Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Endoscopic Surveillance Patterns and Management of Helicobacter pylori in Newly Diagnosed Gastric Intestinal Metaplasia","authors":"SHIVRAM CHANDRAMOULI , ANNIE L. WANG , DAVID A. LEIMAN","doi":"10.1016/j.tige.2024.250904","DOIUrl":"10.1016/j.tige.2024.250904","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250904"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Life Application of Artificial Intelligence for Automatic Characterization of Biliary Strictures: A Transatlantic Experience","authors":"Mariano González-Haba Ruiz , Pedro Pereira , Jessica Widmer , Tiago Ribeiro , Belén Agudo Castillo , Filipe Vilas-Boas , João Ferreira , Miguel Mascarenhas Saraiva , Guilherme Macedo","doi":"10.1016/j.tige.2024.250902","DOIUrl":"10.1016/j.tige.2024.250902","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250902"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Safety of Endoscopic Ultrasound–Guided Liver Biopsy in Patients with Metabolic Dysfunction–Associated Liver Disease","authors":"JEROME C. EDELSON , ERIC M. MONTMINY , CARL L. KAY , TYLER H. DOTY , MATTHEW J. SCHWARTZ , DON C. ROCKEY","doi":"10.1016/j.tige.2025.250918","DOIUrl":"10.1016/j.tige.2025.250918","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250918"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like Peptide-1 Receptor Agonists Are Not Associated With Increased Incidence of Pneumonia After Endoscopic Procedures","authors":"Natalia Tejada ,&nbsp;Ishak Mansi ,&nbsp;Silvio W. de Melo Jr","doi":"10.1016/j.tige.2025.250925","DOIUrl":"10.1016/j.tige.2025.250925","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Despite their favorable cardiometabolic effects, use of glucagon-like peptide-1 receptor agonists (GLP1-RAs), have raised concerns for increasing the risk of aspiration pneumonia after upper esophagogastroduodenoscopy (EGD)/colonoscopy due to slowing gastrointestinal motility. Such risks are yet to be confirmed. This study aimed to examine the association of GLP1-RA use with risk of aspiration pneumonia or any pneumonia in patients undergoing these procedures.</div></div><div><h3>METHODS</h3><div>This retrospective, propensity score (PS)–matched cohort study, with active control design, used data from the Veterans Health Administration of veterans who underwent EGD/colonoscopy procedures during fiscal years 2016-2021 while using GLP1-RA or dipeptidyl peptidase 4 inhibitors (DPP4i), as active comparators. A PS was created using 60 baseline characteristics encompassing demographics, laboratory investigations, medication use, and comorbidities that may increase risk of aspiration or infection. Our 2 coprimary outcomes were incidence of any pneumonia and incidence of aspiration pneumonia within 30 days of the procedure.</div></div><div><h3>RESULTS</h3><div>Of 59,280 EGD/colonoscopy procedures (22,570 GLP1-RA users and 36,710 DPP4i users), we successfully matched 15,943 pairs of patients. Mean (SD) age of patients was 66 (8) years and mean (SD) weighted Charlson comorbidity index was 4.8 (3.2). In the PS-matched cohort, 48 (0.3%) GLP1-RA users had pneumonia vs 57 (0.4%) DPP4i users (odds ratio, 0.84; 95% CI, 0.57-1.23), and 7 (0.04%) GLP1-RA users had aspiration pneumonia vs 9 (0.06%) DPP4i users (odds ratio, 0.78; 95% CI, 0.29-2.09).</div></div><div><h3>CONCLUSION</h3><div>Risks of aspiration pneumonia or any pneumonia after EGD/colonoscopy procedures were similar in GLP1-RA users and active comparators. Withholding GLP1-RA prior to endoscopic procedures may not be necessary.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250925"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Endoscopic Ultrasound–Guided Gastrointestinal Anastomosis for Gastric Outlet Obstruction, Endoscopic Access, and Enteric Decompression","authors":"Michiel Bronswijk ,&nbsp;Giuseppe Vanella ,&nbsp;Roy L.J. van Wanrooij ,&nbsp;Paolo Giorgio Arcidiacono ,&nbsp;Schalk Van der Merwe","doi":"10.1016/j.tige.2025.250915","DOIUrl":"10.1016/j.tige.2025.250915","url":null,"abstract":"<div><div>Endoscopic ultrasound (EUS)-guided gastrointestinal anastomosis techniques using lumen-apposing metal stents are increasingly being used in expert centers throughout the world and have already found their way into day-to-day practice. For patients with gastric outlet obstruction, EUS-guided gastroenterostomy has the potential to become the new reference standard given the most recent prospective data of long-term effectiveness in the setting of oncologic palliation, as well as the promising evidence regarding benign obstruction in poor surgical candidates. For patients with surgically altered anatomy, EUS-directed transgastric or transenteric endoscopic retrograde cholangiopancreatography (ERCP) seems to provide more effective and less invasive alternative to enteroscopy-assisted ERCP and laparoscopy-assisted ERCP. Besides access or management of gastric outlet obstruction, EUS-guided gastrointestinal anastomosis is furthermore increasingly being used for the palliation of afferent loop syndrome, showing high clinical success rates and acceptable safety profile. This also pertains to EUS-directed enterocolostomy, where small series have suggested a potential benefit for patients with malignant intestinal obstruction, although more data are required regarding patient selection and safety. In this review, we discuss the most recent evidence, technical approaches, and future directions for these techniques.