Publications by authors named "Takayuki Ochi"
Article Synopsis
- - The study aimed to assess the effectiveness of duodenum-preserving pancreatic head resection (DPPHR) as a treatment for pancreatic neuroendocrine tumors (PNETs) in relation to curability and patient quality of life post-surgery.
- - Seven patients underwent DPPHR between January 2011 and December 2021, with the procedure showing manageable postoperative complications and achieving complete curative resections without positive tumor margins.
- - The findings suggest that DPPHR is a viable alternative to more invasive surgeries like pancreaticoduodenectomy for treating PNETs, allowing for thorough pathological assessment while minimizing patient recovery concerns.
Article Synopsis
- - The study investigated how new lithotomy stirrups (type 2) affect pressure distribution on lower limbs during laparoscopic and robot-assisted rectal surgery, aiming to minimize the risk of well-leg compartment syndrome (WLCS) and deep venous thrombosis (DVT).
- - Researchers tested 30 participants by measuring pressure on different leg muscles in various positions using both conventional stirrups (type 1) and the new stirrups (type 2) with a specialized sensor.
- - Results showed that the new stirrups significantly reduced pressure on key leg muscles, particularly shifting from the proximal to the more distal soleus muscle, which may lower the likelihood of WLCS and DVT after surgery; however
Background: Although most duodenal carcinomas are pathological adenocarcinomas, a small number of cases have been reported of adenosquamous carcinoma, characterized by variable combinations of two malignant components: adenocarcinoma and squamous cell carcinoma. However, owing to the small number of cases of non-ampullary duodenal adenosquamous carcinoma, there have been no reported cases of emergency pancreaticoduodenectomy for gastrointestinal hemorrhage due to non-ampullary duodenal adenosquamous carcinoma.
Case Presentation: A 66-year-old Japanese male presented to the referring hospital with a chief complaint of abdominal pain, diarrhea, and dark urine that had persisted for 1 month.
Article Synopsis
- - A patient with sigmoid colon cancer and multiple liver metastases achieved complete remission after chemotherapy and a hepatectomy, but later experienced local recurrence and underwent a second surgery.
- - Following laparoscopic sigmoidectomy for a new adenocarcinoma diagnosed via colonoscopy, the patient received further chemotherapy which resulted in the liver metastases shrinking, allowing for a successful right hepatectomy.
- - Despite the initial success, a follow-up revealed local recurrence of liver metastasis, leading to a partial hepatectomy; the patient is currently recurrence-free and continuing treatment with modified FOLFOX.
Article Synopsis
- - A woman in her 70s with locally advanced unresectable pancreatic cancer received 5 courses of modified FOLFIRINOX chemotherapy followed by radiation therapy after being diagnosed with an irregular mass invading nearby arteries, classified as cStage Ⅲ cancer.
- - Her treatment resulted in a significant drop in CA19-9 levels, indicating a partial response to treatment, and led to the decision that her tumor was potentially curable.
- - Eight months after starting treatment, she underwent successful surgery (subtotal stomach-preserving pancreaticoduodenectomy) and was found to be cancer-free with no recurrence at 5 months post-operation.
Article Synopsis
- Inflammatory pseudotumor (IPT) is a rare condition that can be mistaken for cancer, necessitating careful diagnosis.
- A 61-year-old woman presented with a large liver lesion and enlarged lymph nodes, leading to a series of diagnostic and surgical procedures.
- Ultimately, she was diagnosed with IPT after laparoscopic surgery, which allowed for both diagnosis and treatment, and she has remained healthy two years post-surgery.
A 49-year-old female was underwent laparoscopic right hemicolectomy for ascending colon cancer and liver metastasis. Then, she was underwent laparoscopic hepatectomy. She received BEV plus mFOLFOX6 therapy as postoperative adjuvant chemotherapy, but she had liver recurrence.
View Article and Find Full Text PDFBackground: Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson's tumor, is a benign, non-neoplastic vascular lesion that is characterized by reactive proliferation of papillary endothelial cells associated with a thrombus. These lesions typically develop in the vascular regions of the head and neck, oral cavity, or extremities; however, other organ systems have been affected. IPEH in the gastrointestinal tract is rare, with only a few cases reported to date.
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- * Imaging revealed a sizable tumor with rapid growth and thrombosis, leading to an urgent surgery involving right hepatectomy and tumor removal.
- * Following the surgery, the patient was treated with lenvatinib, resulting in a positive outcome with no recurrence after 2 years, highlighting the effectiveness of combined surgical and adjuvant therapies.
