DEN open最新文献

{"title":"Efficacy of Endoscopic Submucosal Dissection for Superficial Esophageal Cancer on the Distal Side of Esophageal Strictures Using a Novel Thin Therapeutic Endoscope","authors":"Erika Uchida,&nbsp;Keiichiro Nakajo,&nbsp;Hiroki Yamashita,&nbsp;Atsushi Inaba,&nbsp;Hironori Sunakawa,&nbsp;Tomohiro Kadota,&nbsp;Kensuke Shinmura,&nbsp;Tomonori Yano","doi":"10.1002/deo2.70300","DOIUrl":"10.1002/deo2.70300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinomas (ESCCs) localized on the distal side of strictures requires dilation to pass a conventional endoscope. While an ultra-slim endoscope can pass without dilation, ESD using it remains clinically challenging. Despite its small outer diameter of only 7.9 mm, the EG-840TP features a 3.2-mm working channel, an auxiliary water channel, and 160° downward angulation capability. We evaluated the efficacy and safety of ESD using the EG-840TP for ESCCs localized on the distal side of strictures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included patients who underwent ESD for ESCCs localized on the distal side of strictures that a conventional endoscope (diameter ≥8.9 mm) could not pass at our institute from December 2015 to November 2024. Patients were categorized into novel thin endoscope (the EG-840TP) and conventional endoscope (treated after stricture dilation) groups. Patients with strictures narrower than 6 mm were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 28 patients (36 lesions), 13 patients (19 lesions) underwent ESD using the novel thin endoscope, whereas 15 patients (17 lesions) underwent ESD using the conventional endoscope. The treatment speed was significantly faster in the novel thin endoscope group (4.91 mm²/min vs. 1.63 mm²/min, <i>p</i> = 0.03). No serious adverse events were observed in either group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ESD using the EG-840TP demonstrated superior efficacy for superficial ESCCs located on the distal side of strictures, offering an alternative to dilation-based approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635492","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":"What Does “High Risk” Mean in Surgical Patients?","authors":"Ece Salihoglu,&nbsp;Ziya Salihoglu","doi":"10.1002/deo2.70323","DOIUrl":"10.1002/deo2.70323","url":null,"abstract":"<p>To the Editor:</p><p>We read the article by Maruta et al. titled “Endoscopic management of acute cholecystitis in high-risk surgical patients” [<span>1</span>].</p><p>This review summarizes the characteristics of each drainage method and compares the clinical outcomes of the three procedures for acute cholecystitis in high-risk surgical patients.</p><p>The authors defined high-risk patients only as “advanced age, deteriorated performance status, or underlying diseases, conservative treatment”. They did not discuss the criteria to define high-risk patients, the inclusion and exclusion criteria, and major and minor morbidities in surgery, anesthesia, and the perioperative period.</p><p>Perioperative risk classification of patients undergoing anesthesia is of essential interest and has been the focus of much research and categorization. Commonly, these investigations were performed by analyzing clinical experiences and large patient series. The ideal categorization system, based on medical doctors’ clinical experiences and in cooperation with other disciplines, has not been developed yet.