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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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Optimizing care for gastric cancer with overt bleeding:Is systemic therapy a valid option?

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World Journal of Clinical Oncology 2025年第1期16卷 1-4页

作者： Emad Qayed Department of Medicine Division of Digestive DiseasesEmory University School of MedicineAtlantaGA 30303United States

Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with *** propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse *** study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.

关键词： Gastric cancer Overt bleeding Systemic therapy Endoscopic therapy Hemostasis

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Incidence and localization of lymphoid follicles in early colorectal neoplasms

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World Journal of Gastroenterology 2005年第43期11卷 6863-6866页

作者： Kuang-I Fu Yasushi Sano Shigeharu Kato Takahiro Fujii Ikura Koba Takayuki Yoshino Atsushi Ochiai Shigeaki Yoshida Takahiro Fujimori division of Gastrointestinal Oncology and digestive endoscopy division of Pathology Department of Surgical and Molecular Pathology

AIM： TO investigate the incidence and Iocalizations of lymphoid follicles （LFs） in early colorectal neoplasms in human beings. METHODS： From July 1992 to September 1999, a total of 1 324 early colorectal neoplasms were removed endoscopically or surgically at our hospital; 1 031 （77.9%） were available for analysis in this study. Localization of LFs was defined histologically： as submucosal LFs, if located under the muscularis mucosa; and as intramucosal LFs, if located across or over the muscularis RESULTS： Histologically, the materials included 903 intramucosal neoplasms and 128 submucosal cancers. Overall incidence of LFs was 27.2% （280/1 031）. The incidence of LFs was significantly higher in females （33.6% vs 24.9%, P = 0.0064）, the right-sided colon （32.2% vs 25.6%, P = 0.0403） and in flat or depressed type lesions （34.6% vs 25.2%, P〈O.O001） as compared to males, left-sided colon and protruding type lesions, respectively. The incidences of intramucosal neoplasms and submucosal cancers were 24.3% and 43.8%, respectively （P〈O.O001）. Localizations of LFs （intramucosal LF/submucosal LF） in depressed, flat, and protruding types were 1/24, 14/36, and 131/74, respectively. CONCLUSION： The incidence of LFs in early human colorectal neoplasms significantly differs by gender, location, macroscopic type, and histology. Moreover,localization significantly differs by macroscopic type.

关键词： Lymphoid follicle Early colorectal neoplasm Carcinogenesis

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Bio-feedback treatment of fecal incontinence: Where are we, and where are we going?

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World Journal of Gastroenterology 2005年第31期11卷 4771-4775页

作者： Giuseppe Chiarioni Barbara Ferri Antonio Morelli Guido Iantorno Gabrio Bassotti Gastroenterological Rehabilitation division of the University of Verona Gastroenterology and digestive endoscopy Institute Gastroenterology and Hepatology Section digestive Motility Unit

Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedback techniques for the treatment of this disorder. Overall, the literature data claim a success rate in more than 70% of cases in the short term. However, recent controlled trials have not confirmed this optimistic view, thus emphasizing the role of standard care. Nonetheless, many authors believe that this should be the first therapeutic approach for fecal incontinence due to the efficacy, lack of side-effects,and scarce invasiveness. Well-designed randomized,controlled trial are eagerly awaited to solve this therapeutic dilemma.

关键词： Biofeedback Fecal incontinence

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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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Early endoscopic ultrasonography in acute biliary pancreatitis: A prospective pilot study

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World Journal of Gastroenterology 2015年第36期21卷 10427-10434页

作者： Andrea Anderloni Marianna Galeazzi Marco Ballarè Michela Pagliarulo Marco Orsello Mario Del Piano Alessandro Repic digestive endoscopy Unit Division of GastroenterologyHumanitas Research Hospital Gastrointestinal and endoscopy Unit AOU "Maggiore della Carità"28100 NovaraItaly

