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18 "Pancreatic neoplasms"
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Original Articles
Efficacy of hemostasis by gastroduodenal covered metal stent placement for hemorrhagic duodenal stenosis due to pancreatobiliary cancer invasion: a retrospective study
Yasunari Sakamoto, Taku Sakamoto, Akihiro Ohba, Mitsuhito Sasaki, Shunsuke Kondo, Chigusa Morizane, Hideki Ueno, Yutaka Saito, Yasuaki Arai, Takuji Okusaka
Received June 18, 2023  Accepted January 15, 2024  Published online June 14, 2024  
DOI: https://doi.org/10.5946/ce.2023.155    [Epub ahead of print]
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Advanced pancreatic and biliary tract cancers can invade the duodenum and cause duodenal hemorrhagic stenosis. This study aimed to evaluate the efficacy of covered self-expandable metal stents in the treatment of cancer-related duodenal hemorrhage with stenosis.
Methods
Between January 2014 and December 2016, metal stents were placed in 51 patients with duodenal stenosis. Among these patients, a self-expandable covered metal stent was endoscopically placed in 10 patients with hemorrhagic duodenal stenosis caused by pancreatobiliary cancer progression. We retrospectively analyzed the therapeutic efficacy of the stents by evaluating the technical and clinical success rates based on successful stent placement, degree of oral intake, hemostasis, stent patency, and overall survival.
Results
The technical and clinical success rates were 100%. All 10 patients achieved a Gastric Outlet Obstruction Scoring System score of three within two weeks after the procedure and had no recurrence of melena. The median stent patency duration and overall survival after stent placement were 52 days (range, 20–220 days) and 66.5 days (range, 31–220 days), respectively.
Conclusions
Endoscopic placement of a covered metal stent for hemorrhagic duodenal stenosis associated with pancreatic or biliary tract cancer resulted in duodenal hemostasis, recanalization, and improved quality of life.
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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
Received May 24, 2023  Accepted September 4, 2023  Published online May 10, 2024  
DOI: https://doi.org/10.5946/ce.2023.142    [Epub ahead of print]
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
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.
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Clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling of pancreatic cancer
Nozomi Okuno, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Yasuhiro Kuraishi, Daiki Fumihara, Takafumi Yanaidani
Clin Endosc 2023;56(2):221-228.   Published online March 7, 2023
DOI: https://doi.org/10.5946/ce.2022.086
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting.
Methods
CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively.
Results
The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375).
Conclusions
To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.

Citations

Citations to this article as recorded by  
  • Tissue acquisition for comprehensive genomic profiling of gallbladder cancer using a forward-viewing echoendoscope in a patient who underwent Roux-en-Y reconstruction
    Michihiro Ono, Shutaro Oiwa, Atsushi Uesugi, Seiya Saito, Ryota Yokoyama, Makoto Usami, Tomoyuki Abe, Miri Fujita, Kohichi Takada, Masahiro Maeda
    Clinical Journal of Gastroenterology.2024; 17(1): 164.     CrossRef
  • Endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling
    Nozomi Okuno, Kazuo Hara
    Journal of Medical Ultrasonics.2024; 51(2): 253.     CrossRef
  • Oil blotting paper for formalin fixation increases endoscopic ultrasound‐guided tissue acquisition‐collected sample volumes on glass slides
    Takuo Yamai, Kenji Ikezawa, Yusuke Seiki, Ko Watsuji, Yasuharu Kawamoto, Takeru Hirao, Kazuma Daiku, Shingo Maeda, Makiko Urabe, Yugo Kai, Ryoji Takada, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Sayoko Tsuzaki, Ayumi Ryu, Satoshi Tanada, Shigenori Na
    Cancer Medicine.2024;[Epub]     CrossRef
  • Endoscopic ultrasound-guided tissue acquisition for personalized treatment in pancreatic adenocarcinoma
    Sang Myung Woo
    Clinical Endoscopy.2023; 56(2): 183.     CrossRef
  • Comparison of the novel Franseen needle versus the fine‐needle aspiration needle in endoscopic ultrasound‐guided tissue acquisition for cancer gene panel testing: A propensity score‐matching analysis
    Tomotaka Mori, Eisuke Ozawa, Akane Shimakura, Kosuke Takahashi, Satoshi Matsuo, Kazuaki Tajima, Yasuhiko Nakao, Masanori Fukushima, Ryu Sasaki, Satoshi Miuma, Hisamitsu Miyaaki, Shinji Okano, Kazuhiko Nakao
    JGH Open.2023; 7(9): 652.     CrossRef
  • Editorial: Endoscopic ultrasound‐guided tissue acquisition in the era of precision medicine
    Tiing Leong Ang, James Weiquan Li, Lai Mun Wang
    Journal of Gastroenterology and Hepatology.2023; 38(10): 1677.     CrossRef
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A multicenter comparative study of endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle versus conventional endoscopic ultrasound-guided fine-needle aspiration to evaluate microsatellite instability in patients with unresectable pancreatic cancer
Tadayuki Takagi, Mitsuru Sugimoto, Hidemichi Imamura, Yosuke Takahata, Yuki Nakajima, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Jun Nakamura, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Ryoichiro Kobashi, Yuko Hashimoto, Goro Shibukawa, Shigeru Marubashi, Takuto Hikichi, Hiromasa Ohira
Clin Endosc 2023;56(1):107-113.   Published online January 16, 2023
DOI: https://doi.org/10.5946/ce.2022.019
AbstractAbstract PDFPubReaderePub
Background
/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC.
Methods
A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018–2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA.
Results
No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation.
Conclusions
EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

