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Original Articles
- Efficacy of double half-pigtail plastic stents for endoscopic biliary drainage of acute calculous cholangitis
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Toshitaka Sakai
, Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Haruka Okano, Kento Hosokawa, Hidehito Sumiya, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Yutaka Noda, Kei Ito - Clin Endosc 2025;58(6):898-908. Published online November 11, 2025
- DOI: https://doi.org/10.5946/ce.2025.134
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Graphical Abstract
Abstract
PDF - Background
/Aims: Plastic stent placement is required when biliary stones cannot be completely removed during the initial endoscopic retrograde cholangiopancreatography (ERCP). Although double half-pigtail plastic stents (DHPs) help prevent stent migration, their clinical utility has not yet been evaluated.
Methods
We retrospectively reviewed data from 221 patients who underwent DHP placement for acute calculous cholangitis (ACC) between January 2015 and March 2024. Patient without complete stone removal during initial ERCP were included. Clinical success, adverse events, recurrent biliary obstruction (RBO), and time to RBO (TRBO) were compared in 21 patients treated with straight plastic stents (STs) under similar conditions.
Results
Clinical success was achieved in 99% of patients in the DHP group and 95% of the ST group (p=0.13). Adverse event rates were comparable between groups. During follow-up, the DHP group had significantly lower stent occlusion (2% vs. 20%, p<0.01) and migration rates (4% vs. 15%, p=0.02), leading to a lower RBO rate (5% vs. 35%, p<0.01). The median TRBO was significantly longer in the DHP group (585 vs. 247 days, p<0.01).
Conclusions
DHPs had comparable efficacy to STs, with significantly fewer stent-related adverse events. This may be a potential option for biliary drainage in ACC.
- 3,042 View
- 78 Download
- Diagnostic value of homogenous delayed enhancement in contrast-enhanced computed tomography images and endoscopic ultrasound-guided tissue acquisition for patients with focal autoimmune pancreatitis
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Keisuke Yonamine, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Hiroaki Kusunose, Toshitaka Sakai, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito
- Clin Endosc 2023;56(4):510-520. Published online April 5, 2023
- DOI: https://doi.org/10.5946/ce.2022.142
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Graphical Abstract
Abstract
PDF
- Background
/Aims: We aimed to investigate (1) promising clinical findings for the recognition of focal type autoimmune pancreatitis (FAIP) and (2) the impact of endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) on the diagnosis of FAIP.
Methods
Twenty-three patients with FAIP were involved in this study, and 44 patients with resected pancreatic ductal adenocarcinoma (PDAC) were included in the control group.
Results
(1) Multivariate analysis revealed that homogeneous delayed enhancement on contrast-enhanced computed tomography was a significant factor indicative of FAIP compared to PDAC (90% vs. 7%, p=0.015). (2) For 13 of 17 FAIP patients (76.5%) who underwent EUS-TA, EUS-TA aided the diagnostic confirmation of AIPs, and only one patient (5.9%) was found to have AIP after surgery. On the other hand, of the six patients who did not undergo EUS-TA, three (50.0%) underwent surgery for pancreatic lesions.
Conclusions
Homogeneous delayed enhancement on contrast-enhanced computed tomography was the most useful clinical factor for discriminating FAIPs from PDACs. EUS-TA is mandatory for diagnostic confirmation of FAIP lesions and can contribute to a reduction in the rate of unnecessary surgery for patients with FAIP. -
Citations
Citations to this article as recorded by
- Clinical Updates in IgG4-Related Pancreatic and Hepatobiliary Disease
Hoyun Lee, Rodrigo Vieira Motta, Emma L Culver
British Journal of Hospital Medicine.2026;[Epub] CrossRef - Predictive factors for the diagnosis of autoimmune pancreatitis using endoscopic ultrasound-guided tissue acquisition: a retrospective study in Japan
Keisuke Yonamine, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Hiroaki Kusunose, Toshitaka Sakai, Kazuaki Miyamoto, Fumisato Kozakai, Haruka Okano, Yuto Matsuoka, Kento Hosokawa, Hidehito Sumiya, Yutaka Noda, Kei Ito
Clinical Endoscopy.2025; 58(3): 457. CrossRef - A new era for autoimmune pancreatitis diagnosis: fine-needle biopsy outperforms fine-needle aspiration in endoscopic ultrasound-guided tissue acquisition
Gunn Huh, Tae Jun Song
Clinical Endoscopy.2025; 58(3): 406. CrossRef - Role of endoscopic ultrasound in diagnosis and management of autoimmune pancreatitis
Gauri Kumbhar, Akhil Mahajan, Rahul Puri, Sridhar Sundaram
Indian Journal of Gastroenterology.2025; 44(6): 824. CrossRef - A multidisciplinary approach is essential for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma
Sung-Hoon Moon
Clinical Endoscopy.2023; 56(4): 457. CrossRef
- Clinical Updates in IgG4-Related Pancreatic and Hepatobiliary Disease
- 5,990 View
- 103 Download
- 5 Web of Science
- 5 Crossref
- Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ
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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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Graphical Abstract
Abstract
PDF
- 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
- Early diagnosis of pancreatic cancer via pancreatic juice cytology with a cell-block method in a patient with altered anatomy
- 6,323 View
- 243 Download
- 2 Web of Science
- 3 Crossref
- Predictive Value of Localized Stenosis of the Main Pancreatic Duct for Early Detection of Pancreatic Cancer
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Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Keisuke Yonamine, Yujiro Kawakami, Yuki Fujii, Kazuaki Miyamoto, Toji Murabayashi, Fumisato Kozakai, Jun Horaguchi, Yutaka Noda, Masaya Oikawa, Takaho Okada, Kei Ito
- Clin Endosc 2019;52(6):588-597. Published online November 20, 2019
- DOI: https://doi.org/10.5946/ce.2019.018
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Abstract
PDF
- Background
/Aims: In this study, we aimed to evaluate the predictive value of localized stenosis of the main pancreatic duct (MPD) for early detection of pancreatic cancer.
