研究者詳細 - 藤井　佑樹

論文 - 藤井　佑樹

分割表示 60 件中 41 - 60 件目／全件表示 >>

Bilateral verses bilateral with tri-segmental endoscopic drainage using metal stents for high-grade malignant hilar biliary obstructions: A multicenter, randomized controlled trial: BRAVE study (BRAVE study). 国際誌

Kazuyuki Matsumoto, Toshiharu Mitsuhashi, Hirofumi Kawamoto, Etsuji Ishida, Masakuni Fujii, Yutaka Akimoto, Hiroyuki Seki, Yuki Ishihara, Taiji Ogawa, Tatsuhiro Yamazaki, Yuki Fujii, Hironari Kato

Medicine 101 ( 40 ) e30857 2022年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Bilateral endoscopic drainage with self-expanding metallic stent (SEMS) can be used to manage hilar malignant biliary obstruction (HMBO) more effectively in comparison to unilateral drainage. An increased drainage area is predicted to prolong stent patency and patient survival. However, few reports have described the utility of trisegmental drainage and the benefits of using trisegmental drainage remain unknown. Thus, we launched a randomized clinical trial (RCT) to compare the clinical outcomes between bilateral and trisegmental drainage using SEMSs in patients with high-grade HMBO. METHODS AND ANALYSIS: This study was conducted as a multicenter randomized control trial (RCT) in 8 high-volume medical centers in Japan, and will prove the non-inferiority of bilateral drainage to trisegmental drainage. Patients with unresectable HMBO with Bismuth type IIIa or IV who pass the inclusion and exclusion criteria will be randomized to receive bilateral or trisegmental drainage at a 1:1 ratio. At each center, the on-site study investigators will obtain informed consent from the candidates, and will use an electronic data capture system (REDCap) to input necessary information, and register candidates with the registration secretariat. The primary endpoint is the rate of non-recurrent biliary obstruction (RBO) at 180 days after SEMSs placement. A -10% non-inferiority margin is assumed in the statistical analysis of the primary endpoint. Secondary endpoints include the rate of technical and clinical success, time to recurrent biliary obstruction (TRBO), causes of RBO, procedure-related adverse events (AEs), procedure time, TRBO with or without endoscopic sphincterotomy, overall survival, and the technical and clinical success rates at reintervention. DISCUSSION: If the non-inferiority of bilateral drainage is demonstrated, it is predicted that the procedure time will be shortened and the medical cost will be reduced, which will be beneficial to the patient and the medical economy. TRIAL REGISTRATION: Registered in Japan Registry of Clinical Trial-Registration (trial number. jRCTs062220038). This version number 1. Protocol dated Jun 23, 2022.

DOI： 10.1097/MD.0000000000030857

PubMed

researchmap

A case of endoscopic retrograde cholangiopancreatography-related main pancreatic duct perforation salvaged by endoscopic ultrasonography-guided pancreatic duct drainage. 査読

Ryosuke Sato, Kazuyuki Matsumoto, Akihiro Matsumi, Kosaku Morimoto, Hiroyuki Terasawa, Yuki Fujii, Tatsuhiro Yamazaki, Koichiro Tsutsumi, Shigeru Horiguchi, Hironari Kato

Clinical journal of gastroenterology 15 ( 6 ) 1179 - 1184 2022年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

We herein report a 78-year-old man who underwent endoscopic retrograde cholangiopancreatography (ERCP) to examine main pancreatic duct (MPD) stenosis. During ERCP, MPD perforation occurred due to the cytology brush maneuver. Endoscopic pancreatic stenting to bridge the perforated site failed because the MPD was bent and formed a loop. Thus, we placed the stent at the proximal perforated side. The patient developed retroperitoneal perforation and pancreatic fistula with infection, showing a worsening condition. Pancreatic duct drainage was not effective, so we performed endoscopic ultrasonography-guided pancreatic duct drainage. Subsequently, he gradually improved and was discharged 3 months after initial ERCP.

