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| 1 | Clinical benefit of radiation therapy and metallic stenting for unresectable hilar cholangiocarcinoma显示文摘AIM:To determine the efficacy of external beam radiotherapy(EBRT),with or without intraluminal brachytherapy(ILBT),in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS:We analyzed 64 patients with locally advanced hilar cholangiocarcinoma,including 25 who underwent resection(17 curative and 8 non-curative),28 treated with radiotherapy,and 11 who received best supportive care(BSC).The radiotherapy group received EBRT(50 Gy,30 fractions),with 11 receiving an additional 24 Gy(4 fractions) ILBT by iridium-192 with remote after loading.ILBT was performed using percutaneous transhepatic biliary drainage(PTBD) route.Uncovered metallic stents(UMS) were inserted into nonresected patients with obstructive jaundice,with the exception of four patients who received percutaneous transhepatic biliary drainage only.UMS were placed endoscopically or percutaneously,depending on the initial drainage procedure.The primary endpoints were patient death or stent occlusion.Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups.Stent patency was compared in the radiotherapy and BSC groups.RESULTS:No statistically significant differences in patient characteristics were found among the resection,radiotherapy,and BSC groups.Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone;cholangitis occurred after endoscopic stenting,and patients were treated with PTBD.A total of 16 patients were administered additional systemic chemotherapy(5-fluorouracil-based regimen in 9,S-1 in 6,and gemcitabine in 1).Overall survival varied significantly among groups,with median survival times of 48.7 mo in the surgery group,22.1 mo in the radiotherapy group,and 5.7 mo in the BSC group.Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery(P = 0.0076).Cumulative survival in the radiotherapy group was significantly longer than in the BSC group(P = 0.0031),but did not differ significantly from those in the non-resection group.Furthermore,the median survival time of patients in the radiotherapy group who were considered for possible resection(excluding the seven patients who were not candidates for surgery due to comorbid disease or age) was 25.9 mo.Stent patency was evaluated only in the 24 patients who received a metallic stent.Stent patency was significantly longer in the radiotherapy than in the BSC group(P = 0.0165).Biliary drainage was not eliminated in any patient.To determine the efficacy of ILBT,we compared survival time and stent patency in the EBRT alone and EBRT plus ILBT groups.However,we found no significant difference in survival time between groups or for stent patencies.Hemorrhagic gastroduodenal ulcers were observed in 5 patients(17.9%),three in the EBRT plus ILBT group and two in the EBRT alone group.Ulcers occurred 5 mo,7 mo,8 mo,16 mo,and 29 mo following radiotherapy.All patients required hospitalization,but blood transfusions were unnecessary.All 5 patients recovered following the administration of anti-ulcer medication.CONCLUSION:Radiotherapy improved patient prognosis and the patency of uncovered metallic stents in patients with locally advanced hilar cholangiocarcinoma,but ILBT provided no additional benefits. | Hiroyuki Isayama Takeshi Tsujino Yousuke Nakai Takashi Sasaki Keiichi Nakagawa Hideomi Yamashita Taku Aoki Kazuhiko Koike | 2012 | World Journal of Gastroenterology2012，18，19： | 24 |
