Clinical Endoscopy

Original Article

Technical Reports of Endoscopic Retrograde Cholangiopancreatography Guidewires on the Basis of Physical Properties: Chang-Il Kwon, Dong Hee Koh, Tae Jun Song, Won Suk Park, Dong Hang Lee, Seok Jeong; Clin Endosc 2020;53(1):65-72. Published online August 6, 2019; DOI: https://doi.org/10.5946/ce.2019.114

Background
/Aims: Using an appropriate guidewire can increase the success rate of selective cannulation in endoscopic retrograde cholangiopancreatography. The purpose of this technical study was to investigate the characteristics of each guidewire type and to evaluate its efficiency and rapidity of insertion.
Methods
We conducted a three-point bending test using a universal testing machine to investigate the flexibility and bending features of each guidewire. 3D-printed silicone tubes with various types of stricture and a hand-made biliary tree silicone model with six-stranded intrahepatic ducts were used to evaluate the success rate and insertion time of each guidewire.
Results
In the three-point bending test, the characteristics of each guidewire were classified. We found that the bending strengths and times were independent of shaft thickness. Using two in vitro biliary duct models, we determined that the success rate and total insertion time were better for guidewires with a resilient shaft and angled tip than for other types of guidewires (p<0.001). Although thickness of the guidewire affected the success rate (p<0.05), it did not affect the total insertion time (p≥0.05).
Conclusions
Among several types of guidewire, some factors (resilient shaft, highly flexible, and angled tip) appeared to be associated with the efficiency and rapidity of the guidewire insertion.

Citations

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Structural factors influencing the clinical performance of 0.025-inch guidewires for pancreatobiliary endoscopy: An experimental study
Takehiko Koga, Naoaki Tsuchiya, Yusuke Ishida, Takanori Kitaguchi, Keisuke Matsumoto, Makoto Fukuyama, Satoki Kojima, Norihiro Kojima, Fumihito Hirai
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Guidewire Impaction in the Main Pancreatic Duct in a Patient with Chronic Pancreatitis: A Case Report
Soyoung Kim, Hoonsub So, Seok Won Jung, Sung Jo Bang
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Efficacy of a newly developed guidewire for selective biliary access
Do Hyun Park, Joung-Ho Han, Tae Hoon Lee, Jae Kook Yang, Ji Sung Lee, Yong Hun Lee, Mamoru Takenaka, Sang-Heum Park
Scientific Reports.2023;[Epub] CrossRef
Efficacy of a Newly Developed Guidewire for Selective Biliary Cannulation: A Multicenter Randomized Controlled Trial
Sung Yong Han, Sung Ill Jang, Dong Hee Koh, Jong Hyun Lee, Dong Uk Kim, Jae Hee Cho, Kyong Joo Lee, Seong-Hun Kim, Min Je Sung, Chang-Il Kwon
Journal of Clinical Medicine.2023; 12(10): 3440. CrossRef
Comparison of Two Types of Guidewires for Malignant Hilar Biliary Obstruction by Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Trial
Sung Yong Han, Jung Wan Choe, Dong Uk Kim, Jong Jin Hyun, Joung-Ho Han, Hoonsub So, Sung Jo Bang, Dong Hee Koh, Seok Jeong
Journal of Clinical Medicine.2023; 12(10): 3590. CrossRef
Comparison of guidewires for successful cannulation of biliary stenosis and targeting of biliary branches in ERCP
Masanori Kobayashi, Hiromune Katsuda, Kazuo Ohtsuka, Ryuichi Okamoto
Endoscopy International Open.2023; 11(09): E805. CrossRef
Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires
Muhammad Aziz, Amna Iqbal, Zohaib Ahmed, Saad Saleem, Wade Lee-Smith, Hemant Goyal, Faisal Kamal, Yaseen Alastal, Ali Nawras, Douglas G. Adler
Endoscopy International Open.2022; 10(07): E990. CrossRef
Experimental study of loop shape using 0.025-inch ERCP guidewires (with videos)
Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Tadahiro Yamada, Masanori Yamada, Kazuya Ueshima, Jun Matsuno, Yoshitaro Yamamoto, Kazuhide Higuchi
Endoscopy International Open.2021; 09(03): E427. CrossRef
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Takeshi Ogura, Kazuhide Higuchi
Clinical Endoscopy.2021; 54(5): 651. CrossRef
Difficult Biliary Cannulation in Endoscopic Retrograde Cholangiopancreatography: Definitions, Risk Factors, and Implications
Brian M. Fung, Teodor C. Pitea, James H. Tabibian
EMJ Hepatology.2021; : 64. CrossRef
Production of ERCP training model using a 3D printing technique (with video)
Chang-Il Kwon, Yeonsun Shin, Jaeok Hong, Minje Im, Guk Bae Kim, Dong Hee Koh, Tae Jun Song, Won Suk Park, Jong Jin Hyun, Seok Jeong
BMC Gastroenterology.2020;[Epub] CrossRef
Clinical Evaluation of a Newly Developed Guidewire for Pancreatobiliary Endoscopy
Shigeto Ishii, Toshio Fujisawa, Hiroyuki Isayama, Shingo Asahara, Shingo Ogiwara, Hironao Okubo, Hisafumi Yamagata, Mako Ushio, Sho Takahashi, Hiroki Okawa, Wataru Yamagata, Yoshihiro Okawa, Akinori Suzuki, Yusuke Takasaki, Kazushige Ochiai, Ko Tomishima,
Journal of Clinical Medicine.2020; 9(12): 4059. CrossRef

