Clinical Endoscopy

Reviews

Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections: Chi Hyuk Oh, Jun Kyu Lee, Tae Jun Song, Jin-Seok Park, Jae Min Lee, Jun Hyuk Son, Dong Kee Jang, Miyoung Choi, Jeong-Sik Byeon, In Seok Lee, Soo Teik Lee, Ho Soon Choi, Ho Gak Kim, Hoon Jai Chun, Chan Guk Park, Joo Young Cho; Clin Endosc 2021;54(4):505-521. Published online July 27, 2021; DOI: https://doi.org/10.5946/ce.2021.185

Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to develope medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on Indications for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.

Citations

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Benign biliary stricture caused by transduodenal lumen-apposing metal stent placement for pancreatic acute necrotic collection
Shuhei Shintani, Takuya Okamoto, Kosuke Hiroe, Hidenori Kimura, Hiroto Inoue, Atsushi Nishida, Osamu Inatomi
International Journal of Gastrointestinal Intervention.2025; 14(1): 24. CrossRef
Optimal timing for lumen-apposing metal stent removal following endoscopic ultrasound-guided drainage of pancreatic fluid collections: a systematic review and meta-analysis
Marcello Maida, Giacomo Emanuele Maria Rizzo, Mario Traina, John Gásdal Karstensen, Rogier P. Voermans, Joan B. Gornals, Nitin Jagtap, Dario Ligresti, Lucio Carrozza, Gabriele Rancatore, Marco Ventimiglia, Antonio Facciorusso, Carlo Fabbri, Andrea Anderlo
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The evolving role of endoscopic ultrasound-guided lumen-apposing metal stents in the management of peri-pancreatic fluid collections
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Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Management of infected necrotizing pancreatitis with open abdomen and negative pressure therapy
Elías G. Loaeza, Sury A. L. Cancino, Roberto E. G. López, Nataly O. Hernández
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Paulina Kluszczyk, Aleksandra Tobiasz, Adam Madej, Piotr Wosiewicz, Sławomir Mrowiec, Beata Jabłońska
Journal of Clinical Medicine.2025; 14(17): 6152. CrossRef
Pancreatic Pseudocyst after Fully Covered Self-expandable Metallic Stent Placement
Mitsuhito Koizumi, Sho Ishikawa, Kaori Marui, Masahito Kokubu, Yusuke Okujima, Yuki Numata, Yoshiki Imamura, Teru Kumagi, Yoichi Hiasa
Internal Medicine.2024; 63(21): 2943. CrossRef
Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions
Miruna Patricia Olar, Maria Iacobescu, Sorana D. Bolboacă, Cristina Pojoga, Ofelia Moșteanu, Radu Seicean, Ioana Rusu, Oana Banc, Cristina Adela Iuga, Andrada Seicean
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Comparative outcome of single versus two double-pigtail stents for endoscopic drainage of pancreatic fluid collections with minimal necrosis: a retrospective analysis
S Giri, S Bhrugumalla, S Gangadhar, S Angadi
Acta Gastro Enterologica Belgica.2024; 87(1): 1. CrossRef
Use of an endoscopic powered debridement device for treatment of post-surgical fatty pancreatic necrosis
Judy Daboul, Shiab Mussad, Anna Cecilia Amaral, Waleed K. Hussain, Peter J. Lee, Samuel Han
Clinical Endoscopy.2024; 57(3): 412. CrossRef
Single double pigtail plastic stent (DPT) is equally effective to two double pigtail plastic stents for endoscopic ultrasonography-guided drainage of "symptomatic peripancreatic fluid collection with 30 % or less necrotic debris"
Hemanta Kumar Nayak, Shubham Gupta, Manas Kumar Panigrahi, Abhijeet Rai, Saswati Kar, Mansi Chaudhary, Ajay Ghosh, Taraprasad Tripathy, Bramhadatta Pattnaik, Subash Chandra Samal
Pancreatology.2024; 24(7): 1211. 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
Drainage for fluid collections post pancreatic surgery and acute pancreatitis: similar but different?
Yousuke Nakai, Saburo Matsubara, Tsuyoshi Mukai, Tsuyoshi Hamada, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda
Clinical Endoscopy.2024; 57(6): 735. CrossRef
Endoscopic ultrasound-guided drainage for local complications related to pancreatitis
Hyung Ku Chon, Seong-Hun Kim
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Cystic fluid biomarkers for the differential diagnosis of inflammatory and non-inflammatory cystic pancreatic lesions (Neutrophil gelatinase-associated lipocalin (NGAL); Interleukin 1 Beta(IL 1β); High-mobility group AT-hook 2(HmgA2))
M. P. Olar, R. Seicean, M. Iacobescu, C. A. Iuga, S. D. Bolboaca, I. Rusu, O. Mosteanu, Z. Sparchez, C. Pojoga, A. H. Nadim, A. Seicean
Endoscopy.2023; 55(S 02): S47. CrossRef
A preferable modality for the differentiation of peripancreatic fluid collections: Endoscopic ultrasound
Ning Xu, Longsong Li, Danqi Zhao, Zixin Wang, Xueting Wang, Runzi Wang, Yanbo Zeng, Lei Zhang, Ning Zhong, Ying Lv, Enqiang Linghu, Ningli Chai
Endoscopic Ultrasound.2022; 11(4): 291. CrossRef
Disconnected pancreatic duct syndrome in acute pancreatitis
A.V. Fedorov, V.N. Ektov, M.A. Khodorkovsky
Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (8): 83. CrossRef
Single balloon enteroscopy-guided endoscopic retrograde pancreatography for the treatment of a symptomatic pancreatic pseudocyst complicated by pancreaticojejunostomy stricture: A case report
Eunae Cho, Chang-Hwan Park, Seo Yeon Cho
Medicine.2022; 101(43): e31293. CrossRef

