Simpler and safer anastomosis by pancreaticogastrostomy using a linear stapler after pancreaticoduodenectomy.

Postoperative pancreatic fistula (POPF) remains a major and serious problem after pancreaticoduodenectomy (PD). In its presence, pancreatic juice may leak from the main duct or branches of the pancreatic stump. To prevent this, we have applied a newly modified anastomosis of pancreaticogastrostomy (PG) using a linear stapler (stapled PG).

Chronological Change of the Clinical Features and Treatment Outcomes for Subarachnoid Hemorrhage in Japan: A Multicenter Retrospective Study.

Aneurysmal subarachnoid hemorrhage (SAH) treatment has progressed, and patients are rapidly aging in Japan. Consequently, dynamic changes must have emerged in the clinical practice of SAH. This study aimed to elucidate chronological changes of aneurysmal SAH and the prognostic factors in the previous quarter century in Japan.

Tumor Vascular Microenvironment of Colorectal Hepatic Metastasis and Chemotherapy Response.

Background: The tumor vascular microenvironment has an important role in tumor progression and metastasis. The objective of this study was to assess the significance of metastatic hepatic tumor vascular microenvironment in relation to the response to systemic fluorouracil-based chemotherapy [folinic acid/fluorouracil/oxaliplatin (FOLFOX) or folinic acid/fluorouracil/irinotecan (FOLFIRI)].

Patients And Methods: A total of 48 consecutive patients with colorectal cancer (CRC) with hepatic metastasis were retrospectively reviewed, and factors such as metastatic tumor vascular microenvironment, chemotherapy response and hepatic resection, were analyzed.

An extremely rare combination of choledochocele and bile duct duplication escalating severe acute pancreatitis and cholangitis: A case report.

Background: Combination of choledochocele and extra-hepatic duct duplication is an extremely rare congenital abnormality.

Case Presentation: The patient was an 81-year-old Japanese man. He visited the emergency room for severe abdominal colic pain.

Hepatic ductoplasty for iatrogenic Bismuth type 2 bile duct stricture: A case report.

Introduction: Biliary enteric anastomosis is a well-known biliary reconstruction method. Anastomosis stricture is one of the complications of this procedure that occurs in some patients over the long-term. We report a successful case of hepatic ductoplasty combined with hepaticojejunostomy (H-J) for the treatment of iatrogenic Bismuth type 2 stricture.

Current assessment of choledochoduodenostomy: 130 consecutive series.

Introduction Cholelithiasis usually can be managed successfully by endoscopic sphincterotomy. Choledochoduodenostomy (CDD) is one of the surgical treatment options but its acceptance remains debated because of the risk of reflux cholangitis and sump syndrome. The aim of this study was to assess the current features and outcomes of patient undergoing CDD.

Feasibility and Validation of Single-Port Laparoscopic Surgery for Simple-Adhesive or Nonadhesive Ileus.

A single incisional laparoscopic surgery (SILS) approach is increasingly being used, taking advantage of the minimally invasive technique. The aim of this study was to evaluate the feasibility and the validation of SILS procedure for small bowel obstruction (SBO). Sixteen consecutive patients with SBO who underwent SILS release of ileus between April 2010 and March 2015 were compared with the conventional multiport laparoscopic treatment group of 16 patients matched for age, gender, and surgical procedure.

Single-port laparoscopic adhesiolysis for torsion ileus.

Single-incisional laparoscopic surgery (SILS) has emerged as an attempt to further enhance the cosmetic benefits and reduce the morbidity of minimally invasive surgery. We present an approach of SILS adhesiolysis to adhesive strangulated ileus. A 70-year-old female patient, who had undergone laparoscopic low anterior resection 6 years before, underwent SILS adhesiolysis to a midline surgical incision wound adhesion site.

Clinical outcomes of laparoscopic adhesiolysis for mechanical small bowel obstruction.

Introduction: Laparoscopy for small bowel obstruction (SBO) has increasingly been performed for the advantages minimally invasive surgery provides. However, its benefit remains unclear.

Methods: From January 2004 to July 2011, we enrolled 28 consecutive patients who underwent a laparoscopic operation for SBO, secondary to postoperative adhesions.

Successful management of a blunt pancreatic trauma by endoscopic stent placement.

The present study reports a case involving a 17-year-old man who was brought to the emergency department of our hospital with severe upper abdominal pain following a blow received in a rugby game. Emergency computed tomography (CT) revealed severe pancreatic neck injury, and the patient was subsequently given conservative treatment in the High Care Unit. Forty-eight hours later, follow-up enhanced CT revealed that the pancreas was clearly lacerated and the amount of peripancreatic fluid was increasing; furthermore, serum amylase and elastase levels were elevated.