Clinical Endoscopy

Gastrointestinal endoscopy’s carbon footprint: Su Bee Park, Jae Myung Cha; Clin Endosc 2023;56(3):263-267. Published online March 31, 2023; DOI: https://doi.org/10.5946/ce.2023.003

Climate change is a global emergency. Consequently, current global targets to combat the climate crisis include reaching net-zero carbon emissions by 2050 and keeping global temperature increases below 1.5 ˚C. In 2014, the healthcare carbon footprint was 5.5% of the total national footprint. Gastrointestinal endoscopy (GIE) has a large carbon footprint compared to other procedures performed in healthcare facilities. GIE was identified as the third largest generator of medical waste in healthcare facilities for the following reasons: (1) GIE is associated with high case volumes, (2) GIE patients and relatives travel frequently, (3) GIE involves the use of many nonrenewable wastes, (4) single-use devices are used during GIE, and (5) GIE is frequently reprocessed. Immediate actions to reduce the environmental impact of GIE include: (1) adhering to guidelines, (2) implementing audit strategies to determine the appropriateness of GIE, (3) avoiding unnecessary procedures, (4) using medication rationally, (4) digitalization, (5) telemedicine, (6) critical pathways, (7) outpatient procedures, (8) adequate waste management, and (9) minimizing single-use devices. In addition, sustainable infrastructure for endoscopy units, using renewable energy, and 3R (reduce, reuse, and recycle) programs are necessary to reduce the impact of GIE on the climate crisis. Consequently, healthcare providers need to work together to achieve a more sustainable future. Therefore, strategies must be implemented to achieve net-zero carbon emissions in the healthcare field, especially from GIE, by 2050.

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Single‐use accessories and endoscopes in the era of sustainability and climate change—A balancing act
Zaheer Nabi, Raymond S. Y. Tang, Sridhar Sundaram, Sundeep Lakhtakia, D. Nageshwar Reddy
Journal of Gastroenterology and Hepatology.2024; 39(1): 7. CrossRef
Impact of power consumption and power saving for GI endoscopy (power on study) on reducing CO2emissions
Anna Fichtl, Veronika Tacheva, Niklas Sturm, Karim Hamesch, Doerte Wichmann, Benjamin Mayer, Martin Müller, Martin Wagner, Thomas Seufferlein, Benjamin M Walter
Gut.2024; 73(6): 892. CrossRef
Green Endoscopy
Vivek Kaul
American Journal of Gastroenterology.2024; 119(9): 1714. CrossRef
Ecogastroenterology: cultivating sustainable clinical excellence in an environmentally conscious landscape
Kassem Sharif, Enrique Rodriguez de Santiago, Paula David, Arnon Afek, Ian M Gralnek, Shomron Ben-Horin, Adi Lahat
The Lancet Gastroenterology & Hepatology.2024; 9(6): 550. CrossRef
Longitudinal impact of screening colonoscopy on greenhouse gas emissions
Hasiya Yusuf, Vinita Gupta, Ikponmwosa Osaghae, Abhishek Kumar, Alejandro Piscoya
PLOS ONE.2024; 19(7): e0307133. CrossRef
Can Gastric Juice Analysis with EndoFaster® Reduce the Environmental Impact of Upper Endoscopy?
Angelo Zullo, Federica Chiovelli, Enrica Esposito, Cesare Hassan, Beatrice Casini
Healthcare.2023; 11(24): 3186. CrossRef

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Sex/gender differences in gastrointestinal endoscopy from the perspective of patients and gastroenterologists: Nayoung Kim; Clin Endosc 2023;56(3):268-282. Published online May 3, 2023; DOI: https://doi.org/10.5946/ce.2022.270

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The sex/gender of gastroenterologists impact patients’ satisfaction, compliance, and clinical outcomes. For instance, female gastrointestinal (GI) endoscopist–patient gender concordance improves health-related outcomes. This finding suggests that it is important to increase the number of female GI endoscopists. While the number of women in the field of gastroenterology is increasing in the United States and Korea by over 28.3%, it is not enough to account for the gender preferences of female patients. GI endoscopists are at a high risk of endoscopy-related injuries. However, there is a different distribution of muscle and fat; male endoscopists are more affected in their back, while females are more affected in the upper extremities. Women are more susceptible to endoscopy-related injuries than men. There is a correlation between the number of colonoscopies performed and musculoskeletal pain. Job satisfaction is lower in young female gastroenterologists (30’ and 40’) than in the opposite gender and other ages. Thus, it is important to address these issues in the development of GI endoscopy.

