論文 - 堤　康一郎

A case of celiac artery dissection diagnosed with EUS. 査読 国際誌

Daisuke Uchida, Kazuhiro Nouso, Hironari Kato, Koichiro Tsutsumi, Kazuhide Yamamoto

Gastrointestinal endoscopy   76 ( 2 )   424 - 5   2012年8月

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記述言語：英語  

DOI： 10.1016/j.gie.2012.03.1398

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Vascular patterns in nodules of intraductal papillary mucinous neoplasms depicted under contrast-enhanced ultrasonography are helpful for evaluating malignant potential. 査読 国際誌

Naoko Kurihara, Hirofumi Kawamoto, Yoshiyuki Kobayashi, Yuko Okamoto, Naoki Yamamoto, Koichiro Tsutsumi, Masakuni Fujii, Hironari Kato, Kazuhide Yamamoto

European journal of radiology   81 ( 1 )   66 - 70   2012年1月

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記述言語：英語  

OBJECTIVES: The purpose of this study is to evaluate the feasibility of contrast-enhanced ultrasonography (CE-US) to differentiate between benign and malignant intraductal papillary mucinous neoplasms (IPMN). PATIENTS AND METHODS: Contrast-enhanced ultrasonography with a contrast agent was performed on 22 consecutive patients with IPMN suspected of being malignant. This revealed 10 carcinomas, 1 borderline lesion and 11 adenomas. All patients underwent surgery, and the histological diagnosis was confirmed by examination of resected specimens. CE-US was performed using a contrast agent. The detection rates of mural nodules were compared between CE-US and contrast-enhanced computed tomography (CE-CT), and the imaging of mural nodules depicted under CE-US was analyzed. RESULTS: Seventeen of 22 resected specimens (77.3%) had mural nodules. There was no significant difference in the detection rate between CE-US (n=15; 88.2%) and CE-CT (n=12; 70.6%). In 12 (80.0%) of these patients, CE-US revealed small vessels in the mural nodule. The spotty or linear-shaped pattern was detected in 4 patients and the branch-shaped pattern in 8. The branch-shaped pattern lesion was associated with carcinoma. These mural nodules were 10mm or more in height. In the perfusion image phase, cystic walls and mural nodules were also enhanced in all cases. CONCLUSION: The vessel shapes of the mural nodules depicted under CE-US were associated with size and pathological findings. These results suggested that CE-US with a contrast agent is a powerful modality with which to evaluate the malignant potential of IPMN.

DOI： 10.1016/j.ejrad.2010.11.027

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Monitoring of CA19-9 and SPan-1 can facilitate the earlier confirmation of progressing pancreatic cancer during chemotherapy 査読

Koichiro Tsutsumi, Hirofumi Kawamoto, Ken Hirao, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Masakuni Fujii, Hironari Kato, Tsuneyoshi Ogawa, Etsuji Ishida, Kenji Kuwaki, Kazuhiro Nouso, Hiroyuki Okada, Kazuhide Yamamoto

Pancreatology   12 ( 5 )   409 - 416   2012年

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier B.V.  

DOI： 10.1016/j.pan.2012.07.009

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A 4-week versus a 3-week schedule of gemcitabine monotherapy for advanced pancreatic cancer: a randomized phase II study to evaluate toxicity and dose intensity. 査読

Ken Hirao, Hirofumi Kawamoto, Ichiro Sakakihara, Yasuhiro Noma, Naoki Yamamoto, Ryo Harada, Koichiro Tsutsumi, Masakuni Fujii, Hironari Kato, Naoko Kurihara, Osamu Mizuno, Tsuneyoshi Ogawa, Etsuji Ishida, Kazuhide Yamamoto