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Case Report

Endoscopic Submucosal Dissection Followed by Concurrent Chemoradiotherapy in Patients with Early Esophageal Cancer with a High Risk of Lymph Node Metastasis: Hee Kyung Kim, Weon Jin Ko, Chang-Il Kwon, Ga Won Song, In Kyun Yoo, Ji Hyun Song, Hak Su Kim, Joo Young Cho; Clin Endosc 2019;52(5):502-505. Published online May 14, 2019; DOI: https://doi.org/10.5946/ce.2018.176

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Endoscopic submucosal dissection is recommended as an alternative therapy for early esophageal cancer. However, achieving curative resection in this procedure remains controversial since precise prediction of lymph node metastasis can be difficult. Here, we present the preliminary results of endoscopic submucosal dissection followed by concurrent chemoradiotherapy for early esophageal cancer with a high risk of lymph node metastasis. From May 2006 to January 2014, six patients underwent concurrent chemoradiotherapy after endoscopic submucosal dissection with a median follow-up period of 63 months. No complications were encountered during concurrent chemoradiotherapy. Although local recurrence did not occur in all patients, two patients were diagnosed with metachronous cancer. Overall, the survival rate was 100%. Thus, endoscopic submucosal dissection followed by concurrent chemoradiotherapy may be a feasible treatment for early esophageal cancer in patients with a high risk of lymph node metastasis. Future prospective large-scale studies are warranted to confirm our results.

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Commentary

Will New Instruments for Endoscopic Ultrasound-Guided Tissue Acquisition Make Us Happy?: Chang-Il Kwon; Clin Endosc 2018;51(6):510-512. Published online November 23, 2018; DOI: https://doi.org/10.5946/ce.2018.164

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Brief Reports

An Unusual Mimicker of a Pancreatic Pseudocyst: Sang Ah Choi, Chang-Il Kwon, Gwangil Kim, Daejung Kim, Sung Hoon Choi; Clin Endosc 2018;51(3):304-305. Published online March 22, 2018; DOI: https://doi.org/10.5946/ce.2017.160

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Immediate Endoscopic Management of an Intramural Hematoma Developed during Colonoscopy: Chang-Il Kwon, Duck Hwan Kim, Sung Pyo Hong; Clin Endosc 2017;50(5):508-509. Published online August 3, 2017; DOI: https://doi.org/10.5946/ce.2017.037

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Perspectives and Management Strategies for Acute Colonic Intramural Hematoma
Reham Samir, Mohamed B Hashem, Hedy A Badary, Ahmed Bahaa, Nader Bakheet
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Guide-Wire Assisted Endobiliary Forceps Biopsy Sampling: Chang-Il Kwon, Tae Hoen Kim, Kyoung Ah Kim; Clin Endosc 2017;50(4):404-405. Published online February 13, 2017; DOI: https://doi.org/10.5946/ce.2016.149

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Endobiliary biopsy
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Focused Review Series: Past, present and future of gastrointestinal stents

Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention: Chang-Il Kwon, Glen A. Lehman; Clin Endosc 2016;49(2):139-146. Published online March 22, 2016; DOI: https://doi.org/10.5946/ce.2016.024

Abstract PDF PubReader ePub

Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, we will discuss basic mechanisms of plastic stent occlusion, along with a systematic summary of previous efforts and related studies to improve stent patency and potential new techniques to overcome existing limitations.

