As a common critical and severe emergency in gastroenterology, esophagogastric variceal bleeding (EGVB) secondary to liver cirrhosis is characterized by high mortality and heavy medical burden, posing a serious threat to human health.Based on the latest domestic and international guidelines and consensus statements for the diagnosis and management of EGVB, we adopted the Delphi expert consultation method.Combined with the current status of diagnosis and treatment for EGVB in Hunan Province, 14 quality control indicators for its clinical management were preliminarily established.This fills the gap in standardized quality control for EGVB within Hunan Province.It bears vital clinical significance for promoting standardized and homogeneous diagnosis and treatment of EGVB across the province, and can serve as a reference for the National Gastroenterology Medical Quality Control Center to formulate relevant national quality control standards, as well as for health administrative authorities to roll out corresponding medical policies.

To explore the clinical application value of a novel domestic peroral cholangioscopy in the diagnosis of intraductal papillary neoplasms of the bile duct (IPNB).

A retrospective analysis was performed on the clinical data of 12 patients diagnosed with intraductal papillary neoplasm of the bile duct (IPNB) who underwent domestic peroral cholangioscopy between January 2020 and December 2025, including 11 patients from the Digestive Endoscopy Center of Jiangsu Provincial Hospital of Chinese Medicine and 1 patient from Nanjing Drum Tower Hospital..Abdominal imaging examinations (CT/MRI) revealed biliary duct dilation or space-occupying lesions in all patients. All patients further received ERCP combined with domestic peroral cholangioscopy.Endoscopic manifestations, biopsy pathological results and complications were recorded.

Among the 12 patients, there were 5 males and 7 females, aged 55 to 84 years old with an average age of (67.9±8.9) years.The main clinical manifestations included right upper abdominal pain (7 cases), right upper abdominal pain complicated with fever (4 cases), jaundice (1 case).Imaging examinations all indicated intrahepatic and/or extrahepatic bile duct dilation, among which filling defects or soft tissue shadows in the bile duct were observed in 6 cases. The morphological findings under peroral cholangioscopy were fish-egg-like lesions (4 cases), papillary lesions (5 cases) and waterweed-like lesions (2 cases), with mucus secretion identified in 8 patients.Lesions were located in hilar bile duct (5 cases), left hepatic duct (2 cases), right hepatic duct (1 case), hilar combined with left hepatic duct (1 case), upper segment and lower segment of common bile duct (1 case each), and the lesion site was unclear in 1 case.Endoscopic biopsy was performed in 10 patients.Pathological diagnoses included IPNB with carcinogenesis (2 cases), IPNB with high-grade intraepithelial neoplasia (2 cases), IPNB with low-grade intraepithelial neoplasia (3 cases), simple IPNB (1 case), chronic mucosal inflammation (2 cases), and no biopsy was conducted in 2 cases.No severe complications occurred after cholangioscopy.Two patients developed hyperamylasemia and one patient suffered from biliary tract infection, all of whom recovered within 48 hours.

Domestic peroral cholangioscopy can directly observe the morphological characteristics of intraductal biliary lesions, and can achieve accurate diagnosis of IPNB combined with biopsy pathology. It features favorable safety and possesses important clinical application value.

To explore the efficacy of radiofrequency ablation combined with biliary endoscopy in treating restenosis after metal stent implantation for malignant biliary obstruction.

A total of 100 patients with restenosis after metal stent implantation for malignant biliary obstruction admitted to the Department of Endoscopic Surgery, Cangzhou Central Hospital of Hebei Province from January 2021 to December 2022 were enrolled as research subjects.Patients were divided into combination group and control group according to treatment regimens, with 50 cases in each group.The combination group received radiofrequency ablation combined with cholangioscopy-guided debridement and stent recanalization, while the control group underwent conventional balloon dilation and stent recanalization.Observation indicators: Primary outcome: clinical success rate; Secondary outcomes: technical success rate; stent patency rate; incidence of adverse events; perioperative indicators.This is a retrospective observational non-randomized study.Baseline balance was achieved only at the statistical level, and selection bias may still exist.

Compared with the control group, the operation time of the combined group was longer and the intraoperative blood loss was lower, and the difference was statistically significant (P<0.05); there were no statistically significant differences in gender, age, body mass index, jaundice duration, Child-Pugh classification, obstruction site, surgical success rate, hospital stay, tumor type, stent diameter, and stent length between the two groups (P>0.05); Compared with the control group, the biliary tract patency rate at 3 months (94%) and 6 months (86%) after surgery in the combined group increased, and the difference was statistically significant (P<0.05), while the patency rate at 1 month after surgery was not statistically significant between the two groups (P>0.05); The complication rate of the control group was 16%, and that of the combined group was 4%, and the difference was statistically significant (P<0.05); The total effective rate of treatment in the control group was 76%, and that in the combined group was 92%, and the difference was statistically significant (P<0.05).

