http://www.umin.ac.jp/ctr/index.htm (ID: UMIN-000002536).

Endoscopic ultrasonography (EUS) has significantly improved our understanding of the complex vascular structural changes that occur in portal hypertension and their clinical and prognostic significance. EUS in combination with color Doppler technique enables us to study the hemodynamic changes in the portal venous system noninvasively, and to determine objectively the effect of different pharmacological agents on portal hypertension. EUS has also found some role in the treatment and follow up of esophageal and gastric varices. It may play a clinical role in the diagnosis of gastric, duodenal, and rectal varices. Recently reported EUS-based devices that measure variceal wall tension and intravariceal pressure noninvasively could have an impact on the identification of patients at high risk of variceal bleeding with the aim of initiating prophylactic treatment, and in the assessment of patients' responses to drug therapy of portal hypertension. EUS is occasionally very helpful in the clinical management of portal hypertension. It is an interesting and important research tool for many experimental indications that are not routinely applied in clinical practice at this time.

Oblique-viewing curved linear array (OV-CLA) echoendoscopes have been widely used to perform endoscopic ultrasonography-guided fine needle aspiration and interventional endoscopic ultrasonography. Recently a prototype forward-viewing curved liner array (FV-CLA) echoendoscope was developed. In the present trial, 11 endoscopists participated in a hands-on trial and a questionnaire survey to evaluate the operation performance and visualization performance of a prototype FV-CLA scope in a phantom model designed for training of endoscopic ultrasonography. The results of our trial suggested that the FV-CLA scope is slightly inferior or equivalent to the conventional OV-CLA scope in operation performance, and that the FV-CLA scope is equivalent to the OV-CLA scope with regard to the visualization performance in a phantom model.

Biliary stenting for unresectable malignant biliary strictures is widely accepted and is routinely done as an effective palliation therapy. However, a consensus among experts is still far from being reached on the selection of stents, placement procedures etc. In 2012, the European Society of Gastrointestinal Endoscopy reported guidelines for biliary stenting. At the Endoscopic Forum Japan 2012, a consensus meeting was held to examine seven statements that had been prepared based on these guidelines.Herein, we report the contents and the results of the examination of three of these statements on biliary stenting for hilar strictures.

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