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4 "Atsuhiro Masuda"
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Drainage for fluid collections post pancreatic surgery and acute pancreatitis: similar but different?
Yousuke Nakai, Saburo Matsubara, Tsuyoshi Mukai, Tsuyoshi Hamada, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda, for the WONDERFUL study group in Japan
Received October 3, 2023  Accepted November 1, 2023  Published online May 17, 2024  
DOI:    [Epub ahead of print]
AbstractAbstract PDFPubReaderePub
Postoperative pancreatic fistulas (POPFs) are common adverse events that occur after pancreatic surgery. Endoscopic ultrasonography (EUS)-guided drainage (EUS-D) is a first-line treatment, similar to that for pancreatic fluid collection (PFCs) after acute pancreatitis. However, some POPFs do not develop fluid collections depending on the presence or location of the surgical drain, whereas others develop fluid collections, such as postoperative fluid collections (POPFCs). Although POPFCs are similar to PFCs, the strategy and modality for POPF management need to be modified according to the presence of fluid collections, surgical drains, and surgical type. As discussed for PFCs, the indications, timing, and selection of interventions or stents for EUS-D have not been fully elucidated for POPFs. In this review, we discuss the management of POPFs and POPFCs in comparison with PFCs due to acute pancreatitis and summarize the topics that should be addressed in future studies.
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  • 108 Download
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Original Article
A novel fully covered metal stent for unresectable malignant distal biliary obstruction: results of a multicenter prospective study
Arata Sakai, Atsuhiro Masuda, Takaaki Eguchi, Keisuke Furumatsu, Takao Iemoto, Shiei Yoshida, Yoshihiro Okabe, Kodai Yamanaka, Ikuya Miki, Saori Kakuyama, Yosuke Yagi, Daisuke Shirasaka, Shinya Kohashi, Takashi Kobayashi, Hideyuki Shiomi, Yuzo Kodama
Clin Endosc 2024;57(3):375-383.   Published online July 10, 2023
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO.
This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events.
A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration.
The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.


Citations to this article as recorded by  
  • Endeavors to prevent stent malfunction: new insights into the risk factors for recurrent biliary obstruction
    Sung-Jo Bang
    Clinical Endoscopy.2024; 57(1): 56.     CrossRef
  • Understanding mechanical properties of biliary metal stents for wise stent selection
    Seok Jeong
    Clinical Endoscopy.2023; 56(5): 592.     CrossRef
  • 3,239 View
  • 77 Download
  • 1 Web of Science
  • 2 Crossref
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Focused Review Series: Endoscopic Management of Postoperative Gastrointestinal Complication: What’s New?
Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome
Hideyuki Shiomi, Arata Sakai, Ryota Nakano, Shogo Ota, Takashi Kobayashi, Atsuhiro Masuda, Hiroko Iijima
Clin Endosc 2021;54(6):810-817.   Published online November 15, 2021
AbstractAbstract PDFPubReaderePub
Afferent loop syndrome (ALS) is a mechanical obstruction of the afferent limbs after gastrectomy with gastrojejunostomy reconstruction. Patients with cancer recurrence require immediate and less invasive treatment because of their poor condition. Percutaneous transhepatic/transluminal drainage (PTD) and endoscopic enteral stenting offer reasonable palliative treatment for malignant ALS but are not fully satisfactory in terms of patient quality of life (QoL) and stent patency. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using a lumen-apposing metal stent may address these shortcomings. Clinical data from 11 reports showed that all patients who had undergone EUS-GE had positive technical and clinical outcomes. The adverse event rate was 11.4%, including only mild or moderate abdominal pain, with no severe adverse events. Indirect comparative studies indicated that patients who had undergone EUS-GE had a significantly superior QoL, a higher clinical success rate, and a lower reintervention rate than those who had undergone PTD or endoscopic enteral stenting. Although the evidence is limited, EUS-GE may be considered as a first-line treatment for malignant ALS because it has better clinical outcomes than other less invasive treatments, such as PTD or endoscopic enteral stenting. Further prospective randomized control trials are necessary to establish EUS-GE as a standard treatment for ALS.


