VideoGIE最新文献_第3页

Endoscopic mucosal resection–assisted mucosal flap creation to facilitate endoscopic submucosal dissection for gastric adenoma amid diffuse fundic gland polyposis 内镜下粘膜切除辅助粘膜瓣的建立，以方便胃腺弥漫性基底腺息肉病中胃腺瘤的内镜下剥离

VideoGIE Pub Date : 2026-09-01 Epub Date: 2026-05-06 DOI: 10.1016/j.vgie.2026.04.047

Rinrada Worapongpaiboon MD, Clement Wu MD, Kasenee Tiankanon MD, Saowanee Ngamruengphong MD

{"title":"Endoscopic mucosal resection–assisted mucosal flap creation to facilitate endoscopic submucosal dissection for gastric adenoma amid diffuse fundic gland polyposis","authors":"Rinrada Worapongpaiboon MD, Clement Wu MD, Kasenee Tiankanon MD, Saowanee Ngamruengphong MD","doi":"10.1016/j.vgie.2026.04.047","DOIUrl":"10.1016/j.vgie.2026.04.047","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic submucosal dissection (ESD) for a gastric lesion in a patient with familial adenomatous polyposis (FAP) with fundic gland polyps is challenging due to dense polyposis, limiting visualization and access during resection.</div></div><div><h3>Methods</h3><div>A 49-year-old woman with FAP and a high-grade dysplastic gastric lesion underwent ESD. Because of dense polyposis obscuring the instrument tip, proximal EMR was performed under saline solution immersion to create a submucosal entry point for the ESD.</div></div><div><h3>Results</h3><div>The proximal EMR enabled clear visualization of the submucosal layer and facilitated safe initiation of ESD. After traction-assisted ESD, en bloc resection was achieved without adverse events. The post-ESD defect was successfully closed with endoscopic suturing. Follow-up upper endoscopy at 3 months showed no local recurrence.</div></div><div><h3>Conclusions</h3><div>This case highlights the technical challenges of performing gastric ESD in patients with FAP and dense fundic gland polyps, in which visualization and access to the submucosal layer are limited. Creating a submucosal entry point with EMR can improve exposure and facilitate safe initiation of ESD. This hybrid approach may serve as a useful strategy for endoscopists facing similar difficult anatomy.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 9","pages":"Pages 397-400"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856486","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}

引用次数: 0

Endoscopic decompression of sigmoid volvulus using a corrugated tube 内镜下波纹管乙状结肠扭转减压术

VideoGIE Pub Date : 2026-09-01 Epub Date: 2026-05-19 DOI: 10.1016/j.vgie.2026.05.004

Dínimo Bolívar-Saénz MD, Daniela Lara-Espinosa MD, MSc(c), Diego Téllez MD, Camilo García MD, Nicolás Lozano-Suárez MD, MSc, RACS

{"title":"Endoscopic decompression of sigmoid volvulus using a corrugated tube","authors":"Dínimo Bolívar-Saénz MD, Daniela Lara-Espinosa MD, MSc(c), Diego Téllez MD, Camilo García MD, Nicolás Lozano-Suárez MD, MSc, RACS","doi":"10.1016/j.vgie.2026.05.004","DOIUrl":"10.1016/j.vgie.2026.05.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Sigmoid volvulus is a major cause of large-bowel obstruction in “volvulus belt” countries, where it accounts for up to 50% of cases. Flexible endoscopic detorsion is the first-line therapy for stable patients; however, recurrence rates may reach 75%. Placement of a rectal decompression tube reduces early recurrence and facilitates elective surgery. In many low-resource settings, commercial tubes are unavailable. This video demonstrates the safe, low-cost use of rectal anesthesia corrugated tubes as a practical alternative.</div></div><div><h3>Methods</h3><div>We present the case of a 74-year-old woman exhibiting clinical and radiographic signs of sigmoid volvulus. After flexible endoscopic detorsion, a rectal anesthesia corrugated tube was placed. This video illustrates the step-by-step technique, focusing on technical details, potential pitfalls, and troubleshooting tips.</div></div><div><h3>Results</h3><div>The patient underwent successful decompression. Radiographic control showed the resolution of the volvulus and correct placement of the tube. The tube stayed in place until the elective laparoscopic sigmoidectomy on day 6. The patient had an uneventful recovery, leading to her discharge on postoperative day 10.</div></div><div><h3>Conclusions</h3><div>Endoscopic decompression combined with the placement of a rectal anesthesia corrugated tube represents a feasible and practical bridge to surgery. This educational video serves as a valuable resource for training endoscopists, particularly in settings with limited resources.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 9","pages":"Pages 369-374"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856488","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}

