Clinical Endoscopy

Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials: Vishali Moond, Priyadarshini Loganathan, Sheza Malik, Dushyant Singh Dahiya, Babu P. Mohan, Daryl Ramai, Michele McGinnis, Deepak Madhu, Mohammad Bilal, Aasma Shaukat, Saurabh Chandan; Clin Endosc 2024;57(6):747-758. Published online August 23, 2024; DOI: https://doi.org/10.5946/ce.2024.081 [Epub ahead of print]

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs).
Methods
Multiple databases were searched in December 2023 for RCTs reporting outcomes of CSP versus CEMR for colorectal polyps ≤10 mm in size. Our primary outcomes were rates of complete and en-bloc resections, while our secondary outcomes were total resection time (seconds) and adverse events, including immediate bleeding, delayed bleeding, and perforation.
Results
The complete resection rates did not significantly differ (CSP, 91.8% vs. CEMR 94.6%), nor did the rates of en-bloc resection (CSP, 98.9% vs. CEMR, 98.3%) or incomplete resection (CSP, 6.7% vs. CEMR, 4.8%). Adverse event rates were similarly insignificant in variance. However, CEMR had a notably longer mean resection time (133.51 vs. 91.30 seconds).
Conclusions
Our meta-analysis of seven RCTs showed that while both CSP and CEMR are equally safe and effective for resecting small (≤10 mm) colorectal polyps, the latter is associated with a longer resection time.

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Outcomes of endoscopic retrograde cholangiopancreatography in patients with situs inversus viscerum: Long Le, Nicholas McDonald, Anders Westanmo, Mohammad Bilal, Dharma Sunjaya; Clin Endosc 2023;56(6):790-794. Published online April 26, 2023; DOI: https://doi.org/10.5946/ce.2022.292

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Background
/Aims: Situs inversus viscerum (SIV) is a congenital condition defined by left-to-right transposition of all visceral organs. This anatomical variant has caused technical challenges in endoscopic retrograde cholangiopancreatography (ERCP). Data on ERCP in patients with SIV are limited to case reports of unknown clinical and technical success rates. This study aimed to evaluate the clinical and technical success rates of ERCP in patients with SIV.
Methods
Data from patients with SIV who underwent ERCP were retrospectively reviewed. The data were collected by querying the nationwide Veterans Affairs Health System database for patients diagnosed with SIV who underwent ERCP. Patient demographics and procedural characteristics were collected.
Results
Eight patients with SIV who underwent ERCP were included. Choledocholithiasis was the most common indication for ERCP (62.5%). The technical success rate was 63%. Subsequent ERCP with interventional radiology–assisted rendezvous has increased the technical success rate to 100%. Clinical success was achieved in 63% of cases. Among cases of subsequent rendezvous ERCP after conventional ERCP failure, clinical success was achieved in 100%.
Conclusions
The clinical and technical success rates of ERCP in patients with SIV were both 63%. In patients with SIV in whom ERCP fails, interventional radiology–assisted rendezvous ERCP can be considered.

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Adaptability in the Midst of Anatomical Challenges: A Case of Situs Inversus Totalis in Laparoscopic Cholecystectomy
Christopher Nguyen, David Schutter
Cureus.2024;[Epub] CrossRef

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Efficacy of wire-guided biopsy forceps for tissue sampling in endoscopic retrograde cholangiopancreatography: a preliminary experience: Manaswita Tappata, Nicholas M. McDonald, Mohamed Abdallah, Mohammad Bilal; Clin Endosc 2023;56(4):527-530. Published online February 15, 2023; DOI: https://doi.org/10.5946/ce.2022.152

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The Clinical and Metabolic Effects of Intragastric Balloon on Morbid Obesity and Its Related Comorbidities: Joon Hyun Cho, Mohammad Bilal, Min Cheol Kim, Jonah Cohen, The Study Group for Endoscopic Bariatric and Metabolic Therapies of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2021;54(1):9-16. Published online January 29, 2021; DOI: https://doi.org/10.5946/ce.2020.302

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Obesity is becoming increasingly prevalent worldwide, and its metabolic sequelae lead to a significant burden on healthcare resources. Options for the management of obesity include lifestyle modification, pharmacological treatment, surgery, and endoscopic bariatric therapies (EBTs). Among these, EBTs are more effective than diet and lifestyle modification and are less invasive than bariatric surgery. In recent years, there have been significant advances in technologies pertaining to EBTs. Of all the available EBTs, there is a significant amount of clinical experience and published data regarding intragastric balloons (IGBs) because of their comparatively long development period. Currently, the United States Food and Drug Administration (FDA) has approved three IGBs, including Orbera (Apollo Endosurgery, Austin, TX, USA), ReShape Duo (ReShape Medical, San Clemente, CA, USA), and Obalon (Obalon Therapeutics, Carlsbad, CA, USA). The aim of this review is to summarize the available literature on the efficacy of IGBs in weight loss and their impact on obesity-related metabolic diseases.

