Abstract Colorectal cancer (CRC) is the third most common cancer in the world. Colonoscopy has contributed significantly to reduction of incidence and mortality of CRC. Integration of artificial intelligence (AI) into colonoscopy practice has addressed the various shortcomings of screening colonoscopies. AI-assisted colonoscopy will help in real-time recognition of type of polyp with probable histology. This will not only save time but will also help to mitigate human errors. Computer-aided detection and computer-aided characterization are two applications of AI, which are being studied extensively with a goal of improvement of polyp and adenoma detection rates. Several studies are being conducted across the globe, which either involve simple decision-making algorithms or complex patterns through neural networks, which imitate the human brain. Most data are collected retrospectively and the research is limited to single-center studies, which might have bias. Therefore, the future research on AI in colonoscopy should aim to develop more sophisticated convolutional neural network and deep learning models that will help to standardize the practice and ensure the same degree of accuracy with all the colonoscopies, irrespective of experience of performing endoscopists. In this review, we will take a closer look at the current state of AI and its integration into the field of colonoscopy.
{"title":"Impact of Artificial Intelligence in Colorectal Polyp Detection and Characterization","authors":"S. Afzalpurkar, Mahesh K Goenka, Rakesh Kochhar","doi":"10.1055/s-0043-1777330","DOIUrl":"https://doi.org/10.1055/s-0043-1777330","url":null,"abstract":"Abstract Colorectal cancer (CRC) is the third most common cancer in the world. Colonoscopy has contributed significantly to reduction of incidence and mortality of CRC. Integration of artificial intelligence (AI) into colonoscopy practice has addressed the various shortcomings of screening colonoscopies. AI-assisted colonoscopy will help in real-time recognition of type of polyp with probable histology. This will not only save time but will also help to mitigate human errors. Computer-aided detection and computer-aided characterization are two applications of AI, which are being studied extensively with a goal of improvement of polyp and adenoma detection rates. Several studies are being conducted across the globe, which either involve simple decision-making algorithms or complex patterns through neural networks, which imitate the human brain. Most data are collected retrospectively and the research is limited to single-center studies, which might have bias. Therefore, the future research on AI in colonoscopy should aim to develop more sophisticated convolutional neural network and deep learning models that will help to standardize the practice and ensure the same degree of accuracy with all the colonoscopies, irrespective of experience of performing endoscopists. In this review, we will take a closer look at the current state of AI and its integration into the field of colonoscopy.","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"36 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139005614","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}
Brij Sharma, V. Bodh, Rajesh Sharma, Ashish Chauhan, Mohit Tripathi, A. Bhateja
{"title":"Accidental Ingestion of Live Ants","authors":"Brij Sharma, V. Bodh, Rajesh Sharma, Ashish Chauhan, Mohit Tripathi, A. Bhateja","doi":"10.1055/s-0043-1777342","DOIUrl":"https://doi.org/10.1055/s-0043-1777342","url":null,"abstract":"","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"3 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139005856","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}
Radhika Chavan, Chaiti Gandhi, Maitrey Patel, Rushil Solanki, S. Rajput
Abstract Endoscopic ultrasound (EUS) examination of the biliary system plays pivotal role in pancreatobiliary studies. EUS offers a safe and noninvasive method of the biliary tract disorder evaluation. Although radial EUS provides a straightforward orientation, practicing biliary system examination with a curvilinear echoendoscope is advisable because of its added therapeutic benefits. Linear EUS may pose challenge in understanding the orientation and tracing nondilated bile duct in the beginning. However, adopting a systematic station-wise approach can help in comprehending the orientation and effectively tracing the entire bile duct. In this review, we have discussed linear EUS examination of the bile duct and gallbladder from various stations and its clinical applications.
