Takehito Otsubo

St. Marianna University School of Medicine · Department of Surgery

BACKGROUND A Bochdalek hernia (BH) is a congenital diaphragmatic hernia that often develops in the neonatal period. BH typically occurs on the left side of the diaphragm. A right-sided BH in an adult is rare. CASE SUMMARY A 45-year-old man was referred to our hospital because of an abnormal shadow seen on chest radiography during a medical check-u...

Laparoscopic surgery has been used to treat gastric submucosal tumors (SMTs). Laparoscopic and endoscopic cooperative surgery (LECS) has been used when subtotal resection has been difficult, which enabled resection of these tumors. In this study, we reviewed the medical records of patients with gastric SMTs who underwent laparoscopic surgery in our...

Background: Esophageal submucosal tumors (SMTs) are rare, occurring in less than 1% of esophageal neoplasms. For surgical treatment of esophageal SMTs, enucleation is usually the procedure of choice for benign tumors. This study aimed at evaluating the surgical technique and outcomes of thoracoscopic enucleation with esophagoscopy for esophageal SM...

Low-grade appendiceal mucinous neoplasm (LAMN) is an appendiceal mucinous tumor that is sometimes noted after appendectomy. As there are no established surgical procedures or postoperative follow-up methods for LAMN, we performed surveillance for three patients with myxoma of the appendix for 60 months according to the 2014 Edition of the Colorecta...

Objective To investigate the influence of endoscopic gallbladder stenting (EGBS) on subsequent cholecystectomy. We retrospectively compared the surgical outcomes of EGBS, followed by elective cholecystectomy with those of immediate cholecystectomy (IC). Patients and Methods A total of 503 patients were included in this study. Patients who underwen...

Objective: We conducted a prospective investigation of the effects of changes in surgical position on central venous pressure (CVP) and stroke volume variation (SVV) and the correlation between CVP and SVV. Methods: Subjects were patients who underwent elective hepatectomy at the St. Marianna University School of Medicine Hospital from November 25,...

Background: In an aging population, hepatectomy, a highly invasive surgical procedure, is increasingly being performed on individuals aged 80 and above in Japan. However, there is a need to evaluate the effectiveness of the eligibility criteria used for patient selection and assess the surgical outcomes and risks associated with the procedure. Meth...

Introduction Timely diagnosis and treatment of intra-abdominal arterial aneurysms before rupture are highly recommended. We successfully prevented rupture through arterial aneurysm excision, highlighting the importance of the lack of reports on resection before rupture. Case presentation A 60-year-old male with previous history of ureteral stones...

Background In recent years, many reports have focused on the usefulness of conversion surgery, in which chemotherapy is given to patients with unresectable advanced gastric cancer (GC) and radical surgery is performed if resection becomes possible. However, no consensus has been reached regarding the usefulness of this strategy. Case presentation...

The right top pulmonary vein (RTPV), a rare pulmonary vein (PV) variant draining the right upper lobe, arises independently from the right superior PV, travels posterior to the right bronchial tree and drains directly into the left atrium (LA) or another PV. We report an RTPV discovered on preoperative computed tomography (CT) scanning in a 60-y-ol...

Objectives: Colonic stent insertion as a bridge to surgery (BTS) has the advantage of avoiding emergency colostomy and is reported to have a lower postoperative complication rate than emergency resection or resection after stoma construction. Nevertheless, there is no consensus on the long-term prognosis; moreover, there are reports of stent insert...

The patient was a 21-year-old female who had undergone surgery for an omphalocele with liver prolapse as a neonate. Abdominal CT showed displacement of the liver due to the previous surgery. The liver was rotated approximately 90° anteriorly ventrally and 90° clockwise. The right lobe of the liver was located cephalad, the left lobe was located cau...

Purpose; To determine the causes of benign hepaticojejunostomy strictures (BHSs) after pancreaticoduodenectomy (PD) and the outcome of endoscopic retrograde cholangiography (ERC) treatment for BHSs. Methods; A total of 175 patients who underwent PD between January 2013 and December 2020 and who were able to be followed up for at least 1 year were i...

The patient was a 50-year-old male. At the age of 48 years, he had undergone total gastrectomy and right hemicolectomy simultaneously for gastric and ascending colon cancers. Since adjuvant chemotherapy has become common practice for patients with ascending colon cancer, capecitabine was administered for 6 months. One year and 6 months after the su...

Background Endoscopic transpapillary gallbladder stenting (EGBS) is considered for patients with contraindications to early surgery for acute calculus cholecystitis. However, evidence regarding the long-term outcomes of EGBS is insufficient to date. The aim of the study was to evaluate the feasibility of EGBS as a bridge to or alternative to surger...

A man in his 50s had undergone steroid therapy for eosinophilic granulomatosis with polyangiitis(EGPA). Since an examination for malignant tumors revealed type 0-Ⅰsp(cT1aN0M0)and type 2(cT2N0M0)lesions in the proximal and mid- transverse colon, respectively, he was referred to our department. Endoscopic resection was performed on the proximal lesio...

