Clinical Endoscopy

Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea: Hyundam Gu, Suyoung Lee, Sol Kim, Hye-Lim Jang, Da-Woon Choi, Kyu Seok Kim, Yu Ri Shin, Dae Young Cheung, Bo-In Lee, Jin Il Kim, Han Hee Lee; Clin Endosc 2024;57(6):790-797. Published online September 23, 2024; DOI: https://doi.org/10.5946/ce.2024.110

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Colonic stenting plays a vital role in the management of acute malignant colonic obstruction. The increasing use of self-expandable metal stents (SEMS) and the diverse challenges posed by colonic obstruction at various locations underscore the importance of effective training for colonic stent placement.
Methods
All the components of the simulator were manufactured using silicone molding techniques in conjunction with three-dimensional (3D) printing. 3D images sourced from computed tomography scans and colonoscopy images were converted into a stereolithography format. Acrylonitrile butadiene styrene copolymers have been used in fused deposition modeling to produce moldings.
Results
The simulator replicated the large intestine from the rectum to the cecum, mimicking the texture and shape of the human colon. It enables training for colonoscopy insertion, cecum intubation, loop reduction, and stenting within stenotic areas. Interchangeable stenotic modules for four sites (rectum, sigmoid colon, descending colon, and ascending colon) were easily assembled for training. These modules integrate tumor contours and blood vessel structures with a translucent center, allowing real-time visualization during stenting. Successful and repeatable demonstrations of stent insertion and expansion using the reusable SEMS were consistently achieved.
Conclusions
This innovative simulator offers a secure colonic stenting practice across various locations, potentially enhancing clinical outcomes by improving operator proficiency during actual procedures.

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Hepatobiliary scintigraphy of bile excretion after endoscopic ultrasound-guided hepaticogastrostomy for malignant biliary obstruction: a retrospective study in Japan: Masanori Yamada, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Tsukasa Yasuda, Toshitaka Fukui; Clin Endosc 2024;57(6):798-806. Published online August 20, 2024; DOI: https://doi.org/10.5946/ce.2023.291

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Hepatobiliary scintigraphy (HBS) is used to evaluate bile excretion. This study aimed to evaluate biliary excretion during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using HBS.
Methods
We retrospectively evaluated 78 consecutive patients with malignant extrahepatic biliary obstruction, who underwent HBS after EUS-HGS between April 2015 and July 2022. The peak time and decay rate were scored with 0, 1, or 2 points based on thresholds of 20 and 35 minutes, and 10% and 50%, respectively. A total score of 4 or 3 was considered indicative of good bile excretion, whereas scores of 2, 1, or 0 indicated poor bile excretion.
Results
The good and poor bile excretion groups included 40 and 38 cases, respectively. The group with good bile excretion had a significantly longer time to recurrent biliary obstruction compared to the poor bile excretion group (not reached vs. 124 days, p=0.026). Multivariate analysis identified the site of obstruction as a significant factor influencing good bile excretion (odds ratio, 3.39; 95% confidence interval, 1.01–11.4, p=0.049), with superior bile excretion observed in cases involving upper biliary obstruction compared to middle or lower biliary obstruction.
Conclusions
In patients with malignant biliary obstruction who underwent HGS, the site of obstruction is significantly associated with stent patency.

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Successful iatrogenic duodenal perforation treatment with endoscopic hand suturing: Michał Spychalski, Michał Łabęcki, Matylda Sobczak, Agnieszka Nawrocka-Kunecka, Przemysław Piotr Kasprzyk; Clin Endosc 2024;57(6):832-833. Published online July 24, 2024; DOI: https://doi.org/10.5946/ce.2024.117

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Gel immersion endoscopic mucosal resection for a grade 1 rectal neuroendocrine tumor (carcinoid): Natsuko Saito, Takeshi Yamashina, Masaaki Shimatani; Clin Endosc 2024;57(6):834-835. Published online September 6, 2024; DOI: https://doi.org/10.5946/ce.2024.064

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Puncture angle on an endoscopic ultrasound image is independently associated with unsuccessful guidewire manipulation of endoscopic ultrasound-guided hepaticogastrostomy: a retrospective study in Japan: Akihisa Ohno, Nao Fujimori, Toyoma Kaku, Kazuhide Matsumoto, Masatoshi Murakami, Katsuhito Teramatsu, Keijiro Ueda, Masayuki Hijioka, Akira Aso, Yoshihiro Ogawa; Clin Endosc 2024;57(5):656-665. Published online July 26, 2024; DOI: https://doi.org/10.5946/ce.2023.244

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Although endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is performed globally, the procedure remains challenging. Guidewire manipulation is the most difficult step, and there are few reports on the factors associated with unsuccessful guidewire manipulation. This study aimed to assess the significance of the puncture angle on EUS images and identify the most effective guidewire rescue method for patients with unsuccessful guidewire manipulation.
Methods
We retrospectively enrolled 115 patients who underwent EUS-HGS between May 2016 and April 2022 at two centers. The puncture angle between the needle and the intrahepatic bile duct was measured through EUS movie records.
Results
Guidewire manipulation was unsuccessful in 28 patients. Receiver operating characteristic (ROC) curves identified an optimal puncture angle cutoff value of 85° (cutoff value, 85°; area under the ROC curve, 0.826; sensitivity, 85.7%; specificity, 81.6%). Multivariate analysis demonstrated that a puncture angle <85° was a significant risk factor for unsuccessful guidewire manipulation (odds ratio, 19.8; 95% confidence interval, 6.42–61.5; p<0.001). Among the 28 unsuccessful cases, 24 patients (85.7%) achieved successful guidewire manipulation using various rescue methods.
Conclusions
The puncture angle observed on EUS is crucial for guidewire manipulation. A puncture angle of <85° was associated with unsuccessful guidewire manipulation.