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Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition of Pancreatic Solid Tumor: Korean Society of Gastrointestinal Endoscopy (KSGE): Moon Jae Chung, Se Woo Park, Seong-Hun Kim, Chang Min Cho, Jun-Ho Choi, Eun Kwang Choi, Tae Hoon Lee, Eunae Cho, Jun Kyu Lee, Tae Jun Song, Jae Min Lee, Jun Hyuk Son, Jin Suk Park, Chi Hyuk Oh, Dong-Ah Park, Jeong-Sik Byeon, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun, Ho Soon Choi, Chan Guk Park, Joo Young Cho; Clin Endosc 2021;54(2):161-181. Published online March 24, 2021; DOI: https://doi.org/10.5946/ce.2021.069

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Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition of pancreatic solid tumor. The strength of recommendation and the level of evidence for each statement were graded according to the Minds Handbook for Clinical Practice Guideline Development 2014. The committee, comprising a development panel of 16 endosonographers and an expert on guideline development methodology, developed 12 evidence-based recommendations in 8 categories intended to help physicians make evidence-based clinical judgments with regard to the diagnosis of pancreatic solid tumor. This clinical practice guideline discusses EUS-guided sampling in pancreatic solid tumor and makes recommendations on circumstances that warrant its use, technical issues related to maximizing the diagnostic yield (e.g., needle type, needle diameter, adequate number of needle passes, sample obtaining techniques, and methods of specimen processing), adverse events of EUS-guided tissue acquisition, and learning-related issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This guideline may not be applicable for all clinical situations and should be interpreted in light of specific situations and the availability of resources. It will be revised as necessary to cover progress and changes in technology and evidence from clinical practice.

Citations

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An optimal curriculum for training in endoscopic ultrasound: a summarized evidence-based literature systematic review
Julieta Montanelli, Ariosto Honorio Hernandez Lara, Ana Karla Uribe Rivera, Juan Manuel Verde, Eike Burmester, Mohammad A. Al-Haddad, Stephan Hollerbach, Peter Vilmann, Monder Abu-Suboh Abadia, Abdenor Badaoui, Paolo Giorgio Arcidiacono, Christoph Schlag,
Surgical Endoscopy.2025; 39(7): 4076. CrossRef
Expanding the horizon of diagnostic endosonograpy: the promise of trans-colorectal endoscopic ultrasound-guided fine-needle aspiration
Hao-Che Chang, Ping-Huei Tseng, Li-Chun Chang
Clinical Endoscopy.2025; 58(6): 859. CrossRef
Role of Endoscopic Ultrasound in the Management of Pancreatic Cancer
Balaji Musunuri, Shiran Shetty
Indian Journal of Surgical Oncology.2024; 15(S2): 269. CrossRef
Endoscopic Ultrasound (EUS) guided biopsy of healthy pig pancreas: Towards the histological diagnosis of chronic pancreatitis.
Julio Iglesias-García, Yessica Domínguez-Novoa, Héctor Lazare-Iglesias, Antonio González-Cantalapiedra, Ihab Abdulkader-Nallib, Óscar Varela-López, José Lariño-Noia, Enrique Domínguez-Muñoz
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef
When ROSE is not possible: Evaluating the diagnostic yield of>4mm tissue specimen with macroscopi c onsite evaluation. 22G EUS-FNB Acquire needle experience
S. Karim, S. Kadir, A. Faryal
Endoscopy.2024; 56(S 02): S153. CrossRef
Optimising EUS-FNB guided tissue acquisition: The significance of TRAP score in solid pancreatic and gastrointestinal lesions for positive diagnostic output
S. Karim, S. Kadir, A. Faryal
Endoscopy.2024; 56(S 02): S380. CrossRef
Endoscopic ultrasound-guided tissue acquisition for personalized treatment in pancreatic adenocarcinoma
Sang Myung Woo
Clinical Endoscopy.2023; 56(2): 183. CrossRef
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
Clinical Endoscopy.2023; 56(3): 353. CrossRef
Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study
Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef
Clinical Endoscopy.2023; 56(5): 658. CrossRef
Endoscopic ultrasound-guided tissue acquisition and gene panel testing for pancreatic cancer
Kentaro SUDO, Emiri KITA, Akiko TSUJIMOTO, Kazuyoshi NAKAMURA, Akiko ODAKA, Makiko ITAMI, Sana YOKOI, Hiroshi ISHII
Suizo.2022; 37(1): 8. CrossRef
Impact of rapid on-site evaluation on diagnostic accuracy of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a single center
Irem Guvendir, Itir Ebru Zemheri, Kamil Ozdil
BMC Gastroenterology.2022;[Epub] CrossRef
Endoscopic Ultrasound Guided Fine Needle Aspiration and Biopsy for Pancreatic Disease
Kwang Hyuck Lee
The Korean Journal of Pancreas and Biliary Tract.2021; 26(4): 241. CrossRef

