Digestive Endoscopy最新文献

{"title":"Effective use of the novel rotatable sphincterotome for reintervention of endoscopic ultrasound-guided antegrade stenting","authors":"Fumisato Kozakai,&nbsp;Yoshihide Kanno,&nbsp;Kei Ito","doi":"10.1111/den.15020","DOIUrl":"10.1111/den.15020","url":null,"abstract":"<p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"795-797"},"PeriodicalIF":5.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659920","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":"Balancing benefits and risks of endotherapy in painless pancreatic stones: New horizons in chronic pancreatitis management","authors":"Takuya Ishikawa,&nbsp;Kentaro Yamao,&nbsp;Hiroki Kawashima","doi":"10.1111/den.15023","DOIUrl":"10.1111/den.15023","url":null,"abstract":"&lt;p&gt;Chronic pancreatitis (CP) is a disease characterized by diffuse chronic changes in the pancreas, including fibrosis, cellular infiltration, and loss of pancreatic parenchyma.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Abdominal pain occurs in approximately 80% of CP cases, but painless cases also exist. Pancreatic duct (PD) stones typically develop during the course of CP, especially in the transition from the compensatory to the decompensatory phase. These stones can cause stagnation of pancreatic juice and increased intraductal pressure, leading to severe epigastric pain and abdominal tenderness.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Current guidelines&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; recommend treatment for cases when PD stones are associated with persistent pain or recurrent pancreatitis. In these cases, treatment aimed at alleviating pancreatic juice obstruction by removing stones is performed. In Japan, multicenter surveys report that the success rate of symptom resolution following PD stone treatment is extremely high, ranging from 90.9% to 98.5%, with minimal differences observed between treatment methods.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Nonoperative methods, such as extracorporeal shock wave lithotripsy and endotherapy, are commonly used for cases involving stones in the main or accessory pancreatic ducts.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;On the other hand, follow-up is generally recommended for asymptomatic cases. However, in cases where pancreatic parenchymal atrophy is not observed and pancreatic juice obstruction due to PD stones is suspected, treatment may be given to aim at improving pancreatic function. Nonetheless, there is currently no established consensus on the treatment of painless PD stones.&lt;/p&gt;&lt;p&gt;In this issue of &lt;i&gt;Digestive Endoscopy&lt;/i&gt;, Ikeura &lt;i&gt;et al&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; focus on painless PD stones and discuss the potential benefits and risks of endoscopic treatment for this particular subgroup. This multicenter cohort study is notable for its robust methodology and large sample size, offering valuable insights into the natural history and management of painless CP. Achieving complete removal of PD stones was associated with a significant reduction in the risk of pancreatic parenchymal atrophy, a key surrogate marker for exocrine insufficiency. This underscores the potential role of endotherapy in preserving pancreatic function even in the absence of pain symptoms. The study highlights the adverse outcomes associated with incomplete stone removal, including an increased risk of glucose tolerance worsening and the onset of new pain episodes. These findings serve as a cautionary note, advocating for meticulous patient selection and technical precision in performing endotherapy. While patients who did not undergo endotherapy experienced significant pancreatic parenchymal loss during follow-up (70.8%), the absence of surgical interventions and low incidence of new pain (4.4%) in this group further emphasize the need to weigh the risks and benefits","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"747-748"},"PeriodicalIF":5.