Digestive Endoscopy最新文献

{"title":"Endoscopic ultrasound-guided gastrojejunostomy: Novel double catheter technique with video","authors":"Pankaj Gupta,&nbsp;Vikas Singla,&nbsp;Pankaj Singh","doi":"10.1111/den.14973","DOIUrl":"10.1111/den.14973","url":null,"abstract":"<p>Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) can provide durable treatment for gastric outlet obstruction.<span>¹</span> Technical challenges have limited widespread adoption of the procedure.<span>²</span> Various techniques such as nasojejunal tube or dedicated balloon-assisted technique have been explained in the literature.<span>³</span> The commonly used technique of nasojejunal catheter-assisted GJ has the limitation of difficulty in correct identification of the desired loop. Multiple small bowel and even colonic loop may get distended with infusion of fluid, and may lead to erroneous puncture of the distal small bowel or colonic loop. We attempted to overcome this difficulty by placing two catheters simultaneously in the jejunum. One catheter placed near the duodenojejunal (DJ) flexure is used to infuse saline for jejunal loop distension and another catheter placed distally acts as a guide to identify the correct proximal jejunal loop. A 64-year-old man with advanced gastric cancer-causing pyloric obstruction underwent EUS-GJ (Video S1). The procedure was performed under general anesthesia with endotracheal intubation in the supine position. Gastroscope (HQ 190; Olympus, Tokyo, Japan) could be negotiated across the pyloric growth and guidewire (Visiglide, G-240-2544S; Olympus) was placed in the jejunum and a catheter (nasobiliary drain, 7F; Devon, Bangalore, India) was placed with the tip at ~50 cm from the DJ flexure. Another guidewire was passed and the catheter was placed with the tip near the DJ flexure, under fluoroscopic guidance (Fig. 1). Linear echoendoscope (GF UCT 180, ME-2 premium plus processer; Olympus) was introduced. Glucagon injection was used for bowel relaxation and a methylene blue-stained normal saline was infused through the proximal catheter and jejunal loop where the distal catheter was identified. A lumen-apposing metal stent (Hot AXIOS Stent and Delivery System, 20 mm ×10 mm; Boston Scientific, Marlborough, MA, USA) was deployed with the freehand puncture technique (Fig. 2). Immediate release of methylene blue-stained fluid through the deployed stent was identified, confirming the position of stent in the bowel lumen. The present technique may overcome the difficulty in identification of the correct bowel loop during EUS-guided gastrojejunostomy.</p><p>Authors declare no conflict of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 5","pages":"548-549"},"PeriodicalIF":5.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14973","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788023","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":"Usefulness of a novel 11F digital single-operator cholangioscopy through a colonoscope in a patient with surgically altered anatomy","authors":"Takafumi Mie,&nbsp;Tsuyoshi Takeda,&nbsp;Takashi Sasaki","doi":"10.1111/den.14968","DOIUrl":"10.1111/den.14968","url":null,"abstract":"<p>Digital single-operator cholangioscopy (DSOC) is useful for evaluating biliary tract malignancies.<span>¹</span> However, DSOC is challenging in patients with surgically altered anatomy (SAA) due to the small channel diameter of the enteroscope. While DSOC insertion through the overtube is useful,<span>^{2, 3}</span> scope manipulation is challenging. Only small biopsy forceps are available with conventional DSOC, resulting in an insufficient specimen. Recently, a novel 11F DSOC (eyeMAX; Micro-Tech, Nanjing, China; working channel, 1.8 mm; working length, 2190 mm)<span>⁴</span> was developed, allowing use of larger biopsy forceps than conventional DSOC.