研究者詳細 - 堤　康一郎

論文 - 堤　康一郎

分割表示 142 件中 101 - 120 件目／全件表示 >>

Prognostic value of altered N-glycosylation of circulating glycoproteins in patients with unresectable pancreatic cancer treated with gemcitabine. 査読国際誌

Koji Miyahara, Kazuhiro Nouso, Yuki Morimoto, Hideaki Kinugasa, Hironari Kato, Naoki Yamamoto, Koichiro Tsutsumi, Kenji Kuwaki, Hideki Onishi, Fusao Ikeda, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Taku Nakahara, Yoshiaki Miura, Hidehisa Asada, Maho Amano, Shin-Ichiro Nishimura, Kazuhide Yamamoto

Pancreas 44 ( 4 ) 551 - 6 2015年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: The objectives of this study were to examine the whole-serum N-glycan profile of patients with unresectable pancreatic cancer and to evaluate the ability of glycans to predict gemcitabine treatment efficacy and patient survival. METHODS: We collected serum from 52 patients with advanced pancreatic cancer before they began gemcitabine monotherapy. The serum glycan profile was measured through comprehensive quantitative high-throughput glycome analysis and compared with the treatment efficacy and patient survival. RESULTS: Of the 61 glycans detected, the serum levels of glycan 4310 (molecular weight [m/z] 1549.566), 6301 (m/z 2032.724), and 9200 (m/z 2010.692) were high in patients with a short time to tumor progression (TTP). Multivariate analysis revealed that a high glycan 9200 concentration was an independent risk factor for shorter TTP (hazard ratio, 2.11; 95% confidence interval, 1.07-4.17) and poor overall survival (hazard ratio, 2.56; 95% confidence interval, 1.08-6.19). The median TTP of patients with up-regulation of 9200 after gemcitabine treatment was shorter than for the remaining patients (91 vs 301 days; P = 0.0005). A similar relationship was observed for overall survival (median, 181 vs 561 days; P = 0.001). CONCLUSIONS: Glycan 9200 is a possible biomarker predicting gemcitabine efficacy survival in patients with unresectable pancreatic cancer.

DOI： 10.1097/MPA.0000000000000321

PubMed

researchmap

Serum N-glycan profiles in patients with intraductal papillary mucinous neoplasms of the pancreas. 査読

Yutaka Akimoto, Kazuhiro Nouso, Hironari Kato, Koji Miyahara, Chihiro Dohi, Yuki Morimoto, Hideaki Kinugasa, Takeshi Tomoda, Naoki Yamamoto, Koichiro Tsutsumi, Kenji Kuwaki, Hideki Onishi, Fusao Ikeda, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada, Maho Amano, Shin-Ichiro Nishimura, Kazuhide Yamamoto

Pancreatology 15 ( 4 ) 432 - 438 2015年4月

Double-balloon enteroscopy for choledochojejunal anastomotic stenosis after hepato-biliary-pancreatic operation. 査読国際誌

Ichiro Sakakihara, Hironari Kato, Shinichiro Muro, Yasuhiro Noma, Naoki Yamamoto, Ryo Harada, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada, Kazuhide Yamamoto, Hiroshi Sadamori, Takahito Yagi

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 27 ( 1 ) 146 - 54 2015年1月

記述言語：英語

BACKGROUND AND AIM: There have been few reports on the success rate of balloon dilation and stent deployment using endoscopic retrograde cholangiopancreatography by double-balloon enteroscopy (DBE-ERCP) or on the follow-up period after stent removal in patients with a reconstructed digestive tract and stenosis of choledochojejunal anastomosis. The present study was designed to evaluate the usefulness of DBE-ERCP in patients with a reconstructed digestive tract and stenosis of choledochojejunal anastomosis. METHODS: Forty-four patients with stenosis of choledochojejunal anastomosis underwent DBE-ERCP at Okayama University Hospital between April 2008 and January 2012 (107 procedures). Rates of reaching choledochojejunal anastomosis, stent deployment, and restenosis after stent removal were retrospectively evaluated. RESULTS: Insertion of DBE into the choledochojejunal anastomotic site succeeded in 38 of 44 patients (86.4%), and anastomotic dilation and stent deployment succeeded in 36 of 44 patients (81.8%). In 32 of 44 patients (72.7%), their anastomotic stenoses were improved, and they achieved stent removal. After stent removal, restenosis of choledochojejunal anastomosis was detected in seven of 32 patients; however, the resolution of restenosis was achieved in all seven of those patients. CONCLUSION: Dilation of choledochojejunal anastomosis combined with stent deployment using DBE-ERCP seems to be a viable first-line treatment for patients with stenosis of choledochojejunal anastomosis.

