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Preoperative blood circulation modification prior to pancreaticoduodenectomy in patients with celiac trunk occlusion:Two case reports

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World Journal of Gastrointestinal Surgery 2022年第11期14卷 1310-1319页

作者： Marco Colella Kohei Mishima Taiga wakabayashi Yoshiki Fujiyama Malek A Al-Omari go wakabayashi Center for Advanced Treatment of HBP Diseases Ageo Central General HospitalAgeo 362-8588SaitamaJapan

BACKGROUND Celiac trunk stenosis or occlusion is a common condition observed in patients undergoing pancreaticoduodenectomy(PD).The risk of upper abdominal organ ischemia or failure increases if the blood circulation in the celiac arterial system is not maintained after the *** SUMMARY We present two cases of elderly patients with distal cholangiocarcinoma and celiac trunk occlusion who underwent *** performed blood circulation modification preoperatively with transcatheter coil embolization of the arterial arcades of the pancreatic head via the superior mesenteric artery to develop collateral communication between the superior mesenteric artery and the common hepatic or splenic arteries to ensure arterial blood flow to the upper abdominal *** postoperative course was marked by delayed gastric emptying,but no major surgical complications,such as biliary or pancreatic fistula,or clinical,biochemical,or radiological evidence of ischemic disease,was *** Preoperative blood circulation modification may be a valid alternative procedure for elderly patients with celiac trunk occlusion who are ineligible for interventional or surgical revascularization.

关键词： Preoperative blood circulation modification Cholangiocarcinoma Pancreaticoduodenectomy Whipple procedure Celiac trunk occlusion Atherosclerosis Transcatheter coil embolization Case report

Repeat laparoscopic anatomical liver resection in a hepatocellular carcinoma patient:a case report

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Hepatoma Research 2022年第1期8卷 248-253页

作者： Kazuharu Igarashi Kohei Mishima Takahiro Ozaki go wakabayashi Department of Surgery Ageo Central General HospitalAgeoSaitama 362-8588Japan Department of General-Pediatric Hepatobiliary Pancreatic Surgery Kitasato University School of MedicineSagamiharaKanagawa 252-0374Japan

Anatomical resection(AR)has been reported to achieve better long-term outcomes than non-anatomical resection for the treatment of hepatocellular carcinoma(HCC).The surgical feasibility and oncological significance of laparoscopic AR(LAR),especially“subsegment resection”,“cone unit resection”,and repeat LAR for HCC,remain *** present a 67-year-old patient with alcoholic liver cirrhosis and HCC who underwent full LAR three times,focusing on the technical aspects of the Glissonean *** LAR for recurrent HCC could be a safe and feasible ***,HCC recurred in the neighboring segment twice,even though pathological vascular invasion and marginal remnants were not *** should investigate the oncological significance and advancements in subsegmentectomy and cone unit resection,in the future.

关键词： Repeat laparoscopic anatomical liver resection HCC Glissonean approach subsegmentectomy cone unit resection

High expressions of caveolins on the proliferating bile ductules in primary biliary cirrhosis

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World Journal of Gastroenterology 2005年第24期11卷 3710-3713页

作者： Hiroaki Yokomori Masaya Oda go wakabayashi Masaki Kitajima Kazunori Yoshimura Masahiko Nomura Toshifumi Hibi Department of Internal Medicine Organized Center of Clinical Medicine Department of Surgery Department of Physiology

AIM: An increase in bile ductular structures is observed in diverse human liver diseases, especially in primary biliary cirrhosis (PBC). These structures harbor the progenitor cell component of the liver. Caveolins are cholesterol-binding proteins involved in the regulation of several intracellular processes including cholesterol transport. This study aims to examine the role of caveolin in ***: Immunohistochemical and Western blottingstudies were performed on human liver specimens obtained from patients with PBC and normal liver samples. The expression of caveolin (CAV)-1 and -2 was determined using specific ***: In normal liver, scanty immunostaining for CAV1 and -2 was observed in bile ductules. In PBC liver samples, the expression levels of CAV-1 and -2 were increased on proliferating bile ductules especially in stage 3 cases, but was sparse on interlobular bile duct in stage 1 specimens. Especially, the regenerating bile ductules at the interface of portal tracts and necrotic areas were immunostained intensely for CAV-1 and -2. These phenomena were confirmed by Western ***: The present results demonstrate increased expression of caveolins in proliferating bile ductules in PBC, which may be related to the homeostasis of cholesterol transport in regenerating bile ductules in PBC liver.

