Gastrointestinal endoscopy最新文献

{"title":"Prognostic value of preoperative intragastric meal distribution in gastric emptying scintigraphy for long-term success of gastric peroral endoscopic myotomy in gastroparesis","authors":"Antoine Debourdeau MD ,&nbsp;Véronique Vitton MD, PhD ,&nbsp;Sandra Gonzalez MD, PhD ,&nbsp;Henri Collet MD ,&nbsp;Yassine Al Tabaa MD ,&nbsp;Marc Barthet MD, PhD ,&nbsp;Jean-Michel Gonzalez MD, PhD","doi":"10.1016/j.gie.2024.05.011","DOIUrl":"10.1016/j.gie.2024.05.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric emptying scintigraphy (GES) is the criterion standard for the diagnosis of gastroparesis. However, data are lacking regarding the prognostic value of preoperative intragastric meal distribution during GES in patients undergoing gastric peroral endoscopic myotomy (G-POEM) for gastroparesis. This study investigated the association of GES morphologic parameters and the long-term clinical success of G-POEM.</div></div><div><h3>Methods</h3><div>This retrospective study included patients who underwent G-POEM for refractory gastroparesis in a tertiary center with preoperative GES data. Intragastric meal distribution was measured using the proximal to distal count ratio (PDCR) at 0, 1, 2 and 4 hours, and the retention index was calculated. Clinical success was defined as a decrease of at least 50% in the Gastroparesis Cardinal Symptom Index total score after G-POEM.</div></div><div><h3>Results</h3><div>In total, 77 patients were included with a mean follow-up of 40.14 months. Clinical success was observed in 54.55% of patients. The retention index was not associated with clinical success. Only PDCR at 0 hours (PDCR0) was associated with clinical success. In univariate analysis, the median PDCR0 was 6.0 (interquartile range, 5.59) in patients with clinical success and 4.29 (interquartile range, 4.51) in patients with clinical failure (<em>P</em> = .019). In multivariate analysis, PDCR0 &gt;5.25 was associated with clinical success (odds ratio, 4.36; 95% confidence interval, 1.55-12.26; <em>P</em> = .00524).</div></div><div><h3>Conclusions</h3><div>This study suggests that in patients with gastroparesis, a high PDCR0 value (suggestive for a preferential fundic meal distribution) during preoperative GES is associated with long-term clinical response to G-POEM.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 598-607"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957050","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":"Evaluating no fixation, endoscopic suture fixation, and an over-the-scope clip for anchoring fully covered self-expandable metal stents in benign upper GI conditions: a comparative multicenter international study (with video)","authors":"Amit Mehta MD ,&nbsp;Ashraf Ashhab MD ,&nbsp;Apurva Shrigiriwar MD ,&nbsp;Redeat Assefa MD ,&nbsp;Andrew Canakis DO ,&nbsp;Michael Frohlinger MD ,&nbsp;Christopher A. Bouvette MD ,&nbsp;Gregus Matus MD ,&nbsp;Paul Punkenhofer MD ,&nbsp;Francesco Vito Mandarino MD ,&nbsp;Francesco Azzolini MD ,&nbsp;Jamil S. Samaan MD ,&nbsp;Rashmi Advani MD ,&nbsp;Shivani K. Desai MD ,&nbsp;Bradley Confer DO ,&nbsp;Vikas K. Sangwan MD ,&nbsp;Jonh J. Pineda-Bonilla MD ,&nbsp;David P. Lee MD ,&nbsp;Kinnari Modi MD ,&nbsp;Chiemeziem Eke MD ,&nbsp;Mouen A. Khashab MD","doi":"10.1016/j.gie.2024.08.015","DOIUrl":"10.1016/j.gie.2024.08.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Fully covered self-expandable metal stents (FCSEMSs) are widely used in benign upper GI conditions, but stent migration remains a limitation. An over-the-scope clip (OTSC) device (Stentfix {SF], Ovesco Endoscopy) for stent anchoring has recently been developed. The aim of this study was to evaluate the effect of OTSC fixation on FCSEMS migration rate.</div></div><div><h3>Methods</h3><div>In this retrospective review of consecutive patients who underwent FCSEMS placement for benign upper GI conditions from January 2011 to October 2022 at 16 centers, the primary outcome was rate of stent migration. The secondary outcomes were clinical success and adverse events.