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

{"title":"The Promise and Challenges of CAD-Assisted Diagnosis in Achalasia.","authors":"Niroshan Muwanwella, Krish Ragunath","doi":"10.1111/den.15076","DOIUrl":"https://doi.org/10.1111/den.15076","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499689","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 Balloon Dilation Using a Novel Nonslip Balloon Catheter in a Patient With Pancreaticojejunal Anastomotic Stricture.","authors":"Koh Kitagawa, Yuki Motokawa, Hitoshi Yoshiji","doi":"10.1111/den.15077","DOIUrl":"https://doi.org/10.1111/den.15077","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369670","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":"Peranal Endoscopic Myectomy for the Recurrent Rectal Adenoma After Multiple Endoscopic Resections.","authors":"Yoshiaki Ando, Takashi Kanesaka, Ryu Ishihara","doi":"10.1111/den.15071","DOIUrl":"https://doi.org/10.1111/den.15071","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369671","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":"Adjustment of Surveillance Intervals for Ulcerative Colitis-Associated Neoplasia Based on Disease Duration.","authors":"Ryoya Sakakibara, Shinya Sugimoto, Yuta Kaieda, Hiroki Kiyohara, Yusuke Yoshimatsu, Kaoru Takabayashi, Soichiro Murakami, Miho Kawaida, Tomohisa Sujino, Naoki Hosoe, Motohiko Kato, Yasushi Iwao, Yohei Mikami, Takanori Kanai","doi":"10.1111/den.15073","DOIUrl":"10.1111/den.15073","url":null,"abstract":"<p><strong>Objectives: </strong>The risk of colitis-associated cancer increases with disease duration in ulcerative colitis (UC), yet surveillance colonoscopy protocols generally stratify risk uniformly for patients with disease lasting over 8 years. This study evaluated whether shorter surveillance intervals might enhance lesion detection rates in patients with extended disease duration.</p><p><strong>Methods: </strong>This retrospective observational study analyzed patients diagnosed with UC-associated neoplasms between 2010 and 2023. Colonoscopies before lesion detection were retrospectively reviewed, and risk stratification was applied according to four established guidelines. The recommended surveillance intervals were recalculated based on the stratified risk, and lesion detection rates were compared across increasing risk categories for specific disease duration.</p><p><strong>Results: </strong>A total of 39 patients were included, with a median disease duration of 21 years (14-27), and a median colonoscopy interval of 1.3 years (1.1-2.2). Lesion detection rates were 72%, 59%, 44%, and 56% for American Society for Gastrointestinal Endoscopy (ASGE), American Gastroenterological Association (AGA), European Crohn's and Colitis Organisation (ECCO), and British Society of Gastroenterology (BSG) guidelines, respectively. Adjusting risk stratification upward by one rank for disease durations of ≥ 15, ≥ 20, ≥ 25, and ≥ 30 years resulted in increased detection rates: 90%, 87%, 82%, and 72% for ASGE; 85%, 82%, 74%, and 64% for AGA; 82%, 74%, 62%, and 49% for ECCO; and 82%, 79%, 72%, and 62% for BSG, respectively. The longest period with a significant difference in detection rates was observed in patients with disease durations of 20-25 years.</p><p><strong>Conclusions: </strong>For patients with long-standing UC, reducing surveillance intervals may improve the detection of colitis-associated neoplasia, with a practical focus on those with 20-25 years of disease duration.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334525","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":"Feasibility of a Novel Nonslip Short-Length Balloon Catheter for Endoscopic Papillary Balloon Dilation in Balloon Enteroscopy-Assisted ERCP: A Prospective Pilot Study (With Video).","authors":"Tadahisa Inoue, Rena Kitano, Hiromu Kutsumi, Tomoya Kitada, Kazumasa Sakamoto, Satoshi Kimoto, Jun Arai, Kiyoaki Ito","doi":"10.1111/den.15069","DOIUrl":"10.1111/den.15069","url":null,"abstract":"<p><p>Endoscopic papillary balloon dilation (EPBD) is an essential procedure, especially in balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP). However, the balloon often slips during the inflation process, and its length is often an impediment if the distance between the papilla and scope is limited or if stones are located close to the papilla. Therefore, this study aimed to examine the feasibility of a novel nonslip, short-length balloon catheter for EPBD in BE-ERCP. This prospective pilot study included 50 eligible patients who underwent BE-ERCP between December 2022 and October 2024. The study outcomes included the technical success and adverse event rates associated with EPBD using the novel balloon catheter in BE-ERCP. EPBD was