Digestive Endoscopy最新文献

{"title":"Response to: Site of puncture in endoscopic ultrasound-guided fine needle biopsy: Does it change diagnostic outcome?","authors":"Sung Woo Ko, Tae Jun Song","doi":"10.1111/den.14997","DOIUrl":"10.1111/den.14997","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 2","pages":"201"},"PeriodicalIF":5.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WEO Newsletter: Towards a Green Endoscopy","authors":"","doi":"10.1111/den.14987","DOIUrl":"10.1111/den.14987","url":null,"abstract":"<p>Cesare Hassan<sup>1,2</sup> Maddalena Menini<sup>1</sup> and Alessandro Repici<sup>1,2</sup></p><p><sup>1</sup>IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089, Milan, Italy and <sup>2</sup>Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy</p><p><i>Correspondence:</i> Cesare Hassan, <i>Humanitas Research Hospital and University</i>, Via Manzoni 56, 20089 Rozzano (Milano) Italy, Tel: +39 (0)282247385, Fax: +390282242595, Email: <span>[email protected]</span></p><p>When we think of endoscopy, we think of innovation, advanced techniques, patient safety, and more. But have we ever stopped to reflect on the environmental price of these accomplishments? Could our practices be harmful to the planet's health?</p><p>To put the issue into perspective, healthcare contributes between 1% and 5% of global environmental impacts, depending on the metric considered, and surpasses 5% in certain national contexts.<span><sup>1</sup></span></p><p>Digestive endoscopy is far from blameless as it is a resource-demanding activity with a substantial but insufficiently evaluated environmental footprint.<span><sup>2</sup></span> Endoscopy is believed to be the third-largest producer of waste within the healthcare sector.<span><sup>3</sup></span></p><p>From the gallons of water and kilowatts of energy used in scope reprocessing to the mountains of single-use plastics discarded daily, our practices are leaving a footprint that can no longer be ignored.</p><p>A single reusable endoscope, over its lifecycle, emits several kilograms of CO2 for every procedure it undergoes—an unsettling irony for a tool designed to save lives. And while single-use devices are often marketed as convenient and hygienic, they create a staggering amount of non-biodegradable waste.</p><p>As endoscopists, we pride ourselves on our ability to solve complex problems, yet we seem reluctant to address one staring us in the face: the unsustainable environmental impact of our work. One could argue that environmentally friendly practices should focus on other sectors rather than healthcare, as patient safety – and healthcare quality - must always come first. Similarly, it could be argued that healthcare workers should direct their attention to advancing care rather than worrying about “recycling waste.”</p><p>However, these views are outdated. What could be more urgent than securing our survival on this planet? And is it truly the case that green endoscopy initiatives would compromise the quality of care? Often, energy-intensive and environmentally harmful practices arise not from necessity but from a lack of awareness—or simple negligence and inattention.</p><p>It's easy to dismiss these issues as beyond our control, but that mindset is part of the problem. The encouraging news is that practical, sustainable solutions are within reach. Leading societies in Gastrointestinal Endoscopy emphasize sustainability ","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 1","pages":"132-134"},"PeriodicalIF":5.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WEO Newsletter: Current state and future development of robotic endoscopy","authors":"","doi":"10.1111/den.14971","DOIUrl":"10.1111/den.14971","url":null,"abstract":"<p>Hon Chi YIP MBChB (CUHK), FRCS(Edin)<sup>1</sup> and Philip Wai Yan, CHIU MD (CUHK), MBChB (CUHK), FRCS(Edin)<sup>2</sup></p><p><sup>1</sup>Division of Upper GI & Metabolic Surgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong and <sup>2</sup>Multi-Scale Medical Robotics Center, InnoHK</p><p>Development of flexible robotic endoscopy has proven to be a much more challenging task than rigid robotic surgical system. The main hurdles that need to be overcome for such a platform include the requirement of much smaller instruments within the GI lumen, as well as the intuitive movement of these instruments within a tortuous gastrointestinal tract. Existing robotic endoscopic systems could be divided into two main types: completely robotized endoscopic systems and robotic add-on system for existing endoscopic platforms. Among these systems, only a few have successfully reported results of human trials, while the majority of the others still remain at pre-clinical stage.</p><p>EndoMaster EASE system is a robotic endoscopic platform that consists of an endoscope mounted to a patient side cart, where two 4 mm robotic instruments (one electrosurgical dissector and one grasper) could be inserted into the target site through the endoscopy channel. The primary endoscopic surgeon controls the robotic instruments from the console unit, with both instruments allowing movement up to 9 Degree of Freedom (DOF). The prototype of the system was first applied in 5 human cases of gastric ESD in 2011 (<span>1</span>). Following system modification into a fully robotic endoscopic platform, a prospective single arm study was recently reported for 43 patients who underwent colorectal ESD using the system (<span>2</span>). Technical success was achieved in 86.1% of the patients, with en-bloc resection rate of 94.6% among those with successful procedure. While the results of the trial are encouraging, further questions remain including the need to downsize the system, the cost and benefit when compared with conventional ESD, etc.