Citations

Citations to this article as recorded by  
  • Oil blotting paper for formalin fixation increases endoscopic ultrasound‐guided tissue acquisition‐collected sample volumes on glass slides
    Takuo Yamai, Kenji Ikezawa, Yusuke Seiki, Ko Watsuji, Yasuharu Kawamoto, Takeru Hirao, Kazuma Daiku, Shingo Maeda, Makiko Urabe, Yugo Kai, Ryoji Takada, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Sayoko Tsuzaki, Ayumi Ryu, Satoshi Tanada, Shigenori Na
    Cancer Medicine.2024;[Epub]     CrossRef
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  • 127 Download
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Focused Review Series: Endoscopic Ultrasound-Guided Therapeutic Intervention: Focus on Technique and Practical Tips
Endoscopic Ultrasound-Guided Local Therapy for Pancreatic Neoplasms
Jun Seong Hwang, Hyun Don Joo, Tae Jun Song
Clin Endosc 2020;53(5):535-540.   Published online September 29, 2020
DOI: https://doi.org/10.5946/ce.2020.181
AbstractAbstract PDFPubReaderePub
Surgical resection is considered the only treatment option for pancreatic cancer and other pancreatic neoplasms with malignant potential, such as neuroendocrine tumors, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms. However, only 10%–20% of all patients with pancreatic cancer present with resectable forms of the disease as the symptoms are rarely manifested during the early stages, and the disease tends to progress rapidly. Furthermore, pancreatic surgery is associated with high rates of morbidity and mortality. The development of linear-array endoscopic ultrasound (EUS) techniques has increased the indications of EUS-guided local therapy for pancreatic neoplasms. We assessed the studies that investigated various treatment modalities, such as fine-needle injection, radiofrequency ablation, irreversible electroporation, and radiotherapy, under EUS guidance to better understand the usefulness of these techniques with respect to the efficacy and associated complications.

Citations

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  • Anticancer effect of a pyrrole‐imidazole polyamide‐triphenylphosphonium conjugate selectively targeting a common mitochondrial DNA cancer risk variant in cervical cancer cells
    Jihang Yao, Keizo Takenaga, Nobuko Koshikawa, Yuki Kida, Jason Lin, Takayoshi Watanabe, Yoshiaki Maru, Yoshitaka Hippo, Seigi Yamamoto, Yuyan Zhu, Hiroki Nagase
    International Journal of Cancer.2023; 152(5): 962.     CrossRef
  • Endoscopic Ultrasound-Guided Local Ablative Therapies for the Treatment of Pancreatic Neuroendocrine Tumors and Cystic Lesions: A Review of the Current Literature
    Alexander M. Prete, Tamas A. Gonda
    Journal of Clinical Medicine.2023; 12(9): 3325.     CrossRef
  • Response of Locally Advanced Pancreatic Cancer to Intratumoral Injection of Large Surface Area Microparticle Paclitaxel
    Neil R. Sharma, Simon K. Lo, Andrew Hendifar, Mohamed O. Othman, Kalpesh Patel, Antonio Mendoza-Ladd, Shelagh Verco, Holly A. Maulhardt, James Verco, Alison Wendt, Alyson Marin, Christian Max Schmidt, Gere diZerega
    Pancreas.2023; 52(3): e179.     CrossRef
  • Multisite Is Superior to Single-Site Intratumoral Chemotherapy to Retard the Outcomes of Pancreatic Ductal Adenocarcinoma in a Murine Model
    Janette Lazarovits, Ron Epelbaum, Jesse Lachter, Yaron Amikam, Jacob Ben Arie
    Cancers.2023; 15(24): 5801.     CrossRef
  • Endoscopic ultrasound-guided injectable therapy for pancreatic cancer: A systematic review
    Jyotroop Kaur, Veeravich Jaruvongvanich, Vinay Chandrasekhara
    World Journal of Gastroenterology.2022; 28(21): 2383.     CrossRef
  • 4,288 View
  • 149 Download
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Focused review series
Current Status of Endoscopic Ultrasound Techniques for Pancreatic Neoplasms
Yousuke Nakai, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure, Kazuhiko Koike
Clin Endosc 2019;52(6):527-532.   Published online July 24, 2019
DOI: https://doi.org/10.5946/ce.2019.025
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasound (EUS) now plays an important role in the management of pancreatic neoplasms. There are various types of pancreatic neoplasms, from benign to malignant lesions, and the role of EUS ranges from the imaging diagnosis to treatment. EUS is useful for the detection, characterization, and tissue acquisition of pancreatic lesions. Recent advancement of contrast-enhanced harmonic EUS and elastography enables better characterization of pancreatic lesions. In addition to these enhanced EUS imaging techniques, EUS-guided tissue acquisition is now the standard procedure to establish the pathological diagnosis of pancreatic neoplasms. While these diagnostic roles of EUS have been established, EUS-guided interventions such as ablation and drainage are also increasingly utilized in the management of pancreatic neoplasms. However, most of these EUS-guided interventions are not yet standardized in terms of techniques and devices and thus need further investigations.

