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{"title":"Comparison of the resection depth between endoscopic mucosal resection and underwater endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumors: A retrospective study","authors":"Toshiki Horii,&nbsp;Yohei Harada,&nbsp;Gen Kitahara,&nbsp;Takuya Wada,&nbsp;Akinori Watanabe,&nbsp;Kenji Ishido,&nbsp;Hisatomo Ikehara,&nbsp;Chika Kusano","doi":"10.1002/deo2.70091","DOIUrl":"https://doi.org/10.1002/deo2.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There is concern that underwater endoscopic mucosal resection (UWEMR) uses buoyancy to elevate the lesion for snare resection, resulting in a shallower resection depth than that in endoscopic mucosal resection (EMR). We aimed to compare conventional EMR and UWEMR in terms of resection depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed cases in which EMR or UWEMR was performed for superficial non-ampullary duodenal epithelial tumors of ≤20 mm between April 2018 and February 2024. The endpoints were histological complete resection rate, en bloc resection rate, presence of muscularis mucosa and submucosa in the resection specimen, and submucosal index calculated from the resection specimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EMR was performed on 19 lesions and UWEMR was performed on 52 lesions. Histological complete and en bloc resection rates were not significantly different between EMR and UWEMR (57.9% and 63.5%, respectively, <i>p</i> = 0.78; 78.9% and 90.4%, respectively, <i>p</i> = 0.24). No significant differences were observed between EMR and UWEMR in the muscularis mucosa of the resected specimens (78.9% and 92.3%, respectively, <i>p</i> = 0.20). The presence of submucosa in resected specimens was encountered less often in EMR cases than in UWEMR cases (57.9% versus [vs.] 84.6%, <i>p</i> = 0.03). There were significant differences in the submucosal index in the resected specimens between EMR and UWEMR cases (median 0.15 [interquartile range 0–0.39] vs. 0.33 [0.17–0.57], <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>UWEMR potentially includes the submucosa within the specimen.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645931","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}

{"title":"Injured submucosal arteries following cold snare polypectomy are significantly fewer versus those after endoscopic mucosal resection for 10–19-mm nonpedunculated colorectal polyps","authors":"Shingo Kurasawa,&nbsp;Ichitaro Horiuchi,&nbsp;Masashi Kajiyama,&nbsp;Hiroe Kitahara,&nbsp;Tsuyoshi Terashima,&nbsp;Akira Horiuchi","doi":"10.1002/deo2.70099","DOIUrl":"https://doi.org/10.1002/deo2.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We compared the frequency of post-polypectomy bleeding or injured submucosal arteries between cold snare polypectomy (CSP) and endoscopic mucosal resection (EMR) for nonpedunculated colorectal polyps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, randomized, single-center study. Patients who underwent CSP or EMR for 10–19-mm nonpedunculated polyps were enrolled in CSP and EMR groups, and we compared the patient and polyp characteristics, the number of clips used, clinical outcomes, adverse events, and pathological features of the resected polyps between these groups. The primary outcome was the presence of injured arteries in the submucosal layer of the resected polyps examined histologically. The secondary outcomes were immediate bleeding and delayed bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-three patients