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1Diagnostic and therapeutic single-operator cholangiopancreatoscopy in biliopancreatic diseases:Prospective multicenter study in Japan显示文摘AIM: To assess the utility and safety of single-operator cholangiopancreatoscopy(SOCPS) using the Spy Glass system in widespread clinical application for biliary and pancreatic diseases.METHODS: This study was a prospective case series conducted in 20 referral centers in Japan. There were 148 patients who underwent SOCPS; 124 for biliary diseases and 24 for pancreatic diseases. The attempted interventions were SOCPS examination, SOCPS-directed tissue sampling, and therapy for stone removal, among others. The main outcomes were related to the procedure success rate in terms of visualizing the target lesions, SOCPS-directed adequate tissue sampling, and complete stone removal. RESULTS: A total of 148 patients were enrolled for the diagnosis of indeterminate biliary and pancreatic lesions or treatment of biliary and pancreatic disease. The overall procedure success rate of visualizing the target lesions was 91.2%(135/148). The overall procedural success rates of visualizing the target lesions of diagnostic SOCPS in the bile duct and pancreatic duct were 95.5%(84/89) and 88.2%(15/17), respectively. Diagnosis: the overall adequate tissue for histologic examination was secured in 81.4% of the 86 patients who underwent biopsy under SOCPS(bile duct, 60/75, 80.0%; pancreatic duct, 10/11, 90.9%). The accuracy of histologic diagnosis using SOCPS-directed biopsies in indeterminate bile duct lesions was 70.7%(53/75). In the pancreatic duct, the accuracy of SOCPS visual impression of intraductal papillary mucinous neoplasm was 87.5%(14/16). Stone therapy: complete biliary and pancreatic stone clearance combined with SOCPS-directed stone therapy using electrohydraulic lithotripsy or laser lithotripsy was achieved in 74.2%(23/31) and 42.9%(3/7) of the patients, respectively. Others: SOCPS using the Spy Glass system was used in cannulation of the cystic duct in two patients and for passing across the obstructed self-expandable metallic stent for a malignant biliary stricture in two patients. All procedures were successful in both SOCPS-guided therapies. The incidence of procedure-related adverse events was 5.4%(8/148). CONCLUSION: SOCPS with direct visualization and biopsy for diagnosis and SOCPS-directed therapy for biliary and pancreatic diseases can be safely performed with a high success rate.Toshio Kurihara Ichiro Yasuda Hiroyuki Isayama Toshio Tsuyuguchi Taketo Yamaguchi Ken Kawabe Yoshinobu Okabe Keiji Hanada Tsuyoshi Hayashi Takao Ohtsuka Syuhei Oana Hiroshi Kawakami Yoshinori Igarashi Kazuya Matsumoto Kiichi Tamada Shomei Ryozawa Hiroki Kawashima Yutaka Okamoto Iruru Maetani Hiroyuki Inoue Takao Itoi 2016World Journal of Gastroenterology2016,22,5:20
2Clinical usefulness and current problems of pancreatic duct stenting for preventing post-ERCP pancreatitis显示文摘Endoscopic retrograde cholangiopancreatography(ERCP) is an endoscopic procedure with high frequency of accidental symptoms, and particularly some patients who develop and aggravate pancreatitis due to the procedure may need treatment of surgery or die. Various attempts were performed so far to prevent post-ERCP pancreatitis, however, it is impossible to completely prevent pancreatitis at this time because there are various factors for occurrence of post-ERCP pancreatitis.One of the most frequent causes of post-ERCP pancreatitis is considered to be congestion of pancreatic juice associated with duodenal papilledema after examination or treatment. Recently it is often reported that use of a pancreatic duct stent may prevent occurrence of pancreatitis which occurs because of an increased inner pressure of the pancreatic duct caused by congestion of pancreatic juice associated with duodenal papilledema. However, there are some patients who develop pancreatitis even if treated with the pancreatic duct stent, thus further clarification of the pathology and advancement of the prophylactic method will be needed.Yuji Sakai Toshio Tsuyuguchi Osamu Yokosuka 2014World Journal of Clinical Cases2014,2,9:11
3Current 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 2015World Journal of Hepatology2015,7,18:11
4Utility 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 2017World Journal of Gastrointestinal Endoscopy2017,9,3:10
