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Preoperative albumin-bilirubin score and liver resection percentage determine postoperative liver regeneration after partial hepatectomy

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World Journal of Gastroenterology 2024年第14期30卷 2006-2017页

作者： Kazuhiro Takahashi Masahiko Gosho Yoshihiro Miyazaki Hiromitsu Nakahashi Osamu Shimomura Kinji Furuya Manami Doi Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi Tsuyoshi Enomoto shinji hashimoto Tatsuya Oda Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery University of TsukubaTsukuba 3058-575IbarakiJapan Department of Biostatistics University of TsukubaTsukuba 3058-575IbarakiJapan

BACKGROUND The success of liver resection relies on the ability of the remnant liver to *** of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are ***,there is limited knowledge about the preoperative factors that influence postoperative *** To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver *** A total of 268 patients who received partial hepatectomy were *** were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)*** regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,*** lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months *** The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,*** RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri *** to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed ***,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.

关键词： Liver regeneration Albumin-bilirubin score Liver resection percentage Partial hepatectomy Human Regeneration index

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Pancreatic neuroendocrine tumor and solid-pseudopapillary neoplasm: Key immunohistochemical profiles for differential diagnosis

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World Journal of Gastroenterology 2016年第38期22卷 8596-8604页

作者： Yusuke Ohara Tatsuya Oda shinji hashimoto Yoshimasa Akashi Ryoichi Miyamoto Tsuyoshi Enomoto Kaishi Satomi Yukio Morishita Nobuhiro Ohkohchi Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Faculty of MedicineUniversity of Tsukuba Department of Diagnostic Pathology Faculty of MedicineUniversity of Tsukuba Diagnostic Pathology Division Tokyo Medical University Ibaraki Medical Center

AIM To reveal better diagnostic markers for differentiating neuroendocrine tumor(NET) from solid-pseudopapillary neoplasm(SPN), focusing primarily on immunohistochemical *** We reviewed 30 pancreatic surgical specimens of NET(24 cases) and SPN(6 cases). We carried out comprehensive immunohistochemical profiling using 9 markers: Synaptophysin, chromogranin A, pancytokeratin, E-cadherin, progesterone receptor,vimentin, α-1-antitrypsin, CD10, and β-*** E-cadherin staining in NETs, and nuclear labeling of β-catenin in SPNs were the most sensitive and specific markers. Dot-like staining of chromogranin A might indicate the possibility of SPNs rather than NETs. The other six markers were not useful because their expression overlapped widely between NETs and SPNs. Moreover, two cases that had been initially diagnosed as NETs on the basis of their morphological features, demonstrated SPN-like immunohistochemical profiles. Careful diagnosis is crucial as we actually found two confusing cases showing disagreement between the tumor morphology and immunohistochemical *** E-cadherin, chromogranin A, and β-catenin were the most useful markers which should be employed for differentiating between NET and SPN.

关键词： Neuroendocrine tumor Pancreas Solidpseudopapillary neoplasm Immunohistochemistry Diagnosis

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Conversion hepatectomy for hepatocellular carcinoma with main portal vein tumour thrombus after lenvatinib treatment: A case report

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World Journal of Hepatology 2021年第3期13卷 384-392页

作者： Kazuhiro Takahashi Jaejeong Kim Amane Takahashi shinji hashimoto Manami Doi Kinji Furuya Ryosuke hashimoto Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi Katsuji Hisakura Tsuyoshi Enomoto Osamu Shimomura Masayuki Noguchi Tatsuya Oda Department of Gastrointestinal and Hepatobiliary Pancreatic Surgery University of TsukubaTsukuba 3058575IbarakiJapan Department of Gastroenterological Surgery Saitama Cancer CenterSaitama 3620806SaitamaJapan Department of Diagnostic Pathology University of TsukubaTsukuba 3058575IbarakiJapan