with 60 eligible polyps were enrolled. The numbers of polyps/patients were 30/26 in the CSP group and 30/27 in the EMR group. The patient and polyp characteristics were similar between the groups. The total number of hemostatic clips used for hemostasis or prophylactic clipping was significantly greater in the EMR group compared to the CSP group (78 vs. 10, <i>p</i> &lt; 0.001). The frequency of immediate bleeding after CSP was similar to that after EMR [6.7% (2/30) vs. 13% (4/30), <i>p</i> = 0.39]. Delayed bleeding did not occur in either group. The presence of injured submucosal arteries after CSP was significantly less frequent than that after EMR: 10% (3/30) versus 67% (20/30), <i>p</i> &lt; 0.001.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the resection of 10–19-mm nonpedunculated colorectal polyps, CSP may decrease post-polypectomy bleeding without prophylactic clipping compared to EMR as it results in fewer injured submucosal arteries. www.clinicaltrials.gov (NCT05930041).</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638684","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}

{"title":"Endoscopic mucosal resection with an over-the-scope clip for colorectal tumors (with video)","authors":"Takahiro Muramatsu,&nbsp;Tomoaki Tashima,&nbsp;Tomonori Kawasaki,&nbsp;Tsubasa Ishikawa,&nbsp;Kodai Esaki,&nbsp;Kei Sugimoto,&nbsp;Masami Sano,&nbsp;Shotaro Ishizaka,&nbsp;Yumi Mashimo,&nbsp;Takao Itoi,&nbsp;Shomei Ryozawa","doi":"10.1002/deo2.70076","DOIUrl":"https://doi.org/10.1002/deo2.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection may result in complications or may be unsuitable for tumors that are difficult to treat endoscopically. We investigated the usefulness of a newly developed endoscopic resection technique—EMR with an over-the-scope clip (EMR-O)—for difficult-to-treat lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We retrospectively examined patients who underwent EMR-O for colorectal tumors between September 2017 and January 2024. Patient and lesion characteristics, technical success rates, en bloc resection rates, R0 resection rates, procedure time, histopathology, and the clinical course were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EMR-O was performed for 18 patients. Indications for EMR-O included residual or recurrent lesions (seven patients; 38.9%), diverticulum lesions (five patients; 27.8%), appendiceal orifice lesions (three patients; 16.7%), T1 cancers (two patients; 11.1%), and subepithelial tumors (one patient; 5.5%). The median lesion size was 11 mm. The rates of technical success, en bloc resection, and R0 resection were 100%, 86.7%, and 86.7%. The median procedure time was 10 min. The only adverse event was diverticulitis (one patient; 5.5%). Intraoperative and delayed perforation and bleeding were not observed. The pathological resection depths were full-thickness for three patients (16.7%), muscularis resection for four patients (22.2%), and deep submucosal resection for 11 patients (61.1%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although EMR-O is limited by the target lesion size, it shortens the procedure time, prevents perforation, and avoids the need for surgery. EMR-O may be a minimally invasive treatment option for small lesions that are difficult to treat endoscopically.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639066","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}

