Clinical Endoscopy

Original Articles

Outcomes of partially covered self-expandable metal stents with different uncovered lengths in endoscopic ultrasound-guided hepaticogastrostomy: a Japanese retrospective study: Takeshi Okamoto, Takashi Sasaki, Tsuyoshi Takeda, Tatsuki Hirai, Takahiro Ishitsuka, Manabu Yamada, Hiroki Nakagawa, Takafumi Mie, Takaaki Furukawa, Akiyoshi Kasuga, Masato Ozaka, Naoki Sasahira; Clin Endosc 2024;57(4):515-526. Published online May 10, 2024; DOI: https://doi.org/10.5946/ce.2023.142

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: The optimal length of the uncovered portion of partially covered self-expandable metal stents (PCSEMSs) used in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) remains unclear. This study investigated the safety and efficacy of PCSEMSs with different uncovered lengths, with a focus on stent migration and time to recurrent biliary obstruction (RBO).
Methods
Outcomes of patients undergoing EUS-HGS using PCSEMSs with 5-mm and 20-mm uncovered portions at our institution from January 2016 to December 2021 were compared.
Results
Sixty-two patients underwent EUS-HGS using PCSEMS (5/20-mm uncovered portions: 32/30). Stent migration occurred only in the 5-mm group. There were no differences in RBO rates (28.1% vs. 40.0%) or median time to RBO (6.8 vs. 7.1 months) between the two groups. Median overall survival (OS) was longer in the 20-mm group (3.1 vs. 4.9 months, p=0.037) due to the higher number of patients that resumed chemotherapy after EUS-HGS (56.7% vs. 28.1%, p=0.029). Good performance status, absence of hepatic metastases, and chemotherapy after EUS-HGS were independent predictors of longer OS.
Conclusions
No migration was observed in patients treated with PCSEMS with 20-mm uncovered portions. Patients treated with PCSEMS with 20-mm uncovered portions performed at least as well as those treated with 5-mm uncovered portions in all material respects.

Citations

Citations to this article as recorded by

Bridging the Gap between Literature and Practice: Nationwide Outcomes of Endoscopic Ultrasound-guided Hepatico-gastrostomy
David M. de Jong, Lydi M.J.W. van Driel, Jurriën G.P. Reijnders, Akin Inderson, Jan Werner Poley, Roy L.J. van Wanrooij, Rogier P. Voermans, Paul Didden, Thomas R. de Wijkerslooth, Foke van Delft, Niels G. Venneman, Robert C. Verdonk, Johanna P. van Nes,
Endoscopy International Open.2026;[Epub] CrossRef
Migration of covered expandable metal stents after endoscopic ultrasound-guided hepaticogastrostomy: stent covering versus stent design?
Todd H. Baron
Clinical Endoscopy.2024; 57(4): 471. CrossRef

6,782 View
245 Download
2 Web of Science
2 Crossref

Risk factors for recurrent stenosis after balloon dilation for benign hepaticojejunostomy anastomotic stricture: Takafumi Mie, Takashi Sasaki, Takeshi Okamoto, Tsuyoshi Takeda, Chinatsu Mori, Yuto Yamada, Takaaki Furukawa, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira; Clin Endosc 2024;57(2):253-262. Published online May 16, 2023; DOI: https://doi.org/10.5946/ce.2022.216

