Through-the-scope suture closure of nonampullary duodenal endoscopic mucosal resection defects: a retrospective multicenter cohort study.

Background: Delayed bleeding is among the most common adverse events associated with endoscopic mucosal resection (EMR) of nonampullary duodenal polyps. We evaluated the rate of delayed bleeding and complete defect closure using a novel through-the-scope (TTS) suturing system for the closure of duodenal EMR defects.

Methods: We reviewed the electronic medical records of patients who underwent EMR for nonampullary duodenal polyps of ≥ 10 mm and prophylactic defect closure with TTS suturing between March 2021 and May 2022 at centers in the USA.

Novel through-the-scope suture closure of colonic EMR defects (with video).

Background And Aims: Large colon polyps removed by EMR can be complicated by delayed bleeding. Prophylactic defect clip closure can reduce post-EMR bleeding. Larger defects can be challenging to close using through-the-scope clips (TTSCs), and proximal defects are difficult to reach using over-the-scope techniques.

A novel through-the-scope helix tack-and-suture device for mucosal defect closure following colorectal endoscopic submucosal dissection: a multicenter study.

Background: Complete closure of large mucosal defects following colorectal endoscopic submucosal dissection (ESD) with through-the-scope (TTS) clips is oftentimes not possible. We aimed to report our early experience of using a novel TTS suturing system for the closure of large mucosal defects after colorectal ESD.

Methods: We performed a retrospective multicenter cohort study of consecutive patients who underwent attempted prophylactic defect closure using the TTS suturing system after colorectal ESD.

Efficacy of using red dichromatic imaging throughout endoscopic submucosal dissection procedure.

Background: Management of bleeding during endoscopic submucosal dissection (ESD) is critical. Red Dichromatic Imaging (RDI), a novel image-enhanced endoscopy technology, has been reported to improve the visibility of deep vessels and bleeding source compared to white light imaging (WLI). We hypothesized that using RDI during the entire cutting process (full time RDI ESD: FTR-ESD), higher R0 resection rate, shorter procedure time and fewer complications could be achieved.

Endoscopic submucosal dissection of a large cecal tumor extending into the appendiceal orifice in a patient with intact appendix.

Video 1Endoscopic submucosal dissection of a cecal laterally spreading tumor-granular type extending into the appendiceal orifice.

Initial multicenter experience using a novel endoscopic tack and suture system for challenging GI defect closure and stent fixation (with video).

Background And Aims: Closure of endoscopic resection defects can be achieved with through-the-scope clips, over-the-scope clips, or endoscopic suturing. However, these devices are often limited by their inability to close large, irregular, and difficult-to-reach defects. Thus, we aimed to assess the feasibility and safety of a novel through-the-scope, suture-based closure system developed to overcome these limitations.

Hemobilia from Biliary Angiodysplasia Diagnosed with Cholangioscopy.

Biliary angiodysplasia is extremely rare. Our background search revealed only a few case reports in the English literature. We present a case of angiodysplasia of the proximal common bile duct in a patient with subacute upper gastrointestinal bleeding and symptomatic anemia.

Investigating endoscopic features of sessile serrated adenomas/polyps by using narrow-band imaging with optical magnification.

Background: A sessile serrated adenoma/polyp (SSA/P) is a common type of colorectal polyp that possesses malignant potential. Although narrow-band imaging (NBI) can easily differentiate neoplastic lesions from hyperplastic polyps (HPs), SSA/Ps can be a challenge to distinguish from HPs.

Objective: To investigate specific endoscopic features of SSA/Ps by using NBI with optical magnification.

Predictive factors for technically difficult endoscopic submucosal dissection in the colorectum.

Background And Study Aims: Because of technical difficulty, colorectal endoscopic submucosal dissection (CR-ESD) is not widely performed. We aimed to determine risk factors for such technical difficulty as defined by long procedure duration (≥  150 min), perforation, and piecemeal resection.

Patients And Methods: Patients with consecutive colorectal tumors treated with ESD between April 2006 and December 2010 were enrolled in a prospective cohort study.

Cold polypectomy techniques for diminutive polyps in the colorectum.

Adequate colonoscopic polypectomy is a very important intervention for the prevention of colorectal cancer progression during screening and surveillance colonoscopy. Whereas various techniques are used for the removal of diminutive polyps, including cold biopsy forceps, hot biopsy forceps, hot snare, and cold snare, hot polypectomy techniques with electrocautery have been associated with an increased risk of electrocautery-related complications, including immediate and/or delayed bleeding or perforation. In contrast, recent studies have found a polypectomy technique without electrocautery, so-called cold polypectomy, to be a safer and more efficacious technique.

Evaluation of common liver problems.

Diseases of the liver and abnormalities of liver enzyme levels are among the most common reasons for gastroenterology consultation for surgical patients. Although the differential diagnosis of liver disease is exceedingly broad, the majority of patients will have one of several common disorders. A familiarity with the major disorders affecting the liver and the approach to patients with liver disease is therefore useful for clinicians from all disciplines.