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Device-assisted enteroscopy: Are we ready to dismiss the spiral?

World Journal of gastroenterology 2024年第26期30卷 3185-3192页

作者： Alessandro Mussetto Elettra Merola Cesare Casadei Daniele Salvi Fabiola Fornaroli Silvia Cocca Margherita Trebbi Armando Gabbrielli Cristiano Spada Andrea Michielan Department of gastroenterology S Maria della Croci HospRavenna 48121Italy Department of gastroenterology unit G.B.Grassi Hospital(ASL Roma 3)Roma 00122Italy Section of digestive endoscopy and gastroenterology Fondazione PoliambulanzaBrescia 25124Italy gastroenterology and endoscopy unit Department of Medicine and SurgeryUniversity of ParmaParma 43125Italy gastroenterology and endoscopy unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy Center for Medical Sciences(CISMed) University of TrentoTrento 38122Italy gastroenterology and digestive endoscopy unit Santa Chiara HospitalAzienda Provinciale per i Servizi SanitariTrento 38122Italy digestive endoscopy unit Fondazione Policlinico Universitario A.Gemelli IRCSSRoma 00168Italy

Motorized spiral enteroscopy(MSE)is the latest advance in device-assisted *** events related to MSE were discussed in a recent large systematic review and meta-analysis and were directly compared with those of balloon enteroscopy in a case-matched study and a randomized controlled *** the real-life application of MSE,an unexpected safety issue emerged regarding esophageal injury and the technique has been withdrawn from the global market,despite encouraging results in terms of diagnostic and therapeutic *** conducted an Italian multicenter real-life prospective study,which was prematurely terminated after the withdrawal of MSE from the *** primary goals were the evaluation of MSE performance(both diagnostic and therapeutic)and its safety in routine endoscopic practice,particularly in the early phase of introduction in the endoscopic unit.A subanalysis,which involved patients who underwent MSE after unsuccessful balloon enteroscopy,demonstrated,for the first time,the promising performance of MSE as a rescue *** its remarkable performance in clinical practice and its potential role as a backup technique following a previously failed enteroscopy,it may be more appropriate to refine and enhance MSE in the future rather than completely abandoning it.

关键词： Motorized spiral enteroscopy Rescue enteroscopy Diagnostic yield Adverse events AGREE classification

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Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

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World Journal of gastroenterology 2024年第1期30卷 70-78页

作者： Alessandro Fugazza Kareem Khalaf Katarzyna M Pawlak Marco Spadaccini Matteo Colombo Marta Andreozzi Marco Giacchetto Silvia Carrara Chiara Ferrari Cecilia Binda Benedetto Mangiavillano Andrea Anderloni Alessandro Repici Division of gastroenterology and digestive endoscopy Humanitas Research Hospital-IRCCSRozzano 20089MilanoItaly Division of gastroenterology St.Michael’s HospitalUniversity of TorontoToronto M5B 1W8ONCanada Department of Anesthesia Humanitas Research Hospital-IRCCSRozzano 20089MilanoItaly gastroenterology and digestive endoscopy unit Forlì-Cesena HospitalsRomagna 47121Italy Gastrointestinal endoscopy unit Humanitas Mater DominiCastellanza 21100Italy gastroenterology and digestive endoscopy unit Fondazione IRCCS Policlinico San MatteoPavia 27100Italy

This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional ***-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of *** procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events,making it a safe and effective option for appropriate ***,EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary ***,patient selection is critical for the success of EUS-GBD,and proper patient selection and risk assessment are important to ensure the safety and efficacy of the *** the field continues to evolve and mature,ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD,ultimately leading to improved outcomes for patients.

关键词： Endoscopic ultrasound-guided gallbladder drainage Gallbladder drainage Acute cholecystitis Malignant obstruction Interventional endoscopic ultrasound Lumen-apposing metal stents

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Artificial intelligence in detection of small bowel lesions and their bleeding risk:A new step forward

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World Journal of gastroenterology 2024年第18期30卷 2482-2484页

作者： Silvia Cocca Giuseppina Pontillo Giuseppe Grande Rita Conigliaro gastroenterology and endoscopy unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy gastroenterology and endoscopy unit Presidio Ospedaliero San Giuseppe Moscati(AversaCE)-ASL CasertaCaserta 81100Italy Department of gastroenterology and digestive endoscopy Azienda Ospedaliero Universitaria di ModenaModena 41121Italy

The present letter to the editor is related to the study with the title“Automatic detection of small bowel(SB)lesions with different bleeding risk based on deep learning models”.Capsule endoscopy(CE)is the main tool to assess SB diseases but it is a time-consuming procedure with a significant error *** development of artificial intelligence(AI)in CE could simplify physicians’*** novel deep learning model by Zhang et al seems to be able to identify various SB lesions and their bleeding risk,and it could pave the way to next perspective studies to better enhance the diagnostic support of AI in the detection of different types of SB lesions in clinical practice.

