Publications by authors named "Satoshi Hirooka"
Article Synopsis
- This study reexamines the extent of lymph node dissection needed for patients with pancreatic ductal adenocarcinoma (PDAC) located in the body (Pb) and tail (Pt) of the pancreas, aiming to find optimal lymphadenectomy areas.
- A retrospective analysis of 177 patients revealed that the highest rates of lymph node metastasis for Pb-PDAC occurred around the splenic artery, while splenic hilum nodes were critical for Pt-PDAC.
- The findings suggest that future guidelines should recommend extensive dissection around the celiac axis and superior mesenteric artery for Pb-PDAC, but limit routine dissection to nodes around the splenic artery and hilum for Pt-PDAC, pending further multicenter
Article Synopsis
- * A study tested the effectiveness of AHCC, a cultured extract, in reducing chemotherapy-related anemia and taste disorders in patients with pancreatic cancer, comparing those who received AHCC to those who received a placebo.
- * Results showed no significant difference in anemia rates between groups, but the AHCC group experienced significantly fewer taste disorders and improved nutrition, suggesting it may enhance quality of life for chemotherapy patients.
Article Synopsis
- The study investigates treatment strategies for patients with multifocal intraductal papillary mucinous neoplasms (MF-IPMNs) and how their surgical outcomes compare to those with unifocal IPMNs.
- A total of 194 patients were analyzed, finding no significant differences in 5-year disease-specific survival rates between those with MF-IPMNs and unifocal IPMNs.
- The research concluded that each cyst in MF-IPMNs should be individually assessed for cancer-related characteristics, highlighting lymph node metastasis as a key survival predictor.
Article Synopsis
- Intraperitoneal chemotherapy with paclitaxel (i.p.-PTX) shows promise as a treatment for pancreatic ductal adenocarcinoma (PDAC) with peritoneal dissemination, potentially improving patient outcomes.
- A study of 101 patients found that those treated with i.p.-PTX had a median survival time of 17.9 months, significantly longer than the 10.2 months for those receiving standard systemic chemotherapy.
- Additionally, patients receiving i.p.-PTX had a higher rate of clinical responses and were more likely to undergo successful conversion surgeries, indicating better overall treatment efficacy.
Article Synopsis
- This study investigates tumor budding, a histological feature where small groups of cancer cells cluster at the edge of a tumor, specifically in cases of duodenal adenocarcinoma (DA).
- Researchers analyzed data from 47 patients who underwent surgery for DA between 2006 and 2018, categorizing tumor budding into low, intermediate, and high levels to determine its impact on patient outcomes.
- The findings indicate that high tumor budding correlates with worse overall survival and increased rates of distant metastasis, highlighting it as a significant prognostic factor in DA cases.
Backgrounds/purpose: The purpose of this study was to identify risk factors and establish a treatment strategy for clinical hepatico-jejunostomy stenosis defined with intrahepatic bile duct dilatation after pancreaticoduodenectomy.
Methods: The 443 patients who underwent PD from April 2006 to December 2015 were analyzed. Clinical characteristics were compared between patients with and without clinical HJ stenosis, and risk factors for clinical HJ stenosis were analyzed.
Article Synopsis
- Pancreatoduodenectomy (PD) is a complex surgical procedure, and understanding its difficulty can enhance patient safety, especially for trainee surgeons.
- A study conducted between 2016 and 2018 involved a questionnaire where chief surgeons rated the difficulty of 99 consecutive PDs, revealing that 29.3% were simple, 40.4% moderate, and 30.3% difficult.
- Key factors that made PD difficult included unrecognized tissue planes, borderline resectable/unresectable status, and preoperative cholangitis, suggesting preoperative assessment can improve surgical outcomes.
Validation of the triple-checked criteria for drain management after pancreatectomy.
J Hepatobiliary Pancreat Sci
February 2022
Article Synopsis
- Drain management is crucial for detecting and treating postoperative pancreatic fistula (CR-POPF), and a study validated a new triple-checked criteria for drain removal based on fluid amylase and C-reactive protein levels.
- The study involved 681 patients, comparing an intervention group using the new criteria from 2017 to 2019 with a control group that followed older criteria from 2012 to 2016.
- Results showed the intervention group had a higher proportion (86.2% vs 76.1%) meeting the new criteria, with improved sensitivity and accuracy for drain removal, while the rates of CR-POPF remained similar between both groups.
Background: We advocated carbohydrate antigen (CA) 19-9 ≥ 150 U/mL and tumor size ≥30 mm as "high-risk markers" for predicting unresectability among patients with radiologically resectable (R) or borderline resectable (BR) pancreatic ductal adenocarcinoma (PDAC). The main aim is to establish a risk scoring system for occult abdominal metastasis (OAM) in R/BR PDAC.
Methods: Predictors of OAM were investigated retrospectively in an experiment cohort from 2006 to 2018.
Active hexose-correlated compound (AHCC) is a standardized extract from cultured Lentinula edodes mycelia, used as a potent biological response modifier in cancer treatment. We evaluated the nutritional effect of AHCC, given during neoadjuvant therapy, to patients with pancreatic ductal adenocarcinoma (PDAC). Thirty patients with resectable or borderline-resectable PDAC received neoadjuvant therapy with gemcitabine plus S-1.
View Article and Find Full Text PDFInvasive micropapillary carcinoma (IMPC) is a rare distinct histopathological subtype, characterized by the presence of carcinoma cells displaying reverse polarity. Only limited clinicopathological information is available regarding pancreatic IMPC. The aim of the present study was to clarify the clinicopathological features of pancreatic IMPC and the usefulness of protein kinase C (PKC)ζ immunostaining for the detection of reverse polarity.