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659968","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 submucosal and intermuscular dissection with miniprobe endosonography guidance for the removal of fish bone spines in the deep muscularis propria of the esophagus","authors":"Bin-Yang Luo,&nbsp;Jia-Huan Liu,&nbsp;Zhu Wang","doi":"10.1111/den.15021","DOIUrl":"10.1111/den.15021","url":null,"abstract":"<p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"798-799"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652239","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":"Peroral endoscopic myotomy in spastic esophageal disorders: Clinical outcomes and optimal approaches","authors":"Tetsuya Tatsuta,&nbsp;Haruhiro Inoue,&nbsp;Yuto Shimamura,&nbsp;Miyuki Iwasaki,&nbsp;Kei Ushikubo,&nbsp;Kazuki Yamamoto,&nbsp;Yohei Nishikawa,&nbsp;Hidenori Tanaka,&nbsp;Ippei Tanaka,&nbsp;Satoshi Abiko,&nbsp;Mayo Tanabe,&nbsp;Kazuya Sumi,&nbsp;Manabu Onimaru,&nbsp;Boldbaatar Gantuya,&nbsp;Hirotake Sakuraba,&nbsp;Shinsaku Fukuda","doi":"10.1111/den.15008","DOIUrl":"10.1111/den.15008","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The efficacy and safety of peroral endoscopic myotomy (POEM) for spastic esophageal disorders (SED), including type III achalasia, distal esophageal spasm (DES), and jackhammer esophagus (JE), remain uncertain due to its rarity. This study aimed to evaluate the clinical outcomes and optimal strategies for managing SED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on patients who underwent POEM for SED between March 2014 and December 2023. Myotomy was tailored to target spastic segments in all cases. For type III achalasia, the myotomy extended into the gastric cardia, while for DES and JE, the procedure either preserved the lower esophageal sphincter (LES) or included a gastric myotomy. Outcomes assessed included procedural details, technical and clinical success, adverse events, and the incidence of gastroesophageal reflux disease (GERD) post-POEM. Clinical success was defined as an Eckardt score of ≤3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2938 POEM procedures, 106 (3.6%) were for SED. The cohort included 58 patients (54.8%) with type III achalasia, 24 (22.6%) with DES, and 24 (22.6%) with JE. The technical success rate was 100%, with clinical success rates of 98.1% at 2–3 months and 92.6% at 1 year. Erosive esophagitis occurred in 27.7% at 2–3 months and 16.1% at 1 year. LES-preserving POEM for DES and JE showed comparable efficacy to POEM with gastric myotomy, with a trend toward reduced GERD incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Peroral endoscopic myotomy is an effective treatment for all types of SED. LES-preserving POEM is a viable strategy for treating DES and JE, offering comparable efficacy, while potentially minimizing GERD risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"758-765"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652349","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":"Efficacy and safety of a novel multi-hole fully covered self-expandable metallic stent for malignant distal biliary obstruction: Multicenter retrospective study","authors":"Sho Takahashi,&nbsp;Tsuyoshi Takeda,&nbsp;Makoto Kobayashi,&nbsp;Kei Saito,&nbsp;Kentaro Suda,&nbsp;Natsuyo Yamamoto,&nbsp;Suguru Mizuno,&nbsp;Rintaro Fukuda,&nbsp;Hiroki Kato,&nbsp;Ko Tomishima,&nbsp;Shigeto Ishii,&nbsp;Toshio Fujisawa,&nbsp;Yuya Hisada,&nbsp;Naminatsu Takahara,&nbsp;Takashi Sasaki,&nbsp;Hirofumi Kogure,&nbsp;Saburo Matsubara,&nbsp;Naoki Sasahira,&nbsp;Yousuke Nakai,&nbsp;Satoshi Mochida,&nbsp;Hiroyuki Isayama","doi":"10.1111/den.15006","DOIUrl":"10.1111/den.15006","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Covered self-expandable metallic stents (CSEMS) are effective for managing malignant distal biliary obstruction (MDBO). However, migration is a significant problem, which requires prevention. The novel multi-hole fully CSEMS (MHSEMS), which features multiple small holes on the covered membrane, is expected to prevent migration. This study aimed to evaluate the efficacy and safety of MHSEMS for MDBO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective cohort study included 111 patients with MDBO who underwent MHSEMS placement between September 2022 and August 2023. The primary outcome was the recurrent biliary obstruction (RBO) rate. The secondary outcomes were adverse event (AE) rates, removability, technical and clinical success rates, and time to RBO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The technical success rate was 100%, and the clinical success rate was 94.6%. AEs occurred in 34.2% of patients, with RBO in 21.0% and non-RBO AEs in 17.1%. RBO included stent migration in 1.9%, stent occlusion in 11.7% (including ingrowth in 5.7%, biliary debris in 2.9%, hemobilia in 1.9%, and food impaction in 1.0%), and nonocclusion cholangitis (requiring biliary drainage) in 5.7%. Non-RBO AEs included post-endoscopic retrograde cholangiopancreatography pancreatitis in 11.7%, cholecystitis in 2.7%, and nonocclusion cholangitis in 2.7%. Stent removal was successful in 88.9% of attempts. The median time to RBO was 446 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The placement of MHSEMS for MDBO was effective and feasible, demonstrating low migration rates, acceptable AEs, and removability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"766-774"},"PeriodicalIF":5.