Clinical Endoscopy

Original Articles

Usefulness of the Forrest Classification to Predict Artificial Ulcer Rebleeding during Second-Look Endoscopy after Endoscopic Submucosal Dissection: Duk Su Kim, Yunho Jung, Ho Sung Rhee, Su Jin Lee, Yeong Geol Jo, Jong Hwa Kim, Jae Man Park, Il-Kwun Chung, Young Sin Cho, Tae Hoon Lee, Sang-Heum Park, Sun-Joo Kim; Clin Endosc 2016;49(3):273-281. Published online March 4, 2016; DOI: https://doi.org/10.5946/ce.2015.086

Background
/Aims: Delayed post-endoscopic submucosal dissection (ESD) bleeding (DPEB) is difficult to predict and there is controversy regarding the usefulness of prophylactic hemostasis during second-look endoscopy. This study evaluated the risk factors related to DPEB, the relationship between clinical outcomes and the Forrest classification, and the results of prophylactic hemostasis during second-look endoscopy.
Methods
Second-look endoscopy was performed on the day after ESD to check for recent hemorrhage or potential bleeding and the presence of artificial ulcers in all patients.
Results
DPEB occurred in 42 of 581 patients (7.2%). Multivariate analysis determined that a specimen size ≥40 mm (odds ratio [OR], 3.03; p=0.003), and a high-risk Forrest classification (Forrest Ib+IIa+IIb; OR, 6.88; p<0.001) were risk factors for DPEB. DPEB was significantly more likely in patients classified with Forrest Ib (OR, 24.35; p<0.001), IIa (OR, 12.91; p<0.001), or IIb (OR, 8.31; p<0.001) ulcers compared with Forrest III ulcers. There was no statistically significant difference between the prophylactic hemostasis and non-hemostasis groups (Forrest Ib, p=0.938; IIa, p=0.438; IIb, p=0.397; IIc, p=0.773) during second-look endoscopy.
Conclusions
The Forrest classification of artificial gastric ulcers during second-look endoscopy seems to be a useful tool for predicting delayed bleeding. However, routine prophylactic hemostasis during second-look endoscopy seemed to not be useful for preventing DPEB.

Citations

Citations to this article as recorded by

Response
Thomas K.L. Lui
Gastrointestinal Endoscopy.2024; 99(4): 664. CrossRef
Outcome of Gastric Fundus and Pylorus Botulinum Toxin A Injection in Obese Patients Class I–II with Normal Pyloric Orifice Structure: A Retrospective Analysis
Murat Ferhat Ferhatoglu, Abdulcabbar Kartal, Ali Ilker Filiz, Abut Kebudi
Bariatric Surgical Practice and Patient Care.2022; 17(3): 148. CrossRef
Forrest Classification for Bleeding Peptic Ulcer: A New Look at the Old Endoscopic Classification
Hsu-Heng Yen, Ping-Yu Wu, Tung-Lung Wu, Siou-Ping Huang, Yang-Yuan Chen, Mei-Fen Chen, Wen-Chen Lin, Cheng-Lun Tsai, Kang-Ping Lin
Diagnostics.2022; 12(5): 1066. CrossRef
Performance Comparison of the Deep Learning and the Human Endoscopist for Bleeding Peptic Ulcer Disease
Hsu-Heng Yen, Ping-Yu Wu, Pei-Yuan Su, Chia-Wei Yang, Yang-Yuan Chen, Mei-Fen Chen, Wen-Chen Lin, Cheng-Lun Tsai, Kang-Ping Lin
Journal of Medical and Biological Engineering.2021; 41(4): 504. CrossRef
Prevention of bleeding in the early postoperative period after intraluminal stomach resection: results of a prospective randomized study
S.G. Shapovalyants, R.V. Plakhov, M.V. Bordikov, E.V. Gorbachev, I.V. Zhitareva, E.D. Fedorov
Endoskopicheskaya khirurgiya.2020; 26(5): 5. CrossRef
Risk factors for delayed bleeding by onset time after endoscopic submucosal dissection for gastric neoplasm
Hyeong Seok Nam, Cheol Woong Choi, Su Jin Kim, Hyung Wook Kim, Dae Hwan Kang, Su Bum Park, Dae Gon Ryu
Scientific Reports.2019;[Epub] CrossRef
Effectiveness of Autologous Platelet-Rich Plasma for the Healing of Ulcers after Endoscopic Submucosal Dissection
Eunju Jeong, In kyung Yoo, Ozlem Ozer Cakir, Hee Kyung Kim, Won Hee Kim, Sung Pyo Hong, Joo Young Cho
Clinical Endoscopy.2019; 52(5): 472. CrossRef
Bleeding in patients who underwent scheduled second-look endoscopy 5 days after endoscopic submucosal dissection for gastric lesions
Koichi Izumikawa, Masaya Iwamuro, Tomoki Inaba, Shigenao Ishikawa, Kenji Kuwaki, Ichiro Sakakihara, Kumiko Yamamoto, Sakuma Takahashi, Shigetomi Tanaka, Masaki Wato, Hiroyuki Okada
BMC Gastroenterology.2018;[Epub] CrossRef
Continuous esomeprazole infusion versus bolus administration and second look endoscopy for the prevention of rebleeding in children with a peptic ulcer
Oana Belei, Laura Olariu, Maria Puiu, Cristian Jinca, Cristina Dehelean, Tamara Marcovici, Otilia Marginean
Revista Española de Enfermedades Digestivas.2018;[Epub] CrossRef
Role of second‐look endoscopy and prophylactic hemostasis after gastric endoscopic submucosal dissection: A systematic review and meta‐analysis
Eun Hye Kim, Se Woo Park, Eunwoo Nam, Chang Soo Eun, Dong Soo Han, Chan Hyuk Park
Journal of Gastroenterology and Hepatology.2017; 32(4): 756. CrossRef
Second-Look Endoscopy after Endoscopic Submucosal Dissection: Can We Obtain Valuable Information?
Hye Kyung Jeon, Gwang Ha Kim
Clinical Endoscopy.2016; 49(3): 212. CrossRef

