Techniques and Innovations in Gastrointestinal Endoscopy最新文献

英文中文

Endoscopic Band Ligation With Sclerotherapy Versus Milligan–Morgan Hemorrhoidectomy for the Treatment of Mixed Hemorrhoids 治疗混合痔的内窥镜带状结扎术和硬化疗法与米利根-摩根痔疮切除术的比较

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2025.250914

Minghua Ai , Weizheng Wang , Jie Li , Xiaoping Tan , Qing Zhang

BACKGROUND AND AIMS

To compare the clinical efficacy of endoscopic band ligation with sclerotherapy (EBS) with that of Milligan–Morgan hemorrhoidectomy (MMH) in the treatment of mixed hemorrhoids.

METHODS

This study was a retrospective, single-center investigation conducted at the First Hospital of Yangtze University. From September 2022 to March 2023, 46 patients who underwent EBS for mixed hemorrhoids were selected in an observation group, whereas 32 patients who underwent MMH for mixed hemorrhoids were allocated to a control group. Surgical-related parameters and adverse events were compared between the 2 groups, and the relationship between the number of endoscopic bands used and pain levels was analyzed.

RESULTS

The observation group demonstrated significantly shorter surgical and hospitalization durations than the control group (P < 0.05). Furthermore, the 2 groups showed decreased postoperative visual analog scale scores, with the observation group exhibiting consistently lower scores at 24 hours, 48 hours, and 1 week postoperatively (P < 0.05). Additionally, visual analog scale scores in the observation group at 4 hour postsurgery were correlated with the number of endoscopic ligation bands applied (R² = 0.1253; P = 0.0158). No significant differences in postoperative anal swelling, overall efficacy, or patient satisfaction were observed between the 2 groups (all P > 0.05). However, the observation group experienced significantly less intraoperative (0% vs 84.4%; P = 0.000) and postoperative bleeding (6.5% vs 34.4%; P = 0.002) and a lower postoperative infection rate (0% vs 9.4%; P = 0.034) than the control group.

CONCLUSION

EBS provides clinical efficacy comparable with that of MMH in the treatment of mixed hemorrhoids. Moreover, the EBS approach is a potentially less invasive and shorter surgical procedure with relatively reduced hospitalization time, lower complication risk, and faster recovery.

背景和目的比较内镜下带状结扎联合硬化剂注射（EBS）与米利根-摩根痔切除术（MMH）治疗混合痔的临床疗效。自2022年9月至2023年3月，46名接受EBS治疗混合痔的患者被选入观察组，32名接受MMH治疗混合痔的患者被分配到对照组。结果观察组的手术时间和住院时间明显短于对照组（P <0.05）。此外，两组的术后视觉模拟量表评分均有所下降，观察组在术后 24 小时、48 小时和 1 周的评分持续较低（P < 0.05）。此外，观察组在术后 4 小时的视觉模拟量表评分与使用的内窥镜结扎带数量相关（R2 = 0.1253；P = 0.0158）。两组患者在术后肛门肿胀、总体疗效或患者满意度方面无明显差异（均为 P > 0.05）。然而，观察组的术中出血量（0% vs 84.4%；P = 0.000）和术后出血量（6.5% vs 34.4%；P = 0.002）明显少于对照组，术后感染率（0% vs 9.4%；P = 0.034）也低于对照组。此外，EBS 方法可能是一种创伤更小、时间更短的手术方法，住院时间相对缩短，并发症风险更低，恢复更快。

