Gastrointestinal endoscopy最新文献

{"title":"Endoscopic devices and techniques for the management of gastric varices (with videos)","authors":"ASGE Technology Committee,&nbsp;Guru Trikudanathan MD, FASGE ,&nbsp;Erik F. Rahimi MD, FASGE ,&nbsp;Amit Bhatt MD ,&nbsp;Juan Carlos Bucobo MD, FASGE ,&nbsp;Vinay Chandrasekhara MD, FASGE ,&nbsp;Andrew P. Copland MD ,&nbsp;Samuel Han MD, MS ,&nbsp;Allon Kahn MD ,&nbsp;Kumar Krishnan MD, FASGE ,&nbsp;Nikhil A. Kumta MD, MS ,&nbsp;David R. Lichtenstein MD, FASGE ,&nbsp;Jorge V. Obando MD ,&nbsp;Rahul Pannala MD, MPH, FASGE ,&nbsp;Mansour A. Parsi MD, MPH, MBA, FASGE ,&nbsp;Monica Saumoy MD, MS ,&nbsp;Arvind J. Trindade MD, FASGE ,&nbsp;Julie Yang MD, FASGE ,&nbsp;Ryan J. Law DO ,&nbsp;ASGE Technology Committee Chair","doi":"10.1016/j.gie.2024.06.038","DOIUrl":"10.1016/j.gie.2024.06.038","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric variceal bleeding occurs less commonly than bleeding from esophageal varices (EVs), although it is associated with higher morbidity and mortality. Bleeding from gastroesophageal varices type 1 (GOV1) is treated like EVs. In contrast, other forms of gastric variceal bleeding, including gastroesophageal varices type 2 (GOV2) and isolated gastric varices types 1 (IGV1) and 2 (IGV2), are treated with varying endoscopic approaches. Nonendoscopic methods include transjugular intrahepatic portosystemic shunt (TIPS) or balloon-occluded retrograde transvenous obliteration (BRTO). This technology report focuses on endoscopic management of gastric varices (GVs).</div></div><div><h3>Methods</h3><div>The MEDLINE database was searched through August 2022 for relevant articles by using key words such as gastric varices, glue, cyanoacrylate, thrombin, sclerosing agents, band ligation, topical hemostatic spray, coils, EUS, TIPS, and BRTO. The article was drafted, reviewed, and edited by the American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee and approved by the Governing Board of the ASGE.</div></div><div><h3>Results</h3><div>Endoscopic injection with cyanoacrylate (CYA) glue has been the primary endoscopic method to treat GVs. EUS-guided angiotherapy with CYA glue and coil embolization has emerged as an alternative method enabling improved detection of GVs with a high technical success for targeting and obliterating GVs. Combining CYA glue with coil therapy allows the coil to act as a scaffold for the glue, reducing the risk of glue embolization and improving outcomes. Alternative injectates or topical treatments have been described but remain poorly studied.</div></div><div><h3>Conclusions</h3><div>The mainstay paradigm for the endoscopic management of gastric variceal bleeding is the injection of CYA glue. The published success of EUS-guided angiotherapy using CYA glue with or without embolization coils has increased our treatment armamentarium.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 496-510"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of EUS-guided shear wave elastography for assessment of hepatic fibrosis: a prospective pilot cohort study","authors":"David L. Diehl MD ,&nbsp;Vikas Sangwan MD ,&nbsp;Sandeep Khurana MD ,&nbsp;Harshit S. Khara MD ,&nbsp;Jianying Zhang MD, MPH, MSc ,&nbsp;Bradley D. Confer DO","doi":"10.1016/j.gie.2024.10.064","DOIUrl":"10.1016/j.gie.2024.10.064","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Noninvasive assessment of liver fibrosis is important in the management of liver disease. EUS-guided shear wave elastography (EUS-SWE) is a newer technology that can measure liver stiffness, thereby estimating hepatic fibrosis. There are limited data comparing EUS-SWE to vibration-controlled transient elastography (VCTE) using liver biopsy as the reference standard, and the reproducibility of EUS-SWE measurements is not known.</div></div><div><h3>Methods</h3><div>In total, 52 patients referred for EUS-guided liver biopsy (EUS-LB) were prospectively enrolled. Patients first underwent VCTE, then 2 consecutive EUS-SWE measurements done first in the left and then another 2 in the right. Bilobar EUS-LB was then done. Receiver operating characteristic curves were developed to compare EUS-SWE to VCTE and correlate to histology. Analysis was performed to determine EUS-SWE variability in paired measurements for each lobe and between right and left liver lobes.