Direct peroral cholangioscopy using an ultraslim upper endoscope for biliary lesions.

Background: The development of direct peroral cholangioscopy (DPOC) using an ultraslim endoscope simplifies biliary cannulation. The conventional techniques are cumbersome to perform and require advanced skills. The recent introduction of the guidewires and balloons has improved the therapeutic outcomes.

Wire-guided selective cannulation of the bile duct with a sphincterotome: a prospective randomized comparative study with the standard method.

Objective: Wire-guided cannulation (WGC) is expected to reduce the incidence of post-ERCP pancreatitis (PEP). Our aim was to compare the incidence of PEP and the success rate of deep biliary cannulation using WGC or the standard cannulation method with contrast injection (STD).

Material And Methods: A total of 172 cases with an intact papilla were randomized into the STD group (n = 86) and the WGC group (n = 86).

Treating bilio-duodenal obstruction: combining new endoscopic technique with 6 Fr stent introducer.

Periampullary cancer may cause not only biliary but also duodenal obstructions. In patients with concomitant duodenal obstructions, endoscopic biliary stenting remains technically difficult and may often require percutaneous transhepatic biliary drainage. We describe a method of metal stent placement via a thin forward-viewing endoscope in patients with simultaneous biliary and duodenal obstruction.

Comparison of ultraflex and niti-s stents for palliation of unresectable malignant gastroduodenal obstruction.

Aim: Self-expandable metallic stents are widely used for palliation of malignant gastric outlet obstruction (GOO), but clinical outcomes of different stents have not been compared. Here, we compared outcomes in patients with a GOO receiving either an Ultraflex (UF) or a Niti-S (NS) stent.

Methods: Prospective outcomes in 53 patients receiving palliative placement of an NS stent for symptomatic GOO over a 3-year period were compared with those obtained retrospectively in 31 patients receiving a UF stent in a previous 5-year period.

[Successful endoscopic removal of pancreatic catheter after Whipple resection being effective for improving repeated pancreatitis-a case report].

A 54-year-old man had repeated pancreatitis since three years after pylorus-preserving pancreatoduodenectomy (PpPD) and reconstruction by the modified Child method. Since abdominal pain appeared after meals, a pancreatic duct tube was removed endoscopically, which resulted in an improvement. It has been postulated that a pancreatic duct tube, used at the anastomosis between the pancreas and gastrointestinal tract, is spontaneously dislodged or creates a spatial gap with the wall of the main pancreatic duct enough to let the pancreatic juice outflow.

Metallic stents for gastric outlet obstruction: reintervention rate is lower with uncovered versus covered stents, despite similar outcomes.

Background: Self-expandable metallic stents (SEMSs) are widely used for palliation of malignant gastric outlet obstruction (GOO). A common complication of their use, however, is stent obstruction caused by tumor ingrowth or hyperplasia. The covered SEMS was designed to prevent these problems.

Gastric emptying in patients with palliative stenting for malignant gastric outlet obstruction.

Background/aims: Palliative stenting for gastric outlet obstruction (GOO) offers a more rapid resumption of oral intake than surgical gastrojejunostomy. Clinically, delayed gastric emptying is observed less frequently in patients with enteral stenting. The aim of this study was to conduct a functional assessment of gastric emptying after stent placement for GOO using isotope scanning.

Self-expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy.

Background: In patients with gastric outlet obstruction (GOO), palliative enteral stenting is a less invasive procedure compared with gastroenterostomy. Most diseases analyzed in previous studies of such stenting were pancreaticobiliary malignancies.

Methods: We reviewed the medical records of patients with GOO secondary to gastric cancer who were admitted to our institution between September 1994 and September 2004.

Efficacy of an overtube for reducing the risk of peristomal infection after PEG placement: a prospective, randomized comparison study.

Background: With the conventional pull method of PEG placement, there is a significant risk of wound infection from contamination of the gastrostomy catheter as it passes through the oral cavity. This study compared the occurrence of peristomal wound infection associated with PEG placement with and without use of an overtube.

Methods: Consecutive patients with dysphagia were randomized to undergo PEG placement with (Group I) or without (Group II) an overtube.

Self-expandable metallic stent placement as palliative treatment of obstructed colorectal carcinoma.

Background: Stent placement in palliation of unresectable colon cancer is an alternative to surgical treatment. The through-the-scope stent for the exclusive treatment of colorectal cancer is not available in Japan. This report describes the use of an esophageal stent and the technical modifications required for its success in the treatment of colorectal strictures.

PEG with introducer or pull method: a prospective randomized comparison.

Background: PEG by the conventional pull method has the potential drawback of being associated with a higher frequency of wound infection, presumably caused by contamination of the gastrostomy catheter as it passes through the oral cavity. This study investigated the occurrence of peristomal wound infection after PEG placement by using the pull and introducer techniques.

Methods: Between September 1999 and May 2002, consecutive patients with dysphagia for whom PEG was recommended were enrolled in the study and randomly assigned to two groups: PEG with the introducer method (Group I) or PEG with the pull method (Group II).