DOI： 10.1111/den.12332

PubMed

researchmap

Successful biliary drainage with peroral direct cholangioscopy in a patient with Roux-en-Y hepaticojejunostomy for congenital biliary dilatation. 査読国際誌

Kazuyuki Matsumoto, Koichiro Tsutsumi, Yuki Baba, Koji Takemoto, Hirofumi Tsugeno, Shigeatsu Fujiki, Hiroyuki Okada

Endoscopy 47 Suppl 1 UCTN E497-8 2015年

Serum anti-60S ribosomal protein L29 antibody as a novel prognostic marker for unresectable pancreatic cancer. 査読国際誌

Shinichiro Muro, Yasuhiro Miyake, Hironari Kato, Koichiro Tsutsumi, Kazuhide Yamamoto

Digestion 91 ( 2 ) 164 - 73 2015年

記述言語：英語

BACKGROUND/AIMS: Recently, we found the presence of anti-60S ribosomal protein L29 antibody (anti-RPL29) in human sera, inhibiting the proliferation of pancreatic cancer cells in vitro. We aimed to estimate the association of serum anti- RPL29 levels with clinical features in patients affected with unresectable pancreatic cancer. METHODS: We retrospectively reviewed 105 patients with unresectable pancreatic cancer. Serum anti-RPL29 levels were measured by the indirect enzyme-linked immunosorbent assay. The cut-off was represented by the 95th percentile in 62 healthy volunteers. RESULTS: Median survival time (MST) was 11.1 months in 49 patients showing serum anti-RPL29 level >cut-off and 7.4 months in 56 patients showing serum anti-RPL29 level ≤ cutoff. In locally advanced disease, MST was 17.9 months in 22 patients showing serum anti-RPL29 level >cut-off and 10.0 months in 19 patients showing serum anti-RPL29 level ≤ cutoff. In metastatic disease, MST was 8.7 months in 27 patients showing serum anti-RPL29 level >cut-off and 5.9 months in 37 patients showing serum anti-RPL29 level ≤ cut-off. In the multivariate Cox proportional hazard model, serum anti- RPL29 level >cut-off, abdominal or back pain, performance status, and metastatic disease were identified as independent prognostic factors. CONCLUSION: Serum anti-RPL29 levels may be a novel candidate for a prognostic marker for unresectable pancreatic cancer.

PubMed

researchmap

An expanded training program for endosonographers improved self-diagnosed accuracy of endoscopic ultrasound-guided fine-needle aspiration cytology of the pancreas. 査読国際誌

Ryo Harada, Hironari Kato, Soichiro Fushimi, Masaya Iwamuro, Hirofumi Inoue, Shinichiro Muro, Ichiro Sakakihara, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada, Kazuhide Yamamoto

Scandinavian journal of gastroenterology 49 ( 9 ) 1119 - 23 2014年9月

記述言語：英語

OBJECTIVE: Rapid on-site evaluation (ROSE) of cytologic adequacy improves the diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). However, on-site advice from a cytotechnologist or cytopathologist is not always available during EUS-FNA. To enhance endosonographers' ability to assess the adequacy of EUS-FNA specimens, we designed an intensive, 2-h interactive training program. The aim of this study was to determine the usefulness of the program. METHODS: Four cytological pictures were selected by a trained cytotechnologist and board-certified cytopathologist from each of the seven patients who underwent EUS-FNA for pancreatic mass in Okayama University Hospital. In total, 28 pictures were used in this study. Twenty endosonographers and 14 cytologists with different levels of EUS-FNA experience evaluated cytological pictures independently before and after the training program. RESULTS: Endosonographers' skill in evaluating the adequacy of EUS-FNA specimens was significantly improved after the completion of the training program (p < 0.001). In contrast, almost all cytologists correctly judged the adequacy of the specimens before taking the training program. CONCLUSIONS: This intensive, 2-h interactive training program is useful for endosonographers and capable of improving ROSE of EUS-FNA specimens.

