論文 - 河上 洋
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Kawakami H., Itoi T., Kuwatani M., Kawakubo K., Kubota Y., Sakamoto N.
Journal of Hepato-Biliary-Pancreatic Sciences 22 ( 4 ) E12 - E21 2015年4月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Hepato-Biliary-Pancreatic Sciences
© 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery. Unresectable malignant hilar biliary obstruction (MHBO) occurs in various diseases, such as cholangiocarcinoma, gallbladder carcinoma, hepatocellular carcinoma, pancreatic cancer, and lymph node metastasis of the hilum of the liver. The majority of patients with advanced MHBO are not candidates for surgical resection because of the tumor location in the hepatic hilum and adjacent areas, advanced tumor stage, or comorbidities. Therefore, these patients often have a poor prognosis in terms of survival and quality of life. Most of these patients will require non-surgical, palliative biliary drainage. To date, various biliary drainage techniques for unresectable MHBO (UMHBO) have been reported. Of these techniques, endoscopic biliary drainage is currently considered to be the most safe and minimally invasive procedure. However, endoscopic biliary drainage for UMHBO is still not standardized regarding the optimal stent, drainage area, stenting method, and reintervention technique. Recently, towards standardization of this technique for UMHBO, clinical research and trials including randomized controlled trials have been performed. In this article, we reviewed the most important issues regarding endoscopic biliary drainage for UMHBO, focusing on prospective studies. We also described in detail the techniques and future perspectives of endoscopic biliary drainage in patients with UMHBO.
DOI： 10.1002/jhbp.186
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Hepatobiliary and Pancreatic: A splenic artery aneurysm presenting as a calcified pancreatic mass
Kawakubo K., Kawakami H., Kuwatani M., Sakamoto N.
Journal of Gastroenterology and Hepatology (Australia) 30 ( 4 ) 655 - 655 2015年4月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Gastroenterology and Hepatology (Australia)
DOI： 10.1111/jgh.12848
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Kuwatani M., Kawakami H., Abe Y., Kawahata S., Kawakubo K., Kubo K., Sakamoto N.
Gut and Liver 9 ( 2 ) 251 - 252 2015年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gut and Liver
A 72-year-old man with jaundice by ampullary adenocarcinoma was treated at our hospital. For biliary decompression, a transpapillary, fully covered, self-expandable metal stent (FCSEMS) was deployed. Four days later, the patient developed acute cholangitis. Endoscopic carbon dioxide cholangiography revealed kinking of the common bile duct above the proximal end of the FCSEMS. A 7-F double-pigtail plastic stent was therefore placed through the FCSEMS to correct the kink, straightening the common bile duct (CBD) and improving cholangitis. This is the first report of a unique use of a double-pigtail plastic stent to correct CBD kinking. The placement of a double-pigtail plastic stent can correct CBD kinking, without requiring replacement or addition of a FCSEMS, and can lead to cost savings.
DOI： 10.5009/gnl14286
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Incidental pancreatic cyst is a significant predictor of mortality? What determines life expectancy? 査読あり
Kawakubo K., Kawakami H., Kuwatani M., Sakamoto N.
Radiology 274 ( 3 ) 2015年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Incidental pancreatic cyst is a significant predictor of mortality? What determines life expectancy? 査読あり
Kawakubo K., Kawakami H., Kuwatani M., Sakamoto N.
Radiology 274 ( 3 ) 2015年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Multidisciplinary treatment of gallbladder cancer--biliary and duodenal stenting
Kawakami H., Kuwatani M., Sakamoto N.
Nihon rinsho. Japanese journal of clinical medicine 73 595 - 600 2015年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Nihon rinsho. Japanese journal of clinical medicine
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Kawakubo K., Kawakami H., Kuwatani M., Kudo T., Abe Y., Kawahata S., Kubo K., Kubota Y., Sakamoto N.