View Article and Find Full Text PDFArticle Synopsis
- A study investigated whether conversion surgery after chemo(radiation)therapy can improve survival outcomes for patients with initially unresectable locally advanced and metastatic pancreatic ductal adenocarcinoma (PDAC).
- Among 468 patients, those who underwent conversion surgery experienced significantly longer median survival times (37.2 months) compared to those who did not undergo surgery (nine months).
- Factors such as lymph node metastasis and large tumor size were linked to early recurrence after surgery, while the type of pancreatic lesion and receiving postoperative chemotherapy influenced overall survival rates.
Background: The requirement for elective cholecystectomy in older patients is unclear. To determine predictors for requiring elective cholecystectomy in older patients, a prospective cohort study was performed.
Methods: All patients with gallstone disease who presented to our department from 2006 to 2018 were included if they met the following criteria: (1) age 75 years or older, (2) presentation for elective cholecystectomy, and (3) preoperative diagnosis of cholecystolithiasis.
Article Synopsis
- The study compared two criteria for drain removal after pancreatectomy: conventional criteria focused on drain fluid amylase levels (DFA) and a new sequentially-checked set of criteria.
- Results showed that patients meeting the sequentially-checked criteria had a higher rate of successful drain removal and significantly lower incidences of complications like clinically relevant postoperative pancreatic fistula (CR-POPF) and intra-abdominal abscess.
- The study concluded that using sequentially-checked criteria enhances safety in drain management, leading to better postoperative outcomes, and introduced a new triple-checked criteria to further reduce false positives in CR-POPF predictions.
Background And Objectives: Edema of the gallbladder may pose a diagnostic challenge because it also occurs in patients without an indication for cholecystectomy.
Methods: We evaluated all consecutive patients with gallstone disease who presented for cholecystectomy at the Department of Surgery of Kansai Medical University from January 2006 to April 2019. Using the prospectively collected database in our department, we obtained information on patients whose final diagnoses were gallbladder edema.
Article Synopsis
- The study investigated the role of adipophilin, a protein linked to aggressive cancer behavior, specifically in pancreatic ductal adenocarcinoma (PDAC).
- Researchers analyzed tissue samples from 181 PDAC patients to assess adipophilin expression and its impact on overall survival (OS) and recurrence-free survival (RFS).
- The results indicated that adipophilin-positive patients had significantly worse OS and RFS, suggesting it could serve as an independent prognostic marker for PDAC.
Background: Recent rapid increases in the aging population have created an impending "Silver Tsunami" in advanced countries. The overall prevalence of gallstone disease and its related complications will soon increase, and there will be a larger demand for gallbladder surgery.
Methods: We examined the outcomes of cholecystectomy according to age among patients with cholelithiasis to determine how a patient's age influences the outcome of cholecystectomy.
Lessons Learned: The triple combination chemotherapy of SOXIRI (S-1/oxaliplatin/irinotecan) in patients with unresectable pancreatic ductal adenocarcinoma was an effective treatment that appeared to be better tolerated than the widely used FOLFIRINOX regimen.SOXIRI regimen may provide an alternative approach for advanced pancreatic cancer.
Background: In our previous phase I study, we determined the recommended dose of a biweekly S-1, oxaliplatin, and irinotecan (SOXIRI) regimen in patients with unresectable pancreatic ductal adenocarcinoma (PDAC).
Aim: Follicular pancreatitis is a recently recognised, distinct clinicopathological entity characterised by the presence of many intrapancreatic lymphoid follicles with reactive germinal centres. However, the clinicopathological and immunological features and causes have not yet been established. We assessed the clinicopathological and immunological profiles of patients with follicular pancreatitis who underwent surgery.
View Article and Find Full Text PDFObjectives: The aim of this dual-center randomized controlled trial was to determine the optimal duration of antimicrobial prophylaxis in patients treated with pancreaticoduodenectomy (PD) who underwent preoperative biliary drainage (PBD) but were without cholangitis.
Background: Some reports showed that PBD in patients undergoing pancreatectomy increased the rate of perioperative complications. However, no clinical trial has evaluated the optimal duration of antimicrobial prophylaxis with a focus on patients who underwent PD following PBD.
Background: Post-operative pancreatic fistula (POPF) is one of the most common and serious complications after pancreaticoduodenectomy (PD). The aim of this study is to retrospectively compare clinically relevant (CR) POPF and other complications after pacreaticojejunostomy (PJ) after modified Kakita (m-Kakita) or modified Blumgart (m-Blumgart) anastomoses without stenting in a single institution.
Methods: One hundred twenty-eight patients underwent PJ using m-Kakita anastomoses (two interrupted penetrating sutures) between January 2009 and December 2011.
Background: Bile leakage after subtotal cholecystectomy (SC) is clinically serious. To prevent such leakage, we developed a new surgical technique in which a free piece of omentum is plugged into the gallbladder stump (omentum plugging technique). We evaluated whether the omentum plugging technique prevents bile leakage after subtotal cholecystectomy.
View Article and Find Full Text PDFIntroduction: Many researchers have addressed overdosage and inappropriate use of antibiotics. Many meta-analyses have investigated antibiotic prophylaxis for low-risk laparoscopic cholecystectomy with the aim of reducing unnecessary antibiotic use. Most of these meta-analyses have concluded that prophylactic antibiotics are not required for low-risk laparoscopic cholecystectomies.
View Article and Find Full Text PDFArticle Synopsis
- Post-operative pancreatic fistula (POPF) is a frequent complication after pancreaticoduodenectomy (PD) and can lead to high mortality rates.
- A study involving 108 patients with a narrow main pancreatic duct examined the effects of a long-internal stent on preventing POPF, comparing 54 patients with stents to 54 without.
- Results showed there was no significant reduction in POPF rates between the two groups, and factors like blood loss and soft pancreatic tissue were identified as key risks for developing POPF.