BACKGROUND Hepatocellular carcinoma(HCC)accompanied by portal vein tumour thrombus(PVTT)presents an aggressive disease course,worsening liver function reserve,and a high recurrence *** practice guidelines recommend systemic therapy as the first-line option for HCC with portal ***,to achieve longer survival in these patients,the treatment strategy should be concluded with removal of the tumour by locoregional *** experienced a case of initially unresectable HCC with main PVTT converted to radical hepatectomy after lenvatinib *** SUMMARY A 59-year-old male with chronic hepatitis C infection visited our clinic as a regular post-surgery ***-enhanced abdominal computed tomography revealed a liver mass diffusely located at the lateral segment with a massive PVTT extending from the umbilical portion to the main and contralateral third-order portal *** the diagnosis of unresectable HCC with Vp4(main trunk/contralateral branch)PVTT,lenvatinib was started at 12 mg/*** computed tomography taken 3 mo after starting lenvatinib showed regression of the PVTT,which had retreated to the contralateral first-order portal *** tolerated the full dose without major adverse *** cessation of lenvatinib for 7 d,radical left lobectomy and PVTT thrombectomy were *** patient’s postoperative course was ***,the primary lesion showed fibrotic changes,with moderately to poorly differentiated tumour cells surrounded by granulation tissues in some *** majority of the PVTT showed *** was alive without recurrence for 8 *** This is the first case of HCC with Vp4 PVTT in which radical conversion hepatectomy was succeeded after lenvatinib treatment.

关键词： Hepatocellular carcinoma Lenvatinib Portal vein tumour thrombus Conversion hepatectomy Case report

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Neuroendocrine carcinoma of the extrahepatic bile duct: A case report

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World Journal of Gastroenterology 2016年第30期22卷 6960-6964页

作者： Yukio Oshiro Ryozo Gen shinji hashimoto Tatsuya Oda Taiki Sato Nobuhiro Ohkohchi Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Faculty of Medicine University of Tsukuba Department of Pathology Faculty of MedicineUniversity of Tsukuba

Neuroendocrine carcinoma(NEC) originating from the gastrointestinal hepatobiliary-pancreas is a rare, invasive, and progressive disease, for which the prognosis is extremely poor. The patient was a 72-year-old man referred with complaints of jaundice. He was diagnosed with middle extrahepatic cholangiocarcinoma(cT 4N1M0, c Stage Ⅳ). He underwent a right hepatectomy combined with extrahepatic bile duct and portal vein resection after percutaneous transhepatic portal vein embolization. Microscopic examination showed a large-cell neuroendocrine carcinoma according to the WHO criteria for the clinicopathologic classification of gastroenteropancreatic neuroendocrine tumors. Currently, the patient is receiving combination chemotherapy with cisplatin and etoposide for postoperative multiple liver metastases. Although NEC is difficult to diagnose preoperatively, it should be considered an uncommon alternative diagnosis.

关键词： Neuroendocrine carcinoma Extrahepatic bile duct Neuroendocrine tumor

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Three-dimensional imaging identified the accessory bile duct in a patient with cholangiocarcinoma

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World Journal of Gastroenterology 2014年第32期20卷 11451-11455页

作者： Ryoichi Miyamoto Yukio Oshiro shinji hashimoto Keisuke Kohno Kiyoshi Fukunaga Tatsuya Oda Nobuhiro Ohkohchi Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation Department of Surgery University of Tsukuba Ibaraki 305-8575 Japan

The development of diagnostic imaging technology, such as multidetector computed tomography(MDCT) and magnetic resonance cholangiopancreatography(MRCP), has made it possible to obtain detailed images of the bile duct. Recent reports have indicated that a 3-dimensional(3D) reconstructed imaging system would be useful for understanding the liver anatomy before surgery. We have investigated a novel method that fuses MDCT and MRCP images. This novel system easily made it possible to detect the anatomical relationship between the vessels and bile duct in the portal hepatis. In this report, we describe a very rare case of extrahepatic cholangiocarcinoma associated with an accessory bile duct from the caudate lobe connecting with the intrapancreatic bile duct. We were unable to preoperatively detect this accessory bile duct using MDCT and MRCP. However, prior to the second operation, we were able to clearly visualise the injured accessory bile duct using our novel 3D imaging modality. In thisreport, we suggest that this imaging technique can be considered a novel and useful modality for understanding the anatomy of the portal hepatis, including the hilar bile duct.

关键词： 3-dimensional imaging Hepatobiliary and pancreatic

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