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Endoscopy International Open

Reiner Köck, Christian Jürgensen, Rupert Fischer-Lampsatis
Background and study aims  Endoscopic ultrasound (EUS)-guided drainage is a well-established procedure for peripancreatic fluid collections (PFC) that develop in the context of acute pancreatitis or following pancreatic surgery. Malignant ascites can occur in a loculated form resembling PFC causing a variety of symptoms, with limited treatment options. There is a paucity of data about application of EUS-guided drainage for these kinds of fluid collections. So far, only one report exists describing clinical success in three cases, using fully-covered self-expanding metal stents (FCSEMS)...
July 2018: Endoscopy International Open
Amnon Sonnenberg
Background and study aims:  In some patients with gastrointestinal bleeding, even multiple consecutive endoscopic procedures fail to achieve lasting hemostasis. The current decision analysis was designed to answer the question of when to continue or abandon a sequence of endoscopic attempts of endoscopic hemostasis. Materials and methods:  A decision tree with a threshold analysis was used to model the decision between continued endoscopy or expectant management...
July 2018: Endoscopy International Open
Filippo Antonini, Sara Giorgini, Lorenzo Fuccio, Lucia Angelelli, Giampiero Macarri
Background and study aims:  This study was designed to evaluate the impact of additional tissue obtained with endoscopic ultrasound (EUS)-guided 25-gauge core biopsy needle (25G-PC) following an unsuccessful fine-needle biopsy (FNB) performed with larger-bore needles for the characterization of gastrointestinal subepithelial lesions (GI-SELs). Patients and methods:  We prospectively collected and retrospectively analyzed information in our database from January 2013 to June 2017 for all patients with GI-SELs who received a EUS-guided FNB (EUS-FNB) with 25G-PC during the same procedure after failure of biopsy performed with larger-bore needle...
July 2018: Endoscopy International Open
Amir Kashani, Gebran Abboud, Simon K Lo, Laith H Jamil
Background and study aims:  Double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (DBE-ERCP) in post-Roux-en-Y gastric bypass (RYGB) patients is a technically challenging procedure. We aimed to determine the success rate of DBE-ERCP performed by a novice to the procedure in post-RYGB after training with an expert. Patients and methods:  Medical records for 103 consecutive post-RYGB patients who underwent DBE-ERCP in a tertiary center were retrospectively reviewed...
July 2018: Endoscopy International Open
Takahiro Amano, Tsutomu Nishida, Hiromi Shimakoshi, Akiyoshi Shimoda, Naoto Osugi, Aya Sugimoto, Kei Takahashi, Kaori Mukai, Dai Nakamatsu, Tokuhiro Matsubara, Masashi Yamamoto, Shiro Hayashi, Sachiko Nakajima, Koji Fukui, Masami Inada
Background and study aims:  Adenoma detection rate (ADR) is a well-known quality indicator (QI) for colonoscopy. It is, however, difficult to evaluate ADR during practice. The aim of this study was to investigate the number of endoscopically detected polyps as a QI for colonoscopy. Patients and methods:  This was a retrospective single-center cohort study of 5,190 consecutive patients who underwent colonoscopy from January 2015 to May 2016. Among these patients, we ultimately enrolled 1,937 patients for initial colonoscopy...
July 2018: Endoscopy International Open
Wee Sing Ngu, Martin Walls, Pradeep Bhandari, Clive Stokes, Nikki Totton, Zoe Hoare, Lexi Bastable, Colin Rees
Background and study aims:  UK Bowel Cancer Screening flexible sigmoidoscopy (BowelScope) currently offers patients aged 55 a one-off flexible sigmoidoscopy for adenoma clearance to decrease colorectal cancer incidence by interrupting the adenoma-carcinoma sequence. Recent evidence has shown maximum benefit in increasing adenoma detection rate (ADR) using the Endocuff Vision device in the left side of the colon and in screening patients. Currently, ADR is low and shows unacceptable variation in BowelScope...
July 2018: Endoscopy International Open
Gunnar Loske, Tobias Schorsch, Frank Rucktaeschel, Wolfgang Schulze, Burkhard Riefel, Vera van Ackeren, Christian Theodor Mueller
Background and study aims:  Endoscopic negative pressure therapy (ENPT) has been developed to treat gastrointestinal leakages. Up to now, ENPT has usually been performed with open-pore polyurethane foam drains (OPD). A big disadvantage of the OPDs is their large diameter. We have developed a new, small-bore open-pore film drainage (OFD). Herein we report our first experience in a case series of 16 patients. Patients and methods:  OFD is constructed with a drainage tube and a very thin double-layered open-pore drainage film (Suprasorb CNP, Drainage Film, Lohmann & Rauscher International, Germany)...