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250915"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Machine Learning Voice-Based Biomarkers for Characterization of Barrett's Esophagus","authors":"AMRIT K. KAMBOJ ,&nbsp;MANOJ K. YARLAGADDA ,&nbsp;MAYO CLINIC BARRETT'S ESOPHAGUS AND VOICE WORKING GROUP ,&nbsp;KEIKO ISHIKAWA ,&nbsp;DIANA M. ORBELO ,&nbsp;MARY PIETROWICZ ,&nbsp;CADMAN L. LEGGETT","doi":"10.1016/j.tige.2024.250903","DOIUrl":"10.1016/j.tige.2024.250903","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250903"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Repair for Sleeve Gastrectomy Leaks Is Associated With a High Rate of Leak Resolution","authors":"Khalid Fahoum ,&nbsp;Tamara Kahan ,&nbsp;Olivia Delau ,&nbsp;Matthew Fasullo ,&nbsp;Ki-Yoon Kim ,&nbsp;Lauren Khanna ,&nbsp;Gregory Haber ,&nbsp;Paresh C. Shah ,&nbsp;Tamas Gonda","doi":"10.1016/j.tige.2024.09.004","DOIUrl":"10.1016/j.tige.2024.09.004","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Staple line leaks following sleeve gastrectomy have significant morbidity and mortality. Endoscopic repair approaches are increasingly being used and studied, but follow-up time is limited, and more data are needed. Our primary aim was to describe long-term outcomes following repair; secondary aims were to compare repair approaches and assess factors associated with clinical success.</div></div><div><h3>METHODS</h3><div>We conducted an observational cohort study of patients who underwent endoscopic repair of a sleeve gastrectomy leak from 2017 to 2023 at our tertiary care center. Patients without available follow-up were excluded. Electronic medical records were reviewed to obtain baseline and clinical characteristics; long-term outcomes were ascertained from the electronic medical record and telephonic conversations with patients. Repairs were classified as drainage when transmural stents were placed and as closure when clips, sutures, and/or an intraluminal stent was placed.</div></div><div><h3>RESULTS</h3><div>A total of 30 patients were included. The majority were females (77%) and Whites (74%), with a median age of 41.0 years (IQR, 35.1-51.8 years). The majority of patients (70%) initially underwent drainage, while the rest underwent closure. Median follow-up time was 1.2 years (IQR, 0.6 -1.6 years). Success rates for the initial repair approach without crossover or requiring surgical repair were 71.4% for drainage and 22.2% for closure (<em>P</em> = 0.02). Overall, 24 (80%) patients had leak resolution at the last follow-up, and the median number of endoscopies was 3 (IQR, 2-4).</div></div><div><h3>CONCLUSION</h3><div>Our study demonstrates a high rate of long-term leak resolution following endoscopic repair of sleeve gastrectomy leaks. An initial drainage approach may be associated with higher clinical success, although this was not noted in the multivariable analysis. Prospective randomized multicenter studies are needed to further evaluate and compare repair approaches.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150897"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Endoscopic Role and Indications of Through-the-Scope Tack and Suture System for Gastrointestinal Closure","authors":"Andrew Canakis ,&nbsp;Abdulhameed Al-Sabban ,&nbsp;Shayan S. Irani","doi":"10.1016/j.tige.2024.09.005","DOIUrl":"10.1016/j.tige.2024.09.005","url":null,"abstract":"<div><div>The development of endoscopic closure devices has revolutionized management options for gastrointestinal defects. The endoscopists’ toolbox has expanded from through-the-scope clips to over-the-scope clips and over-the-scope suturing. The over-the-scope devices are somewhat limited by the target location, maneuverability, and need for device withdrawal for application. The introduction of a novel through-the-scope helix tack suture system enhances the toolbox for defect closure as this device can provide closure throughout the gastrointestinal tract without the need for endoscope withdrawal. Its user-friendly design and compatibility with standard endoscopes allows for complex tissues approximation in challenging locations. Since its approval by the Federal Drug Agency in December 2020, studies have investigated its utility for all types of defects, including perforations, leaks, fistulas, endoscopic resections sites, and even stent fixation. In this review, we will investigate the versatility of this device to understand its role in primary defect closure.