International journal of clinical oncology   16 ( 6 )   637 - 45   2011年12月

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記述言語：英語  

BACKGROUND: This randomized phase II study compared the efficacy and toxicity between 4-week and 3-week schedules of gemcitabine monotherapy in advanced pancreatic cancer. METHODS: Patients with advanced pancreatic cancer were randomly assigned to either a 4-week schedule (gemcitabine at 1000 mg/m² as a 30-min infusion weekly for 3 consecutive weeks every 4 weeks) or a 3-week schedule (gemcitabine at 1000 mg/m² as a 30-min infusion weekly for 2 consecutive weeks every 3 weeks). The primary endpoint was the compliance rate during the first 8 weeks between the two groups. RESULTS: A total of 90 patients were enrolled. The compliance rate during the first 8 weeks was the same (53.3%). For the 4- and 3-week schedules, the tumor response rates were 14.2 and 17.1% (p = 0.92), median progression free survival was 112 and 114 days (p = 0.82), and median overall survival was 206 and 250 days (p = 0.84), respectively. Grade 3-4 neutropenia was the major adverse event in both schedules: 37.7 and 35.5% (p = 0.82). In contrast, thrombocytopenia (platelet count <70000/mm³) was significantly higher for the 4-week schedule: 26.6 and 4.4% (p = 0.008). The mean received dose intensity was equal: 588 and 550 mg/m²/week (p = 0.14). CONCLUSIONS: The 3-week schedule of gemcitabine did not improve the compliance rate during 8 weeks compared with the 4-week schedule, but it attained a comparable efficacy with lower toxicity. Further investigation will be needed to introduce it into daily practice. CLINICAL TRIAL REGISTRATION NUMBER: UMIN ID 974.

DOI： 10.1007/s10147-011-0237-z

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A case of gastric aberrant pancreas diagnosed with EUS-guided FNA. 査読 国際誌

Masakuni Fujii, Hirofumi Kawamoto, Teruya Nagahara, Koichiro Tsutsumi, Hironari Kato, Susumu Shinoura, Satoshi Seno, Hiroyuki Okada, Kazuhide Yamamoto

Gastrointestinal endoscopy   74 ( 2 )   407 - 9   2011年8月

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記述言語：英語  

DOI： 10.1016/j.gie.2011.03.1124

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Single-pattern convergence of K-ras mutation correlates with surgical indication of intraductal papillary mucinous neoplasms. 査読 国際誌

Osamu Mizuno, Hirofumi Kawamoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Masakuni Fujii, Hironari Kato, Ken Hirao, Naoko Kurihara, Etsuji Ishida, Tsuneyoshi Ogawa, Hiroyuki Okada, Kazuhide Yamamoto

Pancreas   39 ( 5 )   617 - 21   2010年7月

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記述言語：英語  

OBJECTIVES: One or more patterns of 6 K-ras mutations are detected in cells from the pancreatic juice of patients with intraductal papillary mucinous neoplasms (IPMNs). We investigated whether these mutations are associated with malignant progression. METHODS: Between January 2002 and December 2007, 53 patients with IPMN were subjected to collection of pure pancreatic juice to evaluate K-ras mutation. According to the histological and radiological findings, the IPMNs were classified into 4 groups: carcinoma group, adenoma group, high-risk group, and low-risk group. We retrospectively investigated the mutation with these groups. RESULTS: In patients with a positive K-ras mutation, a single pattern of K-ras mutation was observed in 80% (8/10) of the carcinoma group, in 71% (5/7) of the adenoma group, in 40% (2/5) of the high-risk group, and in 38% (8/21) of the low-risk group. The rate of a single pattern of K-ras mutation decreased in a stepwise order (P = 0.017). The incidence of a single pattern of K-ras mutation was significantly higher in the patients who received surgical therapy (75%, 12/16) than in those who did not (38%, 10/26; P = 0.033). CONCLUSIONS: The present study suggests that the single-clonal convergence of K-ras mutation is associated with the malignant progression of IPMNs.