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Original Article

Optimal Methods for the Management of Iatrogenic Colonoscopic Perforation: Dae Kyu Shin, Sun Young Shin, Chi Young Park, Sun Mi Jin, Yang Hyun Cho, Won Hee Kim, Chang-Il Kwon, Kwang Hyun Ko, Ki Baik Hahm, Pil Won Park, Jong Woo Kim, Sung Pyo Hong; Clin Endosc 2016;49(3):282-288. Published online February 18, 2016; DOI: https://doi.org/10.5946/ce.2015.046

Abstract PDF PubReader ePub

Background
/Aims: Colonoscopic perforations have been managed with exploratory laparotomy, and have resulted in some morbidity and mortality. Recently, laparoscopic surgery is commonly performed for this purpose. The aim of this study was to compare the outcomes of several management strategies for iatrogenic colonoscopic perforations.
Methods
We retrospectively reviewed the medical records of patients who had been treated for colonoscopic perforation between January 2004 and April 2013 at CHA Bundang Medical Center in Korea.
Results
A total of 41 patients with colonoscopic perforation were enrolled. Twenty patients underwent conservative management with a success rate of 90%. Surgical management was performed in 23 patients including two patients who were converted to surgical management after the failure of the initial conservative management. Among 14 patients who underwent surgery at 8 hours after the perforation, there was no considerable difference in adverse outcomes between the laparotomy group and the laparoscopic surgery group. The medical costs and claim rate were 1.45 and 1.87 times greater in the exploratory laparotomy group, respectively.
Conclusions
Conservative management of colonoscopic perforation could be an option for patients without overt symptoms of peritonitis or with a small defect size. If surgical management is required, laparoscopic surgery may be considered as the initial procedure even with a delayed diagnosis.

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Alexander T. Hawkins, Kenneth W. Sharp, Molly M. Ford, Roberta L. Muldoon, M. Benjamin Hopkins, Timothy M. Geiger
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Mircea Gabriel Mureșan, Ioan Alexandru Balmoș, Iudita Badea, Ario Santini
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Case Report

Communicating Tubular Esophageal Duplication Combined with Bronchoesophageal Fistula: Ju Hwan Kim, Chang-Il Kwon, Ji Young Rho, Sang Woo Han, Ji Su Kim, Suk Pyo Shin, Ga Won Song, Ki Baik Hahm; Clin Endosc 2016;49(1):81-85. Published online January 28, 2016; DOI: https://doi.org/10.5946/ce.2016.49.1.81

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Esophageal duplication (ED) is rarely diagnosed in adults and is usually asymptomatic. Especially, ED that is connected to the esophagus through a tubular communication and combined with bronchoesophageal fistula (BEF) is extremely rare and has never been reported in the English literature. This condition is very difficult to diagnose. Although some combinations of several modalities, such as upper gastrointestinal endoscopy, esophagography, computed tomography, magnetic resonance imaging, and endoscopic ultrasonography, can be used for the diagnosis, the results might be inconclusive. Here, we report on a patient with communicating tubular ED that was incidentally diagnosed on the basis of endoscopy and esophagography during the postoperational evaluation of BEF.

