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World Journal of Gastroenterology 2018年第34期24卷 3958-3964页

作者： Jia-Lin Cheng Jing Cui Yi Wang Zong-Zhen Xu Feng Liu Shu-Bin Liang Hu Tian Taishan Medical University Tai’an 271016Shandong ProvinceChina Department of General Surgery Shandong Provincial Qianfoshan HospitalShandong UniversityJinan 250014Shandong ProvinceChina Department of Pathology Shandong Provincial Qianfoshan HospitalShandong UniversityJinan 250014Shandong ProvinceChina Department of Medical Imaging Shandong Provincial Qianfoshan HospitalShandong UniversityJinan 250014Shandong ProvinceChina

Castleman disease(CD) is a rare disorder of lymph nodes and related tissues. CD generally occurs in the mediastinum, as well as in cervical, retroperitoneal and axillary regions. The disease is classified into two major types: unicentric CD(UCD) and multicentric CD. The occurrence of UCD in the retroperitoneal peripancreatic region is quite rare. We encountered two cases of retroperitoneal peripancreatic UCD in our hospital during the past three years. Following a series of medical examinations, including magnetic resonance imaging, computed tomography, ultrasonography and postoperative histopathological examination, these two patients were diagnosed with UCD,which presented as a retroperitoneal peripancreatic *** mass in each patient was completely excised,and no postoperative radiochemotherapy was *** patients recovered well without recurrence during a follow-up period of 30 mo and 8 mo.

关键词： Unicentric Castleman disease peripancreatic Retroperitoneal Tumor

Clinical outcomes of endoscopic ultrasonography-guided transmural drainage using plastic stent and nasocystic drain for pancreatic and peripancreatic collections

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Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 96-99页

作者： Katsuya Kitamura Akira Yamamiya Yu Ishii Yuta Mitsui Hitoshi Yoshida Division of Gastroenterology Department of Medicine Showa University School of Medicine

To the Editor:Pancreatic and peripancreatic collections(PCs)develop from acute pancreatitis(AP),chronic pancreatitis,surgery,or *** 2012 revised Atlanta classification[1]of AP classified local complications into the following 4 PC types:acute peripancreatic fluid collection(<4 weeks after the onset of acute interstitial edematous pancreatitis),acute necrotic collection(<4 weeks after the onset of acute necrotizing pancreatitis),pancreatic pseudocyst(PPC;≥4 weeks after the onset of acute interstitial edematous pancreatitis),and walled-off necrosis(WON;≥4 weeks after the onset of acute necrotizing pancreatitis).Endoscopic ultrasonographyguided transmural drainage(EUS-TD)has been reported to be a minimally invasive procedure for patients with PCs[2–4].This study aimed to investigate the clinical outcomes of EUS-TD for PCs.

关键词： peripancreatic EUS-TD

Pancreatic fluid collections: What is the ideal imaging technique?

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World Journal of Gastroenterology 2015年第48期21卷 13403-13410页

作者： Narendra Dhaka Jayanta Samanta Suman Kochhar Navin Kalra Sreekanth Appasani Manish Manrai Rakesh Kochhar Departments of Gastro-enterology Postgraduate Institute of Medical Education and Research Department of Radiodiagnosis Government Medical College and Hospital Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research

Pancreatic fluid collections(PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liquid alone or a mixture of fluid and necrotic debris. Management of these different types of collections differs because of the variable quantity of debris; while patients with pseudocysts can be drained by straight-forward stent placement, walledoff necrosis requires multi-disciplinary approach. Differentiating these collections on the basis of clinical severity alone is not reliable, so imaging is primarily performed. Contrast-enhanced computed tomography is the commonly used modality for the diagnosis and assessment of proportion of solid contents in PFCs; however with certain limitations such as use of iodinated contrast material especially in renal failure patients and radiation exposure. Magnetic resonance imaging(MRI) performs better than computed tomography(CT) in characterization of pancreatic/peripancreatic fluid collections especially for quantification of solid debris and fat necrosis(seen as fat density globules), and is an alternative in those situations where CT is contraindicated. Also magnetic resonance cholangiopancreatography is highly sensitive for detecting pancreatic duct disruption and choledocholithiasis. Endoscopic ultrasound is an evolving technique with higher reproducibility for fluid-to-debris component estimation with the added advantage of being a single stage procedure for both diagnosis(solid debris delineation) and management(drainage of collection) in the same sitting. Recently role of diffusion weighted MRI and positron emission tomography/CT with ^(18)F-FDG labeled autologous leukocytes is also emerging for detection of infection noninvasively. Comparative studies between these imaging modalities are still limited. However we look forward to a time when this gap in literature will be fulfilled.