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626852","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":"Successful retrieval of a migrated pancreatic stent via endoscopic ultrasound-guided transluminal drainage using an ultraslim upper endoscope","authors":"Shinsuke Akiyama,&nbsp;Gensho Tanke,&nbsp;Tetsuro Inokuma","doi":"10.1111/den.15015","DOIUrl":"10.1111/den.15015","url":null,"abstract":"<p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"800-801"},"PeriodicalIF":5.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617880","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":"Clinical significance and efficacy of endoscopic ultrasound-guided tissue acquisition for para-aortic lymph node metastasis","authors":"Hidenobu Hara,&nbsp;Susumu Hijioka,&nbsp;Daiki Yamashige,&nbsp;Yoshikuni Nagashio,&nbsp;Yasuhiro Komori,&nbsp;Masaru Kuwada,&nbsp;Soma Fukuda,&nbsp;Shin Yagi,&nbsp;Kohei Okamoto,&nbsp;Daiki Agarie,&nbsp;Mark Chatto,&nbsp;Mao Okada,&nbsp;Yuta Maruki,&nbsp;Chigusa Morizane,&nbsp;Hideki Ueno,&nbsp;Yutaka Saito,&nbsp;Kan Yonemori,&nbsp;Takuji Okusaka","doi":"10.1111/den.15009","DOIUrl":"10.1111/den.15009","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Assessing para-aortic lymph node (PALN) metastasis in solid tumors is crucial for accurate staging. In clinical practice, PALN metastasis is typically diagnosed based on imaging findings; however, the efficacy of endoscopic ultrasound-guided tissue acquisition (EUS-TA) in diagnosing PALN metastasis remains insufficiently understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective study included patients who underwent EUS-TA of PALNs and computed tomography (CT). Final diagnoses were based on pathological findings or 12-month imaging follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 167 patients, technical success was achieved in 162 (97.0%). EUS-TA demonstrated a sensitivity, specificity, and accuracy of 85.1% (63/74), 100% (88/88), and 93.2% (151/162), respectively, for PALN metastasis. These results showed significantly higher sensitivity (28.4% vs. 85.1%, <i>P</i> &lt; 0.001) and accuracy (64.8% vs. 93.2%, <i>P</i> &lt; 0.001) than those of CT. The accuracy of CT and EUS-TA was 86.8% vs. 89.5% for PALNs measuring &lt;5 mm, 51.5% vs. 92.9% for those measuring 5–10 mm, and 84.0% vs. 96.0% for those measuring ≥10 mm, with a significant difference in the 5–10 mm category (<i>P</i> &lt; 0.001). Among the 44 patients diagnosed with resectable pancreatic cancer using CT, the final diagnosis confirmed PALN metastasis in 10 (22.7%) patients, and EUS-TA preoperatively identified PALN metastasis in eight (18.2%) patients. EUS-TA significantly reduced unnecessary surgeries compared with CT-only diagnoses (<i>P</i> = 0.013).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endoscopic ultrasound-guided tissue acquisition of PALNs offers high diagnostic accuracy and can detect PALN metastasis often missed by CT alone. Integrating EUS-TA into preoperative assessments has the potential to substantially reduce unnecessary surgeries, improve patient outcomes, and plan treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"775-786"},"PeriodicalIF":5.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588524","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":"How to improve the diagnostic performance of endoscopic ultrasound-guided tissue acquisition for small gastric subepithelial lesions: Role of proper traction assistance","authors":"Tadahisa Inoue,&nbsp;Fumihiro Okumura","doi":"10.1111/den.15013","DOIUrl":"10.1111/den.15013","url":null,"abstract":"&lt;p&gt;Gastric subepithelial lesions (SELs) are commonly identified during upper gastrointestinal endoscopy. These lesions are covered by normal mucosa and display diverse histological features, leading to a broad differential diagnosis. A key diagnostic consideration is distinguishing between mesenchymal tumors, such as gastrointestinal stromal tumors (GISTs), which require treatment,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; and benign SELs, which typically do not necessitate intervention.