Publications by authors named "Kazunari Nakahara"
Article Synopsis
- - The study aimed to identify causes of benign hepaticojejunostomy strictures (BHSs) after pancreaticoduodenectomy and evaluate the effectiveness of endoscopic retrograde cholangiography (ERC) for treating these strictures.
- - Out of 175 patients who underwent the surgery, 13 developed BHSs, with key risk factors being male sex and a preoperative bile duct diameter of less than 8.8 mm.
- - Treatments using ERC were highly successful, with a 92.3% success rate and no recurrence of strictures after treatment in the follow-up period.
Article Synopsis
- The WONDER-02 trial is a randomized controlled study aimed at comparing the effectiveness of plastic stents versus lumen-apposing metal stents (LAMSs) for treating symptomatic pancreatic pseudocysts through endoscopic ultrasound (EUS) drainage.
- The trial will enroll 80 patients from 26 centers in Japan, dividing them into two groups of 40 to receive either type of stent and assessing outcomes like pseudocyst size reduction and overall health improvements.
- The results will help determine if plastic stents are just as effective as LAMSs, potentially influencing future treatment guidelines for pancreatic pseudocyst patients.
Article Synopsis
- The development of automatic pathological diagnostic systems using AI aims to enhance the efficiency of diagnosing diseases, although challenges like low interpretability and high data requirements persist.
- A new general-purpose approach combining a hyperspectral camera with machine learning shows promise, achieving over 80% accuracy in identifying benign or malignant cells in challenging bile duct biopsy and bile cytology specimens.
- This method could significantly aid in diagnosing bile duct cancer and has the potential for broader applications in general pathological diagnoses.
Article Synopsis
- Recent advancements in gene and protein analysis technologies have improved the identification of target molecules for cancer treatment.
- In September 2021, Japan published the "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" to ensure external diagnostic products are clinically useful and in line with evaluation criteria.
- These guidelines include a clinical questionnaire addressing serious issues, are based on comprehensive literature reviews, and serve as a practical tool for cancer treatment in clinical settings.
Objective: To investigate the influence of endoscopic gallbladder stenting (EGBS) on subsequent cholecystectomy. We retrospectively compared the surgical outcomes of EGBS, followed by elective cholecystectomy with those of immediate cholecystectomy (IC).
Patients And Methods: A total of 503 patients were included in this study.
Background: With the increasing popularity of endoscopic ultrasound (EUS)-guided transmural interventions, walled-off necrosis (WON) of the pancreas is increasingly managed via non-surgical endoscopic interventions. However, there has been an ongoing debate over the appropriate treatment strategy following the initial EUS-guided drainage. Direct endoscopic necrosectomy (DEN) removes intracavity necrotic tissue, potentially facilitating early resolution of the WON, but may associate with a high rate of adverse events.
View Article and Find Full Text PDFBackground And Aims: The efficacy of the suprapapillary placement of inside plastic stents (iPSs) for unresectable malignant hilar biliary obstructions (MHOs) is unknown compared with that of uncovered inside metal stents (iMSs). This randomized controlled trial was designed to evaluate the outcomes of endoscopic placement of these stents for unresectable MHOs.
Methods: This open-label, randomized study was conducted at 12 Japanese institutions.
The novel synthetic self-assembling peptide PuraStat has been approved for hemostasis in endoscopic procedures. Nakahara and colleagues describe their application of PuraStat for hemostasis of refractory fistula bleeding after endoscopic ultrasound-guided hepaticogastrostomy. The effective and technically easy procedure is a useful option when hemostasis cannot be achieved by other means.
View Article and Find Full Text PDFAims: This study aimed to evaluate the effectiveness and safety of stenting with a flexible braided self-expandable metal stent (SEMS) for unresectable malignant gastric outlet obstruction (GOO).
Methods: Palliative stenting was prospectively carried out at seven university hospitals between October 2017 and August 2020. All procedures were performed using a flexible branded SEMS of the same brand.
Background: Endoscopic transpapillary gallbladder stenting (EGBS) is considered for patients with contraindications to early surgery for acute calculus cholecystitis. However, evidence regarding the long-term outcomes of EGBS is insufficient to date. The aim of the study was to evaluate the feasibility of EGBS as a bridge to or alternative to surgery when there are contraindications.
