Clinical Endoscopy

Original Articles

Synergistic effect of independent risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis: a multicenter retrospective study in Japan: Hirokazu Saito, Yoshihiro Kadono, Takashi Shono, Kentaro Kamikawa, Atsushi Urata, Jiro Nasu, Masayoshi Uehara, Ikuo Matsushita, Tatsuyuki Kakuma, Shunpei Hashigo, Shuji Tada; Clin Endosc 2024;57(4):508-514. Published online April 18, 2024; DOI: https://doi.org/10.5946/ce.2023.203

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Background
/Aims: This study aimed to examine the synergistic effect of independent risk factors on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).
Methods
This multicenter retrospective study included 1,273 patients with native papillae who underwent ERCP for bile duct stones in Japan. Independent PEP risk factors were identified using univariate and multivariate analyses. Significant risk factors for PEP in the multivariate analysis were included in the final analysis to examine the synergistic effect of independent risk factors for PEP.
Results
PEP occurred in 45 of 1,273 patients (3.5%). Three factors including difficult cannulation ≥10 minutes, pancreatic injection, and normal serum bilirubin level were included in the final analysis. The incidences of PEP in patients with zero, one, two, and three factors were 0.5% (2/388), 1.9% (9/465), 6.0% (17/285), and 12.6% (17/135), respectively. With increasing risk factors for PEP, the incidence of PEP significantly increased (1 factor vs. 2 factors, p=0.006; 2 factors vs. 3 factors, p=0.033).
Conclusions
As the number of risk factors for PEP increases, the risk of PEP may not be additive; however, it may multiply. Thus, aggressive prophylaxis for PEP is strongly recommended in patients with multiple risk factors.

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Risk factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography: a retrospective single-center study
I.М. Mamontov, D.D. Rjabushhenko, Т.І. Tamm, К.О. Kramarenko, V.V. Nepomniashchyi, A.T. Ustinov
Український радіологічний та онкологічний журнал.2024; 32(3): 287. CrossRef

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Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea: Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee; Clin Endosc 2024;57(4):476-485. Published online April 12, 2024; DOI: https://doi.org/10.5946/ce.2023.198

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/Aims: Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation.
Methods
This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm.
Results
Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79–0.86) and displayed a moderate discriminatory power.
Conclusions
High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy.

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Prevalence and natural course of incidental gastric subepithelial tumors: Dae-Hyuk Heo, Min A Yang, Jae Sun Song, Won Dong Lee, Jin Woong Cho; Clin Endosc 2024;57(4):495-500. Published online March 29, 2024; DOI: https://doi.org/10.5946/ce.2023.124

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Background
/Aims: Gastric subepithelial tumors (SETs) are often encountered during the upper gastrointestinal endoscopic screening. We assessed the prevalence of gastric SETs and the risk factors for their progression.
Methods
We reviewed the electronic medical records of 30,754 patients who underwent upper gastrointestinal endoscopic screening at our medical center between January 2013 and December 2016.
Results
Among the 30,754 patients examined, 599 (1.94%) had gastric SETs. The prevalence increased with age and was 9.56% in patients aged ≥70 years. In total, 262 patients underwent serial endoscopy for more than 6 months. The median age was 68 years (interquartile range [IQR], 61–74), and the number of females was 167 (63.7%). During a median follow-up of 58 months (IQR, 38–75), 22 patients (8.4%) showed significant changes in tumor size. An irregular border (odds ratio, 4.623; 95% confidence interval, 1.093–19.558; p=0.037) was a significant risk factor for progression. Seven patients underwent surgical or endoscopic resections. The pathologies of gastric SETs included leiomyomas (n=3), gastrointestinal stromal tumors (n=2), and lipomas (n=2).
Conclusions
The prevalence of gastric SETs increases with age. Most gastric SETs do not progress during long-term endoscopic examinations, and the risk of an increase in size is low in asymptomatic small SETs without irregular borders.

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Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis
Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
Journal of Clinical Medicine.2024; 13(13): 3725. CrossRef

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Respiratory complications during recovery from gastrointestinal endoscopies performed by gastroenterologists under moderate sedation: Inna Eidelman Pozin, Amir Zabida, Moshe Nadler, Guy Zahavi, Dina Orkin, Haim Berkenstadt; Clin Endosc 2023;56(2):188-193. Published online January 10, 2023; DOI: https://doi.org/10.5946/ce.2022.033