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Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control
Willian Ferreira Igi, Victor Lira de Oliveira, Ayah Matar, Diogo Turiani Hourneaux de Moura
Clinical Endoscopy.2024; 57(3): 309. CrossRef
Evaluating Weight Loss Efficacy in Obesity Treatment with Allurion’s Ingestible Gastric Balloon: A Retrospective Study Utilizing the Scale App Health Tracker
Danut Dejeu, Paula Dejeu, Paula Bradea, Anita Muresan, Viorel Dejeu
Clinics and Practice.2024; 14(3): 765. CrossRef
Mechanism of action and selection of endoscopic bariatric therapies for treatment of obesity
Wissam Ghusn, Gerardo Calderon, Barham K. Abu Dayyeh, Andres Acosta
Clinical Endoscopy.2024; 57(6): 701. CrossRef
Efficacy and safety of intragastric balloon for obesity in Korea
Kwang Gyun Lee, Seung-Joo Nam, Hyuk Soon Choi, Hang Lak Lee, Jai Hoon Yoon, Chan Hyuk Park, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Sung Hoon Jung
Clinical Endoscopy.2023; 56(3): 333. CrossRef
How effective is intragastric balloon insertion as an obesity treatment in Korea?
Youngdae Kim
Clinical Endoscopy.2023; 56(3): 310. CrossRef
Overview on the endoscopic treatment for obesity: A review
Maheeba Abdulla, Nafeesa Mohammed, Jehad AlQamish
World Journal of Gastroenterology.2023; 29(40): 5526. CrossRef
Endoscopic Bariatric Therapy for Obesity and Metabolic Syndrome
Sang Pyo Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(4): 247. CrossRef
Status of bariatric endoscopy–what does the surgeon need to know? A review
Diogo Turiani Hourneaux de Moura, Anna Carolina Batista Dantas, Igor Braga Ribeiro, Thomas R McCarty, Flávio Roberto Takeda, Marco Aurelio Santo, Sergio Carlos Nahas, Eduardo Guimarães Hourneaux de Moura
World Journal of Gastrointestinal Surgery.2022; 14(2): 185. CrossRef
Various Novel and Emerging Technologies in Endoscopic Bariatric and Metabolic Treatments
Hee Kyong Na, Diogo Turiani Hourneaux De Moura
Clinical Endoscopy.2021; 54(1): 25. CrossRef

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Seasonal Impacts on the Incidence of Esophageal Variceal Hemorrhage: A Nationwide Analysis across a Decade: Mohamed Tausif Siddiqui, Mohammad Bilal, Khwaja Fahad Haq, Christopher Nabors, Beth Schorr-Lesnick, David C. Wolf; Clin Endosc 2020;53(2):189-195. Published online December 27, 2019; DOI: https://doi.org/10.5946/ce.2019.094

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Background
/Aims: Seasonal variation has previously been reported in relation to the incidence of non-variceal upper gastrointestinal bleeding; however, the impact of seasonal variation on variceal bleeding is not known.
Methods
We conducted a cross-sectional study using the Nationwide Inpatient Sample database from 2005 to 2014. International Classification of Diseases, Clinical Modification- 9th Revision codes were used to identify patients hospitalized with a primary or secondary diagnosis of esophageal variceal hemorrhage. The data were analyzed based on the month of hospitalization. Our primary aim was to assess seasonal variations in variceal bleeding-related hospitalizations. The secondary aims were to assess the impact of seasonal variation on outcomes in variceal bleeding including in-hospital mortality and healthcare resource utilization.
Results
A total of 348,958 patients hospitalized with esophageal variceal bleeding were included. The highest number of hospitalizations was reported in December (99.3/day) and the lowest was reported in June (90.8/day). In-hospital mortality was highest in January (11.5%) and lowest in June (9.8%). There was no significant difference in hospital length of stay or total hospitalization costs across all months in all years combined.
Conclusions
There appears to be a seasonal variation in the incidence and mortality of variceal hemorrhage in the United States. December was the month with the highest number of daily hospitalizations while the nadir occurred in June.

