Publications by authors named "Akira Maki"

While pancreatic ductal adenocarcinoma (PDAC) originates from exocrine cells of the pancreas, pancreatic neuroendocrine neoplasms (PNENs) arise from pancreatic neuroendocrine cells. The concurrent presence of an exocrine pancreatic tumor and a pancreatic neuroendocrine tumor is referred to broadly as a pancreatic collision tumor. In cases where the lesions are spatially distant, they are termed as multiple primary tumors, a relatively uncommon occurrence.

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Article Synopsis
  • Solitary fibrous tumor (SFT) is a type of spindle cell tumor linked to a specific genetic fusion (NAB2-STAT6) that can occur in any soft tissue, though pancreatic cases are rare.
  • A 36-year-old man experienced abdominal pain and was found to have a mass in the pancreatic tail, but a biopsy did not confirm the diagnosis, leading to potential confusion with other pancreatic tumors.
  • After robotic surgery to remove the tumor, the histopathology showed spindle cells, and specific immunostains confirmed SFT with a low chance of spreading, highlighting the effectiveness of robotic surgery for treatment.
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Background: The adoption of Robotic Pancreaticoduodenectomy (RPD) is increasing globally. Meanwhile, reduced-port RPD (RPRPD) remains uncommon, requiring robot-specific techniques not possible with laparoscopy. We introduce a unique RPRPD technique optimizing surgical field exposure.

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Article Synopsis
  • Ninomiya and team presented a new method for accessing the superior mesenteric artery during robotic pancreaticoduodenectomy.
  • This right lateral approach shifts the superior mesenteric artery to the right side, making it easier to cut and detach from surrounding structures.
  • By simplifying these procedures, the technique may cut down on surgery time and lower the risk of blood loss.
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Background: /Objective: FOLFIRINOX therapy (FFX) for locally advanced pancreatic cancer (LAPC) is increasingly recognized as a potent neoadjuvant therapy that enables transition to conversion surgery (CS). However, predictors of CS achievement after chemotherapy are controversial. This study aimed to demonstrate the efficacy of CS after modified FFX (mFFX) in patients with LAPC and to identify and score predictors of CS.

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A 55-year-old woman had been admitted to a hospital with abdominal bloating. Retroperitoneal liposarcoma was suspected and diagnosed as not resectable. She was then referred to our hospital with dyspnea and difficulties with movement due to the huge mass.

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  • A study analyzed the clinicopathological and survival data of 8 patients with unresectable gastric cancer who underwent conversion surgery after second-line chemotherapy from 2013 to 2020.
  • The patients included 7 males and 1 female, with a median age of 69, and all achieved complete removal of cancer (R0 resection).
  • Results indicated that undergoing conversion surgery after chemotherapy significantly improved median survival times compared to those who did not have surgery, suggesting it may enhance survival for patients with unresectable gastric cancer.
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We herein report 3 cases of advanced gastric cancer with multiple liver metastases who was successfully treated with systemic chemotherapy and underwent conversion surgery with liver resection. There were 2 males and 1 female patients with a range 68 to 74 years of age. Two patients received S-1 plus oxaliplatin therapy and 1 received S-1 plus cisplatin therapy.

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Here, we report a case of living donor liver transplantation (LDLT) complicated with severe acute antibody-mediated rejection (aAMR), although desensitization was performed for preformed donor-specific anti-human leukocyte antigen antibody (DSA). LDLT was performed in a 59-year-old woman with alcoholic cirrhosis with a graft from her 60-year-old husband as a living donor. She had reproductive history of 4 gravidity and parity with her husband.

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Even though S-1 is a widely used chemotherapeutic agent, there is no evidence for its use in an adjuvant setting for biliary tract carcinoma (BTC). Patients who underwent surgical treatment for BTC between August 2007 and December 2018 were selected. Propensity score matching was performed between patients who received S-1 as adjuvant chemotherapy (S-1 group) and those who underwent surgical treatment alone (observation group).

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We report a case of splenic lymph node recurrence 7 years after a distal bile duct carcinoma. A 70s man underwent pylorus ring-preserving pancreaticoduodenectomy for distal bile duct carcinoma in 20XX. The pathological diagnosis was T2N0M0, Stage Ⅱ(Japanese Classification of the Biliary Tract Cancers 5th edition).

