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Clinical Endoscopy update

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  • : 대한소화기내시경학회지(~2011)→Clinical Endoscopy(2012~)

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수록범위 : 44권1호(2011)~52권1호(2019) |수록논문 수 : 822
Clinical Endoscopy
52권1호(2019년) 수록논문
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KCI등재 SCOPUS

1Strategy for Curative Endoscopic Resection of Undifferentiated-Type Early Gastric Cancer

저자 : Jie-hyun Kim

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 9-14 (6 pages)

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Endoscopic resection (ER) of undifferentiated-type early gastric cancer (UD-EGC) has a lower curative resection (CR) rate than differentiated-type EGC. However, if UD-EGC is curatively resected using ER, long-term outcomes can be favorable. Thus, the strategy for CR by ER is important in UD-EGC. To achieve CR in UD-EGC, biological behaviors including tumor growth patterns must be considered. This review aims to describe what is important for curative ER of UD-EGC. Clin Endosc 2019;52:9-14

KCI등재 SCOPUS

2Risk Factors for Lymph Node Metastasis in Undifferentiated-Type Gastric Carcinoma

저자 : Myeong-cherl Kook

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 15-20 (6 pages)

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Undifferentiated-type carcinoma has a high incidence of lymph node metastasis. The independent risk factors for lymph node metastasis in undifferentiated-type carcinoma are invasion depth, tumor size, lymphovascular invasion, and presence of ulcer. In the cases that meet the curative resection criteria, no lymph node metastasis was observed in the Japanese studies, but some metastases were observed in Korean studies. After performing curative endoscopic submucosal dissection, the survival rate is similar to that of gastrectomy. The discrepancy between endoscopy and pathology is high in undifferentiated-type carcinoma. The tumor size in endoscopy is a significant risk factor for non-curative resection, and when the tumor size is small, the non-curative resection rate is significantly reduced. Lymphovascular invasion can be assessed in pathologic examination and D2-40 stain is helpful. The presence of ulcer should be determined by pathology, but ulcer's omission in pathology report makes the analysis difficult. Undifferentiated-type carcinomas with differentiated-type components show higher lymph node metastasis rate than that of pure undifferentiated-type carcinomas. The lymph node metastasis rate of signet ring cell type is lower than that of other undifferentiated-type carcinomas and is similar to differentiated-type carcinomas. The application of these additional histologic findings may improve the indication of endoscopic submucosal dissection. Clin Endosc 2019;52:15-20

KCI등재 SCOPUS

3Is Radical Surgery Necessary for All Patients Diagnosed as Having Non-Curative Endoscopic Submucosal Dissection?

저자 : Si Hyung Lee , Byung Sam Park

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 21-29 (9 pages)

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If a lesion does not meet the expanded indication criteria for treatment with endoscopic therapy for early gastric cancer or has a positive resection margin, it is regarded as suitable for non-curative resection. Non-curative resection is closely related to the risk of local recurrence, lymph node metastasis, and poor prognosis. If the result is confirmed as non-curative resection, additional treatment should be considered depending on the risks of residual tumor, local recurrence, and lymph node metastasis. As lymphatic invasion is the most important risk factor of recurrence and poor prognosis, surgical treatment should be considered if lymphatic invasion is present. If patients are not suitable for additional surgery owing to old age or coexisting severe disease, close surveillance can be an alternative treatment option. Clin Endosc 2019;52:21-29

KCI등재 SCOPUS

4Pitfalls in the Interpretation of Publications about Endoscopic Submucosal Dissection of Early Gastric Cancer with Undifferentiated-Type Histology

저자 : Chang Seok Bang , Gwang Ho Baik

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 30-35 (6 pages)

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Endoscopic submucosal dissection (ESD) is a standard treatment for patients with gastrointestinal neoplasms with a negligible risk of lymph node metastasis. ESD enables en bloc resection of gastrointestinal neoplasms and organ preservation, thereby, avoiding surgical treatment. Although small (<2 cm) intramucosal early gastric cancer with undifferentiated-type histology (EGC-UH) without ulceration is included in the expanded criteria for ESD, controversies remain due to different biology and characteristics compared to EGC with differentiated-type histology. The authors previously presented studies about the technical feasibility of ESD for these lesions using a meta-analysis and retrospective multicenter analysis. However, many pitfalls were identified in the interpretation of studies analyzing histologic discrepancy, mixed-type histology, criteria-based analysis of therapeutic outcomes, interpretation of curative resection, and long-term clinical outcomes. In this review, the authors discuss pitfalls in the interpretation of publications on ESD for EGC-UH. Clin Endosc 2019;52:30-35

KCI등재 SCOPUS

5The Use of Vasoconstrictors in Acute Variceal Bleeding: How Long Is Enough?