</p><p>A 65-year-old man, who had undergone extended right hepatectomy for cystadenocarcinoma of the liver and distal gastrectomy with B-II reconstruction for gastric cancer, presented to our hospital for a tumor located at the hepatic hilum. In the initial session, we inserted an endoscopic nasobiliary drainage tube after endoscopic papillary large balloon dilation (REN [13–15 mm]; Kaneka, Osaka, Japan) (Fig. 1). Postendoscopic retrograde cholangiopancreatography pancreatitis and bleeding from the tumor occurred, which were managed conservatively. In the next session, we inserted an 11F eyeMax into the bile duct over a 0.025 inch guidewire (VisiGlide2; Olympus, Tokyo, Japan) through a colonoscope (EC-760R-V/M; working length, 1330 mm; channel diameter, 3.8 mm; Fujifilm, Tokyo, Japan). A tumor with ulceration was visualized at the hepatic hilum with no evidence of tumor extending to B4 bifurcation or lower bile duct. Mapping biopsy (Radial Jaw 4P; cup diameter, 1.8 mm; Boston Scientific, MA, USA) revealed adenocarcinoma at the hepatic hilum and no malignancy at the B4 bifurcation or lower bile duct (Fig. 2). Although the recommended channel diameter of the 11F eyeMax is 4.2 mm, it can be inserted through a colonoscope with a 3.8 mm channel. Insertion of the 11F eyeMax is difficult when the colonoscope is bent, requiring straightening of the colonoscope. This method allows stable DSOC manipulation and sufficient tissue sample collection in patients with SAA.</p><p>Authors declare no conflict of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"438-439"},"PeriodicalIF":5.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781946","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 of endoscopic radiofrequency ablation for proton pump inhibitor-dependent gastroesophageal reflux disease: Multicenter prospective cohort study","authors":"Yuanxi Jiang,&nbsp;Zhiyu Dong,&nbsp;Ying Chen,&nbsp;Huihui Sun,&nbsp;Junwen Wang,&nbsp;Zhenxiang Wang,&nbsp;Qianqian Meng,&nbsp;Han Lin,&nbsp;Qingwei Zhang,&nbsp;Shengliang Chen,&nbsp;Zhizheng Ge,&nbsp;Luowei Wang,&nbsp;Shuchang Xu","doi":"10.1111/den.14963","DOIUrl":"10.1111/den.14963","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the effects of endoscopic radiofrequency ablation (RFA) on proton pump inhibitor (PPI)-dependent gastroesophageal reflux disease (GERD) in a Chinese population, and to explore the factors associated with favorable efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter, single-armed prospective cohort study was conducted. PPI-dependent GERD patients were enrolled and underwent RFA. The primary outcome was improvement of GERD health-related quality of life (GERD-HRQL). Secondary outcomes were symptom improvement, satisfaction, PPI use, and the indicators of 24-h pH-impedance monitoring. A nomogram to predict complete remission was constructed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 66 patients were included. The GERD-HRQL score was significantly reduced at the 3 month (mean difference, 14.7 [12.6–16.9]), 6 month (mean difference, 15.9 [13.8–18.1]), 12 month (mean difference, 16.7 [14.4–18.9]), 24 month (mean difference, 18.4 [16.2–20.1]), 36 month (mean difference, 18.2 [16.3–20.4]), and 48 month follow-up (mean difference, 16.1 [14.2–18.3]), all <i>P</i> &lt; 0.001. The esophageal and extra-esophageal symptom scores were all significantly decreased. The proportion of satisfaction and no PPI use were significantly higher. With regard to the indicators of 24-h pH-impedance monitoring, acid exposure time (AET), and DeMeester score, but not lower esophageal sphincter (LES) pressure, decreased significantly at the 12 month follow-up. A nomogram based on age, body mass index (BMI), baseline AET, and LES pressure was then constructed and showed good discrimination in the prediction of complete remission following RFA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated that RFA improved life quality as well as symptoms in PPI-dependent GERD patients in a Chinese population. Younger age, higher BMI, lower baseline AET, and higher baseline LES pressure indicate favorable efficacy of RFA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 5","pages":"501-511"},"PeriodicalIF":5.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14963","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781945","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":"Digital single-operator cholangioscopy-guided endoluminal radiofrequency of an intraductal papillary mucinous neoplasia of the bile duct","authors":"Xin Deng,&nbsp;Tong Mou,&nbsp;Qiao Wu","doi":"10.1111/den.14962","DOIUrl":"10.1111/den.14962","url":null,"abstract":"<p>A 77-year-old man with recurrent episodes of abdominal pain was diagnosed with a difficult common bile stone by computed tomography (Fig. 1A). Endoscopic retrograde cholangiopancreatography and digital single-operator cholangioscopy (DSOC) with electrohydraulic lithotripsy cleared the bile duct stones and a small number of papillary