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Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?

World Journal of Gastroenterology 2016年第26期22卷 5909-5916页

作者： toshio fujisawa Koichi Kagawa Kantaro Hisatomi Kensuke Kubota Atsushi Nakajima Nobuyuki Matsuhashi Department of Gastroenterology NTT Medical Center Tokyo Department of Gastroenterology and Hepatology Yokohama City University School of Medicine

Endoscopic papillary balloon dilatation(EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography(ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis(PEP). However, as the efficacy of endoscopic papillary largeballoon dilatation(EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy(EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP.

关键词： Endoscopic papillary balloon dilatation Post-endoscopic retrograde cholangio-pancreatography pancrea

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Pancreatic paraganglioma with draining vessels

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World Journal of Gastroenterology 2015年第31期21卷 9442-9447页

作者： Yoshitsugu Misumi toshio fujisawa Hirotsugu Hashimoto Koichi Kagawa Tamaki Noie Hideyuki Chiba Hajime Horiuchi Yasushi Harihara Nobuyuki Matsuhashi Department of Gastroenterology NTT Medical Center Tokyo Department of Pathology NTT Medical Center Tokyo Department of Surgery NTT Medical Center Tokyo Department of Gastroenterology Omori Red Cross Hospital

A pancreatic paraganglioma is a rare neoplasm that is difficult to distinguish from a pancreatic neuroendocrine tumour. Here we present a case of pancreatic paraganglioma that was surgically resected following preoperative diagnosis of a pancreatic neuroendocrine tumour. Careful evaluation of the endoscopic ultrasonography findings revealed abundant draining ves-sels,which could have led to a correct preoperative diagnosis of pancreatic paraganglioma.

关键词： Paraganglioma Neuroendocrine tumour Draining vesse

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Levovist ultrasonography imaging in intracystic hemorrhage of simple liver cyst

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World Journal of Gastroenterology 2008年第5期14卷 805-807页

作者： Tomoyuki Akiyama Masahiko Inamori Satoru Saito Hirokazu Takahashi Masato Yoneda Koji Fujita toshio fujisawa Yasunobu Abe Hiroyuki Kirikoshi Kensuke Kubota Michio Ueda Kuniya Tanaka Shinji Togo Norio Ueno Hiroshi Shimada Atsushi Nakajima Division of Gastroenterology Yokohama city University Hospital Yokohama 236-0004 Japan Division of Surgery Yokohama city University Hospital Yokohama 236-0004 Japan

The differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is often difficult even with the use of various imaging modalities. A 73-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Ultrasonography (US) demonstrated a heterogeneous echogenic cyst measuring 11 cm × 8 cm in size in S2 of the liver, indicated intracystic hemorrhage of simple liver cyst or cystadenocarcinoma, but the differential diagnosis was considerably difficult. Levovist (Schering, Berlin, Germany) US revealed no enhancement of the intracystic structures, suggesting a clot in the case of intracystic hemorrhage. An operation was performed and the resected lesion showed a solitary benign liver cyst, measuring 5.5 cm × 4.7 cm × 8.5 cm containing a large blood clot. The patient had an uneventful recovery after the surgery. Levovist US may play an important role in discrimination between intracystic hemorrhage of simple hepatic cysts and cystadenocarcinoma of the liver.

关键词：肝囊肿囊腺癌半乳糖氧化酶症状

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中草药对SARS病毒感染的抑制作用

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中国实验动物学报 2005年第S1期13卷 15-16页

作者： Rika Furuta Jyunichi fujisawa toshio Hattori Department of Microbiology Kansai Medical University Department of Microbiology Kansai Medical University Division of Infectious and respiratory diseases Tohoku University

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