Graphical Abstract Abstract PDF

Background
/Aims: Hepaticojejunostomy anastomotic stricture (HJAS) is a feared adverse event associated with hepatopancreatobiliary surgery. Although balloon dilation for benign HJAS during endoscopic retrograde cholangiopancreatography with balloon-assisted enteroscopy has been reported to be useful, the treatment strategy remains controversial. Therefore, we evaluated the outcomes and risk factors of recurrent stenosis after balloon dilation alone for benign HJAS.
Methods
We retrospectively analyzed consecutive patients who underwent balloon-assisted enteroscopy–endoscopic retrograde cholangiopancreatography for benign HJAS at our institution between July 2014 and December 2020.
Results
Forty-six patients were included, 16 of whom had recurrent HJAS after balloon dilation. The patency rates at 1 and 2 years after balloon dilation were 76.8% and 64.2%, respectively. Presence of a residual balloon notch during balloon dilation was an independent predictor of recurrence (hazard ratio, 2.80; 95% confidence interval, 1.01–7.78; p=0.048), whereas HJAS within postoperative 1 year tended to be associated with recurrence (hazard ratio, 2.43; 95% confidence interval, 0.85–6.89; p=0.096). The patency rates in patients without a residual balloon notch were 82.1% and 73.1% after 1 and 2 years, respectively.
Conclusions
Balloon dilation alone may be a viable option for patients with benign HJAS without residual balloon notches on fluoroscopy.

Citations

Citations to this article as recorded by

Efficacy and Safety of a 6‐Month Placement of a Fully Covered Self‐Expanding Metal Stent for Refractory or Recurrent Hepaticojejunostomy Anastomotic Stricture via Balloon Enteroscopy‐Assisted Endoscopic Retrograde Cholangiopancreatography
Taro Hanaoka, Kosuke Okuwaki, Masafumi Watanabe, Tomohisa Iwai, Kai Adachi, Akihiro Tamaki, Junro Ishizaki, Yusaku Manabe, Masayoshi Tadehara, Rikiya Hasegawa, Takaaki Matsumoto, Hiroshi Imaizumi, Mitsuhiro Kida, Chika Kusano
DEN Open.2026;[Epub] CrossRef
Successful treatment of a complete obstruction at the hepaticojejunostomy anastomosis using cholangioscopic biopsy forceps inserted via the endoscopic ultrasound-guided hepaticogastrostomy route
Sho Hasegawa, Kunihiro Hosono, Masato Yoneda
Clinical Endoscopy.2026; 59(2): 311. CrossRef
Endoscopic Management of Pancreatobiliary Diseases in Patients with Surgically Altered Anatomy: A Perspective from Single-Balloon Enteroscopy
Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Suguru Ito, Ryuichi Watanabe, Ryosuke Hamamura, Yoshiki Matsuno
Digestion.2026; : 1. CrossRef
Innovation in the percutaneous management of benign hepaticojejunostomy stricture with multiple lithiasis using SpyGlass Discover and biodegradable stent: a case report
Edison Santiago Borja Villacrés, Jefferson Andrés Carvajal Torres, Santiago Andrés Muñoz-Palomeque
Journal of Surgical Case Reports.2025;[Epub] CrossRef

7,609 View
223 Download
5 Web of Science
4 Crossref

Rotatable sphincterotome as a rescue device for endoscopic retrograde cholangiopancreatography cannulation: a single-center experience: Takeshi Okamoto, Takashi Sasaki, Tsuyoshi Takeda, Takafumi Mie, Chinatsu Mori, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira; Clin Endosc 2024;57(1):96-104. Published online April 25, 2023; DOI: https://doi.org/10.5946/ce.2022.248

Graphical Abstract Abstract PDF

Background
/Aims: Selective bile duct or pancreatic duct cannulation remains a significant initial hurdle in endoscopic retrograde cholangiopancreatography (ERCP) despite advances in endoscopy and accessories. This study evaluated our experience with a rotatable sphincterotome in cases of difficult cannulation.
Methods
We retrospectively reviewed ERCP cases using TRUEtome, a rotatable sphincterotome, as a rescue device for cannulation at a cancer institute in Japan from October 2014 to December 2021.
Results
TRUEtome was used in 88 patients. Duodenoscopes were used for 51 patients, while single-balloon enteroscopes (SBE) were used for 37 patients. TRUEtome was used for biliary and pancreatic duct cannulation (84.1%), intrahepatic bile duct selection (12.5%), and strictures of the afferent limb (3.4%). Cannulation success rates were similar in the duodenoscope and SBE groups (86.3% vs. 75.7%, p=0.213). TRUEtome was more commonly used in cases with steep cannulation angles in the duodenoscope group and in cases requiring cannulation in different directions in the SBE group. There were no significant differences in adverse events between the two groups.
Conclusions
The cannulation sphincterotome was useful for difficult cannulations in both unaltered and surgically altered anatomies. It may be an option to consider before high-risk procedures such as precut and endoscopic ultrasound-guided rendezvous techniques.

