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| 1 | Current status of preoperative drainage for distal biliary obstruction显示文摘Preoperative biliary drainage(PBD) was developed to improve obstructive jaundice, which affects a number of organs and physiological mechanisms in patients waiting for surgery. However, its role in patients who will undergo pancreaticoduodenectomy for biliary obstruction remains controversial. This article aims to review the current status of the use of preoperative drainage for distal biliary obstruction. Relevant articles published from 1980 to 2015 were identified by searching MEDLINE and Pub Med using the keywords 'PBD', 'pancreaticoduodenectomy', and 'obstructive jaundice'. Additional papers were identified by a manual search of the references from key articles. Current studies have demonstrated that PBD should not be routinely performed because of the postoperative complications. PBD should only be considered in carefully selected patients, particularly in cases where surgery had to be delayed. PBD may be needed in patients with severe jaundice, concomitant cholangitis, or severe malnutrition. The optimal method of biliary drainage has yet to be confirmed. PBD should be performed by endoscopic routes rather than by percutaneous routes to avoid metastatic tumor seeding. Endoscopic stenting or nasobiliary drainage can be selected. Although more expensive, the use of metallic stents remains a viable option to achieve effective drainage without cholangitis and reintervention. | Harutoshi Sugiyama Toshio Tsuyuguchi Yuji Sakai Rintaro Mikata Shin Yasui Yuto Watanabe Dai Sakamoto Masato Nakamura Reina Sasaki Jun-ichi Senoo Yuko Kusakabe Masahiro Hayashi Osamu Yokosuka | 2015 | World Journal of Hepatology2015，7，18： | 11 |
| 2 | Utility of endoscopic retrograde cholangiopancreatography on biliopancreatic diseases in patients with Billroth Ⅱ-reconstructed stomach显示文摘AIM To examine the utility of endoscopic retrograde cholangiopancreatography(ERCP) on biliopancreatic diseases in the patients with Billroth II-reconstructed stomach.METHODS For 26 cases of biliopancreatic diseases in patients with Billroth Ⅱ-reconstructed stomach,ERCP was conducted using a straight-view scope or a retrograde obliqueviewing endoscope.All the cases were patients aiming at selective insertion into the bile duct.One patient aimed at diagnosis,and 25 patients aimed at treatment.The cases in which the endoscope reached the duodenal papilla and anastomosis,and insertion into the bile duct became possible,were considered successful.RESULTS The rate of reaching the duodenal papilla and anastomosis was 84.7%(22/26 patients).Among the cases without reaching the duodenal papilla and anastomosis,there were 2 in which the endoscope did not pass due to tumor-induced duodenal infiltration.In 1 case,the fiber did not reach the duodenal papilla due to long afferent loop.The success rate of insertion into the bile duct in patients in which the endoscope reached the duodenal papilla and anastomosis was 90.9%(20/22 patients),and the success rate of procedures including treatment was 86.3%(19/22 patients).After treatment,mild cholangitis was observed in 1 patient(4.5%,1/22 patients) but relieved conservatively.No other accidental symptom was observed.CONCLUSION It was considered that the ERCP for biliopancreatic diseases in patients with Billroth II-reconstructed stomach will become a less invasive,safe and useful examination and treatment approach. | Yuji Sakai Toshio Tsuyuguchi Rintaro Mikata Harutoshi Sugiyama Shin Yasui Masaru Miyazaki Osamu Yokosuka | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，3： | 10 |
