Digestive Endoscopy最新文献

{"title":"Teaching, Not Just Detecting: The Next Chapter for AI in Endoscopy Training","authors":"Maria Eva Argenziano, Yuichi Mori, David J. Tate","doi":"10.1111/den.70122","DOIUrl":"10.1111/den.70122","url":null,"abstract":"<p>Artificial intelligence (AI) has changed the way we look at endoscopic practice. Over the past decade, it has evolved from an experimental tool into an integral part of daily endoscopy, improving accuracy and diagnostic yield. Yet while most attention has gone to how AI helps us detect more, a more pressing question is how it can help us <i>teach</i> better.</p><p>In their narrative review, Ho et al. [<span>1</span>] explore how AI has entered endoscopy training across multiple fields: luminal, hepatobiliary, capsule, and therapeutic endoscopy. They describe an impressive expansion of AI's educational footprint, but also a clear imbalance: detection is accelerating, while human learning risks falling behind.</p><p>The review outlines what could be called the “AI life cycle” of a trainee. Before procedures, AI can simulate and predict; during procedures, it can guide and correct; afterward, it can analyze performance. In reality, most published work focuses on that middle stage, the live procedure, leaving simulation and feedback relatively underdeveloped. We are still spending most of our time on detection, not on longitudinal learning.</p><p>This uneven growth is mirrored in attitudes within the endoscopic community. Many trainees welcome AI for the sense of safety and reassurance it offers, while others, often more senior, worry about overreliance and loss of skill. That tension is understandable: AI's educational value remains fragmented, with most benefits concentrated in high-income settings and early training phases.</p><p>The quantitative evidence is encouraging. In computer-aided detection (CADe) trials, adenoma detection rate has improved by roughly 13%–22% among trainees, and even more among beginners, who often reach near-expert performance in miss rate [<span>2-4</span>]. In capsule endoscopy, AI has shortened reading times and improved accuracy, although performance still falls short of experienced readers [<span>5</span>]. In EUS, studies show higher accuracy in structure recognition and shorter time to lesion identification [<span>6, 7</span>], and in therapeutic endoscopy, AI now assists with vessel and perforation recognition, potentially improving safety and speeding up learning [<span>8</span>]. These are meaningful gains, but they remain mostly procedural rather than educational.</p><p>Learning, however, involves more than precision. Few studies have measured true training outcomes such as knowledge retention, time to proficiency, or safe independent performance. The next challenge is to translate detection into durable learning.</p><p>Practical models already exist. Computer-aided quality tools that assess withdrawal time or mucosal coverage could easily form the basis of automated dashboards for feedback. Integrated with validated training curricula, these tools could provide day-to-day learning support and end-of-rotation assessment. In this way, AI can help trainees recognize more and, crucially, understand why they mis","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183439","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 Resection of a Biliary Fibrous Polyp Detected by Peroral Cholangioscopy Using a Rotatable Basket Catheter Under Fluoroscopic Guidance","authors":"Takahiro Urata,&nbsp;Shingo Ueno,&nbsp;Shun Kawahara","doi":"10.1111/den.70119","DOIUrl":"10.1111/den.70119","url":null,"abstract":"<p>A 45-year-old woman was referred to our hospital with abdominal pain. Magnetic resonance cholangiopancreatography demonstrated a common bile duct (CBD) stone (Figure 1). Endoscopic retrograde cholangiopancreatography confirmed an impacted stone at the confluence of the cystic duct and the CBD. Because of distal bile duct narrowing, electrohydraulic lithotripsy was performed under peroral cholangioscopy (POCS), followed by stone extraction using a basket catheter. After stone removal, POCS revealed a protruding lesion at the cystic duct orifice (Figure 2). The lesion was isochromatic with the surrounding mucosa and was suspected to be an inflammatory polyp. Because its size and location made conventional cholangioscopic forceps inadequate for obtaining sufficient tissue, and direct cholangioscopic manipulation was limited by the narrow distal bile duct, the lesion was resected as a complete excisional biopsy to achieve both a definitive histopathological diagnosis and complete removal. Under fluoroscopic guidance, the lesion was gently captured with a rotatable basket catheter (RASEN2; KANEKA Medical, Japan). By carefully rotating the catheter, the