关键词： Proliferating bile ductule Caveolin Immunohis tochemistry Primary biliary cirrhosis

Serous cystadenocarcinoma of the mesentery in a man:case report and review of literature

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Gastroenterology Report 2014年第4期2卷 306-310页

作者： Toru Obuchi Osamu Shimooki Akira Sasaki Tadashi Abe go wakabayashi Department of Surgery Iwate Medical University School of MedicineIwateJapan Department of Surgery Iwate Prefectural Kuji HospitalIwateJapan

In February 2007,a 41-year-old Japanese male was admitted to our hospital with increasing upper abdominal pain.A contrast-enhanced computed tomography(CT)scan of the abdomen demonstrated a well-demarcated,hypodense cystic mass with a thickened wall in the *** laboratory results were within normal limits,except for increased carcinoembryonic antigen,carbohydrate antigen 19-9,DUPAN-2 and *** patient was diagnosed as having a mesenteric malignant cyst,and during a laparotomy,a right hemicolectomy with mesenteric cystectomy was performed without rupture in March *** the microscopic findings,there was a well-differentiated adenocarcinoma in the inner surface of the cyst and in the fibrous connective tissue of the hypertrophic cystic *** tumor cells were immunohistochemically reactive to cytokeratin(CK)7,CK18 and *** remnant of the malignancy was detected in the resected margin of the colon,cyst,liver or peritoneum nor was an uptake detected in an 18[F]-fluorodeoxyglucose positron emission tomography/CT examination of other ***,the malignancy was concluded to be a serous cystadenocarcinoma of the *** months after the operation,the patient died from peritonitis carcinomatosa due to a small intestine *** report suggests mesenteric cystadenocarcinomas originating in the ovary,oviduct and intestinal mucosa,but these were ruled out in our *** this report,we discuss a case of the malignant transformation of a cyst into adenocarcinoma,which to our knowledge has never been previously reported in a male patient.

关键词： Gastrointestinal surgery immunohistochemical mesenteric cyst cystadenocarcinoma

Expression of adhesion molecules on mature cholangiocytes in canal of Hering and bile ductules in wedge biopsy samples of primary biliary cirrhosis

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World Journal of Gastroenterology 2005年第28期11卷 4382-4389页

作者： Hiroaki Yokomori Masaya Oda Mariko Ogi go wakabayashi Shigeyuki Kawachi Kazunori Yoshimura Toshihiro Nagai Masaki Kitajima Masahiko Nomura Toshifumi Hibi Department of Internal Medicine Kitasato Institute Medical Center Hospital Saitama 364-8501Japan Organized Center of Clinical Medicine International University of Health and Welfare Tokyo 107-0052Japan Laboratory of Pathology Kitasato Institute Medical Center Hospital Saitama 364-8501Japan Department of Surgery School of Medicine Keio UniversityTokyo 160-0016Japan Physiology Saitama Medical School Saitama 350-0495Japan Electron Microscopy Laboratory School of Medicine Keio UniversityTokyo 160-0016Japan Department of Internal Medicine School of Medicine Keio UniversityTokyo 160-0016Japan