</p><p>There are increasing numbers of studies on laparoscopic surgery, but there are few studies on the case of high-risk patients. In some studies, a relationship between pre-operative and postoperative patient information was examined, and an approach was proposed for the selection of surgery type. As stated formerly, although there are studies to determine the risks in Laparoscopic operations. There is no general model to determine the high-risk patient before the surgery [<span>2</span>]. This article does not adequately evaluate high-risk cases [<span>1</span>]. According to the Tokyo 2018 Guidelines, high-risk patients for emergency laparoscopic cholecystectomy in acute cholecystitis have been defined [<span>3</span>].</p><p>The Charlson Comorbidity Index is a widely validated, weighted scoring system used to predict 1- or 10-year mortality. The American Society of Anesthesiologists (ASA) classification is the most commonly used classification for assessing preoperative health status. The ASA classification is only an indicator of physical condition; it is not a risk classification. This subjective classification is based on the patient's self-report [<span>3</span>].</p><p>“In considering drainage strategies for acute cholecystitis, a more detailed definition and discussion of ‘high-risk’ patients remains an important issue.”</p><p>Conceptualization: Salihoğlu Z. Writing – review &amp; editing: Salihoğlu E.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635501","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":"Preoperative Diagnosis of BilIN-3 Based on Peroral Cholangioscopy Leading to Pancreaticoduodenectomy in a Patient with Common Bile Duct Stones: A Case Report","authors":"Nana Shimamoto,&nbsp;Takahiro Abe,&nbsp;Masafumi Chiba,&nbsp;Masayuki Kato,&nbsp;Takeshi Gocho,&nbsp;Takako Kiyokawa,&nbsp;Kazuki Sumiyama","doi":"10.1002/deo2.70319","DOIUrl":"https://doi.org/10.1002/deo2.70319","url":null,"abstract":"<p>Biliary intraepithelial neoplasia (BilIN) is a precursor of bile duct adenocarcinoma that arises in the setting of chronic biliary or liver disease. Because BilIN spreads as a flat or micropapillary lesion, it is difficult to detect by imaging, and biopsy interpretation is often complicated by inflammation or prior instrumentation. Consequently, clinical knowledge remains limited, and standardized diagnostic protocols are lacking. A patient presented with acute cholangitis due to common bile duct (CBD) stones. During plastic stent placement, endoscopic retrograde cholangiopancreatography revealed irregular narrowing of the distal CBD. Peroral cholangioscopy (POCS) showed micropapillary epithelium extending from the bifurcation to the distal duct, progressively thickening the lumen. Pancreatoduodenectomy was performed, and pathology confirmed BilIN-3 with carcinoma in situ. Although BilIN has been visualized by POCS, most reports were descriptive. In this case, characteristic POCS findings guided pancreatoduodenectomy despite nondiagnostic biopsies. The clear correlation between POCS morphology and the final diagnosis underscores the clinical value of cholangioscopy in managing indeterminate distal bile duct strictures.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147579896","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 Case Report of Endoscopic Resection and Laparoscopic-assisted Retrieval of a Giant Brunner's Gland Hyperplasia","authors":"Kazunori Adachi,&nbsp;Chiharu Kawai,&nbsp;Miho Fujita,&nbsp;Hiroyuki Sakakibara,&nbsp;Tatsuya Kawamura,&nbsp;Taishi Takahara,&nbsp;Masahide Ebi,&nbsp;Naotaka Ogasawara,&nbsp;Makoto Sasaki,&nbsp;Masanao Nakamura","doi":"10.1002/deo2.70316","DOIUrl":"https://doi.org/10.1002/deo2.70316","url":null,"abstract":"<p>A 59-year-old man presented with left upper abdominal pain. Contrast-enhanced computed tomography suggested a duodenal intussusception and a mass with mixed fat and soft-tissue density extending from the duodenal bulb to the descending duodenum. Esophagogastroduodenoscopy identified a giant pedunculated lesion originating from the posterior