lesion was detached, and complete excision was achieved without bleeding or perforation. Subsequent POCS confirmed complete resection endoscopically, with no residual lesion or procedure-related adverse events, thereby demonstrating the safety of this approach. Histopathological examination revealed an inflammatory fibrous polyp composed of fibrous stroma with mild epithelial proliferation and inflammatory cell infiltration. No recurrence was observed during follow-up [<span>1-3</span>]. This video demonstrates that a rotatable basket catheter, originally designed for bile duct stone extraction, can be considered a diagnostic and therapeutic option in carefully selected cases of intraductal biliary lesions when conventional cholangioscopic devices are not applicable.</p><p>T.U. contributed to the conception and design of the study, performed the endoscopic procedure, and drafted the manuscript. S.U. and S.K. contributed to data acquisition and interpretation. All authors critically revised the manuscript and approved the final version.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168077","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":"Novel Magnetic Countertraction Enhanced Performance in Colonic Endoscopic Submucosal Dissection: An Ex Vivo Crossover Study (With Video)","authors":"Hon Chi Yip,&nbsp;Wai Shing Chan,&nbsp;Siew Fung Hau,&nbsp;Nicole Miu-yee Cheng,&nbsp;Louis Ho-Shing Lau,&nbsp;Simon Chu,&nbsp;Zhaoyi Zhu,&nbsp;Man Yee Yung,&nbsp;Yee Kit Tse,&nbsp;Zheng Li,&nbsp;Simon Siu-man Ng,&nbsp;Philip Wai-yan Chiu","doi":"10.1111/den.70120","DOIUrl":"10.1111/den.70120","url":null,"abstract":"<p>Endoscopic submucosal dissection (ESD) is technically demanding with the main limitation on the lack of effective countertraction. Existing countertraction methods such as clip-related techniques only provide unidirectional static traction force that may restrict their utility in complicated colorectal ESD. The magnetic countertraction system provides dynamic force by manipulating an external magnetic source. We designed a novel magnetic countertraction system with an internal magnet retractor introducible via the endoscopy channel and the external magnetic effector mounted on a robotic arm that could be easily manipulated. We evaluated the performance and safety of the system in an ex vivo randomized crossover study. ESD was performed on ex vivo porcine colon models with standardized 3 cm target lesions marked at gravity-dependent locations. Endoscopists performed the ESD in pairs, randomized to magnetic countertraction (MAG-ESD) or conventional ESD (C-ESD) first to minimize bias from the learning effect. During MAG-ESD, a flexible internal magnetic retractor was deployed via the endoscopic channel and anchored to the lesion margin. A robotic arm-mounted external permanent magnet (EPM) was positioned above the colon model to engage the retractor and provide dynamic countertraction. Seventy-two ESD (36 MAG-ESD and 36 C-ESD) were performed by 18 endoscopists. MAG-ESD significantly reduced procedure time by 20.4% (<i>p</i> = 0.0002) and workload (NASA-TLX mean difference: −19.81, 95% CI: −25.42 to −14.19). All procedures achieved en bloc resection. MAG-ESD had significantly fewer complications (OR = 0.782, 95% CI: 0.644–0.949), including lower rates of perforation and muscle injury. The novel magnetic countertraction system significantly improved procedural efficiency, reduced operator workload, and enhanced safety in ex vivo colonic ESD.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151338","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":"En Bloc Resection of A Giant Pedunculated Esophageal Mature Teratoma by Endoscopic Submucosal Dissection","authors":"Yuhang Zhang,&nbsp;Ruizhi Wang,&nbsp;Bing Hu","doi":"10.1111/den.70121","DOIUrl":"10.1111/den.70121","url":null,"abstract":"<p>A 21-year-old man complained about progressive dysphagia and hoarseness for 9 months. Endoscopy revealed a giant, lobular 0-Ip mass (stalk diameter 1.5 cm) protruding into the esophageal lumen 20–28 cm from the incisors, with hair on the surface (Figure 1A). Further endoscopic ultrasonography showed that the mass was 3.92 cm × 2.66 cm, originating from submucosa, with mixed echo, clear demarcation, and intact muscularis propria (Figure 1B). Enhanced chest CT also showed a 4.3 cm × 3.2 cm × 10.7 cm mass at the esophageal wall (Figure 1C). Endoscopic submucosal dissection (ESD) of the mass was performed after the patient's consent. Under general anesthesia and intubation, standard ESD procedures were performed (Video S1) with dual knife and insulated tip knife. En bloc resection of the mass was successful, without perforation or bleeding (Figure 1D–F). The attempt to retrieve the whole mass failed. Therefore, we fragmented the mass