The Asian-Pacific Society for Digestive Endoscopy (APSDE) was formerly the Asian Zone of the World Organization of Digestive Endoscopy (OMED), which was established as International Society of Endoscopy (ISE) at its beginning.
In April 1973, the Asian-Pacific Society for Digestive Endoscopy became independent when the 1st Congress of the Society was held. The Congress has been held regularly since then. In the beginning, it was positioned as the Asian-Pacific Zone of the International Society of Endoscopy (ISE). The ISE changed its name to OMED in July 1976.

The Asian-Pacific Zone of OMED changed its name to The Asian-Pacific Society for Digestive Endoscopy and became an independent Society in 1984. Because it was positioned as change of the name, not establishment of a new society, it would be appropriate to regard the Congress held in Kyoto in 1973 as the establishment of the Society. The Society regularly had Congress since then, and from 2000, the Congress is jointly held every year with other gastrointestinal societies under the DDW system.
Among the various businesses managed by APSDE, the most important one is endoscopy education and training. APSDE has held Hands-On training workshops for several times in Bangkok of Thailand, Hanoi and Ho Chi Minh City of Vietnam since 2004. APSDE is also planning to establish training centers in these cities, and some of the centers were actually completed the year before last year. The foundations for these centers were set up and will be managed with corporate donations and APDW surplus fund. Currently, 2 centers are being established in China, 1 in Australia, 1 in Hong Kong and 1 in India, which are going to start operation last year. There are also plans of various activities managed by the committees under the Society. Some of these activities are already started.

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EGD is usually done in the morning following an overnight fast. In patients with concomitant diseases or in older individuals, this prolonged fast may pose a latent risk for the development of complications. Therefore, we investigated the feasibillity of an “afternoon EGD schedule”, which allows patients to have breakfast by 9 in the morning, then to skip lunch and have their EGD done between 3P.M. and 4P.M.. It was found that afternoom endoscopy is fesible under the following conditions : (1)at least 7 hours have passed between breakfast and the EGD ; (2)the fluid intake before the EGD is set to 400ml or more ; (3)diabetic patients who require hemodialysis due to diabetic nephropathy, or patients with severe diabetic peripheral nephropathy are excluded.

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Aim : We aimed to study whether the laparoscopic observation of the liver surface has benefits in determination of the histological stage and activity of autoimmune hepatitis (AIH). Patients and methods : Consecutive 51 AIH patients were enrolled in this study (48.6+/-14.2 year. M/F=4/47, ALT : 119±115 IU/l, IgG : 2001±977 mg/dl). All patients were scored 14.3±3.2 according to the international AIH score. Laparoscopic findings were classified for each of perihepatitis (PH), dent of surface (DS), reddish marking (RM) and white marking (WM) in four grades. Clinical backgrounds, family history and routine blood test (platelet cell count, ALT, T.Bil, ALP, γ-GTP, IgG, ANA, AMA, ASMA) were studied. Histological findings were graded semi-quantitatively in fibrosis, portal and periportal inflammations, interface hepatitis, plasma cell infiltration and hepatocellular rossetes formation.
Results : PH and DS were observed in all and 49(96%) patients, respectively. Thirty-one patients (61%) had RM, of which the grades ware correlated with those of DS, histological activity and portal fibrosis. The grades of RM were not correlated with ALT levels. The grades of DS and RM were higher in ASMA-positive 18 cases, as compared to ASMA-negative cases.
Conclusion : DS and PH were characteristic findings of AIH in diagnostic laparoscopy. We found a significant correlation between RM and histological stage/activity in AIH cases. Laparoscopic observation proved to be beneficial in evaluating clinical condition of AIH.

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Emergency endoscopy was performed under general anesthesia in 2 neonates who required hemostasis due to upper gastrointestinal bleeding. The neonates had vomited associated with hematemesis. In both cases, multiple mucosal lesions, including hemorrhagic ulcers, were seen in the stomach. Hemoclips were applied to these protruding vessels and the bleeding was controlled successfully. Although endoscopic clipping proved useful in both cases, careful and judicious manipulation of the endoscope was required with particular allowances due to the fact that the procedure was being done in neonates.
To improve the safety endoscopic intervention in neonates, the development of a small-diameter fiber-endoscope and the improvement of the peripheral equipment are required. In addition, a coordinated system of neonatal intensive care delivery is vital for the delivery of prompt medical care to critically ill infants.

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A 57-year-old man was admitted to our hospital due to dyspnea on effort and tarry stool. Upper gastrointestinal endoscopy showed a hemorrhagic ulcer with exposed vessel, which was treated successfully by endoscopic hemostasis. On admission he had suffered from disseminated intravascular coagulation and bone scintigraphy revealed diffuse bone metastases. Several examination didn't find any tumor which caused diffuse bone metastases. He was cared with palliative treatment and died at the 19^th day. The autopsy disclosed a disseminated carcinomatosis of bone marrow with type IIc early gastric cancer.