wall of the duodenal bulb with a focal depressed area and marked redness. Narrow-band imaging showed no obvious epithelial neoplastic changes. An upper gastrointestinal series demonstrated an elevated lesion approximately 5 cm in size. Based on these findings, we suspected giant duodenal Brunner's gland hyperplasia. Endoscopic resection was performed under general anesthesia due to the risk of intussusception and potential malignant transformation. En bloc resection was achieved using a scissor-type endoscopic device with traction, and the specimen was safely retrieved under laparoscopic assistance with gentle compression. Histopathological examination revealed lobulated proliferation of Brunner's glands with fibrous septa and adipose tissue in the submucosa, confirming duodenal Brunner's gland hyperplasia.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147579833","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 2025","authors":"","doi":"10.1002/deo2.70317","DOIUrl":"https://doi.org/10.1002/deo2.70317","url":null,"abstract":"&lt;p&gt;The Editorial Board of DEN Open 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 DEN Open during the period of 1 January 2025 to 31 December 2025.&lt;/p&gt;&lt;p&gt;Takao Itoi&lt;/p&gt;&lt;p&gt;Editor-in-Chief&lt;/p&gt;&lt;p&gt;DEN Open&lt;/p&gt;&lt;p&gt;Hiroko Abe&lt;/p&gt;&lt;p&gt;Hiroyuki Abe&lt;/p&gt;&lt;p&gt;Yasuhiko Abe&lt;/p&gt;&lt;p&gt;Yoichi Akazawa&lt;/p&gt;&lt;p&gt;Teppei Akimoto&lt;/p&gt;&lt;p&gt;Ikuo Aoyama&lt;/p&gt;&lt;p&gt;Taiki Aoyama&lt;/p&gt;&lt;p&gt;Masanori Asada&lt;/p&gt;&lt;p&gt;Naoki Asano&lt;/p&gt;&lt;p&gt;Shinya Ashizuka&lt;/p&gt;&lt;p&gt;Maki Ayaki&lt;/p&gt;&lt;p&gt;Goksel Bengi&lt;/p&gt;&lt;p&gt;Michiel Bronswijk&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;Masahide Ebi&lt;/p&gt;&lt;p&gt;Makoto Eizuka&lt;/p&gt;&lt;p&gt;Masato Endo&lt;/p&gt;&lt;p&gt;Shungo Endo&lt;/p&gt;&lt;p&gt;Mitsuru Esaki&lt;/p&gt;&lt;p&gt;Shintaro Fujihara&lt;/p&gt;&lt;p&gt;Toshimitsu Fujii&lt;/p&gt;&lt;p&gt;Yuki Fujii&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;Shusei Fukunaga&lt;/p&gt;&lt;p&gt;Sadahiro Funakoshi&lt;/p&gt;&lt;p&gt;Kohei Funasaka&lt;/p&gt;&lt;p&gt;Shinya Furukawa&lt;/p&gt;&lt;p&gt;Ryunosuke Hakuta&lt;/p&gt;&lt;p&gt;Kenta Hamada&lt;/p&gt;&lt;p&gt;Tsuyoshi Hamada&lt;/p&gt;&lt;p&gt;Yasuhiko Hamada&lt;/p&gt;&lt;p&gt;Osamu Handa&lt;/p&gt;&lt;p&gt;Ryo Harada&lt;/p&gt;&lt;p&gt;Shinichi Hashimoto&lt;/p&gt;&lt;p&gt;Yoshitaka Hata&lt;/p&gt;&lt;p&gt;Yoshito Hayashi&lt;/p&gt;&lt;p&gt;Hisashi Hidaka&lt;/p&gt;&lt;p&gt;Akira Higashimori&lt;/p&gt;&lt;p&gt;Kazutoshi Higuchi&lt;/p&gt;&lt;p&gt;Takuma Higurashi&lt;/p&gt;&lt;p&gt;Susumu Hijioka&lt;/p&gt;&lt;p&gt;Takuto Hikichi&lt;/p&gt;&lt;p&gt;Makoto Hinokuchi&lt;/p&gt;&lt;p&gt;Yuichiro Hirai&lt;/p&gt;&lt;p&gt;Noriyuki Hirakawa&lt;/p&gt;&lt;p&gt;Kingo Hirasawa&lt;/p&gt;&lt;p&gt;Daizen Hirata&lt;/p&gt;&lt;p&gt;Takashi Hirose&lt;/p&gt;&lt;p&gt;Takashi Hisabe&lt;/p&gt;&lt;p&gt;Yasuki Hori&lt;/p&gt;&lt;p&gt;Akira Horiuchi&lt;/p&gt;&lt;p&gt;Yusuke Horiuchi&lt;/p&gt;&lt;p&gt;Kinichi Hotta&lt;/p&gt;&lt;p&gt;Shin Ichihara&lt;/p&gt;&lt;p&gt;Ryoji Ichijima&lt;/p&gt;&lt;p&gt;Katsuro Ichimasa&lt;/p&gt;&lt;p&gt;Chikamasa Ichita&lt;/p&gt;&lt;p&gt;Eikichi Ihara&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;Yohei Ikenoyama&lt;/p&gt;&lt;p&gt;Hajime Imai&lt;/p&gt;&lt;p&gt;Kenichiro Imai&lt;/p&gt;&lt;p&gt;Hiroshi Imaoka&lt;/p&gt;&lt;p&gt;Atsushi Inaba&lt;/p&gt;&lt;p&gt;Kazuya Inoki&lt;/p&gt;&lt;p&gt;Ken Inoue&lt;/p&gt;&lt;p&gt;Mikihiro Inoue&lt;/p&gt;&lt;p&gt;Tadahisa Inoue&lt;/p&gt;&lt;p&gt;Fumiaki Ishibashi&lt;/p&gt;&lt;p&gt;Hirotaka Ishida&lt;/p&gt;&lt;p&gt;Yusuke Ishida&lt;/p&gt;&lt;p&gt;Kazunaga Ishigaki&lt;/p&gt;&lt;p&gt;Shigeto Ishii&lt;/p&gt;&lt;p&gt;Yasutaka Ishii&lt;/p&gt;&lt;p&gt;Eri