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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

World Journal of Gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States Department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy digestive endoscopy unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy Department of Gastroenterology and endoscopy Catholic UniversityRoma 00168Italy Department of Gastroenterology University of Michigan HealthAnn ArborMI 48107United States Department of endoscopy University of VeronaVerona 37121VenetoItaly Gastroenterology unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

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Adenoma and advanced neoplasia detection rates increase from 45 years of age

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World Journal of Gastroenterology 2019年第4期25卷 447-456页

作者： David Karsenti Gaelle Tharsis Pascal Burtin Franck Venezia Gilles Tordjman Agnès Gillet Joelle Samama Karine Nahon-Uzan Philippe Cattan Maryan Cavicchi digestive endoscopy unit Clinique Paris-Bercy digestive endoscopy unit Institut Gustave Roussy

BACKGROUND Colonoscopy is considered a valid primary screening tool for colorectal cancer(CRC). The decreasing risk of CRC observed in patients undergoing colonoscopy is correlated with the adenoma detection rate(ADR). Due to the fact that screening programs usually start from the age of 50, very few data are available on the risk of adenoma between 40 and 49 years. However, the incidence of CRC is increasing in young populations and it is not uncommon in routine practice to detect adenomas or even advanced neoplasia during colonoscopy in patients under 50 *** To compare the ADR and advanced neoplasia detection rate(ANDR) according to age in a large series of patients during routine *** All consecutive patients who were scheduled for colonoscopy were *** criteria were as follows: patients scheduled for partial colonoscopy or interventional colonoscopy(for stent insertion or stenosis dilation).Colonoscopies were performed in our unit by a team of 30 gastroenterologists in2016. We determined the ADR and ANDR in each age group in the whole population and in the population with an average risk of CRC(excluding patients with personal or family history of advanced adenoma or cancer).RESULTS6027 colonoscopies were performed in patients with a median age of 57 years(range, 15-96). The ADR and ANDR were 28.6% and 9.7%, respectively, in the whole population. When comparing patients aged 40-44(n = 382) and 45-49 years (n = 515), a strong increase in all parameters from 45 years was observed, with the ADR rising from 9.7% in patients aged 40-44 to 21.2% between 45 and 49(P <0.001) and the ANDR increasing from 3.1% in patients aged 40-44 to 6.4% in those aged 45-49 years(P < 0.03). With regard to patients aged 50-54(n = 849), a statistically significant increase in the ADR and ANDR was not observed between patients aged 45-49 and those aged 50-54 years. In the population with an average risk of CRC, the ADR and ANDR were still significantly h

关键词： Colorectal cancer Screening Adenoma detection rate Colonoscopy Cohort study

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Colon capsule endoscopy:What we know and what we would like to know

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World Journal of Gastroenterology 2014年第45期20卷 16948-16955页

作者： Cristiano Spada Federico Barbaro Gianluca Andrisani Leonardo Minelli Grazioli Cesare Hassan Isabella Costamagna Mariachiara Campanale Guido Costamagna Department of General Surgery Digestive Endoscopy Unit Catholic University

Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also affected by a small, but definite, risk of major complications (cardiopulmonary complications, perforation, hemorrhage) and even mortality. To improve both acceptability and safety, PillCam Colon Capsule endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) has been developed. CCE represents a non-invasive technique that is able to explore the colon without sedation and air insufflation. The Second Generation of Colon Capsule endoscopy (PillCam Colon 2) (CCE-2) was proven to be an accurate tool to detect colonic neoplastic lesions when used in average risk individuals. To date, the evidence supports the use of CCE-2 in case of colonoscopy failure, in patients unwilling to perform colonoscopy and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease need to be clarified. In this paper, the current “state of the art”, potential application of CCE and future needs are evaluated.

关键词： Colon capsule endoscopy Incomplete colonoscopy Regimen of preparation Accuracy Fields of application

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Helicobacter pylori eradication and reflux disease onset:Did gastric acid get "crazy"?

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World Journal of Gastroenterology 2013年第6期19卷 786-789页

作者： Angelo Zullo Cesare Hassan Alessandro Repici Vincenzo Bruzzese Gastroenterology and digestive endoscopy unit Nuovo Regina Margherita Hospital digestive endoscopy unit IRCCS Istituto Clinico Humanitas

Gastroesophageal reflux disease (GORD) is highly prevalent in the general *** the last decade,a potential relationship between Helicobacter pylori (***) eradication and GORD onset has been *** main putative mechanism is the gastric acid hypersecretion that develops after bacterial cure in those patients with corpus-predominant *** performed a critical reappraisal of the intricate pathogenesis and clinical data available in this *** onset after *** eradication in duodenal ulcer patients has been ascribed to a gastric acid hypersecretion,which could develop following body gastritis ***,the absence of an acid hypersecretive status in these patients is documented by both pathophysiology and clinical ***,duodenal ulcer recurrence is virtually abolished *** *** addition,intra-oesophageal pH recording studies failed to demonstrated increased acid reflux following bacterial ***,oesophageal manometric studies suggest that *** eradication would reduce-rather than favor-acid reflux into the ***,data of clinical studies would suggest that *** eradication is not significantly associated with eitherreflux symptoms or erosive oesophagitis onset,some data suggesting also an advantage in curing the infection when oesophagitis is already ***,the legend of "crazy acid" remains-as all the others a fascinating,but imaginary tale.

