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| 1 | 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 |
| 2 | 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 |
| 3 | Acute appendicitis following endoscopic mucosal resection of cecal adenoma显示文摘Endoscopic mucosal resection(EMR) allows the removal of flat or sessile lesions, laterally spreading tumors, and carcinoma of the colon or the rectum limited to the mucosa or the superficial submucosa. Acute appendicitis is the most common abdominal emergency requiring emergency surgery, and it is also a rare complication of diagnostic colonoscopy and therapeutic endoscopy, including EMR. In the case presented here, a 53-year-old female underwent colonoscopy due to a positive fecal occult blood test and was diagnosed with cecal adenoma. She was referred to our hospital and admitted for treatment. The patient had no other symptoms. EMR was performed, and 7 h after the surgery, the patient experienced right-lower abdominal pain. Laboratory tests performed the following day revealed a WBC count of 16000/mm3, a neutrophil count of 14144/mm3, and a C-reactive protein level of 2.20 mg/d L, indicating an inflammatory response. Computed tomography also revealed appendiceal wall thickening and swelling, so acute appendicitis following EMR was diagnosed. Antibiotics were initiated leading to total resolution of the symptoms, and the patient was discharged on the sixth post-operative day. Pathological analysis revealed a high-grade cecal tubular adenoma. Such acute appendicitis following EMR is extremely rare, and EMR of the cecum may be a rare cause of acute appendicitis. | Yukako Nemoto Junya Tokuhisa Nagasato Shimada Tatsuya Gomi Iruru Maetani | 2015 | World Journal of Gastroenterology2015，21，27： | 9 |
| 4 | Efficacy of intra-arterial contrast-enhanced ultrasonography during transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma显示文摘AIM To assess the usefulness of intra-arterial contrastenhanced ultrasonography(IAUS) during transarterial chemoembolization(TACE) with drug-eluting beads(DEB) for hepatocellular carcinoma(HCC).METHODS Thirty two patients with 39 HCC underwent DEB-TACE guided with IAUS, and examined by contrast-enhanced ultrasonography(CEUS) or dynamic CT after DEB-TACE were enrolled in this study. CEUS findings before DEBTACE and IAUS findings were compared. Treatments judged to be complete and incomplete for lesions were appropriate and insufficient, respectively. Findings on CEUS and/or dynamic CT performed 1, 3 and 6 mo after DEB-TACE were evaluated using m RECIST(CR/PR/SD/PD).RESULTS The treatments were complete and incomplete in 26 and 13 lesions, respectively. On imaging evaluation using CEUS and/or dynamic CT one month after treatment, 25 and 1 lesions were judged to be CR and PR, respectively, and at 6 mo after treatment, the results were CR, PR, SD and PD for 24, 1, 0 and 1 of these lesions, respectively, in the 26 completely treated lesions. Of the 13 lesions in which treatment was incomplete, the results on imaging at one month after treatment were CR, PR, SD and PD for 0, 6, 4 and 3 lesions, respectively. The overall CR rate at 6 mo after treatment was 61.5%(24/39).CONCLUSION A combination of DEB-TACE with IAUS can improve the therapeutic effects in patients with HCC. | Kazue Shiozawa Manabu Watanabe Takashi Ikehara Shuhei Yamamoto Takashi Matsui Yoshinori Saigusa Yoshinori Igarashi Iruru Maetani | 2018 | World Journal of Hepatology2018，10，1： | 7 |