저자 : Gin-ho Lo

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 36-39 (4 pages)

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Vasoconstrictors are often used as the first line therapy for acute esophageal variceal hemorrhage. They might also be used for a few days after endoscopic therapy to prevent early rebleeding. International guidelines recommend the use of vasoconstrictor therapy when acute esophageal variceal hemorrhage is suspected and continuation of the therapy until 3 to 5 days after endoscopic treatment. However, the duration of use of vasoconstrictors after endoscopic therapy is not clear. This review shows that if variceal bleeding is successfully controlled by endoscopic variceal ligation, the combination of vasoconstrictors can be reduced to less than 1 day. Clin Endosc 2019;52:36-39

KCI등재 SCOPUS

6Endoscopic Management of Combined Biliary and Duodenal Obstruction

저자 : Zaheer Nabi , D. Nageshwar Reddy

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 40-46 (7 pages)

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Combined obstruction of the bile duct and duodenum is a common occurrence in periampullary malignancies. The obstruction of gastric outlet or duodenum can follow, occur simultaneously, or precede biliary obstruction. The prognosis in patients with combined obstruction is particularly poor. Therefore, minimally invasive palliation is preferred in these patients to avoid morbidity associated with surgery. Endoscopic palliation is preferred to surgical bypass due to similar efficacy, less morbidity, and shorter hospital stay. The success of endoscopic palliation depends on the type of bilioduodenal stenosis and the presence of previously placed duodenal metal stents. Biliary cannulation is difficult in type II bilioduodenal strictures where the duodenal stenosis is located at the level of the papilla. Consequentially, technical and clinical success is lower in these patients than in those with type I and III bilioduodenal strictures. However, in cases with failure of endoscopic retrograde cholangiopancreatography, with the introduction of endoscopic ultrasound for biliary drainage, the success of endoscopic bilioduodenal bypass is likely to increase further. The safety and efficacy of endoscopic ultrasound-guided drainage has been documented in multiple studies. With the development of dedicated accessories and standardization of drainage techniques, the role of endoscopic ultrasound is likely to expand further in cases with double obstruction. Clin Endosc 2019;52:40-46

KCI등재 SCOPUS

7Endoscopy Timing in Patients with Acute Upper Gastrointestinal Bleeding

저자 : Goncalo Alexandrino , Tiago Dias Domingues , Rita Carvalho , Mariana Nuno Costa , Luis Carvalho Lourenco , Jorge Reis

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 47-52 (6 pages)

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Background/Aims: The role of very early (≤12 hours) endoscopy in nonvariceal upper gastrointestinal bleeding is controversial. We aimed to compare results of very early and early (12-24 hours) endoscopy in patients with upper gastrointestinal bleeding demonstrating low-risk versus high-risk features and nonvariceal versus variceal bleeding.
Methods: This retrospective study included patients with nonvariceal and variceal upper gastrointestinal bleeding. The primary outcome was a composite of inpatient death, rebleeding, or need for surgery or intensive care unit admission. Endoscopy timing was defined as very early and early. We performed the analysis in two subgroups: (1) high-risk vs. low-risk patients and (2) variceal vs. nonvariceal bleeding.
Results: A total of 102 patients were included, of whom 59.8% underwent urgent endoscopy. Patients who underwent very early endoscopy received endoscopic therapy more frequently (p=0.001), but there was no improvement in other clinical outcomes. Furthermore, patients at low risk and with nonvariceal bleeding who underwent very early endoscopy had a higher risk of the composite outcome.
Conclusions: Very early endoscopy does not seem to be associated with improved clinical outcomes and may lead to poorer outcomes in specific populations with upper gastrointestinal bleeding. The actual benefit of very early endoscopy remains controversial and should be further clarified. Clin Endosc 2019;52:47-52

KCI등재 SCOPUS

8Effect of Sending Educational Video Clips via Smartphone Mobile Messenger on Bowel Preparation before Colonoscopy

저자 : Sung Chan Jeon , Jae Hyun Kim , Sun Jung Kim , Hye Jung Kwon , Youn Jung Choi , Kyoungwon Jung , Sung Eun Kim , Won Moon , Moo In Park , Seun Ja Park

