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Lumen-apposing metal stent deployment for walled-off necrosis using semi-free hand technique from the intestine

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 191-193页

作者： Takeshi Ogura Nobu Nishioka kazuhide higuchi nd Department of Internal Medicine Osaka Medical College2-7 DaigakuchouTakatsukishiOsaka 569-8686Japan

Lumen-apposing metal stent (LAMS) deployment under en- doscopic ultrasonography (EUS) guidance has been used for walled-off necrosis (WON) [1] . Recently, LAMS with electrocautery enhanced delivery system has been developed. One of the advan- tages of this stent is that the stent can be delivered without any dilation devices. However, to prevent stent migration into the in- testinal lumen, it is important that stent delivery system should be inserted within the WON. When the diameter of WON is not large enough to insert stent delivery system, contralateral wall of WON may be injured. To prevent this adverse event, guidewire insertion may be useful after puncturing. In addition, according to the re- cent reports [2–4] , EUS-guided LAMS placement for WON drainage has been performed. We herein described a case of LAMS deploy- ment from the second part of the duodenum using semi-free hand technique.

关键词： enough insertion intestine

Hemobilia due to hepatocellular carcinoma： cholangioscopicfindings and novel endoscopic hemostasis

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Hepatobiliary & Pancreatic Diseases International 2018年第3期17卷 275-277页

作者： takeshi ogura atsushi okuda kazuhide higuchi second department of internal medicine osaka medical college2-7 DaigakuchouTakatsukishiOsaka 569-8686Japan

To the Editor：Trauma, inflammation, iatrogenic procedures such as liverbiopsy and percutaneous transhepatic biliary drainage （PTBD）, vascularanomalies, coagulopathy status, and malignancy can causehemobilia [1]. Malignant causes of hemobilia include cholangiocarcinoma,pancreatic cancer, gallbladder tumor, and liver metastasis,but rarely hepatocellular carcinoma （HCC）. Here, we describeachieving endoscopic hemostasis for hemobilia caused by HCC,which was visualized using the single-operator, SPY-DS cholangioscope（Boston Scientific, Tokyo, Japan） under endoscopic retrogradecholangiopancreatography （ERCP） guidance. This scope is a dramaticimprovement over the SpyGlass system in that it is easier to insert into the biliary tract due to a tapered tip, a 120° digitalfield-of-view provides favorable visualization, and new injection and suction functions have been added via a two-port adaptor.

关键词： COVERED METALLIC STENT

Development and validation of a simple and multifaceted instrument,GERD-TEST,for the clinical evaluation of gastroesophageal reflux and dyspeptic symptoms

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World Journal of Gastroenterology 2017年第28期23卷 5216-5228页

作者： Koji Nakada Nobuyuki Matsuhashi Katsuhiko Iwakiri Atsushi Oshio Takashi Joh kazuhide higuchi Ken Haruma Department of Laboratory Medicine Daisan Hospital Jikei University School of Medicine Department of Gastroenterology NTT Medical Center Tokyo Department of Gastroenterology Nippon Medical School Graduate School of Medicine Faculty of Letters Arts and SciencesWaseda University Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Second Department of Internal Medicine Osaka Medical College Department of General Internal Medicine 2 Kawasaki Medical School Kawasaki Hospital

To evaluate the psychometric properties of a newly developed questionnaire, known as the gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), in patients with *** patients with predominant GERD symptoms recruited according to the Montreal definition were treated for 4 wk using a standard dose of proton pump inhibitor (PPI). The GERD-TEST and the Medical Outcome Study Short Form-8 Health Survey (SF-8) were administered at baseline and after 4 wk of treatment. The GERD-TEST contains three domains: the severity of GERD and functional dyspepsia (FD) symptoms (5 items), the level of dissatisfaction with daily life (DS) (4 items), and the therapeutic efficacy as assessed by the patients and medication compliance (4 items).RESULTSA total of 290 patients were eligible at baseline; 198 of these patients completed 4 wk of PPI therapy. The internal consistency reliability as evaluated using the Cronbach’s α values for the GERD, FD and DS subscales ranged from 0.75 to 0.82. The scores for the GERD, FD and DS items/subscales were significantly correlated with the physical and mental component summary scores of the SF-8. After 4 wk of PPI treatment, the scores for the GERD items/subscales were greatly reduced, ranging in value from 1.51 to 1.87 and with a large effect size (P < 0.0001, Cohen’s d; 1.29-1.63). Statistically significant differences in the changes in the scores for the GERD items/subscales were observed between treatment responders and non-responders (P < 0.0001).CONCLUSIONThe GERD-TEST has a good reliability, a good convergent and concurrent validity, and is responsive to the effects of treatment. The GERD-TEST is a simple, easy to understand, and multifaceted PRO instrument applicable to both clinical trials and the primary care of GERD patients.