DOI： 10.1097/MPA.0b013e3181c75d9b

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Prevention of biliary complication in radiofrequency ablation for hepatocellular carcinoma-Cooling effect by endoscopic nasobiliary drainage tube. 査読 国際誌

Tsuneyoshi Ogawa, Hirofumi Kawamoto, Yoshiyuki Kobayashi, Shinichiro Nakamura, Hirokazu Miyatake, Ryo Harada, Koichiro Tsutsumi, Masakuni Fujii, Naoko Kurihara, Hironari Kato, Ken Hirao, Osamu Mizuno, Etsuji Ishida, Hiroyuki Okada, Kazuhide Yamamoto

European journal of radiology   73 ( 2 )   385 - 90   2010年2月

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記述言語：英語  

BACKGROUND AND STUDY AIMS: Biliary stricture after radiofrequency ablation (RFA) for nodules of hepatocellular carcinoma (HCC) close to major bile ducts sometimes causes septic complications and liver failure. Therefore, it may require interventional drainage for decompression during the follow-up period. The purpose of this study is to clarify the feasibility and safety of bile duct cooling using an endoscopic nasobiliary drainage (ENBD) tube in RFA for HCC close to major bile ducts. PATIENTS AND METHODS: Between August 2003 and July 2007, 14 consecutive patients (14 nodules) undergoing RFA with cooling by an ENBD tube for HCCs close to major bile ducts were enrolled in this study. We infused chilled saline solution via the ENBD tube at 1ml/s to prevent heat damage during RFA. As controls, 11 patients (13 nodules) undergoing RFA without cooling close to major bile ducts between April 2001 and August 2003 were reviewed. The major outcomes for evaluation were biliary complications and the secondary outcome was local tumor recurrence. RESULTS: There were no significant differences in tumor recurrence between the two groups. However, the rate of biliary complications was significantly lower in the cooling group than in the non-cooling group (0% vs. 39%, P=0.02). CONCLUSIONS: Cooling of bile ducts via an ENBD tube can prevent biliary complications induced by RFA of HCC close to major bile ducts without increasing local recurrence. This technique increases indication of RFA in difficult cases.

DOI： 10.1016/j.ejrad.2008.10.021

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Long-term outcomes of endoscopic management for biliary strictures after living donor liver transplantation with duct-to-duct reconstruction. 査読 国際誌

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

Transplant international : official journal of the European Society for Organ Transplantation   22 ( 9 )   914 - 21   2009年9月

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記述言語：英語  

Biliary strictures after living donor liver transplantation (LDLT) with duct-to-duct (D-D) reconstruction are associated with postoperative morbidity and mortality. The aims of this study were to evaluate the long-term outcomes of endoscopic deployment of plastic stents, and to investigate factors associated with the stent deployment failure. Between April 2001 and May 2007, 96 patients received LDLT with D-D reconstruction at Okayama University Hospital. Among them, 41 patients (43%) had anastomotic biliary strictures, and all were referred first for endoscopic retrograde cholangiography (ERC). When deployment was unsuccessful, a percutaneous transhepatic procedure was employed. Successful stent deployment was achieved in 35 out of total 41 patients (85%) by both procedures. Among the 35 patients, 28 had their stents removed as a result of strictures resolution. Eight patients underwent ERC and repeated stent deployment as a result of recurrence of the strictures. Finally, 21 out of 41 (51%) patients with biliary stricture were completely treated by endoscopic therapy during the observation period (median 873 days: range 77-2060). By multivariate analysis, biliary leakage was associated with stent deployment failure. Endoscopic deployment of plastic stents is a first-line therapy for patients with biliary stricture after LDLT.

DOI： 10.1111/j.1432-2277.2009.00895.x

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Quantitative assessment of technical proficiency in performing needle-knife precut papillotomy. 査読 国際誌

Hirotoshi Fukatsu, Hirofumi Kawamoto, Ryo Harada, Koichiro Tsutsumi, Masakuni Fujii, Hironari Kato, Ken Hirao, Takashi Nakanishi, Osamu Mizuno, Tsuneyoshi Ogawa, Etsuji Ishida, Hiroyuki Okada, Kohsaku Sakaguchi

