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Stapled gastro/duodenojejunostomy shortens reconstruction time during pylorus-preserving pancreaticoduodenectomy

World Journal of Gastroenterology 2013年第48期19卷 9399-9404页

作者： Norihiro Sato Kei Yabuki Shiro Kohi Yasuhisa Mori noritaka minagawa Toshihisa Tamura Aiichiro Higure Koji Yamaguchi Department of Surgery 1 School of Medicine University of Occupational and Environmental Health Kitakyushu 807-8555 Japan

AIM:To investigate whether a stapled technique is superior to the conventional hand-sewn technique for gastro/duodenojejunostomy during pylorus-preserving pancreaticoduodenectomy(PpPD).METHODS:In October 2010,we introduced a mechanical anastomotic technique of gastro-or duodenojejunostomy using staplers during *** compared clinical outcomes between 19 patients who underwent PpPD with a stapled gastro/duodenojejunostomy(stapled anastomosis group)and 19 patients who underwent PpPD with a conventional hand-sewn duodenojejunostomy(hand-sewn anastomosis group).RESULTS:The time required for reconstruction was significantly shorter in the stapled anastomosis group than in the hand-sewn anastomosis group(186.0±29.4 min vs 219.7±50.0 min,P=0.02).In addition,intraoperative blood loss was significantly less(391.0±212.0 mL vs 647.1±482.1 mL,P=0.03)and the time to oral intake was significantly shorter(5.4±1.7d vs 11.3±7.9 d,P=0.002)in the stapled anastomosis group than in the hand-sewn anastomosis *** were no differences in the incidences of delayed gastric emptying and other postoperative complications between the ***:These results suggest that stapled gastro/duodenojejunostomy shortens reconstruction time during PpPD without affecting the incidence of delayed gastric emptying.

关键词： Pylorus-preserving pancreaticoduodenectomy Stapled anastomosis Gastrojejunostomy Duodenojejunostomy Delayed gastric emptying

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Calcium signaling in cholangiocytes

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World Journal of Gastroenterology 2006年第22期12卷 3466-3470页

作者： noritaka minagawa Barbara E Ehrlich Michael H Nathanson Departments of Medicine and Pharmacology Yale University School of Medicine New Haven CTUnited States Section of Digestive Diseases Yale University School of Medicine 1 Gilbert StreetRoom TAC S241DNew HavenCT 06519United States

Cytosolic Ca^2＋ is an important second messenger in virtually every type of cell. Moreover, Ca^2＋ generally regulates multiple activities within individual cells. This article reviews the cellular machinery that is responsible for Ca^2＋ signaling in cholangiocytes. In addition, two Ca^2＋-mediated events in cholangiocytes are discussed： bicarbonate secretion and apoptosis. Finally, emerging evidence is reviewed that Ca^2＋ signaling is involved in the pathogenesis of diseases affecting the biliary tree and that Ca^2＋ signaling pathways can be manipulated to therapeutic advantage in the treatment of cholestatic disorders.

关键词： Ca^2+ Cholangiocyte Inositol trisphosphate Bile secretion Cholestasis Apoptosis

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Rare combination of familial adenomatous polyposis and gallbladder polyps

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World Journal of Gastroenterology 2014年第46期20卷 17661-17665页

作者： Yasuhisa Mori Norihiro Sato Nobutaka Matayoshi Toshihisa Tamura noritaka minagawa Kazunori Shibao Aiichiro Higure Mitsuhiro Nakamoto Masashi Taguchi Koji Yamaguchi Department of Surgery School of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuoka 807-8555Japan Department of Pathology and Cell Biology School of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuoka 807-8555Japan Department of Internal Medicine School of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuoka 807-8555Japan

Familial adenomatous polyposis is associated with a high incidence of malignancies in the upper gastrointestinal tract (particularly ampullary adenocarcinomas). However, few reports have described a correlation between familial adenomatous polyposis and gallbladder neoplasms. We present a case of a 60-year-old woman with familial adenomatous polyposis who presented with an elevated mass in the neck of the gallbladder (measuring 16 mm × 8 mm in diameter) and multiple small cholecystic polyps. She had undergone a total colectomy for ascending colon cancer associated with familial adenomatous polyposis 22 years previously. The patient underwent laparoscopic cholecystectomy under a preoperative diagnosis of multifocal gallbladder polyps. Pathologic examination of the resected gallbladder revealed more than 70 adenomatous lesions, a feature consistent with adenoma of the gallbladder. This case suggests a requirement for long-term surveillance of the biliary system in addition to the gastrointestinal tract in patients with familial adenomatous polyposis.

关键词： Adenoma Adenomatous polyposis coli Biliary system Familial adenomatous polyposis Gallbladder polyp

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Novel technique of abdominal wall nerve block for laparoscopic colostomy: Rectus sheath block with transperitoneal approach

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World Journal of Gastrointestinal Surgery 2017年第8期9卷 182-185页

作者： Jun Nagata Jun Watanabe Yusuke Sawatsubashi Masaki Akiyama Koichi Arase noritaka minagawa Takayuki Torigoe Kotaro Hamada Yoshifumi Nakayama Keiji Hirata Department of Gastroenterological and General Surgery Wakamatsu Hospital University of Occupational and Environmental Health Department of Surgery Yokosuka Kyosai Hospital Department of Surgery University of Occupational and Environmental Health Department of Anesthesiology Wakamatsu Hospital University of Occupational and Environmental Health

A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel. Twentyfour hours postoperatively, the patient's pain intensity as assessed by the numeric rating scale was 0-1 during coughing, and a continuous intravenous analgesic was not needed. Colostomy is often necessary in colon obstruction. Epidural anesthesia for postoperative pain cannot be used in patients with a coagulation disorder. We report the use of a novel laparoscopic rectus sheath block for colostomy. There has been no literature described about the nerve block with transperitoneal approach. The laparoscopic rectus sheath block was performed safely and had enough analgesic efficacy for postoperative pain. This technique could be considered as an optional anesthetic regimen in acute situations.

关键词： Colorectal cancer Rectus sheath block Colon obstruction Postoperative pain

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