Gastrointestinal Endoscopy

BACKGROUND AND AIMS: Lumen-apposing metal stents (LAMSs) are a novel class of devices that have expanded the spectrum of endoscopic GI interventions. LAMSs with their dumbbell configuration, short saddle length, and large inner luminal diameter provide favorable stent characteristics to facilitate anastomosis formation between the gut lumen and adjacent structures. METHODS: The MEDLINE database was searched through April 2021 for articles related to LAMSs by using additional relevant keywords such as "walled-off pancreatic necrosis," "pseudocysts," "pancreatic fluid collection," "cholecystitis," "gastroenterostomy," in addition to "endoscopic treatment" and "endoscopic management," among others...

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BACKGROUND AND AIMS: Bilomas most frequently result from postoperative bile leaks. The endoscopic conventional treatment is sphincterotomy ± stent placement. In complex cases, such as altered anatomy or failure of conventional treatment, transpapillary/transfistulary (TP/TF) drainage or EUS-guided transmural (EUS-TD) drainage may obviate additional biliary surgery. This study reports our experience with treating biloma secondary to refractory biliary leak with TP/TF or EUS-TD, and evaluates the safety and outcomes associated with this approach...

BACKGROUND AND AIMS: Double right colon examination during colonoscopy has been advocated to reduce the risk of interval cancer in the right colon segment. Whether 2 examinations are necessary when the first examination is performed with a mucosal exposure device is uncertain. We documented the rates of missed adenomas, sessile serrated lesions, and hyperplastic polyps after an initial right colon segment examination by a high level detector using a mucosal exposure device. METHODS: At a single tertiary hospital outpatient practice, we prospectively collected data on the yield of a second examination of the right colon segment, after initial examination by a single high-detecting colonoscopist using a mucosal exposure device...

BACKGROUND AND AIMS: The application of underwater endoscopic mucosal resection (UEMR) for nonpolypoid superficial nonampullary duodenal epithelial tumors (SNADET) has not been comprehensively assessed. Therefore, the current study aimed to validate the efficacy of UEMR versus conventional endoscopic mucosal resection (EMR) and cap-assisted endoscopic mucosal resection (EMRC) for SNADET measuring ≤20 mm. METHODS: We retrospectively analyzed patients with sporadic nonpolypoid SNADET measuring ≤20 mm...

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BACKGROUND AND AIMS: There are many deficiencies of existing biliopancreatic duct endoscopy in the examination of early biliary and pancreatic tumors. This study aimed to evaluate the usefulness and feasibility of a novel ultrafine separable biliopancreatic duct endoscopy device with dual modalities of intraductal ultrasonography (IDUS) and optical coherence tomography (OCT) for the in vivo assessment of biliopancreatic duct system during ERCP. METHODS: Five Bama miniature pigs were selected to probe their common bile duct and branches by using this novel equipment during ERCP...

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BACKGROUND & AIMS: Accurate differentiation between cholangiocarcinoma (CCA) and benign biliary stricture is of paramount importance. Biliary brush cytology is a simple and safe diagnostic approach that provides relatively high specificity; however, sensitivity is limited. Previous reports indicated the aberrations of DNA methylation in CCA. This study was aimed to investigate the diagnostic performance of the methylation index (MI) of HOXA1, NEUROG1 gene promoters in CCA. METHODS: Patients with biliary stricture who underwent endoscopic retrograde cholangiopancreatography (ERCP) with brush cytology in Siriraj Hospital from September 2016 to December 2019 were prospectively enrolled...

BACKGROUND AND AIMS: Lynch syndrome (LS) predisposes to multiple cancers including gastric and small bowel. Data supporting esophagogastroduodenoscopy (EGD) surveillance in LS are limited. Our aim is to describe upper gastrointestinal (UGI) findings in asymptomatic LS patients undergoing EGD surveillance within a hereditary colorectal cancer registry. METHODS: Asymptomatic patients with LS who underwent >1 surveillance EGD were included. Demographics, genotype, and EGD findings were reviewed...

BACKGROUND AND AIMS: We aim to develop and validate a deep learning-based system that covers various aspects of early gastric cancer (EGC) diagnosis, including detecting gastric neoplasm, identifying EGC, and predicting EGC invasion depth and differentiation status. Herein, we provide a state-of-the-art comparison of the system with endoscopists using real-time videos in a nationwide human-machine competition. METHODS: This multicenter, prospective, real-time, competitive comparative, diagnostic study enrolled consecutive patients who received magnifying narrow-band (M-NBI) endoscopy in Peking University Cancer Hospital from June 9, 2020, to November 17, 2020...

BACKGROUND AND AIMS: Common bile duct (CBD) dilation is a frequent indication for endoscopic ultrasound (EUS). Among asymptomatic individuals, biliary dilation may not be clinically significant; however, EUS is often relied upon for the exclusion of benign and malignant pathology that might require further intervention. The yield of EUS evaluation for this indication is not well characterized and has significant implications for health resource utilization because asymptomatic biliary dilation is prevalent...

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BACKGROUND AND AIMS: The effectiveness of vonoprazan relative to that of proton pump inhibitors (PPIs) after gastric endoscopic submucosal dissection (ESD) is unclear. Although previous studies used post-ESD ulcer healing as the outcome measure, post-ESD bleeding rate is the most objective and appropriate outcome measure as it has less ascertainment bias. We aimed to compare the post-ESD bleeding rates between vonoprazan and PPIs. METHODS: This nationwide population-based retrospective cohort study was conducted between 2014 and 2018 and involved nine hospitals...

BACKGROUND AND AIMS: There are no agreed-upon endoscopic signs for the diagnosis of villous atrophy (VA) in celiac disease (CD), necessitating biopsies for diagnosis. Here we evaluated the role of near-focus narrow-band imaging (NF-NBI) for the assessment of villous architecture in suspected CD with the development and further validation of a novel NF-NBI classification. METHODS: Patients with a clinical indication for duodenal biopsy were prospectively recruited...

BACKGROUND AND AIMS: Patient preference for a healthcare professional is mediated by the physician gender. The primary aim was to assess the gender preference for an endoscopist in a cohort of Muslim patients. The secondary aim was to identify factors that influence gender preference. METHODS: This was a multicenter cross-sectional study conducted at 3 tertiary-care hospitals in Pakistan. Consecutive patients scheduled for elective outpatient upper endoscopy or colonoscopy were asked to complete a questionnaire immediately before and after the procedure...