AIM：To examine the expression of intercellular adhesion molecule-1 （ICAM-1） and lymphocyte function-associated antigen-1（LFA-1）expression on canals of Hering （COH）and bile ductules associated with the autoimmune process of bile duct destruction in primary biliary cirrhosis（PBC）．METHODS：Ten wedged liver biopsies of PBC（five cases each of stages 2 and 3）were studied. The liver specimens were processed for transmission electron microscopy. Immunohistochemistry was performed using anti-ICAM-1 and anti-LFA-1 mouse *** situ hybridization was done to examine the messenger RNA expression of ICAM-1 in ***-embedded sections using peptide nucleic acid probes and the catalyzed signal amplification （CSA）***-silver staining for electron microscopy was Derrormed using anti-ICAM and anti-LFA-1 mouse *** immunogold particles on epithelial cells of bileductules and cholangiocytes of CoH cells were counted and analyzed *** blotting was performed to confirm ICAM-1 protein expression．RESULTS：In liver tissues of PBC ***-stochemistry showed aberrant ICAM-1 expression on the plasma membrane of epithelial cells lining bile ductules，and also on mature cholangiocytes but not on hepatocytes in ***-1-positive lymphocytes were closely associated with epithelial cells in bile ***-1 expression at protein level was confirmed by Western *** situ hybridization demonstrated ICAM-1 mRNA expression in bile ductules and LFA-1 mRNA in lymphocytes infiltrating the *** immunoelectron microscopy，ICAM-1 was demonstrated on the basal suface of epithelial cells in bile ductules and on the luminal surfaces of cholangiocytes in damaged *** with intermediate morphology resembling progenitor cells in Coil were not labeled with ICAM-1 and LFA-1．CONCLUSION：De novo expression of ICAM-1 both on mature cholangiocytes in COH and epithelial cells in bile ductules in PBC implies that lymphocyte-indu

关键词： Primary biliary cirrhosis Canal of Hedng Small bile ductile ICAM-1 LFA-1 Immunohistochemistry Western blot Immunogold electron microscopyPrimary biliary cirrhosis Canal of Hedng Small bile ductile ICAM-1 LFA-1 Immunohistochemistry Western blot Immunogold electron microscopy

Coexistence of esophageal superficial carcinoma and multiple leiomyomas:A case report

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World Journal of Gastroenterology 2006年第28期12卷 4588-4592页

作者： Takeshi Iwaya Chihaya Maesawa Noriyuki Uesugi Toshimoto Kimura Kenichiro Ikeda Yusuke Kimura Shingo Mitomo Kaoru Ishida Nobuhiro Sato go wakabayashi Departments of Surgery Ⅰ Iwate Medical University School of MedicineUchimaru 19-1Morioka 020-8505Japan Departments of Pathology Iwate Medical University School of MedicineUchimaru 19-1Morioka 020-8505Japan Division of Pathology Central Clinical LaboratoryIwate Medical University School of MedicineUchimaru 19-1Morioka 020-8505Japan Critical Care Medicine Iwate Medical University School of MedicineUchimaru 19-1Morioka 020-8505Japan

Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have been reported previously. Moreover, there have been few reports of esophageal squamous cell carcinoma overlying submucosal tumors. We describe a 71-yearold man who was diagnosed as having a superficial esophageal cancer coexisting with two or three leiomyoma nodules. During surgery, 10 or more nodules that had not been evident preoperatively were palpable in the submucosal and muscular layers throughout the esophagus. As intramural metastasis of the esophageal cancer was suspected, we considered additional lymphadenectomy, but had to rule out this option because of the patient＇s severe anoxemia. Microscopic examination revealed that all the nodules were leiomyomas （20 lesions, up to 3 cm in diameter）, and that invasion of the carcinoma cells was limited to the submucosal layer overlying a relatively large leiomyoma. This is the first report of superficial esophageal cancer coexisting with numerous solitary leiomyomas. Multiple minute leiomyomas are often misdiagnosed as intramural metastasis, and a leiomyoma at the base of a carcinoma lesion can also be rnisdiagnosed as tumor invasion. The present case shows that accurate diagnosis is required for the management of patients with coexisting superficial esophageal cancer and multiple leiomyomas.