关键词： Capsule endoscopy Small bowel Artificial intelligence Bleeding risk Vascular lesions

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Bowel function and inflammation: Is motility the other side of the coin?

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World Journal of gastroenterology 2024年第14期30卷 1963-1967页

作者： Alba Panarese Division of gastroenterology and digestive endoscopy Department of Medical SciencesCentral Hospital-Azienda OspedalieraTaranto 74123Italy

Digestion and intestinal absorption allow the body to sustain itself and are the emblematic functions of the *** the flip side,functions also arise from its role as an interface with the ***,the gut houses microorganisms,collectively known as the gut microbiota,which interact with the host,and is the site of complex immune *** role in human pathology is complex and scientific evidence is progressively elucidating the functions of the gut,especially regarding the pathogenesis of chronic intestinal diseases and inflammatory conditions affecting various organs and *** editorial aims to highlight and relate the factors involved in the pathogenesis of intestinal and systemic inflammation.

关键词： Motility Inflammation Pathogenesis Vitamin D Microbiota Gut Chronic intestinal pseudo-obstruction

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Two big orifices in the second duodenal portion:A case of an atypical double papilla

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 83-85页

作者： Salvatore Francesco Vadalàdi Prampero Nikola Panic Marco Massidda Chiara Rocchi Pierluigi Maria Rinaldi Ana Malenkovic Milutin Bulajic gastroenterology and GI endoscopy Department Mater Olbia HospitalOlbia 07026Italy digestive endoscopy unit University Clinic"Dr Dragisa Misovic-Dedinje"Belgrade 11000Serbia Radiology Department Mater Olbia HospitalOlbia 07026Italy

With the advent of endoscopic retrograde cholangiopancreatography(ERCP)in the early 1970s,anatomic anomalies of the Vaterian system were described endoscopically[1].Although the occurrence is rare,the common bile duct(CBD)and the pancreatic duct may fail to coalesce during embryologic *** leads to double major papilla because both ducts open into the duodenum separately[1].In this way the cranial duct communicates with the CBD,while the caudal orifice communicates with the pancreatic duct[2].

关键词： orifice Vater atypical

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Novel classification of gastric polyps:The good,the bad and the ugly

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World Journal of gastroenterology 2024年第31期30卷 3640-3653页

作者： Deborah Costa Daryl Ramai Alberto Tringali Department of digestive endoscopy and gastroenterology AULSS2Conegliano HospitalConegliano 31015Italy Department of gastroenterology Division of Hepatology and EndoscopyBrigham and Women's HospitalBostonMA 02115United States

Gastric polyps(GPs)are increasingly *** upper endoscopy,they should be examined with white light and occasionally chromoendoscopy,and their morphology classified according to the Paris *** GPs have a typical endoscopic appearance and can be associated with diseases like Helicobacter pylori *** examination is necessary for an accurate *** most polyps are non-neoplastic and do not require treatment,some carry a risk of malignancy or are already ***,understanding the diagnosis,classification,and management of GPs is crucial for patient *** new classification categorizes GPs into"good","bad",and"ugly"based on their likelihood of becoming *** aim to provide descriptions of the endoscopic appearance,pathology,treatment,and follow-up for different GPs,as well as clinical management flowcharts.

关键词： Gastric polyps Fundic gland polyps Hyperplastic polyps Adenomas Neuroendocrine tumors Early gastric cancer

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Refining the targeted population and achieving better for colorectal cancer screening

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World Journal of gastroenterology 2024年第25期30卷 3140-3142页

作者： Nuo-Ya Zhou Yi-Xiu Lin Liu-Xiang Chen Lian-Song Ye Bing Hu Department of gastroenterology and Hepatology/Medical Engineering Integration Laboratory of digestive endoscopy West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

This editorial comments on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al,who conducted a retrospective study aiming at clarifying the stage at colorectal cancer(CRC)diagnosis based on different diagnostic *** share our opinion about CRC screening *** current situation suggests the need for a more specific and targeted population for CRC screening.

