Publications by authors named "Daisuke Tsugawa"
Article Synopsis
- Preoperative understanding of caudate biliary anatomy is crucial for safely removing perihilar cholangiocarcinoma (PHC) tumors, and the study used endoscopic nasobiliary drainage (ENBD) to visualize these branches.
- The research analyzed 89 PHC patients who underwent ENBD-CT cholangiography and compared findings with 85 patients who had multidetector raw CT (MDCT) scans.
- Results indicated that ENBD-CT cholangiography identified significantly more caudate branches (206) compared to MDCT (62), providing detailed information about their drainage patterns into various hepatic ducts.
Background: Systemic inflammation and altered metabolism are essential hallmarks of cancer. We hypothesized that the rapid turnover protein transthyretin (TTR) (half-life: 2-3 days), compared with the conventional marker albumin (21 days), better reflects the inflammatory/metabolic dynamics of pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy (NAT) and is a useful prognostic marker.
Methods: Serum TTR and albumin levels were measured in 104 consecutive post-NAT PDAC patients before curative resection.
Purpose: The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear.
Methods: We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023.
Article Synopsis
- This study investigates whether postoperative bile leaks affect the prognosis of patients with hepatocellular carcinoma after liver resections.
- It analyzed 781 patients, comparing those with bile leaks to those without, using matched cohorts for a fair comparison.
- The findings suggest that bile leaks do not significantly impact 5-year recurrence-free or overall survival rates in these patients.
Article Synopsis
- Novel adhesives made from porous hydroxyapatite (HAp) ceramics provide a new method for surgical procedures involving biological tissues.
- These adhesives work by allowing water to move from soft tissues into their porous structure, which helps them effectively attach to different tissue types under various hydration conditions.
- Demonstrated during surgeries on porcine livers, these HAp adhesive devices show strong holding capabilities and can be easily detached when needed, indicating their potential use as internal organ retractors in laparoscopic surgeries.
Background/aim: This study aimed to evaluate the utility of the albumin-bilirubin grade for predicting the prognosis after repeat liver resection for patients with recurrent hepatocellular carcinoma.
Patients And Methods: Ninety patients with intrahepatic recurrent hepatocellular carcinoma who underwent repeat liver resection at our institution between 2005 and 2019 were retrospectively analyzed. Cox proportional-hazards regression models evaluated independent preoperative prognostic factors, including the albumin-bilirubin grade.
Intrahepatic cholangiocarcinoma (iCCA) has been subclassified by its gross morphology into the mass-forming (MF), periductal-infiltrating (PI), and intraductal growth (IG) types and their combinations. This classification correlates well with clinical features; for example, MF-iCCA has less lymph-node metastasis and a better prognosis than PI-iCCA. According to the recently accumulated evidence from histological investigations, the WHO classification endorsed a subclassification scheme in which iCCA cases are classified into small- and large-duct types.
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- This study investigates the effectiveness of drainage fluid amylase (DFA) in predicting postoperative pancreatic fistula (CR-POPF) rates after two types of surgery: open distal pancreatectomy (ODP) and laparoscopic distal pancreatectomy (LDP).
- Researchers reviewed data from 294 patients and found that the rate of CR-POPF was significantly higher after ODP compared to LDP, with DFA levels on postoperative days one and three showing distinct optimal cutoff values for the two procedures.
- The findings indicate that while DFA on day three can predict CR-POPF for both surgeries, the cutoff value is notably higher for patients who underwent LDP compared to those who had ODP, suggesting different thresholds may
Background: Venous thromboembolism (VTE) is a potentially fatal complication of hepatectomy. The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding. Therefore, we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.
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- * An intraoperative test showed stable blood flow, but to ensure better blood supply post-surgery, a bypass was created using a vein, alongside a pancreaticoduodenectomy that preserved part of the stomach.
- * The patient's recovery was smooth, indicating that this approach to arterial reconstruction during pancreaticoduodenectomy can be effective for those with atherosclerotic celiac axis stenosis.
Introduction: Surgical resection is considered an effective cure for biliary tract cancer (BTC); however, the prognosis is unsatisfactory despite improved surgical techniques and perioperative management. The recurrence rate remains high even after curative resection. The efficacy of adjuvant chemotherapy in pancreatic and gastric cancers has been previously reported, and the feasibility of adjuvant therapy with S-1 has recently been reported in patients with resected BTC.
View Article and Find Full Text PDFLC-1000 flow cytometry system complements intraoperative peritoneal cytology for pancreatic and biliary tract cancer.
