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Endoscopy-based early enterostomy closure for superior mesenteric arterial occlusion

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World Journal of Gastroenterology 2010年第8期16卷 992-996页

作者： Takatsugu Oida Hisao Kano Kenji Mimatsu Atsushi Kawasaki youichi kuboi Nobutada Fukino Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

AIM:To evaluate the efficacy of endoscopic examination of blood flow and edema in the remnant ***:We retrospectively studied 15 patients who underwent massive bowel resection with enterostomy for superior mesenteric arterial occlusion (SMAO); the patients were divided into a delayed closure group (D group) and an early closure group (E group).RESULTS:The mean duration from initial operation to enterostomy closure was significantly shorter in the E group (18.3 ± 2.1 d) than in the D group (34.3 ± 5.9 d) (P < 0.0001). The duration of hospitalization after surgery was significantly shorter in the E group (33 ± 2.2 d) than in the D group (51 ± 8.9 d) (P < 0.0002).CONCLUSION:Endoscopic examination of blood flow and edema in the remnant bowel is useful to assess the feasibility of early closure of enterostomy in SMAO cases.

关键词： Superior mesenteric arterial occlusion Closure of enterostomy Endoscopic inspection

Impaction of a lithotripsy basket during endoscopic lithotomy of a common bile duct stone

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World Journal of Gastroenterology 2010年第22期16卷 2832-2834页

作者： Nobutada Fukino Takatsugu Oida Atsushi Kawasaki Kenji Mimatsu youichi kuboi Hisao Kano Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

The treatments for common bile duct (CBD) stones are being continually developed. Impaction of the lithotripsy basket during endoscopic removal of CBD stones was seen in 5.9% patients. We report the case of a 66-yearold woman who underwent surgery for the removal of an impacted biliary basket. She was admitted to our hospital with a complaint of right upper abdominal pain. Magnetic resonance cholangiopancreatography revealed a CBD stone (20 mm × 15 mm). We diagnosed her with choledocholithiasis and performed endoscopic retrograde cholangiopancreatography to remove the stone. However, unfortunately, the retrievable basket around the stone became impacted. An endotriptor along with forceps could not be used owing to the entrapment of the basket, and thus we performed urgent surgery. The basket containing the stone was removed through a longitudinal choledochotomy. The wires leading to the basket were cut, and the basket containing the stone was removed via the incision. A T-tube was inserted,and the choledochotomy was closed. The postoperative course was uneventful. In conclusion, if the diameter of a CBD stone is more than 20 mm, then the risk of basket impaction increases, and surgery may be necessary as the initial treatment of the CBD stone.

关键词： Common bile duct gallstones Impacted biliary basket Lithotripsy

Post-gastrectomy spleen enlargement and esophageal varices: Distal vs total gastrectomy

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World Journal of Gastroenterology 2010年第22期16卷 2801-2805页

作者： Takatsugu Oida Kenji Mimatsu Hisao Kano Atsushi Kawasaki youichi kuboi Nobutada Fukino Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

AIM: To study the relationship between platelet count-to-spleen diameter ratio and post-gastrectomy esopha-geal varices (EVs) development in patients without liver cirrhosis or hepatitis. METHODS: We retrospectively studied 92 patients who underwent gastrectomy. They were divided into 2 groups on the basis of the surgical treatment: the distal gastrectomy (DG) group and total gastrectomy (TG) group. The incidence of EVs was determined and postoperative platelet counts, spleen diameters, and platelet count-to-spleen diameter ratios were com-pared between the 2 groups. RESULTS: EVs were not detected during the first 6 mo after surgery in either group; however, at 12 mo after surgery, EVs were detected in 2 patients (3%) in the DG group and in 1 patient (3.6%) in the TG group; their mean platelet count-to-spleen diameter ratio was 2628 ± 409, and 2604 ± 360, ***: Endoscopy should be performed to detect EVs when the platelet count-to-spleen diameter ratio is < 2600.