Surgical endoscopy   23 ( 9 )   2066 - 72   2009年9月

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記述言語：英語  

BACKGROUND: Although needle-knife precut papillotomy (NKPP) is considered a useful alternative for achieving selective biliary cannulation, controversy remains regarding the technical proficiency needed to perform the procedure and its safety. This study evaluated whether procedural experience with NKPP predicted either successful cannulation or the development of complications. METHODS: This study retrospectively investigated 104 patients, out of 589 consecutive patients with native papillary, who underwent NKPP performed by a single endoscopist between October 2002 and July 2006. To demonstrate changes in NKPP, the 104 patients were divided chronologically into two groups according to periods: period A (October 2002 to September 2004) and period B (October 2004 to July 2006). RESULTS: Of the 104 consecutive patients who underwent NKPP, 41 (41/267, 15%) were treated in period A and 63 (63/322, 20%) in period B. There was no significant difference in the overall success rate between periods A (90%) and B (98%) (p = 0.08). However, the initial success rate was higher in period B (95%) than in period A (80%) (p < 0.05). The complication rates were not significantly different between the two groups (10% vs 16%; p = 0.56). Although all complications involved pancreatitis, severe pancreatitis was not observed. CONCLUSION: Whereas the initial success rate for NKPP can increase with procedural experience, the complication rate does not seem to decrease. Furthermore, the need for NKPP does not appear to decrease with increasing endoscopic retrograde cholangiopancreatography (ERCP) experience.

DOI： 10.1007/s00464-008-9969-x

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Cholesterolosis of the common bile duct with anomalous arrangement of the pancreaticobiliary ductal system. 査読 国際誌

Hirotoshi Fukatsu, Hirofumi Kawamoto, Ryo Harada, Masakuni Fujii, Koichiro Tsutsumi, Tsuneyoshi Ogawa, Etsuji Ishida, Hiroyuki Okada, Kohsaku Sakaguchi, Takahito Yagi, Hiroyoshi Matsukawa, Hiroshi Sadamori, Masako Ohmori

Gastrointestinal endoscopy   67 ( 7 )   1172 - 3   2008年6月

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記述言語：英語  

DOI： 10.1016/j.gie.2007.12.031

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Endoscopic deployment of multiple JOSTENT SelfX is effective and safe in treatment of malignant hilar biliary strictures. 査読 国際誌

Hirofumi Kawamoto, Koichiro Tsutsumi, Ryo Harada, Masakuni Fujii, Hironari Kato, Ken Hirao, Naoko Kurihara, Takashi Nakanishi, Osamu Mizuno, Etsuji Ishida, Tsuneyoshi Ogawa, Hirotoshi Fukatsu, Kohsaku Sakaguchi

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association   6 ( 4 )   401 - 8   2008年4月

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記述言語：英語  

BACKGROUND & AIMS: For the treatment of unresectable biliary tract carcinoma with hilar biliary stricture, antitumor therapy and biliary stenting should be addressed in terms of prolonged survival with a good quality of life. However, the endoscopic management of malignant hilar biliary strictures is difficult even for an expert endoscopist. We evaluated the efficacy and safety of the endoscopic deployment of multiple JOSTENT SelfX units in patients with hilar biliary strictures treated with or without chemotherapy. METHODS: Between November 2003 and December 2006, endoscopic deployment of multiple JOSTENT SelfX units in hilar biliary strictures by using a partial stent-in-stent procedure was performed on 41 consecutive patients with primary cholangiocarcinoma (n = 34) and gallbladder carcinoma (n = 7) at a gastroenterologic center of Okayama University Hospital. Thirty-three patients were treated with gemcitabine (n = 25) or S-1 (n = 8). RESULTS: Metallic stent deployment was successfully accomplished in all cases via only endoscopic procedures. During the follow-up period (mean, 210 days), mean patency time was 150 days, and metallic stent obstruction occurred in 15 cases (37%). Although a repeat intervention was required in all metallic stent obstructed cases, the deployment of the second metallic or plastic stent was completed successfully. The remaining 26 cases (63%) required no interventions. The median overall survival period was only 235 days. However, that of the patients receiving chemotherapy was 392 days. CONCLUSIONS: Endoscopic partial stent-in-stent deployment with multiple JOSTENT SelfX prostheses is effective and safe for the treatment of malignant hilar biliary stricture even in patients receiving chemotherapy.

