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First prospective European study for the feasibility and safety of magnetically controlled capsule endoscopy in gastric mucosal abnormalities

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World Journal of Gastroenterology 2022年第20期28卷 2227-2242页

作者： Milán Szalai Krisztina Helle Barbara Dorottya Lovász Ádám Finta András Rosztóczy László Oczella László Madácsy Department of Gastroenterology Endo-Kapszula Health Centre and Endoscopy UnitSzékesfehérvár 8000Hungary Department of Internal Medicine University of SzegedSzeged 6725Hungar

BACKGROUND While capsule endoscopy(CE)is the gold standard diagnostic method of detecting small bowel(SB)diseases and disorders,a novel magnetically controlled capsule endoscopy(MCCE)system provides non-invasive evaluation of the gastric mucosal surface,which can be performed without sedation or *** standard SBCE,passive movement of the CE may cause areas of the complex anatomy of the gastric mucosa to remain unexplored,whereas the precision of MCCE capsule movements inside the stomach promises better visualization of the entire *** To evaluate the Ankon MCCE system’s feasibility,safety,and diagnostic yield in patients with gastric or SB *** Of outpatients who were referred for SBCE,284(male/female:149/135)were prospectively enrolled and evaluated by *** stomach was examined in the supine,left,and right lateral decubitus positions without ***,all patients underwent a complete SBCE study *** gastric mucosa was explored with the Ankon MCCE system with active magnetic control of the capsule endoscope in the stomach,applying three standardized pre-programmed computerized algorithms in combination with manual control of the magnetic *** The urea breath test revealed Helicobacter pylori positivity in 32.7%of *** mean gastric and SB transit times with MCCE were 0 h 47 min 40 s and 3 h 46 min 22 s,*** average total time of upper gastrointestinal MCCE examination was 5 h 48 min 35 *** magnetic movement of the Ankon capsule through the pylorus was successful in 41.9%of *** diagnostic yield for detecting abnormalities in the stomach and SB was 81.9%(68.6%minor;13.3%major pathologies);25.8%of abnormalities were in the SB;74.2%were in the *** diagnostic yield for stomach/SB was 55.9%/12.7%for minor and 4.9%/8.4%for major *** MCCE is a feasible,safe diagnostic method for evaluating gastric mucosal lesions and is a promising non-invasive scree

关键词： Bowel diseases Capsule endoscopy Diagnostic techniques Gastrointestinal diseases Gastric mucosa Helicobacter pylori

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Predicting colorectal adenomatous polyps in patients with chronic liver disease: A novel nomogram

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World Journal of Gastroenterology 2025年第2期31卷 71-84页

作者： Yu-Qin Li Wen-Tao Kuai Lin Chen Ming-Hui Zeng Xue-Mei Tao Jia-Xin Han Yue-Kui Wang Lian-Xin Xu Li-Ying Ge Yong-Gang Liu Shuang Li Liang Xu Yu-Qiang Mi Clinical School of the Second People’s Hospital Tianjin Medical UniversityTianjin 300192China Department of Hepatology Tianjin Second People’s HospitalTianjin 300192China Department of Pathology Clinical School of the Second People’s HospitalTianjin 300110China endoscopy Center Tianjin Second People’s HospitalTianjin 300192China