July 2018: Endoscopy International Open
Ken Yamashita, Shiro Oka, Shinji Tanaka, Kazuki Boda, Daiki Hirano, Kyoku Sumimoto, Takeshi Mizumoto, Yuki Ninomiya, Yuzuru Tamaru, Kenjiro Shigita, Nana Hayashi, Yoji Sanomura, Kazuaki Chayama
Background and study aims : Japanese guidelines for gastroenterological endoscopy have recommended temporary withdrawal of anticoagulants (warfarin, direct oral anticoagulants [DOAC], or heparin) to prevent hemorrhagic complications during endoscopic submucosal dissection (ESD) for colorectal neoplasias (CRNs). However, serious thrombosis might occur during temporary withdrawal of anticoagulants. The current study aimed to evaluate outcomes with anticoagulants in patients undergoing ESD for CRNs...
July 2018: Endoscopy International Open
Raj J Shah, Horst Neuhaus, Mansour Parsi, D Nageshwar Reddy, Douglas K Pleskow
Background and study aims:  Cholangiopancreatoscopy is utilized for diagnosis and therapy of pancreaticobiliary disorders. a fully-disposable, digital, single-operator cholangioscope (DSOC) was developed with high image resolution and wide field-of-view. This bench study compared the new DSOC to the previous semi-disposable, fiber-optic cholangioscope (FSOC) prior to the clinical availability of the DSOC system. Methods : Five experts performed one practice run followed by randomized runs comparing DSOC to FSOC in a biliary tract model consisting of three fixed left-intrahepatic tracts (LIHD), and variable common bile duct (CBD) and right-intrahepatic tracts (RIHD) with seven total lesions in multiple configurations...
July 2018: Endoscopy International Open
Aymeric Becq, Aymeric Histace, Marine Camus, Isabelle Nion-Larmurier, Einas Abou Ali, Olivia Pietri, Olivier Romain, Ulriikka Chaput, Cynthia Li, Philippe Marteau, Christian Florent, Xavier Dray
Background and study aims : Colon capsule endoscopy (CCE) does not possess an objective and reliable scoring system to assess the quality of visualization of the colon mucosa. The aim of this study was to establish a colonic computed assessment of cleansing (CAC) score able to discriminate "adequately cleansed" from "inadequately cleansed" CCE still frames. Patients and methods : Twelve normal and complete CCEs, using the Pillcam Colon 2 system (Medtronic, Minnesota, United States), were prospectively selected amongst a database...
July 2018: Endoscopy International Open
Mahya Faghih, Amitasha Sinha, Robert A Moran, Elham Afghani, Yuval A Patel, Andrew C Storm, Ayesha Kamal, Venkata S Akshintala, Atif Zaheer, Anthony N Kalloo, Vivek Kumbhari, Mouen A Khashab, Vikesh K Singh
Introduction:  Length of stay (LOS) is an important determinant of the severity of post-ERCP pancreatitis (PEP) in the consensus definition. The aim of our study was to evaluate and compare severity of PEP based on the revised Atlanta classification (RAC) and the consensus definition. Patients and methods:  Between 1/2000 and 12/2011, all adult patients admitted with suspicion of PEP after outpatient ERCP were evaluated. PEP was defined using the RAC, but the severity of PEP was defined using both revised Atlanta and consensus definitions...
July 2018: Endoscopy International Open
Kazumi Togo, Tetsuya Ueo, Kenshi Yao, Kurato Wada, Hideho Honda, Syotaro Inoue, Masahide Fukuda, Yuka Yanai, Hirotoshi Yonemasu, Kazunari Murakami
Background and study aims:  The presence of white opaque substance (WOS) is an endoscopic marker of intestinal metaplasia. Considering that the nature of WOS is absorbed lipid droplets, lipase plays an important role in the lipid absorption process and is inactivated at strong acidity. WOS may only be present in a hypochlorhydria state following Helicobacter pylori infection, and, thus, may not be highly sensitive marker, especially in H. pylori- eradicated patients. We investigated the relationship between WOS and gastric acid conditions...
July 2018: Endoscopy International Open
Nassim Hammoudi, Bertrand Brieau, Maximilien Barret, Benoit Bordacahar, Sarah Leblanc, Romain Coriat, Stanislas Chaussade, Frédéric Prat
Obesity and bariatric surgery are major risk factors in gallstone disease. In patients with a past history of Roux-en-Y gastric bypass, Mirizzi's syndrome is a challenging endoscopic situation because of the modified anatomy. Here we report the first case of a patient with a Roux-en-Y gastric bypass treated by intracorporeal lithotripsy with a digital single-operator cholangioscope following an endoscopic retrograde cholangiopancreatography (ERCP) using a percutaneous gastrostomy access.
