Clinical Endoscopy

Reviews

Endoscopic treatment of anastomotic leakage after upper gastrointestinal surgery: endoscopic self-expandable metallic stent or endoscopic vacuum therapy?: Chul-Hyun Lim, Chan Gyoo Kim; Clin Endosc 2026;59(3):327-332. Published online April 1, 2026; DOI: https://doi.org/10.5946/ce.2025.229

Abstract PDF: Anastomotic leakage is a serious complication following upper gastrointestinal (UGI) surgery, associated with high morbidity and mortality rates. Effective management strategies aim to close or cover the defect, contain the leak, and adequately drain the affected area. In recent years, endoscopic techniques have emerged as viable alternatives or adjuncts to surgical interventions. This review discusses two major endoscopic modalities — self-expandable metal stents (SEMS) and endoscopic vacuum therapy (EVT) — in anastomotic leaks after gastric and esophageal cancer surgery. By evaluating the efficacy, indications, and limitations of SEMS and EVT techniques, this article provides a comprehensive overview to assist clinicians in optimizing patient outcomes in UGI postoperative anastomotic leaks.

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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

Abstract PDF Supplementary Material

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 Case of Perforated Peritonitis Caused by the Migration of a Single‐Puncture Gastric Wall Fixation Device Following Percutaneous Endoscopic Gastrostomy
Yuu Kodama, Yuji Mizokami, Hidemitsu Nishizawa, Gen Maeda, Gen Kimura, Yuzo Toyama, Shingo Asahara, Ryuji Nagahama, Hideki Sunagawa
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Comparative Analysis of Conventional Ideal Button Versus New Ideal Button ZERO for Percutaneous Endoscopic Gastrostomy Catheter Replacement
Kazuya Miyaguchi, Hisashi Matsumoto, Yuki Shiko, Yoshikazu Tsuzuki, Maiko Osawa, Rie Shiomi, Keiji Yamamoto, Yohei Kawasaki, Hiroyuki Imaeda
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Buried Balloon Syndrome After Percutaneous Radiologic Gastrostomy: Two Case Reports and a Literature Review
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Journal of the Korean Society of Radiology.2026; 87(1): 157. CrossRef
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Clinical Oncology.2026; 53: 104096. CrossRef
Delayed Terminal Ileal Obstruction From a Retained Percutaneous Endoscopic Gastrostomy (PEG) Bolster Following Cut-and-Push Replacement in a Frail Elderly Patient: A Case Report
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Splenic Artery Hemorrhage as a Rare Delayed Complication of Percutaneous Endoscopic Gastrostomy
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Endoscopic hand suturing combined with radiofrequency coagulation for persistent gastrocutaneous fistula
Atsushi Goto, Koichi Hamabe, Shunsuke Ito, Shinichi Hashimoto, Jun Nishikawa, Taro Takami
Clinical Endoscopy.2026; 59(4): 663. CrossRef
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Jing Xu, KaiWen Xue, XiaoXuan Li, Ying Xu, YueQin Gou, YiFan Liu, LinLin Shan, Jingpu Zhao, YuLong Wang
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Endoscopic gastrostomy as a method of enteral nutrition providing
E. A. Drobyazgin, Yu. V. Chikinev, A. V. Korobeynikov, A. S. Polyakevich, I. V. Peshkova, S. G. Stofin
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The Korean Journal of Medicine.2025; 100(2): 54. CrossRef
Timing of Gastrostomy Relative to Tracheostomy After Complete Cervical Spinal Cord Injury: Impact on Hospitalization Outcomes and Complication Rates
Ahmad Essa, Armaan K. Malhotra, Husain Shakil, Avery B. Nathens, Eva Y. Yuan, Yingshi He, Francois Mathieu, Michael C. Sklar, Jefferson R. Wilson, Christopher D. Witiw, Jetan H. Badhiwala
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Outcomes of early compared with delayed initiation of feeding after placement of percutaneous endoscopic gastrostomy tube: A systematic review and meta‐analysis
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Journal of Parenteral and Enteral Nutrition.2025; 49(6): 682. CrossRef
Predictors of failure of percutaneous endoscopic gastrostomy tube placement: a retrospective study in a tertiary care center in the USA
Ryan Xin, Cassandra Sanossian, Melissa Fazzari, Brandon Mui, Marouf Hossain, Jennifer Katz
Clinical Endoscopy.2025; 58(3): 418. CrossRef
Gastric outlet and duodenal bulb obstruction: A rare complication due to migrated gastrostomy tube
Merve Eren Durmuş, Serkan Öcal, Ayhan Hilmi Çekin, Gökhan Köker
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Oscar Mauricio Ardila Suárez, Erick Ricardo Licona Vera, Sebastián Fernando Niño Ramírez
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Challenges, Perceptions, Training and Needs of Primary Care Nurses in the Management of Patients with Percutaneous Endoscopic Gastrostomy: A Cross-Sectional Study in Southern Spain
María de los Santos Oñate-Tenorio, Nuria Trujillo-Garrido, María de los Ángeles Bernal-Jiménez, María José Santi-Cano
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Single-step replacement of a push-type PEG with a pull-type PEG in a patient with dysphagia
Soo Bin Synn, Su Jin Kim
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Evaluation of Electrolyte Imbalances and Their Impact on Mortality in Percutaneous Endoscopic Gastrostomy Patients in the Emergency Department
Ali Sarıdaş, Naile Fevziye Mısırlıoglu, Nedim Uzun, Türker Acehan, Sumeyye Nur Aydin, Aysun Ekinci, Hafize Uzun
Dicle Tıp Dergisi.2025; 52(4): 659. CrossRef
Predictors of Percutaneous Endoscopic Gastrostomy‐Related Complications in Amyotrophic Lateral Sclerosis: A 19‐Year Retrospective Study From a Tertiary Center
Sang Pyo Lee, Jaeyoung Choi, Jin Hwa Park, Kang Nyeong Lee, Hang Lak Lee, Wonjae Sung
Journal of Digestive Diseases.2025; 26(11-12): 492. CrossRef
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
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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
When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta‐analysis of randomized controlled trials
Matthew L. Bechtold, Zahid Ijaz Tarar, Muhammad N. Yousaf, Ghady Moafa, Abdul M. Majzoub, Xheni Deda, Michelle L. Matteson‐Kome, Srinivas R. Puli
Nutrition in Clinical Practice.2024; 39(5): 1191. CrossRef
The Effect of Oral Diet Training in Indwelling Nasogastric Tube Patients with Prolonged Dysphagia
Byung-chan Choi, Sook Joung Lee, Eunseok Choi, Sangjee Lee, Jungsoo Lee
Nutrients.2024; 16(15): 2424. CrossRef
The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis
Jeffrey L. Roberson, Julia A. Gasior, Sara P. Ginzberg, Emna Bakillah, Jesse Passman, Lauren Shreve, Catherine E. Sharoky, Gregory Nadolski, Katherine R. Courtright, Elinore J. Kaufman
Annals of Surgical Oncology.2024; 31(10): 6931. CrossRef