Citations

Citations to this article as recorded by

Japanese Multi‐Institution Study of Success Rates of Wire‐Guided Biliary Cannulation During Endoscopic Retrograde Cholangiopancreatography in Relation to Guidewire tip Length (JMIT Study) (With Video)
Takeshi Ogura, Yuki Tanisaka, Masanari Sekine, Katsumasa Kobayashi, Hirotsugu Maruyama, Shinji Hirai, Hideyuki Shiomi, Minoru Shigekawa, Masaki Kuwatani, Kenji Ikezawa, Masahiro Itonaga, Mamoru Takenaka, Susumu Hijioka, Tsukasa Ikeura, Shinpei Doi, Nao Fu
DEN Open.2026;[Epub] CrossRef
All‐in‐one sphincterotome with high rotation performance and freely bendable blade for endoscopic sphincterotomy in patients with surgically altered anatomy (a case series with video)
Yasuhito Kunogi, Atsushi Irisawa, Akira Yamamiya, Manabu Ishikawa, Tomoya Sakamoto, Yasunori Inaba, Ken Kashima, Fumi Sakuma, Koh Fukushi, Takumi Maki, Kazunori Nagashima, Yoko Abe, Shuichi Kitada, Akane Yamabe, Keiichi Tominaga
DEN Open.2025;[Epub] CrossRef
Establishing Endoscopic Sphincterotomy in Balloon‐Assisted Endoscopic Retrograde Cholangiopancreatography Using a Novel Rotatable Sphincterotome in Surgically Altered Anatomy: Innovation for Procedural Standardization
Masaaki Shimatani
Digestive Endoscopy.2025; 37(12): 1348. CrossRef
Efficacy and safety of cap-assisted colonoscopy in endoscopic retrograde cholangiopancreatography for patients after Billroth II gastrectomy
Chun-Xiao Hu, Sheng-Yue Zhou, Xiao-Hua Ye
World Chinese Journal of Digestology.2025; 33(9): 707. CrossRef
Balloon-assisted ERCP for bile duct stones in surgically altered anatomy: current techniques, devices, and evolving strategies
Haruka Toyonaga, Makoto Masaki, Arata Oka, Hidetoshi Nakata, Shoji Takayama, Tatsuya Nakagawa, Takuya Takayama, Masahiro Orino, Hironao Matsumoto, Takeshi Yamashina, Masaaki Shimatani
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Non-tip and rotatable sphincterotome for biliary cannulation in patients with Roux-en-Y gastrectomy
Haruo Miwa, Kazuya Sugimori, Kazuki Endo, Ritsuko Oishi, Hiromi Tsuchiya, Takashi Kaneko, Shin Maeda
Endoscopy.2024; 56(S 01): E103. CrossRef
Progress in minimally invasive treatment of biliary pancreatic duct obstruction after digestive tract reconstruction by endoscopic retrograde cholangiopancreatography
Ru-Yi Wang, Zhen Fan
World Chinese Journal of Digestology.2024; 32(7): 490. CrossRef

14,057 View
219 Download
4 Web of Science
7 Crossref

Comparison of tube-assisted mapping biopsy with digital single-operator peroral cholangioscopy for preoperative evaluation of biliary tract cancer: Tsuyoshi Takeda, Takashi Sasaki, Takafumi Mie, Takeshi Okamoto, Chinatsu Mori, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira; Clin Endosc 2022;55(4):549-557. Published online July 20, 2022; DOI: https://doi.org/10.5946/ce.2021.227

