Clinical Endoscopy

Original Articles

Bile acid sequestrants in poor healing after endoscopic therapy of Barrett’s esophagus: Lukas Welsch, Andrea May, Tobias Blasberg, Jens Wetzka, Elisa Müller, Myriam Heilani, Mireen Friedrich-Rust, Mate Knabe; Clin Endosc 2023;56(2):194-202. Published online March 9, 2023; DOI: https://doi.org/10.5946/ce.2022.121

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Background
/Aims: Endoscopic therapy for neoplastic Barrett’s esophagus (BE) has become the standard of care over the past two decades. In clinical practice, we regularly encounter patients who fail to achieve complete squamous epithelialization of the esophagus. Although the therapeutic strategies in the individual stages of BE, dysplasia, and esophageal adenocarcinoma are well studied and largely standardized, the problem of inadequate healing after endoscopic therapy is only marginally considered. This study aimed to shed light on the variables influencing inadequate wound healing after endoscopic therapy and the effect of bile acid sequestrants (BAS) on healing.
Methods
Retrospective analysis of endoscopically treated neoplastic BE in a single referral center.
Results
In 12.1% out of 627 patients, insufficient healing was present 8 to 12 weeks after previous endoscopic therapy. The average follow-up duration was 38.8±18.4 months. Complete healing was achieved in 13 patients already after intensifying proton pump inhibitor therapy. Out of 48 patients under BAS, 29 patients (60.4%) showed complete healing. An additional eight patients (16.7%) improved, but only partial healing was achieved. Eleven (22.9%) patients showed no response to BAS augmented therapy.
Conclusions
In cases of insufficient healing even under exhaustion of proton pump inhibitors, treatment with BAS can be an option as an ultimate healing attempt.

Citations

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Clinicians should be aware of proton pump inhibitor–related changes in the gastric mucosa
Gwang Ha Kim
Clinical Endoscopy.2024; 57(1): 51. CrossRef
Seeking to understand non-responders to ablative therapy for dysplastic Barrett's esophagus
Bryan G. Sauer
Clinical Endoscopy.2023; 56(2): 180. CrossRef

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Long-Term Survival and Tumor Recurrence in Patients with Superficial Esophageal Cancer after Complete Non-Curative Endoscopic Resection: A Single-Center Case Series: Ji Wan Lee, Charles J. Cho, Do Hoon Kim, Ji Yong Ahn, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Sook Ryun Park, Hyun Joo Lee, Yong Hee Kim, Gin Hyug Lee, Hwoon-Yong Jung, Sung-Bae Kim, Jong Hoon Kim, Seung-Il Park; Clin Endosc 2018;51(5):470-477. Published online June 1, 2018; DOI: https://doi.org/10.5946/ce.2018.025

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Background
/Aims: To report the long-term survival and tumor recurrence outcomes in patients with superficial esophageal cancer (SEC) after complete non-curative endoscopic resection (ER).
Methods
We retrieved ER data for 24 patients with non-curatively resected SEC. Non-curative resection was defined as the presence of submucosal and/or lymphovascular invasion on ER pathology. Relevant clinical and tumor-specific parameters were reviewed.
Results
The mean age of the 24 study patients was 66.3±8.3 years. Ten patients were closely followed up without treatment, while 14 received additional treatment. During a mean follow-up of 59.0±33.2 months, the 3- and 5-year survival rates of all cases were 90.7% and 77.6%, respectively. The 5-year overall survival rates were 72.9% in the close observation group and 82.1% in the additional treatment group (p=0.958). The 5-year cumulative incidences of all cases of recurrence (25.0% vs. 43.3%, p=0.388), primary EC recurrence (10.0% vs. 16.4%, p=0.558), and metachronous EC recurrence (16.7% vs. 26.7%, p=0.667) were similar between the two groups.
Conclusions
Patients with non-curatively resected SEC showed good long-term survival outcomes. Given the similar oncologic outcomes, close observation may be an option with appropriate caution taken for patients who are medically unfit to receive additional therapy.

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Close Observation versus Additional Surgery after Noncurative Endoscopic Resection of Esophageal Squamous Cell Carcinoma
Byeong Geun Song, Ga Hee Kim, Charles J. Cho, Hyeong Ryul Kim, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Ho June Song, Yong-Hee Kim, Jun Haeng Lee, Hwoon-Yong Jung, Jae Ill Zo, Young Mog Shim
Digestive Surgery.2021; 38(3): 247. CrossRef
Non-Curative Endoscopic Resection for Superficial Esophageal Cancer
Eun Hye Kim, Jun Chul Park
Clinical Endoscopy.2018; 51(5): 399. CrossRef

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Case Report

Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer: Hyo Jeong Lee, Byong Duk Ye, Jeong-Sik Byeon, Jihun Kim, Young Soo Park, Yong Sang Hong, Yong Sik Yoon, Dong-Hoon Yang; Clin Endosc 2017;50(1):91-95. Published online August 22, 2016; DOI: https://doi.org/10.5946/ce.2016.054

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Intramucosal colorectal cancer (CRC) is thought not to metastasize because the colonic lamina propria lacks lymphatics. Only a few recent case reports have suggested lymph node metastasis from intramucosal CRC, but there is no clear evidence supporting the metastatic potential of intramucosal CRC. Hence, endoscopic resection is regarded as curative treatment for intramucosal CRC. This report describes two cases of unusual local recurrence with distant metastasis in patients who had previously undergone successful endoscopic submucosal dissection for intramucosal CRC. The recurrent colorectal lesions developed at the site of the previous endoscopic submucosal dissection scars in a relatively short-term period, and the pathologic findings showed an “undermining” invasion pattern without surrounding mucosal change. Based on the clinical course and pathological findings, we concluded that the second colorectal lesions were recurrences rather than de novo cancers.