Citations to this article as recorded by  
  • Endoscopic ultrasound‐guided gastrointestinal anastomosis: Are we there yet?
    Vinay Dhir, Cesar Jaurrieta‐Rico, Vivek Kumar Singh
    Digestive Endoscopy.2024;[Epub]     CrossRef
  • Endoscopic ultrasound-guided gastroenterostomy using a novel dumbbell-shaped fully covered metal stent for afferent loop syndrome with long interluminal distance
    Hideyuki Shiomi, Ryota Nakano, Shogo Ota, Hiroko Iijima
    Endoscopy.2023; 55(S 01): E362.     CrossRef
  • Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
    Saburo Matsubara, Sho Takahashi, Naminatsu Takahara, Keito Nakagawa, Kentaro Suda, Takeshi Otsuka, Yousuke Nakai, Hiroyuki Isayama, Masashi Oka, Sumiko Nagoshi
    Journal of Clinical Medicine.2023; 12(10): 3524.     CrossRef
  • Endoscopic ultrasound guided gastroenterostomy: Technical details updates, clinical outcomes, and adverse events
    Jian Wang, Jin-Long Hu, Si-Yu Sun
    World Journal of Gastrointestinal Endoscopy.2023; 15(11): 634.     CrossRef
  • Endoscopic ultrasound-guided intra-afferent loop entero-enterostomy using a forward-viewing echoendoscope and insertion of a metal stent
    Yuki Kawasaki, Susumu Hijioka, Kosuke Maehara, Kiichi Tamada, Takuji Okusaka, Yutaka Saito
    Endoscopy.2022; 54(S 02): E815.     CrossRef
  • Endoscopic ultrasound‐guided gastrojejunostomy for malignant afferent loop syndrome with hemorrhage in a patient with recurrent peritoneal dissemination
    Kenjiro Yamamoto, Takayoshi Tsuchiya, Ryosuke Tonozuka, Shuntaro Mukai, Hiroyuki Kojima, Noriyuki Hirakawa, Takao Itoi
    Journal of Hepato-Biliary-Pancreatic Sciences.2022;[Epub]     CrossRef
  • Current status of, and challenges posed by, endoscopic ultrasound‐guided anastomosis of the digestive tract in patients with afferent loop syndrome
    Toshio Fujisawa, Hiroyuki Isayama
    Digestive Endoscopy.2022; 34(7): 1440.     CrossRef
  • 4,004 View
  • 140 Download
  • 7 Web of Science
  • 7 Crossref
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Case Report
Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review
Arata Sakai, Hideyuki Shiomi, Takao Iemoto, Ryota Nakano, Takuya Ikegawa, Takashi Kobayashi, Atsuhiro Masuda, Yuzo Kodama
Clin Endosc 2020;53(4):491-496.   Published online March 3, 2020
AbstractAbstract PDFPubReaderePub
In this study, we assessed a series of our cases in which endoscopic self-expandable metal stents (SEMSs) were used to treat malignant afferent loop obstruction (ALO) that arose after pancreaticoduodenectomy (PD). We retrospectively examined the records of 7 patients who underwent endoscopic SEMS placement for malignant ALO following PD. Clinical success was achieved in all cases. The median procedure time was 30 min (range, 15–50 min). There were no cases of stent occlusion, and no procedure-related adverse events were encountered. All patients died of their primary disease, and the median overall survival period was 155 days (range, 96–374 days). A re-intervention involving endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting was performed for obstructive jaundice and acute cholangitis in 1 case. In conclusion, endoscopic SEMS placement may be an effective and safe treatment for malignant ALO that arises after PD.


Citations to this article as recorded by  
  • Efficacy of endoscopic ultrasound‐guided gastroenterostomy using self‐expandable metallic stent for afferent loop syndrome: A single‐center retrospective study
    Yuya Hagiwara, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Akihiro Ohba, Yuki Kawasaki, Kotaro Takeshita, Tetsuro Takasaki, Daiki Agarie, Hidenobu Hara, Shin Yagi, Soma Fukuda, Masaru Kuwada, Daiki Yamashige, Kohei Okamoto, Mark Chatto, Shunsuke Kond
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
  • Successful metal stent placement using short single-balloon endoscope for afferent loop syndrome after pancreaticoduodenectomy
    Takuto Furukawa, Yuichi Takano, Jun Noda, Masataka Yamawaki, Tetsushi Azami, Fumitaka Niiya, Fumiya Nishimoto, Naotaka Maruoka, Masatsugu Nagahama
    Progress of Digestive Endoscopy.2024; 104(1): 98.     CrossRef
  • The Role of Endoscopic Management in Afferent Loop Syndrome
    Clement Chun Ho Wu, Elizabeth Brindise, Rami El Abiad, Mouen A. Khashab
    Gut and Liver.2023; 17(3): 351.     CrossRef
  • Early and late effects of endoscopic interventions in patients with malignant afferent loop syndrome: A single‐center experience and literature review
    Kenjiro Yamamoto, Takao Itoi, Yukitoshi Matsunami, Atsushi Sofuni, Takayoshi Tsuchiya, Shuntaro Mukai, Hiroyuki Kojima, Hirohito Minami, Ryosuke Nakatsubo, Ryosuke Tonozuka
    Journal of Hepato-Biliary-Pancreatic Sciences.2023;[Epub]     CrossRef
  • Simultaneous stent placement for biliary and afferent loop obstruction due to tumor recurrence after pancreatoduodenectomy
    Tatsunori Satoh, Hirotoshi Ishiwatari, Kazuma Ishikawa, Hidenori Kimura, Hiroyuki Matsubayashi, Hiroyuki Ono
    Endoscopy.2022; 54(09): E524.     CrossRef
  • Extra-anatomic percutaneous stenting of a malignant afferent loop obstruction following pancreaticoduodenectomy
    Stefan Lam, Sarah Khan, Robert Hutchins, Tim Fotheringham
    International Journal of Gastrointestinal Intervention.2022; 11(2): 77.     CrossRef
  • Endoscopic Transluminal Stent Placement for Malignant Afferent Loop Obstruction
    Chinatsu Yonekura, Takashi Sasaki, Takafumi Mie, Takeshi Okamoto, Tsuyoshi Takeda, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
    Journal of Clinical Medicine.2022; 11(21): 6357.     CrossRef
  • Clinical management for malignant afferent loop obstruction
    Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
    World Journal of Gastrointestinal Oncology.2021; 13(7): 684.     CrossRef
  • Clinical management for malignant afferent loop obstruction
    Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
    World Journal of Gastrointestinal Oncology.2021; 13(7): 509.     CrossRef
  • Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome
    Hideyuki Shiomi, Arata Sakai, Ryota Nakano, Shogo Ota, Takashi Kobayashi, Atsuhiro Masuda, Hiroko Iijima
    Clinical Endoscopy.2021; 54(6): 810.     CrossRef
  • Percutaneous- and EUS-guided gastroenterostomy for malignant afferent limb syndrome
    Dayyan Adoor, Zachary L. Smith
    VideoGIE.2020; 5(11): 542.     CrossRef
  • 4,564 View
  • 99 Download
  • 8 Web of Science
  • 11 Crossref
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