{"title":"Tribute to Our Reviewers 2024","authors":"","doi":"10.1002/deo2.70098","DOIUrl":"https://doi.org/10.1002/deo2.70098","url":null,"abstract":"&lt;p&gt;The Editorial Board of &lt;i&gt;DEN Open&lt;/i&gt; takes this opportunity to acknowledge with particular gratitude the following reviewers who have provided their valuable time and expertise in the evaluation of manuscripts submitted to &lt;i&gt;DEN Open&lt;/i&gt; during the period of 1 January 2024 to 31 December 2024.&lt;/p&gt;&lt;p&gt;Takao Itoi&lt;/p&gt;&lt;p&gt;Editor-in-Chief&lt;/p&gt;&lt;p&gt;&lt;i&gt;DEN Open&lt;/i&gt;&lt;/p&gt;&lt;p&gt;Nobutsugu Abe&lt;/p&gt;&lt;p&gt;Kyoichi Adachi&lt;/p&gt;&lt;p&gt;Yoichi Akazawa&lt;/p&gt;&lt;p&gt;Teppei Akimoto&lt;/p&gt;&lt;p&gt;Shintaro Akiyama&lt;/p&gt;&lt;p&gt;Ikuo Aoyama&lt;/p&gt;&lt;p&gt;Taiki Aoyama&lt;/p&gt;&lt;p&gt;Reiko Ashida&lt;/p&gt;&lt;p&gt;Shinya Ashizuka&lt;/p&gt;&lt;p&gt;Maki Ayaki&lt;/p&gt;&lt;p&gt;Rafael Castro&lt;/p&gt;&lt;p&gt;Shannon Chan&lt;/p&gt;&lt;p&gt;Li-Chun Chang&lt;/p&gt;&lt;p&gt;Hideyuki Chiba&lt;/p&gt;&lt;p&gt;Eduardo De Moura&lt;/p&gt;&lt;p&gt;Akira Dobashi&lt;/p&gt;&lt;p&gt;Osamu Dohi&lt;/p&gt;&lt;p&gt;Shinpei Doi&lt;/p&gt;&lt;p&gt;Alanna Ebigbo&lt;/p&gt;&lt;p&gt;Mitsuru Esaki&lt;/p&gt;&lt;p&gt;Yuki Fujii&lt;/p&gt;&lt;p&gt;Nao Fujimori&lt;/p&gt;&lt;p&gt;Ai Fujimoto&lt;/p&gt;&lt;p&gt;Toshio Fujisawa&lt;/p&gt;&lt;p&gt;Akashi Fujita&lt;/p&gt;&lt;p&gt;Yuji Fujita&lt;/p&gt;&lt;p&gt;Mitsuharu Fukasawa&lt;/p&gt;&lt;p&gt;Nobuhiko Fukuba&lt;/p&gt;&lt;p&gt;Shuichi Fukuda&lt;/p&gt;&lt;p&gt;Hayato Fukui&lt;/p&gt;&lt;p&gt;Shusei Fukunaga&lt;/p&gt;&lt;p&gt;Yoshihiro Furuichi&lt;/p&gt;&lt;p&gt;Kenichi Goda&lt;/p&gt;&lt;p&gt;Osamu Goto&lt;/p&gt;&lt;p&gt;Ryunosuke Hakuta&lt;/p&gt;&lt;p&gt;Natalie Halvorsen&lt;/p&gt;&lt;p&gt;Kenta Hamada&lt;/p&gt;&lt;p&gt;Yasuhiko Hamada&lt;/p&gt;&lt;p&gt;Kazuo Hara&lt;/p&gt;&lt;p&gt;Ryo Harada&lt;/p&gt;&lt;p&gt;Minami Hashimoto&lt;/p&gt;&lt;p&gt;Shinichi Hashimoto&lt;/p&gt;&lt;p&gt;Hisashi Hidaka&lt;/p&gt;&lt;p&gt;Kazutoshi Higuchi&lt;/p&gt;&lt;p&gt;Takuma Higurashi&lt;/p&gt;&lt;p&gt;Takuto Hikichi&lt;/p&gt;&lt;p&gt;Makoto Hinokuchi&lt;/p&gt;&lt;p&gt;Hiroto Hiraga&lt;/p&gt;&lt;p&gt;Kingo Hirasawa&lt;/p&gt;&lt;p&gt;Takashi Hirose&lt;/p&gt;&lt;p&gt;Takashi Hisabe&lt;/p&gt;&lt;p&gt;Yusuke Horiuchi&lt;/p&gt;&lt;p&gt;Kinichi Hotta&lt;/p&gt;&lt;p&gt;Ryoji Ichijima&lt;/p&gt;&lt;p&gt;Katsuro Ichimasa&lt;/p&gt;&lt;p&gt;Eikichi Ihara&lt;/p&gt;&lt;p&gt;Toshiro Iizuka&lt;/p&gt;&lt;p&gt;Yuichiro Ikebuchi&lt;/p&gt;&lt;p&gt;Eriko Ikeda&lt;/p&gt;&lt;p&gt;Hisatomo Ikehara&lt;/p&gt;&lt;p&gt;Atsushi Imagawa&lt;/p&gt;&lt;p&gt;Hajime Imai&lt;/p&gt;&lt;p&gt;Ken Inoue&lt;/p&gt;&lt;p&gt;Tadahisa Inoue&lt;/p&gt;&lt;p&gt;Fumiaki Ishibashi&lt;/p&gt;&lt;p&gt;Yusuke Ishida&lt;/p&gt;&lt;p&gt;Kazunaga Ishigaki&lt;/p&gt;&lt;p&gt;Ryu Ishihara&lt;/p&gt;&lt;p&gt;Naoki Ishii&lt;/p&gt;&lt;p&gt;Hirotoshi Ishiwatari&lt;/p&gt;&lt;p&gt;Ken Ito&lt;/p&gt;&lt;p&gt;Masanori Ito&lt;/p&gt;&lt;p&gt;Nobuhito Ito&lt;/p&gt;&lt;p&gt;Masahiro Itonaga&lt;/p&gt;&lt;p&gt;Hiroyoshi Iwagami&lt;/p&gt;&lt;p&gt;Naoto Iwai&lt;/p&gt;&lt;p&gt;Masaya Iwamuro&lt;/p&gt;&lt;p&gt;Takuji Iwashita&lt;/p&gt;&lt;p&gt;Keisuke Iwata&lt;/p&gt;&lt;p&gt;Taro Iwatsubo&lt;/p&gt;&lt;p&gt;Ryuhei Jinushi&lt;/p&gt;&lt;p&gt;Tomohiro Kadota&lt;/p&gt;&lt;p&gt;Hideki Kamada&lt;/p&gt;&lt;p&gt;Ken Kamata&lt;/p&gt;&lt;p&gt;Takashi Kanesaka&lt;/p&gt;&lt;p&gt;Atsushi Kanno&lt;/p&gt;&lt;p&gt;Yoshihide Kanno&lt;/p&gt;&lt;p&gt;Hiromitsu Kanzaki&lt;/p&gt;&lt;p&gt;Chikatoshi Katada&lt;/p&gt;&lt;p&gt;Motohiko Kato&lt;/p&gt;&lt;p&gt;Tsunetaka Kato&lt;/p&gt;&lt;p&gt;Noriyuki Kawami&lt;/p&gt;&lt;p&gt;Seiji Kawano&lt;/p&gt;&lt;p&gt;Noboru Kawata&lt;/p&gt;&lt;p&gt;Daisuke