthew Peller, Erika Sloan, Thomas Hollander, Juan Pablo Reyes-Genere, Ahmad Bazarbashi, Mohammed Ismail, Gabriel Lang, Vladimir Kushnir, Dayna Early, Samuel Ballentine, Sun-Chuan Dai, Abdul Kouanda, Koushik Das","doi":"10.1016/j.gie.2025.03.1208","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.1208","url":null,"abstract":"<p><strong>Background and aims: </strong>While EUS with fine-needle biopsy (EUS-FNB) of solid pancreatic lesions with or without the use of rapid on-site-evaluation (ROSE) has high diagnostic yield, the utility of ROSE for commercial genomic analysis is unclear.</p><p><strong>Methods: </strong>A multicenter retrospective review was conducted of consecutive patients where genomic analysis was requested from EUS-FNB of solid pancreatic lesions, performed with 22g FNB-needles. Data was collected at two academic centers, one that routinely utilizes ROSE to assess adequacy for all EUS-FNB cases (UCSF, n=44) and a second that does not utilize ROSE (Washington University, n=186).</p><p><strong>Results: </strong>The cohort consisted of 230 patients (mean age 67.3 (SD9.8), 52.6% female). There were no significant differences between patient and tumor characteristics/location in the two groups. Adverse events were uncommon and similar between the groups (1.6% vs 0%). Adequacy for genomic evaluation was high and similar between those without and with ROSE (159/186 (85.5%) vs 39/44 (88.6%), p=0.8). Genomic analysis resulted in potentially actionable mutations in a similar number of patients without and with ROSE (18.3% vs 15.9%, p=0.82). However, compared with FNB without ROSE, FNB with ROSE required more than double the procedure time (mean (SD): 21.1 (10) vs 49.7 (20.6) min, p<0.001) and significantly higher number of median needle passes (3 (IQR 2-3) vs 4 (IQR 3-4), p<0.001).</p><p><strong>Conclusions: </strong>While EUS-FNB with ROSE did not have significantly different adequacy for commercial genomic analysis compared to EUS without ROSE, it required significantly more procedure time and needle passes.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Predictors of Delayed Clearance of Prophylactic Pancreatic Stents following ERCP.","authors":"Joshua Martin, Aisel Alikhanova, Wichit Srikureja, James Buxbaum, John J Kim","doi":"10.1016/j.gie.2025.03.638","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.638","url":null,"abstract":"<p><strong>Background and aims: </strong>Timely evaluation and removal of prophylactic pancreatic stent (PS) placed during endoscopic retrograde cholangiopancreatography (ERCP) are recommended. The aim of the study was to examine the proportion of patients whose prophylactic PS passed or were removed within 4 weeks of ERCP.</p><p><strong>Methods: </strong>Consecutive patients who received ERCP with prophylactic PS (5/2014- 11/2022) at a tertiary center were identified. Primary endpoint was clearance of PS ≤4 weeks from ERCP confirmed by radiologic studies or endoscopy. Multivariate analysis was used to identify endoscopist, patient, and procedure-related factors associated with the primary endpoint.</p><p><strong>Results: </strong>Of 4,724 patients undergoing ERCP, 262 (5.5%) received a prophylactic PS (mean age 56.6±18.5 years, 168 (64%) female). After ERCP, PS was evaluated in ≤2 weeks in 177 (68%, 95%CI 62-73%) patients. Furthermore, PS was cleared at ≤4 weeks in 135 (52%, 95%CI 46-58%) patients by radiologic studies in 86 (33%) or endoscopic removal in 49 (19%). On multivariate analysis, biliary stent placement (AOR=0.5, 95%CI 0.3-0.8) reduced the odds of PS clearance after adjusting for endoscopist-specific clearance rate: top (AOR=11.1, 95%CI 4.0-30.5), second (AOR=5.4, 95%CI 2.5-11.9), and third (AOR=4.1, 95%CI 1.9-9.0) compared to the bottom quartile. During follow-up of 20.1±23.5 months, 47 (37%) of 127 patients with delayed PS clearance demonstrated a median stent dwelling time of 55 days (range, 29 to 929).</p><p><strong>Conclusion: </strong>Prophylactic PS was cleared within 4 weeks in only half of the patients following ERCP. In addition to primarily endoscopist-driven factors, biliary stent placement was associated with delayed clearance of prophylactic PS.