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Volume 56(4); July 2023
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Reviews
Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines
Clin Endosc 2023;56(4):391-408.   Published online June 23, 2023
DOI: https://doi.org/10.5946/ce.2023.062
AbstractAbstract PDFSupplementary MaterialPubReaderePub
With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

Citations

Citations to this article as recorded by  
  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Fast-track discharge following percutaneous endoscopic gastrostomy removal in head and neck cancer patients after remission: a feasibility and safety study
    Daniel Conceição, Luís Correia Gomes, Fátima Francisco, Ivone Frade, Joana Gramacho, Sandra Faias, Isabel Claro
    Journal of Gastrointestinal Surgery.2024; 28(6): 943.     CrossRef
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Complications of endoscopic resection in the upper gastrointestinal tract
Takeshi Uozumi, Seiichiro Abe, Mai Ego Makiguchi, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Yutaka Saito
Clin Endosc 2023;56(4):409-422.   Published online June 21, 2023
DOI: https://doi.org/10.5946/ce.2023.024
AbstractAbstract PDFPubReaderePub
Endoscopic resection (ER) is widely utilized as a minimally invasive treatment for upper gastrointestinal tumors; however, complications could occur during and after the procedure. Post-ER mucosal defect leads to delayed perforation and bleeding; therefore, endoscopic closure methods (endoscopic hand-suturing, the endoloop and endoclip closure method, and over-the-scope clip method) and tissue shielding methods (polyglycolic acid sheets and fibrin glue) are developed to prevent these complications. During duodenal ER, complete closure of the mucosal defect significantly reduces delayed bleeding and should be performed. An extensive mucosal defect that comprises three-quarters of the circumference in the esophagus, gastric antrum, or cardia is a significant risk factor for post-ER stricture. Steroid therapy is considered the first-line option for the prevention of esophageal stricture, but its efficacy for gastric stricture remains unclear. Methods for the prevention and management of ER-related complications in the esophagus, stomach, and duodenum differ according to the organ; therefore, endoscopists should be familiar with ways of preventing and managing organ-specific complications.

Citations

Citations to this article as recorded by  
  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • Risk factors for intraoperative and delayed perforation related with gastric endoscopic submucosal dissection
    Takuya Mimura, Yoshinobu Yamamoto, Haruhisa Suzuki, Kohei Takizawa, Toshiaki Hirasawa, Yoji Takeuchi, Kenji Ishido, Shu Hoteya, Tomonori Yano, Shinji Tanaka, Norihiko Kudara, Masahiro Nakagawa, Yumi Mashimo, Masahiro Ishigooka, Kazutoshi Fukase, Taichi Sh
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
  • Endoscopic submucosal dissection for early gastric cancer: It is time to consider the quality of its outcomes
    Gwang Ha Kim
    World Journal of Gastroenterology.2023; 29(43): 5800.     CrossRef
  • 3,260 View
  • 165 Download
  • 3 Web of Science
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Management of complications related to colorectal endoscopic submucosal dissection
Tae-Geun Gweon, Dong-Hoon Yang
Clin Endosc 2023;56(4):423-432.   Published online July 27, 2023
DOI: https://doi.org/10.5946/ce.2023.104
AbstractAbstract PDFPubReaderePub
Compared to endoscopic mucosal resection (EMR), colonoscopic endoscopic submucosal dissection (C-ESD) has the advantages of higher en bloc resection rates and lower recurrence rates of colorectal neoplasms. Therefore, C-ESD is considered an effective treatment method for laterally spread tumors and early colorectal cancer. However, C-ESD is technically more difficult and requires a longer procedure time than EMR. In addition to therapeutic efficacy and procedural difficulty, safety concerns should always be considered when performing C-ESD in clinical practice. Bleeding and perforation are the main adverse events associated with C-ESD and can occur during C-ESD or after the completion of the procedure. Most bleeding associated with C-ESD can be managed endoscopically, even if it occurs during or after the procedure. More recently, most perforations identified during C-ESD can also be managed endoscopically, unless the mural defect is too large to be sutured with endoscopic devices or the patient is hemodynamically unstable. Delayed perforations are quite rare, but they require surgical treatment more frequently than endoscopically identified intraprocedural perforations or radiologically identified immediate postprocedural perforations. Post-ESD coagulation syndrome is a relatively underestimated adverse event, which can mimic localized peritonitis from perforation. Here, we classify and characterize the complications associated with C-ESD and recommend management options for them.