| 5 | Successful outcomes of EMR-L with 3D-EUS for rectal carcinoids compared with historical controls显示文摘AIM: To assess the results of endoscopic mucosal re-section with a ligation device (EMR-L) combined with three dimensional endoscopic ultrasonography (3D-EUS) using an ultrasonic probe for rectal carcinoids. In addition, diagnosis of the depth and size of lesions by EUS was evaluated. METHODS: Between January 2003 and March 2007, 20 patients underwent EMR-L with 3D-EUS using an ultrasonic probe (group A). 3D-EUS was combined with EMR-L at the time of injection of sterile physiological saline into the submucosal layer. For comparison, 14 rectal carcinoids that had been treated by EMR-L with-out 3D-EUS between April 1998 and December 2002 were evaluated as historical controls (group B). EUS was conducted for all of the patients before treatment to evaluate tumor diameter and depth of invasion. The percentage of complete resection and the verti-cal resection margin were compared between the two groups. RESULTS: The depth of invasion upon histopathologi-cal examination was in complete agreement with the pre-operative fi ndings by EUS. The tumor diameter de-termined by EUS approximated that found in the tissue samples. There were no signifi cant differences in the gender, tumor sites or tumor diameters between the two groups. The rate of complete resection for groups A and B was 100% and 71%, respectively (P < 0.05). The vertical resection margin of group A was longer than that of group B. CONCLUSION: EMR-L is effective as an endoscopictreatment for rectal carcinoids. In combination with 3D-EUS, safe and complete resection is further as-sured. | Tsuyoshi Abe Tadayoshi Kakemura Sumio Fujinuma Iruru Maetani | 2008 | World Journal of Gastroenterology2008，14，25： | 7 |
| 6 | Is endoscopic papillary large balloon dilatation without endoscopic sphincterotomy effective?显示文摘AIM: To evaluate the safety and efficacy of endoscopic papillary large balloon dilatation(EPLBD) without endoscopic sphincterotomy in a prospective study.METHODS: From July 2011 to August 2013, we performed EPLBD on 41 patients with nae papillae prospectively. For sphincteroplasty of EPLBD,endoscopic sphincterotomy(EST) was not performed,and balloon diameter selection was based on the distal common bile duct diameter. The balloon was inflated to the desired pressure. If the balloon waist did not disappear, and the desired pressure was satisfied, we judged the dilatation as complete. We used a retrieval balloon catheter or mechanical lithotripter(ML) to remove stones and assessed the rates of complete stone removal, number of sessions, use of ML and adverse events. Furthermore, we compared the presence or absence of balloon waist disappearance with clinical characteristics and endoscopic outcome.RESULTS: The mean diameters of the distal and maximum common bile duct were 13.5 ± 2.4 mm and16.4 ± 3.1 mm, respectively. The mean maximum transverse-diameter of the stones was 13.4 ± 3.4mm, and the mean number of stones was 3.0 ± 2.4.Complete stone removal was achieved in 97.5%(40/41)of cases, and ML was used in 12.2%(5/41) of cases.The mean number of sessions required was 1.2 ± 0.62.Pancreatitis developed in two patients and perforation in one. The rate of balloon waist disappearance was73.1%(30/41). No significant differences were noted in procedure time, rate of complete stone removal(100% vs 100%), number of sessions(1.1 vs 1.3, P= 0.22), application of ML(13% vs 9%, P = 0.71),or occurrence of pancreatitis(3.3% vs 9.1%, P =0.45) between cases with and without balloon waist disappearance.CONCLUSION: EST before sphincteroplasty may be unnecessary in EPLBD. Further investigations are needed to verify the relationship between the presence or absence of balloon waist disappearance. | Shigefumi Omuta Iruru Maetani Michihiro Saito Hiroaki Shigoka Katsushige Gon Junya Tokuhisa Mieko Naruki | 2015 | World Journal of Gastroenterology2015，21，23： | 5 |
