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Role and timing of endoscopy in acute biliary pancreatitis

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World Journal of Gastroenterology 2015年第40期21卷 11205-11208页

作者： Andrea Anderloni Alessandro Repici Department of Gastroenterology Digestive Endoscopy UnitHumanitas Research Hospital

The role and timing of endoscopy in the setting of acute biliary pancreatitis(ABP) is still being debated. Despite numerous randomized trials have been published,there is an obvious lack of consensus on the indications and timing of endoscopic retrograde cholangiopancreatography(ERCP) in ABP in metaanalyses and nationwide guidelines. The present editorial has been written to clarify the role of endoscopy in ABP. In clinical practice the decision to perform an ERCP is often based on biochemical and radiological criteria despite they already have been shown to be unreliable predictors of common bile duct stone presence. Endoscopic ultrasonography(EUS) is not currently a worldwide standard diagnostic procedure early in the course of acute biliary pancreatitis,but it has been shown to be accurate,safe and cost effective in diagnosing biliary obstructions compared with magnetic resonance cholangiopancreatography and ERCP and therefore in preventing unnecessary ERCP and its related complications. Early EUS in ABP allows,if appropriate,immediate endoscopic treatment and significant spare of unnecessary operative procedures thus reducing possible related complications.

关键词： Acute biliary pancreatitis Choledocolithiasis Comm

Capsule endoscopy in celiac disease

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World Journal of Gastroenterology 2008年第26期14卷 4146-4151页

作者： Cristiano Spada Maria Elena Riccioni Riccardo Urgesi Guido Costamagna Digestive endoscopy Unit Catholic UniversityRome 00168Italy

Video capsule endoscopy is an attractive and patient- friendly tool that provides high quality images of the small bowel. Obscure gastrointestinal bleeding is the primary and most evaluated indication to capsule endoscopy;however,indications are expanding and a small number of preliminary reports have been presented concerning the role of video capsule endoscopy in the diagnosis of celiac disease. The purpose of this review is to update the current knowledge and to hypothesize on future perspectives of the use of video capsule endoscopy in patients with celiac disease.

关键词： Capsule endoscopy Celiac disease Diagnosis of celiac disease Celiac disease complications

Novel image-enhanced endoscopy with i-scan technology

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World Journal of Gastroenterology 2010年第9期16卷 1043-1049页

作者： Shinya Kodashima Mitsuhiro Fujishiro Department of endoscopy and Endoscopic Surgery Graduate School of MedicineThe University of Tokyo

i-scan technology is the newly developed imageenhanced endoscopy technology from PENTAX,*** consists of three types of algorithms:surface enhancement (SE),contrast enhancement (CE),and tone enhancement (TE).SE enhances light-dark contrast by obtaining luminance intensity data for each pixel and applying an algorithm that allows detailed observation of a mucosal surface *** digitally adds blue color in relatively dark areas,by obtaining luminance intensity data for each pixel and applying an algorithm that allows detailed observation of subtle irregularities around the *** enhancement functions work in real time without impairing the original color of the organ,therefore,SE and CE are suitable for screening endoscopy to detect gastrointestinal tumors at an early *** dissects and analyzes the individual RGB components of a normal *** algorithm then alters the color frequencies of each component and recombines the components to a single,new color *** is designed to enhance minute mucosal structures and subtle changes in *** works in real time and consists of three modes such as TE-g for gastric tumors,TE-c for colonic tumors,and TE-e for esophageal *** is suitable mainly for detailed examination of the lesions that are detected in a screening endoscopy.i-scan technology leads us to easier detection,diagnosis and treatment of gastroi ntestinal diseases.