Citations

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Local excision after polypectomy for rectal polyp cancer: when is it worthwhile?
Helen J. S. Jones, Issam al‐Najami, Gunnar Baatrup, Chris Cunningham
Colorectal Disease.2021; 23(4): 868. CrossRef
Presacral lymph node recurrence of rectal intramucosal adenocarcinoma after endoscopic mucosal resection: a case report
Taichi Horino, Yukiharu Hiyoshi, Yuji Miyamoto, Naoya Yoshida, Hideo Baba
Surgical Case Reports.2020;[Epub] CrossRef
Recurrence, death risk, and related factors in patients with stage 0 colorectal cancer
Ming-Hao Hsieh, Pei-Tseng Kung, Wen-Yin Kuo, Tao-Wei Ke, Wen-Chen Tsai
Medicine.2020; 99(36): e21688. CrossRef
Recurrence rate of lateral margin-positive cases after en bloc endoscopic submucosal dissection of colorectal neoplasia
Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2018; 33(6): 735. CrossRef

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Original Articles

Correlation of Endoscopic Findings of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma with Recurrence after Complete Remission: Chang Min Lee, Dong Ho Lee, Byung Kyu Ahn, Jae Jin Hwang, Hyuk Yoon, Young Soo Park, Cheol Min Shin, Nayoung Kim; Clin Endosc 2017;50(1):51-57. Published online March 24, 2016; DOI: https://doi.org/10.5946/ce.2016.015

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Background
/Aims: In gastric mucosa-associated lymphoid tissue (MALT) lymphoma, the clinical significance of various endoscopic findings has not yet been determined. This study aimed to compare the time to complete remission (CR) and relapse-free survival (RFS) in gastric MALT lymphoma based on endoscopic findings.
Methods
In this single-center retrospective cohort study, the medical records of 122 consecutive adult patients with gastric MALT lymphoma were collected over a period of 12 years. CR was defined by the absence of macroscopic or microscopic features of lymphoma on two subsequent follow-ups. Relapse was clinically defined by a positive endoscopic biopsy after CR.
Results
The median time to CR did not differ significantly between treatment methods. However, it was significantly longer in the group with polypoid endoscopic appearance than in the groups with diffuse infiltration or ulceration (7.83, 3.43, and 3.10 months, respectively; p=0.003). Six patients relapsed after CR. Kaplan-Meier analysis showed that RFS differed significantly between groups based on Ann Arbor staging, treatment methods, and initial endoscopic findings.
Conclusions
In gastric MALT lymphoma, the endoscopically defined polypoid type was characterized by a longer duration to CR, with a higher likelihood of recurrence, compared to the endoscopically defined diffuse infiltration or ulceration types.

Citations

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A Case of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma with Special Endoscopic Morphology
Xin Sun, Yanbo Zhen, Pan Pan, Liang Liu
Journal of Digestive Endoscopy.2024;[Epub] CrossRef
Characteristic endoscopic findings of gastrointestinal malignant lymphomas other than mucosa-associated lymphoid tissue lymphoma
T Kanno, T Katano, T Shimura, R Nishigaki, Y Kojima, M Sasaki, Y Okuda, N Sugimura, S Fukusada, Y Mizuno, H Iwasaki, H Nishie, M Tanaka, K Ozeki, E Kubota, S Tanida, H Kataoka
Acta Gastro Enterologica Belgica.2022; 85(3): 477. CrossRef
Diagnosis and Treatment for Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma
Shotaro Nakamura, Mariko Hojo
Journal of Clinical Medicine.2022; 12(1): 120. CrossRef
Normal gastrointestinal tract inflammatory cells and review of select benign hematolymphoid proliferations
Jennifer Y. Ju, Edward B. Stelow, Elizabeth L. Courville
Seminars in Diagnostic Pathology.2021; 38(4): 6. CrossRef
Optimal Initial Workup in Patients With Superficial Primary Gastric MALT Lymphoma
Hee Kyong Na, Sung Hyun Won, Jeong Hoon Lee, Ga Hee Kim, Kee Wook Jung, Ji Yong Ahn, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Journal of Clinical Gastroenterology.2021; 55(9): 785. CrossRef
Endoscopic features and clinical outcomes of colorectal mucosa-associated lymphoid tissue lymphoma
Min Kyung Jeon, Hoonsub So, Jooryung Huh, Hee Sang Hwang, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kee Don Choi, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2018; 87(2): 529. CrossRef
Endoscopic Findings of Gastric Extranodal Marginal Zone B-Cell Mucosa-Associated Lymphoid Tissue Lymphoma
Sang Kil Lee
Clinical Endoscopy.2017; 50(1): 1. CrossRef

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Clinical Outcomes of Argon Plasma Coagulation Therapy for Early Gastric Neoplasms: Kyu Young Kim, Seong Woo Jeon, Hea Min Yang, Yu Rim Lee, Eun Jeong Kang, Hyun Seok Lee, Sung Kook Kim; Clin Endosc 2015;48(2):147-151. Published online March 27, 2015; DOI: https://doi.org/10.5946/ce.2015.48.2.147

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Background/Aims

Argon plasma coagulation (APC) has some merits in the treatment of gastric neoplasms including a shorter operative time and fewer complications compared with endoscopic mucosal resection or endoscopic submucosal dissection. However, there are few reports on the outcomes of gastric neoplasms treated using APC. The aim of this study was to evaluate APC in the treatment of early gastric neoplasms in terms of clinical efficacy, safety, and local recurrence.

Methods

We enrolled 28 patients who received APC therapy at the Kyungpook National University Hospital between May 2007 and April 2013. Clinical outcomes were analyzed.

Results

The median follow-up period was 24.8 months (range, 2 to 78). Among the 28 lesions treated using the APC procedure, tumor recurrence was encountered in seven lesions (25.0%). Recurrence was found in 50% (5/10) of single APC cases and 11% (2/18) of rescue APC cases. The mean time to recurrence was 16.1 months (range, 2 to 78). There were no serious APC-related complications such as perforation, bleeding, or infection.

Conclusions

APC therapy can be a useful treatment with a favorable safety profile for patients with early gastric neoplasms. However, further studies are necessary to determine the long-term prognosis of patients undergoing this treatment.