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Background
/Aims: Data on the incidence of adverse respiratory events during recovery from gastrointestinal endoscopy are limited. The aim of this study was to investigate the incidence of these complications.
Methods
In this retrospective cohort study, data were obtained from the electronic records of 657 consecutive patients, who underwent gastroenterological procedures under sedation.
Results
Pulse oximetry oxygen saturation (SpO2) <90% for <60 seconds occurred in 82 patients (12.5%) and in 11 patients (1.7%), SpO2 of <90% for >60 seconds occurred in 79 patients (12.0%) and in 11 patients (1.7%), and SpO2 <75% occurred in four patients (0.6%) and in no patients during the procedure and recovery period, respectively. No major complications were noted. The occurrence of desaturation during recovery was correlated with desaturation during the procedure (p<0.001). American Society of Anesthesiologists score (odds ratio [OR], 1.867; 95% confidence interval [CI], 1.008–3.458), ischemic heart disease (OR, 1.815; 95% CI, 0.649–5.080), hypertension (OR, 1.289; 95% CI, 0.472–3.516), and diabetes mellitus (OR, 2.406; 95% CI, 0.950–6.095) increased the occurrence of desaturation during recovery.
Conclusions
We found no major complications during recovery after balanced propofol-based sedation administered by a gastroenterologist-nurse team. Patients with the identified risk predictors must be monitored carefully.

Citations

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Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee
Clinical Endoscopy.2024; 57(4): 476. CrossRef

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Cholecystitis after Placement of Covered Self-Expandable Metallic Stents in Patients with Distal Malignant Biliary Obstructions: Masafumi Watanabe, Kosuke Okuwaki, Jun Woo, Mitsuhiro Kida, Hiroshi Imaizumi, Tomohisa Iwai, Hiroshi Yamauchi, Toru Kaneko, Rikiya Hasegawa, Takahiro Kurosu, Naoki Minato, Hiroki Haradome, Wasaburo Koizumi; Clin Endosc 2021;54(4):589-595. Published online November 17, 2020; DOI: https://doi.org/10.5946/ce.2020.136

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Background
/Aims: Cholecystitis can occur after the placement of covered self-expandable metallic stents for distal malignant biliary obstructions. We aimed to identify risk factors for cholecystitis following covered self-expandable metallic stent placement.
Methods
We investigated risk factors related to cholecystitis following covered self-expandable metallic stent placement in 118 patients with distal malignant biliary obstructions between January 1, 2015 and April 30, 2019. Endoscopic assessments and tumor invasion to the arteries feeding the gallbladder were determined by a pancreaticobiliary endoscopist and a radiologist, respectively.
Results
The median patient age was 72 years (men, 61.0%). The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct were observed in 35 (29.7%) and 35 (29.7%) patients, respectively. During the observation period (median, 179 days), cholecystitis occurred in 18 (15.3%) patients. Multivariate analysis revealed the flow of the contrast agent into the gallbladder (p=0.023) and tumor involvement in the orifice of the cystic duct (p=0.005) as significant independent risk factors associated with cholecystitis.
Conclusions
The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct are potential independent risk factors for cholecystitis following the placement of covered self-expandable metallic stents. A follow-up prospective study is warranted to validate their influence.

Citations

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Adverse events of self-expandable metal stent placement for malignant distal biliary obstruction: a large multicenter study
Takashi Tamura, Takuo Yamai, Norimitsu Uza, Tomoaki Yamasaki, Atsuhiro Masuda, Fumimasa Tomooka, Hirotsugu Maruyama, Minoru Shigekawa, Takeshi Ogura, Katsutoshi Kuriyama, Masanori Asada, Hisakazu Matsumoto, Mamoru Takenaka, Koichiro Mandai, Yui Osaki, Ken
Gastrointestinal Endoscopy.2024; 99(1): 61. CrossRef
Fully covered versus partially covered self-expandable metal stents for palliation of distal malignant biliary obstruction: a systematic review and meta-analysis
Giuseppe Vanella, Chiara Coluccio, Alessandro Cucchetti, Roberto Leone, Giuseppe Dell’Anna, Paolo Giuffrida, Carmela Abbatiello, Cecilia Binda, Carlo Fabbri, Paolo Giorgio Arcidiacono
Gastrointestinal Endoscopy.2024; 99(3): 314. CrossRef
Endoscopic Ultrasound–Guided vs Endoscopic Retrograde Cholangiopancreatography–Guided Biliary Drainage as Primary Approach to Malignant Distal Biliary Obstruction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Harishankar Gopakumar, Ritu Raj Singh, Vakya Revanur, Rajanikanth Kandula, Srinivas R. Puli
American Journal of Gastroenterology.2024;[Epub] CrossRef
Cholecystitis in patients with a fully covered self-expandable metal stent with and without externally anchored plastic stents
José Miguel Jiménez-Gutiérrez, Félix Téllez-Avila
Endoscopy.2024; 56(04): 317. CrossRef
Risk factors and treatment strategies for cholecystitis after metallic stent placement for malignant biliary obstruction: a multicenter retrospective study
Akihiro Matsumi, Hironari Kato, Taiji Ogawa, Toru Ueki, Masaki Wato, Masakuni Fujii, Tatsuya Toyokawa, Ryo Harada, Yuki Ishihara, Masahiro Takatani, Hirofumi Tsugeno, Naoko Yunoki, Takeshi Tomoda, Toshiharu Mitsuhashi, Motoyuki Otsuka
Gastrointestinal Endoscopy.2024; 100(1): 76. CrossRef
Covered versus uncovered double bare self-expandable metal stent for palliation of unresectable extrahepatic malignant biliary obstruction: a randomized controlled multicenter trial
Se Woo Park, Kyong Joo Lee, Moon Jae Chung, Jung Hyun Jo, Hee Seung Lee, Jeong Youp Park, Seung Woo Park, Si Young Song, Huapyong Kang, Eui Joo Kim, Yeon Suk Kim, Jae Hee Cho, Seungmin Bang
Gastrointestinal Endoscopy.2023; 97(1): 132. CrossRef
Risk factors for early and late cholecystitis after covered metal stent placement for distal biliary obstruction
Tatsuya Ishii, Tsuyoshi Hayashi, Hajime Yamazaki, Risa Nakamura, Kosuke Iwano, Ryo Ando, Haruka Toyonaga, Toshifumi Kin, Kuniyuki Takahashi, Akio Katanuma
Journal of Hepato-Biliary-Pancreatic Sciences.2023; 30(10): 1180. CrossRef
Efficacy and complications of inoperable malignant distal biliary obstruction treatment by metallic stents: fully covered or uncovered?
Jiangning Gu, Xiaoyi Guo, Yong Sun, Bin Fan, Haoran Li, Ting Luo, Haifeng Luo, Jiao Liu, Feng Gao, Yuan Gao, Guang Tan, Xiaoming Liu, Zhuo Yang
Gastroenterology Report.2022;[Epub] CrossRef
Endoscopic Management of Pancreatobiliary Malignancies
Dong Wook Lee, Eun Young Kim
Digestive Diseases and Sciences.2022; 67(5): 1635. CrossRef

