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

{"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}

{"title":"Impact of a Thinner Snare Wire With Optimal Electrosurgical Unit Settings on the Risk of Delayed Bleeding After Endoscopic Papillectomy: A Propensity Score-Matched Analysis (With Video).","authors":"Kenjiro Yamamoto, Takao Itoi, Takayoshi Tsuchiya, Yuki Joyama, Reina Tanaka, Ryosuke Tonozuka, Shuntaro Mukai, Kazumasa Nagai, Yukitoshi Matsunami, Hiroyuki Kojima, Hirohito Minami, Noriyuki Hirakawa, Kento Shionoya, Atsushi Sofuni","doi":"10.1111/den.70008","DOIUrl":"10.1111/den.70008","url":null,"abstract":"<p><strong>Objectives: </strong>The indications for endoscopic papillectomy (EP) have expanded. However, post-procedural adverse events remain high. We performed ex vivo and clinical studies to determine the usefulness of a thinner snare wire (TSW) for preventing delayed bleeding after EP.</p><p><strong>Methods: </strong>To verify the effect of current flow in the monopolar device, a model of an ampulla lesion was created and then resected using a snare. To examine the coagulation effects produced by varying snare wire diameters, patients who underwent EP for ampullary neoplasms were retrospectively analyzed according to the snare wire diameter in the TSW group and the conventional snare wire (CSW) group. The outcomes were compared after propensity score matching (PSM) to control for selection bias and lack of randomization.</p><p><strong>Results: </strong>In the ex vivo study, thermal denaturation was found to be stronger on the counter electrode plate side. In the clinical study, 102 patients who underwent EP were included (TSW group, n = 52; CSW group, n = 50). The matched cohorts included 29 patients per group. Delayed bleeding was significantly less frequent in the TSW group than in the CSW group after PSM (3.4% vs. 31%; p = 0.012). Although residual lesions tended to be more frequent in the TSW group (p = 0.053), there were no significant differences in other procedural and pathological outcomes.</p><p><strong>Conclusions: </strong>The coagulation effect produced by current flow cannot be ignored. Using a TSW may decrease the incidence of delayed bleeding. It is important to select both a suitable snare wire diameter and appropriate electrosurgical unit settings.</p>","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":"144884352","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 Therapeutic Thin Endoscope Facilitates Gastric Endoscopic Submucosal Dissection in the Cardia and Pylorus: A Case Series Study (With Video).","authors":"Daisuke Minezaki, Teppei Masunaga, Motoki Sasaki, Shoma Murata, Yuri Imura, Anna Tojo, Hinako Sakurai, Kentaro Iwata, Kurato Miyazaki, Mari Mizutani, Michiko Nishikawa, Teppei Akimoto, Yusaku Takatori, Shintaro Kawasaki, Noriko Matsuura, Hideomi Tomida, Atsushi Nakayama, Tomohisa Sujino, Kaoru Takabayashi, Kazuhiro Mizukami, Motohiko Kato, Naohisa Yahagi","doi":"10.1111/den.70017","DOIUrl":"10.1111/den.70017","url":null,"abstract":"<p><p>Endoscopic submucosal dissection (ESD) is an established technique for treating superficial gastric neoplasms. However, performing ESD in the cardia and pylorus remains technically challenging due to the narrow lumens and steep angulations. Recently, a novel therapeutic thin endoscope, featuring a 7.9-mm outer diameter, 160° downward angulation, 3.2-mm working channel, and water jet function, was developed. We aimed to evaluate the feasibility of this novel endoscope for ESD in the cardia and pylorus. We retrospectively reviewed the data from gastric ESD cases in the cardia and pylorus using this novel endoscope at a single tertiary care center between March 2023 and September 2024. Clinical characteristics, procedural details, and treatment outcomes were analyzed. A total of 20 lesions (10 in the cardia, 10 in the pylorus) were included. The median lesion size was 15 mm (interquartile range: 10-30 mm). En bloc resection was successfully achieved in all cases without any adverse events. None of the cases required traction devices. Retroflexion was unnecessary in approximately half of the cases. In conclusion, this novel therapeutic thin endoscope facilitated en bloc resection without any adverse events in all cases; suggesting its feasibility for gastric ESD in anatomically complex regions characterized by narrow lumens and steep angulations.</p>","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":"144884351","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 Glucagon-Like Peptide-1 Receptor Agonists on Retained Gastric Contents During Esophagogastroduodenoscopy: A Propensity Score-Matched Study.","authors":"Hiroyuki Hisada, Yosuke Tsuji, Dai Kubota, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Seiichi Yakabi, Chihiro Takeuchi, Naomi Kakushima, Nobutake Yamamichi, Mitsuhiro Fujishiro","doi":"10.1111/den.70016","DOIUrl":"https://doi.org/10.1111/den.70016","url":null,"abstract":"<p><strong>Objectives: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are commonly used for diabetes management and are associated with delayed gastric emptying, raising concerns about an increased risk of retained gastric contents (RGC) during esophagogastroduodenoscopy (EGD). While this association has been investigated in Western populations, limited data are available for Asian populations.