关键词： Multiple leiomyomas Squamous cell carcinoma Esophagus Coexistence

International consensus statement on robotic hepatectomy surgery in 2018

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World Journal of Gastroenterology 2019年第12期25卷 1432-1444页

作者： Rong Liu go wakabayashi Hong-Jin Kim Gi-Hong Choi Anusak Yiengpruksawan Yuman Fong Jin He Ugo Boggi Roberto I Troisi Mikhail Efanov Daniel Azoulay Fabrizio Panaro Patrick Pessaux Xiao-Ying Wang Ji-Ye Zhu Shao-Geng Zhang Chuan-Dong Sun Zheng Wu Kai-Shan Tao Ke-Hu Yang Jia Fan Xiao-Ping Chen Second Department of Hepatopancreatobiliary Surgery Chinese People’s Liberation Army (PLA) General Hospital Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases Ageo Central General Hospital Department of Surgery Yeungnam University Hospital Division of Hepatobiliary Pancreatic Surgery Department of Surgery Yonsei University College of Medicine Minimally Invasive Surgery Division Department of SurgeryFaculty of Medicine Siriraj Hospital Mahidol University Department of Surgery City of Hope Medical Center Department of Surgery the Johns Hopkins Hospital Division of General and Transplant Surgery Pisa University Hospital Department of Clinical Medicine and Surgery Federico II University Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific Center Hepato-Biliary Center Paul Brousse University Hospital Hepato-Biliary Center Tel Hashomer University Hospital Department of Surgery/Division of HBP Surgery and Transplantation Montpellier University Hospital-School of Medicine Head of the Hepato-biliary and pancreatic surgical unit Nouvel Hopital Civil Department of Liver Surgery and Transplantation Liver Cancer Institute Zhongshan Hospital Fudan University Department of Hepatobiliary Surgery Peking University People’s Hospital Department of Hepatobiliary Surgery 302 Hospital of Chinese PLA Department of Hepatobiliary and Pancreatic Surgery the Affiliated Hospital of Qingdao University Department of Hepatobiliary Surgery the First Affiliated Hospital of Xi’an Jiaotong University Department of Hepatobiliary Surgery Xijing Hospital the Fourth Military Medical University Evidence Based Medicine Center School of Basic Medical Sciences Lanzhou University Hepatic Surgery Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

The robotic surgical system has been applied in liver surgery. However,controversies concerns exist regarding a variety of factors including the safety,feasibility, efficacy, and cost-effectiveness of robotic surgery. To promote the development of robotic hepatectomy, this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts' consensus and recommendations to promote its development. Based on the World Health Organization Handbook for Guideline Development, a Consensus Steering Group and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings. Based on the published articles and expert panel opinion, 7 recommendations were generated by the GRADE method using an evidence-based method, which focused on the safety, feasibility, indication,techniques and cost-effectiveness of hepatectomy. Given that the current evidences were low to very low as evaluated by the GRADE method, further randomized-controlled trials are needed in the future to validate these recommendations.

关键词： Minimally invasive surgery Robotic hepatectomy Laparoscopic hepatectomy Hepatectomy resection Consensus statement

International consensus statement on robotic pancreatic surgery

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Hepatobiliary Surgery and Nutrition 2019年第4期8卷 345-360页

