Updated on 2022/04/13

写真a

 
YAMAO Kentaro
 
Organization
Nagoya University Hospital Diagnostic and Therapeutic Endoscopy Assistant professor of hospital
Title
Assistant professor of hospital

Degree 1

  1. 近畿大学 消化器病態制御学 ( 2017.3   近畿大学 ) 

Research Interests 6

  1. 膵癌早期診断

  2. Pancreatic parenchymal atrophy

  3. 微小膵癌

  4. 内視鏡診断

  5. 超音波診断

  6. 内視鏡治療

Research Areas 1

  1. Life Science / Gastroenterology  / 微小膵癌の診断

Current Research Project and SDGs 1

  1. 膵臓、胆道疾患の診断・治療

Research History 5

  1. Nagoya University   Assistant professor of hospital

    2022.4

  2. Kinki University

    2018.4 - 2022.3

  3. Kinki University

    2013.4 - 2018.3

  4. 尾道総合病院   消化器内科   医員

    2011.4 - 2013.3

  5. 豊橋市民病院   消化器内科   医院

    2009.7 - 2011.3

Education 2

  1. Kinki University   Faculty of Medicine

    2014.4 - 2017.3

  2. 東京医科大学   医学部   医学科

    2000.4 - 2006.3

Professional Memberships 6

  1. 日本内科学会

  2. 日本消化器病学会

  3. 日本消化器内視鏡学会

  4. 日本膵臓学会

  5. 日本胆道学会

  6. 日本超音波学会

▼display all

 

Papers 173

  1. Endoscopic placement of covered versus uncovered self-expandable metal stents for palliation of malignant gastric outlet obstruction. International journal

    Kentaro Yamao, Masayuki Kitano, Yasutaka Chiba, Takeshi Ogura, Takaaki Eguchi, Ichiro Moriyama, Yukitaka Yamashita, Hironari Kato, Takahisa Kayahara, Noriyuki Hoki, Yoshinobu Okabe, Hideyuki Shiomi, Yoshitaka Nakai, Yoshinori Kushiyama, Yoshifumi Fujimoto, Shiro Hayashi, Shigeki Bamba, Yasushi Kudo, Nobuaki Azemoto, Toshiharu Ueki, Norimitsu Uza, Masanori Asada, Kazuya Matsumoto, Hiroko Nebiki, Hiroshi Takihara, Chisio Noguchi, Hideki Kamada, Kojiro Nakase, Daisuke Goto, Tsuyoshi Sanuki, Tetsuya Koga, Shinichi Hashimoto, Hidefumi Nishikiori, Masahiro Serikawa, Keiji Hanada, Ken Hirao, Masaya Ohana, Imakiire Kazuyuki, Takao Kato, Motoyuki Yoshida, Hirofumi Kawamoto

    Gut   Vol. 70 ( 7 ) page: 1244 - 1252   2021.7

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    Language:English   Publishing type:Research paper (scientific journal)  

    OBJECTIVE: Stenting is an established endoscopic therapy for malignant gastric outlet obstruction (mGOO). The choice of stent (covered vs uncovered) has been examined in prior randomised studies without clear results. DESIGN: In a multicentre randomised prospective study, we compared covered (CSEMS) with uncovered self-expandable metal stents (UCSEMS) in patients with mGOO; main outcomes were stent dysfunction and patient survival, with subgroup analyses of patients with extrinsic and intrinsic tumours. RESULTS: Overall survival was poor with no difference between groups (probability at 3 months 49.7% for covered vs 48.4% for uncovered stents; log-rank for overall survival p=0.26). Within that setting of short survival, the proportion of stent dysfunction was significantly higher for uncovered stents (35.2% vs 23.4%, p=0.01) with significantly shorter time to stent dysfunction. This was mainly relevant for patients with extrinsic tumours (stent dysfunction rates for uncovered stents 35.6% vs 17.5%, p<0.01). Subgrouping was also relevant with respect to tumour ingrowth (lower with covered stents for intrinsic tumours; 1.6% vs 27.7%, p<0.01) and stent migration (higher with covered stents for extrinsic tumours: 15.3% vs 2.5%, p<0.01). CONCLUSIONS: Due to poor patient survival, minor differences between covered and uncovered stents may be less relevant even if statistically significant; however, subgroup analysis would suggest to use covered stents for intrinsic and uncovered stents for extrinsic malignancies.

    DOI: 10.1136/gutjnl-2020-320775

    PubMed

  2. Partial Pancreatic Parenchymal Atrophy Is a New Specific Finding to Diagnose Small Pancreatic Cancer (≤10 mm) Including Carcinoma in Situ: Comparison with Localized Benign Main Pancreatic Duct Stenosis Patients Reviewed

    Kentaro Yamao, Mamoru Takenaka, Rei Ishikawa, Ayana Okamoto, Tomohiro Yamazaki, Atsushi Nakai, Shunsuke Omoto, Ken Kamata, Kosuke Minaga, Ippei Matsumoto, Yoshifumi Takeyama, Isao Numoto, Masakatsu Tsurusaki, Takaaki Chikugo, Yasutaka Chiba, Tomohiro Watanabe, Masatoshi Kudo

    Diagnostics   Vol. 10 ( 7 ) page: 445 - 445   2020.7

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:MDPI AG  

    Background: This study aimed to evaluate and identify the specific CT findings by focusing on abnormalities in the main pancreatic duct (MPD) and pancreatic parenchyma in patients with small pancreatic cancer (PC) including carcinoma in situ (CIS). Methods: Nine CT findings indicating abnormalities of MPD and pancreatic parenchyma were selected as candidate findings for the presence of small PC ≤ 10 mm. The proportions of patients positive for each finding were compared between small PC and benign MPD stenosis groups. Interobserver agreement between two independent image reviewers was evaluated using kappa statistics. Results: The final analysis included 24 patients with small PC (including 11 CIS patients) and 28 patients with benign MPD stenosis. The proportion of patients exhibiting partial pancreatic parenchymal atrophy (PPA) corresponding to the distribution of MPD stenosis (45.8% vs. 7.1%, p &lt; 0.01), upstream PPA arising from the site of MPD stenosis (33.3% vs. 3.6%, p = 0.01), and MPD abrupt stenosis (45.8% vs. 14.3%, p = 0.03) was significantly higher in the small PC group than in the benign MPD stenosis group. Conclusions: The presence of partial PPA, upstream PPA, and MPD abrupt stenosis on a CT image was highly suggestive of the presence of small PCs including CIS.

    DOI: 10.3390/diagnostics10070445

    PubMed

  3. Utility and Safety of a Novel Fully Covered Metal Stent in Unresectable Distal Malignant Biliary Obstruction. Reviewed International journal

    Kentaro Yamao, Mamoru Takenaka, Takeshi Ogura, Hiroaki Hashimoto, Hisakazu Matsumoto, Masashi Yamamoto, Tsukasa Ikeura, Akira Kurita, Zhao Liang Li, Hideyuki Shiomi, Yasutaka Chiba, Masatoshi Kudo, Tsuyoshi Sanuki

    Digestive diseases and sciences   Vol. 65 ( 12 ) page: 3702 - 3709   2020.2

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    BACKGROUND: Self-expandable metal stents (SEMSs) are widely used in patients with distal malignant biliary obstruction. A SEMS that can avoid occlusion as much as possible is desirable. AIMS: The aim of this multicenter single-arm prospective study was to assess the clinical effectiveness and safety of a novel fully covered braided SEMS. METHODS: We enrolled consecutive patients with distal malignant biliary obstruction between February 2016 and November 2017 at ten tertiary-care medical centers. RESULTS: We included 79 patients with a median age of 76 years; 47 (59.5%) patients were men. The technical and clinical success rate was 98.7% and 93.6%, respectively. Recurrent biliary obstruction occurred in 14 patients (17.9%); stent ingrowth, overgrowth, migration, and other occurred in five (6.4%), four (5.1%), four (5.1%), and one (1.3%) patients, respectively. All reinterventions in patients with recurrent biliary obstruction were successful via the transpapillary approach. Adverse events occurred in 15 patients (19.2%); cholangitis, pancreatitis, and others occurred in ten (12.8%), three (3.8%), and two (2.6%) patients, respectively. The stent patency probability at 6 months was 48.5%. Median time to stent patency was 171 days, median time to recurrent biliary obstruction was 536 days, and median survival time was 195 days. CONCLUSIONS: We confirmed the utility and safety of a novel fully covered braided SEMS with low axial force and high radial force in patients with malignance biliary obstruction. This novel SEMS is recommended in patients with distal malignant biliary obstruction.

    DOI: 10.1007/s10620-020-06114-8

    PubMed

  4. Clinical Safety and Efficacy of Secondary Prophylactic Pegylated G-CSF in Advanced Pancreatic Cancer Patients Treated with mFOLFIRINOX: A Single-center Retrospective Study Reviewed

    Yamao K, Takenaka M, Yoshikawa T, Ishikawa R, Okamoto A, Yamazaki T, Nakai A, Omoto S, Kamata K, Minaga K, Hagiwara S, Sakurai T, Nishida N, Chiba Y, Watanabe T, Kudo M

    Intern Med   Vol. 58 ( 14 ) page: 1993 - 2002   2019

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    Objective Although modified FOLFIRINOX (mFOLFIRINOX, mFFX) is widely used for patients with advanced pancreatic ductal adenocarcinoma (PDAC), maintenance of the standard dose intensity is often difficult due to the high incidence of neutropenic events. Pegylated granulocyte colony-stimulating factor (G-CSF) (Peg G) is a long-lasting G-CSF agent that is applicable for prophylaxis against neutropenic complications. The aim of this study was to assess the clinical safety and efficacy of mFFX combined with secondary prophylaxis using Peg G in advanced PDAC patients. Methods Advanced PDAC patients who had received more than two cycles of mFFX were analyzed. The clinical safety and efficacy were compared between patients in the Peg G group and those in the non-Peg G group in a retrospective manner. Results Among 45 patients treated with mFFX, 28 exhibited grade 3-4 neutropenia or febrile neutropenia. Among these 28 patients, 4 who received only 1 or 2 mFFX cycles were excluded from this study. Finally, 11 patients in the Peg G group and 13 in the non-Peg G group were enrolled. The combination therapy with Peg G and mFFX markedly prolonged the progression-free survival compared with the non-Peg G group, and its effects were associated with a reduced incidence of neutropenic events as well as lower rates of dosage reduction, delayed chemotherapy due to neutropenic events and altered blood cell counts after chemotherapy. Conclusion The scheduled administration of secondary prophylactic Peg G prolonged the progression-free survival in patients treated with mFFX. The combination therapy of Peg G and mFFX may be recommended in patients who exhibit grade 3-4 neutropenic events after prior mFFX cycles.

    DOI: 10.2169/internalmedicine.2234-18

    PubMed

  5. Outcomes of endoscopic biliary drainage in pancreatic cancer patients with an indwelling gastroduodenal stent: a multicenter cohort study in West Japan. Reviewed International journal

    Kentaro Yamao, Masayuki Kitano, Mamoru Takenaka, Kosuke Minaga, Toshiharu Sakurai, Tomohiro Watanabe, Takahisa Kayahara, Tomoe Yoshikawa, Yukitaka Yamashita, Masanori Asada, Yoshihiro Okabe, Keiji Hanada, Yasutaka Chiba, Masatoshi Kudo

    Gastrointestinal endoscopy   Vol. 88 ( 1 ) page: 66 - 75   2018.7

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Elsevier BV  

    BACKGROUND AND AIMS: Gastroduodenal and biliary obstruction may occur synchronously or asynchronously in advanced pancreatic cancer, and endoscopic double stent placement may be required. EUS-guided biliary drainage (EUS-BD) often is performed after unsuccessful placement of an endoscopic transpapillary stent (ETS), and EUS-BD may be beneficial in double stent placement. This retrospective multicenter cohort study compared the outcomes of ETS placement and EUS-BD in patients with an indwelling gastroduodenal stent (GDS). METHODS: We recorded the clinical outcomes of patients at 5 tertiary-care medical centers who required biliary drainage after GDS placement between March 2009 and March 2014. RESULTS: Thirty-nine patients were included in this study. Patients' mean age was 68.5 years; 23 (59.0%) were men. The GDS overlay the papilla in 23 patients (59.0%). The overall technical success rate was significantly higher with EUS-BD (95.2%) than with ETS placement (56.0%; P < .01). Furthermore, the technical success rate was significantly higher with EUS-BD (93.3%) than with ETS placement (22.2%; P < .01) when the GDS overlies the papilla. The overall clinical success rate of EUS-BD also was significantly higher than for ETS placement (90.5% vs 52.0%, respectively; P = .01), and there was no significant difference in the incidence of adverse events (ETS, 32.0% vs EUS-BD, 42.9%; P = .65). CONCLUSION: Endoscopic double stent placement with EUS-BD is technically and clinically superior to ETS placement in patients with an indwelling GDS. EUS-BD should be considered the first-line treatment option for patients with an indwelling GDS that overlies the papilla. ETS placement remains a reasonable alternative when the papilla is not covered by the GDS.

    DOI: 10.1016/j.gie.2018.01.021

    PubMed

  6. Detection of High-Grade Pancreatic Intraepithelial Neoplasia without Morphological Changes of the Main Pancreatic Duct over a Long Period: Importance for Close Follow-Up for Confirmation Reviewed

    Kentaro Yamao, Mamoru Takenaka, Atsushi Nakai, Shunske Omoto, Ken Kamata, Kosuke Minaga, Takeshi Miyata, Hajime Imai, Toshiharu Sakurai, Tomohiro Watanabe, Naoshi Nishida, Ippei Matsumoto, Yosihumi Takeyama, Takaaki Chikugo, Masatoshi Kudo

    Oncology   Vol. 93 ( 1 ) page: 81 - 86   2017

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:S. Karger AG  

    DOI: 10.1159/000481237

    PubMed

  7. Factors predicting through-the-scope gastroduodenal stenting outcomes in patients with gastric outlet obstruction: a large multicenter retrospective study in West Japan. Reviewed International journal

    Kentaro Yamao, Masayuki Kitano, Takahisa Kayahara, Etsuji Ishida, Hiroshi Yamamoto, Kosuke Minaga, Yukitaka Yamashita, Jun Nakajima, Masanori Asada, Yoshihiro Okabe, Yukio Osaki, Yasutaka Chiba, Hajime Imai, Masatoshi Kudo

    Gastrointestinal endoscopy   Vol. 84 ( 5 ) page: 757 - 763   2016.11

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:MOSBY-ELSEVIER  

    BACKGROUND AND AIMS: Endoscopic gastroduodenal stenting for malignant gastric outlet obstruction recently has become more effective, but the factors that predict gastroduodenal stenting outcomes are poorly defined. This multicenter retrospective cohort study evaluated the clinical outcomes of gastroduodenal stenting in malignant gastroduodenal obstruction and identified factors predicting clinical ineffectiveness, stent dysfunction, and adverse events. METHODS: All consecutive patients with malignant gastroduodenal obstruction who underwent through-the-scope gastroduodenal stenting from 2009 to 2014 at 4 tertiary-care medical centers were identified. Clinically ineffective stenting was defined as symptom recurrence and a gastric outlet obstruction scoring system (GOOSS) score <2. RESULTS: Of the 278 patients (mean age ± standard deviation [SD] 71.7 ± 11.4 years), 121 (43.5%) and 87 (31.3%) had pancreatic and gastric cancer, respectively. Technical success was achieved in 277 patients (99.6%). GOOSS scores rose from 0.5 ± 0.6 to 2.6 ± 0.8. Stenting was ineffective in 32 patients (12.6%). Stent dysfunction that caused symptom recurrence during follow-up developed in 46 patients (16.6%). Adverse events occurred in 49 patients (17.7%). Three or more stenosis sites (odds ratio [OR] = 6.11; P < .01) and Karnofsky performance scores ≤50 (OR = 6.63; P < .01) predicted clinical ineffectiveness. Karnofsky performance scores ≤50 predicted stent dysfunction (hazard ratio [HR] = 3.63; P < .01). Bile duct stenosis (HR = 9.55; P = .02) and liver metastasis (HR = 9.42; P < .01) predicted stent overgrowth. Covered stent predicted stent migration (HR = 12.63; P < .01). Deployment of 2 stents predicted perforation (HR = 854.88; P < .01). CONCLUSIONS: Through-the-scope gastroduodenal stenting tended to be ineffective in patients with poor performance status and long stenosis sites. Stent dysfunction occurred more frequently in patients with poorer performance status. Deployment of 2 stents was a risk factor for perforation. Identification of these risk variables may help yield better gastroduodenal stenting outcomes.

    DOI: 10.1016/j.gie.2016.03.1498

    Web of Science

    PubMed

  8. Synchronous pancreatic and gastric metastasis from an ovarian adenocarcinoma diagnosed by endoscopic ultrasound-guided fine-needle aspiration Reviewed

    Kentaro Yamao, Masayuki Kitano, Masatoshi Kudo, Osamu Maenishi

    ENDOSCOPY   Vol. 47   page: E596 - E597   2015

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    Language:English   Publisher:GEORG THIEME VERLAG KG  

    DOI: 10.1055/s-0034-1393649

    Web of Science

    PubMed

  9. Cross‐wired metal stents for endoscopic bilateral stent‐in‐stent deployment in malignant hilar biliary obstruction: A multicenter, single‐arm, prospective study

    Kentaro Yamao, Takeshi Ogura, Hideyuki Shiomi, Takaaki Eguchi, Hisakazu Matsumoto, Zhao Liang Li, Hiroaki Hashimoto, Yasutaka Chiba, Mamoru Takenaka, Tomohiro Watanabe, Masatoshi Kudo, Tsuyoshi Sanuki

    DEN Open   Vol. 2 ( 1 ) page: e20   2022.4

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Wiley  

    DOI: 10.1002/deo2.20

    PubMed

    Other Link: https://onlinelibrary.wiley.com/doi/full-xml/10.1002/deo2.20

  10. Comparison of Radiation Exposure between Endoscopic Ultrasound-Guided Hepaticogastrostomy and Hepaticogastrostomy with Antegrade Stenting.

    Takenaka M, Rehani MM, Hosono M, Yamazaki T, Omoto S, Minaga K, Kamata K, Yamao K, Hayashi S, Nishida T, Kudo M

    Journal of clinical medicine   Vol. 11 ( 6 )   2022.3

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    DOI: 10.3390/jcm11061705

    PubMed

  11. Value of artificial intelligence with novel tumor tracking technology in the diagnosis of gastric submucosal tumors by contrast-enhanced harmonic endoscopic ultrasonography.

    Tanaka H, Kamata K, Ishihara R, Handa H, Otsuka Y, Yoshida A, Yoshikawa T, Ishikawa R, Okamoto A, Yamazaki T, Nakai A, Omoto S, Minaga K, Yamao K, Takenaka M, Watanabe T, Nishida N, Kudo M

    Journal of gastroenterology and hepatology     2022.1

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    DOI: 10.1111/jgh.15780

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  12. Analysis of Progression Time in Pancreatic Cancer including Carcinoma In Situ Based on Magnetic Resonance Cholangiopancreatography Findings.

    Yamao K, Tsurusaki M, Takashima K, Tanaka H, Yoshida A, Okamoto A, Yamazaki T, Omoto S, Kamata K, Minaga K, Takenaka M, Chikugo T, Chiba Y, Watanabe T, Kudo M

    Diagnostics (Basel, Switzerland)   Vol. 11 ( 10 )   2021.10

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    DOI: 10.3390/diagnostics11101858

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  13. Utility of contrast-enhanced harmonic endoscopic ultrasonography for T-staging of patients with extrahepatic bile duct cancer

    Yasuo Otsuka, Ken Kamata, Tomoko Hyodo, Takaaki Chikugo, Akane Hara, Hidekazu Tanaka, Tomoe Yoshikawa, Rei Ishikawa, Ayana Okamoto, Tomohiro Yamazaki, Atsushi Nakai, Shunsuke Omoto, Kosuke Minaga, Kentaro Yamao, Mamoru Takenaka, Yasutaka Chiba, Tomohiro Watanabe, Takuya Nakai, Ippei Matsumoto, Yoshifumi Takeyama, Masatoshi Kudo

    Surgical Endoscopy     2021.8

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s00464-021-08637-1

    PubMed

    Other Link: https://link.springer.com/article/10.1007/s00464-021-08637-1/fulltext.html

  14. Diagnostic Value of EUS-Guided Fine-Needle Aspiration Biopsy for Gastric Linitis Plastica with Negative Endoscopic Biopsy

    Ryutaro Takada, Kosuke Minaga, Akane Hara, Yasuo Otsuka, Shunsuke Omoto, Ken Kamata, Kentaro Yamao, Mamoru Takenaka, Satoru Hagiwara, Hajime Honjo, Shigenaga Matsui, Takaaki Chikugo, Tomohiro Watanabe, Masatoshi Kudo

    Journal of Clinical Medicine   Vol. 10 ( 16 ) page: 3716 - 3716   2021.8

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    Due to the tendency of gastric linitis plastica (GLP) to cause extensive submucosal infiltration, a superficial endoscopic biopsy sometimes yields no evidence of malignancy, hindering definite diagnosis. The present study was a single-center retrospective analysis of 54 consecutive patients diagnosed with GLP between 2016 and 2020 to evaluate EUS-guided fine-needle aspiration (EUS-FNA) biopsy outcomes in patients with negative endoscopic biopsy findings. A pathological GLP diagnosis was achieved by endoscopic biopsy in 40 patients (74.1%). EUS-FNA biopsy with a 22-gauge needle was performed in 13 of the remaining 14 patients, and GLP diagnosis was confirmed in 10 patients, with a median of three needle passes. The remaining four patients were laparoscopically diagnosed with GLP. The diagnostic ability of EUS-FNA biopsy for GLP was 76.9%, and EUS-FNA biopsy contributed to GLP diagnosis in 18.5% (10/54) of all cases. None of the 13 patients exhibited EUS-FNA biopsy-related adverse events. Univariable and multivariable analyses revealed an absence of superficial ulcerations as a predictor of false-negative endoscopic biopsy findings in patients with GLP. These results suggest EUS-FNA biopsy as a minimally invasive and safe alternative diagnostic modality for GLP in cases where conventional endoscopic biopsy fails to verify malignancy, although prospective studies with larger cohorts are warranted to confirm these findings.

    DOI: 10.3390/jcm10163716

    PubMed

  15. Utility of contrast-enhanced harmonic endoscopic ultrasonography for predicting the prognosis of pancreatic neuroendocrine neoplasms. International journal

    Rei Ishikawa, Ken Kamata, Akane Hara, Hidekazu Tanaka, Ayana Okamoto, Tomohiro Yamazaki, Atsushi Nakai, Shunsuke Omoto, Kosuke Minaga, Kentaro Yamao, Mamoru Takenaka, Yasunori Minami, Tomohiro Watanabe, Yasutaka Chiba, Takaaki Chikugo, Ippei Matsumoto, Yoshifumfi Takeyama, Yuko Matsukubo, Tomoko Hyodo, Masatoshi Kudo

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   Vol. 33 ( 5 ) page: 829 - 839   2021.7

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    BACKGROUND AND AIMS: Pancreatic neuroendocrine neoplasms (PanNENs), including Grade 1 (G1) or G2 tumors, can have a poor prognosis. This study investigated the value of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for predicting the prognosis of PanNENs. METHODS: This single-center, retrospective study included 47 consecutive patients who underwent CH-EUS and were diagnosed with PanNEN by surgical resection or EUS-guided fine needle aspiration between December 2011 and February 2016. Patients were divided into aggressive and non-aggressive groups according to the degree of clinical malignancy. CH-EUS was assessed regarding its capacity for diagnosing aggressive PanNEN, the correspondence between contrast patterns and pathological features, and its ability to predict the prognosis of PanNEN. RESULTS: There were 19 cases of aggressive PanNEN and 28 cases of non-aggressive PanNEN. The aggressive group included three G1, four G2, three G3 tumors, three mixed neuroendocrine non-neuroendocrine neoplasms, and six neuroendocrine carcinomas. CH-EUS was superior to contrast-enhanced computed tomography for the diagnosis of aggressive PanNEN (P < 0.001): hypo-enhancement on CH-EUS was an indicator of aggressive PanNEN, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 94.7%, 100%, 100%, 96.6%, and 97.9%, respectively. Among G1/G2 PanNENs, cases with hypo-enhancement on CH-EUS had a poorer prognosis than those with hyper/iso-enhancement (P = 0.0009). Assessment of 36 resected specimens showed that hypo-enhancement on CH-EUS was associated with smaller and fewer vessels and greater degree of fibrosis. CONCLUSION: Contrast-enhanced harmonic endoscopic ultrasonography may be useful for predicting the prognosis of PanNENs.

    DOI: 10.1111/den.13862

    PubMed

  16. Usefulness of the Novel Snare-over-the-Guidewire Method for Transpapillary Plastic Stent Replacement (with Video). International journal

    Akihiro Yoshida, Mamoru Takenaka, Kota Takashima, Hidekazu Tanaka, Ayana Okamoto, Tomohiro Yamazaki, Atsushi Nakai, Shunsuke Omoto, Kosuke Minaga, Ken Kamata, Kentaro Yamao, Yoriaki Komeda, Naoshi Nishida, Masatoshi Kudo

    Journal of clinical medicine   Vol. 10 ( 13 )   2021.6

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    Unsuccessful stent replacement in transpapillary biliary drainage with plastic stents (PSs) has a significant impact on patient prognosis; thus, a safe and reliable replacement method is required. We aimed to compare the snare-over-the-guidewire (SOG) method, wherein the PS lumen is used as an access route to the biliary tract and the PS is removed with a snare inserted via the inserted guidewire, with the conventional side-of-stent (SOS) method, wherein the biliary approach is performed from the side of the PS. This retrospective single-center study included 244 consecutive patients who underwent biliary PS replacement between January 2018 and July 2020. The procedural success rates were compared between the two methods. A predictive analysis of unsuccessful PS replacement was also performed. The procedural success rate in the SOG group was significantly higher than that in the SOS group (p = 0.026). In the proximal biliary stenosis lesion, the same trend was observed (p = 0.025). Multivariate analysis also showed that the SOS method (p = 0.0038), the presence of proximal biliary stenosis (p < 0.0001), and parapapillary diverticulum (p = 0.0007) were predictors of unsuccessful PS replacement. The SOG method may be useful for biliary PS replacement, especially in cases of proximal hilar bile duct stenosis.