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Predictive Factors for Inaccurate Diagnosis of Swollen Lymph Nodes in Endoscopic Ultrasound-Guided Fine Needle Aspiration: Yuki Fujii, Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Keisuke Yonamine, Yujiro Kawakami, Toji Murabayashi, Fumisato Kozakai, Yutaka Noda, Hiroyuki Okada, Kei Ito; Clin Endosc 2019;52(2):152-158. Published online January 7, 2019; DOI: https://doi.org/10.5946/ce.2018.125

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Background
/Aims: This study aimed to identify the predictive factors for inaccurate endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnosis of swollen lymph nodes without rapid on-site cytopathological evaluation.
Methods
Eighty-three consecutive patients who underwent EUS-FNA for abdominal or mediastinal lymph nodes from January 2008 to June 2017 were included from a prospectively maintained EUS-FNA database and retrospectively reviewed. The sensitivity, specificity, and accuracy of EUS-FNA for the detection of neoplastic diseases were calculated. Candidate factors for inaccurate diagnosis (lymph node size and location, needle type, puncture route, number of passes, and causative disease) were evaluated by comparison between accurately diagnosed cases and others.
Results
The final diagnosis of the punctured lymph node was classified as neoplastic (65 cases: a metastatic lymph node, malignant lymphoma, or Crow-Fukase syndrome) or non-neoplastic (18 cases: a reactive node or amyloidosis). The sensitivity, specificity, and accuracy were 83%, 94%, and 86%, respectively. On multivariate analyses, small size of the lymph node was the sole predictive factor for inaccurate EUS-FNA diagnosis with a significant difference (odds ratios, 19.8; 95% confidence intervals, 3.15–124; p=0.0015).
Conclusions
The lymph node size of <16 mm was the only independent factor associated with inaccurate EUS-FNA diagnosis of swollen lymph nodes.