DOI： 10.3109/00365521.2014.915051

PubMed

researchmap

The efficacy and safety of single-session endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for evaluation of pancreatic masses. 査読国際誌

Yasuhiro Noma, Hirofumi Kawamoto, Hironari Kato, Masaya Iwamuro, Ken Hirao, Masakuni Fujii, Koichiro Tsutsumi, Shigeru Horiguchi, Naoki Yamamoto, Ichiro Sakakihara, Takeshi Tomoda, Kazuyuki Matsumoto, Hiroyuki Okada, Kazuhide Yamamoto

Hepato-gastroenterology 61 ( 134 ) 1775 - 9 2014年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: There have been limited studies evaluating single-session EUS-FNA and ERCP for evaluation of pancreatic masses. The aim of this study was to determine the safety of single-session EUS-FNA and ERCP, and to compare the diagnostic accuracies of cytodiagnosis by EUS-FNA, ERCP, and their combination. METHODOLOGY: A total of 100 patients with pancreatic masses were prospectively enrolled. All patients underwent single-session EUS-FNA and ERCP. The main outcome measurement was frequency of post-procedural complications. Another measurement was diagnostic accuracy of cytodiagnosis by EUS-FNA, ERCP, and their combination. RESULTS: Procedure-related pancreatitis occurred in 10 patients, but all patients were conservatively managed. Cytodiagnosis by EUS-FNA was significantly superior to ERCP in accuracy. In patients with a pancreatic head mass, 3 cases of false negative EUS-FNA were positive on ERCP. The combination procedures improved accuracy compared with EUS-FNA alone. By contrast, in the subgroup of the pancreatic body or tail mass, the combination of EUS-FNA and ERCP did not improve cytodiagnosis compared to that with EUS-FNA alone. CONCLUSIONS: Single-session EUS-FNA and ERCP appears to be as safe as performing each procedure separately. EUS-FNA should be considered the principal procedure for cytodiagnosis. ERCP has only a complementary role in patients with pancreatic head mass.

PubMed

researchmap

Short double-balloon enteroscopy is feasible and effective for endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy. 査読国際誌

Hironari Kato, Koichiro Tsutsumi, Ryo Harada, Hiroyuki Okada, Kazuhide Yamamoto

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 26 Suppl 2 130 - 5 2014年4月

記述言語：英語

Endoscopic retrograde cholangiopancreatography (ERCP) for patients with digestive tract reconstruction is a difficult procedure from an anatomical point of view. A short-type double-balloon enteroscope has a 2.8-mm working channel and a 152-cm working length, and its advantage is that it can accommodate most conventional devices for ERCP. Although the shorter length compared with the long-type balloon-assisted enteroscope (BAE) was suspected of making it difficult or impossible to reach the blind end, in fact, the success rate of reaching the blind end with the short type is similar to that with the long- type BAE. In addition, the success rate of ERCP-related procedures with the short type is satisfactory. However, it remains controversial as to which BAE is more suitable for this procedure. Further randomized controlled trials by high-volume centers are warranted.

DOI： 10.1111/den.12251

PubMed

researchmap

Transplanted liver graft ischemia caused by pediatric ERCP in the prone position. 査読国際誌

Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada, Takahito Yagi, Kazuhide Yamamoto

Endoscopy 46 Suppl 1 UCTN E594-5 2014年

Usefulness of the rendezvous technique for deep scope insertion during endoscopic retrograde cholangiography in a patient with a Roux-en-Y hepaticojejunostomy. 査読国際誌

Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada, Kazuhide Yamamoto

Endoscopy 46 Suppl 1 UCTN E619-20 2014年

A novel technique for partial stent-in-stent placement of three metal biliary stents using a short double-balloon enteroscope. 査読国際誌

Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada, Kazuhide Yamamoto

Endoscopy 46 Suppl 1 UCTN E417-8 2014年

[Two cases of lymphoepithelial cyst of the pancreas confirmed by contrast-enhanced endoscopic ultrasound]. 査読

Kazuyuki Matsumoto, Hironari Kato, Takeshi Tomoda, Ichiro Sakakihara, Yasuhiro Noma, Naoki Yamamoto, Takayuki Sonoyama, Koichiro Tsutsumi, Hiroshi Sadamori, Hiroyuki Okada, Takahito Yagi, Kazuhide Yamamoto

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 110 ( 10 ) 1823 - 30 2013年10月

記述言語：日本語掲載種別：研究論文（学術雑誌）

We report our experience with two cases of lymphoepithelial cysts (LECs) of the pancreas. Both patients were in their sixties. Contrast-enhanced computed tomography revealed masses in the pancreas with multilocular cystic lesions. Endoscopic ultrasound (EUS) findings presented highly echo-dense structures in the cystic masses; however, contrast-enhanced EUS revealed only the septum inside each mass without enhancing the dense structures. Contrast-enhanced EUS was useful for defining the contents in the cystic lesions; therefore, it may be useful for the diagnosis of LEC.

PubMed

researchmap

Clinical utility of high-throughput glycome analysis in patients with pancreatic cancer. 査読

Kazuhiro Nouso, Maho Amano, Yoichi M Ito, Koji Miyahara, Yuki Morimoto, Hironari Kato, Koichiro Tsutsumi, Takeshi Tomoda, Naoki Yamamoto, Shinichiro Nakamura, Sayo Kobayashi, Kenji Kuwaki, Hiroaki Hagihara, Hideki Onishi, Yasuhiro Miyake, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Taku Nakahara, Shin-Ichiro Nishimura, Kazuhide Yamamoto

Journal of gastroenterology 48 ( 10 ) 1171 - 9 2013年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Most of the glycan changes reported in cancers were based on the examinations of a small number of patients or particular proteins. The aim of this study was to determine the changes of the serum N-glycan profile comprehensively in a large number of pancreatic cancer patients and investigate its clinical utility. METHODS: Glycan levels in the serum of 92 pancreatic cancer patients and 243 healthy volunteers (HLT) were examined by comprehensive quantitative high-throughput glycome analysis and were compared with clinical parameters. RESULTS: Out of 66 glycans detected, 15 were differentially expressed in pancreatic cancer, and 10 out of the 15 glycans were significantly up-regulated in cases with distant metastasis. There was a clear increase in overall expression of serum glycans, especially highly-branched glycans with fucose moieties, in pancreatic cancer. Among these 15 glycans, a tri-antennary complex type glycan (m/z 3195) showed the highest area under the receiver operating characteristic curve (AUROC = 0.799) for the diagnosis of pancreatic cancer. The ratio of pairs of glycans on the same path of the biosynthesis pathway (m/z 3195/1914) was found to be significantly higher in pancreatic cancer than in HLT (median = 1.11 and 0.41, respectively; p < 0.0001, AUROC = 0.831). For this pair ratio, the hazard ratio for survival (2.60, 95 % CI = 1.44-4.79) was higher than that of any single glycan and 1-year survival of patients with a high and low ratio was 36.9 and 69.2 %, respectively, (p = 0.001). CONCLUSIONS: Comprehensive glycome analysis can be used to know the presence of pancreatic cancer, distant metastasis, and patient prognosis, simultaneously.

DOI： 10.1007/s00535-012-0732-7

PubMed

researchmap

Dilation of a severe bilioenteric or pancreatoenteric anastomotic stricture using a Soehendra Stent Retriever. 査読国際誌

Koichiro Tsutsumi, Hironari Kato, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Ryo Harada, Hiroyuki Okada, Kazuhide Yamamoto

World journal of gastrointestinal endoscopy 5 ( 8 ) 412 - 6 2013年8月

記述言語：英語

Bilioenteric or pancreatoenteric anastomotic strictures often occur after surgery for a pancreaticobiliary disorder. Therapeutic endoscopic retrograde cholangiopancreatography using balloon enteroscopy has been shown to be feasible and effective in patients with such strictures. However, when a benign anastomotic stricture is severe, a dilation catheter cannot pass through the stricture despite successful insertion of the guidewire. We report on the usefulness of the Soehendra Stent Retriever over a guidewire for dilating a severe bilioenteric or pancreatoenteric anastomotic stricture under short double-balloon enteroscopy, in two patients with surgically altered anatomies.