AIM: To investigate the clinical usefulness of early endoscopic ultrasonography(EUS) in the management of acute biliary pancreatitis(ABP).METHODS: All consecutive patients entering the emergency department between January 2010 and December 2012 due to acute abdominal pain and showing biochemical and/or radiological findings consistent with possible ABP were prospectively enrolled. Patients were classified as having a low,moderate,or high probability of common bile duct(CBD) stones,according to the established risk stratification. Exclusion criteria were: gastrectomy or patient in whom the cause of biliary obstruction was already identified by ultrasonography. All enrolled patients underwent EUS within 48 h of their admission. Endoscopic retrograde cholangiopancreatography was performed immediately after EUS only in those cases with proven CBD stones or sludge. The following parameters were investigated:(1) clinical: age,sex,fever;(2) radiological: dilated CBD; and(3) biochemical: bilirubin,AST,ALT,g GT,ALP,amylase,lipasis,PCR. Association between presence of CBD stone at EUS and the individual predictors wereassessed by univariate logistic regression. Predictors significantly associated with CBD stones(P < 0.05) were entered in a multivariate logistic regression ***: A total of 181 patients with pancreatitis were admitted to the emergency department between January 2010 and December 2012. After exclusion criteria a total of 71 patients(38 females,53.5%,mean age 58 ± 20.12 years,range 27-89 years; 33 males,46.5%,mean age 65 ± 11.86 years,range 41-91 years) were included in the present study. The probability of CBD stones was considered low in 21 cases(29%),moderate in 26(37%),and high in the remaining 24(34%). The 71 patients included in the study underwent EUS,which allowed for a complete evaluation of the target sites in all the cases. The procedure was completed in a mean time of 14.7 min(range 9-34 min),without any notable *** overall CBD

关键词： Acute biliary pancreatitis Choledocolithiasis Comm

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Lumen-apposing metal stents for malignant biliary obstruction: Is this the ultimate horizon of our experience?

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World Journal of Gastroenterology 2019年第29期25卷 3857-3869页

作者： Andrea Anderloni Edoardo Troncone Alessandro Fugazza Annalisa Cappello Giovanna Del Vecchio Blanco Giovanni Monteleone Alessandro Repici digestive endoscopy Unit Division of Gastroenterology Humanitas Research Hospital Milan 20089 Italy Department of Systems Medicine University of Rome “Tor Vergata” Rome 00133 Italy digestive endoscopy Unit Division of Gastroenterology Humanitas University Milan 20089 Italy

In the last years, endoscopic ultrasonography (EUS) has evolved from a purely diagnostic technique to a more and more complex interventional procedure, with the possibility to perform several type of therapeutic interventions. Among these, EUS-guided biliary drainage (BD) is gaining popularity as a therapeutic approach after failed endoscopic retrograde cholangiopancreatography in distal malignant biliary obstruction (MBO), due to the avoidance of external drainage, a lower rate of adverse events and re-interventions, and lower costs compared to percutaneous trans-hepatic BD. Initially, devices created for luminal procedures (e.g., luminal biliary stents) have been adapted to the new trans-luminal EUSguided interventions, with predictable shortcomings in technical success, outcome and adverse events. More recently, new metal stents specifically designed for transluminal drainage, namely lumen-apposing metal stents (LAMS), have been made available for EUS-guided procedures. An electrocautery enhanced delivery system (EC-LAMS), which allows direct access of the delivery system to the target lumen, has subsequently simplified the classic multi-step procedure of EUS-guided drainages. EUS-BD using LAMS and ECLAMS has been demonstrated effective and safe, and currently seems one of the most performing techniques for EUS-BD. In this Review, we summarize the evolution of the EUS-BD in distal MBO, focusing on the novelty of LAMS and analyzing the unresolved questions about the possible role of EUS as the first therapeutic option to achieve BD in this setting of patients.

关键词： Interventional endoscopic ultrasonography Endoscopic ultrasonography-guided biliary drainage Endoscopic ultrasonography-guided choledocho-duodenostomy Biliary metal stent Lumen-apposing metal stent

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Depressed-type (0-IIc) colorectal neoplasm in patients with family history of first-degree relatives with colorectal cancer:A cross-sectional study

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World Journal of Gastroenterology 2006年第19期12卷 3082-3087页

作者： Junko Iwasaki Yasushi Sano Kuang-I Fu Ai Machida Tatsuya Okuno Hikaru Kuwamura Takayuki Yoshino Kiyomi Mera Shigeharu Kato Atsushi Ohtsu Shigeaki Yoshida Takahiro Fujii division of digestive endoscopy and Gastrointestinal Oncology National Cancer Center Hospital East ChibaJapan TF Clinic Tokyo Japan