| 3 | Cholangiopancreatography troubleshooting:the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents显示文摘BACKGROUND:Stent migration in the hepatopancreatic duct might arise as one of the rare complications associated with biliary or pancreatic stenting.Although there are some procedures to retrieve the migrated stent,including surgical,percutaneous,and endoscopic approaches,endoscopy should be attempted first because it is least invasive.This study set out to evaluate the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents.METHODS:Plastic stents that migrated in the bile duct(35 patients)or pancreatic duct(2)were retrieved with endoscopic retrograde cholangiopancreatography.Devices used were snare forceps,a basket catheter,grasping forceps,biopsy forceps,a balloon catheter,and the Soehendra stent retriever.RESULTS:Endoscopic retrieval of migrated stents was performed successfully in 36(97.0%)of the 37 patients.The devices utilized for successful treatment were basket catheter(13 patients),grasping forceps(10),snare forceps(8),balloon catheter(3),biopsy forceps(1),and the Soehendra stent retriever(1).The unsuccessfully treated patient with chronic pancreatitis underwent surgery since the guide wire did not move forward due to bile duct stenosis,and there was also duodenal stenosis.One patient developed mild pancreatitis after withdrawal of the stent;the pancreatitis was relieved with conservative treatment.CONCLUSIONS:Endoscopic retrieval of migrated biliary and pancreatic stents appears to be useful because of its safety and low invasiveness.However,various forceps should be prepared for the retrieval of a migrated stent. | Yuji Sakai Toshio Tsuyuguchi Takeshi Ishihara Harutoshi Sugiyama Reiko Eto Tatsuya Fujimoto Shin Yasui Ryo Tamura Seiko Togo Motohisa Tada Osamu Yokosuka | 2009 | Hepatobiliary & Pancreatic Diseases International2009，8，6： | 8 |
| 4 | Short-and long-term results of endoscopic ultrasoundguided transmural drainage for pancreatic pseudocysts and walled-off necrosis显示文摘AIM To evaluate the short-and long-term results of endoscopic ultrasound-guided transmural drainage(EUS-GTD) for pancreatic fluid collection(PFC) and identify the predictive factors of treatment outcome for walled-off necrosis(WON) managed by EUS-GTD alone.METHODS We investigated 103 consecutive patients with PFC who underwent EUS-GTD between September 1999 and August 2015. Patients were divided into four groups as follows: WON(n = 40), pancreatic pseudocyst(PPC; n = 11), chronic pseudocyst(n = 33), and others(n = 19). We evaluated the short-and long-term outcomes of the treatment. In cases of WON, multiple logistic regression analyses were performed to identify the predictor variables associated with the treatment success. In addition, PFC recurrence was examined in patients followed up for more than 6 mo and internal stent removal after successful EUS-GTD was confirmed.RESULTS In this study, the total technical success rate was 96.1%. The treatment success rate of WON, PPC, chronic pseudocyst, and others was 57.5%, 90.9%, 91.0%, and 89.5%, respectively. Contrast-enhanced computed tomography using the multivariate logistic regression analysis revealed that the treatment success rate of WON was significantly lower in patients with more than 50% pancreatic parenchymal necrosis(OR = 17.0; 95%CI: 1.9-150.7; P = 0.011) and in patients with more than 150 mm of PFC(OR = 27.9; 95%CI: 3.4-227.7; P = 0.002).The recurrence of PFC in the long term was 13.3%(median observation time, 38.8 mo). Mean amylase level in the cavity was significantly higher in the recurrence group than in the no recurrence group(P = 0.02).CONCLUSION The reduction of WON by EUS-GTD alone was associated with the proportion of necrotic tissue and extent of the cavity. The amylase level in the cavity may be a predictive factor for recurrence of PFC. | Yuto Watanabe Rintaro Mikata Shin Yasui Hiroshi Ohyama Harutoshi Sugiyama Yuji Sakai Toshio Tsuyuguchi Naoya Kato | 2017 | World Journal of Gastroenterology2017，23，39： | 7 |
| 5 | Efficacy of multiple biliary stenting for refractory benign biliary strictures due to chronic calcifying pancreatitis显示文摘AIM To investigate endoscopic therapy efficacy for refractory benign biliary strictures(BBS) with multiple biliary stenting and clarify predictors.METHODS Ten consecutive patients with stones in the pancreatic head and BBS due to chronic pancreatitis who underwent endoscopic therapy were evaluated. Endoscopic insertion of a single stent failed in all patients. We used plastic stents(7F, 8.5F, and 10F) and increased stents at intervals of 2 or 3 mo. Stents were removed approximately 1 year after initial stenting. BBS and common bile duct(CBD) diameter were evaluated using cholangiography. Patients were