</p><p>EndoQuest Robotics Endoluminal Surgical (ELS) System is another robotic endoscopic platform that has reached the stage of clinical trials. Targeting solely at transanal endoscopic procedure at the sigmoid and rectum, the system consists of a 2.2 cm diameter 4-DOF Steerable Overtube (Previously named as Colubriscope), which allows insertion of one 6 mm flexible endoscope and two 6 mm robotic instruments with 7-DOF.</p><p>The system has demonstrated feasibility of partial thickness colorectal resection and suture closure in an ex-vivo animal study (<span>3</span>). Human clinical trial is currently underway for resection of lesions in sigmoid and rectum, and the results are eagerly awaited.</p><p>Flex Robotic System (Medrobotics) utilizes a robotized endoscope with two flexible mechanical arms. The 28 mm diameter flexible robotic endoscope is controlled at the console with a joystick, with two working chan","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"36 12","pages":"1394-1397"},"PeriodicalIF":5.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14971","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Pressure Study Integrated System: Promising tool for evaluating the esophagogastric junction, but why not use it in the stomach as well?","authors":"Antoine Debourdeau,&nbsp;Jean-Michel Gonzalez,&nbsp;Veronique Vitton","doi":"10.1111/den.14964","DOIUrl":"10.1111/den.14964","url":null,"abstract":"<p>We extend our sincere congratulations to Dr. Nishikawa and his team for their pioneering work on the Endoscopic Pressure Study Integrated System (EPSIS) for the diagnosis of achalasia and gastroesophageal reflux disease.<span>¹</span> This innovative approach holds great promise for advancing our understanding and diagnostic capabilities in esophageal motility disorders.</p><p>Although the authors focused on the esophagogastric junction, we believe EPSIS has broader applications. It could be highly beneficial for studying functional dyspepsia and gastroparesis. The EPSIS device measures gastric pressure, making it a promising tool for assessing gastric body compliance during routine endoscopy.</p><p>Gastric compliance disorders are a significant pathophysiological aspect of functional dyspepsia. Studies have shown reduced gastric compliance in functional dyspepsia, with barostats indicating a rapid increase in gastric pressure with lower balloon volumes. However, measuring this with a gastric barostat is challenging due to the device's limited availability and poor patient tolerance.<span>²</span></p><p>Interestingly, there is a continuum between functional dyspepsia and gastroparesis, with overlapping profiles in 40% of cases.<span>³</span> Although gastric peroral endoscopic myotomy (G-POEM) effectively treats gastroparesis, about 45% of patients face long-term failure, with unclear underlying causes.</p><p>Our recent research indicates that gastric distensibility is significantly reduced in nonresponders to G-POEM, as evidenced by gastric volumetry.<span>⁴</span> Additionally, gastric emptying scintigraphy meal repartition analysis shows poor utilization of the gastric body and fundus as meal storage areas in nonresponders to G-POEM, which may be related to poor relaxation of the gastric body and fundus.<span>⁵</span></p><p>We believe EPSIS, as described in this study,<span>¹</span> could be useful in confirming these indicators in the pretherapeutic assessment of gastroparetic patients. This could help to determine if impaired gastric accommodation predicts G-POEM failure. We look forward to further developments in this field and how EPSIS can be integrated into broader clinical practice.</p><p>Authors declare no conflict of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 2","pages":"199"},"PeriodicalIF":5.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14964","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis","authors":"Jacquelyn Chi Ying Fok,&nbsp;Anthony Yuen Bun Teoh,&nbsp;Shannon Melissa Chan","doi":"10.1111/den.14946","DOIUrl":"10.1111/den.14946","url":null,"abstract":"<p>With technological advances in endoscopic ultrasonography, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) was introduced as a treatment option for acute cholecystitis. Recently, new studies have emerged, suggesting that EUS-GBD has a lower adverse event rate and reintervention rate, when compared to percutaneous drainage and endoscopic transpapillary gallbladder drainage. There is growing interest in the different technical aspects of EUS-GBD, such as the puncture approach, choice of stents, and long-term management. There are also cohorts on performing EUS-GBD in potential surgical candidates. This review article gathers the latest evidence on EUS-GBD, including its indications, procedural techniques, choice of equipment, outcomes, postprocedural care, and the controversial extended indications.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 1","pages":"93-102"},"PeriodicalIF":5.