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Endoscopic features and treatments of gastric cystica profunda

World Journal of Gastroenterology 2024年第7期30卷 673-684页

作者： Zi-Han Geng Yan Zhu Pei-Yao Fu Yi-Fan Qu Wei-Feng Chen Xia Yang Ping-Hong Zhou Quan-Lin Li endoscopy Center and endoscopy Research Institute Zhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND Gastric cystica profunda(GCP)represents a rare condition characterized by cystic dilation of gastric glands within the mucosal and/or submucosal *** is often linked to,or may progress into,early gastric cancer(EGC).AIM To provide a comprehensive evaluation of the endoscopic features of GCP while assessing the efficacy of endoscopic treatment,thereby offering guidance for diagnosis and *** This retrospective study involved 104 patients with GCP who underwent endoscopic *** demographic and clinical data,regular patient followups were conducted to assess local *** Among the 104 patients diagnosed with GCP who underwent endoscopic resection,12.5%had a history of previous gastric *** primary site predominantly affected was the cardia(38.5%,n=40).GCP commonly exhibited intraluminal growth(99%),regular presentation(74.0%),and ulcerative mucosa(61.5%).The leading endoscopic feature was the mucosal lesion type(59.6%,n=62).The average maximum diameter was 20.9±15.3 mm,with mucosal involvement in 60.6%(n=63).Procedures lasted 73.9±57.5 min,achieving complete resection in 91.3%(n=95).Recurrence(4.8%)was managed via either surgical intervention(n=1)or through endoscopic resection(n=4).Final pathology confirmed that 59.6%of GCP cases were associated with *** analysis indicated that elderly males were more susceptible to GCP associated with ***,multivariate analysis identified lesion morphology and endoscopic features as significant risk *** analysis demonstrated no statistically significant difference in recurrence between GCP with and without EGC(P=0.72).CONCLUSION The findings suggested that endoscopic resection might serve as an effective and minimally invasive treatment for GCP with or without EGC.

关键词： Gastric cystica profunda Early gastric cancer Endoscopic features Endoscopic resection endoscopy

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METTL5 promotes gastric cancer progression via sphingomyelin metabolism

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1925-1946页

作者： Ya-Qiong Zhang Jian Li Zhe Qin De-Ming Li Fang-Zhou Ye Song-Hua Bei Xiao-Hong Zhang Li Feng endoscopy Center Minhang Hospital Affiliated to Fudan UniversityShanghai 201100China

BACKGROUND The treatment of gastric cancer(GC)has caused an enormous social burden *** studies have reported that N6-methyladenosine(m6A)is closely related to tumor ***5 is a m6A methyltransferase that plays a pivotal role in maintaining the metabolic stability of ***,its aberrant regulation in GC has not been fully *** To excavate the role of METTL5 in the development of *** METTL5 expression and clinicopathological characteristics were analyzed via The Cancer Genome Atlas dataset and further verified via immunohistochemistry,western blotting and real-time quantitative polymerase chain reaction in tissue microarrays and clinical *** tumor-promoting effect of METTL5 on HGC-27 and AGS cells was explored in vitro by Cell Counting Kit-8 assays,colony formation assays,scratch healing assays,transwell assays and flow *** tumor-promoting role of METTL5 in vivo was evaluated in a xenograft tumor *** EpiQuik m6A RNA Methylation Quantification Kit was used for m6A ***,liquid chromatography-mass spectrometry was used to evaluate the association between METTL5 and sphingomyelin metabolism,which was confirmed by Enzyme-linked immunosorbent assay and rescue *** addition,we investigated whether METTL5 affects the sensitivity of GC cells to cisplatin via colony formation and transwell *** Our research revealed substantial upregulation of METTL5,which suggested a poor prognosis of GC *** METTL5 expression indicated distant lymph node metastasis,advanced cancer stage and pathological *** increased level of METTL5 correlated with a high degree of m6A ***5 markedly promotes the proliferation,migration,and invasion of GC cells in ***5 also promotes the growth of GC in animal ***5 knockdown resulted in significant changes in sphingomyelin metabolism,which implies that METTL5 may impact the development of GC via sphin

关键词： Gastric cancer METTL5 Sphingomyelin metabolism Cisplatin

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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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Biopsy forceps are useful for measuring esophageal varices in vitro

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 539-545页

作者： Zhi-Hui Duan Sheng-Yun Zhou endoscopy Center Xingtai People’s HospitalXingtai 054000Hebei ProvinceChina

BACKGROUND To avoid acute variceal bleeding in cirrhosis,current guidelines recommend screening for high-risk esophageal varices(EVs)by determining variceal size and identifying red wale ***,visual measurements of EV during routine endoscopy are often *** To determine whether biopsy forceps(BF)could be used as a reference to improve the accuracy of binary classification of variceal *** An in vitro self-made EV model with sizes ranging from 2 to 12 mm in diameter was *** online image-based survey comprising 11 endoscopic images of simulated EV without BF and 11 endoscopic images of EV with BF was assembled and sent to 84 *** endoscopists were blinded to the actual EV size and evaluated the 22 images in random *** The respondents included 48 academic and four private *** accuracy of EV size estimation was low in both the visual(13.81%)and BF-based(20.28%)*** use of open forceps improved the ability of the endoscopists to correctly classify the varices by size(small≤5 mm,large>5 mm)from 71.85%to 82.17%(P<0.001).CONCLUSION BF may improve the accuracy of EV size assessment,and its use in clinical practice should be investigated.

关键词： Accuracy Liver cirrhosis Esophageal varices endoscopy Measurement

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Device-assisted enteroscopy: Are we ready to dismiss the spiral?

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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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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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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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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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Effect of endoscopic sphincterotomy and endoscopic papillary balloon dilation endoscopic retrograde cholangiopancreatographies on the sphincter of Oddi

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1726-1733页

作者： Kai Fu Ying-Ying Yang Hui Chen Guang-Xin Zhang Yan Wang Zhi Yin Department of Gastroentero endoscopy Center Yixing Hospital of Traditional Chinese MedicineWuxi 214200Jiangsu ProvinceChina

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for *** To investigate the effects of different ERCP procedures on the sphincter of *** The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed *** patients were divided into endoscopic sphinc-terotomy(EST,n=24)and endoscopic papillary balloon dilation(EPBD,n=67)*** duration of operation,pancreatic development,pancreatic sphinc-terotomy,intubation difficulties,stone recurrence,and incidence of reflux cho-langitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction in the EST and EPBD *** Differences in hypertension,diabetes,increased bilirubin,small diameter of the common bile duct,or ampullary diverticulum between the two groups were not *** significant differences were observed between the two groups concerning sex and age(<60 years).Patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction were higher in the EST group than in the EPBD *** number of cases of pancreatic development,pancreatic duct sphincterotomy,and difficult intubation were higher in the EST group than in the EPBD *** number of Oddi’s sphincter manometries,ERCP surgical outcomes,and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD *** numbers of stone recurrences,reflux cholangitis,and cholecystitis were higher in the EST group than in the EPBD *** In summary,common bile duct stones,pancreatitis history,and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and *** on this evidence,this study can provide

关键词： Oddi Cholangiopancreatography Endoscopic retrograde Risk factors Endoscopic sphincterotomy Endoscopic papillary balloon dilation

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