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Newer kid on the block 新来的孩子

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Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.001

Scott VanderMeer BS , Linda S. Lee MD

引用次数: 0

Mentorship in advanced endoscopy: a conversation with Peter Draganov and Dennis Yang 高级内窥镜的指导：与彼得·德拉加诺夫和丹尼斯·杨的对话

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.006

Peter Draganov MD, MASGE , Dennis Yang MD, FASGE , Vivek Kaul MD, FASGE

引用次数: 0

Innovations in pain management in patients with chronic pancreatitis 慢性胰腺炎患者疼痛管理的创新

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.005

Sarah Enslin PA-C , Benjamin Bick MD , Sumeet K. Tewani MD , Vivek Kaul MD

引用次数: 0

Renoduodenal fistula caused by a large staghorn calculus revealed on endoscopy 内窥镜显示由鹿角结石引起的肾十二指肠瘘

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.02.002

Lulu Zhang FRACP, MBBS, BSc, Florian Grimpen FRACP, MD

引用次数: 0

Errata for the previously published papers 以前发表的论文的勘误表

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.01.001

引用次数: 0

Errata for the previously published papers 以前发表的论文的勘误表

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.01.002

引用次数: 0

Sex disparities in diagnostic workup of benign pancreaticobiliary disease before endoscopic retrograde cholangiopancreatography 内镜逆行胰胆管造影前良性胰胆管疾病诊断的性别差异

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.007

Sarah Dwyer Holland MD, MS , Garrett Weskamp MD , Gabriel Brutico MD, MBS , Ford Holland MS , David L. Diehl MD , Anjuli Luthra MD , Shaffer Mok MD, MBS

Background and Aims

Women face diagnostic delays in the workup of many diseases. We investigated whether there are sex-based disparities in the diagnostic workup of patients with benign pancreaticobiliary pathologies requiring endoscopic retrograde cholangiopancreatography (ERCP).

Methods

We conducted a multicenter retrospective cohort study including patients undergoing ERCP from December 2017 to 2021 for benign pancreaticobiliary pathologies. We assessed differences between males and females in days from presentation to ERCP, number of healthcare visits before ERCP, symptoms, and diagnostic workup at first visit.

Results

One hundred twenty-eight patients (68 female patients) were identified. Eighteen percent of male patients initially presented with fever or chills versus 6% of female patients (P = .03), but otherwise there were no differences in symptoms. There was no difference between sexes in number of encounters or days from presentation until ERCP (P = .5). Significant differences occurred in the initial diagnostic evaluation. Male patients had liver chemistry testing in 98% of initial visits versus 85% of female patients (P = .01), and 95% had imaging ordered at first visit versus 82% of female patients (P = .03). Excluding febrile patients, male patients remained more likely to have laboratory (P = .02) and imaging evaluations (P = .05) at the initial visit. Thirteen female patients (19%) had an inadequate workup at the first visit for benign pancreaticobiliary conditions compared with 3 male patients (5%, P = .02).

Conclusions

We did not observe sex-based delays in time from presentation to ERCP in our sample; however, women were less likely to have adequate workup for benign pancreaticobiliary conditions at the first visit.

背景和目的妇女在许多疾病的检查中面临诊断延误。我们调查了在需要内镜逆行胆管造影（ERCP）的良性胰胆管病变患者的诊断工作中是否存在基于性别的差异。方法我们进行了一项多中心回顾性队列研究，纳入了2017年12月至2021年接受ERCP治疗的良性胰胆管病变患者。我们评估了男性和女性在从出现到ERCP的天数、ERCP前的医疗保健就诊次数、症状和首次就诊时的诊断检查方面的差异。结果共检出128例患者，其中女性68例。18%的男性患者最初表现为发烧或发冷，而女性患者为6% (P = .03)，但除此之外，症状没有差异。从出现到ERCP的接触次数或天数在性别之间没有差异（P = 0.5）。在最初的诊断评估中出现了显著的差异。男性患者首次就诊时进行肝化学检查的比例为98%，女性患者为85% (P = 0.01)， 95%的患者首次就诊时进行影像学检查，而女性患者为82% （P = 0.03）。除发热患者外，男性患者在初次就诊时仍更有可能进行实验室（P = 0.02）和影像学评估（P = 0.05）。13名女性患者（19%）在首次就诊时对良性胰胆管疾病的检查不充分，而3名男性患者（5%,P = 0.02）。结论：在我们的样本中，我们没有观察到基于性别的从出现到ERCP的时间延迟；然而，女性在第一次就诊时不太可能有足够的良性胰胆管疾病检查。

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引用次数: 0

Beyond the scope: endoscopic ultrasound—assisted appendicoscopy by use of a single-use cholangioscope for endoscopic appendicitis therapy: a case report 超出范围：超声内镜辅助阑尾炎内镜下使用一次性胆管镜治疗阑尾炎：1例报告

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.010

Yu-Cong Chen MD , Yu-Chieh Weng MD , Yang-Bor Lu MD

Endoscopic appendicitis therapy (EAT) is an emerging minimally invasive alternative to surgery. This case highlights using endoscopic ultrasound (EUS) to facilitate cholangioscope-guided appendicoscopy. A 41-year-old woman presented with acute right lower quadrant pain and leukocytosis. Computed tomography confirmed acute appendicitis. The patient opted for EAT. EUS identified appendiceal orientation, enabling smooth cholangioscope intubation via colonoscope. Irrigation cleared purulent discharge. Following rapid recovery, the patient remained asymptomatic at 3-month follow-up. EUS-assisted EAT improves access, precision, and efficiency in endoscopic management of appendicitis. This technique may broaden the role of minimally invasive, organ-preserving approaches as an alternative to surgery in selected patients.