关键词： Helicobacter pylori Oesophageal reflux Oesophagitis Eradication Pathophysiology Clinical studies

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Gastric per-oral endoscopic myotomy:Indications,technique,results and comparison with surgical approach

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World Journal of Gastrointestinal Surgery 2022年第1期14卷 12-23页

作者： Maria Chiara Verga Stefano Mazza Francesco Azzolini Fabrizio Cereatti Clara Benedetta Conti Andrea Drago Sara Soro Biagio Elvo Roberto Grassia Gastroenterology and digestive endoscopy unit ASST CremonaCremona 26100Italy Gastroenterology and digestive endoscopy unit Ospedale San Raffaele IRCCSMilano 20132Italy digestive and Interventional endoscopy unit ASST MonzaMonza 20800Italy

Gastroparesis is a chronic disease of the stomach that causes a delayed gastric emptying,without the presence of a *** 30 years the authors identified pylorospasm as one of the most important pathophysiological mechanisms determining *** with EndoFLIP,a device that assesses pyloric distensibility,increased the knowledge about *** on this data,several pyloric-targeted therapies were developed to treat refractory gastroparesis:Surgical pyloroplasty and endoscopic approach,such as pyloric injection of botulinum and pyloric ***,the success of most of these techniques is still not *** 2013,the first human gastric per-oral endoscopic myotomy(GPOEM)was *** was inspired by the POEM technique,with a similar dissection method,that allows *** results of GPOEM are similar to surgical approach in term of clinical success,adverse events and post-surgical *** the last 8 years GPOEM has gained the attention of the scientific community,as a minimally invasive technique with high rate of clinical success,quickly prevailing as a promising therapy for *** surprisingly,in referral centers,its technical success rate is 100%.One of the main goals of recent studies is to identify those patients that will respond better to the therapies targeted on pylorus and to choose the better approach for each patient.

关键词： Gastric per-oral endoscopic myotomy Pyloroplasty Gastroparesis EndoFLIP Pyloromyotomy Gastroparesis cardinal symptom index

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Endoscopic retrieval of gastric trichobezoar after fragmentation with electrocautery using polypectomy snare and argon plasma coagulation in a pediatric patient

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Gastroenterology Report 2016年第3期4卷 251-253,I0003页

作者： Mohammed Amine Benatta digestive endoscopy unit Military Central HospitalAlgiersAlgeria

Trichobezoars are rare,composed of hair and more common in female pediatric patients with psychiatric *** extraction is the most common removal *** two endoscopic removals after fragmentation have beenreported in the English *** report herein a third case of a trichobezoar that was successfully retrieved afterendoscopic fragmentation with snare polypectomy and argon plasma coagulation in a six-year-old female *** mass was completely removed in 10 pieces after 15 *** patient’s course was *** monthslater,she is doing *** endoscopic removal was effective,minimally invasive and time saving.

关键词： trichobezoar retrieval endoscopic fragmentation

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Role and timing of endoscopy in acute biliary pancreatitis

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World Journal of Gastroenterology 2015年第40期21卷 11205-11208页

作者： Andrea Anderloni Alessandro Repici Department of Gastroenterology Digestive Endoscopy UnitHumanitas Research Hospital

The role and timing of endoscopy in the setting of acute biliary pancreatitis(ABP) is still being debated. Despite numerous randomized trials have been published,there is an obvious lack of consensus on the indications and timing of endoscopic retrograde cholangiopancreatography(ERCP) in ABP in metaanalyses and nationwide guidelines. The present editorial has been written to clarify the role of endoscopy in ABP. In clinical practice the decision to perform an ERCP is often based on biochemical and radiological criteria despite they already have been shown to be unreliable predictors of common bile duct stone presence. Endoscopic ultrasonography(EUS) is not currently a worldwide standard diagnostic procedure early in the course of acute biliary pancreatitis,but it has been shown to be accurate,safe and cost effective in diagnosing biliary obstructions compared with magnetic resonance cholangiopancreatography and ERCP and therefore in preventing unnecessary ERCP and its related complications. Early EUS in ABP allows,if appropriate,immediate endoscopic treatment and significant spare of unnecessary operative procedures thus reducing possible related complications.