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Association between periodic variation of air temperature, humidity, atmospheric pressure and hospital admissions for acute occlusive mesenteric ischaemia
Lin Chen, Jun Wang, Hongqing Zhuo, Zexin Wang, Jizhun Zhang
Scientific Reports.2024;[Epub] CrossRef
Assessing the Predictive Factors for Bleeding in Esophageal Variceal Disease: A Systematic Review
Camila Guinazu, Adolfo Fernández Muñoz, Maria D Maldonado, Jeffry A De La Cruz, Domenica Herrera, Victor S Aruana, Ernesto Calderon Martinez
Cureus.2023;[Epub] CrossRef
α-Adrenergic blockade prevented environmental temperature reduction-induced transient portal pressure surge in cirrhotic and portal hypertensive rats
Hui-Chun Huang, Ching-Chih Chang, Chon Kit Pun, Ming-Hung Tsai, Chiao-Lin Chuang, Shao-Jung Hsu, Yi-Hsiang Huang, Ming-Chih Hou, Fa-Yauh Lee
Clinical Science.2022; 136(20): 1449. CrossRef
Establishment and Evaluation of a Time Series Model for Predicting the Seasonality of Acute Upper Gastrointestinal Bleeding
Zhaoli Fu, Xujie Xi, Beiping Zhang, Yanfeng Lin, Aling Wang, Jianmin Li, Ming Luo, Tianwen Liu
International Journal of General Medicine.2021; Volume 14: 2079. CrossRef
Are there Seasonal Variations in the Incidence and Mortality of Esophageal Variceal Bleeding?
Jeong Ill Suh
Clinical Endoscopy.2020; 53(2): 107. CrossRef

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A Nationwide Assessment of the “July Effect” and Predictors of Post-Endoscopic Retrograde Cholangiopancreatography Sepsis at Urban Teaching Hospitals in the United States: Rupak Desai, Upenkumar Patel, Shreyans Doshi, Dipen Zalavadia, Wardah Siddiq, Hitanshu Dave, Mohammad Bilal, Vikas Khullar, Hemant Goyal, Madhav Desai, Nihar Shah; Clin Endosc 2019;52(5):486-496. Published online May 27, 2019; DOI: https://doi.org/10.5946/ce.2018.190

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Background
/Aims: To analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (July to September) and later (October to June) academic months to assess the “July effect”.
Methods
The National Inpatient Sample (2010–2014) was used to identify ERCP-related adult hospitalizations at urban teaching hospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluate the odds of post-ERCP sepsis and its predictors.
Results
Of 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academic months. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higher incidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during the early academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients with post-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications such as cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis in procedures performed during the early academic months.
Conclusions
The July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into consideration the predictors of post-ERCP sepsis to lower health-care burden.

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A Nationwide Study of the “July Effect” Concerning Postpartum Hemorrhage and Its Risk Factors at Teaching Hospitals across the United States
Zahra Shahin, Gulzar H. Shah, Bettye A. Apenteng, Kristie Waterfield, Hani Samawi
Healthcare.2023; 11(6): 788. CrossRef
July effect in clinical outcomes of esophagogastroduodenoscopy performed at teaching hospitals in the United States
Karthik Gangu, Sanket Basida, Rehmat Ullah Awan, Mohammad Ali Butt, Austin Reed, Rao Afzal, Rahul Shekhar, Harleen Kaur Chela, Ebubekir S. Daglilar, Abu Baker Sheikh
Baylor University Medical Center Proceedings.2023; 36(4): 478. CrossRef
Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?
Shyam Vedantam, Sunil Amin, Ben Maher, Saqib Ahmad, Shanil Kadir, Saad Khalid Niaz, Mark Wright, Nadeem Tehami
Clinical Endoscopy.2022; 55(3): 426. CrossRef
Post-ERCP Pancreatitis: Prevention, Diagnosis and Management
Oscar Cahyadi, Nadeem Tehami, Enrique de-Madaria, Keith Siau
Medicina.2022; 58(9): 1261. CrossRef
Risk factors for infections after endoscopic retrograde cholangiopancreatography (ERCP): a retrospective cohort analysis of US Medicare Fee-For-Service claims, 2015–2021
Susan Hutfless, Yasutoshi Shiratori, Daniel Chu, Simon Liu, Anthony Kalloo
BMJ Open.2022; 12(9): e065077. CrossRef
Clinical coaches and patient safety – Just in time: A descriptive exploratory study
Lorraine Thompson, Frances Lin, Annette Faithfull-Byrne, Judith Gonzalez, Amanda Naumann, Kathryn Geisler, Cheryle Moss
Nurse Education in Practice.2021; 54: 103134. CrossRef
Is the July Effect Real in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography?
Tae Yoon Lee, Yousuke Nakai
Clinical Endoscopy.2019; 52(5): 399. CrossRef

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