    DOI: 10.3390/jcm10132858

    PubMed

  17. Comparison of radiation exposure between endoscopic ultrasound-guided drainage and transpapillary drainage by endoscopic retrograde cholangiopancreatography for pancreatobiliary diseases. International journal

    Mamoru Takenaka, Makoto Hosono, Madan M Rehani, Yasutaka Chiba, Rei Ishikawa, Ayana Okamoto, Tomohiro Yamazaki, Atsushi Nakai, Shunsuke Omoto, Kosuke Minaga, Ken Kamata, Kentaro Yamao, Shiro Hayashi, Tsutomu Nishida, Masatoshi Kudo

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   Vol. 34 ( 3 ) page: 579 - 586   2021.6

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    OBJECTIVES: The transpapillary drainage by endoscopic retrograde cholangiopancreatography (ERCP-D) cannot be performed without fluoroscopy, and there are many situations in which fluoroscopy is required even in endoscopic ultrasound-guided drainage (EUS-D). Previous studies have compared the efficacy, but not the radiation exposure of EUS-D and ERCP-D. While radiation exposure in ERCP-D has been previously evaluated, there is a paucity of information regarding radiation doses in EUS-D. This study aimed to assess radiation exposure in EUS-D compared with that in ERCP-D. METHODS: This retrospective single-center cohort study included consecutive patients who underwent EUS-D and ERCP-D between October 2017 and March 2019. The air kerma (AK: mGy), kerma-area product (KAP: Gycm2 ), fluoroscopy time (FT: min), and procedure time (PT: min) were assessed. The invasive probability weighting method was used to qualify the comparisons. RESULTS: We enrolled 372 and 105 patients who underwent ERCP-D and EUS-D, respectively. The mean AK, KAP, and FT in the EUS-D group were higher by 53%, 28%, and 27%, respectively, than those in the ERCP-D group, whereas PT was shorter by approximately 11% (AK; 135.0 vs. 88.4, KAP; 28.1 vs. 21.9, FT; 20.4 vs. 16.0, PT; 38.7 vs. 43.5). The sub-analysis limited to biliary drainage cases showed the same trend (AK; 128.3 vs. 90.9, KAP; 27.0 vs. 22.2, FT; 16.4 vs. 16.1, PT; 32.5 vs. 44.4). CONCLUSIONS: This is the first study to assess radiation exposure in EUS-D compared with that in ERCP-D. Radiation exposure was significantly higher in EUS-D than in ERCP-D, despite the shorter procedure time.

    DOI: 10.1111/den.14060

    PubMed

  18. Should Contrast-Enhanced Harmonic Endoscopic Ultrasound Be Incorporated into the International Consensus Guidelines to Determine the Appropriate Treatment of Intraductal Papillary Mucinous Neoplasm? International journal

    Tomohiro Yamazaki, Mamoru Takenaka, Shunsuke Omoto, Tomoe Yoshikawa, Rei Ishikawa, Ayana Okamoto, Atsushi Nakai, Kosuke Minaga, Ken Kamata, Kentaro Yamao, Yoriaki Komeda, Tomohiro Watanabe, Naoshi Nishida, Keiko Kamei, Ippei Matsumoto, Yoshifumi Takeyama, Takaaki Chikugo, Yasutaka Chiba, Masatoshi Kudo

    Journal of clinical medicine   Vol. 10 ( 9 )   2021.4

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    This study aimed to investigate whether the incorporation of contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) into the international consensus guidelines (ICG) for the management of intraductal papillary mucinous neoplasm (IPMN) could improve its malignancy diagnostic value. In this single-center retrospective study, 109 patients diagnosed with IPMN who underwent preoperative CH-EUS between March 2010 and December 2018 were enrolled. We analyzed each malignancy diagnostic value (sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV)) by replacing fundamental B-mode EUS with CH-EUS as the recommended test for patients with worrisome features (WF) (the CH-EUS incorporation ICG) and comparing the results to those obtained using the 2017 ICG. The malignancy diagnostic values as per the 2017 ICG were 78.9%, 42.3%, 60.0%, and 64.7% for Se, Sp, PPV, and NPV, respectively. The CH-EUS incorporation ICG plan improved the malignancy diagnostic values (Se 78.9%/Sp, 53.8%/PPV, 65.2%/NPV 70.0%). CH-EUS may be useful in determining the appropriate treatment strategies for IPMN.

    DOI: 10.3390/jcm10091818

    PubMed

  19. A Mimicker of Intraductal Papillary Mucinous Carcinoma of the Pancreas. International journal

    Akihiro Yoshida, Kentaro Yamao, Tomohiro Watanabe

    Gastroenterology   Vol. 161 ( 5 ) page: e8 - e11   2021.4

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    DOI: 10.1053/j.gastro.2021.03.056

    PubMed

  20. Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma. International journal

    Ryota Sagami, Kentaro Yamao, Jun Nakahodo, Ryuki Minami, Masakatsu Tsurusaki, Kazunari Murakami, Yuji Amano

    Cancers   Vol. 13 ( 5 )   2021.2

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    Pancreatic ductal adenocarcinoma (PDAC) arises from precursor lesions, such as pancreatic intra-epithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). The prognosis of high-grade precancerous lesions, including high-grade PanIN and high-grade IPMN, without invasive carcinoma is good, despite the overall poor prognosis of PDAC. High-grade PanIN, as a lesion preceding invasive PDAC, is therefore a primary target for intervention. However, detection of localized high-grade PanIN is difficult when using standard radiological approaches. Therefore, most studies of high-grade PanIN have been conducted using specimens that harbor invasive PDAC. Recently, imaging characteristics of high-grade PanIN have been revealed. Obstruction of the pancreatic duct due to high-grade PanIN may induce a loss of acinar cells replaced by fibrosis and lobular parenchymal atrophy. These changes and additional inflammation around the branch pancreatic ducts (BPDs) result in main pancreatic duct (MPD) stenosis, dilation, retention cysts (BPD dilation), focal pancreatic parenchymal atrophy, and/or hypoechoic changes around the MPD. These indirect imaging findings have become important clues for localized, high-grade PanIN detection. To obtain pre-operative histopathological confirmation of suspected cases, serial pancreatic-juice aspiration cytologic examination is effective. In this review, we outline current knowledge on imaging characteristics of high-grade PanIN.

    DOI: 10.3390/cancers13050945

    PubMed

  21. 【進化するEUS】診断的EUS 造影ハーモニックEUS

    三長 孝輔, 原 茜, 田中 秀和, 大本 俊介, 鎌田 研, 山雄 健太郎, 竹中 完, 工藤 正俊

    消化器内視鏡   Vol. 32 ( 11 ) page: 1641 - 1649   2020.11

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  22. 内視鏡的乳頭切除術後胆管狭窄に対する予防的金属ステント留置の有用性

    岡本 彩那, 竹中 完, 田中 隆光, 田中 秀和, 吉田 晃浩, 吉川 智恵, 石川 嶺, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 62 ( Suppl.2 ) page: 2136 - 2136   2020.10

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  23. 急性膵炎におけるプレサルコペニアの臨床的意義に関しての検討

    田中 隆光, 竹中 完, 吉田 晃弘, 田中 秀和, 吉川 智恵, 石川 嶺, 岡本 彩那, 山崎 友裕, 中井 敦史, 大本 俊輔, 三長 孝輔, 鎌田 研, 山雄 健太郎, 松本 逸平, 竹山 宜典, 工藤 正俊

    日本消化器病学会雑誌   Vol. 117 ( 臨増大会 ) page: A789 - A789   2020.10

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  24. 内視鏡的乳頭切除術後胆管狭窄に対する予防的金属ステント留置の有用性

    岡本 彩那, 竹中 完, 田中 隆光, 田中 秀和, 吉田 晃浩, 吉川 智恵, 石川 嶺, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 62 ( Suppl.2 ) page: 2136 - 2136   2020.10

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  25. Pancreatic neuroendocrine tumor with stenosis of the main pancreatic duct leading to pancreatic pleural effusion: a case report. International journal

    Yuta Yoshida, Ippei Matsumoto, Tomonori Tanaka, Kentaro Yamao, Akihiro Hayashi, Keiko Kamei, Shumpei Satoi, Atsushi Takebe, Takuya Nakai, Mamoru Takenaka, Yoshifumi Takeyama

    Surgical case reports   Vol. 6 ( 1 ) page: 222 - 222   2020.9

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    BACKGROUND: Pancreatic pleural effusion and ascites are defined as fluid accumulation in the thoracic and abdominal cavity, respectively, due to direct leakage of the pancreatic juice. They usually occur in patients with acute or chronic pancreatitis but are rarely associated with pancreatic neoplasm. We present here an extremely rare case of pancreatic neuroendocrine tumor with stenosis of the main pancreatic duct, leading to pancreatic pleural effusion. CASE PRESENTATION: A 51-year-old man complained of dyspnea. Left-sided pleural effusion was detected on the chest X-ray. Pleural puncture was performed, and the pleural fluid indicated a high amylase content (36,854 IU/L). Hence, the patient was diagnosed with pancreatic pleural effusion. Although no tumor was detected, the computed tomography (CT) scan showed a pseudocyst and dilation of the main pancreatic duct in the pancreatic tail. Magnetic resonance cholangiopancreatography showed a fistula from the pseudocyst into the left thoracic cavity. Endoscopic retrograde pancreatic drainage was attempted; however, it failed due to stenosis in the main pancreatic duct in the pancreatic body. Endoscopic ultrasound revealed a hypoechoic mass measuring 15 × 15 mm in the pancreatic body that was not enhanced in the late phase of contrast perfusion and was thus suspected to be an invasive ductal carcinoma. The patient underwent distal pancreatectomy with splenectomy and the postoperative course was uneventful. Histopathological examination confirmed a neuroendocrine tumor of the pancreas (NET G2). The main pancreatic duct was compressed by the tumor. Increased pressure on the distal pancreatic duct by the tumor might have caused formation of the pseudocyst and pleural effusion. To the best of our knowledge, this is the first case report of pancreatic pleural effusion associated with a neuroendocrine tumor. CONCLUSIONS: Differential diagnosis of a pancreatic neoplasm should be considered, especially when a patient without a history of pancreatitis presents with pleural effusion.

    DOI: 10.1186/s40792-020-00987-7

    PubMed

  26. Identification of serum IFN-α and IL-33 as novel biomarkers for type 1 autoimmune pancreatitis and IgG4-related disease. International journal

    Kosuke Minaga, Tomohiro Watanabe, Akane Hara, Ken Kamata, Shunsuke Omoto, Atsushi Nakai, Yasuo Otsuka, Ikue Sekai, Tomoe Yoshikawa, Kentaro Yamao, Mamoru Takenaka, Yasutaka Chiba, Masatoshi Kudo

    Scientific reports   Vol. 10 ( 1 ) page: 14879 - 14879   2020.9

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    IgG4-related disease (IgG4-RD) is a multi-organ autoimmune disease characterized by elevated serum IgG4 concentration. Although serum IgG4 concentration is widely used as a biomarker for IgG4-RD and type 1 autoimmune pancreatitis (AIP), a pancreatic manifestation of IgG4-RD, a significant number of patients have normal serum IgG4 levels, even in the active phase of the disease. Recently, we reported that the development of experimental AIP and human type 1 AIP is associated with increased expression of IFN-α and IL-33 in the pancreas. In this study, we assessed the utility of serum IFN-α and IL-33 levels as biomarkers for type 1 AIP and IgG4-RD. Serum IFN-α and IL-33 concentrations in patients who met the diagnostic criteria for definite type 1 AIP and/or IgG4-RD were significantly higher than in those with chronic pancreatitis or in healthy controls. Strong correlations between serum IFN-α, IL-33, and IgG4 concentrations were observed. Diagnostic performance of serum IFN-α and IL-33 concentrations as markers of type 1 AIP and/or IgG4-RD was comparable to that of serum IgG4 concentration, as calculated by the receiver operating characteristic curve analysis. Induction of remission by prednisolone treatment markedly decreased the serum concentration of these cytokines. We conclude that serum IFN-α and IL-33 concentrations can be useful as biomarkers for type 1 AIP and IgG4-RD.

    DOI: 10.1038/s41598-020-71848-4

    PubMed

  27. A novel teaching tool for visualizing the invisible bile duct axis in 3 dimensions during biliary cannulation (Compact Disc method). Reviewed International journal

    Mamoru Takenaka, Tomoe Yoshikawa, Kosuke Minaga, Kentaro Yamao, Masatoshi Kudo

    VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy   Vol. 5 ( 9 ) page: 389 - 394   2020.9

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    DOI: 10.1016/j.vgie.2020.04.015

    Scopus

    PubMed

  28. Disconnected pancreatic duct syndromeの外科治療症例の検討

    松本 正孝, 松本 逸平, 吉田 雄太, 山雄 健太郎, 川口 晃平, 村瀬 貴昭, 大本 俊介, 亀井 敬子, 里井 俊平, 竹中 完, 武部 敦志, 中居 卓也, 竹山 宜典

    膵臓   Vol. 35 ( 3 ) page: A337 - A337   2020.7

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  29. EUS施行時の鎮静方法の検討

    岡本 彩那, 鎌田 研, 河野 辰哉, 田中 秀和, 石川 嶺, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 竹中 完, 工藤 正俊

    日本消化器病学会雑誌   Vol. 117 ( 臨増総会 ) page: A389 - A389   2020.7

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  30. EUS施行時の鎮静方法の検討

    岡本 彩那, 鎌田 研, 河野 辰哉, 田中 秀和, 石川 嶺, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 竹中 完, 工藤 正俊

    日本消化器病学会雑誌   Vol. 117 ( 臨増総会 ) page: A389 - A389   2020.7

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  31. 急性膵炎に対する局所合併症治療 Walled-off necrosisに対するLAMS with 10 FrENCD持続洗浄治療の有用性について

    竹中 完, 石川 嶺, 岡本 彩那, 中井 敦史, 山崎 友裕, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 松本 逸平, 竹山 宜典, 工藤 正俊

    膵臓   Vol. 35 ( 3 ) page: A209 - A209   2020.7

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  32. 急性膵炎に対する局所合併症治療 Walled-off necrosisに対するLAMS with 10 FrENCD持続洗浄治療の有用性について

    竹中 完, 石川 嶺, 岡本 彩那, 中井 敦史, 山崎 友裕, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 松本 逸平, 竹山 宜典, 工藤 正俊

    膵臓   Vol. 35 ( 3 ) page: A209 - A209   2020.7

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  33. A novel sensitive detection method for DNA methylation in circulating free DNA of pancreatic cancer

    Shinjo Keiko, Hara Kazuo, Nagae Genta, Umeda Takayoshi, Katsushima Keisuke, Suzuki Miho, Murofushi Yoshiteru, Umezu Yuta, Takeuchi Ichiro, Takahashi Satoru, Okuno Yusuke, Matsuo Keitaro, Ito Hidemi, Tajima Shoji, Aburatani Hiroyuki, Yamao Kenji, Kondo Yutaka

    PLOS ONE   Vol. 15 ( 6 )   2020.6

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    Despite recent advances in clinical treatment, pancreatic cancer remains a highly lethal malignancy. In order to improve the survival rate of patients with pancreatic cancer, the development of non-invasive diagnostic methods using effective biomarkers is urgently needed. Here, we developed a highly sensitive method to detect DNA methylation in cellfree (cf)DNA samples based on the enrichment of methyl-CpG binding (MBD) protein coupled with a digital PCR method (MBD-ddPCR). Five DNA methylation markers for the diagnosis of pancreatic cancer were identified through DNA methylation microarray analysis in 37 pancreatic cancers. The sensitivity and specificity of the five markers were validated in another independent cohort of pancreatic cancers (100% and 100%, respectively; n = 46) as well as in The Cancer Genome Atlas data set (96% and 90%, respectively; n = 137). MBD-ddPCR analysis revealed that DNA methylation in at least one of the five markers was detected in 23 (49%) samples of cfDNA from 47 patients with pancreatic cancer. Further, a combination of DNA methylation markers and the KRAS mutation status improved the diagnostic capability of this method (sensitivity and specificity, 68% and 86%, respectively). Genome-wide MBD-sequencing analysis in cancer tissues and corresponding cfDNA revealed that more than 80% of methylated regions were overlapping; DNA methylation profiles of cancerous tissues and cfDNA significantly correlated with each other (R = 0.97). Our data indicate that newly developed MBD-ddPCR is a sensitive method to detect cfDNA methylation and that using five marker genes plus KRAS mutations may be useful for the detection of pancreatic cancers.

    DOI: 10.1371/journal.pone.0233782

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    Scopus

  34. Comparative evaluation of new and conventional classifications of magnifying endoscopy with narrow band imaging for invasion depth of superficial esophageal squamous cell carcinoma (vol 30, dox037, 2017)

    Fujiyoshi T., Tajika M., Tanaka T., Ishihara M., Mizuno N., Hara K., Hijioka S., Imaoka H., Yatabe Y., Hirooka Y., Goto H., Yamao K., Niwa Y.

    DISEASES OF THE ESOPHAGUS   Vol. 33 ( 6 )   2020.6

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    Page 4 Left 38th line (original) On magnified observation of NBI, when we observe the lesion at maximum magnification, the length of the corner of the screen is about 0.5 mm, and the length of one side is about 3 mm (Fig. 3).Using this standard, the size of the AVA can be estimated. (revised) On magnified observation of NBI, when we observe the lesion at maximum magnification, the length of one side is about 3 mm, and the length of the corner of the screen is about 0.5 mm (Fig. 3).Using this standard, the size of the AVA can be estimated. Page 4 Right Fig 3. figure legend (original) Fig 3. Estimate the size of AVA. In magnified observation of NBI, when we observe the lesion by the maximum magnification, the length of the corner of the screen is about 0.5mm[A], and the length of one side is about 3mm [B]. Using this standard, we can estimate the size of AVA. (1 scale is equivalent to 1mm.). NBI, narrow band images; AVA, avascular area. (revised) Fig 3. Estimate the size of AVA. On magnified observation of NBI, when we observe the lesion at maximum magnification, the length of one side is about 3 mm [A], and the length of the corner of the screen is about 0.5 mm [B]. Using this standard, the size of the AVA can be estimated. (1 scale is equivalent to 1mm.). NBI, narrow band images; AVA, avascular area.

    DOI: 10.1093/dote/doaa040

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    Scopus

  35. Improved liver metastasis detection using Kupffer-phase imaging in contrast-enhanced harmonic EUS in patients with pancreatic cancer (with video) Reviewed

    Kosuke Minaga, Masayuki Kitano, Atsushi Nakai, Shunsuke Omoto, Ken Kamata, Kentaro Yamao, Mamoru Takenaka, Masakatsu Tsurusaki, Takaaki Chikugo, Ippei Matsumoto, Yasutaka Chiba, Tomohiro Watanabe, Masatoshi Kudo

    Gastrointestinal Endoscopy   Vol. 93 ( 2 ) page: 433 - 441   2020.6

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    DOI: 10.1016/j.gie.2020.06.051

    PubMed

  36. Endoscopic sphincterotomy to prevent post-ERCP pancreatitis in patients with biliary neoplasms: a multicenter retrospective cohort study.

    Tamura T, Ogura T, Takenaka M, Tanioka K, Itonaga M, Yamao K, Kamata K, Hirono S, Okada KI, Imanishi M, Higuchi K, Yamaue H, Kitano M

    Endoscopy international open   Vol. 8 ( 4 ) page: E513 - E522   2020.4

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    DOI: 10.1055/a-1107-2629

    PubMed

  37. Response to the Letter to the Editor 'Reply to "Clinical Safety and Efficacy of Secondary Prophylactic Pegylated G-CSF in Advanced Pancreatic Cancer Patients Treated with mFOLFIRINOX: A Single-center Retrospective Study" by Dr. Peng Chen' Reviewed

    Kentaro Yamao, Tomohiro Watanabe, Masatoshi Kudo

    Internal Medicine   Vol. 59 ( 6 ) page: 879 - 879   2020.3

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Japanese Society of Internal Medicine  

    DOI: 10.2169/internalmedicine.3958-19

    PubMed

  38. Clinical utility of treatment method conversion during single-session endoscopic ultrasound-guided biliary drainage. Reviewed International journal

    Kosuke Minaga, Mamoru Takenaka, Kentaro Yamao, Ken Kamata, Shunsuke Omoto, Atsushi Nakai, Tomohiro Yamazaki, Ayana Okamoto, Rei Ishikawa, Tomoe Yoshikawa, Yasutaka Chiba, Tomohiro Watanabe, Masatoshi Kudo

    World journal of gastroenterology   Vol. 26 ( 9 ) page: 947 - 959   2020.3

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    BACKGROUND: Although several techniques for endoscopic ultrasound-guided biliary drainage (EUS-BD) are available at present, an optimal treatment algorithm of EUS-BD has not yet been established. AIM: To evaluate the clinical utility of treatment method conversion during single endoscopic sessions for difficult cases in initially planned EUS-BD. METHODS: This was a single-center retrospective analysis using a prospectively accumulated database. Patients with biliary obstruction undergoing EUS-BD between May 2008 and April 2016 were included. The primary outcome was to evaluate the improvement in EUS-BD success rates by converting the treatment methods during a single endoscopic session. Secondary outcomes were clarification of the factors leading to the conversion from the initial EUS-BD and the assessment of efficacy and safety of the conversion as judged by technical success, clinical success, and adverse events (AEs). RESULTS: A total of 208 patients underwent EUS-BD during the study period. For 18.8% (39/208) of the patients, the treatment methods were converted to another EUS-BD technique from the initial plan. Biliary obstruction was caused by pancreatobiliary malignancies, other malignant lesions, biliary stones, and other benign lesions in 22, 11, 4, and 2 patients, respectively. The reasons for the difficulty with the initial EUS-BD were classified into the following 3 procedures: Target puncture (n = 13), guidewire manipulation (n = 18), and puncture tract dilation (n = 8). Technical success was achieved in 97.4% (38/39) of the cases and clinical success was achieved in 89.5% of patients (34/38). AEs occurred in 10.3% of patients, including bile leakage (n = 2), bleeding (n = 1), and cholecystitis (n = 1). The puncture target and drainage technique were altered in subsequent EUS-BD procedures in 25 and 14 patients, respectively. The final technical success rate with 95%CI for all 208 cases was 97.1% (95%CI: 93.8%-98.9%), while that of the initially planned EUS-BD was 78.8% (95%CI: 72.6%-84.2%). CONCLUSION: Among multi-step procedures in EUS-BD, guidewire manipulation appeared to be the most technically challenging. When initially planned EUS-BD is technically difficult, treatment method conversion in a single endoscopic session may result in successful EUS-BD without leading to severe AEs.

    DOI: 10.3748/wjg.v26.i9.947

    PubMed

  39. 【EUSの現状と将来】診断 造影ハーモニック超音波内視鏡の実際と将来展望

    鎌田 研, 原 茜, 岡本 彩那, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 竹中 完, 工藤 正俊

    肝・胆・膵   Vol. 80 ( 3 ) page: 403 - 411   2020.3

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  40. 【肝膵内視鏡治療におけるトラブルシューティング】ERCP関連治療における偶発症予防とトラブルシューティング 失敗しない内視鏡的胆管結石除去術

    竹中 完, 中井 敦史, 大本 俊輔, 三長 孝輔, 鎌田 研, 山雄 健太郎, 工藤 正俊

    消化器内視鏡   Vol. 32 ( 3 ) page: 358 - 364   2020.3

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  41. 【慢性膵炎診療2020】診断 早期慢性膵炎のEUS所見は特異的か 加齢や他疾患の影響は

    竹中 完, 中井 敦史, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 渡邉 智裕, 松本 逸平, 竹山 宜典, 工藤 正俊

    肝・胆・膵   Vol. 80 ( 2 ) page: 295 - 302   2020.2

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  42. Efficacy of a modified double-guidewire technique using an uneven double lumen cannula (uneven method) in patients with surgically altered gastrointestinal anatomy (with video) Reviewed International journal

    Takenaka M, Minaga K, Kamata K, Yamao K, Yoshikawa T, Ishikawa R, Okamoto A, Yamazaki T, Nakai A, Omoto S, Komeda Y, Sakurai T, Watanabe T, Nishida N, Chiba Y, Kwon CI, Jeong S, Lee TH, Kudo M

    Surg Endosc   Vol. 34 ( 3 ) page: 1432 - 1441   2020

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    BACKGROUND: Balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) has been reported to be effective for patients with surgically altered gastrointestinal anatomy. However, selective biliary cannulation remains difficult in BE-ERCP. We examined the usefulness of a modified double-guidewire technique using an uneven double lumen cannula (the uneven method) for BE-ERCP in patients with surgically altered gastrointestinal anatomy. METHODS: To clarify the usefulness of the uneven method for selective biliary cannulation in BE-ERCP in comparison to the pancreatic guidewire (PGW) method, 40 patients with surgically altered gastrointestinal anatomy who underwent BE-ERCP with successful placement of a guidewire in the pancreatic duct were evaluated. The uneven method was used in 18 cases (uneven group) and the PGW method was used in the remaining 22 cases (PGW group). RESULTS: The technical success rate of biliary cannulation was higher in the uneven group than in the PGW group (83.3 vs. 59.0%; P = 0.165). In addition, the time to biliary cannulation were significantly shorter in the uneven group than in the PGW group (6 vs. 18 min; P = 0.004; respectively). In the PGW group, post-ERCP pancreatitis (PEP) occurred in 3 of 22 cases (13.6%). No adverse events, including PEP, occurred in the uneven group. CONCLUSIONS: The uneven method may be a useful option of selective biliary cannulation in BE-ERCP for the patients with surgically altered gastrointestinal anatomy.