DOI： 10.1007/s12328-022-01699-1

PubMed

researchmap

十二指腸乳頭部腫瘍の内視鏡切除術における非完全切除例の取り扱いに関する検討

藤井佑樹, 松本和幸, 加藤博也

胆道 36 ( 3 ) 402 - 402 2022年9月

生体肝移植後胆管狭窄に対する内視鏡治療

山崎辰洋, 松本和幸, 加藤博也, 松三明宏, 宮本和也, 寺澤裕之, 藤井佑樹, 内田大輔, 堀口繁, 堤康一郎

胆道 36 ( 3 ) 344 - 344 2022年9月

Stent-in-stent techniqueにて抜去した胆管金属ステントの2例

松三明宏, 松本和幸, 小幡泰介, 織田崇志, 菊池達也, 宮本和也, 森本光作, 寺澤裕之, 藤井佑樹, 山崎辰洋, 内田大輔, 堀口繁, 堤康一郎, 加藤博也

胆道 36 ( 3 ) 349 - 349 2022年9月

Endoscopic ultrasonography-guided bilateral drainage with antegrade stenting in patient with malignant hilar biliary obstruction after bowel reconstruction. 国際誌

Ryosuke Sato, Kazuyuki Matsumoto, Hiroyuki Terasawa, Yuki Fujii, Tatsuhiro Yamazaki, Shigeru Horiguchi, Hironari Kato

Endoscopy 54 ( S 02 ) E1026-E1027 2022年8月

『胆膵疾患と性差』分枝型IPMNの性差による画像的特徴と長期経過の検討

宮本和也, 松本和幸, 松三明宏, 森本光作, 寺澤裕之, 藤井佑樹, 山崎辰洋, 内田大輔, 堀口繁, 堤康一郎, 加藤博也

日本高齢消化器病学会誌 25 ( 1 ) 161 - 161 2022年7月

胃切後Roux-en-Y再建腸管を有する患者の総胆管結石治療におけるバルーン内視鏡下ERCPの治療戦略

小幡泰介, 堤康一郎, 加藤博也, 織田崇志, 森本光作, 姫井人美, 松三明宏, 上田英次郎, 小川泰司, 寺澤裕之, 藤井佑樹, 山崎辰洋, 松本和幸, 堀口繁, 岡田裕之

Gastroenterological Endoscopy 64 ( Suppl.1 ) 820 - 820 2022年4月

術後腸管症例におけるステント迷入に対するダブルバルン内視鏡を用いたステント抜去法

織田崇志, 松本和幸, 加藤博也, 小幡泰介, 上田英次郎, 姫井人美, 松三明宏, 森本光作, 小川泰司, 寺澤裕之, 藤井佑樹, 山崎辰洋, 堀口繁, 堤康一郎

Gastroenterological Endoscopy 64 ( Suppl.1 ) 765 - 765 2022年4月

胆管空腸吻合術後の肝内結石に対する直接胆道鏡の有用性の検討

松三明宏, 松本和幸, 加藤博也, 小幡泰介, 織田崇志, 上田英次郎, 姫井人美, 森本光作, 小川泰司, 寺澤裕之, 藤井佑樹, 山崎辰洋, 堀口繁, 堤康一郎, 岡田裕之

Gastroenterological Endoscopy 64 ( Suppl.1 ) 821 - 821 2022年4月

Risk Factors for the Development of High-risk Stigmata in Branch-duct Intraductal Papillary Mucinous Neoplasms. 査読