Citations

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Role of EBUS‐TBNA/EUS‐FNA and mass spectrometry for diagnosis and typing of lymph node amyloidosis: 10‐year experience in two tertiary care academic centers
Asghar Naqvi, Michael Bonert, Christian Finley, Katarzyna Czarnecka‐Kujawa, Kazuhiro Yasufuku, Joerg Schwock, Vathany Kulasingam, Rohan John, Hyang‐Mi Ko
Cancer Cytopathology.2023; 131(11): 724. CrossRef
Endoscopic Ultrasound-Guided Fine Needle Biopsy in the Diagnostic Work-Up of Deep-Seated Lymphadenopathies and Spleen Lesions: A Monocentric Experience
Flaminia Bellisario, Fabia Attili, Fabrizia Campana, Federica Borrelli de Andreis, Silvia Bellesi, Elena Maiolo, Eleonora Alma, Rosalia Malafronte, Giuseppe Macis, Luigi Maria Larocca, Salvatore Annunziata, Francesco D’Alò, Stefan Hohaus
Diagnostics.2023; 13(17): 2839. CrossRef
Lymph node FNA cytology: Diagnostic performance and clinical implications of proposed diagnostic categories
Vladislav V. Makarenko, Michelle E. DeLelys, Robert P. Hasserjian, Amy Ly
Cancer Cytopathology.2022; 130(2): 144. CrossRef
Diagnostic accuracy and clinical impact of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in Positron Emission Tomography - Computed Tomography (PET-CT)-positive mediastinal lymphadenopathies in patients with thoracic or extra-thoracic mali
Dominique Béchade, Carine Bellera, Lisa Gauquelin, Isabelle Soubeyran, Pippa McKelvie-Sebileau, Marc Debled, François Chomy, Guilhem Roubaud, Marianne Fonck, Simon Pernot, Alexandre Roch, Anne-Laure Cazeau
Clinics and Research in Hepatology and Gastroenterology.2022; 46(5): 101912. CrossRef
High Diagnostic Accuracy and Safety of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Malignant Lymph Nodes: A Systematic Review and Meta-Analysis
Linbin Chen, Yin Li, Xiaoyan Gao, Shiyong Lin, Longjun He, Guangyu Luo, Jianjun Li, Chunyu Huang, Guobao Wang, Qing Yang, Hongbo Shan
Digestive Diseases and Sciences.2021; 66(8): 2763. CrossRef
Diagnosis of Pancreatic Solid Lesions, Subepithelial Lesions, and Lymph Nodes Using Endoscopic Ultrasound
Akashi Fujita, Shomei Ryozawa, Masafumi Mizuide, Yuki Tanisaka, Tomoya Ogawa, Masahiro Suzuki, Hiromune Katsuda, Yoichi Saito, Tomoaki Tashima, Kazuya Miyaguchi, Eiichi Arai, Tomonori Kawasaki, Yumi Mashimo
Journal of Clinical Medicine.2021; 10(5): 1076. CrossRef
Primary localized gastric amyloidosis: A scoping review of the literature from clinical presentations to prognosis
Xin-Yu Lin, Dan Pan, Li-Xuan Sang, Bing Chang
World Journal of Gastroenterology.2021; 27(12): 1132. CrossRef
Comparison of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Biopsy Device for Lymphadenopathy
Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Tomoya Ogawa, Ryuichiro Araki, Masahiro Suzuki, Hiromune Katsuda, Youichi Saito, Kazuya Miyaguchi, Tomoaki Tashima, Yumi Mashimo, Masami Yasuda, Shomei Ryozawa, Konstantinos Triantafyllou
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
How to Improve the Diagnostic Accuracy of EUS-FNA in Abdominal and Mediastinal Lymphadenopathy?
Tae Hyeon Kim
Clinical Endoscopy.2019; 52(2): 93. CrossRef

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Focused Review Series: Endoscopic and Molecular Imaging of Premalignant GI Lesions, Part II

Barrett Esophagus in Asia: Same Disease with Different Pattern: Hyun Seok Lee, Seong Woo Jeon; Clin Endosc 2014;47(1):15-22. Published online January 24, 2014; DOI: https://doi.org/10.5946/ce.2014.47.1.15

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Barrett esophagus (BE) is considered to develop as a result of chronic gastroesophageal reflux disease (GERD) and to predispose to esophageal adenocarcinoma (EAC). However, the disease pattern of BE in Asia differs from that observed in the West. For example, in the West, the prevalence rates of BE and EAC have progressively increased, whereas although the prevalence rate of GERD is increasing in Asia, the prevalence rates of BE and EAC have remained low in most Asian countries. GERD, hiatal hernia, old age, male sex, abdominal obesity (visceral obesity), smoking, alcohol consumption, and kyphosis are known risk factors for BE in Asia, and most Asian patients have short-segment BE. Helicobacter pylori infection is more prevalent in Asia than in the West. We suggest larger studies with a prospective design be conducted to elaborate further the different patterns of BE in Asia.

