Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society最新文献

{"title":"Usefulness of Endoscopic Ultrasound-Guided Pancreatogastrostomy and the Related Trans-Endosonographically Created Route Procedure for the Management of Refractory Pancreatic Stones (With Video).","authors":"Ko Tomishima, Hiroyuki Isayama, Shigeto Ishii, Akinori Suzuki, Yusuke Takasaki, Sho Takahashi, Shin Arii, Takumi Okuaki, Haruka Hagiwara, Yusuke Yamaguchi, Yasuhisa Jimbo, Ippei Ikoma, Daishi Kabemura, Hiroto Ota, Muneo Ikemura, Tomoya Takahashi, Taito Fukuma, Mako Ushio, Fumi Kurata, Toshio Fujisawa","doi":"10.1111/den.70314","DOIUrl":"https://doi.org/10.1111/den.70314","url":null,"abstract":"<p><p>Endoscopic management of symptomatic pancreatic stones (P-Stones) with main pancreatic duct (MPD) strictures due to chronic pancreatitis remains challenging. For refractory P-Stones, high-quality evidence for endoscopic treatment remains limited, and endoscopic ultrasound-guided pancreatogastrostomy (EUS-PGS) is considered a potential salvage option. This single-center retrospective study enrolled 16 consecutive patients with symptomatic refractory P-Stones who underwent EUS-PGS between June 2017 and June 2025, after failed transpapillary access or, in cases of surgically altered anatomy (SAA), with pancreatojejunal anastomotic stricture. Following EUS-PGS, procedures via the endosonographically created route (ESCR) and conversion to transpapillary approaches were used to manage stones and strictures, with multiple plastic stents placed to maintain ESCR patency. Technical success was defined as P-Stones treatment, and clinical success as symptom improvement after complete stone clearance. EUS-PGS achieved 100% technical and 93.8% clinical success. Complete stone removal was achieved in 15 of 16 cases (93.8%), with 1 case still under treatment. Early adverse events (AEs) occurred in 18.8% of cases (pancreatic leakage, mild pancreatitis), and late AEs in 12.5% (bleeding, stent migration). The median stone removal time was 350 days. Procedural times were similar between the normal anatomy and SAA groups, although the puncture-to-stent interval tended to be longer in the normal anatomy group (40 vs. 25 min, p = 0.05). EUS-PGS demonstrated high technical and clinical success for symptomatic P-Stones, with an acceptable AE rate. However, the long treatment period, often related to the absence of dedicated devices, remains a limitation that warrants improvement.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 10","pages":"e70314"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225255","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":"EUS-Directed ERCP in Surgically Altered Anatomy: Evolution From EDGE, Geographic Disparities of Published Experience, and Safety Challenges.","authors":"Toshio Fujisawa, Ko Tomishima, Hiroyuki Isayama","doi":"10.1111/den.70315","DOIUrl":"https://doi.org/10.1111/den.70315","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 10","pages":"e70315"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220869","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":"Beyond Removability: Can Multi-Hole Covered Metal Stents Overcome the Remaining Challenges in Malignant Hilar Biliary Obstruction?","authors":"Hirofumi Kogure","doi":"10.1111/den.70316","DOIUrl":"https://doi.org/10.1111/den.70316","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 10","pages":"e70316"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225307","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":"A Guidewire Looped-Back Technique for Endoscopic Retrieval of a Migrated Biliary Stent.","authors":"Mayu Sassa, Masanori Kobayashi, Takahiro Kawamura","doi":"10.1111/den.70163","DOIUrl":"10.1111/den.70163","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 5","pages":"e70163"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846880","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":"Nonexposed Muscular Layer Clipping Within a Submucosal Pocket Using a 20-mm Reopenable Clip for Gastric Endoscopic Muscular Dissection.","authors":"Tatsuma Nomura, Katsumi Mukai, Youichirou Baba","doi":"10.1111/den.70167","DOIUrl":"https://doi.org/10.1111/den.70167","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 5","pages":"e70167"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936064","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":"Less Motion, More Strain: Why Ergonomics Matters in Therapeutic Endoscopy.","authors":"Chika Kusano","doi":"10.1111/den.70169","DOIUrl":"https://doi.org/10.1111/den.70169","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 5","pages":"e70169"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944144","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":"Letter to the Editor.","authors":"Tom G Moreels, Pierre H Deprez, Hubert Piessevaux","doi":"10.1111/den.70176","DOIUrl":"10.1111/den.70176","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 5","pages":"e70176"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977679","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":"Comment on \"Ciprofol Versus Propofol for the Prevention of