Gastrointestinal endoscopy最新文献

{"title":"Long slim versus conventional self-expandable metallic stent in bilateral endoscopic side-by-side deployment for unresectable malignant hilar biliary obstruction.","authors":"Ling Xing, Yan-Ting Liu, Xin Ye, Tian-Tian Wang, Jun Wu, Ming-Xing Xia, Bing Hu, Dao-Jian Gao","doi":"10.1016/j.gie.2025.01.040","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.040","url":null,"abstract":"<p><strong>Background and aims: </strong>To compare the advantages of long slim metal stents (LSMS) versus conventional metal stents in bilateral endoscopic side-by-side (SBS) deployment for malignant hilar biliary obstruction (MHBO).</p><p><strong>Methods: </strong>140 consecutive MHBO patients treated by endoscopic bilateral SBS deployment at a high-volume tertiary referral center were analyzed retrospectively, including 50 patients in LSMS group and the other 90 patients in conventional SBS group as control. Propensity score matching (PSM) at a 1:2 ratio was used to reduce selection bias. Primary outcomes were stent patency.</p><p><strong>Results: </strong>After PSM, no significant difference was obseved in stent patency (267 vs. 268 days, P=0.969) or overall survival (OS) (225 vs. 211 days, P=0.883) between the two groups. The technical success rate was 100% in both groups, and the clinical success rate was 91.1% in LSMS group and 92.9% in control group (P=0.735). Early and late adverse events were similar (24.4% vs. 34.3%, P=0.423; 42.2% vs. 38.6%, P=0.697), while the procedure time and bilateral metal stenting time in LSMS group were significantly shorter (41.0 min vs. 57.5 min, P=0.000; 19.0 min vs. 28.5 min, P=0.000). The success rate of endoscopic bilateral revisionary stent insertion in LSMS group was also higher (100% vs. 33.3%, P=0.000).</p><p><strong>Conclusions: </strong>Bilateral LSMS placement is a viable option for MHBO patients with advantages of less operative difficulty and easier future re-intervention over conventional SBS stenting.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382165","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 Gastric Mass Due to Adrenal Tuberculosis Presenting Without Typical Clinical Manifestations of Addison's Disease.","authors":"Chuwei Zheng, Xiaowen Li, Liming Shao, Xia Ji, Jinming Zhang, Muxin Yu","doi":"10.1016/j.gie.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.gie.2025.02.005","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382158","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":"Cholangioscopy-Based Treatment and Diagnosis of an Infrequent Cause of Jaundice: Common Bile Duct Polyp.","authors":"Liying Tao, Hongguang Wang, Qingmei Guo, DongYue Wang, GuangYao Shi, Xiang Guo, Liu Lin","doi":"10.1016/j.gie.2025.01.039","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.039","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364307","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":"SURVEILLANCE FINDINGS IN HIGH-RISK PATIENTS AFTER BASELINE COMPUTER-ASSISTED DETECTION COLONOSCOPY: A PROPENSITY SCORE MATCHING ANALYSIS.","authors":"Thomas Kl Lui, Michael Kl Ko, Elvis Wp To, Wai K Leung","doi":"10.1016/j.gie.2025.01.036","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.036","url":null,"abstract":"<p><strong>Background and aims: </strong>The impact of CADe application on surveillance colonoscopy findings remains unknown. We compare surveillance colonoscopy findings in patients with high-risk lesions detected at baseline, with or without the application of CADe.</p><p><strong>Methods: </strong>We included patients with high-risk baseline lesions and had undergone surveillance colonoscopy. High-risk baseline lesions included advanced adenoma, advanced serrated lesion, or three or more adenomas at baseline colonoscopy. Patients were divided into two groups according to baseline use of CADe (vs conventional), and matched by propensity score matching (PSM) in 1:2 ratio for surveillance interval, baseline characteristics and index colonoscopy findings. The primary outcome was metachronous advanced adenoma (AA) rate.