Article Synopsis
- The article discusses a rare case of intracholecystic papillary neoplasm (ICPN), highlighting its growth from a small benign lesion to a malignant one over two years, monitored through abdominal ultrasounds.
- A 44-year-old man initially presented with a small gallbladder polyp that gradually enlarged, leading to laparoscopic cholecystectomy when it reached 10 mm in size.
- Histological and immunohistochemical analyses confirmed the diagnosis of ICPN with high-grade intraepithelial neoplasia, suggesting that rapidly growing sessile polyps could be significant early indicators of this condition.
In performing PD, it is very important to understand the running and anatomy of the hepatic artery and the positional relation with the tumor before surgery, leading to planning a proper surgical procedure. In this case series, we report 2 cases in which radical resection was achieved by pancreaticoduodenectomy(PD)with combined hepatic artery resection(without reconstruction)while paying attention to the positional relationship between the bifurcated hepatic artery and the tumor in the head of the pancreas. Case 1: A 73-year-old man.
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- This study investigates the link between preoperative exocrine function, measured via the C-trioctanoin breath test, and the development of pancreatic fistula (PF) after pancreaticoduodenectomy (PD).
- It analyzed data from 80 patients who underwent the breath test before surgery, finding a significant correlation between breath test results and the occurrence of PF.
- The research concludes that lower fat absorption levels suggest a decreased risk of PF, indicating the breath test may be a valuable predictive tool for this complication in surgical patients.
The two patterns of pathogenesis for pancreatic colloid carcinoma are reported; (1) progression from ordinary ductal adenocarcinoma, a subtype of invasive pancreatic ductal carcinoma, and (2) progression from papillary adenocarcinoma derived from intraductal papillary mucinous neoplasm (IPMN) or mucinous cystic neoplasm (MCN). Whether these two conditions are the same disease remains controversial. Case Report 1.
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- * Effective collaboration between gynecologists and gastroenterological surgeons is essential for the safe execution of SDF, especially regarding surgical techniques and management before and after the procedure.
- * Regular joint conferences between departments help facilitate communication and utilize each specialty's expertise, leading to safer and more effective surgical outcomes.
Background: Performing major hepatectomy for patients with marginal hepatic function is challenging. In some cases, the procedure is contraindicated owing to the threat of postoperative liver failure. In this case report, we present the first case of marginal liver function (indocyanine green clearance retention rate at 15 min [ICGR15]: 28%) successfully treated with right hepatectomy, resulting in total caudate lobe preservation.
View Article and Find Full Text PDFA preserved pancreatic exocrine function after pancreatectomy may be a crucial cause of pancreatic fistula: paradoxical results of the C-trioctanoin breath test in the perioperative period.
Surg Today
April 2022
Article Synopsis
- This study looked at how a condition called pancreatic fistula (PF) affects the pancreas's ability to work after surgery.
- Researchers tested 96 patients before and one month after their surgery to see how well their bodies absorbed fat.
- They found that patients with PF actually did better at absorbing fat after surgery compared to those without PF, showing that PF doesn’t hurt the pancreas’s function right away.
The spread of the new coronavirus (COVID-19) infection in 2020 has had a significant impact on the treatment of cancer worldwide. During the COVID-19 pandemic, the biggest challenge for pancreatic surgeons is the difficulty in providing oncological care. In this review article, from the standpoint of surgeons, we explain the concept of triaging of patients with pancreatic tumors under the COVID-19 pandemic, and the actual impact of COVID-19 on the treatment of patients with pancreatic tumors.
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- A 66-year-old woman was diagnosed with gallbladder cancer through a CT scan, which showed a tumor with uneven enhancement.
- She had surgery to remove the cancerous gallbladder and received three rounds of chemotherapy with S-1, but developed a 15 mm metastatic tumor in the liver.
- After changing her treatment to a combination of gemcitabine and cisplatin, the liver metastasis shrank to 8 mm, leading to a partial liver resection; the patient is currently alive with no signs of cancer recurrence.
Background: We present a case of pancreatic and splenic metastases following alveolar soft part sarcoma (ASPS), which was successfully treated by surgery.
Case Presentation: A 41-year-old male was referred to our hospital in 2012. Computed tomography (CT) showed the presence of a pancreatic tumor.
Hepatocellular adenoma (HCA) is a benign hepatocyte-derived epithelial tumor. HCA is associated with oral contraceptive use among Caucasian populations. We report a case of hepatocellular adenoma with a pedunculated protuberance and high protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels, which made diagnosis challenging.
View Article and Find Full Text PDF[Current status and prospect of the surgical treatment for pancreatic cancer].
Nihon Shokakibyo Gakkai Zasshi
December 2013