Digestive Endoscopy最新文献

{"title":"Usefulness of a Sphincterotome Blade for Removing a Bile Duct Stone Displaced Into an Intrahepatic Duct","authors":"Akinori Maruta,&nbsp;Shinya Uemura,&nbsp;Masahito Shimizu","doi":"10.1111/den.70291","DOIUrl":"https://doi.org/10.1111/den.70291","url":null,"abstract":"<p>Endoscopic retrograde cholangiopancreatography (ERCP) is the standard treatment for common bile duct stones (CBDSs), and balloon or basket catheters are useful for removal of CBDSs [<span>1-3</span>]. However, CBDSs can sometimes displace into the intrahepatic bile duct (IHBD), making stone removal challenging even with these devices. Here, we report a case in which we successfully removed a CBDS that had displaced into the IHBD using a sphincterotome blade.</p><p>A 59-year-old woman presented with abdominal pain, and various imaging examinations revealed CBDSs. ERCP was performed to remove the stones (Video 1). After endoscopic sphincterotomy with balloon dilation (ESBD) using a dedicated device combining a sphincterotome and a papillary dilation balloon (StoneMaster V; Olympus, Tokyo, Japan), a balloon catheter was used to remove the CBDS. When the balloon catheter was advanced to remove the remaining stone at the hepatic hilum, it could not pass through the stone, and the stone moved further into the peripheral IHBD. The basket catheter also failed to pass through the stone and only pushed it into the IHBD (Figure 1a,b). Therefore, the same sphincterotome used for the papillary intervention was inserted into the bile duct and advanced carefully so that its tip passed the stone without pushing the stone into the IHBD. The sphincterotome blade was extended, and the stone was grasped with the extended cutting wire under fluoroscopic guidance. The stone was successfully removed by carefully withdrawing the catheter while holding the stone in place (Figure 2a–e).</p><p>Although some reports indicate that cholangioscopy-guided electrohydraulic or laser lithotripsy is effective for IHBD stones [<span>4, 5</span>], there is currently no established treatment strategy for CBDSs that have displaced into the IHBD. For IHBD stones that are difficult to remove using a conventional balloon or basket catheter, a sphincterotome blade may be considered as a rescue option in selected cases.</p><p>Akinori Maruta wrote the manuscript. Akinori Maruta, Shinya Uemura, and Masahito Shimizu managed the patients. Akinori Maruta took the correspondence. All authors read and approved the final manuscript.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p><p>Data sharing not applicable to this article as no datasets were generated or analysed during the current study.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994625","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":"Toward a Global Perspective on Serrated Polyp Management","authors":"Joep E. G. IJspeert,&nbsp;Evelien Dekker","doi":"10.1111/den.70294","DOIUrl":"https://doi.org/10.1111/den.70294","url":null,"abstract":"&lt;p&gt;Despite growing recognition of the clinical significance of serrated polyps (SPs), substantial differences remain in how these lesions are approached across different regions of the world. With this in mind, Uraoka et al. provide an overview of current strategies for the management of SPs, highlighting key similarities and differences between Western and Japanese perspectives [&lt;span&gt;1&lt;/span&gt;]. A notable strength of this review is its ambition to promote greater international harmonization. In doing so, it also makes clear that many recommendations are based on a still-evolving evidence base and that several important questions remain unresolved. Framing these differences as a strict dichotomy between “the West” and Japan may oversimplify a more heterogeneous reality, as substantial variation also exists among the United States, the United Kingdom, and continental Europe. In this editorial, we aim to provide a European perspective on the discussed topics.&lt;/p&gt;&lt;p&gt;The nomenclature of SPs has been a source of considerable confusion for many years. In our view, greater international consistency is needed, and the current WHO classification provides the most appropriate framework for achieving this goal [&lt;span&gt;2&lt;/span&gt;]. Accordingly, we favor the overarching term SP rather than serrated lesion. We also support the WHO approach of not distinguishing between low-grade and high-grade dysplasia within sessile serrated lesions (SSLs). Similarly, we do not consider superficially serrated adenoma (SuSA), as discussed in the review, to represent a distinct diagnostic entity. Based on its described histological and molecular characteristics, it appears to overlap substantially with the spectrum of traditional serrated adenomas (TSAs). The need for greater harmonization also extends to the histopathological diagnosis of SSLs. Uraoka et al. acknowledge important differences between Japanese diagnostic criteria and the current WHO classification. Such discrepancies may influence reported prevalence rates, risk estimates, and the comparability of studies across regions. To facilitate international consistency in both clinical practice and research, we believe that the WHO classification should serve as the common reference standard for the diagnosis and reporting of SSLs. Although most Japanese institutions have now adopted the current WHO classification, its transition has resulted in some clinical variability. In response, the Japan Serrated Lesion Expert Team (JSET) was established in 2023 and is currently developing a national expert consensus on clinical management.