</p><p><strong>Methods: </strong>We conducted a retrospective study involving 1324 patients with diabetes who underwent screening EGD between January 2020 and December 2023. Propensity score matching was used to compare 148 patients receiving GLP-1 RA with 148 patients not receiving GLP-1 RA. We evaluated the relationship between GLP-1 RA use and the incidence of RGC during EGD.</p><p><strong>Results: </strong>RGC occurred more frequently in the GLP-1 RA group compared to the non-GLP-1 RA group, both before (12.0% vs. 3.7%, p < 0.001) and after matching (12.2% vs. 3.4%, p = 0.009). The association between GLP-1 RA use and RGC remained consistent in subgroup analyses, including patients without a history of peptic ulcer scars or endoscopic treatment as well as those not receiving DPP-4 inhibitors. Repeated EGD procedures were more frequent in the GLP-1 RA group; however, no cases of aspiration pneumonia after EGD were observed.</p><p><strong>Conclusions: </strong>The use of GLP-1 RA in patients with diabetes significantly increases the risk of RGC during EGD in Asian populations. Implementing precautions, such as recommending a liquid diet the day before EGD, may help mitigate this risk in clinical practice.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877086","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":"Stent Retrieval Technique Using a Basket Catheter With a Rotation Function for Retrieval of Thread-Attached Stent.","authors":"Masafumi Watanabe, Kosuke Okuwaki, Chika Kusano","doi":"10.1111/den.70013","DOIUrl":"https://doi.org/10.1111/den.70013","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801093","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":"Balloon Enteroscopy-Assisted ERCP Versus Endoscopic Ultrasound-Guided Biliary Drainage for Unresectable Malignant Biliary Obstruction in Patients With Surgically Altered Anatomy: A Multicenter Prospective Registration Study.","authors":"Masahiro Itonaga, Mamoru Takenaka, Kenji Ikezawa, Tsukasa Ikeura, Masaaki Shimatani, Masanori Asada, Nao Fujimori, Ryota Sagami, Takeshi Ogura, Hajime Imai, Kazuyuki Matsumoto, Shuhei Shintani, Hideyuki Shiomi, Keiichi Hatamaru, Kosuke Minaga, Ryoji Takada, Ke Wan, Toshio Shimokawa, Masayuki Kitano","doi":"10.1111/den.70010","DOIUrl":"https://doi.org/10.1111/den.70010","url":null,"abstract":"<p><strong>Background and aims: </strong>The present prospective multicenter clinical trial compared the efficacy and safety of balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BEA-ERCP) and endoscopic ultrasound-guided biliary drainage (EUS-BD) as primary drainage methods for patients with surgically altered anatomy (SAA) and unresectable malignant biliary obstruction (MBO).</p><p><strong>Methods: </strong>Technical and clinical success rates, procedure time, adverse events (AEs), and time to recurrent biliary obstruction (TRBO) were compared. Risk factors associated with technical failure were evaluated, and subgroup analysis investigating whether Roux-en-Y reconstruction affected the technical success rate was also performed.</p><p><strong>Results: </strong>Patient characteristics were comparable between the BEA-ERCP (n = 54) and EUS-BD (n = 44) groups. Compared with the BEA-ERCP group, the EUS-BD group had a significantly higher technical success rate, a significantly shorter procedure time, comparable rates of clinical success and AEs, and comparable TRBO. Multivariate analysis showed that BEA-ERCP was an independent predictor of technical failure. Subgroup analysis revealed that the technical success rate was significantly higher with EUS-BD than with BEA-ERCP in patients with Roux-en-Y reconstruction, with no significant difference in those without Roux-en-Y reconstruction.</p><p><strong>Conclusions: </strong>EUS-BD may be a more suitable primary drainage method than BEA-ERCP for patients with SAA and unresectable MBO, especially those with Roux-en-Y reconstruction (University Hospital Medical Information Network 000049224).</p><p><strong>Trial registration: </strong>UMIN000049224.