Citations

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Comparison of Endoscopic Radiofrequency Ablation and Argon Plasma Coagulation in Patients with Gastric Low-Grade Intraepithelial Neoplasia: A Large-Scale Retrospective Study
Nanjun Wang, Ningli Chai, Longsong Li, Huikai Li, Yaqi Zhai, Xiuxue Feng, Shengzhen Liu, Wengang Zhang, Enqiang Linghu, Xiaohua Jiang
Canadian Journal of Gastroenterology and Hepatology.2022; 2022: 1. CrossRef
Long-term Outcomes of Additional Endoscopic Treatments for Patients with Positive Lateral Margins after Endoscopic Submucosal Dissection for Early Gastric Cancer
Tae-Se Kim, Byung-Hoon Min, Yang Won Min, Hyuk Lee, Poong-Lyul Rhee, Jae J. Kim, Jun Haeng Lee
Gut and Liver.2022; 16(4): 547. CrossRef
Post-EMR for colorectal polyps, thermal ablation of defects reduces adenoma recurrence: A meta-analysis
Pujan Kandel, Murtaza Hussain, Deepesh Yadav, Santosh K. Dhungana, Bhaumik Brahmbhatt, Massimo Raimondo, Frank J. Lukens, Ghassan Bachuwa, Michael B. Wallace
Endoscopy International Open.2022; 10(10): E1399. CrossRef
Factors associated with conversion to snare resection during gastric endoscopic submucosal dissection
Su Jin Kim, Cheol Woong Choi, Hyeong Seok Nam, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Dae Gon Ryu
Surgical Endoscopy.2020; 34(4): 1585. CrossRef
Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection
Amir Klein, David J. Tate, Vanoo Jayasekeran, Luke Hourigan, Rajvinder Singh, Gregor Brown, Farzan F. Bahin, Nicholas Burgess, Stephen J. Williams, Eric Lee, Mayenaaz Sidhu, Karen Byth, Michael J. Bourke
Gastroenterology.2019; 156(3): 604. CrossRef
Ablation of residual gastric tumor by argon plasma coagulation after endoscopic resection
Sooyeon Oh, Sang Gyun Kim, Ji Min Choi, Eun Hyo Jin, Jee Hyun Kim, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung
Surgical Endoscopy.2017; 31(3): 1093. CrossRef
Risk-Stratification Model Based on Lymph Node Metastasis After Noncurative Endoscopic Resection for Early Gastric Cancer
Da Hyun Jung, Cheal Wung Huh, Jie-Hyun Kim, Jung Hwa Hong, Jun Chul Park, Yong Chan Lee, Young Hoon Youn, Hyojin Park, Seung Ho Choi, Sung Hoon Noh
Annals of Surgical Oncology.2017; 24(6): 1643. CrossRef

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Late Complications and Stone Recurrence Rates after Bile Duct Stone Removal by Endoscopic Sphincterotomy and Large Balloon Dilation are Similar to Those after Endoscopic Sphincterotomy Alone: Ka Young Kim, Jimin Han, Ho Gak Kim, Byeong Suk Kim, Jin Tae Jung, Joong Goo Kwon, Eun Young Kim, Chang Hyeong Lee; Clin Endosc 2013;46(6):637-642. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.637

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Background/Aims

Between endoscopic sphincterotomy (ES) alone and combined endoscopic sphincterotomy and large balloon dilation (ES-LBD) groups, efficacy and long-term complications, difference in biliary stone recurrence rate, and risk factors of stone recurrence were compared.

Methods

Medical records of 222 patients who underwent ERCP for biliary stone removal were retrospectively reviewed. Patients with dilated CBD ≥11 mm and follow-up longer than 6 months were included.

Results

There were 101 patients in ES-LBD group and 121 patients in ES group. Mean follow-up duration was 25.0 (6-48) months and 13.0 (6-43) months, respectively (p=0.001). There was no difference in number of ERCP sessions, brown pigment stones, angle between mid and distal common bile duct (CBD angle) <135°, and lithotripsy rate. Complete retrieval success rate was excellent in both groups (100% vs. 99%). Early complication rate of ES-LBD and ES alone group was 4 and 4.1%, respectively (p=1.000). One patient in ES-LBD group died from delayed bleeding. Late complication rate was 5.9 and 3.3%, respectively (p=1.000). Stone recurrence rate was 6.9% and 5.8%, respectively (p=0.984). The only Independent risk factor of stone recurrence was presence of periampullary diverticulum.

Conclusions

Late complication and stone recurrence rates were similar between ES-LBD and ES alone groups.