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success of Different Closure Modalities of Gastro-gastric or Jejunal-gastric Fistulas after Endoscopic Ultrasound-directed Transgastric Intervention.","authors":"Tina Boortalary, Tammy Tran, Nicholas McDonald, Michel Kahaleh, Amy Tyberg, Haroon Shahid, Avik Sarkar, Rishi Pawa, Swati Pawa, Frank Ventura, Ethan M Cohen, Matthew Krafft, Shyam Thakkar, Shailendra Singh, John Nasr, Faisal Nimri, Tobias Zuchelli, Duyen Dang, Cyrus Piraka, Kamal M Hassan, Reem Z Sharaiha, Anand Kumar, Alexander Schlachterman, Thomas Kowalski, Faisal Kamal","doi":"10.1016/j.gie.2025.03.640","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.640","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing Standards of Practice for Endoscopic Sleeve Gastroplasty: A Global Expert Consensus using a Modified Delphi Method.","authors":"Pichamol Jirapinyo, Rashmi Advani, Abdulhameed Al-Sabban, Christopher McGowan, Reem Sharaiha, Aayed Alqahtani, Michael Larsen, Janese Laster, Daniel Maselli, Shailendra Singh, Christopher Thompson","doi":"10.1016/j.gie.2025.03.642","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.642","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic sleeve gastroplasty (ESG) is a minimally invasive obesity treatment with established efficacy and safety. However, procedural techniques vary. This study aimed to develop a standardized ESG approach.</p><p><strong>Methods: </strong>A modified Delphi method was used to define key ESG steps. Global ESG experts (≥300 procedures) participated in three survey rounds. Items with ≥70% agreement were included, and those with <70% consensus were discussed. Only items with unanimous final agreement were retained.</p><p><strong>Results: </strong>Six experts participated. The final list of key ESG steps included 27 statements: 6 on cognitive skills (100% consensus) and 21 on technical skills (all with high consensus). The latter covered diagnostic endoscopy/pre-suturing steps (97%), fundamental suturing steps (100%), and suture patterns (97%). Key procedural elements with highest consensus included starting at the incisura, using at least six sutures, and avoiding the fundus.</p><p><strong>Conclusion: </strong>This expert consensus provides step-by-step guidance for safe and effective performance of ESG.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Trial Comparing the Franseen Needle Versus Two Types of Sharpened-Tip Three-Prong Needles in Endoscopic Ultrasound-Guided Tissue Acquisition from Solid Pancreatic Lesions.","authors":"Takuya Ishikawa, Hirotaka Suzuki, Yasuki Hori, Jun Yashika, Hiroki Suhara, Hajime Sumi, Masahiko Ando, Yachiyo Kuwatsuka, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Takeshi Yamamura, Kazuhiro Furukawa, Masanao Nakamura, Hiromi Kataoka, Hiroki Kawashima","doi":"10.1016/j.gie.2025.03.641","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.641","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is crucial for diagnosing pancreatic diseases. Recently, two novel types of sharpened-tip, three-prong fine-needle biopsy (FNB) needles, the Trident needle and the 3-point needle, have been developed to improve puncture performance. In this study, these novel needles were compared with the conventional Franseen needle in EUS-TA from solid pancreatic lesions (SPLs).</p><p><strong>Methods: </strong>In this prospective, multicenter, randomized controlled trial, patients with SPLs ≥ 10 mm were randomized for use of either conventional or novel FNB needles. The primary endpoint was the tissue-collection rate, with secondary endpoints including histological diagnosis, tissue volume, initial puncture success, puncture performance, and adverse events.</p><p><strong>Results: </strong>In total, 185 patients were analyzed. The tissue-collection rates were 96.8% for the conventional needle and 92.6% for the novel FNB needles. The novel needles presented slightly lower tissue-collection rates, although this difference was not statistically significant. Furthermore, this difference was -4.2% (90% confidence interval: -9.53-1.12), which did not indicate noninferiority. However, the novel needles significantly outperformed the conventional needles in terms of initial puncture success and overall puncture performance. No significant differences were found in histological diagnosis, tissue volume, or adverse events between the groups.</p><p><strong>Conclusions: </strong>The conventional FNB needle demonstrated a higher tissue-collection rate but did not surpass the noninferiority margin that was set in this study, with no significant differences in the histological diagnostic performance or the tissue volume between the needles. The superior puncture performance of the novel needles suggests their particular benefit in challenging cases or for less experienced endoscopists.