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Original Article

Feasibility of Wearable Display Glasses for Medical Students in the Endoscopy Room: Kang Won Lee, Hyuk Soon Choi, Hoon Jai Chun, Jae Min Lee, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Soon Ho Um, Hong Sik Lee; Clin Endosc 2021;54(5):694-700. Published online March 15, 2021; DOI: https://doi.org/10.5946/ce.2020.246

Abstract PDF PubReader ePub

Background
/Aims: Several attempts have been made to incorporate smart glasses in the medical field. We applied wearable display glasses to show the position of an observer during endoscopy and compared students’ responses between the conventional and new methods.
Methods
We surveyed 28 medical students regarding the use of wearable display devices. The students used wearable display glasses to observe an endoscopic procedure and answered the prepared questionnaire. Their collected responses were analyzed for statistical correlations between each variable.
Results
The survey of medical students revealed disadvantages including dizziness (dissatisfied and very dissatisfied: 21.5%) and eye fatigue (25% dissatisfied) and advantages including concentration (satisfied and very satisfied: 57.2%) and securing patient rights (71.4%). The students showed more positive than negative reviews regarding the new devices (32.1% vs. 21.5%).
Conclusions
We investigated the advantages and disadvantages of viewing the endoscope image with new wearable display glasses compared to the conventional method using the survey to record user experience. The results revealed relatively positive responses from the medical students in the survey. If the new device compensates for some shortcomings, its use in the endoscopy room will be feasible.

Citations

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A systematic literature review on integrating AI-powered smart glasses into digital health management for proactive healthcare solutions
Boyuan Wang, Ying Zheng, Xihao Han, Liang Kong, Gexin Xiao, Zunxiong Xiao, Shanji Chen
npj Digital Medicine.2025;[Epub] CrossRef
Surgery is not a game: the importance of human centered design in medical extended reality device development
Ali H. Dhanaliwala, Marc Egeth, Mary Beth Privitera
Frontiers in Virtual Reality.2025;[Epub] CrossRef
Role of artificial intelligence in gastric diseases
Eun Jeong Gong, Jieun Woo, Jae Jun Lee, Chang Seok Bang
World Journal of Gastroenterology.2025;[Epub] CrossRef
A remote clinical clerkship program for severe COVID-19 in ICU using smart glasses: questionnaire survey
Nobuyuki Nosaka, Hideo Yamanouch, Kazuki Takada, Kenji Wakabayashi
Journal of the Japanese Society of Intensive Care Medicine.2023; 30(4): 261. CrossRef
Smart Glasses to Facilitate Ultrasound Guided Peripheral Intravenous Access in the Simulation Setting for Thai Emergency Medical Service Providers
Kamonwon Ienghong, Lap Woon Cheung, Pornpawit Wongwan, Korakot Apiratwarakul
Journal of Multidisciplinary Healthcare.2023; Volume 16: 2201. CrossRef

6,311 View
111 Download
4 Web of Science
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Review

Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy: Hyun Lim, Eun Jeong Gong, Byung-Hoon Min, Seung Joo Kang, Cheol Min Shin, Jeong-Sik Byeon, Miyoung Choi, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun; Clin Endosc 2020;53(6):663-677. Published online November 26, 2020; DOI: https://doi.org/10.5946/ce.2020.192

Abstract PDF PubReader ePub

Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. The management of patients using antithrombotic agents and requiring gastrointestinal endoscopy is an important clinical challenge. Although clinical practice guidelines (CPGs) for the management of patients receiving antithrombotic agents and undergoing gastrointestinal endoscopy have been developed in the Unites States, Europe, and Asia Pacific region, it is uncertain whether these guidelines can be adopted in South Korea. After reviewing current CPGs, we identified unmet needs and recognized significant discrepancies in the clinical practice among regions. This is the first CPG in Korea providing information that may assist endoscopists in the management of patients on antithrombotic agents who require diagnostic or elective therapeutic endoscopy. This guideline was developed through the adaptation process as an evidence-based method, with four guidelines retrieved by systematic review. Eligible guidelines were evaluated according to the Appraisal of Guidelines for Research and Evaluation II process, and 13 statements were established using a grading system. This guideline was reviewed by external experts before an official. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

