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| 1 | Clinical benefit of radiation therapy and metallic stenting for unresectable hilar cholangiocarcinoma显示文摘AIM:To determine the efficacy of external beam radiotherapy(EBRT),with or without intraluminal brachytherapy(ILBT),in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS:We analyzed 64 patients with locally advanced hilar cholangiocarcinoma,including 25 who underwent resection(17 curative and 8 non-curative),28 treated with radiotherapy,and 11 who received best supportive care(BSC).The radiotherapy group received EBRT(50 Gy,30 fractions),with 11 receiving an additional 24 Gy(4 fractions) ILBT by iridium-192 with remote after loading.ILBT was performed using percutaneous transhepatic biliary drainage(PTBD) route.Uncovered metallic stents(UMS) were inserted into nonresected patients with obstructive jaundice,with the exception of four patients who received percutaneous transhepatic biliary drainage only.UMS were placed endoscopically or percutaneously,depending on the initial drainage procedure.The primary endpoints were patient death or stent occlusion.Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups.Stent patency was compared in the radiotherapy and BSC groups.RESULTS:No statistically significant differences in patient characteristics were found among the resection,radiotherapy,and BSC groups.Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone;cholangitis occurred after endoscopic stenting,and patients were treated with PTBD.A total of 16 patients were administered additional systemic chemotherapy(5-fluorouracil-based regimen in 9,S-1 in 6,and gemcitabine in 1).Overall survival varied significantly among groups,with median survival times of 48.7 mo in the surgery group,22.1 mo in the radiotherapy group,and 5.7 mo in the BSC group.Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery(P = 0.0076).Cumulative survival in the radiotherapy group was significantly longer than in the BSC group(P = 0.0031),but did not differ significantly from those in the non-resection group.Furthermore,the median survival time of patients in the radiotherapy group who were considered for possible resection(excluding the seven patients who were not candidates for surgery due to comorbid disease or age) was 25.9 mo.Stent patency was evaluated only in the 24 patients who received a metallic stent.Stent patency was significantly longer in the radiotherapy than in the BSC group(P = 0.0165).Biliary drainage was not eliminated in any patient.To determine the efficacy of ILBT,we compared survival time and stent patency in the EBRT alone and EBRT plus ILBT groups.However,we found no significant difference in survival time between groups or for stent patencies.Hemorrhagic gastroduodenal ulcers were observed in 5 patients(17.9%),three in the EBRT plus ILBT group and two in the EBRT alone group.Ulcers occurred 5 mo,7 mo,8 mo,16 mo,and 29 mo following radiotherapy.All patients required hospitalization,but blood transfusions were unnecessary.All 5 patients recovered following the administration of anti-ulcer medication.CONCLUSION:Radiotherapy improved patient prognosis and the patency of uncovered metallic stents in patients with locally advanced hilar cholangiocarcinoma,but ILBT provided no additional benefits. | Hiroyuki Isayama Takeshi Tsujino Yousuke Nakai Takashi Sasaki Keiichi Nakagawa Hideomi Yamashita Taku Aoki Kazuhiko Koike | 2012 | World Journal of Gastroenterology2012，18，19： | 24 |