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Safety and efficacy of endoscopic ultrasound-guided pancreatic duct drainage using a drill dilator: a retrospective study in Japan: Ahmed Sadek, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto, Kenneth Tachi; Clin Endosc 2024;57(5):666-674. Published online June 5, 2024; DOI: https://doi.org/10.5946/ce.2023.272

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Background
/Aims: Dilation of the tract before stent deployment is a challenging step in endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD). In this study, we examined the effectiveness and safety of a novel spiral dilator, Tornus ES (Asahi Intec), for EUS-PDD.
Methods
This was a retrospective, single-arm, observational study at Aichi Cancer Center Hospital. The punctured tract was dilated using a Tornus ES dilator in all EUS-PDD cases. Our primary endpoint was the technical success rate of initial tract dilation. Technical success was defined as successful fistula dilation using a Tornus ES followed by successful stent insertion. Secondary endpoints were procedure times and early adverse events.
Results
A total of 12 patients were included between December 2021 and March 2023. EUS-PDD was performed in 11 patients for post-pancreaticoduodenectomy anastomotic strictures and one patient with pancreatitis with duodenal perforation. The technical success rates of stent insertion and fistula dilation using a Tornus ES dilator was 100%. The median procedure time was 24 minutes. No remarkable adverse events related to the procedure were observed, apart from fever, which occurred in 2 patients.
Conclusions
Tract dilation in EUS-PDD using a Tornus ES is effective and safe.

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A novel spiral dilator for pancreatic duct drainage: catching two birds with one stone
Han Taek Jeong, Jimin Han
Clinical Endoscopy.2024; 57(5): 608. CrossRef

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Endoscopic resection of gastric gastrointestinal stromal tumor using clip-and-cut endoscopic full-thickness resection: a single-center, retrospective cohort in Korea: Yuri Kim, Ji Yong Ahn, Hwoon-Yong Jung, Seokin Kang, Ho June Song, Kee Don Choi, Do Hoon Kim, Jeong Hoon Lee, Hee Kyong Na, Young Soo Park; Clin Endosc 2024;57(3):350-363. Published online February 15, 2024; DOI: https://doi.org/10.5946/ce.2023.144

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Background
/Aims: To overcome the technical limitations of classic endoscopic resection for gastric gastrointestinal stromal tumors (GISTs), various methods have been developed. In this study, we examined the role and feasibility of clip-and-cut procedures (clip-and-cut endoscopic full-thickness resection [cc-EFTR]) for gastric GISTs.
Methods
Medical records of 83 patients diagnosed with GISTs after endoscopic resection between 2005 and 2021 were retrospectively reviewed. Moreover, clinical characteristics and outcomes were analyzed.
Results
Endoscopic submucosal dissection (ESD) and cc-EFTR were performed in 51 and 32 patients, respectively. The GISTs were detected in the upper third of the stomach for ESD (52.9%) and cc-EFTR (90.6%). Within the cc-EFTR group, a majority of GISTs were located in the deep muscularis propria or serosal layer, accounting for 96.9%, as opposed to those in the ESD group (45.1%). The R0 resection rates were 51.0% and 84.4% in the ESD and cc-EFTR groups, respectively. Seven (8.4%) patients required surgical treatment (six patients underwent ESD and one underwent cc-EFTR,) due to residual tumor (n=5) and post-procedure adverse events (n=2). Patients undergoing R0 or R1 resection did not experience recurrence during a median 14-month follow-up period, except for one patient in the ESD group.
Conclusions
cc-EFTR displayed a high R0 resection rate; therefore, it is a safe and effective therapeutic option for small gastric GISTs.

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Endoscopic resection penetrating the muscularis propria for gastric gastrointestinal stromal tumors: advances and challenges
Jin Woong Cho
Clinical Endoscopy.2024; 57(3): 329. CrossRef

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Effective hemostasis under gel immersion endoscopy using inflated balloons on the tip of double balloon endoscope for active bleeding in the small intestine: Shunsuke Horitani, Natsuko Saito, Koki Hosoda, Hironao Matsumoto, Toshiyuki Mitsuyama, Takeshi Yamashina, Masaaki Shimatani, Makoto Naganuma; Clin Endosc 2024;57(3):409-411. Published online February 8, 2024; DOI: https://doi.org/10.5946/ce.2023.146

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Gel immersion in endoscopy: Exploring potential applications
Hiroki Sato, Hidemasa Kawabata, Mikihiro Fujiya
World Journal of Gastroenterology.2025;[Epub] CrossRef

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1 Crossref

Use of an endoscopic powered debridement device for treatment of post-surgical fatty pancreatic necrosis: Judy Daboul, Shiab Mussad, Anna Cecilia Amaral, Waleed K. Hussain, Peter J. Lee, Samuel Han; Clin Endosc 2024;57(3):412-414. Published online February 23, 2024; DOI: https://doi.org/10.5946/ce.2023.120

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Endoscopic ultrasound-guided gastrojejunostomy with a direct technique without previous intestinal filling using a tubular fully covered self-expandable metallic stent: Hakan Şentürk, İbrahim Hakkı Köker, Koray Koçhan, Sercan Kiremitçi, Gülseren Seven, Ali Tüzün İnce; Clin Endosc 2024;57(2):209-216. Published online July 3, 2023; DOI: https://doi.org/10.5946/ce.2023.022

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Background
/Aims: Endoscopic ultrasonography-guided gastrojejunostomy is a minimally invasive method for the management of gastric outlet obstruction. Conventionally, a lumen-apposing metal stent (LAMS) is used to create an anastomosis. However, LAMS is expensive and not widely available. In this report, we described a tubular fully covered self-expandable metallic stent (T-FCSEMS) for this purpose.
Methods
Twenty-one patients (15 men [71.4%]; median age, 66 years; range, 40–87 years) were included in this study. A total of 19 malignant (12 pancreatic, 6 gastric, and 1 metastatic rectal cancer) and 2 benign cases were observed. The proximal jejunum was punctured with a 19 G needle. The stomach and jejunum walls were dilated with a 6 F cystotome, and a 20×80 mm polytetrafluoroethylene T-FCSEMS (Hilzo) was deployed. Oral feeding was initiated after 12 to 18 hours and solid foods after 48 hours.
Results
The median procedure time was 33 minutes (range, 23–55 minutes). After two weeks, 19 patients tolerated oral feeding. In patients with malignancy, the median survival time was 118 days (range, 41–194 days). No serious complications or deaths occurred. All patients with malignancy tolerated oral food intake until they expired.
Conclusions
T-FCSEMS is safe and effective. This stent should be considered as an alternative to LAMS for gastric outlet obstruction.

