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

{"title":"Null Effect of Computer-Aided Detection in Colonoscopy: News or Illusion?","authors":"Cesare Hassan, Yuichi Mori, Tommy Rizkala","doi":"10.1111/den.70023","DOIUrl":"10.1111/den.70023","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980922","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":"Vendor-Agnostic Vision Transformer-Based Artificial Intelligence for Peroral Cholangioscopy: Diagnostic Performance in Biliary Strictures Compared With Convolutional Neural Networks and Endoscopists.","authors":"Ryosuke Sato, Kazuyuki Matsumoto, Masahiro Tomiya, Takayoshi Tanimoto, Akimitsu Ohto, Kentaro Oki, Satoshi Kajitani, Tatsuya Kikuchi, Akihiro Matsumi, Kazuya Miyamoto, Yuki Fujii, Daisuke Uchida, Koichiro Tsutsumi, Shigeru Horiguchi, Yoshiro Kawahara, Motoyuki Otsuka","doi":"10.1111/den.70028","DOIUrl":"https://doi.org/10.1111/den.70028","url":null,"abstract":"<p><strong>Objectives: </strong>Accurate diagnosis of biliary strictures remains challenging. This study aimed to develop an artificial intelligence (AI) system for peroral cholangioscopy (POCS) using a Vision Transformer (ViT) architecture and to evaluate its performance compared to different vendor devices, conventional convolutional neural networks (CNNs), and endoscopists.</p><p><strong>Methods: </strong>We retrospectively analyzed 125 patients with indeterminate biliary strictures who underwent POCS between 2012 and 2024. AI models including the ViT architecture and two established CNN architectures were developed using images from CHF-B260 or B290 (CHF group; Olympus Medical) and SpyScope DS or DS II (Spy group; Boston Scientific) systems via a patient-level, 3-fold cross-validation. For a direct comparison against endoscopists, a balanced 440-image test set, containing an equal number of images from each vendor, was used for a blinded evaluation.</p><p><strong>Results: </strong>The 3-fold cross-validation on the entire 2062-image dataset yielded a robust accuracy of 83.9% (95% confidence interval (CI), 80.9-86.7) for the ViT model. The model's accuracy was consistent between CHF (82.7%) and Spy (86.8%, p = 0.198) groups, and its performance was comparable to the evaluated conventional CNNs. On the 440-image test set, the ViT's accuracy of 78.4% (95% CI, 72.5-83.8) was comparable to that of expert endoscopists (82.0%, p = 0.148) and non-experts (73.0%, p = 0.066), with no statistically significant differences observed.</p><p><strong>Conclusions: </strong>The novel ViT-based AI model demonstrated high vendor-agnostic diagnostic accuracy across multiple POCS systems, achieving performance comparable to conventional CNNs and endoscopists evaluated in this study.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994593","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 Gastroenterostomy for Benign Gastric Outlet Obstruction: Another Option for a Tailored Approach.","authors":"Stefano Francesco Crinò","doi":"10.1111/den.70022","DOIUrl":"https://doi.org/10.1111/den.70022","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980905","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":"Comparison of Direct Endoscopic Necrosectomy With Endoscopic Step-Up Approach After Endoscopic Drainage of Pancreatic Walled-Off Necrosis: Systematic Review and Meta-Analysis.","authors":"Ryan Yuen, Brian Lam, Shannon Melissa Chan, Hon Chi Yip, Anthony Yuen Bun Teoh","doi":"10.1111/den.70021","DOIUrl":"10.1111/den.70021","url":null,"abstract":"<p><strong>Background and study aims: </strong>Direct endoscopic necrosectomy (DEN) is a safe and effective option in the treatment of pancreatic walled-off necrosis (WOPN). Whether DEN should be performed immediately after drainage (DEN) or as a step-up approach (SUA) is unknown. The aim of this meta-analysis was to compare SUA with DEN in the treatment of WOPN.</p><p><strong>Patients and methods: </strong>Electronic databases including EMBASE, PubMed and Cochrane Library were searched for studies on DEN and SUA using equivalent combinations of \"DEN,\" \"Endoscopic step-up approach,\" and \"Walled-off necrosis.\" Studies were included only if they reported all primary outcomes of interest: (1) clinical success, defined as resolution of clinical symptoms of WOPN at 6 months and (2) postprocedural adverse events. Secondary outcomes were technical success, number of additional DEN required and reintervention rate, defined as number of additional DEN and other interventions required per patient.