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대한소화기내시경학회> Clinical Endoscopy

Clinical Endoscopy update

  • : 대한소화기내시경학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 격월
  • : 2234-2400
  • : 2234-2443
  • : 대한소화기내시경학회지(~2011)→Clinical Endoscopy(2012~)

수록정보
수록범위 : 44권1호(2011)~54권6호(2021) |수록논문 수 : 1,196
Clinical Endoscopy
54권6호(2021년 11월) 수록논문
최근 권호 논문
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KCI등재 SCOPUS

2TranspapillaryGallbladder Drainage for Acute Cholecystitis: Two Stents or Not Two Stents

저자 : Jad Abimansour , Ryan Law

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 783-784 (2 pages)

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3Treatment of Walled-off Necrosis - Outcomes are Best When Endoscopy and Percutaneous Interventions are Complimentary, Not Exclusive

저자 : Ji Young Bang , Shyam Varadarajulu

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 785-786 (2 pages)

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4Current Status of Endoscopic Vacuum Therapy in the Management of Esophageal Perforations and Post-Operative Leaks

저자 : Imogen Livingstone , Lily Pollock , Bruno Sgromo , Sotiris Mastoridis

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 787-797 (11 pages)

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Esophageal wall defects, including perforations and postoperative leaks, are associated with high morbidity and mortality and pose a significant management challenge. In light of the high morbidity of surgical management or revision, in recent years, endoscopic vacuum therapy (EVT) has emerged as a novel alternative treatment strategy. EVT involves transoral endoscopic placement of a polyurethane sponge connected to an externalized nasogastric tube to provide continuous negative pressure with the intention of promoting defect healing, facilitating cavity drainage, and ameliorating sepsis. In the last decade, EVT has become increasingly adopted in the management of a diverse spectrum of esophageal defects. Its popularity has been attributed in part to the growing body of evidence suggesting superior outcomes and defect closure rates in excess of 80%. This growing body of evidence, coupled with the ongoing evolution of the technology and techniques of deployment, suggests that the utilization of EVT has become increasingly widespread. Here, we aimed to review the current status of the field, addressing the mechanism of action, indications, technique methodology, efficacy, safety, and practical considerations of EVT implementation. We also sought to highlight future directions for the use of EVT in esophageal wall defects. Clin Endosc 2021;54:787-797

KCI등재 SCOPUS

5Over-the-Scope Clip in the Treatment of Gastrointestinal Leaks and Perforations

저자 : Mike T. Wei , Ji Yong Ahn , Shai Friedland

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 798-804 (7 pages)

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While perforations, postoperative fistulas, and leaks have traditionally led to surgical or interventional radiology consultation for management, the introduction of the over-the-scope clip has allowed increased therapeutic possibilities for endoscopists. While primarily limited to case reports and series, the over-the-scope clip successfully manages gastrointestinal bleeding, perforations, as well as postoperative leaks and fistulas. Retrospective studies have demonstrated a relatively high success rate and a low complication rate. Given the similarity to variceal banding equipment, the learning curve with the over-the-scope clip is rapid. However, given the higher risk of procedures involving the use of the over-the-scope clip, it is essential to obtain the scope in a stable position and grasp sufficient tissue with the cap using a grasping tool and/or suction. From our experience, while closure may be successful in lesions sized up to 3 cm, successful outcomes are obtained for lesions sized <1 cm. Ultimately, given the limited available data, prospective randomized trials are needed to better evaluate the utility of the over-the-scope clip in various clinical scenarios, including fistula and perforation management. Clin Endosc 2021;54:798-804

KCI등재 SCOPUS

6Endoscopic Management of Staple Line Leak after Bariatric Surgery: Surgeon's Perspective

저자 : Yoona Chung , Dae Geun Park , Yong Jin Kim

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 805-809 (5 pages)

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Laparoscopic sleeve gastrectomy (LSG) has become a standalone primary procedure as a bariatric metabolic surgery since the early 2000s. The overall complication rate of LSG is reported to range from 2% to 15%. Staple line leakage (SLL) remains a major adverse event and occurs in approximately 1-6% of patients. Choosing the optimal treatment modality is a complex process. Clinicians must understand that nutritional support and drainage of fluid collection are essential for initial management. Conservative endoscopic management and sufficient drainage can resolve approximately 70% of SLLs. Endoscopic management of bariatric complications has been rapidly evolving in recent years and can be considered in all patients who are hemodynamically stable. We will review the available endoscopic management techniques, including stent placement (self-expanding stents and bariatric-specific stents), clipping, tissue sealant application, and internal drainage (double-pigtail stents [DPS] placement, endoscopic vacuum therapy, and septotomy). Stent placement remains the mainstream treatment for SLLs. However, healing with stents requires multiple sessions/ stents and a long course of recovery. Endoscopic internal drainage is gaining popularity and has the potential to be a superior method. The importance of early intervention and combined endoscopic methods should be recognized. Clin Endosc 2021;54:805- 809

KCI등재 SCOPUS

7Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome

저자 : Hideyuki Shiomi , Arata Sakai , Ryota Nakano , Shogo Ota , Takashi Kobayashi , Atsuhiro Masuda , Hiroko Iijima

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 810-817 (8 pages)