Abstract PDF

Background
/Aims: Digital single-operator cholangioscopy (DSOC)-guided mapping biopsy (DMB) and tube-assisted mapping biopsy (TMB) are two techniques used for preoperative evaluation of biliary tract cancer (BTC). However, data regarding the diagnostic performance of these techniques are limited.
Methods
We retrospectively examined consecutive patients with BTC who underwent either technique at our institution between 2018 and 2020. We evaluated the technical success rate, adequate tissue acquisition rate, and diagnostic performance of these techniques for the evaluation of lateral spread of BTC.
Results
A total of 54 patients were included in the study. The technical success rate of reaching the target sites was 95% for DMB and 100% for TMB. The adequate tissue acquisition rate was 61% for DMB and 69% for TMB. The adequate tissue acquisition rate was low, especially for target sites beyond the secondary biliary radicles. The sensitivity of DMB alone was 39%, which improved to 65% when combined with visual impression. Experts demonstrated a higher negative predictive value and diagnostic accuracy with respect to both DSOC visual impression and DMB for the evaluation of lateral spread of BTC compared to trainees.
Conclusions
Adequate tissue acquisition rates were similar between the two techniques. Since DMB requires expertise, TMB may be an acceptable option when DSOC is unavailable or when DSOC expertise is limited.

Citations

Citations to this article as recorded by

A novel sheath system to improve target access for preoperative mapping biopsy: A randomized trial to inform surgical planning
Hironori Aoi, Kentaro Yamao, Takuya Ishikawa, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Yoshihisa Takada, Takeshi Yamamura, Kazuhiro Furukawa, Masanao Nakamura, Hiroki Kawashima
Surgical Endoscopy.2026; 40(3): 2268. CrossRef
Clinical Practice Guidelines for Peroral Cholangioscopy
Kazumasa Nagai, Akio Katanuma, Shomei Ryozawa, Yoshinobu Okabe, Naoki Okano, Hiroki Kawashima, Hiroshi Kawakami, Hironari Kato, Nobuhiko Hayashi, Atsushi Irisawa, Etsuro Hatano, Ichiro Yasuda, Yoshinori Igarashi, Takao Itoi
Journal of Hepato-Biliary-Pancreatic Sciences.2026; 33(1): 58. CrossRef
Utility of a novel sheath designed for mapping biopsy for preoperative malignant hilar biliary obstruction
Hiroki Sakamoto, Hirotoshi Ishiwatari, Masahiro Yamamura, Takuya Doi, Junya Sato, Yuko Kakuda, Tomoko Norose, Nobuyuki Oike, Teiichi Sugiura, Katsuhiko Uesaka
Endoscopy International Open.2026;[Epub] CrossRef
Leveraging artificial intelligence to differentiate benign from malignant biliary strictures: A step toward precision diagnosis
Ammara Abdul Majeed, Amna Subhan Butt
Artificial Intelligence in Gastroenterology.2026;[Epub] CrossRef
Usefulness of a novel 11F digital single‐operator cholangioscopy through a colonoscope in a patient with surgically altered anatomy
Takafumi Mie, Tsuyoshi Takeda, Takashi Sasaki
Digestive Endoscopy.2025; 37(4): 438. CrossRef
Dose Performing Multiple Biopsy Strokes From the Same Site Improve Specimen Adequacy in Cholangioscopy‐Guided Mapping Biopsy for Extrahepatic Cholangiocarcinoma?
Takahisa Ogawa, Yoshihide Kanno, Shinsuke Koshita, Hiroaki Kusunose, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Haruka Okano, Kento Hosokawa, Hidehito Sumiya, Yutaka Noda, Kei Ito
JGH Open.2025;[Epub] CrossRef
Utility of a novel tapered-tip sheath system for preoperative mapping biopsy of biliary tract cancers
Tomoaki Matsumori, Norimitsu Uza, Kazuhiro Okada, Masahiro Shiokawa, Takahisa Maruno, Yoshihiro Nishikawa, Takeshi Kuwada, Yuya Muramoto, Muneji Yasuda, Hajime Yamazaki, Kojiro Taura, Etsuro Hatano, Yuzo Kodama, Hiroshi Seno
Endoscopy International Open.2025;[Epub] CrossRef
Endoscopic evaluation of indeterminate biliary strictures: Cholangioscopy, endoscopic ultrasound, or both?
Raymond S. Y. Tang
Digestive Endoscopy.2024; 36(7): 778. CrossRef
Cholangioscopy for biliary diseases
Aymeric Becq, Adil Soualy, Marine Camus
Current Opinion in Gastroenterology.2023; 39(2): 67. CrossRef