Citations

Citations to this article as recorded by  
  • Impact of endoscopic ultrasound-guided radiofrequency ablation in managing pancreatic malignancy
    Cosmas Rinaldi Adithya Lesmana
    World Journal of Gastrointestinal Surgery.2023; 15(2): 163.     CrossRef
  • Artificial intelligence assisted endoscopic ultrasound for detection of pancreatic space-occupying lesion: a systematic review and meta-analysis
    Arkadeep Dhali, Vincent Kipkorir, Bahadar S. Srichawla, Harendra Kumar, Roger B. Rathna, Ibsen Ongidi, Talha Chaudhry, Gisore Morara, Khulud Nurani, Doreen Cheruto, Jyotirmoy Biswas, Leonard R. Chieng, Gopal Krishna Dhali
    International Journal of Surgery.2023; 109(12): 4298.     CrossRef
  • Endotherapy in Pancreatic Diseases
    Vaneet Jearth, Surinder S. Rana
    Journal of Digestive Endoscopy.2022; 13(01): 019.     CrossRef
  • Endoscopic Management of Pancreatobiliary Malignancies
    Dong Wook Lee, Eun Young Kim
    Digestive Diseases and Sciences.2022; 67(5): 1635.     CrossRef
  • Bazo accesorio intrapancreático: reporte de caso resuelto con pancreatectomía distal robótica
    Armando Pereyra-Talamantes, Juan Eduardo Flores-Martín, Marco Antonio Gallaga-Rojas, Jesús Emmanuel Rodríguez-Silverio, Erikc González-Azua, Mario Eduardo Alonso-Calamaco, Enrique Jiménez-Chavarría, Héctor F Noyola-Villalobos
    Revista Mexicana de Cirugía Endoscópica.2022; 23(1-2): 41.     CrossRef
  • Dynamic Doppler Ultrasound Assessment of Tissue Perfusion Is a Better Tool than a Single Vessel Doppler Examination in Differentiating Malignant and Inflammatory Pancreatic Lesions
    Przemysław Dyrla, Arkadiusz Lubas, Jerzy Gil, Marek Saracyn, Maciej Gonciarz
    Diagnostics.2021; 11(12): 2289.     CrossRef
  • Differential diagnosis of solid pancreatic masses
    Julio Iglesias-Garcia, Daniel de la Iglesia-Garcia, José M. Olmos-Martinez, José Lariño-Noia, J. Enrique Dominguez-Muñoz
    Minerva Gastroenterologica e Dietologica.2020;[Epub]     CrossRef
  • 5,479 View
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  • 6 Web of Science
  • 7 Crossref
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Original Article
A “Back Light System” for Identification of Sites for Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Solid Pancreatic Masses: A Prospective, Randomized Study with a Crossover Design
Ryo Harada, Hironari Kato, Soichiro Fushimi, Hirofumi Inoue, Daisuke Uchida, Yutaka Akimoto, Takeshi Tomoda, Kazuyuki Matsumoto, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada
Clin Endosc 2019;52(4):334-339.   Published online May 16, 2019
DOI: https://doi.org/10.5946/ce.2019.004
AbstractAbstract PDFPubReaderePub
Background
/Aims: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy of specimen sampling using endosonography. We conducted this study to evaluate the efficacy of the BLS in sampling of specimens by endoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses.
Methods
This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on gross visual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence in the first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium was evaluated by a cytopathologist who was blinded to any clinical information.
Results
A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) with the BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement was observed both with and without BLS (kappa score 0.40 and 0.29, respectively).
Conclusions
The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacy using gross visual inspection.