Methods
Among 689 patients who underwent endoscopic retrograde pancreatography from January 2008 to September 2018, 19 patients with MPD findings were enrolled. These patients showed findings for indicating suspicious pancreatic cancer at an early stage (FiCE); FiCE was defined as a single, localized stenosis in the MPD without a detectable mass (using any other imaging methods) and without other pancreatic diseases, such as definite chronic pancreatitis, intraductal papillary mucinous neoplasm, and autoimmune pancreatitis. Final diagnoses were established by examining resected specimens or through follow-up examinations after an interval of >5 years.
Results
Among 19 patients with FiCE, 11 underwent surgical resection and 8 were evaluated after a >5-year observation period. The final diagnosis of the MPD stenosis was judged to be pancreatic cancer in 9 patients (47%), including 3 with intraepithelial cancer, and to be a non-neoplastic change in 10. The sensitivity, specificity, and accuracy of preoperative pancreatic juice cytology were 75%, 100%, and 88%, respectively.
Conclusions
The predictive value of FiCE for pancreatic cancer prevalence was 47%. Histological confirmation with pancreatic juice cytology is necessary before surgical resection. -
Citations
Citations to this article as recorded by- Clinical and imaging differences between pancreatic carcinoma in situ and T1a/T1b pancreatic ductal adenocarcinoma
Tatsunori Satoh, Shinya Kawaguchi, Eiji Nakatani, Haruna Takahashi, Shinya Endo, Naofumi Shirane, Hideyuki Kanemoto, Kazuya Ohno
Abdominal Radiology.2026;[Epub] CrossRef - Super-resolution deep learning–enhanced 2D MRCP improves main pancreatic duct visualization compared with 3D MRCP
Kumi Ozaki, Shoya Haseyama, Eri Sugioka, Yukichi Tanahashi, Satoshi Goshima
European Journal of Radiology.2026; 203: 113022. CrossRef - Semiannual surveillance facilitates detection of surgically treatable intraductal papillary mucinous neoplasm–derived and concomitant carcinoma: a multicenter prospective observational study
Yosuke Ohashi, Akinori Maruta, Takuya Koizumi, Shota Iwata, Shinya Uemura, Ryuichi Tezuka, Yuhei Iwasa, Mitsuru Okuno, Keisuke Iwata, Tsuyoshi Mukai, Hironao Ichikawa, Naoki Mita, Kensaku Yoshida, Takuji Iwashita, Masahito Shimizu
Pancreatology.2026; 26(5): 738. CrossRef - Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage catheter combined with clinical findings improves diagnostic ability for malignant cases of suspected pancreatic cancer with non-identifiable tumors
Tatsunori Satoh, Junichi Kaneko, Eiji Nakatani, Hirotoshi Ishiwatari, Junya Sato, Akihiko Ohata, Reiko Yamada, Tetsuro Miwata, Kazuma Ishikawa, Fumitaka Niiya, Yosuke Kobayashi, Yasushi Hamaya, Jun Ito, Kazuhito Kawata, Azumi Suzuki, Yasunari Sakamoto, Yu
Pancreatology.2025; 25(1): 125. CrossRef - Perilesional branch duct dilation as a hallmark MRCP feature for differentiating high-grade PanIN from low-grade PanIN
Kentaro Yamao, Yasuo Takehara, Hiroshi Ogawa, Jun Nakahodo, Ryuki Minami, Ryota Sagami, Hidefumi Nishikiori, Muneyori Okita, Hidekazu Takahashi, Yoshihisa Takada, Kota Uetsuki, Tadashi Iida, Yasuyuki Mizutani, Takuya Ishikawa, Hiroki Kawashima
Pancreatology.2025; 25(5): 676. CrossRef - T1 pancreatic body cancer in which serial pancreatic juice aspiration cytological examination is useful for the diagnosis
Ryousuke Tenma, Kenichiro Imai, Takaki Furuyama, Satoru Iida, Yutaka Toukairin, Go Shibuya, Akira Fukuda, Noriyuki Kuniyoshi, Shikohumi Tei
