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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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Diagnosis of autoimmune pancreatitis

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World Journal of Gastroenterology 2014年第44期20卷 16559-16569页

作者： Hiroyuki Matsubayashi Naomi Kakushima Kohei Takizawa Masaki Tanaka Kenichiro Imai Kinichi Hotta Hiroyuki Ono division of endoscopy Shizuoka Cancer Center

Autoimmune pancreatitis(AIP) is a distinct form of chronic pancreatitis that is increasingly being reported. The presentation and clinical image findings of AIP sometimes resemble those of several pancreatic malignancies, but the therapeutic strategy differs appreciably. Therefore, accurate diagnosis is necessary for cases of AIP. To date, AIP is classified into two distinct subtypes from the viewpoints of etiology, serum markers, histology, other organ involvements, and frequency of relapse: type 1 is related to Ig G4(lymphoplasmacytic sclerosing pancreatitis) and type 2 is related to a granulocytic epithelial lesion(idiopathic duct-centric chronic pancreatitis). Both types of AIP are characterized by focal or diffuse pancreatic enlargement accompanied with a narrowing of the main pancreatic duct, and both show dramatic responses to corticosteroid. Unlike type 2, type 1 is characteristically associated with increasing levels of serum Ig G4 and positive serum autoantibodies, abundant infiltration of Ig G4-positive plasmacytes, frequent extrapancreatic lesions, and relapse. These findings have led several countries to propose diagnostic criteria for AIP, which consist of essentially similar diagnostic items; however, several differences exist for each country, mainly due to differences in the definition of AIP and the modalities used to diagnose this disease. An attempt to unite the diagnostic criteria worldwide was made with the publication in 2011 of the international consensus diagnostic criteria for AIP, established at the 2010 Congress of the International Association of Pancreatology(IAP).

关键词： Autoimmune pancreatitis Diagnosis Criteria Japanese International consensus diagnostic criteria

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Endoscopic submucosal dissection for colorectal neoplasms:A review

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World Journal of Gastroenterology 2014年第43期20卷 16153-16158页

作者： Taku Sakamoto Genki Mori Masayoshi Yamada Yuzuru Kinjo Eriko So Seiichiro Abe Yosuke Otake Takeshi Nakajima Takahisa Matsuda Yutaka Saito endoscopy division National Cancer Center Hospital

The introduction of colorectal endoscopic submucosal dissection(ESD)has expanded the application of endoscopic treatment,which can be used for lesions with a low metastatic potential regardless of their *** has the advantage of achieving en bloc resection with a lower local recurrence rate compared with that of piecemeal endoscopic mucosal ***,in the past,surgery was indicated in patients with large lesions spreading to almost the entire circumference of the rectum,regardless of the depth of invasion,as endoscopic resection of these lesions was technically ***,a prime benefit of ESD is significant improvement in the quality of life for patients who have large rectal *** the other hand,ESD is not as widely applied in the treatment of colorectal neoplasms as it is in gastric cancers owing to the associated technical difficulty,longer procedural duration,and increased risk of *** diversify the available endoscopic treatment strategies for superficial colorectal neoplasms,endoscopists performing ESD need torecognize its indications,the technical issues involved in its application,and the associated *** review outlines the methods and type of devices used for colorectal ESD,and the training required by endoscopists to perform this procedure.

关键词： Colorectum Endoscopic submucosal dissection Short-term outcomes Training indication for endoscopic treatment

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Management and associated factors of delayed perforation after gastric endoscopic submucosal dissection

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World Journal of Gastroenterology 2015年第44期21卷 12635-12643页

作者： Haruhisa Suzuki Ichiro Oda Masau Sekiguchi Seiichiro Abe Satoru Nonaka Shigetaka Yoshinaga Takeshi Nakajima Yutaka Saito endoscopy division National Cancer Center Hospital

AIM: To identify the actual clinical management and associated factors of delayed perforation after gastric endoscopic submucosal dissection(ESD).METHODS: A total of 4943 early gastric cancer(EGC) patients underwent ESD at our hospital between January 1999 and June 2012. We retrospectively assessed the actual management of delayed perforation. In addition, to determine the factors associated with delayed perforation, after excluding 123 EGC patients with perforations that occurred during the ESD procedure, we analyzed the following clinicopathological factors among the remaining 4820 EGC patients by comparing the ESD cases with delayed perforation and the ESD cases without perforation: age, sex, chronological periods, clinical indications for ESD, status of the stomach, location, gastric circumference, tumor size, invasion depth, presence/absence of ulceration, histological type, type of resection, and procedure ***: Delayed perforation occurred in 7(0.1%) cases. The median time until the occurrence of delayed perforation was 11 h(range, 6-172 h). Three(43%) of the 7 cases required emergency surgery, while four were conservatively managed without surgical intervention. Among the 4 cases with conservative management, 2 were successfully managed endoscopically using the endoloop-endoclip technique. The median hospital stay was 18 d(range, 15-45 d). There were no delayed perforation-related deaths. Based on a multivariate analysis, gastric tube cases(OR = 11.0; 95%CI: 1.7-73.3; P = 0.013) were significantly associated with delayed ***: Endoscopists must be aware of not only the identified factors associated with delayed perforation, but also how to treat this complicationeffectively and promptly.