关键词： Gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test Patient-reported outcome Gastroesophageal reflux disease Validity Reliability

Technical tips of endoscopic ultrasound-guided choledochoduodenostomy

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World Journal of Gastroenterology 2015年第3期21卷 820-828页

作者： Takeshi Ogura kazuhide higuchi Second Department of Internal Medicine Osaka Medical CollegeOsaka 569-8686Japan

Endoscopic ultrasound(EUS) is clinically useful not only as a diagnostic tool during EUS-guided fine needle aspiration,but also during interventional ***-guided biliary drainage has been developed and performed by experienced ***-guided choledocoduodenostomy(EUS-CDS) is relatively well established as an alternative biliary drainage method for biliary decompression in patients with biliary *** reported technical success rate of EUS-CDS ranges from 50% to 100%,and the clinical success rate ranges from 92% to 100%.Further,the over-all technicalsuccess rate was 93%,and clinical success rate was 98%.Based on the currently available literature,the overall adverse event rate for EUS-CDS is 16%.The data on the cumulative technical and clinical success rate for EUS-CDS is ***,EUS-CDS can still lead to several problems,so techniques or devices that are more feasible and safe need to be ***-CDS has the potential to become a first-line biliary drainage procedure,although standardizing the technique in multicenter clinical trials and comparisons with endoscopic biliary drainage by randomized clinical trials are still needed.

关键词： Endoscopic ultrasound Endoscopic ultrasoundguided

Does endoscopic ultrasound-guided biliary drainage really have clinical impact?

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World Journal of Gastroenterology 2015年第4期21卷 1049-1052页

作者： Takeshi Ogura kazuhide higuchi Second Department of Internal Medicine Osaka Medical CollegeOsaka 569-8686Japan

The well established, gold standard method for treatment of obstructive jaundice involves biliary drainage under endoscopic retrograde cholangiopancreatography(ERCP) performed by pancreatobiliary endoscopists. Recently, interventions using endoscopic ultrasound(EUS) have been developed not only for obtaining cytological and histological diagnosis, but also for biliary drainage as alternative method. EUS-guided biliary drainage(EUSBD) was first reported by Giovannini et al. EUS-BD broadly includes EUS-guided rendezvous technique, EUS-guided choledochoduodenostomy, and EUS-guided hepaticogastrostomy. More recently, EUS-guided antegrade stenting and EUS-guided gallbladder drainage have also been reported. many case reports, series, and retrospective studies on EUS-BD have been reported. However, because prospective studies and comparisons between the different biliary drainage methods have not been reported, the technical success, functional success, adverse events, and stent patency with long-term follow up of EUS-BD are still unclear. Therefore, prospective, randomized controlled studies addressing these issues are needed. Despite this, EUSBD undoubtedly is clinically useful as an alternative biliary drainage method. EUS-BD has the potential to be a first-line biliary drainage method instead of ERCP if results of clinical trials are favorable and the technique is simplified.

关键词： Endoscopic ultrasound Endoscopic ultrasoundguided

Management of gastric fundal varices without gastro-renal shunt in 15 patients

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World Journal of Gastroenterology 2008年第3期14卷 448-453页

作者： Natsuhiko Kameda kazuhide higuchi Masatsugu Shiba Kaori Kadouchi Hirohisa Machida Hirotoshi Okazaki Tetsuya Tanigawa Toshio Watanabe Kazunari Tominaga Yasuhiro Fujiwara Kenji Nakamura Tetsuo Arakawa Department of Gastroenterology Graduate School of Medicine Osaka City University Osaka 569-8686 Japan Second Department of Internal Medicine Osaka Medical College Osaka 569-8686 Japan Department of Radiology Graduate School of Medicine Osaka City University Osaka 569-8686 Japan

AIM:To examine the portal hemodynamics of gastric fundal varices (GV) without gastro-renal shunt (GRS), and to retrospectively investigate the effects of various kinds of treatment on eradication. METHODS: Ninety-four liver cirrhosis patients at high- risk of GV were treated in our hospital and enrolled in this study. We retrospectively examined their characteristics, liver function, and portal hemodynamics of GV. We performed balloon-occluded retrograde transvenous obliteration (BRTO) at first. If it was not technically possible to perform BRTO, endoscopic injection sclerotherapy using α-cyanoacrylate glue (CA) or percutaneous transhepatic obliteration (PTO) was performed. RESULTS: Among the 94 patients, a GRS was present in 79 (84.0%), and absent in the remaining 15 (16.0%). The subphrenic vein was connected to the inferior vena cava as the drainage vein in 13 (86.7%) out of the 15 cases without GRS. We performed BRTO in 6 patients, CA in 4 patients and PTO in 5 patients. The eradication rate was 100% for each procedure, but the rate of early recurrence within 6 mo was 16.7% for BRTO, 50.0% for CA and 40.0% for PTO, respectively. CONCLUSION: We should examine the hemodynamics before treatment of GV irrespective of the existence of GRS. If this hemodynamic examination reveals that the drainage vein connects directly to the inferior vena cava in GV without GRS, BRTO may be an effective treatment for GV with GRS.