View Article and Find Full Text PDFBackground And Aim: The aim of this study was to identify the factors associated with liver-related and non-liver-related mortality of patients with hepatitis C virus (HCV) after sustained virologic response (SVR) to direct-acting antiviral agents (DAAs).
Methods: We conducted a retrospective, single-center cohort study of HCV patients cured by DAAs.
Results: A total of 330 patients with SVR to DAAs were eligible.
Background And Aims: Endoscopic transpapillary gallbladder drainage (ETGBD) has been performed as an alternative therapy against cholecystectomy in patients with acute cholecystitis. To date, few studies have reported the safety, efficacy, and factors affecting ETGBD. We evaluated the clinical outcomes and predictors of technical failure of ETGBD.
View Article and Find Full Text PDFArticle Synopsis
- The video demonstrates a method to straighten a guidewire that has become looped in the gallbladder due to segmental adenomyomatosis.
- This technique involves using a balloon catheter to assist in repositioning the guidewire during the procedure.
- The procedure is specifically aimed at placing a stent in the gallbladder through an endoscopic transpapillary approach.
Successful biliary stenting after portal vein cannulation during endoscopic retrograde cholangiopancreatography.
J Hepatobiliary Pancreat Sci
June 2022
Highlight Cannulation of the portal vein during endoscopic retrograde cholangiopancreatography is a rare complication. Nakahara and colleagues present a case of successful biliary stenting with a guidewire left in the portal vein after recognizing that the portal vein had been cannulated, without subsequent complications such as bleeding or air embolism.
View Article and Find Full Text PDFDouble-guidewire technique for endoscopic transpapillary gallbladder stenting.
J Hepatobiliary Pancreat Sci
June 2022
Highlight Endoscopic transpapillary gallbladder stenting is effective for acute cholecystitis with high surgical risk. However, looping of the guidewire in the cystic duct sometimes impedes placement of the stent. Nakahara and colleagues present a case of successful endoscopic transpapillary gallbladder stenting after straightening the looped guidewire using a double-guidewire technique.
View Article and Find Full Text PDFBackground: Oxaliplatin is a key drug for the chemotherapy of colorectal cancer; however, it is also known to cause non-cirrhotic portal hypertension. We aimed to identify the characteristics of patients who developed esophagogastric varices (EGVs) after treatment with oxaliplatin.
Methods: This study retrospectively analyzed patients with colorectal cancer who were treated with chemotherapy including oxaliplatin between 2010 and 2016.
Video 1Successfully combined therapy of Coca-Cola and endoscopic treatment for a giant diospyrobezoar in the duodenum using the electrosurgical endo-knife and ileus tube.
View Article and Find Full Text PDFBackground And Aims: Although single-balloon enteroscopy (SBE)-assisted or short-type SBE (short SBE)-assisted ERCP has been reported as useful in patients with surgically altered anatomy, most studies had small sample sizes or single-center designs. This study aimed to evaluate the efficacy and factors affecting the procedure results of short SBE-assisted ERCP in patients with surgically altered anatomy.
Methods: This multicenter, retrospective study was conducted at 8 tertiary referral care centers in Japan.
Acute cholangitis (AC) is often associated with disseminated intravascular coagulation (DIC), and endoscopic transpapillary biliary drainage (EBD) under endoscopic retrograde cholangiopancreatography (ERCP) is a treatment of choice. However, no evidence exists on the outcomes of EBD for AC associated with DIC. Therefore, we retrospectively evaluated the treatment outcomes of early EBD and compared endoscopic biliary stenting (EBS) and endoscopic nasobiliary drainage (ENBD).
View Article and Find Full Text PDFObjective: The treatment result of the uncovered metallic stent (uncovered MS) and covered metallic stent (covered MS) for unresectable malignant distal biliary obstruction is controversial. This time, we conducted this study to compare the efficacies and complication rates of uncovered MS and covered MS in unresectable malignant distal biliary obstructions at a prospective randomized multicenter trial.
Materials And Methods: From April 2014 to September 2018, patients with unresectable malignant distal biliary obstruction were randomly assigned to 2 groups: the uncovered MS group and the covered MS group.