Ishikawa&lt;/p&gt;&lt;p&gt;Takuya Ishikawa&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;Satoshi Ito&lt;/p&gt;&lt;p&gt;Masahiro Itonaga&lt;/p&gt;&lt;p&gt;Naoto Iwai&lt;/p&gt;&lt;p&gt;Satoshi Iwai&lt;/p&gt;&lt;p&gt;Taro Iwatsubo&lt;/p&gt;&lt;p&gt;Yugo Iwaya&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;Shunsuke Kamba&lt;/p&gt;&lt;p&gt;Junichi Kaneko&lt;/p&gt;&lt;p&gt;Takashi Kanesaka&lt;/p&gt;&lt;p&gt;Takeshi Kanno&lt;/p&gt;&lt;p&gt;Yoshihide Kanno&lt;/p&gt;&lt;p&gt;Hiromitsu Kanzaki&lt;/p&gt;&lt;p&gt;Ryu Kanzaki&lt;/p&gt;&lt;p&gt;Yuki Kasahara&lt;/p&gt;&lt;p&gt;Chikatoshi Katada&lt;/p&gt;&lt;p&gt;Fumiya Kataoka&lt;/p&gt;&lt;p&gt;Motohiko Kato&lt;/p&gt;&lt;p&gt;Tsunetaka Kato&lt;/p&gt;&lt;p&gt;Nobuhiro Katsukura&lt;/p&gt;&lt;p&gt;Takehiko Katsurada&lt;/p&gt;&lt;p&gt;Koichiro Kawaguchi&lt;/p&gt;&lt;p&gt;Yujiro Kawakami&lt;/p&gt;&lt;p&gt;Noriyuki Kawami&lt;/p&gt;&lt;p&gt;Takuji Kawamura&lt;/p&gt;&lt;p&gt;Shintaro Kawasaki&lt;/p&gt;&lt;p&gt;Kousaku Kawashima&lt;/p&gt;&lt;p&gt;Noboru Kawata&lt;/p&gt;&lt;p&gt;Akihiko Kida&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;Hideaki Kinugasa&lt;/p&gt;&lt;p&gt;Koh Kitagawa&lt;/p&gt;&lt;p&gt;Yoko Kitamura&lt;/p&gt;&lt;p&gt;Hiroki Kiyohara&lt;/p&gt;&lt;p&gt;Kiyoyuki Koba","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615139","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":"Distinct Adenocarcinoma and Neuroendocrine Carcinoma Components (Suspected Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm) Identified by Targeted Biopsy Based on Differences in Endoscopic Findings in an Esophagogastric Junction Carcinoma: A Case Report","authors":"Kakeru Miyashita,&nbsp;Manabu Takeuchi,&nbsp;Takahiro Taguchi,&nbsp;Seiichi Yoshikawa,&nbsp;Keisuke Morita,&nbsp;Masaru Kumagai,&nbsp;Kazuki Natsui,&nbsp;Yohei Koseki,&nbsp;Natsuki Ishikawa,&nbsp;Erina Kodama","doi":"10.1002/deo2.70315","DOIUrl":"https://doi.org/10.1002/deo2.70315","url":null,"abstract":"<p>Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is a rare, highly malignant tumor comprising both neuroendocrine neoplasm (NEN) and non-neuroendocrine neoplasm (non-NEN) components. MiNEN arising at the esophagogastric junction (EGJ) is uncommon, and pretreatment identification of both components remains challenging. A man in his seventies presented with back pain and liver and bone metastases. Esophagogastroduodenoscopy revealed an erythematous, elevated lesion with central depression at the EGJ. Magnifying endoscopy with narrow-band imaging (ME-NBI) showed a granular microsurface (MS) pattern and a dense, irregular microvascular network in the elevated area, while the depressed area exhibited the absence of the MS pattern and fragmented, irregular microvessels. Biopsy of the elevated area revealed well-differentiated tubular adenocarcinoma, whereas the depressed area was positive for synaptophysin and CD56, consistent with neuroendocrine carcinoma (NEC). Although both components were clearly identified endoscopically and histopathologically, evaluation of the proportion of each component within the entire tumor was difficult based solely on biopsy specimens; the lesion was therefore diagnosed as EGJ carcinoma (suspected MiNEN). The patient achieved marked tumor shrinkage after the first course of irinotecan plus cisplatin chemotherapy, but treatment was discontinued due to adverse effects, and he ultimately died of disease progression. This rare case demonstrated identification of both adenocarcinoma and NEC components before treatment through detailed ME-NBI-guided biopsy, leading to suspicion of MiNEN. Precise endoscopic evaluation may play an important role in determining the therapeutic strategy.