A woman in her 80s was diagnosed with an abdominal mass during physical examination. Contrast-enhanced computed tomography(CT)revealed a tumor with contrast enhancement outside the ileocecal region of the intestine, and the ileocolic artery penetrated the tumor. No tumor was detected by colonoscopy. An endoscope could not be passed through due to a...

Purpose: The Senhance digital laparoscopy system (SDLS) is a novel platform developed for digitization in endoscopic surgery. This retrospective study aimed to evaluate the short-term outcome in the initial 30 consecutive patients. Methods: SDLS cholecystectomies were performed in 30 consecutive patients (13 male, 17 female) by a single surgeon...

Background Histiocytic sarcoma is a rare malignant tumor that is similar in characteristics to a mature histiocyte/macrophage and is a relatively new disease entity. In approximately one-third of cases, the site of origin is a lymph node; development from the gastrointestinal tract, spleen, soft tissue, and skin has further been reported. The tumor...

Background and aims Endoscopic transpapillary gallbladder drainage (ETGBD) has been performed as an alternative therapy against cholecystectomy in patients with acute cholecystitis. To date, few studies have reported the safety, efficacy, and factors affecting ETGBD. We evaluated the clinical outcomes and predictors of technical failure of ETGBD....

Background This study aimed to investigate whether preoperative muscle mass is associated with the recurrence of distal cholangiocarcinoma after pancreatoduodenectomy (PD). Methods We retrospectively examined 88 patients who had undergone PD for distal cholangiocarcinoma. The preoperative psoas muscle mass index (PMI) was measured using computed t...

Background: To ensure that highly advanced hepatobiliary-pancreatic surgery (HBPS) is performed safely, the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) board certification system for expert surgeons established a safety committee to monitor surgical safety. Methods: We investigated postoperative mortality rates based on summar...

The patient is a female in her 70s referred for further workup after dilatation of the main pancreatic duct was seen on abdominal ultrasonography performed to evaluate cardiac orbital pain. Contrast-enhanced computed tomography scan showed an approximately 15mm contrast-enhancing mass in the pancreatic head. EUS-FNA was performed and revealed spind...

Background: Endoscopic transpapillary gallbladder stenting (EGBS) is considered for patients with contraindications to early surgery for acute calculus cholecystitis. However, evidence regarding the long-term outcomes of EGBS is insufficient to date. Aims: To evaluate the feasibility of EGBS as a bridge to or alternative to surgery when there are c...

Background Gallbladder cancer (GBC) with liver metastasis is considered unresectable. However, there have been infrequent reports of long-term survival in patients with GBC and liver metastases. Therefore, we examined the characteristics of long-term survivors of gallbladder cancer with liver metastasis. Methods A retrospective multicenter study o...

Highlight Endoscopic transpapillary gallbladder stenting is effective for acute cholecystitis with high surgical risk. However, looping of the guidewire in the cystic duct sometimes impedes placement of the stent. Nakahara and colleagues present a case of successful endoscopic transpapillary gallbladder stenting after straightening the looped guide...

Introduction The appropriate management of postoperative pancreatic fistula (POPF) after gastrectomy is believed to decrease the incidence of subsequent complications. Previous reports have indicated a relationship between subsequent complications of POPF and drain fluid amylase levels (D-AMY), but this indicator did not offer adequate sensitivity...

Objective: The objective of the present study was to investigate the utility of placing a chimney-type (stacked subcutaneous Penrose) drain to prevent surgical site infection (SSI), and particularly superficial SSI (sSSI), following surgery performed for lower gastrointestinal perforation. Subjects and methods: Our subjects were 93 patients who und...

Adrenal lipoma is a rare, benign tumor, reported to account for 0.7% of primary adrenal tumors. A 69-year-old man presented with left lateral abdominal pain. Computed tomography (CT) was performed, and a huge, irregularly shaped retroperitoneal tumor of uneven internal density was identified, with the border between the tumor and the pancreas and k...

Background: Gallbladder cancer (GBC) with liver metastasis is considered unresectable. However, there have been infrequent reports of long-term survival in patients with GBC and liver metastases. Therefore, we examined the characteristics of long-term survivors of gallbladder cancer with liver metastasis. Methods: A retrospective multicenter study...

Background: Cytokines play an important role in the immune response, angiogenesis, cell growth, and differentiation in hepatocellular carcinoma (HCC). Objective: We performed a comprehensive study to identify tumor-related cytokines and pathways involved in HCC pathogenesis. Methods: Cytokine production was evaluated in human HCC tissues and a...

Objectives: During laparoscopic right hemicolectomy, many surgeons make a small incision near the umbilicus after the routine intraperitoneal operation. In this study, we created a precursory small epigastric incision at the center of a line connecting the xiphoid process and umbilicus (the M point, an empirically determined position) at the start...

Objectives: To evaluate future problems in colorectal cancer surgery for elderly patients. Methods: We conducted a retrospective review of patients receiving colorectal cancer surgery in our hospital from January 2010 to December 2018. Patients were divided into the ≥ 85-year-old patient group and the younger patient group. We compared patient back...