| 2 | Diagnostic and therapeutic single-operator cholangiopancreatoscopy in biliopancreatic diseases:Prospective multicenter study in Japan显示文摘AIM: To assess the utility and safety of single-operator cholangiopancreatoscopy(SOCPS) using the Spy Glass system in widespread clinical application for biliary and pancreatic diseases.METHODS: This study was a prospective case series conducted in 20 referral centers in Japan. There were 148 patients who underwent SOCPS; 124 for biliary diseases and 24 for pancreatic diseases. The attempted interventions were SOCPS examination, SOCPS-directed tissue sampling, and therapy for stone removal, among others. The main outcomes were related to the procedure success rate in terms of visualizing the target lesions, SOCPS-directed adequate tissue sampling, and complete stone removal. RESULTS: A total of 148 patients were enrolled for the diagnosis of indeterminate biliary and pancreatic lesions or treatment of biliary and pancreatic disease. The overall procedure success rate of visualizing the target lesions was 91.2%(135/148). The overall procedural success rates of visualizing the target lesions of diagnostic SOCPS in the bile duct and pancreatic duct were 95.5%(84/89) and 88.2%(15/17), respectively. Diagnosis: the overall adequate tissue for histologic examination was secured in 81.4% of the 86 patients who underwent biopsy under SOCPS(bile duct, 60/75, 80.0%; pancreatic duct, 10/11, 90.9%). The accuracy of histologic diagnosis using SOCPS-directed biopsies in indeterminate bile duct lesions was 70.7%(53/75). In the pancreatic duct, the accuracy of SOCPS visual impression of intraductal papillary mucinous neoplasm was 87.5%(14/16). Stone therapy: complete biliary and pancreatic stone clearance combined with SOCPS-directed stone therapy using electrohydraulic lithotripsy or laser lithotripsy was achieved in 74.2%(23/31) and 42.9%(3/7) of the patients, respectively. Others: SOCPS using the Spy Glass system was used in cannulation of the cystic duct in two patients and for passing across the obstructed self-expandable metallic stent for a malignant biliary stricture in two patients. All procedures were successful in both SOCPS-guided therapies. The incidence of procedure-related adverse events was 5.4%(8/148). CONCLUSION: SOCPS with direct visualization and biopsy for diagnosis and SOCPS-directed therapy for biliary and pancreatic diseases can be safely performed with a high success rate. | Toshio Kurihara Ichiro Yasuda Hiroyuki Isayama Toshio Tsuyuguchi Taketo Yamaguchi Ken Kawabe Yoshinobu Okabe Keiji Hanada Tsuyoshi Hayashi Takao Ohtsuka Syuhei Oana Hiroshi Kawakami Yoshinori Igarashi Kazuya Matsumoto Kiichi Tamada Shomei Ryozawa Hiroki Kawashima Yutaka Okamoto Iruru Maetani Hiroyuki Inoue Takao Itoi | 2016 | World Journal of Gastroenterology2016，22，5： | 20 |
| 3 | Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction显示文摘AIM: To determine the optimal method of endoscopic preoperative biliary drainage for malignant distal biliary obstruction.METHODS: Multicenter retrospective study was conducted in patients who underwent plastic stent(PS) or nasobiliary catheter(NBC) placement for resectable malignant distal biliary obstruction followed by surgery between January 2010 and March 2012. Procedurerelated adverse events, stent/catheter dysfunction(occlusion or migration of PS/NBC, developmentof cholangitis, or other conditions that required repeat endoscopic biliary intervention), and jaundice resolution(bilirubin level < 3.0 mg/d L) were evaluated. Cumulative incidence of jaundice resolution and dysfunction of PS/NBC were estimated using competing risk analysis. Patient characteristics and preoperative