Digestive Endoscopy最新文献

{"title":"Endoscopic Papillectomy for Ampullary Tumors in Older Patients: Balancing Oncologic Benefit and Geriatric Risk","authors":"Yoshihisa Takada,&nbsp;Takuya Ishikawa,&nbsp;Kentaro Yamao,&nbsp;Yasuyuki Mizutani,&nbsp;Tadashi Iida,&nbsp;Hironori Aoi,&nbsp;Ryohei Kumano,&nbsp;Kazuhiro Furukawa,&nbsp;Takeshi Yamamura,&nbsp;Hiroki Kawashima","doi":"10.1111/den.70250","DOIUrl":"10.1111/den.70250","url":null,"abstract":"<div>\u0000 \u0000 <p>As population aging accelerates, patients aged ≥ 75 years represent a growing proportion of those diagnosed with ampullary tumors. Endoscopic papillectomy (EP) is an established minimally invasive treatment for ampullary adenoma; however, treatment selection in older patients requires careful consideration of oncologic benefit, procedural risk, geriatric vulnerability, and life expectancy. This review outlines key geriatric assessment tools and evaluates the safety, prognosis, and treatment selection of endoscopic and surgical approaches for ampullary tumors in older patients. With appropriate selection, short-term EP outcomes appear comparable between older and younger patients. However, EP can cause fatal adverse events and often requires long-term surveillance or retreatment. In older patients, long-term prognosis is strongly influenced by comorbidity burden and competing mortality, with a high age-adjusted Charlson Comorbidity Index associated with poorer overall survival. Natural history data from familial adenomatous polyposis and colorectal adenomas provide an indirect time-axis framework for considering surveillance in selected high-risk patients. Management of ampullary tumors in older patients should be guided by integrated assessment of oncologic and geriatric factors rather than chronological age alone. Standardized geriatric assessment may help identify patients best suited for intervention or surveillance. Prospective studies incorporating functional outcomes, quality of life, and treatment-related mortality are needed to support evidence-based decision-making.</p>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610749","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 Performance of Gastric CADe: Beyond Lesion Recognition From the G-CADe Trial","authors":"Ayaka Takasu","doi":"10.1111/den.70246","DOIUrl":"10.1111/den.70246","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610769","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":"A Rare Case of a Colonic Polyp Concealed Within the Appendix","authors":"Yusuke Hanawa,&nbsp;Noriya Uedo,&nbsp;Tomoki Michida","doi":"10.1111/den.70244","DOIUrl":"10.1111/den.70244","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610775","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 Outcomes of Underwater Endoscopic Submucosal Dissection for Duodenal Tumors: A Systematic Review and Meta-Analysis","authors":"Kumiko Kirita,&nbsp;Teppei Akimoto,&nbsp;Yasunori Sato,&nbsp;Motoki Sasaki,&nbsp;Maya Ishizawa,&nbsp;Mai Owada,&nbsp;Ai Katsumi,&nbsp;Yuki Kubo,&nbsp;Misaki Sugawara,&nbsp;Rei Mizobe,&nbsp;Shoma Murata,&nbsp;Yuri Imura,&nbsp;Hinako Sakurai,&nbsp;Anna Tojo,&nbsp;Kurato Miyazaki,&nbsp;Teppei Masunaga,&nbsp;Mari Mizutani,&nbsp;Yusaku Takatori,&nbsp;Shintaro Kawasaki,&nbsp;Noriko Matsuura,&nbsp;Atsushi Nakayama,&nbsp;Tomohisa Sujino,&nbsp;Kaoru Takabayashi,&nbsp;Naohisa Yahagi,&nbsp;Motohiko Kato","doi":"10.1111/den.70247","DOIUrl":"10.1111/den.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Study Aim</h3>\u0000 \u0000 <p>Underwater endoscopic submucosal dissection (U-ESD) has recently been introduced as a technique that may improve visualization and submucosal layer expansion. However, the clinical outcomes of U-ESD for duodenal tumors have not been systematically evaluated. This study aimed to assess the efficacy and safety of U-ESD for duodenal tumors through a systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted using PubMed, Scopus, and the Cochrane Library from database inception to December 12, 2025. Studies evaluating U-ESD for duodenal tumors were included. Primary outcomes included en bloc resection, R0 resection, procedure time, adverse events, and complete mucosal defect closure. Pooled estimates were calculated using a random-effects model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four retrospective studies comprising 298 lesions treated with U-ESD were included. The pooled procedure time was 59 min (95% CI, 48–70 min; <i>I</i>² = 72%). The pooled en bloc resection rate was 99% (95% CI, 97%–100%; <i>I</i>² = 0%), and the pooled R0 resection rate was 89% (95% CI, 81%–93%; <i>I</i>² = 54%). The pooled intraoperative perforation rate was 5% (95% CI, 1%–23%; <i>I</i>² = 88%). The pooled delayed perforation and delayed bleeding rates were 1% (95% CI, 0%–3%; <i>I</i>² = 0%) and 2% (95% CI, 1%–5%; <i>I</i>² = 0%), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current evidence suggests that U-ESD is a feasible treatment option for duodenal tumors and is associated with favorable clinical outcomes. However, the available evidence remains limited, and