{"title":"Endoscopic Band Ligation With Sclerotherapy Versus Milligan–Morgan Hemorrhoidectomy for the Treatment of Mixed Hemorrhoids","authors":"Minghua Ai , Weizheng Wang , Jie Li , Xiaoping Tan , Qing Zhang","doi":"10.1016/j.tige.2025.250914","DOIUrl":"10.1016/j.tige.2025.250914","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>To compare the clinical efficacy of endoscopic band ligation with sclerotherapy (EBS) with that of Milligan–Morgan hemorrhoidectomy (MMH) in the treatment of mixed hemorrhoids.</div></div><div><h3>METHODS</h3><div>This study was a retrospective, single-center investigation conducted at the First Hospital of Yangtze University. From September 2022 to March 2023, 46 patients who underwent EBS for mixed hemorrhoids were selected in an observation group, whereas 32 patients who underwent MMH for mixed hemorrhoids were allocated to a control group. Surgical-related parameters and adverse events were compared between the 2 groups, and the relationship between the number of endoscopic bands used and pain levels was analyzed.</div></div><div><h3>RESULTS</h3><div>The observation group demonstrated significantly shorter surgical and hospitalization durations than the control group (<em>P <</em> 0.05). Furthermore, the 2 groups showed decreased postoperative visual analog scale scores, with the observation group exhibiting consistently lower scores at 24 hours, 48 hours, and 1 week postoperatively (<em>P <</em> 0.05). Additionally, visual analog scale scores in the observation group at 4 hour postsurgery were correlated with the number of endoscopic ligation bands applied (<em>R</em><sup>2</sup> = 0.1253; <em>P</em> = 0.0158). No significant differences in postoperative anal swelling, overall efficacy, or patient satisfaction were observed between the 2 groups (all <em>P ></em> 0.05). However, the observation group experienced significantly less intraoperative (0% vs 84.4%; <em>P</em> = 0.000) and postoperative bleeding (6.5% vs 34.4%; <em>P</em> = 0.002) and a lower postoperative infection rate (0% vs 9.4%; <em>P</em> = 0.034) than the control group.</div></div><div><h3>CONCLUSION</h3><div>EBS provides clinical efficacy comparable with that of MMH in the treatment of mixed hemorrhoids. Moreover, the EBS approach is a potentially less invasive and shorter surgical procedure with relatively reduced hospitalization time, lower complication risk, and faster recovery.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250914"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

International Survey Assessing Gender Disparities in Advanced Therapeutic Endoscopy

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2025.250917

Katarzyna M. Pawlak , Kareem Khalaf , Erin Brennand , Andrei Voiosu , Theodor Voiosu , Giulio Antonelli , Sharan B. Malipatil , Caleb Na , Ahmed H. Mokhtar , Balqis Alabdulkarim , Maryam Mahjoob , Arjun Kundra , Jeanin van Hooft , Uzma Siddiqui , Roberta Maselli , Jeffrey D. Mosko , Jennifer Telford , Nauzer Forbes , Natalia Causada Calo

BACKGROUND AND AIMS

Underrepresentation of women in advanced therapeutic endoscopy is a multifactorial issue. We aim to evaluate the concerns about fluoroscopy use across genders and assess its impact on the representation of women in advanced therapeutic endoscopy.

METHODS

An international survey was distributed in August of 2023 to endoscopic retrograde cholangiopancreatography (ERCP)–performing physicians. The primary outcome was the frequency of concerns related to fluoroscopy exposure. Secondary outcomes included the reasons or implication of these concerns. Subgroup analyses were performed across gender.

RESULTS

ERCP-performing physicians revealed a gender disparity in therapeutic endoscopy, with 72.8% male respondents and 27.2% female respondents. Most participants were staff (67.6%), predominantly men (70.6%). The average age was 38.2 years, with a median institutional ERCP volume of 550 cases. Awareness of fluoroscopy safety standards was 56.1%, but only 51.6% received formal training. Concerns about radiation included cancer risk (73.4%) and fertility (43.9%). Usage of protective equipment was inadequate: thyroid dosimeters (21.9% always used), pelvic dosimeters (13.1%), and leaded goggles (8.4%). Female respondents specifically noted delayed family planning (27.6%) and fear of working while pregnant (40.4%), whereas male respondents focused on general health risks. Additionally, 68.4% of institutions recorded fluoroscopy time, but only 56.1% reported dosimeter use.