Citations

Citations to this article as recorded by  
  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • Is there a best choice of equipment for colorectal endoscopic submucosal dissection?
    Francesco Cocomazzi, Sonia Carparelli, Nunzia Labarile, Antonio Capogreco, Marco Gentile, Roberta Maselli, Jahnvi Dhar, Jayanta Samanta, Alessandro Repici, Cesare Hassan, Francesco Perri, Antonio Facciorusso
    Expert Review of Medical Devices.2024; : 1.     CrossRef
  • 1,728 View
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  • 4 Web of Science
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Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management
Clement Chun Ho Wu, Samuel Jun Ming Lim, Christopher Jen Lock Khor
Clin Endosc 2023;56(4):433-445.   Published online July 17, 2023
DOI: https://doi.org/10.5946/ce.2023.013
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient’s clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

Citations

Citations to this article as recorded by  
  • Prevention of post-ERCP complications
    Lotfi Triki, Andrea Tringali, Marianna Arvanitakis, Tommaso Schepis
    Best Practice & Research Clinical Gastroenterology.2024; 69: 101906.     CrossRef
  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • Double-guidewire technique for selective biliary cannulation does not increase the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with naïve papilla
    Han Taek Jeong, June Hwa Bae, Ho Gak Kim, Jimin Han
    Clinical Endoscopy.2024; 57(2): 226.     CrossRef
  • Could assessment of genetic susceptibility be an effective solution to prevent pancreatitis from occurring after endoscopic retrograde cholangiopancreatography?
    Jae Min Lee
    The Korean Journal of Internal Medicine.2023; 38(6): 783.     CrossRef
  • 3,242 View
  • 311 Download
  • 3 Web of Science
  • 4 Crossref
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Systematic Review and Meta-analysis
Use of abdominal compression device in colonoscopy: a systematic review and meta-analysis
Yousaf Zafar, Ahmed Mustafa Rashid, Syed Sarmad Javaid, Ahmed Kamal Siddiqi, Adnan Zafar, Arsalan Zafar Iqbal, Jagpal Singh Klair, Rajesh Krishnamoorthi
Clin Endosc 2023;56(4):446-452.   Published online May 26, 2023
DOI: https://doi.org/10.5946/ce.2022.304
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes.
Methods
We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated.
Results
Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, –0.76 [–1.49 to –0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28–0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27–0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, –0.48; 95% CI, –1.05 to 0.08; p=0.09) when using an abdominal compression device.
Conclusions
Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.
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Editorials
Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
Jae Myung Park
Clin Endosc 2023;56(4):453-454.   Published online July 10, 2023
DOI: https://doi.org/10.5946/ce.2023.133
PDFPubReaderePub
  • 1,026 View
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A multidisciplinary approach is essential for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma
Sung-Hoon Moon
Clin Endosc 2023;56(4):457-459.   Published online July 11, 2023
DOI: https://doi.org/10.5946/ce.2023.116
PDFPubReaderePub
  • 991 View
  • 60 Download
  • 1 Web of Science
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Original Articles
Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey
Fumiaki Ishibashi, Toshiaki Hirasawa, Hiroya Ueyama, Yohei Minato, Sho Suzuki
Clin Endosc 2023;56(4):460-469.   Published online April 4, 2023
DOI: https://doi.org/10.5946/ce.2022.167
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Diagnosis of Helicobacter pylori-naïve gastric cancer (HPNGC) is becoming increasingly important. This study aimed to explore the quality indicators for HPNGC detection.
Methods
We conducted a cross-sectional, nationwide, web-based survey of gastrointestinal endoscopists in Japan. In addition to questions about the number of HPNGC cases detected in a year and basic information, the questionnaire also consisted of 28 questions: (1) 18 about HPNGC awareness, (2) six about diagnostic proactiveness, and (3) four about interest in HPNGC.
Results
Valid responses were obtained from 712 endoscopists. The Japan Gastroenterological Endoscopy Society-certified endoscopists had a significantly higher HPNGC detection rate than the nonspecialists (0.42% vs. 0.32%, respectively; p=0.008). The results of the multiple regression analysis showed that Japan Gastroenterological Endoscopy Society certification and high awareness and interest scores were independent predictors of the HPNGC detection rate (p=0.012, p<0.001, p=0.024, respectively). Principal component analysis showed that the endoscopists who attended conferences for collecting information on HPNGC had a higher level of awareness.
Conclusions
To improve the detection of HPNGC, it is necessary to increase the awareness of the disease. It is hoped that relevant societies will play an important role in endoscopists’ education.