July 2018: Endoscopy International Open
Praveer Rai, Harish Kc, Amit Goel, Rakesh Aggarwal, Malay Sharma
Background and study aims:  Pseudoaneurysm most commonly involves the splenic artery and is conventionally treated with angioembolization or surgery. Herein we describe six patients with splenic artery pseudoaneurysm who were treated using a new technique of endoscopic ultrasound (EUS)-guided glue and coil injection. Patients and methods:  Six patients (median age 36.7, range: 19 - 60, M: F = 5:1) with splenic artery pseudoaneurysm who had failed angiographic embolization underwent EUS-guided transgastric injection of coil and glue injection between July 2016 and September 2017...
July 2018: Endoscopy International Open
Ina B Pedersen, Magnus Løberg, Geir Hoff, Mette Kalager, Michael Bretthauer, Øyvind Holme
Background and study aims:  Incomplete polyp removal has been estimated to cause 27 % of all colorectal cancers detected soon after colonoscopy. There is limited information regarding polypectomy techniques among endoscopists. The article is a nationwide survey of polypectomy techniques among Norwegian endoscopists. Materials and methods:  We invited all board-certified gastroenterologists in Norway to complete a web-based questionnaire about their polypectomy technique...
July 2018: Endoscopy International Open
Takashi Sasaki, Ikuhiro Yamada, Masato Matsuyama, Naoki Sasahira
Background and study aims  A short-type single-balloon enteroscope with a 3.2-mm working channel makes it possible to insert an enteral stent by the through-the-scope technique in patients with malignant afferent loop obstruction. Here, we report five cases of malignant afferent loop obstruction treated with endoscopic enteral stenting. We also propose a new classification for three types of malignant afferent loop obstruction. Type 1: The obstruction site is located distal to the papilla or the bilioenteric anastomosis...
July 2018: Endoscopy International Open
Harshit S Khara, Truptesh H Kothari, Amitpal S Johal, Shivangi T Kothari, Nina Ahuja, Ashok Bhanushali, Anil Kotru, Andrea Berger, Vivek Kaul, Seth A Gross, Christopher J DiMaio, William B Hale, Rami Abbass, Marvin Ryou, Amrita Sethi, Brian G Turner, Paul Fockens, David L Diehl
Background and study aims : The anatomical meaning of the terms "proximal" and "distal" in relation to the pancreaticobiliary anatomy can be confusing. We aimed to investigate practice patterns of use of the terms "proximal" and "distal" for pancreaticobiliary anatomy amongst various medical specialties. Materials and methods : An online survey link to a normal pancreaticobiliary diagram was emailed to a multispecialty physician pool...
July 2018: Endoscopy International Open
Rajesh Puri, Sumit Bhatia, Rinkesh K Bansal, Randhir Sud
Background and study aims : Endoscopic management using standard accessories is the preferred modality for treatment of benign biliary strictures. However, with difficult strictures, there is frequently failure of endoscopic therapy. We are reporting our experience regarding use of a standard diathermic dilator (cystotome) to aid in stricture dilatation and stent placement in patients with difficult strictures. Patients and methods : Data were analyzed from January 2014 to January 2017 at a single tertiary care center in North India...
July 2018: Endoscopy International Open
Ravishankar Asokkumar, Roy Soetikno, Andres Sanchez-Yague, Lim Kim Wei, Ennaliza Salazar, Jing Hieng Ngu
Background and study aims : Endoscopic treatment of non-variceal upper gastrointestinal bleeding (NVUGIB) with high-risk adverse outcome (HR-AO) features has a high risk of failure. We studied the safety and efficacy of over-the-scope clips (OTSC) to treat these lesions. Patients and methods : We included patients who were treated using OTSC for NVUGIB from January 2015 to October 2017. We studied rebleeding and mortality rates and used the Rockall data and our institution's prior data for comparison...
July 2018: Endoscopy International Open
Yen-I Chen, Mouen A Khashab, Viviane Adam, Ge Bai, Vikesh K Singh, Majidah Bukhari, Olaya Brewer Gutierrez, B Joseph Elmunzer, Robert A Moran, Lea Fayad, Mohamad El Zein, Vivek Kumbhari, Alessandro Repici, Alan N Barkun
Background and study aims:  Endoscopic ultrasound-guided drainage is an effective and accepted primary modality for management of pancreatic pseudocyst (PP). A lumen-apposing metal stent (LAMS) has recently been developed specifically for drainage of pancreatic fluid collections which may be superior to using traditional plastic stents (PS) but is more expensive. Because use of a stent involves a risk of unplanned endoscopy, percutaneous drainage (PCD) and surgery, their costs should also be included in the comparison and a cost-effectiveness analysis of LAMS and PS should therefore be performed...
July 2018: Endoscopy International Open
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