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Protecting Gastroenterologists through Rehabilitation Training: An Overlooked Area of Concern
Sun-Hye Ko, Myong Ki Baeg
Gut and Liver.2023; 17(6): 829. CrossRef

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A practical approach for small bowel bleeding: Sung Eun Kim, Hyun Jin Kim, Myeongseok Koh, Min Cheol Kim, Joon Sung Kim, Ji Hyung Nam, Young Kwan Cho, A Reum Choe, The Research Group for Capsule Endoscopy and Enteroscopy of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2023;56(3):283-289. Published online May 11, 2023; DOI: https://doi.org/10.5946/ce.2022.302

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Gastrointestinal (GI) bleeding is one of the most common conditions among patients visiting emergency departments in Korea. GI bleeding is divided into upper and lower GI bleeding, according to the bleeding site. GI bleeding is also divided into overt and occult GI bleeding based on bleeding characteristics. In addition, obscure GI bleeding refers to recurrent or persistent GI bleeding from a source that cannot be identified after esophagogastroduodenoscopy or colonoscopy. The small intestine is the largest part of the alimentary tract. It extends from the pylorus to the cecum. The small intestine is difficult to access owing to its long length. Moreover, it is not fixed to the abdominal cavity. When hemorrhage occurs in the small intestine, the source cannot be found in many cases because of the characteristics of the small intestine. In practice, small-intestinal bleeding accounts for most of the obscure GI bleeding. Therefore, in this review, we introduce and describe systemic approaches and examination methods, including video capsule endoscopy and balloon enteroscopy, that can be performed in patients with suspected small bowel bleeding in clinical practice.

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Manejo da hemorragia digestiva baixa na emergência: abordagem cirúrgica
Carla Azevedo Zaibak, Sara Monteiro Barbosa, Nathalia Machado De Lima, Jordane Lula Cruz, Angela Maria Pereira Costa, Maria Eduarda da Silva Borges, Mariana Vasconcellos De Oliveira, Danyelly Rodrigues Machado
Cuadernos de Educación y Desarrollo.2024;[Epub] CrossRef
Case 19: A 65-Year-Old Man With Melena and Hematochezia
Hajin Lee, Younghee Choe, Jung Heo, Gwkang Hui Park, Su Young Lee, Young Wook Cho, Hyo Suk Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Aortoduodenal fistula bleeding caused by an aortic stent graft
Seunghyun Hong, Gwang Ha Kim
Clinical Endoscopy.2024; 57(3): 407. CrossRef
Diagnostic Yield and Outcomes of Small Bowel Capsule Endoscopy in Patients with Small Bowel Bleeding Receiving Antithrombotics
Nikos Viazis, Dimitris Christodoulou, Vasilis Papastergiou, Konstantinos Mousourakis, Dimitra Kozompoli, Giannis Stasinos, Konstantina Dimopoulou, Periklis Apostolopoulos, Fotios Fousekis, Christos Liatsos, Nikolaos Kyriakos, Theodoros Argyropoulos, Georg
Diagnostics.2024; 14(13): 1361. CrossRef
Difficult Small Bowel Bleeding in Surgical View
Jung Min Bae
Journal of Acute Care Surgery.2024; 14(2): 41. CrossRef
Jejunal Dieulafoy’s lesion resembling subepithelial mass resulting in profound gastrointestinal hemorrhage
Thanaboon Chaemsupaphan, Tanawat Geeratragool, Napat Angkathunyakul, Arissa Phothisirisakulwong, Monthira Maneerattanaporn
Clinical Endoscopy.2024; 57(4): 552. CrossRef

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Quality indicators in endoscopic retrograde cholangiopancreatography: a brief review of established guidelines: Zubin Dev Sharma, Rajesh Puri; Clin Endosc 2023;56(3):290-297. Published online April 11, 2023; DOI: https://doi.org/10.5946/ce.2022.210

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Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic technique that has many diagnostic and therapeutic implications. It is a procedure with small but significant life-threatening complications. To ensure the best possible care, minimize complications, and improve the quality of health care, a constant review of the performance of the operator using ideal benchmark standards is needed. Hence, quality indicators are necessary. The American and European Societies of Gastrointestinal Endoscopy have provided guidelines on quality measures for ERCP, which describe the skills to be developed and training to be implemented in performing quality ERCP. These guidelines have divided the indicators into pre-procedure, intraprocedural, and post-procedure measures. The focus of this article was to review the quality indicators of ERCP.