Citations

Citations to this article as recorded by  
  • Tissue processing of endoscopic ultrasound-guided fine-needle aspiration specimens from solid pancreatic lesions
    Kenji Notohara, Kaori Nakamura
    Journal of Medical Ultrasonics.2024; 51(2): 261.     CrossRef
  • Macroscopic qualitative evaluation of solid pancreatic lesion specimens from endoscopic ultrasound-guided fine needle aspiration/biopsies
    Kaori Nakamura, Kenji Notohara, Ryoji Nishizaki, Etsuji Ishida, Midori Sato, Akemi Kodera, Junya Itakura, Motowo Mizuno
    Pancreatology.2023; 23(8): 1028.     CrossRef
  • Unfortunately, a “Back Light System” As a Global Positioning System Failed to Guide the Route in 25-G Fine-Needle Aspiration
    Rungsun Rerknimitr, Phonthep Angsuwatcharakon
    Clinical Endoscopy.2019; 52(4): 295.     CrossRef
  • 4,311 View
  • 81 Download
  • 5 Web of Science
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Focused Review Series: Expanding Indication: Interventional Endoscopic Management for Pancreaticobiliary Diseases
Endoscopic Palliation for Biliary and Pancreatic Malignancies: Recent Advances
Zaheer Nabi, D. Nageshwar Reddy
Clin Endosc 2019;52(3):226-234.   Published online January 22, 2019
DOI: https://doi.org/10.5946/ce.2019.003
AbstractAbstract PDFPubReaderePub
Malignancies of the pancreatobiliary system are usually unresectable at the time of diagnosis. As a consequence, a majority of these cases are candidates for palliative care. With advances in chemotherapeutic agents and multidisciplinary care, the survival rate in pancreatobiliary malignancies has improved. Therefore, there is a need to provide an effective and long-lasting palliative care for these patients. Endoscopic palliation is preferred to surgery as the former is associated with equal efficacy and reduced morbidity. The main role of endoscopic palliation in the vast majority of pancreatobiliary malignancies includes biliary and enteral stenting for malignant obstructive jaundice and gastric outlet obstruction, respectively. Recent advances in endoscopic palliation appear promising in imparting long-lasting relief of symptoms. Use of radiofrequency ablation and photodynamic therapy in malignant biliary obstruction has been shown to improve the survival rates as well as the patency of biliary stents. The emergence of endoscopic ultrasound (EUS) as a therapeutic tool has enhanced the capability of minimally invasive palliation in pancreatobiliary cancers. EUS is a valuable alternative to endoscopic retrograde cholangiopancreatography for the palliation of obstructive jaundice. More recently, EUS is emerging as an effective primary modality for biliary and gastric bypass.

