Hiroyuki Maguchi

Teine Keijinkai Hospital

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Intraductal Papillary Neoplasms of the Pancreas: Diagnosis by Endoscopic Pancreatic Biopsy

Endoscopy (1993)

T. Obara Hiroyuki Maguchi Youichi Saitoh Mitsuhiro Sohma Keiichi Tsuji

Intraductal papillary neoplasms of the pancreas (IPN) are rare tumors, distinct from other pancreatic duct cell carcinomas both in terms of papillary polyp formation in the main pancreatic duct and their favorable prognosis. In the present study, endoscopic pancreatic biopsy (EPB) under fluoroscopic control was employed in three cases of IPN to obtain a tissue diagnosis prior to surgery. There were no complications and all biopsy specimens were adequate for histopathological evaluation. In our experience, EPB is a simple, safe and effective method, yielding sufficient material for preoperative tissue diagnosis of pancreatic tumors, especially in the case of IPN.

Papillary tumor

Needle biopsy

10.1055/s-2007-1010317

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Citations (18)

380 REACTIVATION OF HEPATITIS B VIRUS IN HBSAG NEGATIVE PATIENTS UNDERGOING CHEMOTHERAPY FOR LYMPHOMA AND MULTIPLE MYELOMA: PROSPECTIVE SINGLE-INSTITUTION STUDY

Journal of Hepatology (2011)

T. Matsui J H Kang Katsunari Yane Toshifumi Kin Hayato Shida

10.1016/s0168-8278(11)60382-6

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Citations (0)

Diagnosis of PBM and CBD by EUS

Springer eBooks (2018)

Hiroyuki Maguchi Akio Katanuma Kuniyuki Takahashi

Bile duct cancer

10.1007/978-981-10-8654-0_15

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Contents

Gastrointestinal Endoscopy (2010)

Lars Enochsson F. Swahn Urban Arnelo Magnus Nilsson M Lo ̈hr

10.1016/s0016-5107(10)02243-1

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Table S3 from Rb Loss and <i>KRAS</i> Mutation Are Predictors of the Response to Platinum-Based Chemotherapy in Pancreatic Neuroendocrine Neoplasm with Grade 3: A Japanese Multicenter Pancreatic NEN-G3 Study

Susumu Hijioka Waki Hosoda Keitaro Matsuo Makoto Ueno Masayuki Furukawa

<p>Supplementary Table S3. Factors related to overall survival</p>

10.1158/1078-0432.22463228.v1

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Bile duct stenting for unresectable malignant stricture of biliary tract

Kuniyuki Takahashi Hiroyuki Maguchi

Endoscopic Stenting

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Indication of Endoscopic Papillectomy for Tumors of the Papilla of Vater and Its Problems

Digestive Endoscopy (2003)

Hiroyuki Maguchi Kuniyuki Takahashi Akio Katanuma Tsuyoshi Hayashi Akimasa Yoshida

Discussions have just started in Japan as to the indication, technique and complication of endoscopic papillectomy for tumors of the papilla of Vater. We indicate endoscopic papillectomy for tumors satisfying the following: 1 exposed tumor-type adenoma, or carcinoma in adenoma; 2 without invasion of duodenal muscularis; and 3 no infiltration into the pancreas or the bile duct. Endoscopic papillectomy was performed on 12 patients with tumors of the papilla of Vater that satisfied the above criteria. En bloc snare excision was achieved in 11 out of 12 cases without endoscopic sphincterotomy (EST) or epinephrine injection. Pancreatic stenting was done in 8 cases for prevention of pancreatitis, and bile duct stenting in nine cases for prevention of cholangitis. Postoperative early complications were observed in 5 cases; pancreatitis in 2; pancreatitis and bleeding in 1; bleeding in 1; and bleeding and perforation in 1. Neither recurrence nor metastasis of tumor has been detected during the average postoperative period of 620 days. The treatment can be acknowledged as less invasive therapy. However, management of complications is important, for which further study needs to be accumulated.