Citations

Citations to this article as recorded by  
  • Prevalence of Gastric Epithelial Tumors in Helicobacter pylori-uninfected Individuals Undergoing a Medical Checkup
    Eiko Okimoto, Kyoichi Adachi, Yuri Ebisutani, Norihisa Ishimura, Shunji Ishihara
    Internal Medicine.2024;[Epub]     CrossRef
  • Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
    Jae Myung Park
    Clinical Endoscopy.2023; 56(4): 453.     CrossRef
  • 2,616 View
  • 130 Download
  • 1 Web of Science
  • 2 Crossref
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The pattern of metachronous recurrence after endoscopic submucosal dissection for gastric adenocarcinoma and dysplasias
Sunah Suk, Yeon Joo Seo, Dae Young Cheung, Han Hee Lee, Jin Il Kim, Soo-Heon Park
Clin Endosc 2023;56(4):470-478.   Published online April 18, 2023
DOI: https://doi.org/10.5946/ce.2022.259
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated.
Methods
Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary’s Hospital.
Results
A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years-old and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan–Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53–11.40) The histological types of MGN were not related to the primary histology types.
Conclusions
MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm.

Citations

Citations to this article as recorded by  
  • Research Progress in ESD Treatment of Early Gastric Cancer
    亭 贺
    Advances in Clinical Medicine.2024; 14(02): 4201.     CrossRef
  • 1,366 View
  • 75 Download
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Utility of narrow-band imaging with or without dual focus magnification in neoplastic prediction of small colorectal polyps: a Vietnamese experience
Tien Manh Huynh, Quang Dinh Le, Nhan Quang Le, Huy Minh Le, Duc Trong Quach
Clin Endosc 2023;56(4):479-489.   Published online May 24, 2023
DOI: https://doi.org/10.5946/ce.2022.212
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm).
Methods
This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology.
Results
There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001).
Conclusions
NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