Citations

Citations to this article as recorded by

Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
Marko Kozyk, Suprabhat Giri, Sidharth Harindranath, Manan Trivedi, Kateryna Strubchevska, Rakesh Kumar Barik, Sridhar Sundaram
DEN Open.2024;[Epub] CrossRef
Characterization of biliary and duodenal microbiota in patients with primary and recurrent choledocholithiasis
Fang Liu, Zi-Kai Wang, Ming-Yang Li, Xiu-li Zhang, Feng-Chun Cai, Xiang-Dong Wang, Xue-Feng Gao, Wen Li
Health Information Science and Systems.2024;[Epub] CrossRef
Evidence-based clinical practice guidelines for cholelithiasis 2021
Naotaka Fujita, Ichiro Yasuda, Itaru Endo, Hiroyuki Isayama, Takuji Iwashita, Toshiharu Ueki, Kenichiro Uemura, Akiko Umezawa, Akio Katanuma, Yu Katayose, Yutaka Suzuki, Junichi Shoda, Toshio Tsuyuguchi, Toshifumi Wakai, Kazuo Inui, Michiaki Unno, Yoshifu
Journal of Gastroenterology.2023; 58(9): 801. CrossRef
Endoclip papillaplasty (ECPP) versus limited EST plus EPLBD for a decrease in recurrent choledocholithiasis: a prospective cohort study
Xiaofang Lu, Yingchun Wang, Wenzheng Liu, Yaopeng Zhang, Wei Zheng, Xiue Yan, Hong Chang, Yonghui Huang
Surgical Endoscopy.2023; 37(10): 7790. CrossRef
The Clinical Presentations of Liver Abscess Development After Endoscopic Retrograde Cholangiopancreatography with Choledocholithiasis: A 17-Year Follow-Up
An-Che Liu, Wei-Chen Tai, Shao-Ming Chiu, Fai-Meng Sou, Shih-Cheng Yang, Lung-Sheng Lu, Chung-Mou Kuo, Yi-Chun Chiu, Seng-Kee Chuah, Chih-Ming Liang, Cheng-Kun Wu
Infection and Drug Resistance.2023; Volume 16: 6167. CrossRef
Low insertion of cystic duct increases risk for common bile duct stone recurrence
Seong Ji Choi, Jai Hoon Yoon, Dong Hee Koh, Hang Lak Lee, Dae Won Jun, Ho Soon Choi
Surgical Endoscopy.2022; 36(5): 2786. CrossRef
New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
Xu Ji, Zhuo Yang, Shu-Ren Ma, Wen Jia, Qian Zhao, Lu Xu, Ying Kan, Yang Cao, Yao Wang, Bao-Jun Fan
World Journal of Gastrointestinal Surgery.2022; 14(3): 236. CrossRef
Endoscopic Papillary Large Balloon Dilation Reduces Further Recurrence in Patients With Recurrent Common Bile Duct Stones: A Randomized Controlled Trial
Xu Wang, Xiangping Wang, Hao Sun, Gui Ren, Biaoluo Wang, Shuhui Liang, Linhui Zhang, Xiaoyu Kang, Qin Tao, Xuegang Guo, Hui Luo, Yanglin Pan
American Journal of Gastroenterology.2022; 117(5): 740. CrossRef
Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction
Kojiro Tanoue, Hirotsugu Maruyama, Yuki Ishikawa-Kakiya, Yosuke Kinoshita, Kappei Hayashi, Masafumi Yamamura, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Noriko Kamata, Yasuaki Nagami, Koichi Taira, Toshio Wata
World Journal of Hepatology.2022; 14(5): 992. CrossRef
Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction
Kojiro Tanoue, Hirotsugu Maruyama, Yuki Ishikawa-Kakiya, Yosuke Kinoshita, Kappei Hayashi, Masafumi Yamamura, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Noriko Kamata, Yasuaki Nagami, Koichi Taira, Toshio Wata
World Journal of Hepatology.2022; 14(5): 993. CrossRef
Recent developments in antibacterial or antibiofilm compound coating for biliary stents
Tao Wu, Yan Yang, He Su, Yuanhui Gu, Quanming Ma, Yan Zhang
Colloids and Surfaces B: Biointerfaces.2022; 219: 112837. CrossRef
Effect of stent placement on stone recurrence and post-procedural cholangitis after endoscopic removal of common bile duct stones
Jung-Hye Choi, Tae-Yoon Lee, Young-Koog Cheon
The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S27. CrossRef
Need to identify the risk factor for stone recurrence after common bile duct exploration
Kee-Hwan Kim
The Journal of Minimally Invasive Surgery.2021; 24(1): 8. CrossRef
Should Common Bile Duct Exploration for Choledocholithiasis Be a Specialist-Only Procedure?
Russell Hodgson, Daniel Heathcock, Chien-Tse Kao, Rosemary Seagar, Mark Tacey, Jiun Miin Lai, Tuck Leong Yong, Nezor Houli, David Bird
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(7): 743. CrossRef
Increased Risk of Pyogenic Liver Abscess after Endoscopic Sphincterotomy for Treatment of Choledocholithiasis
Cheng-Kun Wu, Chien-Ning Hsu, Wei-Ru Cho, Shih-Cheng Yang, An-Che Liu, Wei-Chen Tai, Chen-Hsiang Lee, Yao-Hsu Yang, Seng-Kee Chuah, Chih-Ming Liang
Infection and Drug Resistance.2021; Volume 14: 2121. CrossRef
Long-term Outcomes of Endoscopic Papillary Large-balloon Dilation for Common Bile Duct Stones
Toji Murabayashi, Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Toshitaka Sakai, Kaori Masu, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Kazuki Endo, Yutaka Noda, Kei Ito
Internal Medicine.2020; 59(7): 891. CrossRef
Clinical significance of different periampullary diverticulum classifications for endoscopic retrograde cholangiopancreatography cannulation
Ping Yue, Ke-Xiang Zhu, Hai-Ping Wang, Wen-Bo Meng, Jian-Kang Liu, Lei Zhang, Xiao-Liang Zhu, Hui Zhang, Long Miao, Zheng-Feng Wang, Wen-Ce Zhou, Azumi Suzuki, Kiyohito Tanaka, Xun Li
World Journal of Gastroenterology.2020; 26(19): 2402. CrossRef
Clinical significance of different periampullary diverticulum classifications for endoscopic retrograde cholangiopancreatography cannulation
Ping Yue, Ke-Xiang Zhu, Hai-Ping Wang, Wen-Bo Meng, Jian-Kang Liu, Lei Zhang, Xiao-Liang Zhu, Hui Zhang, Long Miao, Zheng-Feng Wang, Wen-Ce Zhou, Azumi Suzuki, Kiyohito Tanaka, Xun Li
World Journal of Gastroenterology.2020; 26(19): 2403. CrossRef
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Goshi Fujimoto
International Journal of Surgery Case Reports.2020; 71: 116. CrossRef
Risk factors of stone recurrence after endoscopic retrograde cholangiopancreatography for common bile duct stones
Peng Lujian, Cheng Xianneng, Zhang Lei
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Novel risk factors for recurrent biliary obstruction and pancreatitis after metallic stent placement in pancreatic cancer
Tsuyoshi Takeda, Takashi Sasaki, Takafumi Mie, Takaaki Furukawa, Ryo Kanata, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
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Se Woo Park
The Korean Journal of Gastroenterology.2020; 76(4): 177. CrossRef
Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review
Seongyul Ryu, Ik Hyun Jo, Seonhoo Kim, Yeon-Ji Kim, Woo Chul Chung
The Korean Journal of Gastroenterology.2020; 76(4): 199. CrossRef
Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety
Shigeto Ishii, Hiroyuki Isayama, Mako Ushio, Sho Takahashi, Wataru Yamagata, Yusuke Takasaki, Akinori Suzuki, Kazushige Ochiai, Ko Tomishima, Ryo Kanazawa, Hiroaki Saito, Toshio Fujisawa, Shuichiro Shiina
Journal of Clinical Medicine.2020; 9(12): 3808. CrossRef
Presence of Periampullary Diverticulum is Not a Hurdle to Successful Endoscopic Retrograde Cholangiopancreatography
Jimin Han
Clinical Endoscopy.2019; 52(1): 7. CrossRef
Causes associated with recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography: A large sample sized retrospective study
Feng Deng, Mi Zhou, Ping-Ping Liu, Jun-Bo Hong, Guo-Hua Li, Xiao-Jiang Zhou, You-Xiang Chen
World Journal of Clinical Cases.2019; 7(9): 1028. CrossRef
A nationwide population-based study of common bile duct stone recurrence after endoscopic stone removal in Korea
Byung Kyu Park, Jeong Hun Seo, Han Ho Jeon, Jong Won Choi, Sun Young Won, Yong Suk Cho, Chun Kyon Lee, Haeyong Park, Dong Wook Kim
Journal of Gastroenterology.2018; 53(5): 670. CrossRef
Japan Gastroenterological Endoscopy Society guidelines for endoscopic papillary large balloon dilation
Takao Itoi, Shomei Ryozawa, Akio Katanuma, Yoshinobu Okabe, Hironori Kato, Jun Horaguchi, Takayoshi Tsuchiya, Takuji Gotoda, Naotaka Fujita, Kenjiro Yasuda, Yoshinori Igarashi, Kazuma Fujimoto
Digestive Endoscopy.2018; 30(3): 293. CrossRef
Recurrent common bile duct stones as a late complication of endoscopic sphincterotomy
Tatenda C. Nzenza, Yahya Al-Habbal, Glen R. Guerra, S. Manolas, Tuck Yong, Trevor McQuillan
BMC Gastroenterology.2018;[Epub] CrossRef
Comparison of late adverse events after endoscopic sphincterotomy versus endoscopic papillary large balloon dilation for common bile duct stones: A propensity score‐based cohort analysis
Akinori Maruta, Takuji Iwashita, Shinya Uemura, Kensaku Yoshida, Keisuke Iwata, Tsuyoshi Mukai, Shinpei Doi, Ichiro Yasuda, Kenji Imai, Masahito Shimizu
Digestive Endoscopy.2018; 30(4): 493. CrossRef
Comparison of the Long-Term Outcomes of Endoscopic Papillary Large Balloon Dilation Alone versus Endoscopic Sphincterotomy for Removal of Bile Duct Stones
Tao Li, Jun Wen, Like Bie, Biao Gong
Gastroenterology Research and Practice.2018; 2018: 1. CrossRef
Long-term recurrence of bile duct stones after endoscopic papillary large balloon dilation with sphincterotomy: 4-year extended follow-up of a randomized trial
Gregorios A. Paspatis, Konstantina Paraskeva, Emmanouil Vardas, Vasilios Papastergiou, Aikaterini Tavernaraki, Maria Fragaki, Angeliki Theodoropoulou, Gregorios Chlouverakis
Surgical Endoscopy.2017; 31(2): 650. CrossRef
Advances of recurrent risk factors and management of choledocholithiasis
Jian-Shan Cai, Sun Qiang, Yin Bao-Bing
Scandinavian Journal of Gastroenterology.2017; 52(1): 34. CrossRef
Endoscopic Papillary Large Balloon Dilatation Without Sphincterotomy for the Treatment of Large Common Bile Duct Stone: Long-Term Outcomes at a Single Center
Jin-Seok Park, Seok Jeong, Byung Wook Bang, Ae Ra Kang, Don Haeng Lee
Digestive Diseases and Sciences.2016; 61(10): 3045. CrossRef
The Wire-Grasping Method as a New Technique for Forceps Biopsy of Biliary Strictures: A Prospective Randomized Controlled Study of Effectiveness
Yasunobu Yamashita, Kazuki Ueda, Yuki Kawaji, Takashi Tamura, Masahiro Itonaga, Takeichi Yoshida, Hiroki Maeda, Hirohito Magari, Takao Maekita, Mikitaka Iguchi, Hideyuki Tamai, Masao Ichinose, Jun Kato
Gut and Liver.2016; 10(4): 642. CrossRef
Abdominal manifestations of histiocytic disorders in adults: imaging perspective
Abhijit Sunnapwar, Christine O Menias, Vijaynadh Ojili, Maria Policarpio Nicolas, Rashmi Katre, Kiran Gangadhar, Arpit Nagar
The British Journal of Radiology.2016; 89(1065): 20160221. CrossRef
Short-term and long-term outcomes after endoscopic sphincterotomy versus endoscopic papillary balloon dilation for bile duct stones
Yi Lu, Jia-Chuan Wu, Lei Liu, Li-Ke Bie, Biao Gong
European Journal of Gastroenterology & Hepatology.2014; 26(12): 1367. CrossRef
Long-Term Outcome of Endoscopic Papillary Large Balloon Dilatation
Chang-Il Kwon
Clinical Endoscopy.2013; 46(6): 601. CrossRef

