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

{"title":"Suprapapillary Stent-By-Stent Deployment With Slim-Fully Covered Versus Uncovered Metal Stents for Malignant Hilar Biliary Obstruction: A Multicenter Comparative Study (With Video).","authors":"Tadahisa Inoue, Michihiro Yoshida, Naoaki Yamada, Rena Kitano, Tomoya Kitada, Shun Futagami, Kenta Kachi, Fumihiro Okumura, Itaru Naitoh","doi":"10.1111/den.70031","DOIUrl":"https://doi.org/10.1111/den.70031","url":null,"abstract":"<p><strong>Background: </strong>Bilateral uncovered metal stent (UMS) placement is recommended for unresectable malignant hilar biliary obstructions (MHBO). However, recent improvements in antitumor therapies and patient survival have led to an increasing number of patients outliving UMS patency, necessitating more frequent reinterventions. This study evaluated the efficacy of novel suprapapillary stent-by-stent (SBS) placement using slim fully covered metal stents (FCMS) and compared them with UMS.</p><p><strong>Methods: </strong>A total of 254 patients were included. Technical and clinical success, adverse events (AEs) including recurrent biliary obstruction (RBO), and reintervention were compared between the FCMS and UMS groups. Propensity score matching was performed to adjust for between-group differences.</p><p><strong>Results: </strong>Technical and clinical success rates and early and late AE rates were not significantly different between the groups. The FCMS group demonstrated a significantly lower RBO incidence rate (32.0% vs. 60.8%; p = 0.005) and a significantly longer time to RBO (median, NA vs. 204 days; p = 0.048). However, in the FCMS group, 4.0% of patients required stent removal because of suspected branch occlusion. The technical success rates of reintervention were 100% and 83.3% in the FCMS and UMS groups (p = 0.147), respectively. Compared to the UMS group, the FCMS group demonstrated a significantly shorter reintervention procedure time (median, 20 vs. 31 min; p = 0.005) and a significantly lower number of reinterventions (p = 0.029) and requirement for repeat reinterventions (p = 0.003).</p><p><strong>Conclusions: </strong>Suprapapillary slim FCMS SBS placement may be a promising treatment option for patients with unresectable MHBO. However, early and unique events requiring stent removal should be carefully considered.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076609","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":"Novel Saline-Immersion Endoscopic Hemostasis With Flow-Assisted Coagulation Using Gas-Free Immersion System.","authors":"Tatsuma Nomura, Katsumi Mukai","doi":"10.1111/den.70035","DOIUrl":"https://doi.org/10.1111/den.70035","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066668","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 Multicenter Pivotal Study on the Artificial Intelligence System for Neoplastic Lesions Detection in Upper Gastrointestinal Endoscopy.","authors":"Seiichiro Abe, Yoshiyasu Kitagawa, Waku Hatta, Takao Maekita, Motohiko Kato, Akihito Nagahara, Hiroyuki Osawa, Osamu Dohi, Hirotaka Nakashima, Kazuhiro Furukawa, Shiro Oka, Tomoko Yokoyama, Toru Ito, Ichiro Oda","doi":"10.1111/den.70015","DOIUrl":"https://doi.org/10.1111/den.70015","url":null,"abstract":"<p><strong>Objectives: </strong>This pivotal study aimed to evaluate the performance of the CAD-EYE prototype in identifying esophageal squamous cell carcinoma (ESCC) and gastric neoplasm (GN) for regulatory approval of the Pharmaceuticals and Medical Devices Agency in Japan.</p><p><strong>Methods: </strong>This retrospective study utilized image datasets comprising 15 consecutive video frames captured using non-magnifying white-light imaging (WLI), blue laser/light imaging (BLI), and linked color imaging (LCI). The sensitivity and specificity of the CAD-EYE prototype for successful detection were calculated using the gold standard, which consists of image datasets of neoplastic lesions annotated by experienced endoscopists.