Citations

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Reproducibility of the AGREE II Tool for Assessing the Methodological Quality of Clinical Practice Guidelines for the Management of Antithrombotic Agents in Patients Undergoing GI Endoscopy
Denisse Camille Dayto, Wojciech Blonski, Tea Reljic, Farina Klocksieben, Jeffrey Gill, Rene D. Gomez-Esquivel, Brijesh Patel, Pushpak Taunk, Andrew Sephien, Camille Thelin, Ambuj Kumar
Journal of Clinical Gastroenterology.2025; 59(5): 443. CrossRef
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Tae-Geun Gweon, Hyun Gun Kim, Yunho Jung, Seong Ran Jeon, Soo-Young Na, Yoo Jin Lee, Tae Ho Kim
Gastrointestinal Endoscopy.2025; 101(4): 866. CrossRef
Chronic Kidney Disease Increases Risk of Delayed Post‐Polypectomy Bleeding: A Large‐Scale Propensity Score‐Matched Analysis
Hye Kyung Hyun, Nak‐Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae‐Hyun Yoo, Shin‐Wook Kang, Hae‐Ryong Yun, Cheal Wung Huh
United European Gastroenterology Journal.2025; 13(5): 759. CrossRef
Clinical Advances in Percutaneous Endoscopic Gastrostomy: A 2023 Clinical Practice Guideline-Based Review
Ji Yong Ahn
The Korean Journal of Medicine.2025; 100(2): 54. CrossRef
Minimum Platelet Count Threshold for Safe Colonoscopic Polypectomy: A Large-Scale Propensity Scored-Matched Analysis
Hye Kyung Hyun, Nak-Hoon Son, Cheal Wung Huh, Hyun Chul Lim, So Hyeon Gwon, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
American Journal of Gastroenterology.2025; 120(12): 2918. CrossRef
Management for endoscopic procedures in patients taking antithrombotic agents
Chung Hyun Tae, Ki-Nam Shim
Journal of the Korean Medical Association.2025; 68(8): 536. CrossRef
Clinical Practice Guideline 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
Gut and Liver.2024; 18(1): 10. CrossRef
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The Impact of Sedation on Cardio-Cerebrovascular Adverse Events after Surveillance Esophagogastroduodenoscopy in Patients with Gastric Cancer: A Nationwide Population-Based Cohort Study
Sang Yoon Kim, Jun Kyu Lee, Kwang Hyuck Lee, Jae-Young Jang, Byung-Wook Kim
Gut and Liver.2024; 18(2): 245. 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
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Top tips on the management of antithrombotic agents in the periendoscopic period
Alberto Tringali
Gastrointestinal Endoscopy.2024; 99(6): 1021. CrossRef
IDEN Consensus on 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
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World Journal of Gastroenterology.2022; 28(24): 2721. CrossRef

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Original Articles

Novel Ablation Therapy Using Endoscopic Irreversible Electroporation in the Bile Duct: A Pilot Animal Study: Kang Won Lee, Jae Min Lee, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Soon Ho Um, Hong Sik Lee, Hoon Jai Chun, Chang Duck Kim, Chi Hyuk Oh, Hong Bae Kim; Clin Endosc 2021;54(3):413-419. Published online October 20, 2020; DOI: https://doi.org/10.5946/ce.2020.126

Abstract PDF PubReader ePub

Background
/Aims: Irreversible electroporation (IRE) is a relatively new ablation method. However, the application of IRE ablation in the treatment of biliary disease has not been attempted. A minimally invasive approach using endoscopic retrograde cholangiopancreatography (ERCP) can be a novel therapeutic modality for IRE ablation. In this study, we aimed to investigate the feasibility of endoscopic IRE for the biliary tract using an animal model.
Methods
A new catheter-type electrode was developed for endoscopic IRE ablation of the biliary tract. We performed ERCP and endoscopic IRE ablations in the normal common bile duct of Yorkshire pigs. The experimental setting of IRE was 500 V/cm (50 pulses, 100-µs length). The animals were sacrificed after 24 hr, and the ablated bile duct was examined.
Results
Well-demarcated focal color changes were observed on the mucosa of the common bile duct. The depth of change after IRE was confined to the mucosal and submucosal layers. Apoptotic changes in the bile duct were observed only around the IRE ablation area. Immunohistochemistry assay showed cell death in the bile duct along the electrode.
Conclusions
Endoscopic IRE ablation using ERCP was successfully performed in the common bile duct. It can be a potential option for the treatment of biliary tumors.

Citations

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Balloon‐assisted laser application for endoscopic treatment of biliary stricture
Seonghee Lim, Van Gia Truong, Seok Jeong, Jiho Lee, Byeong‐il Lee, Hyun Wook Kang
Lasers in Surgery and Medicine.2023; 55(10): 912. CrossRef
Biliary complications and efficacy after ablation of peribiliary tumors using irreversible electroporation (IRE) or radiofrequency ablation (RFA)
Somrach Thamtorawat, Rujira Patanawanitkul, Satit Rojwatcharapibarn, Walailak Chaiyasoot, Trongtum Tongdee, Jirawadee Yodying, Sukrit Sorotpinya
International Journal of Hyperthermia.2022; 39(1): 751. CrossRef
Large Animal Models in Pancreas and Biliary Disease
Seok Jeong, Jin-Seok Park, Don Haeng Lee
The Korean Journal of Gastroenterology.2021; 77(3): 99. CrossRef
Comparison of four endoluminal radiofrequency ablation devices and four power generators in an ex vivo bovine liver model
Stephan Rheinheimer, Anna Jacobsen, Philipp Mayer, Hans-Ulrich Kauczor, Andreas Mahnken
World Academy of Sciences Journal.2021;[Epub] CrossRef

