1.Clinical outcomes of permanent stenting with endoscopic ultrasound gallbladder drainage
Eisuke SUZUKI ; Yuji FUJITA ; Kunihiro HOSONO ; Yuji KOYAMA ; Seitaro TSUJINO ; Takuma TERATANI ; Atsushi NAKAJIMA ; Nobuyuki MATSUHASHI
Clinical Endoscopy 2023;56(5):650-657
Background/Aims:
Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD.
Methods:
This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events.
Results:
A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10–1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period.
Conclusions
EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.
2.Nutritional status of calcium and other bone-related nutrients in Japanese type 2 diabetes patients.
Eisuke TOMASTU ; Eri NINOMIYA ; Mizuho ANDO ; Izumi HIRATSUKA ; Yasumasa YOSHINO ; Sahoko SEKIGUCHI-UEDA ; Megumi SHIBATA ; Akemi ITO ; Kazuhiro UENISHI ; Atsushi SUZUKI
Osteoporosis and Sarcopenia 2016;2(2):94-98
OBJECTIVE: Traditional Japanese food appears to be healthy but contains a small amount of milk products. Type 2 diabetes (T2DM) patients commonly reduce their energy intake to control their blood glucose levels. However, nutritional guidance for diabetes does not emphasize calcium (Ca) consumption. The aim of this study is to estimate the nutritional status of Ca and other nutrients, which affect bone and Ca metabolism, in T2DM patients. METHODS: This observational study was conducted with Japanese T2DM patients (n = 96; M/F = 50/46; age: 61.6 ± 10.1 years). We estimated nutrient intake using a simple food frequency questionnaire. RESULTS: Median total energy intake was 1750 kcal/day (1440-1970). Their median daily intake of Ca, vitamin D, and vitamin K was 451 mg (336-560), 10.2 µg (8.5-12), and 206 µg (84-261), respectively. Only 17.7% of the study subjects were found to take more than 600 mg/day of Ca. Protein and salt intake was 78 (64-90) and 10.6 (9.3-12.2) g/day, respectively. Male subjects had more salt, less Ca and vitamin K than female. Daily Ca intake was positively associated with total energy, protein, and lipid intake but not with carbohydrates. Vitamin D intake correlated only with protein intake. CONCLUSION: The daily Ca intake of Japanese T2DM patients appears to be insufficient and could depend on protein and lipid intake. Additionally, these patients should have specific recommendations to ensure sufficient intake of Ca with protein and lipid during energy restriction.
Asian Continental Ancestry Group*
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Blood Glucose
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Calcium*
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Carbohydrates
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Energy Intake
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Female
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Humans
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Male
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Metabolism
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Milk
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Nutritional Status*
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Observational Study
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Vitamin D
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Vitamin K
3.Efficacy of the pocket-creation method with a traction device in endoscopic submucosal dissection for residual or recurrent colorectal lesions
Daisuke IDE ; Tomohiko Richard OHYA ; Mitsuaki ISHIOKA ; Yuri ENOMOTO ; Eisuke NAKAO ; Yuki MITSUYOSHI ; Junki TOKURA ; Keigo SUZUKI ; Seiichi YAKABI ; Chihiro YASUE ; Akiko CHINO ; Masahiro IGARASHI ; Akio NAKASHIMA ; Masayuki SARUTA ; Shoichi SAITO ; Junko FUJISAKI
Clinical Endoscopy 2022;55(5):655-664
Background/Aims:
Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions.
Methods:
We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events.
Results:
En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group.
Conclusions
PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.