Clinical Endoscopy

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Combining low echo reduction and gain adjustment for enhanced pancreatic visualization in endoscopic ultrasound: Akashi Fujita, Masafumi Mizuide, Shomei Ryozawa, Yuki Tanisaka, Ryuhei Jinushi, Ryuichi Watanabe; Clin Endosc 2026;59(1):149-150. Published online July 1, 2025; DOI: https://doi.org/10.5946/ce.2024.358

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Needle Selection Strategy for EUS-Guided Tissue Acquisition Using 22-Gauge Needles in Small Pancreatic Solid Lesions
Akashi Fujita, Shomei Ryozawa, Masafumi Mizuide, Yuki Tanisaka, Suguru Ito, Ryuichi Watanabe, Ryosuke Hamamura, Yoshiki Matsuno
Internal Medicine.2026;[Epub] CrossRef

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Original Article

22-gauge Co-Cr versus stainless-steel Franseen needles for endoscopic ultrasound-guided tissue acquisition in patients with solid pancreatic lesions: Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Rie Shiomi, Takahiro Shin, Kei Sugimoto, Tomoaki Tashima, Yumi Mashimo, Shomei Ryozawa; Clin Endosc 2024;57(2):237-245. Published online January 26, 2024; DOI: https://doi.org/10.5946/ce.2023.011

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Background
/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22-gauge cobalt-chromium (CO-Cr) needles with those of stainless-steel Franseen needles in patients with solid pancreatic lesions.
Methods
Outcomes were compared between the 22-gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless-steel needle (November 2020 to May 2022; group S).
Results
A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences (p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless-steel Franseen needles showed less inter-operator difference than Co-Cr needles (p=0.03).
Conclusions
Both Co-Cr and stainless-steel Franseen needles showed high diagnostic ability. Stainless-steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure.

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Progress and Challenges in Joining for Precision Endoscope Fabrication
Peiquan Xu, Xiaohao Zheng, Leijun Li, Ziyi Wang
Sensors.2026; 26(9): 2828. CrossRef
Needle Selection Strategy for EUS-Guided Tissue Acquisition Using 22-Gauge Needles in Small Pancreatic Solid Lesions
Akashi Fujita, Shomei Ryozawa, Masafumi Mizuide, Yuki Tanisaka, Suguru Ito, Ryuichi Watanabe, Ryosuke Hamamura, Yoshiki Matsuno
Internal Medicine.2026;[Epub] CrossRef
The correlation between tumoral CD8 expression and clinical course in patients with unresectable pancreatic cancer using tissue samples acquired by endoscopic ultrasound‐guided tissue acquisition
Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Ryuichi Watanabe, Ryo Sato, Masanori Yasuda
Journal of Hepato-Biliary-Pancreatic Sciences.2025; 32(2): 132. CrossRef
Optimal tissue acquisition method for pancreatic mass
Kwang Hyun Chung, Sang Hyub Lee
Digestive Endoscopy.2025; 37(6): 629. CrossRef
Endosonographic-guided tissue acquisition for solid pancreatic lesions: Have we reached the ceiling?
Natalie Cosgrove
Gastrointestinal Endoscopy.2025; 102(5): 714. CrossRef
Curved puncture technique using a flexible stainless-steel needle in endoscopic ultrasound-guided hepaticogastrostomy
Haruo Miwa, Yuichi Suzuki, Shotaro Tsunoda, Kazuki Endo, Ritsuko Oishi, Hiromi Tsuchiya, Shin Maeda
Endoscopy.2024; 56(S 01): E1082. CrossRef

6,685 View
182 Download
6 Web of Science
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Review

Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review: Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Rie Shiomi, Takahiro Shin, Kei Sugimoto, Shomei Ryozawa; Clin Endosc 2023;56(6):716-725. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2023.023

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Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. For example, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical practice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE) with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of larger accessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the development in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the challenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as perforation, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regarding SBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated with ERCP.

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9,367 View
429 Download
14 Web of Science
18 Crossref

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