引用次数: 0

Endoscopic ultrasound–guided coil–assisted retrograde transgastric occlusion of shunt efferent for gastric variceal bleeding 超声内镜引导下线圈辅助下经胃逆行阻断分流出管治疗胃静脉曲张出血

VideoGIE Pub Date : 2026-09-01 Epub Date: 2026-04-29 DOI: 10.1016/j.vgie.2026.04.042

Rizwan Ahamed MD, DM, Sasidharan Rajesh MD, PDCC, Cyriac Abby Philips DM, Ajit Tharakan MD, DM, Shobhit Singh DNB, Tharun Tom MD, DM, Nibin Nahaaz MD, DM, Philip Augustine MD, DM

{"title":"Endoscopic ultrasound–guided coil–assisted retrograde transgastric occlusion of shunt efferent for gastric variceal bleeding","authors":"Rizwan Ahamed MD, DM, Sasidharan Rajesh MD, PDCC, Cyriac Abby Philips DM, Ajit Tharakan MD, DM, Shobhit Singh DNB, Tharun Tom MD, DM, Nibin Nahaaz MD, DM, Philip Augustine MD, DM","doi":"10.1016/j.vgie.2026.04.042","DOIUrl":"10.1016/j.vgie.2026.04.042","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided therapy for fundal varices targets the gastric shunt or afferent feeders. In cases with multiple feeders, this may not achieve complete obliteration. We aimed to target the single efferent channel in a patient with multiple feeder vessels.</div></div><div><h3>Methods</h3><div>We describe EUS-guided occlusion of the shunt efferent in a patient with gastric variceal bleed and multiple inflow tracts. The efferent was traced from the left renal vein and targeted with coils and cyanoacrylate glue.</div></div><div><h3>Results</h3><div>Coil plus glue embolization of the shunt efferent achieved complete variceal obliteration. The patient had no further variceal bleeding or decompensation at 6 months. At 1-year follow-up, the patient was asymptomatic; small esophageal varices were noted.</div></div><div><h3>Conclusions</h3><div>EUS-guided coil–assisted retrograde transgastric occlusion is a safe and effective alternative to interventional radiology–guided therapy of gastric varices in cases with multiple afferents or feeder vessels. Development of new esophageal varices is a recognized limitation and should be monitored.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 9","pages":"Pages 393-396"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856491","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}

引用次数: 0

Endoscopic submucosal dissection–assisted double-layer running suturing technique for closure of a gastrocutaneous fistula 内镜下粘膜下剥离辅助双层穿刺术治疗胃皮瘘

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-03 DOI: 10.1016/j.vgie.2026.02.010

Steven Steinway MD, PhD, Joshua Anicetti MD, Daryl Ramai MD, Pichamol Jirapinyo MD, MPH, Christopher C. Thompson MD, MSc

