Digestive Endoscopy最新文献

{"title":"Endoscopic laryngopharyngeal surgery combined with endoscopic submucosal dissection for superficial uvular cancer","authors":"Shinya Sugimoto,&nbsp;Tomohito Fuke,&nbsp;Hayato Nakagawa","doi":"10.1111/den.15046","DOIUrl":"10.1111/den.15046","url":null,"abstract":"<p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 9","pages":"1016-1018"},"PeriodicalIF":4.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993671","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":"New milestone in endoscopic retrograde cholangiopancreatography (ERCP) safety: Key insights from the 2023 Guidelines on Post-ERCP Pancreatitis Prevention and Management","authors":"Susumu Hijioka","doi":"10.1111/den.15043","DOIUrl":"10.1111/den.15043","url":null,"abstract":"&lt;p&gt;Endoscopic retrograde cholangiopancreatography (ERCP) remains a cornerstone in the management of pancreatobiliary diseases; however, it carries a major risk of post-ERCP pancreatitis (PEP). The first PEP guidelines were published in 2015, with the revised 2023 Guidelines for Post-ERCP Pancreatitis Prevention and Management released in 2024 by Mukai &lt;i&gt;et al&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; in &lt;i&gt;Digestive Endoscopy&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;These updated guidelines incorporate new evidence based on the Minds Guidelines and GRADE methodology. The reported incidence of PEP ranges from 3.5% to 10%, with severe pancreatitis occurring in 0.4–0.5% of cases. The mortality rate due to pancreatitis has been reported to be 0.02–0.7%.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Although its mortality rate has declined, this decline underscores the continued importance of refined risk assessment and prevention strategies.&lt;/p&gt;&lt;p&gt;Key advancements include enhanced prevention strategies. Temporary pancreatic duct stenting (PDS) remains a primary preventive measure for high-risk patients. However, there is no established consensus on the specific patient populations that should receive PDS.&lt;/p&gt;&lt;p&gt;A meta-analysis by Sperna Weiland &lt;i&gt;et al&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; found that PDS did not significantly reduce PEP incidence (relative risk 1.25), raising questions regarding its routine use. However, the 2023 Guidelines recommend considering PDS placement in carefully selected high-risk cases.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Specifically, PDS is proposed for patients with both patient-related risk factors (such as sphincter of Oddi dysfunction, history of PEP, female sex, and young age) and procedural risk factors (including pancreatic duct cannulation, multiple cannulation attempts, and precut sphincterotomy). Thus, additional preventive strategies are needed for high-risk cases.&lt;/p&gt;&lt;p&gt;Rectal nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin or diclofenac, are highly effective in reducing both the incidence and severity of PEP.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Most studies have utilized a 100 mg dose; however, in Japan, only 50 mg formulations are available, with insurance coverage limited to this dosage. The efficacy of lower-dose NSAIDs remains inconclusive, necessitating further validation.&lt;/p&gt;&lt;p&gt;International guidelines&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; recommend the use of rectal NSAIDs; however, some high-risk patients remain vulnerable, highlighting the need for further research. Pécsi &lt;i&gt;et al&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; emphasized the importance of individualized prophylaxis, incorporating NSAIDs, aggressive hydration, and advanced cannulation techniques. They advocate for refining risk models, artificial intelligence (AI)-driven risk assessment, and exploring novel prophylactic approaches, such as protease inhibitors and nitrates.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Recent studies have shown promising developments in AI-driven risk assessment for pancreatitis.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Integra","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 9","pages":"960-961"},"PeriodicalIF":4.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061139","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":"Dual thin grasping forceps-assisted over-the-scope clip closure for delayed perforation in the remnant stomach after endoscopic submucosal dissection","authors":"Minami Hashimoto,&nbsp;Takuto Hikichi,&nbsp;Takumi Yanagita","doi":"10.1111/den.15022","DOIUrl":"10.1111/den.15022","url":null,"abstract":"<p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"787-789"},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774966","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 removal of migrated gastric band ring after Fobi pouch gastric bypass","authors":"Povilas Kavaliauskas,&nbsp;Aurelijus Grigaliunas,&nbsp;Gintautas Brimas","doi":"10.1111/den.15017","DOIUrl":"10.1111/den.15017","url":null,"abstract":"<p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"790-791"},"PeriodicalIF":5.