</p><p><strong>Results: </strong>A total of 620, 679, and 682 ESCC datasets were analyzed in the WLI, BLI, and LCI groups, respectively. The sensitivity and specificity of ESCC detection were 85.9% [81.1%-90.6%] and 93.3% [90.8%-95.7%] in the WLI group, 97.6% [95.6%-99.7%] and 92.9% [90.6%-95.3%] in the BLI group, and 96.6% [94.2%-99.1%] and 93.2% [91.0%-95.5%] in the LCI group. The sensitivities for pT1a ESCC were 85.3%, 97.3%, and 97.2% in the WLI, BLI, and LCI groups, respectively. For GN, 841 WLI and 882 LCI datasets were analyzed. The sensitivity, specificity, and specificity in the detection flag of GN detection were 95.5% [92.8%-98.1%], 86.1%, and 85.4% [82.6%-88.2%] in the WLI group, and 93.9% [91.1%-96.7%], 94.4%, and 93.9% [92.0%-95.8%] in the LCI group, respectively. The sensitivities for pT1a early gastric cancer were 93.8% and 92.4% in the WLI and LCI groups, respectively.</p><p><strong>Conclusions: </strong>The CAD-EYE prototype demonstrated high sensitivity in detecting ESCC and GN, highlighting its potential as a promising tool for clinical applications.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042339","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":"Reconsidering Sedation for Endoscopic Retrograde Cholangiopancreatography: The Potential of Remimazolam.","authors":"Kosuke Minaga, Akane Hara, Masatoshi Kudo","doi":"10.1111/den.70034","DOIUrl":"https://doi.org/10.1111/den.70034","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042368","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 Outcomes and Prognostic Factors in Patients Undergoing Salvage Endoscopic Therapy for cT1N0M0 Local Failure After Chemoradiotherapy for Esophageal Cancer: A Multicenter Retrospective Study.","authors":"Keiichiro Nakajo, Tatsunori Minamide, Hiroki Yamashita, Atsushi Inaba, Hironori Sunakawa, Tomohiro Kadota, Kensuke Shinmura, Hiroyuki Ono, Tomonori Yano","doi":"10.1111/den.70033","DOIUrl":"https://doi.org/10.1111/den.70033","url":null,"abstract":"<p><strong>Objectives: </strong>Salvage endoscopic therapy is increasingly recommended for localized, superficial failure at the primary site after chemoradiotherapy for esophageal squamous cell carcinoma. This multicenter retrospective study aimed to evaluate the clinical outcomes and prognostic factors associated with overall survival in patients who underwent salvage endoscopic therapy for cT1N0M0 local failure after chemoradiotherapy or radiotherapy for esophageal squamous cell carcinoma.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with cT1N0M0 local failure after chemoradiotherapy or radiotherapy who underwent endoscopic resection or photodynamic therapy using talaporfin sodium at two Japanese institutions between 2012 and 2021. Clinical outcomes and prognostic factors for overall survival were assessed using multivariate analysis.</p><p><strong>Results: </strong>Complete resection was achieved in 63 of 84 patients (75%) who underwent endoscopic resection, and a local complete response was achieved in 50 of 81 patients (62%) who underwent photodynamic therapy. During a median follow-up of 34 months (range, 2-109 months), 3-year overall survival, disease-specific survival, local recurrence-free survival, and esophagectomy-free survival rates were 79%, 88%, 54%, and 79%, respectively. A high Charlson Comorbidity Index (≥ 3; hazard ratio: 3.3) was significantly associated with poor overall survival (3-year overall survival rate: 64%), although the 3-year disease-specific survival in this group remained high at 94%.</p><p><strong>Conclusions: </strong>We clarified the clinical outcomes and prognosis of salvage endoscopic therapy for cT1 local failure. The Charlson Comorbidity Index may serve as a useful prognostic factor to aid in clinical decision-making.