Journal of Hepato-Biliary-Pancreatic Sciences 22 ( 2 ) 151 - 155 2015年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Hepato-Biliary-Pancreatic Sciences
© 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery. BackgroundBilateral self-expandable metallic stent (SEMS) placement for the management of unresectable malignant hilar biliary obstruction (UMHBO) is technically challenging to perform using the existing metallic stents with thick delivery systems. The recently developed 6-Fr delivery systems could facilitate a single-step simultaneous side-by-side placement through the accessory channel of the duodenoscope. The aim of this study was to evaluate the feasibility of this procedure. MethodsBetween May and September 2013, 13 consecutive patients with UMHBO underwent a single-step simultaneous side-by-side placement of SEMS with the 6-Fr delivery system. The technical success rate, stent patency, and rate of complications were evaluated from the prospectively collected database. ResultsTechnical success was achieved in 11 (84.6%, 95% confidence interval [CI]: 57.8-95.8) patients. The median procedure time was 25-min. Early and late complications were observed in 23% (one segmental cholangitis and two liver abscesses) and 15% (one segmental cholangitis and one cholecystitis) patients, respectively. Median dysfunction free patency was 263 days (95% CI: 37-263). Five patients (38%) experienced stent occlusion that was successfully managed by endoscopic stent placement. ConclusionsA single-step simultaneous side-by-side placement of SEMS with a 6-Fr delivery system was feasible for the management of UMHBO.
DOI： 10.1002/jhbp.173
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Kawakubo K., Kawakami H., Toyokawa Y., Otani K., Kuwatani M., Abe Y., Kawahata S., Kubo K., Kubota Y., Sakamoto N.
Journal of Hepato-Biliary-Pancreatic Sciences 22 ( 1 ) 79 - 85 2015年1月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Hepato-Biliary-Pancreatic Sciences
© 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery. Background Endoscopic double self-expandable metallic stent (SEMS) placement by the partial stent-in-stent (PSIS) method has been reported to be useful for the management of unresectable hilar malignant biliary obstruction. However, it is technically challenging, and the optimal SEMS for the procedure remains unknown. The aim of this study was to identify the risk factors for technical failure of endoscopic double SEMS placement for unresectable malignant hilar biliary obstruction (MHBO). Methods: Between December 2009 and May 2013, 50 consecutive patients with MHBO underwent endoscopic double SEMS placement by the PSIS method. We retrospectively evaluated the rate of successful double SEMS placement and identified the risk factors for technical failure. Results: The technical success rate for double SEMS placement was 82.0% (95% confidence interval [CI]: 69.2-90.2). On univariate analysis, the rate of technical failure was high in patients with metastatic disease and unilateral placement. Multivariate analysis revealed that metastatic disease was a significant risk factor for technical failure (odds ratio: 9.63, 95% CI: 1.11-105.5). The subgroup analysis after double guidewire insertion showed that the rate of technical success was higher in the laser-cut type SEMS with a large mesh and thick delivery system than in the braided type SEMS with a small mesh and thick delivery system. Conclusions: Metastatic disease was a significant risk factor for technical failure of double SEMS placement for unresectable MHBO. The laser-cut type SEMS with a large mesh and thin delivery system might be preferable for the PSIS procedure.
DOI： 10.1002/jhbp.170
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Kawakami H., Kuwatani M., Kubo K., Kubota Y., Kawakubo K., Abe Y., Kawahata S., Homma N., Hida Y., Sakamoto N.
Endoscopy 47 E69 - E70 2015年1月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Kawakami H., Kuwatani M., Abe Y., Kubota Y., Kawakubo K., Kubo K., Kawahata S., Sakamoto N.
Endoscopy 47 ( 1 ) E43 - E44 2015年1月
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Itoi T., Kawakami H., Katanuma A., Irisawa A., Sofuni A., Itokawa F., Tsuchiya T., Tanaka R., Umeda J., Ryozawa S., Doi S., Sakamoto N., Yasuda I.