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Advancements in Research on Challenges in Selective Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography (ERCP)
天雨张
Journal of Clinical Personalized Medicine.2024; 03(01): 100. CrossRef
Development of an Automated Endoscopic Retrograde Cholangiopancreatography Quality Report Card Using an Integrated Analytics Suite
Anmol Singh, Eric Swei, Celestina Tolosa, Matthew Alverson, Todd A. Brenner, Avleen Kaur, Aida Metri, Mohammed Rifat Shaik, Nikhil Bush, Branislav Bujnak, Alexandra T. Strauss, Mouen Khashab, Eun Ji Shin, Vikesh K. Singh, Venkata S. Akshintala
Techniques and Innovations in Gastrointestinal Endoscopy.2024; 26(3): 230. CrossRef
Validity of a virtual reality endoscopic retrograde cholangiopancreatography simulator: can it distinguish experts from novices?
Konstantinos Georgiou, Nikola Boyanov, Pantelis Antonakis, Dimitrios Thanasas, Gabriel Sandblom, Lars Enochsson
Frontiers in Surgery.2023;[Epub] CrossRef

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No difference in outcomes with 15 mm vs. 20 mm lumen-apposing metal stents for endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction: a meta-analysis: Shyam Vedantam, Rahil Shah, Sean Bhalla, Shria Kumar, Sunil Amin; Clin Endosc 2023;56(3):298-307. Published online May 22, 2023; DOI: https://doi.org/10.5946/ce.2022.299

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Background
/Aims: We compared outcomes between use of 15 vs. 20 mm lumen-apposing metal stents (LAMSs) in endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for gastric outlet obstruction.
Methods
Databases were queried for studies that used LAMS for EUS-GE to relieve gastric outlet obstruction, and a proportional meta-analysis was performed.
Results
Thirteen studies were included. The 15 mm and 20 mm LAMS had pooled technical success rates of 93.2% (95% confidence interval [CI], 90.5%–95.2%) and 92.1% (95% CI, 68.4%–98.4%), clinical success rates of 88.6% (95% CI, 85.4%–91.1%) and 89.6% (95% CI, 79.0%–95.1%), adverse event rates of 11.4% (95% CI, 8.1%–15.9%) and 14.7% (95% CI, 4.4%–39.1%), and reintervention rates of 10.3% (95% CI, 6.7%–15.4%) and 3.5% (95% CI, 1.6%–7.6%), respectively. Subgroup analysis revealed no significant differences in technical success, clinical success, or adverse event rates. An increased need for reintervention was noted in the 15 mm stent group (pooled odds ratio, 3.59; 95% CI, 1.40–9.18; p=0.008).
Conclusions
No differences were observed in the technical, clinical, or adverse event rates between 15 and 20 mm LAMS use in EUS-GE. An increased need for reintervention is possible when using a 15 mm stent compared to when using a 20 mm stent.

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Endoscopic gastrointestinal bypass anastomosis using deformable self-assembled magnetic anastomosis rings (DSAMARs) in a pig model
Miaomiao Zhang, Jianqi Mao, Jia Ma, Shuqin Xu, Yi Lyu, Xiaopeng Yan
BMC Gastroenterology.2024;[Epub] CrossRef
Revealing Insights: A Comprehensive Overview of Gastric Outlet Obstruction Management, with Special Emphasis on EUS-Guided Gastroenterostomy
Dimitrios Ziogas, Thomas Vasilakis, Christina Kapizioni, Eleni Koukoulioti, Georgios Tziatzios, Paraskevas Gkolfakis, Antonio Facciorusso, Ioannis S. Papanikolaou
Medical Sciences.2024; 12(1): 9. CrossRef
Lumen-apposing metal stents: A primer on indications and technical tips
Sridhar Sundaram, Suprabhat Giri, Kenneth Binmoeller
Indian Journal of Gastroenterology.2024; 43(5): 886. CrossRef
Advances in self-expandable metal stents for endoscopic ultrasound-guided interventions
Dong Kee Jang, Dong Wook Lee, Seong-Hun Kim, Kwang Bum Cho, Sundeep Lakhtakia
Clinical Endoscopy.2024; 57(5): 588. CrossRef
Endoscopic stenting for malignant gastric outlet obstruction: focusing on comparison of endoscopic stenting and surgical gastrojejunostomy
Sun Gyo Lim, Chan Gyoo Kim
Clinical Endoscopy.2024; 57(5): 571. CrossRef
The Role of Luminal Apposing Metal Stents on the Treatment of Malignant and Benign Gastric Outlet Obstruction
Mihai Rimbaș, Kar Wai Lau, Giulia Tripodi, Gianenrico Rizzatti, Alberto Larghi
Diagnostics.2023; 13(21): 3308. CrossRef

