Publications by authors named "Reina Tanaka"

Article Synopsis
  • Replacing a lumen-apposing metal stent (LAMS) with a double-pigtail plastic stent (DPS) is effective for preventing recurrence of walled-off necrosis, but traditional success rates are low; so a new technique was developed.
  • In the new method, a 7-F DPS is placed inside the LAMS to facilitate its removal while allowing granulation to occur, which stabilizes the DPS; out of 18 patients, 17 had successful replacements with no recurrences observed over 385 days.
  • Prior to this technique, replacing LAMS with DPS had a low success rate (61.8%), and recurrence of pancreatic fluid collection was noted in 15.3% of patients who could
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Viscoelastic relaxation mechanisms of individualized cellulose nanofibers (iCNFs) dispersed in glycerol in the dilute and semidilute regions were investigated by linear viscoelastic and dynamic birefringence measurements. The birefringence relaxation of the iCNFs was described by the orientational and curvature modes of an existing viscoelastic theory for ideal semiflexible polymers (Shankar-Pasquali-Morse theory). However, the Shankar-Pasquali-Morse theory could not fully describe the iCNF viscoelastic relaxation at high frequencies.

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Article Synopsis
  • * The procedure took an average of 27.3 minutes, with significant improvement in GOO symptoms over time, achieving an overall survival rate of about 194 days post-procedure.
  • * While EPASS had a 16.2% rate of mild adverse events, it maintained 100% stent patency, emphasizing its safety and reliability for managing malignant GOO cases.
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Asano and colleagues report their method of inserting a therapeutic video duodenoscope with the use of a splinting tube for challenging cases due to deformity of the pyloric antrum. With accompanying video, they demonstrate how this technique is promising for overcoming difficulties in duodenoscope insertion caused by scope deflection.

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Tract dilation prior to stent placement is an important step in endoscopic ultrasound-guided hepaticogastrostomy. Mukai and colleagues describe their use of a novel catheter with a longer balloon, which enables one-step tract dilation of the gastric wall, liver parenchyma, and bile duct wall, shortening the procedure and reducing bile leakage.

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Objective: Few reports have explored the application of urinary trypsinogen-2 measurement in the early diagnosis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, and none have demonstrated the benefits of noninvasive testing. This study aimed to evaluate the clinical application of the rapid urinary trypsinogen-2 dipstick test (Nipro, Japan) compared with serum amylase and lipase levels for the early diagnosis of post-ERCP pancreatitis (PEP).

Methods: A total of 100 consecutive patients (54 men and 46 women) who were admitted and underwent ERCP at Tokyo Medical University Hospital from August 2021 to December 2021 were recruited.

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Background: Endoscopic ultrasound-guided tissue acquisition is vital for diagnosing pancreatic and peridigestive tract lesions. A new three-prong asymmetry tip needle has been developed for this procedure. In this study, we retrospectively assessed the diagnostic ability, tissue collection volume, and procedural adverse events of the three-prong asymmetry tip needle for solid pancreatic, subepithelial, and other organ lesions.

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Introduction: In median arcuate ligament syndrome (MALS), the celiac artery is compressed, causing an arcade to develop in the pancreatic head, leading to ischemic symptoms and aneurysms.

Patient Concerns: The patient was diagnosed with borderline resectable pancreatic cancer (PC) and MALS. Endoscopic biliary drainage with a covered metal stent (CMS) was performed for the obstructive jaundice.

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Objectives: Endoscopic transpapillary gallbladder drainage (ETGBD) is a highly technical procedure, but few studies have evaluated factors that predict its technical success. Therefore, in this study, we sought to identify predictors of technically successful ETGBD.

Methods: One hundred and eighty-two patients who underwent ETGBD for acute cholecystitis at our hospital were retrospectively investigated.

