Publications by authors named "Mako Ushio"

Article Synopsis
  • The study assessed the effectiveness of the spring-and-loop with clip (S-O clip) in gastric endoscopic submucosal dissection (ESD) by comparing outcomes in 290 patients with early gastric neoplasms who did and did not use the clip.
  • Results indicated that patients using the S-O clip had significantly shorter procedure times (44.4 minutes vs. 61.1 minutes) and higher complete resection rates (97.9% vs. 92.6%) compared to those without the clip.
  • The findings suggest that the S-O clip enhances efficiency and outcomes in ESD, particularly benefiting less experienced endoscopists during procedures.
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Objectives: The Japan Pancreas Society introduced the concept of early chronic pancreatitis (ECP) in 2009, but its epidemiology remains unclear. This study investigated challenges in ECP diagnosis.

Methods: Early chronic pancreatitis was diagnosed in 4 cohorts between April 2019 and November 2021 using the Clinical Diagnostic Criteria for Chronic Pancreatitis 2019.

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Objectives: Pancreatic ductal adenocarcinoma with strong expression of interleukin-13 receptor α2 (IL-13Rα2) was associated with poor prognosis and gemcitabine resistance in an orthotopic mouse model. We evaluated the influence of IL-13Rα2 expression in the endoscopic ultrasound-fine needle aspiration (EUS-FNA) specimen.

Methods: We included patients with pancreatic ductal adenocarcinoma, as diagnosed by EUS-FNA, who received gemcitabine-based chemotherapy (G-CTX).

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One of the reasons for groove pancreatitis is caused by the leakage of pancreatic juice into the space between the pancreatic head, descending duodenum, and common bile duct. Endoscopic drainage of Santorini's duct (SD) via the minor papilla is reportedly efficacious but can be difficult due to duodenal stenosis. We report Santorini's duct drainage using endoscopic ultrasonography-guided pancreaticogastrostomy (EUS-PGS) for a case of groove pancreatitis with gastric outlet obstruction.

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Article Synopsis
  • A study was conducted to evaluate the feasibility and effectiveness of a new type of fully covered self-expandable metallic stent (SFCSEMS) for treating malignant hilar-biliary obstruction (MHBO), which is a complication often caused by advanced cancer.
  • Involving 54 patients, the study found a 100% technical success rate and a 92.5% clinical success rate, though recurrent biliary obstruction occurred in 35.2% of cases after an average of 181 days.
  • The findings suggest that SFCSEMS placement is effective with a low rate of complications and that using the stent in a second procedure shows promise for reducing the rate of further obstructions.
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Objectives: Interventional endoscopic ultrasonography is performed for various situations that require drainage, after which stent migration is the most severe adverse event. Several lumen-apposing metal stents (LAMS) and covered self-expandable metal stents (CSEMS) provide antimigration systems; however, their anchoring ability has not been studied well. Therefore, we measured and compared the anchoring force (ACF) of commercially available LAMS and CSEMS.

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Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an effective biliary drainage procedure in adult cases with difficult biliary access. However, there have been no reports on this procedure being used in pediatric cases. We successfully performed EUS-HGS in a pediatric case with a surgically altered anatomy.

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The emergency declaration (ED) associated with the coronavirus disease-2019 (COVID-19) pandemic in Japan had a major effect on the management of gastrointestinal endoscopy. We retrospectively compared the number of pancreaticobiliary endoscopies and newly diagnosed pancreaticobiliary cancers before (1 April 2018 to 6 April 2020), during (7 April to 25 May 2020), and after the ED (26 May to 31 July). Multiple comparisons of the three groups were performed with respect to the presence or absence of symptoms and clinical disease stage.