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Commentary

Endoscopic Endoluminal Vacuum Therapy or Self-Expandable Metallic Stent: Treatment Option in Anastomotic Leakage after Esophageal Surgery: Chul-Hyun Lim; Clin Endosc 2022;55(1):41-42. Published online January 27, 2022; DOI: https://doi.org/10.5946/ce.2022.011

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Citations

Citations to this article as recorded by

Endoscopic vacuum therapy for gastrointestinal transmural defects: a literature review
Tan Minh Le, Van Huy Tran, Kyu Sung Chung, Seong Woo Jeon
Clinical Endoscopy.2025; 58(2): 181. CrossRef
Endoscopic vacuum therapy for esophageal transmural defects
Ji Hyun Kim, Sung Chul Park
Journal of Innovative Medical Technology.2025; 3(2): 45. CrossRef

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164 Download
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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

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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Surgical and procedural bleed risk stratification for anticoagulated patients undergoing planned surgery: guidance from the ISTH SSC Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis
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Yohei Minato, Tadateru Maehata, Yoshinori Sato, Fumio Itoh, Ken Ohata, Keisuke Tateishi
Clinical Endoscopy.2026; 59(4): 593. CrossRef
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
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Minimum Platelet Count Threshold for Safe Colonoscopic Polypectomy: A Large-Scale Propensity Scored-Matched Analysis
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American Journal of Gastroenterology.2025; 120(12): 2918. CrossRef
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Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
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A systematic critical appraisal of clinical practice guidelines of antithrombotic agents in gastrointestinal endoscopy using the AGREE II tool
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Alberto Tringali
Gastrointestinal Endoscopy.2024; 99(6): 1021. CrossRef
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Anticoagulants Are a Risk Factor for Delayed Bleeding after Colorectal Endoscopic Submucosal Dissection: A HASID Multicenter Study
Seong-Jung Kim, Jun Lee, Hyo-Yeop Song, Geom Seog Seo, Byung Chul Jin, Sang-Wook Kim, Dong Hyun Kim, Hyun-Soo Kim, Hyung-Hoon Oh, Dae-Seong Myung, Young-Eun Joo
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Original Articles

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

Abstract PDF Supplementary Material

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.

