Risk factors for incisional surgical site infections in elective surgery for colorectal cancer: focus on intraoperative meticulous wound management.

Purpose: An incisional surgical site infection (I-SSI) is a frequently observed complication following colorectal surgery. Intraoperative wound management is one of the most important factors that determine the incidence of postoperative I-SSI. The purpose of this study was to assess the impact of the methods used for intraoperative wound management on the incidence of I-SSI following elective surgery for colorectal cancer.

[A case of peritoneal dissemination from mucinous carcinoma of the duodenum, which was associated with tumor thrombosis in the accessory pancreatic duct and successfully treated by chemotherapy].

A 72-year-old woman was admitted with an abdominal tumor, which had been detected by computed tomography scanning. Endoscopic examination of the upper gastrointestinal tract revealed a type 3 tumor in the descending limb of the duodenum. A diagnosis of adenocarcinoma was made on the basis of the histological analysis of the biopsy sample.

Left atrial myxosarcoma with previously detected intestinal metastasis.

Primary cardiac myxosarcoma is a rare disease; it is exceedingly rare for symptoms of systemic metastasis to precede diagnosis of the primary cardiac tumor. We describe the case of a previously healthy 60-year-old man with left atrial myxosarcoma, who had first presented with jejunal intussusception due to intestinal polyposis. Three months after resection of the jejunum, the patient experienced cerebral infarction and pulmonary edema.

Computed tomographic demonstration of a fish bone in abdominal actinomycosis: report of a case.

A 53-year-old man who had the habit of consuming fish bones was referred to our clinic because of a suspected malignant abdominal wall tumor. Computed tomography (CT) showed a mass (10 x 5 cm) in continuity with the transverse abdominal muscle, containing a small calcification. A laparotomy was performed with a preoperative diagnosis of an inflammatory mass due to fish bone penetration from the sigmoid colon.

Bile duct carcinoma arising in metaplastic biliary epithelium of the intestinal type: a case report.

We report herein a case of distal bile duct carcinoma showing intestinal differentiation diagnosed 3 years after endoscopic sphincterotomy for choledocholithiasis. The diagnostic problem in this case was that the granular mucosa, which is a typical finding of superficial mucosal extension of bile duct carcinoma in general, was interpreted as hyperplasia accompanying metaplasia in cholangioscopic biopsy. Discrimination of superficial mucosal cancer extension from hyperplastic mucosa with metaplastic changes was impossible using cholangioscopic examination.

Hepatectomy for proximal bile duct carcinoma in a patient with situs inversus; a case report.

Situs inversus is a rare condition which mandates a full understanding of all anatomic relationships prior to invasive procedures. A 76-year-old woman with situs inversus presented with fever and rigors. She had previously undergone endoscopic sphincterotomy and lithotomy for choledocholithiasis, and laparoscopic cholecystectomy for cholecystolithiasis.

Adenosquamous carcinoma of the jejunum.

Primary adenosquamous carcinomas of the intestine are rare, particularly in the small intestine. One case, in the jejunum of an adult female, is described here. The patient was a 70-year-old Japanese woman presenting with upper abdominal pain.

Most informative projection for portography: quantitative analysis of 47 percutaneous transhepatic portograms.

The goal of this study was to determine which projection for percutaneous transhepatic portography best depicts the anatomy of the proximal portal vein. Portograms ( n = 47) obtained in the anteroposterior, right anterior oblique, and right anterior caudal oblique projections were analyzed retrospectively. Lengths of the right portal trunk, the transverse portion of the left portal vein, and the right anterior and posterior portal branches, as well as angles between the right portal trunk and the transverse portion of the left portal vein and between the right anterior and posterior portal branches were measured in the various projections.

Factors influencing postoperative hospital mortality and long-term survival after radical resection for stage IV gallbladder carcinoma.

Factors influencing postoperative hospital mortality and long-term survival after radical resection of stage IV gallbladder carcinoma remain unclear. The objective of this study was to identify characteristics of patients who are good candidates in terms of surgical risk and long-term survival for radical resection of stage IV gallbladder carcinoma. A retrospective study was made of attempted surgical cure in 72 patients with stage IV gallbladder carcinoma.

Mode of tumor spread and surgical strategy in gallbladder carcinoma.

Background And Aims: The mode and degree of tumor spread in gallbladder carcinoma is poorly documented. The present study classifies the patterns of dissemination of this tumor with a focus on surgical strategy.

Patients And Methods: Surgical specimens from 112 patients who underwent curative resection were reviewed.

[Surgical treatment for advanced gallbladder cancer: indications and limitations].

We have aggressively performed extensive surgery including major liver resection for advanced gallbladder cancer since 1979. The 5-year survival rates for stage IVa and IVb patients after curative resection were 19% and 6%, respectively. Seven patients in the stage IVa group (n = 69) and one in stage IVb (n = 16) have survived for more than 5 years.

Hepaticojejunostomy using a Roux-en-Y jejunal limb via the retrocolic-retrogastric route.

Background: Hepaticojejunostomy following hepatobiliary resection has been performed using a Roux-en-Y jejunal limb via the antecolic or the retrocolic-anteduodenal route. However, in morbidly obese patients difficulty arises from the thickened, foreshortened mesentery of the jejunum and from limited mobility due to intra-abdominal fat deposition.

Methods: We developed new placement of Roux-en-Y jejunal limb in which the limb is placed via the retrocolic-retrogastric route.

Bacteremia after hepatectomy: an analysis of a single-center, 10-year experience with 407 patients.

Background And Aims: Septic complications after hepatectomy remain a difficult problem. Intra-abdominal sources of postoperative infections are well described in the literature. However, no studies have examined the cause and outcome of bacteremia after hepatectomy.