Shinsuke Koshita

ENDOSONOGRAPHY-GUIDED BILIARY DRAINAGE IN CASES WITH DIFFICULT TRANSPAPILLARY ENDOSCOPIC BILIARY DRAINAGE

Background:  Recently, reports on a new endoscopic biliary drainage technique utilizing endosonographic guidance (endosonography‐guided biliary drainage [ESBD]) have been increasing. The aim of this study was to evaluate the efficacy of ESBD in cases with difficult transpapillary endoscopic biliary drainage (EBD).

Therapeutic endoscopic retrograde cholangiography using a single-balloon enteroscope in patients with Roux-en-Y anastomosis

The aim of the present study was to evaluate the usefulness of a single‐balloon enteroscope (SBE) including a newly developed short SBE (SIF‐Y0004) for therapeutic endoscopic retrograde cholangiography (ERC) in patients with Roux‐en‐Y (R‐Y) anastomosis.

Clinical usefulness of double‐guidewire technique for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography

Although biliary cannulation with pancreatic guidewire placement (P‐GW) is useful for difficult cases in endoscopic retrograde cholangiopancreatography (ERCP), the clinical significance of wire‐guided cannulation with P‐GW (double‐guidewire technique: DGT) has not been clarified. The aim of the present study was to evaluate the usefulness of DGT for difficult biliary cannulation after unsuccessful biliary cannulation using a cannula/sphincterotome under guidance of injected contrast with P‐GW (single‐guidewire technique: SGT).

Single-session endoscopic bilateral y-configured placement of metal stents for hilar malignant biliary obstruction.

Background:  The aim of this study was to evaluate the efficacy and safety of endoscopic bilateral biliary metal stent placement for hilar malignant obstruction.

Impact of technical modification of endoscopic papillectomy for ampullary neoplasm on the occurrence of complications.

Aim:  To evaluate the usefulness of a modified technique of endoscopic papillectomy (EP) for lessening the occurrence of complications.

Invasive carcinoma derived from “flat type” branch duct intraductal papillary mucinous neoplasms of the pancreas: impact of classification according to the height of mural nodule on endoscopic ultrasonography

It has been reported that many branch duct intraductal papillary mucinous neoplasms (BD‐IPMN) with a mural nodule (MN) reveal adenocarcinomas. On the other hand, invasive cancer derived from BD‐IPMN without MN on endoscopic ultrasound (EUS) also exists. The aim of this study was to elucidate the clinicopathological features of invasive cancer derived from BD‐IPMN without MN on EUS.

Metallic stent deployment in endosonography-guided biliary drainage: Long-term follow-up results in patients with bilio-enteric anastomosis

Background and Aim:  Although reports on endosonography‐guided biliary drainage (ESBD) have been increasing, only a few reports on deployment of a self‐expandable metal stents (SEMS) have been reported. The aim of the present study was to evaluate the safety and efficacy of SEMS deployment in ESBD.

Intraductal ultrasonography (IDUS) for the diagnosis of biliopancreatic diseases

Intraductal ultrasonography (IDUS) is an imaging modality having unique characteristics and suitable for imaging of a narrow ductal cavity, its wall and the neighbouring structures. As IDUS uses high-frequency ultrasound (12-30MHz), its image quality is very high within approximately 2-cm range of radius. The bile duct and the pancreatic duct, therefore, are good targets for the assessment by IDUS. Biliopancreatic IDUS is mainly performed through the papilla of Vater in the same session as endoscopic retrograde cholangiopancreatography (ERCP). Biliary IDUS is possible through the percutaneous transhepatic route as well. Not many comparative studies on biliopancreatic IDUS have been published. Gallbladder IDUS as well as most pancreatic IDUS are still at the level of clinical research. Constant delineation of Oddis sphincter with the improvement of instruments will expand the use of IDUS for the assessment of the papilla of Vater lesions.

Efficacy and safety of a WallFlex enteral stent for malignant gastric obstruction.

The aim of the present study was to investigate the efficacy and safety of a newly available enteral WallFlex stent for malignant gastric outlet obstruction (GOO).

Intraductal ultrasonography in the diagnosis of bile duct stones: when and whom?

Background and Aim:  Biliary intraductal ultrasonography (IDUS) is highly sensitive in visualizing bile duct stones (BDS). Indications for IDUS, however, in cases of suspected BDS have not yet been established. The aim of the present study was to elucidate adequate indications for IDUS in cases that undergo endoscopic retrograde cholangiopancreatography (ERCP) due to suspected BDS.