Citations

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Reconstruction of Adult Tubular Esophageal Duplication with Supraclavicular Artery Island Flap: A Rare Case Presentation
Xin Yang, Zheng Jiang, Jun Liu, Fei Chen
Ear, Nose & Throat Journal.2023; : 014556132311734. CrossRef
Tubular Duplication of the Esophagus in a Newborn, Treated by Thoracoscopy
Igor Khvorostov, Alexey Gusev, Abdumanap Alkhasov, Sergey Yatsyk, Elena D'yakonova
European Journal of Pediatric Surgery Reports.2022; 10(01): e49. CrossRef
Endoscopic septum division of tubular esophageal duplication in two children and systematic review
Rahşan Özcan, Ali Ekber Hakalmaz, Şenol Emre, Ayşe Karagöz, Çiğdem Tütüncü, Sebuh Kuruğoğlu, Gonca Topuzlu Tekant
Pediatric Surgery International.2022; 38(11): 1525. CrossRef
Endoscopic management of a tubular esophageal duplication in a young adult
Pietro Familiari, Rosario Landi, Francesca Mangiola, Camilla Vittoria Vita, Guido Costamagna
VideoGIE.2020; 5(10): 455. CrossRef
Esophageal duplication and congenital esophageal stenosis
A. Francois Trappey, Shinjiro Hirose
Seminars in Pediatric Surgery.2017; 26(2): 78. CrossRef

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Original Articles

Twenty-Second versus Sixty-Second Dilation Duration in Endoscopic Papillary Balloon Dilation for the Treatment of Small Common Bile Duct Stones: A Prospective Randomized Controlled Multicenter Trial: Byoung Wook Bang, Tae Hoon Lee, Tae Jun Song, Joung-Ho Han, Hyun Jong Choi, Jong Ho Moon, Chang-Il Kwon, Seok Jeong; Clin Endosc 2015;48(1):59-65. Published online January 31, 2015; DOI: https://doi.org/10.5946/ce.2015.48.1.59

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Background/Aims

Endoscopic papillary balloon dilation (EPBD) has been advocated as an alternative therapy to endoscopic sphincterotomy for the treatment of common bile duct (CBD) stones. However, there is no established consensus on the optimal balloon dilation duration (BDD). We prospectively evaluated the efficacy and post-endoscopic retrograde cholangiopancreatography (ERCP) complications between the 20- and 60-second EPBD groups.

Methods

A total of 228 patients with small CBD stones (≤12 mm) were randomly assigned to undergo EPBD with a 20- or 60-second duration at six institutions. We evaluated baseline patient characteristics, endoscopic data, clinical outcomes, and procedure-related complications. In addition, we analyzed risk factors for postprocedural pancreatitis.

Results

CBD stones were removed successfully in 107 of 109 patients (98.1%) in the 20-second group and in 112 of 119 patients (94.1%) in the 60-second group (p=0.146). Post-ERCP pancreatitis developed in seven patients (6.4%) in the 20-second group and nine patients (7.5%) in the 60-second group (p=0.408). In multivariate analysis, contrast dye injection into the pancreatic duct is a significant risk factor for post-EPBD pancreatitis.

Conclusions

Based on the data showing that there were no significant differences in safety and efficacy between the two BDD groups, 20 seconds of BDD may be adequate for treatment of small CBD stones with EPBD.

Citations

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The therapeutic effect of balloon dilatation with different duration for biliary duct calculi: A network meta-analysis
ZhiYuan Yu, Chen Liang, ShiYu Yang, Xu Zhang, Yan Sun
Journal of Minimal Access Surgery.2022; 18(3): 327. CrossRef
The ballooning time in endoscopic papillary balloon dilation for removal of bile duct stones
Qiang Wang, Luyao Fu, Tao Wu, Xiong Ding
Medicine.2021; 100(11): e24735. CrossRef
Nouveautés dans la prise en charge des calculs biliaires à l’UEGW 2015
E. Bories, C. Lefort
Acta Endoscopica.2016; 46(1-2): 20. CrossRef
Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?
Toshio Fujisawa, Koichi Kagawa, Kantaro Hisatomi, Kensuke Kubota, Atsushi Nakajima, Nobuyuki Matsuhashi
World Journal of Gastroenterology.2016; 22(26): 5909. CrossRef
Is the Balloon Dilation Duration in Endoscopic Papillary Balloon Dilation (EPBD) Related to the Occurrence of Post-EPBD Pancreatitis?
Dong Uk Kim
Clinical Endoscopy.2015; 48(1): 6. CrossRef

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Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video): Chang-Il Kwon, Gwangil Kim, Il-Kwun Chung, Won Hee Kim, Kwang Hyun Ko, Sung Pyo Hong, Seok Jeong, Don Haeng Lee; Clin Endosc 2014;47(6):544-554. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.544

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives.