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Tubular fully covered self-expandable metallic stents for endoscopic ultrasound-guided gastrojejunostomy: moving forward or taking a step back?
Rami G. El Abiad, Mouen A. Khashab
Clinical Endoscopy.2024; 57(2): 193. CrossRef
Advances in self-expandable metal stents for endoscopic ultrasound-guided interventions
Dong Kee Jang, Dong Wook Lee, Seong-Hun Kim, Kwang Bum Cho, Sundeep Lakhtakia
Clinical Endoscopy.2024; 57(5): 588. CrossRef
Endoscopic stenting for malignant gastric outlet obstruction: focusing on comparison of endoscopic stenting and surgical gastrojejunostomy
Sun Gyo Lim, Chan Gyoo Kim
Clinical Endoscopy.2024; 57(5): 571. CrossRef

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Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites: Tsukasa Yasuda, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Masanori Yamada, Toshitaka Fukui; Clin Endosc 2024;57(2):246-252. Published online September 7, 2023; DOI: https://doi.org/10.5946/ce.2023.075

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Background
/Aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) is useful for patients with biliary cannulation failure or inaccessible papillae. However, it can lead to serious complications such as bile peritonitis in patients with ascites; therefore, development of a safe method to perform EUS-HGS is important. Herein, we evaluated the safety of EUS-HGS with continuous ascitic fluid drainage in patients with ascites.
Methods
Patients with moderate or severe ascites who underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after the procedure at our institution between April 2015 and December 2022, were included in the study. We evaluated the technical and clinical success rates, EUS-HGS-related complications, and feasibility of re-intervention.
Results
Ten patients underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after completion of the procedure. Median duration of ascites drainage before and after EUS-HGS was 2 and 4 days, respectively. Technical success with EUS-HGS was achieved in all 10 patients (100%). Clinical success with EUS-HGS was achieved in 9 of the 10 patients (90 %). No endoscopic complications such as bile peritonitis were observed.
Conclusions
In patients with ascites, continuous ascites drainage, which is initiated before EUS-HGS and terminated after completion of the procedure, may prevent complications and allow safe performance of EUS-HGS.

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Management of iatrogenic perforations during endoscopic interventions in the hepato-pancreatico-biliary tract
Kirsten Boonstra, Rogier P. Voermans, Roy L.J. van Wanrooij
Best Practice & Research Clinical Gastroenterology.2024; 70: 101890. CrossRef
Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?—A Systematic Review and Meta-Analysis
Saqr Alsakarneh, Mahmoud Y. Madi, Dushyant Singh Dahiya, Fouad Jaber, Yassine Kilani, Mohamed Ahmed, Azizullah Beran, Mohamed Abdallah, Omar Al Ta’ani, Anika Mittal, Laith Numan, Hemant Goyal, Mohammad Bilal, Wissam Kiwan
Journal of Clinical Medicine.2024; 13(13): 3883. CrossRef
Feasibility and safety of EUS-guided biliary drainage in inexperienced centers: a multicenter study in southwest Japan
Takehiko Koga, Yusuke Ishida, Shunpei Hashigo, Yuzo Shimokawa, Hirofumi Harima, Kazuhisa Okamoto, Akihisa Ohno, Tsukasa Miyagahara, Toshihiro Fujita, Satoshi Fukuchi, Kosuke Takahashi, Hiroki Taguchi, Norimasa Araki, Yuichiro Ohtsuka, Toshiyuki Uekitani,
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Endoscopic ultrasound-guided antegrade stenting combined with closure of the puncture route using self-assembling peptide solution in a jaundiced patient with ascites
Hirotsugu Maruyama, Kojiro Tanoue, Tatsuya Kurokawa, Yoshinori Shimamoto, Yuki Ishikawa-Kakiya, Akira Higashimori, Yasuhiro Fujiwara
Endoscopy.2024; 56(S 01): E953. CrossRef
The Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios
Giuseppe Dell’Anna, Rubino Nunziata, Claudia Delogu, Petra Porta, Maria Vittoria Grassini, Jahnvi Dhar, Rukaia Barà, Sarah Bencardino, Jacopo Fanizza, Francesco Vito Mandarino, Ernesto Fasulo, Alberto Barchi, Francesco Azzolini, Guglielmo Albertini Petron
Journal of Clinical Medicine.2024; 13(24): 7731. CrossRef

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Single-pigtail plastic stent made from endoscopic nasobiliary drainage tubes in endoscopic ultrasound-guided gallbladder drainage: a retrospective case series: Koichi Soga; Clin Endosc 2024;57(2):263-267. Published online April 4, 2023; DOI: https://doi.org/10.5946/ce.2022.213

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Technical failure of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is often attributed to device failure. To rectify this problem, we developed a single-pigtail plastic stent (SPPS) for EUS-GBD. We retrospectively reviewed the cases of four patients who underwent EUS-GBD for acute cholecystitis. To prepare the SPPS, a 7.5-Fr endoscopic nasobiliary drainage tube was cut to an appropriate length. The use of SPPS during EUS-GBD was successful from both technical and clinical standpoints. The SPPS spontaneously detached 57 days after the procedure in patient 4 and 412 days after the procedure in patient 1. Patient 1 developed cholecystitis after 426 days and was managed with antibiotics. The other three patients did not develop any complications after surgery. In conclusion, we designed a new SPPS dedicated to EUS-GBD and established its technical feasibility and clinical effectiveness.