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metal stent versus plastic stent in endoscopic ultrasound-guided hepaticogastrostomy for unresectable malignant biliary obstruction: Large single-center retrospective comparative study","authors":"Daiki Yamashige,&nbsp;Susumu Hijioka,&nbsp;Yoshikuni Nagashio,&nbsp;Yuta Maruki,&nbsp;Yasuhiro Komori,&nbsp;Masaru Kuwada,&nbsp;Soma Fukuda,&nbsp;Shin Yagi,&nbsp;Kohei Okamoto,&nbsp;Daiki Agarie,&nbsp;Mark Chatto,&nbsp;Chigusa Morizane,&nbsp;Hideki Ueno,&nbsp;Shunsuke Sugawara,&nbsp;Miyuki Sone,&nbsp;Yutaka Saito,&nbsp;Takuji Okusaka","doi":"10.1111/den.14956","DOIUrl":"10.1111/den.14956","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Whether metal stents (MS) or plastic stents (PS) yield better outcomes for malignant biliary obstruction in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is controversial. We aimed to compare outcomes of initial EUS-HGS performed with MS or PS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method<b>s</b></h3>\u0000 \u0000 <p>In this single-center retrospective study, we included patients (MS/PS groups: <i>n</i> = 151/72) with unresectable malignant biliary obstruction and performed multivariable analysis. The landmark date was defined as day 100 and used to evaluate the time to recurrent biliary obstruction (TRBO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The clinical success rate was similar in both groups. The mean total bilirubin percentage decrease at week 2 was significantly higher in the MS group than in the PS group (−45.1% vs. −23.7%, <i>P</i> = 0.016). Median TRBO was significantly different between the MS and PS groups (183 and 92 days, respectively; <i>P</i> = 0.017). TRBO within 100 days was comparable in both groups but was significantly shorter only after 100 days in the PS group (adjusted hazard ratio 12.8, <i>P</i> &lt; 0.001). Adverse events were significantly more common in the MS group (23.8% vs. 9.7%, <i>P</i> = 0.012), although they occurred relatively frequently even with PS in the cholangitis subgroup (<i>P</i>_interaction = 0.034). After endoscopic re-intervention, TRBO tended to be longer with revision PS (hazard ratio 0.40, <i>P</i> = 0.47).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although MS provided early improvement of jaundice and long stent patency, PS provided a better safety profile and comparable stent patency until 100 days. PS might also be an adequate and optimal palliation method in EUS-HGS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 1","pages":"117-129"},"PeriodicalIF":5.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Site of puncture in endoscopic ultrasound-guided fine needle biopsy: Does it change diagnostic outcome?","authors":"Chandramauli Mishra,&nbsp;Suprabhat Giri","doi":"10.1111/den.14965","DOIUrl":"10.1111/den.14965","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 2","pages":"200"},"PeriodicalIF":5.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic closure using SureClip Traction Band for delayed perforation after colorectal endoscopic submucosal dissection","authors":"Reo Kobayashi,&nbsp;Naohisa Yoshida,&nbsp;Ken Inoue","doi":"10.1111/den.14938","DOIUrl":"10.1111/den.14938","url":null,"abstract":"<p>Delayed perforation (DP) is reported to occur in 0.1–0.4% of colorectal endoscopic submucosal dissection (ESD).<span>^{1, 2}</span> DP can be fatal due to peritonitis and most cases of colorectal DP result in surgery. Various endoscopic closures after ESD are reported for preventing DP.<span>^{3, 4}</span> However, few reports showed the success of endoscopic closure for DP.<span>⁵</span> In this report, we present a case of DP closed with SureClip Traction Band (SCTB; Micro-Tech Co., Nanjing, China). The patient was a 61-year-old woman. She took prednisolone 10 mg/day for Wegener's granulomatosis. A polypoid lesion of 25 mm was detected in the transverse colon (Fig. 1a). En bloc resection was performed with ESD. The ESD defect was closed using MANTIS Closure Device (Boston Scientific, Marlborough, MA, USA) and SureClip (Micro-Tech Co.), considering the negative impact of prednisolone for would healing (Fig. 1b,c). However, tight complete closure was not achieved due to difficult operability. On the day after ESD, the patient presented abdominal pain and computed tomography (CT) showed free air (Fig. 1d). Because of the localized peritonitis, we decided to close it endoscopically. Although no perforation was found, we performed additional closure with SureClip (Fig. 1e,f). However, 3 days after ESD, free air increased with CT (Fig. 2a). Endoscopic closure was performed again and contrast medium leakage was observed (Fig. 2b). The ulcer base was hard and previous clips remained, making closure difficult. Normal mucosa at the edge of the ulcer on the anal side was captured with SCTB. Then the band was gripped with SureClip and deployed at the oral side of the ulcer for closing the ESD defect. Finally, complete closure could be performed with additional SCTB and SureClip (Fig. 2c–f, Video S1). The patient was discharged 11 days after ESD.</p><p>Author N.Y. had a grant from Fujifilm and received a lecture fee from Fujifilm. The other authors have no conflicts of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 2","pages":"206-208"},"PeriodicalIF":5.