and retrieved them using a snare (Figure 1G,H). The wound was finally closed with titanium clips (Figure 1I). The entire procedural time was 104 min. The resected mass (Figure 2A) was pathologically diagnosed as mature teratoma (Figure 2B). No residue or recurrence of the tumor was found upon visit (Figure 2C). Mediastinal teratoma are frequently reported [<span>1</span>], but esophageal teratoma is rare [<span>2</span>]. Usually, patients may be referred to surgical or thoracoscopic resection for curative treatment. Considering the benign nature and clear demarcation of the mature teratoma, ESD is advantageous for its en bloc endoscopic resection. To the best of our knowledge, endoscopic management of giant esophageal teratoma has not been reported. Although the size of the tumor was over 40 mm and the whole procedural time was 104 min, posing risk of technical difficulty of ESD [<span>3</span>], the actual tumor dissection time was 9 min and the stalk size was 15 mm in our case, presenting no obvious resection limitation. Our case shows ESD is feasible for esophagus-derived teratoma, and therefore, may provide a safer, cheaper, and less invasive replacement of surgical interventions [<span>4</span>].</p><p>Yuhang Zhang drafted the manuscript and the video clip. Ruizhi Wang collected the material and made critical revisions. Bing Hu performed the endoscopic resection and conceptualization.</p><p>This work was supported by National Natural Science Foundation of China (82170675) and 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21011).</p><p>Informed consent was obtained from the patient to publish these images.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144816","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":"Comparable Risk of Barrett's Adenocarcinoma Between Japanese Patients With Long-Segment Barrett's Esophagus and Western Populations","authors":"Fumiaki Ishibashi,&nbsp;Sho Suzuki","doi":"10.1111/den.70106","DOIUrl":"10.1111/den.70106","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121065","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":"Double Stent Placement for Malignant Colonic Obstructions Using a Novel Thin Therapeutic Gastroscope","authors":"Yosei Sawai,&nbsp;Tomohiro Shimada,&nbsp;Kei Ito","doi":"10.1111/den.70115","DOIUrl":"10.1111/den.70115","url":null,"abstract":"<p>An 89-year-old woman with rectosigmoid cancer had previously undergone palliative stent placement (Hanarostent, 22 mm, 6 cm; Boston Scientific Japan K.K., Tokyo, Japan). Seven months later, a new malignant obstruction was identified in the proximal sigmoid colon, located 6 cm proximal to the initial stent site, necessitating separate stenting (Figure 1). However, stent placement using a conventional slim colonoscope with an outer diameter of 11.7 mm (PCF-H290ZI; Olympus Corporation, Tokyo, Japan) was unsuccessful, as the scope could not pass through the previously deployed stent, which had narrowed due to cancer ingrowth and formed a sharp angle with the oral lumen. Therefore, we switched to a newly developed thin therapeutic gastroscope with a 7.9-mm outer diameter (EG-840 TP; Fujifilm Medical Co., Tokyo, Japan) [<span>1</span>] (Figure 2). This scope smoothly passed through the narrowed stent and reached the proximal cancer. A second stent (Hanarostent, 22 mm, 6 cm) was successfully deployed through its 3.2-mm working channel (Video S1).</p><p>In general, small-caliber colonoscopes such as PCF-PQ260L with a 9.2-mm outer diameter (Olympus Corporation, Tokyo, Japan) or PCF-H290ZI are recommended for total colonoscopy through previously placed stents [<span>2, 3</span>]. However, in cases where the stent lumen is narrowed due to cancer ingrowth, the novel thin therapeutic gastroscope, which is 1.9-mm slimmer than conventional therapeutic gastroscopes, offers reduced interference when traversing the stent and may help minimize stent-related complications. Additionally, its enhanced flexibility allows smoother advancement through sharply angulated or adhesive colonic segments, which facilitates providing a direct view of the stenotic lumen. Notably, this scope could be advanced through most stenotic segments, enabling easier and more reliable guidewire passage.</p><p>Stent placement has become an established strategy for malignant obstruction as both a bridge to surgery and palliation [<span>4</span>], and this novel thin therapeutic gastroscope may provide a valuable option by enabling traversal of previously placed stents.</p><p>Yosei Sawai: Performed the endoscopic procedure and drafted the initial manuscript. Tomohiro Shimada: Assisted with the endoscopic procedure and revised the manuscript for important intellectual content. Kei Ito: Approved the final version.