Tatsuhiro Yamazaki, Takeshi Tomoda, Hironari Kato, Kazuya Miyamoto, Akihiro Matsumi, Eijiro Ueta, Yuki Fujii, Yosuke Saragai, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 60 ( 20 ) 3205 - 3211 2021年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Objective Strict follow-up is recommended for branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) to avoid missing the development of high-risk stigmata (HRS) at a premalignant stage. This study explored the risk factors associated with the development of HRS during follow-up. Methods We performed a retrospective analysis of 283 patients with BD-IPMN, treated at Okayama University Hospital in Japan between January 2009 and December 2016. Only patients with imaging studies indicative of classical features of BD-IPMN without HRS and followed for over one year were included in the study. We performed radiological follow-up every six months and collected patients' demographic data, cyst characteristics, and clinical outcomes and used univariate logistic regression models to determine the odds of developing HRS. Results Ten patients (3.5%) developed HRS after a median surveillance period of 55.8 months. The main pancreatic duct (MPD) size (5-9 mm) and cyst growth rate (>2.5 mm/year) were both suggested to be possible risk factors for the development of HRS [odds ratio, 14.2; 95% confidence interval (CI), 3.1-65.2, p=0.0006, and odds ratio, 6.1; 95% CI 1.5-25.5, p=0.014]. Regarding the number of worrisome features (WFs), the rate of HRS development was 2.0% (4/199) in cases with no WF, 1.6% (1/62) in cases with single WF and 22.7% (5/22) in cases with multiple WFs, respectively. The rate of HRS development was significantly higher in cases with multiple WFs than in the other cases (p<0.0001). Conclusion MPD dilation, rapid cyst growth, and multiple WFs were significant risk factors for the development of HRS. In the presence of such features, it is necessary to closely follow the development of HRS and avoid missing the best opportunity to perform surgical intervention.

DOI： 10.2169/internalmedicine.7168-21

PubMed

researchmap

Hemosuccus Pancreaticus Due to the Rupture of a Pseudoaneurysm That Developed in an Intraductal Papillary Mucinous Neoplasm.

Taisuke Obata, Kazuyuki Matsumoto, Hironari Kato, Tatsuhiro Yamazaki, Yuki Fujii, Takeshi Tomoda, Shigeru Horiguchi, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 60 ( 13 ) 2033 - 2038 2021年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 76-year-old woman with branch duct intraductal papillary mucinous neoplasm (IPMN) was admitted with epigastric pain and vomiting. She had received warfarin due to a history of deep vein thrombosis. A blood test showed decreased serum hemoglobin and elevated serum amylase. Contrast-enhanced computed tomography revealed acute pancreatitis and formation of a pseudoaneurysm in the IPMN. We suspected rupture of a pseudoaneurysm and performed trans-catheter angiography. Angiography showed extravasation from the posterior superior pancreaticoduodenal artery, and coil embolization was performed. It is important to be alert for the formation of pseudoaneurysm in patients with cystic neoplasms.

DOI： 10.2169/internalmedicine.6445-20

PubMed

researchmap

EUS画像に基づいたIPMN組織亜型予測診断に関する研究国際誌

藤井佑樹

21 ( 3 ) 622 - 629 2021年4月

Low-Density Lipoprotein (LDL)-Triglyceride and Its Ratio to LDL-Cholesterol as Diagnostic Biomarkers for Nonalcoholic Steatohepatitis. 国際誌

Yuki Fujii, Kazuhiro Nouso, Hiroshi Matsushita, Kazuya Kariyama, Toshihiro Sakurai, Yuji Takahashi, Hitoshi Chiba, Shu-Ping Hui, Yasuki Ito, Motoko Ohta, Hiroyuki Okada

The journal of applied laboratory medicine 5 ( 6 ) 1206 - 1215 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the most common type of liver disease, but it is difficult to distinguish its pathogenic phenotype, nonalcoholic steatohepatitis (NASH), from nonalcoholic fatty liver (NAFL) without a liver biopsy. We analyzed serum lipids, including low-density lipoprotein triglyceride (LDL-TG), to elucidate their usefulness for diagnosing NASH. PATIENTS AND METHODS: Serum samples obtained from 35 NASH and 9 NAFL biopsy-confirmed patients and 6 healthy volunteers (HLT) were studied for 13 lipid-related markers and compared between HLT, NAFL, and NASH groups. The relationship between histological findings and the lipid markers was also analyzed. RESULTS: There were significant differences in triglyceride, LDL-TG, the ratio of LDL-TG to the LDL-cholesterol (LDL-TG/LDL-C), small dense LDL-C, and apolipoprotein E between the three groups. Among the 5 lipid components, serum LDL-TG level and the ratio of LDL-TG to the LDL-cholesterol (LDL-TG/LDL-C) were significantly elevated in NASH. The median concentrations of LDL-TG in HLT, NAFL, and NASH were 9, 15, and 20 mg/dL (P < 0.001), and those of LDL-TG/LDL-C were 0.097, 0.102, and 0.173 (P < 0.001), respectively. Although the degree of steatosis was not correlated with the LDL-TG/LDL-C, the ratio was significantly higher in patients with lobular inflammation (P = 0.071), ballooning (P = 0.031), and fibrosis (P < 0.001). The area under the receiver operating characteristic curve of the ratio for distinguishing NASH from NAFL was 0.857. The rest of studied markers showed no significant utility. CONCLUSION: Serum LDL-TG levels and the LDL-TG/LDL-C ratio might serve as simple and noninvasive diagnostic biomarkers for NASH.