    DOI: 10.1007/s00464-019-07228-5

    PubMed

  43. Can Localized Stenosis of the Main Pancreatic Duct be a Predictive Factor for Early Detection of Pancreatic Cancer? Reviewed International journal

    Takenaka M, Yamao K, Kudo M

    Clinical endoscopy   Vol. 52 ( 6 ) page: 523 - 524   2019.11

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    DOI: 10.5946/ce.2019.204

    PubMed

  44. Revisionary antireflux metal stent placement for stent occlusion after endoscopic ultrasound-guided hepaticojejunostomy. Reviewed International journal

    Minaga K, Takenaka M, Okamoto A, Omoto S, Kamata K, Yamao K, Kudo M

    Endoscopy   Vol. 52 ( 5 ) page: E152-E153 - E153   2019.11

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    DOI: 10.1055/a-1032-8272

    PubMed

  45. 遭遇の機会が増えたIPMN/膵嚢胞―現状と課題 2 IPMN/膵嚢胞の診療(4)悪性IPMNとIPMN併存膵癌の診断におけるEUSの役割

    鎌田研, 原茜, 山雄健太郎, 竹中完, 工藤正俊

    臨床消化器内科   Vol. 34 ( 12 ) page: 1476 - 1481   2019.10

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  46. EUS施行時のプロポフォール持続注入による鎮静の有用性の検討 Reviewed

    岡本 彩那, 鎌田 研, 竹中 完, 吉川 智恵, 石川 嶺, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 61 ( Suppl.2 ) page: 2182 - 2182   2019.10

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  47. CLINICAL UTILITY OF ENDOSCOPIC ULTRASOUND-GUIDED DRAINAGE USING CONTRAST-ENHANCED HARMONIC IMAGING IN CASES WITH DIFFICULTIES Reviewed

    Minaga Kosuke, Takenaka Mamoru, Yoshikawa Tomoe, Okamoto Ayana, Ishikawa Rei, Yamazaki Tomohiro, Nakai Atsushi, Omoto Shunsuke, Kamata Ken, Yamao Kentaro, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 89 ( 6 ) page: AB299   2019.6

  48. EXAMINATION OF ACTUAL RADIATION EXPOSURE DOSE OF THE PATIENTS WHO PERFORMED EUS-GUIDED DRAINAGE (EUS-BD/EUS-PD/EUS-CD) Reviewed

    Takenaka Mamoru, Hayashi Shiro, Nishida Tsutomu, Hosono Makoto, Yoshikawa Tomoe, Ishikawa Rei, Okamoto Ayana, Yamazaki Tomohiro, Nakai Atsushi, Omoto Shunsuke, Minaga Kosuke, Kamata Ken, Yamao Kentaro, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 89 ( 6 ) page: AB444 - AB445   2019.6

  49. Novel sphincterotomy device that orientates blade along the axis of the bile duct in patients with Roux-en-Y anastomosis. Reviewed

    Takenaka M, Yoshikawa T, Okamoto A, Nakai A, Minaga K, Yamao K, Kudo M

    Endoscopy   Vol. 51 ( 6 ) page: E132 - E134   2019.6

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    DOI: 10.1055/a-0858-9831

    PubMed

  50. LINEAR EUS TRAINING BY USING SYSTEMATIC SCREENING PROTCOL FOR THE PANCREATOBILIARY SYSTEM Reviewed

    Omoto Shunsuke, Takenaka Mamoru, Ishikawa Rei, Okamoto Ayana, Nakai Atsushi, Yamazaki Tomohiro, Minaga Kosuke, Kamata Ken, Yamao Kentaro, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 89 ( 6 ) page: AB584   2019.6

  51. THE USEFULNESS OF NOVEL CANNULATION METHOD USING A UNIQUE, DOUBLE LUMENS CATHETER (UNEVEN METHOD) FOR THE PATIENTS WITH SURGICALLY ALTERED GASTROINTESTINAL ANATOMY Reviewed

    Takenaka Mamoru, Yoshikawa Tomoe, Ishikawa Rei, Okamoto Ayana, Yamazaki Tomohiro, Nakai Atsushi, Omoto Shunsuke, Minaga Kosuke, Kamata Ken, Yamao Kentaro, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 89 ( 6 ) page: AB223   2019.6

  52. VALUE OF THE BISPECTRAL INDEX MONITOR DURING ENDOSCOPIC ULTRASONOGRAPHY UNDER SEDATION WITH PROPOFOL AND MIDAZOLAM Reviewed

    Okamoto Ayana, Kamata Ken, Takenaka Mamoru, Yoshikawa Tomoe, Ishikawa Rei, Yamazaki Tomohiro, Nakai Atsushi, Omoto Shunsuke, Minaga Kosuke, Yamao Kentaro, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 89 ( 6 ) page: AB602 - AB603   2019.6

  53. A novel technique for stent dysfunction after endoscopic ultrasound-guided hepaticogastrostomy with antegrade stenting. Reviewed International journal

    Okamoto A, Minaga K, Takenaka M, Yoshikawa T, Kamata K, Yamao K, Kudo M

    Endoscopy   Vol. 51 ( 9 ) page: E255-E256 - E256   2019.5

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    DOI: 10.1055/a-0890-3220

    PubMed

  54. [Current status of radiation exposure to crystalline lens in ERCP (endoscopic retrograde cholangiopancreatography)]. Reviewed

    Takenaka M, Hosono M, Nakai A, Omoto S, Minaga K, Kamata K, Yamao K, Hayashi S, Nishida T, Kudo M

    Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   Vol. 116 ( 12 ) page: 1053 - 1055   2019

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    DOI: 10.11405/nisshoshi.116.1053

    PubMed

  55. Efficacy and Safety of Chemotherapy Following Anti-PD-1 Antibody Therapy for Gastric Cancer: A Case of Sclerosing Cholangitis Reviewed

    Kono M, Sakurai T, Okamoto K, Masaki S, Nagai T, Komeda Y, Kamata K, Minaga K, Yamao K, Takenaka M, Watanabe T, Nishida N, Kudo M

    Intern Med   Vol. 58 ( 9 ) page: 1263 - 1266   2019

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    Immunotherapy targeting programmed cell death-1 (PD-1) signaling is becoming the standard of care for advanced gastric cancer. We herein report a patient with gastric adenocarcinoma with peritoneal dissemination who was treated with nab-paclitaxel and ramucirumab following nivolumab and developed sclerosing cholangitis. Endoscopic retrograde cholangiography showed irregular narrowing and widening of the entire intrahepatic biliary system. Intriguingly, the patient receiving second-line chemotherapy with nab-paclitaxel plus ramucirumab prior to being administered nivolumab, however, he had experienced progressive disease. Thereafter, the administration of fourth-line chemotherapy with nab-paclitaxel and ramucirumab following nivolumab resulted in a clinical response. Nivolumab may enhance the efficacy of the subsequent chemotherapy regimens but also induce sclerosing cholangitis.

    DOI: 10.2169/internalmedicine.1981-18

    PubMed

  56. Correction to: Phase II study of sunitinib in Japanese patients with unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumor (Investigational New Drugs, (2013), 31, 5, (1265-1274), 10.1007/s10637-012-9910-y)

    Ito T., Okusaka T., Nishida T., Yamao K., Igarashi H., Morizane C., Kondo S., Mizuno N., Hara K., Sawaki A., Hashigaki S., Kimura N., Murakami M., Ohki E., Chao R.C., Imamura M.

    Investigational New Drugs     2019

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    In the original publication of this article, the license subtype should be CC BYand not CC BY-NC. The original article has been corrected.

    DOI: 10.1007/s10637-019-00757-9

    Scopus

  57. Contrast-enhanced harmonic endoscopic ultrasonography for evaluating the response to chemotherapy in pancreatic cancer. Reviewed International journal

    Tanaka H, Kamata K, Takenaka M, Yoshikawa T, Ishikawa R, Okamoto A, Yamazaki T, Nakai A, Omoto S, Minaga K, Yamao K, Sakurai T, Watanabe T, Nishida N, Chiba Y, Kitano M, Kudo M

    Dig Liver Dis   Vol. 51 ( 8 ) page: 1130 - 1134   2019

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    BACKGROUND AND AIMS: Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) is used for the diagnosis of pancreatic cancer (PC). Here, we examined the usefulness of CH-EUS for evaluating therapeutic responses in PC. METHODS: The study included 23 patients with PC who received chemotherapy. Patients underwent contrast-enhanced computed tomography (CE-CT) and CH-EUS before chemotherapy and at the time of evaluation of the therapeutic response. Patients with a ≧50% reduction in serum carbohydrate antigen 19-9 levels after chemotherapy were defined as "super responders". The incidence of an avascular area in the tumor on CH-EUS after chemotherapy was compared between "super responders" and non-super responders. RESULTS: Nine patients were included in the "super responders" group.Tumor reduction rates did not differ significantly between CE-CT and CH-EUS in the "super responders". The appearance of an avascular area was detected in 7 of 9 super responders (77.8%) and in 4 of 14 non-super responders (28.6%), and the difference was significant (P = 0.036). The mean survival time of patients with an avascular area after chemotherapy was longer than that of without an avascular area. CONCLUSIONS: Detection of avascular areas by CH-EUS after chemotherapy may predict long-term survival of patients with PC.

    DOI: 10.1016/j.dld.2019.03.015

    PubMed

  58. Gankyrin Contributes to Tumorigenesis and Chemoresistance in Sporadic Colorectal Cancer. Digestion Reviewed International journal

    Sakurai T, Komeda Y, Nagai T, Kamata K, Minaga K, Yamao K, Takenaka M, Hagiwara S, Watanabe T, Nishida N, Kashida H, Nakagawa K, Kudo M

    Digestion   Vol. 100 ( 3 ) page: 192 - 200   2019

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    BACKGROUND: Although Gankyrin is overexpressed in many malignancies, the role of Gankyrin for tumorigenesis and chemoresistance remains to be elucidated in sporadic colorectal cancer (CRC). AIMS: We investigate whether Gankyrin affects Adenomatous polyposis coli (Apc) inactivation-induced tumorigenesis and therapeutic response to anti-angiogenic agents. METHODS: Epithelial cell-specific APC and/or Gankyrin-deficient mice were used. The patients with metastatic CRC (n = 53) who were enrolled in this study underwent resection of primary cancer followed by systemic chemotherapy containing bevacizumab. We determined whether gene expression in CRC tissues before chemotherapy is associated with radiological responses. RESULTS: Deletion of Gankyrin in epithelial cell reduced the expression of c-Myc, a critical mediator of the APC signaling pathway, and interleukin-6. Gankyrin deficiency decreased the expression of Bmi1, a downstream molecule of c-Myc, and the activity of V-Akt murine thymoma viral oncogene homolog and extracellular signal-regulated protein kinase, leading to reduced Apc inactivation-induced tumorigenesis. Of 53 patients, 38 (72%) had increased Gankyrin expression in tumor cells. The enhanced Gankyrin expression in tumor cells was associated with unfavorable progression-free survival (log-rank test p = 0.026). CONCLUSION: Gankyrin in epithelial cell contributes to the development of sporadic CRC and the expression could serve as a biomarker to predict therapeutic response in patients with metastatic CRC.

    DOI: 10.1159/000494969

    PubMed

  59. Invasive ductal carcinoma arising in mucinous cystic neoplasm of pancreas: A case report

    Sawai H., Kurimoto M., Koide S., Kiriyama Y., Haba S., Matsuo Y., Morimoto M., Koide H., Kamiya A., Yamao K.

    American Journal of Case Reports   Vol. 20   page: 242 - 247   2019

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    Objective: Rare co-existance of disease or pathology Background: Mucinous cystic neoplasm (MCN) of the pancreas is a rare mucin-producing cystic neoplasm that has a characteristic histological feature referred to as ovarian-type stroma (OS) underlying the epithelium. Pancreatic ductal carcinoma arises from MCN as a precursor lesion, but data on progression pathways are limited. Case Report: A 40-year-old female was referred to our hospital for further investigation of a pancreatic cyst. Further examination showed a 7.0 cm multilocular cyst in the pancreatic tail and a solid mass in the thick septum of the cystic tumor. Distal pancreatectomy and splenectomy were performed. Histological examination revealed a moderately differentiated invasive ductal carcinoma (IDC) with a diameter of 0.5 cm in the thick septum of the cystic lesion and a cyst wall composed of epithelium with low-grade to severe dysplasia. The epithelium covered an OS. Pathological diagnosis was IDC arising in MCN of the pancreas. Immunohistochemical examination showed that MUC1 expression was negative in MCN but positive in IDC. KRAS mutation was observed in both MCN and IDC regions. Conclusions: We present a rare case of moderately differentiated pancreatic IDC arising in MCN. To elucidate the underlying progression pathway, we explored the correlation between KRAS mutation and MUC expression as a clinicopathological parameter.

    DOI: 10.12659/AJCR.914092

    Scopus

  60. Intestinal dysbiosis mediates experimental autoimmune pancreatitis via activation of plasmacytoid dendritic cells Reviewed International journal

    Kamata K, Watanabe T, Minaga K, Hara A, Yoshikawa T, Okamoto A, Yamao K, Takenaka M, Park A, Kudo M

    Int Immunol   Vol. 31 ( 12 ) page: 795 - 809   2019

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    Autoimmune pancreatitis (AIP) is a pancreatic manifestation of a newly proposed disease entity, IgG4-related disease (IgG4-RD), characterized by enhanced IgG4 antibody responses and involvement of multiple organs. We have previously reported that innate immune activation contributes to the development of AIP and IgG4-RD, as these diseases are characterized by the production of IFN-α and IL-33 by plasmacytoid dendritic cells (pDCs) that mediate chronic fibroinflammatory responses. In this study, we investigated the roles played by innate immunity against intestinal microflora in experimental AIP induced in MRL/MpJ mice by repeated administrations of 100 µg of polyinosinic-polycytidylic acid [poly (I:C)]. Bowel sterilization with a broad spectrum of antibiotics inhibited pancreatic accumulation of pDCs producing IFN-α and IL-33, and thereby suppressed the development of AIP. Mice treated with 10 µg of poly (I:C) developed severe AIP equivalent to that induced by 100 µg of poly (I:C) upon co-housing with mice treated with 100 µg of poly (I:C). Fecal microbiota transplantation (FMT) from donor mice treated with 100 µg of poly (I:C) led to the development of severe AIP in the recipient mice upon injection with 10 µg of poly (I:C). Induction of severe AIP in mice with 10 µg of poly (I:C) was associated with pancreatic accumulation of pDCs producing IFN-α and IL-33 in the co-housing and FMT experiments. These data collectively suggest that innate immune responses against intestinal microflora are involved in the development of experimental AIP, and that intestinal dysbiosis increases sensitivity to experimental AIP via activation of pDCs.

    DOI: 10.1093/intimm/dxz050

    PubMed

  61. 膵管内乳頭粘液性腫瘍術後フォローアップにおけるEUSの有用性 Reviewed

    鎌田 研, 竹中 完, 三長 孝輔, 大本 俊介, 宮田 剛, 山雄 健太郎, 今井 元, 中井 敦史, 田中 秀和, 千葉 康敬, 渡邉 智裕, 櫻井 俊治, 西田 直生志, 筑後 考章, 松本 逸平, 竹山 宜典, 北野 雅之, 工藤 正俊

      Vol. 61 ( 4 ) page: 417 - 426   2019

  62. A Novel Diagnostic Method to Detect Aberrant DNA Methylation in cfDNA of Pancreas Cancer Patients

    Shinjo Keiko, Katsushima Keisuke, Nagae Genta, Aburatani Hiroyuki, Yamao Kenji, Kondo Yutaka

    CANCER SCIENCE   Vol. 109   page: 205 - 205   2018.12

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  63. 【EUSによる消化管疾患の診断-現状と最新の話題】造影ハーモニックEUSによる消化管粘膜下腫瘍の診断

    鎌田 研, 竹中 完, 石川 嶺, 吉川 智恵, 岡本 彩那, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 櫻井 俊治, 松井 繁長, 渡邉 智裕, 西田 直生志, 樫田 博史, 工藤 正俊

    胃と腸   Vol. 53 ( 13 ) page: 1795 - 1799   2018.12

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    <文献概要>EUSは上部消化管粘膜下腫瘍(SMT)の診断に用いられているが,上部消化管SMTの良悪性鑑別には限界がある.本稿では,造影ハーモニックEUSによる上部消化管粘膜下腫瘍の診断に関する前向き研究1報と後ろ向き研究6報の合計7報の研究をもとに上部消化管SMTの鑑別診断について調べた.造影ハーモニックEUSによるGISTとそれ以外の上部消化管SMTの鑑別診断に関する3つの報告では,hyper-enhancementがGISTの造影ハーモニックEUS所見であり,診断能は感度84.5〜100%,特異度73.3〜100%であった.一方,low-grade malignancy GISTとhigh-grade malignancy GISTの鑑別診断に関する4つの報告では,造影ハーモニックEUSによるhigh-grade malignancy GISTの診断能は感度53.8〜100%,特異度63〜100%であった.またhigh-grade malignancy GISTでは造影ハーモニックEUSにおいてirregular vesselsが高率に認められた.hyper-enhancementか否かおよびirregular vesselsの有無を確認することで上部消化管SMTの鑑別診断が可能であることが示唆された.

  64. Novel metallic stent designed for endoscopic bilateral stent-in-stent placement in patients with hilar malignant biliary obstruction. Reviewed International journal

    Takenaka M, Yamao K, Minaga K, Nakai A, Omoto S, Kamata K, Kudo M

    Endoscopy   Vol. 51 ( 2 ) page: E30 - E31   2018.11

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    DOI: 10.1055/a-0767-6143

    PubMed

  65. EUS施行時の鎮静に対するBISモニターの有用性の検討

    岡本 彩那, 鎌田 研, 竹中 完, 石川 嶺, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 60 ( Suppl.2 ) page: 2126 - 2126   2018.10

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  66. 膵癌の門脈浸潤診断における造影ハーモニックEUSと造影CTの診断能の比較検討

    中井 敦史, 鎌田 研, 竹中 完, 石川 嶺, 岡本 彩那, 大本 俊介, 三長 孝輔, 山雄 健太郎, 兵頭 朋子, 松本 逸平, 竹山 宜典, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 60 ( Suppl.2 ) page: 2126 - 2126   2018.10

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  67. 術前水平方向進展度診断にSpyGlass DSが有用であった遠位胆管癌の2例

    東原 久美, 三長 孝輔, 岡本 彩那, 榎木 英介, 石川 嶺, 中井 敦史, 大本 俊介, 鎌田 研, 山雄 健太郎, 竹中 完, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 60 ( Suppl.2 ) page: 2153 - 2153   2018.10

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  68. Molecular Scoring of Hepatocellular Carcinoma for Predicting Metastatic Recurrence and Requirements of Systemic Chemotherapy.

    Nishida N, Nishimura T, Kaido T, Minaga K, Yamao K, Kamata K, Takenaka M, Ida H, Hagiwara S, Minami Y, Sakurai T, Watanabe T, Kudo M

    Cancers   Vol. 10 ( 10 )   2018.9

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    DOI: 10.3390/cancers10100367

    PubMed

  69. Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of localized gallbladder lesions

    Ken Kamata, Mamoru Takenaka, Masayuki Kitano, Shunsuke Omoto, Takeshi Miyata, Kosuke Minaga, Kentaro Yamao, Hajime Imai, Tosiharu Sakurai, Naoshi Nishida, Hiroshi Kashida, Takaaki Chikugo, Yasutaka Chiba, Takuya Nakai, Yoshifumi Takeyama, Andrea Lisotti, Pietro Fusaroli, Masatoshi Kudo

    Gastroenterological Endoscopy   Vol. 60   page: 1611 - 1620   2018.9

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    Copyright© 2018 Japan Gastroenterological Endoscopy Society. All rights reserved. Background and Aim: Differential diagnosis of localized gallbladder lesions is challenging. The aim of the present study was to evaluate the utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for diagnosis of localized gallbladder lesions. Methods: One hundred and twenty-five patients with localized gallbladder lesions were evaluated by CH-EUS between March 2007 and February 2014. This was a single-center retrospective study. Utilities of fundamental B-mode EUS (FB-EUS) and CH-EUS in the differentiation of gallbladder lesions and sludge plug were initially compared. Thereafter, these two examinations were compared with respect to their accuracy in the diagnosis of malignant lesions. Five reviewers blinded to the clinicopathological results evaluated microcirculation patterns in the vascular and perfusion images. Results: In the differentiation between gallbladder lesions and sludge plug, FB-EUS had a sensitivity, specificity, and accuracy of 82%, 100%, and 95%, respectively, whereas CH-EUS had a sensitivity, specificity, and accuracy of 100%, 99%, and 99%, respectively. FB-EUS-based diagnosis of carcinomas based on tumor size and/or shape had a sensitivity, specificity, and accuracy of 61-87%, 71-88%, and 74-86%, respectively. Additional information regarding irregular vessel patterns in the vascular image and/or heterogeneous enhancement in the perfusion image on CH-EUS increased the sensitivity, specificity, and accuracy for the diagnosis of carcinomas to 90%, 98 %, and 96%, respectively. There was a significant difference between FB-EUS and CH-EUS in terms of carcinoma diagnosis. Conclusion: CH-EUS was useful for the evaluation of localized gallbladder lesions.

    DOI: 10.11280/gee.60.1611

    Scopus

  70. Cystic duct antegrade stenting for cholangitis after the long-term deployment of lumen-apposing metal stents for calculous cholecystitis.

    Kamata K, Takenaka M, Minaga K, Nakai A, Omoto S, Miyata T, Yamao K, Imai H, Sakurai T, Watanabe T, Nishida N, Kudo M

    Endoscopic ultrasound   Vol. 7 ( 5 ) page: 349 - 350   2018.9

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    DOI: 10.4103/eus.eus_91_17

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  71. A novel method of biliary cannulation for patients with Roux-en-Y anastomosis using a unique, uneven, double lumen cannula (Uneven method). Reviewed

    Takenaka M, Yamao K, Kudo M

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   Vol. 30 ( 6 ) page: 808 - 809   2018.8

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    DOI: 10.1111/den.13253

    PubMed

  72. Neurilemmoma Mimicking a Multilocular Cystic Lesion of the Liver: A Case Report. Reviewed

    Yoshida A, Yamao K, Takenaka M, Nakai A, Omoto S, Kamata K, Minaga K, Miyata T, Imai H, Matsumoto I, Takeyama Y, Chikugo T, Kudo M

    Internal medicine (Tokyo, Japan)   Vol. 57 ( 23 ) page: 3377 - 3380   2018.8

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    Neurilemmomas are benign tumors arising from the sheaths of peripheral nerves. They appear rarely in the abdominal cavity. We herein report an 80-year-old man with a multilocular cystic neurilemmoma mimicking a liver lesion. Preoperative images showed a lesion in the porta hepatis. Although a preoperative diagnosis was difficult, surgery was undertaken because of the possibility of malignancy. Histologically, the tumor consisted of spindle-shaped cells with positivity for S-100 protein. The final diagnosis was a neurilemmoma. Porta hepatic neurilemmomas are rare. When we encounter a multilocular cystic lesion of the liver, neurilemmoma should be considered in the differential diagnosis.

    DOI: 10.2169/internalmedicine.0881-18

    PubMed

  73. 肝外胆管癌における造影ハーモニックEUSの有用性についての検討

    大塚 康生, 鎌田 研, 竹中 完, 石川 嶺, 岡本 彩那, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 筑後 孝章, 兵頭 朋子, 中居 卓也, 竹山 宜典, 工藤 正俊

    胆道   Vol. 32 ( 3 ) page: 567 - 567   2018.8

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  74. Development of a sensitive method to detect aberrant DNA methylation in cfDNA for pancreas cancer diagnosis

    Shinjo Keiko, Katsushima Keisuke, Suzuki Miho, Nagae Genta, Aburatani Hiroyuki, Yamao Kenji, Kondo Yutaka

    CANCER RESEARCH   Vol. 78 ( 13 )   2018.7

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  75. A MULTICENTER PROSPECTIVE STUDY OF EUS-GUIDED HEPATICOGASTROSTOMY COMBINED WITH ANTEGRADE STENT PLACEMENT Reviewed

    Ogura Takeshi, Kitano Masayuki, Takenaka Mamoru, Minaga Kosuke, Yamao Kentaro, Yamashita Yukitaka, Hatamaru Keiichi, Noguchi Chishio, Kuroda Taira, Nishikiori Hidefumi, Higuchi Kazuhide, Chiba Yasutaka

    GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page: AB146   2018.6

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  76. NEW METHOD FOR DIFFICULT BILIARY CANNULATION USING THE NOVEL UNEVEN DOUBLE LUMEN CANNULA (DLC METHOD) Reviewed

    Takenaka Mamoru, Nakai Atsushi, Omoto Shunsuke, Miyata Takeshi, Minaga Kosuke, Kamata Ken, Yamao Kentaro, Imai Hajime, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page: AB209 - AB210   2018.6

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  77. THE EFFICIENCY AND SAFETY OF ENDOSCPIC SPHINCTEROTOMY TO PREVENT POST-ERCP PANCREATITIS IN BILIARY NEOPLASM; A MULTICENTER RETROSPECTIVE COHORT STUDY Reviewed

    Tamura Takashi, Itonaga Masahiro, Yamao Kentaro, Imanishi Miyuki, Minaga Kosuke, Hirono Seiko, Okada Ken-ichi, Higuchi Kazuhide, Takenaka Mamoru, Ogura Takeshi, Yamaue Hiroki, Kitano Masayuki

    GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page: AB227 - AB228   2018.6

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  78. 膵NETの最新の画像診断と治療 造影ハーモニックEUSによる膵神経内分泌腫瘍の悪性度評価

    石川 嶺, 鎌田 研, 竹中 完, 田中 秀和, 中井 敦史, 大本 俊介, 宮田 剛, 三長 孝輔, 山雄 健太郎, 今井 元, 工藤 正俊

    膵臓   Vol. 33 ( 3 ) page: 346 - 346   2018.5

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  79. 造影ハーモニックEUSは膵癌の術前治療の効果判定に有用か?

    田中 秀和, 鎌田 研, 竹中 完, 石川 嶺, 中井 敦史, 大本 俊介, 三長 孝輔, 宮田 剛, 山雄 健太郎, 今井 元, 工藤 正俊

    膵臓   Vol. 33 ( 3 ) page: 505 - 505   2018.5

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  80. 造影ハーモニックEUSによる膵癌の門脈浸潤診断の検討

    中井 敦史, 鎌田 研, 大本 俊介, 宮田 剛, 三長 孝輔, 山雄 健太郎, 今井 元, 竹中 完, 樫田 博史, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 60 ( Suppl.1 ) page: 738 - 738   2018.4

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  81. Endoscopic Ultrasound-Guided Rendezvous Technique for Failed Biliary Cannulation in Benign and Resectable Malignant Biliary Disorders. Reviewed

    Shiomi H, Yamao K, Hoki N, Hisa T, Ogura T, Minaga K, Masuda A, Matsumoto K, Kato H, Kamada H, Goto D, Imai H, Takenaka M, Noguchi C, Nishikiori H, Chiba Y, Kutsumi H, Kitano M

    Digestive diseases and sciences   Vol. 63 ( 3 ) page: 787 - 796   2018.3

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    DOI: 10.1007/s10620-018-4908-8

    PubMed

  82. Multicenter prospective evaluation study of endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting (with video). Reviewed

    Ogura T, Kitano M, Takenaka M, Okuda A, Minaga K, Yamao K, Yamashita Y, Hatamaru K, Noguchi C, Gotoh Y, Kuroda T, Yokota T, Nishikiori H, Sagami R, Higuchi K, Chiba Y

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   Vol. 30 ( 2 ) page: 252 - 259   2018.3

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    DOI: 10.1111/den.12976

    PubMed

  83. 十二指腸穿破をきたした正中球状靱帯症候群による膵十二指腸動脈瘤の一例

    高島 耕太, 大本 俊介, 三長 孝輔, 竹中 完, 中井 敦史, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 米田 頼晃, 松井 繁長, 工藤 正俊

    日本消化器病学会雑誌   Vol. 115 ( 臨増総会 ) page: A355 - A355   2018.3

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  84. 膵体部の膵神経内分泌腫瘍に合併した膵性胸水の一例

    河野 辰哉, 山雄 健太郎, 中井 敦史, 大本 俊介, 鎌田 研, 三長 孝輔, 宮田 剛, 今井 元, 松本 逸平, 竹山 宜典, 田中 伴典, 筑後 孝章, 林 暁洋, 工藤 正俊

    日本消化器病学会雑誌   Vol. 115 ( 臨増総会 ) page: A395 - A395   2018.3

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  85. Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis. Reviewed International journal

    Minaga K, Takenaka M, Kamata K, Yoshikawa T, Nakai A, Omoto S, Miyata T, Yamao K, Imai H, Sakamoto H, Kitano M, Kudo M

    Cancers   Vol. 10 ( 2 )   2018.2

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    The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation.

    DOI: 10.3390/cancers10020050

    PubMed

  86. A case of successful transluminal drainage of walled-off necrosis under contrast-enhanced harmonic endoscopic ultrasonography guidance Reviewed

    Minaga K, Takenaka M, Omoto S, Miyata T, Kamata K, Yamao K, Imai H, Watanabe T, Kitano M, Kudo M

    J Med Ultrason   Vol. 45 ( 1 ) page: 161 - 165   2018

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    We report a case of successful transluminal drainage of walled-off necrosis (WON) under contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) guidance. Recently, EUS-guided transluminal drainage (EUS-TD) of WON has been increasingly used as a minimally invasive treatment option with reportedly high technical and clinical success rates; however, B-mode EUS occasionally fails to depict the target lesion and its margins, particularly in cases where the target shows a heterogeneous echogenicity. In our case, EUS-TD was attempted for infected WON, but visualization using B-mode EUS imaging was poor. Thus, CH-EUS was performed to enhance the contrast between the targeted WON and its surrounding tissues. Immediately after injecting a sonographic contrast agent, WON and its margins were clearly identified as an avascular area and were punctured under CH-EUS guidance. CH-EUS enables the assessment of the microvasculature and hemodynamics of the target lesion in real time. It may also provide valuable information and could be a useful modality for EUS-TD to clearly visualize target lesions and their margins and to decisively puncture them, even when they could not be identified using B-mode EUS.

