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Totally Laparoscopic Total Gastrectomy with D2 Lymphadenectomy for Advanced Gastric Cancer

Surgical Science 2015年第6期6卷 247-254页

作者： Hironobu Takano Yuma Ebihara yo kurashima Soichi Murakami Toshiaki Shichinohe Satoshi Hirano Department of Gastroenterological Surgery II Hokkaido University Graduate School of Medicine Sapporo Japan

Introductions: Gastrectomy, which is the standard surgical procedure for gastric cancer, has gradually come to be performed laparoscopically. Laparoscopic distal gastrectomy (LDG) has been adopted gradually and performed for advanced gastric cancer. However, laparoscopic total gastrectomy (LTG) has not been as widely accepted as LDG due to technical difficulties, especially with reconstruction and proper D2 lymphadenectomy. The purpose of the current study was to determine the utility of TLTG with concomitant splenectomy and D2 lymphadenectomy (TLTGS) for advanced gastric cancer (AGC). Materials and Methods: Between January 2006 and May 2014, 10 consecutive patients who underwent TLTGS for AGC and 76 patients who underwent TLTG with D1 lymphadenectomy were included in this study. These two groups were compared in terms of perioperative results, with assessment of intraoperative and postoperative outcomes. Results: There were no significant differences in patients’ characteristics between the two groups. Operative time was longer in the TLTGS group than in the TLTG group. However, the rate of patients with postoperative complications including major complications was not different between the groups, and no patient in the TLTGS group had anastomotic leakage or pancreatic fistula. Conclusions: In the short-term, TLTGS had good postoperative outcomes and was useful and acceptable for AGC.

关键词： Advanced Gastric Cancer Totally Laparoscopic Total Gastrectomy D2 Lymphadenectomy

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Hilar cholangiocarcinoma with intratumoral calcification: A case report

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World Journal of Gastroenterology 2015年第38期21卷 10926-10930页

作者： Kazuho Inoko Takahiro Tsuchikawa Takehiro Noji yo kurashima Yuma Ebihara Eiji Tamoto Toru Nakamura Soichi Murakami Keisuke Okamura Toshiaki Shichinohe Satoshi Hirano Department of Gastroenterological Surgery II Hokkaido University Graduate School of Medicine

This report describes a rare case of hilar cholangiocarcinoma with intratumoral calcification that mimicked hepatolithiasis. A 73-year-old man presented to a local hospital with a calcified lesion in the hepatic hilum. At first,hepatolithiasis was diagnosed,and he underwent endoscopic stone extraction via the transpapillary route. This treatment strategy failed due to biliary stricture. He was referred to our hospital,and further examination suggested the existence of cholangiocarcinoma. He underwent left hepatectomy with caudate lobectomy and extrahepatic bile duct resection. Pathological examination revealed hilar cholangiocarcinoma with intratumoral calcification,while no stones were found. To the best of our knowledge,only one case of calcified hilar cholangiocarcinoma has been previously reported in the literature. Here,we report a rare case of calcified hilar cholangiocarcinoma and reveal its clinicopathologic features.

关键词： Cholangiocarcinoma Klatskin tumor Calcification Li

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