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Dedicated Cold Snare vs. Traditional Snare for Polypectomy of Diminutive and Small Lesions in a Porcine Model: A Research Group for Endoscopic Instruments and Stents (REIS) Study: Han Hee Lee, Bo-In Lee, Jung-Wook Kim, Hyun Lim, Si Hyung Lee, Jun-Hyung Cho, Yunho Jung, Kyoung Oh Kim, Chan Gyoo Kim, Kee Myung Lee, Jong-Jae Park, Myung-Gyu Choi, Hoon Jai Chun, Ho Gak Kim; Clin Endosc 2021;54(3):390-396. Published online September 10, 2020; DOI: https://doi.org/10.5946/ce.2020.096

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Background
/Aims: The aim of this in vivo animal study was to evaluate the effectiveness and safety of dedicated cold snare (DCS) compared with those of traditional snare (TS) for cold snare polypectomy (CSP).
Methods
A total of 36 diminutive (5 mm) and 36 small (9 mm) pseudolesions were made by electrocoagulation in the colons of mini-pigs.
Results
For the diminutive lesions, there were no significant differences in technical success rate, procedure time, or complete resection rate between the DCS and TS groups; the rate of uneven resection margin in the DCS group was significantly lower than that of the TS group. For small lesions, technical success rate and complete resection rate were significantly higher in the DCS group than in the TS group (100% [18/18] vs. 55.6% [10/18], p=0.003; 94.4% [17/18] vs. 40% [4/10], p=0.006). In addition, the procedure duration was significantly shorter, and the rate of uneven resection margin was significantly lower in the DCS group (28.5 sec vs. 66.0 sec, p=0.006; 11.1% [2/18] vs. 100% [10/10], p<0.001). Two cases of perforation occurred in the DCS group. Multivariate analysis revealed that DCS use was independently associated with complete resection.
Conclusions
DCS is superior to TS in terms of technical success, complete resection, and reducing the duration of the procedure for CSP of small polyps.

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Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer: Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun; Clin Endosc 2020;53(2):142-166. Published online March 30, 2020; DOI: https://doi.org/10.5946/ce.2020.032

Abstract PDF Supplementary Material PubReader ePub

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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Recent Development of Computer Vision Technology to Improve Capsule Endoscopy: Junseok Park, Youngbae Hwang, Ju-Hong Yoon, Min-Gyu Park, Jungho Kim, Yun Jeong Lim, Hoon Jai Chun; Clin Endosc 2019;52(4):328-333. Published online February 21, 2019; DOI: https://doi.org/10.5946/ce.2018.172

Abstract PDF PubReader ePub

Capsule endoscopy (CE) is a preferred diagnostic method for analyzing small bowel diseases. However, capsule endoscopes capture a sparse number of images because of their mechanical limitations. Post-procedural management using computational methods can enhance image quality. Additional information, including depth, can be obtained by using recently developed computer vision techniques. It is possible to measure the size of lesions and track the trajectory of capsule endoscopes using the computer vision technology, without requiring additional equipment. Moreover, the computational analysis of CE images can help detect lesions more accurately within a shorter time. Newly introduced deep leaning-based methods have shown more remarkable results over traditional computerized approaches. A large-scale standard dataset should be prepared to develop an optimal algorithms for improving the diagnostic yield of CE. The close collaboration between information technology and medical professionals is needed.

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KAPSUL ENDOSKOPİYASI İLƏ İNCƏ BAĞIRSAQ MÜAYİNƏSİNDƏ MÖVCUD VƏZİYYƏT VƏ GƏLƏCƏK PERSPEKTİVLİYİ
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Application of Artificial Intelligence in Capsule Endoscopy: Where Are We Now?: Youngbae Hwang, Junseok Park, Yun Jeong Lim, Hoon Jai Chun; Clin Endosc 2018;51(6):547-551. Published online November 30, 2018; DOI: https://doi.org/10.5946/ce.2018.173

Abstract PDF PubReader ePub

Unlike wired endoscopy, capsule endoscopy requires additional time for a clinical specialist to review the operation and examine the lesions. To reduce the tedious review time and increase the accuracy of medical examinations, various approaches have been reported based on artificial intelligence for computer-aided diagnosis. Recently, deep learning–based approaches have been applied to many possible areas, showing greatly improved performance, especially for image-based recognition and classification. By reviewing recent deep learning–based approaches for clinical applications, we present the current status and future direction of artificial intelligence for capsule endoscopy.

