論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Gel Immersion vs. Water Immersion Endoscopic Ultrasound for Visualization of the Duodenal Papilla and Periampullary Lesions: A Dual-Center Retrospective Study With Blinded Evaluation of Archived Videos.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
掲載区分	国外
巻・号・頁	pp.Online ahead of print
著者・共著者	Haruka Toyonaga, Toshifumi Kin, Hajime Yamazaki, Hironao Matsumoto, Kimi Sumimoto, Makoto Masaki, Arata Oka, Takuya Takayama, Tatsuya Nakagawa, Masataka Kano, Masahiro Orino, Kazuki Hama, Kosuke Iwano, Ryo Ando, Tatsuya Ishii, Masayo Motoya, Tsuyoshi Hayashi, Kuniyuki Takahashi, Akio Katanuma, Masaaki Shimatani, Makoto Naganuma
発行年月	2026/03
概要	BACKGROUND AND STUDY AIMS:Accurate visualization of the duodenal papilla is essential during endoscopic ultrasound (EUS). Water immersion (WI)-EUS improves papillary visibility by expanding the duodenal lumen, but maintaining sufficient water can be difficult. Gel immersion (GI)-EUS offers more stable visualization, though comparative data remain limited.PATIENTS AND METHODS:This dual-center retrospective study included 200 patients who underwent GI-EUS (n = 101) or WI-EUS (n = 99) for ampullary evaluation. Archived videos were randomized and independently assessed by two blinded pancreatobiliary EUS experts. Delineation quality was evaluated using predefined parameters: duodenal distension, liquid retention, and artifact reduction. Optimal delineation success was defined as complete scores for all parameters.RESULTS:GI-EUS achieved a significantly higher optimal delineation success rate than WI-EUS (60.4% vs. 32.3%, p < 0.001) while requiring less liquid volume (100 mL vs. 150 mL, p < 0.001). Multivariable analysis identified GI as an independent factor associated with delineation success (adjusted OR: 2.83, 95% CI: 1.43-5.57). Inter-observer agreement was substantial, and adverse event rates were similarly low between groups.CONCLUSIONS:Compared with WI, GI-EUS significantly improves ampullary delineation with enhanced liquid stability and clarity, supporting clinical utility in pancreatobiliary EUS evaluations.
DOI	10.1002/jhbp.70090
PMID	41792593