DEN open最新文献

{"title":"Liver metastatic recurrence after curative endoscopic submucosal dissection for slightly submucosal invasive gastric cancer: A case report and literature review","authors":"Masahiro Niikawa,&nbsp;Teppei Akimoto,&nbsp;Kumiko Kirita,&nbsp;Yuji Yoshida,&nbsp;Tomomi Okubo,&nbsp;Korenobu Hayama,&nbsp;Tsutomu Hatori,&nbsp;Osamu Goto,&nbsp;Shunji Fujimori,&nbsp;Katsuhiko Iwakiri","doi":"10.1002/deo2.70041","DOIUrl":"https://doi.org/10.1002/deo2.70041","url":null,"abstract":"<p>In Japan, differentiated-type early gastric cancer with submucosal invasion &lt;500 µm, tumor diameter &lt;3 cm, no lymphovascular invasion, and negative resection margin are included in pathological curative criteria after endoscopic resection (ER). However, there are a few reports presenting local or metastatic recurrence after ER for the lesions described above. A 72-year-old man was diagnosed with early gastric cancer and underwent endoscopic submucosal dissection (ESD). Pathological diagnosis was well-differentiated tubular adenocarcinoma, 8 × 6 mm, T1b1(SM1; 428 µm below the muscularis mucosae), negative lymphovascular invasion, and negative resection margin, which was included in curative criteria. Eighteen months after ESD, the laboratory studies indicated an increase in carcinoembryonic antigen of 17.6 ng/mL (normal range &lt;5 ng/mL). While endoscopy showed no local recurrence finding, contrast-enhanced computed tomography (CT) showed a metastatic liver tumor in S4. Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging and ¹⁸F-fluorodeoxyglucose positron emission tomography/CT revealed metastatic liver tumors in S4, S5, and S8. The liver biopsy specimen showed tubular adenocarcinoma and the findings of immunochemical staining were similar to that of the specimen of prior ESD. Thus, he was diagnosed with multiple liver metastatic recurrences after curative ER. Currently, it has been 3 years and 5 months since ESD and 1 year and 11 months since liver metastatic recurrence, and the patient has survived receiving 5th-line systemic chemotherapy. Here, we report a rare case of liver metastatic recurrence 18 months after curative ESD for early gastric cancer.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362927","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":"Use of a short educational video to improve the accuracy of colorectal polyp morphology assessment: A multicenter randomized controlled study","authors":"Takahiro Utsumi,&nbsp;Takahiro Horimatsu,&nbsp;Yoshitaka Nishikawa,&nbsp;Akira Teramoto,&nbsp;Daizen Hirata,&nbsp;Mineo Iwatate,&nbsp;Shinwa Tanaka,&nbsp;Nobuaki Ikezawa,&nbsp;Masaya Esaki,&nbsp;Shozo Osera,&nbsp;Chikara Ebisutani,&nbsp;Hiroaki Saito,&nbsp;Nobukazu Agatsuma,&nbsp;Yukiko Hiramatasu,&nbsp;Yuki Nakanishi,&nbsp;Yasushi Sano,&nbsp;Hiroshi Seno","doi":"10.1002/deo2.70066","DOIUrl":"https://doi.org/10.1002/deo2.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although accurate assessment of polyp morphology helps endoscopists select the appropriate management for colorectal polyps, some studies have reported unsatisfactory accuracy in such assessment. This study aimed to clarify the usefulness of a short educational video available on the Internet for accurate polyp morphology assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a multicenter randomized controlled trial. Participants were randomly assigned to the pre- or post-education groups after a pre-test comprising images of 42 polyps, including 12 laterally spreading tumors. Participants who scored ≥ 80% on the pre-test were excluded. Only the post-education group completed the diagnostic test after watching an online educational video. The primary outcome was the difference in diagnostic accuracy between the pre-test and diagnostic tests for each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 296 endoscopists enrolled from 48 institutions, 34 missed the test deadline, and 29 who scored ≥ 80% in the pre-test were excluded. The primary outcome analysis sets were 117 and 116 in the pre- and post-education groups, respectively. The mean pre-test accuracies in the pre-education and post-education groups were 60.6% and 60.7%, respectively. The difference in diagnostic accuracy between the pre-test and diagnostic test was significantly higher in the post-education than the pre-education group (12.0 points, 95% confidence interval [CI] 9.9–14.1 and 2.3 points, 95% CI 0.9–3.6; <i>p </i>&lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This