CONCLUSION

Gender disparities in fluoroscopy exposure concerns warrant the need for improved training and safety standards to foster equity in therapeutic endoscopy. Addressing these issues through targeted education and policy changes will not only enhance awareness of radiation risks but also promote a more inclusive environment for both male and female practitioners.

{"title":"International Survey Assessing Gender Disparities in Advanced Therapeutic Endoscopy","authors":"Katarzyna M. Pawlak , Kareem Khalaf , Erin Brennand , Andrei Voiosu , Theodor Voiosu , Giulio Antonelli , Sharan B. Malipatil , Caleb Na , Ahmed H. Mokhtar , Balqis Alabdulkarim , Maryam Mahjoob , Arjun Kundra , Jeanin van Hooft , Uzma Siddiqui , Roberta Maselli , Jeffrey D. Mosko , Jennifer Telford , Nauzer Forbes , Natalia Causada Calo","doi":"10.1016/j.tige.2025.250917","DOIUrl":"10.1016/j.tige.2025.250917","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Underrepresentation of women in advanced therapeutic endoscopy is a multifactorial issue. We aim to evaluate the concerns about fluoroscopy use across genders and assess its impact on the representation of women in advanced therapeutic endoscopy.</div></div><div><h3>METHODS</h3><div>An international survey was distributed in August of 2023 to endoscopic retrograde cholangiopancreatography (ERCP)–performing physicians. The primary outcome was the frequency of concerns related to fluoroscopy exposure. Secondary outcomes included the reasons or implication of these concerns. Subgroup analyses were performed across gender.</div></div><div><h3>RESULTS</h3><div>ERCP-performing physicians revealed a gender disparity in therapeutic endoscopy, with 72.8% male respondents and 27.2% female respondents. Most participants were staff (67.6%), predominantly men (70.6%). The average age was 38.2 years, with a median institutional ERCP volume of 550 cases. Awareness of fluoroscopy safety standards was 56.1%, but only 51.6% received formal training. Concerns about radiation included cancer risk (73.4%) and fertility (43.9%). Usage of protective equipment was inadequate: thyroid dosimeters (21.9% always used), pelvic dosimeters (13.1%), and leaded goggles (8.4%). Female respondents specifically noted delayed family planning (27.6%) and fear of working while pregnant (40.4%), whereas male respondents focused on general health risks. Additionally, 68.4% of institutions recorded fluoroscopy time, but only 56.1% reported dosimeter use.</div></div><div><h3>CONCLUSION</h3><div>Gender disparities in fluoroscopy exposure concerns warrant the need for improved training and safety standards to foster equity in therapeutic endoscopy. Addressing these issues through targeted education and policy changes will not only enhance awareness of radiation risks but also promote a more inclusive environment for both male and female practitioners.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250917"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Traction-Assisted Endoscopic Submucosal Dissection of Colonic Lesions: A North American Experience

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2024.250900

Farid Abushamat, Fares Ayoub, Mai A. Khalaf, Tara Keihanian, Salmaan Jawaid, Mohamed O. Othman

BACKGROUND AND AIMS

Traction-assisted endoscopic submucosal dissection (TA-ESD) is a proposed technique to improve the efficiency of endoscopic submucosal dissection (ESD). Multiple studies primarily from Asian centers yielded mixed results in terms of procedure time, en bloc resection rate, and R0 resection rate of TA-ESD in comparison with those of conventional endoscopic submucosal dissection (C-ESD). We performed the first comparison of TA-ESD with C-ESD at a high-volume North American center.

METHODS

This was a retrospective cohort-matched study of all patients who underwent colonic ESD at a single center in the United States by a single operator. The study group were patients who underwent TA-ESD and were matched with a C-ESD case on a 1:1 basis based upon location within the colon, lesion size, and scope stabilization device usage. The baseline characteristics and procedure-related outcomes were compared between the groups.