neoplasms located at the hilar bile ducts were found incidentally (Fig. 1D). Tissues were collected under direct visualization with biopsy forceps and pathological examination revealed intraductal papillary mucinous neoplasia of the bile duct (IPNB). A novel radiofrequency operation electrode was inserted into the bile duct through DSOC (Fig. 1B). DSOC-guided endoluminal radiofrequency ablation (RFA) was used to destroy the lesions under direct vision (Fig. 1C; Video S1). After RFA, these neoplasms became necrotic (Fig. 1E) and pathological examination revealed charring of the tissues after RFA. No adverse events occurred. Finally, the patient has remained in good health and we plan to continue long-term follow-up.</p><p>IPNB is a relatively rare tumor derived from the biliary epithelium and is known as one of the premalignant lesions in the biliary duct.<span>¹</span> Previous studies have reported endoscopic RFA was one of the local treatment options.<span>^{2, 3}</span> However, traditional RFA is guided by fluoroscopic images and cannot destroy the lesions precisely. To our knowledge, this is the first report that a DSOC-guided endoluminal radiofrequency catheter was used to ablate IPNB. This novel technique could be an accurate and microinvasive treatment method for selected patients with bile duct-related disorders.</p><p>Authors declare no conflict of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"436-437"},"PeriodicalIF":5.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741585","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":"Comparison of fully versus partially covered metal stents in endoscopic ultrasound-guided hepaticogastrostomy for malignant biliary obstruction (with video)","authors":"Sung Hyun Cho,&nbsp;Seong Je Kim,&nbsp;Tae Jun Song,&nbsp;Dongwook Oh,&nbsp;Dong-Wan Seo","doi":"10.1111/den.14952","DOIUrl":"10.1111/den.14952","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using a fully covered metal stent (FCMS) or partially covered metal stent (PCMS) is performed to manage unresectable malignant biliary obstruction (MBO) following unsuccessful endoscopic retrograde cholangiopancreatography. This study aimed to compare FCMS and PCMS for EUS-HGS in patients with MBO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the EUS database to analyze consecutive patients with MBO who underwent EUS-HGS between November 2017 and March 2023. We performed a 1:1 matching using propensity score matching based on potential confounding factors. Stent patency, technical success, clinical success, adverse events, reintervention, and overall survival were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The technical success rate of EUS-HGS was 92% (123/134). A total of 80 patients with technical success (40 FCMS, 40 PCMS) were selected after propensity score matching. The two groups showed similar rates of clinical success (90% vs. 88%; <i>P</i> = 0.999), early adverse events (15% vs. 20%; <i>P</i> = 0.556), late adverse events (18% vs. 33%; <i>P</i> = 0.121), reintervention (20% vs. 38%; <i>P</i> = 0.084), and median overall survival (4.1 months [95% confidence interval (CI) 2.6–5.5] vs. 3.8 months [95% CI 1.9–5.7]; <i>P</i> = 0.609). During follow-up, the FCMS group showed higher patency rates (85% vs. 60% at 6 months; 76% vs. 43% at 12 months; <i>P</i> = 0.030).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FCMS and PCMS for EUS-HGS in patients with unresectable MBO showed similar rates of clinical success, as well as early and late adverse events. However, the FCMS group showed a higher cumulative stent patency rate compared to the PCMS group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 5","pages":"532-540"},"PeriodicalIF":5.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14952","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741492","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":"Linked color imaging and upper gastrointestinal neoplasia","authors":"Shoko Ono,&nbsp;Masaki Inoue,&nbsp;Masayuki Higashino,&nbsp;Shuhei Hayasaka,&nbsp;Shugo Tanaka,&nbsp;Hiroki Egami,&nbsp;Naoya Sakamoto","doi":"10.1111/den.14957","DOIUrl":"10.1111/den.14957","url":null,"abstract":"<p>White light imaging (WLI) can sometimes miss early upper gastrointestinal (UGI) neoplasms, particularly minimal changes and flat lesions. Moreover, endoscopic diagnosis of UGI neoplasia is strongly influenced by the condition