    DOI: 10.1007/s10396-017-0784-7

    PubMed

  87. Dysbiosis-Associated Polyposis of the Colon—Cap Polyposis Reviewed International journal

    Okamoto K, Watanabe T, Komeda Y, Okamoto A, Minaga K, Kamata K, Yamao K, Takenaka M, Hagiwara S, Sakurai T, Tanaka M, Sakamoto H, Fujimoto K, Kudo M

    Front. Immunol   Vol. 9   page: 918 - 922   2018

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    Cap polyposis is a rare gastrointestinal disease characterized by multiple inflammatory polyps located between the distal colon and the rectum. Despite the lack of clarity regarding its pathogenesis, mucosal prolapse, chronic inflammatory responses, and Helicobacter pylori infection are considered key contributors to the development of this disease entity. Although it is now generally accepted that dysbiosis of gut microbiota is associated with intestinal and extra-intestinal diseases, alterations of intestinal microbiota have been poorly defined in cap polyposis. Here, we report a patient with H. pylori-negative cap polyposis who was successfully treated with antibiotics and exhibited dramatic alterations in intestinal microbiota composition after antibiotic treatment. The patient was treated with oral administration of ampicillin and metronidazole and showed regression of cap polyposis 6 months after antibiotic treatment. Fecal microbiota analysis using the next-generation sequencing technology revealed a significant alteration in the intestinal microbiota composition following antibiotic treatment-a marked reduction of Blautia, Dorea, and Sutterella was observed concomitant with a marked increase in Fusobacterium. These data suggest that cap polyposis may originate from dysbiosis and that microbiome-targeted therapy may be useful in this disorder.

    DOI: 10.3389/fimmu.2018.00918

    PubMed

  88. Cystic duct antegrade stenting for cholangitis after the long-term deployment of lumen-apposing metal stents for calculous cholecystitis Reviewed

    Kamata K, Takenaka M, Minaga K, Nakai A, Omoto S, Miyata T, Yamao K, Imai H, Sakurai T, Watanabe T, Nishida N, Kudo M

    Endosc Ultrasound   Vol. 7 ( 5 ) page: 349 - 350   2018

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    DOI: 10.4103/eus.eus_91_17.

  89. Erythropoietic Protoporphyria-related Hepatopathy Successfully Treated with Phlebotomy.

    Akihiro Yoshida, Satoru Hagiwara, Tomohiro Watanabe, Naoshi Nishida, Hiroshi Ida, Toshiharu Sakurai, Yoriaki Komeda, Kentaro Yamao, Mamoru Takenaka, Eisuke Enoki, Masatomo Kimura, Masako Miyake, Akira Kawada, Masatoshi Kudo

    Internal medicine (Tokyo, Japan)   Vol. 57 ( 17 ) page: 2505 - 2509   2018

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    A 27-year-old man bearing an erythropoietic protoporphyria (EPP)-associated ferrochelatase (FECH) mutation was admitted to our hospital for general malaise and marked elevation of the serum levels of hepatobiliary enzymes and bilirubin. Initial treatment with plasma exchange did not reduce the blood protoporphyrin or serum liver enzyme levels, so phlebotomy was started. Surprisingly, weekly phlebotomy normalized the serum levels of liver enzymes, accompanied by a marked reduction in the blood protoporphyrin levels. The clinical course of this case strongly suggests that phlebotomy may be a suitable treatment option for EPP-related hepatopathy.

    DOI: 10.2169/internalmedicine.0673-17

    PubMed

  90. "Molecular scoring of hepatocellular carcinoma for predicting metastatic recurrence and requirements of systemic chemotherapy" Reviewed

    Nishida N, Nishimura T, Kaido T, Minaga K, Yamao K, Kamata K, Takenaka M, Ida H, Hagiwara S,MinamiY, Sakurai T, Watanabe T, Kudo M

    Cancers   Vol. 10   page: 367 - 367   2018

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    DOI: 10.3390/cancers10100367.

  91. Value of additional endoscopic ultrasonography for surveillance after surgical removal of intraductal papillary mucinous neoplasms. Reviewed International journal

    Kamata K, Takenaka M, Minaga K, Omoto S, Miyata T, Yamao K, Imai H, Nakai A, Tanaka H, Chiba Y, Watanabe T, Sakurai T, Nishida N, Chikugo T, Matsumoto I, Takeyama Y, Kitano M, Kudo M

    Dig Endosc   Vol. 30 ( 5 ) page: 659 - 666   2018

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    BACKGROUND AND AIM: This study evaluated the utility of endoscopic ultrasonography (EUS) combined with contrast-enhanced harmonic EUS (CH-EUS) for surveillance of the remnant pancreas after surgery for intraductal papillary mucinous neoplasm (IPMN). METHODS: This was a single-center, retrospective, descriptive study. A total of 134 consecutive patients who underwent surgical resection for IPMN between April 2009 and March 2015 were evaluated. Rates of recurrence and development of IPMN-concomitant pancreatic ductal adenocarcinoma (PDAC) during follow up were assessed. Clinical findings of patients with recurrence or development of PDAC were also evaluated. RESULTS: Of 134 resected IPMN 56 (41.8%) and 78 (58.2%) were classified as benign and malignant, respectively. Patients were followed up for a median of 29 months, 33 (24.6%) by both contrast-enhanced computed tomography (CE-CT) and EUS, and 101 (75.4%) by computed tomography (CT) alone. Thirteen patients (9.7%) showed tumor recurrence, five with intra-pancreatic recurrence and eight with extra-pancreatic metastases. An enhancing mural nodule within the dilated main pancreatic duct was successfully detected by EUS in one patient, but not by CE-CT. Two patients developed IPMN-concomitant PDAC during follow up. EUS combined with CH-EUS successfully detected small IPMN-concomitant PDAC in two patients, whereas these lesions were not detected by CT. CH-EUS was useful for better visualization of the margins of IPMN-concomitant PDAC in one of these two patients. CONCLUSION: Endoscopic ultrasonography combined with CH-EUS may improve follow up of patients with resected IPMN.

    DOI: 10.1111/den.13176

    PubMed

  92. Endoscopic ultrasound-guided biliary drainage using a newly designed metal stent with a thin delivery system: a preclinical study in phantom and porcine models. Reviewed

    Minaga K, Kitano M, Itonaga M, Imai H, Miyata T, Yamao K, Tamura T, Nuta J, Warigaya K, Kudo M

    Journal of medical ultrasonics (2001)   Vol. 45 ( 3 ) page: 391 - 397   2017.12

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    DOI: 10.1007/s10396-017-0850-1

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  93. Comparative evaluation of new and conventional classifications of magnifying endoscopy with narrow band imaging for invasion depth of superficial esophageal squamous cell carcinoma

    Fujiyoshi T., Tajika M., Tanaka T., Ishihara M., Mizuno N., Hara K., Hijioka S., Imaoka H., Yatabe Y., Hirooka Y., Goto H., Yamao K., Niwa Y.

    DISEASES OF THE ESOPHAGUS   Vol. 30 ( 11 ) page: 1 - 8   2017.11

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    A new classification of magnifying endoscopy with narrow band imaging (ME-NBI) for diagnosing and staging superficial esophageal squamous cell carcinoma (SESCC) was proposed by the Japan Esophageal Society in 2011. This study aimed to compare the new classification with the conventional classifications (Inoue's classification and Arima's classification). This was a prospective analysis of data from a single cancer center involving 151 consecutive patients with 156 SESCCs that were endoscopically or surgically resected. Initially, only ME-NBI images were selected and reviewed independently by three experienced endoscopists. White light imaging (WLI) was then evaluated separately after an interval. The diagnostic performance of each classification and interobserver agreement were assessed, and the WLI findings that affect the diagnosis by the new classification were identified. The specificity for classifying invasive depth as epithelium (EP)/lamina propria mucosae (LPM) confined was higher with the new classification than with Inoue's classification (0.512 vs. 0.349; P = 0.02) and Arima's classification (0.512 vs. 0.279; P < 0.01). However, the sensitivity was lower (0.902 vs. 1.000; P < 0.01) compared with Arima's classification. The concordance rates of three evaluators (κ values) were 0.52 for the new classification, 0.50 for Inoue's classification, and 0.23 for Arima's classification. On multivariate analysis, thickness on WLI independently affected the accuracy of diagnosis with the new classification (OR 3.23; 95%CI, 1.30-8.03). The new classification is superior to conventional classifications with respect to specificity for diagnosing SESCC with depth EP/LPM. Thickness on WLI was a factor negatively affecting the diagnostic performance of the new classification.

    DOI: 10.1093/dote/dox037

    Web of Science

    Scopus

  94. Endoscopic ultrasound-guided choledochoduodenostomy with novel use of contrast-enhanced harmonic imaging. Reviewed International journal

    Minaga K, Takenaka M, Kamata K, Miyata T, Yamao K, Imai H, Kudo M

    Endoscopy   Vol. 49 ( 11 ) page: E281 - E282   2017.11

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    DOI: 10.1055/s-0043-117939

    PubMed

  95. 膵炎における腸管免疫機構破綻と重症化機序

    渡邉智裕, 三長孝輔, 鎌田研, 山雄健太郎, 竹中完, 工藤正俊

    肝•胆•膵   Vol. 75 ( 5 ) page: 991 - 996   2017.11

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  96. EUS-guided approaches for bile duct stones: A single-center experience Reviewed

    Minaga Kosuke, Takenaka Mamoru, Kamata Ken, Miyata Takeshi, Yamao Kentaro, Imai Hajime, Omoto Shunsuke, Nakai Atsushi, Yoshikawa Tomoe, Watanabe Tomohiro, Kudo Masatoshi

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   Vol. 32   page: 240   2017.9

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  97. Achievement of long-term stent patency in endoscopic ultrasonography-guided right bile duct drainage after left hepatic lobectomy (with video). Reviewed

    Minaga K, Takenaka M, Miyata T, Yamao K, Kamata K, Kitano M, Kudo M

    Endoscopic ultrasound   Vol. 6 ( 6 ) page: 412 - 413   2017.7

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    DOI: 10.4103/eus.eus_9_17

    PubMed

  98. Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of localized gallbladder lesions. Reviewed International journal

    Kamata K, Takenaka M, Kitano M, Omoto S, Miyata T, Minaga K, Yamao K, Imai H, Sakurai T, Nishida N, Kashida H, Chikugo T, Chiba Y, Nakai T, Takeyama Y, Lisotti A, Fusaroli P, Kudo M

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   Vol. 30 ( 1 ) page: 98 - 106   2017.6

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    BACKGROUND AND AIM: Differential diagnosis of localized gallbladder lesions is challenging. The aim of the present study was to evaluate the utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for diagnosis of localized gallbladder lesions. METHODS: One hundred and twenty-five patients with localized gallbladder lesions were evaluated by CH-EUS between March 2007 and February 2014. This was a single-center retrospective study. Utilities of fundamental B-mode EUS (FB-EUS) and CH-EUS in the differentiation of gallbladder lesions and sludge plug were initially compared. Thereafter, these two examinations were compared with respect to their accuracy in the diagnosis of malignant lesions. Five reviewers blinded to the clinicopathological results evaluated microcirculation patterns in the vascular and perfusion images. RESULTS: In the differentiation between gallbladder lesions and sludge plug, FB-EUS had a sensitivity, specificity, and accuracy of 82%, 100%, and 95%, respectively, whereas CH-EUS had a sensitivity, specificity, and accuracy of 100%, 99%, and 99%, respectively. FB-EUS-based diagnosis of carcinomas based on tumor size and/or shape had a sensitivity, specificity, and accuracy of 61-87%, 71-88%, and 74-86%, respectively. Additional information regarding irregular vessel patterns in the vascular image and/or heterogeneous enhancement in the perfusion image on CH-EUS increased the sensitivity, specificity, and accuracy for the diagnosis of carcinomas to 90%, 98%, and 96%, respectively. There was a significant difference between FB-EUS and CH-EUS in terms of carcinoma diagnosis. CONCLUSION: CH-EUS was useful for the evaluation of localized gallbladder lesions.

    DOI: 10.1111/den.12900

    PubMed

  99. EUS下ドレナージを行った急性閉塞性化膿性胆管炎をきたした総胆管結石の1例

    三長 孝輔, 大本 俊介, 門阪 薫平, 松田 友彦, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 北野 雅之, 工藤 正作

    和歌山医学   Vol. 68 ( 2 ) page: 88 - 88   2017.6

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  100. Optimal intake of clear liquids during preparation for afternoon colonoscopy with low-volume polyethylene glycol plus ascorbic acid

    Tajika Masahiro, Tanaka Tsutomu, Ishihara Makoto, Hirayama Yutaka, Oonishi Sachiyo, Mizuno Nobumasa, Hara Kazuo, Hijioka Susumu, Imaoka Hiroshi, Fujiyoshi Toshihisa, Hieda Nobuhiro, Okuno Nozomi, Yoshida Tsukasa, Yamao Kenji, Bhatia Vikram, Ando Masahiko, Niwa Yasumasa

    ENDOSCOPY INTERNATIONAL OPEN   Vol. 5 ( 6 ) page: E416 - E423   2017.6

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    DOI: 10.1055/s-0043-106185

    Web of Science

  101. Impact of avascular areas, as measured by contrast-enhanced harmonic EUS, on the accuracy of fine-needle aspiration for pancreatic adenocarcinoma. Reviewed International journal

    Kamata K, Takenaka M, Omoto S, Miyata T, Minaga K, Yamao K, Imai H, Sakurai T, Nishida N, Chikugo T, Chiba Y, Matsumoto I, Takeyama Y, Kudo M

    Gastrointestinal endoscopy   Vol. 87 ( 1 ) page: 158 - 163   2017.6

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    BACKGROUND AND AIMS: EUS-guided FNA (EUS-FNA) is used for the diagnosis of pancreatic adenocarcinoma, but sometimes the method results in a false negative. Occasionally, an avascular area may be observed within the pancreatic adenocarcinoma tumor during contrast-enhanced harmonic EUS (CH-EUS). The aim of this study was to evaluate whether the diagnostic sensitivity of EUS-FNA for pancreatic adenocarcinoma was affected by the presence of avascularity on CH-EUS. METHODS: Two hundred ninety-two patients with pancreatic adenocarcinoma who presented at Kindai University Hospital for EUS-FNA and CH-EUS between June 2009 and August 2013 were retrospectively evaluated. This was a single-center retrospective analysis of prospectively collected data held in a registry. The overall sensitivity of EUS-FNA for the diagnosis of pancreatic adenocarcinoma was calculated. The sensitivities of cytology, histology, and the combination of cytology and histology were also evaluated. These variables were individually evaluated according to the presence or absence of an avascular area on CH-EUS to assess whether the diagnostic sensitivity of EUS-FNA for pancreatic adenocarcinoma was related to the presence of an avascular area within the tumors. RESULTS: The overall sensitivity of EUS-FNA was 90.8% (265/292). The sensitivities of EUS-FNA for lesions with and without an avascular area were 72.9% (35/48) and 94.3% (230/244), respectively, with the difference being statistically significant (P < .001). CONCLUSIONS: EUS-FNA has lower sensitivity for pancreatic adenocarcinoma with avascular areas on CH-EUS.

    DOI: 10.1016/j.gie.2017.05.052

    PubMed

  102. Stent migration during EUS-guided hepaticogastrostomy in a patient with massive ascites: Troubleshooting using additional EUS-guided antegrade stenting. Reviewed International journal

    Kamata K, Takenaka M, Minaga K, Omoto S, Miyata T, Yamao K, Imai H, Kudo M

    Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology   Vol. 18 ( 2 ) page: 120 - 121   2017.6

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    EUS-guided hepaticogastrostomy (EUS-HGS) is useful for treating obstructive jaundice. However, stent migration may sometimes occur both during and after the procedure. This report describes a patient with pancreatic cancer and massive ascites who underwent EUS-HGS combined with EUS-guided antegrade stenting (EUS-AS), with additional EUS-AS playing a role in troubleshooting for stent migration during EUS-HGS.

    DOI: 10.1016/j.ajg.2017.05.016

    PubMed

  103. Improved Diagnosis of Liver Metastases Using Kupffer-Phase Image of Contrast-Enhanced Harmonic Endoscopic Ultrasonography in Patients With Pancreatic Cancer Reviewed

    Minaga Kosuke, Takenaka Mamoru, Kitano Masayuki, Imai Hajime, Yamao Kentaro, Kamata Ken, Miyata Takeshi, Omoto Shunsuke, Yoshikawa Tomoe, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 85 ( 5 ) page: AB53   2017.5

  104. Investigation on the Efficacy of Alteration of Treatment Methods for Difficult Cases in Eus-Bd Reviewed

    Minaga Kosuke, Takenaka Mamoru, Kitano Masayuki, Imai Hajime, Yamao Kentaro, Kamata Ken, Miyata Takeshi, Omoto Shunsuke, Yoshikawa Tomoe, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 85 ( 5 ) page: AB493   2017.5

  105. ソナゾイド造影EUSを用いた膵癌肝転移検出に関する検討

    三長 孝輔, 竹中 完, 北野 雅之, 中井 敦史, 大本 俊介, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 渡邉 智裕, 工藤 正俊

    膵臓   Vol. 32 ( 3 ) page: 552 - 552   2017.5

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  106. 超音波内視鏡を用いた膵疾患診療 基本から応用まで EUSガイド下神経ブロックの成績と治療効果予測因子の検討

    三長 孝輔, 竹中 完, 宮田 剛, 中井 敦史, 大本 俊介, 鎌田 研, 山雄 健太郎, 今井 元, 渡邉 智裕, 工藤 正俊

    膵臓   Vol. 32 ( 3 ) page: 329 - 329   2017.5

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  107. 膵疾患診療におけるERCPの役割を見直す 慢性膵炎に対する経乳頭的金属ステント留置、短期間抜去の有用性

    竹中 完, 大本 俊介, 三長 孝輔, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 工藤 正俊

    膵臓   Vol. 32 ( 3 ) page: 422 - 422   2017.5

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  108. 慢性膵炎の進展予防を目的とした治療 その適応と限界 早期慢性膵炎のEUS所見の妥当性、早期治療介入の意義について

    竹中 完, 大本 俊介, 三長 孝輔, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 工藤 正俊

    膵臓   Vol. 32 ( 3 ) page: 360 - 360   2017.5

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  109. 急性膵炎の後期合併症に対する手術・インターベンション治療の現状と課題 当院におけるWONに対するstep-up approachの検討

    竹中 完, 大本 俊介, 三長 孝輔, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 工藤 正俊

    膵臓   Vol. 32 ( 3 ) page: 377 - 377   2017.5

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  110. 慢性膵炎診断における超音波の役割 早期慢性膵炎EUS所見の臨床的意義について

    竹中 完, 大本 俊介, 三長 孝輔, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 樫田 博史, 工藤 正俊

    超音波医学   Vol. 44 ( Suppl. ) page: S242 - S242   2017.4

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  111. 造影ハーモニックEUSによる上部消化管粘膜下腫瘍の鑑別診断 EUS-FNA診断との併用

    鎌田 研, 竹中 完, 大本 俊介, 宮田 剛, 三長 孝輔, 山雄 健太郎, 今井 元, 筑後 孝章, 安田 卓司, 工藤 正俊

    超音波医学   Vol. 44 ( Suppl. ) page: S438 - S438   2017.4

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  112. 硬化性胆管炎と診断された膵癌、閉塞性黄疸の1例

    中井 敦史, 山雄 健太郎, 大本 俊介, 鎌田 研, 三長 孝輔, 宮田 剛, 今井 元, 竹中 完, 松本 逸平, 竹山 宜典, 筑後 孝章, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 59 ( Suppl.1 ) page: 1061 - 1061   2017.4

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  113. Endoscopic ultrasonography-guided choledochoduodenostomy using a newly designed laser-cut metal stent: Feasibility study in a porcine model. Reviewed International journal

    Minaga K, Kitano M, Gon C, Yamao K, Imai H, Miyata T, Kamata K, Omoto S, Takenaka M, Kudo M

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   Vol. 29 ( 2 ) page: 211 - 217   2017.3

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    BACKGROUND AND AIM: Endoscopic ultrasonography (EUS)-guided choledochoduodenostomy (EUS-CDS) is increasingly used in the treatment of malignant distal biliary obstruction. Standardized use of this technique requires improvements in instruments, including more convenient and safer devices. The present study was designed to evaluate the resistance force to migration (RFM) of a newly designed laser-cut metal stent and the feasibility of EUS-CDS using this stent. METHODS: This experimental study used a porcine model of biliary dilatation involving five male pigs. The new stent is a fully covered laser-cut stent with anti-migration anchoring hooks. The RFM of the new stents was compared with those of three commercially available covered metal stents using a phantom model. In the animal study, after ligation of Vater's ampulla with endoscopic clips, the dilated common bile duct was punctured under EUS guidance, followed by EUS-CDS using the new stent. One week after the procedure, the stents were removed endoscopically and the fistulas were assessed after the pigs were killed. Technical feasibility and clinical outcomes were evaluated. RESULTS: Among the four stents, the new stent had the highest RFM. Metal stent placement was successful in all five pigs, with no procedure-related complications occurring during and 1 week after endoscopic intervention. All stents remained in place without migration and were removed easily using a snare. At necropsy, fistulas were created between the bile duct and duodenum in all pigs. CONCLUSION: EUS-CDS using a newly designed metal stent was feasible and effective in this porcine model of biliary dilatation.

    DOI: 10.1111/den.12741

    PubMed

  114. A Case of Pancreatic Carcinoma in situ Diagnosed by Repeated Pancreatic Juice Cytology. Reviewed International journal

    Miyata T, Takenaka M, Omoto S, Kamata K, Minaga K, Yamao K, Imai H, Kudo M

    Oncology   Vol. 93 Suppl 1   page: 98 - 101   2017

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    Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage (ENPD) has a high diagnostic yield and might be useful for the diagnosis of early-stage pancreatic cancer. A 67-year-old man presented with a pancreatic cyst occasionally detectable in the body of the pancreas by ultrasonography (US). No obvious pancreatic tumor was detected by US, computed tomography (CT), magnetic resonance cholangiopancreatography, and endoscopic ultrasound (EUS) (although the latter did reveal a weak, low echoic area). Endoscopic retrograde pancreatography showed irregular narrowing of the main pancreatic duct (MPD) at the pancreatic body. Pancreatic juice cytology was also performed, but did not give evidence of a malignancy. Therefore, the patient was followed up. CT and EUS performed after 3 months showed the same findings as did endoscopic retrograde pancreatography; however, the results of repeated pancreatic juice cytology performed via ENPD tube revealed a suspected malignancy on 2 of 6 occasions. Therefore, we performed a central pancreatectomy. Histopathological examination of a resected specimen revealed carcinoma in situ in the narrow MPD at the body of the pancreas. In the current case, repeated pancreatic juice cytology via ENPD was effective. A weak low echoic area around the MPD stricture on EUS might be related to the inflammatory change accompanying carcinoma in situ of the pancreas.

    DOI: 10.1159/000481240

    PubMed

  115. Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of submucosal tumors of the upper gastrointestinal tract Reviewed International journal

    Kamata K, Takenaka M, Kitano M, Omoto S, Miyata T, Minaga K, Yamao K, Imai H, Sakurai T, Watanabe T, Nishida N, Chikugo T, Chiba Y, Imamoto H, Yasuda T, Lisotti A, Fusaroli P, Kudo M

    J Gastroenterol Hepatol   Vol. 32 ( 10 ) page: 1686 - 1692   2017

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    BACKGROUND AND AIM: The study aims to evaluate contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for the differential diagnosis of submucosal tumors (SMT) of the upper gastrointestinal tract. METHODS: Between June 2008 and May 2015, 157 consecutive patients with submucosal lesions of the upper gastrointestinal tract were evaluated by CH-EUS. This was a single-center retrospective analysis of prospectively collected data in a registry. The data from 73 patients who later underwent surgical resection were analyzed in this study. Surgical specimens served as the final diagnoses. The two CH-EUS variables of blood flow (hyper-enhancement vs hypo-enhancement) and homogeneity of enhancement pattern were evaluated. RESULTS: The final diagnoses were 58 gastrointestinal stromal tumors (GISTs) and 15 benign SMTs (two lipomas, five leiomyomas, five schwannomas, two glomus tumors, and one ectopic pancreas). On CH-EUS, 49 of 58 (84.5%) GISTs presented with hyper-enhancement, whereas 4 of 15 (26.7%) benign SMTs showed hyper-enhancement; 21 of 58 (36.2%) GISTs showed inhomogeneous contrast enhancement, while only 2 of 15 (13.3%) benign SMTs demonstrated inhomogeneous contrast enhancement. If hyper-enhancement was considered to indicate GISTs, the sensitivity, specificity, and accuracy were 84.5%, 73.3%, and 82.2%, respectively. If inhomogeneous enhancement was considered to indicate GISTs, the sensitivity, specificity, and accuracy were 36.2%, 86.7%, and 46.6%, respectively. In lesions of less than 2 cm, hyper-enhancement was a more sensitive indicator of GISTs than inhomogeneous enhancement. CONCLUSIONS: Hyper-enhancement and inhomogeneous enhancement were found to be a characteristic of GISTs. CH-EUS was useful for discrimination of benign SMTs from GISTs.

    DOI: 10.1111/jgh.13766

    PubMed

  116. Comparative Study of Clarithromycin- versus Metronidazole-Based Triple Therapy as First-Line Eradication for Helicobacter pylori. Reviewed International journal

    Adachi T, Matsui S, Watanabe T, Okamoto K, Okamoto A, Kono M, Yamada M, Nagai T, Komeda Y, Minaga K, Kamata K, Yamao K, Takenaka M, Asakuma Y, Sakurai T, Nishida N, Kashida H, Kudo M

    Oncology   Vol. 93 Suppl 1   page: 15 - 19   2017

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    INTRODUCTION: Clarithromycin (CAM)-based triple therapy comprising proton pump inhibitors and amoxicillin is administered as first-line eradication treatment against Helicobacter pylori infection. However, the eradication rate achieved with CAM-based triple therapy has decreased to <80% owing to the emergence of CAM-resistant strains. This prospective randomized study aimed to compare the efficacy of CAM-based and metronidazole (MNZ)-based triple therapy in terms of H. pylori eradication. METHODS: H. pylori-positive patients were treated with CAM-based triple therapy comprising esomeprazole and amoxicillin (EAC group) or with MNZ-based triple therapy comprising esomeprazole and amoxicillin (EAM group). RESULTS: H. pylori eradication rates achieved in the intention-to-treat (ITT) and per protocol (PP) analyses were 70.6 and 72.7%, respectively, in the EAC group. Eradication rates obtained via ITT and PP analyses were 91.7 and 94.3%, respectively, in the EAM group. In the EAC group, eradication rates were significantly lower in patients harboring CAM-resistant strains than in those harboring CAM-sensitive strains. In contrast, eradication rates were comparable between patients harboring CAM-resistant strains and those harboring CAM-sensitive strains in the EAM group. CONCLUSION: MNZ-based triple therapy consisting of esomeprazole and amoxicillin is superior to CAM-based triple therapy containing esomeprazole and amoxicillin as first-line eradication treatment against H. pylori.