RESULTS

In total, 138 colonic ESD cases were included (69 TA-ESD and 69 C-ESD). There were no significant differences in the baseline characteristics between the groups. Mean procedure time was 91.0 minutes (SD: 32.5) for TA-ESD and 85.4 minutes (SD: 39.3) for C-ESD (P = 0.36). En bloc resection was achieved in 69 (100%) of the TA-ESDs and 67 (97.1%) of the C-ESDs (P = 0.15). R0 resection was achieved in 52 (75.4%) of the TA-ESDs and 48 (69.6%) of the C-ESDs (P = 0.45).

CONCLUSION

We did not show a significant difference in procedure time, en bloc resection, R0 resection, or adverse events. Further randomized prospective studies that are sufficiently powered and stratified by operator experience level are needed to further elucidate the utility of the technique.

{"title":"Traction-Assisted Endoscopic Submucosal Dissection of Colonic Lesions: A North American Experience","authors":"Farid Abushamat, Fares Ayoub, Mai A. Khalaf, Tara Keihanian, Salmaan Jawaid, Mohamed O. Othman","doi":"10.1016/j.tige.2024.250900","DOIUrl":"10.1016/j.tige.2024.250900","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Traction-assisted endoscopic submucosal dissection (TA-ESD) is a proposed technique to improve the efficiency of endoscopic submucosal dissection (ESD). Multiple studies primarily from Asian centers yielded mixed results in terms of procedure time, en bloc resection rate, and R0 resection rate of TA-ESD in comparison with those of conventional endoscopic submucosal dissection (C-ESD). We performed the first comparison of TA-ESD with C-ESD at a high-volume North American center.</div></div><div><h3>METHODS</h3><div>This was a retrospective cohort-matched study of all patients who underwent colonic ESD at a single center in the United States by a single operator. The study group were patients who underwent TA-ESD and were matched with a C-ESD case on a 1:1 basis based upon location within the colon, lesion size, and scope stabilization device usage. The baseline characteristics and procedure-related outcomes were compared between the groups.</div></div><div><h3>RESULTS</h3><div>In total, 138 colonic ESD cases were included (69 TA-ESD and 69 C-ESD). There were no significant differences in the baseline characteristics between the groups. Mean procedure time was 91.0 minutes (SD: 32.5) for TA-ESD and 85.4 minutes (SD: 39.3) for C-ESD (<em>P</em> = 0.36). En bloc resection was achieved in 69 (100%) of the TA-ESDs and 67 (97.1%) of the C-ESDs (<em>P</em> = 0.15). R0 resection was achieved in 52 (75.4%) of the TA-ESDs and 48 (69.6%) of the C-ESDs (<em>P</em> = 0.45).</div></div><div><h3>CONCLUSION</h3><div>We did not show a significant difference in procedure time, en bloc resection, R0 resection, or adverse events. Further randomized prospective studies that are sufficiently powered and stratified by operator experience level are needed to further elucidate the utility of the technique.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250900"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reopenable Clip-Over-the-Line Method for Troubleshooting Iatrogenic Gastrointestinal Perforations

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2024.250901

Takeshi Yasuda, Narutoshi Ando, Tamae Hashimoto, Yoshiaki Kanai, Yoichi Sakamoto, Yuki Endo, Tomohiro Soda, Takako Akazawa, Tsuguhiro Matsumoto, Norihito Yamauchi, Akira Muramatsu, Hiromu Kutsumi

引用次数: 0

Understanding Patients’ Current Acceptability of Artificial Intelligence During Colonoscopy for Polyp Detection: A Single-Center Study

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2024.250905

Kathryn A. Schmidt , Shubham Sood , Saam Dilmaghani , Cadman Leggett , Ross Dierkhising , Mayank Goyal , Barbara A. Barry , Xuan Zhu , Nayantara Coelho-Prabhu

BACKGROUND AND AIMS

Research into potential applications of artificial intelligence (AI) in healthcare have witnessed a meteoric rise. A primary application in gastroenterological care is colonoscopy. Before AI tools become ubiquitous in healthcare, it is critical to appreciate the perspective of the potential beneficiaries, particularly patients. This study evaluated patient acceptability of AI in colonoscopy, particularly for polyp detection and diagnosis.

