Publications by authors named "Jong-Ho Moon"
Article Synopsis
- The 2013 Asia-Pacific consensus on managing hilar cholangiocarcinoma was updated due to new evidence regarding endoscopic treatment for malignant hilar biliary obstruction (MHBO).
- A review of literature using a PICO framework led to the creation of consensus statements and key concepts, with expert approval through the modified Delphi method.
- The final recommendations address diagnosis, biliary drainage strategies, recurrent obstruction management, cholecystitis post-stenting, and pre-stenting treatments, but emphasize that they should complement, not replace, multidisciplinary decisions for individual patients.
Article Synopsis
- Lumen-apposing metal stents (LAMSs) were studied against plastic stents for treating infected walled-off necrosis (WON), focusing on their safety and efficacy.
- The study included 46 patients, finding no significant difference in the total number of endoscopic necrosectomy procedures required between the two groups, but LAMS showed a higher clinical success rate at 8 weeks.
- LAMS treatment led to no adverse events, while one patient with a plastic stent experienced significant bleeding.
Endobiliary radiofrequency ablation (RFA) can be an effective palliative treatment, but few studies have evaluated its outcomes for malignant obstruction in the hilar bile duct, which has a thin wall and complex duct-vascular contacts. We evaluated the efficacy and safety of temperature-controlled endobiliary RFA, which can reduce the risk of unintentional thermal injury by maintaining the temperature of the ablation segment, in the treatment of inoperable hilar cholangiocarcinoma (CCA). After propensity score matching, 64 patients with inoperable hilar CCA were categorized to the RFA + stent group (endobiliary RFA with stenting; n=32) or stent-only group (stenting only; n=32).
View Article and Find Full Text PDFBackground: Disposable digital single-operator cholangioscopy (D-SOC) and direct peroral cholangioscopy (D-POC) using an ultraslim endoscope are established POC modalities for the diagnosis and treatment of various biliary diseases. We compared the usefulness of D-SOC and D-POC for the diagnosis of intraductal superficial lesions of the bile duct (ISL-Bs).
Methods: 38 consecutive patients with suspected biliary diseases who underwent both D-SOC and D-POC were enrolled.
Background/aims: : Peroral cholangioscopy (POC) has been used to assess intrahepatic duct (IHD) lesions but with a limited role. A new multibending (MB) ultraslim endoscope has been designed to improve POC performance. We evaluated the usefulness of POC using the MB ultraslim endoscope for the management of IHD lesions.
View Article and Find Full Text PDFIntroduction: Endoscopic ultrasound (EUS)-guided drainage of symptomatic pancreatic fluid collections (PFCs) using the Hot-Axios device has recently been associated with a significant risk of bleeding. This adverse event (AE) seems to occur less frequently with the use of a different device, the Spaxus stent. The aim of the current study was to compare the rates of bleeding between the two stents.
View Article and Find Full Text PDFArticle Synopsis
- Lumen-apposing metal stents (LAMSs) are crucial for ultrasonography-guided gallbladder drainage (EUS-GBD) in patients who are not fit for surgery, especially those with acute cholecystitis.
- A retrospective study of 54 patients showed a 100% technical success rate for LAMS placement, with 76.67% of patients achieving clinical success and only 5.6% experiencing adverse events.
- Patients typically left the hospital after about 5 days, highlighting EUS-GBD as a safe and effective option for high-risk surgical patients.
Background And Aims: EUS-guided hepaticogastrostomy (EUS-HPG) has a risk of serious procedural adverse events (AEs), but few dedicated devices for EUS-HPG are available. We evaluated the feasibility of a new partially covered self-expandable metal stent (PCSEMS) with an anchoring flange for EUS-HPG.
Methods: The feasibility of a stent featuring a proximal radiopaque uncovered portion 1.
Article Synopsis
- The study evaluates the effectiveness of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using a new electrocautery lumen apposing metal stent (EC-LAMS) as a first-line treatment for patients with distal malignant biliary obstruction (DMBO) who may not be suitable for surgery.
- Out of 37 patients, the technical success of EC-LAMS placement was 100%, with a clinical success rate showing significant bilirubin reduction, although 10.8% experienced some adverse events, like bleeding and impaction.
- The findings suggest that EUS-GBD with EC-LAMS is a viable palliative option for managing malignant jaundice, with
Background And Aims: Indirect diagnostic modalities are unsatisfactory for detecting intraductal neoplasm of the bile duct (IN-B), which can be detected by peroral cholangioscopy (POC) with narrow-band imaging (NBI). We investigated the POC findings of IN-B and developed a feasible endoscopic classification system.
Methods: Four hundred seventy-one patients who underwent direct POC from April 2008 to July 2020 were enrolled.
Endoscopic retrograde cholangiopancreatography (ERCP) represents the gold standard for jaundice palliation in malignant biliary obstruction (MBO) patients. Biliary drainage using electrocautery lumen apposing metal stent (EC-LAMS) is currently a well-established procedure when ERCP fails. We aimed to assess the technical and clinical success of a new EC-LAMS as the first approach to the palliation of malignant jaundice due to MBO in patients unfit for surgery.
View Article and Find Full Text PDFMalignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment method for biliary malignancies. However, most of the patients with MHO cannot undergo surgeries on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases.
View Article and Find Full Text PDFBackground/purpose: Compared with currently available duodenoscopy-assisted systems, direct peroral cholangioscopy (DPOC) using an ultra-slim endoscope is limited by technical difficulties. The multibending (MB) ultra-slim endoscope was introduced as a dedicated cholangioscope for DPOC to challenge the technical problem. We retrospectively analyzed the clinical utility of DPOC using an MB endoscope with free-hand insertion into the bile duct in patients with biliary diseases.
View Article and Find Full Text PDFBackground And Aims: Endoscopic ultrasound (EUS) guided choledochoduodenostomy using a lumen-apposing metal stent (LAMS) allows access to the biliary system with a sufficiently large diameter stent. However, an appropriate endoscope for this purpose is required. We evaluated the feasibility of per-oral cholangioscopy (POC) using a multibending ultra-slim endoscope through a LAMS for EUS-guided choledochoduodenostomy.
View Article and Find Full Text PDFBackground: An electrocautery-enhanced delivery system with a lumen-apposing metal stent (LAMS) is available for one-step endoscopic ultrasound-guided transmural drainage (EUS-TD). Bipolar electrosurgery has several potential clinical advantages, including reduced collateral thermal damage, enhanced hemostasis, and no requirement for a return electrode plate. In this study, we compared the technical feasibility and safety of a newly developed bipolar electrocautery-enhanced delivery system with a conventional delivery system for EUS-TD using a LAMS in a porcine model.
View Article and Find Full Text PDFBackground And Aims: Direct peroral cholangioscopy (POC) can be useful when combined with narrow-band imaging (NBI) to explore the etiologies of indeterminate biliary strictures. We evaluated the efficacy of NBI compared with that of conventional white-light imaging (WLI) during POC diagnosis of indeterminate biliary strictures.
Methods: Consecutive patients with indeterminate biliary strictures were enrolled from 2016 to 2019.