Citations

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Prevalence of Barrett’s Esophagus and Esophageal Adenocarcinoma With and Without Gastroesophageal Reflux: A Systematic Review and Meta-analysis
Bibek Saha, Kornpong Vantanasiri, Babu P. Mohan, Rohit Goyal, Nikita Garg, Danielle Gerberi, John B. Kisiel, Siddharth Singh, Prasad G. Iyer
Clinical Gastroenterology and Hepatology.2024; 22(7): 1381. CrossRef
Low-grade dysplasia in Barrett's esophagus: A problematic diagnosis
Muhannad Sarem, Francisco J. Martínez Cerezo, Maria Lujan Salvia Favieres, Rodolfo Corti
Gastroenterología y Hepatología.2023; 46(8): 637. CrossRef
Low-grade dysplasia in Barrett's esophagus: A problematic diagnosis
Muhannad Sarem, Francisco J. Martínez Cerezo, Maria Lujan Salvia Favieres, Rodolfo Corti
Gastroenterología y Hepatología (English Edition).2023; 46(8): 637. CrossRef
Is There an Increasing Incidence of Gastroesophageal Junctional Adenocarcinoma and Barrett Esophagus in Asia? A Review of Diagnostic Conundrums
Phei Oon Tan, Alex Yu Sen Soh, Chika Kusano, Yeong Yeh Lee, Takuji Gotoda
Digestion.2022; 103(1): 37. CrossRef
Thailand guideline 2020 for medical management of gastroesophageal reflux disease
Monthira Maneerattanaporn, Rapat Pittayanon, Tanisa Patcharatrakul, Chalermrat Bunchorntavakul, Siam Sirinthornpanya, Panyavee Pitisuttithum, Asawin Sudcharoen, Uayporn Kaosombatwattana, Kawin Tangvoraphongchai, Reawika Chaikomin, Kamin Harinwan, Karjpong
Journal of Gastroenterology and Hepatology.2022; 37(4): 632. CrossRef
Quality indicators in esophagogastroduodenoscopy
Sang Yoon Kim, Jae Myung Park
Clinical Endoscopy.2022; 55(3): 319. CrossRef
Epidemiological Review of Gastroesophageal Junction Adenocarcinoma in Asian Countries
Noriaki Manabe, Kazuhiro Matsueda, Ken Haruma
Digestion.2022; 103(1): 29. CrossRef
Reply: Need for evidence on surveillance endoscopy in achalasia-related Barret esophagus and adenocarcinoma in Asian population
Hiroki Sato, Yuto Shimamura, Shinwa Tanaka, Hironari Shiwaku, Hitomi Minami, Chiaki Sato, Ryo Ogawa, Haruhiro Inoue
Journal of Gastroenterology.2022; 57(10): 813. CrossRef
Barrett's Esophagus
Yong Kang Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(3): 177. CrossRef
Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region
Guan Sen Kew, Alex Yu Sen Soh, Yeong Yeh Lee, Takuji Gotoda, Yan-Qing Li, Yan Zhang, Yiong Huak Chan, Kewin Tien Ho Siah, Daniel Tong, Simon Ying Kit Law, Andrew Ruszkiewicz, Ping-Huei Tseng, Yi-Chia Lee, Chi-Yang Chang, Duc Trong Quach, Chika Kusano, Sho
World Journal of Gastrointestinal Oncology.2021; 13(4): 279. CrossRef
Risk Prediction of Barrett’s Esophagus in a Taiwanese Health Examination Center Based on Regression Models
Po-Hsiang Lin, Jer-Guang Hsieh, Hsien-Chung Yu, Jyh-Horng Jeng, Chiao-Lin Hsu, Chien-Hua Chen, Pin-Chieh Wu
International Journal of Environmental Research and Public Health.2021; 18(10): 5332. CrossRef
Relationship between time-varying status of reflux esophagitis and Helicobacter pylori and progression to long-segment Barrett’s esophagus: time-dependent Cox proportional-hazards analysis
Genki Usui, Tomohiro Shinozaki, Toyohisa Jinno, Kazutoshi Fujibayashi, Teppei Morikawa, Toshiaki Gunji, Nobuyuki Matsuhashi
BMC Gastroenterology.2020;[Epub] CrossRef
Challenges to diagnostic standardization of Barrett's esophagus in Asia
Yu Sen Alex Soh, Yeong Yeh Lee, Takuji Gotoda, Prateek Sharma, Khek‐Yu Ho
Digestive Endoscopy.2019; 31(6): 609. CrossRef
Presence of columnar-lined esophagus is negatively associated with the presence of esophageal varices in Japanese alcoholic men
Akira Yokoyama, Kenro Hirata, Rieko Nakamura, Tai Omori, Takeshi Mizukami, Junko Aida, Katsuya Maruyama, Tetsuji Yokoyama
World Journal of Gastroenterology.2017; 23(39): 7150. CrossRef
Unchanging pattern of prevalence of esophageal cancer, overall and by histological subtype, in the endoscopy service of the main referral hospital in the central region of Rio Grande do Sul State, in Southern Brazil
R. B. Fagundes, D. de Carli, R. V. Xaubet, J. C. Cantarelli
Diseases of the Esophagus.2016; 29(6): 603. CrossRef
Dietary magnesium, calcium:magnesium ratio and risk of reflux oesophagitis, Barrett’s oesophagus and oesophageal adenocarcinoma: a population-based case–control study
Qi Dai, Marie M. Cantwell, Liam J. Murray, Wei Zheng, Lesley A. Anderson, Helen G. Coleman
British Journal of Nutrition.2016; 115(2): 342. CrossRef
A Model for Predicting the Future Risk of Incident Erosive Esophagitis in an Asymptomatic Population Undergoing Regular Check-ups
Soo Hoon Kang, Yaeji Lim, Hyuk Lee, Joungyoun Kim, Sangah Chi, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Hee Jung Son, Seungho Ryu, Poong-Lyul Rhee, Jae J. Kim
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Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus
Kwong Ming Fock, Nicholas Talley, Khean Lee Goh, Kentaro Sugano, Peter Katelaris, Gerald Holtmann, John E Pandolfino, Prateek Sharma, Tiing Leong Ang, Michio Hongo, Justin Wu, Minhu Chen, Myung-Gyu Choi, Ngai Moh Law, Bor-Shyang Sheu, Jun Zhang, Khek Yu H
Gut.2016; 65(9): 1402. CrossRef
Prevalence of Barrett’s Esophagus in Asian Countries: A Systematic Review and Meta-analysis
Seiji Shiota, Siddharth Singh, Ashraf Anshasi, Hashem B. El-Serag
Clinical Gastroenterology and Hepatology.2015; 13(11): 1907. CrossRef
Association Between Alcohol Consumption and the Risk of Barrett's Esophagus
Qin Xu, Wei Guo, Xingang Shi, Wei Zhang, Tianyi Zhang, Cheng Wu, Jian Lu, Rui Wang, Yanfang Zhao, Xiuqiang Ma, Jia He
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Barrett's esophagus and risk of esophageal adenocarcinoma: A retrospective analysis
Hung‐Wei Wang, Chia‐Jung Kuo, Wey‐Ran Lin, Chen‐Ming Hsu, Yu‐Pin Ho, Chun‐Jung Lin, Kuang‐Hua Chen, Ming‐Yao Su, Cheng‐Tang Chiu
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Risk factors of early proximal gastric carcinoma in Chinese diagnosed using WHO criteria
Cheng Fang, Qin Huang, Lin Lu, Jiong Shi, Qi Sun, Gui Fang Xu, Jason Gold, Hiroshi Mashimo, Xiao Ping Zou
Journal of Digestive Diseases.2015; 16(6): 327. CrossRef
Association of Visceral Fat Area, Smoking, and Alcohol Consumption with Reflux Esophagitis and Barrett's Esophagus in Japan
Juntaro Matsuzaki, Hidekazu Suzuki, Masao Kobayakawa, John M. Inadomi, Michiyo Takayama, Kanako Makino, Yasushi Iwao, Yoshinori Sugino, Takanori Kanai, Norikazu Maeda
PLOS ONE.2015; 10(7): e0133865. CrossRef

