Gastrointestinal endoscopy最新文献

英文中文

Pancreatic fluid collections in 3 dimensions: seeing is revealing 三维胰液收集：看到是有意义的

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-19 DOI: 10.1016/j.gie.2025.09.048

Field F. Willingham MD, MPH

引用次数: 0

Editors 编辑器

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-19 DOI: 10.1016/S0016-5107(25)02481-2

引用次数: 0

Long-term Outcomes of EUS-guided Gastroenterostomy (LONG-RANGE study): a prospective cohort study tracking symptom recurrence, reintervention timelines and stent modifications over time eus引导下胃肠造口术的长期结果（长期研究）：一项追踪症状复发、再干预时间线和支架修改的前瞻性队列研究

IF 7.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-17 DOI: 10.1016/j.gie.2026.01.007

Giuseppe Vanella, Francesco Frigo, Francesca Perelli, Rukaia Barà, Roberto Leone, Rosa Claudia Stasio, Patrick Maisonneuve, Stefano Partelli, Francesca Aleotti, Giulia Orsi, Marina Macchini, Gianpaolo Balzano, Michele Reni, Massimo Falconi, Gabriele Capurso, Paolo Giorgio Arcidiacono

引用次数: 0

Prospective cohort study of palliative treatment of esophageal cancer with liquid nitrogen spray cryotherapy 液氮喷雾冷冻治疗食管癌姑息性治疗的前瞻性队列研究

IF 7.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-17 DOI: 10.1016/j.gie.2025.12.291

Cary C. Cotton, Swathi Eluri, Vivek Kaul, Neil R. Sharma, Stuart R. Gordon, Toufic Kachaamy, George Smallfield, Jason Samarasena, Arvind Trindade, Field F. Willingham, Eugene Zolotarevsky, Jeremy Barber, Shivangi Kothari, Kenneth J. Chang, Petros Benias, Matthew J. McKinley, Arjun K. Juneja, Nicholas J. Shaheen

BACKGROUND AND AIMSPalliation of dysphagia associated with advanced esophageal cancer is challenging. Previous studies suggest liquid-nitrogen spray cryotherapy (LNSC) is effective to palliate obstructive esophageal cancer. We sought to prospectively examine the utility, safety, and efficacy of serial applications of repeated palliative LNSC in this population.METHODSWe performed a prospective cohort trial of LNSC for persistent esophageal cancer without the possibility of resection for palliation of obstructive symptoms. We used repeated measures and competing risks analyses to study the course of patients treated over two years. Efficacy of treatment was assessed using quality-of-life scores 14 days after treatment, using general cancer (QLQ-C30) and esophageal cancer-specific (QLQ-OES18) quality-of-life questionnaires, as well as ordinal dysphagia scores. Complications were assessed using structured interviews and classified according to Common Terminology Criteria.RESULTSOn repeated treatments, each participant (N = 49) improved their QLQ-C30 score by a mean 1.7 (95% confidence interval (CI) 0.1 - 3.3) and improved their QLQ-OES18 score by a mean 1.8 (95% CI 0.4-3.3). For each subsequent round of treatment, the effect improved 0.1 (95% CI 0.3-0.4) for the QLQ-C30 score and worsened -0.2 (95% CI -0.5 - 0.2) for QLQ-OES18 score. There was no signifcant improvement in the ordinal dysphagia score. 19 (39.6%) of 48 participants with a feedng tube at baseline required a feeding tube or stent at a mean of 8 months. While unrelated serious adverse events were common (38.8%), only two patients had events possibly related to LNSC (4.1%, melena and dysphagia).CONCLUSIONSSpray cryotherapy had a durable and repeatable benefit for palliation of obstructive symptoms of esophageal cancer and quality of life in the majority of patients, without the need for feeding tube or esophageal stent placement. Treatments were generally well-tolerated.