作者： Rong Liu go wakabayashi Chinnusamy Palanivelu Allan Tsung Kehu Yang Brian KPgoh Charing Ching-Ning Chong Chang Moo Kang Chenghong Peng Eli Kakiashvili Ho-Seong Han Hong-Jin Kim Jin He Jae Hoon Lee Kyoichi Takaori Marco Vito Marino Shen-Nien Wang Tiankang Guo Thilo Hackert Ting-Shuo Huang Yiengpruksawan Anusak Yuman Fong Yuichi Nagakawa Yi-Ming Shyr Yao-Ming Wu Yupei Zhao Department of Hepatopancreatobiliary Surgical Oncology Chinese People’s Liberation Army(PLA)General HospitalBeijing 100853China Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases Ageo Central General HospitalAgeoJapan Division of Gastrointestinal Surgery and Minimal Access Surgery GEM Hospital and Research CentreCoimbatoreIndia Division of Surgical Oncology Gastrointestinal Disease Specific Research GroupThe Ohio State University Wexner Medical Center Department of SurgeryColumbusOHUSA Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore Department of Surgery Division of Hepatobiliary and Pancreatic SurgeryPrince of Wales Hospitalthe Chinese University of Hong KongHong KongChina Division of HBP Surgery Yonsei University College of MedicinePancreatobiliary Cancer CenterYonsei Cancer CenterSeverance HospitalSeoulKorea Pancreatic Disease Centre Ruijin HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200025China Department of General Surgery Galilee Medical CenterNahariyaIsrael Department of Surgery Seoul National University College of MedicineSeoul National University Bundang HospitalSeoulKorea Department of Surgery Yeungnam University HospitalDaeguKorea Department of Surgery The Johns Hopkins HospitalBaltimoreMDUSA Division of Hepatobiliary&Pancreas Surgery Department of SurgeryAsan Medical CenterSeoulKorea Department of Surgery Kyoto University HospitalShogoinSakyo-KuKyotoJapan Department of General Surgery Azienda OspedalieraOspedali Riuniti Villa Sofia-CervelloPalermoItaly Division of General and Digestive Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Department of General Surgery Gansu Provincial HospitalLanzhou 730030China Department of General Visceral and Transplantation SurgeryHeidelberg University HospitalHeidelbergGermany Division of General Surge

The robotic surgical system has been applied to various types of pancreatic surgery. However, controversies exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. This study aimed to evaluate the current status of robotic pancreatic surgery and put forth experts' consensus and recommendations to promote its development. Based on the WHO Handbook for Guideline Development, a Consensus Steering Group* and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 19 topics were analyzed. The first 16 recommendations were generated by GRADE using an evidence-based method (EBM) and focused on the safety, feasibility, indication, techniques, certification of the robotic surgeon, and cost-effectiveness of robotic pancreatic surgery. The remaining three recommendations were based on literature review and expert panel opinion due to insufficient EBM results. Since the current amount of;evidence was low/meager as evaluated by the GRADE method, further randomized controlled trials (RCTs) are needed in the future to validate these recommendations.

关键词： Robotic surgery consensus statement pancreatectomy pancreaticoduodenectomy pancreatic enucleation

Do brood parasitic Common Cuckoos develop brood patches during the breeding season?

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Avian Research 2024年第3期15卷 363-368页

作者： Jun-Seo go Hae-Ni Kim Sue-Jeong Jin Myeong-Chan Cha Heesoo Lee Jin-Won Lee Korea Institute of Ornithology&Department of Biology Kyung Hee University02447SeoulRepublic of Korea Bird Research SaeZiP 12504YangpyeongRepublic of Korea

Many birds develop brood patches on their ventral apterium under hormonal regulation to effectively transmit body heat to eggs during *** developed patch has several characteristics,including de-feathering,vascularization,and ***,little is known about whether avian brood parasites that do not incubate their eggs exhibit brood patch development during the breeding *** this study,we measured the size of the ventral apterium in 114 Common Cuckoos(Cuculus canorus)captured in the field throughout the breeding season and examined the appearance of the ventral apterium to confirm the development of brood *** also examined whether morphological traits and various factors correlated with the size of the ventral apterium(sternal apterium and abdominal apterium)and how it changed during the breeding *** found no clear signs of brood patch development in Common Cuckoos captured throughout the breeding season,indicating that they likely did not develop brood patches on the ventral apterium during this *** also found that ventral apterium size was positively correlated with wing length and body *** addition,Common Cuckoos with newly growing feathers on the boundary of the ventral apterium with pteryla were frequently observed as seasons progressed to the *** conclusion,Common Cuckoos exhibit neither brood patch development nor the vestigial characteristics of ancestral brood patches,except for the growth of feathers on boundary the ventral *** studies examining brood patches across different groups of avian brood parasites are valuable for enhancing our understanding of the developmental and physiological adaptations of avian brood parasites.

关键词： Brood parasitism Brood patch Common Cuckoo Pterylosis Re-feathering Ventral apterium