</div></div><div><h3>Results</h3><div>A total of 311 (no fixation [NF] 122, SF 94, endoscopic suturing [ES] 95) patients underwent 316 stenting procedures. Compared with the NF group (n = 49, 39%), the rates of stent migration were significantly lower in the SF (n = 16, 17%, <em>P</em> = .001) and ES (n = 23, 24%, <em>P</em> = .01) groups. The rates of stent migration were not different between the SF and ES groups (<em>P</em> = .2). On multivariate analysis, SF (odds ratio [OR], 0.34, 95% CI, 0.17-0.70, <em>P</em> &lt; .01) and ES (OR, 0.46, 95% CI, 0.23-0.91; <em>P</em> = .02) were independently associated with decreased risk of stent migration. Compared with the NF group (n = 64; 52%), there were higher rates of clinical success in the SF (n = 64; 68%; <em>P</em> = .03) and ES (n = 66; 69%; <em>P</em> = .02) groups. There was no significant difference in the rates of adverse events among the 3 groups.</div></div><div><h3>Conclusion</h3><div>Stent fixation using OTSCs is safe and effective at preventing stent migration and may also result in improved clinical response.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 589-597"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046576","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-guided gastroenterostomy for malignant gastric outlet obstruction: impact of clinical and demographic factors on outcomes","authors":"Ravi Teja Pasam MBBS, MPH ,&nbsp;Thomas Mathews MD ,&nbsp;Kimberly F. Schuster BA ,&nbsp;Daniel Szvarca MD ,&nbsp;Trent Walradt MD ,&nbsp;Pichamol Jirapinyo MD, MPH ,&nbsp;Christopher C. Thompson MD, MSc","doi":"10.1016/j.gie.2024.10.053","DOIUrl":"10.1016/j.gie.2024.10.053","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided gastroenterostomy (EUS-GE) has emerged as an alternative to surgical gastrojejunostomy and endoluminal stenting for malignant gastric outlet obstruction (MGOO). Studies regarding factors associated with the EUS-GE outcomes are limited.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted with consecutive patients who underwent EUS-GE for MGOO from January 2016 to November 2023. Primary outcomes were technical success (establishing EUS-GE) and clinical success (low-residue diet tolerance without re-intervention at 90-day follow-up). Secondary outcomes were adverse events (AEs), reinterventions, and full regular diet tolerance.</div></div><div><h3>Results</h3><div>Technical success and clinical success rates were 92.70% (127 of 137) and 88.00%, respectively, with 42.86% of the patients tolerating a regular diet. Patients with peritoneal carcinomatosis had lower odds of technical success (odds ratio [OR], .19; 95% confidence interval [CI], .04-.93). Obstruction at the level of stomach, compared with duodenum, had lower odds of clinical success (OR, .06; 95% CI, .006-.56). AE and reintervention rates were 14.17% and 8.66%. Nasogastric tube decompression before EUS-GE was associated with lower AE rates in multivariable analysis (OR, .32; 95% CI, .11-.95). Prior GI surgery was associated with reintervention in multivariable analysis (OR, 4.09; 95% CI, 1.02-16.45; <em>P</em> = .047).</div></div><div><h3>Conclusions</h3><div>EUS-GE has high technical and clinical success rates, with many patients tolerating a regular diet. Routine nasogastric tube decompression should be considered to minimize AEs. MGOO at the level of the stomach is associated with lower clinical success rates. Extra care should be taken while performing EUS-GE in patients with peritoneal carcinomatosis. Prior GI surgery is a likely risk factor for reintervention.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 580-588.e1"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567300","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 endoscopy in pregnancy: a review","authors":"Hadie Razjouyan MD, MPH,&nbsp;Jennifer L. Maranki MD, MSc, FASGE","doi":"10.1016/j.gie.2024.10.058","DOIUrl":"10.1016/j.gie.2024.10.058","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 520-526"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567378","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":"Information for readers","authors":"","doi":"10.1016/S0016-5107(25)00019-7","DOIUrl":"10.1016/S0016-5107(25)00019-7","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Page A16"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520824","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 cause of recurrent