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Case Report

A Submucosal Tumor-Like Recurrence of Early Esophageal Cancer after Endoscopic Submucosal Dissection: Jeong Cheon Choi, Gwang Ha Kim, Do Youn Park, Hyeog Gyu Seoung, Yong Jae Lee, Ji Hye Kim, Tae Kyun Kim, Hoseok I; Clin Endosc 2013;46(2):182-185. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.182

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Early esophageal cancer is defined as a tumor invading the mucosa with or without lymph node or distant organ metastasis. In the current guidelines for early esophageal cancer, absolute indication for endoscopic resection include lesions limited to the epithelium or lamina propria mucosa not exceeding two-thirds of the circumference, and relative indications include lesions limited to the muscularis mucosa or the upper third of the submucosal layer and not accompanied by clinical evidence of lymph node metastasis. After endoscopic submucosal dissection for early esophageal cancer, locally recurrent cancer can occur, especially in the case of incomplete resection. Here, we report a rare case of a submucosal tumor-like recurrence after endoscopic resection of early esophageal cancer.

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Long-Term Outcome after Endoscopic Submucosal Dissection in Patients with Superficial Esophageal Squamous Cell Carcinoma: A Single-Center Study
Dong Chan Joo, Gwang Ha Kim, Do Youn Park, Joon Hyung Jhi, Geun Am Song
Gut and Liver.2014; 8(6): 612. CrossRef

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Original Article

Short-term Clinical Outcomes Based on Risk Factors of Recurrence after Removing Common Bile Duct Stones with Endoscopic Papillary Large Balloon Dilatation: Jung Ho Kim, Yeon Suk Kim, Dong Kyu Kim, Min Su Ha, Young Jun Lee, Jong Joon Lee, Sang Jin Lee, In Sik Won, Yang Suh Ku, Yun Soo Kim, Ju Hyun Kim; Clin Endosc 2011;44(2):123-128. Published online December 31, 2011; DOI: https://doi.org/10.5946/ce.2011.44.2.123

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Background/Aims

Recurrence is an important late complication of endotherapy of bile duct stones. Endoscopic papillary large balloon dilation (EPLBD) can be used as an alternative method of removing difficult bile duct stones. The aim of this study was to evaluate short term clinical outcomes after removing common bile duct (CBD) stones using EPLBD.

Methods

A retrospective review was performed based on the medical records of 141 patients who received EPLBD, with or without endoscopic sphincterotomy, between September 2008 and February 2010. Of these, 50 patients, were enrolled in the study. Clinical and endoscopic parameters were analyzed to identify risk factors for CBD stones recurrence.

Results

Male:Female ratio was 22:28 (mean age, 67.4±14.4 years). Recurrence rate was 24.0% (12/50). Mean follow-up period was 10.8±4.5 months. Nineteen (38.0%) had a history of surgery and 20 (40.0%) were comorbid with periampullary diverticula. Mean diameters of the stones and CBD were 13.8±4.3 mm and 20.1±7.2 mm, respectively. In univariate analysis, large CBD stones (≥12 mm) and angulated CBD (angle ≤145°) were identified as the significant predictors of recurrence. In multivariate analysis, angulated CBD (angle ≤145°) was the significant independent risk factor for recurrence.