| 2 | Short term results of endoscopic submucosal dissection in superficial esophageal squamous cell neoplasms显示文摘AIM: To evaluate the efficacy of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. METHODS: Between July 2007 and March 2009, 27 consecutive superficial esophageal squamous cell neoplasms in 25 enrolled patients were treated by endoscopic submucosal dissection. The therapeutic efficacy, complications, and follow-up results were assessed. RESULTS: The mean size of the lesions was 21 ± 13 mm (range 2-55 mm); the mean size of the resection specimens was 32 ± 12 mm (range 10-70 mm). The enblock resection rate was 100% (27/27), and en block resection with tumor-free lateral/basal margins was 88.9% (24/27). Perforation occurred in 1 patient who was managed by conservative medical treatments. None of the patients developed local recurrence or distant metastasis in the follow-up period. CONCLUSION: Endoscopic submucosal dissection is applicable to superficial esophageal squamous cell neoplasms with promising results. | Kouichi Nonaka Shin Arai Keiko Ishikawa Masamitsu Nakao Yousuke Nakai Osamu Togawa Koji Nagata Michio Shimizu Yutaka Sasaki Hiroto Kita | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，2： | 19 |
| 3 | Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction显示文摘AIM: To determine the optimal method of endoscopic preoperative biliary drainage for malignant distal biliary obstruction.METHODS: Multicenter retrospective study was conducted in patients who underwent plastic stent(PS) or nasobiliary catheter(NBC) placement for resectable malignant distal biliary obstruction followed by surgery between January 2010 and March 2012. Procedurerelated adverse events, stent/catheter dysfunction(occlusion or migration of PS/NBC, developmentof cholangitis, or other conditions that required repeat endoscopic biliary intervention), and jaundice resolution(bilirubin level < 3.0 mg/d L) were evaluated. Cumulative incidence of jaundice resolution and dysfunction of PS/NBC were estimated using competing risk analysis. Patient characteristics and preoperative biliary drainage were also evaluated for association with the time to jaundice resolution and PS/NBC dysfunction using competing risk regression analysis.RESULTS: In total, 419 patients were included in the study(PS, 253 and NBC, 166). Primary cancers included pancreatic cancer in 194 patients(46%), bile duct cancer in 172(41%), gallbladder cancer in three(1%), and ampullary cancer in 50(12%). The median serum total bilirubin was 7.8 mg/d L and 324 patients(77%) had ≥ 3.0 mg/d L. During the median time to surgery of 29 d [interquartile range(IQR), 30-39 d]. PS/NBC dysfunction rate was 35% for PS and 18% for NBC [Subdistribution hazard ratio(SHR) = 4.76; 95%CI: 2.44-10.0, P < 0.001]; the pig-tailed tip was a risk factor for PS dysfunction. Jaundice resolution was achieved in 85% of patients and did not depend on the drainage method(PS or NBC).CONCLUSION: PS has insufficient patency for preoperative biliary drainage. Given the drawbacks of external drainage via NBC, an alternative method of internal drainage should be explored. | Naoki Sasahira Tsuyoshi Hamada Osamu Togawa Ryuichi Yamamoto Tomohisa Iwai Kiichi Tamada Yoshiaki Kawaguchi Kenji Shimura Takero Koike Yu Yoshida Kazuya Sugimori Shomei Ryozawa Toshiharu Kakimoto Ko Nishikawa Katsuya Kitamura Tsunao Imamura Masafumi Mizuide Nobuo Toda Iruru Maetani Yuji Sakai Takao Itoi Masatsugu Nagahama Yousuke Nakai Hiroyuki Isayama | 2016 | World Journal of Gastroenterology2016，22，14： | 18 |
| 4 | Improvement of prognosis for unresectable biliary tract cancer显示文摘AIM:To evaluate the chemotherapeutic outcomes and confirm the recent improvement of prognosis for unresectable biliary tract cancer.METHODS:A total of 186 consecutive patients with unresectable biliary tract cancer,who had been treated with chemotherapy between 2000 and 2009 at five institutions in Japan,were retrospectively analyzed.These patients were divided into three groups based on the year beginning chemotherapy:Group A(2000-2003),Group B(2004-2006),and Group C(2007-2009).The data were fixed at the end of December 2011.Overall survival and time-to-progression were analyzed and compared chronologically.RESULTS:No patient characteristics were significantly different among the three groups.The gallbladder was involved in about half of the patients in each group,and metastatic biliary tract cancer was