followed for ≥ 6 mo after therapy, interviewed for cholestasis symptoms, and underwent liver function testing every visit. Patients with complete and incomplete stricture dilations were compared.RESULTS Endoscopic therapy was completed in 8(80%) patients, whereas 2(20%) patients could not continue therapy because of severe acute cholangitis and abdominal abscess, respectively. The mean number of stents was 4.1 ± 1.2. In two(20%) patients, BBS did not improve; thus, a biliary stent was inserted. BBS improved in six(60%) patients. CBD diameter improved more significantly in the complete group than in the incomplete group(6.1 ± 1.8 mm vs 13.7 ± 2.2 mm, respectively, P = 0.010). Stricture length was significantly associated with complete stricture dilation(complete group; 20.5 ± 3.0 mm, incomplete group; 29.0 ± 5.1 mm, P = 0.011). Acute cholangitis did not recur during the mean follow-up period of 20.6 ± 7.3 mo.CONCLUSION Sequential endoscopic insertion of multiple stents is effective for refractory BBS caused by chronic calcifying pancreatitis. BBS length calculation can improve patient selection procedure for therapy. | Hiroshi Ohyama Rintaro Mikata Takeshi Ishihara Yuji Sakai Harutoshi Sugiyama Shin Yasui Toshio Tsuyuguchi | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，1： | 6 |
| 6 | Comparison of endoscopic papillary balloon dilatation and endoscopic sphincterotomy for bile duct stones显示文摘Endoscopic treatment for bile duct stones is low-invasive and currently considered as the first choice of the treatment. For the treatment of bile duct stones, papillary treatment is necessary, and the treatments used at the time are broadly classified into two types; endoscopic papillary balloon dilatation where bile duct closing part is dilated with a balloon and endoscopic sphincterotomy(EST) where bile duct closing part is incised. Both procedures have advantages and disadvantages. Golden standard is EST, however, there are patients with difficulty for EST, thus we must select the procedure based on understanding of the characteristics of the procedure, and patient backgrounds. | Yuji Sakai Toshio Tsuyuguchi Harutoshi Sugiyama Masahiro Hayashi Jun-ichi Senoo Yuko Kusakabe Shin Yasui Rintaro Mikata Osamu Yokosuka | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，10： | 6 |
| 7 | Corticosteroid and nucleoside analogue for hepatitis B virus-related acute liver failure显示文摘The early introduction of combination therapy of high-dose corticosteroid and nucleoside analogue is beneficial for the rescue of severe acute exacerbation of chronic hepatitis B. | Keiichi Fujiwara Shin Yasui Osamu Yokosuka | 2015 | World Journal of Gastroenterology2015，21，36： | 6 |
| 8 | Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis by pancreatic duct stenting using a loop-tipped guidewire显示文摘AIM: To examine whether it is possible to prevent the occurrence of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis in patients experiencing difficulties with selective biliary duct cannulation by pancreatic duct stenting using a looptipped guidewire.METHODS: Procedure success rate, frequency of unintended insertion of the guidewire into side branches of the pancreatic duct, and incidence of procedural accidents were examined using a loop-tipped guidewire(Group A, 20 patients), and a conventional straighttype guidewire(Group B, 20 patients).RESULTS: The success rate of the procedure was 100% in both groups. Unintended insertion of the guidewire into a side branch of the pancreatic duct occurred 0.056 ± 0.23(0-1) times in Group A and 2.3 ±1.84(0-5) times in Group B; thus, unintended insertion of the guidewire into a side branch of the pancreatic duct was seen significantly less frequently in Group A. There were no procedural accidents in Group A, whereas pancreatitis occurred in one Group B patient; however, the difference between the two groups was not statistically significant. The serum amylase level after ERCP was 257.15 ± 136.4(88-628) IU/L in Group A, and 552.05 ± 534.57(101-2389) IU/L in Group B, showing a significantly lower value in Group A. Hyperamylasemia was found in two patients(10%) in Group A, and nine(45%) in Group B, showing a significantly lower value in Group A.CONCLUSION: The results suggest that in patients who experience difficulties with biliary cannulation, the use of a loop-tipped guidewire for pancreatic duct stenting may assist with the prevention of post-ERCP pancreatitis, and thereby to a reduction of the risk of post-ERCP pancreatitis or hyperamylasemia. | Yuji Sakai Toshio Tsuyuguchi Harutoshi Sugiyama Masahiro Hayashi Jun-ichi Senoo Reina Sasaki Yuko Kusakabe Masato Nakamura Shin Yasui Rintaro Mikata Masaru Miyazaki Osamu Yokosuka | 2016 | World Journal of Clinical Cases2016，4，8： | 5 |