Citations

Citations to this article as recorded by  
  • Effectiveness of Dual-Focus Magnification on Confidence Levels in Optical Diagnosis of Small Colorectal Polyps
    Tien M Huynh, Quang D Le, Nhan Q Le , Huy M Le , Duc T Quach
    Cureus.2024;[Epub]     CrossRef
  • Implementing narrow banding imaging with dual focus magnification for histological prediction of small rectosigmoid polyps in Vietnamese setting
    Tien Manh Huynh, Quang Dinh Le, Nhan Quang Le, Huy Minh Le, Duc Trong Quach
    JGH Open.2024;[Epub]     CrossRef
  • The role of narrow-band imaging with or without dual focus in the detection of polyps smaller than 10 mm, especially diminutive polyps
    Jin Hwa Park
    Clinical Endoscopy.2023; 56(4): 455.     CrossRef
  • Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
    Yong Soo Kwon, Su Young Kim
    Journal of the Korean Medical Association.2023; 66(11): 652.     CrossRef
  • 2,505 View
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Safety and feasibility of opening window fistulotomy as a new precutting technique for primary biliary access in endoscopic retrograde cholangiopancreatography
Yasuhiro Kuraishi, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Takafumi Yanaidani, Sho Ishikawa, Tsukasa Yasuda, Masanori Yamada, Nobumasa Mizuno
Clin Endosc 2023;56(4):490-498.   Published online April 27, 2023
DOI: https://doi.org/10.5946/ce.2022.130
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common and serious complication of endoscopic retrograde cholangiopancreatography. To prevent this event, a unique precutting method, termed opening window fistulotomy, was performed in patients with a large infundibulum as the primary procedure for biliary cannulation, whereby a suprapapillary laid-down H-shaped incision was made without touching the orifice. This study aimed to assess the safety and feasibility of this novel technique.
Methods
One hundred and ten patients were prospectively enrolled in this study. Patients with a papillary roof size ≥10 mm underwent opening window fistulotomy for primary biliary access. In addition, the incidence of complications and success rate of biliary cannulation were evaluated.
Results
The median size of the papillary roof was 6 mm (range, 3–20 mm). Opening window fistulotomy was performed in 30 patients (27.3%), none of whom displayed PEP. Duodenal perforation was recorded in one patient (3.3%), which was resolved by conservative treatment. The cannulation rate was high (96.7%, 29/30 patients). The median duration of biliary access was 8 minutes (range, 3–15 minutes).
Conclusions
Opening window fistulotomy demonstrated its feasibility for primary biliary access by achieving great safety with no PEP complications and a high success rate for biliary cannulation.

Citations

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  • Comments on ‘Safety and feasibility of opening window fistulotomy as a new precutting technique for primary biliary access in endoscopic retrograde cholangiopancreatography’
    Masood Muhammad Karim, Adeel Ur Rehman, Faisal Wasim Ismail, Om Parkash
    Clinical Endoscopy.2024; 57(2): 280.     CrossRef
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Medical disputes related to advanced endoscopic procedures with endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the management of pancreas and biliary tract diseases
Yoon Suk Lee, Jae-Young Jang, Jun Yong Bae, Eun Hye Oh, Yehyun Park, Yong Hwan Kwon, Jeong Eun Shin, Jun Kyu Lee, Tae Hee Lee, Chang Nyol Paik
Clin Endosc 2023;56(4):499-509.   Published online March 28, 2023
DOI: https://doi.org/10.5946/ce.2022.208
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aimed to evaluate the characteristics of endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasonography (EUS)-related adverse events (AEs) that eventually lead to medical disputes or claims on medical professional liability.
Methods
Medical disputes for ERCP/EUS-related AEs filed in the Korea Medical Dispute Mediation and Arbitration Agency between April 2012 and August 2020 were evaluated using corresponding medical records. AEs were categorized into three sections: procedure-related, sedation-related, and safety-related AEs.
Results
Among a total of 34 cases, procedure-related AEs were 26 (76.5%; 12 duodenal perforations, 7 post-ERCP pancreatitis, 5 bleedings, 2 perforations combined with post-ERCP pancreatitis); sedation-related AEs were 5 (14.7%; 4 cardiac arrests, 1 desaturation), and safety-related AEs were 5 (8.8%; 1 follow-up loss for stent removal, 1 asphyxia, 1 fall). Regarding clinical outcomes, 20 (58.8%) were fatal and eventually succumbed to AEs. For the types of medical institutions, 21 cases (61.8%) occurred at tertiary or academic hospitals, and 13 (38.2%) occurred at community hospitals.
Conclusions
The ERCP/EUS-related AEs filed in Korea Medical Dispute Mediation and Arbitration Agency showed distinct features: duodenal perforation was the most frequent AE, and clinical outcomes were fatal, resulting in at least more than permanent physical impairment.
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Diagnostic value of homogenous delayed enhancement in contrast-enhanced computed tomography images and endoscopic ultrasound-guided tissue acquisition for patients with focal autoimmune pancreatitis
Keisuke Yonamine, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Hiroaki Kusunose, Toshitaka Sakai, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito
Clin Endosc 2023;56(4):510-520.   Published online April 5, 2023
DOI: https://doi.org/10.5946/ce.2022.142
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: We aimed to investigate (1) promising clinical findings for the recognition of focal type autoimmune pancreatitis (FAIP) and (2) the impact of endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) on the diagnosis of FAIP.
Methods
Twenty-three patients with FAIP were involved in this study, and 44 patients with resected pancreatic ductal adenocarcinoma (PDAC) were included in the control group.
Results
(1) Multivariate analysis revealed that homogeneous delayed enhancement on contrast-enhanced computed tomography was a significant factor indicative of FAIP compared to PDAC (90% vs. 7%, p=0.015). (2) For 13 of 17 FAIP patients (76.5%) who underwent EUS-TA, EUS-TA aided the diagnostic confirmation of AIPs, and only one patient (5.9%) was found to have AIP after surgery. On the other hand, of the six patients who did not undergo EUS-TA, three (50.0%) underwent surgery for pancreatic lesions.
Conclusions
Homogeneous delayed enhancement on contrast-enhanced computed tomography was the most useful clinical factor for discriminating FAIPs from PDACs. EUS-TA is mandatory for diagnostic confirmation of FAIP lesions and can contribute to a reduction in the rate of unnecessary surgery for patients with FAIP.