13,962 View
137 Download
15 Web of Science
11 Crossref

Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea: Yu Kyung Cho, Jeong Seop Moon, Dong Su Han, Yong Chan Lee, Yeol Kim, Bo Young Park, Il-Kwun Chung, Jin-Oh Kim, Jong Pil Im, Jae Myung Cha, Hyun Gun Kim, Sang Kil Lee, Hang Lak Lee, Jae Young Jang, Eun Sun Kim, Yunho Jung, Chang Mo Moon, Ethics and Quality Control Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2016;49(6):542-547. Published online March 2, 2016; DOI: https://doi.org/10.5946/ce.2015.113

Abstract PDF PubReader ePub

Background
/Aims: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions.
Methods
We surveyed the staff of institutional endoscopic units via e-mail.
Results
Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program.
Conclusions
Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

Citations

Citations to this article as recorded by

Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5‐year experience in an endoscopy center
Shu‐Hui Chen, Theophile Liu, Huei‐Wen Lai, Hui‐Lan Chang, Hsu‐Heng Yen
Advances in Digestive Medicine.2022; 9(2): 103. CrossRef
A nationwide survey on the effectiveness of training on endoscope reprocessing within the national cancer screening program in Korea
Hye Young Shin, Da Hun Jang, Jae Kwan Jun
American Journal of Infection Control.2021; 49(8): 1031. CrossRef
Polyp missing rate and its associated risk factors of referring hospitals for endoscopic resection of advanced colorectal neoplasia
Jae Gyu Shin, Hyung Wook Kim, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Medicine.2017; 96(19): e6742. CrossRef
Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
Clinical Endoscopy.2017; 50(4): 345. CrossRef
How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program
Yu Kyung Cho
Clinical Endoscopy.2016; 49(4): 312. CrossRef
How Can We Propagate the National Endoscopy Quality Improvement Program and Improve the Quality of Endoscopic Screening?
Dong-Hoon Yang
Gut and Liver.2016; 10(5): 657. CrossRef
The Importance of an Endoscopic Quality Assessment Program Reflecting Real Practice
In Kyung Yoo, Yoon Tae Jeen
Clinical Endoscopy.2016; 49(6): 495. CrossRef

10,545 View
138 Download
5 Web of Science
7 Crossref

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

Citations to this article as recorded by

Comparison of synchronous dual wavelength diode laser versus conventional endo-knives for esophageal endoscopic submucosal dissection: an animal study
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

8,082 View
74 Download
3 Web of Science
2 Crossref

Case Reports

Electrohydraulic Lithotripsy of an Impacted Enterolith Causing Acute Afferent Loop Syndrome: Young Sin Cho, Tae Hoon Lee, Soon Oh Hwang, Sunhyo Lee, Yunho Jung, Il-Kwun Chung, Sang-Heum Park, Sun-Joo Kim; Clin Endosc 2014;47(4):367-370. Published online July 28, 2014; DOI: https://doi.org/10.5946/ce.2014.47.4.367

Abstract PDF PubReader ePub

Afferent loop syndrome caused by an impacted enterolith is very rare, and endoscopic removal of the enterolith may be difficult if a stricture is present or the normal anatomy has been altered. Electrohydraulic lithotripsy is commonly used for endoscopic fragmentation of biliary and pancreatic duct stones. A 64-year-old man who had undergone subtotal gastrectomy and gastrojejunostomy presented with acute, severe abdominal pain for a duration of 2 hours. Initially, he was diagnosed with acute pancreatitis because of an elevated amylase level and pain, but was finally diagnosed with acute afferent loop syndrome when an impacted enterolith was identified by computed tomography. We successfully removed the enterolith using direct electrohydraulic lithotripsy conducted using a transparent cap-fitted endoscope without complications. We found that this procedure was therapeutically beneficial.

