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RISS 인기검색어
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- 저자 : Yui Kishimoto (검색결과 3 건)
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Yui Kishimoto,Naoki Okano,Ken Ito,Kensuke Takuma,Seiichi Hara,Susumu Iwasaki,Kensuke Yoshimoto,Yuto Yamada,Koji Watanabe,Yusuke Kimura,Hiroki Nakagawa,Yoshinori Igarashi 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.2
Background/Aims: Endoscopic evaluation of intraductal papillary mucinous neoplasms (IPMNs) is useful in determining whetherthe lesions are benign or malignant. This study aimed to examine the usefulness of peroral pancreatoscopy (POPS) in determiningthe prognosis of IPMNs. Methods: POPS with videoscopy was performed using the mother–baby scope technique. After surgery, computed tomography/magnetic resonance cholangiopancreatography or ultrasonography and blood tests were performed every 6 months during thefollow-up. Results: A total of 39 patients with main pancreatic duct (MPD)–type IPMNs underwent POPS using a videoscope, and theprotrusions in the MPD were observed in 36 patients. The sensitivity and specificity of cytology/biopsy performed at the time ofPOPS were 85% and 87.5%, respectively. Of 19 patients who underwent surgery, 18 (95%) patients had negative surgical margins and1 (5%) patient had a positive margin. Conclusions: In IPMNs with dilatation of the MPD, POPS is considered effective if the lesions can be directly observed. Thediagnosis of benign and malignant lesions is possible depending on the degree of lesion elevation. However, in some cases, slightlyelevated lesions may increase in size during the follow-up or multiple lesions may be simultaneously present; therefore, carefulfollow-up is necessary.
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Naoki Okano,Yoshinori Igarashi,Seiichi Hara,Kensuke Takuma,Itaru Kamata,Yui Kishimoto,Takahiko Mimura,Ken Ito,Yasukiyo Sumino 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.2
Background/Aims: In recent years, endoscopic snare papillectomy has been performed to treat tumors of the ampulla of Vater. Thisprocedure requires accurate preoperative evaluation. In this study, we diagnosed the focal extension of such tumors by using endoscopicultrasonography (EUS) and intraductal ultrasonography (IDUS), and examined the indications for endoscopic snare papillectomy. Methods: The subjects were 48 patients with a papillary tumor (13 patients, surgical resection; 35 patients, endoscopic snare papillectomy)who were evaluated preoperatively with EUS and IDUS. The tumor-node-metastasis classification was used for the endosonographicevaluation and pathological diagnosis of these tumors. Results: The diagnostic accuracy of EUS was 97% for diagnosing adenomas and pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors,and 50% for pT3–4 tumors, for an overall accuracy of 85% for T-staging. The diagnostic accuracy of IDUS was 94% for adenomasand pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors, and 100% for pT3–4 tumors, for an overall accuracy of 80% for T-staging. Conclusions: EUS and IDUS are highly capable of evaluating tumors of the ampulla of Vater preoperatively. However, these techniquesare not sufficient for evaluating the focal extension of carcinomas preoperatively. Currently, endoscopic snare papillectomy is adequatefor treating adenomas and pTis tumors.
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Ito Ken,Okano Naoki,Takuma Kensuke,Iwasaki Susumu,Watanabe Koji,Kimura Yusuke,Yamada Yuto,Yoshimoto Kensuke,Hara Seiichi,Kishimoto Yui,Matsuda Takahisa,Igarashi Yoshinori 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.4
Background/Aims: Many Japanese institutions use electromagnetic extracorporeal shock wave lithotripsy (ESWL) systems for treating pancreatic duct stones. However, there are no reports on direct comparisons between recent electromagnetic lithotripters. This study aimed to verify whether the new electromagnetic lithotripter can improve the efficiency of pancreatic stone fragmentation, and to clarify the role of combined endoscopic treatment on the clearance of pancreatic duct stones. Methods: We retrospectively identified 208 patients with pancreatolithiasis who underwent endoscopic adjunctive treatment after pancreatic ESWL at a single Japanese center over a 17-year period. We evaluated the outcome data of this procedure performed with SLX-F2 (last 2 years; group A) and Lithostar/Lithoskop (first 15 years; group B), as well as additional endoscopic treatments for pancreatolithiasis. We also performed logistic regression analysis to detect various factors associated with the procedure. Results: For pancreatic head stones, ESWL disintegration was achieved in 93.7% of group A patients and 69.0% of group B patients (p=0.004), and adjunctive endoscopic treatment removed stones in 96.8% of group A patients and 73.0% of group B patients (p=0.003). Multivariate analysis revealed that lithotripter type (odds ratio, 6.99; 95% confidence interval, 1.56 to 31.33; p<0.01) and main pancreatic duct stricture (odds ratio, 2.87; 95% confidence interval, 1.27 to 6.45; p<0.01) were significant factors for ESWL fragmentation. Conclusions: The SLX F2 showed high performance in fragmenting the pancreatic duct stones. In addition, endoscopic adjunctive treatment improved the overall success rate of the procedure. The improved ESWL lithotripter has many advantages for patients undergoing pancreatic lithotripsy treatment.
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