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Fukuma T, Ishii S, Fujisawa T, Takahashi K, Nakamura T, Shibata F, Tomishima K, Takasaki Y, Suzuki A, Takahashi S, Ito K, Ushio M, Ikemura M, Kabemura D, Ota H, Nakai Y, Kogure H, Takahara N, Isayama H. Development of a Dedicated X-Ray Fluoroscopic Apparatus for Therapeutic Pancreatobiliary Endoscopy: A Review. J Clin Med 2025; 14:1214. [PMID: 40004745 PMCID: PMC11856850 DOI: 10.3390/jcm14041214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Revised: 01/30/2025] [Accepted: 02/07/2025] [Indexed: 02/27/2025] Open
Abstract
In recent years, pancreaticobiliary endoscopy (PBE) has evolved to include a wide range of endoscopic procedures used to treat various diseases. Several interventional endoscopic ultrasonography procedures have been developed for conditions that cannot be treated with conventional endoscopic methods. As PBE continues to advance, it is crucial to improve fluoroscopic systems to enhance image quality, ensure patient safety, reduce radiation exposure, and ensure the operation of video-recording systems. The difficult procedures require the precise imaging of thin pancreatic/biliary branch devices, including guidewires, catheters, and stents. It is crucial to reduce noise caused by patient breathing and movement, while retaining the necessary movement in the image on the screen. A stable table is effective for ensuring the safety of patients during the procedure. A reduction in radiation exposure is important, and the flame rate conversion technique is effective. Ensuring high-quality recording is useful for the video presentation of PBE procedures. In collaboration with Fujifilm (Tokyo, Japan), we researched and developed various functions in fluoroscopic systems for PBE. In this review, we outline the requirements for fluoroscopic procedures in PBE, the evolution of technology to date, and its prospects, while also presenting the commercial equipment currently available.
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Affiliation(s)
- Taito Fukuma
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Shigeto Ishii
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Toshio Fujisawa
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Keiko Takahashi
- Medical System Research & Development Center, MS R&D Department, FUJIFILM Corporation, Chiba 277-0804, Japan; (K.T.); (T.N.)
| | - Tadashi Nakamura
- Medical System Research & Development Center, MS R&D Department, FUJIFILM Corporation, Chiba 277-0804, Japan; (K.T.); (T.N.)
| | - Futoshi Shibata
- Modality Solution Division, Medical System Business Division, XR Product Marketing Group, FUJIFILM Corporation, Tokyo 107-0052, Japan;
| | - Ko Tomishima
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Yusuke Takasaki
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Akinori Suzuki
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Sho Takahashi
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Koichi Ito
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Mako Ushio
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Muneo Ikemura
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Daishi Kabemura
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Hiroto Ota
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
| | - Yousuke Nakai
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (Y.N.); (N.T.)
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | - Hirofumi Kogure
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo 101-8309, Japan;
| | - Naminatsu Takahara
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (Y.N.); (N.T.)
| | - Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan; (T.F.); (S.I.); (T.F.); (K.T.); (Y.T.); (A.S.); (S.T.); (K.I.); (M.U.); (M.I.); (D.K.); (H.O.)
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Tabibian JH, Lindor KD. Primary sclerosing cholangitis: a review and update on therapeutic developments. Expert Rev Gastroenterol Hepatol 2013; 7:103-14. [PMID: 23363260 DOI: 10.1586/egh.12.80] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary sclerosing cholangitis (PSC) is a chronic, cholestatic, idiopathic liver disease characterized by fibro-obliterative inflammation of the hepatic bile ducts. In a clinically significant proportion of patients, PSC progresses to cirrhosis, end-stage liver disease, and in some cases, cholangiocarcinoma. Despite clinical trials of nearly 20 different pharmacotherapies over several decades, safe and effective medical therapy, albeit critically needed, remains to be established. PSC is pathogenically complex, with genetic, immune, enteric microbial, environmental and other factors being potentially involved and, thus, not surprisingly, it manifests as a clinically heterogeneous disease with a relatively unpredictable course. It is likely that this complexity and clinical heterogeneity are responsible for the negative results of clinical trials, but novel insights about and approaches to PSC may shift this trend. The authors herein provide a review of previously tested pharmacologic agents, discuss emerging fundamental concepts and present viewpoints regarding how identifying therapies for PSC may evolve over the next several years.
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Affiliation(s)
- James H Tabibian
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
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