Kikuchi&lt;/p&gt;&lt;p&gt;Toshifumi Kin&lt;/p&gt;&lt;p&gt;Satoshi Kinoshita&lt;/p&gt;&lt;p&gt;Koh Kitagawa&lt;/p&gt;&lt;p&gt;Katsuya Kitamura&lt;/p&gt;&lt;p&gt;Yoko Kitamura&lt;/p&gt;&lt;p&gt;Masanori Kobayashi&lt;/p&gt;&lt;p&gt;Yousuke Kobayashi&lt;/p&gt;&lt;p&gt;Shinya Kodashima&lt;/p&gt;&lt;p&gt;Takehiko Koga&lt;/p&gt;&lt;p&gt;Hirofumi Kogure&lt;/p&gt;&lt;p&gt;Yoriaki Komeda&lt;/p&gt;&lt;p&gt;Yoshiyasu Kono&lt;/p&gt;&lt;p&gt;Shinsuke Koshita&lt;/p&gt;&lt;p&gt;Kensuke Kubota&lt;/p&gt;&lt;p&gt;Takahiro Kudo&lt;/p&gt;&lt;p&gt;Yu-Ting Kuo&lt;/p&gt;&lt;p&gt;Chika Kusano&lt;/p&gt;&lt;p&gt;Takamichi Kuwahara&lt;/p&gt;&lt;p&gt;Toshio Kuwai&lt;/p&gt;&lt;p&gt;Yasuharu Maeda&lt;/p&gt;&lt;p&gt;Mai Makiguchi&lt;/p&gt;&lt;p&gt;Akinori Maruta&lt;/p&gt;&lt;p&gt;Hirotsugu Maruyama&lt;/p&gt;&lt;p&gt;Atsuhiro Masuda&lt;/p&gt;&lt;p&gt;Saburo Matsubara&lt;/p&gt;&lt;p&gt;Akihisa Matsuda&lt;/p&gt;&lt;p&gt;Takahisa Matsuda&lt;/p&gt;&lt;p&gt;Hiroshi Matsumoto&lt;/p&gt;&lt;p&gt;Kazuyuki Matsumoto&lt;/p&gt;&lt;p&gt;Tomoaki Matsumura&lt;/p&gt;&lt;p&gt;Yukitoshi ","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629895","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}

{"title":"Revealing autoimmune gastritis: Polypoid nodule scar development after endoscopic submucosal dissection for early gastric cancer","authors":"Naoya Masuda,&nbsp;Kenji Yamazaki,&nbsp;Yasuhiko Maruyama,&nbsp;Ryoji Kushima,&nbsp;Nae Hasebe,&nbsp;Noritaka Ozawa,&nbsp;Shogo Shimizu,&nbsp;Masahito Shimizu","doi":"10.1002/deo2.70094","DOIUrl":"https://doi.org/10.1002/deo2.70094","url":null,"abstract":"<p>Endoscopic submucosal dissection (ESD), the standard treatment for early gastric cancer, typically results in homogeneous flat scars. However, in some cases, polypoid nodule scars (PNS) may develop, complicating the cancer recurrence assessment. This case report describes a 60-year-old man with a history of <i>Helicobacter pylori</i> infection who underwent two ESD procedures: first for early antral gastric cancer and then for gastric body adenoma. Subsequently, an erythematous protruding lesion developed at the antral ESD scar site. Lesion biopsy revealed regenerative and hyperplastic tissue growth, consistent with PNS. Despite <i>H. pylori</i> eradication therapy and discontinuation of potassium-competitive acid blockers and H₂-receptor antagonists, the lesion continued to enlarge. PNS growth may be caused by excessive mucosal regeneration and enhanced antral peristalsis, suggesting that hypergastrinemia, which may enhance these effects, may be an underlying cause. Further, elevated serum gastrin levels, decreased pepsinogen levels, the presence of antiparietal cell antibodies, and consistent pathological findings confirmed autoimmune gastritis (AIG).</p><p>This case highlights the diagnostic challenges of AIG, especially in cases of active or previous <i>H. pylori</i> infection because typical endoscopic features may be obscured. Persistent PNS after ESD warrants the consideration of excessive mucosal regeneration and enhanced peristalsis, with AIG as a potential cause because of its association with hypergastrinemia. To our knowledge, this is the first case report describing a potential link between AIG and PNS.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595207","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}