{"title":"Linear Endoscopic Ultrasound Examination of the Biliary System and Its Clinical Applications","authors":"Radhika Chavan, Chaiti Gandhi, Maitrey Patel, Rushil Solanki, S. Rajput","doi":"10.1055/s-0043-1777341","DOIUrl":"https://doi.org/10.1055/s-0043-1777341","url":null,"abstract":"Abstract Endoscopic ultrasound (EUS) examination of the biliary system plays pivotal role in pancreatobiliary studies. EUS offers a safe and noninvasive method of the biliary tract disorder evaluation. Although radial EUS provides a straightforward orientation, practicing biliary system examination with a curvilinear echoendoscope is advisable because of its added therapeutic benefits. Linear EUS may pose challenge in understanding the orientation and tracing nondilated bile duct in the beginning. However, adopting a systematic station-wise approach can help in comprehending the orientation and effectively tracing the entire bile duct. In this review, we have discussed linear EUS examination of the bile duct and gallbladder from various stations and its clinical applications.","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"40 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138595172","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}
Endoscopic retrograde cholangiopancreatography (ERCP) is used to treat common bile duct stones
内镜逆行胰胆管造影术（ERCP）用于治疗胆总管结石
{"title":"The Jolting Method: An Efficient Method for Extracting Multiple Common Bile Duct Stones Completely in a Single Procedure","authors":"Shun Ishido, Masanori Kobayashi, R. Okamoto","doi":"10.1055/s-0043-1777331","DOIUrl":"https://doi.org/10.1055/s-0043-1777331","url":null,"abstract":"Endoscopic retrograde cholangiopancreatography (ERCP) is used to treat common bile duct stones","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"27 1","pages":"243 - 244"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193644","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}
P. Pal, P. Rebala, Z. Nabi, Rajesh Gupta, M. Tandan, D. N. Reddy, Endoscopy Video
{"title":"Endoscopic Setons Placement for Complex Perianal Fistulizing Crohn's Disease by Fistuloscopy Using Ultra-thin Endoscope Introduced into Fistula Cavity","authors":"P. Pal, P. Rebala, Z. Nabi, Rajesh Gupta, M. Tandan, D. N. Reddy, Endoscopy Video","doi":"10.1055/s-0043-1777346","DOIUrl":"https://doi.org/10.1055/s-0043-1777346","url":null,"abstract":"","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"1 1","pages":"245 - 246"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195042","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}
Uday C. Ghoshal, Saikat Chakrabarti, Mahesh K Goenka
Abstract Artificial intelligence (AI) is a computer technology for mathematical modeling that uses nonlinear statistical analysis. While multilayer perceptron network is used for prediction of clinical outcome, convolutional neural network is used for detection of lesion in an image and its classification. In this issue of the journal, an article reviewed the impact of AI in colorectal polyp detection and characterization. This is an upcoming area of gastroenterology, which has already reached the doorstep of practicing clinicians and in the near future, it may bring a paradigm shift in clinical practice. It is expected that this thought-provoking review will stimulate endoscopists to take up research in this important field of application of an AI-based computer technology for endoscopic detection of gastrointestinal lesions.
{"title":"Artificial Intelligence in Colonoscopic Polyp Detection and Characterization: Merging Computer Technology and Endoscopic Skill for Better Patient Care","authors":"Uday C. Ghoshal, Saikat Chakrabarti, Mahesh K Goenka","doi":"10.1055/s-0043-1778059","DOIUrl":"https://doi.org/10.1055/s-0043-1778059","url":null,"abstract":"Abstract Artificial intelligence (AI) is a computer technology for mathematical modeling that uses nonlinear statistical analysis. While multilayer perceptron network is used for prediction of clinical outcome, convolutional neural network is used for detection of lesion in an image and its classification. In this issue of the journal, an article reviewed the impact of AI in colorectal polyp detection and characterization. This is an upcoming area of gastroenterology, which has already reached the doorstep of practicing clinicians and in the near future, it may bring a paradigm shift in clinical practice. It is expected that this thought-provoking review will stimulate endoscopists to take up research in this important field of application of an AI-based computer technology for endoscopic detection of gastrointestinal lesions.","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"39 6","pages":"239 - 242"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139187761","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}
Vikas Pemmada, Athish Shetty, Megha Murali, Shiran Shetty, B. Musunuri, Siddheesh Rajpurohit, G. Bhat
Abstract Background Medications can rarely cause esophageal injury and present with acute symptoms. Multiple factors, including the type of medication, comorbidity, and method of ingestion play a role in causing drug-induced or pill esophagitis (PE). We analyzed the clinical, endoscopic, and histopathological profiles of PE cases at our gastroenterology outpatient clinic. Methods Medical records of PE cases were reviewed retrospectively over a period of 5 years at a tertiary care hospital in India from May 2017 to May 2022. The data were collected and analyzed using descriptive statistical analysis. Results A total of 30 patients diagnosed with PE were involved in the study. A slight male preponderance of 56.7% was noted with a mean age of 40.7 years. Odynophagia was the dominant symptom (70%) with a mean duration of symptoms of 5.63 days. The most common location was at the mid-esophagus (80%) followed by the lower esophagus (10%). The majority (56.7%; 17/30) had over-the-counter (OTC) drug consumption, followed by doxycycline (33.3%; 10/30). Kissing ulcers were seen in 30% of the subjects; 90% of the patients received a combination of proton pump inhibitors and sucralfate suspension for 2 weeks along with discontinuation of the causative drug, with a 96.7% resolution rate. Conclusion OTC medication and antibiotics such as doxycycline are the leading cause of PE. Prompt recognition and discontinuation of the causative drug are crucial in preventing complications. Patient education is vital in preventing PE regarding the usage of OTC medicines in developing countries.