{"title":"Endoscopic submucosal dissection–assisted double-layer running suturing technique for closure of a gastrocutaneous fistula","authors":"Steven Steinway MD, PhD, Joshua Anicetti MD, Daryl Ramai MD, Pichamol Jirapinyo MD, MPH, Christopher C. Thompson MD, MSc","doi":"10.1016/j.vgie.2026.02.010","DOIUrl":"10.1016/j.vgie.2026.02.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastrocutaneous fistulas are rare and challenging adverse events that can have considerably high morbidity and mortality rates. They result from an abnormal connection between the stomach and the skin. They can be caused by various factors, including infection, trauma, anastomotic leaks, and removal of percutaneous endoscopic gastrostomy (PEG) tubes. Endoscopic management of chronic gastrocutaneous fistulas is associated with modest success rates, with reported closure rates of approximately 50%. Effective intervention is necessary to prevent adverse events. We present an endoscopic approach for closing a chronic gastrocutaneous fistula resistant to typical therapy.</div></div><div><h3>Methods</h3><div>An 85-year-old female patient with a complex history including a previous hiatal hernia repair presented with persistent leakage from a gastrocutaneous fistula after removal of a PEG tube that had been in place for 5 years. Two prior standard endoscopic closure attempts were unsuccessful. We used an advanced endoscopic technique involving mucosal dissection, argon plasma coagulation, and a 2-layer running suture with clip placement.</div></div><div><h3>Results</h3><div>Immediate endoscopic evaluation after the procedure confirmed complete closure without adverse events. At the 3-month follow-up, clinical assessment demonstrated successful closure with resolution of local symptoms.</div></div><div><h3>Conclusions</h3><div>This case demonstrates the feasibility of an endoscopic submucosal dissection–assisted, double-layer endoscopic suturing approach for the closure of a chronic gastrocutaneous fistula refractory to conventional endoscopic therapies.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 325-328"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647242","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}

引用次数: 0

Endoscopic ultrasound—assisted rendezvous technique followed by dual-duct drainage using a double-lumen papillotome: a salvage strategy for postendoscopic papillectomy stricture 内窥镜超声辅助交会技术后采用双腔乳头清扫器双管引流：一种内窥镜乳头切除术后狭窄的抢救策略

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-06 DOI: 10.1016/j.vgie.2026.02.013

Go Endo MD, Naminatsu Takahara MD, PhD, Hiroto Nishio MD, Kensaku Noguchi MD, PhD, Tatsuya Sato MD, PhD, Ryunosuke Hakuta MD, PhD, Yousuke Nakai MD, PhD, Mitsuhiro Fujishiro MD, PhD

{"title":"Endoscopic ultrasound—assisted rendezvous technique followed by dual-duct drainage using a double-lumen papillotome: a salvage strategy for postendoscopic papillectomy stricture","authors":"Go Endo MD, Naminatsu Takahara MD, PhD, Hiroto Nishio MD, Kensaku Noguchi MD, PhD, Tatsuya Sato MD, PhD, Ryunosuke Hakuta MD, PhD, Yousuke Nakai MD, PhD, Mitsuhiro Fujishiro MD, PhD","doi":"10.1016/j.vgie.2026.02.013","DOIUrl":"10.1016/j.vgie.2026.02.013","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Papillary stricture is a clinically relevant late adverse event of endoscopic papillectomy (EP) and may result in concurrent cholangitis and pancreatitis. Although endoscopic drainage is the first-line modality, biliary and pancreatic duct access can be challenging because of fibrotic strictures after EP. This article aims to demonstrate the feasibility of EUS-assisted rendezvous (EUS-RV) combined with a double-lumen papillotome (MagicTome; PIOLAX Inc, Yokohama, Japan) to achieve dual-duct access.</div></div><div><h3>Methods</h3><div>We present a case of a 70-year-old woman with cholangitis and pancreatitis caused by post-EP stricture. After a failed ERCP, a salvage EUS-RV was performed to access the biliary duct, followed by pancreatic duct cannulation using a double-lumen papillotome.</div></div><div><h3>Results</h3><div>The distal bile duct was punctured from the duodenum with a 19-gauge needle (EZ Shot 3 Plus; Olympus, Tokyo, Japan), and a 0.025-inch guidewire (VisiGlide 2; Olympus) was advanced through the stricture into the duodenum. The guidewire was retrieved with biopsy forceps, and biliary access was established. Subsequently, using a double-lumen papillotome, we cannulated the pancreatic duct. Balloon dilation and plastic stent placement were performed in both ducts without adverse events. The stents were removed after 12 months. No recurrence was observed during 12 months of follow-up.</div></div><div><h3>Conclusions</h3><div>EUS-RV combined with a double-lumen papillotome is a useful salvage strategy for complete post-EP strictures. This method can be applied to difficult cannulation, particularly when dual-duct access is required.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 333-336"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647433","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}