Citations

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  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • Palliative Interventions and Best Supportive Care in Biliary Malignancy
    Christine Chung, Lauren Wancata
    Surgical Clinics of North America.2024;[Epub]     CrossRef
  • Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis
    Floris W. Haijer, Cornelis B. Van Vliet, Marjolein G. J. Brusse-Keizer, Job A. M. Van der Palen, Marjo J. Kerbert-Dreteler, Jeroen J. Kolkman, Dirk Uhlmann
    International Journal of Hepatology.2023; 2023: 1.     CrossRef
  • Endoscopic and Endosonographic Palliation for Triple Obstruction Caused by Recurrent Gallbladder Cancer: A Case Report
    Young Rong Kim, Chi Hyuk Oh, Min Jae Yang
    The Korean Journal of Pancreas and Biliary Tract.2023; 28(1): 19.     CrossRef
  • Endoscopic Management of Pancreatobiliary Malignancies
    Dong Wook Lee, Eun Young Kim
    Digestive Diseases and Sciences.2022; 67(5): 1635.     CrossRef
  • Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction
    Kojiro Tanoue, Hirotsugu Maruyama, Yuki Ishikawa-Kakiya, Yosuke Kinoshita, Kappei Hayashi, Masafumi Yamamura, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Noriko Kamata, Yasuaki Nagami, Koichi Taira, Toshio Wata
    World Journal of Hepatology.2022; 14(5): 993.     CrossRef
  • Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction
    Kojiro Tanoue, Hirotsugu Maruyama, Yuki Ishikawa-Kakiya, Yosuke Kinoshita, Kappei Hayashi, Masafumi Yamamura, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Noriko Kamata, Yasuaki Nagami, Koichi Taira, Toshio Wata
    World Journal of Hepatology.2022; 14(5): 992.     CrossRef
  • Pancreatic Cancer: Challenges and Opportunities in Locoregional Therapies
    Alaa Y. Bazeed, Candace M. Day, Sanjay Garg
    Cancers.2022; 14(17): 4257.     CrossRef
  • Endoscopic retrograde cholangiopancreatography: Current practice and future research
    David J Sanders, Shivanand Bomman, Rajesh Krishnamoorthi, Richard A Kozarek
    World Journal of Gastrointestinal Endoscopy.2021; 13(8): 260.     CrossRef
  • Early malfunction of a biliary self-expandable metal stent with an antireflux valve
    Sang Hoon Kim, Chi Hyuk Oh, Jae Min Lee, Seong Ji Choi, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hoon Jai Chun, Hong Sik Lee, Chang Duck Kim
    Medicine.2020; 99(16): e19750.     CrossRef
  • Endosonography-guided Radiofrequency Ablation in Pancreatic Diseases
    Giuseppe Vanella, Gabriele Capurso, Paolo G. Arcidiacono
    Journal of Clinical Gastroenterology.2020; 54(7): 591.     CrossRef
  • Efficacy and safety of radiofrequency ablation in patients with unresectable malignant biliary strictures
    Martha Claudia Galindo Orozco, Angélica Hernández Guerrero, Juan Octavio Alonso Larraga, Eduardo Ramírez Solis, José Guillermo de la Mora Levy, María del Carmen Manzano Robleda
    Revista Española de Enfermedades Digestivas.2020;[Epub]     CrossRef
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  • 9 Web of Science
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Focused Review Series: Expanding the Indication with Safety Issue of Endoscopic Ultrasound
Future Perspectives on Endoscopic Ultrasonography-Guided Therapy for Pancreatic Neoplasm
Woo Hyun Paik, Sang Hyub Lee, Sunguk Jang
Clin Endosc 2018;51(3):229-234.   Published online May 18, 2018
DOI: https://doi.org/10.5946/ce.2018.063
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasonography (EUS)-guided therapy with ethanol injection or catheter-based radiofrequency ablation for pancreatic neoplasm has been conducted as a potential alternate treatment modality for patients who are not eligible for surgery. On the basis of the limited number of studies available, EUS-guided ablation therapy with the aforementioned methods for small pancreatic neoplasms has demonstrated promising technical feasibility and safety profiles. To be considered as a legitimate alternative option to surgery, however, EUS-guided ablation therapy must provide a long-term efficacy profile along with the consensus among experts regarding its treatment parameter. This review focuses on the clinical issues and future perspectives of EUS-guided therapy for pancreatic neoplasm.

Citations

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  • An updated review on ablative treatment of pancreatic cystic lesions
    Andrew Canakis, Ryan Law, Todd Baron
    Gastrointestinal Endoscopy.2020; 91(3): 520.     CrossRef
  • Endosonography-guided Radiofrequency Ablation in Pancreatic Diseases
    Giuseppe Vanella, Gabriele Capurso, Paolo G. Arcidiacono
    Journal of Clinical Gastroenterology.2020; 54(7): 591.     CrossRef
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  • 134 Download
  • 3 Web of Science
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Original Article
Usefulness of Endoscopic Transpapillary Tissue Sampling for Malignant Biliary Strictures and Predictive Factors of Diagnostic Accuracy
Hiroki Tanaka, Shimpei Matsusaki, Youichirou Baba, Yoshiaki Isono, Tomohiro Sase, Hiroshi Okano, Tomonori Saito, Katsumi Mukai, Tetsuya Murata, Hiroki Taoka
Clin Endosc 2018;51(2):174-180.   Published online August 31, 2017
DOI: https://doi.org/10.5946/ce.2017.082
AbstractAbstract PDFPubReaderePub
Background
/Aims: It is sometimes difficult to distinguish between malignant and benign biliary strictures using imaging studies alone, and pathological diagnosis is necessary. The aim of this study was to determine the usefulness of endoscopic transpapillary tissue sampling and factors predictive of diagnostic accuracy.
Methods
From April 2008 to December 2014, 136 patients underwent endoscopic transpapillary tissue sampling for malignant biliary strictures. The cytological and histological findings were reported as negative, suspicious, or positive. Suspicious and positive findings were defined as pathologically positive.
Results
The sensitivity was 65.0% for forceps biopsy, 49.5% for brush cytology, 46.2% for bile aspiration cytology, and 21.9% for endoscopic nasobiliary drainage cytology. The combination of these procedures improved the sensitivity (72.8%). Endoscopic transpapillary tissue sampling was more sensitive for lesions of biliary origin (91.4%) than for extrabiliary lesions (66.3%). In surgical cases, the sensitivity for tumors with an infiltrative growth pattern (53.3%) was significantly lower than for a tumor with an expanding or intermediate growth pattern (87.5%).
Conclusions
Combining procedures can improve diagnostic accuracy. It may be possible to predict the sensitivity of endoscopic transpapillary tissue sampling by evaluating the etiology and tumor growth pattern using preoperative imaging studies.