multicenter randomized controlled trial demonstrated the usefulness of a short educational video for accurate polyp morphology assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111088","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":"Detection of multiple signet ring cell carcinomas using texture and color enhancement imaging led to a diagnosis of hereditary diffuse gastric cancer","authors":"Jumpei Yamamoto,&nbsp;Akira Dobashi,&nbsp;Sei Adachi,&nbsp;Yuta Takano,&nbsp;Kenji Takeshita,&nbsp;Misayo Miyake,&nbsp;Masami Iwamoto,&nbsp;Shintaro Tsukinaga,&nbsp;Naoto Takahashi,&nbsp;Kazuki Sumiyama","doi":"10.1002/deo2.70071","DOIUrl":"10.1002/deo2.70071","url":null,"abstract":"<p>Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant cancer caused by <i>CDH1</i> mutation. HDGC causes multiple signet ring cell carcinomas (SRCCs) throughout the stomach. Few reports exist on the endoscopic findings during screening endoscopy, leading to the diagnosis of HDGC in its early stages. Recently, a new image-enhancement endoscopy technique, texture and color enhancement imaging (TXI), has been developed to improve the visibility of early gastric cancer. To the best of our knowledge, the use of TXI leading to HDGC diagnosis has not been reported. In this report, TXI contributed to the diagnosis of HDGC, and the patient was treated with total gastrectomy. A 27-year-old woman with a family history of gastric cancer underwent esophagogastroduodenoscopy, which revealed two pale lesions in the lower body of the stomach. Histological examination of the biopsy specimen revealed SRCC and the patient was referred to our hospital for treatment. Multiple lesions were found in the lower body using TXI, and a targeted biopsy confirmed other SRCCs. We suspected her disease to be HDGC, and the patient underwent a total gastrectomy. Histopathology showed multiple SRCCs (&gt;60), but no lymph node metastases. Genetic testing revealed <i>CDH1</i> mutations. The final pathological stage of the tumor was pT1a(m) N0M0 Stage I. TXI may be helpful in detecting multiple SRCCs in patients with HDGC. Endoscopists should be aware of HDGC, and careful investigation of the entire stomach is required for patients with diffuse-type gastric cancer before treatment.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082739","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":"Efficacy and safety of endoscopic ultrasonography-guided radiofrequency ablation of small pancreatic neuroendocrine neoplasms: A prospective, pilot study","authors":"Kazuyuki Matsumoto,&nbsp;Daisuke Uchida,&nbsp;Yasuto Takeuchi,&nbsp;Hironari Kato,&nbsp;Yuki Fujii,&nbsp;Kei Harada,&nbsp;Nao Hattori,&nbsp;Ryosuke Sato,&nbsp;Taisuke Obata,&nbsp;Akihiro Matsumi,&nbsp;Kazuya Miyamoto,&nbsp;Shigeru Horiguchi,&nbsp;Koichiro Tsutsumi,&nbsp;Kazuya Yasui,&nbsp;Ryo Harada,&nbsp;Masakuni Fujii,&nbsp;Motoyuki Otsuka","doi":"10.1002/deo2.70073","DOIUrl":"10.1002/deo2.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic ultrasonography (EUS)-guided radiofrequency ablation has recently been introduced as one of the management strategies for small pancreatic neuroendocrine neoplasms (PNENs). However, prospective data on its safety and efficacy remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective pilot study was conducted at Okayama University Hospital from May 2023 to December 2024. Patients with grade 1 PNENs ≤15 mm, confirmed by EUS-guided fine-needle aspiration, were included. The primary endpoint was safety (adverse events [AEs] evaluated according to the 2010 guidelines of the American Society for Gastrointestinal Endoscopy. Severe AEs were defined as moderate or higher in American Society for Gastrointestinal Endoscopy grading and grade ≥3. Secondary endpoints included efficacy (complete response on contrast-enhanced computed tomography at 1 and 6 months), treatment details, device failure, diabetes mellitus exacerbation, and overall survival at 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients with non-functional PNENs (median age: 64 years; median tumor size: 10 mm) were treated. AEs occurred in two patients (40%, 2/5), although none was severe. Both patients developed asymptomatic pseudocysts, one experienced mild pancreatitis, and both resolved with conservative treatment. The complete response rates on contrast-enhanced computed tomography at one and 6 months were 100%. The median procedure time was 16 min without any device failure, and the median hospitalization was 5 days. None of the patients developed new-onset or worsening diabetes mellitus. The 6-month overall survival rate was 100%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EUS-guided radiofrequency ablation demonstrated a high complete response rate with no severe AEs in this pilot study, suggesting a minimally invasive option for small, low-grade PNENs (jRCTs062230014).