背景和目的晚期食管癌相关的吞咽困难的治疗具有挑战性。既往研究表明液氮喷雾冷冻治疗（LNSC）对缓解梗阻性食管癌是有效的。我们试图前瞻性地研究在这一人群中重复姑息性LNSC系列应用的实用性、安全性和有效性。方法：我们进行了一项前瞻性队列试验，采用LNSC治疗无法切除的持续性食管癌，以缓解梗阻性症状。我们使用重复测量和竞争风险分析来研究两年以上患者的治疗过程。采用治疗后14天的生活质量评分、一般癌症（QLQ-C30）和食管癌特异性（QLQ-OES18）生活质量问卷以及顺序吞咽困难评分来评估治疗效果。采用结构化访谈对并发症进行评估，并根据通用术语标准进行分类。结果在重复治疗中，每个参与者（N = 49）的QLQ-C30评分平均提高了1.7分（95%置信区间（CI） 0.1 ~ 3.3）， QLQ-OES18评分平均提高了1.8分（95% CI 0.4 ~ 3.3）。在随后的每一轮治疗中，QLQ-C30评分的效果提高了0.1 (95% CI 0.3-0.4)， QLQ-OES18评分的效果恶化了0.2 （95% CI -0.5 -0.2）。正常吞咽困难评分无明显改善。48名基线时使用饲管的患者中有19名（39.6%）在平均8个月时需要使用饲管或支架。虽然不相关的严重不良事件很常见（38.8%），但只有2例患者发生可能与LNSC相关的事件（4.1%，黑黑和吞咽困难）。结论喷雾冷冻治疗对于缓解食管癌梗阻性症状和改善大多数患者的生活质量具有持久和可重复的益处，无需置管或食管支架。治疗总体耐受良好。

{"title":"Prospective cohort study of palliative treatment of esophageal cancer with liquid nitrogen spray cryotherapy","authors":"Cary C. Cotton, Swathi Eluri, Vivek Kaul, Neil R. Sharma, Stuart R. Gordon, Toufic Kachaamy, George Smallfield, Jason Samarasena, Arvind Trindade, Field F. Willingham, Eugene Zolotarevsky, Jeremy Barber, Shivangi Kothari, Kenneth J. Chang, Petros Benias, Matthew J. McKinley, Arjun K. Juneja, Nicholas J. Shaheen","doi":"10.1016/j.gie.2025.12.291","DOIUrl":"https://doi.org/10.1016/j.gie.2025.12.291","url":null,"abstract":"BACKGROUND AND AIMSPalliation of dysphagia associated with advanced esophageal cancer is challenging. Previous studies suggest liquid-nitrogen spray cryotherapy (LNSC) is effective to palliate obstructive esophageal cancer. We sought to prospectively examine the utility, safety, and efficacy of serial applications of repeated palliative LNSC in this population.METHODSWe performed a prospective cohort trial of LNSC for persistent esophageal cancer without the possibility of resection for palliation of obstructive symptoms. We used repeated measures and competing risks analyses to study the course of patients treated over two years. Efficacy of treatment was assessed using quality-of-life scores 14 days after treatment, using general cancer (QLQ-C30) and esophageal cancer-specific (QLQ-OES18) quality-of-life questionnaires, as well as ordinal dysphagia scores. Complications were assessed using structured interviews and classified according to Common Terminology Criteria.RESULTSOn repeated treatments, each participant (N = 49) improved their QLQ-C30 score by a mean 1.7 (95% confidence interval (CI) 0.1 - 3.3) and improved their QLQ-OES18 score by a mean 1.8 (95% CI 0.4-3.3). For each subsequent round of treatment, the effect improved 0.1 (95% CI 0.3-0.4) for the QLQ-C30 score and worsened -0.2 (95% CI -0.5 - 0.2) for QLQ-OES18 score. There was no signifcant improvement in the ordinal dysphagia score. 19 (39.6%) of 48 participants with a feedng tube at baseline required a feeding tube or stent at a mean of 8 months. While unrelated serious adverse events were common (38.8%), only two patients had events possibly related to LNSC (4.1%, melena and dysphagia).CONCLUSIONSSpray cryotherapy had a durable and repeatable benefit for palliation of obstructive symptoms of esophageal cancer and quality of life in the majority of patients, without the need for feeding tube or esophageal stent placement. Treatments were generally well-tolerated.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"16 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995276","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}

引用次数: 0

EUS-guided ethanol lavage as a novel therapeutic modality for symptomatic simple renal cysts eus引导下乙醇灌洗治疗单纯性肾囊肿的新方法

IF 7.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-17 DOI: 10.1016/j.gie.2025.12.288