DOI： 10.4253/wjge.v5.i8.412

PubMed

researchmap

Management of occluded metallic stents in malignant hilar biliary stricture. 査読国際誌

Masakuni Fujii, Hirofumi Kawamoto, Koichiro Tsutsumi, Hironari Kato, Ken Hirao, Naoko Kurihara, Osamu Mizuno, Etsuji Ishida, Tsuneyoshi Ogawa, Hirotoshi Fukatsu, Kazuhide Yamamoto

Hepato-gastroenterology 60 ( 123 ) 447 - 51 2013年5月

記述言語：英語

BACKGROUND/AIMS: Little is known about the management of occluded multiple metallic stent (MS) deployed in malignant hilar biliary strictures (HBS). The purpose of this study was to evaluate the endoscopic management of occluded multiple MSs deployed in HBS. METHODOLOGY: Fifty-five patients with unresectable biliary tract carcinoma had multiple MSs inserted due to HBS. The endoscopic intervention through the duodenal papilla was performed on 30 cases that had MS occlusion. The procedure success rate, the survival time after the procedure and the number of endoscopic interventions before death were analyzed, retrospectively. RESULTS: The causes of MS obstruction were tissue ingrowth (n=20), sludge (n=7), tumor overgrowth (n=2), and hemobilia (n=1). Endoscopic cleaning or deployment of plastic stents or metallic stents was performed on these patients and was successfully accomplished only via the transpapillary approach. The survival time after MS obstruction was 219 days. The median number of endoscopic interventions before death was 3. The median interval of endoscopic intervention after the first plastic stent occlusion was 84 days. CONCLUSIONS: Our long-term data regarding the endoscopic management of occluded MSs deployed in malignant hilar biliary strictures are acceptable although the patency time of plastic stents deployed after MS occlusion was relatively short.

PubMed

researchmap

Endoscopic bilateral deployment of multiple metallic stents for malignant hilar biliary strictures. 査読国際誌

Hironari Kato, Koichiro Tsutsumi, Ryo Harada, Hiroyuki Okada, Kazuhide Yamamoto

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 25 Suppl 2 75 - 80 2013年5月

記述言語：英語

Jaundice and cholangitis are associated with morbidity and mortality for patients with malignant hilar biliary strictures. Endoscopic biliary drainage is considered a useful procedure for palliation of unresectable malignant hilar biliary strictures. However, even today, the devices and methods to effectively achieve the drainage of these strictures are under debate. Endoscopic bilateral deployment of multiple metallic stents for malignant hilar biliary strictures is a feasible and useful procedure, providing long-term patency and the preservation of functional liver volume. We report the cases of two patients who underwent endoscopic bilateral deployment of multiple metallic stents using the partial stent-in-stent method. Both of the patients had malignant hilar biliary stricture due to biliary tract cancer. The cancers were unresectable and the patients decided to receive chemotherapy. Before the chemotherapy, bilateral deployment of metallic stents was carried out and each patient has been receiving chemotherapy without occlusion of the metallic stents for several months.

DOI： 10.1111/den.12061

PubMed

researchmap

Dilatation by Soehendra Stent Retriever is Feasible and Effective in Multiple Deployment of Metallic Stents to Malignant Hilar Biliary Strictures 査読

Hironari Kato, Hirofumi Kawamoto, Yasuhiro Noma, Takayuki Sonoyama, Koichiro Tsutsumi, Masakuni Fujii, Hiroyuki Okada, Kazuhide Yamamoto

HEPATO-GASTROENTEROLOGY 60 ( 122 ) 286 - 290 2013年3月

A case of acute afferent loop syndrome treated by transgastric drainage with EUS. 査読国際誌