</div></div><div><h3>Results</h3><div>The most common indication for EUS-LB was non-alcoholic steatohepatitis fibrosis staging in 46% of patients. Right lobe SWE had a strong correlation with fibrosis stage ρ = 0.571 (<em>P</em> &lt; .0001) whereas left lobe EUS-SWE had a moderate correlation ρ = 0.368 (<em>P</em> &lt; .0079). Both EUS-SWE and VCTE were similar for discrimination of all stages of fibrosis based on empiric receiver operating characteristic curves. However, the variance between paired consecutive EUS-SWE measurements was 3.5 times higher in the left lobe compared to the right lobe (<em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>EUS-SWE provides an assessment of hepatic fibrosis comparable to VCTE. EUS-SWE in the left lobe has 3.5 times higher variance between consecutive measurements compared to the right.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 659-662"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of preoperative intragastric meal distribution in gastric emptying scintigraphy for long-term success of gastric peroral endoscopic myotomy in gastroparesis","authors":"Antoine Debourdeau MD ,&nbsp;Véronique Vitton MD, PhD ,&nbsp;Sandra Gonzalez MD, PhD ,&nbsp;Henri Collet MD ,&nbsp;Yassine Al Tabaa MD ,&nbsp;Marc Barthet MD, PhD ,&nbsp;Jean-Michel Gonzalez MD, PhD","doi":"10.1016/j.gie.2024.05.011","DOIUrl":"10.1016/j.gie.2024.05.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric emptying scintigraphy (GES) is the criterion standard for the diagnosis of gastroparesis. However, data are lacking regarding the prognostic value of preoperative intragastric meal distribution during GES in patients undergoing gastric peroral endoscopic myotomy (G-POEM) for gastroparesis. This study investigated the association of GES morphologic parameters and the long-term clinical success of G-POEM.</div></div><div><h3>Methods</h3><div>This retrospective study included patients who underwent G-POEM for refractory gastroparesis in a tertiary center with preoperative GES data. Intragastric meal distribution was measured using the proximal to distal count ratio (PDCR) at 0, 1, 2 and 4 hours, and the retention index was calculated. Clinical success was defined as a decrease of at least 50% in the Gastroparesis Cardinal Symptom Index total score after G-POEM.</div></div><div><h3>Results</h3><div>In total, 77 patients were included with a mean follow-up of 40.14 months. Clinical success was observed in 54.55% of patients. The retention index was not associated with clinical success. Only PDCR at 0 hours (PDCR0) was associated with clinical success. In univariate analysis, the median PDCR0 was 6.0 (interquartile range, 5.59) in patients with clinical success and 4.29 (interquartile range, 4.51) in patients with clinical failure (<em>P</em> = .019). In multivariate analysis, PDCR0 &gt;5.25 was associated with clinical success (odds ratio, 4.36; 95% confidence interval, 1.55-12.26; <em>P</em> = .00524).</div></div><div><h3>Conclusions</h3><div>This study suggests that in patients with gastroparesis, a high PDCR0 value (suggestive for a preferential fundic meal distribution) during preoperative GES is associated with long-term clinical response to G-POEM.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 598-607"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating no fixation, endoscopic suture fixation, and an over-the-scope clip for anchoring fully covered self-expandable metal stents in benign upper GI conditions: a comparative multicenter international study (with video)","authors":"Amit Mehta MD ,&nbsp;Ashraf Ashhab MD ,&nbsp;Apurva Shrigiriwar MD ,&nbsp;Redeat Assefa MD ,&nbsp;Andrew Canakis DO ,&nbsp;Michael Frohlinger MD ,&nbsp;Christopher A. Bouvette MD ,&nbsp;Gregus Matus MD ,&nbsp;Paul Punkenhofer MD ,&nbsp;Francesco Vito Mandarino MD ,&nbsp;Francesco Azzolini MD ,&nbsp;Jamil S. Samaan MD ,&nbsp;Rashmi Advani MD ,&nbsp;Shivani K. Desai MD ,&nbsp;Bradley Confer DO ,&nbsp;Vikas K. Sangwan MD ,&nbsp;Jonh J. Pineda-Bonilla MD ,&nbsp;David P. Lee MD ,&nbsp;Kinnari Modi MD ,&nbsp;Chiemeziem Eke MD ,&nbsp;Mouen A. Khashab MD","doi":"10.1016/j.gie.2024.08.015","DOIUrl":"10.1016/j.gie.2024.08.