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150898"},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Transpapillary Gallbladder Drainage With 2 Stents Versus 1 Stent Reduces Reinterventions: A Multicenter Study","authors":"James D. Haddad ,&nbsp;Natalie Wilson ,&nbsp;Vijay S. Are ,&nbsp;Shawn L. Shah ,&nbsp;Danny Issa ,&nbsp;Tarek Sawas ,&nbsp;Mohammad Bilal ,&nbsp;Thomas Tielleman","doi":"10.1016/j.tige.2024.09.006","DOIUrl":"10.1016/j.tige.2024.09.006","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Endoscopic transpapillary gallbladder drainage (ETGBD) is a therapeutic option for gallstone-related gallbladder disease in nonsurgical candidates. However, the optimal stenting strategy and follow-up has not been established. We aimed to determine whether there was a decreased need for unplanned reintervention in patients undergoing placement of two transpapillary gallbladder stents compared with that in those undergoing placement of one stent.</div></div><div><h3>METHODS</h3><div>We performed a multicenter retrospective analysis of patients undergoing ETGBD between June 2013 and October 2022. The primary outcome was clinical success as defined by resolution of symptoms without the need for another drainage strategy. Secondary outcomes included the adverse events of postendoscopic retrograde cholangiopancreatography pancreatitis, cholangitis, bleeding, perforation, or death. Factors associated with placement of two stents, unplanned reintervention, and adverse events were assessed.</div></div><div><h3>RESULTS</h3><div>We included 75 patients who underwent ETGBD, with a median follow-up of 407 days (IQR: 71-1504 days). Technical and clinical success were 88.2% and 81.3%, respectively. Unplanned reintervention was significantly lower in the double stenting group (0% vs 25.4%; <em>P</em> = 0.02). Use of a 7 French stent (odds ratio [OR]: 15.5; 95% CI: 1.9-125; <em>P</em> = 0.01) and presence of a percutaneous cholecystostomy tube (OR: 10.8; 95% CI: 2.8-41.3; <em>P</em> = 0.001) were associated with placement of two stents. There was no significant difference in adverse events between groups (OR: 0.9; 95% CI: 0.09-8.8; <em>P</em> = 0.94).</div></div><div><h3>CONCLUSION</h3><div>ETGBD is safe and effective in nonoperative candidates. Single transpapillary gallbladder stenting is associated with more unplanned reinterventions, and 7 French stent diameter and previous percutaneous cholecystostomy tube may be associated with ability to place a second stent. Endoscopists should consider planned exchange of solitary transpapillary gallbladder stents or interval placement of a second stent if placement of two stents was unsuccessful at the index procedure.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150899"},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Cancer Screening: A Narrative Review","authors":"Jihane Meziani,&nbsp;Gwenny M. Fuhler,&nbsp;Marco J. Bruno,&nbsp;Djuna L. Cahen,&nbsp;Kasper A. Overbeek","doi":"10.1016/j.tige.2024.08.001","DOIUrl":"10.1016/j.tige.2024.08.001","url":null,"abstract":"<div><div>Pancreatic cancer (PC) is one of the most lethal cancer types. Despite advancements that have led to some modest improvements in survival rates over the past decade, PC still has a dismal prognosis. Patients diagnosed with early-stage disease have higher survival rates. Unfortunately, PC seldom manifests itself early, and symptoms prompting diagnostic investigations usually develop when the disease is already advanced. PC screening may lead to better patient outcomes through detection of asymptomatic early-stage cancers and precursor lesions. Population-based screening is deemed unfeasible because of the low incidence of PC. However, screening of individuals with an inherited lifetime risk of ≥5%-10% for developing PC may prove beneficial. In the context of high-risk individuals, screening is referred to as surveillance. Yet, critical aspects such as suitable candidates for surveillance, the ideal time to initiate and discontinue surveillance, as well as the most effective surveillance method, preferred surveillance modalities, and optimal surveillance interval remain unclear. Herein, we summarize the current state of knowledge regarding PC surveillance by reviewing current expert consensus statements and guidelines. In addition, we review the management of identified lesions, the yield in different cohorts, and future directions to improve the outcomes of individuals at high-risk of developing PC.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 4","pages":"Pages 323-334"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}