{"title":"Pill Esophagitis: Clinical and Endoscopic Profile","authors":"Vikas Pemmada, Athish Shetty, Megha Murali, Shiran Shetty, B. Musunuri, Siddheesh Rajpurohit, G. Bhat","doi":"10.1055/s-0043-1777356","DOIUrl":"https://doi.org/10.1055/s-0043-1777356","url":null,"abstract":"Abstract Background Medications can rarely cause esophageal injury and present with acute symptoms. Multiple factors, including the type of medication, comorbidity, and method of ingestion play a role in causing drug-induced or pill esophagitis (PE). We analyzed the clinical, endoscopic, and histopathological profiles of PE cases at our gastroenterology outpatient clinic. Methods Medical records of PE cases were reviewed retrospectively over a period of 5 years at a tertiary care hospital in India from May 2017 to May 2022. The data were collected and analyzed using descriptive statistical analysis. Results A total of 30 patients diagnosed with PE were involved in the study. A slight male preponderance of 56.7% was noted with a mean age of 40.7 years. Odynophagia was the dominant symptom (70%) with a mean duration of symptoms of 5.63 days. The most common location was at the mid-esophagus (80%) followed by the lower esophagus (10%). The majority (56.7%; 17/30) had over-the-counter (OTC) drug consumption, followed by doxycycline (33.3%; 10/30). Kissing ulcers were seen in 30% of the subjects; 90% of the patients received a combination of proton pump inhibitors and sucralfate suspension for 2 weeks along with discontinuation of the causative drug, with a 96.7% resolution rate. Conclusion OTC medication and antibiotics such as doxycycline are the leading cause of PE. Prompt recognition and discontinuation of the causative drug are crucial in preventing complications. Patient education is vital in preventing PE regarding the usage of OTC medicines in developing countries.","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"121 11","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138608303","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}
Nikhil Sonthalia, V. Patil, Awanish Tewari, Akash Roy, Mahesh K Goenka
Abstract Background and Objectives : Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) for pain relief in chronic pancreatitis (CP) has wide variation in results as reported in the literature. The objective was to find out the efficacy of EUS-CPB in painful CP from our region where phenotype of CP is different from West and to find out factors favoring response to EUS-CPB. Methods and Results : Patients with known CP who underwent EUS-CPB were assessed for response to CPB. Response to EUS-CPB was recorded as more than 50% reduction in visual analogue scale (VAS) score for pain severity at 1 week, 4 weeks, 12 weeks and 24 weeks after procedure. Factors between responders and nonresponders were analyzed. Among 29 patients who underwent EUS-CPB during the study period, response was seen in 72.4% patients after the procedure. The mean time to response to EUS-CPB was 1.22 (± 0.43) days. Mean duration of response was 8 months (± 4.73). Short duration of painful CP (≤2 years) was seen in 15 patients (51.72%) and long duration (>2 years) was seen in 14 (48.27%). Among responders (21/29), those patients who had short duration of disease had significantly lower median VAS score at 12 weeks, (1 versus 3, p- value= 0.026) and at 24 weeks, (1.5 versus 2.5, p -value= 0.049), as compared to those with longer duration of disease. Overall, 83.3% males responded as compared to 54.54% females ( p = 0.04). Significant proportion of subjects who responded either stopped or used analgesics occasionally ( p < 0.0001). There was no statistically significant difference in response to EUS-CPB with respect to age, prior history of endoscopic retrograde cholangiopancreatography (ERCP), etiology of CP, prior history of surgery, or whether only EUS-CBP was done ( p > 0.05 for all). Conclusion : EUS-CPB can be effective when used in select group of painful CP patient who are not immediate candidates for surgery especially in early course of disease. It can be offered to patients with persistent pain despite optimum medical therapy. When effective, it can reduce need for analgesic medication at least in short to medium term.