Methods

This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed.

Results

A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm²/sec vs. 1.57 mm²/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities.

Conclusions

ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.

Citations

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Jian Tang, Shufang Ye, Xueliang Ji, Jun Li, Feng Liu
Surgical Endoscopy.2018; 32(12): 5037. CrossRef
Technological review on endoscopic submucosal dissection: available equipment, recent developments and emerging techniques
Georgios Mavrogenis, Juergen Hochberger, Pierre Deprez, Morteza Shafazand, Dimitri Coumaros, Katsumi Yamamoto
Scandinavian Journal of Gastroenterology.2017; 52(4): 486. CrossRef

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Commentary

Long-Term Outcome of Endoscopic Papillary Large Balloon Dilatation: Chang-Il Kwon; Clin Endosc 2013;46(6):601-602. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.601

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Case Report

Endoscopic Resection of Giant Colonic Lipoma: Case Series with Partial Resection: Gun Woo Kim, Chang-Il Kwon, Sang Hee Song, Sun Mi Jin, Kyung Ho Kim, Jie Hye Moon, Sung Pyo Hong, Pil Won Park; Clin Endosc 2013;46(5):586-590. Published online September 30, 2013; DOI: https://doi.org/10.5946/ce.2013.46.5.586

Abstract PDF PubReader ePub

Colonic lipoma, a very rare form of benign tumor, is typically detected incidentally in asymptomatic patients. The size of lipoma is reported variously from 2 mm to 30 cm, with higher likelihood of symptoms as the size is bigger. Cases with symptom or bigger lesion are surgically resected in principle; endoscopic resection, which has developed recently with groundbreaking advance of endoscopic excision technology, is being used more often but with rare report of success due to high chance of complications such as bowel perforation or bleeding. The authors report here, together with a literature review, our experiences of three cases of giant colonic lipomas showing complete remission after aggressive unroofing technique, at certain intervals, using snare catheter at the origin of the lipoma so that the remaining lipoma could be drained out of the exposed surface spontaneously, in order to reduce complications.

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A giant colonic lipoma
Tara M. Connelly, Cillian Clancy, Shaomin Hu, Joshua Sommovilla
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Jenson Phung, Morgan Freeman, Mohammad Bilal
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Jun Yong Bae, Hun Kyu Kim, Yee Jin Kim, Se Woong Kim, Youngeun Lee, Chang Beom Ryu, Moon Sung Lee
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Kenneth Ford, Samantha Lopez, Gaurav Synghal, Yomi Fayiga, Brittany Carter, Anuj Kandel, Kenneth Ford
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U. B. Urmonov, S. G. Afanasyev, A. Yu. Dobrodeev, A. V. Avgustinovich, M. Yu. Volkov, N. V. Vasiliev, E. N. Samtsov
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Michiel Bronswijk, Anne‐Marie Vandenbroucke, Peter Bossuyt
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Special Issue Article of IDEN 2013

Functional Self-Expandable Metal Stents in Biliary Obstruction: Chang-Il Kwon, Kwang Hyun Ko, Ki Baik Hahm, Dae Hwan Kang; Clin Endosc 2013;46(5):515-521. Published online September 30, 2013; DOI: https://doi.org/10.5946/ce.2013.46.5.515

Abstract PDF PubReader ePub

Biliary stents are widely used not only for palliative treatment of malignant biliary obstruction but also for benign biliary diseases. Each plastic stent or self-expandable metal stent (SEMS) has its own advantages, and a proper stent should be selected carefully for individual condition. To compensate and overcome several drawbacks of SEMS, functional self-expandable metal stent (FSEMS) has been developed with much progress so far. This article looks into the outcomes and defects of each stent type for benign biliary stricture and describes newly introduced FSEMSs according to their functional categories.