of the surrounding mucosa. Recently, image-enhanced endoscopy techniques have been developed and used in clinical practice; one of which is linked color imaging (LCI), which has an expanded color range for better recognition of slight differences in mucosal color and enables easy diagnosis and differentiation of noncancerous mucosa from carcinoma. LCI does not require magnified observation and can clearly visualize structures using an ultrathin scope; therefore, it is useful for screening and surveillance endoscopy. LCI is particularly useful for detecting gastric cancer after <i>Helicobacter pylori</i> eradication, which accounts for most gastric cancers currently discovered, and displays malignant areas in orange or orange–red surrounded by intestinal metaplasia in lavender. Data on the use of convolutional neural network and computer-aided diagnosis with LCI for UGI neoplasm detection are currently being collected. Further studies are needed to determine the clinical role of LCI and whether it can replace WLI.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"352-361"},"PeriodicalIF":5.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14957","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711723","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":"Usefulness of the right lateral decubitus push method in endoscopic submucosal dissection for upper gastric lesions","authors":"Takuya Matsunaga,&nbsp;Naoyuki Tominaga,&nbsp;Shinichi Ogata","doi":"10.1111/den.14945","DOIUrl":"10.1111/den.14945","url":null,"abstract":"<p>Endoscopic submucosal dissection (ESD) for lesions in the gastric fundus and greater curvature remains challenging owing to difficulties in achieving tangential access with conventional endoscopy, despite the widespread adoption of ESD. Recent reports highlight the need for improved techniques in managing lesions, such as “fundic gland-type gastric cancer” in these regions. Our institution previously introduced the “right lateral decubitus push method” (RPM), wherein the patient is positioned in the right lateral decubitus position, allowing tangential access to the lesion by advancing the endoscope (Fig. 1). This method facilitates a horizontal approach, stabilizes endoscopic operations by increasing the contact area between the endoscope and the gastric wall, and is simple to perform and cost-effective. RPM also permits the use of traction methods<span>¹</span> and multibending endoscopes.<span>²</span> However, the method increases the risk of the gastric contents flooding the esophagogastric junction,<span>³</span> necessitating frequent oral suction or the use of an overtube to prevent aspiration pneumonia.<span>^{4, 5}</span> The feasibility and maneuverability of RPM should be assessed preoperatively in each patient, as the method may not be suitable for all patients. We retrospectively compared the treatment outcomes of 16 cases in which ESD was performed using RPM for lesions from the gastric fundus to the upper greater curvature from January 2010 to December 2020, with 10 cases receiving conventional methods (cESD) (Table 1). Although there were no statistically significant differences in treatment outcomes between the groups, the RPM group showed lower rates of postoperative bleeding and intraoperative perforation, as well as shorter operative times versus the cESD group. Aspiration pneumonia was not observed, likely owing to preventive measures. RPM enabled safe and complete ESD for challenging lesions in the gastric fundus and greater curvature that were difficult to access with conventional left lateral decubitus ESD (Video S1). RPM offers a viable alternative for difficult gastric ESDs, improving accessibility and stability during the procedure.</p><p>Authors declare no conflict of interest for this article.</p><p>Approval of the research protocol by an Institutional Reviewer Board: This study was performed with the approval of the Saga Medical Centre Koseikan Ethics Committee (Approval number: 21-03-01-02).</p><p>Informed Consent: In this study, informed consent was obtained from patients using the opt-out method..</p><p>Registry and the Registration No. of the study/trial: N/A.</p><p>Animal Studies: N/A.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 3","pages":"300-301"},"PeriodicalIF":5.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711727","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}