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| 1 | Intraductal neoplasm of the intrahepatic bile duct: Clinicopathological study of 24 cases显示文摘AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ , high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy. | Yoshiki Naito Hironori Kusano Osamu Nakashima Eiji Sadashima Satoshi Hattori Tomoki Taira Akihiko Kawahara Yoshinobu Okabe Kazuhide Shimamatsu Jun Taguchi Seiya Momosaki Koji Irie Rin Yamaguchi Hiroshi Yokomizo Michiko Nagamine Seiji Fukuda Shinichi Sugiyama Naoyo Nishida Koichi Higaki Munehiro Yoshitomi Masafumi Yasunaga Koji Okuda Hisafumi Kinoshita Masayoshi Kage Masamichi Nakayama Makiko Yasumoto Jun Akiba Hirohisa Yano | 2012 | World Journal of Gastroenterology2012，18，28： | 16 |
| 2 | Current status of preoperative drainage for distal biliary obstruction显示文摘Preoperative biliary drainage(PBD) was developed to improve obstructive jaundice, which affects a number of organs and physiological mechanisms in patients waiting for surgery. However, its role in patients who will undergo pancreaticoduodenectomy for biliary obstruction remains controversial. This article aims to review the current status of the use of preoperative drainage for distal biliary obstruction. Relevant articles published from 1980 to 2015 were identified by searching MEDLINE and Pub Med using the keywords 'PBD', 'pancreaticoduodenectomy', and 'obstructive jaundice'. Additional papers were identified by a manual search of the references from key articles. Current studies have demonstrated that PBD should not be routinely performed because of the postoperative complications. PBD should only be considered in carefully selected patients, particularly in cases where surgery had to be delayed. PBD may be needed in patients with severe jaundice, concomitant cholangitis, or severe malnutrition. The optimal method of biliary drainage has yet to be confirmed. PBD should be performed by endoscopic routes rather than by percutaneous routes to avoid metastatic tumor seeding. Endoscopic stenting or nasobiliary drainage can be selected. Although more expensive, the use of metallic stents remains a viable option to achieve effective drainage without cholangitis and reintervention. | Harutoshi Sugiyama Toshio Tsuyuguchi Yuji Sakai Rintaro Mikata Shin Yasui Yuto Watanabe Dai Sakamoto Masato Nakamura Reina Sasaki Jun-ichi Senoo Yuko Kusakabe Masahiro Hayashi Osamu Yokosuka | 2015 | World Journal of Hepatology2015，7，18： | 11 |
| 3 | Utility of endoscopic retrograde cholangiopancreatography on biliopancreatic diseases in patients with Billroth Ⅱ-reconstructed stomach显示文摘AIM To examine the utility of endoscopic retrograde cholangiopancreatography(ERCP) on biliopancreatic diseases in the patients with Billroth II-reconstructed stomach.METHODS For 26 cases of biliopancreatic diseases in patients with Billroth Ⅱ-reconstructed stomach,ERCP was conducted using a straight-view scope or a retrograde obliqueviewing endoscope.All the cases were patients aiming at selective insertion into the bile duct.One patient aimed at diagnosis,and 25 patients aimed at treatment.The cases in which the endoscope reached the duodenal papilla and anastomosis,and insertion into the bile duct became possible,were considered successful.RESULTS The rate of reaching the duodenal papilla and anastomosis was 84.7%(22/26 patients).Among the cases without reaching the duodenal papilla and anastomosis,there were 2 in which the endoscope did not pass due to tumor-induced duodenal infiltration.In 1 case,the fiber did not reach the duodenal papilla due to long afferent loop.The success rate of insertion into the bile duct in patients in which the endoscope reached the duodenal papilla and anastomosis was 90.9%(20/22 patients),and the success rate of procedures including treatment was 86.3%(19/22 patients).After treatment,mild cholangitis was observed in 1 patient(4.5%,1/22 patients) but relieved conservatively.No other accidental symptom was observed.CONCLUSION It was considered that the ERCP for biliopancreatic diseases in patients with Billroth II-reconstructed stomach will become a less invasive,safe and useful examination and treatment approach. | Yuji Sakai Toshio Tsuyuguchi Rintaro Mikata Harutoshi Sugiyama Shin Yasui Masaru Miyazaki Osamu Yokosuka | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，3： | 10 |