biliary drainage were also evaluated for association with the time to jaundice resolution and PS/NBC dysfunction using competing risk regression analysis.RESULTS: In total, 419 patients were included in the study(PS, 253 and NBC, 166). Primary cancers included pancreatic cancer in 194 patients(46%), bile duct cancer in 172(41%), gallbladder cancer in three(1%), and ampullary cancer in 50(12%). The median serum total bilirubin was 7.8 mg/d L and 324 patients(77%) had ≥ 3.0 mg/d L. During the median time to surgery of 29 d [interquartile range(IQR), 30-39 d]. PS/NBC dysfunction rate was 35% for PS and 18% for NBC [Subdistribution hazard ratio(SHR) = 4.76; 95%CI: 2.44-10.0, P < 0.001]; the pig-tailed tip was a risk factor for PS dysfunction. Jaundice resolution was achieved in 85% of patients and did not depend on the drainage method(PS or NBC).CONCLUSION: PS has insufficient patency for preoperative biliary drainage. Given the drawbacks of external drainage via NBC, an alternative method of internal drainage should be explored. | Naoki Sasahira Tsuyoshi Hamada Osamu Togawa Ryuichi Yamamoto Tomohisa Iwai Kiichi Tamada Yoshiaki Kawaguchi Kenji Shimura Takero Koike Yu Yoshida Kazuya Sugimori Shomei Ryozawa Toshiharu Kakimoto Ko Nishikawa Katsuya Kitamura Tsunao Imamura Masafumi Mizuide Nobuo Toda Iruru Maetani Yuji Sakai Takao Itoi Masatsugu Nagahama Yousuke Nakai Hiroyuki Isayama | 2016 | World Journal of Gastroenterology2016，22，14： | 18 |
| 4 | Improvement of prognosis for unresectable biliary tract cancer显示文摘AIM:To evaluate the chemotherapeutic outcomes and confirm the recent improvement of prognosis for unresectable biliary tract cancer.METHODS:A total of 186 consecutive patients with unresectable biliary tract cancer,who had been treated with chemotherapy between 2000 and 2009 at five institutions in Japan,were retrospectively analyzed.These patients were divided into three groups based on the year beginning chemotherapy:Group A(2000-2003),Group B(2004-2006),and Group C(2007-2009).The data were fixed at the end of December 2011.Overall survival and time-to-progression were analyzed and compared chronologically.RESULTS:No patient characteristics were significantly different among the three groups.The gallbladder was involved in about half of the patients in each group,and metastatic biliary tract cancer was present in three quarters of the enrollees.In Group A,5-fluorouracilbased chemotherapies were primarily selected as firstline chemotherapy,and only 24% were treated with second-line chemotherapy.In Group B,gemcitabine or S-1 monotherapy was mainly introduced as firstline chemotherapy,and 51% of the patients who were refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with monotherapy.In Group C,the combination therapy with gemcitabine and S-1 was mainly chosen as first-line chemotherapy,and 53% of the patients refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with combination therapy.The median timeto-progressions were 4.4 mo,3.5 mo and 5.9 mo in Groups A,B and C,respectively(4.4 mo vs 3.5 mo vs 5.9 mo,P < 0.01).The median overall survivals were 7.1,7.3,and 11.7 mo in Groups A,B and C(7.1 mo vs 7.3 mo vs 11.7 mo,P = 0.03).Induction rates of all three drugs(gemcitabine,platinum analogs,and fluoropyrimidine) in Groups A,B and C were 4%,2% and 27%(4% vs 2% vs 27%,P < 0.01).CONCLUSION:The prognosis of unresectable biliary tract cancer has improved recently.Using three effective drugs(gemcitabine,platinum analogs,and fluoropyrimidine) may improve the prognosis of this cancer. | Takashi Sasaki Hiroyuki Isayama Yousuke Nakai Naminatsu Takahara Naoki Sasahira Hirofumi Kogure Suguru Mizuno Hiroshi Yagioka Yukiko Ito Natsuyo Yamamoto Kenji Hirano Nobuo Toda Minoru Tada Masao Omata Kazuhiko Koike | 2013 | World Journal of Gastroenterology2013，19，1： | 8 |
