DEN open最新文献

{"title":"Complications of Endoscopic Pressure Study Integrated System: Review of 1205 Cases in 10 Years’ Experience","authors":"Miyuki Iwasaki,&nbsp;Ippei Tanaka,&nbsp;Haruhiro Inoue,&nbsp;Masachika Saino,&nbsp;Kei Ushikubo,&nbsp;Kazuki Yamamoto,&nbsp;Yohei Nishikawa,&nbsp;Kaori Owada,&nbsp;Satoshi Abiko,&nbsp;Mayo Tanabe","doi":"10.1002/deo2.70173","DOIUrl":"https://doi.org/10.1002/deo2.70173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The Endoscopic Pressure Study Integrated System (EPSIS) is a novel endoscopic tool to assess lower esophageal sphincter (LES) function by monitoring intragastric pressure (IGP) through insufflation. While previous studies have confirmed its diagnostic utility for LES dysfunction-related disorders such as gastroesophageal reflux disease and achalasia, there have been no reports evaluating its safety. Thus, this study aimed to assess its complication rates and detailed characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 1205 consecutive EPSIS cases performed between December 2015 and September 2024 at our institution. Cases with adverse events (AEs) were identified, and clinical characteristics, waveform patterns, IGP parameters, and need for additional treatment were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AEs occurred in 35 cases (2.9%), including 32 cases (2.7%) of micro-mucosal bleedings (MMBs) and three cases (0.25%) of superficial mucosal tears (SMTs). All cases were minor (Clavien-Dindo grade I), without the need for any additional intervention. All 35 cases exhibited an uphill waveform. SMTs were associated with pressure spikes due to vomiting or belching. No serious AEs, including perforations or active bleeding, were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EPSIS is a safe and minimally invasive procedure, with low complication rates comparable to routine upper endoscopy. To maintain its safety, EPSIS should be performed under sedation with CO₂ insufflation. In addition, insufflation during EPSIS should be controlled so that the IGP is maintained less than 25 mmHg. However, this threshold may vary depending on the patient's underlying conditions or clinical background; therefore, further research is warranted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635250","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":"Improving Operator Depth Vision in Gastrointestinal Endoscopy: A Pilot Study of a New Three-dimensional Imaging System","authors":"Xiaoqing Lin,&nbsp;Kohei Ono,&nbsp;Ken Ohata,&nbsp;Etsuko Yamabe,&nbsp;Hidenori Eida,&nbsp;Miyuzen Kanamori,&nbsp;Naoki Tomita,&nbsp;Toshifumi Iida,&nbsp;Susumu Banjoya,&nbsp;Tomoya Kimura,&nbsp;Hiroshi Yamazaki,&nbsp;Koichi Furuta,&nbsp;Nao Takeuchi,&nbsp;Yoshiaki Kimoto,&nbsp;Yuki Kano,&nbsp;Yohei Minato,&nbsp;Shunya Takayanagi,&nbsp;Shinya Nagae,&nbsp;Yohei Ito,&nbsp;Ryoju Negishi,&nbsp;Eiji Sakai,&nbsp;Hideyuki Chiba,&nbsp;Zhen Ding","doi":"10.1002/deo2.70174","DOIUrl":"https://doi.org/10.1002/deo2.70174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Traditional two-dimensional (2D) gastrointestinal endoscopy lacks depth perception, leading to potential diagnostic errors. This study evaluates a novel software-based three-dimensional (3D) endoscopy system that converts 2D images into 3D, compatible with existing endoscopes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized comparative study was conducted with 32 endoscopists at NTT Medical Center. Participants were assigned to perform snaring tasks using either 2D or 3D imaging in short- and long-distance scenarios. Success rates in first attempts were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the long-distance scenario, the first-attempt success rate was significantly higher in the 3D group (53.13%) compared to the 2D group (21.88%, <i>p</i> = 0.01). The 3D system provided a notable improvement in depth perception and distance judgment, especially for less experienced endoscopists. No significant difference was observed in the time per attempt between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The new 3D system enhances depth perception and distance judgment, particularly benefiting less experienced