</p><p><b>Clinical Registration</b>: N/A</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147579898","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":"Choledocholithiasis Caused by a Migrated Surgical Clip 10 Years After Laparoscopic Cholecystectomy: A Case Report","authors":"Hirotaka Nomiya,&nbsp;Kazuya Ofuji,&nbsp;Hironori Naito,&nbsp;Takuto Nosaka,&nbsp;Arisa Tsuji,&nbsp;Ryotaro Sugata,&nbsp;Tadayoshi Otsuki,&nbsp;Seiichi Taguchi,&nbsp;Yasunari Nakamoto,&nbsp;Hiroyuki Suto","doi":"10.1002/deo2.70318","DOIUrl":"https://doi.org/10.1002/deo2.70318","url":null,"abstract":"<p>A 75-year-old man presented with epigastric pain 10 years after undergoing a laparoscopic cholecystectomy for acute calculous cholecystitis. Prior to surgery, severe inflammation necessitated ligation and clipping of the gallbladder neck. On admission, laboratory tests revealed elevated cholestatic liver enzyme levels and hyperbilirubinemia. Computed tomography (CT) revealed intrahepatic bile duct dilatation, multiple common bile duct (CBD) stones, and a metallic artifact in the distal CBD. Endoscopic retrograde cholangiopancreatography revealed multiple CBD stones and a linear radiopaque shadow. Abdominal radiography revealed the disappearance of two cholecystectomy clips, indicating that the surgical clips had migrated from the peritoneal cavity into the CBD. Endoscopic sphincterotomy was performed, followed by staged stone extraction. A basket catheter was used to retrieve a fractured cholesterol stone, revealing a surgical clip — confirmed to be the nidus — at its core. The remaining stones were fragmented and removed endoscopically, with an uneventful recovery. In contrast, the other missing clip was not identified on subsequent CT or plain radiography, suggesting possible spontaneous passage. This case illustrates that migrated surgical clips can act as a nidus for CBD stone formation, presenting as late-onset cholangitis even a decade after cholecystectomy.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615138","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 Removal of Superabsorbent Polymer Material Ingested From a Diaper: A Case Report and Review of the Literature","authors":"Ichiro Mizushima,&nbsp;Yuji Nakamura","doi":"10.1002/deo2.70314","DOIUrl":"https://doi.org/10.1002/deo2.70314","url":null,"abstract":"<p>A 75-year-old woman with dementia was hospitalized for open reduction and internal fixation of a right femoral stem periprosthetic fracture. While under postoperative observation, she ingested a large amount of disposable diaper material containing a superabsorbent polymer. Emergency endoscopic removal was performed on the same day. A large amount of polymer material was found in the stomach and removed using an endoscopic retrieval net. No post-procedural complications occurred. The patient was discharged from the hospital uneventfully.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147567723","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":"Evaluation of Visibility With an Eye-tracking System: Effectiveness of Narrow-Band Imaging for Detecting Colorectal Adenoma and Serrated Lesions","authors":"Moegi Mochizuki,&nbsp;Akiko Ohno,&nbsp;Shiori Tsubata,&nbsp;Ryutaro Sumi,&nbsp;Takahiro Shirakawa,&nbsp;Ryosuke Kaji,&nbsp;Yoko Jinbo,&nbsp;Yu Hada,&nbsp;Jun Miyoshi,&nbsp;Tadakazu Hisamatsu","doi":"10.1002/deo2.70311","DOIUrl":"https://doi.org/10.1002/deo2.70311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Image-enhanced endoscopy may reduce colorectal cancer mortality by improving lesion detection. Narrow-band imaging and texture and color enhancement imaging are widely used, but their diagnostic efficacy compared with white light imaging remains unclear. This study evaluated narrow-band imaging and texture and color enhancement imaging versus white light imaging for detecting