DEN open最新文献

{"title":"Efficacy of peroral endoscopic myotomy for improving sleep problems in patients with achalasia","authors":"Toshihiro Ohmiya,&nbsp;Hironari Shiwaku,&nbsp;Hiroki Okada,&nbsp;Akio Shiwaku,&nbsp;Suguru Hasegawa","doi":"10.1002/deo2.70064","DOIUrl":"10.1002/deo2.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Achalasia is an esophageal motility disorder of unknown etiology. However, no studies have determined the populations in which sleep problems occur and whether they are improved by peroral endoscopic myotomy (POEM). We investigated the rate of sleep problems assessed by GERD-Q (AGQ) in achalasia patients, evaluated whether POEM improves these issues, and identified factors associated with sleep improvement after POEM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed the data of patients who were diagnosed with achalasia and who underwent POEM at a single institution between March 2016 and December 2020. We examined the Eckardt symptom score and the GERD-Q before and 3 months after POEM to assess the presence of sleep problems (AGQ) and other symptoms. The univariate logistic regression analysis was performed to identify factors associated with sleep problem (AGQ) improvement after POEM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 177 patients were included. The average age was 52.6 ± 17.2 years. Preoperatively, dysphagia (172 [97.2%]), regurgitation (123 [69.5%]), sleep problems (AGQ; 110 [62.1%]), chest pain (102 [57.6%]), and weight loss (83 [46.9%]) were observed. Before POEM, 62.1% of patients experienced sleep problems (AGQ) compared with 9.6% after POEM (<i>p</i> &lt; 0.0001). Postoperative dysphagia and regurgitation were significant factors determining whether patients continued to experience sleep problems (AGQ) after POEM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sleep problems (AGQ) were the third most common symptom in &gt; 60% of patients with achalasia. Improving dysphagia and regurgitation using the POEM procedure improved sleep problems (AGQ).</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11746064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018731","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":"Correction to “Comparison of remimazolam and midazolam for sedation during colonoscopy in Japanese patients: A propensity score matching analysis”","authors":"","doi":"10.1002/deo2.70059","DOIUrl":"10.1002/deo2.70059","url":null,"abstract":"<p>Ogura K, Ichijima R, Ikehara H et al. Comparison of remimazolam and midazolam for sedation during colonoscopy in Japanese patients: A propensity score matching analysis. <i>DEN Open</i> 2024; <b>5</b>: e412.</p><p>In Tables 1 and 2, the <i>N</i> = 206 for the midazolam group and the <i>N</i> = 60 for the remimazolam group are incorrect. The correct numbers are <i>N</i> = 208 and <i>N</i> = 40. Accordingly, the adverse event rate for the remimazolam group in Table 2 is <i>n</i> = 1, 2.5%, and the correct <i>p</i>-value is 0.16.</p><p>The correct Table 1 and Table 2 are as follow.</p><p>We apologize for this error.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018644","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 study benchmarking colon polyp with computer-aided detection (CADe) software","authors":"Nikolaos Papachrysos,&nbsp;Pia Helén Smedsrud,&nbsp;Kim V. Ånonsen,&nbsp;Tor Jan D. Berstad,&nbsp;Håvard Espeland,&nbsp;Andreas Petlund,&nbsp;Per J. Hedenström,&nbsp;Pål Halvorsen,&nbsp;Jonas Varkey,&nbsp;Hugo L. Hammer,&nbsp;Michael A. Riegler,&nbsp;Thomas de Lange","doi":"10.1002/deo2.70061","DOIUrl":"10.1002/deo2.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Computer-aided detection software (CADe) has shown promising results in real-time polyp detection, but a limited head-to-head comparison of the available CADe systems has been performed. Moreover, such systems have not been compared to endoscopists using standardized videos. This study aims to compare the performance of three CADe systems in detecting polyps, employing a novel standardized methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Videos from 300 colonoscopies conducted at Oslo University Hospital were analyzed. Short video clips (20–45 s) presenting normal mucosa or polyps were randomly selected. These videos were then streamed through each CADe system from Medtronic, Olympus, and Augere Medical. Each system featured diverse configurations, resulting in a total of six software settings. Sensitivity and false positivity (FP) were assessed by comparing the CADe systems to both the mean of the systems and pairwise between them. Furthermore, the systems’ performance was compared to the performance of five endoscopists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CADe systems’ sensitivity ranged between 84.9% and 98.7%, with statistically significant differences observed between the systems, both in comparison to the mean and to each other. FP rates ranged between 1.2% and 5.6%, also differing