DOI： 10.1093/jalm/jfaa044

PubMed

researchmap

当院における肝門部領域良性胆道狭窄に対するInside stentの有用性の検討

皿谷洋祐, 加藤博也, 上田英次郎, 松三明宏, 宮本和也, 藤井佑樹, 山崎辰洋, 内田大輔, 友田健, 堀口繁, 堤康一郎, 岡田裕之

胆道 34 ( 3 ) 582 - 582 2020年8月

[Synchronous double primary cancers of a mixed adenoneuroendocrine carcinoma of the distal bile duct and a carcinoma in situ in the perihilar bile duct].

Yuki Fujii, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Masaya Oikawa, Takaho Okada, Yutaka Noda, Takashi Sawai, Kei Ito

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 117 ( 2 ) 178 - 188 2020年

記述言語：日本語掲載種別：研究論文（学術雑誌）

We report the rare case of a 69-year-old man who underwent resection of a mixed adenoneuroendocrine carcinoma (MANEC) of the distal bile duct and a carcinoma in situ in the perihilar bile duct. The patient was admitted to our hospital for obstructive jaundice. Imaging studies revealed a mass in the distal bile duct, and an abnormal epithelium was detected in the perihilar bile duct using peroral cholangioscopy. Bile cytology and transpapillary biopsy of the tumor revealed adenocarcinoma. We diagnosed this patient with distal cholangiocarcinoma with extensive intraepithelial progression toward the perihilar bile duct and performed a subtotal stomach-preserving pancreaticoduodenectomy and left hepatectomy. According to the histological examination of the resected specimens, we found a MANEC in the distal bile duct and a carcinoma in situ in the perihilar bile duct. Together, they were diagnosed as synchronous double primary cancers due to the lack of pathological transition between them.

DOI： 10.11405/nisshoshi.117.178

PubMed

researchmap

Diagnostic Ability of Convex-Arrayed Endoscopic Ultrasonography for Major Vascular Invasion in Pancreatic Cancer. 国際誌

Yuki Fujii, Kazuyuki Matsumoto, Hironari Kato, Yosuke Saragai, Saimon Takada, Sho Mizukawa, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Shigeru Horiguchi, Noriyuki Tanaka, Hiroyuki Okada

Clinical endoscopy 52 ( 5 ) 479 - 485 2019年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: This study aimed to examine the diagnostic ability of endoscopic ultrasonography (EUS) for major vascular invasion in pancreatic cancer and to evaluate the relationship between EUS findings and pathological distance. METHODS: In total, 57 consecutive patients who underwent EUS for pancreatic cancer before surgery were retrospectively reviewed. EUS image findings were divided into four types according to the relationship between the tumor and major vessel (types 1 and 2: invasion, types 3 and 4: non-invasion). We also compared the EUS findings and pathologically measured distances between the tumors and evaluated vessels. RESULTS: The sensitivity, specificity, and accuracy of EUS diagnosis for vascular invasion were 89%, 92%, and 91%, respectively, in the veins and 83%, 94%, and 93%, respectively, in the arteries. The pathologically evaluated distances of cases with type 2 EUS findings were significantly shorter than those of cases with type 3 EUS findings in both the major veins (median [interquartile range], 96 [0-742] µm vs. 2,833 [1,076-5,694] µm, p=0.012) and arteries (623 [0-854] µm vs. 3,097 [1,396-6,000] µm, p=0.0061). All cases with a distance of ≥1,000 µm between the tumors and main vessels were correctly diagnosed. CONCLUSION: Tumors at a distance ≥1,000 µm from the main vessels were correctly diagnosed by EUS.

