Gastrointestinal endoscopy最新文献

英文中文

Frequency of errors in colorectal lesion description and management prior to referral to a tertiary center 转诊至三级中心前结肠直肠病变描述和处理错误的频率。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.10.056

Yervant Ichkhanian MD, Rachel E. Lahr BA, John J. Guardiola MD, Douglas K. Rex MD

Background and Aims

Accurate reporting of polyp characteristics is crucial for effective resource allocation in endoscopic resection referrals. We present our experience with prereferral management of challenging colorectal lesions.

Methods

We reviewed a prospectively collected database of consecutive referrals for endoscopic resection of challenging colorectal lesions. The database included details of prior colonoscopies. We assessed prereferral management using established guidelines.

Results

Among 1826 referred lesions in 1508 patients, size estimates were missing for 421 (24%) lesions; 56 (3.2%) were twice as large as previously estimated, and 65 (3.7%) were half the previous estimate. Morphologic descriptions were absent for 376 (22%) polyps. Tattooing was performed for 822 (47%) lesions, with 195 (24%) placed correctly. Of the 872 (61%) polyps that underwent biopsy, only 11 (1.3%) were classified high risk by the referring endoscopist.

Conclusions

Errors in prereferral management of challenging colorectal lesions are frequent. Improved adherence to national guidelines could enhance practice.

背景和目的：准确报告息肉特征对于有效分配内镜切除转诊资源至关重要。我们介绍了对具有挑战性的结直肠病变进行转诊前管理的经验：方法：我们回顾了前瞻性收集的连续转诊数据库，这些转诊患者均接受了具有挑战性的结直肠病变内镜切除术。该数据库包括先前结肠镜检查的详细信息。我们根据既定指南对转诊前的管理进行了评估：在 1826 名患者的 1826 个转诊病灶中，421 个（24%）病灶的大小估计值缺失；56 个（3.2%）病灶的大小是之前估计值的两倍，65 个（3.7%）病灶的大小是之前估计值的一半。376个（22%）息肉没有形态学描述。对 822 个（47%）病灶进行了纹身，其中 247 个（30%）纹身位置正确。在进行活检的 1,103 个（77%）息肉中，只有 11 个（1.1%）被转诊内镜医师列为高危息肉：结论：在转诊前处理具有挑战性的结直肠病变时经常出现错误。加强对国家指南的遵守可以提高诊疗水平。

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引用次数: 0

EUS-directed transduodenal ERCP in concomitant gastric outlet and biliary obstruction eus引导的经十二指肠ERCP在并发胃出口和胆道梗阻中的应用。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.12.003

Vivek Kesar MD , William F. Abel MD , Jay Bapaye MD , Reid D. Wasserman DO , Jonathan Rozenberg DO , Subhash Garikipati MD , Klaus E. Mönkemüller MD , Varun Kesar MD , Paul Yeaton MD

Background and Aims

Patients with concomitant gastric outlet obstruction (GOO) and biliary obstruction often have limited management options, particularly in the setting of severe debility. We detail the use of EUS-guided gastroduodenal placement of a lumen-apposing metal stent (LAMS) as a conduit for transduodenal ERCP: EUS-directed transduodenal ERCP.

Methods

Nine patients who developed GOO with indwelling biliary metal stents or with anticipated biliary stent placement were retrospectively included.

Results

A 20 mm × 10 mm LAMS was deployed for creation of gastroduodenostomy in all patients. ERCP was performed via the gastroduodenal LAMS with resolution of jaundice in 100% of patients. GOO score improved to 3 in all patients.

Conclusions

This study demonstrates excellent outcomes (resolution of jaundice and GOO) in all chronically ill, poor surgical candidates. Placement of a LAMS allowed for both treatment of GOO and ERCP access for present and future stent exchange.

背景和目的：伴有胃出口梗阻（GOO）和胆道梗阻的患者通常只有有限的治疗选择，特别是在严重虚弱的情况下。我们详细介绍了EUS引导下胃十二指肠放置腔旁金属支架（LAMS）作为经十二指肠ERCP的导管：EUS引导的经十二指肠ERCP （EDDE）。方法：回顾性分析9例留置胆道金属支架或预期放置胆道金属支架后发生粘稠的患者。结果：所有患者均采用20mm × 10mm的LAMS进行胃十二指肠吻合。ERCP通过胃十二指肠LAMS进行，100%的患者黄疸消退。所有患者的GOOSS评分均提高至3分。结论：本研究显示了所有慢性疾病，不良手术候选人的良好结果（黄疸和粘粘症的消退）。LAMS既可以治疗粘稠症，也可以为当前和未来的支架置换提供ERCP通道。

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引用次数: 0

One-stop solution: diagnosis and treatment of common hepatic artery pseudoanerysm on EUS (with video) 一站式解决方案：超声内镜下肝总动脉假性动脉瘤诊治。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.12.012

Guan-Jun Kou MD, Xiao-Li Jia MM, Ning Zhong MD

引用次数: 0

Editors

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/S0016-5107(25)00091-4

引用次数: 0

A note from the Editor-in-Chief

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2025.01.034

Douglas G. Adler MD, FACG, AGAF, FASGE

引用次数: 0

Feasibility of submucosal tunneling endoscopic resection for a bleeding GI stromal tumor (with video) 粘膜下隧道内窥镜切除术治疗出血性胃肠道间质瘤的可行性。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.10.051

Ahmad Madkour MD, Ashraf Albreedy MD, Ahmed Elgammal MSc, Amr Elfouly MD, Dalia Abd El-Kareem MD, Hassan Atalla MD

引用次数: 0

Endoscopic resection of post-transduodenal ampullectomy recurrent ampullary adenoma using clip-with-line traction method (with video) 使用带线夹牵引法在内镜下切除经十二指肠肛门切除术后复发的杏仁腺瘤（附视频）。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.12.007

Yi-Jun Liao MD, Yen-Chun Peng MD, PhD, Wan-Tzu Lin MD

引用次数: 0

Pearls learned from a decade of experience with peroral endoscopic myotomy

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.12.027

Alexander Schlachterman MD

引用次数: 0

Concerns regarding bleeding risk of cold snare resection for colorectal polyps in patients with antiplatelet agents

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.10.061

Jing Qiao MD, Ying-Gang Xu MD, Jia-Su Li MD

引用次数: 0

Self-assembling peptide use in colonic diverticular bleeding: Too early to tell?

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-04-01 DOI: 10.1016/j.gie.2024.12.022

Banreet Singh Dhindsa MD

引用次数: 0

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