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Endoscopy under general anesthesia for detecting synchronous lesions of head and neck squamous cell carcinoma: Jin Hee Noh, Do Hoon Kim; Clin Endosc 2023;56(3):308-309. Published online April 28, 2023; DOI: https://doi.org/10.5946/ce.2023.069

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Nasopharyngeal examination during transoral upper gastrointestinal endoscopy
Vui Heng Chong
Clinical Endoscopy.2024; 57(1): 137. CrossRef

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How effective is intragastric balloon insertion as an obesity treatment in Korea?: Youngdae Kim; Clin Endosc 2023;56(3):310-312. Published online May 26, 2023; DOI: https://doi.org/10.5946/ce.2023.073

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Cell block created from pancreatic duct lavage is another jigsaw puzzle to diagnose early pancreatic ductal adenocarcinoma: Rungsun Rerknimitr; Clin Endosc 2023;56(3):313-314. Published online April 21, 2023; DOI: https://doi.org/10.5946/ce.2023.029

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Efficacy of endoscopy under general anesthesia for the detection of synchronous lesions in oro-hypopharyngeal cancer: Yoichiro Ono, Kenshi Yao, Yasuhiro Takaki, Satoshi Ishikawa, Kentaro Imamura, Akihiro Koga, Kensei Ohtsu, Takao Kanemitsu, Masaki Miyaoka, Takashi Hisabe, Toshiharu Ueki, Atsuko Ota, Hiroshi Tanabe, Seiji Haraoka, Satoshi Nimura, Akinori Iwashita, Susumu Sato, Rumie Wakasaki; Clin Endosc 2023;56(3):315-324. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2022.072

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Background
/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma.
Methods
This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia.
Results
Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness.
Conclusions
Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.

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Nasopharyngeal examination during transoral upper gastrointestinal endoscopy
Vui Heng Chong
Clinical Endoscopy.2024; 57(1): 137. CrossRef
Endoscopy under general anesthesia for detecting synchronous lesions of head and neck squamous cell carcinoma
Jin Hee Noh, Do Hoon Kim
Clinical Endoscopy.2023; 56(3): 308. CrossRef

2,512 View
199 Download
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Accuracy of administrative claim data for gastric adenoma after endoscopic resection: Ga-Yeong Shin, Hyun Ho Choi, Jae Myung Park, Sang Yoon Kim, Jun Young Park, Donghoon Kang, Yu Kyung Cho, Sung Soo Kim, Myung-Gyu Choi; Clin Endosc 2023;56(3):325-332. Published online March 21, 2023; DOI: https://doi.org/10.5946/ce.2022.147

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Background
/Aims: Administrative databases provide valuable information for large-cohort studies. This study aimed to evaluate the diagnostic accuracy of an administrative database for resected gastric adenomas.
Methods
Data of patients who underwent endoscopic resection for benign gastric lesions were collected from three hospitals. Gastric adenoma cases were identified in the hospital database using International Classification of Diseases (ICD) 10-codes. The non-adenoma group included patients without gastric adenoma codes. The diagnostic accuracy for gastric adenoma was analyzed based on the pathological reports of the resected specimen.
Results
Among 5,095 endoscopic resections with codes for benign gastric lesions, 3,909 patients were included in the analysis. Among them, 2,831 and 1,078 patients were allocated to the adenoma and non-adenoma groups, respectively. Regarding the overall diagnosis of gastric adenoma with ICD-10 codes, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.7%, 88.5%, 95.2%, and 96.8%, respectively. There were no significant differences in these parameters between the tertiary and secondary centers.
Conclusions
Administrative codes of gastric adenoma, according to ICD-10 codes, showed good accuracy and can serve as a useful tool to study prognosis of these patients in real-world data studies in the future.

