DEN open最新文献

{"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}

{"title":"Multiple esophageal ulcers in a pediatric case of granulomatosis with polyangiitis: A case report","authors":"Yuki Kimura,&nbsp;Takashi Ishige,&nbsp;Takuya Nishizawa,&nbsp;Yoshiko Igarashi,&nbsp;Yoshihito Saito,&nbsp;Ryusuke Yagi,&nbsp;Maiko Tatsuki,&nbsp;Reiko Hatori,&nbsp;Hayato Ikota,&nbsp;Takumi Takizawa","doi":"10.1002/deo2.70089","DOIUrl":"https://doi.org/10.1002/deo2.70089","url":null,"abstract":"<p>A 14-year-old girl presented with diarrhea and bloody stools was initially diagnosed with infectious colitis and anal fissure. The patient was treated with antibiotics; however, the symptoms persisted and purpura appeared on the patient's lower abdomen. Abdominal computed tomography indicated diffuse wall thickening of the entire colon. A colonoscopy revealed extensive edema, several ulcers, and mucosal friability, resulting in the diagnosis of ulcerative colitis. Blood tests revealed hypoalbuminemia, increased inflammatory marker levels, and high proteinase3 anti-neutrophil cytoplasmic antibody (PR3-ANCA) levels. Urinalysis showed hematuria and casts, raising the suspicion of concurrent vasculitis syndrome. Esophagogastroduodenoscopy revealed multiple punched-out ulcers in the esophagus. Granulomatosis with polyangiitis with gastrointestinal involvement was diagnosed combined with the positive PR3-ANCA results and skin and renal involvement. Steroid therapy was initiated, leading to the rapid improvement of diarrhea, purpura, and esophageal ulcers. While high PR3-ANCA levels are occasionally observed in ulcerative colitis, esophageal ulcers in patients with granulomatosis with polyangiitis often result in poor symptoms. Thus, esophagogastroduodenoscopy should be considered in patients with high PR3-ANCA levels, even in the absence of upper gastrointestinal symptoms.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497318","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 risk factors to inform early detection of gastric cancer after Helicobacter pylori eradication: Meta-analysis and systematic review","authors":"Masaaki Kodama,&nbsp;Osamu Handa,&nbsp;Mitsushige Sugimoto,&nbsp;Takahiro Kotachi,&nbsp;Masaaki Kobayashi,&nbsp;Susumu Take,&nbsp;Shu Hoteya,&nbsp;Katsuhiro Mabe,&nbsp;Takahisa Murao,&nbsp;Ken Namikawa,&nbsp;Takashi Kawai,&nbsp;Kazunari Murakami,&nbsp;Research committee for the Establishment of Risk Evaluation of Gastric Cancer after H. pylori Eradication in Endoscopic Findings, The Japanese Society for Helicobacter Research, Japan","doi":"10.1002/deo2.70086","DOIUrl":"https://doi.org/10.1002/deo2.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> eradication reduces but cannot eliminate the risk of gastric cancer (GC). The prevalence of post-eradication GC has been rising. Characterization of the endoscopic findings of post-eradication GC may facilitate its early detection. We performed a meta-analysis and systematic review to clarify endoscopic risk factors to accelerate the early diagnosis of post-eradication GC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medline and PubMed were searched for randomized controlled trials, cohort studies, and case-control studies published in the English-language medical literature between January 1997 and July 2023. The included articles assessed the correlation between post-eradication GC and pre- and post-eradication endoscopic findings, and associated post-eradication GC with gastric atrophy, intestinal metaplasia (IM), map-like redness, and xanthoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 963 articles were retrieved. In these articles, 66 papers were finally included, comprising randomized controlled trials, cohort studies, and case-control studies. The included articles addressed gastric atrophy (16 studies), IM (eight studies), map-like redness (six studies), and xanthoma (two studies). Risk ratio (RR) of incident post-eradication GC was 3.40 (95%confidence interval [95%CI]: 1.98–5.84; <i>p </i>&lt; 0.001) in cases of severe atrophy, 5.38 (95%CI: 3.62–8.00) in cases of severe IM, 2.34 (95%CI: 1.16–4.68) in cases with post-eradication map-like redness, and 2.75 (95% CI: 1.78–4.26) in cases with xanthoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endoscopic atrophy, IM, and xanthoma observed at pre- and post-eradication time points and post-eradication map-like redness were suggested as endoscopic risk factors for post-eradication GC. Further studies are needed to clarify the risk of post-eradication GC based on these risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497316","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":"Proton pump inhibitor-induced large gastric polyps can regress within 2 months after discontinuation: Experience from two cases","authors":"Tomoki Inaba,&nbsp;Kenji Yamauchi,&nbsp;Shigenao Ishikawa,&nbsp;Hugh Shunsuke Colvin,&nbsp;Koichi Izumikawa,&nbsp;Kumiko Yamamoto,&nbsp;Sakuma Takahashi,&nbsp;Masaki Wato,&nbsp;Satoko Nakamura,&nbsp;Seiji Kawano","doi":"10.1002/deo2.70090","DOIUrl":"https://doi.org/10.1002/deo2.70090","url":null,"abstract":"<p>The long-term use of proton pump inhibitors (PPIs) can induce fundic gland polyps (FPs) in the stomach, sometimes leading to numerous large FPs (LFPs). Although PPI discontinuation can reduce LFP size and number, the underlying process remains unstudied.