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Endoscopy: Advances in Endoscopic Management of Gastrointestinal Tract and Pancreatobiliary...
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Endoscopy: Advances in Endoscopic Management of Gastrointestinal Tract and Pancreatobiliary Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 March 2025 | Viewed by 3163

Special Issue Editor

Dr. Hemant Goyal

E-Mail Website
Guest Editor
Baptist Medical Center, Baptist Health, Jacksonville, FL, USA
Interests: gastroenterology and hepatology; endoscopy; gastrointestinal and biliopancreatic cancers; inflammatory bowel diseases (IBDs); irritable bowel syndrome (IBS); constipation and diarrhea; liver cirrhosis; colorectal cancer/polyps
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of gastrointestinal endoscopy has evolved from a diagnostic into a minimally invasive therapeutic modality over the past three decades. As advancements in techniques and instruments continue to progress rapidly, the significance of endoscopic therapies has become paramount in the management of various gastrointestinal diseases. With an increasing number of lesions being diagnosed by screening endoscopies, endoscopic mucosal resection is becoming the preferred approach for the resection of polyps and early malignancies. Endoscopic submucosal dissection allows for the en-bloc resection of larger lesions, including colorectal cancer. The evolving landscape of endoscopic capabilities, including the utilization of new instruments and the expanding roles of "third-space endoscopy" enables the safe resection of significant subepithelial lesions. The increasing use of endoscopic ultrasound has enabled the refinement of internal biliary drainage and ablation of pancreato-biliary neoplasms. The use of over-the-scope clips allows for the endoscopic closure of gastrointestinal tract defects which were traditionally treated surgically. Biotechnological advances have expanded stenting options with fully covered metal stents, plastic stents, as well as biodegradable stents. Endoscopic therapies continue to show promising potential in anti-reflux and bariatric procedures.

We are glad to announce this Special Issue dedicated to publishing the most recent therapeutic advances in the endoscopic management of gastrointestinal and pancreatobiliary diseases. We look forward to receiving your original research, review articles, and meta-analyses providing insights into clinical practice as well as advances in future innovations in advanced endoscopy.

Dr. Hemant Goyal
Guest Editor

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Keywords

  • gastrointestinal disease
  • gastrointestinal oncology
  • endoscopic retrograde cholangio-pancreatography
  • endoscopic mucosal resection
  • endoscopic submucosal dissection
  • endoscopic ultrasound
  • endoscopic ultrasound-guided biliary drainage
  • endoscopic sleeve gastroplasty
  • per-oral endoscopic myotomy
  • radiofrequency ablation
  • third-space endoscopy

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Published Papers (4 papers)