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712365","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 Practice Guidelines for post-ERCP pancreatitis 2023","authors":"Shuntaro Mukai,&nbsp;Yoshifumi Takeyama,&nbsp;Takao Itoi,&nbsp;Tsukasa Ikeura,&nbsp;Atsushi Irisawa,&nbsp;Eisuke Iwasaki,&nbsp;Akio Katanuma,&nbsp;Katsuya Kitamura,&nbsp;Mamoru Takenaka,&nbsp;Morihisa Hirota,&nbsp;Toshihiko Mayumi,&nbsp;Toshio Morizane,&nbsp;Ichiro Yasuda,&nbsp;Shomei Ryozawa,&nbsp;Atsushi Masamune","doi":"10.1111/den.15004","DOIUrl":"10.1111/den.15004","url":null,"abstract":"<p>The Clinical Practice Guidelines for post-ERCP pancreatitis (PEP) 2023 provide updated recommendations for the prevention, diagnosis, and management of PEP. Endoscopic retrograde cholangiopancreatography (ERCP), a valuable procedure for diagnosing and treating pancreatobiliary diseases, can result in PEP as the most common adverse event. Since the first guidelines were published in 2015, advances in techniques and new research findings have necessitated this revision. The guidelines developed using the GRADE methodology target adult patients undergoing ERCP. They offer a comprehensive framework for clinicians to minimize the risk of PEP. For high-risk patients, endoscopic ultrasound before ERCP is recommended to avoid unnecessary procedures. The guidelines also discuss procedural and patient-related risk factors for PEP, highlighting that operator experience does not significantly affect PEP rates if performed under the supervision of skilled endoscopists. The diagnostic criteria include monitoring serum pancreatic enzyme levels postprocedure, and early computed tomography is advised in suspected cases. For treatment, the guidelines recommend following acute pancreatitis protocols. Key preventive measures include the use of temporary pancreatic duct stents and rectal nonsteroidal anti-inflammatory drugs, both of which are supported by strong evidence for reducing the incidence of PEP. Overall, these guidelines aim to enhance clinical outcomes by reducing PEP incidence and improving its management through evidence-based practices.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":"573-587"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712362","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":"What has changed and remained the same in the past 55 years regarding the prediction and prevention of postendoscopic retrograde cholangiopancreatography pancreatitis?","authors":"Mamoru Takenaka,&nbsp;Masatoshi Kudo","doi":"10.1111/den.15025","DOIUrl":"10.1111/den.15025","url":null,"abstract":"&lt;p&gt;Although 55 years have passed since endoscopic retrograde cholangiopancreatography (ERCP) was first reported in 1968,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; post-ERCP pancreatitis (PEP) remains a major clinical challenge. A systematic review of 108 randomized controlled trials conducted between 1977 and 2012 revealed a 9.7% incidence of PEP among 13,296 patients in the control group.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Further, a prospective multicenter observational study involving 3739 cases reported a PEP incidence of 6.9%.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Notably, several studies have documented an increasing trend in PEP incidence over time. An analysis of 1.22 million hospitalizations in the United States from 2011 to 2017 showed rising hospitalization and fatality rates associated with PEP.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; This trend may be attributed to the development and increased use of new therapeutic devices such as metal stents and cholangioscopes over the past 55 years. Meanwhile, there has been significant progress in understanding and preventing PEP, with studies identifying predictive factors and preventive strategies for PEP. Unlike 55 years ago, clinicians can now assess patient-related and procedure-related risk factors for PEP before ERCP and consider appropriate preventive measures. However, effective prediction and prevention require a comprehensive understanding of the latest advancements.&lt;/p&gt;&lt;p&gt;In this issue of &lt;i&gt;Digestive Endoscopy&lt;/i&gt;, Kato &lt;i&gt;et al&lt;/i&gt;. present an in-depth review titled “Current status and issues for prediction and prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis.”&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; This article explores the latest prediction models, scoring systems, and newly identified patient factors. The following is a summary of changes and enduring aspects regarding PEP over the past 55 years.&lt;/p&gt;&lt;p&gt;In the early days of ERCP, knowledge about the risk factors for PEP was limited. There was no awareness that groups, such as young women, were at higher risk of developing PEP. Today, extensive research has identified various risk factors, often broadly categorized as patient-related factors (e.g. younger age or female sex) and procedure-related factors (e.g. difficult cannulation, repeated pancreatic duct instrumentation, or pancreatic duct guidewire placement). In recent years, anatomical factors such as large pancreatic parenchymal volume, high pancreatic fat content, and specific duodenal papilla morphology have been reported as risk factors for PEP.&lt;/p&gt;&lt;p&gt;As also emphasized by Kato &lt;i&gt;et al&lt;/i&gt;.,&lt;sup&gt;5&lt;/sup&gt; it is rare for patients undergoing ERCP to possess only a single risk factor, and several studies have reported the prediction of PEP using a prediction model and scoring system. In addition, artificial intelligence has been reported to be a helpful option for dealing with the increasingly complex risk factors of PEP in an integrated manner. The development of PEP prediction models has been reported, with fu","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"373-375"},"PeriodicalIF":5.