pancreatitis: intraductal papillary mucinous neoplasm in the duct of Santorini (with video)","authors":"Peijing Bao MB,&nbsp;Guangchao Li MD,&nbsp;Ning Zhong MD,&nbsp;Yanqing Li MD,&nbsp;Peng Wang MD","doi":"10.1016/j.gie.2024.10.050","DOIUrl":"10.1016/j.gie.2024.10.050","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 679-680"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564254","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":"Endoscopic scoring of immune-mediated colitis disease activity","authors":"Viktoria Bergqvist MD, PhD,&nbsp;Peter Gedeon MD, PhD,&nbsp;Erik Hertervig MD, PhD,&nbsp;Jan Marsal MD, PhD","doi":"10.1016/j.gie.2024.10.007","DOIUrl":"10.1016/j.gie.2024.10.007","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 695-696"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519298","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":"Use patterns, technical challenges, and patient selection associated with single-use duodenoscopes and duodenoscopes with single-use endcaps in the United States and Canada","authors":"Monique T. Barakat MD, PhD ,&nbsp;Kelita Singh MD ,&nbsp;Mike Wei MD,&nbsp;Shai Friedland MD,&nbsp;Subhas Banerjee MD","doi":"10.1016/j.gie.2024.09.043","DOIUrl":"10.1016/j.gie.2024.09.043","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The extent of adoption, patient selection, and use patterns of single-use duodenoscopes and duodenoscopes with single-use endcaps have not yet been characterized, and large-scale assessments of endoscopist-reported function and challenges have not been reported.</div></div><div><h3>Methods</h3><div>An anonymous 6-minute electronic survey assessing use and experience with single-use duodenoscopes and duodenoscopes with novel design features was distributed to U.S. and Canadian endoscopy centers, and responses were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>The survey was notable for a 70.2% response rate, with representation from academic (68.9%), community (18%), and veterans affairs (8.2%) centers. Most institutions used standard reprocessable duodenoscopes and duodenoscopes with single-use endcaps (34.4%) or a mix of standard reprocessable duodenoscopes, duodenoscopes with single-use endcaps, and single-use duodenoscopes (29.5%). No center used only single-use duodenoscopes. Some institutions (10.3%) planned to transition to duodenoscopes with a single-use endcap, 10.3% to a mix of single-use duodenoscopes and duodenoscopes with a single-use endcap, and 1.7% to single-use duodenoscopes alone. Challenges were reported with each type of novel duodenoscope, and selection patterns for use were characterized.</div></div><div><h3>Conclusions</h3><div>This first of its kind, large-scale survey of use patterns and functionality of newly introduced duodenoscopes is notable for the fairly widespread use of duodenoscopes with single-use endcaps and more limited use of single-use duodenoscopes. Both novel duodenoscope designs are associated with mechanical limitations that respondents indicate represent challenges to successful completion of ERCPs.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 663-668"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377752","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":"Impact of difficult biliary cannulation on post-ERCP pancreatitis: secondary analysis of the stent versus indomethacin trial dataset","authors":"Samuel Han MD, MS ,&nbsp;Jingwen Zhang MS ,&nbsp;Valerie Durkalski-Mauldin PhD ,&nbsp;Lydia D. Foster MS ,&nbsp;Jose Serrano MD, PhD ,&nbsp;Gregory A. Coté MD ,&nbsp;Ji Young Bang MD ,&nbsp;Shyam Varadarajulu MD ,&nbsp;Vikesh K. Singh MD ,&nbsp;Mouen Khashab MD ,&nbsp;Richard S. Kwon MD ,&nbsp;James M. Scheiman MD ,&nbsp;Field F. Willingham MD ,&nbsp;Steven A. Keilin MD ,&nbsp;J. Royce Groce MD ,&nbsp;Peter J. Lee MBBS ,&nbsp;Somashekar G. Krishna MD ,&nbsp;Amitabh Chak MD ,&nbsp;Adam Slivka MD, PhD ,&nbsp;Daniel Mullady MD ,&nbsp;Georgios I. Papachristou MD, PhD","doi":"10.1016/j.gie.2024.10.003","DOIUrl":"10.1016/j.gie.2024.10.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Difficult biliary cannulation (DBC) is a known risk factor for developing post-ERCP pancreatitis (PEP). To better understand how DBC increases PEP risk, we examined the interplay between technical aspects of DBC and known PEP risk factors.