Gastrointestinal endoscopy最新文献

{"title":"Meta-analysis of single session versus two-stage endoscopic ultrasound directed transgastric ERCP (EDGE) in gastric bypass patients.","authors":"Sahib Singh, Bishnu Sapkota, Noam Peleg, Saurabh Chandan, Kelita Singh, Savio John, Hafiz Muzaffar Akbar Khan, Mohammad Bilal, Douglas G Adler","doi":"10.1016/j.gie.2026.10.011","DOIUrl":"https://doi.org/10.1016/j.gie.2026.10.011","url":null,"abstract":"<p><strong>Background and aims: </strong>Studies have shown variable outcomes when comparing single session endoscopic ultrasound directed transgastric endoscopic retrograde cholangiopancreatography (SS EDGE) and two-stage EDGE. We conducted a meta-analysis.</p><p><strong>Methods: </strong>Online databases were searched for studies comparing SS EDGE to two-stage EDGE in patients with gastric bypass. The outcomes of interest were technical success, clinical success, stent dislodgement/migration, overall adverse events (AEs), persistent fistula and patients with weight gain. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated.</p><p><strong>Results: </strong>A total of 7 observational studies with 346 patients (47% SS EDGE, 53% two-stage EDGE) were included. The mean age was 58 years and 23% patients were males. Around 80% EDGE procedures were done for biliary pathologies with the rest being for pancreatic pathologies. When comparing the two approaches, no significant differences were found with respect to technical success (OR 0.34, 95% CI 0.03 to 3.53, p = 0.37), clinical success (OR 1.88, 95% CI 0.38 to 9.17, p = 0.44), stent dislodgement/migration (OR 1.70, 95% CI 0.88 to 3.31, p = 0.12), overall AEs (OR 1.45, 95% CI 0.38 to 5.48, p = 0.58), persistent fistula (OR 1.00, 95% CI 0.32 to 3.09, p = 0.99), and patients with weight gain (OR 1.25, 95% CI 0.32 to 4.84, p = 0.75).</p><p><strong>Conclusion: </strong>SS EDGE and two-stage EDGE were found to have similar outcomes in terms of efficacy and safety.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223777","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":"Bicentric comparison of 3-year clinical outcomes between endoscopic ultrasound-guided embolization with coil and hemostatic adjunct versus balloon-occluded retrograde transvenous obliteration for treatment of bleeding gastric varices: A propensity-score matched study.","authors":"Noppachai Siranart, Thomas J Wang, Peter Konyn, Ahmad N Bazarbashi, Pichamol Jirapinyo, Christopher C Thompson, Stephen D Zucker, Marvin Ryou","doi":"10.1016/j.gie.2026.10.010","DOIUrl":"https://doi.org/10.1016/j.gie.2026.10.010","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic ultrasound-guided coil injection (EUS-COIL) and balloon-occluded retrograde transvenous obliteration (BRTO) performed by interventional radiology (IR) are both effective obliterative procedures to treat gastric varices. Comparative studies are lacking. Our aim was to assess clinical outcomes for EUS-COIL versus BRTO for treatment of acute gastric variceal bleeding.</p><p><strong>Methods: </strong>This retrospective cohort study included all patients admitted to two tertiary care centers between 2009-2024 who underwent either EUS-COIL or BRTO for bleeding gastric varices. The primary outcomes were technical/clinical success and adverse events. Secondary outcomes included transfusions, reintervention, length of hospital stay, further hepatic decompensation (esophageal variceal hemorrhage, new ascites, or new hepatic encephalopathy (HE)), and all-cause mortality. Subgroup analyses were performed in patients with cirrhosis, including with propensity score matching (PSM) which was conducted 1:1 for age, sex, Child-Pugh classification, MELD-Na score, and hemoglobin level on admission. Outcomes over the 36-months post-intervention were assessed using time-to-event analysis.</p><p><strong>Results: </strong>A total of 94 patients were included (48 EUS-COIL, 46 BRTO), of whom 60 patients with cirrhosis (30 per group) were analyzed after propensity score matching. In the matched cohort, technical success was 100% in both groups and clinical success was 100% versus 93.3% (p=0.49). The EUS-COIL group experienced significantly fewer adverse events (3% vs 37%; p=0.003) and had a longer time-to-reintervention (65 ± 52 days vs 10 ± 9.6 days; p=0.022) over a median follow-up 900 ± 790 days. The incidence of further hepatic decompensation was lower in the EUS-COIL group (10% vs 40%; p=0.007), as was the likelihood of further hepatic decompensation (HR 0.28 (95%CI: 0.08-0.984), p = 0.047) compared to BRTO. No significant differences were observed with regard to post-procedural transfusion requirements, rates of reintervention, length of hospital stay, and mortality in cirrhosis patients. In the unmatched cohort, technical (100% vs 80%; p=0.001) and clinical (100% vs 89%; p=0.03) success were higher with EUS-COIL than BRTO.</p><p><strong>Conclusions: </strong>In patients with gastric variceal hemorrhage, EUS-COIL demonstrated higher rates of technical/clinical success and lower rates of adverse events (both peri-procedural and on long-term follow-up) compared to BRTO. EUS-COIL had significantly lower rates of further hepatic decompensation. While larger prospective studies are required, these data suggest that EUS-COIL, when available, may be the preferred initial therapy for bleeding gastric varices as part of a step-up strategy.