| 4 | Cholangiopancreatography troubleshooting:the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents显示文摘BACKGROUND:Stent migration in the hepatopancreatic duct might arise as one of the rare complications associated with biliary or pancreatic stenting.Although there are some procedures to retrieve the migrated stent,including surgical,percutaneous,and endoscopic approaches,endoscopy should be attempted first because it is least invasive.This study set out to evaluate the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents.METHODS:Plastic stents that migrated in the bile duct(35 patients)or pancreatic duct(2)were retrieved with endoscopic retrograde cholangiopancreatography.Devices used were snare forceps,a basket catheter,grasping forceps,biopsy forceps,a balloon catheter,and the Soehendra stent retriever.RESULTS:Endoscopic retrieval of migrated stents was performed successfully in 36(97.0%)of the 37 patients.The devices utilized for successful treatment were basket catheter(13 patients),grasping forceps(10),snare forceps(8),balloon catheter(3),biopsy forceps(1),and the Soehendra stent retriever(1).The unsuccessfully treated patient with chronic pancreatitis underwent surgery since the guide wire did not move forward due to bile duct stenosis,and there was also duodenal stenosis.One patient developed mild pancreatitis after withdrawal of the stent;the pancreatitis was relieved with conservative treatment.CONCLUSIONS:Endoscopic retrieval of migrated biliary and pancreatic stents appears to be useful because of its safety and low invasiveness.However,various forceps should be prepared for the retrieval of a migrated stent. | Yuji Sakai Toshio Tsuyuguchi Takeshi Ishihara Harutoshi Sugiyama Reiko Eto Tatsuya Fujimoto Shin Yasui Ryo Tamura Seiko Togo Motohisa Tada Osamu Yokosuka | 2009 | Hepatobiliary & Pancreatic Diseases International2009，8，6： | 8 |
| 5 | Comparison of endoscopic papillary balloon dilatation and endoscopic sphincterotomy for bile duct stones显示文摘Endoscopic treatment for bile duct stones is low-invasive and currently considered as the first choice of the treatment. For the treatment of bile duct stones, papillary treatment is necessary, and the treatments used at the time are broadly classified into two types; endoscopic papillary balloon dilatation where bile duct closing part is dilated with a balloon and endoscopic sphincterotomy(EST) where bile duct closing part is incised. Both procedures have advantages and disadvantages. Golden standard is EST, however, there are patients with difficulty for EST, thus we must select the procedure based on understanding of the characteristics of the procedure, and patient backgrounds. | Yuji Sakai Toshio Tsuyuguchi Harutoshi Sugiyama Masahiro Hayashi Jun-ichi Senoo Yuko Kusakabe Shin Yasui Rintaro Mikata Osamu Yokosuka | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，10： | 6 |
| 6 | Endoscopic papillary large balloon dilation for removal of bile duct stones显示文摘AIM:To investigate the efficacy and outcomes of endoscopic papillary large balloon dilation(EPLBD)for bile duct stones in a multicenter prospective study.METHODS:Lithotomy by EPLBD was conducted in 124patients with bile duct stones≥13 mm in size or with three or more bile duct stones≥10 mm.After endoscopic sphincterotomy,the papilla was dilated using balloons 12-20 mm in diameter fitting the bile duct diameter.RESULTS:The success rate of first-time lithotomy was 86.3%(107/124)and the final lithotomy success rate was 100%(124/124).Lithotripsy was needed in10 of the 124(13.6%)patients.Adverse events due to the treatment procedure occurred in 6(4.8%)patients,all of which were mild.Performing large balloon dilation