关键词： Acute biliary pancreatitis Choledocolithiasis Comm

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Gallbladder biliary lithotripsy:A new rationale applied to old treatment

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World Journal of Gastroenterology 2022年第7期28卷 763-765页

作者： Lorenzo Dioscoridi Massimiliano Mutignani digestive endoscopy unit ASST NiguardaMilan 20100Italy

Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS)*** endotherapy permits to treat biliary stones in the main bile duct by standard ERCP and gallbladder stones by EUS-guided cholecystoduodenostomy eventually associated to intracorporeal lithotripsy to achieve optimal results.

关键词： Endoscopic ultrasound-guided gallbladder drainage Biliary lithotripsy Gallstone lithotripsy Gallbladder biliary lithotripsy New rationale

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Large balloon dilation post endoscopic sphincterotomy in removal of difficult common bile duct stones:A literature review

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World Journal of Gastroenterology 2014年第24期20卷 7760-7766页

作者： Olivier Rouquette Gilles Bommelaer Armo Abergel Laurent Poincloux digestive endoscopy unit CHU Estaing63000 Clermont-FerrandFrance

Endoscopic sphincterotomy (ES) is the standard therapy in common bile duct (CBD) stones extraction. Large stones (≥ 12 mm) or multiple stones extraction may be challenging after ES alone. Endoscopic sphincterotomy followed by large balloon dilation (ESLBD) has been described as an alternative to ES in these indications. Efficacy, safety, cost-effectiveness and technical aspects of the procedure have been here reviewed. PubMed and Google Scholar search resulted in forty-one articles dealing with CBD stone extraction with 12 mm or more dilation balloons after ES. ESLBD is at least as effective as ES, and reduces the need for additional mechanical lithotripsy. Adverse events rates are not statistically different after ESLBD compared to ES for pancreatitis, bleeding and perforation. However, particular attention should be paid in patients with CBD strictures, which is identified as a risk factor of perforation. ESLBD is slightly cost-effective compared to ES. A small sphincterotomy is usually performed, and may reduce bleeding rates compared to full sphincterotomy. Dilation is performed with 12-20 mm enteral balloons. Optimal inflation time is yet to be determined. The procedure can be performed safely even in patients with peri-ampullary diverticula and surgically altered anatomy. ESLBD is effective and safe in the removal of large CBD stones, however, small sphincterotomy might be preferred and CBD strictures should be considered as a relative contraindication.

关键词： Bile duct stone Endoscopic papillary large balloon dilation Endoscopic sphincterotomy Endoscopic retrograde cholangiopancreatography Mechanical lithotripsy

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Non-guided self-learning program for high-proficiency optical diagnosis of diminutive and small colorectal lesions: A single-endoscopist pilot study

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World Journal of Gastroenterology 2019年第10期25卷 1278-1287页

作者： Marco Bustamante-Balén Carla Satorres Lorena Puchades Belén Navarro Natalia García-Morales Noelia Alonso Marta Ponce Lidia Argüello Vicente Pons-Beltrán Gastrointestinal endoscopy Research Group Gastrointestinal Endoscopy UnitDigestive Diseases DepartmentLa Fe Polytechnic University Hospital digestive Diseases Department La Fe Polytechnic University Hospital Gastrointestinal endoscopy unit Digestive Diseases DepartmentLa Fe Polytechnic University Hospital

BACKGROUND The implementation of optical diagnosis(OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause is the lack of a standardized learning tool. Since the factors related to better learning are not well described, strong evidence upon which a consistent learning tool could be designed is lacking. We hypothesized that a self-designed learning program may be enough to achieve competency in OD of diminutive lesions of the *** To assess the accuracy of OD of diminutive lesions in real colonoscopies after application of a self-administered learning *** This was a single-endoscopist prospective pilot study, in which an experienced endoscopist followed a self-designed, self-administered learning program in OD of colorectal lesions. An assessment phase divided in two halves with a 6-mo period in between without performance of OD was developed in a populationbased colorectal cancer screening program. The accomplishment of the Preservation and Incorporation of Valuable Endoscopic Innovations criteria and performance measures were calculated overall and in the two halves of the assessment phase, assessing their response to the 6-mo stopping period. The evolution of performance through blocks of 50 lesions was also *** Overall, 152 patients and 522 lesions(≤ 5 mm: 399, and 6-9 mm: 123) were included. The negative predictive value for the OD of adenoma in rectosigmoid lesions diagnosed with high confidence was 91.7% [95% confidence interval(CI):87.3-96.6]. The proportion of agreement on surveillance interval between OD and pathological diagnosis was higher than 95%. Overall accuracy for diminutive lesions diagnosed with high confidence was 89.5%(95%CI: 86.3-92.7). The overall accuracy of OD was similar in the two halves of the assessment phase [90.1(95%CI: 85.6-94.7) vs 88.2(95%CI: 87.9-95.9)]. All the other performance parameters we

关键词： Optical diagnosis Accuracy Learning Polyp Colonoscopy Education

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