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Article Synopsis
  • * Researchers analyzed 79 patients, identifying that those with prolonged reductions in CA 19-9 levels lasting more than 3 months had a significantly better chance of long-term survival.
  • * A 44% baseline reduction in CA 19-9 was established as a critical marker for prognosis, with a reduction lasting over 3 months showing substantial predictive value for favorable outcomes.
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Background: Interventional endoscopic ultrasound-guided procedures (I-EUS) are widely accepted as salvage procedures in ERCP-failed cases, and to drain fluid collected in the abdominal cavity. Although I-EUS has a relatively high incidence of complications and is severe/fatal in some cases, no follow-up strategy has been established. In our institution, plain computed tomography (P-CT) is performed routinely the day after I-EUS.

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Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is becoming increasingly popular. However, the risk factors for stent migration into the abdominal cavity remain unknown. Forty-eight patients undergoing EUS-HGS with placement of a long, partially covered self-expandable metallic stent (LPC-SEMS) were studied retrospectively to identify risk factors of stent migration.

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Background And Aims: The goals of the management of benign biliary stricture (BBS) are to relieve symptoms and resolve short-/long-term stricture. We performed fully covered self-expandable metallic stent (hereafter, FCSEMS) placement for BBS using various methods and investigated the treatment outcomes and adverse events (AEs).

Methods: We retrospectively studied patients who underwent FCSEMS placement for refractory BBS through various approaches between January 2017 and February 2020.

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Article Synopsis
  • Management of bile duct stones (BDSs) in patients with surgically altered anatomies is difficult, leading to a comparison of two techniques: endoscopic ultrasound-guided antegrade (EUS-AG) and double-balloon enteroscopy-assisted endoscopic retrograde cholangiography (DB-ERC).
  • A retrospective study of 54 patients showed EUS-AG had a higher technical success rate (87.0%) compared to DB-ERC (64.5%), and was quicker (averaging about 52 minutes versus 73 minutes for DB-ERC).
  • Although the adverse event rates were similar for both methods, the EUS-AG showed comparable effectiveness in complete stone removal, making it a desirable option for treating
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Background: The guidewire (GW) plays an important role in pancreatobiliary endoscopy. GW quality is a critical factor in the effectiveness and efficiency of pancreatobiliary endoscopy. In this study, we evaluate a new 0.

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Chronic pancreatitis (CP) is associated with a risk of pancreatic cancer and is characterized by irreversible morphological changes, fibrosis, calcification, and exocrine and endocrine insufficiency. CP is a progressive disease with a poor prognosis and is typically diagnosed at an advanced stage. The Japan Pancreas Society proposed criteria for early CP in 2009, and their usefulness has been reported.

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Article Synopsis
  • Endoscopic management techniques for common bile duct stones (CBDS) vary, and it remains unclear which method is the most effective and safe.
  • A literature review of 26 studies involving nearly 4,000 patients compared five endoscopic procedures: EST, EPBD, ESBD, EPLBD, and ESLBD, each showing different effectiveness and adverse event rates.
  • While ESBD is recommended for small CBDS due to its superior effectiveness, the evidence is not robust; for large stones, EPLBD and ESLBD are equally effective and safe.
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Follow-up computed tomography revealed a 40-mm pancreatic tail cyst in a 59-year-old man with type 1 diabetes mellitus. An intraductal papillary mucinous neoplasm was suspected; mucinous cystic neoplasm (MCN) was not considered because the patient was a man. During follow-up, cyst infection occurred but was improved by conservative treatment.

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Background/aim: A sufficiently open papilla is needed to remove common bile duct stones (CBDS) but endoscopic sphincterotomy (EST) requires a high level of skill and is difficult with endoscopic papillary balloon dilation (EPBD). The main adverse event of EST is bleeding and perforation and that of EPBD is post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. To reduce these adverse events we employed minimal EST followed by papillary dilation (ESBD), and retrospectively evaluated its efficacy and safety compared with EST.

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Primary sclerosing cholangitis (PSC) is characterized by idiopathic biliary stricture followed by progressive cholestasis and fibrosis. When diagnosing PSC, its differentiation from other types of sclerosing cholangitis and cholangiocarcinoma is necessary. The cholangioscopic findings of PSC have not been investigated sufficiently.

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