{"title":"The effectiveness of a body positioning device for controlling patient movement and additional sedative use during endoscopic retrograde cholangiopancreatography: A retrospective analysis","authors":"Haruka Masuda,&nbsp;Tsutomu Nishida,&nbsp;Kengo Matsumoto,&nbsp;Dai Nakamatsu,&nbsp;Shiro Hayashi,&nbsp;Masashi Yamamoto","doi":"10.1002/deo2.70095","DOIUrl":"https://doi.org/10.1002/deo2.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endoscopic retrograde cholangiopancreatography requires precise body movement control for procedural safety and efficiency. Sedatives are commonly used but pose risks, especially in elderly patients. This study evaluated the effectiveness of the Medo V-Fix device in controlling patient movement during endoscopic retrograde cholangiopancreatography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of 1723 endoscopic retrograde cholangiopancreatography procedures performed between January 2021 and March 2024, 1,528 were analyzed after excluding cases with missing data. Patients were divided into two groups, the device group (<i>n</i> = 697) and the nondevice group (<i>n</i> = 831). The groups were compared with respect to body movement control, additional sedative administration, sedation-related complications, and procedure discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics were similar between the groups. Body movement control was better with the device (good, 65.7%; poor, 24.0%; and very poor, 10.3%) than without it (good, 48.1%; poor, 30.7%; and very poor, 21.2%; <i>p</i> &lt; 0.0001). The device reduced the need for manual assistance and additional sedatives. Fewer patients in the device group (9.5% vs. 15.6%, <i>p</i> = 0.0003) required an additional thiopental dose, and the dose was lower (4.5 mg vs. 6 mg, <i>p</i> = 0.0015). No procedure discontinuation occurred in the device group, whereas five discontinuations occurred in the nondevice group. Although hypoxemia was more frequent in the device group (14.5% vs. 8.8%, <i>p</i> = 0.0005), no severe adverse events occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Medo V-Fix device significantly improved body movement control and reduced the need for additional doses of sedatives and manual intervention. Despite a higher incidence of mild hypoxemia, these events were appropriately managed with routine monitoring, indicating that the device increases procedural safety and efficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595303","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}

{"title":"Endoscopic ultrasonography-guided removal of a stent that had migrated into the pancreas post-pancreaticojejunostomy: A case report","authors":"Satoshi Kajitani,&nbsp;Kazuyuki Matsumoto,&nbsp;Kentaro Oki,&nbsp;Akihiro Matsumi,&nbsp;Kazuya Miyamoto,&nbsp;Yuki Fujii,&nbsp;Daisuke Uchida,&nbsp;Koichiro Tsutsumi,&nbsp;Shigeru Horiguchi,&nbsp;Motoyuki Otsuka","doi":"10.1002/deo2.70096","DOIUrl":"https://doi.org/10.1002/deo2.70096","url":null,"abstract":"<p>A 64-year-old woman had undergone subtotal stomach-preserving pancreaticoduodenectomy for locally advanced pancreatic head cancer. She had an uneventful postoperative course with no recurrence. However, approximately 18 months after surgery, she presented with recurrent abdominal pain. Although contrast-enhanced computed tomography abdominal radiographs showed internal stent migration to the residual pancreas, dilatation of the tail side of the pancreatic duct was observed. The impaired internal stent was considered to be the cause of the abdominal pain. An attempt to remove the stent via balloon-assisted endoscopy was unsuccessful as the pancreaticojejunostomy site could not be reached. Consequently, endoscopic ultrasonography-guided pancreatic duct drainage was performed, and a plastic stent was placed through the jejunal site to the stomach. Two months later, the endosonographically/endoscopic ultrasonography-guided created route was dilated, and an endoscopic introducer was inserted into the pancreatic duct. Biopsy forceps were advanced through the sheath, allowing the successful removal of the stent by direct grasping. The symptoms of the patient improved, and she was discharged without complications.