引用次数: 0

Cholecystocolonic fistula resulting from biliary stent migration 胆道支架移位引起的胆囊结肠瘘

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-27 DOI: 10.1016/j.vgie.2026.03.005

Preeyati Chopra MBBS, Rachael Hagen DO, Teresa Da Cunha MD, Vaibhav Mehendiratta MD, Osama Siddique MD

{"title":"Cholecystocolonic fistula resulting from biliary stent migration","authors":"Preeyati Chopra MBBS, Rachael Hagen DO, Teresa Da Cunha MD, Vaibhav Mehendiratta MD, Osama Siddique MD","doi":"10.1016/j.vgie.2026.03.005","DOIUrl":"10.1016/j.vgie.2026.03.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Patients may require biliary stent placement for cholecystitis, but stent dislocation rarely results in colonic perforation. We describe a patient whose biliary stent dislodged between the transverse colon and gallbladder, creating a fistula. We aim to highlight the importance of early recognition and describe a minimally invasive approach to fistula closure.</div></div><div><h3>Methods</h3><div>We used a novel technique using simultaneous bidirectional endoscopy, performing colonoscopy and ERCP concurrently to repair a cholecystocolonic fistula caused by biliary stent migration.</div></div><div><h3>Results</h3><div>This combined approach enabled direct visualization of the fistula via the colonoscope, allowing precise grasping and closure of the fistulous tract during the withdrawal of the biliary stent through the ERCP scope. During the same session, the eroding biliary plastic stent was replaced, minimizing procedure time and anesthesia exposure to the patient.</div></div><div><h3>Conclusions</h3><div>Simultaneous bidirectional endoscopy can be considered an effective approach to the management of biliary-enteric fistulas. This technique allows closure under direct visualization while addressing the underlying stent in a single session. This approach has the potential to reduce adverse events by avoiding surgical interventions. Wider adoption of this technique may benefit select patients with similar presentations.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 350-351"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647437","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}

引用次数: 0

Saline-immersion technique for endoscopic submucosal dissection with traction for an ileocecal adenoma involving the ileal outlet 盐水浸泡技术用于内镜下粘膜下剥离并牵引治疗累及回肠出口的回盲腺瘤

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-12 DOI: 10.1016/j.vgie.2026.03.001

Georgios Mavrogenis MD, Stamatina Vogli MD, Dimitrios Madianos MD

{"title":"Saline-immersion technique for endoscopic submucosal dissection with traction for an ileocecal adenoma involving the ileal outlet","authors":"Georgios Mavrogenis MD, Stamatina Vogli MD, Dimitrios Madianos MD","doi":"10.1016/j.vgie.2026.03.001","DOIUrl":"10.1016/j.vgie.2026.03.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic submucosal dissection (ESD) of lesions involving the ileocecal valve and terminal ileum is technically challenging. The saline-immersion technique for ESD combined with countertraction may improve visualization, safety, and dissection efficiency in these complex locations.</div></div><div><h3>Methods</h3><div>A 71-year-old patient underwent ESD for a 4-cm nongranular flat adenoma involving the entire ileocecal valve and extending into the distal terminal ileum. The procedure was performed with the patient under general anesthesia using a pediatric colonoscope (PCF-H190TL; Olympus, Tokyo, Japan) with a tapered hood (ST Hood; Fujifilm, Tokyo, Japan). After chromoendoscopic margin delineation, the lumen was filled with saline solution, and submucosal dissection was completed under saline immersion using ENDO CUT current (Erbe VIO 3, Tübingen, Germany). Two clip-and-band complexes provided internal countertraction to improve exposure and facilitate controlled dissection.</div></div><div><h3>Results</h3><div>En bloc resection, including the ileocecal valve and ileal extension, was achieved. Hemostasis was secured with hot biopsy forceps, and partial defect closure was performed with clips. The postoperative course was uneventful, and the patient was discharged after 48 hours. Oral budesonide was administered for 2 months to reduce the risk of stricture. At 3-month follow-up, the patient was asymptomatic without endoscopic recurrence.</div></div><div><h3>Conclusions</h3><div>Under–saline solution ESD with clip-and-band traction appears safe and effective for extensive ileocecal lesions, providing stable visualization, reliable countertraction, and easy access to the submucosal space.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 352-355"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647438","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}