&lt;/p&gt;&lt;p&gt;According to the Guidelines for GIST,&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; tumor size is a critical criterion for histopathological diagnosis, with a threshold of 20 mm. However, tissue diagnosis is advised for any tumor exhibiting irregular margins, ulceration, depression, or evidence of growth, regardless of size. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is the first-line diagnostic approach in such cases.&lt;/p&gt;&lt;p&gt;Since differentiating GISTs is critical in SEL diagnosis, obtaining high-quality tissue samples that preserve structure and enable immunohistochemical evaluation is essential. Recent advancements in needles used for EUS-TA have significantly improved diagnostic capabilities. Although traditional fine-needle aspiration (FNA) needles were commonly used, newer fine-needle biopsy (FNB) needles, such as the Franseen and fork-tip needles, have been developed, with innovative designs that enable the acquisition of high-quality specimens.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; These advancements have enhanced diagnostic accuracy.&lt;/p&gt;&lt;p&gt;A meta-analysis comparing FNB and FNA needles for gastrointestinal SELs showed that FNB needles achieved significantly higher diagnostic accuracy than FNA needles (odds ratio 4.10, 95% confidence interval 2.48–6.79; &lt;i&gt;P&lt;/i&gt; &lt; 0.0001).&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; However, the unique tip design of FNB needles reduces puncture performance compared to FNA needles. While this limitation is usually not an issue for easily accessible lesions, it poses challenges in more difficult cases, such as small gastric SELs, where achieving adequate puncture with an FNB needle can be challenging and remains a practical limitation.&lt;/p&gt;&lt;p&gt;In gastric SETs, respiratory motion and the high mobility of the lesions often make puncture challenging. The lesion may shift during the attempt, complicating efforts to secure it for puncture. Positioning the lesion at approximately the 3 o'clock direction on the EUS screen, instead of the conventional 6 o'clock position, can sometimes help. Applying upward angulation to the scope and using the probe to “cradle” the tumor helps stabilize the lesion, reducing its movement and facilitating puncture. However, this technique requires the tumor to be sufficiently large to be cradled effectively. Consequently, smaller gastric SETs remain particularly challenging, underscoring the need for tailored diagnostic methods for these cases.&lt;/p&gt;&lt;p&gt;A forward-viewing echoendoscope equipped with a cap attached to its tip has been reported as a pot","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 5","pages":"521-523"},"PeriodicalIF":5.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588525","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: WEO Update from Lars Aabakken, MD President of WEO","authors":"","doi":"10.1111/den.15012","DOIUrl":"https://doi.org/10.1111/den.15012","url":null,"abstract":"&lt;p&gt;WEO has made significant strides as a global organization for the endoscopists. 2024 was another year of progress and increasing collaborations with other endoscopic societies.&lt;/p&gt;&lt;p&gt;WEO remains committed to the promotion of quality endoscopic education and practice throughout the world. 2024 was no exception and we have continued to evolve and conduct educational meetings not just in person but virtually and in hybrid formats to ensure we reach out to a wider audience and needs. This also keeps our environmental sustainability goals in mind.&lt;/p&gt;&lt;p&gt;What is needed today is the democratization of access to GI endoscopy especially to the developing world to improve global health. WEO in its part has expanded its efforts towards training and endoscopy facilitation in developing areas, in South America, in South-East Asia, and extensively in sub-Saharan Africa, building on an increasing number of official WEO training centers across the region. Since the easing of restrictions due to the recent COVID pandemic, this work is now a priority and WEO will increase its efforts towards this goal. WEO is aiming to contribute its part to make endoscopic education and training available to all and in doing so improve health care access and outcomes. As a part of our commitment and to streamline our efforts further WEO has decided to organize ENDO 2026 in Cape Town, South Africa, in conjunction with the South African societies, SAGES, SASES, and ASSA (South African Gastroenterology Society, South African Society of Endoscopic Surgeons, Association of Surgeons of South Africa). It is our hope that all our physician and industry partners will continue to support this initiative.