Resection of lesions in the ileum of patients with IgG4-related disease may ameliorate disease progression without steroid administration.

Background: IgG4-related disease (IgG4-RD) is a pathological condition that is characterized by an infiltrate composed of IgG4-positive plasma cells and recently recognized as an immune-mediated condition. It causes tissue throughout the body to become stiff and thickened due to autoimmune reactions that cause fibrosis and scarring. Disease-related changes commonly occur in the salivary glands, bile duct, pancreas, and lungs, but are seldom seen in the small bowel.

Design and synthesis of benzoacridines as estrogenic and anti-estrogenic agents.

Estrogens play undisputedly important physiological roles, but lifetime exposure to estrogens has also been linked to the development of breast cancer. Moreover, imbalanced estrogen levels have been associated with various symptoms such as osteoporosis and menopausal disorders. For the improvement of such estrogen imbalances, estrogenic reagents with regulatory properties have shown promising potential.

Multiple Liver Abscesses with a Skin Pustule due to Chromobacterium violaceum.

A 69-year-old woman was admitted to our hospital with the chief complaints of fever and fatigue. We initially treated the patient for a tick-borne disease after noticing a pustule on her leg; however, abdominal computed tomography (CT) showed multiple low-density areas in the liver and Chromobacterium violaceum was isolated from a blood culture. We diagnosed her with multiple liver abscesses secondary to Chromobacterium violaceum bacteremia.

Index of convexity: A novel method for assessing liver functional reserve using technetium-99m-galactosyl human serum albumin liver scintigraphy.

Preoperative evaluation of liver functional reserve is important in hepatobiliary surgery. Although the indocyanine green retention rate at 15 minutes (ICG-R15) is the gold standard for this purpose, a new method without technical complexity would be preferable. We assessed the usefulness of the previously established index of convexity (IOC).

Pancreatoduodenectomy With Systematic Mesopancreas Dissection Using a Supracolic Anterior Artery-first Approach.

Objective: To describe the details of the surgical technique of pancreatoduodenectomy (PD) with systematic mesopancreas dissection (SMD-PD), using a supracolic anterior artery-first approach.

Background: An artery-first approach in PD has been advocated in pancreatic cancer to judge resectability, clear the superior mesenteric artery margin from invasion, or reduce blood loss. However, the efficacy of an artery-first approach in mesopancreas dissection remains unclear.

Favorable outcome after repeat resection for colorectal liver metastases.

Background: The rate of recurrence after liver resection for colorectal liver metastases (CLM) is high, and repeat resection (RR) is reserved with curative intent in selected patients. This study evaluated the benefit of RR for recurrence after liver resection for CLM.

Methods: Data were collected on 287 consecutive patients who underwent primary curative hepatectomy between January 1999 and October 2008 for CLM at our institution.

Repeat hepatectomy for recurrent liver metastasis from gastric carcinoma.

Background: The efficacy of repeat hepatectomy for recurrent hepatocellular carcinoma and colorectal liver metastases is widely accepted. However, the benefits of such treatment for intrahepatic recurrence of gastric cancer liver metastasis remain unknown. This study sought to clarify the survival benefit for patients undergoing repeat hepatectomy for gastric cancer liver metastasis.

Long-term results of hepatic resection for non-colorectal, non-neuroendocrine liver metastasis.

Background/aims: The significance of surgical resection for non-colorectal non-neuroendocrine tumor liver metastasis (NCNNLM) remains controversial. The present study sought to clarify the long-term outcomes of surgical resection for NCNNLM and prognostic factors after hepatectomy in a single institution.

Methodology: From 1993 to 2009, 145 patients underwent hepatectomy for NCNNLM.

Preoperative transarterial chemoembolization for hepatocellular carcinoma.

Background/aims: The effects of transarterial chemoembolization (TACE) prior to hepatectomy for patients with hepatocellular carcinoma (HCC) are controversial.

Methodology: Clinicopathological profiles and prognosis were compared between patients who underwent hepatic resection following preoperative TACE (Group A, 69 patients) or only resection (Group B, 158 patients). Univariate and multivariate analyses were used to evaluate whether TACE influenced patient prognosis.

Is hepatic resection for recurrent or persistent hepatocellular carcinoma justified?

Background/aims: The safety and effectiveness of hepatic resection for recurrent or refractory hepatocellular is not established, particularly in cases treated by non-surgical treatment.

Methodology: Surgical outcomes of 38 patients who underwent curative hepatic resection for recurrent or refractory disease after previous treatment were evaluated. Univariate and multivariate analyses were performed to identify prognostic predictors.

[A case of transverse colon cancer with multiple liver metastases and hepatic pedicle lymph node involvement showing pathological complete response by XELOX plus bevacizumab].

A 70-year-old woman was referred to our hospital because of abdominal pain. Abdominal computed tomography(CT)and colonoscopy revealed transverse colon cancer with multiple liver metastases, with involvement of the hepatic pedicle and superior mesenteric artery lymph nodes. The patient received eight courses of XELOX plus bevacizumab, and CT showed a decrease in the size of the liver metastases and hepatic pedicle lymphadenopathy.

[Surgical indication and survival benefit of hepatectomy for gastric cancer liver metastasis].

Liver resection is now widely accepted as a potentially curative treatment for colorectal liver metastasis. However, the efficacy of surgical resection for gastric cancer liver metastasis(GLM)remains unclear. Based on our 18-year experience with 64 patients who underwent curative hepatectomy for GLM, we discuss the indication and efficacy of surgical resection for GLM.

Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections.