METHODS

In this cross-sectional survey study, patients undergoing outpatient colon cancer screening or surveillance colonoscopies at Mayo Clinic, Rochester, from September 2023 to February 2024 completed an electronic self-administered survey via tablet computer including questions regarding AI in colonoscopy. The primary outcome was patient perspectives on AI, and secondary outcomes included patient factors influencing their perspective. Statistical analyses were performed using Pearson's chi-square test and ordinal logistic regression.

RESULTS

Five hundred eight participants completed the survey. Younger age, male gender, and higher education were associated with higher AI familiarity and perceived importance, while males and those who believed in AI's positive outcomes were more comfortable with AI-assisted polyp detection.

CONCLUSION

This study is the first to assess patient perceptions of AI in colonoscopy. While patients generally believe AI can improve health outcomes, there is uncertainty about its current use, indicating a gap in knowledge and awareness. Key findings highlight that beliefs in AI's efficacy are linked to increased comfort with AI-assisted procedures, with significant demographic variations in perceptions, particularly across gender, age, and education. Addressing disparities through targeted education and transparent communication is crucial for fostering patient acceptance and trust in AI-assisted colonoscopy.

{"title":"Understanding Patients’ Current Acceptability of Artificial Intelligence During Colonoscopy for Polyp Detection: A Single-Center Study","authors":"Kathryn A. Schmidt , Shubham Sood , Saam Dilmaghani , Cadman Leggett , Ross Dierkhising , Mayank Goyal , Barbara A. Barry , Xuan Zhu , Nayantara Coelho-Prabhu","doi":"10.1016/j.tige.2024.250905","DOIUrl":"10.1016/j.tige.2024.250905","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Research into potential applications of artificial intelligence (AI) in healthcare have witnessed a meteoric rise. A primary application in gastroenterological care is colonoscopy. Before AI tools become ubiquitous in healthcare, it is critical to appreciate the perspective of the potential beneficiaries, particularly patients. This study evaluated patient acceptability of AI in colonoscopy, particularly for polyp detection and diagnosis.</div></div><div><h3>METHODS</h3><div>In this cross-sectional survey study, patients undergoing outpatient colon cancer screening or surveillance colonoscopies at Mayo Clinic, Rochester, from September 2023 to February 2024 completed an electronic self-administered survey via tablet computer including questions regarding AI in colonoscopy. The primary outcome was patient perspectives on AI, and secondary outcomes included patient factors influencing their perspective. Statistical analyses were performed using Pearson's chi-square test and ordinal logistic regression.</div></div><div><h3>RESULTS</h3><div>Five hundred eight participants completed the survey. Younger age, male gender, and higher education were associated with higher AI familiarity and perceived importance, while males and those who believed in AI's positive outcomes were more comfortable with AI-assisted polyp detection.</div></div><div><h3>CONCLUSION</h3><div>This study is the first to assess patient perceptions of AI in colonoscopy. While patients generally believe AI can improve health outcomes, there is uncertainty about its current use, indicating a gap in knowledge and awareness. Key findings highlight that beliefs in AI's efficacy are linked to increased comfort with AI-assisted procedures, with significant demographic variations in perceptions, particularly across gender, age, and education. Addressing disparities through targeted education and transparent communication is crucial for fostering patient acceptance and trust in AI-assisted colonoscopy.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250905"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic Ultrasound-guided Biliary Interventions

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2025.250916

Hiroyuki Isayama, Ko Tomishima, Shigeto Ishii, Yusuke Takasaki, Mako Ushio, Toshio Fujisawa