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034866","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":"Efficacy and Safety of Double Guidewire Versus Transpancreatic Sphincterotomy in Difficult Biliary Cannulation: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Larissa Mercadante de Assis, Mateus Pereira Funari, Luiza Bicudo de Oliveira, Benjamin Ian Richter, Miriam Chinzon, Vitor Hernandes Lopes, Matheus Oliveira Veras, Marcos Eduardo Lera Dos Santos, Gustavo Oliveira Luz, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura","doi":"10.1111/den.70029","DOIUrl":"https://doi.org/10.1111/den.70029","url":null,"abstract":"<p><strong>Background: </strong>Difficult biliary cannulation is a key challenge in endoscopic retrograde cholangiopancreatography and a major risk factor for post-ERCP pancreatitis. When the pancreatic duct is unintentionally accessed, double guidewire (DGW) is the primary rescue strategy, while transpancreatic sphincterotomy (TPS) is an alternative. Previous evidence suggests that TPS may achieve higher cannulation success and lower PEP rates compared to DGW, though direct comparative data remain limited. This review and meta-analysis assess the clinical outcomes of TPS and DGW in the setting of difficult biliary cannulation.</p><p><strong>Methods: </strong>This review involved searching Medline, Embase, Lilacs, Central Cochrane, and Google Scholar. Outcomes assessed included PEP, successful biliary cannulation, mean cannulation time, and other adverse events (bleeding, cholangitis, perforation).</p><p><strong>Results: </strong>A total of 463 patients from five randomized controlled trials were included. The DGW group showed a higher risk of PEP pancreatitis and other adverse events (p = 0.009; RR = 1.81 [1.16, 2.83]; I² = 34%) and (p = 0.03; RR = 2.20 [1.10, 4.39]; I² = 0%), respectively. A significant difference favoring TPS was found for successful cannulation and mild pancreatitis (p = 0.001; RR = 1.79 [1.26, 2.54]; I² = 40%) and (p = 0.01; RR = 2.26 [1.20, 4.28]; I² = 35%), respectively. No significant difference was observed for mean cannulation time or moderate to severe PEP (p = 0.18; SMD = -0.37 [-0.91, 0.17]; I² = 79%) and (p = 0.32; RR = 1.50 [0.67, 3.36]; I² = 0%), respectively. A restricted analysis excluding two studies affected by external factors inflating the pancreatitis rate did not reveal a significant difference (p = 0.61; RR = 1.16 [0.66, 2.04]; I² = 0%).</p><p><strong>Conclusion: </strong>Prior studies comparing TPS and DGW yield different results. This may occur because there are technical variables that are difficult to control. Overall, TPS demonstrated superior cannulation success, may have lower PEP rates, and fewer other complications, although more homogeneous studies are needed to validate these findings.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024840","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-Guided Gallbladder Drainage Using a Lumen-Apposing Metal Stent for Acute Cholecystitis in a High-Risk Elderly Patient.","authors":"Rei Ryozawa, Katsuya Kitamura, Takao Itoi","doi":"10.1111/den.70026","DOIUrl":"https://doi.org/10.1111/den.70026","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016785","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 Device for Endoscopic Necrosectomy: Over-the-Scope-Grasper and Practical Tips for Its Use.","authors":"Akira Shirohata, Arata Sakai, Atsuhiro Masuda","doi":"10.1111/den.70030","DOIUrl":"https://doi.org/10.1111/den.70030","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024897","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":"Establishing Endoscopic Sphincterotomy in Balloon-Assisted Endoscopic Retrograde Cholangiopancreatography Using a Novel Rotatable Sphincterotome in Surgically Altered Anatomy: Innovation for Procedural Standardization.","authors":"Masaaki Shimatani","doi":"10.1111/den.70024","DOIUrl":"https://doi.org/10.1111/den.70024","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006985","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":"Visualization of Appendiceal Diverticula During Endoscopic Retrograde Appendicitis Therapy.","authors":"Zhiqian Chen, Xianhui Zeng, Dailan Yang","doi":"10.1111/den.70025","DOIUrl":"https://doi.org/10.1111/den.70025","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994598","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}