    DOI: 10.1159/000481224

    PubMed

  117. Clinical Significance of Bmi1 Expression in Inflammatory Bowel Disease International journal

    Yamada M, Sakurai T, Komeda Y, Nagai T, Kamata K, Minaga K, Yamao K, Takenaka M, Hagiwara S, Matsui S, Watanabe T, Nishida N, Kashida H, Kudo M

    Oncology   Vol. 93 ( Suppl 1 ) page: 20 - 26   2017

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    BACKGROUND: Although the stem cell marker Bmi1 is overexpressed in many malignancies, its role in inflammation-associated cancer is unclear. Colitis-associated cancer (CAC) is caused by chronic intestinal inflammation and often results from refractory inflammatory bowel disease (IBD). METHODS: To assess the involvement of Bmi1 in the development of CAC, we analyzed the gene expression of colon tissues collected from 111 patients with IBD and CAC. RESULTS: In the colonic mucosa of patients with ulcerative colitis, the expression of Bmi1 correlated significantly with the expression of inflammatory cytokines such as IL-6, IL-17, IL-23, and tumor necrosis factor α (TNF-α). In the colonic mucosa of patients with Crohn's disease, the expression of Bmi1 correlated significantly with the expression of TNF-α and IL-23. The expression of Bmi1 was enhanced in the colonic mucosae of refractory IBD, suggesting that Bmi1 expression might be related to increased cancer risk. In addition, patients with high Bmi1 expression showed significantly lower response rates upon subsequent anti-TNF-α therapy as compared to patients with low Bmi1 expression. In human CAC specimens, the expression of Bmi1 was upregulated in nontumor tissues as well as tumors. CONCLUSIONS: Bmi1 expression is related to a refractory clinical course of IBD and upregulated in refractory IBD and CAC. Measurement of Bmi1 expression is a promising approach for the advanced treatment and personalized management of IBD patients.

    DOI: 10.1159/000481225

    PubMed

  118. Clinical Analysis of Esophageal Stricture in Patients Treated with Intralesional Triamcinolone Injection after Endoscopic Submucosal Dissection for Superficial Esophageal Cancer. Reviewed International journal

    Okamoto K, Matsui S, Watanabe T, Asakuma Y, Komeda Y, Okamoto A, Rei I, Kono M, Yamada M, Nagai T, Arizumi T, Minaga K, Kamata K, Yamao K, Takenaka M, Sakurai T, Nishida N, Kashida H, Chikugo T, Kudo M

    Oncology   Vol. 93 Suppl 1   page: 9 - 14   2017

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    INTRODUCTION: Endoscopic submucosal dissection (ESD) has been widely used in the resection of superficial esophageal cancers. Since its use has been extended to cases involving large esophageal tumors occupying nearly the whole or the whole circumference of the lumen, the occurrence of esophageal stricture has increased. Although endoscopic injection of triamcinolone (TA) is widely used for the prevention of postoperative stricture, a significant number of patients still develop stricture after TA injection therapy. METHODS: We performed a retrospective study to identify the clinical parameters that predispose post-ESD patients to esophageal stricture after TA injection therapy. RESULTS: A total of 207 patients who were diagnosed with superficial esophageal cancer and subsequently underwent ESD were enrolled in this study. Among these patients, 53 patients and 57 lesions bearing mucosal defects covering greater than two-thirds of the esophageal circumference after ESD were treated with TA injection therapy. The rate of esophageal stricture was found to be highest in cases involving mucosal defects that covered more than seven-eighths of the circumference. CONCLUSION: Endoscopic TA injection is not sufficient for preventing esophageal stricture in patients bearing mucosal defects covering more than seven-eighths of the esophageal circumference after ESD.

    DOI: 10.1159/000481223

    PubMed

  119. Characterization of Pancreatic Tumors with Quantitative Perfusion Analysis in Contrast-Enhanced Harmonic Endoscopic Ultrasonography International journal

    Omoto S, Takenaka M, Kitano M, Miyata T, Kamata K, Minaga K, Arizumi T, Yamao K, Imai H, Sakamoto H, Harwani Y, Sakurai T, Watanabe T, Nishida N, Takeyama Y, Chiba Y, Kudo M

    Oncology   Vol. 93 ( Suppl 1 ) page: 55 - 60   2017

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    OBJECTIVES: This study evaluated whether quantitative perfusion analysis with contrast-enhanced harmonic (CH) endoscopic ultrasonography (EUS) characterizes pancreatic tumors, and compared the hemodynamic parameters used to diagnose pancreatic carcinoma. METHODS: CH-EUS data from pancreatic tumors of 76 patients were retrospectively analyzed. Time-intensity curves (TIC) were generated to depict changes in signal intensity over time, and 6 parameters were assessed: baseline intensity, peak intensity, time to peak, intensity gain, intensity at 60 s (I60), and reduction rate. These parameters were compared between pancreatic carcinomas (n = 41), inflammatory pseudotumors (n = 14), pancreatic neuroendocrine tumors (n = 14), and other tumors (n = 7). All 6 TIC parameters and subjective analysis for diagnosing pancreatic carcinoma were compared. RESULTS: Values of peak intensity and I60 were significantly lower and time to peak was significantly longer in the groups with pancreatic carcinomas than in the other 3 tumor groups (p < 0.05). Reduction rate was significantly higher in pancreatic carcinomas than in pancreatic neuroendocrine tumors (p < 0.05). Areas under the receiver-operating characteristic curves for the diagnosis of pancreatic carcinoma using subjective analysis, baseline intensity, peak intensity, intensity gain, I60, time to peak, and reduction rate, were 0.817, 0.664, 0.810, 0.751, 0.845, 0.777, and 0.725, respectively. I60 was the most accurate parameter for differentiating pancreatic carcinomas from the other groups, giving values of sensitivity/specificity of 92.7/68.6% when optimal cutoffs were chosen. CONCLUSIONS: In pancreatic carcinomas, TIC patterns were markedly different from the other tumor types, with I60 being the most accurate diagnostic parameter. Quantitative perfusion analysis is useful for differentiating pancreatic carcinomas from other pancreatic tumors.

    DOI: 10.1159/000481231

    PubMed

  120. Association between the Risk Factors for Pancreatic Ductal Adenocarcinoma and Those for Malignant Intraductal Papillary Mucinous Neoplasm International journal

    Kamata K, Takenaka M, Nakai A, Omoto S, Miyata T, Minaga K, Matsuda T, Yamao K, Imai H, Chiba Y, Sakurai T, Watanabe T, Nishida N, Chikugo T, Matsumoto I, Takeyama Y, Kudo M

    Oncology   Vol. 93 ( Suppl 1 ) page: 102 - 106   2017

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    BACKGROUND AND AIMS: Risk factors for pancreatic ductal adenocarcinoma (PDAC) include diabetes mellitus, chronic pancreatitis, obesity, a family history of pancreatic cancer, and a history of smoking or alcohol consumption. The aim of this study was to evaluate the association between risk factors for PDAC and malignant intraductal papillary mucinous neoplasm (IPMN). METHODS: The study included 134 consecutive patients with IPMN who underwent surgical resection at Kindai University Hospital between April 2009 and March 2015. Data on the presence or absence of mural nodules (MNs) and risk factors for PDAC were evaluated. Multivariable logistic regression analysis was performed with malignant IPMN as the outcome variable and MNs and risk factors for PDAC as explanatory variables. RESULTS: The odds ratio of malignant IPMN to MNs was 3.88 (95% confidence interval [CI] 1.53-9.84; p = 0.004), whereas that of malignant IPMN to smoking history was 1.66 (95% CI 0.74-3.71; p = 0.22). When the presence of MNs was considered as a predictive factor for malignancy, the sensitivity and specificity were 88.5 and 32.1%, respectively, whereas when the presence of both smoking history and MNs was considered, the specificity improved to 73.2%, with a decrease in sensitivity to 42.3%. CONCLUSIONS: The presence of both a smoking history and MNs was a valuable predictive factor for malignant IPMN with high specificity. A smoking history should be considered before surgical resection in addition to the presence of MNs.

    DOI: 10.1159/000481234

    PubMed

  121. Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis: Long-term outcomes after removal of a self-expandable metal stent Reviewed International journal

    Kamata K, Takenaka M, Kitano M, Omoto S, Miyata T, Minaga K, Yamao K, Imai H, Sakurai T, Watanabe T, Nishida N, Kudo M

    World J Gastroenterol   Vol. 23 ( 4 ) page: 661 - 667   2017

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    AIM: To assess the long-term outcomes of this procedure after removal of self-expandable metal stent (SEMS). The efficacy and safety of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with SEMS were also assessed. METHODS: Between January 2010 and April 2015, 12 patients with acute calculous cholecystitis, who were deemed unsuitable for cholecystectomy, underwent EUS-GBD with a SEMS. EUS-GBD was performed under the guidance of EUS and fluoroscopy, by puncturing the gallbladder with a needle, inserting a guidewire, dilating the puncture hole, and placing a SEMS. The SEMS was removed and/or replaced with a 7-Fr plastic pigtail stent after cholecystitis improved. The technical and clinical success rates, adverse event rate, and recurrence rate were all measured. RESULTS: The rates of technical success, clinical success, and adverse events were 100%, 100%, and 0%, respectively. After cholecystitis improved, the SEMS was removed without replacement in eight patients, whereas it was replaced with a 7-Fr pigtail stent in four patients. Recurrence was seen in one patient (8.3%) who did not receive a replacement pigtail stent. The median follow-up period after EUS-GBD was 304 d (78-1492). CONCLUSION: EUS-GBD with a SEMS is a possible alternative treatment for acute cholecystitis. Long-term outcomes after removal of the SEMS were excellent. Removal of the SEMS at 4-wk after SEMS placement and improvement of symptoms might avoid migration of the stent and recurrence of cholecystitis due to food impaction.

    DOI: 10.3748/wjg.v23.i4.661

    PubMed

  122. Rescue EUS-guided intrahepatic biliary drainage for malignant hilar biliary stricture after failed transpapillary re-intervention Reviewed International journal

    Minaga K, Takenaka M, Kitano M, Chiba Y, Imai H, Yamao K, Kamata K, Miyata T, Omoto S, Sakurai T, Watanabe T, Nishida N, Kudo M

    Surg Endosc   Vol. 31 ( 11 ) page: 4764 - 4772   2017

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    BACKGROUND: Treatment of unresectable malignant hilar biliary stricture (UMHBS) is challenging, especially after failure of repeated transpapillary endoscopic stenting. Endoscopic ultrasonography-guided intrahepatic biliary drainage (EUS-IBD) is a recent technique for intrahepatic biliary decompression, but indications for its use for complex hilar strictures have not been well studied. The aim of this study was to assess the feasibility and safety of EUS-IBD for UMHBS after failed transpapillary re-intervention. METHODS: Retrospective analysis of all consecutive patients with UMHBS of Bismuth II grade or higher who, between December 2008 and May 2016, underwent EUS-IBD after failed repeated transpapillary interventions. The technical success, clinical success, and complication rates were evaluated. Factors associated with clinical ineffectiveness of EUS-IBD were explored. RESULTS: A total of 30 patients (19 women, median age 66 years [range 52-87]) underwent EUS-IBD for UMHBS during the study period. Hilar biliary stricture morphology was classified as Bismuth II, III, or IV in 5, 13, and 12 patients, respectively. The median number of preceding endoscopic interventions was 4 (range 2-14). EUS-IBD was required because the following procedures failed: duodenal scope insertion (n = 4), accessing the papilla after duodenal stent insertion (n = 5), or achieving desired intrahepatic biliary drainage (n = 21). Technical success with EUS-IBD was achieved in 29 of 30 patients (96.7%) and clinical success was attained in 22 of these 29 (75.9%). Mild peritonitis occurred in three of 30 (10%) and was managed conservatively. Stent dysfunction occurred in 23.3% (7/30). There was no procedure-related mortality. On multivariable analysis, Bismuth IV stricture predicted clinical ineffectiveness (odds ratio = 12.7, 95% CI 1.18-135.4, P = 0.035). CONCLUSIONS: EUS-IBD may be a feasible and effective rescue alternative with few major complications after failed transpapillary endoscopic re-intervention in patients with UMHBS, particularly for Bismuth II or III strictures.

    DOI: 10.1007/s00464-017-5553-6

    PubMed

  123. Prophylactic Suturing Closure Is Recommended after Endoscopic Treatment of Colorectal Tumors in Patients with Antiplatelet/Anticoagulant Therapy International journal

    Sakurai T, Adachi T, Kono M, Arizumi T, Kamata K, Minaga K, Yamao K, Komeda Y, Takenaka M, Hagiwara S, Watanabe T, Nishida N, Kashida H, Kudo M

    Oncology   Vol. 93 ( Suppl 1 ) page: 27 - 29   2017

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    The prophylactic closure of mucosal defects after endoscopic resection is known to prevent postoperative bleeding in colorectal lesions. However, closure of large mucosal defects is difficult with conventional clips only, and several closure techniques have been previously described; use of an Endoloop, 8-ring loop, or loop clip and a small incision around the mucosal defect. Given that the prophylactic closure requires much cost and time, the application should be limited to high-risk cases. Medication of antithrombotics or antiplatelet agents would be one of the reasonable indications for prophylactic closure of mucosal defects after endoscopic resection of colorectal tumors.

    DOI: 10.1159/000481226

    PubMed

  124. Primary Hepatic Adenosquamous Carcinoma Associated with Primary Sclerosing Cholangitis Reviewed

    Kentaro Yamao, Mamoru Takenaka, Hajime Imai, Atsushi Nakai, Shunske Omoto, Ken Kamata, Kosuke Minaga, Takeshi Miyata, Toshiharu Sakurai, Tomohiro Watanabe, Naoshi Nishida, Ippei Matsumoto, Yosihumi Takeyama, Takaaki Chikugo, Masatoshi Kudo

    Oncology   Vol. 93 ( 1 ) page: 76 - 80   2017

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    DOI: 10.1159/000481236

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  125. Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration International journal

    Minaga K, Takenaka M, Katanuma A, Kitano M, Yamashita Y, Kamata K, Yamao K, Watanabe T, Maguchi H, Kudo M

    Oncology   Vol. 93 ( Suppl 1 ) page: 107 - 112   2017

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    Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been widely used for diagnosis of both inflammatory and tumor lesions located in and adjacent to the gastrointestinal tract. EUS-FNA has been considered to be a safe technique with few complications, as shown in recent review articles in which EUS-FNA-related morbidity and mortality rates were reported to be <1%. It should be noted, however, that needle tract seeding, although uncommon, can occur after diagnostic EUS-FNA and that this complication affects the prognosis of patients. Although an accurate value for the frequency of needle tract seeding caused by EUS-FNA has not been reported, the numbers of case reports on needle tract seeding have been rapidly increasing, especially in Japan. These case reports regarding EUS-FNA-related needle tract seeding prompted us to reevaluate the safety of EUS-FNA because this complication may have a significant influence on patients' prognoses. In this review, we summarize the clinical features and outcomes of needle tract seeding after EUS on the basis of the previously reported cases and provide useful information to prevent and reduce this serious complication.

    DOI: 10.1159/000481235

    PubMed

  126. Risk Factors for Postoperative Bleeding in Endoscopic Submucosal Dissection of Colorectal Tumors International journal

    Okamoto K, Watanabe T, Komeda Y, Kono T, Takashima K, Okamoto A, Kono M, Yamada M, Arizumi T, Kamata K, Minaga K, Yamao K, Nagai T, Asakuma Y, Takenaka M, Sakurai T, Matsui S, Nishida N, Chikugo T, Kashida H, Kudo M

    Oncology   Vol. 93 ( Suppl 1 ) page: 35 - 42   2017

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    BACKGROUND: Colonoscopic removal of adenomatous polyps or early cancer prevents death from colorectal cancer. Endoscopic submucosal dissection (ESD), which enables endoscopists to perform en bloc resection of flat or depressed colorectal tumors >20 mm, has recently been introduced and become a standard procedure in Japan. Although postoperative bleeding (POB) is a major complication associated with ESD, risk factors for POB have not been fully identified. METHODS: A total of 451 patients (509 lesions) who underwent colorectal ESD were retrospectively analyzed to identify clinical parameters associated with POB. RESULTS: POB occurred in 14 patients, and 7 of them had received antithrombotic therapy before ESD. Uni- and multivariate analyses revealed that antithrombotic therapy and rectal tumor location were strongly associated with POB following colorectal ESD. The incidence of POB was higher in patients on heparin bridge therapy (HBT) for the replacement of antithrombotic therapy than in patients with no HBT. Four of 7 patients (57.1%) on antithrombotic therapy experienced POB from the rectal lesions. CONCLUSION: Antithrombotic therapy and rectal lesions result in a higher POB incidence after colorectal ESD.

    DOI: 10.1159/000481228

    PubMed

  127. Utility of Endoscopic Ultrasound-Guided Hepaticogastrostomy with Antegrade Stenting for Malignant Biliary Obstruction after Failed Endoscopic Retrograde Cholangiopancreatography International journal

    Imai H, Takenaka M, Omoto S, Kamata K, Miyata T, Minaga K, Yamao K, Sakurai T, Nishida N, Watanabe T, Kitano M, Kudo M

    Oncology   Vol. 93 ( Suppl 1 ) page: 69 - 75   2017

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    BACKGROUND: Endoscopic ultrasound (EUS)-guided biliary drainage (BD) is a well-recognized alternative BD method after unsuccessful endoscopic transpapillary drainage. EUS-guided hepaticogastrostomy (HGS) with antegrade stenting (AGS) was recently applied to the treatment of malignant obstructive jaundice. OBJECTIVE: To assess the efficacy and safety of HGS combined with AGS for treatment of malignant biliary stricture-induced obstructive jaundice. DESIGN: Retrospective cohort study. SETTING: Single academic tertiary care center. PATIENTS: From January 2006 to December 2014, endoscopic retrograde cholangiopancreatography was attempted in patients with obstructive jaundice; it was successful in 641 patients and impossible in 154 patients (postsurgically altered anatomy or duodenal stenosis, n = 101; difficult cannulation, n = 53). In total, 145 patients underwent EUS-guided BD; HGS and HGS with AGS were attempted in 42 patients (Group A, January 2006-August 2011) and 37 patients (Group B, September 2011-December 2014), respectively. INTERVENTIONS: Under EUS and fluoroscopy guidance, HGS and HGS with AGS were performed via needle puncture, guidewire insertion, puncture-hole dilation, and stent placement. MAIN OUTCOME MEASUREMENTS: Groups A and B were compared in terms of technical success, functional success, adverse event rates, re-intervention rates, patient survival time, and time to stent dysfunction or patient death. The two groups were also compared in a subgroup analysis of only 28 patients who underwent chemotherapy. RESULTS: The technical success rate was significantly higher in Group A than B (97.6 vs. 83.8%, p = 0.03). The functional success rate was comparable between the two groups (90.2 vs. 90.3%), although the rate of adverse events was significantly higher in Group A than B (26.1 vs. 10.8%, p = 0.03). The re-intervention rate tended to be higher in Group A than B (16.7 vs. 8.1%, p = 0.25). Groups A and B did not differ significantly in terms of median overall patient survival (75 vs. 61 days, p = 0.70) or median time to stent dysfunction or patient death (68 vs. 63 days, p = 0.08). Among patients who underwent chemotherapy, there was no difference in overall patient survival time between the two groups (121 vs. 157 days, p = 0.08), although time to stent dysfunction or patient death was significantly shorter in Group A than B (71 vs. 95 days, p = 0.02). CONCLUSION: Although the technical success rate of HGS with AGS was lower than that of HGS, HGS with AGS was superior to HGS in terms of adverse event rate and stent patency in patients receiving chemotherapy.

    DOI: 10.1159/000481233

    PubMed

  128. The usefulness of computed tomography immediately after ERCP for early detection of post ERCP pancreatitis Reviewed

    Miyata Takeshi, Takenaka Mamoru, Kitano Masayuki, Matsuda Tomohiko, Omoto Syunsuke, Kamata Ken, Minaga Kosuke, Yamao Kentaro, Imai Hajime, Kudo Masatoshi

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   Vol. 31   page: 248   2016.11

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  129. Incidence and risk factors for anastomotic stenosis of continuous hepaticojejunostomy after pancreaticoduodenectomy

    Asano Tomonari, Natsume Seiji, Senda Yoshiki, Sano Tsuyoshi, Matsuo Keitaro, Kodera Yasuhiro, Hara Kazuo, Ito Seiji, Yamao Kenji, Shimizu Yasuhiro

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   Vol. 23 ( 10 ) page: 628 - 635   2016.10

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    Background: There have been no reports showing the incidence of anastomotic stenosis of continuous hepaticojejunostomy (HJ) and identifying its risk factors for patients who underwent pancreaticoduodenectomy (PD). Method: We retrospectively investigated 200 patients whose HJ was established by unified method, single layered continuous suture. HJ stenosis was diagnosed with endoscopic or radiologic examinations. Uni and multivariable unconditional logistic modeling were performed to explore the predictive factors and to estimate odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Sixteen patients (8.0%) were diagnosed as HJ stenosis. Multivariable analysis showed that body mass index (BMI) (OR: 1.24; 95% CI: 1.03–1.51), absence of preoperative biliary stenting (OR: 11.10; 95% CI: 1.22–101.12), operative time (OR: 1.74 per one hour increase; 95% CI: 1.01–2.98), age (OR: 1.58 per 10 years increase; 95% CI: 0.88–2.85), and absence of nodal metastasis (OR: 3.43; 95% CI: 0.90–13.12) correlated with HJ stenosis. Among these, BMI and preoperative biliary stenting were associated with stenosis with a lower P-value than the others (P = 0.026 and 0.033, respectively). Conclusions: The incidence of HJ stenosis was 8.0%. Close attention would be needed especially for patients at high risk of HJ stenosis, such as high BMI or absence of preoperative biliary stenting.

    DOI: 10.1002/jhbp.385

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  130. IPMN切除例からみた国際診療ガイドラインの妥当性およびEUS実施の意義の検証

    松田 友彦, 北野 雅之, 大本 俊介, 鎌田 研, 三長 孝輔, 宮田 剛, 山雄 健太郎, 工藤 正俊

    Gastroenterological Endoscopy   Vol. 58 ( Suppl.2 ) page: 1976 - 1976   2016.10

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  131. Evaluation of anti-migration properties of biliary covered self-expandable metal stents. Reviewed International journal

    Minaga K, Kitano M, Imai H, Harwani Y, Yamao K, Kamata K, Miyata T, Omoto S, Kadosaka K, Sakurai T, Nishida N, Kudo M

    World journal of gastroenterology   Vol. 22 ( 30 ) page: 6917 - 6924   2016.8

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    AIM: To assess anti-migration potential of six biliary covered self-expandable metal stents (C-SEMSs) by using a newly designed phantom model. METHODS: In the phantom model, the stent was placed in differently sized holes in a silicone wall and retracted with a retraction robot. Resistance force to migration (RFM) was measured by a force gauge on the stent end. Radial force (RF) was measured with a RF measurement machine. Measured flare structure variables were the outer diameter, height, and taper angle of the flare (ODF, HF, and TAF, respectively). Correlations between RFM and RF or flare variables were analyzed using a linear correlated model. RESULTS: Out of the six stents, five stents were braided, the other was laser-cut. The RF and RFM of each stent were expressed as the average of five replicate measurements. For all six stents, RFM and RF decreased as the hole diameter increased. For all six stents, RFM and RF correlated strongly when the stent had not fully expanded. This correlation was not observed in the five braided stents excluding the laser cut stent. For all six stents, there was a strong correlation between RFM and TAF when the stent fully expanded. For the five braided stents, RFM after full stent expansion correlated strongly with all three stent flare structure variables (ODF, HF, and TAF). The laser-cut C-SEMS had higher RFMs than the braided C-SEMSs regardless of expansion state. CONCLUSION: RF was an important anti-migration property when the C-SEMS did not fully expand. Once fully expanded, stent flare structure variables plays an important role in anti-migration.

    DOI: 10.3748/wjg.v22.i30.6917

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  132. EUS-guided gallbladder drainage for rescue treatment of malignant distal biliary obstruction after unsuccessful ERCP. Reviewed International journal

    Imai H, Kitano M, Omoto S, Kadosaka K, Kamata K, Miyata T, Yamao K, Sakamoto H, Harwani Y, Kudo M

    Gastrointestinal endoscopy   Vol. 84 ( 1 ) page: 147 - 151   2016.7

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    BACKGROUND AND AIMS: EUS-guided bile duct drainage (EUS-BD) is a well-recognized rescue biliary drainage method after unsuccessful ERCP. EUS-guided gallbladder drainage (EUS-GBD) was recently used to treat acute cholecystitis. The aim of this study was to assess the efficacy and safety of EUS-GBD for malignant biliary stricture-induced obstructive jaundice after unsuccessful ERCP as well as unsuccessful or impractical EUS-BD. METHODS: Between January 2006 and October 2014, 12 patients with obstructive jaundice due to unresectable malignant distal biliary stricture underwent EUS-GBD after ERCP failed. EUS-GBD was performed under the guidance of EUS and fluoroscopy by puncturing the gallbladder with a needle, inserting a guidewire, dilating the puncture hole, and placing a stent. The technical and functional success rates, adverse events rate, overall patient survival time, and stent dysfunction rate during patient survival were measured. RESULTS: The rates of technical success, functional success, adverse events, and stent dysfunction were 100%, 91.7%, 16.7%, and 8.3%, respectively. The median survival time after EUS-GBD was 105 days (range 15 - 236 days). CONCLUSIONS: EUS-GBD is a possible alternative route for decompression of the biliary system when ERCP is unsuccessful.

    DOI: 10.1016/j.gie.2015.12.024

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  133. Predictors of pain response in patients undergoing endoscopic ultrasound-guided neurolysis for abdominal pain caused by pancreatic cancer. Reviewed International journal

    Minaga K, Kitano M, Sakamoto H, Miyata T, Imai H, Yamao K, Kamata K, Omoto S, Kadosaka K, Sakurai T, Nishida N, Chiba Y, Kudo M

    Therapeutic advances in gastroenterology   Vol. 9 ( 4 ) page: 483 - 494   2016.7

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    BACKGROUND: Interventional endoscopic ultrasound (EUS)-guided procedures such as EUS-guided celiac ganglia neurolysis (EUS-CGN) and EUS-guided broad plexus neurolysis (EUS-BPN) were developed to treat abdominal cancer-associated pain; however, these procedures are not always effective. The aim of this study was to explore predictors of pain response in EUS-guided neurolysis for pancreatic cancer-associated pain. METHODS: This was a retrospective analysis of prospectively collected data of 112 consecutive patients who underwent EUS-BPN in our institution. EUS-CGN was added in cases of visible celiac ganglia. The neurolytic-spread area was divided into six sections and evaluated by post-procedural computed tomography scanning. Pain intensity was assessed using a visual analog scale (VAS), and a decrease in VAS scores by ⩾3 points after neurolysis was considered a good pain response. Univariable and multivariable logistic regression analyses were performed to explore predictors of pain response at 1 and 4 weeks, and complications. RESULTS: A good pain response was obtained in 77.7% and 67.9% of patients at 1 and 4 weeks, respectively. In the multivariable analysis of these patients, the combination method (EUS-BPN plus CGN) was a significant positive predictive factor at 1 week (odds ratio = 3.69, p = 0.017) and 4 weeks (odds ratio = 6.37, p = 0.043). The numbers of neurolytic/contrast spread areas (mean ± SD) were 4.98 ± 1.08 and 4.15 ± 1.12 in patients treated with the combination method and single method, respectively (p < 0.001). There was no significant predictor of complications. CONCLUSIONS: EUS-BPN in combination with EUS-CGN was a predictor of a good pain response in EUS-guided neurolysis for pancreatic cancer-related pain. The larger number of neurolytic/contrast spread areas may lead to better outcomes in patients receiving combination treatment.