</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070243","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":"Successful treatment with hyperbaric oxygen therapy for ulcerative esophageal stricture after chemoradiotherapy: A case report","authors":"Tetsuyuki Tateda,&nbsp;Hidezumi Kikuchi,&nbsp;Keisuke Furusawa,&nbsp;Yusuke Matsuoka,&nbsp;Taka Asari,&nbsp;Yohei Sawada,&nbsp;Satoru Nakagawa,&nbsp;Tatsuta Tetsuya,&nbsp;Daisuke Chinda,&nbsp;Hirotake Sakuraba","doi":"10.1002/deo2.70072","DOIUrl":"10.1002/deo2.70072","url":null,"abstract":"<p>Severe esophageal strictures resulting from chemoradiotherapy pose persistent therapeutic challenges despite the availability of treatments such as endoscopic balloon dilation and medications. Hyperbaric oxygen therapy (HBOT) has emerged as a promising treatment option for refractory radiation-induced injury to several organs. Herein, we present the case of a 79-year-old male patient with refractory radiation-induced ulcerative esophageal strictures after chemoradiotherapy. Despite multiple interventions, including endoscopic balloon dilation, steroids, and proton-pump inhibitors, the patient remained unable to tolerate oral intake. HBOT was initiated, leading to significant improvement in the esophageal ulcers and strictures within 1 month. HBOT was well tolerated; the patient experienced a sustained improvement in his quality of life. Two years after HBOT, esophagogastroduodenoscopy confirmed persistent improvement in esophageal ulcers and strictures. This case highlights the potential of HBOT as a therapeutic option for ulcerative esophageal strictures unresponsive to conventional treatments.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070267","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":"Efficacy of e-learning using video content in improving trainees’ biliary cannulation skills and understanding (with video)","authors":"Junichi Kaneko,&nbsp;Yosuke Kobayashi,&nbsp;Masaki Takinami,&nbsp;Masaharu Kimata,&nbsp;Masafumi Nishino,&nbsp;Yurimi Takahashi,&nbsp;Yashiro Yoshizawa,&nbsp;Go Murohisa,&nbsp;Yoshisuke Hosoda,&nbsp;Takanori Yamada","doi":"10.1002/deo2.70068","DOIUrl":"10.1002/deo2.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>E-learning with video content was created to improve trainees’ biliary cannulation techniques; this study aimed to evaluate its educational effect prospectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>E-learning program was conducted using videos demonstrating biliary cannulation for 24 papillae, targeting trainees with 2–6 years of experience in endoscopic retrograde cholangiopancreatography. Ten consecutive cases of biliary cannulation for native papillae performed by trainees were prospectively assessed before and after the e-learning, respectively. The primary outcome was the difficult biliary cannulation rate; the secondary outcomes included a comprehension score assigned by the trainer for each biliary cannulation (maximum of 6 points), trainee failure rate, and adverse events incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven trainees participated in the e-learning program. The overall and per-trainee analyses showed no significant differences in the difficult biliary cannulation rate, trainee failure rate, and adverse event incidence before and after e-learning. However, the overall analysis showed a significant increase in comprehension scores after e-learning (median 4 vs. 5, <i>p </i>&lt; 0.01) and the per-trainee analysis revealed that the rate of comprehension score ≥5 increased significantly after e-learning (<i>p </i>= 0.02). Comprehension score &lt;5 (odds ratio: 4.31, <i>p </i>&lt; 0.01) and endoscopic retrograde cholangiopancreatography experience &lt;3 years (odds ratio: 2.15, <i>p = </i>0.01) were independent risk factors for difficult biliary cannulation. Additionally, the difficult biliary cannulation incidence showed a negative correlation with the comprehension score (<i>p </i>&lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>E-learning using video content did not result in a reduction in the difficult biliary cannulation rate. However, it significantly enhanced procedural understanding, indicating its potential to support future acquisition of biliary cannulation skills.