BACKGROUND Colorectal polyps are commonly observed in patients with chronic liver disease(CLD)and pose a significant clinical concern because of their potential for *** To explore the clinical characteristics of colorectal polyps in patients with CLD,a nomogram was established to predict the presence of adenomatous polyps(AP).METHODS Patients with CLD who underwent colonoscopy at Tianjin Second People’s Hospital from January 2020 to May 2023 were *** data including laboratory results,colonoscopy findings,and pathology reports were *** variables for the nomogram were identified through least absolute shrinkage and selection operator regression,followed by multivariate logistic *** performance of the model was evaluated using the area under the receiver area under curve,as well as calibration curves and decision curve *** The study enrolled 870 participants who underwent colonoscopy,and the detection rate of AP in patients with CLD was 28.6%.Compared to individuals without polyps,six risk factors were identified as predictors for AP occurrence:Age,male sex,body mass index,alcohol consumption,overlapping metabolic dysfunction-associated steatotic liver disease,and serum ferritin *** novel nomogram(AP model)demonstrated an area under curve of 0.801(95%confidence interval:0.756-0.845)and 0.785(95%confidence interval:0.712-0.858)in the training and validation *** curves indicated good agreement among predicted and actual probabilities(training:χ^(2)=11.860,P=0.157;validation:χ^(2)=7.055,P=0.530).The decision curve analysis underscored the clinical utility of the nomogram for predicting the risk of *** The AP model showed reasonable accuracy and provided a clinical foundation for predicting the occurrence of AP in patients with CLD,which has a certain predictive value.

关键词： Metabolic dysfunction associated steatotic liver disease Fatty liver Chronic liver disease Colorectal adenomas Hepatitis Risk factors

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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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Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis: A review of the literature

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World Journal of Gastrointestinal Surgery 2019年第2期11卷 53-61页

作者： Benedetto Mangiavillano Mouen A Khashab Ilaria Tarantino Silvia Carrara Rossella Semeraro Francesco Auriemma Mario Bianchetti Leonardo Henry Eusebi Chen Yen-I Luca De Luca Mario Traina Alessandro Repici Gastrointestinal endoscopy unit Humanitas-Mater Domini Humanitas Huniversity Division of Gastroenterology and Hepatology Johns Hopkins Hospital Gastroenterology and endoscopy unit Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) Digestive endoscopy unit Division of Gastroenterology Humanitas Clinical and Research Center IRCCS Digestive endoscopy unit Istituto Clinico Humanitas Research Hospital unit of Gastroenterology Department of Medical and Surgical Sciences S. Orsola-Malpighi Hospital University of Bologna Gastroenterology and Digestive endoscopy unit Ospedali Riuniti Marche Nord Digestive endoscopy unit Division of Gastroenterology Humanitas Research Hospital

Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary, peri-ampullary, and pancreatic head neoplasia. Surgical bypass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique, with a high technical success in expert hands. In recent years, endoscopic ultrasonography(EUS) has evolved from a diagnostic to a therapeutic procedure, and is now increasingly used to guide biliary drainage, especially in cases of failed endoscopic retrograde cholangiopancreatography(ERCP). The advent of lumen-apposing metal stents(LAMS) has expanded EUS therapeutic options, and changed the management of synchronous bilioduodenal stenosis. The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach, also considering the advent of an interventional EUS approach using LAMS.

关键词： Malignant biliary strictures Malignant duodenal stenosis Bilio-duodenal stenosis Biliary self-expandable metal stent Duodenal self-expandable metal stent Lumen-apposing metal stents Gastro-jejunostomy

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Characteristics of superficial esophageal squamous cell carcinomas undetectable with narrow-band imaging endoscopy

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Gastroenterology Report 2021年第5期9卷 402-407,I0001页

作者： Shingo Ono Akira Dobashi Hiroto Furuhashi Akio Koizumi Hiroaki Matsui Yuko Hara Kazuki Sumiyama Department of endoscopy The Jikei University School of MedicineTokyoJapan