</p><p><strong>Results: </strong>Of 403 patients with high-risk baseline lesions and surveillance colonoscopy, 162 patients were included after PSM. In patients with baseline use of CADe, both the AA detection rate (11.1% vs 24.1%, p=0.05) and the number of AA per colonoscopy (0.1 vs 0.3, p=0.01) were significantly lower than those with conventional colonoscopy. Similar pattern was observed for detection rate of adenoma (44.4% vs 63.0%, p=0.02) and the mean number of adenomas detected per colonoscopy (adenoma: 0.6 vs 1.2, p=0.01). The cumulative incidence of patients with any metachronous adenoma or serrated lesion was significantly lower in patients with baseline use of CADe than conventional colonoscopy (log rank p=0.05).</p><p><strong>Conclusions: </strong>Patients who had CADe use at baseline colonoscopy had significantly lower rates of metachronous lesions, including advanced adenoma, on surveillance colonoscopy.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364328","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":"Thirty-day hospital admission following high-risk outpatient ERCP: incidence and analysis of risk factors based on a secondary analysis of the Stent Versus Indomethacin trial data set.","authors":"Patrick Yachimski, Jingwen Zhang, Gregory A Coté, Steven A Edmundowicz, Sachin Wani, Raj Shah, Ji Young Bang, Shyam Varadarajulu, Vikesh K Singh, Mouen Khashab, Richard S Kwon, James M Scheiman, Field F Willingham, Steven A Keilin, Georgios I Papachristou, Amitabh Chak, Adam Slivka, Daniel Mullady, Vladimir Kushnir, James Buxbaum, Rajesh Keswani, Timothy B Gardner, Nauzer Forbes, Amit Rastogi, Andrew Ross, Joanna Law, Yen-I Chen, Alan Barkun, Zachary L Smith, Jose Serrano, Bret Petersen, Andrew Y Wang, John R Saltzman, Rebecca L Spitzer, Collins Ordiah, Cathie Spino, Lydia D Foster, Valerie Durkalski-Mauldin, B Joseph Elmunzer","doi":"10.1016/j.gie.2025.01.035","DOIUrl":"10.1016/j.gie.2025.01.035","url":null,"abstract":"<p><strong>Background and aims: </strong>ERCP carries potential for serious adverse events, and there is risk for unplanned health encounters after the procedure. The primary objective of this study was to identify the rate of 30-day hospital admission after outpatient ERCP in patients at elevated risk for post-ERCP pancreatitis based on patient- and procedure-related risk factors. We also explored whether pancreatitis rates and lengths of hospital stay differ with delayed hospitalization (versus admission immediately after ERCP) and identified factors associated with 30-day hospital admission.</p><p><strong>Methods: </strong>High-risk patients in the Stent Versus Indomethacin trial who underwent outpatient ERCP were identified. The primary outcome was hospital admission within 30 days after outpatient ERCP. Patient and procedural factors associated with 30-day hospital admission were explored by means of univariable analysis followed by multivariable analysis, controlling for potential known confounders.</p><p><strong>Results: </strong>Among 768 patients at high risk for post-ERCP pancreatitis who underwent outpatient ERCP and were discharged home, 21.9% required hospitalization within 30 days. Compared with patients who underwent outpatient ERCP but were admitted immediately to the hospital after the procedure, patients who were discharged after ERCP and admitted later had a higher incidence of post-ERCP pancreatitis (40.5% vs 30.9%; P = .04), moderate to severe post-ERCP pancreatitis (24.4% vs 13.8%; P < .01), and longer length of hospital stay (6.2 d vs 3.7 d; P < .001). Factors associated with 30-day hospitalization included patient age (odds ratio [OR], 0.98; 95% CI, 0.97-0.99), biliary stent placement (OR, 1.62; 95% CI, 1.05-2.48), and attempt at pancreatic duct cannulation (OR, 1.64; 95% CI, 1.02-2.64).</p><p><strong>Conclusions: </strong>High-risk patients who undergo outpatient ERCP and are discharged home are at considerable risk for hospital admission within 30 days and have an increased rate of pancreatitis and longer length of hospital stay compared with outpatients admitted to the hospital immediately after ERCP, and some factors may predict this outcome. These findings should influence decision making and informed consent when electing to proceed with high-risk ERCP, recognizing that patients with sphincter of Oddi dysfunction were over-represented in this cohort, which may limit generalizability to a typical ERCP practice.