</p><p>A 63-year-old woman on esomeprazole (20 mg daily for 10 years) was scheduled for endoscopic LFP removal. After PPI discontinuation, her LFPs regressed to &lt;10 mm within 35 days. A 60-year-old male physician on rabeprazole (10 mg daily for 12 years) had LFPs detected via esophagogastroduodenoscopy screening. He opted for weekly esophagogastroduodenoscopy with pathological evaluations to monitor changes post-discontinuation.</p><p>One week after PPI withdrawal, gastric juice acidity and viscosity increased, with erosion observed on nearly all LFP surfaces. By day 35, all LFPs regressed and resembled sporadic FPs. This study demonstrated that PPI-induced LFPs regress within a short period post-discontinuation and suggests that LFP volume reduction is linked to gastric environment changes, particularly increased acidity.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497317","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 features of gastric neuroendocrine tumors","authors":"Katsunori Matsueda,&nbsp;Noriya Uedo,&nbsp;Masanori Kitamura,&nbsp;Takashi Kanesaka,&nbsp;Muneshin Morita,&nbsp;Satoki Shichijo,&nbsp;Akira Maekawa,&nbsp;Yoji Takeuchi,&nbsp;Koji Higashino,&nbsp;Tomoki Michida,&nbsp;Ryu Ishihara,&nbsp;Seiji Kawano,&nbsp;Motoyuki Otsuka","doi":"10.1002/deo2.70088","DOIUrl":"https://doi.org/10.1002/deo2.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The endoscopic features of gastric neuroendocrine tumors (G-NETs) remain unclarified. The present study investigated the endoscopic features of G-NETs in relation to the clinicopathological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed consecutive patients with G-NETs who received endoscopic or surgical treatment between January 2005 and December 2023. The endoscopic and clinicopathological findings of the lesions were analyzed to provide diagnostic information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 29 patients, the characteristic endoscopic findings of G-NETs on white-light images were reddish color (66%), dilated vessels (83%), submucosal tumor-like marginal elevation (59%), and central depression (48%). The gross appearance of G-NETs was classified into two macroscopic subtypes: reddish polypoid lesions (<i>n</i> = 17) and submucosal tumor-like lesions (<i>n</i> = 9). Magnifying narrow-band imaging endoscopy revealed an absent microsurface pattern plus an irregular microvascular pattern in all cases of reddish polypoid lesions with central depressions (100%, 9/9). The findings of a reddish polypoid lesion and an absent microsurface pattern plus an irregular microvascular pattern corresponded to the subepithelial NET component close to the non-neoplastic surface epithelium. Additionally, reddish polypoid lesions were significantly more frequent in type 1 G-NETs than in type 3 G-NETs (80% vs. 11%, <i>p </i>&lt; 0.001), while submucosal tumor-like lesions were significantly more frequent in type 3 G-NETs than in type 1 G-NETs (78% vs. 10%, <i>p </i>&lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These endoscopic features should increase the index of suspicion and help clinicians to correctly diagnose G-NETs through the pathological examination of biopsy specimens.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497319","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 retrograde cholangiopancreatography and endoscopic cystogastrostomy in very young children (aged <5 years): Feasibility, success, and safety","authors":"Ujjal Poddar,&nbsp;Arghya Samanta,&nbsp;Samir Mohindra,&nbsp;Vijay Datta Upadhyaya,&nbsp;Basant Kumar,&nbsp;Anshu Srivastava,&nbsp;Moinak Sen Sarma,&nbsp;Surender Kumar Yachha","doi":"10.1002/deo2.70085","DOIUrl":"https://doi.org/10.1002/deo2.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Paucity of data and concerns about potential lower effectiveness and more adverse events limit the use of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic cystogastrostomy in younger children even in high-volume centers. We retrospectively analyzed indications, success rates, and adverse events of all the children (&lt;18 years) who underwent ERCP and endoscopic cystogastrostomy between January 2010 to May 2024 at our center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data, including patient demographics, indications for the procedure, technical details, and adverse events, were collected from our prospectively kept database and compared according to age groups (&lt;1 year, 1–5 years, 5–10 years, and 10–18 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 286 ERCP (273 therapeutic and 13 diagnostic) and 57 endoscopic cystogastrostomy were performed in 222 (138 boys) and 55 children (32 boys), respectively, during the study period with 20% ERCP procedures in under-five children. In children &lt;5 years, the majority of the ERCPs were for biliary diseases (87%), while pancreatic duct procedures (39.5%) were done in higher numbers in children &gt;5 years. For biliary ERCP, choledochal cyst (15, 33%) was the most common etiology in under-five children and choledocholithiasis (60, 34%) in children &gt;5 years. Cannulation and technical success rates were 95% and 92%, respectively with no significant difference across age groups. Adverse events were noted in 36 (16%) with post-ERCP pancreatitis (8%) being the most common. All adverse events were managed conservatively with no mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ERCP can safely be performed in all children, including those under five with various hepato-pancreato-biliary diseases with high technical success rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475416","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}