关键词： Gastrointestinal tumor Gastrointestinal endoscopy

Clinical impact of endoscopy position detecting unit(UPD-3) for a non-sedated colonoscopy

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世界胃肠病学杂志：英文版 2015年第16期21卷 4903-4910页

作者： Masakatsu Fukuzawa Junichi Uematsu Shin Kono Sho Suzuki Takemasa Sato Naoko Yagi Yuichiro Tsuji Kenji Yagi Chika Kusano Takuji Gotoda Takashi Kawai Fuminori Moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University endoscopy Center Tokyo Medical University Hospital

AIM:To evaluate whether an endoscopy position detecting unit(UPD-3) can improve cecal intubation rates, cecal intubation times and visual analog scale(VAS) pain scores, regardless of the colonoscopist's level of ***:A total of 260 patients(170 men and 90women)who underwent a colonoscopy were divided into the UPD-3-guided group or the conventional group(no UPD-3 guidance).Colonoscopies were performed by experts(experience of more than 1000colonoscopies)or trainees(experience of less than 100colonoscopies).Cecal intubation rates,cecal intubation times,insertion methods(straight insertion:shortening the colonic fold through the bending technique;roping insertion:right turn shortening technique)and patient discomfort were *** discomfort during the endoscope insertion was scored by the VAS that was divided into 6 degrees of ***:The cecum intubation rates,cecal intubation times,number of cecal intubations that were performed inendoscopy for the procedures performed by trainees.

关键词： Colonoscopy Training endoscopy positiondetecting unit

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

Colon capsule endoscopy:What we know and what we would like to know

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World Journal of Gastroenterology 2014年第45期20卷 16948-16955页

作者： Cristiano Spada Federico Barbaro Gianluca Andrisani Leonardo Minelli Grazioli Cesare Hassan Isabella Costamagna Mariachiara Campanale Guido Costamagna Department of General Surgery Digestive Endoscopy Unit Catholic University

Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also affected by a small, but definite, risk of major complications (cardiopulmonary complications, perforation, hemorrhage) and even mortality. To improve both acceptability and safety, PillCam Colon Capsule endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) has been developed. CCE represents a non-invasive technique that is able to explore the colon without sedation and air insufflation. The Second Generation of Colon Capsule endoscopy (PillCam Colon 2) (CCE-2) was proven to be an accurate tool to detect colonic neoplastic lesions when used in average risk individuals. To date, the evidence supports the use of CCE-2 in case of colonoscopy failure, in patients unwilling to perform colonoscopy and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease need to be clarified. In this paper, the current “state of the art”, potential application of CCE and future needs are evaluated.

关键词： Colon capsule endoscopy Incomplete colonoscopy Regimen of preparation Accuracy Fields of application

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

Endoscopic non-technical skills team training:The next step in quality assurance of endoscopy training

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World Journal of Gastroenterology 2014年第46期20卷 17507-17515页

作者： Manmeet Matharoo Adam Haycock Nick Sevdalis Siwan Thomas-Gibson the Wolfson Unit for endoscopy St.Mark’s HospitalHarrow HA1 3UJUnited Kingdom Department of Surgery and Cancer Imperial CollegeSt.Mary’s campusNorfolk PlaceLondon W2 1NYUnited Kingdom

AIM: To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes.

关键词： Patient safety Bowel cancer screening Teamwork endoscopy Training Adverse events

Colonoscopic perforation:A report from World Gastroenterology Organization endoscopy training center in Thailand

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World Journal of Gastroenterology 2008年第43期14卷 6722-6725页

作者： Varut Lohsiriwat Sasithorn Sujarittanakarn Thawatchai Akaraviputh Narong Lertakyamanee Darin Lohsiriwat Udom Kachinthorn Siriraj GI endoscopy center Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Siriraj GI endoscopy center Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand

AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） endoscopy Training Center in Thailand. METHODS： All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients＇ characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS： A total of 17357 endoscopic procedures of the colon （13 699 colonoscopies and 3658 flexible sigmoidoscopies） were performed in Siriraj hospital over a 9-year period. Fifteen patients （0.09%） had CP： 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon （80%）, followed by the transverse colon （13%）. Perforations were caused by direct trauma from either the shaft or the tip of the endoscope （n = 12,80%） and endoscopic polypectomy （n = 3, 20%）. All patients with CP underwent surgical management： primary repair （27%） and bowel resection （73%）. The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION： CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.

关键词： Colonoscopic perforation Colonoscopy Complication Incidence endoscopy training center