successful in 100% (50/50) of the patients. Successful EPBD solely on the first inflation attempt without any slippage was achieved in 98% (49/50) cases; it was achieved in 100% (37/37) and 92% (12/13) of the procedures performed by experts and trainees, respectively, with no significant difference (p = 0.260). The incidence rate of adverse events was 4% (2/50). Two cases of mild pancreatitis occurred, which were treated conservatively. No stone entrapment between the balloon and the bile duct wall occurred in patients with choledocholithiasis. EPBD with the novel nonslip short-length balloon showed a low adverse event rate and a high success rate on the first attempt without slippage, which was maintained even when performed by trainees. This novel balloon offers a useful alternative to conventional balloons for EPBD during BE-ERCP.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334534","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 Novel Switching of Artificial Intelligence to Generate Simultaneously Multimodal Images to Assess Inflammation and Predict Outcomes in Ulcerative Colitis-(With Video).","authors":"Marietta Iacucci, Irene Zammarchi, Giovanni Santacroce, Bisi Bode Kolawole, Ujwala Chaudhari, Rocio Del Amor, Pablo Meseguer, Valery Naranjo, Miguel Puga-Tejada, Ivan Capobianco, Ilaria Ditonno, Andrea Buda, Brian Hayes, Rory Crotty, Raf Bisschops, Subrata Ghosh, Enrico Grisan","doi":"10.1111/den.15067","DOIUrl":"https://doi.org/10.1111/den.15067","url":null,"abstract":"<p><strong>Objectives: </strong>Virtual Chromoendoscopy (VCE) is pivotal for assessing activity and predicting outcomes in Ulcerative Colitis (UC), though interobserver variability and the need for expertise persist. Artificial intelligence (AI) offers standardized VCE-based assessment. This study introduces a novel AI model to detect and simultaneously generate various endoscopic modalities, enhancing AI-driven inflammation assessment and outcome prediction in UC.</p><p><strong>Methods: </strong>Endoscopic videos in high-definition white-light, iScan2, iScan3, and NBI from UC patients of the international PICaSSO iScan and NBI cohort (302 and 54 patients, respectively) were used to develop a neural network to identify the acquisition modality of each frame and for inter-modality image switching. 2535 frames from 169 videos of the iScan cohort were switched to different modalities and trained a deep-learning model for inflammation assessment. Subsequently, the model was tested on a subset of the iScan and NBI cohorts (72 and 51 videos, respectively). Performance in predicting endoscopic and histological activity and outcomes was evaluated.</p><p><strong>Results: </strong>The model efficiently classified and converted images across modalities (92% accuracy). Performance in predicting endoscopic and histological remission was excellent, especially with different modalities combined in both iScan (accuracy 81.3% and 89.6%; AUROC 0.92 and 0.89 by UCEIS and PICaSSO, respectively) and the NBI cohort. Moreover, it showed a remarkable ability in predicting clinical outcomes.</p><p><strong>Conclusions: </strong>Our multimodal \"AI-switching\" model innovatively detects and transitions between different endoscopic modalities, refining inflammation assessment and outcome prediction in UC by integrating model-derived images.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303777","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":"World Endoscopy Organization guidelines on endoscopic retrograde cholangiopancreatography biliary cannulation and sphincterotomy techniques.","authors":"Stefano Francesco Crinò, Lars Aabakken, Amol Bapaye, Shannon Chan, Mitsuhiro Kida, Ryan Law, Fauze Maluf-Filho, Parit Mekaroonkamol, Eduardo Guimarães Hourneaux de Moura, Alexandre Bestetti, Ibrahim Mostafa, Do Hyun Park, Ruveena Bhavani Rajaram, Nageshwar D Reddy, Dong Wan Seo, Rapat Pittayanon, Anthony Yuen Bun Teoh","doi":"10.1111/den.15060","DOIUrl":"https://doi.org/10.1111/den.15060","url":null,"abstract":"<p><p>Recent guidelines on biliary cannulation are lacking. This guideline is an initiative of the World Endoscopy Organization (WEO) with the involvement of a panel of experts from Asia, Europe, and America. Relevant clinical questions on four areas (post-endoscopic retrograde cholangiopancreatography [ERCP] pancreatitis [PEP] prophylaxis, biliary cannulation techniques, sphincterotomy/papillary balloon dilation, and biliary cannulation in special circumstances) were developed and answered after systematic reviews of the literature and using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Successful biliary cannulation and sphincterotomy are cornerstones of ERCP and are indispensable for almost all therapeutic and