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108730","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 Using a Forward-Viewing Echoendoscope and Lumen-Apposing Metal Stent in a Patient With Acute Cholecystitis After Gastrectomy With Billroth II Reconstruction","authors":"Kenji Matsuo,&nbsp;Kotaro Takeshita,&nbsp;Satoshi Asai","doi":"10.1111/den.70117","DOIUrl":"10.1111/den.70117","url":null,"abstract":"<p>Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an effective treatment for acute cholecystitis (ACC) in patients unfit for cholecystectomy [<span>1, 2</span>]. However, advancing an oblique-viewing echoendoscope to the duodenum is technically challenging in post-gastrectomy patients, making EUS-GBD difficult to perform [<span>3</span>]. The feasibility of EUS interventions using a forward-viewing echoendoscope (FVE) in post-gastrectomy patients has been reported [<span>4, 5</span>]. We present a case of ACC in a patient with Billroth II reconstruction in whom FVE-assisted duodenal access enabled EUS-GBD using a lumen-apposing metal stent (LAMS). An 85-year-old man with dementia, a large abdominal aortic aneurysm, and a previous distal gastrectomy with Billroth II reconstruction presented with fever and computed tomography (CT)-confirmed ACC. Because surgical risk was prohibitive and inadvertent removal of external or naso-gallbladder drains was likely, endoscopic transpapillary GBD was performed using a 7-Fr, 15-cm spiral plastic stent. Nonetheless, no improvement was observed within two days, and follow-up CT revealed persistent gallbladder distension. As transpapillary drainage was considered insufficient due to viscous purulent bile, EUS-GBD with an FVE was planned as salvage therapy. Scope passage through the afferent limb was impeded by sharp angulation near the ligament of Treitz. Using a previously reported technique in which a catheter and guidewire are advanced into the blind end of the afferent limb to straighten the loop and facilitate scope passage [<span>4</span>], successful deep insertion of the FVE was achieved. EUS visualized a markedly distended gallbladder (&gt; 40 mm). A 15-mm LAMS was deployed between the duodenal bulb and gallbladder, resulting in immediate bile drainage. The patient's ACC resolved promptly without adverse events. Two months later, without poor prognostic factors, the LAMS was removed and replaced with a 7-Fr, 4-cm double-pigtail plastic stent. To our knowledge, this is among the first video reports of EUS-GBD using an FVE with LAMS in a patient with Billroth II reconstruction (Figures 1 and 2 and Video S1).</p><p>K.M. designed the study and drafted the manuscript. S.A. supervised the study and critically revised the manuscript for important intellectual content. K.M. and K.T. contributed to the investigation, video editing, and resource collection. All authors approved the final version of the manuscript submitted for publication.</p><p>The authors have nothing to report.</p><p>This study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of Tane General Hospital (approval no. 2024-43).</p><p>The authors declare no conflicts of interest.</p><p>The authors have nothing to report.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108784","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":"Dynamic Nature of White Opaque Substance in Duodenal Epithelial Tumors: A Paradigm Shift in Endoscopic Diagnosis","authors":"Masao Yoshida","doi":"10.1111/den.70108","DOIUrl":"10.1111/den.70108","url":null,"abstract":"&lt;p&gt;Kuribara et al. present a novel and clinically relevant observation regarding the dynamics of the white opaque substance (WOS) in superficial non-ampullary duodenal epithelial tumors (SNADETs) [&lt;span&gt;1&lt;/span&gt;]. By systematically analyzing serial endoscopic examinations obtained before treatment, they suggest that the conventional assumption that WOS represents a static endoscopic feature may not be definitive, offering new insights into its diagnostic interpretation.&lt;/p&gt;&lt;p&gt;SNADETs are being detected with increasing frequency, likely due to advances in high-resolution endoscopic technology and a growing awareness of duodenal lesions. Moreover, the advent of image-enhanced endoscopy, specifically the combination of magnifying endoscopy with narrow-band imaging (NBI), has facilitated a more detailed assessment of neoplastic lesions [&lt;span&gt;2&lt;/span&gt;]. Consequently, differentiation between neoplastic and non-neoplastic lesions, along with accurate histological grading before treatment, has become a focal point in the evaluation of SNADETs.