| 7 | Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias显示文摘AIM:To prospectively investigate the effi cacy of the revised Vienna Classifi cation for diagnosing colorectal epithelial neoplastic lesions in cold biopsy specimens.METHODS:Patients were selected for inclusion if they had colorectal epithelial lesions that were not considered suitable for direct endoscopic resection.These included colorectal polyps ≥ 10 mm and lesions suspected of being carcinomas capable of invading the colorectal submucosa or beyond,including strictures,based on the cold biopsies obtained from each lesion prior to resection.We investigated the relationship between diagnoses based on cold biopsy samples using the revised Vienna Classification and resected specimens of the same lesions,and the therapeutic implications of diagnoses made using the revised Vienna Classification.The same cold biopsy specimens were also examined using the Japanese Group Classifi cation guidelines,and compared with the resected specimens of the same lesions for reference.RESULTS:A total of 179 lesions were identified.The sensitivity,specificity,positive and negative predictive values of the revised Vienna Classification for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 22.2%,100%,100%,and 71.4%,respectively,and for distinguishing between intramucosal lesions and those invading the submucosa or beyond was 59.7%,100%,100%,and 37.6%,respectively.The sensitivity,specificity,positive and negative predictive values of the Japanese Group Classification for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 83.3%,91.4%,83.3%,and 91.4%,respectively,and for distinguishing between intramucosal lesions and those invading the submucosa or beyond was 95.1%,91.4%,97.9%,and 82.1%,respectively.A total of 137 of 144 carcinomas that had invaded the submucosa or beyond and three high-grade intraepithelial neoplasias were diagnosed as 'carcinoma' using the Japanese Group Classif ication system.CONCLUSION:The revised Vienna Classifi cation for cold biopsy specimens has high positive predictive value in the diagnosis of colorectal carcinoma invasive to the submucosa or beyond. | Kenji Tominaga Sumio Fujinuma Takuro Endo Yoshihisa Saida Kei Takahashi Iruru Maetani | 2009 | World Journal of Gastroenterology2009，15，19： | 5 |
| 8 | Safety and efficacy of metallic stent for unresectable distal malignant biliary obstruction in elderly patients显示文摘AIM To study the safety of insertion of metallic stents in elderly patients with unresectable distal malignant biliary obstruction.METHODS Of 272 patients with unresectable distal malignant biliary obstruction, 184 patients under the age of 80 were classified into Group A, and 88 subjects aged 80 years or more were classified into Group B. The safety of metallic stent insertion, metal stent patency period, and the obstruction rate were examined in each group.RESULTS In Group B, patients had a significantly worse per-formance status, high blood pressure, heart disease, cerebrovascular disease, and dementia; besides the rate of patients orally administered antiplatelet drugs or anticoagulants tended to be higher(P < 0.05). Metallic stents were successfully inserted in all patients. The median patency period was 265.000 ± 26.779(1-965) d; 252.000 ± 35.998(1-618) d in Group A and 269.000 ± 47.885(1-965) d in Group B, with no significant difference between the two groups. Metallic stent obstruction occurred in 82 of the 272(30.15%) patients; in 53/184(28.80%) patients in Group A and in 29/88(32.95%) of those in Group B, showing no significant difference between the two groups. Procedural accidents due to metal stent insertion occurred in 24/272(8.8%) patients; in 17/184(9.2%) of patients in Group A and in 7/88(8.0%) of those in Group B, with no significant difference between the two groups, either.CONCLUSION These results suggested that metallic stents can be safely inserted to treat unresectable distal malignant biliary obstruction even in elderly patients aged 80 years or more. | Yuji Sakai Tomohisa Iwai Kenji Shimura Katsushige Gon Kazuya Koizumi Masashi Ijima Kazuro Chiba Seigo Nakatani Harutoshi Sugiyama Toshio Tsuyuguchi Terumi Kamisawa Iruu Maetani Mitsuhiro Kida | 2018 | World Journal of Gastroenterology2018，24，1： | 4 |