Background The detection rate of narrow-band imaging(NBI)for superficial esophageal squamous cell carcinoma(SESCC),including high-grade intraepithelial neoplasia,is significantly higher than that of white-light ***,there are SESCCs that are undetectable by NBI but detectable by Lugol chromoendoscopy(LCE)and the characteristics of these SESCCs are still ***,this study aimed to clarify the characteristics of SESCC that are undetectable using *** Patients with current SCC or a history of SCC in the head and neck or in the esophagus were *** inspection of the esophagus was initiated by NBI,followed by *** were taken of all suspected SESCC lesions during NBI observation and Lugol-voiding lesions(LVLs)that were irregularly shaped and>5mmand/or pink in color during LCE *** characteristics of SESCC that were undetectable with NBI were statistically *** Overall,147 lesions in 105 cases were histologically diagnosed as *** in 15 cases were NBI-undetectable lesions,all of which were macroscopic flat type(0-IIb).The median sizes of the NBI-undetectable lesions and NBI-detectable lesions were both 15mm(P=0.47).Multivariate analysis revealed independent factors for NBI-undetectable lesions such as numerous irregularly shaped LVLs(odds ratio[OR]:4.94,95%confidence interval[CI]:1.39–17.5,P<0.05)and anterior wall position(OR:4.99,95%CI:1.58–15.8,P<0.05).Conclusions The detection of SESCCs with NBI is challenging when lesions are morphologically completely flat,in cases with numerous irregularly shaped LVLs,and if located at the anterior wall.

关键词： esophageal squamous cell carcinoma narrow-band imaging Lugol chromoendoscopy Lugol-voiding lesions

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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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Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy

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World Journal of Gastrointestinal endoscopy 2015年第6期7卷 582-592页

作者： Helga Bertani Marzio Frazzoni Santi Mangiafico Angelo Caruso Mauro Manno Vincenzo Giorgio Mirante Flavia Pigò Carmelo Barbera Raffaele Manta Rita Conigliaro Digestive endoscopy unit Baggiovara Hospital Digestive Pathophysiology unit Baggiovara Hospital

In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neoplastic disease at early stage, thus the diagnosis of cholangiocarcinoma is achieved usually at unresectable stage. In the last decades the role of endoscopy has moved from a diagnostic role to an invaluable therapeutic tool for patients affected by malignant bile duct obstruction. One of the major issues for cholangiocarcinoma is bile ducts occlusion, leading to jaundice, cholangitis and hepatic failure. Currently, endoscopy has a key role in the work up of cholangiocarcinoma, both in patients amenable to surgical intervention as well as in those unfit for surgery or not amenable to immediate surgical curative resection owing to locally advanced or advanced disease, with palliative intention. endoscopy allows successful biliary drainage and stenting in more than 90% of patients with malignant bile duct obstruction, and allows rapid reduction of jaundice decreasing the risk of biliary sepsis. When biliary drainage and stenting cannot be achieved with endoscopy alone, endoscopic ultrasound-guided biliary drainage represents an effective alternative method affording successful biliary drainage in more than 80% of cases. The purpose of this review is to focus on the currently available endoscopic management options in patients with cholangiocarcinoma.

关键词： Cholangiocarcinoma Malignant bile ductobstruction Interventional endoscopy Endoscopictherapy Self-expandable metal stent

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Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy

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World Journal of Gastroenterology 2016年第41期22卷 9196-9204页

作者： Akira Dobashi Kenichi Goda Noboru Yoshimura Tomohiko R Ohya Masayuki Kato Kazuki Sumiyama Masato Matsushima Shinichi Hirooka Masahiro Ikegami Hisao Tajiri Department of endoscopy The Jikei University School of Medicine Department of endoscopy The Jikei University Katsushika Medical Center Division of Clinical Epidemiology The Jikei University School of Medicine Department of Pathology The Jikei University School of Medicine Department of Innovative Interventional endoscopy Research The Jikei University School of Medicine

AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: "intervascular background coloration"; "proliferation of intrapapillary capillary loops(IPCL)"; and "dilation", "tortuosity", "change in caliber", and "various shapes(VS)" of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's *** Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria,

关键词： Simplified criteria Narrow Band Imaging Magnifying endoscopy Esophageal cancer Squamous cell carcinoma Endoscopic diagnosis Classification Superficial squamous cell carcinoma Stepwise logistic regression analysis

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