</p><p><strong>Results: </strong>In this study, 1290 patients from 15 studies were included. There were no significant differences in clinical success (SUA: 94%, 95% CI: [91%-96%]; DEN: 90%, 95% CI: [83%-94%]; p = 0.14), adverse events (SUA: 16%, 95% CI: [10%-24%]; DEN: 16%, 95% CI: [10%-24%]; p = 0.97), technical success (SUA: 99%, 95% CI: [98%-99%]; DEN: 98%, 95% CI: [95%-99%]; p = 0.07), reinterventions (SUA: 1.48, 95% CI: [0.80-2.17]; DEN: 0.99, 95% CI: [0.48-1.51]; p = 0.26), and number of additional DEN required per patient (SUA: 0.93, 95% CI: [0.45-1.39]; DEN: 1.24, 95% CI: [0.57-1.92]; p = 0.44).</p><p><strong>Conclusions: </strong>SUA and DEN were comparable in clinical success, adverse events, technical success, reinterventions, and additional DEN required.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980926","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":"Resetting the Clock: Adjusting the Timing of Surveillance for Ulcerative Colitis-Associated Colorectal Neoplasia.","authors":"Yasuharu Maeda, Shin-Ei Kudo, Masashi Misawa","doi":"10.1111/den.70027","DOIUrl":"https://doi.org/10.1111/den.70027","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980869","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":"Unique Side-By-Side Technique for Malignant Hilar Biliary Obstruction Using Novel Multi-Hole Self-Expandable Metallic Stents.","authors":"Ritsuko Oishi, Haruo Miwa, Shin Maeda","doi":"10.1111/den.70014","DOIUrl":"https://doi.org/10.1111/den.70014","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980857","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":"Potentially Causal Associations Between Extensive Gastric Atrophy and Esophageal Squamous Cell Carcinoma: A Nationwide Retrospective Cohort Study in Japan.","authors":"Kenta Watanabe, Sho Fukuda, Dai Kubota, Nobutake Yamamichi, Yu Takahashi, Yoshitaka Watanabe, Kyoichi Adachi, Norihisa Ishimura, Tomoyuki Koike, Hideyuki Sugawara, Kiyotaka Asanuma, Yasuhiko Abe, Takashi Kon, Eikichi Ihara, Kazuhiro Haraguchi, Yoshihiro Otsuka, Rie Yoshimura, Yugo Iwaya, Takuma Okamura, Noriaki Manabe, Akira Horiuchi, Mio Matsumoto, Kengo Onochi, So Takahashi, Tatsuki Yoshida, Yosuke Shimodaira, Katsunori Iijima","doi":"10.1111/den.70019","DOIUrl":"https://doi.org/10.1111/den.70019","url":null,"abstract":"<p><strong>Objectives: </strong>A potential association between esophageal squamous cell carcinoma (ESCC) and gastric atrophy (GA) has been reported. However, most published studies have used case-control designs, leading to selection bias. This study aimed to investigate the causal association between ESCC and GA using a nationwide cohort.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on consecutive participants who underwent endoscopy at 17 health check-up institutes in Japan between 2013 and 2017, with at least one follow-up endoscopy by December 2022. GA was evaluated endoscopically and classified into atrophy-free, closed-type, and open-type GA. The association between ESCC incidence and GA was estimated using the Kaplan-Meier method and Cox regression.</p><p><strong>Results: </strong>Among 33,461 participants, 17,398 (52.0%), 8257 (24.7%), and 7804 (23.3%) were classified into atrophy-free, closed-type GA, and open-type GA, respectively. Seventy-seven ESCCs were identified during a median 6-year follow-up period. The incidence of ESCC was 24 cases (0.024%/year) in the atrophy-free group, 15 cases (0.031%/year) in the closed-type GA group, and 38 cases (0.089%/year) in the open-type GA group, with a significantly higher incidence observed in the open-type GA group (p < 0.001). After adjusting for established risk factors (e.g., age, sex, drinking, and smoking), open-type GA, but not closed-type GA, was an independent risk factor for ESCC (adjusted hazard ratio: 2.72, 95% confidence interval: 1.58-4.69).</p><p><strong>Conclusions: </strong>This Japanese nationwide cohort study provides new evidence suggesting a causal association between extensive GA and the subsequent development of ESCC.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980889","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 Course of Blown-Out Myotomy After Peroral Endoscopic Myotomy in Patients With Achalasia-Related Esophageal Motility Disorders.","authors":"Hiroshi Tanabe, Hirofumi Abe, Shinwa Tanaka, Hiroya Sakaguchi, Chise Ueda, Tatsuya Nakai, Hitomi Hori, Shinya Hoki, Satoshi Urakami, Tetsuya Yoshizaki, Masato Kinoshita, Fumiaki Kawara, Takashi Toyonaga, Yuzo Kodama","doi":"10.1111/den.70018","DOIUrl":"https://doi.org/10.1111/den.70018","url":null,"abstract":"<p><strong>Objectives: </strong>Blown-out myotomy (BOM) is a diverticular-like change that develops at the myotomy site after surgical or peroral endoscopic myotomy (POEM). This study aimed to elucidate BOM's incidence, clinical course, and risk factors after POEM.