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 53-58 (6 pages)

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Background/Aim: We aimed to evaluate the efficacy of sending educational video clips via smartphone mobile messenger (SMM) on enhancing bowel preparation before colonoscopy.
Methods: This was a prospective, endoscopist-blinded, randomized controlled study. Patients in the SMM group received two video clips sent via SMM that explained the diet and regimen for bowel preparation, whereas those in the control group did not receive any video clips. We compared the quality of bowel preparation between the two groups, which was assessed by an endoscopist using the Ottawa scale.
Results: Between August and November 2014, 140 patients in the SMM group and 141 patients in the control group underwent colonoscopic examination. The total Ottawa score of the SMM group was significantly lower than that of the control group (5.47±1.74 vs. 5.97±1.78, p=0.018). These results were particularly prominent in the younger age group; the total Ottawa score of patents in the SMM group aged <40 years was significantly lower than that of patients in the control group aged <40 years (5.10±1.55 vs. 6.22±2.33, p=0.034).
Conclusions: We demonstrated that sending educational video clips via SMM could result in better bowel preparation, especially in the younger age group. Clin Endosc 2019;52:53-58

KCI등재 SCOPUS

9Single-Stage Endoscopic Stone Extraction and Cholecystectomy during the Same Hospitalization

저자 : Toshiaki Terauchi , Hiroharu Shinozaki , Satoshi Shinozaki , Yuichi Sasakura , Masaru Kimata , Junji Furukawa , Alan Kawarai Lefor , Yoshiro Ogata , Kenji Kobayashi

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 59-64 (6 pages)

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Background/Aims: The clinical impact of single-stage endoscopic stone extraction by endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy during the same hospitalization remains elusive. This study aimed to determine the efficacy and safety of single-stage ERCP and cholecystectomy during the same hospitalization in patients with cholangitis.
Methods: We retrospectively reviewed the medical records of 166 patients who underwent ERCP for mild to moderate cholangitis due to choledocholithiasis secondary to cholecystolithiasis from 2012 to 2016.
Results: Complete stone extraction was accomplished in 92% of patients (152/166) at the first ERCP. Among 152 patients who underwent complete stone extraction, cholecystectomy was scheduled for 119 patients (78%). Cholecystectomy was performed during the same hospitalization in 89% of patients (106/119). We compared two groups of patients: those who underwent cholecystectomy during the same hospitalization (n=106) and those who underwent cholecystectomy during a subsequent hospitalization (n=13). In the delayed group, cholecystectomy was performed about three months after the first ERCP. There were no significant differences between the groups in terms of operative time, rate of postoperative complications, and interval from cholecystectomy to discharge.
Conclusions: Single-stage endoscopic stone extraction is recommended in patients with mild to moderate acute cholangitis due to choledocholithiasis. The combination of endoscopic stone extraction and cholecystectomy during the same hospitalization is safe and feasible. Clin Endosc 2019;52:59-64

KCI등재 SCOPUS

10Impact of Periampullary Diverticulum on ERCP Performance: A Matched Case-Control Study

저자 : Juan E. Corral , Omar Y. Mousa , Paul T. Kröner , Victoria Gomez , Frank J. Lukens

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 52권 1호 발행 연도 : 2019 페이지 : pp. 65-71 (7 pages)

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Background/Aims: Periampullary diverticulum (PAD) is frequently encountered during endoscopic retrograde cholangiopancreatography (ERCP) and has been associated with stone formation in the bile duct. The effects of PAD on the ERCP procedure have been often debated. We aimed to compare the therapeutic success of ERCP between patients with PAD and matched controls.
Methods: We reviewed all ERCPs with findings of PAD in a national database (n=1,089) and compared them with age- and gender-matched controls in a 1:3 fashion (n=3,267). Demographics, endoscopic findings, visualization of main structures, and therapeutic success rates were compared between groups. Secondary analysis compared PAD cases and controls who had gallstone disease.
Results: The average cohort age was 68.4±14.3 years and 55.1% were male. ERCP success was similar in both groups, and no significant inter-group differences were found in the multivariate analysis. The presence of PAD did not affect the rates of sphincterotomy or visualization of main biliary structures. Secondary analysis showed similar success rates for gallstone removal between patients with PAD and controls.
Conclusions: PAD may not be considered a hinderance to ERCP success. Further research is needed to determine the best approach to cannulate the ampulla and provide endoscopic therapy for different subtypes of PAD. Clin Endosc 2019;52:65-71

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