endoscopists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635251","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 Endoscopic Ultrasound-guided Gastroenterostomy for Benign Gastric Outlet Obstruction","authors":"Suprabhat Giri,&nbsp;Saroj Kanta Sahu,&nbsp;Gaurav Khatana,&nbsp;Prasanna Gore,&nbsp;Preetam Nath,&nbsp;Bipadabhanjan Mallick,&nbsp;Jimmy Narayan,&nbsp;Aditya Kale,&nbsp;Sridhar Sundaram","doi":"10.1002/deo2.70170","DOIUrl":"https://doi.org/10.1002/deo2.70170","url":null,"abstract":"<p>Benign gastric outlet obstruction (GOO) often results from intrinsic conditions like peptic strictures, caustic-induced stricture, and surgical anastomoses, and extrinsic conditions like pancreatitis, hematoma, and superior mesenteric artery syndrome. While traditional management involved surgery or endoscopic balloon dilation, endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a minimally invasive alternative using lumen-apposing metal stents (LAMS). We aimed to summarize the currently available literature on EUS-GE in treating benign GOO. EUS-GE demonstrates high technical success rates, ranging from 95% to 100%, and significant clinical success, typically exceeding 80% in patients with benign GOO. It offers advantages by bypassing the obstruction and potentially providing longer-lasting relief compared to enteral stenting without the morbidity of surgery. Furthermore, it can serve as a bridge to definitive treatment, allowing for nutritional optimization before surgery or resolution of the underlying condition with subsequent stent removal in a notable proportion of patients. Despite the high efficacy, EUS-GE is associated with multiple adverse events like maldeployment, bleeding, and ascites with or without infection. Thus, EUS-GE is a promising and effective minimally invasive modality for managing benign GOO, particularly in patients who fail conventional endoscopic therapies or are poor surgical candidates. However, current evidence is limited by the retrospective nature of many studies, small sample sizes, and the need for longer-term follow-up to assess stent durability and the optimal management of indwelling LAMS. Larger prospective studies are warranted to further define the role of EUS-GE in benign GOO and compare it with other treatment strategies.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519861","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":"Treatment of Hepatocellular Carcinoma Using Endoscopic Ultrasound-guided Radiofrequency Ablation: A Case Series","authors":"Yogesh Harwani,&nbsp;Shreya Butala,&nbsp;Varun Shukla,&nbsp;Anand Patel,&nbsp;Surbhi Dogra Jani","doi":"10.1002/deo2.70171","DOIUrl":"https://doi.org/10.1002/deo2.70171","url":null,"abstract":"<p>Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an emerging technique for treating pancreatic and neuroendocrine tumors in patients who are not candidates for surgery. However, there is limited evidence of EUS-RFA in hepatic cancers. The present case series describes five elderly patients with compensated cirrhotic hepatocellular carcinomas (HCCs) treated locally using EUS-RFA. Alpha-fetoprotein levels were reduced in patients after 1 month of the procedure. Computed tomography analysis also reported a reduction in HCCs in patients postoperatively. Repeat computed tomography triple-phase abdomen also showed complete radiological response to treatment in lesions &lt;3 cm. None of the patients reported any procedural adverse event. EUS-RFA offers safe ablation of &lt;3 cm HCC lesions.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520099","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 a 6-Month Placement of a Fully Covered Self-Expanding Metal Stent for Refractory or Recurrent Hepaticojejunostomy Anastomotic Stricture via Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography","authors":"Taro Hanaoka,&nbsp;Kosuke Okuwaki,&nbsp;Masafumi Watanabe,&nbsp;Tomohisa Iwai,&nbsp;Kai Adachi,&nbsp;Akihiro Tamaki,&nbsp;Junro Ishizaki,&nbsp;Yusaku Manabe,&nbsp;Masayoshi Tadehara,&nbsp;Rikiya Hasegawa,&nbsp;Takaaki Matsumoto,&nbsp;Hiroshi Imaizumi,&nbsp;Mitsuhiro Kida,&nbsp;Chika Kusano","doi":"10.1002/deo2.70172","DOIUrl":"https://doi.org/10.1002/deo2.