Citations

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  • A new tool for bile duct tissue sampling: ex vivo clinical evaluation of intraductal cryobiopsy for cholangioscopy
    Lukas Wirsing, Walter Linzenbold, Simon U. Jaeger, Phillip Stahl, German Ott, Tobias Leibold, Markus Enderle, Jörg Albert, Jan Peveling-Oberhag
    Endoscopy International Open.2022; 10(06): E809.     CrossRef
  • Increased accuracy of FNA-based cytological diagnosis of pancreatic lesions by use of an ethanol-based fixative system: A STROBE compliant study
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Focused Review Series: EUS-Guided Therapeutic Interventions
Endoscopic Ultrasound-Guided Direct Intervention for Solid Pancreatic Tumors
Jimin Han, Kenneth J. Chang
Clin Endosc 2017;50(2):126-137.   Published online March 30, 2017
DOI: https://doi.org/10.5946/ce.2017.034
AbstractAbstract PDFPubReaderePub
Development and use of linear-array echoendoscope and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) have made endoscopic ultrasound (EUS) more of an interventional procedure than a purely diagnostic procedure. This is a literature review of previously published clinical studies on EUS-guided direct intervention for solid pancreatic tumors, including EUS-guided fine needle injection (EUS-FNI) of antitumor agents, EUS-guided fiducial marker placement, EUS-guided brachytherapy and EUS-guided tumor ablation.

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    Seong-Hun Kim, Eun Ji Shin
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Case Report
Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation
Hong Min Kim, Ji Min Chu, Won Hee Kim, Sung Pyo Hong, Ki Baik Hahm, Kwang Hyun Ko
Clin Endosc 2015;48(4):328-331.   Published online July 24, 2015
DOI: https://doi.org/10.5946/ce.2015.48.4.328
AbstractAbstract PDFPubReaderePub

Secondary achalasia or pseudoachalasia is a rare esophageal motor abnormality, which mimics primary achalasia; it is not easily distinguishable from idiopathic achalasia by manometry, radiological examination, or endoscopy. Although the majority of reported pseudoachalasia cases are associated with neoplasms at or near the esophagogastric (EG) junction, other neoplastic processes or even chronic illnesses such as rheumatoid arthritis can lead to the development of pseudoachalasia, for example, mediastinal masses, gastrointestinal (GI) tumors of the liver and biliary tract, and non-GI malignancies. Therefore, even if a patient presents with the typical findings of achalasia, we should be alert to the possibility of other GI malignancies besides EG tumors. For instance, pancreatic cancer was found in the case reported here; only four such cases have been reported in the literature. A 47-year-old man was admitted to our center with a 3-month history of dysphagia. His endoscopic and esophageal manometric findings were compatible with primary achalasia. However, unresponsiveness to diverse conventional achalasia treatments led us to suspect secondary achalasia. An active search led to a diagnosis of pancreatic mucinous cystadenocarcinoma invading the gastric fundus and EG junction. This rare case of pseudoachalasia caused by pancreatic carcinoma emphasizes the need for suspecting GI malignancies other than EG tumors in patients refractory to conventional achalasia treatment.

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Reviews
Endoscopic Ultrasound-Guided Treatment of Pancreatic Cystic and Solid Masses
Jaihwan Kim
Clin Endosc 2015;48(4):308-311.   Published online July 24, 2015
DOI: https://doi.org/10.5946/ce.2015.48.4.308
AbstractAbstract PDFPubReaderePub

Pancreatic tumor is one of the most difficult diseases to diagnose and treat because of its anatomical location and characteristics. Recently, there have been several innovative trials on the treatment of pancreatic tumors using endoscopic ultrasound (EUS) because it allows selective access to the difficult to reach target organ along the gastrointestinal tract and can differentiate vessels by color Doppler. Among these trials, several have investigated EUS-guided ethanol lavage with or without paclitaxel for pancreatic cystic tumors. These studies show a 33% to 79% complete resolution rate with a favorable safety profile. Compared to EUS-guided ethanol lavage for pancreatic cystic tumors, EUS-guided radiofrequency ablation is considered a less invasive treatment method for pancreatic cancer. Although there are still several difficulties and concerns about complications, one clinical study reported 72.8% feasibility with favorable safety, and therefore, we anticipate the results of ongoing studies with these new less invasive techniques.