| 5 | 胆道肿瘤临床实践指南(英文第三版)显示文摘日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确定推荐意见、推荐强度以及推荐说明。根据证据推荐分级的评估、制订与评价(GRADE)系统,推荐强度被分为1级(强)或者2级(弱)。英文第三版胆道肿瘤临床实践指南中提出的31个临床问题涵盖:(1)预防性治疗;(2)诊断;(3)胆道引流;(4)外科治疗;(5)化疗;(6)放疗。31个临床问题中,14个问题给予推荐强度为强的推荐意见,14个问题给予推荐强度为弱的推荐意见,剩余的3个问题未给予推荐意见。每条推荐意见都进行推荐强度说明。最新版指南基于循证医学证据,为临床提供了重要建议。未来与癌症登记数据库协作将是评估指南和建立新证据的关键。 | Masato Nagino Satoshi Hirano Hideyuki Yoshitomi Taku Aoki Katsuhiko Uesaka Michiaki Unno Tomoki Ebata Masaru Konishi Keiji Sano Kazuaki Shimada Hiroaki Shimizu Ryota Higuchi Toshifumi Wakai Hiroyuki Isayama Takuji Okusaka Toshio Tsuyuguchi Yoshiki Hirooka Junji Furuse Hiroyuki Maguchi Kojiro Suzuki Hideya Yamazaki Hiroshi Kijima Akio Yanagisawa Masahiro Yoshida Yukihiro Yokoyama Takashi Mizuno Itaru Endo 杨翼飞(译) 仇毓东(译) 赵梦珂(译) 伏旭(译) 蔡正华(译) 毛凉(审校) | 2021 | 中华消化外科杂志2021，20，4： | 7 |
| 6 | Clinical analysis of high serum IgE in autoimmune pancreatitis显示文摘AIM: To clarify the clinical significance of high serum IgE in autoimmune pancreatitis (AIP). METHODS: Forty-two AIP patients, whose IgE was measured before steroid treatment, were analyzed. To evaluate the relationship between IgE levels and the disease activity of AIP, we examined (1) Frequency of high IgE (> 170 IU/mL) and concomitant allergic dis-eases requiring treatment; (2) Correlations between IgG, IgG4, and IgE; (3) Relationship between the presence of extrapancreatic lesions and IgE; (4) Re-lationship between clinical relapse and IgE in patients treated with steroids, and (5) Transition of IgE before and after steroid treatment. RESULTS: IgE was elevated in 36/42 (86%) patients.Concomitant allergic disease was observed in seven patients (allergic rhinitis in three, bronchial asthma in three, and urticaria in one). There were no signifi-cant correlations between IgG, IgG4, and IgE (r = -0.168 for IgG, and r = -0.188 for IgG4). There was no significant difference in IgE in the patients with and without extrapancreatic lesions (526 ± 531 IU/mL vs 819 ± 768 IU/mL, P = 0.163), with and without clini-cal relapse (457 ± 346 IU/mL vs 784 ± 786 IU/mL, P = 0.374). There was no significant difference in IgE between before and after steroid treatment (723 ± 744 IU/mL vs 673 ± 660 IU/mL, P = 0.633). CONCLUSION: Although IgE does not necessarily reflect the disease activity, IgE might be useful for the diagnosis of AIP in an inactive stage. | Kenji Hirano Minoru Tada Hiroyuki Isayama Kazumichi Kawakubo Hiroshi Yagioka Takashi Sasaki Hirofumi Kogure Yousuke Nakai Naoki Sasahira Takeshi Tsujino Nobuo Toda Kazuhiko Koike | 2010 | World Journal of Gastroenterology2010，16，41： | 4 |
| 7 | Evaluation of effects of a novel endoscopically applied radiofrequency ablation biliary catheter using an ex-vivo pig liver显示文摘 | Takao Itoi Hiroyuki Isayama Atsushi Sofuni Fumihide Itokawa Miho Tamura Yusuke Watanabe Fuminori Moriyasu Michel Kahaleh Nagy Habib Toshitaka Nagao Tomohisa Yokoyama Kazuhiko Kasuya Hiroshi Kawakami | 2012 | Journal of Hepato-Biliary-Pancreatic Sciences2012，，5： | 3 |
| 8 | Risk factors for pancreatitis following transpapillary self-expandable metal stent placement显示文摘 | Kazumichi Kawakubo Hiroyuki Isayama Yousuke Nakai Osamu Togawa Naoki Sasahira Hirofumi Kogure Takashi Sasaki Saburo Matsubara Natsuyo Yamamoto Kenji Hirano Takeshi Tsujino Nobuo Toda Minoru Tada Masao Omata Kazuhiko Koike | 2012 | Surgical Endoscopy2012，，3： | 2 |
