The global prevalence of obesity continues to rise, while traditional therapies face challenges due to limited efficacy, invasiveness, and economic burdens. Endoscopic bariatric and metabolic therapies (EBMTs) have emerged as novel approaches to obesity management, characterized by their minimally invasive nature, reversibility, and targeted therapeutic mechanisms. This review systematically expounds the technical classifications and mechanisms of EBMTs, focusing on the clinical value of gastric and small intestinal intervention techniques. Gastric intervention techniques primarily comprise space-occupying devices and anatomical reconstruction: the former achieves short-term weight reduction through physical volume restriction but exhibits device-dependent efficacy, while the latter sustains long-term outcomes via endoscopic suturing or folding that induces durable morphological changes. Small intestinal intervention techniques improve metabolic regulation via gut-pancreas axis modulation, encompassing digestive diversion-driven alterations in chyme transit patterns and mucosal ablation-activated regeneration of endocrine microenvironments. Future studies should prioritize large-scale longitudinal studies to validate the efficacy and safety of EBMTs, thereby establishing evidence-based support for the precision management of obesity and related metabolic disorders.
Objective To investigate the severe complications recently after endoscopic sphincterotomy (EST) and related risk factors. Methods Two thousands one hundred and twenty patients after EST in People’s Hospital of Leshan city in recent 15 years were collected to be analyzed. The incidence rates of severe complications were observed and related risk factors were analyzed. Results Thirty four cases (1.60%) in 2 120 patients presented severe complications in 72 h after EST: Nine were with hemorrhage, 23 with acute pancreatitis, 1 with duodenum perforation and 1 with septicemia. Acute pancreatitis was the most remarkable severe complication. The duodenal papilla with tumor or inflammation, and oddi dysfunction were the primary risk factors of hemorrhage or acute pancreatitis, respectively. The rate of oddi dysfunction patients with acute pancreatitis reached up to 44.68% (21/47). Conclusions Acute pancreatitis is the most common severe complications recently after EST and sphincter of oddi dysfunction is the most remarkable risk factor.
Esophageal diseases include esophageal malignant diseases and benign diseases, with a high incidence in our country. Along with the development of the endoscopic technique, many of them which required medical treatment or surgery in the past can now be cured by endoscopic surgery. This article is an overview of long-term follow-up of endoscopic surgery for the common esophageal disease, such as early squamous cell carcinoma, esophageal stricture, achalasia and submucosal tumor of the esophagus.
目的 探討內鏡下治療膽管乳頭狀瘤的價值。方法 6例經病理學檢查證實的膽管乳頭狀瘤患者在行“膽道探查+ T管引流術”后6～8周行膽道鏡下高頻電刀燒灼術，對術后治療效果進行評估。結果 6例患者術后膽汁引流量逐漸增多至100～400 ml/d(平均250 ml/d)，膽汁黏稠度明顯減輕，黃疸減退。術后隨訪1～3年，平均2年，3例患者術后黃疸、腹痛明顯減輕，至今無復發； 2例在繼續治療中； 1例患者隨訪半年，T管引流通暢，但因嚴重肺部感染并發多器官功能衰竭死亡。結論 內鏡下高頻電刀燒灼治療膽管乳頭狀瘤能有效緩解患者的臨床癥狀，明顯提高患者的生存質量。
Esophageal cancer is an aggressive malignancy with high morbidity and poor prognosis. Symptoms of early esophageal cancer are insidious and difficult to detect, while advanced esophageal obstruction, lesion infiltration and metastasis seriously affect patients’ quality of life. Early detection and treatment can help to increase the survival chance of patients. Recently, artificial intelligence (AI) has shown remarkable success in diagnosis of esophageal cancer, highlighting the great potential of new AI-assisted diagnostic modalities. This paper aims to review recent progress of AI in the diagnosis of esophageal cancer and to prospect its clinical application.
Esophageal cancer is a serious threat to the health of Chinese people. The key to solve this problem is early diagnosis and early treatment, and the most important method is endoscopic screening. The rapid development of artificial intelligence (AI) technology makes its application and research in the field of digestive endoscopy growing, and it is expected to become the "right-hand man" for endoscopists in the early diagnosis of esophageal cancer. Currently, the application of multimodal and multifunctional AI systems has achieved good performance in the diagnosis of superficial esophageal squamous cell carcinoma and precancerous lesions. This study summarized and reviewed the research progress of AI in the diagnosis of superficial esophageal squamous cell carcinoma and precancerous lesions, and also explored its development direction in the future.
Objective To evaluate the therapeutic effects of endoscopic treatment on biliary tract complications after liver transplantation. Methods The clinical data of 55 patients with biliary tract complications after liver transplantation undergoing endoscopic treatment from January 2006 to June 2009 were analyzed retrospectively. Results Ninety-eight times of endoscopic treatment were performed in 55 patients. There were 11 cases of biliary fistula, 4 cases of bile duct stricture with biliary fistula, 21 cases of bile duct stricture, 12 cases of bile duct stricture with biliary sludge or stones, 3 cases of biliary sludge or stones, 2 cases of angular distortion of the bile duct and papilla duodeni stenosis in 2 cases. Different procedures including biliary tract dilation, endoscopic nasobiliary drainage, endoscopic sphincterotomy, stone extraction technique and biliary stent placement were performed in different biliary tract complications. The endoscopic treatments were successful in 46 cases (83.6%). The procedure related complications were found in 13 times (13.3%). Conclusion Endoscopy may serve as the primary modality for treating biliary tract complications after liver transplantation with safety and effectiveness.