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364372","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":"At the Focal Point: ERCP in Altered Anatomy: Managing a Large Bile Duct Stone in a Type 4 Hiatal Hernia using a Savary wire.","authors":"Matthew T Moyer","doi":"10.1016/j.gie.2025.01.038","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.038","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364304","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":"Endoscopist adenoma detection rate associated with neoplasia detection during subsequent-round colonoscopy in fecal immunochemical test-based colorectal cancer screening: cross-sectional analysis of the SCREESCO randomized controlled trial.","authors":"Masau Sekiguchi, Marcus Westerberg, Christian Löwbeer, Anna Forsberg","doi":"10.1016/j.gie.2025.01.037","DOIUrl":"10.1016/j.gie.2025.01.037","url":null,"abstract":"<p><strong>Background and aims: </strong>In colorectal cancer screening with the fecal immunochemical test (FIT), the optimal follow-up after first-round colonoscopy for a positive FIT, particularly after negative colonoscopy, is unknown. Therefore, using Screening of Swedish Colons (SCREESCO) study data, we aimed to elucidate the risk factors for the detection of colorectal neoplasia in second-round colonoscopy, which can affect recommendations for the optimal follow-up.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis using data from SCREESCO participants undergoing colonoscopy after a positive 2-stool FIT, with a positivity cutoff value of ≥10 μg/g feces, in both the first and second rounds separated by a 2-year interval. We assessed the associations between colorectal neoplasia detection in second-round colonoscopy and participant characteristics, FIT concentrations, first-round colonoscopy results, and endoscopists' adenoma detection rates (ADRs), which were categorized as very low, low, intermediate, and high.</p><p><strong>Results: </strong>This study included 343 individuals. Despite negative first-round colonoscopies (n = 230), colorectal cancer and advanced colorectal neoplasia (ACN) were detected in 0.9% and 8.3% of participants in the second-round colonoscopy, respectively. An association was demonstrated between the first-round endoscopists' ADRs and the risk of second-round ACN detection. The multivariable odds ratios of the first-round intermediate and high ADRs, compared with the very low ADR, for second-round ACN detection were 0.17 (95% confidence interval [CI], 0.02-0.79) and 0.19 (95% CI, 0.04-0.86), respectively.</p><p><strong>Conclusions: </strong>The impact of endoscopists' ADRs on ACN detection in subsequent-round colonoscopies underscores the importance of considering ADR for optimal follow-up after first-round colonoscopy in an FIT-based screening program.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364321","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 single-center pilot study on the efficacy and safety of acetic acid–enhanced magnifying endoscopy with narrow-band imaging for diagnosis of colorectal epithelial neoplasms","authors":"Takeshi Shimizu MD,&nbsp;Taku Yamagata MD,&nbsp;Yoshihide Kanno MD,&nbsp;Megumi Tanaka MD,&nbsp;Tomohiro Shimada MD,&nbsp;Daichi Komabayashi MD,&nbsp;Hiroki Sato MD,&nbsp;Yuta Shibuya MD,&nbsp;Kei Ito MD, PhD","doi":"10.1016/j.gie.2024.08.010","DOIUrl":"10.1016/j.gie.2024.08.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>We investigated the ideal acetic acid (AA) concentration for AA-enhanced narrow-band imaging magnifying endoscopy (ANBI-ME) in the diagnosis of superficial colorectal neoplasms and evaluated its clinical efficacy.</div></div><div><h3>Methods</h3><div>During the exploratory phase, we investigated 4 concentrations (1.5%, 2.25%, 3.0%, and 4.5%) in rotation by performing ANBI-ME on 50 superficial colorectal neoplasms at each concentration. A favorable AA concentration was determined by evaluating the diagnostic accuracy, AA whitening duration (AD), peristalsis, and bleeding after endoscopic resection. In the validation phase, we assessed interobserver agreements for ANBI-ME with the determined AA concentration and intermethodologic agreements between that and subsequently conducted crystal violet–stained magnifying endoscopy (CV-ME) with the exploratory set and 98 additional patients.