引用次数: 0

Hybrid endoscopic submucosal dissection—endoscopic mucosal resection of large polyps at the ileocecal valve 混合内镜粘膜下夹层-内镜粘膜切除术治疗回盲瓣大息肉

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-04-27 DOI: 10.1016/j.vgie.2026.04.007

Taylor Bowler DO, Rahul Karna MD, Abubaker Abdalla MD, Nabeel Azeem MD

{"title":"Hybrid endoscopic submucosal dissection—endoscopic mucosal resection of large polyps at the ileocecal valve","authors":"Taylor Bowler DO, Rahul Karna MD, Abubaker Abdalla MD, Nabeel Azeem MD","doi":"10.1016/j.vgie.2026.04.007","DOIUrl":"10.1016/j.vgie.2026.04.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic resection of polyps at the ileocecal valve (ICV) remains challenging. Herein, we present a review of the current literature and a case series with video of hybrid endoscopic submucosal dissection—endoscopic mucosal resection (ESD-EMR) for the management of polyps at the ICV.</div></div><div><h3>Methods</h3><div>This article and accompanying video outline the technique of hybrid ESD-EMR. This technique was ultimately used for the management of ICV polyps in 10 patients at a single-center institution.</div></div><div><h3>Results</h3><div>As outlined in the video, endoscopic submucosal dissection was first performed to create a “trench” for the snare to anchor into the lesion and ensure negative margins at the ileal aspect of the lesion. Endoscopic mucosal resection was then performed in a piecemeal or en bloc fashion to complete resection of the polyp. Technical success of the procedure was 100%. Adverse events were noted in 20% of cases, consisting of 1 case of postpolypectomy syndrome (American Society for Gastrointestinal Endoscopy [ASGE] grade I) and 1 case of early bleeding (ASGE grade IIIa). One patient had residual disease on follow-up that was easily managed endoscopically. No patients required surgical referral after endoscopic resection.</div></div><div><h3>Conclusion</h3><div>We conclude that hybrid ESD-EMR may be an effective resection strategy for the management of large polyps at the ICV.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 363-367"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647439","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}

引用次数: 0

Autoimmune cholangiopathy presenting as a mimicker of hilar cholangiocarcinoma 自身免疫性胆管病表现为肝门胆管癌的模拟物

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-12 DOI: 10.1016/j.vgie.2026.02.014

Nicholas Hebda MD, Ikechukwu Achebe MD, Prashanth Rau MD, Navine Nasser-Ghodsi MD, Neil B. Marya MD