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Original Articles

Clinical Outcomes and Risk Factors of Rebleeding Following Endoscopic Therapy for Nonvariceal Upper Gastrointestinal Hemorrhage: Ki Tae Suk, Hyun-Soo Kim, Chang Seob Lee, Il Young Lee, Moon Young Kim, Jae Woo Kim, Soon Koo Baik, Sang Ok Kwon, Dong Ki Lee, Young Lim Ham; Clin Endosc 2011;44(2):93-100. Published online December 31, 2011; DOI: https://doi.org/10.5946/ce.2011.44.2.93

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Background/Aims

Rebleeding after endoscopic therapy for non-variceal upper gastrointestinal hemorrhage (NGIH) is the most important predictive factor of mortality. We evaluated the risk factors of rebleeding in patients undergoing endoscopic therapy for the NGIH.

Methods

Between January 2003 and January 2007, 554 bleeding events in 487 patients who underwent endoscopic therapy for NGIH were retrospectively enrolled. We reviewed the clinicoendoscopical characteristics of patients with rebleeding and compared them with those of patients without rebleeding.

Results

The incidence of rebleeding was 21.7% (n=120). In the multivariate analysis, initial hemoglobin level ≤9 g/dL (p=0.002; odds ratio [OR], 2.433), inexperienced endoscopist with less than 2 years of experience in therapeutic endoscopy (p=0.001; OR, 2.418), the need for more 15 cc of epinephrine (p=0.001; OR, 2.570), injection therapy compared to thermal and injection therapy (p=0.001; OR, 2.840), and comorbidity with chronic renal disease (p=0.004; OR, 2.908) or liver cirrhosis (p=0.010; OR, 2.870) were risk factors for rebleeding following endoscopic therapy.

Conclusions

Together with patients with low hemoglobin level at presentation, chronic renal disease, liver cirrhosis, the need for more 15 cc of epinephrine, or therapy done by inexperienced endoscopist were risk factors for the development of rebleeding.