Citations

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Comparison of complete resection rates in cold snare polypectomy using two different wire diameter snares: A randomized controlled study
Toshiki Horii, Sho Suzuki, Akihiro Sugita, Misa Yamauchi, Hisatomo Ikehara, Chika Kusano, Takuji Gotoda
Journal of Gastroenterology and Hepatology.2023; 38(5): 752. CrossRef
Comparison of the clinical efficacy of cold snare polypectomy using a thin-wire snare and thick-wire snare for small colorectal polyps
Hong Jin Yoon, Yunho Jung, Young Sin Cho, Il-Kwun Chung
International Journal of Gastrointestinal Intervention.2023; 12(4): 183. CrossRef
Big Issues on Small Polyps: An Ideal Device, But Is It for an Ideal Indication?
Yoji Takeuchi
Clinical Endoscopy.2021; 54(3): 297. CrossRef
Cold versus hot polypectomy/endoscopic mucosal resection–A review of current evidence
Raquel Ortigão, Jochen Weigt, Ahmed Afifi, Diogo Libânio
United European Gastroenterology Journal.2021; 9(8): 938. CrossRef

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Bleeding after Endoscopic Resection in Patients with End-Stage Renal Disease on Dialysis: A Multicenter Propensity Score-Matched Analysis: In Kyung Yoo, Chan Gyoo Kim, Young Ju Suh, Younkyung Oh, Gwang Ho Baik, Sun Moon Kim, Young Dae Kim, Chul-Hyun Lim, Jung Won Jeon, Su Jin Hong, Byoung Wook Bang, Joon Sung Kim, Jun-Won Chung; Clin Endosc 2020;53(4):452-457. Published online October 25, 2019; DOI: https://doi.org/10.5946/ce.2019.107

Abstract PDF

Background
/Aims: Frequent bleeding after endoscopic resection (ER) has been reported in patients with end-stage renal disease (ESRD). We aimed to evaluate the association and clinical significance of bleeding with ER in ESRD patients on dialysis.
Methods
Between February 2008 and December 2018, 7,571 patients, including 47 ESRD patients on dialysis who underwent ER for gastric neoplasia, were enrolled. A total of 47 ESRDpatients on dialysis were propensity score-matched 1:10 to 470 non-ESRD patients, to adjust for between-group differences in variables such as age, sex, comorbidities, anticoagulation use, tumor characteristics, and ER method. Matching was performed using an optimal matching algorithm. For the matched data, clustered comparisons were performed using the generalized estimating equation method. Medical records were retrospectively reviewed. Frequency and outcomes of post-ER bleeding were evaluated.
Results
Bleeding was more frequent in the ESRD with dialysis group than in the non-ESRD group. ESRD with dialysis conferred a significant risk of post-ER bleeding (odds ratio, 6.1; 95% confidence interval, 2.7–13.6; p<0.0001). All post-ER bleeding events were controlled using endoscopic hemostasis except in 1 non-ESRD case that needed surgery.
Conclusions
ESRD with dialysis confers a bleeding risk after ER. However, all bleeding events could be managed endoscopically without sequelae. Concern about bleeding should not stop endoscopists from performing ER in ESRD patients on dialysis.

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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
Prediction and prevention of post-procedural bleedings in patients with cirrhosis
Alix Riescher-Tuczkiewicz, Pierre-Emmanuel Rautou
Clinical and Molecular Hepatology.2025; 31(Suppl): S205. CrossRef
Risk of Post-polypectomy Bleeding After Colorectal Endoscopic Mucosal Resection in Patients with Chronic Kidney Disease: A Propensity-Matched Analysis of the US Collaborative Network
Azizullah Beran, Khaled Elfert, Feenalie N. Patel, Mouhand Mohamed, Daryl Ramai, Almaza Albakri, Nasir Saleem, Faisal Kamal, Andrew Canakis, Khaled Srour, Danial H. Shaikh, Shyam Thakkar, Douglas K. Rex, Indira Bhavsar-Burke, John J. Guardiola
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Digestive Endoscopy.2023; 35(7): 869. CrossRef
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Case Report

Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel: Chung-Jo Choi, Hyun Lim, Dong-Suk Kim, Yong-Seol Jeong, Sang-Young Park, Jeong-Eun Kim; Clin Endosc 2019;52(6):612-615. Published online May 20, 2019; DOI: https://doi.org/10.5946/ce.2019.020

Abstract PDF

Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.