    DOI: 10.1177/1756283X16644248

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  134. New endoscopic ultrasonography techniques for pancreaticobiliary diseases. Reviewed International journal

    Kamata K, Kitano M, Omoto S, Kadosaka K, Miyata T, Minaga K, Yamao K, Imai H, Kudo M

    Ultrasonography (Seoul, Korea)   Vol. 35 ( 3 ) page: 169 - 179   2016.7

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    Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases, especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it is not sufficient for the differential diagnosis of various types of lesions. In order to address the limitations of EUS, new techniques have been developed to improve the characterization of the lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used for diagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNA needle with a core trap has recently been developed. Contrast-enhanced harmonic EUS is a new imaging modality that uses an ultrasonographic contrast agent to visualize blood flow in fine vessels. This technique is useful in the diagnosis of pancreatic solid lesions and in confirming the presence of vascularity in mural nodules for cystic lesions. EUS elastography analyzes several different variables to measure tissue elasticity, color patterns, and strain ratio, using analytical techniques such as hue-histogram analysis, and artificial neural networks, which are useful for the diagnosis of chronic pancreatitis and pancreatic cancer.

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  135. Modified single transluminal gateway transcystic multiple drainage technique for a huge infected walled-off pancreatic necrosis: A case report. Reviewed International journal

    Minaga K, Kitano M, Imai H, Yamao K, Kamata K, Miyata T, Matsuda T, Omoto S, Kadosaka K, Yoshikawa T, Kudo M

    World journal of gastroenterology   Vol. 22 ( 21 ) page: 5132 - 5136   2016.6

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    We report a successful endoscopic ultrasonography-guided drainage of a huge infected multilocular walled-off necrosis (WON) that was treated by a modified single transluminal gateway transcystic multiple drainage (SGTMD) technique. After placing a wide-caliber fully covered metal stent, follow-up computed tomography revealed an undrained subcavity of WON. A large fistula that was created by the wide-caliber metal stent enabled the insertion of a forward-viewing upper endoscope directly into the main cavity, and the narrow connection route within the main cavity to the subcavity was identified with a direct view, leading to the successful drainage of the subcavity. This modified SGTMD technique appears to be useful for seeking connection routes between subcavities of WON in some cases.

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  136. EUS-Guided Intrahepatic Biliary Drainage for Treatment of Obstructive Jaundice in Patients With Malignant Hilar Biliary Stricture After Ineffective or Unsuccessful Transpapillary Approach Reviewed

    Minaga Kosuke, Kitano Masayuki, Imai Hajime, Yamao Kentaro, Kamata Ken, Miyata Takeshi, Matsuda Tomohiko, Omoto Shunsuke, Kadosaka Kumpei, Yoshikawa Tomoe, Kudo Masatoshi

    GASTROINTESTINAL ENDOSCOPY   Vol. 83 ( 5 ) page: AB521   2016.5

  137. Urgent endoscopic ultrasound-guided choledochoduodenostomy for acute obstructive suppurative cholangitis-induced sepsis. Reviewed International journal

    Minaga K, Kitano M, Imai H, Yamao K, Kamata K, Miyata T, Omoto S, Kadosaka K, Yoshikawa T, Kudo M

    World journal of gastroenterology   Vol. 22 ( 16 ) page: 4264 - 4269   2016.4

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    Acute obstructive suppurative cholangitis (AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis.

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  138. 消化器疾患の診断と治療におけるEUSの役割 EUSガイド下ドレナージを中心としたWONの治療成績及び内視鏡治療不成功因子の解析(Role of EUS in Diagnosis and Treatment of Digestive Diseases EUS-guided interventions for walled-off pancreatic necrosis: clinical outcomes of a step-up approach and risk factors for failed endoscopic treatment)

    三長 孝輔, 北野 雅之, 今井 元, 山雄 健太郎, 鎌田 研, 宮田 剛, 松田 友彦, 大本 俊介, 門阪 薫平, 工藤 正俊

    超音波医学   Vol. 43 ( Suppl. ) page: S322 - S322   2016.4

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  139. Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of pancreatic cysts. Reviewed International journal

    Kamata K, Kitano M, Omoto S, Kadosaka K, Miyata T, Yamao K, Imai H, Sakamoto H, Harwani Y, Chikugo T, Chiba Y, Matsumoto I, Takeyama Y, Kudo M

    Endoscopy   Vol. 48 ( 1 ) page: 35 - 41   2016.1

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    BACKGROUND AND STUDY AIM: Comparison of fundamental B-mode endoscopic ultrasonography (FB-EUS) and contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) in the differential diagnosis of pancreatic cysts according to presence of mural nodules. PATIENTS AND METHODS: Between April 2007 and April 2012, FB-EUS and CH-EUS data were prospectively collected from 581 consecutive patients with pancreatic cysts, and were retrospectively analyzed from 70 with subsequent cyst resection. Presence and height of mural nodules as detected on FB-EUS and CH-EUS were evaluated, and thence accuracies of both methods for diagnosing mucinous versus nonmucinous and malignant versus benign cysts. RESULTS: On pathological examination 48 cysts were mucinous and 22 were nonmucinous; 30 cysts were malignant (high grade dysplasia or invasive carcinoma) and 40 were benign. If presence of a mural nodule was considered to indicate a mucinous cyst, FB-EUS and CH-EUS accuracies did not differ significantly (respectively: sensitivity 85 % vs. 79 %; specificity 46 % vs. 96 %; accuracy 73 % vs. 84 %, P = 0.057). If presence of mural nodule was considered to indicate malignancy, CH-EUS was significantly more accurate than FB-EUS (respectively: sensitivity 97 % vs. 97 %; specificity 75 % vs. 40 %; accuracy 84 % vs. 64 %, P = 0.0001). For diagnosing malignancy by evaluating mural nodule height, the area under the receiver operating characteristic (AUROC) was 0.84 and 0.93 for FB-EUS and CH-EUS, respectively (P = 0.028). Presence of a mural nodule of height ≥ 4 mm on CH-EUS was a sign of malignancy (false-positive fraction 0.2; true-positive fraction 0.93; odds ratio 56.0). CONCLUSIONS: CH-EUS is more accurate than FB-EUS for diagnosing malignant pancreatic cysts.

    DOI: 10.1055/s-0034-1393564

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  140. Hepaticogastrostomy guided by real-time contrast-enhanced harmonic endoscopic ultrasonography: a novel technique. Reviewed International journal

    Minaga K, Kitano M, Yoshikawa T, Omoto S, Kamata K, Yamao K, Kudo M

    Endoscopy   Vol. 48   page: E228 - E229   2016

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    DOI: 10.1055/s-0042-109059

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  141. Usefulness of serum procalcitonin for diagnosis of acute pancreatitis Reviewed

    Omoto Shunsuke, Kitano Masayuki, Sakamoto Hiroki, Imai Hajime, Yamao Kentaro, Kamata Ken, Miyata Takeshi, Minaga Kosuke, Kadosaka Kumpei, Kudo Masatoshi

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   Vol. 30   page: 141   2015.12

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  142. Poor prognosis of common-type invasive ductal carcinomas that originate in the branching pancreatic duct

    Ando Masataka, Shimizu Yasuhiro, Sano Tsuyoshi, Senda Yoshiki, Nimura Yuji, Yamao Kenji, Nagino Masato, Yanagisawa Akio

    SURGERY TODAY   Vol. 45 ( 10 ) page: 1291 - 1298   2015.10

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    Purpose: To clarify the incidence, clinicopathological features and prognosis of pancreatic invasive ductal carcinomas (IDCs) with different tumor origin sites in the pancreatic duct. Methods: Based on the relationship between the invasive cancer area (ICA) and the main pancreatic duct (MPD), IDCs less than 2 cm in diameter were classified into two groups: type I, in which the ICA and MPD were separated, and type II, in which the MPD passed through the ICA. The clinicopathological findings and prognosis of each type were compared in a total of 37 patients. Results: The incidences of IDC types I and II were 18.9 and 81.1 %, respectively. Although there was no difference in local invasion, both node involvement and venous invasion tended to occur more frequently in type I IDC, and the three-year survival rate was significantly lower for type I (28.6 %) than type II (71.8 %) IDC. Conclusions: The prognosis of IDCs that originated in the branching pancreatic duct (BPD) distant from the MPD (type I) was worse than the prognosis of IDCs that originated in either the MPD or the BPD close to the MPD (type II). These data suggest that the progression and degree of malignancy of IDCs may vary depending on the site of tumor origin in the pancreatic duct.

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  143. Aberrant TET1 Methylation Closely Associated with CpG Island Methylator Phenotype in Colorectal Cancer

    Ichimura Norihisa, Shinjo Keiko, An Byonggu, Shimizu Yasuhiro, Yamao Kenji, Ohka Fumiharu, Katsushima Keisuke, Hatanaka Akira, Tojo Masayuki, Yamamoto Eiichiro, Suzuki Hiromu, Ueda Minoru, Kondo Yutaka

    CANCER PREVENTION RESEARCH   Vol. 8 ( 8 ) page: 702 - 711   2015.8

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    Inactivation of methylcytosine dioxygenase, ten-eleven translocation (TET) is known to be associated with aberrant DNA methylation in cancers. Tumors with a CpG island methylator phenotype (CIMP), a distinct subgroup with extensive DNA methylation, show characteristic features in the case of colorectal cancer. The relationship between TET inactivation and CIMP in colorectal cancers is not well understood. The expression level of TET family genes was compared between CIMP-positive (CIMP-P) and CIMP-negative (CIMP-N) colorectal cancers. Furthermore, DNA methylation profiling, including assessment of the TET1 gene, was assessed in colorectal cancers, as well as colon polyps. The TET1 was silenced by DNA methylation in a subset of colorectal cancers as well as cell lines, expression of which was reactivated by demethylating agent. TET1 methylation was more frequent in CIMP-P (23/55, 42%) than CIMP-N (2/113, 2%, P < 0.0001) colorectal cancers. This trend was also observed in colon polyps (CIMP-P, 16/40, 40%; CIMP-N, 2/24, 8%; P = 0.002), suggesting that TET1 methylation is an early event in CIMP tumorigenesis. TET1 methylation was significantly associated with BRAF mutation but not with hMLH1 methylation in the CIMP-P colorectal cancers. Colorectal cancers with TET1 methylation have a significantly greater number of DNA methylated genes and less pathological metastasis compared to those without TET1 methylation (P = 0.007 and 0.045, respectively). Our data suggest that TET1 methylation may contribute to the establishment of a unique pathway in respect to CIMP-mediated tumorigenesis, which may be incidental to hMLH1 methylation. In addition, our findings provide evidence that TET1 methylation may be a good biomarker for the prediction of metastasis in colorectal cancer.

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  144. Clinical practice guidelines for the management of biliary tract cancers 2015: The 2<sup>nd</sup> English edition

    Miyazaki M., Yoshitomi H., Miyakawa S., Uesaka K., Unno M., Endo I., Ota T., Ohtsuka M., Kinoshita H., Shimada K., Shimizu H., Tabata M., Chijiiwa K., Nagino M., Hirano S., Wakai T., Wada K., Iasayama H., Okusaka T., Tsuyuguchi T., Fujita N., Furuse J., Yamao K., Murakami K., Yamazaki H., Kijima H., Nakanuma Y., Yoshida M., Takayashiki T., Takada T.

    Journal of Hepato-Biliary-Pancreatic Sciences   Vol. 22 ( 4 ) page: 249 - 273   2015.4

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    Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidence-based approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via http://www.jshbps.jp/en/guideline/biliary-tract2.html.

    DOI: 10.1002/jhbp.233

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  145. Prospective Evaluation of a Transnasal Endoscopy Utilizing Flexible Spectral Imaging Color Enhancement (FICE) with the Valsalva Maneuver for Detecting Pharyngeal and Esophageal Cancer

    Tanaka T., Niwa Y., Tajika M., Ishihara M., Imaoka H., Mizuno N., Hara K., Hijioka S., Hirooka Y., Goto H., Yamao K.

    HEPATO-GASTROENTEROLOGY   Vol. 61 ( 134 ) page: 1627 - 1634   2014.9

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  146. Prospective evaluation of a transnasal endoscopy utilizing flexible spectral imaging color enhancement (FICE) with the valsalva maneuver for detecting pharyngeal and esophageal cancer

    Tanaka T., Niwa Y., Tajika M., Ishihara M., Imaoka H., Mizuno N., Hara K., Hijioka S., Hirooka Y., Goto H., Yamao K.

    Hepato-Gastroenterology   Vol. 61 ( 134 ) page: 1627 - 1634   2014.9

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    Background/Aims: This study evaluated the efficacy and safety of transnasal endoscopy (TNE) with flexible spectral imaging color enhancement (FICE) for detection of superficial cancer in the pharyngeal and esophageal regions for high-risk populations. Methodology: Patients who previously had head and neck or esophageal squamous cell carcinoma were enrolled. Screening was conducted using TNE with conventional white-light endoscopy (WLE) followed by FICE chromoendoscopy. For observation of the pharyngeal region, the Valsalva maneuver was employed. Results: 99 patients were eligible. Six esophageal cancers were detected in four patients (4.0%). The sensitivity, specificity, and accuracy for the detection of cancer were 25.0% (95% CI, 3.4-71.0), 97.8% (95% CI, 92.1-99.8), and 94.9% (95% CI, 88.4-98.1), respectively for WLE; 100% (95% CI, 451%-100%), 96.8% (95% CI, 90.7%-99.3%), and 96.9% (95% CI, 89.3%-99.1%), respectively for FICE chromoendoscopy. Pain in the nose and nasal hemorrhage were observed in 3 (3.0%) and 2 patients (2.0%), respectively. Following the Valsalva maneuver, endoscopic scores significantly increased from a mean of 1.1 (0.8-1.4) to 2.0 (1.3-2.6) (p<0.05). Conclusions: TNE with the Valsalva maneuver is a promising screening method for the pharyngeal and esophageal regions. TNE with FICE chromoendoscopy for detecting pharyngeal and esophageal cancer was more sensitive than WLE. © H.G.E. Update Medical Publishing S.A.

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  147. 自己免疫性膵炎の診断、治療におけるEUSの役割

    大本 俊介, 北野 雅之, 門坂 薫平, 宮田 剛, 鎌田 研, 山雄 健太郎, 今井 元, 坂本 洋城, 工藤 正俊

    膵臓   Vol. 29 ( 3 ) page: 545 - 545   2014.6

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  148. 膵神経内分泌腫瘍に対するEUSの有用性

    今井 元, 北野 雅之, 工藤 正俊, 大本 俊介, 門阪 薫平, 宮田 剛, 鎌田 研, 山雄 健太郎, 坂本 洋城

    Gastroenterological Endoscopy   Vol. 56 ( Suppl.1 ) page: 1132 - 1132   2014.4

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  149. 造影ハーモニックEUS(CH-EUS)における膵腫瘍の血流評価の有用性について

    大本 俊介, 田中 梨絵, 門阪 薫平, 鎌田 研, 宮田 剛, 山雄 健太郎, 今井 元, 坂本 洋城, 北野 雅之, 工藤 正俊

    超音波医学   Vol. 41 ( Suppl. ) page: S580 - S580   2014.4

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  150. 造影ハーモニックEUS(CH-EUS)における膵腫瘍の血流評価の有用性について

    大本 俊介, 田中 梨絵, 門阪 薫平, 鎌田 研, 宮田 剛, 山雄 健太郎, 今井 元, 坂本 洋城, 北野 雅之, 工藤 正俊

    超音波医学   Vol. 41 ( 2 ) page: 245 - 245   2014.3

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  151. Hepatitis virus infection affects DNA methylation in mice with humanized livers

    Okamoto Y., Shinjo K., Shimizu Y., Sano T., Yamao K., Gao W., Fujii M., Osada H., Sekido Y., Murakami S., Tanaka Y., Joh T., Sato S., Takahashi S., Wakita T., Zhu J., Issa J.P.J., Kondo Y.

    Gastroenterology   Vol. 146 ( 2 ) page: 562 - 572   2014.2

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    Background & Aims Cells of tumors associated with chronic inflammation frequently have altered patterns of DNA methylation, including hepatocellular carcinomas. Chronic hepatitis has also been associated with aberrant DNA methylation, but little is known about their relationship. Methods Pyrosequencing was used to determine the methylation status of cultured Huh7.5.1 hepatoma cells after hepatitis C virus (HCV) infection. We also studied mice with severe combined immunodeficiency carrying the urokinase-type plasminogen activator transgene controlled by an albumin promoter (urokinase-type plasminogen activator/severe combined immunodeficient mice), in which up to 85% of hepatocytes were replaced by human hepatocytes (chimeric mice). Mice were given intravenous injections of hepatitis B virus (HBV) or HCV, liver tissues were collected, and DNA methylation profiles were determined at different time points after infection. We also compared methylation patterns between paired samples of hepatocellular carcinomas and adjacent nontumor liver tissues from patients. Results No reproducible changes in DNA methylation were observed after infection of Huh7.5.1 cells with HCV. Livers from HBV- and HCV-infected mice had genome-wide, time-dependent changes in DNA methylation, compared with uninfected urokinase-type plasminogen activator/severe combined immunodeficient mice. There were changes in 160 ± 63 genes in HBV-infected and 237 ± 110 genes in HCV-infected mice. Methylation of 149 common genes increased in HBV- and HCV-infected mice; methylation of some of these genes also increased in hepatocellular carcinoma samples from patients compared with nontumor tissues. Expression of Ifng, which is expressed by natural killer cells, increased significantly in chimeric livers, in concordance with induction of DNA methylation, after infection with HBV or HCV. Induction of Ifng was reduced after administration of an inhibitor of natural killer cell function (anti-asialo GM1). Conclusions In chimeric mice with humanized livers, infection with HBV and HCV appears to activate a natural kill cell-dependent innate immune response. This contributes to the induction and accumulation of aberrant DNA methylation in human hepatocytes. © 2014 by the AGA Institute.

    DOI: 10.1053/j.gastro.2013.10.056

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  152. 膵腫瘍性病変診断における造影ハーモニックEUS検査の有用性 Reviewed

    山雄健太郎, 北野雅之, 工藤正俊

    超音波TECHNO   Vol. 26   page: 76 - 78   2014

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  153. Phase II study of sunitinib in Japanese patients with unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumor

    Ito T., Okusaka T., Nishida T., Yamao K., Igarashi H., Morizane C., Kondo S., Mizuno N., Hara K., Sawaki A., Hashigaki S., Kimura N., Murakami M., Ohki E., Chao R.C., Imamura M.

    Investigational New Drugs   Vol. 31 ( 5 ) page: 1265 - 1274   2013.10

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    Background. Pancreatic neuroendocrine tumors (NETs) are rare but are frequently diagnosed at advanced stages and require systemic therapy. Patients and methods. This multicenter, open-label, phase II study evaluated sunitinib in Japanese patients with well-differentiated pancreatic NET. Patients received sunitinib 37.5 mg/day on a continuous daily dosing (CDD) schedule. The primary endpoint was clinical benefit rate (CBR; percentage of complete responses [CRs] plus partial responses [PRs] plus stable disease [SD] ≥24 weeks). Secondary endpoints included objective response rate (ORR), tumor shrinkage, progression-free survival (PFS) probability, safety, pharmacokinetics, and biomarkers. Results. Twelve patients received treatment. The CBR was 75 % (95 % confidence interval [CI], 43-94) and included 6 patients with a PR and 3 with SD. The ORR was 50 % (95 % CI, 21-79). PFS probability was 91 % (95 % CI, 54-99) at 6 months and 71 % (95 % CI, 34-90) at 12 months. Commonly reported treatment-emergent (all-causality), any-grade adverse events included diarrhea (n = 10), hand-foot syndrome and hypertension (both n = 8), fatigue and headache (both n = 7), and neutropenia (n = 6). No deaths on study were reported; one death due to disease progression occurred >28 days after end of treatment. Sunitinib on a CDD schedule resulted in sustained drug concentrations without accumulation across cycles. Tumor responses in all 12 patients did not appear to correlate with decreases in chromogranin A levels. Conclusions. Sunitinib 37.5 mg/day on a CDD schedule demonstrated antitumor activity in Japanese patients with unresectable, well-differentiated pancreatic NET. Commonly reported adverse events were consistent with the known safety profile of sunitinib. © 2012 The Author(s).

    DOI: 10.1007/s10637-012-9910-y

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  154. 【ドレナージ大全】胆道ドレナージ術 急性胆嚢炎 急性胆嚢炎に対するEUSガイド下ドレナージ術

    今井 元, 北野 雅之, 大本 俊介, 門阪 薫平, 宮田 剛, 鎌田 研, 山雄 健太郎, 坂本 洋城, 工藤 正俊

    胆と膵   Vol. 34 ( 臨増特大 ) page: 925 - 928   2013.10

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    急性胆嚢炎に対するドレナージ治療として、EUS下穿刺術を応用したEUS下胆嚢ドレナージ術(EUS-GBD)が報告されている。EUS観察下で胃前庭部または十二指腸球部より腫大した胆嚢を穿刺する。穿刺後、生理食塩水にて胆嚢内を洗浄した上で、胆嚢内にガイドワイヤーをコイリングする要領で留置し、続いて穿刺孔を拡張する。最後に経鼻ドレナージチューブ、両端ピッグテイルステントあるいは金属ステントを留置する。新しい手技のため、報告が少ないが、手技成功率97〜100%、臨床症状改善率100%と良好な成績が得られている。主な偶発症として、胆汁性腹膜炎気腹症、ステントの迷入、逸脱がある。今後、EUS-GBDは経皮経肝胆嚢ドレナージ術、経皮経肝胆嚢吸引穿刺法、内視鏡的経鼻胆嚢ドレナージ術、内視鏡的胆嚢ステント留置術と同様、急性胆嚢炎に対する治療選択肢となりうる。(著者抄録)

  155. 十二指腸狭窄を合併した閉塞性黄疸に対して十二指腸ステント留置術とEUS-guided Choledochoduodenostomyを施行した膵頭部癌の1例

    田中 梨絵, 宮田 剛, 大本 俊介, 門阪 薫平, 鎌田 研, 山雄 健太郎, 今井 元, 坂本 洋城, 北野 雅之

    胆道   Vol. 27 ( 3 ) page: 630 - 630   2013.8

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  156. The aldehyde dehydrogenase 2 (ALDH2) Glu504Lys polymorphism interacts with alcohol drinking in the risk of stomach cancer

    Matsuo Keitaro, Oze Isao, Hosono Satoyo, Ito Hidemi, Watanabe Miki, Ishioka Kuka, Ito Seiji, Tajika Masahiro, Yatabe Yasushi, Niwa Yasumasa, Yamao Kenji, Nakamura Shigeo, Tajima Kazuo, Tanaka Hideo

    CARCINOGENESIS   Vol. 34 ( 7 ) page: 1510 - 1515   2013.7

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    The impact of alcohol on the risk of stomach cancer is controversial. Although aldehyde dehydrogenase 2 (ALDH2) Glu504Lys (rs671) polymorphism has a strong effect on acetaldehyde metabolism, little is known about its impact on stomach cancer risk when combined with alcohol drinking. This case-control study included a total of 697 incident stomach cancer case subjects and 1372 non-cancer control subjects who visited Aichi Cancer Center between 2001 and 2005. We estimated odds ratios (OR) and 95% confidence intervals (CI) for ALDH2 genotypes and alcohol consumption using logistic regression models after adjustment for potential confounders, including Helicobacter pylori infection. The ALDH2 504Lys allele was associated with the risk of stomach cancer, with adjusted ORs of 1.40 (95% CI, 1.11-1.76) for Glu/Lys and 1.73 (1.12-2.68) for Lys/Lys compared with Glu/Glu. Heavy drinking was associated with risk (OR 1.72, 1.17-2.52) after adjustment for ALDH2 genotype and other confounders. Moreover, ORs for heavy drinking were 1.28 (0.77-2.12) for those with ALDH2 Glu/Glu and 3.93 (1.99-5.79) for those with the ALDH2 Lys allele relative to non-drinkers with the Glu/Glu genotype (P for interaction = 0.0054). In conclusion, ALDH2 and alcohol drinking showed interaction for risk factors of stomach cancer, indicating that acetaldehyde plays a role in stomach carcinogenesis. ©The Author 2013.Published by Oxford University Press. All rights reserved.

    DOI: 10.1093/carcin/bgt080

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  157. SUCCESSFUL TREATMENT OF ENTERIC ANISAKIASIS THROUGH ENDOSCOPIC EXTRACTION USING : A DOUBLE-BALLOON ENTEROSCOPE

    AMANO Mio, FUKUMOTO Akira, YAMAO Kentaro, IMAGAWA Hiroki, HASHIMOTO Yoshimasa, IIBOSHI Tomohiro, ONOGAWA Seiji, HIRANO Naomichi, HANADA Keiji, YONEHARA Syuji

    Gastroenterological Endoscopy   Vol. 55 ( 5 ) page: 1643 - 1649   2013.5

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    A 52-year-old man was referred to our hospital with intermittent abdominal pain. He had consumed raw fish 1 day prior to the onset of his symptom. Abdominal ultrasonography and computed tomography were conducted, which indicated thickening of the ileal wall and accumulation of ascites. Based on his clinical history and these images, enteric anisakiasis was suspected. He then underwent double-balloon enteroscopy (DBE) via the anal approach. DBE revealed edematous mucosa in the ileum and an Anisakis sp. larva invading the ileal wall. The entire larva was successfully retrieved using biopsy forceps, following which his symptoms completely resolved. Thus, we believe that, when enteric anisakiasis is suspected, DBE should be performed for diagnosis and endoscopic extraction.

    DOI: 10.11280/gee.55.1643

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    Other Link: http://search.jamas.or.jp/link/ui/2013245244

  158. Prospective clinical study of endoscopic ultrasound-guided choledochoduodenostomy with direct metallic stent placement using a forward-viewing echoendoscope

    Hara K., Yamao K., Hijioka S., Mizuno N., Imaoka H., Tajika M., Kondo S., Tanaka T., Haba S., Takeshi O., Nagashio Y., Obayashi T., Shinagawa A., Bhatia V., Shimizu Y., Goto H., Niwa Y.

    ENDOSCOPY   Vol. 45 ( 5 ) page: 392 - 396   2013.5

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    A prospective clinical study was conducted to evaluate the safety, feasibility, and efficacy of endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) with direct metallic stent placement using a prototype forward-viewing echoendoscope. The indication for EUS - CDS in this study was lower biliary obstruction only, and not failed endoscopic biliary drainage, because the aim was to evaluate EUS - CDS for first-line biliary drainage therapy. The technical and functional success rates were 94 % (17 /18) and 94 % (16 /17), respectively. Early complications (focal peritonitis) were encountered in two patients (11 %). No patients developed late complications. EUS - CDS with direct metallic stent placement using a forward-viewing echoendoscope was generally feasible and effective for malignant distal biliary tract obstruction. The forward-viewing echoendoscope was useful, especially for deploying the metallic stent. © Georg Thieme Verlag KG Stuttgart - New York.