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Original Article

Is There a Change in Patient Preference for a Female Colonoscopist during the Last Decade in Korea?: Jung Min Lee, Eun Sun Kim, Hoon Jai Chun, In Kyung Yoo, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Bora Keum, Yeon Seok Seo, Hong Sik Lee, Yoon Tae Jeen, Jong-Jae Park, Sang Woo Lee, Soon Ho Um, Chang Duck Kim; Clin Endosc 2018;51(1):72-79. Published online October 10, 2017; DOI: https://doi.org/10.5946/ce.2017.057

Abstract PDF PubReader ePub

Background
/Aims: Patients may feel embarrassed during colonoscopy. Our study aimed to assess changes in patient preference, over the past decade, for the sex of their colonoscopist.
Methods
Prospective studies were performed at a single health center from July to September 2008, and from July to September 2016. Subjects included colonoscopy patients (2008: 354, 2016: 304) who were asked to complete a questionnaire before colonoscopy.
Results
In 2016, 69 patients (24.9%) expressed a sex preference, compared with 46 patients (14.6%) in 2008. By 2016, female patient preference for a female colonoscopist had significantly increased to 95% (odds ratio [OR], 2.678; 95% confidence interval [CI], 1.418– 5.057; P=0.002). In multivariate analysis, patient sex (OR, 4.404; P=0.000), patient age (OR, 0.977; 95% CI, 0.961–0.992; P=0.004), and year of procedure (OR, 1.674; 95% CI, 1.028–2.752) were statistically significant factors in sex preference. Between 2008 and 2016, female patients preferred a female colonoscopist because of embarrassment. Male patients also preferred a male colonoscopist, and the primary reason shifted from expertise to patient embarrassment (2008: 29%, 2016: 63%).
Conclusions
Patients have an increased gender preference for the colonoscopist because of embarrassment. Taking this into account can increase patient satisfaction during colonoscopy.

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Focused Review Series: Endoscopic Accessories Used for ESD

Accessory Devices Frequently Used for Endoscopic Submucosal Dissection: Hyuk Soon Choi, Hoon Jai Chun; Clin Endosc 2017;50(3):224-233. Published online May 31, 2017; DOI: https://doi.org/10.5946/ce.2017.070

Abstract PDF PubReader ePub

Endoscopic submucosal dissection (ESD) is increasingly being considered an essential component of treatment for early gastrointestinal cancers and subepithelial tumors. The ESD technique owes its popularity to the development of sophisticated instruments used for ESD. With an increase in the number of ESD procedures performed, there is rapid development in the number and types of endoscopic accessory devices used for such procedures. Despite the large numbers of new devices developed and marketed, the use of ESD instruments and accessory devices is largely determined by individual preferences and experiences. Accessory devices frequently used during ESD are important tools for ESD techniques. Each instrument possesses characteristic advantages and disadvantages associated with its use, and no one instrument is superior in all respects to others. In this article, we review the characteristics of endoscopic electrical knives, cap and hood, and hemostatic devices commonly used in ESD.

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Case Report

Gastric Perforation Caused by an Intragastric Balloon: Endoscopic Findings: In Kyung Yoo, Hoon Jai Chun, Yoon Tae Jeen; Clin Endosc 2017;50(6):602-604. Published online May 18, 2017; DOI: https://doi.org/10.5946/ce.2017.015

Abstract PDF Supplementary Material PubReader ePub

Intragastric balloon (IGB) insertion has been most frequently used in the West as an effective endoscopic treatment for morbid obesity, in practice. Recently, there is a growing number of cases requiring IGB deployment for obesity treatment in Korea. One of the reported complications of IGB use is gastric perforation. A 47-year-old woman was admitted to the hospital with mild symptoms, 7 weeks after having an IGB placed. Esophagogastroduodenoscopy was performed and gastric ulcer perforation was observed in the ulcer base, where food particles were impacted. Laparoscopic primary repair was done successfully. This was a case of gastric perforation, secondary to poor compliance with a proton-pump inhibitor (PPI). PPI and Helicobacter pylori eradication are important for ulcer prevention following IGB deployment.

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Focused Review Series: Roles of Bariatric Endoscopy in Obesity Treatment

Recent Trends in Endoscopic Bariatric Therapies: Hyuk Soon Choi, Hoon Jai Chun; Clin Endosc 2017;50(1):11-16. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.007

Abstract PDF PubReader ePub

Obesity and its associated metabolic diseases including diabetes mellitus are severe medical problems that are increasing in prevalence worldwide and result in significant healthcare expenses. While behavioral and pharmacological treatment approaches are partly effective in the short term, their effects are not long-lasting. Although previous studies have described bariatric surgery as the most effective treatment for obesity, it is associated with morbidity, mortality, and economic burden. Endoluminal interventions performed entirely using gastrointestinal flexible endoscopy offer alternative approaches to the treatment of obesity that are safer and more cost-effective than current surgical approaches. The use of endoluminal techniques in the field of metabolic obesity disease has diverse promising applications including endoscopic gastroplasty, intragastric balloon, endoluminal malabsorptive bariatric procedures, and gastric electrical stimulation (GES) for the modulation of gastric emptying. This review discusses recent trends and roles in endoscopic bariatric therapies using the currently available endoluminal and transgastric technologies.

