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Role of interventional inflammatory bowel disease in the era of biologic therapy: a position statement from the Global Interventional IBD Group  Bo Shen,

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Presentation on theme: "Role of interventional inflammatory bowel disease in the era of biologic therapy: a position statement from the Global Interventional IBD Group  Bo Shen,"— Presentation transcript:

1 Role of interventional inflammatory bowel disease in the era of biologic therapy: a position statement from the Global Interventional IBD Group  Bo Shen, MD, Gursimran Kochhar, MD, Udayakumar Navaneethan, MD, Xiuli Liu, MD, PhD, Francis A. Farraye, MD, MSc, Yago Gonzalez-Lama, MD, David Bruining, MD, Darrell S. Pardi, MD, MS, Martin Lukas, MD, Martin Bortlik, MD, Kaicun Wu, MD, PhD, Ajit Sood, MD, David A. Schwartz, MD, William J. Sandborn, MD Roger Charles, MD, Yan Chen, MD, PhD, Maria Begoña González Suárez, MD, Marietta Iaccuci, MD, Tako Kabayashi, MD, PhD, Paulo Kotze, MD, PhD, Nan Lan, MD, Yue Li, MD, Ren Mao, MD, PhD Bo Shen, MD, Gursimran Kochhar, MD, Udayakumar Navaneethan, MD, Xiuli Liu, MD, PhD, Francis A. Farraye, MD, MSc, Yago Gonzalez-Lama, MD, David Bruining, MD, Darrell S. Pardi, MD, MS, Martin Lukas, MD, Martin Bortlik, MD, Kaicun Wu, MD, PhD, Ajit Sood, MD, David A. Schwartz, MD, William J. Sandborn, MD Roger Charles, MD, Yan Chen, MD, PhD, Maria Begoña González Suárez, MD, Marietta Iaccuci, MD, Tako Kabayashi, MD, PhD, Paulo Kotze, MD, PhD, Nan Lan, MD, Yue Li, MD, Ren Mao, MD, PhD  Gastrointestinal Endoscopy  Volume 89, Issue 2, Pages (February 2019) DOI: /j.gie Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

2 Figure 1 Endoscopic balloon dilation of strictures. A primary stricture before and during balloon dilation (A, B). An anastomotic stricture undergoing balloon dilation resulting in a small perforation (C), which was treated with endoscopic clipping on site (D). Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

3 Figure 2 Endoscopic stricturotomy. A and B, Needle-knife stricturotomy of a primary colonic stricture from Crohn’s disease, followed by deployment of endoclips to maintain luminal patency and to prevent bleeding. C and D, Isolated knife stricturotomy of an ileocolonic anastomotic stricture. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

4 Figure 3 Endoscopic stent treatment of a stricture. A and B, Lumen-apposing metal stent for a short, tight ileocolonic anastomotic stricture. C and D, Self-expanding metal stent for a primary Crohn’s disease–associated stricture. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

5 Figure 4 Endoscopic fistulotomy. A short, superficial ileocolonic fistula detected with a soft-tip guidewire (A), which provided guidance for electroincision of the fistula track (B and C). D, Postprocedural view of the fistula track. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

6 Figure 5 Depiction of endoscopic fistulotomy.
(Courtesy of Kochhar G, Shen B. Gastrointest Endosc 2018;88:87-94.) Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

7 Figure 6 Depiction of endoscopy-guided seton placement. Incision and drainage of a perianal abscess with a needle-knife (A), followed by insertion of a soft-tip guidewire through the fistula track (B), and introduction and securing of a seton (C and D). (Courtesy of Shen B. Gastrointest Endosc 2017;85: ) Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

8 Figure 7 Endoscopy-guided pigtail stent placement. A suture line leak (A) leading to presacral abscess, which was treated with incision and drainage with placement of a pigtail stent (B-D). Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

9 Figure 8 Endoscopic clipping of anastomotic and suture line leaks. A and B, A small enterocutaneous fistula from ileo-ileal anastomosis leak, which was treated with through-the-scope clips. C and D, A larger enterocutaneous fistula from ileo-ileal anastomosis leak, which was treated with over-the-scope clips. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

10 Figure 9 Endoscopic sinusotomy. Artist's depiction of a large presacral sinus from an ileal pouch-anal anastomosis leak, which was treated with needle-knife sinosotomy and endoclips (A). The sinus opening at 11 o’clock (B), which underwent electroincision and placement of endoclips (C). (Courtesy of Lan N, Hull TL, Shen B. Gastrointest Endosc 2019;89: ) Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

11 Figure 10 Members of the Global Interventional IBD Group in an animal lab for inflammatory bowel disease strictures in the Czech Republic. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions


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