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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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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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Rising incidence of acute hepatitis A among adults and clinical characteristics in a tertiary care center of Pakistan

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World Journal of Virology 2025年第1期14卷 73-82页

作者： Yumna Shahid Amna Subhan Butt Iqra Jamali Faisal Wasim Ismail division of gastroenterology Department of MedicineAga Khan University HospitalKarachi 74800Pakistan Department of Medicine Aga Khan University HospitalKarachi 74800Pakistan

BACKGROUND For decades,hepatitis A virus(HAV)has been a leading cause of acute hepatitis among children and was less prevalent among ***,recently a paradigm shift has been observed in the epidemiology of HAV,as evident by cases of acute hepatitis due to HAV among *** To estimate frequency of HAV in acute viral hepatitis and compare characteristics in HAV and hepatitis E virus(HEV)*** This was a trend analysis conducted at Aga Khan University Hospital Karachi(Sindh,Pakistan)from February 2024 to May *** aged 18 years and older diagnosed with acute viral hepatitis attributed to hepatotropic viruses in 2024 were *** compare the trend patients admitted with acute hepatitis during 2019-2023 were also *** regarding clinical and laboratory parameters were *** yearly trend of acute hepatitis due to HAV and HEV was analyzed,and comparative analysis was done between HAV and HEV cases among *** A total of 396 patients were found to have acute hepatitis during our study *** was diagnosed in 234 patients(59%)while 157 patients(39.6%)were found to have acute HEV ***,acute hepatitis B virus infection was identified in 3 patients(0.7%),whereas acute hepatitis C virus infection was found in 2(0.5%)cases of acute *** trends showed increasing occurrence of HAV infection among adults over last 5 *** patients with acute HAV were younger than patients with HEV(28 years±8 years vs 30 years±8 years;P<0.01).Higher levels of total bilirubin were seen in HEV infection,while higher levels of alanine transaminase were seen in HAV ***,a higher proportion of acute liver failure(ALF),coagulopathy,and mortality were observed in *** An increase in acute hepatitis A cases among adults shows less severity than hepatitis E,highlighting the need for better sanitation,hygiene,and adult hepatitis A vaccination programs.

关键词： Acute hepatitis Hepatitis A virus Hepatitis E virus Acute liver failure Hepatotropic virus Vaccination

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Meta-analysis and systematic review of colorectal endoscopic mucosal resection

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World Journal of gastroenterology 2009年第34期15卷 4273-4277页

作者： Srinivas R Puli Yasuo Kakugawa Takuji Gotoda Daphne Antillon Yutaka Saito Mainor R Antillon division of gastroenterology and Hepatology University of Missouri-Columbia endoscopy division National Cancer Center Hospital

AIM:To evaluate the proportion of successful complete cure en-bloc resections of large colorectal polyps achieved by endoscopic mucosal resection(EMR). METHODS:Studies using the EMR technique to resect large colorectal polyps were *** complete cure en-bloc resection was defined as one piece margin-free polyp *** were searched for in Medline,Pubmed,and the Cochrane Control Trial Registry,among other sources. RESULTS:An initial search identified 2620 reference articles,from which 429 relevant articles were selected and *** was extracted from 25 studies(n =5221)which met the inclusion *** the studies used snares to perform *** proportion of en-bloc resections using a random effect model was 62.85%(95%CI:51.50-73.52).The pooled proportion for complete cure en-bloc resections using a random effect model was 58.66%(95%CI:47.14-69.71).With higher patient load(>200 patients),this complete cure en-bloc resection rate improves from 44.19%(95%CI: 24.31-65.09)to 69.17%(95%CI:51.11-84.61). CONCLUSION:EMR is an effective technique for the resection of large colorectal polyps and offers an alternative to surgery.

关键词： Meta-analysis Systematic review Polyps Endoscopic mucosal resection En-bloc resection

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Balloon overtube-guided colorectal endoscopic submucosal dissection

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World Journal of gastroenterology 2009年第48期15卷 6086-6090页

作者： Tomohiko Ohya Ken Ohata Kazuki Sumiyama Yousuke Tsuji Ikuro Koba Nobuyuki Matsuhashi Hisao Tajiri Department of endoscopy The Jikei University School of Medicine division of gastroenterology Kanto Medical Center NTT EC division of gastroenterology and Hepatology Yamaga Chou Hospital Department of endoscopy Department of Gastroenterology and HepatologyThe Jikei University School of Medicine

AIM:To evaluate the usefulness of a balloon overtube to assist colorectal endoscopic submucosal dissection(ESD)using a ***:The results of 45 consecutive patients who underwent colorectal ESD were analyzed in a single tertiary endoscopy *** preoperative evaluation of access to the lesion,difficulties were experienced in the positioning and stabilization of a gastroscope in 15 patients who were thus assigned to the balloonguided ESD group.A balloon overtube was placed with a gastroscope to provide an endoscopic channel to the lesion in cases with preoperatively identified difficulties related to *** ESD was performed following standard procedures.A submucosal fluid bleb was created with hyaluronic acid solution.A circumferential mucosal incision was made to marginate the *** isolated lesion was finally excised from the deeper layers with repetitive electrosurgical dissections with needle *** success of colorectal ESD,procedural feasibility,and procedure-related complications were the main outcomes and ***:The overall en bloc excision rate of colorectal ESD during this study at our institution was 95.6%.En bloc excision of the lesion was successfully achieved in 13 of the 15 patients(86.7%)in the balloon overtube-guided colorectal ESD group,which was comparable to the results of the standard ESD group with better accessibility to the lesion(30/30,100%,not statistically significant).CONCLUSION:Use of a balloon overtube can improve access to the lesion and facilitate scope manipulation for colorectal ESD.