关键词： Early gastric cancer Endoscopic submucosal dissect

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Gut virome:New key players in the pathogenesis of inflammatory bowel disease

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World Journal of Methodology 2025年第2期15卷 27-43页

作者： Helal F Hetta Rehab Ahmed Yasmin N Ramadan Hayam Fathy Mohammed Khorshid Mohamed M Mabrouk Mai Hashem Department of Medical Microbiology and Immunology Faculty of MedicineAssiut UniversityAssiut 71515Egypt division of Microbiology Immunology and BiotechnologyFaculty of pharmacyUniversity of TabukTabuk 71491Saudi Arabia division of Microbiology Immunology and BiotechnologyDepartment of Natural Products and Alternative MedicineFaculty of PharmacyUniversity of TabukTabuk 71491Saudi Arabia Department of Internal Medicine Division HepatogastroenterologyAssiut UniversityAssiut 71515Egypt Department of Clinical Research Egyptian Developers of Gastroenterology and Endoscopy FoundationCairo 11936Egypt Department of Internal Medicine Faculty of Medicine.Tanta UniversityTanta 31527Egypt Department of Tropical Medicine Gastroenterology and HepatologyAssiut University HospitalAssiut 71515Egypt

Inflammatory bowel disease(IBD)is a chronic inflammatory illness of the *** the mechanism underlying the pathogenesis of IBD is not fully under-stood,it is believed that a complex combination of host immunological response,environmental exposure,particularly the gut microbiota,and genetic suscept-ibility represents the major *** gut virome is a group of viruses found in great frequency in the gastrointestinal tract of *** gut virome varies greatly among individuals and is influenced by factors including lifestyle,diet,health and disease conditions,geography,and *** majority of research has focused on the significance of gut bacteria in the progression of IBD,although viral populations represent an important component of the *** conducted this review to highlight the viral communities in the gut and their expected roles in the etiopathogenesis of IBD regarding published research to date.

关键词： Inflammatory bowel disease Pathogenesis Gut virome Bacteriophage Eukaryotic viruses

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Difficult colorectal polypectomy:Technical tips and recent advances

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World Journal of Gastroenterology 2023年第17期29卷 2600-2615页

作者： Sukit Pattarajierapan Hiroyuki Takamaru Supakij Khomvilai Surgical endoscopy Colorectal division Department of SurgeryFaculty of MedicineChulalongkorn UniversityBangkok 10330Thailand endoscopy division National Cancer Center HospitalTokyo 104-0045Japan

Colonoscopy has been shown to be an effective modality to prevent colorectal cancer(CRC)*** reduction is achieved by detecting and removing adenomas,which are precursors of *** colorectal polyps are small and do not pose a significant challenge for trained and skilled ***,up to 15%of polyps are considered“difficult”,potentially causing life-threatening complications.A difficult polyp is defined as any polyp that is challenging for the endoscopist to remove owing to its size,shape,or *** polypectomy techniques and skills are required to resect difficult colorectal *** were various polypectomy techniques for difficult polyps such as endoscopic mucosal resection(EMR),underwater EMR,Tip-in EMR,endoscopic submucosal dissection(ESD),or endoscopic full-thickness *** selection of the appropriate modality depends on the morphology and endoscopic *** technologies have been developed to aid endoscopists in performing safe and effective polypectomies,especially complex procedures such as *** advances include video endoscopy system,equipment assisting in advanced polypectomy,and closure devices/techniques for complication *** should know how to use these devices and their availability in practice to enhance polypectomy *** review describes several useful strategies and tips for managing difficult colorectal *** also propose the stepwise approach for difficult colorectal polyps.

关键词： Adenoma Colonic polyps Colonoscopy Endoscopic mucosal resection Endoscopic submucosal dissection Polypectomy

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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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Comparison of Hemospray~? and Endoclot? for the treatment of gastrointestinal bleeding

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World Journal of Gastroenterology 2019年第13期25卷 1592-1602页

作者： Francesco Vitali Andreas Naegel Raja Atreya Steffen Zopf Clemens Neufert Juergen Siebler Markus F Neurath Timo Rath Ludwig Demling endoscopy Center of Excellence Division of Gastroenterology Friedrich-Alexander-University