{"title":"Endoscopic Ultrasound-Guided Celiac Plexus Block Can Be a Useful Procedure for Pain Relief in Chronic Pancreatitis When Used Selectively","authors":"Nikhil Sonthalia, V. Patil, Awanish Tewari, Akash Roy, Mahesh K Goenka","doi":"10.1055/s-0043-1777737","DOIUrl":"https://doi.org/10.1055/s-0043-1777737","url":null,"abstract":"Abstract Background and Objectives : Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) for pain relief in chronic pancreatitis (CP) has wide variation in results as reported in the literature. The objective was to find out the efficacy of EUS-CPB in painful CP from our region where phenotype of CP is different from West and to find out factors favoring response to EUS-CPB. Methods and Results : Patients with known CP who underwent EUS-CPB were assessed for response to CPB. Response to EUS-CPB was recorded as more than 50% reduction in visual analogue scale (VAS) score for pain severity at 1 week, 4 weeks, 12 weeks and 24 weeks after procedure. Factors between responders and nonresponders were analyzed. Among 29 patients who underwent EUS-CPB during the study period, response was seen in 72.4% patients after the procedure. The mean time to response to EUS-CPB was 1.22 (± 0.43) days. Mean duration of response was 8 months (± 4.73). Short duration of painful CP (≤2 years) was seen in 15 patients (51.72%) and long duration (>2 years) was seen in 14 (48.27%). Among responders (21/29), those patients who had short duration of disease had significantly lower median VAS score at 12 weeks, (1 versus 3, p- value= 0.026) and at 24 weeks, (1.5 versus 2.5, p -value= 0.049), as compared to those with longer duration of disease. Overall, 83.3% males responded as compared to 54.54% females ( p = 0.04). Significant proportion of subjects who responded either stopped or used analgesics occasionally ( p < 0.0001). There was no statistically significant difference in response to EUS-CPB with respect to age, prior history of endoscopic retrograde cholangiopancreatography (ERCP), etiology of CP, prior history of surgery, or whether only EUS-CBP was done ( p > 0.05 for all). Conclusion : EUS-CPB can be effective when used in select group of painful CP patient who are not immediate candidates for surgery especially in early course of disease. It can be offered to patients with persistent pain despite optimum medical therapy. When effective, it can reduce need for analgesic medication at least in short to medium term.","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"8 1","pages":"203 - 210"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139188299","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}
Rajesh Puri, Zubin Sharma, S. Dhampalwar, Abhishek Kathuria, B. Sahu
Abstract The word endo-hepatology evokes many perceptions. Some believe it to be the emerging new interventional branch and some believe it to be an extension of endoscopy. Nonetheless, it has continued to evolve into an exciting area of active work. With the advent of endoscopic ultrasound (EUS) based procedures, new vistas have opened up. EUS-guided liver biopsies, portal hypertension management, and multiple new procedures are being described. EUS also plays a large role in the management of patients in the peritransplant period. With this review, we present an overview of the role of EUS in the field of hepatology as well as during the peritransplant period and its applications.
摘要 内科肝病学这个词会让人产生很多联想。有些人认为它是新兴的介入性分支，有些人则认为它是内窥镜的延伸。尽管如此，它仍在不断发展成为一个令人兴奋的活跃领域。随着以内窥镜超声（EUS）为基础的手术的出现，开辟了新的前景。EUS 引导下的肝脏活组织检查、门静脉高压管理以及多种新程序正在被描述。EUS 还在围移植期患者的管理中发挥着重要作用。通过这篇综述，我们概述了 EUS 在肝脏病学领域和围移植期的作用及其应用。
{"title":"Endo-Hepatology: The Buzz Goes Much beyond Liver Biopsy—A Narrative Review","authors":"Rajesh Puri, Zubin Sharma, S. Dhampalwar, Abhishek Kathuria, B. Sahu","doi":"10.1055/s-0043-1777735","DOIUrl":"https://doi.org/10.1055/s-0043-1777735","url":null,"abstract":"Abstract The word endo-hepatology evokes many perceptions. Some believe it to be the emerging new interventional branch and some believe it to be an extension of endoscopy. Nonetheless, it has continued to evolve into an exciting area of active work. With the advent of endoscopic ultrasound (EUS) based procedures, new vistas have opened up. EUS-guided liver biopsies, portal hypertension management, and multiple new procedures are being described. EUS also plays a large role in the management of patients in the peritransplant period. With this review, we present an overview of the role of EUS in the field of hepatology as well as during the peritransplant period and its applications.","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":"30 2","pages":"227 - 238"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194133","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}
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