    DOI: 10.1055/s-0032-1326076

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  159. Percutaneous transhepatic sclerotherapy for recurrent bleeding ileal varices diagnosed by capsule endoscopy and computed tomography during percutaneous transhepatic venography.

    Hashimoto Y, Amano H, Fukumoto A, Amano M, Sagami S, Yamao K, Iiboshi T, Onogawa S, Hirano N, Hanada K, Hino F

    Hepatology research : the official journal of the Japan Society of Hepatology   Vol. 43 ( 4 ) page: 436 - 40   2013.4

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    DOI: 10.1111/j.1872-034X.2012.01083.x

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  160. Cigarette Smoking and Pancreatic Cancer Risk: A Revisit with an Assessment of the Nicotine Dependence Phenotype

    Nakao Makoto, Hosono Satoyo, Ito Hidemi, Oze Isao, Watanabe Miki, Mizuno Nobumasa, Yatabe Yasushi, Yamao Kenji, Niimi Akio, Tajima Kazuo, Tanaka Hideo, Matsuo Keitaro

    ASIAN PACIFIC JOURNAL OF CANCER PREVENTION   Vol. 14 ( 7 ) page: 4409 - 4413   2013

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    Background: Cigarette smoking is a well-established risk factor of pancreatic cancer (PC). Although an association between nicotine dependence phenotype, namely time to first cigarette (TTFC) after waking, and the risk of several smoking-related cancers has been reported, an association between TTFC and PC risk has not been reported. We assessed the impact of smoking behavior, particularly TTFC, on PC risk in a Japanese population. Materials and Methods: We conducted a case-control study using 341 PC and 1,705 non-cancer patients who visited Aichi Cancer Center in Nagoya, Japan. Exposure to risk factors, including smoking behavior, was assessed from the results of a self-administered questionnaire. The impact of smoking on PC risk was assessed with multivariate logistic regression analysis adjusted for potential confounders to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Cigarettes per day (CPD) and/or smoking duration were significantly associated with PC risk, consistent with previous studies. For TTFC and PC risk, we found only a suggestive association: compared with a TTFC of more than 60 minutes, ORs were 1.15 (95%CI, 0.65-2.04) for a TTFC of 30-60 minutes and 1.35 (95%CI, 0.85-2.15) for that of 0-30 minutes (p trend=0.139). After adjustment for CPD or smoking duration, no association was observed between TTFC and PC. Conclusions: In this study, we found no statistically significant association between TTFC and PC risk. Further studies concerning TTFC and PC risk are warranted.

    DOI: 10.7314/APJCP.2013.14.7.4409

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  161. Selected Polymorphisms of Base Excision Repair Genes and Pancreatic Cancer Risk in Japanese

    Nakao Makoto, Hosono Satoyo, Ito Hidemi, Watanabe Miki, Mizuno Nobumasa, Sato Shigeki, Yatabe Yasushi, Yamao Kenji, Ueda Ryuzo, Tajima Kazuo, Tanaka Hideo, Matsuo Keitaro

    JOURNAL OF EPIDEMIOLOGY   Vol. 22 ( 6 ) page: 477 - 483   2012.11

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    Background: Although several reports have described a possible association between DNA repair genes and pancreatic cancer (PC) in smokers, this association has not been fully evaluated in an Asian population. We assessed the impact of genetic polymorphisms in the base excision repair (BER) pathway on PC risk among Japanese. Methods: This case-control study compared the frequency of 5 single-nucleotide polymorphisms (SNPs) of BER genes, namely rs1052133 in OGG1, rs1799782 and rs25487 in XRCC1, rs1130409 in APE1, and rs1136410 in PARP1. SNPs were investigated using the TaqMan assay in 185 PC cases and 1465 controls. Associations of PC risk with genetic polymorphisms and gene-environment interaction were examined with an unconditional logistic regression model. Exposure to risk factors was assessed from the results of a self-administered questionnaire. We also performed haplotype-based analysis. Results: We observed that the minor allele of rs25487 in XRCC1 was significantly associated with PC risk in the per-allele model (odds ratio = 1.29, CI = 1.01-1.65; trend P = 0.043). Haplotype analysis of XRCC1 also showed a statistically significant association with PC risk. No statistically significant interaction between XRCC1 polymorphisms and smoking status was seen.Conclusions: Our findings suggest that XRCC1 polymorphisms affect PC risk in Japanese. © 2012 by the Japan Epidemiological Association.

    DOI: 10.2188/jea.JE20120010

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  162. [A case of mucosal Schwann cell hamartoma].

    Sagami S, Fukumoto A, Amano M, Yamao K, Hashimoto Y, Iiboshi T, Onogawa S, Hirano N, Hanada K, Amano H, Hino F, Yonehara S

    Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   Vol. 109 ( 10 ) page: 1776 - 83   2012.10

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  163. Aberrant DNA methylation associated with aggressiveness of gastrointestinal stromal tumour

    Okamoto Y., Sawaki A., Ito S., Nishida T., Takahashi T., Toyota M., Suzuki H., Shinomura Y., Takeuchi I., Shinjo K., An B., Ito H., Yamao K., Fujii M., Murakami H., Osada H., Kataoka H., Joh T., Sekido Y., Kondo Y.

    Gut   Vol. 61 ( 3 ) page: 392 - 401   2012.3

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    Background and aims: The majority of gastrointestinal stromal tumors (GISTs) have KIT mutations; however, epigenetic abnormalities that could conceivably potentiate the aggressiveness of GISTs are largely unidentified. Our aim was to establish epigenetic profiles associated with the malignant transformation of GISTs. Methods: Methylation of four tumor suppressor genes, RASSF1A, p16, CDH1, and MGMT was analyzed in GISTs. Additionally, genome-wide DNA methylation profiles were compared between small, malignant-prone, and malignant GISTs using methylated GpG island amplification microarrays (MCAM) in a training set (n=40). Relationships between the methylation status of genes identified by MCAM and clinical features of the disease were tested in a validation set (n=75). Results: Methylation of RASSF1A progressively increased from small to malignant GISTs. p16 was specifically methylated in malignant-prone and malignant GISTs. MCAM analysis showed that more genes were methylated in advanced than in small GISTs (average of 473 genes vs 360 genes, respectively, P=0.012). Interestingly, the methylation profile of malignant GISTs was prominently affected by their location. Two genes, REC8 and PAX3, which were newly-identified via MCAM analysis, were differentially methylated in small and malignant GISTs in the training and validation sets. Patients with methylation of at least REC8, PAX3, or p16 had a significantly poorer prognosis (P=0.034). Conclusion: Our results suggest that GIST is not, in epigenetic terms, a uniform disease and that DNA methylation in a set of genes is associated with aggressive clinical behavior and unfavorable prognosis. The genes identified may potentially serve as biomarkers for predicting aggressive GISTs with poor survivability.

    DOI: 10.1136/gut.2011.241034

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  164. Interaction between IGF-1 polymorphisms and overweight for the risk of pancreatic cancer in Japanese

    Nakao M., Hosono S., Ito H., Watanabe M., Mizuno N., Yatabe Y., Yamao K., Ueda R., Tajima K., Tanaka H., Matsuo K.

    International Journal of Molecular Epidemiology and Genetics   Vol. 2 ( 4 ) page: 354 - 366   2011.12

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    Although several reports have described a possible association between insulin-like growth factors-1 (IGF-1) and pancreatic cancer (PC) risk, this association has not been evaluated in the non-Caucasian population. To assess the impact of IGF-1 polymorphisms on PC risk in Japanese, we conducted a case-control study which compared the frequency of ten single nucleotide polymorphisms (SNPs) and haplotypes of IGF-1. SNPs were investigated using the TaqMan method in 176 patients with PC and 1402 control subjects. Exposure to risk factors was assessed from the results of a self-administered questionnaire. Associations and gene-environment interactions were examined using an unconditional logistic regression model. We did not observe any significant main effect of IGF-1 loci, but did find interactions between rs5742714 and past and/or current body-mass index (BMI) status. Among patients with BMI ≥ 25 at age 20, an increased PC risk was observed with the addition of the minor allele for rs5742714 (trend P = 0.048) and rs6214 (P = 0.043). Among patients with current BMI ≥ 25, an increased or decreased PC risk was observed with the addition of the minor allele for rs5742714 (trend P = 0.046), rs4764887 (P = 0.031) and rs5742612 (P = 0.038). Haplotype analysis of IGF-1 showed a significant association among patients who were either or both previously or currently overweight. These findings suggest that IGF-1 polymorphisms may affect the development of PC in the Japanese population in combination with obesity. Further studies to confirm these findings are warranted.

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  165. Association between insulin-like growth factor-1 polymorphisms and stomach cancer risk in a Japanese population

    Ennishi Daisuke, Shitara Kohei, Ito Hidemi, Hosono Satoyo, Watanabe Miki, Ito Seiji, Sawaki Akira, Yatabe Yasushi, Yamao Kenji, Tajima Kazuo, Tanimoto Mitsune, Tanaka Hideo, Hamajima Nobuyuki, Matsuo Keitaro

    CANCER SCIENCE   Vol. 102 ( 12 ) page: 2231 - 2235   2011.12

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    The insulin-like growth factor (IGF) signaling system plays a central role in cellular growth, differentiation and proliferation. Although the association between IGF1 gene polymorphisms and cancer risk has been evaluated for several carcinomas, this association has not yet been examined for stomach cancer. We investigated the association between IGF1 polymorphisms and the risk of stomach cancer in a Japanese population. A total of 703 patients with stomach cancer and 1462 non-cancer control subjects were enrolled in this case-control study. Associations between polymorphisms of 10 IGF1 loci and the risk of stomach cancer were evaluated using odds ratios (OR) and 95% confidence intervals (CI) in multiple logistic regression models. We observed that the C allele in rs1520220 and the G allele in rs4764887 were significantly associated with stomach cancer risk in the per-allele model after adjusting for other risk factors (OR: 1.14 [95% CI: 1.00-1.30] and OR: 1.18 [95% CI: 1.02-1.36], respectively). We also observed a positive and dose-dependent association between the number of risk alleles and stomach cancer risk (P-trend: 0.019) when examining the two loci in the same model. These associations were still seen after adjusting for potential confounders, including sex, age, smoking status, history of diabetes and family history of stomach cancer. We did not find any significant interaction between these factors and the number of risk alleles. In conclusion, we observed a significant association between IGF1 polymorphisms and stomach cancer risk among a Japanese population. Examination of the biological significance of IGF1 is warranted. © 2011 Japanese Cancer Association.

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  166. Recurrent autoimmune hemolytic anemia induced by XELOX chemotherapy for colon cancer

    Ogura T., Tajika M., Niwa Y., Kawai H., Kondo S., Sawaki A., Mizuno N., Hara K., Hijioka S., Nakamura M., Higuchi K., Goto H., Yamao K.

    Journal of Japanese Society of Gastroenterology   Vol. 108 ( 10 ) page: 1712 - 1719   2011.10

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    We describe a 54-year old woman with oxaliplatin-induced autoimmune hemolytic anemia and review the clinical features of similar published cases. The present patient had metastatic colon cancer and was admitted to our hospital with a floating sensation and general malaise on day 4 after undergoing the last of 4 cycles of a 7 th round of chemotherapy with XELOX. Laboratory data revealed 4.6g/d/ hemoglobin and 8.77 mg/d/ creatinine. Direct and indirect Coombs tests of a blood sample for blood transfusion were both positive. We diagnosed immune hemolysis with acute renal failure based on the clinical course and blood samples showing haptoglobin <10mg/d/. We treated her with hemodialysis, plasmapheresis and immune suppression with prednisolone, which improved the anemia and renal failure.

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  167. ABO Genotype and the Risk of Gastric Cancer, Atrophic Gastritis, and Helicobacter pylori Infection

    Nakao Makoto, Matsuo Keitaro, Ito Hidemi, Shitara Kohei, Hosono Satoyo, Watanabe Miki, Ito Seiji, Sawaki Akira, Iida Shinsuke, Sato Shigeki, Yatabe Yasushi, Yamao Kenji, Ueda Ryuzo, Tajima Kazuo, Hamajima Nobuyuki, Tanaka Hideo

    CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION   Vol. 20 ( 8 ) page: 1665 - 1672   2011.8

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    Background: Although several studies have investigated the association between ABO blood type and risk of gastric cancer (GC), atrophic gastritis (AG), and Helicobacter pylori (HP) infection, no study has investigated these associations by using ABO genotype. Methods: We conducted a case-control study in 703 patients with GC and 1,465 noncancer patients. Wealso conducted a cross-sectional study by using 1,406 of these 1,465 controls, who were examined for pepsinogens and anti-HP IgG antibody levels in serum. ABO genotype was determined from single nucleotide polymorphisms in ABO gene. We used rs8176719 to mark the O allele, and rs8176746 and rs8176747 to mark the B allele. ORs and 95% CIs were calculated by a multivariate logistic model. Results: We observed significant associations between ABO genotype and GC, AG, and HP infection. ORs (95% CIs) of GC were 0.70 (0.50-0.99) for OO and 0.53 (0.36-0.77) for BO relative to AA genotype. An increased risk of GC was observed with addition of the A allele (P trend < 0.001), and a decreased risk with that of the B allele (P trend = 0.023). An OR of AG was 0.73 (95% CI, 0.53-0.99) for blood type B relative to blood type A, and an OR of HP infection was 0.39 (95% CI, 0.17-0.87) for BB relative to AA genotype. Conclusion: This study identified a statistically significant association between ABO genotype and GC risk. In addition, ABO gene locus may influence AG prevalence and HP infection. Impact: Further studies are necessary to confirm these findings. ©2011 AACR.

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  168. Prospective Clinical Study of EUS-Guided Choledochoduodenostomy for Malignant Lower Biliary Tract Obstruction

    Hara Kazuo, Yamao Kenji, Niwa Yasumasa, Sawaki Akira, Mizuno Nobumasa, Hijioka Susumu, Tajika Masahiro, Kawai Hiroki, Kondo Shinya, Kobayashi Yuji, Matumoto Kazuya, Bhatia Vikram, Shimizu Yasuhiro, Ito Akihiro, Hirooka Yoshiki, Goto Hidemi

    AMERICAN JOURNAL OF GASTROENTEROLOGY   Vol. 106 ( 7 ) page: 1239 - 1245   2011.7

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    Objectives: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) has recently been reported as an alternative to percutaneous transhepatic biliary drainage (PTBD) in cases of biliary obstruction, when endoscopic biliary drainage (EBD) is unsuccessful. However, prospective studies of EUS-CDS have not yet been performed. We conducted a prospective study to evaluate the safety, feasibility, and efficacy of EUS-CDS in patients with malignant lower biliary tract obstruction. Methods: A prospective study to confirm the safety of EUS-CDS was carried out in 6 patients, followed by a trial to evaluate the feasibility and efficacy of EUS-CDS in 12 additional patients. We placed a plastic stent from the duodenal bulb into the extrahepatic bile duct under EUS guidance using an oblique viewing echoendoscope, needle knife, guidewire, and biliary dilators. Results: The site of extrahepatic bile duct puncture was the common hepatic duct in 15 patients and the common bile duct in 3 patients. Mean diameter of the punctured extrahepatic bile ducts was 10 mm (range: 6-20 mm). Technical and functional success rates were 94% (17/18) and 100% (17/17), respectively. Median procedure time was 30 min (range: 10-52 min). Median duration to first oral intake after the procedure was 1 day (range: 1-3 days). Early complications were encountered in three (17%) patients, including focal peritonitis in two patients and hemobilia in one patient. During the follow-up period (median: 163 days; range: 46-484 days), 12 stent occlusion events were observed in nine patients. Re-intervention with exchange of the occluded stent was successful in 8 of 12 (66%) times. Severe early and late complications were not encountered in any patients in this study. Median duration of stent patency by Kaplan-Meier analysis was 272 days. Conclusions: EUS-CDS is safe, feasible, and effective as an alternative to PTBD and EBD in cases of malignant distal biliary tract obstruction. Prospective randomized studies are needed to compare the safety and efficacy of various kinds of endoscopic devices used in EUS-CDS and to compare EUS-CDS with PTBD or EBD. © 2011 by the American College of Gastroenterology.

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  169. ABO blood group alleles and the risk of pancreatic cancer in a Japanese population

    Nakao Makoto, Matsuo Keitaro, Hosono Satoyo, Ogata Saeko, Ito Hidemi, Watanabe Miki, Mizuno Nobumasa, Iida Shinsuke, Sato Shigeki, Yatabe Yasushi, Yamao Kenji, Ueda Ryuzo, Tajima Kazuo, Tanaka Hideo

    CANCER SCIENCE   Vol. 102 ( 5 ) page: 1076 - 1080   2011.5

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    Several studies have investigated a possible association between the ABO blood group and the risk of pancreatic cancer (PC), but this association has not been fully evaluated in Asian populations. The present study aimed to assess the impact of genotype-derived ABO blood types, particularly ABO alleles, on the risk of PC in a Japanese population. We conducted a case-control study using 185 PC and 1465 control patients who visited Aichi Cancer Center in Nagoya, Japan. Using rs8176719 as a marker for the O allele, and rs8176746 and rs8176747 for the B allele, all participants' two ABO alleles were inferred. The impact of ABO blood type on PC risk was examined by multivariate analysis, with adjustment for potential confounders to estimate odds ratios (OR) and 95% confidence intervals (CI). An increased risk of PC was observed with the addition of any non-O allele (trend P=0.012). Compared with subjects with the OO genotype, those with AO and BB genotypes had significantly increased OR of 1.67 (CI, 1.08-2.57) and 3.28 (CI, 1.38-7.80), respectively. Consistent with earlier reports showing a higher risk of PC for individuals with the non-O blood type, the previously reported protective allele (T) for rs505922 was found to be strongly correlated (r2=0.96) with the O allele. In conclusion, this case-control study showed a statistically significant association between ABO blood group and PC risk in a Japanese population. Further studies are necessary to define the mechanisms by which the ABO gene or closely linked genetic variants influence PC risk. © 2011 Japanese Cancer Association.

    DOI: 10.1111/j.1349-7006.2011.01907.x

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  170. Distinct Profiles of Epigenetic Evolution between Colorectal Cancers with and without Metastasis

    Ju Hai-xing, An Byonggu, Okamoto Yasuyuki, Shinjo Keiko, Kanemitsu Yukihide, Komori Koji, Hirai Takashi, Shimizu Yasuhiro, Sano Tsuyoshi, Sawaki Akira, Tajika Masahiro, Yamao Kenji, Fujii Makiko, Murakami Hideki, Osada Hirotaka, Ito Hidemi, Takeuchi Ichiro, Sekido Yoshitaka, Kondo Yutaka

    AMERICAN JOURNAL OF PATHOLOGY   Vol. 178 ( 4 ) page: 1835 - 1846   2011.4

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    Liver metastasis is a fatal step in the progression of colorectal cancer (CRC); however, the epigenetic evolution of this process is largely unknown. To decipher the epigenetic alterations during the development of liver metastasis, the DNA methylation status of 12 genes, including 5 classical CpG island methylator phenotype (CIMP) markers, was analyzed in 62 liver metastases and in 78 primary CRCs (53 stage I-III; 25 stage IV). Genome-wide methylation analysis was also performed in stage I-III CRCs and in paired primary and liver metastatic cancers. Methylation frequencies of MGMT and TIMP3 increased progressively from stage I-III CRCs to liver metastasis (P = 0.043 and P = 0.028, respectively). The CIMP-positive cases showed significantly earlier recurrence of disease than did CIMPnegative cases with liver metastasis (P = 0.030), whereas no such difference was found in stage I-III CRCs. Genomewide analysis revealed that more genes were methylated in stage I-III CRCs than in paired stage IV samples (P = 0.008). Hierarchical cluster analysis showed that stage I-III CRCs and stage IV CRCs were clustered into two distinct subgroups, whereas most paired primary and metastatic cancers showed similar methylation profiles. This analysis revealed distinct methylation profiles between stage I-III CRCs and stage IV CRCs, whichmayreflect differences in epigenetic evolution during progression of the disease. In addition, most methylation status in stage IV CRCs seems to be established before metastasis. Copyright © 2011 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.ajpath.2010.12.045

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  171. Characteristic methylation profile in CpG island methylator phenotype-negative distal colorectal cancers

    An Byonggu, Kondo Yutaka, Okamoto Yasuyuki, Shinjo Keiko, Kanemitsu Yukihide, Komori Koji, Hirai Takashi, Sawaki Akira, Tajika Masahiro, Nakamura Tsuneya, Yamao Kenji, Yatabe Yasushi, Fujii Makiko, Murakami Hideki, Osada Hirotaka, Tani Tohru, Matsuo Keitaro, Shen Lanlan, Issa Jean-Pierre J., Sekido Yoshitaka

    INTERNATIONAL JOURNAL OF CANCER   Vol. 127 ( 9 ) page: 2095 - 2105   2010.11

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    Language:Japanese   Publisher:International Journal of Cancer  

    Aberrant DNA methylation is involved in colon carcinogenesis. Although the CpG island methylator phenotype (CIMP) is defined as a subset of colorectal cancers (CRCs) with remarkably high levels of DNA methylation, it is not known whether epigenetic processes are also involved in CIMP-negative tumors. We analyzed the DNA methylation profiles of 94 CRCs and their corresponding normal-appearing colonic mucosa with 11 different markers, including the five classical CIMP markers. The CIMP markers were frequently methylated in proximal CRCs (p < 0.01); however, RASSF1A methylation levels were significantly higher in distal CRCs, the majority of which are CIMP-negative (p < 0.05). Similarly, methylation levels of RASSF1A and SFRP1 in the normal-appearing mucosae of distal CRC cases were significantly higher than those in the proximal CRC cases (p < 0.05). They were also positively correlated with age (RASSF1A, p < 0.01; SFRP1, p < 0.01). Microarray-based genome-wide DNA methylation analysis of 18 CRCs revealed that 168 genes and 720 genes were preferentially methylated in CIMP-negative distal CRCs and CIMP-positive CRCs, respectively. Interestingly, more than half of the hypermethylated genes in CIMP-negative distal CRCs were also methylated in the normal-appearing mucosae, indicating that hypermethylation in CIMP-negative distal CRCs is more closely associated with age-related methylation. By contrast, more than 60% of the hypermethylated genes in CIMP-positive proximal CRCs were cancer specific (p < 0.01). These data altogether suggest that CpG island promoters appear to be methylated in different ways depending on location, a finding which may imply the presence of different mechanisms for the acquisition of epigenetic changes during colon tumorigenesis. © 2010 UICC.

    DOI: 10.1002/ijc.25225

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  172. Corticosteroids Correct Aberrant CFTR Localization in the Duct and Regenerate Acinar Cells in Autoimmune Pancreatitis

    Ko Shigeru B. H., Mizuno Nobumasa, Yatabe Yasushi, Yoshikawa Toshiyuki, Ishiguro Hiroshi, Yamamoto Akiko, Azuma Sakiko, Naruse Satoru, Yamao Kenji, Muallem Shmuel, Goto Hidemi

    GASTROENTEROLOGY   Vol. 138 ( 5 ) page: 1988 - U114   2010.5

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    Background & Aims: Corticosteroids are now widely accepted as a treatment for autoimmune pancreatitis (AIP). However, the molecular mechanism by which steroid treatment improves AIP remains largely unknown. The aim of this study was to elucidate cellular mechanisms by which corticosteroids improve both pancreatic exocrine function and histopathology in AIP. Methods: Pancreatic exocrine function was evaluated by the secretin-stimulated function test and pancreatic biopsy specimens were processed for histologic analysis at the time of diagnosis and 3 months after initiation of steroid treatment. Expression and localization of proteins was assayed by immunohistochemistry. Analysis of immunoglobulin (Ig)G4-positive plasma cells was used to verify inflammation in AIP. Results: The number of IgG4-positive plasma cells in pancreatic sections was decreased by steroid treatment, indicating reduced inflammation. Fluid, bicarbonate (HCO3-), and digestive enzyme secretions all were impaired in most patients with AIP. Corticosteroids improved both HCO3- and digestive enzyme secretion. A large fraction of the cystic fibrosis transmembrane conductance regulator (CFTR), which plays a central role in pancreatic duct HCO3- secretion, was mislocalized to the cytoplasm of duct cells before treatment. Corticosteroids corrected the localization of CFTR to the apical membrane, accounting for the improved HCO3- secretion. Steroid treatment resulted in regeneration of acinar cells, accounting for restored digestive enzyme secretion. Conclusions: Corticosteroids reduce inflammation and restore both digestive enzyme and HCO3- secretion in patients with AIP by regenerating acinar cells and correcting CFTR localization in pancreatic duct cells. Mislocalization of CFTR may explain aberrant HCO3- secretion in other forms of pancreatitis. © 2010 AGA Institute.

    DOI: 10.1053/j.gastro.2010.01.001

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  173. Is <sup>18</sup>F-fluorodeoxyglucose positron emission tomography meaningful for estimating the efficacy of corticosteroid therapy in patients with autoimmune pancreatitis?

    Shigekawa M., Yamao K., Sawaki A., Hara K., Takagi T., Bhatia V., Nishio M., Tamaki T., El-Amin H., El-Abdeen Z., Sayed A., Mizuno N.

    Journal of Hepato-Biliary-Pancreatic Sciences   Vol. 17 ( 3 ) page: 269 - 274   2010.5

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    Background: Autoimmune pancreatitis (AIP) is often misdiagnosed as pancreatic cancer (PC). Both conditions accumulate 18F- fluorodeoxyglucose (FDG), so FDG positron emission tomography (FDG-PET) is not discriminatory. This study aimed to evaluate the pattern of FDG accumulation, and the change in FDG uptake after steroid treatment in AIP and PC. Methods: We compared FDG-PET patterns between 18 patients with AIP and 20 patients with PC, and also evaluated the short-term changes in FDG uptake after steroid therapy. Results: FDG uptake was observed in 88.9% in AIP and 90.0% in PC. FDG uptake in extra-abdominal lymph nodes was seen more frequently in AIP, and uptake in salivary glands, eyes and biliary ducts was seen only in AIP. Follow-up PET was performed in 6 AIP patients and in 3 PC patients. Changes in SUVmax after steroid therapy were estimated within 1 week in 5 AIP patients and in all 3 PC patients, retrospectively. In 4 AIP patients, the change in SUV max was more than 10%. On the other hand, in PC, SUVmax increased or remained almost unchanged (within 10%). Conclusions: FDG-PET pattern at baseline, and a decrease in FDG uptake after a short steroid trial can be useful for discriminating AIP from PC. © Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2009.