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070247","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":"Reopenable clip over-the-line method in endoscopic full-thickness resection of gastric submucosal tumors: A historical control study","authors":"Satoki Shichijo,&nbsp;Noriya Uedo,&nbsp;Hitoshi Mori,&nbsp;Yushi Kawakami,&nbsp;Yasuhiro Tani,&nbsp;Hiroyoshi Iwagami,&nbsp;Minoru Kato,&nbsp;Shunsuke Yoshii,&nbsp;Takashi Kanesaka,&nbsp;Koji Higashino,&nbsp;Tomoki Michida,&nbsp;Ryu Ishihara,&nbsp;Naoki Shinno,&nbsp;Hisashi Hara,&nbsp;Yoshitomo Yanagimoto,&nbsp;Kazuyoshi Yamamoto,&nbsp;Takeshi Omori","doi":"10.1002/deo2.70067","DOIUrl":"10.1002/deo2.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic full-thickness resection for gastric submucosal tumors is gradually gaining popularity, and secure and amenable closure is key to its success. This study aimed to compare the reopenable clip over-the-line method with the purse-string method for defect closure after endoscopic full-thickness resection for gastric submucosal tumors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This historical control trial included 37 consecutive patients with 37 gastric submucosal tumors, who underwent endoscopic full-thickness resection between January 2021 and July 2024. All lesions were resected en bloc. After excluding three patients who underwent non-full-thickness resection, 34 patients were analyzed. Post-endoscopic full-thickness resection defects were closed using the purse-string method (<i>n</i> = 18) until 2022 and the reopenable clip over-the-line method (<i>n</i> = 16) from 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median (interquartile range) time for defect closure was longer in the reopenable clip over-the-line method group of 33 (31–57) min than in the purse-string method group of 26 (24–35) min (<i>p</i> = 0.013). The visual analog scale pain score at the umbilical region was lower (<i>p</i> = 0.048) after the reopenable clip over-the-line method than after the purse-string method. In the reopenable clip over-the-line method group, post-procedural abdominal pain was confined to the epigastrium, whereas it extended to the umbilical or left lateral regions in the purse-string method group. The reopenable clip over-the-line method group commenced the diet (<i>p</i> = 0.001) and discharged (<i>p</i> = 0.024) earlier than the purse-string method group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Reopenable clip over-the-line method facilitated secure post-endoscopic full-thickness resection defect closure, reduced post-procedural abdominal pain, and shortened the fasting and hospitalization periods after endoscopic full-thickness resection in gastric submucosal tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070264","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":"Peroral endoscopic myotomy for complex achalasia and the POEM difficulty score: An update","authors":"Carmen Ching Hui Yee,&nbsp;Michael Youssef,&nbsp;Matthew Woo,&nbsp;Robert Bechara","doi":"10.1002/deo2.70055","DOIUrl":"10.1002/deo2.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We present an update on the (peroral endoscopic myotomy (POEM) difficulty score [PDS] by introducing a novel knife with waterjet functionality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective review of patients who underwent POEM between May 2018 and July 2023 at the Kingston Health Sciences Center. Demographic and procedural variables were compared using descriptive and inferential statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred thirty-nine consecutive POEMs were included in the study. Seventy-four (56.7% male; aged 56.7 ± 16.5 years) complex achalasia (CA) and 65 (55.4% female; aged 47.3 ± 20.2 years) non-CA POEM procedures were performed. PDS correlates moderately with procedural efficiency with a correlation coefficient of 0.595 (Spearman's <i>p</i> &lt; 0.001). The mean efficiency for non-CA was 3.3 ± 1.2 min/cm compared to CA as follows: type III 3.3 ± 1.3 min/cm; prior myotomy 5.3 ± 2.3 min/cm; ≧4 prior procedures 4.0 ± 1.7 min/cm; sigmoid type 5.2 ± 2.4 min/cm. The median PDS for non-CA was 1 (1–5). In comparison, the median PDS for CA is as follows: type III 3 (2–4); prior myotomy 4 (3–5); ≧4 prior procedures 3 (1.25–4); sigmoid