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Endoscopic ultrasound-guided retrieval of a migrated plastic stent from a pelvic abscess
Koichi Soga, Yuto Suzuki, Fuki Hayakawa, Takeshi Fujiwara, Yo Fujimoto, Ikuhiro Kobori, Masaya Tamano
Endoscopy.2024; 56(S 01): E870. CrossRef
Usefulness of inserting a modified single‐pigtail plastic stent into a metallic stent in endoscopic ultrasound-guided gallbladder drainage
Koichi Soga
Endoscopy.2023; 55(S 01): E1081. CrossRef

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A remnant cystic duct presenting as a duodenal subepithelial tumor: Gwang Ha Kim, Dong Chan Joo; Clin Endosc 2024;57(2):268-269. Published online February 2, 2024; DOI: https://doi.org/10.5946/ce.2023.275

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Nightmare of straight-type plastic stent migration into the peripheral bile duct: what is my savior?: Yun Chae Lee, Shayan Irani, Hyung Ku Chon; Clin Endosc 2024;57(1):134-136. Published online August 3, 2023; DOI: https://doi.org/10.5946/ce.2023.132

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Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review: Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Rie Shiomi, Takahiro Shin, Kei Sugimoto, Shomei Ryozawa; Clin Endosc 2023;56(6):716-725. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2023.023

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Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. For example, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical practice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE) with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of larger accessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the development in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the challenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as perforation, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regarding SBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated with ERCP.

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Advanced technical tips and recent insights in ERCP using balloon‐assisted endoscopy
Masaaki Shimatani, Toshiyuki Mitsuyama, Takeshi Yamashina, Masahiro Takeo, Shunsuke Horitani, Natsuko Saito, Hironao Matsumoto, Masahiro Orino, Masataka Kano, Takafumi Yuba, Takuya Takayama, Tatsuya Nakagawa, Shoji Takayama
DEN Open.2024;[Epub] CrossRef
Efficacy of texture and color enhancement imaging for short‐type single‐balloon enteroscopy‐assisted biliary cannulation in patients with Roux‐en‐Y gastrectomy: Multicenter study (with video)
Yuki Tanisaka, Mamoru Takenaka, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Takahiro Shin, Kei Sugimoto, Ken Kamata, Kosuke Minaga, Shunsuke Omoto, Tomohiro Yamazaki, Shomei Ryozawa
Digestive Endoscopy.2024; 36(9): 1030. CrossRef
Progress in minimally invasive treatment of biliary pancreatic duct obstruction after digestive tract reconstruction by endoscopic retrograde cholangiopancreatography
Ru-Yi Wang, Zhen Fan
World Chinese Journal of Digestology.2024; 32(7): 490. CrossRef
Endoscopic Management of Biliary and Pancreatic Pathologies in Roux-en-Y Gastric Bypass Patients: Development of a Treatment Algorithm Based on 9-Year Experience
Laurent Monino, Lancelot Marique, Yannick Deswysen, Maximilien Thoma, Pierre H. Deprez, Pierre Goffette, Benoit Navez, Tom G. Moreels
Obesity Surgery.2024; 34(10): 3717. CrossRef
Use of short single-balloon enteroscopy in patients with surgically altered anatomy: a single-center experience
Songming Ding, Shanjie Dong, Hengkai Zhu, Yiting Hu, Shusen Zheng, Qiyong Li
Scientific Reports.2024;[Epub] CrossRef
Emergency Laparoscopic Common Bile Duct Exploration for Acute Cholangitis in Cases with Difficulty with an Endoscopic Approach
Naoki Matsumoto, Isao Sato, Yoshihide Chino, Makoto Mizutani, Tomotake Tabata, Tomoyuki Tagi, Shigeyoshi Shimaoka, Takafumi Oe
The Japanese Journal of Gastroenterological Surgery.2024; 57(11): 535. CrossRef
Development and evaluation of artificial organ models for ERCP training in patients with surgically altered anatomies
Kai Koch, Benedikt Duckworth-Mothes, Ulrich Schweizer, Karl-Ernst Grund, Tom G. Moreels, Alfred Königsrainer, Dörte Wichmann
Scientific Reports.2023;[Epub] CrossRef
Simplified single-session EUS-guided transhepatic antegrade stone removal for management of choledocholithiasis in patients with surgically altered anatomy
Tingting Yu, Suning Hou, Haiming Du, Wei Zhang, Jiao Tian, Yankun Hou, Jun Yao, Senlin Hou, Lichao Zhang
Gastroenterology Report.2023;[Epub] CrossRef

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Usefulness of the S-O clip for duodenal endoscopic submucosal dissection: a propensity score-matched study: Ippei Tanaka, Dai Hirasawa, Hiroaki Saito, Junichi Akahira, Tomoki Matsuda; Clin Endosc 2023;56(6):769-777. Published online May 24, 2023; DOI: https://doi.org/10.5946/ce.2022.195

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Background
/Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associated with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the effectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNADETs.
Methods
Consecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively enrolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group) and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while procedure time and R0 resection rate were the secondary outcomes.
Results
After propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraoperative perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was observed in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003).
Conclusions
The S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duodenal ESD.