present in three quarters of the enrollees.In Group A,5-fluorouracilbased chemotherapies were primarily selected as firstline chemotherapy,and only 24% were treated with second-line chemotherapy.In Group B,gemcitabine or S-1 monotherapy was mainly introduced as firstline chemotherapy,and 51% of the patients who were refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with monotherapy.In Group C,the combination therapy with gemcitabine and S-1 was mainly chosen as first-line chemotherapy,and 53% of the patients refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with combination therapy.The median timeto-progressions were 4.4 mo,3.5 mo and 5.9 mo in Groups A,B and C,respectively(4.4 mo vs 3.5 mo vs 5.9 mo,P < 0.01).The median overall survivals were 7.1,7.3,and 11.7 mo in Groups A,B and C(7.1 mo vs 7.3 mo vs 11.7 mo,P = 0.03).Induction rates of all three drugs(gemcitabine,platinum analogs,and fluoropyrimidine) in Groups A,B and C were 4%,2% and 27%(4% vs 2% vs 27%,P < 0.01).CONCLUSION:The prognosis of unresectable biliary tract cancer has improved recently.Using three effective drugs(gemcitabine,platinum analogs,and fluoropyrimidine) may improve the prognosis of this cancer. | Takashi Sasaki Hiroyuki Isayama Yousuke Nakai Naminatsu Takahara Naoki Sasahira Hirofumi Kogure Suguru Mizuno Hiroshi Yagioka Yukiko Ito Natsuyo Yamamoto Kenji Hirano Nobuo Toda Minoru Tada Masao Omata Kazuhiko Koike | 2013 | World Journal of Gastroenterology2013，19，1： | 8 |
| 5 | Clinical analysis of high serum IgE in autoimmune pancreatitis显示文摘AIM: To clarify the clinical significance of high serum IgE in autoimmune pancreatitis (AIP). METHODS: Forty-two AIP patients, whose IgE was measured before steroid treatment, were analyzed. To evaluate the relationship between IgE levels and the disease activity of AIP, we examined (1) Frequency of high IgE (> 170 IU/mL) and concomitant allergic dis-eases requiring treatment; (2) Correlations between IgG, IgG4, and IgE; (3) Relationship between the presence of extrapancreatic lesions and IgE; (4) Re-lationship between clinical relapse and IgE in patients treated with steroids, and (5) Transition of IgE before and after steroid treatment. RESULTS: IgE was elevated in 36/42 (86%) patients.Concomitant allergic disease was observed in seven patients (allergic rhinitis in three, bronchial asthma in three, and urticaria in one). There were no signifi-cant correlations between IgG, IgG4, and IgE (r = -0.168 for IgG, and r = -0.188 for IgG4). There was no significant difference in IgE in the patients with and without extrapancreatic lesions (526 ± 531 IU/mL vs 819 ± 768 IU/mL, P = 0.163), with and without clini-cal relapse (457 ± 346 IU/mL vs 784 ± 786 IU/mL, P = 0.374). There was no significant difference in IgE between before and after steroid treatment (723 ± 744 IU/mL vs 673 ± 660 IU/mL, P = 0.633). CONCLUSION: Although IgE does not necessarily reflect the disease activity, IgE might be useful for the diagnosis of AIP in an inactive stage. | Kenji Hirano Minoru Tada Hiroyuki Isayama Kazumichi Kawakubo Hiroshi Yagioka Takashi Sasaki Hirofumi Kogure Yousuke Nakai Naoki Sasahira Takeshi Tsujino Nobuo Toda Kazuhiko Koike | 2010 | World Journal of Gastroenterology2010，16，41： | 4 |
| 6 | Risk factors for pancreatitis following transpapillary self-expandable metal stent placement显示文摘 | Kazumichi Kawakubo Hiroyuki Isayama Yousuke Nakai Osamu Togawa Naoki Sasahira Hirofumi Kogure Takashi Sasaki Saburo Matsubara Natsuyo Yamamoto Kenji Hirano Takeshi Tsujino Nobuo Toda Minoru Tada Masao Omata Kazuhiko Koike | 2012 | Surgical Endoscopy2012，，3： | 2 |
| 7 | Covered metallic stents in the management of malignant and benign pancreatobiliary strictures显示文摘 | Hiroyuki Isayama Yousuke Nakai Osamu Togawa Hirofumi Kogure Yukiko Ito Takashi Sasaki Naoki Sasahira Kenji Hirano Takeshi Tsujino Minoru Tada Takao Kawabe Masao Omata | 2009 | Journal of Hepato - Biliary - Pancreatic Surgery2009，，5： | 2 |