Citations

Citations to this article as recorded by  
  • A multidisciplinary approach is essential for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma
    Sung-Hoon Moon
    Clinical Endoscopy.2023; 56(4): 457.     CrossRef
  • 1,803 View
  • 75 Download
  • 1 Web of Science
  • 1 Crossref
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Case Report
Portal cavernography during endoscopic retrograde cholangiopancreatography: from bilhemia to hemobilia
Rawad A. Yared, Paraskevas Gkolfakis, Arnaud Lemmers, Vincent Huberty, Thierry Degrez, Jacques Devière, Daniel Blero
Clin Endosc 2023;56(4):521-526.   Published online January 5, 2023
DOI: https://doi.org/10.5946/ce.2021.276
AbstractAbstract PDFPubReaderePub
Portobiliary fistulas are rare but may lead to life-threatening complications. Biliary plastic stent-induced portobiliary fistulas during endoscopic retrograde cholangiopancreatography have been described. Herein, we present a case of portal cavernography and recurrent hemobilia after endoscopic retrograde cholangiopancreatography in which a portobiliary fistula was detected in a patient with portal biliopathy. This likely indicates a change in clinical presentation (from bilhemia to hemobilia) after biliary drainage that was successfully treated by placement of a fully covered, self-expandable metallic stent.
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Brief Reports
Efficacy of wire-guided biopsy forceps for tissue sampling in endoscopic retrograde cholangiopancreatography: a preliminary experience
Manaswita Tappata, Nicholas M. McDonald, Mohamed Abdallah, Mohammad Bilal
Clin Endosc 2023;56(4):527-530.   Published online February 15, 2023
DOI: https://doi.org/10.5946/ce.2022.152
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Successful treatment of a refractory bile leak with endoclips during percutaneous necrosectomy
Kelli C. Kosako Yost, Paul A. Muña Aguon, Sakolwan Suchartlikitwong, Nael Haddad, Nina Rawal, Rawad Mounzer, Teodor C. Pitea
Clin Endosc 2023;56(4):531-533.   Published online April 27, 2023
DOI: https://doi.org/10.5946/ce.2022.103
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  • 1,427 View
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Boost Your Learning with Quiz
Rare cause of granulomatous enteritis
Seung Min Hong, Byeong Kyu Park, Dong Hoon Baek
Clin Endosc 2023;56(4):534-536.   Published online May 9, 2023
DOI: https://doi.org/10.5946/ce.2023.014
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