| 9 | Covered metallic stents in the management of malignant and benign pancreatobiliary strictures显示文摘 | Hiroyuki Isayama Yousuke Nakai Osamu Togawa Hirofumi Kogure Yukiko Ito Takashi Sasaki Naoki Sasahira Kenji Hirano Takeshi Tsujino Minoru Tada Takao Kawabe Masao Omata | 2009 | Journal of Hepato - Biliary - Pancreatic Surgery2009，，5： | 2 |
| 10 | Japanese multicenter experience of endoscopic necrosectomy for infected walled-off pancreatic necrosis: The JENIPaN study显示文摘 | I. Yasuda M. Nakashima T. Iwai H. Isayama T. Itoi H. Hisai H. Inoue H. Kato A. Kanno K. Kubota A. Irisawa H. Igarashi Y. Okabe M. Kitano H. Kawakami T. Hayashi T. Mukai N. Sata M. Kida T. Shimosegawa | 2013 | Endoscopy2013，，： | 2 |
| 11 | Factors Predictive of Adverse Events Following Endoscopic Papillary Large Balloon Dilation: Results from a Multicenter Series显示文摘 | Soo Jung Park Jin Hong Kim Jae Chul Hwang Ho Gak Kim Don Haeng Lee Seok Jeong Sang-Woo Cha Young Deok Cho Hong Ja Kim Jong Hyeok Kim Jong Ho Moon Sang-Heum Park Takao Itoi Hiroyuki Isayama Hirofumi Kogure Se Joon Lee Kyo Tae Jung Hye Sun Lee Todd H. Baron | 2013 | Digestive Diseases and Sciences2013，，4： | 2 |
| 12 | Outcomes after clearance of pancreatic stones with or without pancreatic stenting显示文摘 | Naoki Sasahira Minoru Tada Hiroyuki Isayama Kenji Hirano Yousuke Nakai Natsuyo Yamamoto Takeshi Tsujino Nobuo Toda Yutaka Komatsu Haruhiko Yoshida Takao Kawabe Masao Omata | 2007 | Journal of Gastroenterology2007，，1： | 2 |
| 13 | Measurement of radial and axial forces of biliary self-expandable metallic stents显示文摘 | Hiroyuki Isayama Yousuke Nakai Yoshihide Toyokawa Osamu Togawa Chimyon Gon Yukiko Ito Yoko Yashima Hiroshi Yagioka Hirofumi Kogure Takashi Sasaki Toshihiko Arizumi Saburo Matsubara Natsuyo Yamamoto Naoki Sasahira Kenji Hirano Takeshi Tsujino Nobuo Toda Mi | 2009 | Gastrointestinal Endoscopy2009，，1： | 2 |
| 14 | A prospective randomized study of covered versus uncovered diamond stents for the management of distal malignant biliary obstruction显示文摘 | Isayama H Komatsu Y Tsujino T | | 0，，05： | 1 |
| 15 | Neonatal lupus erythematosus complicated by improved congenital complete heart block 显示文摘 | Isayama T Inamura N Shiono N | 2013 | Pediatr Int2013，55，4： | 1 |
| 16 | Diagnostic utility of biopsy specimens for autoimmune pancreatitis显示文摘 | Kenji Hirano Noriyoshi Fukushima Minoru Tada Hiroyuki Isayama Suguru Mizuno Keisuke Yamamoto Yoko Yashima Hiroshi Yagioka Takashi Sasaki Hirofumi Kogure Yousuke Nakai Naoki Sasahira Takeshi Tsujino Takao Kawabe Masashi Fukayama Masao Omata | 2009 | Journal of Gastroenterology2009，，7： | 1 |
| 17 | Cholecystitis After Metallic Stent Placement in Patients With Malignant Distal Biliary Obstruction显示文摘 | Hiroyuki Isayama Takao Kawabe Yousuke Nakai Takeshi Tsujino Naoki Sasahira Natsuyo Yamamoto Toshihiko Arizumi Osamu Togawa Saburou Matsubara Yukiko Ito Takashi Sasaki Kenji Hirano Nobuo Toda Yutaka Komatsu Minoru Tada Haruhiko Yoshida Masao Omata | 2006 | Clinical Gastroenterology and Hepatology2006，，9： | 1 |
| 18 | Diabetes is a useful diagnostic clue to improve the progosis of pancreatic cancer显示文摘 | Mizuno S Nakai Y Isayama H | 2013 | Pancreatology2013，13，3： | 1 |
| 19 | Neonatal lupus erythematosus complicated by improved congenital complete heart block 显示文摘 | Isayama T Inamura N Shiono N | 2013 | Pediatr Int2013，55，4： | 1 |
| 20 | Endoscopic retrograde cholangiopancreatography for distal malignant biliary stricture 显示文摘 | Isayama H Nakai Y Kawakubo K | 2012 | Gastrointest Endosc Clin N Am2012，22，： | 1 |
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