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden and Cost of Post-ERCP Pancreatitis Among Commercially Insured People Undergoing ERCP.","authors":"Anna Tavakkoli, Kandice A Kapinos, B Joseph Elmunzer, Richard S Kwon, David M Troendle, Song Zhang, Amit G Singal","doi":"10.1016/j.gie.2025.03.639","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.639","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic Retrograde Cholangiopancreatography (ERCP) is the primary therapeutic procedure for pancreaticobiliary diseases. Post-ERCP pancreatitis can occur in up to 10-15% of cases; however, there are few data describing the incidence and financial burden of post-ERCP pancreatitis in a nationally representative sample in the U.S. Our study aimed to: 1) characterize the 30-day incidence of post-ERCP pancreatitis; 2) identify patient-and procedure factors associated with post-ERCP pancreatitis; and 3) describe 30-day direct and out-of-pocket (OOP) costs among patients with post-ERCP pancreatitis.</p><p><strong>Methods: </strong>We used the Merative MarketScan commercial claims data to identify inpatient and outpatient ERCPs occurring from 2019-2021. The primary outcome was the development of post-ERCP pancreatitis within 30 days of an ERCP. The main measure of financial burden was the total direct and OOP costs of the index ERCP and all encounters within 30 days after the index ERCP. We used multivariable regression to identify factors and estimate adjusted costs of post-ERCP pancreatitis.</p><p><strong>Results: </strong>Among 27,482 patients who underwent a total of 42,212 ERCPs during the study period, post-ERCP pancreatitis was observed in 5.7% of patients. In multivariable analysis, the highest odds of post-ERCP pancreatitis was observed among the youngest age group ≤17 years undergoing ERCP (OR 1.53, 95% CI 1.06-2.21). The 30-day adjusted mean direct costs among persons with and without post-ERCP pancreatitis were $38,569 and $30,103, respectively (difference: $8,483). The population-level cost of post-ERCP pancreatitis ranged from $85,833,757 to 432,648,810 across a range of reported estimates for post-ERCP pancreatitis and annual ERCP volume in the US.</p><p><strong>Conclusions: </strong>Post-ERCP pancreatitis is relatively uncommon, occurring in 5-6% of individuals, but results in substantial financial burden.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopists' knowledge, perceptions and attitudes toward the use of artificial intelligence in endoscopy: A systematic review.","authors":"Nicholas Wan, Celine Chan, Jin Lin Tan, Mohamed Asif Chinnaratha, Rajvinder Singh","doi":"10.1016/j.gie.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.001","url":null,"abstract":"<p><strong>Background & aims: </strong>Artificial Intelligence (AI) is rapidly evolving in the field of gastrointestinal endoscopy. This systematic review aims to summarise the current perspectives of endoscopists on AI in endoscopy, as well as to identify its challenges.</p><p><strong>Methods: </strong>Electronic databases were searched to identify studies conducted on endoscopists' opinions on the use of AI in endoscopy. Qualitative synthesis of included studies was conducted by categorizing into five domains: 1) Knowledge, perception and attitude toward AI, 2) Impacts of AI on endoscopic performance, 3) Impact of AI on endoscopists, 4) Impact of AI on patients and 5) Barriers toward the implementation of AI.</p><p><strong>Results: </strong>Ten studies were included, comprising 1587 endoscopists across Europe (32.6%), North America (42.8%), and Asia (24.6%). Domain 1: Most (69-100%) had basic knowledge of AI. Majority (79.5-87.5%) expressed interest and optimism. Domain 2: Most (62.5-97%) felt that AI would positively impact endoscopic performance and quality. Domain 3: There were mixed perceptions, 6.2-62.8% suggested that AI would lead to operator dependence. 21-81.3% felt that AI would prolong procedural time. Most (71-100%) disagreed that AI would replace them. Domain 4: Majority (81.3%) felt that AI would improve patient care. Domain 5: Most (75.2-91%) identified costs as barriers to AI implementation. Opinions on ethics and regulation varied (12.5-100% and 35-88%, respectively), with majority advocating for clear guidelines and regulations.</p><p><strong>Conclusion: </strong>There is a positive attitude toward the use of AI in endoscopy. Concerns regarding the impact on clinical practice, costs and medicolegal considerations remain. Establishing robust regulatory frameworks is crucial to the integration of AI into endoscopy.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Cause of Dysphagia and colonic lesions.","authors":"Cong Dai, Yu-Hong Huang","doi":"10.1016/j.gie.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.005","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of primary signet-ring cell carcinoma with a rare endoscopic presentation.","authors":"Xiuxiu Yin, Fujian Li, Huilan Ye, Guo Zhang","doi":"10.1016/j.gie.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.gie.2025.03.004","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}