Yoonchan Lee, Raed Mohammed Alghazal, Sung Hyun Cho, Gunn Huh, Dongwook Oh, Tae Jun Song, Dong-Wan Seo

BACKGROUND AND AIMSEndoscopic ultrasound-guided ethanol lavage (EUS-EL) has not been evaluated for the treatment of symptomatic simple renal cysts. This study aimed to assess the feasibility, safety, and efficacy of EUS-EL.METHODSIn this pilot study conducted at a single center from March 2018 to October 2024, patients with radiologically confirmed simple renal cysts and relevant clinical indications underwent EUS-EL. Using a 19-gauge needle, cyst fluid was aspirated under real-time EUS guidance and replaced with 99% ethanol. Treatment outcomes included technical success, volume reduction on follow-up imaging, and adverse events.RESULTSFourteen patients with 20 renal cysts were enrolled. Most cysts were located in the left kidney (75%). The median baseline cyst volume was 127.0 mL (IQR, 63.4-215.1 mL), which decreased to 4.4 mL (IQR, 0.9-9.6 mL) at final follow-up, with a median volume reduction of 96.3%. Complete resolution (≥95% volume reduction) was achieved in 13 cysts (65.0%), partial resolution in 6 (30.0%), and 1 cyst (5.0%) showed persistent volume. Technical success was 100%, and no major complications occurred. One patient (7.1%) experienced a minor adverse event that was self-limiting.CONCLUSIONSEUS-EL appears technically feasible and safe for treating simple renal cysts, with preliminary results supporting further evaluation in larger prospective studies.

背景：超声引导下乙醇灌洗（EUS-EL）治疗单纯性肾囊肿的效果尚未得到评价。本研究旨在评估EUS-EL的可行性、安全性和有效性。方法本研究于2018年3月至2024年10月在单中心开展，对影像学证实单纯性肾囊肿且符合相关临床指征的患者行EUS-EL检查。在实时EUS引导下，使用19号针抽吸囊肿液，并用99%乙醇替代。治疗结果包括技术成功、随访成像体积减小和不良事件。结果14例肾囊肿患者共20例。大多数囊肿位于左肾（75%）。中位基线囊肿体积为127.0 mL (IQR, 63.4-215.1 mL)，最终随访时降至4.4 mL (IQR, 0.9-9.6 mL)，中位体积减少96.3%。13例（65.0%）囊肿完全溶解（体积缩小≥95%），6例（30.0%）囊肿部分溶解，1例（5.0%）囊肿体积持续存在。技术成功率100%，无重大并发症发生。1例患者（7.1%）出现了自限性的轻微不良事件。结论seus - el治疗单纯性肾囊肿在技术上可行且安全，初步结果支持在更大规模的前瞻性研究中进一步评估。

{"title":"EUS-guided ethanol lavage as a novel therapeutic modality for symptomatic simple renal cysts","authors":"Yoonchan Lee, Raed Mohammed Alghazal, Sung Hyun Cho, Gunn Huh, Dongwook Oh, Tae Jun Song, Dong-Wan Seo","doi":"10.1016/j.gie.2025.12.288","DOIUrl":"https://doi.org/10.1016/j.gie.2025.12.288","url":null,"abstract":"BACKGROUND AND AIMSEndoscopic ultrasound-guided ethanol lavage (EUS-EL) has not been evaluated for the treatment of symptomatic simple renal cysts. This study aimed to assess the feasibility, safety, and efficacy of EUS-EL.METHODSIn this pilot study conducted at a single center from March 2018 to October 2024, patients with radiologically confirmed simple renal cysts and relevant clinical indications underwent EUS-EL. Using a 19-gauge needle, cyst fluid was aspirated under real-time EUS guidance and replaced with 99% ethanol. Treatment outcomes included technical success, volume reduction on follow-up imaging, and adverse events.RESULTSFourteen patients with 20 renal cysts were enrolled. Most cysts were located in the left kidney (75%). The median baseline cyst volume was 127.0 mL (IQR, 63.4-215.1 mL), which decreased to 4.4 mL (IQR, 0.9-9.6 mL) at final follow-up, with a median volume reduction of 96.3%. Complete resolution (≥95% volume reduction) was achieved in 13 cysts (65.0%), partial resolution in 6 (30.0%), and 1 cyst (5.0%) showed persistent volume. Technical success was 100%, and no major complications occurred. One patient (7.1%) experienced a minor adverse event that was self-limiting.CONCLUSIONSEUS-EL appears technically feasible and safe for treating simple renal cysts, with preliminary results supporting further evaluation in larger prospective studies.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"47 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995275","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}