advanced diagnostic procedures. However, adverse events, particularly PEP, may commonly occur and impair patients' outcomes. A high cannulation rate and a low rate of PEP are quality indicators for ERCP and should be the goal of all endoscopists. With this guideline we aimed to provide clinical practice advice applicable worldwide, regardless of resources and expertise availability. The main recommendations focus on specific aspects of ERCP, including pre-, intra-, and postprocedural measures to reduce the risk of PEP, the technique for an initial biliary cannulation attempt, options for cannulation in cases of difficult biliary access, alternatives to ERCP in case of failure (percutaneous- and endoscopic ultrasound-guided), and biliary access in altered anatomy (periampullary diverticulum and postsurgical anatomy) and in the presence of duodenal stenosis.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303779","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 Method to Release a Denture Clasp Embedded in the Cervical Esophagus Using Balloon Dilation.","authors":"Rei Miyake, Yohei Nishikawa, Haruhiro Inoue","doi":"10.1111/den.15070","DOIUrl":"https://doi.org/10.1111/den.15070","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303776","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":"Transcolonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Pancreatic Head Cancer With Difficult Access From the Upper Gastrointestinal Tract.","authors":"Indria Melianti, Kazuo Hara, Nozomi Okuno","doi":"10.1111/den.15064","DOIUrl":"https://doi.org/10.1111/den.15064","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303778","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":"Computer-aided detection for esophageal achalasia (with video).","authors":"Hironari Shiwaku, Masashi Misawa, Haruhiro Inoue, Kai Jiang, Masahiro Oda, Pietro Familiari, Guido Costamagna, Yuto Shimamura, Yuichiro Ikebuchi, Yugo Iwaya, Masaki Ominami, Bu'Hussain Hayee, Khek-Yu Ho, Jimmy B Y So, Hein Myat Thu Htet, Pradeep Bhandari, Kevin Grimes, Helmut Messmann, Bianca Maria Quarta Colosso, Roberta Maselli, Cesare Hassan, Alessandro Repici, Stavros N Stavropoulos, Norio Fukami, Robert Bechara, Michel Kahaleh, Amrita Sethi, Torsten Beyna, Horst Neuhaus, Philip W Y Chiu, Esperanza Grace Santi, Prateek Sharma, Nikolas Eleftheriadis, Hitomi Minami, Gregory Haber, Peter V Draganov, Stefan Seewald, Akio Shiwaku, Yoshiyuki Shiwaku, Kensaku Mori, Shin-Ei Kudo, Suguru Hasegawa","doi":"10.1111/den.15028","DOIUrl":"https://doi.org/10.1111/den.15028","url":null,"abstract":"<p><strong>Objectives: </strong>Achalasia is an esophageal motility disorder that impairs quality of life and is often missed (20-50%) on endoscopy. A newly developed computer-aided detection (CAD) software has shown high accuracy for achalasia diagnosis in preclinical settings. However, its benefit in a clinical setting remains unclear.</p><p><strong>Methods: </strong>Between February and August 2023, 83 endoscopists from 27 centers assessed 50 randomized endoscopic videos (25 achalasia, 25 nonachalasia) without and with CAD. Endoscopists assessed videos without CAD, then with CAD after 2 months. The primary end-point was improvement in sensitivity for nonexperienced endoscopists (no endoscopic experience of achalasia). Sensitivity, specificity, and accuracy with and without CAD were compared using the McNemar test.</p><p><strong>Results: </strong>Sensitivity for diagnosing achalasia increased significantly with CAD, rising from 74.2% (95% confidence interval [CI] 72.2-76.0%) to 91.2% (95% CI 89.9-92.4%) for all readers, showing a difference of 17.1% (95% CI 15.1-19.0%). Specifically, sensitivity improved from 66.9% (95% CI 63.6-70.0%) to 91.9% (95% CI 89.9-93.6%) among nonexperienced endoscopists, resulting in a difference of 25.0% (95% CI 21.7-28.4%), and from 79.5% (95% CI 77.1-81.8%) to 90.8% (95% CI 89.0-92.3%) among experienced endoscopists (endoscopic experience of at least one achalasia case), with a difference of 11.3% (95% CI 8.9-13.6%). Accuracy and specificity improved significantly with CAD assistance, regardless of reader's experience.</p><p><strong>Conclusion: </strong>CAD improves achalasia detection by 17%, confirming preclinical results. The benefit was higher for nonexperienced endoscopists. CAD assistance may lead to prompt and effective treatment, minimizing the risk of false-negative diagnosis in clinical practice.</p><p><strong>Trial registration: </strong>This study was registered in the University Hospital Medical Information Network Clinical Trial Registry (https://www.umin.ac.jp/ctr/) number: UMIN000053047.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287426","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}