Conclusions

Close follow-up seems necessary in patients with angulated CBD (angle ≤145°).

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Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
Marko Kozyk, Suprabhat Giri, Sidharth Harindranath, Manan Trivedi, Kateryna Strubchevska, Rakesh Kumar Barik, Sridhar Sundaram
DEN Open.2024;[Epub] CrossRef
Risk factors and management of primary choledocholithiasis: a systematic review
Jie Zhang, Xiaofeng Ling
ANZ Journal of Surgery.2021; 91(4): 530. CrossRef
Efficacy and safety of conversion of percutaneous cholecystostomy to endoscopic transpapillary gallbladder stenting in high-risk surgical patients
Hyung Ku Chon, Chan Park, Dong Eun Park, Tae Hyeon Kim
Hepatobiliary & Pancreatic Diseases International.2021; 20(5): 478. CrossRef
Alterations of the Bile Microbiome in Recurrent Common Bile Duct Stone
Cheng Ye, Wence Zhou, Hui Zhang, Long Miao, Gen Lv, Abdelwahab Omri
BioMed Research International.2020; 2020: 1. CrossRef
Clinical Impact of Common Bile Duct Angulation for Recurrence of Bile Duct Stones
Se Woo Park
The Korean Journal of Gastroenterology.2020; 76(4): 177. CrossRef
Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review
Seongyul Ryu, Ik Hyun Jo, Seonhoo Kim, Yeon-Ji Kim, Woo Chul Chung
The Korean Journal of Gastroenterology.2020; 76(4): 199. CrossRef
Causes associated with recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography: A large sample sized retrospective study
Feng Deng, Mi Zhou, Ping-Ping Liu, Jun-Bo Hong, Guo-Hua Li, Xiao-Jiang Zhou, You-Xiang Chen
World Journal of Clinical Cases.2019; 7(9): 1028. CrossRef
Japan Gastroenterological Endoscopy Society guidelines for endoscopic papillary large balloon dilation
Takao Itoi, Shomei Ryozawa, Akio Katanuma, Yoshinobu Okabe, Hironori Kato, Jun Horaguchi, Takayoshi Tsuchiya, Takuji Gotoda, Naotaka Fujita, Kenjiro Yasuda, Yoshinori Igarashi, Kazuma Fujimoto
Digestive Endoscopy.2018; 30(3): 293. CrossRef
Mid‐term outcome of endoscopic sphincterotomy combined with large balloon dilation
Fumihide Itokawa, Takao Itoi, Atsushi Sofuni, Toshio Kurihara, Takayoshi Tsuchiya, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Junko Umeda, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjyo, Fuminori Moriyasu, Kazuhiko Kasuya, Akihiko Tsuchida
Journal of Gastroenterology and Hepatology.2015; 30(1): 223. CrossRef
Which Is the Better Treatment for the Removal of Large Biliary Stones? Endoscopic Papillary Large Balloon Dilation versus Endoscopic Sphincterotomy
Woo Hyun Paik, Ji Kon Ryu, Jin Myung Park, Byeong Jun Song, Jaihwan Kim, Joo Kyung Park, Yong-Tae Kim
Gut and Liver.2014; 8(4): 438. CrossRef
Endoscopic papillary balloon dilation for difficult common bile duct stones: Our experience
Maddalena Zippi
World Journal of Clinical Cases.2013; 1(1): 19. CrossRef

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Recurrent Gastric Cancer at the Duodenal Stump after Billroth II Subtotal Gastrectomy: Jeong Guil Lee, M.D., Hwa Young Lee, M.D., Seon Mi Jin, M.D., Il Park, M.D., Sang Jong Lee, M.D., Woo Joong Kim, M.D. and Yoon Hee Lee, M.D.*; Korean J Gastrointest Endosc 2010;40(4):266-269. Published online April 30, 2010

Abstract PDF: Many studies have shown that gastric stump cancer develops after distal gastrectomy, particularly after Billroth II reconstruction. But, recurrent cancer at the duodenal stump following Billroth II type distal gastrectomy for gastric cancer is extremely rare. We report a case of duodenal stump cancer in a 64-year-old man underwent Billroth II distal gastrectomy. (Korean J Gastrointest Endosc 2010;40: 266-269)

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Clinical Features of Re-infection of Helicobacter pylori after Successful Eradication: Jai Hwan Kim, M.D., Hyo Joon Yang, M.D., Eun Sun Jang, M.D., Eun Ju Jo, M.D., Hyun Jin Jo, M.D., Jae Young Chun, M.D., Jong Kyung Choi, M.D., Sung Wook Hwang, M.D., Sang Hyub Lee, M.D.*, Young Soo Park, M.D.*, Jin Hyeok Hwang, M.D.*, Jin Wook Kim, M.D.*,; Korean J Gastrointest Endosc 2008;37(3):161-166. Published online September 30, 2008

Abstract PDF: Background
/Aims:Studies on re-infection of Helicobacter pylori are limited. This study was designed to determine if there are clinical features of H. pylori re- infection related to gastroduodenal diseases or histological findings. Methods: From a population of patients that were treated for H. pylori eradication from May 2003 to September 2007, 129 subjects were enrolled. Regimens were PPI-based triple or quadruple agents and follow-up methods were UBT, CLO or histology. Results: A total of 29 subjects experienced a recurrence (within one year, 17 subjects; between one and two years, eight subjects; more than two years, four subjects). Recurrence periods were 2 to 32 months, and the mean period was 12.62± 8.40 months. Among 29 subjects, eight subjects had chronic atrophic gastritis, 14 subjects had a peptic ulcer, five subjects had stomach cancer and two subjects had a MALT lymphoma; there were no statistical differences of the odds ratio between matched diseases. By use of the Updated Sydney System, neither H. pylori colonization density nor neutrophil infiltration nor monocyte infiltration grade in histology was associated with recurrence or re-infection. Conclusions: Neither histological findings nor gastroduodenal diseases was associated with H. pylori re-infection. The re-infection rate in this study was approximately 6.2%. This rate was slightly higher than rates reported in other recent studies in Korea. (Korean J Gastrointest Endosc 2008;37:161-166)