colorectal lesions, including adenomas and serrated lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Images of 29 colorectal lesions (19 adenomas and 10 serrated lesions) measuring 10 mm or less were captured using white light imaging, narrow-band imaging, and texture and color enhancement imaging mode 1. Twelve endoscopists (six experts and six non-experts) identified lesions in randomly presented images while eye movements were recorded. Detection rates and times were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Detection rates for adenomas and serrated lesions did not differ significantly among white light imaging, narrow-band imaging, and texture and color enhancement imaging in either group. However, detection time varied significantly. Among experts, adenomas were detected faster with narrow-band imaging than with white light imaging and texture and color enhancement imaging; serrated lesions were detected faster with narrow-band imaging than with texture and color enhancement imaging. Among non-experts, narrow-band imaging also shortened detection time compared with white light imaging for both lesion types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Narrow-band imaging enables quicker detection of adenomas and serrated lesions than white light imaging and texture and color enhancement imaging for both experts and non-experts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147566127","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":"Utility of Combined Indigo Carmine and Red Dichromatic Imaging for Pit Pattern Diagnosis in Colorectal Lesions: A Comparison with Crystal Violet","authors":"Mitsunobu Saito,&nbsp;Shinji Yoshii,&nbsp;Takakazu Miyake,&nbsp;Tsukasa Yamakawa,&nbsp;Nobuaki Matsuda,&nbsp;Motonari Kamei,&nbsp;Tomomi Tateyama,&nbsp;Daisuke Takeuchi,&nbsp;Hiroshi Nakase","doi":"10.1002/deo2.70308","DOIUrl":"https://doi.org/10.1002/deo2.70308","url":null,"abstract":"<p>Crystal violet (CV) staining is the standard for diagnosing pit patterns in colorectal lesions; however, it has drawbacks such as complexity and potential carcinogenicity. This study aimed to evaluate whether combining indigo carmine (IC) with red dichromatic imaging (RDI) provides diagnostic performance comparable to CV.</p><p>Fifty colorectal lesions resected at a single institution were evaluated using magnified images obtained using three methods: IC alone, IC + RDI, and CV. One representative image from each method was selected for each lesion, yielding 150 randomized images. Three expert endoscopists and three trainees independently assessed the pit pattern diagnosis and visibility scores (5-point scale) as the primary evaluation parameters.</p><p>Across all lesions, no significant differences were observed in the inter-observer agreement rate of pit pattern diagnosis among the modalities in either group. However, for sessile serrated lesions (SSLs), IC + RDI tended to outperform CV in both groups. Regarding visibility scores, CV was significantly superior to RDI for both experts (4.33 vs. 3.67, <i>p</i> = 0.0014) and trainees (4.0 vs. 3.5, <i>p</i> = 0.019) across all lesions. For SSLs, experts evaluated visibility significantly higher for IC + RDI versus IC (4.67 vs 3.17, <i>p</i> = 0.021), although the difference between IC + RDI and CV was not significant.</p><p>In conclusion, IC+RDI improved pit visibility in SSLs and showed diagnostic agreement comparable to CV in experts. However, CV remained superior for carcinoma, particularly among trainees. IC+RDI may be considered a safe and practical option in selected settings, especially for improving pit visualization in SSLs.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147565329","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}