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Fully covered self-expandable metal stents (FCSEMSs) are widely used in benign upper GI conditions, but stent migration remains a limitation. An over-the-scope clip (OTSC) device (Stentfix {SF], Ovesco Endoscopy) for stent anchoring has recently been developed. The aim of this study was to evaluate the effect of OTSC fixation on FCSEMS migration rate.</div></div><div><h3>Methods</h3><div>In this retrospective review of consecutive patients who underwent FCSEMS placement for benign upper GI conditions from January 2011 to October 2022 at 16 centers, the primary outcome was rate of stent migration. The secondary outcomes were clinical success and adverse events.</div></div><div><h3>Results</h3><div>A total of 311 (no fixation [NF] 122, SF 94, endoscopic suturing [ES] 95) patients underwent 316 stenting procedures. Compared with the NF group (n = 49, 39%), the rates of stent migration were significantly lower in the SF (n = 16, 17%, <em>P</em> = .001) and ES (n = 23, 24%, <em>P</em> = .01) groups. The rates of stent migration were not different between the SF and ES groups (<em>P</em> = .2). On multivariate analysis, SF (odds ratio [OR], 0.34, 95% CI, 0.17-0.70, <em>P</em> &lt; .01) and ES (OR, 0.46, 95% CI, 0.23-0.91; <em>P</em> = .02) were independently associated with decreased risk of stent migration. Compared with the NF group (n = 64; 52%), there were higher rates of clinical success in the SF (n = 64; 68%; <em>P</em> = .03) and ES (n = 66; 69%; <em>P</em> = .02) groups. There was no significant difference in the rates of adverse events among the 3 groups.</div></div><div><h3>Conclusion</h3><div>Stent fixation using OTSCs is safe and effective at preventing stent migration and may also result in improved clinical response.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 589-597"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided gastroenterostomy for malignant gastric outlet obstruction: impact of clinical and demographic factors on outcomes","authors":"Ravi Teja Pasam MBBS, MPH ,&nbsp;Thomas Mathews MD ,&nbsp;Kimberly F. Schuster BA ,&nbsp;Daniel Szvarca MD ,&nbsp;Trent Walradt MD ,&nbsp;Pichamol Jirapinyo MD, MPH ,&nbsp;Christopher C. Thompson MD, MSc","doi":"10.1016/j.gie.2024.10.053","DOIUrl":"10.1016/j.gie.2024.10.053","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided gastroenterostomy (EUS-GE) has emerged as an alternative to surgical gastrojejunostomy and endoluminal stenting for malignant gastric outlet obstruction (MGOO). Studies regarding factors associated with the EUS-GE outcomes are limited.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted with consecutive patients who underwent EUS-GE for MGOO from January 2016 to November 2023. Primary outcomes were technical success (establishing EUS-GE) and clinical success (low-residue diet tolerance without re-intervention at 90-day follow-up). Secondary outcomes were adverse events (AEs), reinterventions, and full regular diet tolerance.</div></div><div><h3>Results</h3><div>Technical success and clinical success rates were 92.70% (127 of 137) and 88.00%, respectively, with 42.86% of the patients tolerating a regular diet. Patients with peritoneal carcinomatosis had lower odds of technical success (odds ratio [OR], .19; 95% confidence interval [CI], .04-.93). Obstruction at the level of stomach, compared with duodenum, had lower odds of clinical success (OR, .06; 95% CI, .006-.56). AE and reintervention rates were 14.17% and 8.66%. Nasogastric tube decompression before EUS-GE was associated with lower AE rates in multivariable analysis (OR, .32; 95% CI, .11-.95). Prior GI surgery was associated with reintervention in multivariable analysis (OR, 4.09; 95% CI, 1.02-16.45; <em>P</em> = .047).