after endoscopic sphincterotomy in patients with large stones or multiple stones in the bile duct is considered to ensure the safety of treatment and to reduce the need for lithotripsy.CONCLUSION:It is suggested that treatment by EPLBD for large bile duct stones may be safe and useful. | Yuji Sakai Toshio Tsuyuguchi Yoshiaki Kawaguchi Nobuto Hirata So Nakaji Katsuya Kitamura Shigeru Mikami Tatsuya Fujimoto Masashi Ijima Eishin Kurihara Shuhei Oana Takayoshi Nishino Ryo Tamura Dai Sakamoto Masato Nakamura Takao Nishikawa Harutoshi Sugiyama Hitoshi Yoshida Tetsuya Mine Osamu Yokosuka | 2014 | World Journal of Gastroenterology2014，20，45： | 6 |
| 7 | Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis by pancreatic duct stenting using a loop-tipped guidewire显示文摘AIM: To examine whether it is possible to prevent the occurrence of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis in patients experiencing difficulties with selective biliary duct cannulation by pancreatic duct stenting using a looptipped guidewire.METHODS: Procedure success rate, frequency of unintended insertion of the guidewire into side branches of the pancreatic duct, and incidence of procedural accidents were examined using a loop-tipped guidewire(Group A, 20 patients), and a conventional straighttype guidewire(Group B, 20 patients).RESULTS: The success rate of the procedure was 100% in both groups. Unintended insertion of the guidewire into a side branch of the pancreatic duct occurred 0.056 ± 0.23(0-1) times in Group A and 2.3 ±1.84(0-5) times in Group B; thus, unintended insertion of the guidewire into a side branch of the pancreatic duct was seen significantly less frequently in Group A. There were no procedural accidents in Group A, whereas pancreatitis occurred in one Group B patient; however, the difference between the two groups was not statistically significant. The serum amylase level after ERCP was 257.15 ± 136.4(88-628) IU/L in Group A, and 552.05 ± 534.57(101-2389) IU/L in Group B, showing a significantly lower value in Group A. Hyperamylasemia was found in two patients(10%) in Group A, and nine(45%) in Group B, showing a significantly lower value in Group A.CONCLUSION: The results suggest that in patients who experience difficulties with biliary cannulation, the use of a loop-tipped guidewire for pancreatic duct stenting may assist with the prevention of post-ERCP pancreatitis, and thereby to a reduction of the risk of post-ERCP pancreatitis or hyperamylasemia. | Yuji Sakai Toshio Tsuyuguchi Harutoshi Sugiyama Masahiro Hayashi Jun-ichi Senoo Reina Sasaki Yuko Kusakabe Masato Nakamura Shin Yasui Rintaro Mikata Masaru Miyazaki Osamu Yokosuka | 2016 | World Journal of Clinical Cases2016，4，8： | 5 |
| 8 | Endoscopic papillary large balloon dilation for bile duct stones in elderly patients显示文摘AIM: To investigate whether endoscopic papillary large balloon dilation(EPLBD) can be safety and effectively performed in patients aged ≥ 80 years. METHODS: Lithotomy by EPLBD was conducted in 106 patients with bile duct stones ≥ 13 mm in size or with three or more bile duct stones ≥ 10 mm. The patients were divided into group A(< 80 years) and group B(≥ 80 years). Procedure success rate, number of endoscopic retrograde cholangiopancreatographies(ERCP), and incidence of complications were examined in both groups.RESULTS: Group B tended to include significantly more patients with peripapillary diverticulum, hypertension, hyperlipemia, cerebrovascular disease/dementia, respiratory disease/cardiac disease, and patients administered an anticoagulant or antiplatelet agent(P < 0.05). The success rate of the initial lithotomy was 88.7(94/106)%. The final lithotomy rate was 100(106/106)%. Complications due to treatment procedure occurred in 4.72(5/106)% of the patients. There was no significant difference in procedure success rate, number of ERCP, or incidence of complications between group A and group B.CONCLUSION: EPLBD can be safely performed in elderly patients, the same as in younger patients. | Yuji Sakai Toshio Tsuyuguchi Harutoshi Sugiyama Reina Sasaki Dai Sakamoto Masato Nakamura Yuuto Watanabe Takao Nishikawa Shin Yasui Rintaro Mikata Osamu Yokosuka | 2015 | World Journal of Clinical Cases2015，3，4： | 4 |