关键词： Balloon overtube Colorectal neoplasm Early colorectal cancer En bloc tumor excision Endoscopic submucosal dissection Laterally spreading tumor

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Decreased levels of plasma adiponectin associated with increased risk of colorectal cancer

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World Journal of gastroenterology 2010年第10期16卷 1252-1257页

作者： Sayaka Otake Hiroaki Takeda Shoichiro Fujishima Tadahisa Fukui Tomohiko Orii Takeshi Sato Yu Sasaki Shoichi Nishise Sumio Kawata Department of gastroenterology Yamagata University Faculty of Medicine division of endoscopy Yamagata University Hospital

AIM:To investigate the association between adiponectin levels and risk of colorectal adenoma and cancer (early and advanced).METHODS: A cross-sectional study in a cohort of hospital-based patients was conducted between January 2004 and March 2006 at Yamagata University Hospital. Male subjects, who had colorectal tumors detected by endoscopic examination, were enrolled according to inclusion and exclusion criteria. Based on the T factor of the TNM system, intraepithelial carcinoma and submucosally invasive carcinoma were def ined as early cancer, and invasion into the muscularis propria or deeper was defined as advanced cancer. The plasma levels of glucose, insulin, total cholesterol, triglyceride, high sensitivity C-reactive protein, insulin like growth factor (IGF)-1, IGF binding protein-3, adiponectin, leptin, and resistin were measured. Each factor level was designated low or high, and the risk of adenoma or cancer was estimated by univariate and multivariate logistic regression ***: We enrolled 124 male subjects (47 with adenoma, 34 with early cancer, 17 with advanced cancer, and 26 without tumors as controls). In patients with adenoma, high triglyceride and low adiponectin were associated with a significant increase in the odds ratio (OR) by univariate analysis. Only a low adiponectin level was related to increased adenoma risk, with an adjusted OR for low level (<11 μg/mL) to high (≥11 μg/mL) of 5.762 (95% confidence interval (CI):1.683-19.739, P=0.005). In the patients with early cancer, high body mass index, high triglyceride, and low adiponectin were associated with a significant increase in OR in univariate analysis. Imultivariate analysis, only low adiponectin was significantly associated with early cancer, with an adjusted OR of 4.495 (95% CI:1.090-18.528, P=0.038). However, in patients with advanced cancer, low adiponectin was not recognized as a significant risk factor for advanced ***: A decreased level of adiponectin is str

关键词： Adenoma Early colorectal cancer Metabolic syndrome Adipokines Colonoscopy Resistin Leptin Body mass index

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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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Use of color Doppler ultrasonography in the diagnosis of anomalous connection in pancreatobiliary disease

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World Journal of gastroenterology 2005年第7期11卷 1018-1022页

作者： Hiroki Kawashima Yoshiki Hirooka Akihiro Itoh Senju Hashimoto Terutomo Itoh Kazuo Hara Akira Kanamori Naoki Ohmiya Yasumasa Niwa Hidemi Goto Department of gastroenterology Department of endoscopy

AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was ***: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.

关键词： Color Doppler ultrasonography Anomalous connection in pancreatobiliary disease Gallbladder cancer Gallbladder wall blood flow Endoscopic ultrasonography

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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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High-definition colonoscopy with i-Scan:Better diagnosis for small polyps and flat adenomas

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World Journal of gastroenterology 2012年第37期18卷 5231-5239页

作者： Pier Alberto Testoni Chiara Notaristefano Cristian Vailati Milena Di Leo Edi Viale division of gastroenterology and Gastrointestinal endoscopy Vita-Salute San Raffaele UniversityScientific Institute San Raffaele

AIM： To investigate if high-definition （HD） colonoscope with i-Scan gave a higher detection rate of mucosal le- sions vs standard white-light instruments. METHODS： Data were collected from the computer- ized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 con- secutive colonoscopies that were performed over 1 year with standard white-light （n = 849） or HD＋ with i-Scan （n = 252） instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients＇ main details and family history for colorectal cancer, indication for colonoscopy （screening, diagnos- tic or surveillance）, type of instrument used （standard white-light or HD＋ plus i-Scan）, name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or imme- diately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protruding lesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. RESULTS： Eight hundred and forty-nine colonosco- pies were carried with the standard white-light video colonoscope and 252 with the HD＋ plus i-Scan video colonoscope, The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6%, 24.0%, 21.7% and 24.1% of them with the HD＋ plus i-Scan technique. There were no significant differences be- tween the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures （47.4%）. The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD＋ plus i-Scan mode （171/252 = 67.9%） than with the standard white-light technique （4

关键词： Colonoscopy High-definition+ with i-Scancolonoscopy White-light colonoscopy Colonic polyps Nonprotruding lesions Adenoma detection rate With-drawal time Surface enhancement Contrast enhance-ment Tone enhancement

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