内镜下阑尾炎治疗（EAT）是一种新兴的微创手术替代方法。本病例强调使用超声内镜（EUS）促进胆道镜引导下的阑尾镜检查。一位41岁的女性表现为急性右下腹疼痛和白细胞增多。计算机断层扫描证实急性阑尾炎。病人选择了EAT。EUS识别阑尾方向，使胆管镜插管顺利通过结肠镜。灌溉清除了脓性分泌物。在快速恢复后，患者在3个月的随访中仍无症状。eus辅助下的内镜下阑尾炎治疗提高了内镜下阑尾炎治疗的可及性、精确性和效率。这项技术可以扩大微创，器官保存方法的作用，作为手术的替代选择。

引用次数: 0

Safety and efficacy of endoscopic sleeve gastroplasty after liver transplantation 肝移植术后内镜下袖胃成形术的安全性和有效性

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.013

Benjamin I. Richter MD , Yazan Abboud MD , Jay Phansalkar BS , Keri E. Lunsford MD, PhD , Zaid Tafesh MD , Arpit Amin MD , Dhvani Dosh MD, MPH , Ahmed Al-Khazraji MD , Suut Gokturk MD , Paul Gaglio MD , Kaveh Hajifathalian MD, MPH

Background and Aims

Obesity after liver transplantation (LT) can compromise patient outcomes. We report safety and efficacy data on endoscopic sleeve gastroplasty (ESG) after LT.

Methods

This is a retrospective case series of patients who underwent ESG after LT.

Results

All 5 patients underwent ESG at a median 47.3 months (interquartile range [IQR], 34.4-67.4 months) after LT. Patients were predominantly male (4/5, 80%) with median age 61 years (IQR, 51-61 years) and preoperative body mass index 38.8 kg/m² (IQR, 37.1-42.6 kg/m²). Median follow-up after ESG was 18.8 months (IQR, 8.2-19.8 months). Median total body weight loss was 27.2% (IQR, 8.0%-30.0%) at the end of follow-up. Weight loss plateau occurred in 2 patients, with 5 postoperative adverse events in 4 patients (80%) that were mild, and none exceeded grade I on the Clavien-Dindo scale. No patient missed doses of immunosuppressive medications. Liver graft function remained stable.

Conclusions

Our data support the use of ESG after LT, although more data are needed to validate our findings.

背景和目的肝移植术后肥胖会影响患者的预后。结果5例患者均在lt后中位47.3个月（四分位间距[IQR]， 34.4-67.4个月）接受了ESG治疗。患者以男性为主（4/ 5,80%），中位年龄61岁（IQR， 51-61岁），术前体重指数38.8 kg/m2 （IQR, 37.1-42.6 kg/m2）。ESG术后中位随访时间为18.8个月（IQR, 8.2-19.8个月）。随访结束时，中位总体重减轻27.2% （IQR, 8.0%-30.0%）。2例患者出现体重下降平台期，4例患者（80%）出现5例术后不良事件，均为轻度，均未超过Clavien-Dindo分级I级。没有患者漏服免疫抑制药物。肝移植功能保持稳定。sour数据支持肝移植后ESG的使用，尽管需要更多的数据来验证我们的发现。

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引用次数: 0

Submucosal tunneling endoscopic resection with bidirectional full-thickness resection of gastrointestinal stromal tumor: a case report 粘膜下隧道内镜双向全层切除胃肠道间质瘤1例

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.009

Farimah Fayyaz MD , Preethi Jagannath MBBS , Jose Antonio Almario MD , Mouen A. Khashab MD

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Whereas surgical resection remains the criterion standard for high-risk lesions, minimally invasive endoscopic techniques are emerging as viable alternatives. Exophytic subepithelial lesions pose unique challenges for standard endoscopic techniques, including incomplete resection and potential injury to adjacent structures. This case report presents a novel bidirectional full-thickness resection (FTR) technique for resecting an exophytic gastric GIST in a 63-year-old man. The procedure involved submucosal tunneling, peritoneal entry, and circumferential FTR from both the peritoneal and the tunnel sides, ensuring complete removal of the lesion. Mucosal incision closure was achieved by use of an endoscopic suturing system, with no postprocedural adverse events. The diagnosis of GIST was confirmed histopathologically. Twenty-one months after the procedure, no recurrence was observed on imaging. Bidirectional FTR potentially enhances visualization, improves resection completeness, and minimizes procedural risks, making it a promising technique for managing exophytic subepithelial lesions.

胃肠道间质瘤（gist）是最常见的胃肠道间质肿瘤。尽管手术切除仍然是高风险病变的标准，微创内镜技术正在成为可行的替代方案。外生性上皮下病变对标准内窥镜技术提出了独特的挑战，包括不完全切除和对邻近结构的潜在损伤。本病例报告介绍了一种新的双向全层切除术（FTR）技术，用于切除63岁男性外生性胃间质瘤。该手术包括粘膜下隧道，腹膜进入，并从腹膜和隧道两侧进行周向FTR，以确保完全切除病变。使用内镜缝合系统实现粘膜切口闭合，无术后不良事件。经组织病理学证实为GIST。术后21个月影像学检查未见复发。双向FTR潜在地增强了可视化，提高了切除的完整性，并将手术风险降至最低，使其成为治疗外生性上皮下病变的一种很有前途的技术。

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