Publications by authors named "Toshitaka Fukui"
Background/aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding.
View Article and Find Full Text PDFBackground/aims: Hepatobiliary scintigraphy (HBS) is used to evaluate bile excretion. This study aimed to evaluate biliary excretion during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using HBS.
Methods: We retrospectively evaluated 78 consecutive patients with malignant extrahepatic biliary obstruction, who underwent HBS after EUS-HGS between April 2015 and July 2022.
Article Synopsis
- Perforated esophageal cancer can lead to rare complications like mediastinal abscesses, which are difficult to treat.
- A 71-year-old man with this condition underwent endoscopic ultrasound-guided abscess drainage (EUS-AD) to manage the abscess before surgery, as traditional treatment was ineffective.
- After successfully draining the abscess and improving his condition, the patient received curative surgery followed by chemotherapy, remaining free of cancer recurrence two years later.
Article Synopsis
- EUS-guided pancreaticojejunostomy (EUS-PJS) is an effective procedure for treating strictures after Whipple surgery, showing a 100% technical success rate among 10 patients studied.
- The study, conducted at Aichi Cancer Center Hospital, found that while there were some minor adverse events like fever, overall safety was high with no serious complications.
- With a median follow-up of 9.5 months, some patients achieved a stent-free state, suggesting EUS-PJS may reduce the need for further interventions and create a permanent drainage solution.
Background/aims: Dilation of the tract before stent deployment is a challenging step in endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD). In this study, we examined the effectiveness and safety of a novel spiral dilator, Tornus ES (Asahi Intec), for EUS-PDD.
Methods: This was a retrospective, single-arm, observational study at Aichi Cancer Center Hospital.
Background/aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) performed at the intrahepatic bile duct segment 3 (B3) is widely used for biliary drainage. Although performing post-puncture procedures is easier in the intrahepatic bile duct segment 2 (B2) when using a conventional oblique-viewing (OV) EUS scope, this method may cause transesophageal puncture and severe adverse events. We evaluated the safety and efficacy of B2 puncture using a novel OV-EUS scope.
View Article and Find Full Text PDFObjective Adverse events such as bile leakage and bleeding are among the issues that need to be resolved in EUS-guided choledochoduodenostomy (EUS-CDS). To overcome this problem, we developed a new EUS-CDS technique using a 19-G Franseen needle without tract dilation. This study aimed to evaluate the safety and efficacy of the new EUS-CDS technique.
View Article and Find Full Text PDFBackground/aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a highly accurate method for diagnosing pancreatic neuroendocrine tumors (PNETs); however, some PNETs are difficult to diagnose. Recently, the efficacy of needle-based confocal laser endomicroscopy (nCLE) in diagnosing solid pancreatic masses has been reported. However, the efficacy of nCLE in the diagnosis of PNETs remains unknown and only a small number of cases have been reported.
View Article and Find Full Text PDFBackground/aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) is useful for patients with biliary cannulation failure or inaccessible papillae. However, it can lead to serious complications such as bile peritonitis in patients with ascites; therefore, development of a safe method to perform EUS-HGS is important. Herein, we evaluated the safety of EUS-HGS with continuous ascitic fluid drainage in patients with ascites.
View Article and Find Full Text PDFPancreatic and biliary diseases encompass a range of conditions requiring accurate diagnosis for appropriate treatment strategies. This diagnosis relies heavily on imaging techniques like endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography. Artificial intelligence (AI), including machine learning and deep learning, is becoming integral in medical imaging and diagnostics, such as the detection of colorectal polyps.
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- EUS-FNA/FNB is a procedure evaluated for its effectiveness in diagnosing gallbladder lesions, with this study analyzing a large cohort to establish its accuracy and safety.
- Out of 187 patients, the procedure showed a high diagnostic accuracy of 97% and had a sampling adequacy of 98%, with only one minor complication reported.
- The study concluded that EUS-FNA/FNB is a reliable method for identifying gallbladder lesions, and targeting liver invasion sites could enhance diagnostic accuracy.
Article Synopsis
- The study assessed the safety and effectiveness of using aggressive hydration and rectal non-steroidal anti-inflammatory drugs to prevent pancreatitis after an ERCP procedure.
- Conducted at 12 medical centers with 231 patients, the trial found that only 5.6% developed post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) after treatment.
- Results indicate that this combined approach is a safe and effective preventive strategy, including for elderly patients.
Tract dilation is one of the most difficult stages of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), especially for beginners. To overcome this problem, we applied a special dedicated dilator. Herein, we retrospectively evaluate the safety and usefulness of a novel drill dilator in EUS-HGS.
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