Purpose: The indication for hepatectomy in cases of gastric cancer liver metastases (GLM) remains unclear and it remains controversial whether surgical resection is beneficial for GLM. The objective of this retrospective study was to clarify the indications for and benefit of hepatectomy for GLM.

Methods: Seventy-three patients underwent hepatectomies for GLM from January 1993 to January 2011.

Mesenteric fibromatosis of the transverse colon with the reconstruction of the superior mesenteric arteries: report of a case.

In general, with large mesenteric tumors it may be rather difficult to determine whether infiltration into adjacent large vessels occurred. We wish to stress the importance of preparation for microsurgery when a huge lesion appears close to a large artery in preoperative images, based on our experience of successful microscopical reconstruction of a superior mesenteric artery (SMA) and marked improvement of blocked vascular flow to the small intestine during the surgery. We have experienced a case of mesenteric fibromatosis (MF) invading the SMA and vein, contrary to preoperative expectation.

The implications of positive peritoneal lavage cytology in potentially resectable pancreatic cancer.

Background: The clinical implications of peritoneal lavage cytology (CY) status in patients with potentially resectable pancreatic cancer have not been established.

Method: We retrospectively reviewed clinical data from 254 consecutive patients who underwent macroscopically curative resection for pancreatic cancer from February 2003 to December 2010 in our institution. Correlations between CY status and survival and clinicopathological findings were investigated.

Liver resection for multiple colorectal liver metastases with surgery up-front approach: bi-institutional analysis of 736 consecutive cases.

Background: Preoperative chemotherapy has become more common in the management of multiple resectable colorectal liver metastases; however, the benefit is unclear. This study examined clinical outcomes following liver resection for multiple colorectal liver metastases with the surgery up-front approach.

Methods: Data collected prospectively over a 16-year period for 736 patients who underwent hepatic resection at two different centers were reviewed.

Impact of previous hepatectomy on short-term outcomes of repeat hepatectomy for liver tumors with a special concern of operative time.

Background/aims: Repeat hepatectomy is widely accepted as a treatment for primary or metastatic liver malignancy. However, it entails a longer operative time and is associated with additional operative risks. The goal of the present study was to evaluate the impact of previous hepatectomy on the short-term outcomes of repeat hepatectomy, especially in operative time.

Significance of anatomic resection for early and advanced hepatocellular carcinoma.

Purpose: Although it remains controversial whether local ablation or surgery is better for early-stage hepatocellular carcinoma (HCC), surgical resection is the first choice for advanced HCC. Anatomic hepatic resection is the preferred procedure to improve prognosis, but to date, its superiority has been demonstrated only for early-stage HCC. This study aimed to evaluate the effect of anatomic resection in advanced HCC in which surgical resection is the first choice.

Repeat treatment for recurrent hepatocellular carcinoma: is it validated?

Purpose: Hepatocellular carcinoma (HCC) usually recurs repeatedly and locoregional treatment is attempted unless liver function has deteriorated. This study was aimed to evaluate the effect of repeated treatment on patient prognosis.

Methods: The HCC recurrence pattern and types of treatment for recurrence after hepatic resection were reviewed in 134 patients.

Safety and efficacy of hepatic vein reconstruction for colorectal liver metastases.

Background: Colorectal liver metastases with hepatic vein (HV) involvement may require combined resection of the liver and HV. However, the short- and long-term outcomes of such a procedure remain unclear.

Methods: We reviewed 16 cases of liver resection with major HV resection and reconstruction.

Predictive factors for bile leakage after hepatectomy: analysis of 505 consecutive patients.

Background: Bile leakage is the most common complication after hepatectomy and its incidence is not declining. The aim of the present study was to identify predictive factors for bile leakage.

Methods: Clinical data from 505 consecutive patients who underwent hepatectomy without extrahepatic bile duct resection in our department between January 2006 and December 2009 were reviewed retrospectively.

Improved survival of left-sided pancreas cancer after surgery.

Objective: Resective therapeutic strategy for left-sided pancreatic adenocarcinoma is open to debate. The post-resection outcomes and factors influencing post-resection survival for adenocarcinoma of the body and tail of the pancreas were analyzed to determine the effectiveness of surgery.

Methods: A total of 73 patients with adenocarcinoma of the body or tail of the pancreas who underwent resection between 1994 and June 2007 were evaluated for overall survival.

Simultaneous resection of colorectal cancer and synchronous liver metastases: initial experience of laparoscopy for colorectal cancer resection.

Background/aims: Although laparoscopy is accepted for treatment of colorectal cancer, there is no established consensus for its use when resection of synchronous liver metastases is performed simultaneously. The purpose of this study was to evaluate whether laparoscopic colorectal resection with simultaneous resection of synchronous liver metastases was technically feasible and whether it may be a therapeutic option.

Methods: Ten patients underwent laparoscopic resection for primary colorectal cancer, combined with synchronous resection of liver metastases.

Risk factors for clinical pancreatic fistula after distal pancreatectomy: analysis of consecutive 100 patients.

Background: The mortality associated with distal pancreatectomy (DP) has declined to <5% in recent years in high-volume centers. However, morbidity remains high, ranging from 32% to 57%. Pancreatic fistula (PF) is the most common complication after DP.

Widespread and multifocal carcinomas in situ (CISs) through almost the entire pancreas: report of a case with preoperative cytological diagnosis.

Purpose: It is imperative for prognostic improvement of pancreatic cancer that we try to diagnose carcinoma in situ (CIS) of lesions, i.e., precursors of invasive ductal carcinomas (IDCs) at an early stage, because results of treatment of patients with IDCs themselves continue to be rather unsatisfactory.