Clinical Endoscopy

Original Articles

Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ: Hiroaki Kusunose, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Kazuki Endo, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito; Clin Endosc 2023;56(3):353-366. Published online November 16, 2022; DOI: https://doi.org/10.5946/ce.2022.021

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Background
/Aims: This study aimed to clarify the efficacy and safety of pancreatic duct lavage cytology combined with a cell-block method (PLC-CB) for possible pancreatic ductal adenocarcinomas (PDACs).
Methods
This study included 41 patients with suspected PDACs who underwent PLC-CB mainly because they were unfit for undergoing endoscopic ultrasonography-guided fine needle aspiration. A 6-Fr double lumen catheter was mainly used to perform PLC-CB. Final diagnoses were obtained from the findings of resected specimens or clinical outcomes during surveillance after PLC-CB.
Results
Histocytological evaluations using PLC-CB were performed in 87.8% (36/41) of the patients. For 31 of the 36 patients, final diagnoses (invasive PDAC, 12; pancreatic carcinoma in situ, 5; benignancy, 14) were made, and the remaining five patients were excluded due to lack of surveillance periods after PLC-CB. For 31 patients, the sensitivity, specificity, and accuracy of PLC-CB for detecting malignancy were 94.1%, 100%, and 96.8%, respectively. In addition, they were 87.5%, 100%, and 94.1%, respectively, in 17 patients without pancreatic masses detectable using endoscopic ultrasonography. Four patients developed postprocedural pancreatitis, which improved with conservative therapy.
Conclusions
PLC-CB has an excellent ability to detect malignancies in patients with possible PDACs, including pancreatic carcinoma in situ.

Citations

Citations to this article as recorded by

Early diagnosis of pancreatic cancer via pancreatic juice cytology with a cell-block method in a patient with altered anatomy
Yasuo Otsuka, Kosuke Minaga, Akane Hara, Kentaro Yamao, Mamoru Takenaka, Takaaki Chikugo, Masatoshi Kudo
Endoscopy International Open.2024; 12(06): E764. CrossRef
Role of endoscopic retrograde cholangiopancreatography in early diagnosis of pancreatic cancer
Yasutaka ISHII, Masahiro SERIKAWA, Shinya NAKAMURA, Juri IKEMOTO, Shiro OKA
Suizo.2024; 39(4): 247. CrossRef
Cell block created from pancreatic duct lavage is another jigsaw puzzle to diagnose early pancreatic ductal adenocarcinoma
Rungsun Rerknimitr
Clinical Endoscopy.2023; 56(3): 313. CrossRef

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Safety and Recipient Satisfaction of Propofol Sedation in Outpatient Endoscopy: A 24-Hour Prospective Investigation Using a Questionnaire Survey: Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Yoshiki Koike, Taku Yamagata, Toshitaka Sakai, Kaori Masu, Keisuke Yonamine, Kazuaki Miyamoto, Megumi Tanaka, Tomohiro Shimada, Fumisato Kozakai, Kazuki Endo, Haruka Okano, Daichi Komabayashi, Takeshi Shimizu, Shohei Suzuki, Kei Ito; Clin Endosc 2021;54(3):340-347. Published online December 11, 2020; DOI: https://doi.org/10.5946/ce.2020.138

Abstract PDF PubReader ePub

Background
/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy.
Methods
In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated.
Results
Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations.
Conclusions
Propofol sedation was found to be safe—without severe adverse events or accidents—for outpatient endoscopy on the basis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.

Citations

Citations to this article as recorded by

Comparison of sedation with pentazocine or pethidine hydrochloride for endoscopic ultrasonography in outpatients: A single‐center retrospective study
Makiko Urabe, Kenji Ikezawa, Yusuke Seiki, Ko Watsuji, Yasuharu Kawamoto, Takeru Hirao, Yugo Kai, Ryoji Takada, Takuo Yamai, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Kazuyoshi Ohkawa
DEN Open.2025;[Epub] CrossRef
Risk factors for adverse reactions to nurse-administered propofol during outpatient endoscopy: a cross-sectional study
Renzo Inca Villanueva, Cynthia Bazán Montero, María Estela Bulnes-Montánchez, Lary Salazar Alva, José Salvador Carrillo, Alejandra Zevallos, Fernando Salazar
BMC Anesthesiology.2025;[Epub] CrossRef
Remimazolam and Its Place in the Current Landscape of Procedural Sedation and General Anesthesia
Matthew Brohan, Janette Brohan, Basavana Goudra
Journal of Clinical Medicine.2024; 13(15): 4362. CrossRef
How to implement adverse events as a quality indicator in gastrointestinal endoscopy
Tom G. Moreels
Digestive Endoscopy.2024; 36(1): 89. CrossRef
Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam
Ji Hyung Nam, Dong Kee Jang, Jun Kyu Lee, Hyoun Woo Kang, Byung-Wook Kim, Byung Ik Jang
Clinical Endoscopy.2022; 55(2): 234. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef

5,236 View
165 Download
8 Web of Science
6 Crossref

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