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14938","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New milestone for clinical research about biliary drainage","authors":"Atsushi Kanno,&nbsp;Hironori Yamamoto","doi":"10.1111/den.14934","DOIUrl":"10.1111/den.14934","url":null,"abstract":"&lt;p&gt;Endoscopic bile duct stenting has been the first-line treatment for bile duct obstruction, regardless of resectability or benign/malignant status,&lt;span&gt;&lt;sup&gt;1-3&lt;/sup&gt;&lt;/span&gt; although the criteria for evaluating the outcome of bile duct stents have not been adequately explored. For example, since the definition of stent occlusion varied across different articles, a meta-analysis of bile duct stent outcomes was summarized as stent dysfunction in terms of results. Furthermore, while stent occlusion due to tumor invasion was the main stent dysfunction in the case of inserted plastic stents or uncovered self-expandable metallic stents (SEMS), the advent of covered SEMS has made it necessary to consider stent migration or dislocation as a stent dysfunction.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; In this context, a need existed for common definitions regarding procedure-related early outcomes for stents, outcomes of stents during follow-up, and adverse events. Previous TOKYO criteria defined terms associated with the technical and clinical success of biliary stenting, recurrent biliary obstruction (RBO) and related factors, and adverse events.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Technical success was defined as the ability of the stent to adequately bypass the planned bile duct stenosis site, and clinical success was defined as a normal or 50% reduction in total bilirubin levels within 14 days of stent placement. In addition, RBO was defined as an outcome measure, including occlusion or deviation, used to assess the duration of stent function from the date of stent placement. An important aspect of RBO was that it focused on symptoms rather than stent patency alone. The time of symptom recurrence due to stent occlusion or deviation was specified as the time of onset of RBO, and this time point was to be used for assessment. The causes of obstruction of the RBO, such as internal growths associated with tumor growth, tumor growths on the edge of the stent, biliary debris or food residues, the direction of stent dislocation or migration (intrahepatic bile duct or duodenal papillary side), and whether pancreatitis or cholecystitis was present, were to be described separately. In addition, items on survival and contingencies other than RBOs have been created and described uniformly to provide an overall clinical picture from the results of clinical studies.&lt;/p&gt;&lt;p&gt;The progress of biliary drainage over the past decade has been so rapid that it has become increasingly difficult to cover it in the previous TOKYO criteria. For example, balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) for cases with altered anatomy has become widely used.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; In ERCP for patients with altered anatomy, the rate of reach to the bile duct orifice should be included in the assessment of technical success.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Endoscopic ultrasound-biliary drainage (EUS-BD) is also widely recognized as a common procedure. It does not bypass the bil","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"36 11","pages":"1211-1212"},"PeriodicalIF":5.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14934","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is endoscopic ultrasound-guided gastroenterostomy better than surgical gastrojejunostomy or duodenal stenting?","authors":"Anthony Yuen Bun Teoh,&nbsp;Shannon Melissa Chan,&nbsp;Hon Chi Yip","doi":"10.1111/den.14929","DOIUrl":"10.1111/den.14929","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gastrojejunostomy is a critical procedure for managing gastric outlet obstruction. While surgical gastrojejunostomy has traditionally been the standard approach, endoscopic ultrasound (EUS)-guided gastroenterostomy has emerged as a promising endoscopic alternative. This comprehensive review aims to explore the development, techniques, outcomes, and comparative effectiveness of EUS-guided gastroenterostomy in comparison to duodenal stenting and surgical gastrojejunostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted using electronic databases to identify relevant studies published up to April 2024. The search included keywords related to EUS-guided gastrojejunostomy, surgical gastrojejunostomy, and duodenal stenting. Studies reporting on technical success, clinical success, complications, recurrence rates, quality of life, and long-term outcomes were included for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The development of EUS-guided gastroenterostomy has evolved significantly over the years, driven by device advancements and improved endoscopic techniques. Comparative studies have shown that the technique offers several advantages, including the ability to create an anastomosis without the need for surgery, reduced invasiveness, shorter hospital stays, and potentially improved patient outcomes as compared to duodenal stenting and surgical gastrojejunostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endoscopic ultrasound-guided gastroenterostomy represents a promising alternative to surgical gastrojejunostomy and duodenal stenting for the management of gastric outlet obstruction. The technique has evolved significantly, offering a less invasive and more effective treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 1","pages":"77-84"},"PeriodicalIF":5.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}