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Original Articles

Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea: Seung-Joo Nam, Hoon Jai Chun, Jeong Seop Moon, Sung Chul Park, Young-Jae Hwang, In Kyung Yoo, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hong Sik Lee, Chang Duck Kim; Clin Endosc 2016;49(3):266-272. Published online February 22, 2016; DOI: https://doi.org/10.5946/ce.2015.085

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea.
Methods
We performed a cross-sectional survey of health-care providers in the endoscopy units of three university-affiliated hospitals in Korea. We analyzed the job stress levels by using the Korean occupational stress scale, contributing factors, and job satisfaction.
Results
Fifty-nine workers completed the self-administered questionnaires. The job stress scores for the endoscopy unit workers (46.39±7.81) were relatively lower compared to those of the national sample of Korean workers (51.23±8.83). Job stress differed across job positions, with nurses showing significantly higher levels of stress (48.92±7.97) compared to doctors (42.59±6.37). Job stress and job satisfaction were negatively correlated with each other (R² =0.340, p<0.001).
Conclusions
An endoscopy unit is composed of a heterogeneous group of health-care professionals (i.e., nurses, fellows, and professors), and job stress and job satisfaction significantly differ according to job positions. Job demand, insufficient job control, and job insecurity are the most important stressors in the endoscopy unit.

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Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry: Yun Jeong Lim, Oh Young Lee, Yoon Tae Jeen, Chi Yeon Lim, Dae Young Cheung, Jae Hee Cheon, Byong Duk Ye, Hyun Joo Song, Jin Su Kim, Jae Hyuk Do, Kwang Jae Lee, Ki-Nam Shim, Dong Kyung Chang, Cheol Hee Park, Byung Ik Jang, Jeong Seop Moon, Hoon Jai Chun, Myung-Gyu Choi, Jin Oh Kim, Korean Gut Image Study Group; Clin Endosc 2015;48(5):399-404. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.399

Abstract PDF PubReader ePub

Background/Aims

Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry.

Methods

Twenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed.

Results

A total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age.

Conclusions

CE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.

Citations

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Survey of Endoscope Reprocessing in Korea: Jeong Bae Park, Jae Nam Yang, Yun Jeong Lim, Ja Seol Koo, Jae Young Jang, Sang Hoon Park, Su Jin Hong, Sang-Woo Kim, Hoon Jai Chun, Disinfection Management Committee of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2015;48(1):39-47. Published online January 31, 2015; DOI: https://doi.org/10.5946/ce.2015.48.1.39

Abstract PDF PubReader ePub

Background/Aims

There is a growing emphasis on quality management in endoscope reprocessing. Previous surveys conducted in 2002 and 2004 were not practitioner-oriented. Therefore, this survey is significant for being the first to target actual participants in endoscope reprocessing in Korea.

Methods

This survey comprised 33 self-filled questions, and was personally delivered to nurses and nursing auxiliaries in the endoscopy departments of eight hospitals belonging to the society. The anonymous responses were collected after 1 week either by post or in person by committee members.

Results

The survey included 100 participants. In the questionnaire addressing compliance rates with the reprocessing guideline, the majority (98.9%) had a high compliance rate compared to 27% of respondents in 2002 and 50% in 2004. The lowest rate of compliance with a reprocessing procedure was reported for transporting the contaminated endoscope in a sealed container. Automated endoscope reprocessors were available in all hospitals. Regarding reprocessing time, more than half of the subjects replied that reprocessing took more than 15 minutes (63.2%).

Conclusions

The quality management of endoscope reprocessing has improved as since the previous survey. A national survey expanded to include primary clinics is required to determine the true current status of endoscope reprocessing.

Citations

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Review

A Review of Current Disinfectants for Gastrointestinal Endoscopic Reprocessing: Sanghoon Park, Jae Young Jang, Ja Seol Koo, Jeong Bae Park, Yun Jeong Lim, Su Jin Hong, Sang-Woo Kim, Hoon Jai Chun, Disinfection Management Committee, The Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2013;46(4):337-341. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.337

Abstract PDF PubReader ePub

Gastrointestinal endoscopy is gaining popularity for diagnostic and therapeutic purposes. However, concerns over endoscope-related nosocomial infections are increasing, together with interest by the general public in safe and efficient endoscopy. For this reason, reprocessing the gastrointestinal endoscope is an important step for effective performance of endoscopy. Disinfectants are essential to the endoscope reprocessing procedure. Before selecting an appropriate disinfectant, their characteristics, limitations and means of use must be fully understood. Herein, we review the characteristics of several currently available disinfectants, including their uses, potency, advantages, and disadvantages. Most disinfectants can be used to reprocess gastrointestinal endoscopes if the manufacturer's guidelines are followed. The selection and use of a suitable disinfectant depends on the individual circumstances of each endoscopy suite.

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Original Articles

Feasibility of Obtaining Quantitative 3-Dimensional Information Using Conventional Endoscope: A Pilot Study: Jong Jin Hyun, Hoon Jai Chun, Bora Keum, Yeon Seok Seo, Yong Sik Kim, Yoon Tae Jeen, Hong Sik Lee, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu, Jong-Wook Lim, Dong-Gi Woo, Young-Joong Kim, Myo-Taeg Lim; Clin Endosc 2012;45(3):182-188. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.182

Abstract PDF PubReader ePub

Background/Aims

Three-dimensional (3D) imaging is gaining popularity and has been partly adopted in laparoscopic surgery or robotic surgery but has not been applied to gastrointestinal endoscopy. As a first step, we conducted an experiment to evaluate whether images obtained by conventional gastrointestinal endoscopy could be used to acquire quantitative 3D information.

