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Novel procedure for hepatic venous outflow block after liver resection:A case report

World Journal of Clinical Cases 2024年第29期12卷 6320-6326页

作者： Hisanobu Higashi Yuta Abe Kodai Abe Yutaka Nakano Masayuki Tanaka shutaro hori Yasushi Hasegawa Hiroshi Yagi Minoru Kitago Yuko Kitagawa Department of Surgery National Hospital Organization Saitama HospitalWako 351-0102Japan Department of Surgery Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND Postoperative complications like remnant hepatic vein(HV)outflow block and liver torsion can occur after right *** falciform ligament fixation is typically used to prevent liver *** report a novel procedure to manage outflow *** SUMMARY An 80-year-old man developed HV outflow block after remnant right hepatectomy,despite liver fixation and intraoperative HV flow *** had a history of cholangiocellular carcinoma and had undergone posterior segmentectomy and *** falciform ligament fixation was inadequate to maintain liver *** surgery was performed,using an omental flap and mobilized right side colon with ileocecal region to prevent liver dislocation due to intraabdominal *** postoperative course was *** This is the first report providing a novel surgical procedure when the falciform ligament is insufficient for remnant liver fixation.

关键词： Hepatectomy Postoperative complications Budd-Chiari syndrome Hepatic vein outflow block Emergency surgery Case report

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Peritoneal dissemination of pancreatic cancer caused by endoscopic ultrasound-guided fine needle aspiration:A case report and literature review

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World Journal of Gastroenterology 2021年第3期27卷 294-304页

作者： Hideaki Kojima Minoru Kitago Eisuke Iwasaki Yohei Masugi Yohji Matsusaka Hiroshi Yagi Yuta Abe Yasushi Hasegawa shutaro hori Masayuki Tanaka Yutaka Nakano Yusuke Takemura Seiichiro Fukuhara Yoshiyuki Ohara Michiie Sakamoto Shigeo Okuda Yuko Kitagawa Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Division of Gastroenterology and Hepatology Department of Internal MedicineKeio University School of MedicineTokyo 160-8582Japan Department of Pathology Keio University School of MedicineTokyo 160-8582Japan Department of Radiology Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)is a biopsy technique widely used to diagnose pancreatic tumors because of its high sensitivity and *** needle-tract seeding caused by EUS-FNA has been recently reported,dissemination of pancreatic cancer cells is generally considered to be a rare complication that does not affect patient ***,the frequency of dissemination and needle-tract seeding appears to have been *** present a case of peritoneal dissemination of pancreatic cancer due to preoperative *** SUMMARY An 81-year-old man was referred to the Department of Surgery of our hospital in Japan owing to the detection of a pancreatic mass on computed tomography during medical ***-gastric EUS-FNA revealed that the mass was an adenocarcinoma;hence laparoscopic distal pancreatectomy with lymphadenectomy was *** intraoperative peritoneal dissemination and liver metastasis were visually detected,and pelvic lavage cytology was negative for carcinoma *** postoperative surgical specimen was negative for carcinoma cells at the dissected margin and the cut end margin;however,pathological findings revealed adenocarcinoma cells on the peritoneal surface proximal to the needle puncture site,and the cells were suspected to be disseminated via ***,the patient received adjuvant therapy with S-1(tegafur,gimeracil,and oteracil potassium);however,computed tomography performed 5 mo after surgery revealed liver metastasis and cancerous *** patient received palliative therapy and died 8 mo after the *** The indications of EUS-FNA should be carefully considered to avoid iatrogenic dissemination,especially for cancers in the pancreatic body or tail.

关键词： Case report Pancreatic carcinoma Endoscopic ultrasound-guided fine needle aspiration Peritoneal dissemination Cancerous peritonitis Biopsy

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Colon perforation due to antigenemia-negative cytomegalovirus gastroenteritis after liver transplantation: A case report and review of literature

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World Journal of Gastroenterology 2019年第15期25卷 1899-1906页

作者： Takahiro Yokose Hideaki Obara Masahiro Shinoda Yutaka Nakano Minoru Kitago Hiroshi Yagi Yuta Abe Yohei Yamada Kentaro Matsubara Go Oshima shutaro hori Sho Ibuki Hisanobu Higashi Yuki Masuda Masanori Hayashi Miho Kawaida Takehiko Mori Takumi Fujimura Ken Hoshino Kaori Kameyama Tatsuo Kuroda Yuko Kitagawa Department of Surgery Keio University School of Medicine Department of Pathology Keio University School of Medicine Division of Hematology Department of Medicine Keio University School of Medicine

BACKGROUND Cytomegalovirus(CMV) remains a critical complication after solid-organ transplantation. The CMV antigenemia(AG) test is useful for monitoring CMV infection. Although the AG-positivity rate in CMV gastroenteritis is known to be low at onset, almost all cases become positive during the disease course. We treated a patient with transverse colon perforation due to AG-negative CMV gastroenteritis, following a living donor liver transplantation(LDLT).CASE SUMMARY The patient was a 52-year-old woman with decompensated liver cirrhosis as a result of autoimmune hepatitis who underwent a blood-type compatible LDLT with her second son as the donor. On day 20 after surgery, upper and lower gastrointestinal endoscopy(GE) revealed multiple gastric ulcers and transverse colon ulcers. The biopsy tissue immunostaining confirmed a diagnosis of CMV gastroenteritis. On day 28 after surgery, an abdominal computed tomography revealed transverse colon perforation, and simple lavage and drainage were performed along with an urgent ileostomy. Although the repeated remission and aggravation of CMV gastroenteritis and acute cellular rejection made the control of immunosuppression difficult, the upper GE eventually revealed an improvement in the gastric ulcers, and the biopsy samples were negative for CMV. The CMV-AG test remained negative, therefore, we had to evaluate the status of the CMV infection on the basis of the clinical symptoms and *** This case report suggests a monitoring method that could be useful for AGnegative CMV gastroenteritis after a solid-organ transplantation.

关键词： Cytomegalovirus gastrointestinal disease Colon perforation Antigenemia negative Liver transplantation Case report

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