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| 1 | Clinical outcomes of ampullary neoplasms in resected margin positive or uncertain cases after endoscopic papillectomy显示文摘BACKGROUND Endoscopic papillectomy(EP) for benign ampullary neoplasms could be a lessinvasive alternative to pancreatoduodenectomy(PD). There are some problems and limitations with EP. The post-EP resection margins of ampullary tumors are often positive or uncertain because of the burning effect of EP. The clinical outcomes of resected margin positive or uncertain cases after EP remain unknown.AIM To investigate the clinical outcomes of resected margin positive or uncertain cases after EP.METHODS Between January 2007 and October 2018, all patients with ampullary tumors who underwent EP at Kobe University Hospital were included in this study. The indications for EP were as follows: adenoma, as determined by preoperative endoscopic biopsy, without bile/pancreatic duct extension, according to endoscopic ultrasound or intraductal ultrasound. The clinical outcomes of resected margin positive or uncertain cases after EP were retrospectively investigated.RESULTS Of the 45 patients, 29 were male, and 16 were female. The mean age of the patients was 65 years old. Forty-one patients(89.5%) underwent en bloc resection,and 4 patients(10.5%) underwent piecemeal resection. After EP, 33 tumors were histopathologically diagnosed as adenoma, and 12 were diagnosed as adenocarcinoma. The resected margins were positive or uncertain in 24 patients(53.3%). Of these cases, 15 and 9 were diagnosed as adenoma and adenocarcinoma, respectively. Follow-up observation was selected for all adenomas and 5 adenocarcinomas. In the remaining 4 adenocarcinoma cases,additional PD was performed. Additional PD was performed in 4 cases, and residual carcinoma was found after the additional PD in 1 of these cases. In the follow-up period, local tumor recurrence was detected in 3 cases. Two of these cases involved primary EP-diagnosed adenoma. The recurrent tumors were also adenomas detected by biopsy. The remaining case involved primary EPdiagnosed adenocarcinoma. The recurrent tumor was also an adenocarcinoma.All of the recurrent tumors were successfully treated with argon plasma coagulation(APC). There was no local or lymph node recurrence after the APC.The post-APC follow-up periods lasted for 57.1 to 133.8 mo. No ampullary tumor-related deaths occurred in all patients.CONCLUSION Resected margin positive or uncertain cases after EP could be managed by endoscopic treatment including APC, even in cases of adenocarcinoma. EP could become an effective less-invasive first-line treatment for early stage ampullary tumors. | Arata Sakai Masahiro Tsujimae Atsuhiro Masuda Takao Iemoto Shigeto Ashina Kohei Yamakawa Takeshi Tanaka Shunta Tanaka Yasutaka Yamada Ryota Nakano Yu Sato Manabu Kurosawa Takuya Ikegawa Seiji Fujigaki Takashi Kobayashi Hideyuki Shiomi Yoshifumi Arisaka Tomoo Itoh Yuzo Kodama | 2019 | World Journal of Gastroenterology2019，25，11： | 9 |
| 2 | Possible involvement of myofibroblasts in cellular recover of uranyl acetate - induced acute renal failure in rats显示文摘 | SUN D F FUJIGAKI Y FUJIMOTO T | 2000 | Am J Pathol2000，157，4： | 1 |
| 3 | The mechanism of interferon-gamma induced anti Toxoplasma gondii by 2, 3- dioxygenase and/or inducible nitric oxide synthase vary among tissues显示文摘 | Fujigaki S Takemura M Hamakawa H | 2003 | Adv Exp Med Biol2003，527，97： | 1 |
| 4 | Pixel-to-pixel correspon- dence adjustment in DMD camera by moir6 methodology 显示文摘 | R i S Fujigaki M Matui T | 2006 | Experimental Mechanics2006，46，1： | 1 |