DOI： 10.1016/j.cgh.2007.12.036

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Santorinicele in a patient with unresectable pancreatic cancer. 査読

Hirotoshi Fukatsu, Hirofumi Kawamoto, Koichiro Tsutsumi, Masakuni Fujii, Hironari Kato, Ken Hirao, Naoko Kurihara, Tsuneyoshi Ogawa, Etsuji Ishida, Yuko Okamoto, Hiroyuki Okada, Kohsaku Sakaguchi

Internal medicine (Tokyo, Japan)   47 ( 1 )   33 - 5   2008年

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記述言語：英語  

A santorinicele is defined as a focal cystic dilatation of the terminal portion of the dorsal pancreatic duct at the minor papilla; most cases have been reported in patients with pancreas divisum. It has been suggested that a santorinicele results from a combination of a minor papilla obstruction which prevents the flow of pancreatic juice and a weakness of the duodenal wall where the dorsal pancreatic duct terminates. However, these conditions can occur in patients with invasive ductal cancer in the pancreatic head. We encountered a rare case of a santorinicele with unresectable adenocarcinoma of the pancreatic head in an 81-year-old woman.

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Endoscopic 3-branched partial stent-in-stent deployment of metallic stents in high-grade malignant hilar biliary stricture (with videos). 査読 国際誌

Hirofumi Kawamoto, Koichiro Tsutsumi, Masakuni Fujii, Ryo Harada, Hironari Kato, Ken Hirao, Naoko Kurihara, Takashi Nakanishi, Osamu Mizuno, Etsuji Ishida, Tsuneyoshi Ogawa, Hirotoshi Fukatsu, Kohsaku Sakaguchi

Gastrointestinal endoscopy   66 ( 5 )   1030 - 7   2007年11月

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記述言語：英語  

BACKGROUND: In view of the recent advancement in endoscopic devices for biliary endoscopic intervention, the expert endoscopist can address complex morbidity. However, endoscopic 3-branched partial stent-in-stent deployment of metallic stents (MS) in patients with malignant hilar biliary stricture is technically demanding. OBJECTIVES: To evaluate the efficacy and safety of endoscopic 3-branched partial stent-in-stent deployment of MS. DESIGN: Case study. SETTING: Gastroenterological Center, Okayama University Hospital. PATIENTS: Nine consecutive patients (mean age 63 years, range 52-84 years, mean follow-up period 5 months) with malignant hilar biliary stricture were enrolled. They had cytologically or histologically proven unresectable biliary-tract carcinoma with hilar biliary stricture type IIIa or IV according to Bismuth's classification. INTERVENTIONS: Endoscopic 3-branched partial stent-in-stent deployment of MS in hilar biliary strictures by using a JOSTENT SelfX stent. MAIN OUTCOME MEASUREMENTS: The success rate of the procedure, stent patency time, reinterventions, and complications. RESULTS: Endoscopic 3-branched partial stent-in-stent deployment was successfully accomplished in all cases. The MS became obstructed in 3 cases (33%), mean 1.5 months, range 1.4 to 2.7 months. However, no MS obstruction occurred in the other 6 patients (67%), mean 11 months, range 4.7 to 16.4 months. In the obstructed cases, the deployment of 2 or 3 tube stents was completed successfully. One case of cholecystitis was observed as a short-term complication. LIMITATION: The small number of cases. CONCLUSIONS: Endoscopic 3-branched partial stent-in-stent deployment of a JOSTENT SelfX stent was effective in selected patients with high-grade malignant hilar biliary stricture.