| 8 | Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity显示文摘BACKGROUND Endoscopy-based Kyoto classification for gastritis and pathological topographic distribution of neutrophil infiltration are correlated with gastric cancer risk.AIM To investigate the association between Kyoto classification and the topographic distribution of neutrophil activity.METHODS Kyoto classification score,ranging from 0 to 8,consisted of atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Neutrophil activity was scored according to the updated Sydney System using biopsy samples obtained from the greater curvature of the corpus and the antrum.The participants were divided into four categories,inactive stomach,antrumpredominant gastritis,pangastritis,and corpus-predominant gastritis,based on the topographic distribution of neutrophil activity.Effects of sex,age,body mass index,drinking habit,smoking habit,family history of gastric cancer,serum Helicobacter pylori(H.pylori)antibody,and Kyoto score on topography of neutrophil infiltration were analyzed.RESULTS A total of 327 patients(comprising 50.7%women,with an average age of 50.2 years)were enrolled in this study.H.pylori infection rate was 82.9%with a mean Kyoto score of 4.63.The Kyoto score was associated with the topographic distribution of neutrophil activity.Kyoto scores were significantly higher in the order of inactive stomach,antrum-predominant gastritis,pangastritis,and corpuspredominant gastritis(3.05,4.57,5.21,and 5.96,respectively).Each individual score of endoscopic findings(i.e.,atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness)was correlated with the topographic distribution of neutrophil activity.On multivariate analysis,the Kyoto score,age,and serum H.pylori antibody were independently associated with the topographic distribution of neutrophil activity.CONCLUSION The Kyoto classification score was associated with the topographic distribution of neutrophil activity. | Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Yoshiki Sakaguchi Yousuke Nakai Hidenobu Watanabe Hidekazu Suzuki Chizu Tanikawa Koichi Matsuda Kazuhiko Koike | 2020 | World Journal of Gastroenterology2020，26，34： | 2 |
| 9 | Kyoto classification in patients who developed multiple gastric carcinomas after Helicobacter pylori eradication显示文摘BACKGROUND Endoscopic Kyoto classification predicts gastric cancer risk;however,the score in the patients with primary gastric cancer after Helicobacter pylori(H.pylori)eradication therapy is unknown.AIM To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed after H.pylori eradication.METHODS The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer after H.pylori eradication.The score was compared between single gastric cancer group and multiple gastric cancers group.RESULTS The Kyoto score at the time of diagnosis of 45 cases of gastric cancer after H.pylori eradication was 4.0 points in average.The score was 3.8 points in the single gastric cancer group,and 5.1 points in the multiple gastric cancers group.The multiple group had a significantly higher score than the single group(P=0.016).In the multiple gastric cancers group,all the patients(7/7)had 5 or higher Kyoto score,while in single gastric cancer group,the proportion of patients with a score of 5 or higher was less than half,or 44.7%(17/38).CONCLUSION Patients diagnosed with gastric cancer after H.pylori eradication tended to have advanced gastritis.In particular,in cases of multiple gastric cancers developed after H.pylori eradication,the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus. | Kosuke Sakitani Toshihiro Nishizawa Akira Toyoshima Shuntaro Yoshida Tatsuya Matsuno Tomoharu Yamada Masatoshi Irokawa Yoshiyuki Takahashi Yousuke Nakai Osamu Toyoshima Kazuhiko Koike | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，9： | 2 |