Citations

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Dieulafoy’s lesion of the upper GI tract: a comprehensive nationwide database analysis
Yichen Wang, Pardeep Bansal, Si Li, Zaid Iqbal, Mahesh Cheryala, Marwan S. Abougergi
Gastrointestinal Endoscopy.2021; 94(1): 24. CrossRef
Analysis of rebleeding in cases of an upper gastrointestinal bleed in a single center series
Rita Jiménez Rosales, Juan Gabriel Martínez-Cara, Francisco Vadillo-Calles, Eva Julissa Ortega-Suazo, Patricia Abellán-Alfocea, Eduardo Redondo-Cerezo
Revista Española de Enfermedades Digestivas.2018;[Epub] CrossRef
Continuing use of antithrombotic medications for patients with bleeding gastroduodenal ulcer requiring endoscopic hemostasis: a case–control study
Keisuke Kawasaki, Shotaro Nakamura, Koichi Kurahara, Tomohiro Nagasue, Shunichi Yanai, Akira Harada, Hiroki Yaita, Tadahiko Fuchigami, Takayuki Matsumoto
Scandinavian Journal of Gastroenterology.2017; : 1. CrossRef
Multidisciplinary Approach to Refractory Upper Gastrointestinal Bleeding: Case Series of Angiographic Embolization
Ko Eun Lee, Ki-Nam Shim, Chung Hyun Tae, Min Sun Ryu, Sun Young Choi, Chang Mo Moon, Seong-Eun Kim, Hey-Kyung Jung, Sung-Ae Jung
Journal of Korean Medical Science.2017; 32(9): 1552. CrossRef
Successful Endoscopic Hemostasis Is a Protective Factor for Rebleeding and Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding
Yong Jae Han, Jae Myung Cha, Jae Hyun Park, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee
Digestive Diseases and Sciences.2016; 61(7): 2011. CrossRef
Rebleeding after Initial Endoscopic Hemostasis in Peptic Ulcer Disease
Mi Jin Hong, Sun-Young Lee, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park, Chan Sup Shim, Choon Jo Jin
Journal of Korean Medical Science.2014; 29(10): 1411. CrossRef
Chronic Kidney Disease, Hemodynamic Instability, and Endoscopic High-Risk Appearance Are Associated with 30-Day Rebleeding in Patients with Non-Variceal Upper Gastrointestinal Bleeding
Yoo Jin Lee, Eun Soo Kim, Yu Jin Hah, Kyung Sik Park, Kwang Bum Cho, Byoung Kuk Jang, Woo Jin Chung, Jae Seok Hwang
Journal of Korean Medical Science.2013; 28(10): 1500. CrossRef

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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

Abstract PDF PubReader ePub

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°).

Citations

Citations to this article as recorded by

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Hyung Ku Chon, Chan Park, Dong Eun Park, Tae Hyeon Kim
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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
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Se Woo Park
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Seongyul Ryu, Ik Hyun Jo, Seonhoo Kim, Yeon-Ji Kim, Woo Chul Chung
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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
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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
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Maddalena Zippi
World Journal of Clinical Cases.2013; 1(1): 19. CrossRef

7,983 View
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11 Crossref

Risk Factors Predicting the Development of Complication after Foreign Body Ingestion: Sung Hoon Jung, M.D., Chang Nyol Paik, M.D., Kang Moon Lee, M.D., Woo Chul Chung, M.D., Jeong Rok Lee, M.D., U-Im Chang, M.D. and Jin Mo Yang, M.D.; Korean J Gastrointest Endosc 2009;38(4):199-204. Published online April 30, 2009

Abstract PDF: Background
/Aims: Complications related to foreign body ingestion are uncommon, and especially a food bolus, but some ingested foreign bodies are associated with severe and life threatening morbidity. The aim of this study is determine the predictive risk factors for complications resulting from foreign body ingestion in patients who are without gastrointestinal tract obstruction. Methods: We retrospectively analyzed the data of 147 patients who were diagnosed with a foreign body in the GI tract without obstruction between Jan. 2000 to Aug. 2008. Results: Animal bone fragment and coin were the most common type of foreign bodies in adults and children, respectively. Multivariate analysis showed age (p=0.019), the duration of impaction (p=0.013) and the location of the impacted foreign body (p=0.011) were significant independent risk factors associated with the development of complications. Especially, the most important risk factor for children was the location of the impacted foreign body and for adults it was the duration of impaction. Conclusions: Old age, a longer duration of impaction and impaction at the upper esophageal sphincter or upper esophagus are important predictive factors of complication after foreign body ingestion in patients without gastrointestinal tract obstruction. For cases with these factors, more intensive awareness by the physician should be adapted. (Korean J Gastrointest Endosc 2009;38:199-204)

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Risk Factors for Post-ERCP Pancreatitis in Patients Pretreated with Nafamostat Mesilate: Il Doo Kim, M.D., Dae Hwan Kang, M.D., Jin Hyun Park, M.D., Jung Ho Bae, M.D., Pyo Jun Kim, M.D., Yong Wook Kim, M.D., Cheol Woong Choi, M.D., Jae Sup Eum, M.D., Sun Mi Lee, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D. and Geun Am Song, M.D.; Korean J Gastrointest Endosc 2008;37(4):265-270. Published online October 30, 2008