AIM： TO investigate the correlation of depressed-type （0-IIc） colorectal neoplasm and family history of firstdegree relatives （FDR） with colorectal cancer （CRC）. METHODS： This cross-sectional study was conducted from June 2000 to October 2002 at National Cancer Center Hospital East. Eligible patients undergoing initial total colonoscopy were surveyed regarding family history of CRC among FDR by a questionnaire prior to colonoscopic examinations. All endoscopic findings during colonoscopy were recorded and the macroscopic classification of the early stage neoplasm/cancer was classified into two types （0-IIc vs non 0-IIc）. Odds ratios （OR） and 95% confidence intervals （CI） were calculated by univariate and multivariate logistic regression to estimate the association between macroscopic features and clinicopathological data including gender, age, and family history of FDR with CRC. RESULTS： The OR of an association between family history of FDR with CRC and overall early stage neoplasm adjusted by gender and age was 1.85 （95% CI： 1.31-2.61, P = 0.0004）, that for non 0-IIc neoplasm was 1.71 （95% CI： 1.22-2.41, P = 0.0017） and for 0-IIc colorectal neoplasm was 2.78 （95% CI： 1.49-5.16, P = 0.0031）. CONCLUSION： Our study shows a significant association between a family history of FDR with CRC and 0-IIc colorectal neoplasm. When patients with a family history of FDR with CRC undergo colonoscopy, colonoscopists should check carefully for not only polypoid, but also depressed-type （0-IIc） lesions.

关键词： Depressed-type Family history Colorecta cancer First-degree relative Colonoscopy

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Capsule endoscopy in celiac disease

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World Journal of Gastroenterology 2008年第26期14卷 4146-4151页

作者： Cristiano Spada Maria Elena Riccioni Riccardo Urgesi Guido Costamagna digestive endoscopy Unit Catholic UniversityRome 00168Italy

Video capsule endoscopy is an attractive and patient- friendly tool that provides high quality images of the small bowel. Obscure gastrointestinal bleeding is the primary and most evaluated indication to capsule endoscopy;however,indications are expanding and a small number of preliminary reports have been presented concerning the role of video capsule endoscopy in the diagnosis of celiac disease. The purpose of this review is to update the current knowledge and to hypothesize on future perspectives of the use of video capsule endoscopy in patients with celiac disease.

关键词： Capsule endoscopy Celiac disease Diagnosis of celiac disease Celiac disease complications

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Size does not determine the grade of malignancy of early invasive colorectal cancer

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World Journal of Gastroenterology 2009年第22期15卷 2708-2713页

作者： Takahisa Matsuda Yutaka Saito Takahiro Fujii Toshio Uraoka Takeshi Nakajima Nozomu Kobayashi Fabian Emura Akiko Ono Tadakazu Shimoda Hiroaki Ikematsu Kuang-I Fu Yasushi Sano Takahiro Fujimori endoscopy division National Cancer Center Hospital Clinical Laboratory division National Cancer Center Hospital division of digestive endoscopy and Gastrointestinal Oncology National Cancer Center Hospital East Department of Surgical and Molecular Pathology Dokkyo University School of Medicine

AIM： To clarify the clinicopathological characteristics of small and large early invasive colorectal cancers （EI-CRCs）, and to determine whether malignancy grade depends on size. METHODS： A total of 583 consecutive EI-CRCs treated by endoscopic mucosal resection or surgery at the National Cancer Center Hospital between 1980 and 2004 were enrolled in this study. Lesions were classified into two groups based on size： small （≤10 ram） and large （〉10 ram）. Clinicopathological features, incidence of lymph node metastasis （LNM） and risk factors for LNM, such as depth of invasion, lymphovascular invasion （LVI） and poorly differentiated adenocarcinoma （PDA） were analyzed in all resected specimens. RESULTS： There were 120 （21%） small and 463 （79%） large lesions. Histopathological analysis of the small lesion group revealed submucosal deep cancer （sin： 1〉1000 μm） in 90 （75%） cases, LVI in 26 （22%） cases, and PDA in 12 （10%） cases. Similarly, the large lesion group exhibited submucosal deep cancer in 380 （82%） cases, LVI in 125 （27%） cases, and PDA in 79 （17%） cases. The rate of LNM was 11.2% and 12.1% in the small and large lesion groups, ***： Small EI-CRC demonstrated the same aggressiveness and malignant potential as large cancer.

关键词： Colorectal cancer Submucosal invasion Lymph node metastasis Endoscopic mucosal resection

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