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Re-Endoscopic Mucosal Resection for a Residual or Locally Recurrent Gastric Lesion after Endoscopic Mucosal Resection: Jae Hyuck Chang, M.D., In Seok Lee, M.D., Chan Ran You, M.D., Kwan Woo Nam, M.D., Jung Hyun Kwon, M.D., Jung Pil Suh, M.D., Ho Sung Park, M.D., Chang Nyol Paik, M.D., Jae Myung Park, M.D., Yu Kyung Cho, M.D., Sang Woo Kim, M.D., Myung Gyu Choi, M.D. and I; Korean J Gastrointest Endosc 2007;35(1):6-13. Published online July 30, 2007

Abstract PDF: Background
/Aims: Re-endoscopic mucosal resection of a residual or locally recurrent gastric lesion after endoscopic mucosal resection (EMR) is often difficult due to submucosal fibrosis. The aim of this study was to investigate the factors related to the local recurrence of gastric lesions and the results of re-EMR. Methods: We retrospectively reviewed 245 patients with adenoma or early gastric cancer (EGC) treated by EMR. The factors related to local recurrence after EMR were analyzed. Ten patients with local recurrences after complete resection were treated with re-EMR and analyzed. Results: The mean size of the re-EMR lesions was 15.1 mm (5∼30 mm). Seven patients were treated with endoscopic submucosal dissection (ESD) and three were treated with conventional EMR. En bloc resection was performed in eight patients (80%) and complete resection was performed in nine patients (90%). Bleeding was a complication of re-EMR in five patients (50%). There was no recurrent lesion after re-EMR in nine patients over a mean follow-up duration of 14.7 months. The local recurrence rate was significantly higher when the tumor was resected piecemeal (p＜0.001). Conclusions: Local recurrences occurred more frequently when the tumors were resected piecemeal. Re-EMR was a possible tool for the treatment of residual or locally recurrent lesions in 90% of the patients. Re-EMR may be the treatment of choice for a locally recurrent lesion after EMR according to the indication.

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The Clinical Effect of Supplementary Argon Plasma Coagulation after Endoscopic Mucosal Piecemeal Resection of a Gastric Adenoma and Carcinoma: Sang Joon Park, M.D., Kee Myung Lee, M.D., Deok Ki Kim, M.D., Sung Jae Sin, M.D., Jae Ho Jung, M.D., Sung Hyeon Jung, M.D., Byeong Moo Yoo, M.D., Ki Baik Hahm, M.D. and Jin Hong Kim, M.D.; Korean J Gastrointest Endosc 2007;34(6):291-297. Published online June 30, 2007

Abstract PDF: Background/Aims: This study was designed to determine the effect of supplementary argon plasma coagulation (APC) after piecemeal resection of a gastric adenoma or an intramucosal adenocarcinoma. Methods: Cases of 62 lesions of 56 consecutive patients with either a gastric adenoma or carcinoma were retrospectively reviewed at the Ajou University Medical Center. APC was performed after an endoscopic complete resection using the piecemeal method of endoscopic mucosal resection (EMR) for patients in the EMR-APC group. For patients in the EMR group, APC was not performed. Results: There was no significant difference in the recurrence rate of the cancers for both groups (9.7%, for the EMR group, 6.5% for the EMR-APC group). The recurrence rate of a low grade dysplasia was 6.7% (EMR group) and 6.3% (EMR-APC group) (p=1.000), the recurrence rate for a high grade dysplasia was 11.1% (EMR group) and 25.0% (EMR-APC group) (p=1.000), and the recurrence rate for an intramucosal adenocarcinoma was 14.3% (EMR group) and 0% (EMR-APC group) (p=0.389). The recurrence rates of lesions in which the lesion size was less than 20 mm and over 20 mm for each group were 6.7% and 9.1% (EMR group) (p=1.000) versus 12.5% and 0% (EMR-APC group) (p=0.520). There was also no significant statistical difference in the recurrence rates for both groups according to the location and macroscopic type of lesion. Conclusions: Supplementary treatment with APC could not significantly reduce the recurrence rate after complete piecemeal resection determined macroscopically. A large- scale and prospective study is necessary to elucidate the clinical significance of supplementary APC for gastric neoplasm treatment.

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Long-term Outcome of Endoscopic Mucosal Resection for Gastric Adenoma and Factors Related to Recurrence: Yeom Seok Lee, M.D., Kyung Hoon Chae, M.D., Won Seok Heo, M.D., Jae Hoon Jung, M.D., Yoon Sae Kang, M.D., Yeon Soo Kim, M.D., Ki Oh Park, M.D., Seon Mun Kim, M.D., Jae Kyu Seong, M.D., Seok Hyun Kim, M.D., Byung Seok Lee, M.D. and Hyun Yong Jeong, M.D.; Korean J Gastrointest Endosc 2005;30(3):119-125. Published online March 31, 2005

Abstract PDF: Background
/Aims: Endoscopic mucosal resection (EMR) has been known as a method of local treatment for early gastric cancer (EGC) or gastric adenoma. It has been widely accepted as a useful method due to its minimal invasiveness, safety and satisfactory result. The purpose of this study was to identify the factors affecting the recurrence after EMR. Methods: Three hundred twenty adenomas in 297 patients were treated by EMR from January, 1991 until July 2003. Among those, 197 lesions in 184 patients that could have been followed-up were analyzed retrospectively. Results: The mean follow-up period was 15.0 (1∼89) months. Of the 197 lesions, there were 35 recurrences (17.7%). The recurrence rate was higher in lesions associated with severe mucosal atrophy and intestinal metaplasia in surrounding mucosa (p=0.035). Other factors showed no statistically significant difference in recurrence rate. Conclusions: In this study, we concluded that the presence of intestinal metaplasia and severe atrophic background mucosa were related to the recurrence of gastric adenoma after EMR. (Korean J Gastrointest Endosc 2005; 30:119⁣125)

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베체트 장염의 대장내시경 분류에 따른 내과적 치료 효과 및 누적 수술률 분석 ( Analysis of the Efficacy of Medical Treatment and the Cumulative Operation Rates of Behcet's Colitis According to the Colonoscopic Classification ): Korean J Gastrointest Endosc 2000;20(4):254-261. Published online November 30, 1999

