Publications by authors named "Takuya Mizumoto"
Article Synopsis
- - The study analyzed the effectiveness of various hepatic functional tests, specifically modified ALBI score, indocyanine green clearance (ICG-R15), and 99mTc-galactosyl human serum albumin (LHL15) scintigraphy, in predicting posthepatectomy liver failure (PHLF) among patients undergoing liver surgery.
- - Out of 413 patients studied, 19% experienced PHLF, with major hepatectomy, mALBI grade, ICG-R15, and presence of esophagogastric varices identified as significant independent risk factors for developing this complication.
- - The results suggested that LHL15, esophagogastric varices assessment, and the mALBI
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.
Article Synopsis
- The study investigates the impact of task division among console surgeons during robotic pancreaticoduodenectomy (RPD) on surgical outcomes and education from 2009 to 2023.
- It compares two methods: a single console surgeon versus multiple surgeons, revealing that the multiple approach significantly reduced operation time and postoperative complications.
- The findings suggest that using a multiple approach not only improves surgical results but also enhances learning opportunities for less experienced surgeons.
Article Synopsis
- The study compares two surgical techniques for distal pancreatectomy: robot-assisted approach (RAA) using a laparoscopic vessel-sealing device (LAVSD) and pure-robotic approach (PRA).
- RAA demonstrated significantly shorter operation times and fewer major complications compared to PRA among 62 patients analyzed.
- Despite no statistically significant difference in hospital stay duration, RAA is considered a safe and effective alternative for less experienced surgeons.
Article Synopsis
- Pancreatojejunostomy is a complex surgery often performed during robotic pancreaticoduodenectomy (RPD), and the modified Blumgart anastomosis (mBA) method lacks established technical guidelines for robotic use.
- A study at Fujita Health University analyzed data from 78 RPD patients between 2009 and 2023, focusing on the implementation of robotic mBA.
- Results showed a postoperative pancreatic fistula rate of 18%, with no severe complications, and an average anastomotic time of 80 minutes, suggesting that robotic mBA can be a viable standard method for this procedure.
Article Synopsis
- Robotic pancreaticoduodenectomy (RPD) is complex, requiring 20-50 cases for surgeons to improve, with this study examining 76 RPD cases from a hospital over nearly 14 years to track surgical performance evolution.* -
- Patients were categorized into three groups based on the surgeons' experience: competency, proficiency, and mastery, with significant reductions in operation time and major complications as experience increased across these groups.* -
- Results showed that average operation time significantly decreased from 921.5 minutes to 609.2 minutes, and major complications dropped from 52.2% to 9.1% as surgical techniques were optimized, indicating improved surgeon training and procedural efficiency.*
Article Synopsis
- Pancreatic tumor enucleation is a surgical method that removes tumors while preserving pancreatic function, and can be done with minimally invasive techniques.
- The da Vinci SP robotic platform, a new single-port robotics technology, was used for this procedure in a male patient in his 70s with a pancreatic neuroendocrine tumor.
- The surgery took 139 minutes with minimal blood loss (4 mL), and the patient recovered well, going home six days post-operation, suggesting that this method is both effective and less invasive.
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.
Surgical techniques and outcomes of minimally invasive anatomic liver resection (AR) using the extrahepatic Glissonian approach for hepatocellular carcinoma (HCC) are undefined. In 327 HCC cases undergoing 185 open (OAR) and 142 minimally invasive (MIAR; 102 laparoscopic and 40 robotic) ARs, perioperative and long-term outcomes were compared between the approaches, using propensity score matching. After matching (91:91), compared to OAR, MIAR was significantly associated with longer operative time (643 vs.
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- Robotic surgery offers benefits like high optical magnification and precise movement of forceps but has limitations such as a narrow surgical field and lack of tactile feedback.
- In a case involving an 80-year-old man undergoing robotic distal pancreatectomy, injury to the splenic artery resulted in severe and uncontrollable bleeding.
- Surgeons must remain vigilant about the interaction of robotic instruments with surrounding structures, emphasizing the need for regular assessments of the surgical field to prevent errors.
Background: Anatomic liver resection (ALR) has been established to eliminate the tumor-bearing hepatic region with preservation of the remnant liver volume for liver malignancies. Recently, laparoscopic ALR has been widely applied; however, there are few reports on laparoscopic segmentectomy 2. This study aimed to present the standardization of laparoscopic segmentectomy 2 with surgical outcomes.
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- Right-sided ligamentum teres (RSLT) is a rare condition where the fetal umbilical vein connects abnormally to the portal vein, which can affect liver surgeries.* -
- An 80-year-old woman underwent multiple treatments for liver metastasis from sigmoid cancer and was referred after complications from previous therapies led to the discovery of RSLT.* -
- The patient had a successful left trisectionectomy after a procedure called portal vein embolization (PVE) increased her liver volume, highlighting the importance of understanding vascular anomalies for safe surgery.*
Stapling is the standard method for pancreatic transection during laparoscopic distal pancreatectomy. Although most surgeons use a 60 mm cartridge stapler, space limitations created by laparoscopic surgery make the instrument difficult to handle, especially during pancreatic transection at the neck. Therefore, we currently use a 45 mm cartridge stapler for laparoscopic pancreatic transection at the neck.