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Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning
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Dennis Chang, Purvi Patel, Seth Persky, Joseph Ng, Alan Kaell
ACG Case Reports Journal.2020; 7(4): e00347. CrossRef
Persisting bleeding from the duodenal ulcer in patients with occlusion of the celiac trunk: a case report
Andrzej Żyluk, Samir Zeair, Janusz Kordowski, Ewa Gabrysz-Trybek
Polish Journal of Surgery.2020; 93(SUPLEMENT): 54. CrossRef

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Original Articles

Factors Affecting Endoscopic Curative Resection of Gastric Cancer in the Population-Based Screening Era: Yoon Gwon Mun, Myung-Gyu Choi, Chul-Hyun Lim, Han Hee Lee, Dong Hoon Kang, Jae Myung Park, Kyo Young Song; Clin Endosc 2018;51(5):478-484. Published online June 1, 2018; DOI: https://doi.org/10.5946/ce.2018.006

Abstract PDF

Background
/Aims: Since population-based screening for gastric cancer in Korea was implemented, endoscopic treatment of early gastric cancer has become increasingly popular. This study investigates factors affecting endoscopic curative resection of early gastric cancer in population-based screening for gastric cancer.
Methods
We retrospectively reviewed data of patients with newly diagnosed gastric cancer who underwent treatment at Seoul St. Mary’s Hospital. All patients completed questionnaires about clinical information, including interval between surveillance tests for gastric cancer.
Results
Of 469 gastric cancer patients, 147 (31.3%) had undergone curative endoscopic resection, 260 (55.4%) had undergone curative surgical resection, and 62 (13.3%) underwent non-curative resection or were in an inoperable state. Patients with curative endoscopic resection had fewer alarm symptoms/signs than other groups. In multivariate analysis, regular surveillance endoscopy was the only factor predicting curative endoscopic resection (odds ratio [OR], 6.099; 95% confidence interval [CI], 2.532–14.933). In addition, patients undergoing gastric cancer screening had a significantly higher rate of endoscopic curative resection compared with subjects who had never been screened. (1-year interval: OR, 49.969; 95% CI, 6.340–393.827, 2-year interval: OR, 15.283; 95% CI, 1.833–127.406, over 2-year interval: OR, 10.651; 95% CI, 1.248–90.871). Shorter screening test intervals were associated with higher rates of endoscopic curative resection.
Conclusions
Regular surveillance testing was the independent factor predicting curative endoscopic resection of gastric cancer.

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A model established using marital status and other factors from the Surveillance, Epidemiology, and End Results database for early stage gastric cancer
Lixiang Zhang, Baichuan Zhou, Panquan Luo, Aman Xu, Wenxiu Han, Zhijian Wei
Journal of Investigative Medicine.2022; 70(6): 1373. CrossRef
Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea
Si Hyung Lee, Min Cheol Kim, Seong Woo Jeon, Kang Nyeong Lee, Jong Jae Park, Su Jin Hong
Clinical Endoscopy.2020; 53(2): 196. CrossRef
The More, the Better: Is This True in Endoscopy for Gastric Cancer Screening?
Seong Woo Jeon
Clinical Endoscopy.2018; 51(5): 402. CrossRef

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Comparison of Clinical Outcomes Associated with Pull-Type and Introducer-Type Percutaneous Endoscopic Gastrostomies: Sin Won Lee, Jeong Hoon Lee, Hyungjin Cho, Yeonjung Ha, Hyun Lim, Ji Yong Ahn, Kwi Sook Choi, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim; Clin Endosc 2014;47(6):530-537. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.530

Abstract PDF

Background/Aims

Percutaneous endoscopic gastrostomy (PEG) is a method of providing enteral nutrition using endoscopy. The PEG techniques differ according to the insertion method, and include the pull type, push type, and introducer type. The aim of this study was to compare the clinical outcomes associated with the pull-type and introducer-type PEG insertion techniques, which included the adverse events, at our tertiary care center in Korea.