potential biases and concerns regarding generalizability warrant cautious interpretation of these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610783","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":"Computer-Aided Detection Systems: Can Efficacy Be Evaluated as a Single Technological Concept?","authors":"Shunsuke Kamba,&nbsp;Kazuki Sumiyama","doi":"10.1111/den.70242","DOIUrl":"10.1111/den.70242","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594885","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":"Building Trustworthy Artificial Intelligence for Gastrointestinal Endoscopy","authors":"Yuichi Mori","doi":"10.1111/den.70243","DOIUrl":"https://doi.org/10.1111/den.70243","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148553441","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 “Methodology Assessment of Endoscopic Ultrasound Radiofrequency Ablation (EUS-RFA) for Pancreatic Neoplasms: Results From an International Survey”","authors":"","doi":"10.1111/den.70245","DOIUrl":"https://doi.org/10.1111/den.70245","url":null,"abstract":"<p>\u0000 <span>A. Lisotti</span>, <span>M. Tacelli</span>, <span>S. F. Crinò</span>, <span>G. Masciangelo</span>, <span>P. Fusaroli</span>, <span>M. Barthet</span>, <span>N. Thosani</span>, <span>M. C. Conti Bellocchi</span>, <span>S. Leblanc</span>, <span>T. Khoury</span>, <span>P. G. Arcidiacono</span>, <span>A. Facciorusso</span>, <span>F. Caillol</span>, <span>M. Giovannini</span>, <span>L. Fuccio</span>, <span>J. Samanta</span>, <span>A. Y. B. Teoh</span>, <span>T. Ogura</span>, <span>R. F. Havre</span>, <span>S. G. Krishna</span>, <span>B. Kovacevic</span>, <span>V. Dhir</span>, <span>P. Vilmann</span>, <span>S. Lakhtakia</span>, <span>B. Napoléon</span>, <span>K. D. Pham</span>, <span>EUS-RFA Methodology Study Group</span>, “ <span>Methodology Assessment of Endoscopic Ultrasound Radiofrequency Ablation (EUS-RFA) for Pancreatic Neoplasms: Results From an International Survey</span>,” <i>Digestive Endoscopy</i> <span>38</span>, no. <span>7</span> (<span>2026</span>): e70212, https://doi.org/10.1111/den.70212.\u0000 </p><p>The EUS-RFA Methodology study group was omitted from the author list of the above article.</p><p>The online article has been corrected to include the EUS-RFA Methodology study group in the author list.</p><p>We apologize for this error.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.70245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148553436","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":"The Use of Endoscopic Ultrasound-Guided Vascular Embolization for Acute Duodenal Tumor-Related Bleeding: A Pilot Study (With Video)","authors":"Haiyan Li,&nbsp;Guilian Cheng,&nbsp;Zhenyun Gong,&nbsp;Jiayi Zhang,&nbsp;Beinan Hu,&nbsp;Jianjun Zhu,&nbsp;Longjiang Xu,&nbsp;Duanmin Hu","doi":"10.1111/den.70241","DOIUrl":"https://doi.org/10.1111/den.70241","url":null,"abstract":"<div>\u0000 \u0000 <p>Acute gastrointestinal bleeding caused by duodenal tumors remains a clinical challenge. Conventional endoscopic hemostasis has limited efficacy in preventing rebleeding, and surgical resection presents significant risks and is often not feasible. Endoscopic ultrasound-guided embolization (EUS-VE) with cyanoacrylate is widely performed for variceal bleeding, but its application to tumor-related bleeding is uncommon. In this study, we used EUS-VE for acute duodenal tumor-related bleeding. A total of 13 EUS-VE procedures were performed in 12 patients from August 2024 to December 2025. The technical success rate was 100%, and the clinical success rate within 30 days was 84.6% (11/13). Among the 12 patients, the 90-day rebleeding and mortality events occurred in 1 (8.33%) and 3 (25%) patients, respectively. Three patients (25%) developed fever after EUS-VE, including one case suspected to be procedure-related. This pilot study suggests that EUS-VE may be a feasible alternative for duodenal tumor-related bleeding. Its efficacy and safety require further validation with larger sample sizes.</p>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148553502","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":"World Endoscopy Organization Position Statements for the Role of Endoscopy on the Diagnosis and Treatment of Superficial Non-Ampullary Duodenal Epithelial Tumors","authors":"Vitor Nunes Arantes,&nbsp;Josué Aliaga Ramos,&nbsp;Fabian Emura,&nbsp;Noriya Uedo,&nbsp;Seiichiro Abe,&nbsp;Hiroyuki Aihara,&nbsp;Naomi Kakushima,&nbsp;Xuemei Liu,&nbsp;Hon Chi Yip,&nbsp;Mario Dinis-Ribeiro,&nbsp;Mitsuhiro Fujishiro,&nbsp;WEO Stomach and Duodenal Diseases Committee","doi":"10.1111/den.70240","DOIUrl":"https://doi.org/10.1111/den.70240","url":null,"abstract":"<div>\u0000 \u0000 <p>The implementation of screening endoscopy and the increasing availability of image-enhanced endoscopy (IEE) has significantly improved the detection of superficial non-ampullary duodenal epithelial tumors (SNADETs). At the same time, growing experience with advanced endoscopic resection (ER) techniques throughout the gastrointestinal (GI) tract has recently extended