&lt;/p&gt;&lt;p&gt;In this diagnostic context, the WOS is often a key point during endoscopic evaluation. Originally described by Yao et al. as an endoscopic feature of gastric epithelial tumors [&lt;span&gt;3&lt;/span&gt;], WOS appears as milk-white mucosa (MWM) under conventional white-light imaging [&lt;span&gt;4&lt;/span&gt;]. Its presence often obscures the underlying vascular pattern, masking the tumor surface even under NBI. Subsequent histological analyses revealed that this whitish appearance was caused by the accumulation of lipid droplets within the superficial tumor epithelium, confirmed via Oil Red O staining. Furthermore, WOS is commonly associated with lesions exhibiting an intestinal phenotype, suggesting its utility as an endoscopic marker of this specific phenotype. Therefore, WOS has attracted the attention of endoscopists for diagnosing gastrointestinal epithelial tumors.&lt;/p&gt;&lt;p&gt;Various studies have elucidated the clinical relevance of WOS in duodenal epithelial lesions. Yoshimura et al. noted that MWM was present in more than 90% of SNADETs. They categorized MWM distribution into “entire” and “marginal” types, noting that the entire type was more frequently associated with low-grade adenoma (LGA), whereas the marginal type predominated in high-grade adenoma or carcinoma (HGA/Ca) [&lt;span&gt;4&lt;/span&gt;]. Nakayama et al. proposed that WOS is valuable for distinguishing neoplastic from non-neoplastic tissues, suggesting that lesions showing WOS within an open-loop structure—characterized by a linear or arc-like mucosal configuration—are likely neoplastic [&lt;span&gt;5&lt;/span&gt;]. Kikuchi et al. developed a diagnostic algorithm based on surface structural and vascular patterns seen under magnifying NBI. They indicated that an absent vascular pattern, indicative of WOS, combined with a monotype surface pattern is characteristic of LGA [&lt;span&gt;6&lt;/span&gt;]. Additionally, an association with epithelial subtype has been documented: tumors with an intestinal","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108646","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":"Ciprofol Versus Propofol for the Prevention of Hypoxia During Gastrointestinal Endoscopy Procedures in Overweight Patients: A Multicenter, Randomized, Controlled Trial","authors":"Renlong Zhou,&nbsp;Wanbing Dai,&nbsp;Zhongxue Su,&nbsp;Yanhong Lian,&nbsp;Penglu Wen,&nbsp;Linzhong Zhang,&nbsp;Lingchun Kong,&nbsp;Zhen Hua,&nbsp;Yanxia Sun,&nbsp;Huaguo Zhao,&nbsp;Qunchao Wang,&nbsp;Weifeng Yu,&nbsp;Diansan Su","doi":"10.1111/den.70102","DOIUrl":"10.1111/den.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>To compare the incidence of hypoxia and other sedation-related adverse events (AEs) in overweight patients undergoing gastrointestinal (GI) endoscopy who were sedated using ciprofol or propofol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized, controlled trial was conducted in five hospitals in China between September 2022 and August 2023. Patients were randomized into either ciprofol or propofol sedation. The primary outcome was the total incidence of hypoxia and severe hypoxia. The secondary outcomes were hypoxia incidence, severe hypoxia incidence, subclinical respiratory depression incidence, endoscopy success rate, injection pain incidence, and corrective hypoxic measures proportion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1018 patients were randomized into either ciprofol group (<i>n</i> = 506) or propofol group (<i>n</i> = 512). The mean BMI was 26.23 kg/m² in the ciprofol group and 26.17 kg/m² in the propofol group. Compared with propofol, ciprofol showed lower incidences of total hypoxia and severe hypoxia in both the full analysis set (FAS) and per-protocol analysis set (PPS). The lower incidence was particularly significant for severe hypoxia (4.35% vs. 7.62%, <i>p</i> = 0.028 in FAS). The injection pain incidence was significantly lower in the ciprofol group than in the propofol group (2.57% vs. 13.28%, <i>p</i> &lt; 0.001 in FAS). Moreover, fewer patients in the ciprofol group required oxygen-correction therapy (20.40% vs. 25.70%, <i>p</i> = 0.047 in PPS), and ciprofol had a lower incidence of AEs associated with sedation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>During GI endoscopy, overweight patients are significantly less prone to hypoxia when sedated with ciprofol than with propofol, offering a safer alternative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov (NCT05518929)</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108651","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":"Integrating Artificial Intelligence Into Endoscopy Education: Evidence, Gaps, and Future Directions","authors":"Weihao Cheng,&nbsp;Shangxuan Li,&nbsp;Zekai Yu","doi":"10.1111/den.70114","DOIUrl":"https://doi.org/10.1111/den.70114","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 2","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193318","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}