Major duodenal papilla

Perforation

Duodenoscopy

10.1046/j.1443-1661.15.s.10.x

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Citations (52)

ENDOSCOPIC ULTRASONOGRAPHY-GUIDED PANCREATICOGASTROSTOMY FOR A CASE OF OCCLUSION OF GASTRO-PANCREATIC ANASTOMOSIS AFTER PANCREATICODUODENECTOMY

Digestive Endoscopy (2009)

Akio Katanuma Hiroyuki Maguchi Mituharu Fukazawa Akira Kurita Tamaki Ichiya

Background: EUS‐guided pancreaticogastrostomy is described as an alternative to surgery for ductal decompression when endoscopic transpapillary access is impossible. We report a case where EUS‐guided pancreaticogastrostomy of the pancreatic duct was effective for dilatation of the pancreatic duct caused from occlusion of gastro‐pancreatic anastomosis constructed after resection of pancreaticoduodenectomy. Patients and methods: The patient was a 79‐year‐old woman who had undergone operation for IPMN in the pancreatic head in 1998. Nine years after the operation, she visited us for back pain, and conspicuous dilatation of the main pancreatic duct was found. By observing curved liner array EUS scope, we successfully punctured the main pancreatic duct and placed a plastic stent. Results: After the treatment, the subjective symptom was alleviated and reduction of the dilatation of pancreatic duct was observed in image findings. Conclusion: Endoscopic ultrasonography guided pancreaticogastrostomy appears to be an effective treatment for a case of occlusion of gastro‐pancreatic anastomosis after pancreaticoduodenectomy.

Endoscopic ultrasonography

10.1111/j.1443-1661.2009.00854.x

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Citations (8)

Ultrasonographic diagnosis for pancreatic neoplasms

Choonpa Igaku (2010)

Hiroyuki Maguchi Manabu Osanai Akio Katanuma Kuniyuki Takahashi

臨床の場で遭遇する膵腫瘍の診断名の数は限られ，各腫瘍の病理と画像所見の特徴を把握しておくことで鑑別診断の多くが可能となる．膵腫瘍は大きく充実性と嚢胞性に分けられる．充実性には，通常型膵癌，内分泌腫瘍，Solid-pseudopapillary neoplasm（SPN），特殊型膵癌（腺扁平上皮癌，退形成性癌など），腺房細胞癌があり，嚢胞性では，漿液性嚢胞腫瘍（serous cystic neoplasm: SCN），粘液性嚢胞腫瘍（mucinous cystic neoplasm: MCN），膵管内乳頭粘液性腫瘍（intraductal papillary mucinous neoplasm: IPMN）の鑑別を行うことになる．但し，充実性腫瘍の嚢胞化あるいは充実性腫瘍の周囲に貯留嚢胞や仮性嚢胞を形成する場合には充実と嚢胞の混在する病態を呈するため鑑別診断に際し注意する必要がある．充実性腫瘍の鑑別診断で問題となるのは，特殊型膵癌（腺扁平上皮癌，退形成性癌など）と腺房細胞癌，非典型的所見を呈する内分泌腫瘍である．特に，内分泌腫瘍は内部の嚢胞化や主膵管内腫瘍栓など，種々の所見を呈するため注意を要する．嚢胞性腫瘍では，SCNにおいてmicro cystとmacro cystの混在，あるいはmacro cyst主体の例が少なくないことを認識しておく必要がある．MCNとIPMNでは，共通の被膜の有無，嚢胞の構造が内に向かうか外に向かうかが鑑別ポイントとなる．膵腫瘍の鑑別診断において体外式US，EUS，IDUSなど超音波診断の果す役割は大きい．

Neoplasm

Serous Cystadenoma

10.3179/jjmu.37.425

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Citations (1)

Follow-up of branch duct IPMN. Various clinical approaches

Suizo (2005)

Hiroyuki Maguchi Manabu Osanai Kuniyuki Takahashi Akio Katanuma

Intraductal papillary-mucinous neoplasm (IPMN) の分枝型は, 組織学的には腺癌, 腺腫のほか過形成病変が加わり, 臨床的には主膵管型に比べ浸潤癌の頻度が低く, 長期間進展しない例が多い. このため, 手術適応例と経過観察例が存在することになる.手術適応の判定因子としては, 画像診断による結節状隆起・壁在結節 (mural nodule) の評価, 主膵管径・拡張分枝径の測定がある. 国際的には, 拡張分枝径が重要視され, 次に隆起の存在, 主膵管の拡張が悪性を示唆する所見となっている. 一方, 本邦では隆起の高さを最も重要とし, 次に主膵管の拡張が重要との意見が多い. いずれにしても, 治療方針の決定ならびに経過観察には, 膵管の評価と拡張分枝内の隆起の評価の両者が求められ, 前者にはUS, CT, MRCPの組み合わせ, 後者にはEUSが必要である. また最近では, IPMNと通常型膵管癌の併存が注目されており, 経過観察に際し膵全体の評価を怠ってはならない. さらに, IPMN症例には他臓器癌の合併頻度が高く, 定期的な全身検索も重要である.

10.2958/suizo.20.522

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Citations (3)