    DOI: 10.1007/s00534-009-0172-9

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Books 3

  1. 【消化器診療の疑問、これで納得!外来・病棟・当直での初期対応や鑑別診断から検査・画像・薬物治療まで、よくある悩みに答えます】 (第7章)(番外編) 研修医のお悩み相談室 消化器疾患の症例呈示がうまくできません。プレゼンのコツを教えてください

    山雄 健太郎( Role: Sole author)

    レジデントノート15巻8号  2013.8 

  2. 【内視鏡検査・治療の基礎知識と看護の役割】 緊急内視鏡にかかわる際の心得と注意点

    山雄 健太郎( Role: Sole author)

    達人ナース: 経験知の伝授誌 34巻2号  2013.2 

  3. 期待される最新研究 病診連携システムを用いた膵癌の早期診断

    山雄 健太郎, 飯星 知博, 花田 敬士, 片山 壽( Role: Joint author)

    膵・胆道癌Frontier 2巻1号 Page42-45  2012.3 

MISC 43

  1. 【胆膵疾患の最新画像診断】3D-CT解析を用いた膵実質萎縮による膵癌早期診断

    山雄 健太郎, 竹中 完, 田中 秀和, 田中 隆光, 吉田 晃浩, 石川 嶺, 岡本 彩那, 中井 敦, 山崎 友裕, 大本 俊介, 鎌田 研, 三長 孝輔, 渡邉 智裕, 工藤 正俊

    胆と膵   Vol. 41 ( 8 ) page: 713 - 718   2020.8

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    Language:Japanese   Publisher:医学図書出版(株)  

    膵癌は予後不良な癌腫であり、予後改善が急務である。小膵癌の場合、CTやMRIでの直接指摘が困難であるため、尾側膵管拡張を伴う主膵管狭窄などの間接所見が診断の契機となる。しかしながら主膵管狭窄は慢性膵炎などの良性疾患でも認められる。近年、上皮内癌を含む腫瘍径10mm以下の微小膵癌において膵実質の部分萎縮(やせ)が診断の指標になるとの報告が散見される。ただし膵臓は膵頭部が膨大している、門脈から腹側へ圧排を受けるなどの構造をしているため、通常のCTでは萎縮がやや評価しにくい。3D-CTは本来立体構造をした膵臓をそのまま3D画像として可視化できるため、この技術を用いて膵臓を抽出することで膵実質の萎縮を直感的かつ簡便に評価できる。3D-CTによる膵実質の萎縮評価は膵癌の早期診断および予後改善に寄与すると考える。(著者抄録)

  2. Walled-off necrosisに対するContrast enhanced EUS-guided cyst drainageの有用性

    竹中完, 高島耕太, 田中秀和, 福永朋洋, 吉田晃浩, 岡本彩那, 山崎友裕, 大本俊介, 三長孝輔, 鎌田研, 山雄健太郎, 工藤正俊

    膵臓(Web)   Vol. 36 ( 3 )   2021

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  3. Pathogenesis of Acute Cholangitis and Cholecystitis

    竹中完, 岡本彩那, 山崎友裕, 大本俊介, 三長孝輔, 鎌田研, 山雄健太郎, 工藤正俊

    臨床消化器内科   Vol. 36 ( 9 )   2021

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  4. 急性膵炎からアプローチする膵癌早期診断

    山雄健太郎, 竹中完, 工藤正俊

    日本消化器病学会雑誌(Web)   Vol. 118   2021

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  5. 当院における局所進行切除不能膵癌に対するconversion surgeryの短期・長期成績の検討

    吉田雄太, 松本逸平, 川口晃平, 松本正孝, 李東河, 村瀬貴昭, 亀井敬子, 里井俊平, 武部敦志, 中居卓也, 鎌田研, 山雄健太郎, 竹中完, 竹山宜典

    膵臓(Web)   Vol. 36 ( 3 )   2021

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  6. 【進化するEUS】診断的EUS 造影ハーモニックEUS

    三長 孝輔, 原 茜, 田中 秀和, 大本 俊介, 鎌田 研, 山雄 健太郎, 竹中 完, 工藤 正俊

    消化器内視鏡   Vol. 32 ( 11 ) page: 1641 - 1649   2020.11

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    Language:Japanese   Publisher:(株)東京医学社  

  7. 【肝胆膵における結石診療のベストプラクティス】胆嚢結石症 Confluence stoneとMirizzi症候群はどう違うのか Biliobiliary fistulaと合わせて

    竹中 完, 石川 嶺, 岡本 彩那, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 工藤 正俊

    肝胆膵   Vol. 81 ( 2 ) page: 305 - 312   2020.8

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  8. 【肝胆膵における結石診療のベストプラクティス】胆嚢結石症 Confluence stoneとMirizzi症候群はどう違うのか Biliobiliary fistulaと合わせて

    竹中 完, 石川 嶺, 岡本 彩那, 山崎 友裕, 中井 敦史, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 工藤 正俊

    肝・胆・膵   Vol. 81 ( 2 ) page: 305 - 312   2020.8

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  9. 膵管狭窄症例におけるCT間接所見の検討 微小膵癌と良性膵管狭窄症例の比較

    山雄 健太郎, 竹中 完, 松本 逸平, 竹山 宜典, 沼本 勲男, 鶴崎 正勝, 工藤 正俊

    膵臓   Vol. 35 ( 3 ) page: A345 - A345   2020.7

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  10. 【知っておきたい新たな処置具-特徴とその開発意図】ERCP関連 Uneven Double Lumen Cannula

    竹中 完, 三長 孝輔, 鎌田 研, 山雄 健太郎, 工藤 正俊

    消化器内視鏡   Vol. 32 ( 6 ) page: 862 - 864   2020.6

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  11. EUS施行時の鎮静方法の検討

    岡本彩那, 鎌田研, 河野辰哉, 田中秀和, 石川嶺, 山崎友裕, 中井敦史, 大本俊介, 三長孝輔, 山雄健太郎, 竹中完, 工藤正俊

    日本消化器病学会雑誌(Web)   Vol. 117   2020

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  12. Disconnected pancreatic duct syndromeの外科治療症例の検討

    松本正孝, 松本逸平, 吉田雄太, 山雄健太郎, 川口晃平, 村瀬貴昭, 大本俊介, 亀井敬子, 里井俊平, 竹中完, 武部敦志, 中居卓也, 竹山宜典

    膵臓(Web)   Vol. 35 ( 3 )   2020

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  13. Walled-off necrosisに対するLAMS with10FrENCD持続洗浄治療の有用性について

    竹中完, 石川嶺, 岡本彩那, 中井敦史, 山崎友裕, 大本俊介, 三長孝輔, 鎌田研, 山雄健太郎, 松本逸平, 竹山宜典, 工藤正俊

    膵臓(Web)   Vol. 35 ( 3 )   2020

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  14. 術後膵液瘻(POPF)に対するEUS下ドレナージの有用性

    中井敦史, 山雄健太郎, 竹中完, 竹山宜典, 工藤正俊

    膵臓(Web)   Vol. 35 ( 3 )   2020

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  15. 膵管狭窄症例におけるCT間接所見の検討-微小膵癌と良性膵管狭窄症例の比較-

    山雄健太郎, 竹中完, 松本逸平, 竹山宜典, 沼本勲男, 鶴崎正勝, 工藤正俊

    膵臓(Web)   Vol. 35 ( 3 )   2020

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  16. 膵癌早期診断のための3D CT解析による膵実質萎縮の検討

    山雄健太郎, 竹中完, 石川嶺, 沼本勲, 鶴崎正勝, 渡邉智裕, 工藤正俊

    日本消化器病学会雑誌(Web)   Vol. 117   2020

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  17. 急性膵炎におけるプレサルコペニアの臨床的意義に関しての検討

    田中隆光, 竹中完, 吉田晃弘, 田中秀和, 吉川智恵, 石川嶺, 岡本彩那, 山崎友裕, 中井敦史, 大本俊輔, 三長孝輔, 鎌田研, 山雄健太郎, 松本逸平, 竹山宜典, 工藤正俊

    日本消化器病学会雑誌(Web)   Vol. 117   2020

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  18. 内視鏡的乳頭切除術後胆管狭窄に対する予防的金属ステント留置の有用性

    岡本彩那, 竹中完, 田中隆光, 田中秀和, 吉田晃浩, 吉川智恵, 石川嶺, 山崎友裕, 中井敦史, 大本俊介, 三長孝輔, 鎌田研, 山雄健太郎, 工藤正俊

    Gastroenterological Endoscopy (Web)   Vol. 62 ( Supplement2 )   2020

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  19. ERCP(内視鏡的逆行性胆管膵管造影検査)における水晶体被ばくの現状

    竹中 完, 細野 眞, 中井 敦史, 大本 俊介, 三長 孝輔, 鎌田 研, 山雄 健太郎, 林 史郎, 西田 勉, 工藤 正俊

    日本消化器病学会雑誌   Vol. 116 ( 12 ) page: 1053 - 1055   2019.12

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  20. 膵癌/胆道癌における早期診断の進歩 膵癌診断のための新たなアプローチ法の提案 3D CT解析による膵実質萎縮の検討

    山雄 健太郎, 竹中 完, 工藤 正俊

    日本消化器病学会雑誌   Vol. 116 ( 臨増大会 ) page: A573 - A573   2019.11

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  21. 【膵癌における内視鏡診断・治療の最前線】術後膵液瘻に対する内視鏡的ドレナージの現状

    竹中 完, 中井 敦史, 吉川 智恵, 石川 嶺, 岡本 彩那, 山崎 友裕, 大本 俊輔, 三長 孝輔, 鎌田 研, 山雄 健太郎, 亀井 敬子, 松本 逸平, 竹山 宜典, 工藤 正俊

    胆と膵   Vol. 40 ( 9 ) page: 807 - 814   2019.9

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    膵癌術後合併症の膵切除後膵液瘻(POPF)はときに重篤な経過をたどるが、内視鏡的ドレナージはPOPFの治療において外科的治療と並ぶ重要な治療の一つである。内視鏡的ドレナージには、経乳頭的に主膵管内にドレナージチューブを留置して持続吸引を行うTrans-papillary drainageと、EUSガイド下に膵液貯留腔にドレナージを置くEUS-guided drainageがあり、それぞれの長所短所を理解したうえで、状況に応じた使い分けが求められる、EUS-guided drainageの時期は、急性膵炎後のWalled Off Necrosis(WON)に対するEUS-guided drainageの適応が発症4週間以降であることを踏まえ、術後4週間を待たれる症例が多いが、近年4週間以内の早期ドレナージの有効性も報告されており、症例に応じて4週間を待つことなく、EUS-guided drainageを行うことも考慮に入れるべきである。いずれの処置も適応が正しいかどうか、処置後合併症の対応、外科的ドレナージへのconversionの時期を含め、常に外科と内科で密にディスカッションを行い、患者にとってもっともよい治療法を施設として選択できるように取り組むことが肝要である。(著者抄録)

  22. 【術後内視鏡診療のすべて】消化器手術後の内視鏡検査 サーベイランスと異時性病変の診断 消化管再建術後における超音波内視鏡を用いたスクリーニング検査

    鎌田 研, 原 茜, 田中 秀和, 石川 嶺, 岡本 彩那, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 竹中 完, 工藤 正俊

    消化器内視鏡   Vol. 31 ( 9 ) page: 1331 - 1336   2019.9

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    Language:Japanese   Publisher:(株)東京医学社  

  23. 【術後内視鏡診療のすべて】消化器手術後の内視鏡検査 サーベイランスと異時性病変の診断 消化管再建術後における超音波内視鏡を用いたスクリーニング検査

    鎌田 研, 原 茜, 田中 秀和, 石川 嶺, 岡本 彩那, 中井 敦史, 大本 俊介, 三長 孝輔, 山雄 健太郎, 竹中 完, 工藤 正俊

    消化器内視鏡   Vol. 31 ( 9 ) page: 1331 - 1336   2019.9

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    Language:Japanese   Publisher:(株)東京医学社  

  24. 【膵癌における内視鏡診断・治療の最前線】術後膵液瘻に対する内視鏡的ドレナージの現状

    竹中 完, 中井 敦史, 吉川 智恵, 石川 嶺, 岡本 彩那, 山崎 友裕, 大本 俊輔, 三長 孝輔, 鎌田 研, 山雄 健太郎, 亀井 敬子, 松本 逸平, 竹山 宜典, 工藤 正俊

    胆と膵   Vol. 40 ( 9 ) page: 807 - 814   2019.9

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    膵癌術後合併症の膵切除後膵液瘻(POPF)はときに重篤な経過をたどるが、内視鏡的ドレナージはPOPFの治療において外科的治療と並ぶ重要な治療の一つである。内視鏡的ドレナージには、経乳頭的に主膵管内にドレナージチューブを留置して持続吸引を行うTrans-papillary drainageと、EUSガイド下に膵液貯留腔にドレナージを置くEUS-guided drainageがあり、それぞれの長所短所を理解したうえで、状況に応じた使い分けが求められる、EUS-guided drainageの時期は、急性膵炎後のWalled Off Necrosis(WON)に対するEUS-guided drainageの適応が発症4週間以降であることを踏まえ、術後4週間を待たれる症例が多いが、近年4週間以内の早期ドレナージの有効性も報告されており、症例に応じて4週間を待つことなく、EUS-guided drainageを行うことも考慮に入れるべきである。いずれの処置も適応が正しいかどうか、処置後合併症の対応、外科的ドレナージへのconversionの時期を含め、常に外科と内科で密にディスカッションを行い、患者にとってもっともよい治療法を施設として選択できるように取り組むことが肝要である。(著者抄録)

  25. 膵癌早期診断の最前線 微小膵癌診断の新たなアプローチ法 3D CTによる膵実質萎縮評価から見えてきたもの

    山雄 健太郎, 竹中 完, 吉川 智恵, 石川 嶺, 岡本 彩那, 中井 敦, 山崎 友宏, 大本 俊介, 鎌田 研, 三長 孝輔, 松本 逸平, 竹山 宜典, 鶴崎 正勝, 渡邉 智裕, 工藤 正俊

    膵臓   Vol. 34 ( 3 ) page: A33 - A34   2019.6

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    Language:Japanese   Publisher:日本膵臓学会  

  26. IPMN切除例からみた新ガイドラインの検証と,造影ハーモニックEUSの有用性について

    山崎友裕, 大本俊介, 竹中完, 吉川智恵, 石川嶺, 岡本彩那, 中井敦史, 三長孝輔, 鎌田研, 山雄健太郎

    日本消化器病学会雑誌(Web)   Vol. 116   2019

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  27. EUS施行時のプロポフォール持続注入による鎮静の有用性の検討

    岡本彩那, 鎌田研, 竹中完, 吉川智恵, 石川嶺, 山崎友裕, 中井敦史, 大本俊介, 三長孝輔, 山雄健太郎, 工藤正俊

    Gastroenterological Endoscopy (Web)   Vol. 61 ( Supplement2 )   2019

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  28. Current status of radiation exposure to crystalline lens in ERCP (endoscopic retrograde cholangiopancreatography)

    竹中完, 細野眞, 細野眞, 中井敦史, 大本俊介, 三長孝輔, 鎌田研, 山雄健太郎, 林史郎, 西田勉, 工藤正俊

    日本消化器病学会雑誌(Web)   Vol. 116 ( 12 )   2019

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  29. 3D CTによる膵実質萎縮の評価が進展範囲診断に有用であった8mm膵癌の1例

    山雄健太郎, 三長孝輔, 竹中完, 樫田博史, 松本逸平, 竹山宜典, 鶴崎正勝, 前西修, 筑後孝章, 工藤正俊

    日本消化器画像診断研究会プログラム・抄録集   Vol. 71st   2019

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  30. 南大阪地域における急性膵炎地域連携モデル構築への取り組み

    竹中完, 大本俊介, 吉川智恵, 石川嶺, 岡本彩那, 山崎友裕, 中井敦史, 三長孝輔, 鎌田研, 山雄健太郎, 松本逸平, 竹山宜典, 工藤正俊

    膵臓(Web)   Vol. 34 ( 3 )   2019

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  31. 重症膵炎症例におけるプレサルコペニアと予後の関連性についての検討

    竹中完, 大本俊介, 竹山宜典, 吉川智恵, 石川嶺, 岡本彩那, 山崎友裕, 中井敦史, 三長孝輔, 鎌田研, 山雄健太郎, 松本逸平, 工藤正俊

    膵臓(Web)   Vol. 34 ( 3 )   2019

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  32. 術前診断に難渋した膵頭部・尾部同時性多発癌の一例

    岡本彩那, 三長孝輔, 竹中完, 吉川智恵, 石川嶺, 山崎友裕, 中井敦史, 大本俊介, 鎌田研, 山雄健太郎, 松本逸平, 大谷知之, 工藤正俊

    日本消化器病学会雑誌(Web)   Vol. 116   2019

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  33. 血清IFN-α/IL-33が治療効果判定に有用と考えられた自己免疫性膵炎/IgG4関連疾患の1例

    原茜, 三長孝輔, 岡本彩那, 石川嶺, 山崎友裕, 中井敦史, 大本俊介, 鎌田研, 山雄健太郎, 竹中完, 渡邉智裕, 安川覚, 工藤正俊

    日本消化器病学会近畿支部例会プログラム・抄録集   Vol. 111th   2019

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  34. 膵癌診断のための新たなアプローチ法の提案-3D CT解析による膵実質萎縮の検討-

    山雄健太郎, 竹中完, 工藤正俊

    日本消化器がん検診学会雑誌   Vol. 57 ( Supplement )   2019

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  35. 膨張性発育により胆嚢から総胆管内にまで連続性充満をぎたした胆管腺扁平上皮癌の一例

    大本俊介, 竹中完, 山雄健太郎, 山崎友裕, 前西修, 筑後孝章, 柳生行伸, 鶴崎正勝, 松本逸平, 竹山宜典, 工藤正俊

    日本消化器画像診断研究会プログラム・抄録集   Vol. 70th   2019

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  36. 微小膵癌診断の新たなアプローチ法-3D CTによる膵実質萎縮評価から見えてきたもの-

    山雄健太郎, 竹中完, 吉川智恵, 石川嶺, 岡本彩那, 中井敦, 山崎友宏, 大本俊介, 鎌田研, 三長孝輔, 松本逸平, 竹山宜典, 鶴崎正勝, 渡邉智裕, 工藤正俊

    膵臓(Web)   Vol. 34 ( 3 )   2019

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  37. Interventional EUSの偶発症予防と対処 超音波内視鏡下瘻孔形成術における胆汁漏出の予防

    鎌田研, 竹中完, 三長孝輔, 石川嶺, 吉川智恵, 岡本彩那, 山崎友裕, 中井敦史, 大本俊介, 山雄健太郎, 工藤正俊

    月刊消化器・肝臓内科   Vol. 4 ( 6 ) page: 470 - 473   2018.12

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    Language:Japanese   Publisher:(有)科学評論社  

    J-GLOBAL

  38. 選択的胆管挿管100%をめざして―We’re gonna do it!―乳頭形態別の胆管挿管ストラテジー【動画付】

    竹中完, 向井秀一, 吉川智恵, 石川嶺, 岡本彩那, 山崎友祐, 中井敦史, 大本俊介, 三長孝輔, 鎌田研, 山雄健太郎, 工藤正俊

    胆と膵   Vol. 39 ( 12 ) page: 1309 - 1317   2018.12

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    Language:Japanese   Publisher:医学図書出版(株)  

    胆管挿管をマスターすることは内視鏡的逆行性胆管膵管造影(ERCP)関連主義の基本中の基本である。胆管挿管の基本は、乳頭部の形態が千差万別であり全く同じものは一つとして存在しないことをまず認識し、これまでに多くの先人が胆管挿管に対する検討を行い、蓄積してきた多くの知見を学び、対峙した乳頭の形態、大きさ、口側隆起の形態から乳頭内の胆管と膵管の合流形式を予想し、その症例でとりうるスコープポジションと胆管挿管との兼ね合いを理解し、難渋することも頭に入れ、挿管のストラテジーを組み立てることが挿管成功率の向上につながり、挿管困難症例克服の重要な鍵となる。すべての処置を愛護的に行うことは言うまでもなく、ERCP歴がある症例はスコープの挿入前に上記内容を把握することが胆管挿管成功につながることは言うまでもなく遂行すべきである。(著者抄録)

    J-GLOBAL

  39. Biliary access大辞典 III.経乳頭的biliary access~salvage technique~Uneven Double Lumen Cannulaを用いた胆管カニュレーションテクニック(Uneven method)【動画付】

    竹中完, 吉川智恵, 石川嶺, 岡本彩那, 山崎友祐, 中井敦史, 大本俊介, 三長孝輔, 鎌田研, 山雄健太郎, 有坂好史, 工藤正俊

    胆と膵   Vol. 39 ( 臨増特大 ) page: 1013‐1020 - 1020   2018.11

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    J-GLOBAL

  40. 胆膵ドレナージupdate[3.困難例とトラブルシューティング]胆管・膵管プラスチックステント迷入への対処

    竹中完, 三長孝輔, 鎌田研, 山雄健太郎, 工藤正俊

    消化器内視鏡   Vol. 30 ( 11 ) page: 1605 - 1611   2018.11

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    J-GLOBAL

  41. A case of gallbladder carcinoma with interesting contrast-enhanced harmonic EUS image

    吉川智恵, 鎌田研, 竹中完, 大本俊介, 三長孝輔, 山雄健太郎, 今井元, 榎木英介, 木村雅友, 松本逸平, 竹山宜典, 工藤正俊

    胆道   Vol. 32 ( 4 ) page: 775‐781 - 781   2018.10

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    本症例は、胆嚢腺筋腫症におけるRokitansky-Aschoff sinus(RAS)内に進展し、一部で浸潤を認めるpT2(SS)胆嚢癌の1例である。胆嚢内にpolypoidに増殖する乳頭型腫瘍を呈し、内部で領域性に異なる増殖パターンを呈した。病理学的に、乳頭型腺癌の組織像を呈し、不整な乳頭腺管状構築をとりながら増殖している領域と充実性の構造を示し、密な腫瘍細胞の増殖を認める領域に分かれていた。造影ハーモニックEUSでは、腫瘤は造影早期より腫瘍血管構造が描出された後、均一かつ強く濃染される領域と少し遅れて内部に太く蛇行する異常血管が緩徐に造影され、その後不均一に造影される領域に2分された。本症例の胆嚢癌は、異なる組織成分の存在を示唆する興味深い造影ハーモニックEUS画像を呈した。(著者抄録)

    DOI: 10.11210/tando.32.775

    J-GLOBAL

  42. どうする膵嚢胞[各論 IPMN]IPMNの経過観察におけるEUSの今後

    鎌田研, 竹中完, 中井敦史, 大本俊介, 宮田剛, 三長孝輔, 山雄健太郎, 今井元, 樫田博史, 工藤正俊

    消化器内視鏡   Vol. 30 ( 5 ) page: 606 - 610   2018.5

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    J-GLOBAL

  43. 術後膵液瘻(POPF)に対するEUS下ドレナージの有用性

    中井敦史, 竹中完, 山雄健太郎, 松本逸平, 竹山宜典, 工藤正俊

    膵臓   Vol. 33 ( 3 )   2018

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Presentations 20

  1. EUSにて認められた低エコー域が診断の契機となった膵上皮内癌の1例

    山雄 健太郎, 福本 晃, 飯星 知博, 天野 美緒, 佐上 晋太郎, 橋本 義政, 小野川 靖二, 平野 巨通, 花田 敬士, 天野 始, 日野 文明, 大林 諒人

    JDDW2011  2011.10 

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    Presentation type:Poster presentation  

  2. 超音波検査発見胆膵病変の精密検査のストラテジー 膵上皮内癌診断のために着目すべき初回画像所見は何か?

    山雄 健太郎, 飯星 知博, 花田 敬士

    JDDW2012  2012.9 

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    Presentation type:Symposium, workshop panel (public)  

  3. 慢性膵炎に対する内視鏡治療の現状 外科的治療を行った慢性膵炎症例の長期成績

    山雄 健太郎, 花田 敬士, 福田 敏勝

    Gastroenterological Endoscopy  2013.4  (一社)日本消化器内視鏡学会

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    Event date: 2013.4

    Language:Japanese  

  4. 非EST症例に対する経カテーテル胆道内視鏡(Trans-catheter endoscopy; TCE)のコツとピットフォール

    山雄 健太郎, 坂本 洋城, 北野 雅之, 工藤 正俊

    第49回日本胆道学会学術集会  2013.9  第49回日本胆道学会学術集会

  5. 診断に苦慮した十二指腸GISTの一例

    山雄 健太郎, 岡村 正造, 浦野 文博, 藤田 基和, 山田 雅弘, 北畠 秀介, 石黒 裕規, 山本 英子, 林 寛子, 山田 哲, 大林 友彦, 川口 彩, 河合 学

    日本消化器病学会総会  2010.4 

  6. 膵空腸吻合の工夫と術後管理 膵液瘻に対するEUS下ドレナージ術の有用性

    山雄 健太郎, 北野 雅之, 工藤 正俊, 竹山 宜典

    日本膵臓学会  2014.7 

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    Presentation type:Symposium, workshop panel (public)  

  7. 膵Hamartomaの2例

    山雄 健太郎, 飯星 知博, 花田 敬士

    日本膵臓学会  2012.6 

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  8. 胸腔内に穿破した縦隔内膵仮性嚢胞の1例

    山雄 健太郎, 浦野 文博, 藤田 基和, 山田 雅弘, 北畠 秀介, 山本 英子, 林 寛子, 大林 友彦, 河合 学, 川口 彩, 岡村 正造

    JDDW2010  2010.10 

  9. 胆管結石治療困難例への戦略 経乳頭処置困難総胆管結石に対するrendezvous法の手技と成績

    山雄 健太郎, 北野 雅之, 工藤 正俊

    JDDW 2014  2014.10 

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    Presentation type:Symposium, workshop panel (public)  

  10. 経乳頭処置困難総胆管結石症例に対するEUS-rendezvous法の成績

    山雄 健太郎, 北野 雅之, 工藤 正俊

    日本胆道学会  2015.9 

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    Presentation type:Oral presentation (general)  

  11. 消化管術後症例に対するダブルバルーン内視鏡を用いたERCP関連処置における主乳頭正面視の工夫

    山雄 健太郎, 花田 敬士, 飯星 知博

    日本胆道学会  2011.9 

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    Presentation type:Poster presentation  

  12. 消化管術後症例に対するダブルバルーン内視鏡を用いたERCP関連処置における主乳頭正面視の工夫

    山雄 健太郎, 花田 敬士, 飯星 知博

    日本胆道学会  2011.8 

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  13. 消化管狭窄の内視鏡治療 上部 悪性胃十二指腸狭窄に対する治療戦略 胆道狭窄合併例に対するEUS下胆道ドレナージ術も含めて

    山雄 健太郎, 北野 雅之, 工藤 正俊

    日本消化器内視鏡学会総会  2014.5 

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    Presentation type:Symposium, workshop panel (public)  

  14. 慢性膵炎に対する内視鏡治療の現状 外科的治療を行った慢性膵炎症例の長期成績

    山雄 健太郎, 花田 敬士, 福田 敏勝

    日本消化器病学会総会  2013.5 

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    Presentation type:Symposium, workshop panel (public)  

  15. 当院における悪性胆道疾患に対するSpyglassの使用経験と課題

    山雄 健太郎, 飯星 知博, 花田 敬士

    日本胆道学会  2012.9 

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    Presentation type:Oral presentation (general)  

  16. 当院におけるEUS下ドレナージ術の成績. ワークショップ1「内視鏡ステント治療の現状と問題点(胆膵)」

    山雄 健太郎, 北野 雅之, 工藤 正俊

    日本消化器内視鏡学会近畿支部第91回支部例会  2013.11  日本消化器内視鏡学会近畿支部第91回支部例会

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    Venue:大阪国際交流センター, 大阪  

  17. 壊死性膵炎の予後改善を目指した治療の新展開 当院におけるPancreatic fluid collectionに対する治療成績

    山雄 健太郎, 北野 雅之, 工藤 正俊

    日本消化器内視鏡学会総会  2015.4 

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    Presentation type:Symposium, workshop panel (public)  

  18. 切除不能膵癌の治療選択 胃十二指腸ステントおよびステント留置下胆道ドレナージ術の治療成績の検討

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