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595300","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}

{"title":"Non-exposed endoscopic wall-inversion surgery for an early gastric cancer arising from heterotopic submucosal gastric glands: A case report","authors":"Takeshi Abe,&nbsp;Yosuke Toya,&nbsp;Kyohei Sugai,&nbsp;Mizuki Komai,&nbsp;Shunichi Yanai,&nbsp;Haruka Nikai,&nbsp;Shigeaki Baba,&nbsp;Ryo Sugimoto,&nbsp;Naoki Yanagawa,&nbsp;Takayuki Matsumoto","doi":"10.1002/deo2.70097","DOIUrl":"https://doi.org/10.1002/deo2.70097","url":null,"abstract":"<p>A 74-year-old man, who was scheduled for surgery against the main duct-type intraductal papillary mucinous neoplasm of the pancreas, was found to have a subepithelial lesion of the stomach under esophagogastroduodenoscopy. Endoscopic ultrasound-guided fine needle aspiration for the gastric lesion revealed adenocarcinoma cells. We thus considered carcinomas arising from heterotopic submucosal gastric glands and metastases from the pancreatic lesion as differential diagnoses. We first non-exposed endoscopic wall-inversion surgery to the lesion as a total biopsy. The gastric lesion was diagnosed as early gastric cancer originating from heterotopic submucosal gastric glands. The patient subsequently underwent a pylorus-preserving pancreatoduodenectomy for the intraductal papillary mucinous neoplasm. Our experience suggests non-exposed endoscopic wall-inversion surgery is a useful and minimally invasive option for the diagnosis and treatment of gastric submucosal lesions, which are presumed to be malignant in nature.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595301","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}

{"title":"A comparative assessment of contamination rates in gastrointestinal endoscope reprocessing: sterilization versus high-level disinfection","authors":"Tanyaporn Chantarojanasiri,&nbsp;Rachanikorn Rungrueangmaitree,&nbsp;Siriporn Thongsri,&nbsp;Urasa Jampa-ngern,&nbsp;Thawee Ratanachu-Ek","doi":"10.1002/deo2.70093","DOIUrl":"https://doi.org/10.1002/deo2.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the disparity in culture results between sterilization and high-level disinfection (HLD) for duodenoscopes and linear endoscopic ultrasound (EUS), and to assess the effectiveness of different bacterial contamination detection methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a prospective randomized study, including duodenoscopes and linear EUS with adenosine triphosphate bioluminescence assay values below 200 relative light units after manual cleaning which were randomly assigned to undergo either sterilization or HLD in a 1:1 ratio. Following disinfection, all endoscopes were subjected to adenosine triphosphate bioluminescence assay testing and cultures using both swab and liquid samples from endoscope channels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Totally 752 endoscopes (444 duodenoscopes and 308 linear EUS) were studied. After disinfection, the positive culture rates for the sterilization and HLD groups were 5.9% and 7.2%, respectively (<i>p</i> = 0.460). No