| 9 | Evaluation of endoscopic biliary stenting for obstructive jaundice caused by hepatocellular carcinoma显示文摘AIM:To review the usefulness of endoscopic biliary stenting for obstructive jaundice caused by hepatocellular carcinoma and identify problems that may need to be addressed.METHODS:The study population consisted of 36 patients with obstructive jaundice caused by hepatocellular carcinoma(HCC)who underwent endoscopic biliary stenting(EBS)as the initial drainage procedure at our hospital.The EBS technical success rate and drainage success rate were assessed.Drainage was considered effective when the serum total bilirubin level decreased by 50%or more following the procedure compared to the pre-drainage value.Survival time after the procedure and patient background characteristics were assessed comparatively between the successful drainage group(group A)and the non-successful drainage group(group B).The EBS stent patency duration in the successful drainage group(group A)was also assessed.RESULTS:The technical success rate was 100%for both the initial endoscopic nasobiliary drainage and EBS in all patients.Single stenting was placed in 21 patients and multiple stenting in the remaining 15 patients.The drainage successful rate was 75%and the median interval to successful drainage was 40 d(2-295 d).The median survival time was 150 d in group A and 22 d in group B,with the difference between the two groups being statistically significant(P<0.0001).There were no statistically significant differences between the two groups with respect to patient background characteristics,background liver condition,or tumor factors;on the other hand,the two groups showed statistically significant differences in patients without a history of hepatectomy(P=0.009)and those that received multiple stenting(P=0.036).The median duration of stent patency was 43 d in group A(2-757 d).No early complications related to the EBS technique were encountered.Late complications occurred in 13 patients(36.1%),including stent occlusion in 7,infection in 3,and distal migration in 3.CONCLUSION:EBS is recommended as the initial drainage procedure for obstructive jaundice caused by HCC,as it appears to contribute to prolongation of survival time. | Gen Sugiyama Yoshinobu Okabe Yusuke Ishida Fumihiko Saitou Ryuichi Kawahara Hiroto Ishikawa Hiroyuki Horiuchi Hisafumi Kinoshita Osamu Tsuruta Michio Sata | 2014 | World Journal of Gastroenterology2014，20，22： | 4 |
| 10 | Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: a prospective Japanese multicenter study显示文摘AIM: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction.METHODS: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, selfexpandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline.RESULTS: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients(10.3%) in the form of mild pneumonitis. No other morbidities or mortalitieswere observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients(7.7%) on account of tumor growth.CONCLUSION: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients' quality of life. | Reina Sasaki Yuji Sakai Toshio Tsuyuguchi Takao Nishikawa Tatsuya Fujimoto Shigeru Mikami Harutoshi Sugiyama Osamu Yokosuka | 2016 | World Journal of Gastroenterology2016，22，14： | 2 |
| 11 | Development and evaluation of FSSG: frequency scale for the symptoms of GERD显示文摘 | Motoyasu Kusano Yasuyuki Shimoyama Sayaka Sugimoto Osamu Kawamura Masaki Maeda Keiko Minashi Shiko Kuribayashi Tatsuya Higuchi Hiroaki Zai Kyoko Ino Tsutomu Horikoshi Tadashi Sugiyama Munetoshi Toki Tsuneo Ohwada Masatomo Mori | 2004 | Journal of Gastroenterology2004，，9： | 2 |