Gastrointestinal Endoscopy 81 ( 1 ) 111 - 118 2015年1月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gastrointestinal Endoscopy
© 2015 American Society for Gastrointestinal Endoscopy. Background There are currently no prospective, controlled trials of endoscopic transpapillary gallbladder drainage in patients with acute cholecystitis. Objective We evaluated the technical success rate and efficacy of endoscopic transpapillary gallbladder drainage by using either endoscopic nasogallbladder drainage (ENGBD) or endoscopic gallbladder stenting (EGBS) for patients with acute cholecystitis. Design Randomized, controlled study. Setting Tertiary-care referral centers. Patients Seventy-three consecutive patients with acute cholecystitis were randomized. Interventions ENGBD by using a 5F or 7F tube (n = 37) or EGBS (n = 36) by using a 7F stent. Main Outcome and Measurements Technical success, clinical success, adverse events, and procedure-related pain score. Results The overall technical success rates in the ENGBD and EGBS groups were 91.9% and 86.1%, respectively (P > .05). The mean procedure times of ENGBD and EGBS were 20.3 ± 12.1 and 22.2 ± 14.5 minutes, respectively (P > .05). The overall clinical success rates by per protocol analysis were 94.1% and 90.3% in the ENGBD and EGBS groups, respectively, whereas the rates by intention-to-treat analysis were 86.5% and 77.8%, respectively (P > .05). Moderate adverse events were observed in the ENGBD (n = 2) and EGBS (n = 1) groups. The mean visual analog score of postprocedure pain in the ENGBD group was significantly higher than that in the EGBS group (1.3 ± 1.1 vs 0.4 ± 0.8, respectively; P < .001). Limitations Small sample size and the participation of multiple endoscopists who may have different levels of experience in endoscopic transpapillary gallbladder drainage. Conclusions Both ENGBD and EGBS appear to be suitable for the treatment of acute cholecystitis in patients who are poor candidates for emergency cholecystectomy. (Clinical trial registration number: UMIN000012316.)
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Kudo T., Kawakami H., Hayashi T., Yasuda I., Mukai T., Inoue H., Katanuma A., Kawakubo K., Ishiwatari H., Doi S., Yamada R., Maguchi H., Isayama H., Mitsuhashi T., Sakamoto N.
Gastrointestinal Endoscopy 80 ( 6 ) 1030 - 1037.e1 2014年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gastrointestinal Endoscopy
© 2014 by the American Society for Gastrointestinal Endoscopy. Background EUS-guided FNA (EUS-FNA) has a high diagnostic accuracy for pancreatic diseases. However, although most reports have typically focused on cytology, histological tissue quality has rarely been investigated. The effectiveness of EUS-FNA combined with high negative pressure (HNP) suction was recently indicated for tissue acquisition, but has not thus far been tested in a prospective, randomized clinical trial. Objective To evaluate the adequacy of EUS-FNA with HNP for the histological diagnosis of pancreatic lesions by using 25-gauge needles. Design Prospective, single-blind, randomized, controlled crossover trial. Setting Seven tertiary referral centers. Patients Patients referred for EUS-FNA of pancreatic solid lesions. From July 2011 to April 2012, 90 patients underwent EUS-FNA of pancreatic solid masses by using normal negative pressure (NNP) and HNP with 2 respective passes. The order of the passes was randomized, and the sample adequacy, quality, and histology were evaluated by a single expert pathologist. Intervention EUS-FNA by using NNP and HNP. Main Outcome Measurements The adequacy of tissue acquisition and the accuracy of histological diagnoses made by using the EUS-FNA technique with HNP. Results We found that 72.2% (65/90) and 90% (81/90) of the specimens obtained using NNP and HNP, respectively, were adequate for histological diagnosis (P =.0003, McNemar test). For 73.3% (66/90) and 82.2% (74/90) of the specimens obtained by using NNP and HNP, respectively, an accurate diagnosis was achieved (P =.06, McNemar test). Pancreatitis developed in 1 patient after this procedure, which subsided with conservative therapy. Limitations This was a single-blinded, crossover study. Conclusion Biopsy procedures that combine the EUS-FNA with HNP techniques are superior to EUS-FNA with NNP procedures for tissue acquisition. (Clinical trial registration number: UMIN000005939.).