5Cholangiopancreatography 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 2009Hepatobiliary & Pancreatic Diseases International2009,8,6:8
6胆道肿瘤临床实践指南(英文第三版)显示文摘日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确定推荐意见、推荐强度以及推荐说明。根据证据推荐分级的评估、制订与评价(GRADE)系统,推荐强度被分为1级(强)或者2级(弱)。英文第三版胆道肿瘤临床实践指南中提出的31个临床问题涵盖:(1)预防性治疗;(2)诊断;(3)胆道引流;(4)外科治疗;(5)化疗;(6)放疗。31个临床问题中,14个问题给予推荐强度为强的推荐意见,14个问题给予推荐强度为弱的推荐意见,剩余的3个问题未给予推荐意见。每条推荐意见都进行推荐强度说明。最新版指南基于循证医学证据,为临床提供了重要建议。未来与癌症登记数据库协作将是评估指南和建立新证据的关键。Masato Nagino Satoshi Hirano Hideyuki Yoshitomi Taku Aoki Katsuhiko Uesaka Michiaki Unno Tomoki Ebata Masaru Konishi Keiji Sano Kazuaki Shimada Hiroaki Shimizu Ryota Higuchi Toshifumi Wakai Hiroyuki Isayama Takuji Okusaka Toshio Tsuyuguchi Yoshiki Hirooka Junji Furuse Hiroyuki Maguchi Kojiro Suzuki Hideya Yamazaki Hiroshi Kijima Akio Yanagisawa Masahiro Yoshida Yukihiro Yokoyama Takashi Mizuno Itaru Endo 杨翼飞(译) 仇毓东(译) 赵梦珂(译) 伏旭(译) 蔡正华(译) 毛凉(审校) 2021中华消化外科杂志2021,20,4:7
7Short-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 2017World Journal of Gastroenterology2017,23,39:7
8Efficacy 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 2017World Journal of Gastrointestinal Endoscopy2017,9,1:6
9Comparison 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 2016World Journal of Gastrointestinal Endoscopy2016,8,10:6
10Endoscopic papillary large balloon dilation for removal of bile duct stones显示文摘AIM:To investigate the efficacy and outcomes of endoscopic papillary large balloon dilation(EPLBD)for bile duct stones in a multicenter prospective study.METHODS:Lithotomy by EPLBD was conducted in 124patients with bile duct stones≥13 mm in size or with three or more bile duct stones≥10 mm.After endoscopic sphincterotomy,the papilla was dilated using balloons 12-20 mm in diameter fitting the bile duct diameter.RESULTS:The success rate of first-time lithotomy was 86.3%(107/124)and the final lithotomy success rate was 100%(124/124).Lithotripsy was needed in10 of the 124(13.6%)patients.Adverse events due to the treatment procedure occurred in 6(4.8%)patients,all of which were mild.Performing large balloon dilation after endoscopic sphincterotomy in patients with large stones or multiple stones in the bile duct is considered to ensure the safety of treatment and to reduce the need for lithotripsy.CONCLUSION:It is suggested that treatment by EPLBD for large bile duct stones may be safe and useful.Yuji Sakai Toshio Tsuyuguchi Yoshiaki Kawaguchi Nobuto Hirata So Nakaji Katsuya Kitamura Shigeru Mikami Tatsuya Fujimoto Masashi Ijima Eishin Kurihara Shuhei Oana Takayoshi Nishino Ryo Tamura Dai Sakamoto Masato Nakamura Takao Nishikawa Harutoshi Sugiyama Hitoshi Yoshida Tetsuya Mine Osamu Yokosuka 2014World Journal of Gastroenterology2014,20,45:6
11Is ERCP really necessary in case of suspected spontaneous passage of bile duct stones?显示文摘AIM:To investigate the usefulness of magnetic resonance cholangiopancreatography (MRCP) and the need for endoscopic retrograde cholangiopancreatography (ERCP) in cases of suspected spontaneous passage of stones into the common bile duct.METHODS:Thirty-six patients with gallbladder stones were clinically suspected of spontaneous passage of stones into the common bile duct because they presented with clinical symptoms such as abdominal pain and fever,and showed signs of inflammatory reaction and marked rise of hepatobiliary enzymes.These symptoms resolved and they showed normalized values of blood biochemical parameters after conservative treatment without evidence of stones in the common bile duct on MRCP.All these patients were subjected to ERCP within 3 d of MRCP to check for the presence of stones.RESULTS:No stones were detected by ERCP in any patient,confi rming the results of MRCP.CONCLUSION:When clinical symptoms improve,blood biochemical parameters have normalized,and MRCP shows there are no stones in the common bile duct,it can be considered the stone has spontaneously passed and thus ERCP is not necessary.Yuji Sakai Toshio Tsuyuguchi Takeshi Ishihara Seigo Yukisawa Tadashi Ohara Masaru Tsuboi Yoshihiko Ooka Kazuki Kato Kiyotake Katsuura Michio Kimura Makoto Takahashi Kazuhisa Nemoto Masaru Miyazaki Osamu Yokosuka 2009World Journal of Gastroenterology2009,15,26:6
12Prevention 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 2016World Journal of Clinical Cases2016,4,8:5