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Article Synopsis
  • - Tonozuka and colleagues highlight a new ultra-thin peroral cholangioscope designed for challenging biliary stricture cases, featuring a tip diameter of just 2.3 mm.
  • - This innovative cholangioscope simplifies the insertion process compared to conventional scopes, easing accessibility for medical professionals.
  • - It's also cost-effective and versatile, making it a valuable tool in the field of biliary procedures.
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Transpapillary endoscopic biliary drainage is the gold standard for resolving malignant biliary obstruction. Stent migration occasionally occurs and is troublesome to retrieve. Yamamoto and colleagues report with accompanying video on the successful retrieval of a proximally migrated stent using biopsy forceps through a guiding sheath cannula.

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A considerable material discontinuity between the enamel and dentin might jeopardize the tooth's mechanical durability over time without the attenuation of the dentin-enamel junction (DEJ). However, the critical loading transmission mechanism at the DEJ remains understudied. This study aimed to define the extent and effective width of the DEJ, along with its mechanical competence.

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Background And Aims: Bilioenteric anastomotic stricture (BES) is a well-known adverse event after bilioenterostomy. Recently, EUS-guided antegrade intervention (EUS-AI) has been developed for cases that are difficult to treat by balloon enteroscopy-assisted ERCP. However, no data are available on the long-term outcomes after EUS-AI.

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Article Synopsis
  • This study investigates how different needle types and the angle of the echoendoscope affect the ease (puncturability) of inserting needles for diagnosing gastrointestinal lesions using EUS-guided techniques.
  • Researchers compared several 22-gauge fine-needle aspiration (FNA) and biopsy (FNB) needles to measure their resistance when being advanced through tissue.
  • Results showed that FNB needles had higher resistance compared to FNA needles, with SharkCore exhibiting the lowest resistance, making it the best option when a tight angle is needed during insertion.
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Background/purpose: A peroral cholangioscope (POCS) can allow direct visualization of the biliary mucosa and its use is becoming more widespread due to improvements in functionality, image quality, and operability, as well as the development of related devices. Recently, a novel mother-baby peroral cholangioscope (nMB-POCS) with a large (2-mm) accessory channel has been developed. In this study, we evaluated the feasibility of this novel POCS in a dry simulation and animal model.

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Background/purpose: Shear wave elastography (SWE) is a clinical method used to evaluate liver hardness. In this study, we assessed its applicability in assessing the pancreas and its potential for diagnosing chronic pancreatitis.

Methods: We performed SWE on 59 patients who underwent abdominal ultrasound, and measured the computed tomography (CT) values of the pancreas.

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Background: Eradication of hepatitis C virus (HCV) from chronic HCV-infected patients could improve liver function and prevent hepatocarcinogenesis in the long term. Eradication of HCV by direct-acting antivirals (DAAs) also leads to dynamic immunological changes. We report a case of recurrent coronavirus disease 2019 (COVID-19) that developed immediately after combination treatment with DAAs for HCV infection and decompensated cirrhosis.

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Urgent or emergency endoscopic retrograde cholangiopancreatography (ERCP) is indicated for gallstone-induced acute cholangitis and pancreatitis. The technique and optimal timing of ERCP depend on the disease state, its severity, anatomy, patient background, and the institutional situation. Endoscopic transpapillary biliary drainage within 24 h is recommended for moderate to severe acute cholangitis.

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Background/purpose: Although the lumen-apposing metal stent (LAMS) is useful for interventional endoscopic ultrasound (EUS) procedures, there has been some concern about the potential for stent-induced adverse events because of the high lumen-apposing force. A newly designed LAMS with less lumen-apposing force has been developed for use with a physician-controlled electrocautery-enhanced delivery system. The aim of this animal study was to evaluate the feasibility of performing interventional EUS using this newly designed LAMS system.

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Background And Objectives: Several studies have demonstrated that EUS-guided fine-needle biopsy (EUS-FNB) is useful for diagnosing gastrointestinal subepithelial lesions (GI SELs). However, there is limited evidence regarding the use of Franseen needles during EUS-FNB for patients with GI SELs. In addition, the optimal approach for diagnosing small SELs is unclear.

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High-intensity focused ultrasound (HIFU) is a novel advanced therapy for unresectable pancreatic cancer (PC). HIFU therapy with chemotherapy is being promoted as a novel method to control local advancement by tumor ablation. We evaluated the therapeutic effects of HIFU therapy in locally advanced and metastatic PC.

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