关键词： Gastric fundal varices Gastro-renal shunt Balloon-occluded retrograde transvenous obliteration

BRIEF ARTICLE New reduced volume preparation regimen in colon capsule endoscopy

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World Journal of Gastroenterology 2012年第17期18卷 2092-2098页

作者： Yasuo Kakugawa Yutaka Saito Shoichi Saito Kenji Watanabe Naoki Ohmiya Mitsuyuki Murano Shiro Oka Tetsuo Arakawa Hidemi Goto kazuhide higuchi Shinji Tanaka Hideki Ishikawa Hisao Tajiri Division of Screening Technology and Development Research Center for Cancer Prevention and ScreeningNational Cancer CenterTokyo 104-0045Japan Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan Department of Endoscopy Jikei University School of MedicineTokyo 105-8461Japan Department of Gastroenterology Osaka City University Graduate School of MedicineOsaka 545-8685Japan Department of Therapeutic Medicine Nagoya University Graduate School of MedicineNagoya 466-8560Japan Second Department of Internal Medicine Osaka Medical CollegeOsaka 569-8686Japan Department of Endoscopy Hiroshima University HospitalHiroshima 734-8551Japan Department of Molecular-Targeting Cancer Prevention Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyoto 602-0841Japan

AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule ***:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method"(group A) with the "conventional volume method"(group B) preparation *** A did not drink polyethylene glycol electrolyte lavage solution(PEGELS) the day before the capsule procedure,while group B drank 2 *** the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule(PillCam COLON capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that *** videos were reviewed for grading of cleansing level,RESULTS:Sixty-four subjects were enrolled,with results from 60 *** A and B included 31 and 29 subjects,***-nine(94%) subjects in group A and 25(86%) subjects in group B had adequate bowel preparation(ns).Twenty-two(71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16(55%) of the 29 subjects in group B(ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than ***:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.

关键词： Colon capsule endoscopy Polyethylene glycol electrolyte lavage solution Colon cleanliness Reduced volume preparation method Isotonic magnesium citrate

A case of mucosa-associated lymphoid tissue lymphoma forming multiple lymphomatous polyposis in the small intestine

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World Journal of Gastroenterology 2007年第9期13卷 1453-1457页

作者： Naoto Hirata Kazunari Tominaga Kensuke Ohta Kaori Kadouchi Hirotoshi Okazaki Tetsuya Tanigawa Masatsugu Shiba Toshio Watanabe Yasuhiro Fujiwara Shiro Nakamura Nobuhide Oshitani kazuhide higuchi Tetsuo Arakawa Department of Gastroenterology Osaka City University Graduate School of Medicine 1-4-3 Asahimachi Abeno-ku Osaka 545-8585 Japan Department of Hematology Osaka City University Graduate School of Medicine1-4-3 Asahimachi Abeno-kuOsaka 545-8585 Japan Department of Gastroenterology Rinku General Medical Center 2-3 Rinkuouraikita Izumisano Osaka 598-0048Japan

A 50-year old woman suffering from diabetes had a CT scan that revealed a diffuse thickening of small intestinal wall and swollen paraaortic lymph nodes. An esophago gastroduodenoscopy (EGD) confirmed multiple polypoid lesions in the duodenum and small intestine, and conventional histological testing revealed non-specific inflammatory changes. Further examinations including the immunohistochemical profiles of the biopsied specimens led us to diagnose the lesion as a marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type, forming multiple lymphomatous polyposis sequentially spreading from duodenal bulb to terminal ileum. According to Lugano’s classification, its staging was clinically diagnosed as stage Ⅱ. Two courses of a standard CHOP (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and predonisolone) regimen with rituximab reduced the lesion and the patient had a almost complete response. A 5-year follow- up EGD and histological examinations detected no recurrence of the disease.

关键词： Intestinal lymphoma Hucosa-associated lymphoid tissue lymphoma Hultiple lymphomatous polyposis

Successful treatment of giant rectal varices by modified percutaneous transhepatic obliteration with sclerosant:Report of a case

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World Journal of Gastroenterology 2006年第33期12卷 5408-5411页

作者： Hirotoshi Okazaki kazuhide higuchi Masatsugu Shiba Shirou Nakamura Tomoko Wada Kazuki Yamamori Ai Machida Kaori Kadouchi Akihiro Tamori Kazunari Tominaga Toshio Watanabe Yasuhiro Fujiwara Kenji Nakamura Tetsuo Arakawa Department of Gastroenterology Osaka City University Graduate School of Medicine Osaka Japan Department of Gastroenterology Osaka City University Graduate School of Medicine Osaka Japan Department of Radiology Osaka City University Graduate School of Medicine Osaka Japan

We present a female patient with continuous melena, diagnosed with rectal variceal bleeding. She had a history of esophageal varices, which were treated with endoscopic therapy. Five years after the treatment of esophageal varices, continuous melena occurred. Since colonoscopy showed that the melena was caused by giant rectal varices, we thought that they were not suitable to receive endoscopic treatment. We chose the modified percutaneous transhepatic obliteration with sclerosant, which is one of the interventional radiology techniques but a new clinical procedure for rectal varices. After the patient received this therapy, her condition of rectal varices was markedly improved.

关键词： Rectal varices Modified percutaneoustranshepatic obliteration with sclerosant