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Background: Drip infusion cholangiography with computed tomography (DIC-CT) is a major preoperative modality used for patients undergoing laparoscopic cholecystectomy (LC).

Methods: This study included 218 patients for whom preoperative DIC-CT images were obtained prior to undergoing LC. The association between gallbladder (GB) opacification in DIC-CT and the operative time was assessed.

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Background: The effect of bystander interventions has been extensively evaluated by cerebral function after 1 month post-resuscitation. However, patients who received bystander cardiopulmonary resuscitation (BCPR) and achieved the return of spontaneous circulation (ROSC) before the arrival of the emergency medical system (EMS) are routinely defined with an unknown electrocardiogram (ECG) and are usually excluded before analysis. The aim is to determine the influence of excluding patients with unknown first monitored rhythm, which includes cases of bystander ROSC, from the out-of-hospital cardiac arrest (OHCA) database.

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A 46-year-old woman with epigastric pain was found to have a tumor of the pancreatic head. Computed tomography(CT) revealed a plethoric and poorly-marginated, 7 cm tumor in the pancreatic head. The superior mesenteric vein(SMV)was infiltrated from the duodenal inferior margin and a 6 cm occlusion extended to the merger with the splenic vein.

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It is known that gastrointestinalbl eeding occurs due to portalstenosis as a complication in the hepato-biliary-pancreatic region at later postoperative stages. Our department has treated 5 portal stent cases since 2015. The pressure difference between the hepatic side and intestinalside at the portalstenosis site decreased from 9-14(median: 10)cmH2O to 0-6 (median: 2)cmH2O in all cases before and after placement of the stent, resulting in hemostasis(observation period 4-18 months, median: 12 months).

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We report a case of pancreatic metastasis of pulmonary pleomorphic carcinoma with duodenal invasion after left lower lobectomy. A 65-year-old male underwent left lower lobectomy for left lung cancer in 2016. The final pathological finding was a diagnosis is of pleomorphic carcinoma, pT2bN0M0, stageⅡA.

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Neuroendocrine carcinoma(NEC)is known as rapid tumor growth, high grade malignancy and poor prognosis. We report a case of huge pancreatic NEC successfully performed conversion surgery after EP therapy. A 70-year-old female, was presented to our hospital with appetite loss.

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Although the safety of pancreaticoduodenectomy(PD)with hyperbilirubinemia has been reported, the permissible value of preoperative serum bilirubin is unknown. A 58-year-old man developed obstructive jaundice due to duodenal adenocarcino- ma. The initial serum bilirubin value was 26.

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FOLFIRINOX therapy has a high response rate for pancreatic carcinoma, but has serious adverse effects. FOLFIRINOX therapy was administered to 11 patients with locally advanced pancreatic carcinoma at our hospital. We investigated the usefulness of primary prophylactic administration of pegfilgrastim(PegG).

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Article Synopsis
  • Unresectable pancreatic cancer can lead to duodenal blockages, requiring surgical intervention.
  • Two case studies are presented where patients underwent duodenal bypass surgeries and began chemotherapy treatment afterward.
  • Both patients experienced quick recovery, improved health status, and weight gain, indicating that duodenum bypass is preferable for maintaining stable digestion and facilitating early chemotherapy.
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The annular pancreas is a rare congenital anomaly in which a ring of the pancreas parenchyma surrounds the second part of the duodenum. Malignant tumors are extremely rare in patients with an annular pancreas. A 64-year-old man presented with appetite loss and vomiting.

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Background/Purpose. The purpose of this study was to clarify whether preoperative gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) and simultaneous treatment of suspected early hepatocellular carcinoma (eHCC) at the time of resection for progressed HCC affected patient prognosis following hepatic resection. Methods.

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Nanoporous materials, such as zeolites, activated carbons, and metal-organic frameworks (MOFs), are peculiar platforms in which a variety of guest molecules are stored, reacted, and/or separated. The size of the nanopores is essential to realize advanced functions. In this work, we demonstrate a very simple but innovative method for the control of nanopore size, that is, reversible and continuous control by mechanical force loaded to soft nanoporous materials.

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