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A method of “Noninjecting Resection using Bipolar Soft coagulation mode; NIRBS” for superficial non-ampullary duodenal epithelial tumor: a pilot study
Mitsuo Tokuhara, Yasushi Sano, Yoshifumi Watanabe, Hidetoshi Nakata, Hiroko Nakahira, Shingo Furukawa, Takuya Ohtsu, Naohiro Nakamura, Takashi Ito, Ikuko Torii, Takeshi Yamashina, Masaaki Shimatani, Makoto Naganuma
BMC Gastroenterology.2024;[Epub] CrossRef
Traction methods for endoscopic submucosal dissection
Ji Hyun Kim, Sung Chul Park
Journal of Innovative Medical Technology.2024; 2(2): 47. CrossRef

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Significance of rescue hybrid endoscopic submucosal dissection in difficult colorectal cases: Hayato Yamaguchi, Masakatsu Fukuzawa, Takashi Kawai, Takahiro Muramatsu, Taisuke Matsumoto, Kumiko Uchida, Yohei Koyama, Akira Madarame, Takashi Morise, Shin Kono, Sakiko Naito, Naoyoshi Nagata, Mitsushige Sugimoto, Takao Itoi; Clin Endosc 2023;56(6):778-789. Published online July 26, 2023; DOI: https://doi.org/10.5946/ce.2022.268

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Background
/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is performed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing perforation. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of rescue hybrid ESD (RH-ESD).
Methods
We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group (SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes.
Results
Resection time was significantly shorter in the following order: RH-ESD (149 [90–197] minutes) >C-ESD (90 [60–140] minutes) >SH-ESD (52 [29–80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dissection rate was significantly lower in the piecemeal resection group (25% [20%–30%]) than in the en bloc resection group (40% [20%–60%]).
Conclusions
RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoiding surgery.

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Planned Hybrid Endoscopic Submucosal Dissection as Alternative for Colorectal Neoplasms: A Propensity Score-Matched Study
Yu-xin Zhang, Xun Liu, Fang Gu, Shi-gang Ding
Digestive Diseases and Sciences.2024; 69(3): 949. CrossRef
Understanding hybrid endoscopic submucosal dissection subtleties
João Paulo de Souza Pontual, Alexandre Moraes Bestetti, Diogo Turiani Hourneaux de Moura
Clinical Endoscopy.2023; 56(6): 738. CrossRef

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The efficacy of a novel integrated outside biliary stent and nasobiliary drainage catheter system for acute cholangitis: a single center pilot study: Naosuke Kuraoka, Tetsuro Ujihara, Hiromi Kasahara, Yuto Suzuki, Shun Sakai, Satoru Hashimoto; Clin Endosc 2023;56(6):795-801. Published online April 11, 2023; DOI: https://doi.org/10.5946/ce.2022.289

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Endoscopic biliary drainage is the gold standard treatment for cholangitis. The two methods of biliary drainage are endoscopic biliary stenting and nasobiliary drainage. A novel integrated outside biliary stent and nasobiliary drainage catheter system (UMIDAS NB stent; Olympus Medical Systems) was recently developed. In this study, we evaluated the efficacy of this stent in the treatment of cholangitis caused by common bile duct stones or distal bile duct strictures.
Methods
We conducted a retrospective pilot study by examining the medical records of patients who required endoscopic biliary drainage for cholangitis due to common bile duct stones or distal bile duct strictures, and who were treated with a UMIDAS NB stent, between December 2021 and July 2022.
Results
Records of 54 consecutive patients were reviewed. Technical and clinical success rates were 47/54 (87.0%) and 52/54 (96.3%), respectively. Adverse events were observed in 12 patients, with six patients experiencing pancreatitis as an adverse event, following endoscopic retrograde cholangiopancreatography (ERCP). Regarding late adverse events, five cases of biliary stent migration into the bile duct were observed. Disease-related death occurred in one patient.
Conclusions
The outside-type UMIDAS NB stent is an efficacious new method for biliary drainage and can be applied to many indications.

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Evaluation of a new method, “non-injection resection using bipolar soft coagulation mode (NIRBS)”, for colonic adenomatous lesions: Mitsuo Tokuhara, Masaaki Shimatani, Kazunari Tominaga, Hiroko Nakahira, Takuya Ohtsu, Katsuyasu Kouda, Makoto Naganuma; Clin Endosc 2023;56(5):623-632. Published online May 18, 2023; DOI: https://doi.org/10.5946/ce.2022.200

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Background
/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called “non-injection resection using bipolar soft coagulation mode (NIRBS)” method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method.
Methods
We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer.
Results
A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1–35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation.
Conclusions
NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.

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International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Clinical Endoscopy.2024; 57(2): 141. CrossRef
IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
The Korean Journal of Gastroenterology.2024; 83(6): 217. CrossRef
International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Gut and Liver.2024; 18(5): 764. CrossRef
A method of “Noninjecting Resection using Bipolar Soft coagulation mode; NIRBS” for superficial non-ampullary duodenal epithelial tumor: a pilot study
Mitsuo Tokuhara, Yasushi Sano, Yoshifumi Watanabe, Hidetoshi Nakata, Hiroko Nakahira, Shingo Furukawa, Takuya Ohtsu, Naohiro Nakamura, Takashi Ito, Ikuko Torii, Takeshi Yamashina, Masaaki Shimatani, Makoto Naganuma
BMC Gastroenterology.2024;[Epub] CrossRef

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Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management: Clement Chun Ho Wu, Samuel Jun Ming Lim, Christopher Jen Lock Khor; Clin Endosc 2023;56(4):433-445. Published online July 17, 2023; DOI: https://doi.org/10.5946/ce.2023.013

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Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient’s clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