Progress of Digestive Endoscopy.2025; 106(1): 132. CrossRef - Minor papilla approach improves technical success of nasopancreatic drainage-based pancreatic juice cytology for early pancreatic cancer diagnosis
Tatsunori Satoh, Shinya Kawaguchi, Haruna Takahashi, Yuichi Masui, Masanori Matsuda, Asami Kawai, Shinya Endo, Takafumi Kurokami, Naofumi Shirane, Kazuya Ohno
Endoscopy International Open.2025;[Epub] CrossRef - Efficient Assessment of Tumor Vascular Shutdown by Photodynamic Therapy on Orthotopic Pancreatic Cancer Using High-Speed Wide-Field Waterproof Galvanometer Scanner Photoacoustic Microscopy
Jaeyul Lee, Sangyeob Han, Til Bahadur Thapa Magar, Pallavi Gurung, Junsoo Lee, Daewoon Seong, Sungjo Park, Yong-Wan Kim, Mansik Jeon, Jeehyun Kim
International Journal of Molecular Sciences.2024; 25(6): 3457. 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 - Difference of Risk of Pancreatic Cancer in New-Onset Diabetes and Long-standing Diabetes: A Population-based Cohort Study
Hee Seung Lee, Wonjeong Chae, Min Je Sung, Jiyoung Keum, Jung Hyun Jo, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Si Young Song, Eun-Cheol Park, Chung Mo Nam, Sung-In Jang, Seungmin Bang
The Journal of Clinical Endocrinology & Metabolism.2023; 108(6): 1338. CrossRef - 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
Clinical Endoscopy.2023; 56(3): 353. CrossRef - Main pancreatic duct stenosis without detecting tumor
Katsuhiko SATO, Minoru SHIGEKAWA, Teppei YOSHIOKA, Shuhei YAMAMOTO, Takayuki MATSUMAE, Kazuhiro KOZUMI, Yu SATO, Jyunya OKABE, Takahiro KODAMA, Hayato HIKITA, Tomohide TATSUMI, Tetsuo TAKEHARA
Suizo.2023; 38(2): 147. CrossRef - Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study
Shinya Nakamura, Yasutaka Ishii, Masahiro Serikawa, Keiji Hanada, Noriaki Eguchi, Tamito Sasaki, Yoshifumi Fujimoto, Atsushi Yamaguchi, Shinichiro Sugiyama, Bunjiro Noma, Michihiro Kamigaki, Tomoyuki Minami, Akihito Okazaki, Masanobu Yukutake, Teruo Mouri
Diagnostics.2023; 13(16): 2696. CrossRef - Endoscopic approach in the diagnosis of high‐grade pancreatic intraepithelial neoplasia
Keiji Hanada, Akihiro Shimizu, Keisuke Kurihara, Morito Ikeda, Takuya Yamamoto, Yasuhiro Okuda, Susumu Tazuma
Digestive Endoscopy.2022; 34(5): 927. CrossRef - Current Screening Strategies for Pancreatic Cancer
Petr Vanek, Ondrej Urban, Vincent Zoundjiekpon, Premysl Falt
Biomedicines.2022; 10(9): 2056. CrossRef - Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma
Ryota Sagami, Kentaro Yamao, Jun Nakahodo, Ryuki Minami, Masakatsu Tsurusaki, Kazunari Murakami, Yuji Amano
Cancers.2021; 13(5): 945. CrossRef - New-Onset or Exacerbation of Diabetes Mellitus Is a Clue to the Early Diagnosis of Pancreatic Cancer
Tetsuya Takikawa, Kazuhiro Kikuta, Kiyoshi Kume, Shin Hamada, Shin Miura, Naoki Yoshida, Seiji Hongo, Yu Tanaka, Ryotaro Matsumoto, Takanori Sano, Mio Ikeda, Masahiro Iseki, Michiaki Unno, Atsushi Masamune
The Tohoku Journal of Experimental Medicine.2020; 252(4): 353. CrossRef - Can Localized Stenosis of the Main Pancreatic Duct be a Predictive Factor for Early Detection of Pancreatic Cancer?
Mamoru Takenaka, Kentaro Yamao, Masatoshi Kudo
Clinical Endoscopy.2019; 52(6): 523. CrossRef
- Clinical and imaging differences between pancreatic carcinoma in situ and T1a/T1b pancreatic ductal adenocarcinoma
- 8,611 View
- 134 Download
- 17 Web of Science
- 18 Crossref
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