| 12 | Long-term outcomes of combination of endoscopic submucosal dissection and laparoscopic lymph node dissection without gastrectomy for early gastric cancer patients who have a potential risk of lymph node metastasis显示文摘 | Nobutsugu Abe Hirohisa Takeuchi Atsuko Ohki Osamu Yanagida Tadahiko Masaki Toshiyuki Mori Masanori Sugiyama | 2011 | Gastrointestinal Endoscopy2011，，4： | 2 |
| 13 | Endoscopic diagnosis of intraductal papillary mucinous neoplasm of the bile duct显示文摘 | Toshio Tsuyuguchi Yuji Sakai Harutoshi Sugiyama Kaoru Miyakawa Takeshi Ishihara Masayuki Ohtsuka Masaru Miyazaki Osamu Yokosuka | 2010 | Journal of Hepato - Biliary - Pancreatic Sciences2010，，3： | 1 |
| 14 | Use of F-18 Fluorodeoxyglucose Positron Emission Tomography With Dual-Phase Imaging to Identify Intraductal Papillary Mucinous Neoplasm显示文摘 | Masayoshi Saito Takeshi Ishihara Motohisa Tada Toshio Tsuyuguchi Rintaro Mikata Yuji Sakai Katsunobu Tawada Harutoshi Sugiyama Jo Kurosawa Masayuki Otsuka Yoshitaka Uchida Katsuhiro Uchiyama Masaru Miyazaki Osamu Yokosuka | 2013 | Clinical Gastroenterology and Hepatology2013，，： | 1 |
| 15 | Histopathological prognostic factors predicting para-aortic lymph node metastasis in patients with endometrioid uterine cancer显示文摘 | Yuko Karube Toshio Fujimoto Osamu Takahashi Hiroshi Nanjyo Hideki Mizunuma Nobuo Yaegashi Toru Sugiyama Hirohisa Kurachi Akira Sato Toshinobu Tanaka | 2010 | Gynecologic Oncology2010，，2： | 1 |
| 16 | Development and evaluation of FSSG: frequency scale for the symptoms of GERD显示文摘 | Motoyasu Kusano Yasuyuki Shimoyama Sayaka Sugimoto Osamu Kawamura Masaki Maeda Keiko Minashi Shiko Kuribayashi Tatsuya Higuchi Hiroaki Zai Kyoko Ino Tsutomu Horikoshi Tadashi Sugiyama Munetoshi Toki Tsuneo Ohwada Masatomo Mori | 2004 | Journal of Gastroenterology2004，，9： | 1 |
| 17 | Prognostic factors of acute cholangitis in cases managed using the Tokyo Guidelines显示文摘 | Toshio Tsuyuguchi Harutoshi Sugiyama Yuji Sakai Takao Nishikawa Osamu Yokosuka Toshihiko Mayumi Seiki Kiriyama Masamichi Yokoe Tadahiro Takada | 2012 | Journal of Hepato-Biliary-Pancreatic Sciences2012，，5： | 1 |
| 18 | Endoscopic diagnosis of intraductal papillary mucinous neoplasm of the bile duct显示文摘 | Toshio Tsuyuguchi Yuji Sakai Harutoshi Sugiyama Kaoru Miyakawa Takeshi Ishihara Masayuki Ohtsuka Masaru Miyazaki Osamu Yokosuka | 2010 | Journal of Hepato - Biliary - Pancreatic Sciences2010，，3： | 1 |
| 19 | New tapered metallic stent for unresectable malignant hilar bile duct obstruction显示文摘AIM: To examine the usefulness of a new tapered metallic stent(MS) in patients with unresectable malignant hilar bile duct obstruction.METHODS: This new tapered MS was placed in 11 patients with Bismuth Ⅱ or severer unresectable malignant hilar bile duct obstruction, as a prospective study. The subjects were six patients with bile duct carcinoma, three with gallbladder cancer, and two with metastatic bile duct obstruction. Stenosis morphology was Bismuth Ⅱ: 7, Ⅲa: 3, and Ⅳ: 1. UMIN Clinical Trial Registry(UMIN000004758).RESULTS: MS placement was 100%(11/11) successful. There were no procedural accidents. The mean patency period was 208.401 d, the median survival period was 142.000 d, and the mean survival period was 193.273 d. Occlusion rate was 36.4%(4/11); the causes of occlusion were ingrowth and overgrowth in 2 patients each, 18.2%, respectively. Patients with occlusion underwent endoscopic treatment one more time and all were treatable. CONCLUSION: The tapered MS proved useful in patients with unresectable malignant hilar bile duct obstruction because it provided a long patency period, enabled re-treatment by re-intervention, and no procedural accidents occurred. | Yuji Sakai Toshio Tsuyuguchi Takao Nishikawa Harutoshi Sugiyama Reina Sasaki Dai Sakamoto Yuto Watanabe Masato Nakamura Shin Yasui Rintaro Mikata Osamu Yokosuka | 2015 | World Journal of Clinical Cases2015，3，10： | 1 |
| 20 | Endoscopic treatment or surgery for undifferentiated early gastric cancer?显示文摘 | Nobutsugu Abe Takashi Watanabe Masanori Sugiyama Osamu Yanagida Tadahiko Masaki Toshiyuki Mori Yutaka Atomi | 2004 | The American Journal of Surgery2004，，： | 1 |
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