&lt;/p&gt;&lt;p&gt;Uraoka et al. discuss several strategies to improve the detection of SPs in the proximal colon, emphasizing the importance of a high-quality colonoscopy. We fully agree that a high-quality colonoscopy forms the cornerstone of adequate polyp detection. The ESGE has recently revised its Quality Improvement Initiative document, which is expected to be published shortly. The updated document ad","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994612","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":"Transcending Boundaries in Gastrointestinal Endoscopy Training With Telementoring","authors":"Wei-Chih Liao","doi":"10.1111/den.70290","DOIUrl":"10.1111/den.70290","url":null,"abstract":"&lt;p&gt;The rapid evolution of gastrointestinal (GI) endoscopy has transformed the diagnosis and management of digestive diseases. Over the past two decades, advances such as endoscopic submucosal dissection (ESD), peroral endoscopic myotomy (POEM), therapeutic endoscopic ultrasound (EUS), endoscopic full-thickness resection, and other complex therapeutic procedures have substantially expanded the capabilities of endoscopy. However, the increasing sophistication of these procedures highlights the limitation of the current training paradigm for GI endoscopy. Disseminating new and increasingly complex procedural skills equitably across diverse healthcare settings, particularly to remote, under-served regions, has become ever more important yet challenging.&lt;/p&gt;&lt;p&gt;Training opportunities remain concentrated in relatively few high-volume referral centers, whereas the demand for advanced endoscopy continues to increase worldwide. Distance and boundaries limited institutional resources, whereas workforce shortages, travel costs, and regulatory barriers restrict access to expert mentorship, particularly in low-resource and geographically isolated regions. Against this background, the World Endoscopy Organization (WEO) Position Statement on Telementoring in Gastrointestinal Endoscopy represents an important milestone in endoscopy education by providing the first international framework for implementing telementoring in a structured, standardized, and responsible manner [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The principal contribution of this Position Statement is not simply its endorsement of telementoring. Remote mentoring has already demonstrated technical feasibility in both surgery and GI endoscopy [&lt;span&gt;2-4&lt;/span&gt;]. Rather, the document recognizes that successful telementoring should be regarded as a comprehensive educational strategy requiring the same rigor in curriculum design, competency assessment, governance, and quality assurance expected of conventional endoscopy training. In doing so, the Statement shifts the discussion from whether telementoring is possible to how it should be implemented effectively and safely.&lt;/p&gt;&lt;p&gt;Early reports of telementoring understandably focused on technological capability. Improvements in internet connectivity, image transmission, and audiovisual communication have enabled experts to provide real-time procedural guidance across long distances. The COVID-19 pandemic further accelerated adoption by forcing educators to explore alternatives to traditional face-to-face teaching [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;However, technology alone cannot produce competent endoscopists. The WEO Position Statement appropriately places educational principles ahead of technical considerations [&lt;span&gt;1&lt;/span&gt;]. Rather than emphasizing communication platforms or hardware specifications, it addresses learner selection, mentor qualifications, curriculum development, procedural planning, communication strategies, competency assessment, institutional responsibilities,","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992774","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":"EUS-GBD for Acute Perforated Cholecystitis, a New Paradigm Shift","authors":"Delfien Coevoet,&nbsp;Pierre Henri Deprez","doi":"10.1111/den.70283","DOIUrl":"10.1111/den.70283","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992787","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":"Risk Management in ERCP and Endoscopic Ultrasound","authors":"Takashi Tamura,&nbsp;Reiko Ashida,&nbsp;Yuki Kawaji,&nbsp;Masahiro Itonaga,&nbsp;Yasunobu Yamashita,&nbsp;Masayuki Kitano","doi":"10.1111/den.70288","DOIUrl":"10.1111/den.70288","url":null,"abstract":"<div>\u0000 \u0000 <p>Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are essential for the diagnosis and treatment of pancreatobiliary disease but also carry risks of clinical adverse events (AEs). Acute pancreatitis, bleeding, perforation, and cholangitis are the main AEs associated with ERCP. Acute pancreatitis is the most frequent AE and can become severe and even fatal. Diagnostic EUS is relatively safe, although events such as pancreatitis, bleeding, infection, and needle tract seeding via the puncture site