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Prevention of post-ERCP complications
Lotfi Triki, Andrea Tringali, Marianna Arvanitakis, Tommaso Schepis
Best Practice & Research Clinical Gastroenterology.2024; 69: 101906. CrossRef
International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Clinical Endoscopy.2024; 57(2): 141. CrossRef
Double-guidewire technique for selective biliary cannulation does not increase the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with naïve papilla
Han Taek Jeong, June Hwa Bae, Ho Gak Kim, Jimin Han
Clinical Endoscopy.2024; 57(2): 226. CrossRef
Computed tomography-based prediction of pancreatitis following biliary metal stent placement with the convolutional neural network
Tsuyoshi Hamada, Koichiro Yasaka, Yousuke Nakai, Rintaro Fukuda, Ryunosuke Hakuta, Kazunaga Ishigaki, Sachiko Kanai, Kensaku Noguchi, Hiroki Oyama, Tomotaka Saito, Tatsuya Sato, Tatsunori Suzuki, Naminatsu Takahara, Hiroyuki Isayama, Osamu Abe, Mitsuhiro
Endoscopy International Open.2024; 12(06): E772. CrossRef
IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
The Korean Journal of Gastroenterology.2024; 83(6): 217. CrossRef
International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Gut and Liver.2024; 18(5): 764. CrossRef
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
Comparison of the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with and without diabetes: a meta-analysis
Fang Jia, Fujing Lv, Shutian Zhang
Surgical Endoscopy.2024;[Epub] CrossRef
Could assessment of genetic susceptibility be an effective solution to prevent pancreatitis from occurring after endoscopic retrograde cholangiopancreatography?
Jae Min Lee
The Korean Journal of Internal Medicine.2023; 38(6): 783. CrossRef

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Utility of narrow-band imaging with or without dual focus magnification in neoplastic prediction of small colorectal polyps: a Vietnamese experience: Tien Manh Huynh, Quang Dinh Le, Nhan Quang Le, Huy Minh Le, Duc Trong Quach; Clin Endosc 2023;56(4):479-489. Published online May 24, 2023; DOI: https://doi.org/10.5946/ce.2022.212

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Background
/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm).
Methods
This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology.
Results
There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was signiﬁcantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001).
Conclusions
NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

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Effectiveness of Dual-Focus Magnification on Confidence Levels in Optical Diagnosis of Small Colorectal Polyps
Tien M Huynh, Quang D Le, Nhan Q Le , Huy M Le , Duc T Quach
Cureus.2024;[Epub] CrossRef
Implementing narrow banding imaging with dual focus magnification for histological prediction of small rectosigmoid polyps in Vietnamese setting
Tien Manh Huynh, Quang Dinh Le, Nhan Quang Le, Huy Minh Le, Duc Trong Quach
JGH Open.2024;[Epub] CrossRef
The role of narrow-band imaging with or without dual focus in the detection of polyps smaller than 10 mm, especially diminutive polyps
Jin Hwa Park
Clinical Endoscopy.2023; 56(4): 455. CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef

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Safety and feasibility of opening window fistulotomy as a new precutting technique for primary biliary access in endoscopic retrograde cholangiopancreatography: Yasuhiro Kuraishi, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Takafumi Yanaidani, Sho Ishikawa, Tsukasa Yasuda, Masanori Yamada, Nobumasa Mizuno; Clin Endosc 2023;56(4):490-498. Published online April 27, 2023; DOI: https://doi.org/10.5946/ce.2022.130

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Background
/Aims: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common and serious complication of endoscopic retrograde cholangiopancreatography. To prevent this event, a unique precutting method, termed opening window fistulotomy, was performed in patients with a large infundibulum as the primary procedure for biliary cannulation, whereby a suprapapillary laid-down H-shaped incision was made without touching the orifice. This study aimed to assess the safety and feasibility of this novel technique.
Methods
One hundred and ten patients were prospectively enrolled in this study. Patients with a papillary roof size ≥10 mm underwent opening window fistulotomy for primary biliary access. In addition, the incidence of complications and success rate of biliary cannulation were evaluated.
Results
The median size of the papillary roof was 6 mm (range, 3–20 mm). Opening window fistulotomy was performed in 30 patients (27.3%), none of whom displayed PEP. Duodenal perforation was recorded in one patient (3.3%), which was resolved by conservative treatment. The cannulation rate was high (96.7%, 29/30 patients). The median duration of biliary access was 8 minutes (range, 3–15 minutes).
Conclusions
Opening window fistulotomy demonstrated its feasibility for primary biliary access by achieving great safety with no PEP complications and a high success rate for biliary cannulation.

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Comments on ‘Safety and feasibility of opening window fistulotomy as a new precutting technique for primary biliary access in endoscopic retrograde cholangiopancreatography’
Masood Muhammad Karim, Adeel Ur Rehman, Faisal Wasim Ismail, Om Parkash
Clinical Endoscopy.2024; 57(2): 280. CrossRef

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Is simply covering the patient's mouth with a surgical mask during transnasal endoscopy sufficient as an anti-COVID-19 measure?: Yohei Nose, Tomo Ishida, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima; Clin Endosc 2023;56(3):381-383. Published online April 21, 2023; DOI: https://doi.org/10.5946/ce.2022.199

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Side-viewing scope insertion using a large-diameter overtube designed for colonoscopy in a patient with a cascade stomach: Hirokazu Saito, Yoshitaka Kadowaki, Atsushi Fujimoto, Kana Ohmoto, Shuji Tada; Clin Endosc 2023;56(2):256-257. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2022.089

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Endoscopic ultrasound-guided coiling and glue is safe and superior to endoscopic glue injection in gastric varices with severe liver disease: a retrospective case control study: Kapil D. Jamwal, Rajesh K. Padhan, Atul Sharma, Manoj K. Sharma; Clin Endosc 2023;56(1):65-74. Published online January 3, 2023; DOI: https://doi.org/10.5946/ce.2021.119