| 9 | Sofosbuvir treatment and hepatitis C virus infection显示文摘Hepatitis C virus(HCV) infection is a serious problem worldwide.The use of interferon-based therapy has made HCV eradication challenging.The recent appearance of direct-acting antiviral agents(DAAs) has changed HCV therapy.Combining the use of DAAs with peginterferon and ribavirin has improved treatment efficacy.Furthermore,the combination of different orally administered DAAs has enabled interferon-free therapy with much higher efficacy and safety.In particular,sofosbuvir,a nucleotide-based NS5 B inhibitor,prevents HCV RNA synthesis by acting as a 'chain terminator'.Treatment with sofosbuvir has attained an extremely high rate of sustained virologic response.The current review summarizes the efficacy and safety of sofosbuvir therapy. | Masato Nakamura Tatsuo Kanda Yuki Haga Reina Sasaki Shuang Wu Shingo Nakamoto Shin Yasui Makoto Arai Fumio Imazeki Osamu Yokosuka | 2016 | World Journal of Hepatology2016，8，3： | 4 |
| 10 | Endoscopic papillary large balloon dilation for bile duct stones in elderly patients显示文摘AIM: To investigate whether endoscopic papillary large balloon dilation(EPLBD) can be safety and effectively performed in patients aged ≥ 80 years. METHODS: Lithotomy by EPLBD was conducted in 106 patients with bile duct stones ≥ 13 mm in size or with three or more bile duct stones ≥ 10 mm. The patients were divided into group A(< 80 years) and group B(≥ 80 years). Procedure success rate, number of endoscopic retrograde cholangiopancreatographies(ERCP), and incidence of complications were examined in both groups.RESULTS: Group B tended to include significantly more patients with peripapillary diverticulum, hypertension, hyperlipemia, cerebrovascular disease/dementia, respiratory disease/cardiac disease, and patients administered an anticoagulant or antiplatelet agent(P < 0.05). The success rate of the initial lithotomy was 88.7(94/106)%. The final lithotomy rate was 100(106/106)%. Complications due to treatment procedure occurred in 4.72(5/106)% of the patients. There was no significant difference in procedure success rate, number of ERCP, or incidence of complications between group A and group B.CONCLUSION: EPLBD can be safely performed in elderly patients, the same as in younger patients. | Yuji Sakai Toshio Tsuyuguchi Harutoshi Sugiyama Reina Sasaki Dai Sakamoto Masato Nakamura Yuuto Watanabe Takao Nishikawa Shin Yasui Rintaro Mikata Osamu Yokosuka | 2015 | World Journal of Clinical Cases2015，3，4： | 4 |
| 11 | Current status of diagnosis and therapy for intraductal papillary neoplasm of the bile duct显示文摘Bile duct epithelial tumours showing papillary neoplasm in the bile duct lumen are present in the intrahepatic and extrahepatic bile ducts.Clinicopathological images of these tumours are distinctive and diverse,including histological images with a low to high grade dysplasia,infiltrating and noninfiltrating characteristics,excessive mucus production,and similarity to intraductal papillary mucinous neoplasm(IPMN)of the pancreas.The World Health Organization Classification of Tumours of the Digestive System in 2010 named these features,intraductal papillary neoplasm of the bile duct(IPNB),as precancerous lesion of biliary carcinoma.IPNB is currently classified into type 1 that is similar to IPMN,and type 2 that is not similar to IPMN.Many of IPNB spreads superficially,and diagnosis with cholangioscopy is considered mandatory to identify accurate localization and progression.Prognosis of IPNB is said to be better than normal bile duct cancer. | Yuji Sakai Masayuki Ohtsuka Harutoshi Sugiyama Rintaro Mikata Shin Yasui Izumi Ohno Yotaro Iino Jun Kato Toshio Tsuyuguchi Naoya Kato | 2021 | World Journal of Gastroenterology2021，27，15： | 3 |