have been reported with EUS-guided tissue acquisition. In addition, therapeutic EUS has specific AEs, including peritonitis due to leakage of bile or pancreatic fluid, stent migration, and bleeding. Risk management in pancreatobiliary endoscopy requires a multifaceted approach, including sedation strategies appropriate to the patient's background and procedural difficulty, antithrombotic management, and preventive measures for and early response to procedure-specific AEs. In recent years, safety has steadily improved with the establishment of post-ERCP pancreatitis preventive measures such as rectal nonsteroidal anti-inflammatory drugs administration and pancreatic duct stent placement. In therapeutic EUS, recent advances include the development of metal stents with thin-diameter delivery systems and lumen-apposing metal stents, as well as technical refinements in stent deployment. This review summarizes the latest evidence and guidelines regarding anesthesia management, AEs, prevention strategies, and management approaches related to ERCP and diagnostic and therapeutic EUS. Systematic risk assessment and standardized techniques are key to ensuring safe, high-quality endoscopic pancreatobiliary care.</p>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972398","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":"Correction to “Long-Term Outcomes After Endoscopic Papillary Large Balloon Dilation With Endoscopic Sphincterotomy for Difficult Biliary Stones: A Multicenter Retrospective Longitudinal Study”","authors":"","doi":"10.1111/den.70287","DOIUrl":"10.1111/den.70287","url":null,"abstract":"<p>\u0000 <span>A. Mauro</span>, <span>E. Lozova</span>, <span>G. Vanella</span>, et al., “ <span>Long-Term Outcomes After Endoscopic Papillary Large Balloon Dilation With Endoscopic Sphincterotomy for Difficult Biliary Stones: A Multicenter Retrospective Longitudinal Study</span>,” <i>Digestive Endoscopy</i> <span>38</span>, no. <span>7</span> (<span>2026</span>): e70204, https://doi.org/10.1111/den.70204.\u0000 </p><p>The i-EUS group collaborators were inadvertently omitted from the author list of the above article, and Reference 22 was incomplete.</p><p>The author list has been corrected to include “i-EUS collaborators.” In addition, Reference 22 has been corrected to read “Consulted on February 13, 2026, https://www.i-eus.org/.”</p><p>The online version of the article has been updated to reflect these corrections.</p><p>We apologize for these errors.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964045","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":"Double-Lumen Catheter-Assisted Gel Immersion During Laser Lithotripsy Through a Lumen-Apposing Metal Stent for Large Gallbladder Stones After EUS-Guided Gallbladder Drainage","authors":"Tadahisa Inoue,&nbsp;Shun Futagami,&nbsp;Kiyoaki Ito","doi":"10.1111/den.70274","DOIUrl":"10.1111/den.70274","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964068","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 Submucosal Dissection of Cecal Lesion via Redirectable Traction Control Technique Using a Clip-Band Traction Device","authors":"Takahiro Muramatsu,&nbsp;Masakatsu Fukuzawa,&nbsp;Takao Itoi","doi":"10.1111/den.70278","DOIUrl":"10.1111/den.70278","url":null,"abstract":"<p>The cecum has thin muscular layers and forms a blind end; therefore, during endoscopic submucosal dissection (ESD), the muscular layer is vertically oriented against the knife, thereby increasing the risk of perforation [<span>1</span>]. Additionally, the cecum is a closed space, which restricts endoscopic maneuverability. Although the pocket creation method and traction devices can be useful for cecal ESD [<span>2-4</span>], an optimal strategy has not been established. Notably, a recent study demonstrated the usefulness of a novel clip-band traction device for colorectal ESD [<span>5</span>]. Herein, we present a video of successful ESD for a cecal lesion using a redirectable traction control technique (RETRACT), which allows free modification of the traction direction using a clip-band device (Video 1). A 58-year-old man presented with a 40-mm protruding lesion (type 0-Is) in the cecum (Figures 1a,b and 2a). First, the mucosal and circumferential incisions were completed with positional changes (Figure 2b,c). A clip-band traction device was attached to the proximal side of the lesion. The third band was fixed to the opposite normal mucosa, facilitating access to the submucosal layer. However, as dissection progressed, the muscular layer became directly opposed to the dissection plane, making further dissection difficult (Figure 2d–h). Therefore, we detached the third band, grasped the unused second band with a reopenable clip, and redirected the band to achieve the optimal traction direction (RETRACT; Figure 2i–k). This technique enabled access to the remaining submucosal layer and successful en bloc resection (Figure 2l–o). Histopathological examination of the specimen revealed high-grade dysplasia. In conclusion, RETRACT is a simple technique requiring only clips and one traction-band device. Even in the narrow cecal space, traction direction can be modified without scope withdrawal, and it may be a useful option in selected cases when the initial traction direction becomes unfavorable.