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Gastric Cancer Incidence and Mortality After Endoscopic Resection of Gastric Adenoma: A Nationwide Cohort Study
Jae Myung Park, Songhee Cho, Ga-Yeong Shin, Jayoun Lee, Minjee Kim, Hyeon Woo Yim
American Journal of Gastroenterology.2023;[Epub] CrossRef

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Efficacy and safety of intragastric balloon for obesity in Korea: Kwang Gyun Lee, Seung-Joo Nam, Hyuk Soon Choi, Hang Lak Lee, Jai Hoon Yoon, Chan Hyuk Park, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Sung Hoon Jung, Korean Research Group for Endoscopic Management of Metabolic Disorder and Obesity; Clin Endosc 2023;56(3):333-339. Published online December 13, 2022; DOI: https://doi.org/10.5946/ce.2022.143

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Background
/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea.
Methods
We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed.
Results
In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain.
Conclusions
IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

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Intragastric Balloons
D.T.H. de Moura, Sergio A. Sánchez-Luna, Adriana Fernandes Silva, Alexandre Moraes Bestetti
Gastrointestinal Endoscopy Clinics of North America.2024; 34(4): 687. CrossRef
Effectiveness and Safety of the Allurion Swallowable Intragastric Balloon for Short-term Weight Loss: A Systematic Review and Meta-analysis
Adriana Fernandes Silva, Alexandre Moraes Bestetti, Angelo So Taa Kum, Beanie Conceição Medeiros Nunes, Matheus de Oliveira Veras, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
Obesity Surgery.2024; 34(10): 3735. CrossRef
Endoscopic treatment of obesity: A protocol of updated systematic review with network meta-analysis of randomized controlled trials
Eun Jeong Gong, Chang Seok Bang, Gwang Ho Baik, Dong Keon Yon
PLOS ONE.2024; 19(9): e0308410. CrossRef
How effective is intragastric balloon insertion as an obesity treatment in Korea?
Youngdae Kim
Clinical Endoscopy.2023; 56(3): 310. CrossRef
Laparoscopy-assisted trans-hiatal endoscopic removal of an intragastric balloon after placement-related esophageal perforation
Pablo Cortegoso Valdivia, Giorgio Dalmonte, Marina Valente, Lucia Ballabeni, Federica Gaiani, Gian Luigi de' Angelis, Federico Marchesi
Endoscopy.2023; 55(S 01): E1137. CrossRef

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Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States: Dushyant Singh Dahiya, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Amandeep Singh, Rajat Garg, Chin-I Cheng, Mohammad Al-Haddad, Madhusudhan R. Sanaka, Neil Sharma; Clin Endosc 2023;56(3):340-352. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2022.166

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Background
/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.
Methods
We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.
Results
From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.
Conclusions
Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

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Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain
Cureus.2024;[Epub] CrossRef
Clinicopathological Features of Elderly Patients with Colonic Volvulus
Mehmet Onur Gul, Selda Oğuz Aşlayan, Kadir Çorbacı, Aytaç Selman, Emre Berat Akçay, Oğuzhan Sunamak, Cebrail Akyüz
European Journal of Therapeutics.2024; 30(3): 303. CrossRef
Incidental Sigmoid Volvulus after a Ground-level Fall: An Unusual Case Report
Ziya Karimov, Elchin Shirinov, Gunay Huseynova, Mirhuseyn Mammadov, Meltem Songür Kodik
Caucasian Medical Journal.2023; 1(3): 36. CrossRef
Colonic Volvulus
Samantha L. Savitch, Calista M. Harbaugh
Clinics in Colon and Rectal Surgery.2023;[Epub] CrossRef

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Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ: Hiroaki Kusunose, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Kazuki Endo, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito; Clin Endosc 2023;56(3):353-366. Published online November 16, 2022; DOI: https://doi.org/10.5946/ce.2022.021