关键词： Spleen enlargement Esophageal varices Platelet count Distal gastrectomy Total gastrectomy

Pericardiocentesis with cisplatin for malignant pericardial effusion and tamponade

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World Journal of Gastroenterology 2010年第6期16卷 740-744页

作者： Takatsugu Oida Kenji Mimatsu Hiso Kano Atsushi Kawasaki youichi kuboi Nobutada Fukino Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

AIM:To evaluate the role and outcome of pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. METHODS:We retrospectively studied 7 patients who underwent pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal *** pericardiocentesis,we performed catheterization of the pericardial space under ultrasonogram *** etiology of the pericardial fluid was confirmed by cytological ***,cisplatin(10 mg in 20 mL normal saline) was instilled into the pericardial space. RESULTS:The mean total volume of the aspirated effusion fluid was 782±264 mL(range,400-1200 mL) . The drainage catheter was successfully removed in all patients,and the mean duration of pericardial drainagewas 7.7±2.7 d(range,5-13 d) .No fluid reaccumulation was *** survival time was 120±71 d(range,68-268 d) . CONCLUSION:Pericardiocentesis along with catheter drainage appears to be a safe and effective for pericardial malignant effusion and tamponade,and cisplatin instillation prevents recurrence.

关键词： Malignant pericardial effusion Cardiac tamponade Esophageal cancer Pericardiocentesis Cisplatin

A case of asymptomatic intraductal papillary neoplasm of the bile duct without hepatolithiasis

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World Journal of Gastroenterology 2008年第10期14卷 1625-1629页

作者： Junpei Hayashi Shyun-ichi Matsuoka Makiko Inami Shu Ohshiro Akiyasu Ishigami Hirotoshi Fujikawa Masahide Miyagawa Kenji Mimatsu youichi kuboi Hisao Kanou Takatsugu Oida Makiko Inami Shu Ohshiro Mitsuhiko Moriyama Department of Gastroenterology Social Insurance Yokohama Central Hospital Yokohama 231-8553 Japan Department of Surgery Social Insurance Yokohama Central Hospital Yokohama 231-8553 Japan Division of Gastroenterology and Hepatology Department of Medicine Nihon University School of Medicine Tokyo 173-8610 Japan

A 65-year-old woman was found to have dilatation of the intrahepatic bile duct in the right anterior segment during a general health. Laboratory data were within normal ranges and no solid mass was detected in her abdominal computer tomography (CT) or nuclear magnetic resonance imaging (MRI). However, endoscopic retrograde cholangiopancreatography (ERCP) demonstrated an obstruction of the right bile duct. Intraoperative cholangiography showed stenosis of the intrahepatic bile duct in the anterior inferior segment (B5) and narrowness of the intrahepatic bile duct in the anterior superior segment (B8), so that we strongly suspected intrahepatic cholangiocarcinoma (ICC). Histologically, surgically resected liver specimens, without tumor mass by macroscopic observation, showed intraductal papillary proliferation with fibrovascular cores and intraductal spreading of carcinoma in situ throughout a considerable area, especially in bile ductules around the peripheral small portal area. Furthermore, the immunohistochemical profile of the tumor (MUC5AC+/CK7+) was compatible with an intraductal papillary neoplasm of the bile duct (IPN-B). Consequently, this case was diagnosed as IPN-B with spreading CIS, stageⅠ(pT1, pN0, P0, H1, M0). We report a case of IPN-B with interesting histopathologicalfindings and emphasize that cholangiography is especially helpful for the diagnosis of bile duct dilatation due to infiltration of carcinoma cells.

关键词： Cholangiocarcinoma Intraductal papillary neoplasm, Dilated bile duct Hepatectomy MUC

Adenocarcinoma arising from heterotopic pancreas at the third portion of the duodenum

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World Journal of Gastroenterology 2015年第13期21卷 4082-4088页

作者： Nobutada Fukino Takatsugu Oida Kenji Mimatsu youichi kuboi Kazutoshi Kida Department of Surgery Japan Community Healthcare Organization Yokohama Central HospitalKanagawa 231-8553Japan Department of General Surgical Science Nihon University HospitalTokyo 101-8309Japan

A 62-year-old Japanese man presented to our hospital with a history of weight loss of 6 kg in 4 mo. Imaging examinations revealed a tumor located on the third portion of the duodenum with stenosis. We suspected duodenal carcinoma and performed pancreas-preserving segmental duodenectomy. Adenocarcinoma arising from a heterotopic pancreas at the third portion of the duodenum was finally diagnosed by immunohistochemical staining. Malignant transformation in the duodenum arising from a heterotopic pancreas is extremely rare; to our knowledge, only 13 cases have been reported worldwide, including the present case. The most common location of malignancy is the proximal duodenum at the first and descending portion. Herein, we describe the first case of adenocarcinoma arising from a heterotopic pancreas, which was located in the third portion of the duodenum, with a review of the literature.

关键词： Adenocarcinoma Heterotopic pancreas Duodenum Segme