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of a multicenter, randomized controlled trial comparing rectal indomethacin alone with the combination of rectal indomethacin and prophylactic pancreatic duct (PD) stent placement for PEP prophylaxis in high-risk patients. Participants were categorized into 3 groups: DBC with high preprocedure risk for PEP, DBC without high preprocedure risk for PEP, and non-DBC at high preprocedure risk for PEP.</div></div><div><h3>Results</h3><div>In all, 1601 participants (84.1%) experienced DBC, which required a mean of 12 cannulation attempts (standard deviation, 10) and mean duration of 14.7 minutes (standard deviation, 14.9). PEP rate was highest (20.7%) in DBC with a high preprocedure risk, followed by non-DBC with a high preprocedure risk (13.5%), and then DBC without a high preprocedure risk (8.8%). Increasing number of PD wire passages (adjusted odds ratio [aOR], 1.97; 95% confidence interval [CI], 1.25-3.1) was associated with PEP in DBC, but PD injection, pancreatic sphincterotomy, and number of cannulation attempts were not associated with PEP. Combining indomethacin with PD stent placement lowered the risk of PEP (aOR, .61; 95% CI, .44-.84) in DBCs. This protective effect was evident in up to at least 4 PD wire passages.</div></div><div><h3>Conclusions</h3><div>DBC confers higher PEP risk in an additive fashion to preprocedural risk factors. PD wire passages appear to add the greatest PEP risk in DBCs, but combining indomethacin with PD stent placement reduces this risk, even with increasing PD wire passages.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 617-628"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399940","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":"Optimal visual gaze pattern of endoscopists for improving adenoma detection during colonoscopy (with video)","authors":"Mizuki Nagai MD ,&nbsp;Fumiaki Ishibashi MD, PhD ,&nbsp;Kosuke Okusa DrEng ,&nbsp;Kentaro Mochida MD ,&nbsp;Eri Ozaki MD, PhD ,&nbsp;Tetsuo Morishita MD, PhD ,&nbsp;Sho Suzuki MD, PhD","doi":"10.1016/j.gie.2024.09.028","DOIUrl":"10.1016/j.gie.2024.09.028","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Visual gaze pattern (VGP) analysis quantifies endoscopists’ specific eye movements. VGP during colonoscopy may be associated with polyp detection. However, the optimal VGP to maximize detection performance remains unclear. This study evaluated the optimal endoscopic VGP that enabled the highest colorectal adenoma detection rate.</div></div><div><h3>Methods</h3><div>This randomized controlled trial was conducted between July and December 2023. We developed an eye-tracking and feedback (ETF) system that instructed endoscopists to correct their gaze toward the periphery of an endoscope screen with an audible alert. Patients who underwent colonoscopy were randomly assigned to 4 groups: 3 intervention groups, in which the endoscopist’s gaze was instructed to a different level of the peripheral screen area using the ETF system (the periphery of 4 × 4, 5 × 5, and 6 × 6 divisions of the screen), and a control group in which the endoscopist did not receive instructions. The primary outcome was the number of adenomas detected per colonoscopy (APC).</div></div><div><h3>Results</h3><div>In total, 189 patients were enrolled. The APC and adenoma detection rate were significantly higher in the 6 × 6 group than in the control group (1.82 ± 2.41 vs 0.59 ± 1.17, <em>P</em> = .002; 68.9% vs 30.8%, <em>P</em> = .002). The APC and the number of screen divisions were positively correlated (<em>R</em> = 0.985, <em>P</em> = .0152). The rate at which the endoscopist gazed at the periphery of the screen was positively correlated with the number of divisions (<em>R</em> = 0.964, <em>P</em> = .0363).</div></div><div><h3>Conclusions</h3><div>Colorectal adenoma detection was improved by correcting the endoscopist’s gaze to the periphery of the screen, especially by dividing the screen into 6 × 6 segments.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 639-646.e3"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344842","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}