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Predictive factors for the failure of endoscopic stent-instent self-expandable metallic stent placement to treat malignant hilar biliary obstruction 预览
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作者 Mitsuru Sugimoto Tadayuki Takagi +10 位作者 Rei Suzuki Naoki Konno Hiroyuki Asama Ko Watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai Mika Takasumi Yuki Sato Takuto Hikichi Hiromasa Ohira 《世界胃肠病学杂志:英文版》 SCIE CAS 2017年第34期6273-6280,共8页
AIM To investigate the factors predictive of failure when placing a second biliary self-expandable metallic stents(SEMSs). METHODS This study evaluated 65 patients with an unresectable malignant hilar biliary obstruct... AIM To investigate the factors predictive of failure when placing a second biliary self-expandable metallic stents(SEMSs). METHODS This study evaluated 65 patients with an unresectable malignant hilar biliary obstruction who were examined in our hospital. Sixty-two of these patients were recruited to the study and divided into two groups: the success group, which consisted of patients in whom a stent-in-stent SEMS had been placed successfully, and the failure group, which consisted of patients in whom the stent-in-stent SEMS had not been placed successfully. We compared the characteristics of the patients, the stricture state of their biliary ducts, and the implemented endoscopic retrograde cholangiopancreatography(ERCP) procedures between the two groups.RESULTS The angle between the target biliary duct stricture and the first implanted SEMS was significantly larger in the failure group than in the success group. There were significantly fewer wire or dilation devices(ERCP catheter, dilator, or balloon catheter) passing the first SEMS cell in the failure group than in the success group. The cut-off value of the angle predicting stent-in-stent SEMS placement failure was 49.7 degrees according to the ROC curve(sensitivity 91.7%, specificity 61.2%). Furthermore, the angle was significantly smaller in patients with wire or dilation devices passing the first SEMS cell than in patients without wire or dilation devices passing the first SEMS cell. CONCLUSION A large angle was identified as a predictive factor for failure of stent-in-stent SEMS placement. 展开更多
关键词 内视镜的 stent-in-stent 自我可扩充的金属性的 stent 放置 预兆的因素 内视镜后退 cholangiopancreatography 恶意的 hilar 胆汁的阻塞 自我可扩充的金属性的 stent
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Influence of night duty on endoscopic therapy for bile duct stones 预览
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作者 Mitsuru Sugimoto Tadayuki Takagi +9 位作者 Rei Suzuki Naoki Konno Hiroyuki Asama Ko Watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai Mika Takasumi Takuto Hikichi Hiromasa Ohira 《世界胃肠病学杂志:英文版》 SCIE CAS 2016年第42期9387-9393,共7页
AIM To examine the influence of night duty(ND) on endoscopic therapy for biliary duct stones.METHODS The subjects consisted of 133 patients who received initial endoscopic therapy for biliary duct stones performed by ... AIM To examine the influence of night duty(ND) on endoscopic therapy for biliary duct stones.METHODS The subjects consisted of 133 patients who received initial endoscopic therapy for biliary duct stones performed by eight endoscopists after they had been on(ND group, n = 34 patients) or not [day duty(DD) group, n = 99 patients]. Patient characteristics(age, gender, history of abdominal surgery, transverse diameter of the largest stone, number of stones), years of experience of the endoscopists, endoscopic procedures [sphincterotomy, papillary balloon dilation(EPBD), papillary large balloon dilation(EPLBD)], and outcomes of initial endoscopy(procedure time; rate of stone removal by the first endoscopist; proceduresuccess rate by the first endoscopist: removal of stones or endoscopic retrograde biliary drainage; rate of final stone removal; final procedure success rate; complications; hospitalization after the procedure) were compared retrospectively between the two groups. History of abdominal surgery and treatment outcomes were also compared between the groups for each of the four endoscopists who performed most of the procedures in the ND group.RESULTS There were no significant differences regarding the number of treatments performed by each endoscopist or the years of experience between the ND and DD groups. The frequency of endoscopic retrograde cholangiopancreatography procedures did not differ significantly between the groups. There were also no significant differences regarding patient characteristics: age, gender, history of abdominal surgery(ND 7: Billroth II 4, R-Y 3; DD 18: double tract reconstruction 1, Billroth I 3, Billroth II 6, R-Y 7, duodenoduodenostomy for annular pancreas 1), transverse diameter of largest stone, and number of stones between the two groups. Among the treatment procedures, the endoscopic s p h i n c t e r o t o m y a n d E P B D r a t e s d i d n o t d i f f e r significantly between the groups. However, EPLBD was performed more frequently in the ND group [47.1%(16/34) v s 19.2% 展开更多