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Kuwatani M., Kawakami H., Zen Y., Kawakubo K., Kudo T., Abe Y., Kubo K., Sakamoto N.
Hepato-gastroenterology 61 ( 135 ) 1852 - 1856 2014年10月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Hepato-gastroenterology
BACKGROUND/AIMS: IgG4-related sclerosing cholangitis (IgG4-SC) is a newly established entity. The purpose of this study was to investigate the differences in intraductal ultrasonography (IDUS) findings between IgG4-SC and bile duct (BD) cancer (BDC) as well as the relationship among BD wall thickness, serological and pathological findings in IgG4-SC. METHODOLOGY: Based on the diagnostic criteria of IgG4-SC, we reviewed patients in our hospital between April 2005 and June 2013, and analyzed the data obtained from 32 patients with IgG4-SC and 40 patients with BDC. RESULTS: Regarding IDUS findings, significantly more cases in BDC indicated rigid/papillary inner margin than in IgG4-SC, while biopsy was more efficient. There were no significant correlations between BD wall thickness and serum IgG/IgG4 levels or the number of IgG4-positive cells of the BD specimens. All the IgG4-SC patients without steroid treatment revealed discordant results in the shifts of IgG, IgG4 and BD wall thickness between the 1st and 2nd examinations, while all patients with steroid had completely concordant results of the shifts. CONCLUSIONS: IDUS findings alone are insufficient for differentiation between IgG4-SC and BDC. BD wall thickness, serum IgG and IgG4 proportionally shift and reflect the effect of steroid on IgG4-SC after steroid treatment, not before it.
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Hirano S., Tanaka E., Tsuchikawa T., Matsumoto J., Kawakami H., Nakamura T., Kurashima Y., Ebihara Y., Shichinohe T.
Journal of Hepato-Biliary-Pancreatic Sciences 21 ( 8 ) 533 - 540 2014年8月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Hepato-Biliary-Pancreatic Sciences
Due to advances in endoscopic equipment and techniques, preoperative endoscopic biliary drainage (EBD) has been developed to serve as an alternative to percutaneous transhepatic biliary drainage (PTBD). This study sought to clarify the benefit of EBD in comparison to PTBD in patients who underwent radical resections of hilar cholangiocarcinoma. One hundred and forty-one patients underwent radical surgery for hilar cholangiocarcinoma between 2000 and 2008 were retrospectively divided into two groups based on the type of preoperative biliary drainage, PTBD (n = 67) or EBD (n = 74). We investigated if the different biliary drainage methods affected postoperative survival and mode of recurrence after median observation period of 82 months. The survival rate for patients who underwent EBD was significantly higher than those who had PTBD (P = 0.004). Multivariate analysis revealed that PTBD was one of the independent factors predictive of poor survival (hazard ratio: 2.075, P = 0.003). Patients with PTBD more frequently developed peritoneal seeding in comparison to those who underwent EBD (P = 0.0003). PTBD was the only independent factor predictive of peritoneal seeding. In conclusion, EBD might confer an improved prognosis over PTBD due to prevention of peritoneal seeding, and is recommended as the initial procedure for preoperative biliary drainage in patients with hilar cholangiocarcinoma. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
DOI： 10.1002/jhbp.76
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Kawakami H., Itoi T., Sakamoto N.