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    Seong-Ryong Kim, Song Cheol Kim, Ki Byung Song, Kwang-Min Park, Dae Wook Hwang, Jae Hoon Lee, Sang Hyun Shin, Bong Jun Kwak, Young-Joo Lee
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Neoplasia in Chronic Pancreatitis: How to Maximize the Yield of Endoscopic Ultrasound-Guided Fine Needle Aspiration
Ji Young Bang, Shyam Varadarajulu
Clin Endosc 2014;47(5):420-424.   Published online September 30, 2014
DOI: https://doi.org/10.5946/ce.2014.47.5.420
AbstractAbstract PDFPubReaderePub

When performing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), identifying neoplasia in the setting of chronic pancreatitis can be technically challenging. The morphology of an ill-defined mass on sonography, presence of calcifications or intervening collaterals, reverberation from a biliary stent, low yield of tissue procurement, and interpretative errors in cytopathology can result in both false-negative and false-positive results. Although these challenges cannot be completely eliminated, elastography or contrast-enhanced imaging can aid in differentiating an inflammatory mass from a neoplasm. Also, performing more passes of FNA, procuring core biopsy material, performing rapid onsite evaluation, conducting ancillary pathology studies, and even repeating the procedure on a different day can aid in improving the diagnostic performance of EUS-FNA. This review provides a concise update and offers practical tips to improving the diagnostic yield of EUS-FNA when sampling solid pancreatic mass lesions in the setting of chronic pancreatitis.

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    Nam Hee Kim, Hong Joo Kim
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    Mohamed A. Abdallah, Khalid Ahmed, Wesam Taha, Abdullahi Musa, Erin E. Reardon, Abubaker O. Abdalla, Guru Trikudanathan
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    Clara Benedetta Conti, Fabrizio Cereatti, Roberto Grassia
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    Clara Benedetta Conti, Fabrizio Cereatti, Roberto Grassia
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    Utpal Mondal, Nichole Henkes, Sandeep Patel, Laura Rosenkranz
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Case Report
Gastrointestinal Cancers in a Peutz-Jeghers Syndrome Family: A Case Report
Sang Hee Song, Kun Woo Kim, Won Hee Kim, Chang Il Kwon, Kwang Hyun Ko, Ki Baik Hahm, Pil Won Park, Sung Pyo Hong
Clin Endosc 2013;46(5):572-575.   Published online September 30, 2013
DOI: https://doi.org/10.5946/ce.2013.46.5.572
AbstractAbstract PDFPubReaderePub

A 17-year-old man was diagnosed as Peutz-Jeghers syndrome (PJS) because of pigmented lip and multiple gastrointestinal polyps. He had anemia and underwent polypectomy on the duodenum and colon. His maternal family members were patients with PJS. His mother used to be screened with endoscopy to remove large polyps. One and half years later, he underwent jejunal segmental resection due to intussusceptions. He underwent endoscopic polypectomy every 2 to 3 years. When he was 23 years old, high-grade dysplasia was found in colonic polyp and his mother underwent partial pancreatectomy due to intraductal papillary mucinous carcinoma. When he was 27 years old, diffuse gastric polyps on the greater curvature of corpus expanded and grew. Therefore, wide endoscopic polypectomy was done. Histological examination revealed focal intramucosal carcinoma and low-grade dysplasia in hamartomatous polyps. We report cases of cancers occurred in first-degree relatives with PJS.

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Special Issue Articles of IDEN 2013
Technical Advances in Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition for Pancreatic Cancers: How Can We Get the Best Results with EUS-Guided Fine Needle Aspiration?
Prashant Kedia, Monica Gaidhane, Michel Kahaleh
Clin Endosc 2013;46(5):552-562.   Published online September 30, 2013
DOI: https://doi.org/10.5946/ce.2013.46.5.552
AbstractAbstract PDFPubReaderePub

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is one of the least invasive and most effective modality in diagnosing pancreatic adenocarcinoma in solid pancreatic lesions, with a higher diagnostic accuracy than cystic tumors. EUS-FNA has been shown to detect tumors less than 3 mm, due to high spatial resolution allowing the detection of very small lesions and vascular invasion, particularly in the pancreatic head and neck, which may not be detected on transverse computed tomography. Furthermore, this minimally invasive procedure is often ideal in the endoscopic procurement of tissue in patients with unresectable tumors. While EUS-FNA has been increasingly used as a diagnostic tool, most studies have collectively looked at all primary pancreatic solid lesions, including lymphomas and pancreatic neuroendocrine neoplasms, whereas very few studies have examined the diagnostic utility of EUS-FNA of pancreatic ductal carcinoma only. As with any novel and advanced endoscopic procedure that may incorporate several practices and approaches, endoscopists have adopted diverse techniques to improve the tissue procurement practice and increase diagnostic accuracy. In this article, we present a review of literature to date and discuss currently practiced EUS-FNA technique, including indications, technical details, equipment, patient selection, and diagnostic accuracy.