Hypoxia During Gastrointestinal Endoscopy Procedures in Overweight Patients: A Multicenter, Randomized, Controlled Trial\".","authors":"Neeraj Singh, Monika Srivastav","doi":"10.1111/den.70170","DOIUrl":"10.1111/den.70170","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 5","pages":"e70170"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935973","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":"Clinical Performance of Computer-Aided Detection System for Gastric Neoplasms: A Non-Randomized Confirmatory Trial (G-CADe Trial) (With Video).","authors":"Osamu Dohi, Takashi Ueno, Yoshiyasu Kitagawa, Yuichiro Hirai, Naoto Iwai, Yoshimasa Miura, Hiroyuki Osawa, Takuto Suzuki, Seiichiro Abe","doi":"10.1111/den.70172","DOIUrl":"10.1111/den.70172","url":null,"abstract":"<p><strong>Objectives: </strong>Computer-aided detection systems (CAD EYE EW10-EG01; Fujifilm, Tokyo, Japan) approved for clinical use in Japan have been developed to support endoscopists in the detection of gastric neoplasms during esophagogastroduodenoscopy (EGD). This prospective study aimed to evaluate the clinical performance of CAD EYE for gastric neoplasms by using white-light imaging (WLI) and linked color imaging (LCI) under real-world clinical conditions.</p><p><strong>Methods: </strong>This multicenter, non-randomized, confirmatory trial enrolled patients with histologically confirmed gastric neoplasms at four Japanese institutions. Each lesion was sequentially observed during EGD using WLI-CAD EYE and LCI-CAD EYE. The primary endpoint was the sensitivity of the CAD EYE response for known gastric neoplasms, and the secondary endpoints included the characteristics of lesions without CAD EYE response and newly identified lesions.</p><p><strong>Results: </strong>A total of 174 lesions were analyzed using the WLI-CAD EYE and 173 using the LCI-CAD EYE. The overall sensitivities were 92.0% (95% confidence interval [CI], 86.9%-95.5%) and 96.5% (95% CI, 92.6%-98.7%), respectively. The lower bound of the 95% CI for LCI-CAD EYE exceeded the prespecified threshold of 90%, fulfilling the confirmatory criteria. WLI-CAD EYE and LCI-CAD EYE responses were observed in 57.4% and 59.2% of known lesions in a distant view, respectively. WLI-CAD EYE showed relatively low sensitivity for lesions < 10 mm (88.9%) and those located on the anterior wall (79.4%), whereas LCI-CAD EYE achieved ≥ 90% sensitivity in all subgroups.</p><p><strong>Conclusions: </strong>LCI-CAD EYE demonstrated a high sensitivity for known gastric epithelial neoplasms in a clinical setting.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 5","pages":"e70172"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950416","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":"Impact of Artificial Intelligence-Assisted Endoscopy on Screening for Upper Gastrointestinal Cancer in a Large-Scale Health Screening Facility.","authors":"Chihiro Goto, Ryo Nakagawa, Ryosuke Horio, Akane Kurosugi, Tatsuya Kaneko, Tsubasa Ishikawa, Yuki Ohta, Takashi Taida, Kenichiro Okimoto, Tomoaki Matsumura, Jun Kato","doi":"10.1111/den.70159","DOIUrl":"10.1111/den.70159","url":null,"abstract":"<p><strong>Objectives: </strong>Artificial intelligence (AI)-assisted endoscopy has been developed for the early detection of upper gastrointestinal cancer; however, its clinical effectiveness remains insufficiently evaluated. This study assessed its effectiveness in a health screening facility.</p><p><strong>Methods: </strong>This retrospective cohort study compared AI-assisted and non-AI-assisted upper gastrointestinal endoscopy at Omiya City Clinic, Japan (April 2021-March 2024). Participants who underwent endoscopy between April 2021 and March 2023 were classified as the non-AI group, while those examined between April 2023 and March 2024 comprised the AI group. The AI-assisted system was introduced in April 2023. The primary outcome was cancer detection rate (CDR), with secondary outcomes including biopsy rate and positive predictive value (PPV). Propensity score matching (PSM) was performed for age, sex, alcohol consumption, smoking, Helicobacter pylori infection history, endoscopist experience, and prior-year endoscopy to minimize bias.</p><p><strong>Results: </strong>In total, 17,662 were included in the AI group and 32,318 in the non-AI group. PSM created 17,662 matched pairs. In the AI group, the CDR for gastric cancer (GC) was significantly higher compared to the non-AI group (0.10% vs. 0.03%, p < 0.05). The biopsy rate was slightly higher in the AI group, with no significant difference, whereas the PPV of biopsy for gastric cancer and esophageal cancer was significantly increased (4.84% vs. 2.16%, p < 0.05).</p><p><strong>Conclusions: </strong>In a clinical screening setting, AI-assisted endoscopy significantly improved the CDR of GC and enhanced the PPV of biopsies. These findings highlight AI-assisted endoscopy as a valuable tool for early GC diagnosis in screening environments.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"38 5","pages":"e70159"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824293","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}