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12 pages, 1778 KiB  
Article
Association Between Longer Cecal Intubation Time and Detection and Miss Rate of Colorectal Neoplasms
by Ji Min Choi, Seon Hee Lim, Yoo Min Han, Jooyoung Lee, Eun Hyo Jin, Ji Yeon Seo and Jung Kim
J. Clin. Med. 2024, 13(23), 7080; https://doi.org/10.3390/jcm13237080 (registering DOI) - 23 Nov 2024
Viewed by 142
Abstract
Background/Aims: A longer cecal intubation time (CIT) occurs during colonoscopy under difficult insertion conditions, which may hinder meticulous mucosal observation. However, whether a longer CIT has detrimental effects on the detection of adenomas remains unclear. We evaluated the effects of CIT on the [...] Read more.
Background/Aims: A longer cecal intubation time (CIT) occurs during colonoscopy under difficult insertion conditions, which may hinder meticulous mucosal observation. However, whether a longer CIT has detrimental effects on the detection of adenomas remains unclear. We evaluated the effects of CIT on the detection and miss rates of colorectal neoplasms in asymptomatic participants. Methods: Healthy examinees who underwent colonoscopy between March and July 2011, August 2015, and December 2016 were retrospectively enrolled. The primary outcome was the adenoma detection rate (ADR) across CIT quartiles, while the secondary outcomes included the mean number of adenomas, advanced ADR (AADR), clinically significant serrated lesion (CSSP) detection, adenoma miss rate (AMR), miss rate of CSSPs and any colorectal neoplasms, and the mean number of missed colorectal neoplasms in relation to CIT. Results: Overall, 12,402 participants were classified into quartiles according to the CIT. The longer the CIT, the lower the ADR (p < 0.001), AADR (p = 0.004), and mean number of adenomas (p < 0.001). The CSSP detection rate was not associated with CIT. On follow-up colonoscopy, AMR showed marginal increase with longer CIT (p = 0.065). The missed rates of CSSPs (p = 0.002) and colorectal neoplasms (p = 0.001) also increased with longer CIT. In the multivariate analysis, CIT was significantly associated with ADR, AADR, and AMR. Conclusions: Longer CIT was associated with lower ADR and higher AMR. Meticulous inspection is important for high-quality colonoscopy, particularly in patients requiring a longer CIT. Full article
(This article belongs to the Special Issue Endoscopy: Advances in Endoscopic Management of Gastrointestinal Tract and Pancreatobiliary Disorders)
12 pages, 1458 KiB  
Article
Impact of Duodenal Papilla Morphology on the Success of Transpancreatic Precut Sphincterotomy
by Yi-Peng Chen, Yi-Jun Liao, Yen-Chun Peng, Chun-Fang Tung, Hsin-Ju Tsai, Sheng-Shun Yang and Chia-Chang Chen
J. Clin. Med. 2024, 13(22), 6940; https://doi.org/10.3390/jcm13226940 - 18 Nov 2024
Viewed by 269
Abstract
Background: This study aimed to evaluate whether the morphology of the duodenal major papilla is linked to transpancreatic precut sphincterotomy (TPS) failure. Methods: We conducted a retrospective review of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at our institution. The inclusion [...] Read more.
Background: This study aimed to evaluate whether the morphology of the duodenal major papilla is linked to transpancreatic precut sphincterotomy (TPS) failure. Methods: We conducted a retrospective review of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at our institution. The inclusion criteria involved patients with a naïve major duodenal papilla who required TPS due to difficult biliary cannulation. Papilla morphology was classified using Haraldsson’s system, as follows: regular (Type 1), small (Type 2), protruding or pendulous (Type 3), and creased or ridged (Type 4). The analysis focused on identifying risk factors for TPS failure and related complications. Results: A total of 103 cases were analyzed, with an overall TPS success rate of 85.44%. There were no significant differences in age, gender, ERCP indications, or the prevalence of juxtapupillary diverticula across the four papilla types. The TPS failure rates by papilla type were Type 1 (10.53%), Type 2 (0%), Type 3 (16.67%), and Type 4 (28%). Type 4 papilla had a significantly higher failure rate compared to Type 1 and Type 2 in the univariate analysis (p = 0.028), but this was not statistically significant in the multivariate analysis (p = 0.052). Age emerged as an independent risk factor for TPS failure. Conclusions: Duodenal papilla morphology may influence the success rate of TPS, with advanced age being a key risk factor for failure. Identifying high-risk factors such as Type 4 papilla and older age can help endoscopists adjust their techniques early, potentially improving outcomes and minimizing complications. Full article
(This article belongs to the Special Issue Endoscopy: Advances in Endoscopic Management of Gastrointestinal Tract and Pancreatobiliary Disorders)
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12 pages, 2850 KiB  
Article
Dedicated Echoendoscope for Interventional Endoscopic Ultrasound: Comparison with a Conventional Echoendoscope
by Toshio Fujisawa, Shigeto Ishii, Yousuke Nakai, Hirofumi Kogure, Ko Tomishima, Yusuke Takasaki, Koichi Ito, Sho Takahashi, Akinori Suzuki and Hiroyuki Isayama
