Publications by authors named "Toki Kawai"
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
- - 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.
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 PDFArticle Synopsis
- A study compared two types of surgery for patients with certain types of tumors to see which might lead to fewer problems afterward.
- The results showed that one surgery, called DPPHR, had a much lower chance of causing liver problems and infections compared to the other surgery, PD.
- The researchers believe that keeping some parts of the digestive system intact during DPPHR helps prevent these issues after surgery.
Article Synopsis
- * 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
- A 50-year-old woman fainted because her blood sugar was really low, and doctors found a small tumor in her pancreas that was causing the problem.
- They planned to remove the tumor using a special device called an artificial pancreas to help keep her blood sugar levels steady during surgery.
- During the operation, her blood sugar dropped a lot, but the doctors adjusted the artificial pancreas to keep it from getting too low, and they successfully managed her levels throughout the procedure.
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.
Herein, we report an extremely rare case of intraductal tubulopapillary carcinoma (ITPC) that was detected due to the pancreatic duct dilatation newly appeared on CT after surgery for gallbladder cancer associated with pancreaticobiliary maljunction. Present case: a 77-year-old female. Extended cholecystectomy, extra-bile duct resection, and hepaticojejunostomy was performed and resected specimen showed that this gallbladder tumor was papillary adenocarcinoma, pT2(ss), pN0, pDM0, pHM0, pEM0.
View Article and Find Full Text PDFIn 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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- - A 72-year-old man with chronic pancreatitis was diagnosed with unresectable locally advanced pancreatic cancer after imaging revealed a tumor in the pancreas suspected to invade nearby arteries.
- - He underwent chemotherapy with gemcitabine and nab-paclitaxel, resulting in tumor shrinkage, which allowed for the possibility of surgery.
- - Following surgery, the tumor was confirmed as tubular adenocarcinoma, with a moderate histological response to the pre-surgery chemotherapy treatment.
Article Synopsis
- 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 PDFArticle 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.
Article Synopsis
- 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 PDFObjectives: Although large hepatectomy (i.e., resection of 2-3 segments) is an increasingly common treatment for hepatocellular carcinoma and cholangiocarcinoma, it can lead to liver failure.
View Article and Find Full Text PDFArticle Synopsis
- - Patients who had pancreaticoduodenectomy (PD) often face long-term quality of life issues due to pancreatic dysfunction, leading to digestive problems and fatty liver.
- - A study analyzed 73 patients post-PD, comparing a group that received lower-titer pancreatic enzyme preparations to a group that received a higher-titer preparation called pancrelipase.
- - Results showed that the pancrelipase group had better nutritional status, with higher serum albumin and cholesterol levels, and overall improved health indicators compared to the lower-titer group, suggesting pancrelipase's effectiveness in preventing fatty liver and enhancing nutrition post-surgery.
Article Synopsis
- A 67-year-old man with multiple liver metastases from metastatic colorectal cancer received TAS-102 combined with bevacizumab (Bmab) as a fifth-line chemotherapy treatment.* -
- After 3 months on this regimen, imaging showed a 13% reduction in the size of the liver metastases.* -
- The treatment was found to be safe and effective, with neutropenia being the most significant side effect, and the patient was able to continue for 6 months.*