Citations

Citations to this article as recorded by

Migrated Pancreaticojejunal Stent Forming a Stent–Stone Complex in the Jejunum with Resultant Small Bowel Obstruction: A Case Report
Jiwon Kim, Young Han Kim, Byung-Hee Lee
Journal of the Korean Society of Radiology.2023; 84(2): 512. CrossRef
Use of a pneumatic device for intraluminal enterolith fragmentation in horses
Bruna Machado Amaral Rosa, Peterson Triches Dornbusch, Juan Carlos Duque Moreno, Jackson Schade
Equine Veterinary Education.2023;[Epub] CrossRef
Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction
Shuai Wang, Xiaohui Yang, Yixiong Zheng, Yulian Wu
Journal of International Medical Research.2021;[Epub] CrossRef
Diagnosis and treatment of the afferent loop syndrome
Panotpol Termsinsuk, Tanyaporn Chantarojanasiri, Nonthalee Pausawasdi
Clinical Journal of Gastroenterology.2020; 13(5): 660. CrossRef
Cola Dissolution Therapy via Ileus Tube Was Effective for Ileus Secondary to Small Bowel Obstruction Induced by an Enterolith
Yuga Komaki, Shuji Kanmura, Akihito Tanaka, Mari Nakashima, Fukiko Komaki, Hiromichi Iwaya, Shiho Arima, Fumisato Sasaki, Yuichiro Nasu, Shiroh Tanoue, Shinichi Hashimoto, Akio Ido
Internal Medicine.2019; 58(17): 2473. CrossRef
Intestinal stones: A rare cause of bowel obstruction
Emilio de León Castorena, Miriam Daniela de León Castorena
SAGE Open Medical Case Reports.2019;[Epub] CrossRef
Afferent loop obstruction with obstructive jaundice and ileus due to an enterolith after distal gastrectomy: A case report
Koki Sato, Masataka Banshodani, Masahiro Nishihara, Junko Nambu, Yasuo Kawaguchi, Fumio Shimamoto, Keizo Sugino, Hideki Ohdan
International Journal of Surgery Case Reports.2018; 50: 9. CrossRef
Afferent Loop Syndrome after Roux-en-Y Total Gastrectomy Caused by Volvulus of the Roux-Limb
Hideki Katagiri, Kana Tahara, Kentaro Yoshikawa, Alan Kawarai Lefor, Tadao Kubota, Ken Mizokami
Case Reports in Surgery.2016; 2016: 1. CrossRef

6,931 View
70 Download
10 Web of Science
8 Crossref

Endoscopic Removal of a Proximally Migrated Metal Stent during Balloon Sweeping after Stent Trimming: Nam Jun Cho, Tae Hoon Lee, Sang-Heum Park, Han Min Lee, Kyung Hee Hyun, Suck-Ho Lee, Il-Kwun Chung, Sun-Joo Kim; Clin Endosc 2013;46(4):418-422. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.418

Abstract PDF PubReader ePub

Placement of a self-expanding metal stent (SEMS) is an effective method for palliation of a malignant biliary obstruction. However, metal stents can cause various complications, including stent migration. Distally migrated metal stents, particularly covered SEMS, can be removed successfully in most cases. Stent trimming using argon plasma coagulation may be helpful in difficult cases despite conventional methods. However, no serious complications related to the trimming or remnant stent removal method have been reported due to the limited number of cases. In particular, proximal migration of a remnant fragmented metal stent after stent trimming followed by balloon sweeping has not been reported. We report an unusual case of proximal migration of a remnant metal stent during balloon sweeping following stent trimming by argon plasma coagulation. The remnant metal stent was successfully removed with rotation technique using a basket and revised endoscopically.

Citations

Citations to this article as recorded by

Safe and reliable removal of a migrated biliary metal stent with a snare placed over the balloon using the two-devices-in-one-channel method
Kazuya Sumi, Jun Ushio, Hisaki Kato, Akinori Komagata, Yuki Kawasaki, Takayoshi Ito, Haruhiro Inoue
Endoscopy.2025; 57(S 01): E222. CrossRef
Successful removal of a proximally migrated biliary fully covered self‐expandable metal stent using a sphincterotome
Kazuya Koizumi, Karen Kimura, Ryuhei Jinushi
Digestive Endoscopy.2024; 36(3): 374. CrossRef
Endoscopic Management of a Proximally Migrated Fully Covered SEMS Using the Stent-in-Stent Technique
Arunchai Chang, Varayu Prachayakul
Case Reports in Medicine.2020; 2020: 1. CrossRef
Burning and cutting: a unique technique for management of migrated uncovered metal biliary stents
Shivangi Kothari, Truptesh H. Kothari, Vivek Kaul
VideoGIE.2020; 5(11): 562. CrossRef
Recalcitrant embedded biliary self-expanding metal stents: a novel technique for endoscopic extraction
Marc Bernon, Christo Kloppers, Jessica Lindemann, Jake E.J. Krige, Eduard Jonas
VideoGIE.2019; 4(2): 72. CrossRef
Endoscopic management of internally migrated pancreatic duct stents (with video)
Suryaprakash Bhandari, Atul Sharma, Rajesh Bathini, Amit Maydeo
Indian Journal of Gastroenterology.2016; 35(2): 91. CrossRef

8,155 View
90 Download
6 Crossref

First
Prev
Page of 1
Next
Last

Search