Methods

Two endoscopes (GIF-H260) were used in a Borrmann type I tumor model made of clay. The endoscopes were calibrated by correcting the barrel distortion and perspective distortion. Obtained images were converted to gray-level image, and the characteristics of the images were obtained by edge detection. Finally, data on 3D parameters were measured by using epipolar geometry, two view geometry, and pinhole camera model.

Results

The focal length (f) of endoscope at 30 mm was 258.49 pixels. Two endoscopes were fixed at predetermined distance, 12 mm (d₁₂). After matching and calculating disparity (v2-v1), which was 106 pixels, the calculated length between the camera and object (L) was 29.26 mm. The height of the object projected onto the image (h) was then applied to the pinhole camera model, and the result of H (height and width) was 38.21 mm and 41.72 mm, respectively. Measurements were conducted from 2 different locations. The measurement errors ranged from 2.98% to 7.00% with the current Borrmann type I tumor model.

Conclusions

It was feasible to obtain parameters necessary for 3D analysis and to apply the data to epipolar geometry with conventional gastrointestinal endoscope to calculate the size of an object.

Citations

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Assessment on the Potential Role of Applying Cryoprobe for Tissue Ablation: Min Ho Seo, Yoon Tae Jeen, Sang Jung Park, Sun Young Kim, Hye Jin Cho, Hyuk Sun Choi, Hoon Jai Chun, Chang Duck Kim, Ho Sang Ryu, Yang Seok Chae; Clin Endosc 2012;45(1):67-72. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.67

Abstract PDF PubReader ePub: Background/Aims
Cryotherapy is the therapeutic application for tissue ablation. Clinical applications of cryotherpy such as in pulmonology have increased. Until now, its development in gastroenterology has been insignificant. But, as clinical application such as mucosal ablation on Barrett's esophagus became possible, various applications have been developed. Therefore, it is important to make standards of tissue injury's extent in cryotherapy prior to clinical trial. We evaluated the tissue injury according to the application of cryoprobe with a pig model.
Methods
Cryoprobe was applied to several different segments of the esophagus and stomach for various lengths of time using various number of probe's contact in a pig model. After 48 hours, esophagus and stomach were harvested and histological tissue injury was assessed. The extent of tissue injury was decided by the injury of the deepest layer.
Results
Endoscopic application of cryoprobe on esophagus and stomach resulted in a dose-dependent injury: esophageal necrosis was limited to the submucosa after 10 seconds of cryotherapy, and extended to involve the transmural necrosis after over 15 seconds. Necrosis on stomach was extended to involve the transmural necrosis after over 20 seconds.
Conclusions
Positive relationship was seen between the duration and frequency of cryoprobe application and the extent of tissue injury.

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Comparison on the Efficacy of Disinfectants Used in Automated Endoscope Reprocessors: PHMB-DBAC versus Orthophthalaldehyde: Sun Young Kim, Hong Sik Lee, Jong Jin Hyun, Min Ho Seo, Sun Young Yim, Ha Young Oh, Hye Sook Kim, Bora Keum, Yeon Seok Seo, Yong Sik Kim, Yoon Tae Jeen, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu; Clin Endosc 2011;44(2):109-115. Published online December 31, 2011; DOI: https://doi.org/10.5946/ce.2011.44.2.109

Abstract PDF PubReader ePub

Background/Aims

Since endoscopes are reusable apparatus classified as semicritical item, thorough reprocessing to achieve high-level disinfection is of utmost importance to prevent spread of infection. To improve disinfection efficacy and safety, disinfectants and endoscope reprocessors are continuously evolving. This study aimed to compare the efficacy of the combination of polyhexamethylenebiguanide hydrochloride-alkyldimethylbenzylammonium chloride (PHMB-DBAC) and orthophthalaldehyde (OPA) used respectively in ultrasonographic cleaning incorporated automated endoscope reprocessors: COOLENDO (APEX Korea) or OER-A (Olympus Optical).

Methods

A total of 86 flexible upper endoscopes were randomly reprocessed with either COOLENDO/PHMB-DBAC or OER-A/OPA. Culture samplings were done at two sites (endoscope tip and working channel) which were later incubated on blood agar plate. Bacterial colonies were counted and identified.

Results

The culture-positive rate at the endoscope tip and working channel was 0% and 2.33% for COOLENDO/PHMB-DBAC and 4.65% and 0% for OER-A/OPA. Staphylococcus hominis was cultured from one endoscope reprocessed with COOLENDO/PHMB-DBAC and Pseudomonas putida was isolated from two endoscopes reprocessed with OER-A/OPA.

Conclusions

The reprocessing efficacy of COOLENDO/PHMB-DBAC was non-inferior to that of OER-A/OPA (p=0.032; confidence interval, -0.042 to 0.042). During the study period, significant side effect of PHMB-DBAC was not observed.

Citations

Citations to this article as recorded by

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