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-assisted ERCP) is performed for hepaticojejunostomy anastomotic stricture (HJAS) after biliary-enteric anastomosis. Although endoscopic balloon dilation (EBD) and plastic stent (PS) placement are commonly performed, they result in high recurrence rates. Studies have demonstrated the efficacy of fully covered self-expanding metal stents (FCSEMS) in HJAS management; however, none have systematically evaluated the outcomes of 6-month placement. Therefore, this retrospective study aimed to evaluate the efficacy and safety of a 6-month FCSEMS placement for benign refractory or recurrent HJAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated patients who underwent initial treatment with EBD alone or EBD plus PS placement via BE-assisted ERCP between April 2015 and March 2024. Among them, patients with refractory or recurrent HJAS received 6-month FCSEMS placements. The study outcomes were HJAS resolution, adverse events (AEs), and recurrence rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 92 patients who underwent initial EBD alone or EBD with PS placement, the HJAS resolution rate was 90.2%. The median follow-up period after the initial treatment was 16.1 months, with recurrence observed in 48.2% of patients. Among the 34 patients with refractory or recurrent HJAS, FCSEMS placement achieved a resolution rate of 97.1% in a median of 182 days. AEs occurred in 14.7% of patients (moderate, <i>n</i> = 3; mild, <i>n</i> = 2) following FCSEMS placement. During a median follow-up of 30.9 months, no recurrence was observed after HJAS resolution using FCSEMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 6-month FCSEMS placement for refractory or recurrent HJAS showed high efficacy and safety, indicating its potential as a preferred treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519860","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":"Clinical Characteristics and Outcomes of Incomplete Cardia Reconstruction Cases Following Multiple Anti-reflux Mucosectomy/Anti-reflux Mucosal Ablation Treatments","authors":"Ippei Tanaka,&nbsp;Haruhiro Inoue,&nbsp;Mayo Tanabe,&nbsp;Yoshiaki Kimoto,&nbsp;Kei Ushikubo,&nbsp;Kazuki Yamamoto,&nbsp;Yohei Nishikawa,&nbsp;Nikko Theodore Valencia Raymundo,&nbsp;Kazuya Sumi","doi":"10.1002/deo2.70169","DOIUrl":"https://doi.org/10.1002/deo2.70169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Anti-reflux mucosectomy (ARMS) and anti-reflux mucosal ablation (ARMA) are novel endoscopic treatments for proton pump inhibitor or potassium-competitive acid blocker-refractory gastroesophageal reflux disease. These procedures induce scarring of the artificial ulcer at the gastric cardia, which tightens the enlarged cardiac opening. However, we encountered patients with unresolved symptoms due to insufficient cardiac shrinkage despite multiple ARMS/ARMA treatments. This study analyzed the frequency and characteristics of the refractory cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients who underwent ARMS/ARMA treatments at our institution from January 2014 to October 2022. Refractory cases were defined as those undergoing multiple ARMS/ARMA treatments but with insufficient cardiac shrinkage and also persistence of reflux symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 131 ARMS/ARMA patients, seven (5.3%) cases were categorized as refractory cases. The male-to-female ratio was 5:2, with a mean age of 70 (58–73) years, and a mean BMI of 20.4 (20.0–24.0). Gastroesophageal reflux disease grades were grade <i>N</i> (<i>n</i> = 2), M (<i>n</i> = 2), B (<i>n</i> = 2), and C (<i>n</i> = 1). All had NERD diagnosis confirmed by pH monitoring. One patient underwent ARMS twice, two underwent ARMA after ARMS, and four had ARMA more than twice, but none achieved sufficient cardia shrinkage. Finally, three cases were managed with medication, while four required surgical fundoplication, which improved their symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Approximately 5% of ARMS/ARMA cases could not achieve sufficient cardiac shrinkage. However, the surgical treatment performed as a final step was effective, which may suggest that ARMS/ARMA