13Endoscopic 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 2015World Journal of Clinical Cases2015,3,4:4
14Safety and efficacy of metallic stent for unresectable distal malignant biliary obstruction in elderly patients显示文摘AIM To study the safety of insertion of metallic stents in elderly patients with unresectable distal malignant biliary obstruction.METHODS Of 272 patients with unresectable distal malignant biliary obstruction, 184 patients under the age of 80 were classified into Group A, and 88 subjects aged 80 years or more were classified into Group B. The safety of metallic stent insertion, metal stent patency period, and the obstruction rate were examined in each group.RESULTS In Group B, patients had a significantly worse per-formance status, high blood pressure, heart disease, cerebrovascular disease, and dementia; besides the rate of patients orally administered antiplatelet drugs or anticoagulants tended to be higher(P < 0.05). Metallic stents were successfully inserted in all patients. The median patency period was 265.000 ± 26.779(1-965) d; 252.000 ± 35.998(1-618) d in Group A and 269.000 ± 47.885(1-965) d in Group B, with no significant difference between the two groups. Metallic stent obstruction occurred in 82 of the 272(30.15%) patients; in 53/184(28.80%) patients in Group A and in 29/88(32.95%) of those in Group B, showing no significant difference between the two groups. Procedural accidents due to metal stent insertion occurred in 24/272(8.8%) patients; in 17/184(9.2%) of patients in Group A and in 7/88(8.0%) of those in Group B, with no significant difference between the two groups, either.CONCLUSION These results suggested that metallic stents can be safely inserted to treat unresectable distal malignant biliary obstruction even in elderly patients aged 80 years or more.Yuji Sakai Tomohisa Iwai Kenji Shimura Katsushige Gon Kazuya Koizumi Masashi Ijima Kazuro Chiba Seigo Nakatani Harutoshi Sugiyama Toshio Tsuyuguchi Terumi Kamisawa Iruu Maetani Mitsuhiro Kida 2018World Journal of Gastroenterology2018,24,1:4
15Diagnostic utility of peroral cholangioscopy for various bile-duct lesions显示文摘Yoshihiro Fukuda Toshio Tsuyuguchi Yuji Sakai Shin Tsuchiya Hiromitsu Saisyo 2005Gastrointestinal Endoscopy2005,,3:3
16Current 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 2021World Journal of Gastroenterology2021,27,15:3
17Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: a prospective Japanese multicenter study显示文摘AIM: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction.METHODS: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, selfexpandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline.RESULTS: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients(10.3%) in the form of mild pneumonitis. No other morbidities or mortalitieswere observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients(7.7%) on account of tumor growth.CONCLUSION: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients' quality of life.Reina Sasaki Yuji Sakai Toshio Tsuyuguchi Takao Nishikawa Tatsuya Fujimoto Shigeru Mikami Harutoshi Sugiyama Osamu Yokosuka 2016World Journal of Gastroenterology2016,22,14:2
18Guidelines for the management of biliary tract and ampullary carcinomas: surgical treatment显示文摘Satoshi Kondo Tadahiro Takada Masaru Miyazaki Shuichi Miyakawa Kazuhiro Tsukada Masato Nagino Junji Furuse Hiroya Saito Toshio Tsuyuguchi Masakazu Yamamoto Masato Kayahara Fumio Kimura Hideyuki Yoshitomi Satoshi Nozawa Masahiro Yoshida Keita Wada Satoshi 2008Journal of Hepato - Biliary - Pancreatic Surgery2008,,1:2
19Methods and timing of biliary drainage for acute cholangitis: Tokyo Guidelines显示文摘Masato Nagino Tadahiro Takada Yoshifumi Kawarada Yuji Nimura Yuichi Yamashita Toshio Tsuyuguchi Keita Wada Toshihiko Mayumi Masahiro Yoshida Fumihiko Miura Steven M. Strasberg Henry A. Pitt Jacques Belghiti Sheung-Tat Fan Kui-Hin Liau Giulio Belli Xiao-Pi 2007Journal of Hepato-Biliary-Pancreatic Surgery2007,,1:2
20Diagnosis of biliary tract and ampullary carcinomas显示文摘Kazuhiro Tsukada Tadahiro Takada Masaru Miyazaki Shuichi Miyakawa Masato Nagino Satoshi Kondo Junji Furuse Hiroya Saito Toshio Tsuyuguchi Fumio Kimura Hideyuki Yoshitomi Satoshi Nozawa Masahiro Yoshida Keita Wada Hodaka Amano Fumihiko Miura 2008Journal of Hepato - Biliary - Pancreatic Surgery2008,,1:1
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