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Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy
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Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (5 November 2020) | Viewed by 15855

Special Issue Editor

Dr. Ivo Boškoski

E-Mail Website
Guest Editor
1. Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
2. Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, 00168 Roma, Italy
Interests: ERCP; EUS; percutaneous approach

Special Issue Information

Dear Colleagues,

Biliopancreatic endoscopy has undergone important changes and expansion over the last two decades. Not only are technologies around ERCP expanding, but also the different subtypes of procedures and indications are becoming more widespread, and subsequently, the number of professionals performing these techniques and coming from different specialties is increasing. The aim of this issue is to provide a comprehensive overview of all available multidisciplinary techniques that are involved in the treatment of biliopancreatic diseases. The advent of excellent imaging, better visualization, and excellent software makes the approach to biliopancreatic diseases by definition multidisciplinary. Team collaboration is essential for this highly dynamic environment. High definition cholangioscopy, 3D imaging of the biliopancreatic system, radiofrequency ablation, and endomicroscopy are some of the cutting-edge procedures that will be approached. Original research articles, cutting-edge procedures, literature reviews, and metanalyses are welcome.

Dr. Ivo Boškoski, MD, PhD
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ERCP
  • EUS
  • Cholangioscopy RFA
  • 3D imaging
  • Percutaneous drainage
  • Endomicroscopy
  • Biliopancreatic surgery
  • Robotic endoscopy

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Published Papers (5 papers)

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Research

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20 pages, 1746 KiB  
Article
Comparative Efficacy of Various Stents for Palliation in Patients with Malignant Extrahepatic Biliary Obstruction: A Systematic Review and Network Meta-Analysis
by Chan Hyuk Park, Se Woo Park, Jang Han Jung, Eun Suk Jung, Jung Hee Kim and Da Hae Park
J. Pers. Med. 2021, 11(2), 86; https://doi.org/10.3390/jpm11020086 - 30 Jan 2021
Cited by 14 | Viewed by 2843
Abstract
Although many studies have investigated the efficacy of stent placement for patients with malignant extrahepatic biliary obstruction, the clinical outcomes and adverse events of biliary stenting have not been comprehensively evaluated. We searched all relevant randomized-controlled trials that evaluated the comparative efficacy of [...] Read more.
Although many studies have investigated the efficacy of stent placement for patients with malignant extrahepatic biliary obstruction, the clinical outcomes and adverse events of biliary stenting have not been comprehensively evaluated. We searched all relevant randomized-controlled trials that evaluated the comparative efficacy of biliary stents, including the plastic stents, uncovered self-expandable metal stents (SEMSs), and covered SEMSs in patients with malignant extrahepatic biliary obstructions. Twenty-one studies with 2326 patients were included. Both uncovered and covered SEMSs had a lower risk of recurrent biliary obstruction (RBO) compared to plastic stents (risk ratio (RR) (95% confidence interval [CI]): uncovered vs. plastic, 0.46 (0.35–0.62); covered vs. plastic, 0.46 (0.34–0.62)). A comparison of the groups using SEMSs revealed that tumor ingrowth was common in the uncovered SEMS group, while stent migration, tumor overgrowth, and occlusion by sludge were common in the covered SEMS group; however, the overall risk of RBO did not differ between these groups (RR (95% CI): uncovered vs. covered: 1.02 (0.80–1.30)). Although the main causes of RBO vary across stents, RBO risk was similar between uncovered and covered SEMS groups. Both SEMSs have superior efficacy in terms of RBO compared to plastic stents. Full article
(This article belongs to the Special Issue Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy)
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11 pages, 3703 KiB  
Article
Comparison of the Diagnostic Performance of Novel Slim Biopsy Forceps with Conventional Biopsy Forceps for Biliary Stricture: A Multicenter Retrospective Study
by Eun Suk Jung, Se Woo Park, Jung Hee Kim, Jang Han Jung, Min Jae Yang and Da Hae Park
J. Pers. Med. 2021, 11(1), 55; https://doi.org/10.3390/jpm11010055 - 17 Jan 2021
Viewed by 2390
Abstract
Novel slim biopsy forceps provide some technical advantages to facilitate a more accurate diagnosis, although we are not aware of any comparative studies. Therefore, we compared tissue acquisition and diagnostic accuracy between novel slim biopsy forceps and conventional biopsy forceps in cases with [...] Read more.
Novel slim biopsy forceps provide some technical advantages to facilitate a more accurate diagnosis, although we are not aware of any comparative studies. Therefore, we compared tissue acquisition and diagnostic accuracy between novel slim biopsy forceps and conventional biopsy forceps in cases with a biliary stricture. We reviewed 341 patients who underwent endoscopic retrograde cholangiopancreatography for the histological confirmation of biliary stricture at two tertiary hospitals between 2013 and 2020. The primary endpoint was the forceps’ diagnostic accuracies. We included 276 patients who underwent biopsy using the novel forceps (n = 130) or conventional forceps (n = 146). The novel forceps provided 81.7% sensitivity, 100.0% specificity, positive-predictive value (PPV) of 100.0%, and negative-predictive value (NPV) of 57.8%, with an accuracy of 85.4% when the diagnosis by endobiliary biopsy included suspected or positive malignancy. The conventional forceps provided 61.7% sensitivity, 100.0% specificity, PPV of 100.0%, and NPV of 36.1%, with an accuracy of 68.5%. Only novel forceps use was significantly associated with an accurate diagnosis (odds ratio: 2.70, 95% confidence interval: 1.52–5.00). There were no significant inter-group differences in the procedure-related rates of adverse events. Endobiliary biopsy using novel forceps offered better diagnostic performance and more acceptable procedure-related adverse events than conventional forceps. Full article
(This article belongs to the Special Issue Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy)
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Review