引用次数: 0

Computer Aided Polyp Detection Multi-center International Randomized Controlled Study with a Focus on Community Clinics: GAIN Clinical Trial 计算机辅助息肉检测多中心国际随机对照研究，重点是社区诊所：GAIN临床试验

IF 7.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-17 DOI: 10.1016/j.gie.2025.12.290

Cadman L. Leggett, R.Scooter Plowman, Lindsey Surace, Emmanuel Gorospe, Jesse Lachter, Dana Ben-Ami Shor, Keith Friedenberg, David A. Leiman, Simon Schlachter, Anil Patwardhan, Roman Goldenberg, Ehud Rivlin, Leera Choi, Nayantara Coelho-Prabhu, Tonya Kaltenbach, Michael Wallace

BACKGROUND/AIMSComputer-aided polyp detection (CADe) systems can enhance polyp detection, although their performance has largely been evaluated at academic rather than community practices. This randomized controlled trial evaluated the impact of the DEtection of Elusive Polyps (DEEP2) CADe system on colonoscopy quality metrics.METHODSParticipants undergoing routine colonoscopies were randomized to a control arm, standard-of-care high-definition white light endoscopy (HD-WLE), or an intervention arm, HD-WLE with real-time DEEP2 system assistance. Co-primary endpoints: adenomas per colonoscopy (APC; superiority evaluation at a 0.025 level of significance), and percent positive agreement (PPA, defined [per regulatory request] as the proportion of histologically-confirmed clinically-significant excised lesions relative to total lesions; non-inferiority evaluation with a lower 95% CI threshold of -10%). Secondary endpoints included: adenoma detection rate (ADR), polyp detection rate (PDR), polyps per colonoscopy (PPC), false positive rate (FPR), and false alarm rate (FAR).RESULTSThis study enrolled 1407 participants, most in community clinics (n=1208, 85.9%). Use of the DEEP2 system resulted in significantly higher APC (0.74 vs 0.60; difference, 0.14; P=0.0002). The PPA difference was -0.06 (95% CI, -0.15 - 0.03; P=0.09). There was a numerical, but not statistically significant, ADR improvement (42.9% vs 38.9%; P=0.031). A post-hoc analysis revealed significant benefit in APC and ADR with the DEEP2 system only within community clinics.CONCLUSIONSThese results support the incorporation of CADe devices into colonoscopy practice for improving efficacy and quality over standard-of-care, particularly in community practices.

计算机辅助息肉检测（CADe）系统可以增强息肉检测，尽管其性能在很大程度上是在学术上而不是社区实践中评估的。这项随机对照试验评估了探测难以捉摸的息肉（DEEP2） CADe系统对结肠镜检查质量指标的影响。方法接受常规结肠镜检查的参与者被随机分配到标准护理高清白光内窥镜（HD-WLE）对照组和实时DEEP2系统辅助的高清白光内窥镜干预组。共同主要终点：结肠镜下腺瘤（APC，优势评估为0.025显著性水平）和阳性一致性百分比（PPA，定义为[根据监管要求]组织学证实的临床显著切除病变相对于总病变的比例；非劣效性评估，95% CI阈值较低为-10%）。次要终点包括：腺瘤检出率（ADR）、息肉检出率（PDR）、每次结肠镜息肉率（PPC）、假阳性率（FPR）和虚警率（FAR）。结果本研究共纳入1407名受试者，大部分来自社区诊所（n=1208, 85.9%）。使用DEEP2系统可显著提高APC （0.74 vs 0.60；差异为0.14；P=0.0002）。PPA差异为-0.06 （95% CI, -0.15 - 0.03； P=0.09）。不良反应的改善（42.9% vs 38.9%； P=0.031）在数值上无统计学意义。事后分析显示，仅在社区诊所使用DEEP2系统在APC和ADR方面有显著的益处。结论：这些结果支持将CADe设备纳入结肠镜检查实践，以提高标准护理的疗效和质量，特别是在社区实践中。