6,917 View
210 Download
8 Web of Science
9 Crossref

Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using a 20-Gauge Menghini Needle with a Lateral Forward Bevel and a 22-Gauge Franseen Needle: A Single-Center Large Cohort Study: Takafumi Mie, Takashi Sasaki, Ryo Kanata, Takaaki Furukawa, Tsuyoshi Takeda, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira; Clin Endosc 2021;54(5):730-738. Published online March 4, 2021; DOI: https://doi.org/10.5946/ce.2020.251

Abstract PDF

Background
/Aims: Several fine-needle biopsy (FNB) needles are available for endoscopic ultrasound (EUS)-guided tissue acquisition. However, there is disagreement on which type of needle has the best diagnostic yield. The aim of this study was to compare the performance and safety of two commonly used EUS-FNB needles.
Methods
We retrospectively analyzed consecutive patients who underwent EUS-FNB between June 2016 and March 2020 in our hospital. Two types of needles were evaluated: a 20-gauge Menghini needle with a lateral forward bevel and a 22-gauge Franseen needle. Rapid on-site evaluation was performed in all the cases. A multivariate analysis was performed to clarify the negative predictive factors for obtaining a histological diagnosis. Propensity score matching was performed to compare the diagnostic yields of these two needles.
Results
We analyzed 666 patients and 690 lesions. The overall diagnostic rate of histology alone was 88.8%, and the overall adverse event rate was 1.5%. Transduodenal access and small lesions (≤2 cm) were identified as negative predictive factors for obtaining a histological diagnosis. After propensity score matching, 482 lesions were analyzed. The diagnostic accuracy rates of histology in the M and F needle groups were 89.2% and 88.8%, respectively (p=1.00).
Conclusions
Both the needles showed high diagnostic yield, and no significant difference in performance was observed between the two.

Citations

Citations to this article as recorded by

Adverse events of 20–22G second‐generation endoscopic ultrasound‐guided fine‐needle biopsy needles for solid lesions in the upper gastrointestinal tract and adjacent organs: Systematic review and meta‐analysis
Cheng‐ye Pan, Shi‐min Wang, Dong‐hao Cai, Jia‐yi Ma, Shi‐yu Li, Yibin Guo, Sun Jing, Jin Zhendong, Kaixuan Wang
Digestive Endoscopy.2025; 37(5): 490. CrossRef
Primary Pancreatic Lymphoma: Endosonography-Guided Tissue Acquisition Diagnosis
Anna Carolina Orsini-Arman , Rodrigo Cañada T Surjan, Filadélfio E Venco, José C Ardengh
Cureus.2023;[Epub] CrossRef
Diagnostic Yield of Serial Pancreatic Juice Aspiration Cytologic Examination With Brush Cytology for Pancreatic Ductal Stenosis
Takafumi Mie, Takashi Sasaki, Tsuyoshi Takeda, Takeshi Okamoto, Chinatsu Mori, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
Pancreas.2022; 51(8): 995. CrossRef
Pancreatic follicular lymphoma: a report of two cases and literature review
Takeshi Okamoto, Takashi Sasaki, Noriko Nishimura, Manabu Takamatsu, Chinatsu Mori, Takafumi Mie, Takaaki Furukawa, Yuto Yamada, Tsuyoshi Takeda, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Dai Maruyama, Naoki Sasahira
Clinical Journal of Gastroenterology.2021; 14(6): 1756. CrossRef

8,062 View
116 Download
4 Web of Science
4 Crossref

First
Prev
Page of 1
Next
Last

Search