J. Clin. Med. 2024, 13(10), 2840; https://doi.org/10.3390/jcm13102840 - 11 May 2024
Cited by 2 | Viewed by 1033
Abstract
Background/Objective: Interventional endoscopic ultrasound (I-EUS) is technically difficult and has risks of severe adverse events due to the scarcity of dedicated endoscopes and tools. A new EUS scope was developed for I-EUS and was modified to increase the puncture range, reduce the [...] Read more.
Background/Objective: Interventional endoscopic ultrasound (I-EUS) is technically difficult and has risks of severe adverse events due to the scarcity of dedicated endoscopes and tools. A new EUS scope was developed for I-EUS and was modified to increase the puncture range, reduce the blind area, and overcome guidewire difficulties. We evaluated the usefulness and safety of a new EUS scope compared to a conventional EUS scope. Methods: All I-EUS procedures were performed at Juntendo University Hospital from April 2020 to April 2022. The primary outcomes included the procedure time and fluoroscopy time. The secondary outcomes included the technical success rate and the rates of procedure-related adverse events. Clinical data were retrospectively reviewed and statistically analyzed between the new and conventional EUS scopes. Results: In total, 143 procedures in 120 patients were analyzed. The procedure time was significantly shorter with the new EUS scope, but the fluoroscopy time was not different. Among the patients only undergoing EUS-guided biliary drainage (EUS-BD), 79 procedures in 74 patients were analyzed. Both the procedure time and fluoroscopy time were significantly shorter with the new EUS scope. Multivariate analysis revealed that a new EUS scope and use of covered metal stents could reduce the fluoroscopy time. The technical success rate and the adverse event rate were not significantly different between the total I-EUS and the EUS-BD only groups. However, the conventional scope showed stent deviation during stent placement, which did not happen with the new scope. Conclusions: The new EUS scope reduced procedure time for total I-EUS and fluoroscopy time for EUS-BD compared to a conventional EUS scope because of the improvement suitable for I-EUS. Full article
(This article belongs to the Special Issue Endoscopy: Advances in Endoscopic Management of Gastrointestinal Tract and Pancreatobiliary Disorders)
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29 pages, 4240 KiB  
Systematic Review
Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?—A Systematic Review and Meta-Analysis
by Saqr Alsakarneh, Mahmoud Y. Madi, Dushyant Singh Dahiya, Fouad Jaber, Yassine Kilani, Mohamed Ahmed, Azizullah Beran, Mohamed Abdallah, Omar Al Ta’ani, Anika Mittal, Laith Numan, Hemant Goyal, Mohammad Bilal and Wissam Kiwan
J. Clin. Med. 2024, 13(13), 3883; https://doi.org/10.3390/jcm13133883 - 1 Jul 2024
Viewed by 1306
Abstract
Background/Objectives: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has emerged as an alternative option for biliary drainage in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). Limited data exist on the safety and efficacy of EUS-HGS. In this comprehensive meta-analysis, we aim to study the safety and [...] Read more.
Background/Objectives: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has emerged as an alternative option for biliary drainage in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). Limited data exist on the safety and efficacy of EUS-HGS. In this comprehensive meta-analysis, we aim to study the safety and efficacy of EUS-HGS in cases of failed conventional ERCP. Methods: Embase, PubMed, and Web of Science databases were searched to include all studies that evaluated the efficacy and safety of EUS-HGS. Using the random effect model, the pooled weight-adjusted event rate estimate for clinical outcomes in each group were calculated with 95% confidence intervals (CIs). The primary outcomes were technical and clinical success rates. Secondary outcomes included overall adverse events (AEs), rates of recurrent biliary obstruction (RBO), and rates or re-intervention. Results: Our analysis included 70 studies, with a total of 3527 patients. The pooled technical and clinical success rates for EUS-HGS were 98.1% ([95% CI, 97.5–98.7]; I2 = 40%) and 98.1% ([95% CI, 97.5–98.7]; I2 = 40%), respectively. The pooled incidence rate of AEs with EUS-HGS was 14.9% (95% CI, 12.7–17.1), with bile leakage being the most common (2.4% [95% CI, 1.7–3.2]). The pooled incidence of RBO was 15.8% [95% CI, 12.2–19.4], with a high success rate for re-intervention (97.5% [95% CI, 94.7–100]). Conclusions: Our analysis showed high technical and clinical success rates of EUS-HGS, making it a feasible and effective alternative to ERCP. The ongoing development of dedicated devices and techniques is expected to make EUS-HGS more accessible and safer for patients in need of biliary drainage. Full article
(This article belongs to the Special Issue Endoscopy: Advances in Endoscopic Management of Gastrointestinal Tract and Pancreatobiliary Disorders)
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