Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan.

Background: Endoscopic ultrasound-guided biliary drainage (EUS-BD) is considered to be an effective salvage procedure for failed endoscopic retrograde cholangiopancreatography in patients with unresectable malignant biliary obstruction. The aim of this retrospective study was to evaluate the efficacy and feasibility of EUS-BD.

Methods: From November 2006 to May 2012, a total of 64 patients who underwent EUS-BD (44 EUS-guided choledochoduodenostomy [EUS-CDS] and 20 EUS-guided hepaticogastrostomy [EUS-HGS]) at seven tertiary-care referral centers in Japan were included.

Distinctive histopathologic findings of pancreatic hamartomas suggesting their "hamartomatous" nature: a study of 9 cases.

Pancreatic hamartoma is a rare tumor, and its characteristic histopathologic features have not yet been fully evaluated. In this study, we collected 9 cases of pancreatic hamartoma to elucidate distinctive histopathologic features that can serve to establish this tumor as a clear disease entity and thus formulate useful histopathologic criteria for this tumor. The cases comprised 4 men and 5 women with a mean age of 62.

Percutaneous transhepatic sclerotherapy for recurrent bleeding ileal varices diagnosed by capsule endoscopy and computed tomography during percutaneous transhepatic venography.

We report a case of acute uncontrolled gastrointestinal bleeding in a patient with liver cirrhosis. A 64-year-old man was admitted to our hospital for further investigation of blood in stools. Preliminary examination by computed tomography (CT) as well as upper and lower endoscopy could not detect the bleeding source.

[A case of mucosal Schwann cell hamartoma].

A 40-year-old man was referred to our hospital because of a positive fecal occult blood test. Colonoscopy revealed many small whitish nodules in the mucosa of the sigmoid colon. Specimens endoscopically resected from the lesions revealed spindle cell proliferation in the lamina propria.

Value of cytodiagnosis using endoscopic nasopancreatic drainage for early diagnosis of pancreatic cancer: establishing a new method for the early detection of pancreatic carcinoma in situ.

Objectives: We examined the results of pancreatic juice cytodiagnosis using the method of endoscopic nasopancreatic drainage (ENPD) to identify pancreatic carcinoma in situ and compared the images and pathologic diagnosis of pancreatic carcinoma in situ as well as clinicopathologic characteristics.

Methods: In patients who underwent endoscopic retrograde cholangiopancreatography and had ENPD place, only patients presenting with focal stenosis and distal dilatation of the main pancreatic duct were included in the ENPD placement group. Endoscopic nasopancreatic drainage was conducted 27 times in 20 patients in the ENPD placement group.

[A case of Helicobacter pylori-negative depressed type gastric adenoma].

A 75-year-old woman was referred to our hospital for further examination of gastric antral abnormal endoscopic findings. Endoscopic study of the stomach revealed a depressed lesion in the gastric antrum. Atrophic findings were not recognized in the background gastric mucosa, and Helicobacter pylori infection was not detected by histology, an urea breath test, a rapid urease test and serological test.

Endoscopic ultrasound-guided choledochoduodenostomy for palliative biliary drainage in cases with inoperable pancreas head carcinoma.

Background: Endoscopic transpapillary biliary drainage (EBD) or stenting is the gold standard treatment for inoperable malignant biliary obstruction. When the papilla cannot be traversed because of pyloric or duodenal stenosis, or the catheter cannot be introduced, or because of previous surgery, the usual alternative method is considered to be percutaneous transhepatic biliary drainage (PTBD). We herein report our experiences with four cases with inoperable pancreatic head carcinoma associated with obstructive jaundice treated by endoscopic ultrasonography-guided biliary drainage (EUS-BD).

[A case of pancreatic solid-pseudopapillary tumor without cystic component in an elderly man].

We encountered a solid pseudopapillary tumor (SPT) without any cyst component in an elderly man. A literature survey of SPT without cystic component suggested that the size and vascularity of a tumor were related to lack of cystic component. The prognosis of this disease was comparatively good, but elderly or middle aged case and cases without capsule seem to have high malignant potential.

Gemcitabine suppresses malignant ascites of human pancreatic cancer: correlation with VEGF expression in ascites.

It has been reported that vascular endothelial growth factor (VEGF) is a potent angiogenic factor that also has the ability to increase vascular permeability. VEGF plays an important role in the development of malignant ascites in various cancers. Gemcitabine has been prescribed for patients with inoperable human pancreatic ductal carcinoma as a first-line chemotherapy.