&lt;/p&gt;&lt;p&gt;What we are as an organization today and how we continue to grow is mostly due to the efforts of several volunteer faculty, members, member societies and of course our industry partners. As the old African quote says “It takes a village to raise a child” WEO as an organization is indebted to the contributions of everyone involved for its growth and mission. Collaboration with sister societies has been our key pillar and WEO will forge stronger bonds with these organizations, individual members and our industry partners. While it is not easy to list all of the WEO activities, some of the key activities are listed below. WEO encourages everyone to contribute their ideas and join forces in creating globally uniform standards, access and delivery of endoscopic care.&lt;/p&gt;&lt;p&gt;The &lt;i&gt;Promoting Best Standards of Practice Series&lt;/i&gt; of educational broadcasts included four webinars organized by the WEO Standards of Practice Committee 2024.&lt;/p&gt;&lt;p&gt;Video Capsule Endoscopy Network (VCEN) 2024: Launched this year, the program developed by Jean-Francois Rey, featured three webinars from March to October, culminating in the WEO Capsule Endoscopy Global Summit on November 30 in Chongquing, China, with Lars Aabakken as conference president.&lt;/p&gt;&lt;p&gt;A VCE session and hands-on training was organized at EN","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 3","pages":"311-313"},"PeriodicalIF":5.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565064","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 management of primary sclerosing cholangitis","authors":"Suguru Mizuno,&nbsp;Yoshihito Uchida,&nbsp;Satsuki Ando,&nbsp;Masamitsu Nakao,&nbsp;Kayoko Sugawara,&nbsp;Nobuaki Nakayama,&nbsp;Yukinori Imai,&nbsp;Tomoaki Tomiya,&nbsp;Satoshi Mochida","doi":"10.1111/den.15010","DOIUrl":"10.1111/den.15010","url":null,"abstract":"<p>Primary sclerosing cholangitis (PSC) is a progressive autoimmune hepatobiliary disease characterized by fibrotic strictures in the bile ducts, leading to chronic cholestasis and cirrhosis. Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method for evaluating the condition of the bile ducts, and has high sensitivity and specificity, making it the first-line diagnostic tool for PSC. However, the importance of endoscopic retrograde cholangiopancreatography (ERCP) remains unchanged. ERCP is particularly useful in differentiating PSC from cholangiocarcinoma. It allows for tissue sampling from strictures and offers superior spatial resolution to detect subtle changes in the bile ducts. Endoscopic ultrasonography (EUS) is a minimally invasive endoscopic modality with growing importance in the management of pancreato-biliary diseases. Although the role of EUS in PSC patients has not been established, future research in this area is warranted. ERCP is particularly important for patients who are not eligible for liver transplantation, as it allows bile drainage from the dominant or high-grade strictures through balloon dilation and stenting, alleviating symptoms and extending survival. Balloon dilation is currently considered superior to biliary stenting, due to its lower risk of bacterial cholangitis. However, refractory complications, such as bacterial cholangitis and pancreatitis, can still occur in some cases. Therefore, careful patient selection and involvement of highly skilled specialists are essential. In the diagnosis and treatment of PSC, it is crucial to perform endoscopic procedures tailored to its unique pathophysiology. Further research is needed to optimize treatment protocols and improve outcomes. This review presents the latest insights on these topics.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"723-732"},"PeriodicalIF":5.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574773","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}