Gut and Liver 8 ( 4 ) 341 - 355 2014年7月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gut and Liver
Endoscopic drainage for pancreatic and peripancreatic fluid collections (PFCs) has been increasingly used as a minimally invasive alternative to surgical or percutaneous drainage. Recently, endoscopic ultrasound-guided transluminal drainage (EUS-TD) has become the standard of care and a safe procedure for nonsurgical PFC treatment. EUS-TD ensures a safe puncture, avoiding intervening blood vessels. Single or multiple plastic stents (combined with a nasocystic catheter) were used for the treatment of PFCs for EUS-TD. More recently, the use of covered self-expandable metallic stents (CSEMSs) has provided a safer and more efficient approach route for internal drainage. We focused our review on the best approach and stent to use in endoscopic drainage for PFCs. We reviewed studies of EUS-TD for PFCs based on the original Atlanta Classification, including case reports, case series, and previous review articles. Data on clinical outcomes and adverse events were collected retrospectively. A total of 93 patients underwent EUS-TD of pancreatic pseudocysts using CSEMSs. The treatment success and adverse event rates were 94.6% and 21.1%, respectively. The majority of complications were of mild severity and resolved with conservative therapy. A total of 56 patients underwent EUS-TD using CSEMSs for pancreatic abscesses or infected walled-off necroses. The treatment success and adverse event rates were 87.8% and 9.5%, respectively. EUS-TD can be performed safely and efficiently for PFC treatment. Larger diameter CSEMSs without additional fistula tract dilation for the passage of a standard scope are needed to access and drain for PFCs with solid debris.
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Kawakubo K., Kawakami H., Kuwatani M., Haba S., Kudo T., Abe Y., Kawahata S., Onodera M., Ehira N., Yamato H., Eto K., Sakamoto N.
Gut and Liver 8 ( 3 ) 329 - 332 2014年5月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gut and Liver
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are essential for diagnosing and treating pancreatobiliary diseases. Single-session EUS and ERCP are considered to be essential in reducing the duration of hospital stays; however, complications are a primary concern. The aim of this study was to evaluate the safety and efficacy of single-session EUS and ERCP. Sixty-eight patients underwent single-session EUS and ERCP at a tertiary referral center between June 2008 and December 2012. We retrospectively reviewed patient data from a prospectively maintained EUS-ERCP database and evaluated the procedural characteristics and complications. Thirty-eight patients (56%) underwent diagnostic EUS, and 30 patients (44%) underwent EUS fine-needle aspiration, which had an overall accuracy of 100%. Sixty patients (89%) underwent therapeutic ERCP, whereas the remaining eight procedures were diagnostic. Thirteen patients underwent biliary stone extraction, and 48 underwent biliary drainage. The median total procedural time was 75 minutes. Complications were observed in seven patients (10%). Six complications were post-ERCP pancreatitis, which were resolved using conservative management. One patient developed Mallory-Weiss syndrome, which required endoscopic hemostasis. No sedation-related cardiopulmonary complications were observed. Single-session EUS and ERCP provided accurate diagnosis and effective management with a minimal complication rate.
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Kawakubo K., Isayama H., Kato H., Itoi T., Kawakami H., Hanada K., Ishiwatari H., Yasuda I., Kawamoto H., Itokawa F., Kuwatani M., Iiboshi T., Hayashi T., Doi S., Nakai Y.
Journal of Hepato-Biliary-Pancreatic Sciences 21 ( 5 ) 328 - 334 2014年5月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Hepato-Biliary-Pancreatic Sciences
Background Endoscopic ultrasound-guided biliary drainage (EUS-BD) is considered to be an effective salvage procedure for failed endoscopic retrograde cholangiopancreatography in patients with unresectable malignant biliary obstruction. The aim of this retrospective study was to evaluate the efficacy and feasibility of EUS-BD. Methods From November 2006 to May 2012, a total of 64 patients who underwent EUS-BD (44 EUS-guided choledochoduodenostomy [EUS-CDS] and 20 EUS-guided hepaticogastrostomy [EUS-HGS] ) at seven tertiary-care referral centers in Japan were included. The primary outcome was the technical success rate, and the secondary outcomes were the incidence of complications, stent dysfunction rate, time to stent dysfunction, and overall survival. Results The technical success rate for both EUS-CDS and EUS-HGS was 95%. The reasons for technical failure were two failed dilations of the anastomosis in EUS-CDS and one puncture failure in EUS-HGS. The stent dysfunction rate and 3-month dysfunction-free patency rate were 21% and 80% for EUS-CDS and 32% and 51% for EUS-HGS. There were 12 (six in EUS-CDS and six in EUS-HGS) procedure-related complications (19%): five cases of bile leakage (3/2), three stent misplacements (1/2), one pneumoperitoneum (1/0), two cases of bleeding (1/1), one perforation (1/0), and one biloma (0/1). Bile leakage was more frequently observed in patients who underwent plastic stent placement (11%) than in those with covered metal stents (4%). Conclusions This Japanese multicenter study revealed a high success rate in EUS-BD. However, the complication rate was as high as that in previous series. Covered metal stents may be useful to reduce bile leakage in EUS-BD. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
DOI： 10.1002/jhbp.27
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Kudo T., Kawakami H., Kuwatani M., Eto K., Kawahata S., Abe Y., Onodera M., Ehira N., Yamato H., Haba S., Kawakubo K., Sakamoto N.