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15 pages, 2782 KiB  
Review
Personalized Approach to the Role of Endoscopic Ultrasound in the Diagnosis and Management of Pancreaticobiliary Malignancies
by Michael Makar, Eric Zhao and Amy Tyberg
J. Pers. Med. 2021, 11(3), 180; https://doi.org/10.3390/jpm11030180 - 4 Mar 2021
Cited by 5 | Viewed by 2516
Abstract
Pancreaticobiliary malignancies arise from different areas within the pancreas and biliary tree. Endoscopic ultrasound (EUS) is a well-recognized diagnostic and therapeutic modality in the treatment of pancreaticobiliary diseases, and more specifically, pancreaticobiliary malignancies. Traditionally used for diagnostic purposes, EUS plays a critical role [...] Read more.
Pancreaticobiliary malignancies arise from different areas within the pancreas and biliary tree. Endoscopic ultrasound (EUS) is a well-recognized diagnostic and therapeutic modality in the treatment of pancreaticobiliary diseases, and more specifically, pancreaticobiliary malignancies. Traditionally used for diagnostic purposes, EUS plays a critical role in tissue sampling and cancer staging. The emergence of the new field of interventional EUS has allowed EUS to also play a critical role in therapeutic management. Novel interventional EUS procedures such as EUS-guided gastrojejunostomy (EUS-GE), EUS-guided biliary drainage (EUS-BD), and EUS-guided gallbladder drainage (EUS-GLB) can be utilized to treat complications of pancreaticobiliary malignancies such as gastric outlet obstruction, obstructive jaundice, and cholecystitis. In addition, interventional EUS procedures can be utilized for the palliation of unresectable malignancies both for source control with EUS-radiofrequency ablation (EUS-RFA) and for the treatment of abdominal pain refractory to opioid medications with EUS-guided celiac axis neurolysis. However, patient selection remains a critical component in both diagnostic and therapeutic interventions and must be tailored to individual patient wishes, disease pathology, and overall prognosis. Full article
(This article belongs to the Special Issue Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy)
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20 pages, 7200 KiB  
Review
Personalized Endoscopy in Complex Malignant Hilar Biliary Strictures
by Ivo Boškoski, Tommaso Schepis, Andrea Tringali, Pietro Familiari, Vincenzo Bove, Fabia Attili, Rosario Landi, Vincenzo Perri and Guido Costamagna
J. Pers. Med. 2021, 11(2), 78; https://doi.org/10.3390/jpm11020078 - 29 Jan 2021
Cited by 6 | Viewed by 4366
Abstract
Malignant hilar biliary obstruction (HBO) represents a complex clinical condition in terms of diagnosis, surgical and medical treatment, endoscopic approach, and palliation. The main etiology of malignant HBO is hilar cholangiocarcinoma that is considered an aggressive biliary tract’s cancer and has still today [...] Read more.
Malignant hilar biliary obstruction (HBO) represents a complex clinical condition in terms of diagnosis, surgical and medical treatment, endoscopic approach, and palliation. The main etiology of malignant HBO is hilar cholangiocarcinoma that is considered an aggressive biliary tract’s cancer and has still today a poor prognosis. Endoscopy plays a crucial role in malignant HBO from the diagnosis to the palliation. This technique allows the collection of cytological or histological samples, direct visualization of the suspect malignant tissue, and an echoendoscopic evaluation of the primary tumor and its locoregional staging. Because obstructive jaundice is the most common clinical presentation of malignant HBO, endoscopic biliary drainage, when indicated, is the preferred treatment over the percutaneous approach. Several endoscopic techniques are today available for both the diagnosis and the treatment of biliary obstruction. The choice among them can differ for each clinical scenario. In fact, a personalized endoscopic approach is mandatory in order to perform the proper procedure in the singular patient. Full article
(This article belongs to the Special Issue Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy)
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Other

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12 pages, 2411 KiB  
Essay
Clinical Management of Bile Duct Diseases: Role of Endoscopic Ultrasound in a Personalized Approach
by Torsten Beyna and Christian Gerges
J. Pers. Med. 2021, 11(1), 1; https://doi.org/10.3390/jpm11010001 - 22 Dec 2020
Cited by 6 | Viewed by 2888
Abstract
Biliary diseases are common, but clinical symptoms are often unspecific and direct access and visualization of the biliopancreatic system for diagnostic purpose is difficult. In the last decades endoscopic ultrasound (EUS) has become a primary method in the gastrointestinal tract. It significantly changed [...] Read more.
Biliary diseases are common, but clinical symptoms are often unspecific and direct access and visualization of the biliopancreatic system for diagnostic purpose is difficult. In the last decades endoscopic ultrasound (EUS) has become a primary method in the gastrointestinal tract. It significantly changed the role of endoscopy in diagnostic imaging in the gastrointestinal tract and adjacent organs. EUS has become an effective diagnostic tool in biliary stone disease as well as in the diagnosis of indeterminate biliary strictures. Furthermore, an EUS-directed transmural approach emerged as a safe and effective alternative to ERCP in patients requiring biliary drainage, in particular as a backup method if standard ERCP-approach fails. Development of new techniques, specific accessories and stents during the last decade led to an enormous step forward in terms of efficacy and safety of an EUS-directed approach. In the current article technical and clinical aspects of EUS-guided diagnostic and therapeutic approaches in different clinical indications will be discussed together with a review of the available data. Full article
(This article belongs to the Special Issue Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy)
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