J Hepatobiliary Pancreat Sci
September 2023
Background: The exfoliative cell analyzer, LC-1000, is medical device that utilizes the principles of flow cytometry, and might provide digital diagnostic information for cytology using a different approach from conventional cytomorphology. In this study, wae examined the usefulness of the LC-1000 as a diagnostic support system for intraoperative peritoneal lavage cytology and its prognostic impact for pancreatic (PC) and biliary tract cancer (BTC).
Methods: Patients with PC and BTC who underwent surgical treatment were included.
Background: The safety and efficacy of laparoscopic liver resection (LLR) have been reported worldwide. However, those of LLR for tumors located in Couinaud's segment 8 are not sufficiently investigated.
Methods: We retrospectively analyzed 108 patients who underwent liver resection for hepatocellular carcinoma (HCC) in segment 8 at Kobe University Hospital and Hyogo Cancer Center between January 2010 and December 2021.
Article Synopsis
- Postoperative cholangitis is a common issue following pancreaticoduodenectomy, negatively affecting patients' quality of life, and this study sought to identify factors that contribute to its recurrence.
- The study analyzed medical records from patients who had the surgery between 2015 and 2019, defining recurrence as having at least two episodes of cholangitis within a year post-surgery.
- Key risk factors for recurrence identified were the presence of internal stents, a firm pancreas, constipation, and elevated bilirubin levels, with long-term stent placement further increasing recurrence rates.
Transarterial chemoembolization (TACE) is performed for pancreatic neuroendocrine tumor (PanNEN) liver metastases; however, the safety and efficacy of TACE procedures, especially for patients who have undergone previous pancreatic surgery, have not been established. We reviewed 48 TACE procedures (1-6 procedures/patient) performed on 11 patients with PanNEN liver metastases, including 16 TACE procedures (4-6 procedures/patient) for 3 patients with a history of biliary-enteric anastomosis. The overall tumor objective response rate was 94%.
View Article and Find Full Text PDFBackground: Less intra-abdominal adhesions are expected following laparoscopic surgery. Although an initial laparoscopic approach for primary liver tumors may have advantages in patients who require repeat hepatectomies for recurrent liver tumors, this has not been sufficiently investigated.
Methods: Patients who underwent repeat hepatectomies for recurrent liver tumors at our hospital between 2010 and 2022 were retrospectively analyzed.
Background/aim: Recently, the Global Leadership Initiative on Malnutrition (GLIM), which includes the world's leading clinical nutrition societies, proposed the first global diagnostic criteria for malnutrition. However, the association between malnutrition diagnosed by the GLIM criteria and prognosis in patients with resected extrahepatic cholangiocarcinoma (ECC) remains unknown. This study aimed to investigate the predictive validity of the GLIM criteria for the prognosis of patients with resected ECC.
View Article and Find Full Text PDFBackground: Post-transplantation weight control is important for long-term outcomes; however, few reports have examined postoperative weight change. This study aimed to identify perioperative factors contributing to post-transplantation weight change.
Methods: Twenty-nine patients who underwent liver transplantation between 2015 and 2019 with an overall survival of >3 years were analyzed.
Background: Intracholecystic papillary neoplasm (ICPN) is one of the precursors of gallbladder cancer defined in the 2010 World Health Organization classification of tumors. We herein report ICPN with pancreaticobiliary maljunction (PBM), which is a high-risk factor for biliary cancer.
Case Presentation: A 57-year-old female presented with abdominal pain.
Article Synopsis
- Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia where red blood cells clump together at lower temperatures, leading to anemia symptoms, and splenectomy is usually not effective for it.
- A 60-year-old man diagnosed with CAD experienced persistent anemia and was treated with conventional methods like blood transfusions, but his condition did not improve.
- After a splenectomy, aimed at investigating a possible malignancy and alleviating his anemia, the patient's condition improved significantly, suggesting splenectomy could be a potential treatment for refractory CAD.
Background: Bile leakage is a major complication after liver transplantation and remains as a significant source of morbidity and mortality. In 2011, the International Study Group of Liver Surgery (ISGLS) defined bile leakage as a drain/serum bilirubin ratio ≥3. However, to our knowledge there is no literature assessing serum and drain bilirubin concentrations after liver transplantation.
View Article and Find Full Text PDFIntroduction: With the aging of the population in Japan, gallbladder cancer (GBC) in the elderly is increasing. However, the available clinical data are limited, and the optimal treatment is still controversial. The aim of this study was to evaluate the benefit of surgical resection in GBC patients ≥75 years of age.
View Article and Find Full Text PDFBackground: Laparoscopic caudate lobe resection is a challenging procedure. Several researchers have reported the safety of laparoscopic liver resections;1.Transl Gastroenterol Hepatol.
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