Endosonographic/endoscopic ultrasound–guided biliary drainage/anastomosis (EUS-BD/A) is widely accepted as a salvage procedure when conventional endoscopic retrograde cholangiopancreatography (ERCP) fails or is difficult. Although this procedure carries risks of severe adverse events (AEs), including perforation and bile leakage due to unattached organs, the risk of postprocedural pancreatitis in EUS-BD/A is extremely low. The intrahepatic bile duct approach is more challenging than extrahepatic because it involves penetrating the liver parenchyma. To establish EUS-BD/A as a standard primary biliary drainage procedure, it is essential to confirm its feasibility compared with ERCP, evaluate expanded indications, develop dedicated devices, and establish AE management strategies. EUS-BD/A showed similar technical and clinical success rates and AE rates, with ERCP and incidence of pancreatitis was significantly lower. Expanded indications for EUS-BD/A include primary drainage, preoperative use, pediatric patients, patients with massive ascites, and reintervention for stent occlusion; however, further evidence is required to support these indications. The development of devices to improve technical success and reduce AE rates is critical to establishing this procedure, but current devices remain insufficient for EUS-BD/A. In Japan, dedicated devices for EUS-BD/A include sharp-tip bougie dilators, drill-type dilators, sharp-tip balloon dilators, and covered self-expandable metallic stents with effective anchoring. Reducing the gap between the device and guidewire is particularly important for endosonographic/endoscopic ultrasound–guided hepaticogastrostomy. Management of AEs and the establishment of follow-up strategies are crucial as well. We herein summarize the prevention and management of AEs, including mediastinitis due to esophageal puncture, bile leakage, bleeding, and perforation, and introduce our follow-up strategy. Our ultimate goal is to establish EUS-BD/A as a standard primary biliary drainage procedure. Continuous efforts are necessary to advance various aspects of EUS-BD/A.

{"title":"Endoscopic Ultrasound-guided Biliary Interventions","authors":"Hiroyuki Isayama, Ko Tomishima, Shigeto Ishii, Yusuke Takasaki, Mako Ushio, Toshio Fujisawa","doi":"10.1016/j.tige.2025.250916","DOIUrl":"10.1016/j.tige.2025.250916","url":null,"abstract":"<div><div>Endosonographic/endoscopic ultrasound–guided biliary drainage/anastomosis (EUS-BD/A) is widely accepted as a salvage procedure when conventional endoscopic retrograde cholangiopancreatography (ERCP) fails or is difficult. Although this procedure carries risks of severe adverse events (AEs), including perforation and bile leakage due to unattached organs, the risk of postprocedural pancreatitis in EUS-BD/A is extremely low. The intrahepatic bile duct approach is more challenging than extrahepatic because it involves penetrating the liver parenchyma. To establish EUS-BD/A as a standard primary biliary drainage procedure, it is essential to confirm its feasibility compared with ERCP, evaluate expanded indications, develop dedicated devices, and establish AE management strategies. EUS-BD/A showed similar technical and clinical success rates and AE rates, with ERCP and incidence of pancreatitis was significantly lower. Expanded indications for EUS-BD/A include primary drainage, preoperative use, pediatric patients, patients with massive ascites, and reintervention for stent occlusion; however, further evidence is required to support these indications. The development of devices to improve technical success and reduce AE rates is critical to establishing this procedure, but current devices remain insufficient for EUS-BD/A. In Japan, dedicated devices for EUS-BD/A include sharp-tip bougie dilators, drill-type dilators, sharp-tip balloon dilators, and covered self-expandable metallic stents with effective anchoring. Reducing the gap between the device and guidewire is particularly important for endosonographic/endoscopic ultrasound–guided hepaticogastrostomy. Management of AEs and the establishment of follow-up strategies are crucial as well. We herein summarize the prevention and management of AEs, including mediastinitis due to esophageal puncture, bile leakage, bleeding, and perforation, and introduce our follow-up strategy. Our ultimate goal is to establish EUS-BD/A as a standard primary biliary drainage procedure. Continuous efforts are necessary to advance various aspects of EUS-BD/A.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250916"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic Ultrasound-Guided Gallbladder Drainage for Acute Cholecystitis and for Expanded Indications: Technique and Outcomes