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A 32-year-old woman developed epigastralgia ; on EGD examination, a swollen submucosal tumor (SMT) located at the gastric body was noted. Subsequently the patient's symptom improved ; the EGD examination done at that time revealed a collapsed SMT. The EUS showed that the SMT was a hypoechoic heterogeneous mass located in the fourth layer of the gastric wall. However, the patient's epigastralgia recurred, and on re-examination, a swollen SMT was found. A laparoscopic-assisted partial gastrectomy was done. On histology, a diagnosis of a gastric duplication was made. In this paper, we report this rare case with unique EUS findings and review the literature.

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Colonoscopy in a peritoneal dialysis patient can cause severe complications like peritonitis. Because dialysis technique has rapidly progressed, prognosis of dialysis patients has been improved. Therefore, we are going to have to perform colonoscopy for peritoneal dialysis patients more frequently. We have encountered two cases in peritoneal dialysis patients who underwent endoscopic mucosal resection. Case 1 developed a peritonitis following colonoscopy and made a full recovery fortunately. We could perform colonoscopy without complications in Case 2 by administering antibiotic agent and empting peritoneal cavity before colonoscopy.
We report these cases with a review of the literature and call your attention to preventing complications of colonoscopy in a peritoneal dialysis.

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A 62-year-old man with turbid nail, and skin hyperpigmentation was referred for diarrhea, and a positive fecal occult blood test. This patient had received upper GI and colonoscopy which revealed gastric and colorectal polyposis. We, therefore, diagnosed this case as Cronkhite-Canada syndrome (CCS). NBI can clearly visualize the microvascular structure of colorectal tumors and has been reported to be a useful and simple method for differentiating between colorectal neoplastic and non-neoplastic polyps without chromoendoscopy. So we observed multiple colorectal polyps in this CCS patient using NBI colonoscopy with magnification. Use of NBI identified the difference of colorectal adenomas from related inflammatory hyperplastic polyps with CCS. Consequently, we could perform an endoscopic mucosal resection efficiently and appropriately.

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A 68-year-old man complained of dyspnea. He was a heavy drinker and had been diagnosed as having chronic pancreatitis when he was 64 years old. Chest X-ray showed a right pleural effusion ; biochemical analyses of the pleural effusion demonstrated significantly high amylase levels. CT and MRCP images showed a cystic lesion ; a pancreatopleural fistula was suspected. An ENPD tube was placed in the distal main pancreatic duct, and octreotide acetate therapy was instituted. Even though the pleural effusion resolved after treatment, pancreatic cancer could not be ruled out. Thus, surgery was performed. Since no cancer was found, a pancreatojejunostomy was performed as a radical treatment. His postoperative course was uneventful. Currently, he is doing well and has no complaints.

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A 41-year-old man with severe acute pancreatitis was admitted to our hospital. The severity of acute pancreatitis was improved by intensive care therapy. However, a peripancreatic abscess developed near the pancreatic body through the left pelvis cavity. Percutaneous drainage for a peripancreatic abscess by CT guidance was not successful. Therefore, both a 7F double-pigtail stent and a 6F single-pigtail nasobilliary tube were placed in the abscess cavity under EUS guidance. Besides another abscess developed near the pancreatic head, we put a 7F double-pigtail stent into the abscess through the same route. Then the sizes of the abscesses were reduced and clinical status was ameliorated. EUS-guided drainage could be a quite useful technique for the treatment of pancreatic abscesses.

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Selective deep biliary cannulation is a basis for therapeutic ERCP. Conventional contrast-assisted biliary cannulation is widely used in Japan. Wire-guided cannulation (WGC) technique is a new method and reported to increase the cannulation rate and decrease post-ERCP pancreatitis in some prospective studies. The method of WGC is as follows : a hydrophilic-tipped guidewire is preloaded into a sphincterotome, the sphincterotome is bowed to align correctly with the axis of the bile duct on the papilla, then the guidewire is carefully advanced into the common bile duct under fluoroscopy after a minimal insertion of the sphincterotome in the papilla, followed by insertion of the sphincterotome and contrast injection to verify deep bile duct cannulation.
WGC is reported to reduce post-ERCP pancreatitis by avoiding mechanical damage of the papilla and the contrast injection in the pancreatic duct. The disadvantages of WGC are the cost of a sphincterotome and the risk of complications such as mechanical damage to the papilla or perforation of bile duct by a guidewire due to inexperience in the guidewire manipulations. WGC is one of the useful biliary cannulation methods, but skillfulness in both WGC and conventional contrast-assisted cannulation is necessary for the expert endoscopists. Further randomized controlled studies are needed to confirm the utility of WGC in Japan.

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