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796300","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":"One Best Way or Many Voices? AI Strategies in the Era of Diverse Endoscopic Imaging for Ulcerative Colitis.","authors":"Yasuharu Maeda, Shin-Ei Kudo, Masashi Misawa","doi":"10.1111/den.70012","DOIUrl":"https://doi.org/10.1111/den.70012","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790897","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's Response to the World Health Organization's Global Initiative on Artificial Intelligence for Health.","authors":"Nayantara Coelho-Prabhu, Purnima Bhat, Rakesh Kalapala, Junaid Mushtaq, Hisao Tajiri, Yuichi Mori","doi":"10.1111/den.70011","DOIUrl":"https://doi.org/10.1111/den.70011","url":null,"abstract":"<p><p>In response to the World Health Organization's (WHO) Global Initiative on Artificial Intelligence (AI) for Health, the World Endoscopy Organization (WEO) highlights the unique challenges and opportunities AI presents for gastrointestinal endoscopy, particularly in resource-limited settings. While AI technologies have shown promise in improving diagnostic accuracy and efficiency in high-resource environments, their implementation in low- and middle-income countries is hindered by infrastructural, economic, regulatory, and training barriers. This commentary explores how these challenges may exacerbate existing healthcare disparities, emphasizing the need for localized datasets, affordable AI models, simplified regulatory frameworks, and workforce capacity building. The WEO supports WHO's call for equitable AI deployment and advocates for region-specific solutions, including mobile and offline AI tools, public-private partnerships, locally developed algorithms aligned with prevalent disease patterns, and a flexibly adapted regulatory framework. By leveraging WEO's training networks and fostering collaboration among governments, clinicians, and industry, the integration of AI into endoscopy can become more accessible and relevant to underserved populations. The commentary underscores that AI should not be seen as a luxury but as a tool to bridge global disparities in care quality. Ensuring responsible and inclusive AI integration requires both global coordination and context-specific adaptations to truly benefit all healthcare systems.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786086","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":"Safety and Feasibility of Intensive Downstaging Polypectomy With Low-Power Pure-Cut Hot Snare Polypectomy in Patients With Familial Adenomatous Polyposis (With Video).","authors":"Yasuhiro Tani, Satoki Shichijo, Yuta Fujimoto, Yoshiaki Ando, Gentaro Tanabe, Yuya Asada, Tomoya Ueda, Daiki Kitagawa, Atsuko Kizawa, Takehiro Ninomiya, Yuki Okubo, Minoru Kato, Shunsuke Yoshii, Takashi Kanesaka, Koji Higashino, Noriya Uedo, Ryu Ishihara, Tomoki Michida, Yoji Takeuchi","doi":"10.1111/den.70009","DOIUrl":"https://doi.org/10.1111/den.70009","url":null,"abstract":"<p><p>Intensive endoscopic resection for downstaging polyp burden (IDP) strategically prevents colorectal cancer and potentially avoiding surgical treatment in patients with familial adenomatous polyposis (FAP). The safety and efficacy of low-power pure-cut hot-snare polypectomy (LPPC-HSP) for sporadic colorectal polyps have been recently reported. This prospective study, therefore, aimed to clarify the safety and efficacy of IDP in combination with LPPC-HSP in patients with FAP. This single-centre prospective study recruited patients diagnosed with FAP and scheduled for IDP. The primary outcome was the rate of severe adverse events including postoperative bleeding and perforation. The secondary outcomes were adverse events per the Clavien-Dindo classification, abdominal pain, hematochezia after the procedure, emergency colonoscopy, and rehospitalization. Patients with FAP who underwent IDP with conventional hot snare polypectomy using bipolar snares from January 2021 to December 2021 were examined as historical controls (bipolar group) for comparison with patients who underwent IDP with LPPC-HSP (LPPC-HSP group). Among 36 patients with FAP enrolled between July 2023 and June 2024, 33 were included in the analysis. The median age was 31 years, and 16 patients were male. A total of 6581 polyps were resected. Two patients (one with postoperative bleeding and the other with postoperative bleeding and delayed perforation) in the LPPC-HSP group (n = 33) and four patients (all with postoperative bleeding) in the bipolar group (n = 37) experienced severe adverse events (p = 0.677). In conclusion, LPPC-HSP is feasible and may be considered a treatment option for patients with FAP undergoing IDP. TRIAL REGISTRATION: UMIN-CTR: UMIN000051414.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777055","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":"Loop-assisted reopenable clip-over-the-line method as a modified closure method for a mucosal defect after gastric endoscopy submucosal dissection.","authors":"Satoshi Ono, Chinari Tanaka, Mitsuhiro Fujishiro","doi":"10.1111/den.15037","DOIUrl":"10.1111/den.15037","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"893-894"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053482","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}