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    Jingjing Zhou, Ting Cai, Dongwen Wu, Xiong Chen, Fen Wang
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    Bekir Turgut, Süleyman Bakdik, Fatih Öncü, İlknur Küçükosmanoğlu, Meryem İlkay Eren Karanis, Ramazan Saygin Kerimoğlu, Mustafa Saraçoğlu
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    Kosuke Takahashi, Ichiro Yasuda, Nobuhiko Hayashi, Takuji Iwashita, Mitsuru Okuno, Tsuyoshi Mukai, Masatoshi Mabuchi, Seiji Adachi, Shinpei Doi, Johji Imura, Eisuke Ozawa, Hisamitsu Miyaaki, Kazuhiko Nakao
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    Nam Hee Kim, Hong Joo Kim
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    Woo Hyun Paik
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    Seong‐Hun Kim, Kai Ding, Avani Rao, Jin He, Manoop S. Bhutani, Joseph M. Herman, Amol Narang, Eun Ji Shin
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Role of Repeated Endoscopic Ultrasound-Guided Fine Needle Aspiration for Inconclusive Initial Cytology Result
Eun Young Kim
Clin Endosc 2013;46(5):540-542.   Published online September 30, 2013
DOI: https://doi.org/10.5946/ce.2013.46.5.540
AbstractAbstract PDFPubReaderePub

For tissue diagnosis of suspected pancreatic cancer, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the procedure of choice with high safety and accuracy profiles. However, about 10% of cytologic findings of EUS-FNA are inconclusive. In that situation, careful observation, surgical exploration, or alternative diagnostic tools such as bile duct brushing with endoscopic retrograde cholangiopancreatography or computed tomography-guided biopsy can be considered. However, some concerns and/or risks of these options render repeat EUS-FNA a reasonable choice. Repeated EUS-FNA may impose substantial clinical impact with low risk.

Citations

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  • An Unusual Presentation of a Solid Pseudopapillary Tumor of the Pancreas Mimicking Adenocarcinoma
    Hyung Ku Chon, Keum Ha Choi, Tae Hyeon Kim
    Clinical Endoscopy.2020; 53(5): 615.     CrossRef
  • Repeat Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Patients with Suspected Pancreatic Cancer: Diagnostic Yield and Associated Change in Access to Appropriate Care
    Robert A. Mitchell, Dylan Stanger, Constantin Shuster, Jennifer Telford, Eric Lam, Robert Enns
    Canadian Journal of Gastroenterology and Hepatology.2016; 2016: 1.     CrossRef
  • Impact of endoscopic ultrasound-guided fine-needle aspiration and multidisciplinary approach in the management of abdominal or mediastinal mass
    Giovanna Del Vecchio Blanco, Manuela Coppola, Elena Mannisi, Gerolamo Bevivino, Vincenzo Formica, Ilaria Portarena, Samanta Romeo, Pierpaolo Sileri, Mario Roselli, Francesco Pallone, Omero Alessandro Paoluzi
    European Journal of Gastroenterology & Hepatology.2015; 27(9): 1045.     CrossRef
  • Impact of inconclusive endoscopic ultrasound‐guided fine‐needle aspiration results in the management and outcome of patients with solid pancreatic masses
    Bo Sun, Xiujiang Yang, Bo Ping, Yiping He, Zhaozhen Zhang
    Digestive Endoscopy.2015; 27(1): 130.     CrossRef
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Case Report
Endoscopic Removal of a Proximally Migrated Metal Stent during Balloon Sweeping after Stent Trimming
Nam Jun Cho, Tae Hoon Lee, Sang-Heum Park, Han Min Lee, Kyung Hee Hyun, Suck-Ho Lee, Il-Kwun Chung, Sun-Joo Kim
Clin Endosc 2013;46(4):418-422.   Published online July 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.4.418
AbstractAbstract PDFPubReaderePub

Placement of a self-expanding metal stent (SEMS) is an effective method for palliation of a malignant biliary obstruction. However, metal stents can cause various complications, including stent migration. Distally migrated metal stents, particularly covered SEMS, can be removed successfully in most cases. Stent trimming using argon plasma coagulation may be helpful in difficult cases despite conventional methods. However, no serious complications related to the trimming or remnant stent removal method have been reported due to the limited number of cases. In particular, proximal migration of a remnant fragmented metal stent after stent trimming followed by balloon sweeping has not been reported. We report an unusual case of proximal migration of a remnant metal stent during balloon sweeping following stent trimming by argon plasma coagulation. The remnant metal stent was successfully removed with rotation technique using a basket and revised endoscopically.

Citations

Citations to this article as recorded by  
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