| 5 | Accurate pixel-to-pixel correspondence adjustment in a digital mi- cromirror device camera by using the phase-shifting moir6 method显示文摘 | Ri Shien Fujigaki Motoharu Matui Tom | 2006 | Applied Optics2006，45，27： | 1 |
| 6 | Mechanism of increases in L-kynurenine and quinolinic acid in renal insufficiency显示文摘 | Saito K Fujigaki S Heyes MP | 2000 | Am J Physiol Renal Physiol2000，279，3： | 1 |
| 7 | Reliabilityand validity of the Japanese version of Job Content Questionnaire:replication and extension in computer company employees显示文摘 | Kawakami N Fujigaki Y | 1996 | Ind Health1996，34，： | 1 |
| 8 | Immunohistochemical study on caveolin-1 in regenerating process of tubular cells in gentamicin-induced acute tubular injury in rats显示文摘 | Fujigaki Y Sakakima M Sun Y | 2007 | Virchows Arch2007，450，6： | 1 |
| 9 | Mechanism of increases in L-kynurenine and quinolinic acid in renal insufficiency 显示文摘 | Kuniaki Saito Suwako Fujigaki Melvyn PH | 2000 | Am J Physiol Renal physiol2000，279，： | 1 |
| 10 | The citation system: Citation networks as repeatedly focusing on difference, continuous reevaluation, and as persistent knowledge accumulation 显示文摘 | Fujigaki Y | 1998 | Scientometries1998，43，1： | 1 |
| 11 | Genotyping of hepatitis C virus by melting curve analysis with SYBR green I显示文摘 | Fujigaki H Takemura M Takahashi K | 2004 | Ann Clin Biochem2004，41，2： | 1 |
| 12 | The signal transducer and activator of transcription 1alpha and interferon regulatory factor 1 are not essential for the induction of IDO by lipopolysaccharide显示文摘 | Fujigaki H Saito K Fujigaki S | 2006 | Journal of Biochemistry2006，139，4： | 1 |
| 13 | Polymorphism of genes encoding toll-like receptors and inflammatory cytokines in perio- dontal disease in the Japanese population显示文摘 | Imamura Y Fujigaki Y Oomori Y | 2008 | J Int Acad Period- ontol2008，10，3： | 1 |
| 14 | Mechanism of increases in L - kynurenine and quinolinic acid in renal insufficiency显示文摘 | Saito K Fujigaki S Heyes HP | 2000 | Am J Physiol Renal Physiol2000，279，： | 1 |
| 15 | Indoleamine 2, 3 - diox- ygenase is highly expressed in human adult T - cell leukemia/lym- phoma and chemotherapy changes tryptophan catabolism in serum and reduced activityty显示文摘 | HOSHI M ITO H FUJIGAKI H | 2009 | Leuk Res2009，33，1： | 1 |
| 16 | Accurate pixel-to-pixel correspondence adjustment in a digital micro-mirror device camera by using the phase shifting Moiré method显示文摘 | Shien Ri Motoharu Fujigaki Toru Matui | 2006 | Applied Optics2006，45，27： | 1 |
| 17 | Absolute phase analysis method for three-dimensional surface profilometry using frequency-modulated grating显示文摘 | Ikeda Yasuyuki Yoneyama Satoru Fujigaki Motoharu | 2003 | Opt Eng2003，42，5： | 1 |
| 18 | Immunoelectron microscopic study on type Ⅰ,Ⅱ and Ⅲ TGF-beta receptors on visceral glomerular epithelial cells in relation to glomerular basement membrane alterations in proteinuric rats显示文摘 | Fujigaki Y Watanabe T Ikegaya N | 2000 | Nephrol Dial Transplant2000，15，2： | 1 |
| 19 | Genotyping and the quantification of hepatitis C virus by the melting curves in light cycler显示文摘 | TAKEMURA M FUJIGAKI H TAKAHASHI K | 2004 | Rinsho Byori2004，52，2： | 1 |
| 20 | The signal trans- ducer and activator of transcription 1 alpha and interferon regulatory factor 1 are not essential for the induction of indoleamine 2, 3 - dioxygenase by lipopolysaeeharide: involvement of p38 mitogen - activated protein kinase and nuclear factor - κB pathways, and synergistic effect of several pro-inflammatory cytokines显示文摘 | FUJIGAKI H SAITO K FUJIGAKI S | 2006 | Bio- ehem2006，139，4： | 1 |
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