{"title":"Autoimmune cholangiopathy presenting as a mimicker of hilar cholangiocarcinoma","authors":"Nicholas Hebda MD, Ikechukwu Achebe MD, Prashanth Rau MD, Navine Nasser-Ghodsi MD, Neil B. Marya MD","doi":"10.1016/j.vgie.2026.02.014","DOIUrl":"10.1016/j.vgie.2026.02.014","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Autoimmune cholangiopathy can mimic cholangiocarcinoma. This video highlights the presentation and management of a patient with obstructive jaundice in the setting of a biliary stricture concerning for hilar cholangiocarcinoma who had resolution of her symptoms with steroids.</div></div><div><h3>Methods</h3><div>A 49-year-old woman without autoimmune history presented with abdominal pain and jaundice and was found to have elevated liver enzymes (total bilirubin, 4.7 mg/dL; alkaline phosphatase, 405 U/L; aspartate aminotransferase, 174 U/L; and alanine aminotransferase, 530 U/L), a mass at the hepatic duct confluence, and a filling defect in the common bile duct on cross-sectional imaging. Serum carbohydrate antigen 19-9 (9 U/mL) and immunoglobulin G4 (IgG4)/IgG (7.2%) were normal. After multiple negative samples obtained by EUS/ERCP, including brushing, biopsy, and fluorescence in situ hybridization, she opted to trial systemic steroids for suspected autoimmune cholangiopathy.</div></div><div><h3>Results</h3><div>After 4 weeks of prednisone, an EUS/ERCP was performed and noted improvement in biliary duct dilatation, duct wall thickness, and stricture size. The periductal mass was not appreciated. Repeat cholangioscopy noted gross improvement in duct stenosis and neovascular changes. At 4-month follow-up, she remained clinically asymptomatic, with normal laboratory values and no radiographic evidence of a hilar mass or bile duct stricture.</div></div><div><h3>Conclusions</h3><div>Autoimmune cholangiopathy can mimic cholangiocarcinoma and should be considered when the cytopathology result of hilar strictures is repeatedly negative.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 342-345"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647434","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}

引用次数: 0

Multiple traction band—assisted endoscopic submucosal dissection of a giant colorectal lipoma after unsuccessful unroofing 巨大结直肠脂肪瘤去顶失败后多次牵引带内镜下粘膜下剥离术

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-27 DOI: 10.1016/j.vgie.2026.03.003

Hiroshi Yamazaki MD, Yohei Minato MD, Koichi Furuta MD, Shinya Nagae MD, Nao Takeuchi MD, Ryoju Negishi MD, Hideki Chiba MD, PhD, Ken Ohata MD, PhD

{"title":"Multiple traction band—assisted endoscopic submucosal dissection of a giant colorectal lipoma after unsuccessful unroofing","authors":"Hiroshi Yamazaki MD, Yohei Minato MD, Koichi Furuta MD, Shinya Nagae MD, Nao Takeuchi MD, Ryoju Negishi MD, Hideki Chiba MD, PhD, Ken Ohata MD, PhD","doi":"10.1016/j.vgie.2026.03.003","DOIUrl":"10.1016/j.vgie.2026.03.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Large colorectal lipomas can cause symptoms such as abdominal pain, bleeding, and intussusception. Despite increasing reports of endoscopic treatments, endoscopic resection of large lipomas remains technically challenging. Here, we report a case of successful endoscopic submucosal dissection (ESD) using multiple traction bands for a large lipoma after failed unroofing.</div></div><div><h3>Methods</h3><div>A 55-year-old woman with chronic abdominal pain had a 70-mm submucosal tumor in the ascending colon, confirmed to be a lipoma. Initial unroofing failed because of poor electrical conductivity of the lipoma. Two months later, with the patient having persistent symptoms and a remaining 50-mm lipoma, ESD was performed. Multiple traction bands were clipped between the lipoma and the contralateral wall to lift the tumor and improve visualization.</div></div><div><h3>Results</h3><div>ESD was successfully performed using multiple traction devices applied sequentially to maintain tension and visibility during dissection. The lesion was completely removed en bloc, and the defect was closed using the clip-with-line pulley–securing technique. Histology confirmed a benign lipoma. The patient remained symptom free with no recurrence at 1-year follow-up.</div></div><div><h3>Conclusions</h3><div>Multiple traction–assisted ESD is a safe and effective approach for large colorectal lipomas, enabling minimally invasive resection while reducing the risk of perforation and recurrence.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 356-358"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647432","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}

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