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Background
/Aims: Gastric varices (GV) are present in 25% of cirrhotic patients with high rates of rebleeding and mortality. Data on endoscopic ultrasound (EUS)-guided treatment in severe liver disease (model for end stage liver disease sodium [MELD-Na] >18 and Child-Turcotte-Pugh [CTP] C with GV) are scarce. Thus, we performed a retrospective comparison of endoscopic glue injection with EUS-guided therapy in cirrhotic patients with large GV.
Methods
A retrospective study was performed in the tertiary hospitals of India. A total of 80 patients were recruited. The inclusion criteria were gastroesophageal varices type 2, isolated gastric varices type 1, bleeding within 6 weeks, size of GV >10 mm, and a MELD-Na >18. Treatment outcomes and complications of endoscopic glue injection and EUS-guided GV therapy were compared.
Results
In this study, the patients’ age, sex, liver disease severity (CTP, MELD-Na) and clinical parameters were comparable. The median number of procedures, injected glue volume, complications, and GV obturation were better in the EUS group, respectively. On subgroup analysis of the EUS method (e.g., direct gastric fundus vs. paragastric collateral [PGC] coil placement), PGC coil placement showed decreased coil requirement, less injected glue volume, decreased luminal coil extrusion, and increased successful GV obturation.
Conclusions
EUS-guided treatment is more efficient and safer, and requires a smaller number of treatment sessions, as compared to endoscopic treatment in severe liver disease patients with large GV. Furthermore, PGC coil placement increases the complete obliteration of GV.

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Efficacy of clip-assisted endoscopic cyanoacrylate injection therapy for gastric varices: A Meta-analysis
Yong-Cai Lv, Yan-Hua Yao, Jing-Jing Lei
World Chinese Journal of Digestology.2024; 32(2): 158. CrossRef
Advances in the endoscopic management of gastric varices
Xin‐Tong Chi, Ting‐Ting Lian, Ze‐Hao Zhuang
Digestive Endoscopy.2024; 36(8): 884. CrossRef
EUS-Guided Vascular Interventions: Recent Advances
Sahib Singh, Saurabh Chandan, Sumant Inamdar, Kambiz S. Kadkhodayan, Jahnvi Dhar, Jayanta Samanta, Antonio Facciorusso
Journal of Clinical Medicine.2024; 13(16): 4835. CrossRef
Trends in endovascular treatment and prevention of portal bleeding
S.V. Mikhin, P.V. Mozgovoy, A.V. Kitaeva, D.E. Gorbunov, I.V. Mikhin
Khirurgiya. Zhurnal im. N.I. Pirogova.2024; (3): 38. CrossRef
In an era of EUS-guided interventions, direct glue injection remains relevant in management algorithm for bleeding isolated gastric varices -1
P. Krishna Bharadwaj, Santhosh E. Kumar, Sudipta Dhar Chowdhury, Ebby George Simon, Shyamkumar Nidugala Keshava, A. J. Joseph, Reuben Thomas Kurien, Uday George Zachariah, Ashish Goel
Indian Journal of Gastroenterology.2024;[Epub] CrossRef
EUS-Guided Coil Placement for Secondary Prophylaxis in Large Gastric Varices - A Pediatric Case Report Authors
Guillermo Costaguta, Alejandro Costaguta
SSRN Electronic Journal.2024;[Epub] CrossRef
Endoscopic ultrasound-guided therapies in the treatment of gastric varices: An in-depth examination of associated adverse events
Anastasios Manolakis, Kyriaki Tsagkidou, Konstantinos Eleftherios Koumarelas
World Journal of Gastrointestinal Endoscopy.2024; 16(12): 640. CrossRef
Safety and Efficacy of Novel Cost-Effective EUS Coiling and Glue Technique for the Management of Large Gastric Varices: A Long-Term Follow-up Study
Shivam Khare, Anil Arora, Jijo Varghese, Vikas Singla, Asif Rahman, Ashish Kumar, Piyush Ranjan, Mandhir Kumar, Praveen Sharma, Naresh Bansal, Shrihari Anikhindi, Munish Sachdeva, Asheish Khandelwal, Mayank Gupta, Suprabhat Giri
Journal of Digestive Endoscopy.2024; 15(04): 222. CrossRef
EUS-guided coiling plus glue injection compared with endoscopic glue injection alone in endoscopic treatment for gastric varices: a systematic review and meta-analysis
Cynthia Florencio de Mesquita, Vanio L.J. Antunes, Natalia Junkes Milioli, Matheus Vanzin Fernandes, Tulio L. Correa, Otavio Cosendey Martins, Radhika Chavan, Stefano Baraldo
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Role of endoscopic ultrasound in the secondary prevention of gastric varices
Joung-Ho Han
Clinical Endoscopy.2023; 56(1): 50. CrossRef
Management of Gastric Varices: GI Perspective
Catherine Vozzo, Vibhu Chittajallu, Brooke Glessing, Ashley Faulx, Amitabh Chak, Richard C.K. Wong
Digestive Disease Interventions.2023; 07(04): 266. CrossRef

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Trans-cavity lumen-apposing metal stent removal: an alternative safe modality: Giacomo Emanuele Maria Rizzo, Ilaria Tarantino; Clin Endosc 2023;56(1):129-131. Published online January 18, 2023; DOI: https://doi.org/10.5946/ce.2022.105

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Aerosol extractor for COVID-2019 prevention during endoscopic procedure: Takuto Hikichi, Tsunetaka Kato, Ryoichiro Kobashi, Minami Hashimoto, Jun Nakamura; Clin Endosc 2022;55(6):815-818. Published online August 29, 2022; DOI: https://doi.org/10.5946/ce.2022.025

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Retrospective study about clinical severity and epidemiological analysis of the COVID-19 Omicron subvariant lineage-infected patients in Hohhot, China
Yanhai Wang, Guohui Yu, Jingru Shi, Xiaqing Zhang, Jianxin Huo, Meng Li, Jiaxi Chen, Liyuan Yu, Yan Li, Zhiliang Han, Jianwen Zhang, Xuna Ren, Yujie Wang, Wu Yuntana
BMC Infectious Diseases.2024;[Epub] CrossRef