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Anti-fibrotic and anti-stricture effects of biodegradable biliary stents braided with dexamethasone-impregnated sheath/core structured monofilaments
Ju-Ro Lee, Seung Won Yang, Chang-Il Kwon, Kyu Seok Kim, Se Hwan Park, Myeong Jin Jang, Ga Hee Kim, Min Je Sung, Gwangil Kim, Jun Sik Son, Yoon Ki Joung
Acta Biomaterialia.2024; 178: 137. CrossRef
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Nga T. Nguyen, Hasan A. Khan, Kian Abdul-Baki, Woongsoon Choi, Neel K. Shroff, Zahra Akhtar, Peeyush Bhargava
Clinical Imaging.2023; 103: 109986. CrossRef
Research progress on biliary stents

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Gutian Zhao, Yuan Tian, Rixin Hua, Qingwei Liu, Jie Cheng, Gensheng Wu, Yi Zhang, Zhonghua Ni
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Preliminary application of brachytherapy with double-strand 125I seeds and biliary drainage for malignant obstructive jaundice
Zong-Ming Li, De-Chao Jiao, Xin-Wei Han, Qin-Yu Lei, Xue-Liang Zhou, Miao Xu
Surgical Endoscopy.2022; 36(7): 4932. CrossRef
A viewpoint on material and design considerations for oesophageal stents with extended lifetime
Caitlin E. Jackson, Liam S. J. Johnson, Dominic A. Williams, Hans-Ulrich Laasch, Derek W. Edwards, Alison G. Harvey
Journal of Materials Science.2022; 57(1): 3. CrossRef
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Saswat Choudhury, Sonal Asthana, Shervanthi Homer-Vanniasinkam, Kaushik Chatterjee
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Tsuyoshi Hamada, Yousuke Nakai, Hiroyuki Isayama, Kazuhiko Koike
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Yuan Tian, Jing Zhang, Jie Cheng, Gensheng Wu, Yi Zhang, Zhonghua Ni, Gutian Zhao
Journal of Applied Polymer Science.2021;[Epub] CrossRef
Mechanical properties and degradation process of biliary self‐expandable biodegradable stents
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Digestive Endoscopy.2021; 33(7): 1158. CrossRef
Biodegradable Stent/Tube for Pancreatic and Biliary Disease
Chang-Il Kwon
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Drug-eluting Biliary Stent
Sung Ill Jang, Dong Ki Lee
The Korean Journal of Pancreas and Biliary Tract.2020; 25(1): 11. CrossRef
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Dong Wook Lee, Jimin Han
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Relief of Obstruction in the Management of Pancreatic Cancer
Chang-Il Kwon
The Korean Journal of Gastroenterology.2019; 74(2): 69. CrossRef
The Stent Patency and Migration Rate of Different Shaped Plastic Stents in Bile Flow Phantom Model and In Vivo Animal Bile Duct Dilation Model
Chang-Il Kwon, Gwangil Kim, Seok Jeong, Don Haeng Lee, Kyoung Ah Kim, Kwang Hyun Ko, Joo Young Cho, Sung Pyo Hong
Digestive Diseases and Sciences.2017; 62(5): 1246. CrossRef
Current Status of Biliary Metal Stents
Hyeong Seok Nam, Dae Hwan Kang
Clinical Endoscopy.2016; 49(2): 124. CrossRef
Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention
Chang-Il Kwon, Glen A. Lehman
Clinical Endoscopy.2016; 49(2): 139. CrossRef
Time Sequence Evaluation of Biliary Stent Occlusion by Dissection Analysis of Retrieved Stents
Chang-Il Kwon, Mark A. Gromski, Stuart Sherman, Jeffrey J. Easler, Ihab I. El Hajj, James Watkins, Evan L. Fogel, Lee McHenry, Glen A. Lehman
Digestive Diseases and Sciences.2016; 61(8): 2426. CrossRef
Bile Flow Phantom Model and Animal Bile Duct Dilation Model for Evaluating Biliary Plastic Stents with Advanced Hydrophilic Coating
Chang-Il Kwon, Gwangil Kim, Seok Jeong, Won Seop Lee, Don Haeng Lee, Kwang Hyun Ko, Sung Pyo Hong, Ki Baik Hahm
Gut and Liver.2016; 10(4): 632. CrossRef
Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent
Dong Hoon Yang, Sang Wook Park, Hyeung Chul Moon, Kyoung Wan You, Seo Joon Eun, Seung Ki Moon, Choel Min Bak, Shin Hyoung Jo
Korean Journal of Pancreas and Biliary Tract.2016; 21(4): 222. CrossRef
Reintervention for occluded metal stent in malignant bile duct obstruction: A prospective randomized trial comparing covered and uncovered metal stent
Ban Seok Lee, Ji Kon Ryu, Dong Kee Jang, Kwang Hyun Chung, Won Jae Yoon, Jaihwan Kim, Sang Myung Woo, Sang Hyub Lee, Woo Jin Lee, Yong‐Tae Kim
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Stephen Thomas, Rina P. Patel, Aytekin Oto
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Allyson Berent, Chick Weisse, Mark Schattner, Hans Gerdes, Peter Chapman, Michael Kochman
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Recent Advances in Gastrointestinal Stent Development
Jin-Seok Park, Seok Jeong, Don Haeng Lee
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Stents with specialized functions: drug-eluting stents and stents with antireflux devices
Sung Ill Jang, Dong Ki Lee
Gastrointestinal Intervention.2015; 4(1): 50. CrossRef
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Gerardo Blanco Rodríguez, Juan Manuel Blancas Valencia, Gustavo Varela Fascinetto, José Alejandro Hernández Plata, Juan Manuel Alcantar Fierros, Gustavo Teyssier Morales, Jaime Penchyna Grub
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Biomaterials Research.2014;[Epub] CrossRef