| 10 | Outcomes after clearance of pancreatic stones with or without pancreatic stenting显示文摘 | Naoki Sasahira Minoru Tada Hiroyuki Isayama Kenji Hirano Yousuke Nakai Natsuyo Yamamoto Takeshi Tsujino Nobuo Toda Yutaka Komatsu Haruhiko Yoshida Takao Kawabe Masao Omata | 2007 | Journal of Gastroenterology2007，，1： | 2 |
| 11 | Measurement of radial and axial forces of biliary self-expandable metallic stents显示文摘 | Hiroyuki Isayama Yousuke Nakai Yoshihide Toyokawa Osamu Togawa Chimyon Gon Yukiko Ito Yoko Yashima Hiroshi Yagioka Hirofumi Kogure Takashi Sasaki Toshihiko Arizumi Saburo Matsubara Natsuyo Yamamoto Naoki Sasahira Kenji Hirano Takeshi Tsujino Nobuo Toda Mi | 2009 | Gastrointestinal Endoscopy2009，，1： | 2 |
| 12 | Diagnostic utility of biopsy specimens for autoimmune pancreatitis显示文摘 | Kenji Hirano Noriyoshi Fukushima Minoru Tada Hiroyuki Isayama Suguru Mizuno Keisuke Yamamoto Yoko Yashima Hiroshi Yagioka Takashi Sasaki Hirofumi Kogure Yousuke Nakai Naoki Sasahira Takeshi Tsujino Takao Kawabe Masashi Fukayama Masao Omata | 2009 | Journal of Gastroenterology2009，，7： | 1 |
| 13 | Cholecystitis After Metallic Stent Placement in Patients With Malignant Distal Biliary Obstruction显示文摘 | Hiroyuki Isayama Takao Kawabe Yousuke Nakai Takeshi Tsujino Naoki Sasahira Natsuyo Yamamoto Toshihiko Arizumi Osamu Togawa Saburou Matsubara Yukiko Ito Takashi Sasaki Kenji Hirano Nobuo Toda Yutaka Komatsu Minoru Tada Haruhiko Yoshida Masao Omata | 2006 | Clinical Gastroenterology and Hepatology2006，，9： | 1 |
| 14 | Pancreatic Tuberculosis with a Pancreaticobiliary Fistula 显示文摘 | Yousuke Nakai Takeshi Tsujino Takao Kawabe | 2007 | Dig Dis Sci2007，52，： | 1 |
| 15 | Short- and long-term outcomes of endoscopic papillary large balloon dilation with or without sphincterotomy for removal of large bile duct stones显示文摘 | Hirofumi Kogure Takeshi Tsujino Hiroyuki Isayama Naminatsu Takahara Rie Uchino Tsuyoshi Hamada Koji Miyabayashi Suguru Mizuno Dai Mohri Yoko Yashima Kazumichi Kawakubo Takashi Sasaki Natsuyo Yamamoto Yousuke Nakai Kenji Hirano Naoki Sasahira Minoru Tada K | 2013 | Scandinavian Journal of Gastroenterology2013，，1： | 1 |
| 16 | The endoscopic ultrasonography-guided rendezvous technique for biliary cannulation: a technical review显示文摘 | Hiroyuki Isayama Yousuke Nakai Kazumichi Kawakubo Hiroshi Kawakami Takao Itoi Natsuyo Yamamoto Hirofumi Kogure Kazuhiko Koike | 2013 | Journal of Hepato-Biliary-Pancreatic Sciences2013，，4： | 1 |
| 17 | Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy显示文摘 | Yousuke Nakai Hiroyuki Isayama Takashi Sasaki Naoki Sasahira Takeshi Tsujino Hirofumi Kogure Hiroshi Yagioka Yoko Yashima Osama Togawa Toshihiko Arizumi Saburo Matsubara Kenji Hirano Minoru Tada Masao Omata Kazuhiko Koike | 2010 | Critical Reviews in Oncology and Hematology2010，，： | 1 |
| 18 | Bezafibrate for the treatment of primary sclerosing cholangitis显示文摘 | Suguru Mizuno Kenji Hirano Minoru Tada Keisuke Yamamoto Yoko Yashima Hiroshi Yagioka Kazumichi Kawakubo Yukiko Ito Hirofumi Kogure Takashi Sasaki Toshihiko Arizumi Osamu Togawa Saburo Matsubara Yousuke Nakai Naoki Sasahira Takeshi Tsujino Hiroyuki Isayama | 2010 | Journal of Gastroenterology2010，，7： | 1 |
| 19 | Multicenter phase II study of S-1 monotherapy as second-line chemotherapy for advanced biliary tract cancer refractory to gemcitabine显示文摘 | Takashi Sasaki Hiroyuki Isayama Yousuke Nakai Suguru Mizuno Keisuke Yamamoto Hiroshi Yagioka Yoko Yashima Kazumichi Kawakubo Hirofumi Kogure Osamu Togawa Saburo Matsubara Yukiko Ito Naoki Sasahira Kenji Hirano Takeshi Tsujino Nobuo Toda Minoru Tada Masao | 2012 | Investigational New Drugs2012，，2： | 1 |
| 20 | Endoscopic evaluation of factors contributing to intrapancreatic biliary stricture in autoimmune pancreatitis显示文摘 | Kenji Hirano Minoru Tada Hiroyuki Isayama Keisuke Yamamoto Suguru Mizuno Hiroshi Yagioka Yoko Yashima Takashi Sasaki Hirofumi Kogure Osamu Togawa Toshihiko Arizumi Saburo Matsubara Yousuke Nakai Naoki Sasahira Takeshi Tsujino Takao Kawabe Masao Omata | 2010 | Gastrointestinal Endoscopy2010，，1： | 1 |
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