treatment serves as a treatment option between medical therapy and surgical treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524481","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":"Gel Immersion Endoscopic Submucosal Dissection Using a Scissor-type Knife for Superficial Non-ampullary Duodenal Epithelial Tumors","authors":"Osamu Dohi,&nbsp;Naoto Iwai,&nbsp;Hayato Fukui,&nbsp;Mayuko Seya,&nbsp;Tomoko Ochiai,&nbsp;Junki Yumoto,&nbsp;Hiroki Mukai,&nbsp;Katsuma Yamauchi,&nbsp;Hajime Miyazaki,&nbsp;Takeshi Yasuda,&nbsp;Takuma Yoshida,&nbsp;Tsugitaka Ishida,&nbsp;Hiroaki Kitae,&nbsp;Yukiko Morinaga,&nbsp;Reo Kobayashi,&nbsp;Ryohei Hirose,&nbsp;Ken Inoue,&nbsp;Naohisa Yoshida,&nbsp;Kazuhiko Uchiyama,&nbsp;Tomohisa Takagi,&nbsp;Hideyuki Konishi,&nbsp;Yoshito Itoh","doi":"10.1002/deo2.70157","DOIUrl":"https://doi.org/10.1002/deo2.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to compare the short-term therapeutic outcomes between conventional endoscopic submucosal dissection (C-ESD) and gel immersion ESD (GI-ESD) for superficial non-ampullary duodenal epithelial tumors (SNADETs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on patients with SNADETs who underwent C-ESD or GI-ESD between June 2016 and May 2024. To reduce proficiency bias, the first 50 cases per endoscopist were excluded. C-ESD was performed using a scissor-type knife under CO₂ insufflation, while GI-ESD was performed using the same knife under gel immersion. Primary outcomes included en bloc and R0 resection rates; secondary outcomes were resection time, adverse events, and inflammatory response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 51 C-ESD and 49 GI-ESD procedures were analyzed. Both groups achieved 100% en bloc resection. R0 resection rates were comparable (C-ESD: 92.6%, GI-ESD: 90.2%, <i>p</i> = 0.661). Muscle layer exposure was significantly lower in the GI-ESD group (1.9%) than in the C-ESD group (16.7%, <i>p</i> = 0.032). The mean white blood cell count was also significantly lower in the GI-ESD group (<i>p</i> = 0.038). The incidence of adverse events in the C-ESD and GI-ESD groups was 5.6% and 1.9%, respectively (<i>p</i> = 0.627). However, no cases of perforation or aspiration were observed in the GI-ESD group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GI-ESD is a safe and effective alternative to conventional ESD for SNADETs, offering comparable resection outcomes and low risk of adverse events with a reduced risk of muscle layer exposure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520241","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":"Capsule Endoscopy in Inflammatory Bowel Disease: Current Status and Issues in Clinical Practice","authors":"Teppei Omori,&nbsp;Haruka Wada,&nbsp;Tatsuya Mitsui,&nbsp;Mari Hayashida,&nbsp;Noritaka Hibi,&nbsp;Daisuke Saito,&nbsp;Tadakazu Hisamatsu","doi":"10.1002/deo2.70166","DOIUrl":"https://doi.org/10.1002/deo2.70166","url":null,"abstract":"<p>Inflammatory bowel diseases include Crohn's disease (CD) and ulcerative colitis (UC), both of which require endoscopic evaluation of mucosal surfaces. Capsule endoscopy has been used in clinical practice since 2000 as a minimally invasive means of mucosal evaluation. In Japan, there is an innovative algorithm that incorporates capsule endoscopy into the diagnostic algorithm for CD. However, capsule retention is a potential complication, and intestinal patency must be evaluated using a patency capsule or other means before capsule ingestion. In addition, the pathophysiology of CD is a combination of inflammation and stenosis, so the interpretation of score values remains an issue to be addressed. Colon capsule endoscopy for UC is useful in understanding the localization and severity of colorectal inflammation. However, capsule endoscopy is not appropriate for cancer surveillance in patients with UC, and further improvements in bowel preparation are needed. Despite these issues, capsule endoscopy, which allows noninvasive observation of mucosal surfaces, is attractive, and further development is expected.