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Original Article

Angular Positioning of Stent Increases Bowel Perforation after Self-Expandable Metal Stent Placement for Malignant Colorectal Obstruction: Jeong Guil Lee, Kwang Ho Yoo, Chang-Il Kwon, Kwang Hyun Ko, Sung Pyo Hong; Clin Endosc 2013;46(4):384-389. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.384

Abstract PDF PubReader ePub

Background/Aims

Some factors like stent wires, balloon dilatation and use of guide wires seems to increase perforation after self-expandable metal stent (SEMS) placement, but few studies mentioned about the relationship between angulation of malignant stricture and perforation. The present study aimed to confirm that more angular positioning of stents increases perforation.

Methods

This study was conducted with retrospectively evaluation at Digestive Disease Center, CHA Bundang Medical Center, CHA University. Between January 2002 and August 2011, SEMS was inserted in 130 patients with malignant colorectal obstruction. We studied the difference in the angle of stenosis between perforation and non-perforation groups using fluorography images.

Results

SEMS insertion was performed in 130 cases of obstruction due to colon cancer. Perforation occurred in eight patients (6.2%) of them. Thirteen cases were excluded from the analysis due to poor fluoroscopic images. Among the eight patients with perforation, the mean stenosis angle was 109.9° compared to 153.1° in the nonperforation group, indicating that the angle was more acute in the perforation group (p=0.016).

Conclusions

This study shows that more angular positioning of stent increases bowel perforation after SEMS placement for malignant colorectal obstruction.

Citations

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S.V. Davydova, A.G. Fedorov, O.A. Yun, A.E. Klimov
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Hiroshi Takeyama, Kotaro Kitani, Tomoko Wakasa, Masanori Tsujie, Yoshinori Fujiwara, Shigeto Mizuno, Masao Yukawa, Yoshio Ohta, Masatoshi Inoue
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Se Hui Oh, Nak Jun Choi, Sang Hyuk Seo, Min Sung An, Kwang Hee Kim, Ki Beom Bae, Jin Won Hwang, Sang Heon Lee, Ji Hyun Kim, Sam Ryong Jee, Mi Seon Kang, Kwan Hee Hong
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Chen-Wang Chang, Jau-Min Wong, Chien-Chih Tung, I-Lun Shih, Horng-Yuan Wang, Shu-Chen Wei
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Derek J. Boyle, Christopher Thorn, Ashish Saini, Colin Elton, Gary K. Atkin, Ian C. Mitchell, Kevin Lotzof, Adrian Marcus, Pawan Mathur
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Nandakumar Srinivasan, Richard A. Kozarek
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Review

Unusual Complications Related to Endoscopic Retrograde Cholangiopancreatography and Its Endoscopic Treatment: Chang-Il Kwon, Sang Hee Song, Ki Baik Hahm, Kwang Hyun Ko; Clin Endosc 2013;46(3):251-259. Published online May 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.3.251