This study only reflects the true clinical effect differences between the two complete clinical intervention schemes.Due to the confounding effect of the dual intervention of biliary endoscopy and radiofrequency ablation, it cannot be determined that the therapeutic advantage is solely caused by radiofrequency ablation alone.The combined radiofrequency ablation and biliary endoscopy direct vision scheme performs better in increasing the overall clinical effectiveness rate and prolonging the biliary patency time, and does not increase the risk of complications, and thus has clinical reference value.

To explore the associations between lesion severity and lesion location, prior treatment history of achalasia (AC) in patients with AC combined with esophageal neoplastic lesions, and provide evidence for risk stratification and endoscopic surveillance of AC patients.

A single-center retrospective study enrolled patients diagnosed with AC combined with esophageal neoplastic lesions hospitalized in Chinese PLA General Hospital from January 2014 to December 2023.Patients were divided into prior AC treatment group and non-prior AC treatment group based on whether AC intervention was performed before lesion detection.Esophageal lesions were dichotomized into low-grade lesions (low-grade intraepithelial neoplasia, LGIN) and high-grade/invasive lesions(high-grade intraepithelial neoplasia HGIN/Tis+ invasive esophageal cancer).Fisher′s exact test was used to compare categorical variables; independent sampletest or Mann-Whitney U test was adopted for measurement data according to data distribution.Two-sided P<0.05 indicated exploratory statistically significant difference.

A total of 18 eligible patients were enrolled, including 5 cases of LGIN, 2 cases of HGIN/Tis, and 11 cases of invasive esophageal cancer. Nine patients had received AC intervention (prior AC treatment group), and 9 had no AC treatment history (non-prior AC treatment group).Lesions in prior AC treatment group were predominantly located in the lower esophagus (77.8%), including 5 LGIN and 4 HGIN/Tis or invasive cancer.Lesions in non-prior AC treatment group mostly occurred in the middle esophagus (66.7%), all presented as HGIN/Tis or invasive esophageal cancer with an esophageal dilatation rate of 88.9%.Distribution differences between groups: lesion location Fisher P=0.036, prior AC treatment Fisher P=0.029, esophageal dilatation Fisher P=0.099.No obvious distribution difference was observed between dysphagia duration and lesion severity.

Exploratory distribution differences exist between lesion severity and lesion location, prior AC treatment history in AC patients with esophageal neoplastic lesions. Lesions in lower esophagus or patients with AC intervention history are mostly low-grade intraepithelial neoplasia, while patients with middle esophageal lesions and without AC treatment are prone to high-grade and invasive lesions.Long-term endoscopic surveillance is recommended for AC patients with long disease duration, middle esophageal mucosal abnormalities, advanced age, male gender and alcohol drinking history.

To explore the application value of imaging examinations and digestive endoscopy in the diagnosis and treatment of gastrointestinal foreign body in children, especially in complicated cases with unclear history and protracted course.

Two cases of esophageal stenosis in children with dysphagia and no clear history of foreign body ingestion were reported, and the diagnosis and treatment process was shared.The specific application of imaging and endoscopic techniques in diagnosis and treatment was analyzed, providing ideas for clinical diagnosis and treatment.

Both cases were ultimately diagnosed with esophageal foreign bodies via electronic gastroscopy, which revealed impacted foreign bodies at the stricture sites (the parents later recalled histories of foreign body ingestion over 6 months and 2 years prior, respectively).Both children underwent endoscopic foreign body removal in the operating room.Intraoperatively, hook knives were used for gradual radial incisions, and snare devices were employed to piecemeal resect locally hyperplastic granulation tissue.After dissection and exposure of the foreign bodies, they were successfully removed using foreign body forceps combined with guidewires.In Case 1, esophageal perforation and pneumothorax were detected during the procedure, and closed thoracic drainage with placement of a covered retrievable esophageal stent was performed for perforation sealing.In Case 2, esophageal perforation and ulceration were complicated, and a nasogastric feeding tube along with an esophageal drainage tube was inserted. Postoperatively, both patients received regular endoscopic treatment for secondary esophageal strictures.To date, both patients are able to eat normally via the oral route and show satisfactory growth and development.