DOI： 10.5946/ce.2018.163

PubMed

researchmap

Intracholecystic papillary-tubular neoplasm of the gallbladder originating in the cystic duct with extensive intraepithelial progress in the common bile duct.

Yuki Fujii, Yutaka Noda, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Keisuke Yonamine, Yujiro Kawakami, Toji Murabayashi, Fumisato Kozakai, Takashi Sawai, Toru Furukawa, Kei Ito

Clinical journal of gastroenterology 12 ( 3 ) 197 - 204 2019年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 59-year-old man with anorexia who had a history of cholecystectomy was referred to our hospital. Imaging examinations revealed a contrast-enhanced tumor in the residual cystic duct and a part of the common bile duct. Endoscopic retrograde cholangiopancreatography and peroral-cholangioscopy showed a papillary tumor with movement and a change in the shape. Under a diagnosis of primary cystic duct cancer, subtotal stomach-preserving pancreaticoduodenectomy was performed. The microscopic examination of a resected specimen revealed intracholecystic papillary-tubular neoplasm located in the residual cystic duct, forming a polypoid protrusion to the common bile duct and extensive intraepithelial progress in the common bile duct.

DOI： 10.1007/s12328-018-0927-4

PubMed

researchmap

Predictive Factors for Inaccurate Diagnosis of Swollen Lymph Nodes in Endoscopic Ultrasound-Guided Fine Needle Aspiration. 国際誌

Yuki Fujii, Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Keisuke Yonamine, Yujiro Kawakami, Toji Murabayashi, Fumisato Kozakai, Yutaka Noda, Hiroyuki Okada, Kei Ito

Clinical endoscopy 52 ( 2 ) 152 - 158 2019年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: This study aimed to identify the predictive factors for inaccurate endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnosis of swollen lymph nodes without rapid on-site cytopathological evaluation. METHODS: Eighty-three consecutive patients who underwent EUS-FNA for abdominal or mediastinal lymph nodes from January 2008 to June 2017 were included from a prospectively maintained EUS-FNA database and retrospectively reviewed. The sensitivity, specificity, and accuracy of EUS-FNA for the detection of neoplastic diseases were calculated. Candidate factors for inaccurate diagnosis (lymph node size and location, needle type, puncture route, number of passes, and causative disease) were evaluated by comparison between accurately diagnosed cases and others. RESULTS: The final diagnosis of the punctured lymph node was classified as neoplastic (65 cases: a metastatic lymph node, malignant lymphoma, or Crow-Fukase syndrome) or non-neoplastic (18 cases: a reactive node or amyloidosis). The sensitivity, specificity, and accuracy were 83%, 94%, and 86%, respectively. On multivariate analyses, small size of the lymph node was the sole predictive factor for inaccurate EUS-FNA diagnosis with a significant difference (odds ratios, 19.8; 95% confidence intervals, 3.15-124; p=0.0015). CONCLUSION: The lymph node size of <16 mm was the only independent factor associated with inaccurate EUS-FNA diagnosis of swollen lymph nodes.

DOI： 10.5946/ce.2018.125

PubMed

researchmap

Percutaneous transhepatic cholangioscopy using SpyGlassDS for an anastomotic stenosis after choledochojejunostomy. 国際誌

Yuki Fujii, Shinsuke Koshita, Kei Ito

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 30 ( 6 ) 806 - 807 2018年11月

　前のページ - 次のページ　

<藤井 佑樹>

論文 - 藤井 佑樹

<藤井　佑樹>

論文 - 藤井　佑樹