| 12 | New tapered metallic stent for unresectable malignant hilar bile duct obstruction显示文摘AIM: To examine the usefulness of a new tapered metallic stent(MS) in patients with unresectable malignant hilar bile duct obstruction.METHODS: This new tapered MS was placed in 11 patients with Bismuth Ⅱ or severer unresectable malignant hilar bile duct obstruction, as a prospective study. The subjects were six patients with bile duct carcinoma, three with gallbladder cancer, and two with metastatic bile duct obstruction. Stenosis morphology was Bismuth Ⅱ: 7, Ⅲa: 3, and Ⅳ: 1. UMIN Clinical Trial Registry(UMIN000004758).RESULTS: MS placement was 100%(11/11) successful. There were no procedural accidents. The mean patency period was 208.401 d, the median survival period was 142.000 d, and the mean survival period was 193.273 d. Occlusion rate was 36.4%(4/11); the causes of occlusion were ingrowth and overgrowth in 2 patients each, 18.2%, respectively. Patients with occlusion underwent endoscopic treatment one more time and all were treatable. CONCLUSION: The tapered MS proved useful in patients with unresectable malignant hilar bile duct obstruction because it provided a long patency period, enabled re-treatment by re-intervention, and no procedural accidents occurred. | Yuji Sakai Toshio Tsuyuguchi Takao Nishikawa Harutoshi Sugiyama Reina Sasaki Dai Sakamoto Yuto Watanabe Masato Nakamura Shin Yasui Rintaro Mikata Osamu Yokosuka | 2015 | World Journal of Clinical Cases2015，3，10： | 1 |
| 13 | Efficacy of combination therapy of antiviral and immunosuppressive drugs for the treatment of severe acute exacerbation of chronic hepatitis B显示文摘 | Keiichi Fujiwara Shin Yasui Yutaka Yonemitsu Kenichi Fukai Makoto Arai Fumio Imazeki Akihiro Suzuki Hiroshi Suzuki Tomohito Sadahiro Shigeto Oda Osamu Yokosuka | 2008 | Journal of Gastroenterology2008，，9： | 1 |
| 14 | Opportunistic infection in patients with acute liver failure显示文摘 | Makoto Arai Tatsuo Kanda Shin Yasui Keiichi Fujiwara Fumio Imazeki Akira Watanabe Takeyuki Sato Shigeto Oda Osamu Yokosuka | 2014 | Hepatology International2014，，2： | 1 |
| 15 | Ten‐year long‐term results after non‐surgical management of hepatolithiasis, including cases with choledochoenterostomy显示文摘 | Toshio Tsuyuguchi Kaoru Miyakawa Harutoshi Sugiyama Yuji Sakai Takao Nishikawa Dai Sakamoto Masato Nakamura Shin Yasui Rintaro Mikata Osamu Yokosuka | 2014 | J Hepatobiliary Pancreat Sci2014，，11： | 1 |
| 16 | Natural interferon-beta treatment for patients with chronic hepatitis C in Japan显示文摘Chronic hepatitis C virus(HCV) infection can cause liver cirrhosis and hepatocellular carcinoma(HCC). Several studies have demonstrated that the eradication of HCV reduces the occurrence of HCC. In Japan, as many people live to an advanced age, HCV-infected patients are also getting older, and the age at HCC diagnosis has also increased. Although older HCV-infected patients have a risk of developing HCC, the treatment response to peginterferon-alpha plus ribavirin therapy is relatively poor in these patients because of drop-out or discontinuation of this treatment due to adverse events. It is established that the mechanism of action between interferon-alpha and interferon-beta is slightly different. Short-term natural interferon-beta monotherapy is effective for patients with acute hepatitis C and patients infected with HCV genotype 2 and low viral loads. Natural interferon-beta plus ribavirin for 48 wk or for 24 wk are also effective for some patients with HCV genotype 1 or HCV genotype 2. Natural interferon-beta plus ribavirin has been used for certain 'difficult-totreat' HCV-infected patients. In the era of direct-acting anti-virals, natural interferon-beta plus ribavirin may be one of the therapeutic options for special groups of HCV-infected patients. In the near future, signal transduction pathways of interferon-beta will inform further directions. | Reina Sasaki Tatsuo Kanda Shingo Nakamoto Yuki Haga Masato Nakamura Shin Yasui Xia Jiang Shuang Wu Makoto Arai Osamu Yokosuka | 2015 | World Journal of Hepatology2015，7，8： | 0 |
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