Methods

We retrospectively reviewed 141 cases that had undergone PEG insertion at our center from January 2009 to June 2012. The indications for PEG insertion and the acute and chronic complications caused by each type of PEG insertion were analyzed.

Results

The indications for PEG insertion in our cohort included neurologic disease (58.7%), malignancy (21.7%), and other indications (19.6%). Successful PEG insertions were performed on 136 cases (96.5%), and there were no PEG-associated deaths. Bleeding was the most frequent acute complication (12.8%), and wound problems were the most frequent chronic complications (8.8%). There were no statistically significant differences between the pull-type and introducer-type PEG insertion techniques in relation to complication rates in our study population.

Conclusions

PEG insertion is considered a safe procedure. The pull-type and introducer-type PEG insertion techniques produce comparable outcomes, and physicians may choose either of these approaches according to the circumstances.

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Yun-Kai Hu, Bo-Wu He, Yu-Gang Su, Yong-Tang Chen, Qing-Jing Ru
World Chinese Journal of Digestology.2025; 33(5): 412. CrossRef
Single-step replacement of a push-type PEG with a pull-type PEG in a patient with dysphagia
Soo Bin Synn, Su Jin Kim
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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
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
Clinical Endoscopy.2023; 56(4): 391. 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
The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef
Buried T-Bar after Gastrostomy Placement in Children
Soon Chul Kim
Indian Journal of Pediatrics.2022; 89(8): 833. CrossRef
Nationwide Survey for Pediatric Gastrostomy Tube Placement in Korea
Sangwoo Lee, Byung-Ho Choe, Ben Kang, Soon Chul Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef
Clinical Outcomes of Enteral Feeding Protocol Via Percutaneous Endoscopic Gastrostomy: A Single‐Center, Retrospective Study
Jin Hee Noh, Hee Kyong Na, Ji Yong Ahn, Suk‐Kyung Hong, Jiyoun Kim, Jina Yang, Hwoon‐Yong Jung
Nutrition in Clinical Practice.2021; 36(1): 225. CrossRef
Relationship of early acute complications and insertion site in push method percutaneous endoscopic gastrostomy
Hiroshi Suzuki, Satoru Joshita, Tadanobu Nagaya, Koichi Sato, Akihiro Ito, Tomoaki Suga, Takeji Umemura
Scientific Reports.2020;[Epub] CrossRef
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Hee Kyong Na, Ji Yong Ahn, Gin Hyug Lee, Jeong Hoon Lee, Do Hoon Kim, Kee Wook Jung, Kee Don Choi, Ho June Song, Hwoon‐Yong Jung
Journal of Gastroenterology and Hepatology.2019; 34(3): 561. CrossRef
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Emily Clarke, Narrie Pitts, Andrew Latchford, Stephen Lewis
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Antibacterial gauzes are effective in preventing infections after percutaneous endoscopic gastrostomy placement
Denise Strijbos, Erik J. Schoon, Wouter Curvers, Pieter Friederich, Hajo J. Flink, Arnold Stronkhorst, Lennard P.L. Gilissen
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Bryan Silon, John C. Fang
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Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions: Hea Jung Sung, Yu Kyung Cho, Eun Young Park, Sung Jin Moon, Chul Hyun Lim, Jin Su Kim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Myung-Gyu Choi, Kyu Yong Choi; Clin Endosc 2013;46(6):627-632. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.627

Abstract PDF

Background/Aims

We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions.

Methods

Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging.

Results

Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology.

Conclusions

EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA.

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Performance and Cost of Disposable Biopsy Forceps in Upper Gastrointestinal Endoscopy: Comparison with Reusable Biopsy Forceps: Chul-Hyun Lim, Myung-Gyu Choi, Won Chul Kim, Jin Soo Kim, Yu Kyung Cho, Jae Myung Park, In Seok Lee, Sang Woo Kim, Kyu Yong Choi, In-Sik Chung; Clin Endosc 2012;45(1):62-66. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.62

Abstract PDF

Background/Aims

It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy.

Methods

Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue.

Results

Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as ₩8,021. The adequacy of the sample was excellent for both forceps.

Conclusions

Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered.

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Byoung Kwan Son, Byung-Wook Kim, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
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