{"title":"Computer Aided Polyp Detection Multi-center International Randomized Controlled Study with a Focus on Community Clinics: GAIN Clinical Trial","authors":"Cadman L. Leggett, R.Scooter Plowman, Lindsey Surace, Emmanuel Gorospe, Jesse Lachter, Dana Ben-Ami Shor, Keith Friedenberg, David A. Leiman, Simon Schlachter, Anil Patwardhan, Roman Goldenberg, Ehud Rivlin, Leera Choi, Nayantara Coelho-Prabhu, Tonya Kaltenbach, Michael Wallace","doi":"10.1016/j.gie.2025.12.290","DOIUrl":"https://doi.org/10.1016/j.gie.2025.12.290","url":null,"abstract":"BACKGROUND/AIMSComputer-aided polyp detection (CADe) systems can enhance polyp detection, although their performance has largely been evaluated at academic rather than community practices. This randomized controlled trial evaluated the impact of the DEtection of Elusive Polyps (DEEP2) CADe system on colonoscopy quality metrics.METHODSParticipants undergoing routine colonoscopies were randomized to a control arm, standard-of-care high-definition white light endoscopy (HD-WLE), or an intervention arm, HD-WLE with real-time DEEP2 system assistance. Co-primary endpoints: adenomas per colonoscopy (APC; superiority evaluation at a 0.025 level of significance), and percent positive agreement (PPA, defined [per regulatory request] as the proportion of histologically-confirmed clinically-significant excised lesions relative to total lesions; non-inferiority evaluation with a lower 95% CI threshold of -10%). Secondary endpoints included: adenoma detection rate (ADR), polyp detection rate (PDR), polyps per colonoscopy (PPC), false positive rate (FPR), and false alarm rate (FAR).RESULTSThis study enrolled 1407 participants, most in community clinics (n=1208, 85.9%). Use of the DEEP2 system resulted in significantly higher APC (0.74 vs 0.60; difference, 0.14; P=0.0002). The PPA difference was -0.06 (95% CI, -0.15 - 0.03; P=0.09). There was a numerical, but not statistically significant, ADR improvement (42.9% vs 38.9%; P=0.031). A post-hoc analysis revealed significant benefit in APC and ADR with the DEEP2 system only within community clinics.CONCLUSIONSThese results support the incorporation of CADe devices into colonoscopy practice for improving efficacy and quality over standard-of-care, particularly in community practices.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"10 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995277","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}

引用次数: 0

Fluoroscopy-free Direct Solitary Cholangioscopy versus Endoscopic Retrograde Cholangiography for Clearance of Noncomplex Biliary Stones: A Noninferiority Randomized Controlled Trial 无透视直接单独胆管镜检查与内镜逆行胆管造影清除非复杂胆结石：一项非劣效性随机对照试验

IF 7.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-17 DOI: 10.1016/j.gie.2025.12.283

Subhas Banerjee, Mahesh K. Goenka, Mohan Ramchandani, Raj J. Shah, Sundeep Lakhtakia, Wiriyaporn Ridtitid, Janak N. Shah, Nirav Thosani, Mihir S. Wagh, Guido Costamagna, Joyce A. Peetermans, Matthew J. Rousseau, Rungsun Rerknimitr

BACKGROUND & AIMSEndoscopic removal of noncomplex bile-duct stones is typically accomplished by endoscopic retrograde cholangiography (ERC), requiring fluoroscopy-associated radiation exposure. Fluoroscopy exposure must be limited or is unavailable for some high-risk patients. We conducted a direct comparison of efficacy and safety of ERC versus fluoroscopy-free direct solitary cholangioscopy (DSC) for noncomplex bile-duct stone removal.METHODSEligible patients were aged 18 years or older with noncomplex common-bile-duct or common-hepatic-duct stones. The primary outcome was complete stone clearance by ERC, validated by DSC; or by fluoroscopy-free DSC, validated by ERC. Secondary outcomes included 1) radiation exposure to the patient, 2) procedure duration, 3) device- or procedure-related serious adverse events (SAEs) reported by 30 days.RESULTSOf 250 patients randomized, 126 were assigned to ERC and 124 to DSC. Mean age was 52.0 years, and 100 (40.0%) patients were male. On an intention-to-treat basis, complete stone clearance was achieved in 112 (88.9%) of patients by ERC, and in 108 (87.1%) by fluoroscopy-free DSC (between-group difference, 1.8%; one-sided upper limit of 95% confidence interval, 8.9%; noninferiority margin 10.0%; P=0.029 for noninferiority). For ERC versus DSC, median dose area product was 2106 versus 0 Gy.cm2 and median index procedure duration was 11.9 versus 22.1 minutes, respectively. Procedure-related SAEs occurred in 5 (4.0%) ERC patients and 7 (5.6%) DSC patients.CONCLUSIONClearance rates of noncomplex biliary stones and rates of SAEs were comparable for ERC versus fluoroscopy-free DSC, with lower exposure to fluoroscopy-associated radiation during DSC. (ClinicalTrials.gov no. NCT03421340).