Abstract PDF: Backgound/Aims: Pancreatitis is the most common and important complication of an endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to identify risk factors for post ERCP-pancreatitis in patients pretreated with nafamostat mesilate, a synthetic protease inhibitor. Methods: A total of 247 patients who underwent an ERCP were evaluated prospectively. Potential risk factors of post-ERCP pancreatitis in patients pretreated with nafamostat mesilate were evaluated. Results: Twenty-four patients (9.7%) and nine patients (3.6%) developed post-ERCP hyperamylasemia and pancreatitis, respectively. As determined by univariate analysis among the potential risk factors, we found a procedure time over 20 minutes, pancreatic duct cannulation over four times, prior post-ERCP pancreatitis and the absence of a common bile duct (CBD) stone as risk factors for post-ERCP hyperamylasemia. We also found a patient age under 60 years, a procedure time over 20 minutes, pancreatic duct cannulation over four times and the absence of a CBD stone as risk factors for post-ERCP pancreatitis (p＜0.05). As determined by multivariate analysis, pancreatic cannulation over four times is independently associated with post-ERCP hyperamylasemia (p=0.038; OR, 5.165; 95% CI, 1.093∼24.412) and post-ERCP pancreatitis (p=0.002; OR, 33.122; 95% CI, 3.526∼311.138). Conclusions: A repeated pancreatic duct cannulation is the most important risk factor for post-ERCP pancreatitis in patients pretreated with nafamostat mesilate. (Korean J Gastrointest Endosc 2008; 37:265-270)

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A Study on Clinical Characteristics of Mallory-Weiss Syndrome with Complicated Course: Hang Lak Lee, M.D., Dong Soo Han, M.D., Jong Pyo Kim, M.D., Jin Bae Kim, M.D., Joon Yong Park, M.D., Joo Hyun Sohn, M.D. and Joon Soo Hahm, M.D.; Korean J Gastrointest Endosc 2003;26(6):405-409. Published online June 30, 2003

Abstract PDF: Background
/Aims: Mallory-Weiss syndrome is a benign and self-limiting disease, but occasionally cases with complications are encountered. The aim of this study was to identify the risk factors for complicated course and predisposing factors of Mallory-Weiss syndrome, and its associated conditions. Methods: Fifty-nine patients diagnosed as having Mallory-Weiss syndrome were subjects of this study. Patients' medical records were reviewed retrospectively. A complicated course was defined if there was a need for transfusion of ＞6 pints, evidence of shock, rebleeding or angiographic or surgical interventions. Results: Risk factors for a complicated Mallory-Weiss syndrome in univariate analysis were the followings; low hemoglobin, melena, presence of visible vessel or active bleeding on initial endoscopy. In multivariate analysis, the presence of visible vessel and active bleeding on initial endoscopy were the only significant risk factors. Predisposing factors of Mallory-Weiss syndrome were as follows: vomiting after alcohol intake (62.7%), vomiting without alcohol (18.6%), nausea (1%), cough (1%), seizure (1%) and unknown etiology (13.6%). Associated medical conditions were as follows: alcoholic liver disease (45.8%), hiatal hernia (27.1%) and liver cirrhosis (18.6%). Conclusions: We suggest that the presence of visible vessel and active bleeding on initial endoscopy are a independent risk factors of Mallory-Weiss syndrome with a complicated course. In such patients, aggressive treatment and careful observations are essential. (Korean J Gastrointest Endosc 2003;26:405⁣409)

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원저 : 식도 위장관 ; 소화성 궤양의 재출혈 위험인자 및 에탄올 주입치료의 효과에 관한 연구 ( Original Articles : Esophagus , Stomach & Intestine ; The Risk Factors of Re-bleeding in Peptic Ulcer Patients and the Efficacy of Ethanol Injection Therapy ): Korean J Gastrointest Endosc 1998;18(4):485-498. Published online November 30, 1997

Abstract PDF: Background
/Aims: Acute peptic ulcer bleeding is the most common cause of upper gastrointestinal bleeding, and needs urgent management in cases including large amounts of blood loss. Ernergency endoscopy was performed and evaluation was made on the risk factors of rebleeding in peptic ulcer patients and the efficacy of ethanol injection therapy. Methods: The clinical and endoscopic variables were evaluated according to the rebleeding rates and the efficacy of ethanol injection therapy for hemostasis and prevention of rebleeding in 161 cases including gastric ulcers (GU) with bleeding (M: F 134: 27, mean age 56.5 years) and 136 cases including duodenal ulcers (DU) with bleeding (M: F 111: 25, mean age 40.7 years). (Korean J Gastrointest Endosc 18: 485-498, 1998) (continue)

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