Abstract PDF: Background
/Aims : The lesions of Behcet's colitis showed aphthoid or punched-out ulceration, but the macroscopic types of lesions have not been defined. The aim of this study was to predict the clinical outcome of patients with Behcets colitis according to colonoscopic findings. Methods : We retrospectively reviewed the medical records and colonoscopic photographs of 50 patients with Behcet's colitis. Colonoscopic findings were categorized according to three types: volcano-, geographic- and aphthous-type. The efficacy of medical treatment was assessed by follow-up colonoscopy or double-contrast barium enema 4 to 8 weeks after treatment and recurrence of the lesions was evaluated during the follow-up period. Cumulative operation rates were obtained by the Kaplan-Meier method. Results : Macroscopic types of colonic ulcers revealed 25 out of 50 (50%) patients with volcano-type, 11 (22%) with geographic-type, and 14 (28%) with aphthous-type lesions. Complete remission rates by medical treatment and operation rates in volcano-type ulcerations were 6 of 25 (24%) and 13 of 25 (52%), geographic-type 8 of 11 (73%) and 1 of ll (9%), and aphthous-type 9 of 14 (64%) and 2 of 14 (14%), respectively. The recurrence rate in volcano-type ulcerations was 9 of 19 (47%), geographic-type 1 of 9 (11%) and aphthous-type 1 of 11 (9%), Conclusions: Volcano-type ulcerations in Behcets colitis showed less favorable response to medical treatment and more episodes of operation and recurrence than geographic- and aphthous-type ulcerations. (Korean J Gastrointest Endosc 2000;20:254-261)

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내시경적 유두괄약근 절개술을 이용한 간외담관결석 제거 후 결석 재발에 영향을 미치는 인자 ( Factor Influencing the Recurrence of CBD Stones after an Endoscopic Sphincteromy ): Korean J Gastrointest Endosc 1999;19(4):581-587. Published online November 30, 1998

Abstract PDF: Background
/Aims: Long term results of an endoscopic sphincterotomy (EST) have still been poorly estimated. The aim of this study was to assess late complications of EST. Methods: The rate of late complications were retrospectively evaluated in with 91 patients (mean age, 59.1 years; range, 28∼86 years; M：F, 44：47), who underwent EST for choledocholithiasis. Results: Forty six patients (50.5%) had their gallbladder in situ, and 45 patients (49.5%) underwent cholecystectomy. Early complications (＜30 days) such as hemorrhage, pancreatitis, and perforation occurred in 7 patients (7.7%). During a mean period of 53.4 months (range, 24∼134 months), 26 patients (28.0%) developed late complications, including a recurrence of CBD stones in 20 patients (22.0%) (8-gallbladder in situ, 12-cholecystectomized). An univariate analysis of risk factors for stone recurrence revealed dilated ducts, stone sizes, and stone numbers which were not related with stone recurrence. The history of choledocholithotomy with cholecystectomy was significantly related to stone recurrence. Conclusions: After EST for bile duct stones, late complications occurred in a significant proportion of patients and it was determined that a history of choledocholithotomy with cholecystectomy was significantly correlated with stone recurrence. (Korean J Gastrointest Endosc 19: 581∼587, 1999)

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식도정맥류에 대한 내시경적 결찰술과β차단제의 병합치료효과 (Combined Therapy of Endoscopic Variceal Ligation andβ-Blocker for Esophageal Varices ): Korean J Gastrointest Endosc 1999;19(2):165-170. Published online November 30, 1998

Abstract PDF: Background
/Aims: Endoscopic variceal ligation (EVL) has been accepted as safe and useful treatment for esophageal varices. However, the main problem is the recurrence after eradication of varices.β-blockers have been shown to be effective for prevention of vari-ceal bleeding. We evaluate the efficacy of the combined therapy of EVL and β-blocker against recurrence of esophageal varices. Methods: 39 patients followed from October 1992 through February 1998 after eradication of esophageal varices by EVL were divided into two groups: group 1; 20 patients received EVL alone, group 2; 19 patients received EVL and propranolol for follow-up periods. The rate of recurrence and rebleeding were observed in two groups. Results: Follow-up periods in group 1 and 2 after an initial eradication of esophageal varices were 1039.6 (291-1499) and 928.3 (448-1793) days, re-spectively. During follow-up periods, the recurrence rate was lower in group 2 (27.8%) than group 1 (60.0%) (p ＜0.05). The periods from last session to recurrence were 609.1 (128-1460) and 666.2 (405-1007) days in group 1 and 2, respectively. The rebleeding and mortality rates were 15.0% and 25.0% in group 1. Conclusions: Combined therapy of EVL and β-blocker could decrease the recurrence rate after eradication of esophageal varices, as compared with EVL alone. The further large, long-term study should be re-quired.(Korean J Gastrointest Endosc 19: 165 ∼170, 1999)

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식도정맥류에 대한 내시경적 정맥류 결찰요법 후 재출혈 및 재발과 연관된 위험인자들 ( Risk Factors Associated with Rebleeding and Recurrence Following Endoscopic Variceal Ligation ): Korean J Gastrointest Endosc 1999;19(1):1-8. Published online November 30, 1998

Abstract PDF: the first EVL was associated with rebleeding (p=0.01); whereas, age, Child class, grade and extent of varices, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p ＞0.05). Persistence of esophageal ulcer at 2 weeks after the first EVL was associated with rebleeding also in multivariate analysis (relative risk 5.87, p=0.01). 3) In univariate analysis, grade (p=0.01) and extent (p=0.01) of varices were related to recurrence; whereas, age, Child class, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p ＞0.05). In multivariate analysis, grade of varices was the only risk factor associated with recurrence (relative risk 3.76, p=0.01). Conclusions: 1) Persistence of esophageal ulcer at second week after the first EVL was associated with rebleeding. 2) Frequent follow-up endoscopic examinations are necessary in patients who present with high grade of varices since risk of recurrence is high even after successful EVL. (Korean J Gastrointest Endosc 19: 1 ∼8, 1999)

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원저 : 식도 위장관 ; 위선종의 내시경적 점막 절제술 및 추적 관찰 ( Original Articles : Esophagus , Stomach & Intestine ; Endoscopic Mucosal Resection of Gastric Adenoma : A Follew-up Study ): Korean J Gastrointest Endosc 1998;18(5):658-664. Published online November 30, 1997

Abstract PDF: Background
/Aims: Endoscopic mucosal resection (EMR) is a useful method in both the accurate diagnosis and treatment of gastric mucosal lesions. A gastric adenoma is a neoplastic lesion which has malignant potential, and therefore it is advisable to have it removed completely when discovered. We evaluated the role of EMR in the treatment of gastric adenomas by analyzing the follow-up endoscopic results of patients treated with EMR for such lesions. Methods: We analyzed the initial endoscopic findings, EMR results, and follow-up endoscopic outcomes of 35 patients with 41 gastric adenomas, from June 1994 to January 1997 in Seoul National University Hospital. (Korean J Gastrointest Endose 18: 658-664, 1998) (continue)

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