关键词 夜里税 内视镜的 therap 胆汁管石头 石头的移动 过程时间
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Efficacy of endoscopic ultrasonography-guided fine needleaspiration for pancreatic neuroendocrine tumor grading 预览 被引量:1
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作者 Sugimoto, Mitsuru Takagi, Tadayuki +11 位作者 Hikichi, Takuto Suzuki, Rei Watanabe, Ko Nakamura, Jun Kikuchi, Hitomi Konno, Naoki Waragai, Yuichi Asama, Hiroyuki Takasumi, Mika Watanabe, Hiroshi Obara, Katsutoshi Ohira, Hiromasa 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2015年第26期8118-8124,共7页
AIM To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA)for grading pancreatic neuroendocrine tumors (PNETs).METHODS: A total of 22 patients were diagnosedwith PNET by EU... AIM To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA)for grading pancreatic neuroendocrine tumors (PNETs).METHODS: A total of 22 patients were diagnosedwith PNET by EUS-FNA between October 2001 andDecember 2013 at Fukushima Medical UniversityHospital. Among these cases, we targeted 10 PNETpatients who were evaluated according to the WorldHealth Organization (WHO) 2010 classification. Surgerywas performed in eight patients, and chemotherapywas performed in two patients due to multiple livermetastases.Specimens obtained by EUS-FNA werefirst stained with hematoxylin and eosin and thenstained with chromogranin, synaptophysin, CD56, andKi-67. The specimens were graded by the Ki-67 indexaccording to the WHO 2010 classification. Specimensobtained by surgery were graded by the Ki-67 index and mitotic count (WHO 2010 classification). For theeight specimens obtained by EUS-FNA, the Ki-67 indexresults were compared with those obtained by surgery.In the two cases treated with chemotherapy, theeffects and prognoses were evaluated.RESULTS: The sampling rate for histological diagnosisby EUS-FNA was 100%. No adverse effects wereobserved. The concordance rate between specimensobtained by EUS-FNA and surgery was 87.5% (7/8).For the two cases treated with chemotherapy,case 1 received somatostatin analog therapy andtranscatheter arterial infusion (TAI) targeting multipleliver metastases. Subsequent treatment consisted ofeverolimus. During chemotherapy, the primary tumorremained unconfirmed, although the multiple liver metastasesdiminished dramatically. Case 2 was classifiedas neuroendocrine carcinoma (NEC) according tothe Ki-67 index of a specimen obtained by EUS-FNA;therefore, cisplatin and irinotecan therapy was started.However, severe adverse effects, including renalfailure and diarrhea, were observed, and the therapyregimen was changed to cisplatin and etoposide. TAItargeting multiple liver metastases was performed.Although the liver metastases diminish 展开更多
关键词 PANCREATIC NEUROENDOCRINE tumor Endoscopicultrasonography-guided fine NEEDLE ASPIRATION Ki-67index World Health Organization classification 2010 Chemotherapy
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Endoscopic therapy for esophageal hematoma with blue rubber bleb nevus syndrome 预览
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作者 Mika Takasumi Takuto Hikichi +11 位作者 Tadayuki Takagi Masaki Sato Rei Suzuki Ko Watanabe Jun Nakamura Mitsuru Sugimoto Yuichi Waragai Hitomi Kikuchi Naoki Konno Hiroshi Watanabe Katsutoshi Obara Hiromasa Ohira 《世界胃肠内镜杂志:英文版(电子版)》 2014年第12期630-634,共5页
A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome(BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestin... A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome(BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestinal(GI) tract but her GI tract had never been examined. An upper gastrointestinal endoscopy revealed a large bleeding esophageal hematoma positioned between the thoracic esophagus and the gastric cardia. An endoscopic injection of polidocanol was used to stop the hematoma from bleeding. The hematoma was incised using the injectionneedle to reduce the pressure within it. Finally, argon plasma coagulation(APC) was applied to the edge of the incision. The esophageal hematoma disappeared seven days later. Two months after the endoscopic the rapy, the eso phage alulcerhealed and the hemangioma did not relapse. This rare case of a large esophageal hematoma originating from a hemangioma with BRBNS was treated using a combination of endoscopic therapy with polidocanol injection, incision, and APC. 展开更多
关键词 Blue rubber BLEB NEVUS syndrome Endoscopic injection SCLEROTHERAPY INCISION ESOPHAGEAL HEMATOMA ESOPHAGEAL hemangioma
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