Publications by authors named "Toshifumi Kin"

Article Synopsis
  • * Analyzing data from 1183 patients, it found that completing 6 months of postoperative adjuvant therapy significantly improved overall, disease-specific, and recurrence-free survival, especially for high-risk patients.
  • * Additionally, neoadjuvant therapy showed benefits for those with borderline resectable IPMC, and any treatment for recurrence after surgery was linked to longer survival compared to no treatment.
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Background: The natural history of branch-duct intraductal papillary mucinous cystic neoplasms (BD-IPMNs) in the pancreas remains unclear. This study aimed to answer this clinical question by focusing on the development of concomitant pancreatic ductal adenocarcinomas (cPDAC).

Methods: The Japan Pancreas Society conducted a prospective multicenter surveillance study of BD-IPMN every six months for five years.

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Objectives: Unresectable ampullary cancer (AC) is a rare disease entity. The risk factors for recurrent biliary obstruction (RBO) following endoscopic biliary stenting (EBS) for unresectable AC remain unknown. In this study we aimed to evaluate the cumulative RBO rate and to identify risk factors for RBO following palliative EBS in patients with unresectable AC.

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Gallbladder wall thickening is relatively common in clinical settings, and for appropriate diagnosis, the size, shape, internal structure, surface contour, and vascularity of the gallbladder wall must be evaluated. Morphological evaluation is the most important; however, some gallbladder lesions resemble gallbladder cancer in imaging studies, making differential diagnosis challenging. Vascular evaluation is indispensable for a precise diagnosis in these cases.

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Article Synopsis
  • Precut papillotomy can be challenging due to difficulty identifying biliary orifices; this study investigates the effectiveness of Texture and Color Enhancement Imaging (TXI) compared to traditional White Light Imaging (WLI) for this purpose.
  • The study analyzed 20 patients who had undergone bile duct cannulation, assessing how well evaluators could identify biliary orifices using both TXI and WLI in randomized image presentations.
  • Results indicated that TXI offered better accuracy (50.6% vs. 35.6%), higher visibility scores, and greater color differentiation from surrounding tissue compared to WLI, suggesting TXI is a valuable tool for improving biliary cannulation outcomes.
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Image-enhanced endoscopy (IEE) has advanced gastrointestinal disease diagnosis and treatment. Traditional white-light imaging has limitations in detecting all gastrointestinal diseases, prompting the development of IEE. In this review, we explore the utility of IEE, including texture and color enhancement imaging and red dichromatic imaging, in pancreatobiliary (PB) diseases.

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For pancreatic masses, an evaluation of their vascularity using contrast-enhanced ultrasonography can help improve their characterization. This study was designed to evaluate the utility and safety of contrast-enhanced transabdominal ultrasonography (CE-TUS) and endoscopic ultrasonography (CE-EUS) in the diagnosis of pancreatic masses including solid or cystic masses. This multi-center comparative open-label superiority study is designed to compare Plain (P)-TUS/EUS alone with P-TUS/P-EUS plus CE-TUS/CE-EUS.

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Article Synopsis
  • The study evaluated the effectiveness of preoperative pancreatic juice cytology (PJC) in diagnosing intraductal papillary mucinous neoplasm (IPMN) of the pancreas to inform treatment strategies.
  • Out of 1,130 patients, 852 underwent PJC, showing an overall accuracy of 55% for distinguishing cancerous from noncancerous lesions, with varying rates based on IPMN type.
  • Despite low sensitivity, the high positive predictive value suggests PJC may still be useful in uncertain surgical cases but is generally not recommended as a reliable diagnostic tool.
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Toyonaga and colleagues present a novel "tip-in endoscopic papillectomy" approach for resecting ampullary tumors, aiming to minimize complications like perforation and residual tumor by adapting the colonic polyp endoscopic mucosal resection tip-in method. The technique is described with accompanying video in a case of ampullary tumor near a diverticulum.

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Background And Aims: We compared ERCP using a balloon-assisted endoscope (BE-ERCP) with EUS-guided antegrade treatment (EUS-AG) for removal of common bile duct (CBD) stones in patients with Roux-en-Y (R-Y) gastrectomy.

Methods: Consecutive patients who had previous R-Y gastrectomy undergoing BE-ERCP or EUS-AG for CBD stones in 16 centers were retrospectively analyzed.

Results: BE-ERCP and EUS-AG were performed in 588 and 59 patients, respectively.

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Background: Cholecystitis is a major adverse event after self-expandable metallic stent placement for distal biliary obstruction (DBO). Covered self-expandable metallic stent (CSEMS) is being increasingly used, but few studies have investigated risk factors for cholecystitis limited to CSEMS. The present study aimed to identify risk factors for cholecystitis after CSEMS.

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Toyonaga and colleagues demonstrate, with accompanying video, the use of low echo reduction, which is a novel endoscopic ultrasound function provided by a new endoscopic ultrasound processor that increases contrast without white-out. Low echo reduction might be useful in improving lesion boundaries and needle visibility during endoscopic ultrasound-guided tissue acquisition.

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Background/objectives: The detection of malignancy is a major concern in the management of intraductal papillary mucinous neoplasm (IPMN). The height of the mural nodule (MN), estimated using endoscopic ultrasound (EUS) and computed tomography (CT), has been considered crucial for predicting malignant IPMN. Currently, whether surveillance using CT or EUS alone is sufficient for detecting MNs remains unclear.

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Background And Aims: Acute cholecystitis is occasionally observed after biliary drainage using a covered self-expandable metal stent (CSEMS) for distal biliary obstruction (DBO). Gallbladder drainage before CSEMS placement may reduce cholecystitis. This study aimed to examine the preventive effect of endoscopic gallbladder stent placement (EGBS) on cholecystitis with CSEMSs.

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