World Journal of Gastroenterology 20 ( 13 ) 3620 - 3627 2014年4月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：World Journal of Gastroenterology
AIM: To evaluate the safety and diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in a cohort of pancreatic cancer patients. METHODS: Of 213 patients with pancreatic cancer evaluated between April 2007 and August 2011, 82 were thought to have resectable pancreatic cancer on the basis of cross-sectional imaging findings. Of these, 54 underwent EUS-FNA before surgery (FNA+ group) and 28 underwent surgery without preoperative EUSFNA (FNA- group). RESULTS: All 54 lesions were visible on EUS, and all 54 attempts at FNA were technically successful. The diagnostic accuracy according to cyto logy and histology findings was 98.1% (53/54) and 77.8% (42/54), respectively, and the total accuracy was 98.1% (53/54). One patient developed mild pancreatitis after EUS-FNA but was successfully treated by conservative therapy. No severe complications occurred after EUS-FNA. In the FNA+ and FNA- groups, the median relapse-free survival (RFS) was 742 and 265 d, respectively (P = 0.0099), and the median overall survival (OS) was 1042 and 557 d, respectively (P = 0.0071). RFS and OS were therefore not inferior in the FNA+ group. These data indicate that the use of EUS-FNA did not influence RFS or OS, nor did it increase the risk of peritoneal recurrence. Conclusion: In patients with resectable pancreatic cancer, preoperative EUS-FNA is a safe and accurate diagnostic method. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
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Endoscopic ultrasound-guided rendezvous technique for difficult cannulation into the bile duct
Kawakubo K., Kawakami H., Isayama H., Sakamoto N.
Gastroenterological Endoscopy 56 ( 3 ) 504 - 514 2014年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gastroenterological Endoscopy
The endoscopic ultrasound (EUS)-guided rendezvous technique was reported to be a useful salvage method for patients with failed cannulation. In such patients, after bile duct puncture under EUS guidance, cholangiography was obtained. Then the guidewire was inserted through the needle into the bile duct and further antegradely advanced through the papilla into the duodenum. The echoendoscope was removed leaving the guidewire in place, followed by duodenoscope insertion. Finally, the bile duct was cannulated alongside of the guidewire or over the guidewire. The EUS-guided rendezvous technique is a complicated procedure and not yet standardized due to the absence of dedicated devices. However, the EUS-guided rendezvous technique allows reliable bile duct cannulation because of bile duct access under ultrasonographic guidance compared to conventional retrograde bile duct cannulation using the ERCP technique. However, the possibility of serious complications, such as bile leak or peritonitis, should be of concern due to bile duct access through the peritoneum or retroperitoneum. To gain familiarity with various approach routes in the EUS-guided rendezvous technique is essential for a successful procedure.
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Kawakami H., Isayama H., Maguchi H., Kuwatani M., Kawakubo K., Kudo T., Abe Y., Kawahata S., Kubo K., Koike K., Sakamoto N.
Endoscopy 46 ( 2 ) 2014年2月
記述言語：日本語 掲載種別：研究論文（学術雑誌）