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Background
/Aims: This study aimed to clarify the efficacy and safety of pancreatic duct lavage cytology combined with a cell-block method (PLC-CB) for possible pancreatic ductal adenocarcinomas (PDACs).
Methods
This study included 41 patients with suspected PDACs who underwent PLC-CB mainly because they were unfit for undergoing endoscopic ultrasonography-guided fine needle aspiration. A 6-Fr double lumen catheter was mainly used to perform PLC-CB. Final diagnoses were obtained from the findings of resected specimens or clinical outcomes during surveillance after PLC-CB.
Results
Histocytological evaluations using PLC-CB were performed in 87.8% (36/41) of the patients. For 31 of the 36 patients, final diagnoses (invasive PDAC, 12; pancreatic carcinoma in situ, 5; benignancy, 14) were made, and the remaining five patients were excluded due to lack of surveillance periods after PLC-CB. For 31 patients, the sensitivity, specificity, and accuracy of PLC-CB for detecting malignancy were 94.1%, 100%, and 96.8%, respectively. In addition, they were 87.5%, 100%, and 94.1%, respectively, in 17 patients without pancreatic masses detectable using endoscopic ultrasonography. Four patients developed postprocedural pancreatitis, which improved with conservative therapy.
Conclusions
PLC-CB has an excellent ability to detect malignancies in patients with possible PDACs, including pancreatic carcinoma in situ.

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Early diagnosis of pancreatic cancer via pancreatic juice cytology with a cell-block method in a patient with altered anatomy
Yasuo Otsuka, Kosuke Minaga, Akane Hara, Kentaro Yamao, Mamoru Takenaka, Takaaki Chikugo, Masatoshi Kudo
Endoscopy International Open.2024; 12(06): E764. CrossRef
Role of endoscopic retrograde cholangiopancreatography in early diagnosis of pancreatic cancer
Yasutaka ISHII, Masahiro SERIKAWA, Shinya NAKAMURA, Juri IKEMOTO, Shiro OKA
Suizo.2024; 39(4): 247. CrossRef
Cell block created from pancreatic duct lavage is another jigsaw puzzle to diagnose early pancreatic ductal adenocarcinoma
Rungsun Rerknimitr
Clinical Endoscopy.2023; 56(3): 313. CrossRef

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Utility of forward-view endoscopic ultrasound in fine-needle aspiration in patients with a surgically altered upper gastrointestinal anatomy: Asmaa Bakr, Kazuo Hara, Moaz Elshair, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Daiki Fumihara, Takafumi Yanaidani, Samy Zaky, Hanaa Omar; Clin Endosc 2023;56(3):367-374. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2021.238

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) using oblique-view EUS in patients with a surgically altered anatomy (SAA) of the upper gastrointestinal tract is limited because of difficult scope insertion due to the disturbed anatomy. This study aimed to investigate the efficiency of forward-view (FV)-EUS in performing FNA in patients with a SAA.
Methods
We retrospectively investigated 32 patients with a SAA of the upper gastrointestinal tract who visited Aichi Cancer Center Hospital in Nagoya, Japan, between January 2014 and December 2020. We performed-upper gastrointestinal EUS-FNA using FV-EUS combined with fluoroscopic imaging to confirm tumor recurrence or to make a decision before chemotherapy or after a failure of diagnosis by radiology.
Results
We successfully performed EUS-FNA in all studied patients (100% technical success), with the specificity, sensitivity, and accuracy of 100%, 87.5%, and 87.8%, respectively, with no complications.
Conclusions
EUS-FNA using FV-EUS combined with fluoroscopic imaging is an effective and safe technique for tissue acquisition in patients with a SAA.

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Successful removal of remnant cystic duct stump stone using single-operator cholangioscopy-guided electrohydraulic lithotripsy: two case reports: Sung Hyeok Ryou, Hong Ja Kim; Clin Endosc 2023;56(3):375-380. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2021.273

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Cholecystectomy is the best method for treating gallstone diseases. However, 10%–30% of patients who undergo a cholecystectomy continue to complain of upper abdominal pain, dyspepsia, or jaundice—this is referred to as postcholecystectomy syndrome. Cystic duct stump stones are a troublesome cause of postcholecystectomy syndrome. Conventionally, surgery is mainly performed to remove cystic duct stump stones. However, repeated surgery can cause complications, such as postoperative bleeding, biliary injury, and wound infection. As an alternative method of surgery, endoscopic retrograde cholangiopancreatography is sometimes used to remove cystic duct stump stones, although the success rate is not high due to technical difficulties. Recently, peroral cholangioscopy, which can directly observe the bile duct, has been suggested as an alternative method. We report two cases in which a cystic duct stump stone was successfully removed via a single-operator cholangioscopy, after failure with an endoscopic retrograde cholangiopancreatography.

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