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- An 81-year-old woman developed portal vein thrombosis (PVT) after major liver surgery for cancer, leading to significant complications including liver failure.* -
- Emergency procedures involved using a catheter to aspirate the thrombus, followed by the administration of anticoagulants, resulting in partial restoration of blood flow in the affected veins.* -
- After continuous treatment, the patient's thrombi resolved completely within 16 days, and she was discharged 76 days post-surgery without any recurrence of PVT over the next 6 months.*
Needle tract seeding of pancreatic tail adenocarcinoma identified on laparoscopy.
J Hepatobiliary Pancreat Sci
February 2023
Introduction: Although the relationship between systemic inflammatory responses and prognosis has been known in various cancers, it remains unclear which scores are most valuable for determining the prognosis of extrahepatic cholangiocarcinoma. We aimed to verify the usefulness of various inflammation-based scores as prognostic factors in patients with resected extrahepatic cholangiocarcinoma.
Methods: We analyzed consecutive patients undergoing surgical resection for extrahepatic cholangiocarcinoma at our institution between January 2000 and December 2019.
Background: Although liver transplantation is widely accepted as the therapeutic strategy for end-stage liver failure, complication of hepatic venous outflow obstruction remains lethal. Currently, ensuring a single wide orifice in both the graft and recipient inferior vena cava has been proposed to avoid hepatic venous outflow obstruction with no theoretical concept.
Methods: We herein report a standardization technique for the reconstruction of the hepatic vein based on the causal analysis.
Article Synopsis
- A 68-year-old man with a history of gastric cancer underwent examination for dilated pancreatic duct and was diagnosed with early-stage pancreatic cancer, leading to a planned distal pancreatectomy (DP).
- During the surgery, indocyanine green (ICG) fluorography was used to assess blood flow to the remnant stomach, showing increased fluorescence indicative of good blood supply.
- Digital subtraction angiography (DSA) revealed that the left inferior phrenic artery (LIPA) supplied over half of the remnant stomach, highlighting its crucial role in maintaining blood flow after the removal of other arteries.
Objective: This study aimed to determine whether retrocolic alimentary tract reconstruction is noninferior to antecolic reconstruction in terms of DGE incidence after pancreatoduodenectomy (PD) and investigated patients' postoperative nutritional status.
Summary Of Background Data: The influence of the route of alimentary tract reconstruction on DGE after PD is controversial.
Methods: Patients from 9 participating institutions scheduled for PD were randomly allocated to the retrocolic or antecolic reconstruction groups.
Background: The optimal treatment for isolated local recurrence (ILR) of pancreatic adenocarcinoma (PDAC) after surgical resection remains unclear. This study aimed to evaluate the safety and efficacy of proton radiotherapy (PRT) for ILR of PDAC after surgery.
Methods: The medical records of patients with ILR of PDAC after surgery who underwent proton beam therapy between 2011 and 2015 at Hyogo Ion Beam Medical Center were retrospectively studied.
Background: Lactate production is exacerbated by surgical stress. We sought to determine whether branched-chain amino acid (BCAA) supplementation could decrease blood lactate levels in patients undergoing hepatectomy.
Methods: A total of 275 consecutive patients who underwent hepatectomy of ≥2 segments were retrospectively reviewed.
Article Synopsis
- The study investigates the relationship between preoperative serum elastase 1 levels and the risk of recurrence in patients with resectable well-differentiated pancreatic neuroendocrine neoplasms (PanNETs).
- Findings show that higher elastase 1 levels are linked to larger tumors, WHO grade 2 tumors, microscopic venous invasion, and significantly increased rates of recurrence.
- A cutoff level of 250 ng/dL for elastase 1 was identified, showing high specificity and accuracy for predicting postoperative recurrence, with lower recurrence-free survival rates for patients with elevated elastase 1 levels.
A 72-year-old woman had severe watery diarrhea and weight loss. Computed tomography demonstrated a 55mm tumor in pancreatic tail with enlargement of para-aortic lymph nodes. There was no apparent liver metastasis.
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- A 69-year-old woman discovered pancreatic tail cancer during a CT scan after a breast cancer procedure; further checks revealed metastases in nearby lymph nodes.
- She sought a second opinion at another hospital where she was diagnosed with sarcoidosis, complicating her cancer diagnosis due to existing lymphadenopathy.
- After undergoing distal pancreatectomy in 2014 and with a follow-up showing no recurrence 39 months later, the case highlighted the challenges of diagnosing cancer when sarcoidosis is present.