statistically significantly between the systems. The CADe systems achieving the highest sensitivity also exhibited the highest FP. Statistically significant differences in the alert delay were observed between different CADe systems and endoscopists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights significant differences between commercially available CADe software regarding sensitivity and FP, but a superior performance compared to endoscopists. The software with the highest sensitivity also exhibited the highest FP, highlighting the need for further refinement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018643","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 diagnosis and management of eosinophilic esophagitis","authors":"Fumio Tanaka,&nbsp;Akinari Sawada,&nbsp;Sayaka Tanaka,&nbsp;Kenichi Kohashi,&nbsp;Yasuhiro Fujiwara","doi":"10.1002/deo2.70063","DOIUrl":"10.1002/deo2.70063","url":null,"abstract":"<p>Eosinophilic esophagitis is a chronic allergic inflammatory disease, and its incidence and prevalence have recently increased. Eosinophilic esophagitis has not become a rare disease; thus, knowledge for diagnosing it is needed in current clinical practice. The adequate management of endoscopic procedures is particularly important for the diagnosis and evaluation of inflammatory activity and therapeutic responses. The therapeutic options for eosinophilic esophagitis include anti-acid drugs such as proton pump inhibitors, potassium-competitive acid blockers, swallowed topical corticosteroids, biologics, and dietary elimination therapies. Moreover, endoscopic esophageal dilation is a therapeutic option for fibrotic strictures due to eosinophilic esophagitis to improve obstructive symptoms, such as dysphagia and food impaction. In this review, we describe the endoscopic characteristics of eosinophilic esophagitis, including an endoscopic reference score and an optimal biopsy protocol to diagnose and evaluate the therapeutic response. We also describe a current therapeutic management of eosinophilic esophagitis.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018732","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":"Usefulness and safety of remimazolam in upper gastrointestinal endoscopy: A comparative study between elderly and non-elderly patients","authors":"Ryoji Ichijima,&nbsp;Hisatomo Ikehara,&nbsp;Daisuke Yamaguchi,&nbsp;Yasuhiko Nagata,&nbsp;Kanako Ogura,&nbsp;Mitsuru Esaki,&nbsp;Yosuke Minoda,&nbsp;Hiroyuki Ono,&nbsp;Yuki Maeda,&nbsp;Shinsuke Kiriyama,&nbsp;Tetsuya Sumiyoshi,&nbsp;Yuichi Kanmura","doi":"10.1002/deo2.70057","DOIUrl":"10.1002/deo2.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In gastroenterology, sedation demand is increasing, although elderly patients are more prone to experiencing adverse events. Remimazolam, a novel ultra-short-acting benzodiazepine, may reduce recovery time after endoscopic procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a secondary analysis of the investigator-initiated trial, which investigated the efficacy and safety of remimazolam in gastrointestinal endoscopy (REM-IICT JP01). Remimazolam sedation was administered during upper gastrointestinal endoscopy. Patients were divided into two groups: 45 non-elderly and 11 elderly patients (aged ≥65 years). The primary outcome was sedation success. Secondary outcomes included the dose required for sedation, time to awakening, time to regain the ability to walk, and occurrence of adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Endoscopic sedation was successful in 95.6% of the non-elderly group and 100% of the elderly group. The total dose of remimazolam was significantly higher in the non-elderly group (4.0 [3.0–8.0] mg) than in the elderly group (3.0 [2.0–3.0] mg; <i>p</i> &lt; 0.01). The time to awakening was 0.0 (0.0–10.0) min in the non-elderly group compared to 0.0 (0.0–30.0) min (<i>p</i> = 0.98) in the elderly group. The time to regain the ability to walk was significantly longer in the elderly group (5.0 [0.0–60.0] min) than in the non-elderly group (5.0 [0.0–30.0] min; <i>p</i> = 0.03). During the procedure, adverse events included hypotension in two cases (4.4%) in the non-elderly group and hypoxemia in one case (9.0%) in the elderly group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Upper gastrointestinal endoscopy with remimazolam was effective and safe, regardless of age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018765","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 incisional balloon dilation combined with anti-scarring agents for postoperative esophageal anastomotic strictures","authors":"Ken Kumagai,&nbsp;Yutaka Takada,&nbsp;Ayaka Sugimoto,&nbsp;Shinjiro Sakagami,&nbsp;Yuri Akioka,&nbsp;Rie Mitani,&nbsp;Akihiro Oshima,&nbsp;Masayuki Kitade,&nbsp;Manami Oshiro,&nbsp;Sonoka Katsuyama,&nbsp;Shogo Ota,&nbsp;Kanna Adachi,&nbsp;Yukari Shimada,&nbsp;Motohito Hayashi,&nbsp;Atsushi Itami,&nbsp;Toshinao