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694565","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":"Guidelines for endoscopic management of nonvariceal upper gastrointestinal bleeding (second edition)","authors":"Mitsuhiro Fujishiro,&nbsp;Mikitaka Iguchi,&nbsp;Satoshi Ono,&nbsp;Kohei Funasaka,&nbsp;Yasuhisa Sakata,&nbsp;Tatsuya Mikami,&nbsp;Mikinori Kataoka,&nbsp;Shunji Shimaoka,&nbsp;Tomoki Michida,&nbsp;Yoshinori Igarashi,&nbsp;Shinji Tanaka","doi":"10.1111/den.15019","DOIUrl":"10.1111/den.15019","url":null,"abstract":"<p>The Japan Gastroenterological Endoscopy Society has prepared Guidelines for Endoscopic Practice in Nonvariceal Upper Gastrointestinal Bleeding as part of the initiative to develop evidence-based endoscopic practice guidelines. Hemorrhagic gastroduodenal (peptic) ulcers are the primary cause of nonvariceal upper gastrointestinal bleeding. With the advent of a super-aged society, the cases caused by <i>Helicobacter pylori</i> are on the decline, whereas those caused by drugs (e.g. aspirin) have been increasing. Endoscopic hemostasis is currently the first-line treatment for nonvariceal upper gastrointestinal bleeding, and various methods have been devised for this purpose. It is recommended to stabilize the vital signs of the patient before and after endoscopic hemostasis with appropriate management based on an assessment of the severity of illness, in addition to the administration of acid secretion inhibitors. These guidelines describe the evaluation and initial treatment of nonvariceal upper gastrointestinal bleeding, as well as the selection of endoscopic hemostasis for nonvariceal upper gastrointestinal bleeding and its management after endoscopic hemostasis. This is achieved by classifying nonvariceal upper gastrointestinal bleeding into two main categories, namely, peptic ulcer and other types of gastrointestinal bleeding. We prepared statements for any available literature with supporting evidence, including the levels of evidence and recommendations. New evidence has been pooled since the publication of the first edition in this area; however, the levels of evidence and recommendations mostly remain low.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 5","pages":"447-469"},"PeriodicalIF":5.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671741","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":"Submucosal marking peroral endoscopic myotomy: Novel method of peroral endoscopic myotomy","authors":"Hideomi Tomida,&nbsp;Yoshiou Ikeda,&nbsp;Yoichi Hiasa","doi":"10.1111/den.15018","DOIUrl":"10.1111/den.15018","url":null,"abstract":"<p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"792-794"},"PeriodicalIF":5.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671744","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":"Development and validation of a risk score for incomplete resection during endoscopic papillectomy: PANETH score","authors":"Cecilia Binda,&nbsp;Antonio Facciorusso,&nbsp;Stefano Fabbri,&nbsp;Massimiliano Mutignani,&nbsp;Andrea Tringali,&nbsp;Roberto Di Mitri,&nbsp;Alessandro Fugazza,&nbsp;Romano Sassatelli,&nbsp;Armando Gabbrielli,&nbsp;Paolo Giorgio Arcidiacono,&nbsp;Francesco Maria Di Matteo,&nbsp;Chiara Coluccio,&nbsp;Marco Di Marco,&nbsp;Cristiano Spada,&nbsp;Alberto Fantin,&nbsp;Claudio De Angelis,&nbsp;Raffaele Macchiarelli,&nbsp;Francesco Perri,&nbsp;Mauro Manno,&nbsp;Luigi Cugia,&nbsp;Alessandro Mussetto,&nbsp;Alessandro Repici,&nbsp;Ilaria Tarantino,&nbsp;Andrea Anderloni,&nbsp;Carlo Fabbri,&nbsp;i-EUS group","doi":"10.1111/den.15005","DOIUrl":"10.1111/den.15005","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic papillectomy (EP) is the gold standard treatment for ampullary adenomas. However, EP is still burdened by a nonnegligible rate of incomplete resections (IR). Different predictors have been linked to higher rates of IR, but the interaction between these factors is still unclear. The aim of the study was to develop a scoring system (hereby called PANETH score) able to quantify the risk of IR after EP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent EP in 19 Italian centers in 2016–2021 were included. IR was defined as the presence of residual tumor in lateral or endoampullary margins after EP. Predictors for IR were analyzed by logistic regression and were used to obtain an easy-to-use numeric score. The performance of the model was evaluated with a receiver operating characteristic curve analysis and tested by means of 10-fold cross-validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 430 patients were included. On multivariate analysis, laterally spreading tumor (odds ratio [OR] 5.81, 3.21–7.65; <i>P</i> = 0.02), intraductal extension (OR 6.92, 3.33–9.87; <i>P</i> &lt; 0.0001), and bile duct dilation (OR 2.61, 1.22–4.32; <i>P</i> = 0.004) were significant predictors of IR. The score was calculated by the sum of regression coefficients of each predictor. A ≥3 score indicated a 4-fold risk of IR (<i>P</i> &lt; 0.0001). The internal validation resulted in an area under the curve of 0.83 and an overall error rate of 0.11.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed PANETH score may represent a reliable and easily applicable tool to predict the risk of IR after EP to optimize patient selection and risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 7","pages":"749-757"},"PeriodicalIF":5.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671738","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":"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}