BACKGROUND Gastrointestinal(GI) bleeding is a common indication for endoscopy. For refractory cases, hemostatic powders(HP) represent "touch-free" *** To analyze short term(ST-within 72 h-) and long-term(LT-within 30 d-) success for achieving hemostasis with HP and to directly compare the two agents Hemospray(HS) and Endoclot(EC).METHODS HP was applied in 154 consecutive patients(mean age 67 years) with GI *** were followed up for 1 mo(mean follow-up: 3.2 mo).RESULTS Majority of applications were in upper GI tract(89%) with following bleeding sources: peptic ulcer disease(35%), esophageal varices(7%), tumor bleeding(11.7%), reflux esophagitis(8.7%), diffuse bleeding and erosions(15.3%). Overall ST success was achieved in 125 patients(81%) and LT success in 81 patients(67%). Re-bleeding occurred in 27% of all patients. In 72 patients(47%), HP was applied as a salvage hemostatic therapy, here ST and LT success were 81% and64%, with re-bleeding in 32%. As a primary hemostatic therapy, ST and LT success were 82% and 69%, with re-bleeding occurring in 22%. HS was more frequently applied for upper GI bleeding(P = 0.04)CONCLUSION Both HP allow for effective hemostasis with no differences in ST, LT success and re-bleeding.

关键词： Hemostatic powder Gastrointestinal bleeding Hemospray Endoclot Haemostasis

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CO_2 insufflation for potentially diffi cult colonoscopies: Effi cacy when used by less experienced colonoscopists

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World Journal of Gastroenterology 2009年第41期15卷 5186-5192页

作者： Toshio Uraoka Jun Kato Motoaki Kuriyama Keisuke Hori Shin Ishikawa Keita Harada Koji Takemoto Sakiko Hiraoka Hideyuki Fujita Joichiro Horii Yutaka Saito Kazuhide Yamamoto Department of endoscopy Okayama University Hospital Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences division of endoscopy National Cancer Center Hospital

AIM： To clarify the effectiveness of CO2 insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists. METHODS： One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO2 or standard air insuffiation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist （EC） group and a less experienced colonoscopist （LEC） group. Study measurements included a 100-mm visual analogue scale （VAS） for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times. RESULTS： Examination times did not differ, however, VAS scores in the CO2 group were significantly better than in the air group （P〈 0.001, two-way ANOVA） from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group （P = 0.29）, however, VAS scores for CO2 insufflation were significantly better than air insufflation in the LEC group （P = 0.023） immediately after colonoscopies and up to 4 h afterwards. CONCLUSION： CO2 insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.

关键词： CO2 insufflation Colonoscopy Difficult colonoscopy Experienced colonoscopist Training

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Endoscopic and biopsy diagnoses of superficial, nonampullary, duodenal adenocarcinomas

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World Journal of Gastroenterology 2015年第18期21卷 5560-5567页

作者： Naomi Kakushima Hideyuki Kanemoto Keiko Sasaki Noboru Kawata Masaki Tanaka Kohei Takizawa Kenichiro Imai Kinichi Hotta Hiroyuki Matsubayashi Hiroyuki Ono division of endoscopy Shizuoka Cancer Center division of Hepato-Biliary-Pancreatic Surgery Shizuoka Cancer Center division of Pathology Shizuoka Cancer Center

AIM: To investigate the accuracy of endoscopic or biopsy diagnoses of superficial nonampullary duodenal epithelial tumors(NADETs).METHODS:Clinicopathological data were reviewed for84 superficial NADETs from 74 patients who underwent surgery or endoscopic resection between September2002 and August 2014 at a single prefectural cancer *** NADETs were defined as lesions confined to the mucosa or *** and clinicopathological data were retrieved from charts,endoscopic and pathologic *** reports included endoscopic diagnosis,location,gross type,diameter,color,and presence or absence of *** diagnoses were made by an endoscopist in charge of the examination before biopsy specimens were *** images were obtained using routine,front-view,high-resolution video endoscopy,and chromoendoscopy with indigocarmine was performed for all *** images were reviewed by at least two endoscopists to assess endoscopic findings indicative of *** diagnoses based on endoscopy and biopsy findings were compared with histological diagnoses of resected ***,specificity,and accuracy were assessed for endoscopic diagnosis and biopsy ***:The majority(81%)of the lesions were located in the second portion of the *** median lesion diameter was 14.5 mm according to final *** was performed for 49 lesions from 39 patients,and 35 lesions from 35 patients were endoscopically *** histology confirmed 65carcinomas,15 adenomas,and 3 hyperplasias.A finaldiagnosis of duodenal carcinoma was made for 91%(52/57)of the lesions diagnosed as carcinoma by endoscopy and 93%(42/45)of the lesions diagnosed as carcinoma by *** sensitivity,specificity,and accuracy of endoscopic diagnoses were 80%,72%,and 78%,respectively,whereas those of biopsy diagnoses were 72%,80%,and 74%,*** diagnoses of carcinomas were made in88%(57/65)of

关键词： Biopsy Endoscopic diagnosis Duodenal adenoma Duodenal carcinoma Duodenal neoplasms

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