Itani","doi":"10.1002/deo2.70062","DOIUrl":"10.1002/deo2.70062","url":null,"abstract":"<p>The management of locally advanced esophageal cancer typically involves esophagectomy; however, postoperative complications, particularly anastomotic stricture, remain prevalent. Anastomotic stricture can severely compromise patients' quality of life by leading to difficulties in food intake. Although endoscopic balloon dilation has become a standard treatment for gastrointestinal strictures, its efficacy is often limited due to the risk of perforation and the potential for recurrent stricture, necessitating multiple interventions. Recent advancements have introduced endoscopic radial incision and cutting methods, which aim to enhance patency by excising scar tissue. We experienced a case resistant to the radial incision and cutting therapy, necessitating further intervention strategies. This report details our experience utilizing a novel technique, endoscopic incisional balloon dilation, which combines endoscopic incisional technique and balloon dilation therapy with anti-scarring medications, in cases of refractory anastomotic strictures following esophageal cancer resection. We present three challenging cases in which endoscopic incisional balloon dilation yielded significant clinical improvements, alongside supportive literature. Our findings suggest that endoscopic incisional balloon dilation is an effective and safer alternative to conventional methods, capable of addressing complex stricture scenarios while potentially enhancing patient outcomes and quality of life.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018738","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":"Post-endoscopic sphincterotomy delayed bleeding occurs in patients with just 1-day interruption of direct oral anticoagulants or hemodialysis","authors":"Sho Hasegawa,&nbsp;Yusuke Kurita,&nbsp;Yuma Yamazaki,&nbsp;Shinichi Nihei,&nbsp;Takeshi Iizuka,&nbsp;Noboru Misawa,&nbsp;Kunihiro Hosono,&nbsp;Itaru Endo,&nbsp;Noritoshi Kobayashi,&nbsp;Kensuke Kubota,&nbsp;Atsushi Nakajima","doi":"10.1002/deo2.70060","DOIUrl":"10.1002/deo2.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Endoscopic sphincterotomy (EST), especially when anticoagulants are used, carries a significant risk of delayed bleeding. However, the relationship between the use of antithrombotic agents, including direct oral anticoagulants, and post-EST bleeding remains unclear. This study aimed to identify the risk factors for post-EST delayed bleeding when antithrombotic agents were administered according to the guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed cases of patients who underwent endoscopic retrograde cholangiopancreatography and EST between January 2018 and August 2022, focusing on those with normal anatomy and naïve papillae. We examined the incidence of post-EST bleeding, endoscopic retrograde cholangiopancreatography procedure details, severity and timing of post-EST delayed bleeding, hemostatic interventions, and factors related to post-EST delayed bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 502 patients included, 76 (15%) were taking antithrombotic agents. Post-endoscopic retrograde cholangiopancreatography delayed bleeding was noted in seven patients (1.4%). Mild, moderate, and severe delayed bleeding occurred in four, one, and two cases, respectively. Hemostatic injection completely controlled cases of delayed bleeding. Multivariate analysis identified a 1-day direct oral anticoagulants interruption (odds ratio: 20.5, 95% confidence interval: 3.33–125, <i>p</i> = 0.0011) and dialysis (odds ratio: 38.7, 95% confidence interval: 2.4–624, <i>p</i> = 0.0099) as significant risk factors for delayed bleeding. No thromboembolic events related to the discontinuation of antithrombotic drugs were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A 1-day direct oral anticoagulants interruption and dialysis are independent risk factors for post-EST delayed bleeding, necessitating careful consideration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018670","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":"Role of balloon dilation test in identifying suitable candidates for gastric peroral endoscopic myotomy","authors":"Boldbaatar Gantuya,&nbsp;Haruhiro Inoue,&nbsp;Kazuki Yamamoto,&nbsp;Miyuki Iwasaki,&nbsp;Kei Ushikubo,&nbsp;Yohei Nishikawa,&nbsp;Hidenori Tanaka,&nbsp;Ippei Tanaka,&nbsp;Mayo Tanabe,&nbsp;Satoshi Abiko,&nbsp;Yuto Shimamura","doi":"10.1002/deo2.70049","DOIUrl":"10.1002/deo2.