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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real-life application of MSE,an unexpected safety issue emerged regarding esophageal injury and the technique has been withdrawn from the global market,despite encouraging results in terms of diagnostic and therapeutic *** conducted an Italian multicenter real-life prospective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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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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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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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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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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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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Topic highlight on texture and color enhancement imaging in gastrointestinal diseases

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World Journal of gastroenterology 2024年第14期30卷 1934-1940页

作者： Osamu Toyoshima Toshihiro Nishizawa Keisuke Hata department of gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan department of gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan department of gastroenterology Nihonbashi Muromachi Mitsui Tower Midtown ClinicTokyo 103-0022Japan

Olympus Corporation developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic *** topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting.A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate(ADR)and the mean number of adenomas per procedure(MAP)of TXI compared with those of white-light imaging(WLI)observation(58.7%vs 42.7%,adjusted relative risk 1.35,95%CI:1.17-1.56;1.36 vs 0.89,adjusted incident risk ratio 1.48,95%CI:1.22-1.80,respectively).A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI(1.5 vs 1.0,adjusted odds ratio 1.4,95%CI:1.2-1.6;58.2%vs 46.8%,1.5,1.0-2.3,respectively).A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure(0.29 vs 0.30,difference for non-inferiority-0.01,95%CI:-0.10 to 0.08).A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis.A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI(0.71%vs 0.29%).A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI(69.2%vs 52.5%and 85.3%vs 78.7%,res-pectively).In conclusion,TXI can improve gastrointestinal lesion detection and qualitative ***,further studies on the efficacy of TXI in clinical practice are required.

关键词： endoscopy Texture and color enhancement imaging White-light imaging Narrow-band imaging Colorectal neoplasm Gastric cancer Adenoma Ulcerative colitis Helicobacter infections Colonoscopy

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Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 139-145页

作者： Wellington Andraus Francisco Tustumi Alexandre Chagas Santana Rafael Soares Nunes Pinheiro Daniel Reis Waisberg Liliana Ducatti Lopes Rubens Macedo Arantes Vinicius Rocha Santos Rodrigo Bronze de Martino Luiz Augusto Carneiro D’Albuquerque department of gastroenterology Transplantation UnitUniversidade de São PauloSão PauloBrazil

Background:Perihilar cholangiocarcinoma(phCCC)is a dismal *** is no consensus regard-ing the best treatment for patients with unresectable *** present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical *** sources:The search was conducted in PubMed,Embase,Cochrane,and *** related references were searched *** criteria were:reports in English or Portuguese literature that a)patients with confirmed diagnosis of phCCC;b)patients treated with a curative intent;c)patients with the outcomes of liver resection and liver *** reports,reviews,letters,editorials,conference abstracts and papers with full-text unavailability were excluded from the ***:Most of the current literature is based on observational retrospective studies with low grades of *** resection has better long-term outcomes than systemic chemotherapy or palliation ther-apy and liver transplantation is a good alternative for selected patients with unresectable *** candidates for resection or transplantation should be medically fit and free of intrahepatic or extrahep-atic *** a general rule,patients presenting with a tumor having a longitudinal size>3 cm or extending below the cystic duct,lymph node disease,confirmed extrahepatic dissemination;intraoper-atively diagnosed metastatic disease;a history of other malignancies within the last five years,and did not complete chemoradiation regimen and were medically unfit should not be considered for *** of these criteria should be individually *** transplantation or resection should only be considered in highly experienced hepatobiliary centers,and any decision-making must be based on a multidisciplinary ***:phCCC is a complex condition with high *** therapies,including hepatec-tomy and liv

关键词： Liver transplantation Cholangiocarcinoma Liver neoplasms

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Endoscopic polidocanol foam sclerobanding for the treatment of grade Ⅱ-Ⅲ internal hemorrhoids:A prospective,multi-center,randomized study

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World Journal of gastroenterology 2024年第27期30卷 3326-3335页

作者： Chun-Ying Qu Fei-Yu Zhang Yi Zhang Ming-Ming Li Zheng-Hong Li Mei-Hong Cai Lei-Ming Xu Feng Shen Wen Wang Wu-Lian Lin Feng-Yu Gao Hao Zhang Guang-Yu Chen department of gastroenterology&endoscopy Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China department of gastroenterology The 900th Hospital of the People’s Liberation Army Joint Service Support ForceFuzhou 350025Fujian ProvinceChina department of endoscopy Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao UniversityJinan 250014Shandong ProvinceChina department of endoscopy Baoshan People’s Hospital of Yunnan ProvinceBaoshan 678000Yunnan ProvinceChina department of gastroenterology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural *** To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and *** This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL *** patients were followed-up for 12 ***-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile *** One hundred and ninety-five patients were enrolled,with 98 in the EFSB *** was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of *** prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours *** median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

关键词： Internal hemorrhoids Endoscopic therapy Polidocanol foam Sclerotherapy Rubber band ligation Sclerobanding

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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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