Kazuyuki Matsumoto, Hironari Kato, Takeshi Tomoda, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Takayuki Sonoyama, Koichiro Tsutsumi, Hiroyuki Okada, Kazuhide Yamamoto, Hirofumi Kawamoto

Gastrointestinal endoscopy 77 ( 1 ) 132 - 3 2013年1月

Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy. 査読国際誌

Koichiro Tsutsumi, Hironari Kato, Takeshi Tomoda, Kazuyuki Matsumoto, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Takayuki Sonoyama, Hiroyuki Okada, Kazuhide Yamamoto

World journal of gastroenterology 18 ( 45 ) 6674 - 6 2012年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Endoscopic intervention is less invasive than percutaneous or surgical approaches and should be considered the primary drainage procedure in most cases with obstructive jaundice. Recently, therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using double-balloon enteroscopy (DBE) has been shown to be feasible and effective, even in patients with surgically altered anatomies. On the other hand, endoscopic partial stent-in-stent (PSIS) placement of self-expandable metallic stents (SEMSs) for malignant hilar biliary obstruction in conventional ERCP has also been shown to be feasible, safe and effective. We performed PSIS placement of SEMSs for malignant hilar biliary obstruction due to liver metastasis using a short DBE in a patient with Roux-en-Y anastomosis and achieved technical and clinical success. This procedure can result in quick relief from obstructive jaundice in a single session and with short-term hospitalization, even in patients with surgically altered anatomies.

DOI： 10.3748/wjg.v18.i45.6674

PubMed

researchmap

Diagnostic usefulness of precise examinations with intraductal ultrasonography, peroral cholangioscopy and laparoscopy of immunoglobulin G4-related sclerosing cholangitis. 査読国際誌

Shigeru Horiguchi, Fusao Ikeda, Hidenori Shiraha, Naoki Yamamoto, Ichiro Sakakihara, Yasuhiro Noma, Koichiro Tsutsumi, Hironari Kato, Hiroaki Hagihara, Tetsuya Yasunaka, Shinichiro Nakamura, Haruhiko Kobashi, Hirofumi Kawamoto, Kazuhide Yamamoto

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 24 ( 5 ) 370 - 3 2012年9月

記述言語：英語

Herein, a case of immunoglobulin G4 (IgG4)-related sclerosing cholangitis is reported. IgG4 was diagnosed based on observations from peroral cholangioscopy and laparoscopy, and these methods are proposed for definitive and precise diagnosis of this disease. A 76-year-old male patient with inguinal Paget's disease had intrahepatic bile duct dilatations detected with computed tomography at his periodic check-up. Magnetic resonance cholangiography showed stenosis of the upper common bile duct and poststenotic dilatation of left intrahepatic bile ducts. The portal tract and bilateral intrahepatic bile ducts were surrounded by a low-density area, facing a tumor-like lesion at segment 2. Cytological examinations of the stenotic and dilated lesions revealed no cellular atypia. Histological examination of the tumor showed normal liver tissue with infiltration of lymphocytes, indicating an inflammatory pseudotumor. Peroral cholangioscopy excluded the possibility of biliary cancer and indicated that the stenotic legion was of submucosal, not mucosal, origin. Laparoscopic observations showed discoloration with wide yellowish-white lobular markings and wide depressed lesions at segments 2 and 7. Liver histology showed mild cholangitis with infiltration of IgG4-positive plasma cells around the bile ducts. Serum IgG4 levels were elevated. From these findings, the patient was diagnosed with IgG4-related sclerosing cholangitis. After treatment with prednisolone, blood liver enzymes and IgG4 rapidly normalized, bile duct dilatations improved, and the hepatic pseudotumor disappeared. The cholangitis did not recur. In this case, biliary cancer was ruled out by observation with peroral cholangioscopy, and the spread of cholangitis in the liver periphery was verified with laparoscopy; this information could not be obtained with other modalities.

DOI： 10.1111/j.1443-1661.2012.01300.x

PubMed

researchmap

　前のページ - 次のページ　

<堤 康一郎>

論文 - 堤 康一郎

<堤　康一郎>

論文 - 堤　康一郎