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[Two cases of patients with hepatocellular carcinoma (HCC) that developed in cryptogenic cirrhosis suggestive of nonalcoholic steatohepatitis (NASH) as background liver disease after clinical courses of 26 years]. 査読

Koichiro Tsutsumi, Haruo Nakayama, Yoshitaka Sakai, Yasuhiro Kojima, Naohiro Dairaku, Toshiaki Ojima, Masao Kusano, Shinichi Ikeya, Yoshiki Sugai, Nobuo Hiwatashi

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   104 ( 5 )   690 - 7   2007年5月

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記述言語：日本語  

We report two cases of patients with hepatocellular carcinoma (HCC) that developed in cryptogenic cirrhosis suggestive of nonalcoholic steatohepatitis (NASH) as background liver disease. Case 1 was a 68-year-old woman, and case 2 was a 46-year-old man. They were admitted to our department for evaluation and treatment of HCC. The causes of the underlying liver disease were not determined from blood tests. However, histological analysis of non-tumor tissues of the liver revealed cirrhosis with few fat droplets. Both patients had undergone liver biopsy 26 years before the treatment of HCC. Histological review of the biopsy specimens revealed NASH (case 1) and fatty liver (case 2), respectively. It was suggested that these cases progressed from NASH and fatty liver, respectively, to NASH-related cirrhosis (so called burned-out NASH), eventually, developing HCC. These findings suggest that substantial number of burned-out NASH cases may be included in those with cryptogenic cirrhosis. These two patients are indicative cases that may reveal the long-term natural course of fatty liver and NASH.

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Periampullary carcinoid tumor.

H. Fukatsu, H. Kawamoto, M. Fujii, K. Tsutsumi, H. Kato, K. Hirao, N. Kurihara, Y. Okamoto, T. Ogawa, E. Ishida, H. Okada, K. Sakaguchi

Endoscopy   39   E49 - 50   2007年

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1055/s-2006-945068

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Multiple stenting in a patient with a high-grade malignant hilar biliary stricture: endoscopic four-branched partial stent-in-stent deployment of metallic stents.

H. Kawamoto, K. Tsutsumi, M. Fujii, R. Harada, H. Kato, K. Hirao, N. Kurihara, T. Nakanishi, O. Mizuno, E. Ishida, T. Ogawa, H. Fukatsu, K. Sakaguchi

Endoscopy   39   E167 - 168   2007年

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1055/s-2007-966612

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盲腸に発生した腺扁平上皮癌の1例

草野 昌男, 森 菜緒子, 堤 康一郎, 遠藤 克哉, 阿部 靖彦, 小島 康弘, 境 吉孝, 野口 謙治, 小島 敏明, 鹿志村 純也, 池谷 伸一, 樋渡 信夫

Progress of Digestive Endoscopy   64 ( 2 )   128,9 - 129,9   2004年6月

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記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2004&ichushi_jid=J04450&link_issn=&doc_id=20040621170046&doc_link_id=10.11641%2Fpde.64.2_128&url=https%3A%2F%2Fdoi.org%2F10.11641%2Fpde.64.2_128&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

6年5ヵ月の経過観察中に腺腫4病変に癌化がみられた1例

草野 昌男, 森 菜緒子, 堤 康一郎, 遠藤 克哉, 阿部 靖彦, 小島 康弘, 境 吉孝, 野口 謙治, 小島 敏明, 鹿志村 純也, 池谷 伸一, 樋渡 信夫

Progress of Digestive Endoscopy   65 ( 1 )   84 - 84   2004年6月

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記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

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膵管狭細型膵炎と鑑別困難な膵癌の1例

鹿志村 純也, 境 吉孝, 堤 康一郎, 森 菜緒子, 遠藤 克哉, 阿部 靖彦, 小島 康広, 野口 謙治, 小島 敏明, 草野 昌男, 池谷 伸一, 樋渡 信夫

Progress of Digestive Endoscopy   64 ( 1 )   102 - 102   2003年11月

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記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

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盲腸に発生した腺扁平上皮癌の1例

草野 昌男, 森 菜緒子, 堤 康一郎, 遠藤 克哉, 阿部 靖彦, 小島 康弘, 境 吉孝, 野口 謙治, 小島 敏明, 鹿志村 純也, 池谷 伸一, 樋渡 信夫

Progress of Digestive Endoscopy   64 ( 1 )   90 - 90   2003年11月

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記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

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