type 3 (2–4). PDS excluding the presence of spastic contractions correlated better with procedural velocity, with a correlation coefficient of 0.645 (Spearman's <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PDS continues to moderately correlate with procedural efficiency using the novel knife. The presence of spastic contractions correlated poorly with procedural efficiency. Thus, it may be omitted in further studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049141","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":"Dual snare endoscopic extraction of a gastric foreign body using a dual-channel endoscope","authors":"Amitjeet Singh,&nbsp;Edward Young,&nbsp;Rajvinder Singh","doi":"10.1002/deo2.70065","DOIUrl":"10.1002/deo2.70065","url":null,"abstract":"<p>Foreign body ingestion, though rare, poses significant health risks, with 10%–20% of cases requiring endoscopic intervention. This article presents a novel case of a 16-year-old female who ingested a cigarette lighter, leading to abdominal pain and radiographic confirmation of a gastric foreign body. Initial attempts at retrieval using grasping forceps and snares were unsuccessful due to the object's size and shape, risking potential complications. We employed a dual-channel endoscope utilizing a push-pull technique with two snares, one capturing the blunt end and the other the sharp edge of the lighter. This method facilitated safe extraction through the gastroesophageal junction without causing trauma. This case highlights the efficacy of dual snares in the endoscopic retrieval of challenging foreign bodies and emphasizes the importance of appropriate techniques in preventing complications during such procedures.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049122","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 use of endoscopic ultrasound in tandem with endoscopic retrograde cholangiopancreatography in the 2019 American Society for Gastrointestinal Endoscopy guideline for patients at high risk of choledocholithiasis can help to avoid diagnostic endoscopic retrograde cholangiopancreatography in individuals without ascending cholangitis","authors":"Apichet Sirinawasatien,&nbsp;Jiravit Chanchairungcharoen,&nbsp;Thanapon Yaowmaneerat,&nbsp;Jirat Jiratham-opas,&nbsp;Kanokpoj Chanpiwat,&nbsp;Tanyaporn Chantarojanasiri,&nbsp;Siriboon Attasaranya,&nbsp;Kannikar Laohavichitra,&nbsp;Jerasak Wannaprasert,&nbsp;Thawee Ratanachu-ek","doi":"10.1002/deo2.70058","DOIUrl":"10.1002/deo2.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Choledocholithiasis is the leading cause of biliary pancreatitis and biliary sepsis. Endoscopic retrograde cholangiopancreatography (ERCP) is considered a minimally invasive treatment for choledocholithiasis. However, diagnostic ERCP should be avoided. We conducted a prospective trial in high-risk choledocholithiasis patients based on the American Society for Gastrointestinal Endoscopy (ASGE) 2019 criteria to investigate the diagnostic accuracy of the current guideline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter, prospective cohort study included 240 consecutive patients. The primary outcome was the performance of the criteria in predicting choledocholithiasis. The secondary outcome was a percentage reduction in diagnostic ERCP when endoscopic ultrasound was used in tandem with ERCP in individuals without ascending cholangitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall criteria revealed a positive common bile duct (CBD) stone in 87.1% of patients. Regarding the diagnostic performance of each criterion, ascending cholangitis had a specificity of 67.7% and a positive predictive value (PPV) of 90.2%; total bilirubin &gt;4 mg/dL and dilated CBD had a specificity of 74.2% and a PPV of 55.6%; and CBD stone on ultrasound/cross-sectional imaging had a specificity of 58.1% and a PPV of 89.2%. Of the 138 patients without ascending cholangitis who met the other two high-risk criteria and were sent for EUS first, 21 cases (15.2%) were able to avoid a diagnostic ERCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current ASGE 2019 criteria yield acceptable choledocholithiasis diagnostic accuracy. Using endoscopic ultrasound to confirm CBD stones before ERCP can help almost half of patients with the specific condition of total bilirubin &gt;4 mg/dL and dilated CBD to avoid diagnostic ERCP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026228","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}