关键词： Acute pancreatitis Contrast-enhancedcomputed tomography Magnetic resonance imaging Endoscopic ultrasound Positron emission tomographyscan Pancreatic fluid collections Acute necroticcollections Acute peripancreatic fluid collections Pseudocysts Walled-off necrosis

Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using self-expanding metal stents without fluoroscopy

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World Journal of Gastrointestinal Endoscopy 2018年第5期10卷 93-98页

作者： Barbara Braden Andreas Koutsoumpas Michael A Silva Zahir Soonawalla Christoph F Dietrich Translational Gastroenterology Unit Oxford University Hospitals Hepatobiliary Surgery Oxford University Hospitals Caritas Krankenhaus Bad Mergentheim

AIM To investigate whether endoscopic ultrasound(EUS)-guided insertion of fully covered self-expandable metal stents in walled-off pancreatic necrosis(WOPN) is feasible without *** Patients with symptomatic pancreatic WOPN undergoing EUS-guided transmural drainage using self-expandable and fully covered self expanding metal stents(FCSEMS) were included. The EUS visibility of each step involved in the transmural stent insertion was assessed by theoperators as "visible" or "not visible":(1) Access to the cyst by needle or cystotome;(2) insertion of a guide wire;(3) introducing of the diathermy and delivery system;(4) opening of the distal flange; and(5) slow withdrawal of the delivery system until contact of distal flange to cavity wall. Technical success was defined as correct positioning of the FCSEMS without the need of *** In total, 27 consecutive patients with symptomatic WOPN referred for EUS-guided drainage were included. In 2 patients large traversing arteries within the cavity were detected by color Doppler, therefore the insertion of FCSEMS was not attempted. In all other patients(92.6%) EUS-guided transgastric stent insertion was technically successful without fluoroscopy. All steps of the procedure could be clearly visualized by EUS. Nine patients required endoscopic necrosectomy through the FCSEMS. Adverse events were two readmissions with fever and one self-limiting bleeding; there was no procedure-related mortality. CONCLUSION The good endosonographic visibility of the FCSEMS delivery system throughout the procedure allows safe EUS-guided insertion without fluoroscopy making it available as bedside intervention for critically ill patients.

关键词： Necrotizing pancreatitis peripancreatic fluid collection Therapeutic endoscopic ultrasound Transmural drainage Acute pancreatitis

Electrocautery vs non-electrocautery dilation catheters in endoscopic ultrasonography-guided pancreatic fluid collection drainage

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World Journal of Gastrointestinal Endoscopy 2016年第13期8卷 458-465页

作者： Katsuya Kitamura Akira Yamamiya Yu Ishii Tomohiro Nomoto Tadashi Honma Hitoshi Yoshida Division of Gastroenterology Department of Medicine Showa University School of Medicine

AIM: To investigate the safety and utility of an electrocautery dilation catheter for endoscopic ultrasonography(EUS)-guided pancreatic fluid collection ***: A single-center, exploratory, retrospective study was conducted between August 2010 and August 2014. This study was approved by the Medical Ethics Committee of our institution. Informed, written consent was obtained from each patient prior to the procedure. The subjects included 28 consecutive patients who underwent EUS-guided transmural drainage(EUS-TD) for symptomatic pancreatic and peripancreatic fluid collections(PFCs) by fine needle aspiration using a 19-gauge needle. These patients were retrospectively divided into two groups based on the use of an electrocautery dilation catheter as a fistula dilation device; 15 patients were treated with an electrocautery dilation catheter(electrocautery group), and 13 patients were treated with a non-electrocautery dilation catheter(non-electrocautery group). We evaluated the technical and clinical successes and the adverse events associated with EUS-TD for the treatment of PFCs between the two ***: There were no significant differences in age, sex, type, location and diameter of PFCs between the groups. Thirteen patients(87%) in the electrocauterygroup and 10 patients(77%) in the non-electrocautery group presented with infected PFCs. The technical success rates of EUS-TD for the treatment of PFCs were 100%(15/15) and 100%(13/13) for the electrocautery and the non-electrocautery groups, respectively. The clinical success rates of EUS-TD for the treatment of PFCs were 67%(10/15) and 69%(9/13) for the electrocautery and the non-electrocautery groups, respectively(P = 0.794). The procedure time of EUS-TD for the treatment of PFCs in the electrocautery group was significantly shorter than that of the non-electrocautery group(mean ± SD: 30 ± 12 min vs 52 ± 20 min, P < 0.001). Adverse events associated with EUS-TD for the treatment of PFCs occurred in

关键词： Electrocautery dilation catheter Endoscopic ultrasonography-guided transmural drainage Fistula dilation device Pancreatic and peripancreatic fluid collection Procedure time