</div></div><div><h3>Results</h3><div>The diagnostic accuracies were 89.3% (42/47) for 1.5% AA, 92.0% (46/50) for 2.25% AA, 96.8% (61/63) for 3.0% AA, and 97.8% (46/47) for 4.5% AA, with no significant difference (<em>P</em> = .26). A significant positive correlation was observed between AA concentration and AD (<em>P</em> &lt; .001). No significant differences in hyperperistalsis or post-resection bleeding were observed. The optimal AA concentration was determined to be 4.5%. In the validation analysis, the accuracy rates were 72.4% (105/145) with the use of AMBI-ME and 68.3% (99/145) with the use of CV-ME (<em>P</em> = .43). Strong agreements were noted between observers (κ: 0.87 for ANBI-ME, 0.83 for CV-ME) and between the methods (κ: 0.87 and 0.81 for each observer).</div></div><div><h3>Conclusions</h3><div>For diagnosing colorectal lesions, an AA concentration of 4.5% in ANBI-ME was safe and effective. Its diagnostic performance was similar to CV-ME, and future large-sample studies may confirm its potential as a reliable alternative endoscopic diagnostic method.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 416-424"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999752","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":"Application of endoscopic purse-string sutures in refractory nonvariceal GI bleeding: a multicenter study (with video)","authors":"Feifan Chen MD ,&nbsp;Yifan Jia MD ,&nbsp;Ling Xiao MD ,&nbsp;Li Yang MD ,&nbsp;Jinlin Yang MD ,&nbsp;Jianmei Zeng MD ,&nbsp;Limao Xu MD ,&nbsp;Xue Xiao MD, PhD","doi":"10.1016/j.gie.2024.09.020","DOIUrl":"10.1016/j.gie.2024.09.020","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Nonvariceal GI bleeding (GIB) is a common medical emergency. Endoscopic hemostasis is recommended, but some patients experienced recurrent bleeding after conventional endoscopic hemostasis. Originally, the purse-string suture (PSS) was used for lesion closure during EMR. Here, we evaluated the effectiveness of the endoscopic PSS in controlling refractory bleeding.</div></div><div><h3>Methods</h3><div>We retrospectively collected data from 3 hospitals of patients who underwent endoscopic PSS for refractory nonvariceal GIB. Clinical success was defined as no recurrent bleeding, and patients were discharged according to medical advice.</div></div><div><h3>Results</h3><div>From October 2017 to May 2024, 36 patients who received PSS treatments were included. Of these 36 patients, 83.3% (30) achieved clinical success. In refractory upper GIB, the clinical success rate was 81.25% (26/32), and in lower GIB, the clinical success rate was 100% (4/4).</div></div><div><h3>Conclusions</h3><div>The endoscopic PSS is effective in treating refractory nonvariceal GIB.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 446-451"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283754","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":"Rates of repeat EGD in nondiabetic adults with glucagon-like peptide-1 receptor agonist prescription: a retrospective matched cohort study","authors":"Abbinaya Elangovan MD ,&nbsp;Pearl Aggarwal MD ,&nbsp;David C. Kaelber MD ,&nbsp;Raj Shah MD","doi":"10.1016/j.gie.2024.10.004","DOIUrl":"10.1016/j.gie.2024.10.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Data on endoscopic outcomes in adults without diabetes who are taking glucagon-like peptide-1 receptor agonists (GLP-1RAs) are limited. Therefore, we compared repeat EGD in this population with those not taking GLP-1RAs using a retrospective matched case-control study.</div></div><div><h3>Methods</h3><div>Using the TriNetX health research platform (Cambridge, Mass, USA), we analyzed adults with a body mass index ≥27 kg/m² without diabetes who underwent diagnostic EGD. The study group included individuals with ≥3 GLP-1RA prescriptions and undergoing EGD ≥30 days after the initial GLP-1RA prescription. The control group included individuals who were never prescribed GLP-1RAs but had an EGD after the prescription of other weight loss medications. Outcomes were compared using the risk ratio (RR) in matched cohorts.</div></div><div><h3>Results</h3><div>No significant difference in repeat EGD (5.4% vs 4.2%; RR, 1.28; 95% confidence interval [CI], .95-1.71) or new diagnosis of gastroparesis (1.1% vs .6%; RR; 2.00; 95% CI, .94-4.27) was noted between the groups.</div></div><div><h3>Conclusions</h3><div>GLP-1RAs may not substantially increase the risk of repeat endoscopy in individuals without diabetes.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 441-445"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399939","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}