Esophageal foreign body impaction is a common cause of acquired esophageal stenosis in children.For cases with unclear history of foreign body ingestion, long time of impaction, and high risk of complications, attention should be paid to the detailed evaluation of imaging and digestive endoscopy to obtain key diagnostic clues and assist in making the optimal treatment decision.Multidisciplinary preoperative evaluation and precise endoscopic operation during surgery can help effectively deal with complications and avoid unnecessary surgical operations.At the same time, public health education should be strengthened to raise awareness of gastrointestinal foreign bodies in children and promote early diagnosis and treatment.

To systematically summarize the risk factors for hypoxemia and related adverse events in older patients undergoing gastrointestinal endoscopy under sedation or anesthesia, and to provide evidence for preprocedural risk stratification and perioperative prevention.

A systematic review was conducted in accordance with PRISMA 2020. PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and major Chinese databases were searched from inception to August 23, 2026. Observational studies reporting extractable data on risk factors were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analysis was performed with RevMan 5.3.

Ten studies involving a total of 8, 284 participants were included, with NOS scores ranging from 7 to 9. Pooled analyses showed that advanced age (OR=2.99), higher body mass index (BMI; OR=3.54), hypertension (OR=1.73), a history of smoking (OR=2.58), and a history of alcohol consumption (OR=1.41) were associated with an increased risk of the outcome. Pulmonary disease/chronic obstructive pulmonary disease (COPD; RR=2.41), a history of snoring (OR=3.53), and higher American Society of Anesthesiologists (ASA) physical status (OR=3.11) were also significantly associated with increased risk. Sex (OR=1.17, P=0.07) and diabetes mellitus (random-effects OR=1.30, P=0.16) were not significantly associated with the outcome.

Current evidence suggests that advanced age, higher BMI, a history of snoring, hypertension, smoking, alcohol consumption, pulmonary disease/COPD, and higher ASA physical status may increase the risk of hypoxemia or related adverse events during gastrointestinal endoscopy under sedation or anesthesia in older patients. These factors should be considered in preprocedural assessment and individualized oxygenation and airway-management strategies. Because some included studies used composite adverse-event outcomes and several risk factors showed substantial heterogeneity, these findings require further confirmation in high-quality prospective studies.

Acute biliary pancreatitis (ABP) is a major type of acute pancreatitis in China, with high incidence and rapid progression.Improper management can lead to severe complications. Endoscopic retrograde cholangiopancreatography (ERCP) is a primary therapeutic approach for ABP.It enables the management of intrahepatic and extrahepatic bile duct stones, thereby reducing the occurrence of ABP and improving patient outcomes.This review elaborates on the current application of ERCP in ABP, including the indications, optimal timing for intervention, and associated complications.

To construct a nursing quality evaluation scale for gastroenterology and to provide a tool for improving clinical nursing quality and nursing management.

The primary items of the nursing quality evaluation table were determined by literature review, question collection and selecting the important contents of the previous quality evaluation scale.From September to October 2024, 14 nursing experts from Beijing third-level A hospital conducted two rounds of Delphi expert letter consultation, and finally determined the digestive specialty nursing quality evaluation table.

The effective recoveries of 2 rounds of expert correspondence questionnaires were 92.86% and 100%, the expert authority coefficients were 0.820 and 0.855, and Kendall harmony coefficients were 0.151 and 0.223 (all RHO<0.001), respectively.The final evaluation table of nursing quality includes 4 primary indexes and 50 secondary indexes.

The evaluation table of digestive nursing quality constructed in this study has high reliability and validity, and is an effective tool for digestive nursing managers to accurately and effectively evaluate the quality of digestive nursing.

To explore the postoperative nursing methods and effects of super-minimally invasive stepwise full-thickness resection (sft-SMIR) in locally advanced rectal cancer patients after neoadjuvant therapy.

Twelve patients with locally advanced rectal cancer who underwent sft-SMIR after neoadjuvant chemoradiotherapy in our department were selected. Based on the surgical approach and the pathophysiological characteristics of patients after neoadjuvant therapy, perioperative stepwise characteristic nursing was implemented, including individualized bowel preparation and anal preservation cognitive intervention before surgery, minimally invasive position protection during surgery, targeted complication care after surgery, dedicated tube care, psychological counseling, and continuous guidance after discharge.

All 12 patients had their postoperative complications effectively controlled through targeted nursing care.After treatment, they were discharged smoothly and showed good recovery during follow-up outside the hospital.

By implementing specialized perioperative nursing care for patients undergoing super minimally invasive stepwise full-thickness resection (sft-SMIR) and neoadjuvant therapy, postoperative complications can be significantly reduced, nursing quality improved, patient recovery accelerated, and their quality of life enhanced, providing a reference for clinical nursing practices in such surgeries.