| Project/Area Number |
09670569
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Gastroenterology
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| Research Institution | Jichi Medical School |
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Principal Investigator |
TAMADA Kiichi Jichi Med.Sch., Medicine, Lecturer, 医学部, 講師 (90291632)
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| Co-Investigator(Kenkyū-buntansha) |
IDO Kenichi Jichi Med.Sch., Medicine, Assistant professor, 医学部, 助教授 (80112621)
UENO Norio Jichi Med.Sch., Medicine, Lecturer, 医学部, 講師 (40168646)
TOMIYAMA Takeshi Jichi Med.Sch., Medicine, Assistant, 医学部, 助手 (50301445)
OHASHI Akira Jichi Med.Sch., Medicine, Assiatant, 医学部, 助手 (60301446)
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| Project Period (FY) |
1997 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥2,900,000 (Direct Cost: ¥2,900,000)
Fiscal Year 1998: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 1997: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Keywords | Intraductal ultrasonography / IDUS / Endoscopic balloon sphincteroplasty : / EBS / Biliary tract cancer / bile duct cancer / 胆管内超音波検査 / Intraductal ultrasonography: IDUS / 内視鏡的乳頭拡張術 / Endoscopic Balloon sphincteroplasty:EBS / 胆管癌 / 肝外胆管癌 / 胆管 / 進展度診断 |
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| Research Abstract |
1) Analysis of bile duct wall structures demonstrated by Intraductal ultrasonography (IDUS). Experiments in a water tank with resected bile duct specimen was conducted. Inner hypo-echoic layer on IDUS corresponded to the fibro- and fibromuscular layer histologically. Outer hyper-echoic layer on DUS corresponded to the subserosal fat tissue histologically.
2) Assessment of Oddi function after endoscopic balloon sphincteroplasty (EBS). Thin-caliber microtransducer was introduced into the papilla via the transpapillary route at the time of pre-EBS, I month after EBS, and 12 months after BBS.Basic pressure, maximum amplitude, and frequency of the construction of sphincter Oddi were evaluated. There was no significant difference in these factors pre- and post-EBS.These results suggested that function of Oddi sphincter was preserved after the therapy under EBS.
3) Assessment of tumor extension of the biliary tract cancer using IDUS.In the patients with extrahepatic bile duct cancer (n-43), IDUS accurately assessed serosal invasion in 93%, pancreatic parenchymal invasion in 91 %, right hepatic artery invasion in 98%, portal vein invasion in 95%, and pericholedochal lymph nodesmetastases in 74%.
4) Characterization of bile duct lesions demonstrated by IDUS.Transpapillary bile duct biopsy under EBS along the guidewire was established as a safe procedure, when IDUS showed the lesions in the bile duct.
5) Establishment of safe method of EBS.We performed lithotripsy under EBS in 150 patients, with the successful stone clearance of 96%, and with the complication (mild pancreatitis) of 6%. Our results suggested that injection of 0.1% Epinephrine to the papilla and replacement of endoscopic naso-biliary drainage (ENBD) were useful to prevent post-EBS pancreatitis.
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