背景和目的内镜下非复杂性胆管结石的切除通常通过内镜逆行胆管造影（ERC）完成，需要透视相关的辐射暴露。必须限制透视暴露，或者对一些高危患者不能透视。我们直接比较了ERC与无透视直接单独胆管镜（DSC）在非复杂胆管结石清除中的疗效和安全性。方法18岁及以上非复杂性胆总管结石或肝总管结石患者。主要终点是ERC完全清除结石，DSC验证；或通过ERC验证的无透视DSC。次要结局包括1)患者的辐射暴露，2)手术持续时间，3)30天内报告的与器械或手术相关的严重不良事件（SAEs）。结果在250例随机患者中，126例被分配到ERC， 124例被分配到DSC。平均年龄52.0岁，男性100例（40.0%）。在意向治疗基础上，112例（88.9%）患者通过ERC完全清除结石，108例（87.1%）患者通过无透视DSC（组间差异为1.8%；95%置信区间的单侧上限为8.9%；非劣效性边际为10.0%；非劣效性P=0.029）。ERC和DSC的中位剂量面积积分别为2106 Gy和0 Gy。Cm2和中位指数手术时间分别为11.9分钟和22.1分钟。5例（4.0%）ERC患者和7例（5.6%）DSC患者发生手术相关的SAEs。结论ERC与无透视DSC的非复杂胆结石清除率和SAEs率相当，DSC期间透视相关辐射暴露更低。(ClinicalTrials.gov没有。NCT03421340)。

{"title":"Fluoroscopy-free Direct Solitary Cholangioscopy versus Endoscopic Retrograde Cholangiography for Clearance of Noncomplex Biliary Stones: A Noninferiority Randomized Controlled Trial","authors":"Subhas Banerjee, Mahesh K. Goenka, Mohan Ramchandani, Raj J. Shah, Sundeep Lakhtakia, Wiriyaporn Ridtitid, Janak N. Shah, Nirav Thosani, Mihir S. Wagh, Guido Costamagna, Joyce A. Peetermans, Matthew J. Rousseau, Rungsun Rerknimitr","doi":"10.1016/j.gie.2025.12.283","DOIUrl":"https://doi.org/10.1016/j.gie.2025.12.283","url":null,"abstract":"BACKGROUND & AIMSEndoscopic removal of noncomplex bile-duct stones is typically accomplished by endoscopic retrograde cholangiography (ERC), requiring fluoroscopy-associated radiation exposure. Fluoroscopy exposure must be limited or is unavailable for some high-risk patients. We conducted a direct comparison of efficacy and safety of ERC versus fluoroscopy-free direct solitary cholangioscopy (DSC) for noncomplex bile-duct stone removal.METHODSEligible patients were aged 18 years or older with noncomplex common-bile-duct or common-hepatic-duct stones. The primary outcome was complete stone clearance by ERC, validated by DSC; or by fluoroscopy-free DSC, validated by ERC. Secondary outcomes included 1) radiation exposure to the patient, 2) procedure duration, 3) device- or procedure-related serious adverse events (SAEs) reported by 30 days.RESULTSOf 250 patients randomized, 126 were assigned to ERC and 124 to DSC. Mean age was 52.0 years, and 100 (40.0%) patients were male. On an intention-to-treat basis, complete stone clearance was achieved in 112 (88.9%) of patients by ERC, and in 108 (87.1%) by fluoroscopy-free DSC (between-group difference, 1.8%; one-sided upper limit of 95% confidence interval, 8.9%; noninferiority margin 10.0%; P=0.029 for noninferiority). For ERC versus DSC, median dose area product was 2106 versus 0 Gy.cm2 and median index procedure duration was 11.9 versus 22.1 minutes, respectively. Procedure-related SAEs occurred in 5 (4.0%) ERC patients and 7 (5.6%) DSC patients.CONCLUSIONClearance rates of noncomplex biliary stones and rates of SAEs were comparable for ERC versus fluoroscopy-free DSC, with lower exposure to fluoroscopy-associated radiation during DSC. (ClinicalTrials.gov no. NCT03421340).","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"30 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995274","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}