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2025.250912

Andrea Anderloni , Cecilia Binda , Aurelio Mauro , Stefano Mazza , Carlo Fabbri , Anthony Y.B. Teoh

Interventional endoscopic ultrasound (EUS) is constantly evolving, thanks to its efficacy for the treatment of several clinical conditions, leading to an extension of applications and indications over the years. Among these, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has become the preferred treatment for acute cholecystitis (AC) in high surgical risk patients, thanks to the introduction of electrocautery-enhanced lumen-apposing metal stents, which allowed a higher standardization of the technique, although still improving. Despite the significant progress made over the past 10 years, there are still a number of debated issues, above all due to application of this technique in a wider variety of broadened indications, beyond AC. Indeed, increasing evidences are emerging on EUS-GBD as treatment in case of distant malignant biliary obstruction in both primary and rescue scenarios. Additionally, there is preliminary evidence on AC prevention following the implantation of fully-covered self-expandable metal stents during endoscopic retrograde cholangiopancreatography in the malignant setting and on the treatment of gallstone-related diseases in not surgically fit patients. With an emphasis on technical considerations and outcomes, this review attempts to update the current indications for EUS-GBD and provide an overview of potential new fields of application for this technique.

{"title":"Endoscopic Ultrasound-Guided Gallbladder Drainage for Acute Cholecystitis and for Expanded Indications: Technique and Outcomes","authors":"Andrea Anderloni , Cecilia Binda , Aurelio Mauro , Stefano Mazza , Carlo Fabbri , Anthony Y.B. Teoh","doi":"10.1016/j.tige.2025.250912","DOIUrl":"10.1016/j.tige.2025.250912","url":null,"abstract":"<div><div>Interventional endoscopic ultrasound (EUS) is constantly evolving, thanks to its efficacy for the treatment of several clinical conditions, leading to an extension of applications and indications over the years. Among these, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has become the preferred treatment for acute cholecystitis (AC) in high surgical risk patients, thanks to the introduction of electrocautery-enhanced lumen-apposing metal stents, which allowed a higher standardization of the technique, although still improving. Despite the significant progress made over the past 10 years, there are still a number of debated issues, above all due to application of this technique in a wider variety of broadened indications, beyond AC. Indeed, increasing evidences are emerging on EUS-GBD as treatment in case of distant malignant biliary obstruction in both primary and rescue scenarios. Additionally, there is preliminary evidence on AC prevention following the implantation of fully-covered self-expandable metal stents during endoscopic retrograde cholangiopancreatography in the malignant setting and on the treatment of gallstone-related diseases in not surgically fit patients. With an emphasis on technical considerations and outcomes, this review attempts to update the current indications for EUS-GBD and provide an overview of potential new fields of application for this technique.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250912"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Distinct Breath Metabolome Signature Is Linked With Eosinophilic Esophagitis: A Proof-of-Concept Study Assessing Volatile Organic Compounds

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2025.250913

CLAIRE A. BEVERIDGE , XUEFENG ZHANG , ANDREI I. IVANOV , JONATHAN MARK BROWN , SCOTT GABBARD , FLORIAN RIEDER

引用次数: 0

Endoscopic Surveillance Patterns and Management of Helicobacter pylori in Newly Diagnosed Gastric Intestinal Metaplasia

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2024.250904

SHIVRAM CHANDRAMOULI , ANNIE L. WANG , DAVID A. LEIMAN

引用次数: 0

Real-Life Application of Artificial Intelligence for Automatic Characterization of Biliary Strictures: A Transatlantic Experience

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 DOI: 10.1016/j.tige.2024.250902

Mariano González-Haba Ruiz , Pedro Pereira , Jessica Widmer , Tiago Ribeiro , Belén Agudo Castillo , Filipe Vilas-Boas , João Ferreira , Miguel Mascarenhas Saraiva , Guilherme Macedo

引用次数: 0

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

Techniques and Innovations in 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.

﹀