to the duodenum—an organ traditionally regarded with caution by endoscopists due to its substantial risk of major treatment related complications. These advances have made it possible to achieve successful endoscopic managements of duodenal superficial neoplasms, allowing organ-preservation and reducing the need for highly invasive surgical procedures. Despite this progress, a comprehensive global statement dedicated specifically to the diagnosis and management of duodenal neoplasms has been lacking. Current approaches remain heterogeneous, with substantial geographic variability. To address this gap, we developed an international position statement to guide the diagnosis and management of SNADETs. Nine position statements were formulated regarding the role of endoscopy in diagnosing SNADETs, highlighting the importance of a routine inspection of the first and second part of the duodenum, the role of high-definition endoscopy in the identification of SNADETs, and the increasing role of IEE in the characterization of duodenal neoplasms. In addition, seven statements were developed emphasizing that ER is the preferred approach to manage SNADETs, but it carries a substantial risk of complications, thus complete wound closure after ER should be routinely adopted. A thorough understanding of the current endoscopic strategies and advances to address duodenal neoplastic lesions will ensure a safe, minimally invasive, and effective management of SNADETs globally.</p>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148553501","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":"WEO DEN Newsletter issue 38-7 – July 2026","authors":"","doi":"10.1111/den.70239","DOIUrl":"10.1111/den.70239","url":null,"abstract":"&lt;p&gt;\u0000 &lt;b&gt;\u0000 &lt;span&gt;Histopathology for Endoscopists&lt;/span&gt;\u0000 &lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;&lt;span&gt;Case 4.&lt;/span&gt; Beware of the flat polyps in the right colon&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;Richard Kinsey, MD&lt;/p&gt;&lt;p&gt;Nalini M Guda MD,&lt;/p&gt;&lt;p&gt;A 58-year-old presented for high-risk screening colonoscopy. Patient's mother was diagnosed with colon cancer at a younger age (&lt;60 years). Bowel preparation was good and during withdrawal a small 3-5mm polyp was identified that was resected by cold snare polypectomy (Figure 1).&lt;/p&gt;&lt;p&gt;Histopathological examination was performed and the specimen was viewed after Hematoxylin and Eosin stain under 100X magnification (Figure 2).&lt;/p&gt;&lt;p&gt;This specimen showed sessile serrated adenoma on the left side of the image while the right side of the image showed conventional tubular adenoma and hence diagnosed as sessile serrated adenoma with dysplasia (WHO classification). The current classification by WHO does not differentiate the degree of dysplasia.&lt;/p&gt;&lt;p&gt;Sessile serrated adenomas (SSP/SSA) are clinically significant. Based on the United States Multi-Society Task force on colorectal cancer, SSP ≥ 10mm or have dysplasia are considered advanced precancerous lesions hence high risk and should undergo surveillance at closer intervals (3 – year interval). SSP &lt;10 mm and no dysplasia carry low risk and can undergo surveillance at usual 5–10-year intervals (number of lesion and size dependent). The adjusted odds ratio for SSA with dysplasia to develop subsequent malignancy is 10.3 (95% CI 2.1-50.3) compared to individuals with no polyps. SSA with dysplasia should be considered high risk neoplastic lesions since there is a 12% rate of invasive carcinoma within the polyps.&lt;/p&gt;&lt;p&gt;Sessile serrated adenomas follow a different pathway than a traditional adenoma – carcinoma sequence. SSA develops malignancy by BRAF mutation. Once there is mutation there is epigenetic progression which accumulates slowly over years. After a long indolent time of 10-15 years these lesions develop dysplasia which is a critical transition. At this point 75% of the lesions have MLH1 deficient pathway which causes mismatch repair deficiency (dMMR) and microsatellite instability-high (MSI-H) and this generates exceptional tumor burden. The MLH1 proficient pathway which occurs in 25% acquires APC and TP53 mutations and can produce mesenchymal carcinomas.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Clinical Significance:&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;SSA can have direct implications for interval cancers. SSA/SSL are often flat with mucous cap and are predominantly on the right colon and are difficult to detect endoscopically. There is narrow window after a long indolent phase when these lesions develop dysplasia and progress to malignancy. Hence a good bowel preparation with careful examination of the colonic mucosa is critical to prevent colorectal neoplasia.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Suggested References:&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;Li D, Doherty AR, Raju M, ","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521492","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}