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124 Download
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Percutaneous endoscopy (peritoneoscopy) and lithotripsy for retrieval of dropped gallstones post-cholecystectomy: Nariman Nezami, Keywan Behbahani, David R. Elwood, Wendy R. Greene, Bill S. Majdalany, Jamil Shaikh; Clin Endosc 2022;55(6):819-823. Published online October 19, 2022; DOI: https://doi.org/10.5946/ce.2021.278

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Minimally Invasive Strategies for Symptomatic Dropped Gallstones
Rebecca Choi, Aron Michael Devane, Ravi N. Srinivasa, Theodore X. Hu, Jacob Schick, Harjit Singh
Journal of Vascular and Interventional Radiology.2025; 36(1): 192. CrossRef
Percutaneous Endoscopy and Image-guided Retrieval of Dropped Gallstones – A Case Series
Ali Husnain, Allison Reiland, Albert A. Nemcek, Riad Salem, Alexander P. Nagle, Ezra Teitelbaum, Ahsun Riaz
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(4): 361. CrossRef
Colangioscopia percutánea utilizando SpyGlass Discover para el manejo de coledocolitiasis difícil en anatomía alterada: reporte de caso
V. Sánchez-Cerna, G. Araujo-Almeyda, J. Aliaga-Ramos, T. Reyes-Mugruza, W. Celedonio-Campos
Revista de Gastroenterología de México.2024; 89(3): 451. CrossRef
Percutaneous cholangioscopy utilizing SpyGlass Discover for difficult-to-treat choledocholithiasis in an altered anatomy: A case report
V. Sánchez-Cerna, G. Araujo-Almeyda, J. Aliaga-Ramos, T. Reyes-Mugruza, W. Celedonio-Campos
Revista de Gastroenterología de México (English Edition).2024; 89(3): 451. CrossRef

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Efficacy of the pocket-creation method with a traction device in endoscopic submucosal dissection for residual or recurrent colorectal lesions: Daisuke Ide, Tomohiko Richard Ohya, Mitsuaki Ishioka, Yuri Enomoto, Eisuke Nakao, Yuki Mitsuyoshi, Junki Tokura, Keigo Suzuki, Seiichi Yakabi, Chihiro Yasue, Akiko Chino, Masahiro Igarashi, Akio Nakashima, Masayuki Saruta, Shoichi Saito, Junko Fujisaki; Clin Endosc 2022;55(5):655-664. Published online May 31, 2022; DOI: https://doi.org/10.5946/ce.2022.009

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Background
/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions.
Methods
We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events.
Results
En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group.
Conclusions
PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.

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Novel adjustable traction “noose knot” method for colorectal endoscopic submucosal dissection
Junki Tokura, Daisuke Ide, Keigo Suzuki, Chihiro Yasue, Akiko Chino, Masahiro Igarashi, Shoichi Saito
Endoscopy.2024; 56(S 01): E55. CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
Efficacy and safety of salvage endoscopy in the treatment of residual or recurrent colorectal neoplasia after endoscopic resection: a systematic review and meta-analysis
Juan Du, Ting Zhang, Lei Wang, Hao Zhang, Wenquan Yi
Surgical Endoscopy.2024; 38(6): 3027. CrossRef
Is there a best choice of equipment for colorectal endoscopic submucosal dissection?
Francesco Cocomazzi, Sonia Carparelli, Nunzia Labarile, Antonio Capogreco, Marco Gentile, Roberta Maselli, Jahnvi Dhar, Jayanta Samanta, Alessandro Repici, Cesare Hassan, Francesco Perri, Antonio Facciorusso
Expert Review of Medical Devices.2024; 21(7): 561. CrossRef
The Derivation and External Validation of a Fibrosis Risk Model for Colorectal Tumours Undergoing Endoscopic Submucosal Dissection
Sandro Sferrazza, Marcello Maida, Giulio Calabrese, Antonio Facciorusso, Lorenzo Fuccio, Leonardo Frazzoni, Roberta Maselli, Alessandro Repici, Roberto Di Mitri, João Santos-Antunes
Journal of Clinical Medicine.2024; 13(15): 4517. CrossRef
Traction methods for endoscopic submucosal dissection
Ji Hyun Kim, Sung Chul Park
Journal of Innovative Medical Technology.2024; 2(2): 47. CrossRef
Difficult colorectal polypectomy: Technical tips and recent advances
Sukit Pattarajierapan, Hiroyuki Takamaru, Supakij Khomvilai
World Journal of Gastroenterology.2023; 29(17): 2600. CrossRef
Endoscopic full-thickness resection versus endoscopic submucosal dissection for challenging colorectal lesions: a randomized trial
Gianluca Andrisani, Cesare Hassan, Margherita Pizzicannella, Francesco Pugliese, Massimiliano Mutignani, Chiara Campanale, Giorgio Valerii, Carmelo Barbera, Giulio Antonelli, Francesco Maria Di Matteo
Gastrointestinal Endoscopy.2023; 98(6): 987. CrossRef
Combination of endoscopic submucosal dissection techniques, a practical solution for difficult cases
Dong-Hoon Yang
Clinical Endoscopy.2022; 55(5): 626. CrossRef

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Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer: Atsushi Goto, Takeshi Okamoto, Ryo Ogawa, Kouichi Hamabe, Shinichi Hashimoto, Jun Nishikawa, Taro Takami; Clin Endosc 2022;55(4):520-524. Published online July 28, 2022; DOI: https://doi.org/10.5946/ce.2021.262

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Background
/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety.
Methods
Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment.
Results
Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed.
Conclusions
Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis Clinical trial number (UMIN000037567).

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Predictors of stricture after endoscopic submucosal dissection of the esophagus and steroids application
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