significant difference in contamination rates was observed between duodenoscopes and linear EUS (5.9% and 7.5%, respectively; <i>p</i> = 0.379), and no significant association between contamination rates and the presence of biliary stones was seen (7.3% vs. 6.9%; <i>p</i> = 0.613). The detection rate of bacteria from liquid samples taken from endoscope channels was 0.5%, which was significantly lower than the swabbing method (6.0%, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found no statistically significant difference in contamination rates between sterilization and HLD methods for gastrointestinal endoscope reprocessing. The type of endoscope and the presence of biliary stones did not influence the positive culture rate. The swabbing method showed significantly higher bacterial detection when compared with liquid samples.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581373","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}

{"title":"Difficult biliary cannulation during endoscopic retrograde cholangiopancreatography for distal malignant biliary obstruction caused by pancreatic cancer: An observational study","authors":"Jun Noda,&nbsp;Yuichi Takano,&nbsp;Naoki Tamai,&nbsp;Masataka Yamawaki,&nbsp;Tetsushi Azami,&nbsp;Fumitaka Niiya,&nbsp;Naotaka Maruoka,&nbsp;Masatsugu Nagahama","doi":"10.1002/deo2.70092","DOIUrl":"https://doi.org/10.1002/deo2.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Distal malignant biliary obstruction (DMBO) caused by pancreatic cancer often complicates endoscopic retrograde cholangiopancreatography (ERCP), particularly biliary cannulation. While various factors influencing difficult biliary cannulation (DBC) have been studied, data specific to pancreatic cancer-related distant malignant biliary obstruction#x000A0;remains limited. This study identifies factors affecting ERCP success in this patient population to improve clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 119 ERCP procedures for distant malignant biliary obstruction owing to pancreatic cancer with naïve papilla at Showa University Fujigaoka Hospital (January 2020–September 2024). Patient characteristics, duodenal invasion, ampullary bile duct status, papillary morphology, trainee involvement, and adverse events were evaluated. Multivariate analysis identified predictive factors of DBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After excluding 17 ERCP failures, 102 patients were analyzed and categorized into non-DBC (<i>n</i> = 40) and DBC (<i>n</i> = 62) groups. The DBC incidence rate was 60.8%. The absence of the ampullary bile duct (odds ratio [OR]: 2.58, 95% confidence interval [CI]: 1.02–6.51; <i>p</i> = 0.04) and the macroscopic appearance of type III papillary morphology (enlarged/protruding; OR: 3.32; 95% CI: 1.07–10.30; <i>p</i> = 0.04) were significantly associated with DBC. Adverse events were slightly more frequent in the DBC group; however, this difference was not statistically significant. Alternative cannulation was performed more often in patients without the ampullary bile duct; however, no difference in adverse events was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The absence of the ampullary bile duct and type III papillary morphology are anatomical risk factors for DBC during ERCP for patients with pancreatic cancer. Early consideration of alternative cannulation techniques or biliary drainage methods may be necessary for such patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554696","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}