</p><p><strong>Patients and methods: </strong>This retrospective, single-center study evaluated patients who underwent POEM for achalasia or non-achalasia motility disorders at our institution between April 2015 and March 2023. Endoscopic grade at surveillance was classified as Grade 0, no diverticular-like changes; Grade 1, mild diverticular-like changes; Grade 2, obvious diverticular-like changes with a septum; and Grade 3, obvious diverticular-like changes with food retention. Grades 2 and 3 were defined as endoscopic BOM. The incidence and clinical course of BOM were evaluated using the Kaplan-Meier method, and factors associated with BOM were assessed using univariate analysis.</p><p><strong>Results: </strong>Of 598 patients, 28 (4.7%) developed BOM during the study period. The 1-, 2-, and 5-year incidence rates of endoscopic BOM were 3.1%, 6.6%, and 8.1%, respectively. Progression of BOM grade mainly occurred between 1 and 3 years after POEM and then plateaued in the Kaplan-Meier curve. Male sex (71.4% vs. 48.1%, p = 0.019), a thin esophageal muscle layer during myotomy (67.9% vs. 40.4%, p = 0.005), and clinical reflux after POEM (78.6% vs. 36.8%, p < 0.001) were significantly associated with BOM.</p><p><strong>Conclusions: </strong>The incidence of BOM after POEM is low. BOM grade progression occurred within 3 years after POEM. Male sex, a thin esophageal muscle layer, and clinical reflux were associated with BOM.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980913","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 of Texture and Color Enhancement Imaging for Identification of Colorectal Polyps: A Prospective Crossover Randomized Trial.","authors":"Yusuke Biwata, Eiji Sakai, Yu Nomura, Yu Honda, Hikaru Fusimi, Kiho Shinagawa, Yuichiro Sakurai, Tumugi Jono, Yohei Fujino, Koki Meguro, Yusuke Takai, Akito Iwasaki, Tomoki Shimizu, Haruto Sanada, Atsushi Nakajima","doi":"10.1111/den.70001","DOIUrl":"https://doi.org/10.1111/den.70001","url":null,"abstract":"<p><strong>Objective: </strong>To reveal the efficacy of texture and color enhancement imaging (TXI), which highlights changes in the brightness, color, and texture of colorectal polyps, we conducted a prospective crossover randomized trial.</p><p><strong>Methods: </strong>Between June 2022 and January 2023, 700 consecutive patients who underwent colonoscopy were randomly assigned (1:1) to the TXI or white-light imaging (WLI) groups. After the first inspection of the right colon, the endoscope was reinserted into the cecum, and a second inspection was performed using another mode. The outcomes measured were polyp detection rate (PDR), adenoma detection rate (ADR), serrated lesion detection rate (SDR), and mean number of lesions per colonoscopy. Missed lesion analyses were also performed.</p><p><strong>Results: </strong>Although the PDR and ADR were significantly higher in the TXI group (37.5% vs. 28.4%, p = 0.01; and 31.8% vs. 24.9%, p = 0.03, respectively), the SDR did not differ between the two groups (8.6% vs. 6.5%, p = 0.24). More polyps were identified in the TXI group than in the WLI group at the first inspection (0.54 vs. 0.42, p = 0.01). The polyp miss rate was significantly lower in the TXI group than in the WLI group (19.9% vs. 32.4%, p = 0.003). Although small polyps (< 5 mm) tended to be missed in both groups, the miss rate of moderate-sized polyps (5-9 mm) was significantly lower in the TXI group (12.3% vs. 38.2%, p = 0.001).</p><p><strong>Conclusions: </strong>Compared to WLI, TXI exhibited a higher PDR and ADR in the right colon.</p><p><strong>Trial registration: </strong>UMIN000048038.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980880","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":"Recanalization Using a Temperature-Controlled RF Catheter for Ingrowth Stent Occlusion in a Patient With Hilar Malignant Biliary Obstruction.","authors":"Kenjiro Yamamoto, Hiroyuki Kojima, Takao Itoi","doi":"10.1111/den.70002","DOIUrl":"10.1111/den.70002","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884353","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}