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215881","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":"Top Tips for Endoscopic Management of Lynch Syndrome and Familial Adenomatous Polyposis.","authors":"Bryson W Katona","doi":"10.1016/j.gie.2026.09.048","DOIUrl":"https://doi.org/10.1016/j.gie.2026.09.048","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192589","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":"Top Tips for building ESD practice.","authors":"Mohamed O Othman, Martha Ann, Harold M Selzman","doi":"10.1016/j.gie.2026.09.047","DOIUrl":"https://doi.org/10.1016/j.gie.2026.09.047","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192672","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":"Pharyngoesophageal fistula secondary to self-expanding metal stent placement for radiation-induced pharyngoesophageal stricture.","authors":"Lexis Khetsavanh, Ron Karni, Nirav Thosani, Wasseem Skef","doi":"10.1016/j.gie.2026.10.001","DOIUrl":"https://doi.org/10.1016/j.gie.2026.10.001","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148267","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":"Enteral Access Decision-Making in Clinical Practice: Nasogastric and Nasojejunal Tubes, Percutaneous Endoscopic Gastrostomy, Percutaneous Endoscopic Gastrostomy With Jejunal Extension, and Direct Percutaneous Endoscopic Jejunostomy.","authors":"Andrew Ofosu","doi":"10.1016/j.gie.2026.09.046","DOIUrl":"https://doi.org/10.1016/j.gie.2026.09.046","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148123","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 case of non-anastomotic biliary stricture.","authors":"Songming Ding, Shanjie Dong, Hengkai Zhu, Shusen Zheng, Qiyong Li","doi":"10.1016/j.gie.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.gie.2026.10.002","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147767","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":"Role of remimazolam in gastrointestinal endoscopy: American Society for Gastrointestinal Endoscopy clinical practice update.","authors":"Daryl Ramai, Markus W Hollmann, Sudipta Sen, Faisal Ali, Sara Ghoneim, Sydney Greenberg, Sunil Gupta, Manol Jovani, Calvin Lee, Jorge D Machicado, Jared Magee, Sultan Mahmood, Guillermo A Ortiz, Michael D Rice, Monica Saumoy, Sumit K Singla, Christopher W Teshima, Nirav C Thosani","doi":"10.1016/j.gie.2026.08.019","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.019","url":null,"abstract":"<p><p>This clinical practice update provides evidence-based recommendations on the use of remimazolam, a novel ultra-short-acting benzodiazepine, for procedural sedation during GI endoscopy. Remimazolam was approved by the Food and Drug Administration in July 2020 for use in procedural sedation. It offers rapid onset, short duration of action, and organ-independent metabolism, making it an alternative to traditional sedatives such as midazolam and propofol. This update synthesizes data from randomized controlled trials, meta-analyses, and real-world studies, addressing efficacy, safety, dosing, and patient selection. It aims to assist clinicians in optimizing sedation while minimizing risks, particularly in high-risk populations. Previous guidelines, such as the 2018 American Society for Gastrointestinal Endoscopy guidelines on sedation and anesthesia in GI endoscopy, focused on midazolam and propofol but did not include remimazolam. This update incorporates emerging evidence to guide the integration of remimazolam into practice.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136043","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":"2026 best of systematic reviews and meta-analyses in gastrointestinal endoscopy.","authors":"Babu P Mohan","doi":"10.1016/j.gie.2026.08.029","DOIUrl":"10.1016/j.gie.2026.08.029","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812614","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":"Serrated Polyposis Syndrome: A Review and Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer.","authors":"Douglas K Rex, Joseph C Anderson, Carol A Burke, Brian C Jacobson, Folasade P May, Swati G Patel, N Jewel Samadder, Elena M Stoffel, Douglas J Robertson","doi":"10.1016/j.gie.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.gie.2026.09.002","url":null,"abstract":"<p><p>Serrated polyposis syndrome (SPS) is the most common polyposis syndrome, yet SPS often goes unrecognized. SPS diagnosis is based on clinical criteria established by the World Health Organization and includes the size, cumulative lifetime number, and location of serrated polyps throughout the colon. Individuals with SPS have an increased risk of prevalent and incident colorectal cancer (CRC). Meticulous inspection, clearing of the colon and frequent surveillance colonoscopy is recommended to decrease incident CRC. Colorectal surgery is indicated for individuals diagnosed with cancer or whose polyp burden cannot be managed endoscopically by expert endoscopists. There is no common germline pathogenic variant associated with SPS. Germline genetic testing is indicated only in individuals who meet criteria for a known hereditary syndrome in the appropriate clinical setting. First-degree relatives of patients with SPS are at heightened risk of CRC and should undergo colonoscopic screening.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080638","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}