| 9 | Randomized phase II study of gemcitabine and S-1 combination versus gemcitabine alone in the treatment of unresectable advanced pancreatic cancer (Japan Clinical Cancer Research Organization PC-01 study)显示文摘 | Masato Ozaka Yuji Matsumura Hiroshi Ishii Yasushi Omuro Takao Itoi Hisatsugu Mouri Keiji Hanada Yasutoshi Kimura Iruru Maetani Yoshinobu Okabe Masaji Tani Takaaki Ikeda Susumu Hijioka Ryouhei Watanabe Shinya Ohoka Yuki Hirose Masafumi Suyama Naoto Egawa A | 2012 | Cancer Chemotherapy and Pharmacology2012，，5： | 3 |
| 10 | Treating bilio-duodenal obstruction: Combining new endoscopic technique with 6 Fr stent introducer显示文摘Periampullary cancer may cause not only biliary but also duodenal obstructions. In patients with concomitant duodenal obstructions, endoscopic biliary stenting remains technically difficult and may often require percutaneous transhepatic biliary drainage. We describe a method of metal stent placement via a thin forwardviewing endoscope in patients with simultaneous biliary and duodenal obstruction. In two consecutive patients with biliary and duodenal obstruction due to pancreatic cancer, a new biliary metal stent mounted in a slim delivery catheter was placed via a thin forward viewing endoscope after passage across the duodenal stenosis without balloon dilation. In both patients, with our new placement technique, metallic stents were successfully placed in a short time without adverse events. After biliary stenting, one patient received curative resection and the other received duodenal stenting for palliation. Metallic stent placement with a forward-viewing thin endoscope is a beneficial technique, which can avoid percutaneous drainage in patients with bilio-duodenal obstructions due to periampullary cancer. | Iruru Maetani Tomoko Nambu Shigefumi Omuta Takeo Ukita Hiroaki Shigoka | 2010 | World Journal of Gastroenterology2010，16，22： | 2 |
| 11 | High-spatial-resolution thr- ee-dimensional MR cholangiography using a high-sampling-efficie- ncy technique (SPACE) at 3 T:comparison with the convention- al constant flip angle sequence in healthy volunteers显示文摘 | Arizono S Isoda H Maetani YS | 2008 | J Magn Reson Imaging2008，28，： | 1 |
| 12 | MR imaging of intrahepatic cholangiocarcinoma with pathologic correlation显示文摘 | Maetani Y Itoh K Watanabe C | 2001 | AJR2001，176，6： | 1 |
| 13 | BACKGROUND AND CLINICAL IMPACT OF TISSUE CONGESTION IN RIGHT-LOBE LIVING-DONOR LIVER GRAFTS: A MAGNETIC RESONANCE IMAGING STUDY显示文摘 | Hidekazu Yamamoto Yoji Maetani Tetsuya Kiuchi Takashi Ito Satoshi Kaihara Hiroto Egawa Kyo Itoh Yasuo Kamiyama Koichi Tanaka | 2003 | Transplantation2003，，1： | 1 |
| 14 | Free radical scavenger protects against inner hair cell loss after cochlear ischemia 显示文摘 | Maetani T Hakuba N Taniguchi M | 2003 | Neuroreport2003，14，14： | 1 |
| 15 | Expansion of selection criteria for patients with hepatocellular carcinoma in living donor liver transplantation显示文摘 | Takashi Ito Yasutsugu Takada Mikiko Ueda Hironori Haga Yoji Maetani Fumitaka Oike Kohei Ogawa Seisuke Sakamoto Yasuhiro Ogura Hiroto Egawa Koichi Tanaka Shinji Uemoto | 2007 | Liver Transpl2007，，12： | 1 |
| 16 | MR imaging of intrahepatic cholangiocarcinoma with pathologic correlation 显示文摘 | Maetani Y hoh K Watanabe C | 2001 | AJR2001，176，12： | 1 |
| 17 | MR imaging of intrahepatic cholangiocarcinoma with pathologic correlation显示文摘 | Maetani Y hoh K Watanabe C | 2001 | AJR2001，176，6： | 1 |
| 18 | MR imaging of intrahepat- ic cholangiocarcinoma with pathologic correlation 显示文摘 | Maetani Y Itoh K Watanabe C | 2001 | AJR Am JRoentgenol2001，176，6： | 1 |
| 19 | MR Imaging of intrahepatic cholangiocarcinoma with pathologic correlation显示文摘 | Maetani Y Itoh K Watanabe C | 2001 | AJR2001，176，6： | 1 |
| 20 | Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: a multicenter study 显示文摘 | Maetani I Isayama H Mizumoto Y | 2007 | Gastrointest Endosc2007，66，2： | 1 |
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