</p><p>Takahiro Muramatsu wrote and edited the manuscript. Takahiro Muramatsu approved the manuscript. Takahiro Muramatsu, Masakatsu Fukuzawa, and Takao Itoi reviewed the literature and revised the manuscript for intellectual content.</p><p>The authors have nothing to report.</p><p>Informed consent was obtained from the patient for the publication of this report.</p><p>The authors declare no conflicts of interest.</p><p>The data that support the findings of this study are available from the corresponding author upon reasonable request.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964105","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":"Optimizing Endoscopic Assessment of Postoperative Crohn's Disease: A Scoping Review","authors":"Sarianne G. Bosch,&nbsp;Michiel T. J. Bak,&nbsp;Sun-Ho Lee,&nbsp;Oddeke Van Ruler,&nbsp;Léon Maggiori,&nbsp;Johan Burisch,&nbsp;Jakob B. Seidelin,&nbsp;Byong Duk Ye,&nbsp;Sang Hyoung Park,&nbsp;Mark S. Silverberg,&nbsp;Matthieu Allez,&nbsp;Annemarie C. DeVries,&nbsp;Nassim Hammoudi,&nbsp;the IMPACT consortium","doi":"10.1111/den.70286","DOIUrl":"10.1111/den.70286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postoperative endoscopic recurrence after ileocecal resection in Crohn's disease (CD) occurs frequently and typically precedes clinical and surgical relapse. Endoscopic scoring systems are central to postoperative management, yet their optimal use remains debated. The aim was to provide a summary and critical appraisal of established and novel endoscopic scoring systems used for recurrence in adult CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was conducted based on a systematic search in PubMed, EMBASE, and the Cochrane Library databases. Following qualitative synthesis, narrative reviews and studies involving pediatric or animal populations were excluded. Remaining evidence was integrated and critically appraised. The interpretation of findings was further refined through expert discussion within the IMPACT consortium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Rutgeerts score (RS) remains the most widely used index in clinical studies, but shows important limitations, including moderate interobserver reproducibility, limited differentiation between anastomotic and ileal lesions, and reduced applicability to modern anastomotic configurations. Modified and updated RS variants, as well as newer indices, emphasize lesion location and postoperative anatomy, and may improve prognostic stratification in selected cohorts. The choice of postoperative endoscopic index and the threshold used to define recurrence has major clinical implications. Heterogeneity in anatomic lesions considered, cutoffs for adapting treatments, and reproducibility limit the universal adoption of any single index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endoscopic indices remain essential for classification and standardization for postoperative disease recurrence in CD but should be interpreted together with their current level of validation. These findings highlight the need for further validation, harmonization of definitions, and refinement of postoperative endoscopic evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964101","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 Papillectomy May Be a Feasible Treatment Option for Elderly Patients With Ampullary Tumors: A Multicenter Retrospective Study","authors":"Noriki Kasuga,&nbsp;Yusuke Kurita,&nbsp;Yusuke Sekino,&nbsp;Keiki Nagai,&nbsp;Yuji Fujita,&nbsp;Riko Hemmi,&nbsp;Daiki Imanaga,&nbsp;Manato Kaneda,&nbsp;Shota Matsumoto,&nbsp;Masato Suzuki,&nbsp;Shin Yagi,&nbsp;Kensuke Kubota,&nbsp;Masato Yoneda","doi":"10.1111/den.70284","DOIUrl":"10.1111/den.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic papillectomy (EP) is a minimally invasive treatment for ampullary tumors; however, its safety in elderly patients remains unclear. We aimed to evaluate the feasibility and clinical outcomes of EP in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective study included 255 patients with ampullary tumors who underwent EP between April 2008 and September 2025 at three collaborating institutions. Patients aged ≥ 75 years were defined as elderly; complication rates and clinical outcomes were compared with the non-elderly group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The elderly group had a significantly higher Charlson Comorbidity Index (1.0 [0–8] vs. 0 [0–7]; <i>p</i> = 0.028). The elderly group demonstrated significantly lower rates of overall complications (29.0% vs. 48.9%; <i>p</i> = 0.004), delayed bleeding (4.3% vs. 23.1%; <i>p</i> &lt; 0.001), and pancreatitis (11.6% vs. 23.1%; <i>p</i> = 0.041) than the non-elderly group. Serious complications rate (4.3% vs. 4.8%; <i>p</i> = 1.000), median hospital stay (12 [7–73] vs. 13 [4–40] days; <i>p</i> = 0.408) were comparable between groups. Multivariate analysis showed that age ≥ 75 years was independently associated with a reduced risk of delayed bleeding (<i>p</i> = 0.002; odds ratio [OR], 0.14) and pancreatitis (<i>p</i> = 0.029; OR, 0.39).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EP in patients aged ≥ 75 years was associated with lower complication rates and may be a feasible treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921260","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}