引用次数: 0

CLINICAL RESPONSE TO GASTRIC PERORAL ENDOSCOPIC MYOTOMY AND ITS ASSOCIATION TO CHANGES IN PYLORIC IMPEDANCE PLANIMETRY MEASUREMENTS: A SYSTEMATIC REVIEW AND META ANALYSIS 经口胃镜下肌切开术的临床反应及其与幽门阻抗平面测量变化的关系：一项系统综述和荟萃分析

IF 7.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-16 DOI: 10.1016/j.gie.2026.01.008

Harsimran Kalsi, Saurabh Chandan, Jay Bapaye, Babu P. Mohan, Abdullah Abbasi, Sagar Pathak, Ernesto Robalino Gonzaga, Deepanshu Jain, Natalie D. Cosgrove, Kambiz S. Kadkhodayan, Mustafa A. Arain, Muhammad K. Hasan, Maham Hayat, Dennis Yang

引用次数: 0

The 2025 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board 2025年医学出版十大内窥镜主题：美国胃肠内窥镜学会编辑委员会的年度审查

IF 7.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-14 DOI: 10.1016/j.gie.2026.01.005

Melissa Martinez, Lara Dakhoul, Mahesh Kumar Goenka, Victoria Gomez, Lyndon V. Hernandez, Dennis Jensen, Inessa Khaykis, Luis F. Lara, Micheal Tadros, Edward Villa, John R. Saltzman

引用次数: 0

ASGE consensus recommendations on the endoscopic management of eosinophilic esophagitis - part 2: disease assessment, monitoring, and pediatric considerations. ASGE关于嗜酸性粒细胞性食管炎内镜治疗的共识建议-第2部分：疾病评估、监测和儿科注意事项

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2026-01-08 DOI: 10.1016/j.gie.2025.10.032

Evan S Dellon, Gary W Falk, David A Katzka, Jenifer Lightdale, Amanda B Muir, Albert J Bredenoord, Dominique D Bailey, Joy W Chang, Glenn T Furuta, Nirmala Gonsalves, Thomas Greuter, Sandeep K Gupta, Girish Hiremath, Jennifer L Horsley-Silva, Alfredo J Lucendo, Kristle L Lynch, Calies Menard-Katcher, Fouad Moawad, Salvatore Oliva, Kathryn A Peterson, Hamish Philpott, Philip E Putnam, Alain M Schoepfer, Diana L Snyder, Alex Straumann, Josh B Wechsler, Prateek Sharma

Esophagogastroduodenoscopy is essential to evaluate symptoms of suspected eosinophilic esophagitis (EoE), assess endoscopic findings, obtain biopsy specimens for histopathologic evaluation, perform esophageal dilation, confirm the diagnosis, and monitor the condition. The American Society for Gastrointestinal Endoscopy (ASGE) previously provided consensus recommendations on the approach to endoscopy in EoE across topics of endoscopic diagnosis, endoscopic grading, and esophageal dilation. Because additional areas of endoscopy still required guidance, we performed an independent modified Delphi process focusing on pediatric considerations, disease assessment, and disease monitoring. A core group of EoE experts reviewed published guidelines and developed a set of patient-centered recommendation statements informed by literature review. A multidisciplinary group of adult and pediatric international EoE experts then voted on the statements over 2 Delphi rounds. All statements with 80% agreement were accepted for inclusion. This process yielded 28 consensus statements. Pediatric-specific statements covered when to suspect EoE and perform endoscopy, how to grade endoscopic severity, and when and how to perform esophageal dilation in children. Statements across all age ranges addressed the role of less-invasive monitoring, performing diagnostic endoscopy off treatment, the need to consider symptoms, endoscopic features, and histologic findings when assessing disease activity, treatment-based monitoring intervals, and the approach to esophageal biopsies during monitoring. Coupled with the original consensus work, we provide a comprehensive endoscopic approach to EoE as well as practical guidance for procedure-related aspects in the field to facilitate high-quality endoscopic care to patients with EoE.