</div></div><div><h3>Conclusions</h3><div>EUS-GE has high technical and clinical success rates, with many patients tolerating a regular diet. Routine nasogastric tube decompression should be considered to minimize AEs. MGOO at the level of the stomach is associated with lower clinical success rates. Extra care should be taken while performing EUS-GE in patients with peritoneal carcinomatosis. Prior GI surgery is a likely risk factor for reintervention.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 580-588.e1"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of endoscopy in pregnancy: a review","authors":"Hadie Razjouyan MD, MPH,&nbsp;Jennifer L. Maranki MD, MSc, FASGE","doi":"10.1016/j.gie.2024.10.058","DOIUrl":"10.1016/j.gie.2024.10.058","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 520-526"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for readers","authors":"","doi":"10.1016/S0016-5107(25)00019-7","DOIUrl":"10.1016/S0016-5107(25)00019-7","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Page A16"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of recurrent pancreatitis: intraductal papillary mucinous neoplasm in the duct of Santorini (with video)","authors":"Peijing Bao MB,&nbsp;Guangchao Li MD,&nbsp;Ning Zhong MD,&nbsp;Yanqing Li MD,&nbsp;Peng Wang MD","doi":"10.1016/j.gie.2024.10.050","DOIUrl":"10.1016/j.gie.2024.10.050","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 679-680"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic scoring of immune-mediated colitis disease activity","authors":"Viktoria Bergqvist MD, PhD,&nbsp;Peter Gedeon MD, PhD,&nbsp;Erik Hertervig MD, PhD,&nbsp;Jan Marsal MD, PhD","doi":"10.1016/j.gie.2024.10.007","DOIUrl":"10.1016/j.gie.2024.10.007","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 695-696"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use patterns, technical challenges, and patient selection associated with single-use duodenoscopes and duodenoscopes with single-use endcaps in the United States and Canada","authors":"Monique T. Barakat MD, PhD ,&nbsp;Kelita Singh MD ,&nbsp;Mike Wei MD,&nbsp;Shai Friedland MD,&nbsp;Subhas Banerjee MD","doi":"10.1016/j.gie.2024.09.043","DOIUrl":"10.1016/j.gie.2024.09.043","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The extent of adoption, patient selection, and use patterns of single-use duodenoscopes and duodenoscopes with single-use endcaps have not yet been characterized, and large-scale assessments of endoscopist-reported function and challenges have not been reported.</div></div><div><h3>Methods</h3><div>An anonymous 6-minute electronic survey assessing use and experience with single-use duodenoscopes and duodenoscopes with novel design features was distributed to U.S. and Canadian endoscopy centers, and responses were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>The survey was notable for a 70.2% response rate, with representation from academic (68.9%), community (18%), and veterans affairs (8.2%) centers. Most institutions used standard reprocessable duodenoscopes and duodenoscopes with single-use endcaps (34.4%) or a mix of standard reprocessable duodenoscopes, duodenoscopes with single-use endcaps, and single-use duodenoscopes (29.5%). No center used only single-use duodenoscopes. Some institutions (10.3%) planned to transition to duodenoscopes with a single-use endcap, 10.3% to a mix of single-use duodenoscopes and duodenoscopes with a single-use endcap, and 1.7% to single-use duodenoscopes alone. Challenges were reported with each type of novel duodenoscope, and selection patterns for use were characterized.</div></div><div><h3>Conclusions</h3><div>This first of its kind, large-scale survey of use patterns and functionality of newly introduced duodenoscopes is notable for the fairly widespread use of duodenoscopes with single-use endcaps and more limited use of single-use duodenoscopes. Both novel duodenoscope designs are associated with mechanical limitations that respondents indicate represent challenges to successful completion of ERCPs.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 663-668"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}