Abstract PDF PubReader ePub

Endoscopic retrograde cholangiopancreatography (ERCP)-induced complications, once occurred, can lead to significant morbidity. Commonly 5% to 10% of patients experience procedure related complications such as post-ERCP pancreatitis, biliary hemorrhage, and cholangitis, in descending order. However, complications such as perforation, pneumothorax, air embolism, splenic injury, and basket impaction are rare but are associated with high mortality if occurred. Such unexpected unusual complications might extend the length of hospitalization, require urgent surgical intervention, and put the patient in miserable condition leading to permanent disability or mortality. Although these ERCP-induced complications can be minimized by a skilled operator using advanced techniques and devices, the occurrence of unusual complications are hard to expect and induce very difficult management condition. In this review, we will focus on the uncommon complications related to ERCP. This review is also aimed at suggesting optimal endoscopic treatment strategies for several complications based on our institutional experiences.

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Brief Report

Balloon Catheter Assisted Biliary Stent Insertion: Chang-Il Kwon, Kwang Hyun Ko; Clin Endosc 2013;46(2):201-202. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.201

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Differentiated approach of using extraction balloon catheters in endoscopic biliary surgery
A. E. Kotovskiy, B. M. Magomedova, K. G. Glebov, A. A. Martyntsov, A. K. Mahmudova, A. S. Prividentseva
Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2021; 26(3): 123. CrossRef

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Focused Review Series: Globalization and Universalization of ESD

Endoscopic Submucosal Dissection (ESD) Training and Performing ESD with Accurate and Safe Techniques: Chang-Il Kwon; Clin Endosc 2012;45(4):347-349. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.347

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Introduction of endoscopic submucosal dissection (ESD) has brought about a renaissance in therapeutic endoscopy. For the globalization and universalization of ESD, the number of physicians who can perform ESD has rapidly increased with general ex vivo and in vivo training using animal models and hand-on courses. In this focused review series, world-renowned ESD experts described the published studies or their own precious experiences about ESD training and performing ESD with accurate and safe techniques. First, Dr. Adolfo Parra-Blanco reviewed on ex vivo and in vivo models for ESD training. Next, Dr. Joo Young Cho described detailed practical settings and current status of hands-on courses using ex vivo and in vivo models in Korea. Dr. Takashi Toyonaga described quality controlled ESD and basic techniques to prevent complications. Dr. Tsuneo Oyama reviewed recently published methods to facilitate ESD. Dr. Jae-Young Jang reviewed the usefulness of magnifying and narrow band imaging to measure the depth of invasion before ESD.

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Victor Efrén Gallardo Cabrera, Oscar Hernández Mondragón, Dulce María Rascón Martínez, Gerardo Blanco Velasco, Roberto Ramos González, Amina Evelyn Tun Abraham, Juan Manuel Blancas Valencia
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Training in endoscopic submucosal dissection
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World Journal of Gastrointestinal Endoscopy.2013; 5(8): 369. CrossRef

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Case Report

An Impacted Pancreatic Stone in the Papilla Induced Acute Obstructive Cholangitis in a Patient with Chronic Pancreatitis: Kwang-Ho Yoo, Chang-Il Kwon, Sang-Wook Yoon, Won Hee Kim, Jung Min Lee, Kwang Hyun Ko, Sung Pyo Hong, Pil Won Park; Clin Endosc 2012;45(1):99-102. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.99

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Obstructive jaundice is very rarely caused by impaction of a pancreatic stone in the papilla. We report here on a case of obstructive jaundice with acute cholangitis that was caused by an impacted pancreatic stone in the papilla in a patient with chronic pancreatitis. A 48-year-old man presented with acute obstructive cholangitis. Abdominal computed tomography with the reconstructed image revealed distal biliary obstruction that was caused by a pancreatic stone in the pancreatic head, and there was also pancreatic ductal dilatation and parenchymal atrophy of the pancreatic body and tail with multiple calcifications. Emergency duodenoscopy revealed an impacted pancreatic stone in the papilla. Precut papillotomy using a needle knife was performed, followed by removal of the pancreatic stone using grasping forceps. After additional sphincterotomy, a large amount of dark-greenish bile juice gushed out. The patient rapidly improved and he has remained well.

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Anurag J. Shetty, C. Ganesh Pai, Shiran Shetty, Girisha Balaraju
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