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Afferent loop syndrome (ALS) is a mechanical obstruction of the afferent limbs after gastrectomy with gastrojejunostomy reconstruction. Patients with cancer recurrence require immediate and less invasive treatment because of their poor condition. Percutaneous transhepatic/transluminal drainage (PTD) and endoscopic enteral stenting offer reasonable palliative treatment for malignant ALS but are not fully satisfactory in terms of patient quality of life (QoL) and stent patency. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using a lumen-apposing metal stent may address these shortcomings. Clinical data from 11 reports showed that all patients who had undergone EUS-GE had positive technical and clinical outcomes. The adverse event rate was 11.4%, including only mild or moderate abdominal pain, with no severe adverse events. Indirect comparative studies indicated that patients who had undergone EUS-GE had a significantly superior QoL, a higher clinical success rate, and a lower reintervention rate than those who had undergone PTD or endoscopic enteral stenting. Although the evidence is limited, EUS-GE may be considered as a first-line treatment for malignant ALS because it has better clinical outcomes than other less invasive treatments, such as PTD or endoscopic enteral stenting. Further prospective randomized control trials are necessary to establish EUS-GE as a standard treatment for ALS. Clin Endosc 2021;54:810-817

KCI등재 SCOPUS

8The Role of Endoscopy in Small Bowel Neuroendocrine Tumors

저자 : Ji Yoon Yoon , Nikhil A. Kumta , Michelle Kang Kim

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 818-824 (7 pages)

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Small bowel neuroendocrine tumors (NETs) represent approximately one-third of NETs of the gastrointestinal tract, and their incidence is increasing. When determining if endoscopic resection is appropriate, endoscopic ultrasound is used to assess the lesion size and depth of invasion for duodenal NETs. A number of techniques, including endoscopic mucosal resection (EMR), band-assisted EMR (band-EMR), endoscopic submucosal dissection (ESD), and over-the-scope clip-assisted endoscopic full-thickness resection (EFTR), have been studied; however, the best technique for endoscopic resection remains unclear. The vast majority of currently available data are retrospective, and prospective studies with longer follow-up times are required. For jejunal and ileal NETs, endoscopic techniques such as video capsule endoscopy (VCE) and balloon enteroscopy (BE) assist in diagnosis. This includes localization of the primary NET in metastatic disease where initial workup has been negative, and the identification of multifocal disease, which may change management and prognostication. Clin Endosc 2021;54:818-824

KCI등재 SCOPUS

9Endoscopic Evaluation of Biliary Strictures: Current and Emerging Techniques

저자 : Roy Huynh , Corinne Owers , Christopher Pinto , Thuy-my Nguyen , Titus Kwok

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 825-832 (8 pages)

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The diagnosis of biliary strictures in clinical practice can be challenging. Discriminating between benign and malignant biliary strictures is important to prevent the morbidity and mortality associated with incorrect diagnoses. Missing a malignant biliary stricture may delay surgery, resulting in poor prognostic outcomes. Conversely, it has been demonstrated that approximately 20% of patients who undergo surgery for suspected biliary malignancies have a benign etiology on histopathology. Traditional tissue sampling using endoscopic retrograde cholangiography does not always produce a definitive diagnosis, with a considerable proportion of cases remaining as indeterminate biliary strictures. Recent advances in endoscopic techniques have the potential to improve the diagnostic and prognostic accuracy of biliary strictures. Clin Endosc 2021;54:825-832

KCI등재 SCOPUS

10Stent versus Balloon Dilation for the Treatment of Dominant Strictures in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis

저자 : Marina Tucci Gammaro Baldavira Ferreira , Igor Braga Ribeiro , Diogo Turiani Hourneaux De Moura , Thomas R. Mccarty , Alberto Machado Da Ponte Neto , Galileu Ferreira Ayala Farias , Antônio Afonso De Miranda Neto , Pedro Victo

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 54권 6호 발행 연도 : 2021 페이지 : pp. 833-842 (10 pages)

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Background/Aims: The endoscopic management of primary sclerosing cholangitis (PSC)-associated dominant strictures remains challenging. This systematic review and meta-analysis aimed to compare balloon dilation and stent placement in the treatment of dominant strictures among PSC patients.
Methods: Literature searches on MEDLINE, EMBASE, Cochrane CENTRAL and Lilacs/Bireme were performed for studies published until December 2020. Measured outcomes included clinical efficacy, stricture recurrence, cumulative recurrencefree rate, transplant rate, 5-year survival rate, and adverse events (i.e., pancreatitis, cholangitis, bleeding, perforation and death).
Results: A total of 5 studies (n=467) were included. Based on pooled analyses, there were no differences in clinical efficacy (risk difference [RD], -0.13; 95% confidence interval [CI], -0.58 to 0.33; I2=93%) or transplant rates (RD, -0.09; 95% CI, -0.19 to 0.01; I2=0%); however, the risk of occurrence of adverse events was lower with balloon dilatation than with stent placement (RD, -0.34; 95% CI, -0.45 to -0.23; I2=61%). Among the types of adverse events reported, only the rates of cholangitis/bacteremia were significantly lower in balloon dilation patients (RD, -0.19; 95% CI, -0.25 to -0.13; I2=51%).
Conclusions: Compared to balloon dilation, stent placement for dominant strictures in PSC appeared to have higher complication rates without significant differences in efficacy. Clin Endosc 2021;54:833-842

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