食管胃十二指肠镜检查对于评估疑似嗜酸性粒细胞性食管炎（EoE）的症状、评估内镜检查结果、获得活检标本进行组织病理学评估、进行食管扩张、确认诊断和监测病情至关重要。美国胃肠内窥镜学会（ASGE）此前就内镜诊断、内镜分级和食管扩张的内镜治疗方法提供了共识建议。由于内窥镜检查的其他领域仍然需要指导，我们执行了一个独立的修改德尔菲过程，重点关注儿科考虑、疾病评估和疾病监测。EoE专家核心小组审查了已发表的指南，并通过文献综述制定了一套以患者为中心的推荐声明。一个由成人和儿童国际EoE专家组成的多学科小组随后对两轮德尔菲的陈述进行了投票。所有符合80%的陈述均被接受纳入。这一进程产生了28项协商一致声明。儿科特定陈述包括何时怀疑EoE并进行内窥镜检查，如何对内窥镜严重程度进行分级，以及何时以及如何对儿童进行食管扩张。所有年龄段的人都讨论了微创监测的作用，治疗后进行诊断性内窥镜检查，在评估疾病活动性时考虑症状、内窥镜特征和组织学发现的必要性，基于治疗的监测间隔，以及监测期间食管活检的方法。结合最初的共识工作，我们提供了一个全面的内镜下治疗EoE的方法，以及该领域手术相关方面的实用指导，以促进对EoE患者的高质量内镜护理。

{"title":"ASGE consensus recommendations on the endoscopic management of eosinophilic esophagitis - part 2: disease assessment, monitoring, and pediatric considerations.","authors":"Evan S Dellon, Gary W Falk, David A Katzka, Jenifer Lightdale, Amanda B Muir, Albert J Bredenoord, Dominique D Bailey, Joy W Chang, Glenn T Furuta, Nirmala Gonsalves, Thomas Greuter, Sandeep K Gupta, Girish Hiremath, Jennifer L Horsley-Silva, Alfredo J Lucendo, Kristle L Lynch, Calies Menard-Katcher, Fouad Moawad, Salvatore Oliva, Kathryn A Peterson, Hamish Philpott, Philip E Putnam, Alain M Schoepfer, Diana L Snyder, Alex Straumann, Josh B Wechsler, Prateek Sharma","doi":"10.1016/j.gie.2025.10.032","DOIUrl":"https://doi.org/10.1016/j.gie.2025.10.032","url":null,"abstract":"<p><p>Esophagogastroduodenoscopy is essential to evaluate symptoms of suspected eosinophilic esophagitis (EoE), assess endoscopic findings, obtain biopsy specimens for histopathologic evaluation, perform esophageal dilation, confirm the diagnosis, and monitor the condition. The American Society for Gastrointestinal Endoscopy (ASGE) previously provided consensus recommendations on the approach to endoscopy in EoE across topics of endoscopic diagnosis, endoscopic grading, and esophageal dilation. Because additional areas of endoscopy still required guidance, we performed an independent modified Delphi process focusing on pediatric considerations, disease assessment, and disease monitoring. A core group of EoE experts reviewed published guidelines and developed a set of patient-centered recommendation statements informed by literature review. A multidisciplinary group of adult and pediatric international EoE experts then voted on the statements over 2 Delphi rounds. All statements with 80% agreement were accepted for inclusion. This process yielded 28 consensus statements. Pediatric-specific statements covered when to suspect EoE and perform endoscopy, how to grade endoscopic severity, and when and how to perform esophageal dilation in children. Statements across all age ranges addressed the role of less-invasive monitoring, performing diagnostic endoscopy off treatment, the need to consider symptoms, endoscopic features, and histologic findings when assessing disease activity, treatment-based monitoring intervals, and the approach to esophageal biopsies during monitoring. Coupled with the original consensus work, we provide a comprehensive endoscopic approach to EoE as well as practical guidance for procedure-related aspects in the field to facilitate high-quality endoscopic care to patients with EoE.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932451","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Gastrointestinal endoscopy

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