Clinical Endoscopy

Case Report

Endoscopic Management of Gastrointestinal Leaks and Perforation with Polyglycolic Acid Sheets: Sojung Han, Hyunsoo Chung, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee; Clin Endosc 2017;50(3):293-296. Published online March 8, 2017; DOI: https://doi.org/10.5946/ce.2016.121

Gastrointestinal (GI) leakage, fistulae, and perforations can be serious and life threatening. There has been a paradigm shift in the management approach of these conditions, from surgical to conservative, including endoscopic management. Here, we report two cases of endoscopic closure of a GI fistula and perforation using polyglycolic acid (PGA) sheets with fibrin glue. The first case is of an anastomotic leak detected after subtotal gastrectomy with gastroduodenostomy. After failed application of endoclips, a PGA sheet was applied, and the fistula was successfully closed. The second case was of a 15-mm large perforated gastric ulcer, which was also successfully closed with a PGA sheet. This is the first case report that PGA sheet was used for the treatment of overt perforation. The outcome of these cases suggest that endoscopic closure using PGA sheets can be considered as a useful alternative for the management of GI leakage, fistulae, and perforations.

Citations

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Hyun Deok Lee, Eunwoo Lee, Sang Gyun Kim, Cheol Min Shin, Jun Chul Park, Kee Don Choi, Seokyung Hahn, Soo-Jeong Cho
American Journal of Gastroenterology.2023; 118(5): 892. CrossRef
Large anastomotic leak: endoscopic treatment using combined fibrin glue and polyglycolic acid (PGA) sheets
Soo In Choi, Ji Young Park
BMJ Case Reports.2021; 14(8): e240188. CrossRef
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Hideaki Kawabata, Yuji Okazaki, Naonori Inoue, Yukino Kawakatsu, Misuzu Hitomi, Masatoshi Miyata, Shigehiro Motoi
Endoscopy International Open.2018; 06(08): E994. CrossRef
Successful Endoscopic Closure Using Polyglycolic Acid Sheets with Fibrin Glue for Nonhealing Duodenal Ulcer with Perforation after Proton Beam Therapy of Liver Tumor
Ko Watanabe, Takuto Hikichi, Jun Nakamura, Minami Hashimoto, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Naoki Konno, Mika Takasumi, Yuki Sato, Hiroki Irie, Takashi Kimura, Akira Kenjo, Shigeru Marubashi, Katsutoshi Obara, Hiromasa Ohira
Case Reports in Gastroenterology.2018; 12(3): 679. CrossRef

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Original Article

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

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Advances in Digestive Medicine.2022; 9(2): 103. CrossRef
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Hye Young Shin, Da Hun Jang, Jae Kwan Jun
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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

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7 Crossref

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