关键词： Colorectal cancer Screening Early diagnosis Technology Cost-effectiveness

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The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope:A multicenter retrospective international study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 71-76页

作者： Alessandro Fugazza Matteo Colombo Michel Kahaleh V.Raman Muthusamy Bick Benjamin Wim Laleman Carmelo Barbera Carlo Fabbri Jose Nieto Abed Al-Lehibi Mohan Ramchandani Amy Tyberg Haroon Shahid Avik Sarkar Dean Ehrlich Stuart Shermand Cecilia Binda Marco Spadaccini Andrea Iannone Kareem Khalaf Nageshwar Reddy Andrea Anderloni Alessandro Repici Division of gastroenterology and digestive endoscopy Humanitas Research Hospital-IRCCSVia Manzoni 5620089RozzanoMilanoItaly gastroenterology Rutgers Robert Wood JohnsonNew BrunswickNew JerseyUSA Vatche and Tamar Manoukian Division of digestive Diseases University of CaliforniaLos Angeles School of Medicine at UCLALos AngelesCaliforniaUSA Division of digestive and Liver Disorders Indiana University School of MedicineIndianapolisINUSA Department of gastroenterology and Hepatology University Hospitals LeuvenKU Leuven3000 LeuvenBelgium U.O.C.di Gastroenterologia ed Endoscopia Digestiva Ospedale Giuseppe MazziniASL TeramoItaly gastroenterology and digestive endoscopy unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly Borland Groover Clinic JacksonvilleFloridaUSA Department of gastroenterology and Hepatology King Fahad Medical CityRiyadhSaudi Arabia Asian Institute of gastroenterology HyderabadIndia Section of gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Department of Biomedical Sciences Humanitas UniversityVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly

Background: Duodenoscope-related multidrug-resistant organism(MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography(ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score(1 to 10) on performance rating of the single-use duodenoscope, and adverse event(AE) rate. Results: A total of 66 patients(26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47(71.2%) grade 3 and 19(28.8%) grade 4. The technical success rate was 98.5%(65/66). Procedural duration was 64(interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66(1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients(6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis(PEP), 1 cholangitis and 1 ***: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.

关键词： Single-operator cholangioscopy Single-use duodenoscope Endoscopic retrograde cholangiopancreatography Indeterminate biliary stricture Difficult biliary stones

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Serum urate is associated with an increased risk of inflammatory bowel disease: A bidirectional Mendelian randomization study

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World Journal of Clinical Cases 2024年第5期12卷 891-902页

作者： Song Zhang Xue Fang Le Kang Xiang-Yu Sui Miao Liu Yu-Jia Luo Shuo Fu Zhao-Shen Li Sheng-BingZhao Yu Bai Department of gastroenterology Changhai HospitalShanghai 200433China Department of gastroenterology Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghai 200433China digestive endoscopy Center Changhai HospitalNaval/Second Military Medical UniversityShanghai 200433China National Clinical Research Center for digestive Diseases Shanghai 200433China

BACKGROUND Previous studies have indicated bidirectional associations between urate levels and inflammatory bowel disease(IBD),including ulcerative colitis(UC)and Crohn’s disease(CD).However,it remains unclear whether the observations are causal because of confounding *** To investigate the causal associations between urate levels and IBD using bidirec-tional Mendelian randomization(MR).METHODS Independent genetic variants for urate levels and IBD were selected as instru-mental variables from published genome-wide association studies(GWASs).Summary statistics for instrument-outcome associations were retrieved from three separate databases for IBD(the UK Biobank,the FinnGen database and a large GWAS meta-analysis)and one for urate levels(a large GWAS meta-analysis).MR analyses included the inverse-variance-weighted method,weighted-median estimator,MR-Egger and sensitivity analyses(MR-PRESSO).A meta-analysis was also conducted to merge the data from separate outcome databases using a fixed-effects *** Genetically higher serum urate levels were strongly associated with an increased risk of UC[odds ratio(OR):1.95,95%confidence interval(CI):1.86-2.05]after outlier correction,and the ORs(95%CIs)for IBD and CD were 0.94(95%CI:0.86-1.03)and 0.91(95%CI:0.80-1.04),*** studies have confirmed the positive association between urate levels and ***,genetically predicted IBD was inversely related to urate levels(OR:0.97,95%CI:0.94-0.99).However,no association was observed between genetically influenced UC or CD and urate *** Urate levels might be risk factors for UC,whereas genetically predicted IBD was inversely associated with urate *** findings provide essential new insight for treating and preventing IBD.

关键词： Inflammatory bowel disease Urate levels Antioxidant Mendelian randomization Single nucleotide polymorphism

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Scale offers the possibility of identifying adherence to lifestyle interventions in patients with non-alcoholic fatty liver disease

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World Journal of gastroenterology 2024年第25期30卷 3179-3181页

作者： Cen-Qin Liu Bing Hu Department of gastroenterology and Hepatology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of gastroenterology and Hepatology/Medical Engineering Integration Laboratory of digestive endoscopy West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD *** et al established a prediction system to evaluate adherence to lifestyle interventions in patients with NAFLD and choose optimal ***,we discuss the application scenarios of the scale and the areas warranting further attention,aiming to provide a possible reference for clinical recommend-ations.

关键词： Nonalcoholic fatty liver disease Dietary and lifestyle interventions Scale Adherence Exercise

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