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Predicting successful outcomes of gastric peroral endoscopic myotomy (G-POEM) is essential for identifying patients who are most likely to benefit from the procedure. This study aimed to evaluate the utility of the balloon dilation test (BDT) in optimizing patient selection for G-POEM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted from February 2021 to December 2023, including patients with refractory gastroparesis unresponsive to conventional medical treatments. All patients completed the Gastroparesis Cardinal Symptom Index (GCSI) questionnaire before and after G-POEM. The pyloric ring balloon dilation test was performed prior to G-POEM, with only patients who showed a positive response included. Procedural and clinical outcomes were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients (three female and two male) with refractory gastroparesis were included. The median G-POEM procedure time was 60 minutes (interquartile range [IQR] 32.5–110), and technical success was achieved in all cases. At a median follow-up of 10 months (IQR 6–34), clinical response was observed in all patients (100%). The GCSI score improved significantly from a median of 17 (IQR 8–33) to 0 (IQR 0–4.5; <i>p</i> &lt; 0.03) indicating significant improvement in clinical symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A positive response to the balloon dilation test appears to be a reliable predictor of successful short-term outcomes following G-POEM in patients with refractory gastroparesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018759","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":"Identification of the course of plastic stent-induced pancreatic duct mucosal change in chronic pancreatitis using peroral pancreatoscopy (with video)","authors":"Kensuke Takuma,&nbsp;Naoki Okano,&nbsp;Yusuke Kimura,&nbsp;Koji Watanabe,&nbsp;Hiroki Nakagawa,&nbsp;Kensuke Hoshi,&nbsp;Masashi Miura,&nbsp;Naobumi Tochigi,&nbsp;Yoshinori Igarashi,&nbsp;Takahisa Matsuda","doi":"10.1002/deo2.70050","DOIUrl":"10.1002/deo2.70050","url":null,"abstract":"<p>Stent-induced ductal change is a complication of endoscopic treatment of the main pancreatic duct in chronic pancreatitis. Most previous reports have been based on morphological duct changes observed via pancreatography. Here, we describe a case of stent-induced ductal change in which the course of the mucosal changes was observed through peroral pancreatoscopy with a videoscopy.</p><p>The patient presented with chronic alcoholic pancreatitis. Main pancreatic duct stenosis in the pancreatic head was identified and a 10-Fr plastic stent was inserted. Follow-up pancreatography revealed a focally elevated duct change of approximately 4.5 mm at the distal tip of the stent, and peroral pancreatoscopy was performed. The elevated ductal change was identified as a clear villiform-like nodular mucosal change with the spread of pale papillary and granular mucosa. Reassessment after stent removal showed an improvement in the elevated mucosal lesion, with residual discoloration and mucosal retraction suggestive of scarring. The stent may cause irreversible changes, undetectable morphologically by pancreatography, likely underestimating stent-induced ductal change in chronic pancreatitis.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980956","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":"Novel gel-immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)","authors":"Noriaki Sugawara,&nbsp;Taro Iwatsubo,&nbsp;Yosuke Mori,&nbsp;Kazuki Takayama,&nbsp;Shun Sasaki,&nbsp;Noriyuki Nakajima,&nbsp;Hironori Tanaka,&nbsp;Akitoshi Hakoda,&nbsp;Satoshi Harada,&nbsp;Kazuhiro Ota,&nbsp;Toshihisa Takeuchi,&nbsp;Hiroki Nishikawa","doi":"10.1002/deo2.70056","DOIUrl":"10.1002/deo2.70056","url":null,"abstract":"<p>Endoscopic injection sclerotherapy (EIS) is a useful prophylactic hemostatic procedure for esophageal varices. However, injecting sclerosing agents into blood vessels is technically challenging and often ineffective. Gel-immersion EIS (GI-EIS) may facilitate easier intravascular sclerosing agent injection by dilating the varices and enhancing scope stability by maintaining low intra-gastrointestinal pressure. Therefore, we aimed to evaluate the effectiveness and safety of this procedure. This retrospective study included 18 patients (14 men and four women; median age, 70 years; age range, 18–83 years) who underwent GI-EIS at Osaka Medical Pharmaceutical University Hospital between December 1, 2022, and January 30, 2024. Patients who were at least 18 years of age at the time of treatment were included. No patients were excluded from the study. Thirty-four punctures were performed. The donor vessel angiography success rate was 88.2% (30 of 34 punctures). The clinical success rate was 94.4% (17 of 18 patients). Esophageal varices in most patients disappeared or were reduced by 1 month after treatment. Adverse events related to the procedure included fever (three patients) and chest pain (one patient); however, both were resolved with conservative treatment. No respiratory deterioration due to aspiration occurred during the procedure. The results of this study demonstrate that GI-EIS is a safe, clinically feasible, and effective treatment option for prophylactic hemostasis of esophageal varices.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980957","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}