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492920","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":"Barrett's Esophageal Adenocarcinoma with Neuroendocrine Cell Carcinoma Treated by Endoscopic Submucosal Dissection: A Case Report and Literature Review","authors":"Yo Kubota,&nbsp;Kenji Ishido,&nbsp;Kusutaro Doi,&nbsp;Gen Kitahara,&nbsp;Takuya Wada,&nbsp;Akinori Watanabe,&nbsp;Hisatomo Ikehara,&nbsp;Chika Kusano","doi":"10.1002/deo2.70167","DOIUrl":"https://doi.org/10.1002/deo2.70167","url":null,"abstract":"<p>Barrett's esophageal adenocarcinoma (BEA) with neuroendocrine cell carcinoma (NEC) is a rare disease with a poor prognosis. We report a case of BEA with NEC treated by endoscopic submucosal dissection (ESD) with en bloc resection and long-term survival was achieved without additional treatment. An 84-year-old man underwent an upper gastrointestinal endoscopy, which revealed an erythematous lesion within a short-segment Barrett's esophagus (BE) at the esophagogastric junction. A diagnosis of well-differentiated tubular adenocarcinoma (tub1) was made after biopsy, specifically, BEA (EG, Type 0-IIa, 15 mm, cT1a), and ESD was performed. Histopathological findings showed differentiated adenocarcinoma in Barrett's esophageal mucosa background, with 20% of all tumors having NEC components. The final diagnosis was adenocarcinoma (tub1&gt;tub2) with focal neuroendocrine cell carcinoma in BE, EG, Type 0-IIa, 13 × 9 mm, pT1a-DMM, ly0, v0 pHM0, pVM0. Considering the patient's advanced age and wishes, we decided to follow up without any additional treatment. The patient has survived 52 months after ESD without metastatic recurrence. Even if histopathological findings after ESD reveal BEA with NEC and en bloc resection, careful follow-up is necessary because of the high risk of recurrence.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473102","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 Multihole Partially Covered Self-Expandable Metal Stents for Distal Malignant Biliary Obstruction: A Single-Center Retrospective Study","authors":"Kengo Matsumoto,&nbsp;Kazuhide Iwasa,&nbsp;Asuka Watanabe,&nbsp;Hiroki Takiyama,&nbsp;Satoru Okabe,&nbsp;Naoto Osugi,&nbsp;Dai Nakamatsu,&nbsp;Masashi Yamamoto,&nbsp;Shiro Hayashi,&nbsp;Koji Fukui,&nbsp;Tsutomu Nishida","doi":"10.1002/deo2.70168","DOIUrl":"https://doi.org/10.1002/deo2.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Covered self-expandable metal stents (SEMS) are the standard for managing unresectable distal malignant biliary obstruction (DMBO), as they prolong the time to recurrent biliary obstruction (TRBO). However, fully covered SEMS (FCSEMS) increases the risk of cholecystitis and pancreatitis. This exploratory study evaluated a novel multihole partially covered SEMS (MHSEMS) designed to reduce these risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The clinical data of 26 DMBO patients treated with MHSEMSs were retrospectively compared with those of 63 patients treated with FCSEMSs between April 2018 and October 2024. The outcomes included clinical success, early complications, and recurrent biliary obstruction (RBO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The baseline characteristics, including age (median 78 years), sex distribution (55.2% vs. 57.7% male), BMI (20.5 vs. 19.8), tumor size (27 mm vs. 30 mm), and stricture length (20 mm vs. 19.5 mm), were comparable between the groups. Procedural factors, including initial papillary cannulation (34.9% vs. 26.9%) and pancreatography (12.9% vs. 15.4%), were also similar in terms of incidence. Early complications were less common in the MHSEMS group (7.7% vs. 23.8%), with no cases of cholecystitis observed. Fewer early complications were observed with MHSEMS, suggesting potential clinical benefits. The RBO rates (7.7% vs. 15.9%, <i>p</i> = 0.28) and median TRBO (151 vs. 141.5 days, <i>p</i> = 0.87) were also comparable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the differences in outcomes were not statistically significant, the incidence of early complications was lower, especially for cholecystitis, with the MHSEMS in the management of DMBO. Larger prospective studies are needed to confirm these preliminary findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339531","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}