Endoscopic transpapillary gallbladder drainage (ETGBD) for acute cholecystitis is challenging. We evaluated the influence of pre-procedural imaging and cystic duct cholangiography on ETGBD. Patients who underwent ETGBD for acute cholecystitis were retrospectively examined. The rate of gallbladder contrast on cholangiography, the accuracy of cystic...

Background/Purpose There is no evidence regarding the optimal balloon dilation time during endoscopic papillary large balloon dilation (EPLBD). The study aim was to evaluate the efficacy of 2-min extended balloon dilation for EPLBD. Methods 205 patients who underwent EPLBD during endoscopic retrograde cholangiopancreatography (ERCP) for bile duct...

Objectives Evidence regarding the incidence and clinical outcome of cystic duct perforation (CDP) during endoscopic transpapillary gallbladder drainage (ETGBD) is inadequate. The present study aimed to evaluate the incidence and management of CDP during ETGBD. Methods Between March 2011 and December 2019, 249 patients underwent initial ETGBD for a...

Objectives: Self-expandable metallic stent (SEMS) therapy for malignant colorectal strictures has been covered by the national insurance in Japan since 2012. There has been a gradual increase in the use of bridge to surgery (BTS), in which a stent is inserted for obstructive colorectal cancer to avoid emergency surgery, following which elective sur...

Background: Neuromuscular and vascular hamartoma is a rare lesion of the small intestine, with only 26 cases reported since its initial description in 1982. No occurrence of hamartoma in the appendix has been reported until now. Case presentation: A 60-year-old man had been suffering from longstanding right lower quadrant pain. Abdominal compute...

Background Artery-first approach pancreatoduodenectomy (AFA-PD) is an important technique for treating pancreatic ductal adenocarcinoma (PDAC). However, it remains unknown whether performing complete lymphadenectomy around the entire superior mesenteric artery (SMA) is associated with better outcomes. In this retrospective study, we aimed to invest...

PurposeConsidering the initial treatment of hepatocellular carcinoma (HCC), the best prognostic index for Child–Pugh classes B and C (CP-BC) patients has not been yet established. This study aimed to elucidate the risk factors for disease-free survival (DFS) and overall survival (OS) in multicenter patients with a poor liver functional reserve afte...

We describe a patient with a pancreatic hamartoma. The patient is a 65-year-old woman followed for a hepatic cyst. She was asymptomatic, but a pancreatic tumor was incidentally found and she was referred for further evaluation. Serum tumor markers and hormone levels were within normal limits. Dynamic computed tomography scan showed a well-demarcate...

Background/Purpose We investigated whether the daily level of total bilirubin in the bile (LTB) excreted from the future remnant liver (FRL) can predict post‐hepatectomy liver failure (PHLF) in patients with obstructive jaundice undergoing hepatectomy. Methods Seventy‐four patients who underwent biliary drainage and collection of bile juice from t...

An 84-year-old man was admitted to our hospital complaining of postprandial abdominal pain. He had undergone distal gastrectomy and Roux-en-Y reconstruction for gastric cancer six years previously, and cholecystectomy and bile duct duodenal anastomosis for cholecystolithiasis, choledocholithiasis, and parapapillary duodenal diverticulum syndrome on...

Removability is one of the important features of biliary covered self-expandable metal stents (CSEMS). In this study, we evaluated the diagnostic ability of washing cytology of removed CSEMS. For 14 removed CSEMS that had been placed for the biliary strictures (12 malignant, 2 benign), the surface of CSEMS was washed with saline, and pathological e...

Background: Endoscopic transpapillary gallbladder drainage (ETGBD) for acute cholecystitis (AC) after self-expandable metal stent (SEMS) placement is technically challenging and there are no reports about its outcome in a several cases. This study aims to assess the outcomes of ETGBD for AC after SEMS placement. Methods: Between April 2011 and A...

Although vascular invasion is an important factor in the progression and treatment of hepatocellular carcinoma (HCC), it remains difficult to determine, on the basis of preoperative imaging alone, whether vascular invasion, especially microvascular invasion, has occurred. The current retrospective study enrolled 292 patients who, between 2004 and 2...

We report a case of intractable recto-vaginal fistula after rectal cancer cured by conservative treatment. The case was a woman in her 40s. Laparoscopic low anterior resection and double stapling technique (DST) anastomosis were performed for rectal cancer. Postoperatively, suture failure was found and ileostomy was performed. Recto-vaginal fistula...

An 81-year-old man presented with left lateral abdominal pain lasting for 3 days and was referred to our hospital with a suspicion of gastrointestinal perforation. He also had left lateral abdominal pain 3 years previously and was treated conservatively at another clinic. On physical examination in our hospital, no peritoneal irritation was observe...

A 51-year-old woman underwent a CT scan performed that revealed a neoplastic lesion in the upper abdomen, and she was referred to our surgical department. Abdominal CT showed a tumor of about 50 mm lying between the posterior wall of the gastric minor curvature and the pancreas. Continuity with the surrounding tissue was not clear. Ultrasonography...

[Purpose] This study aimed to determine an optimal method for estimating adult hernial orifice diameter using computed tomography (CT) performed with the patient in the prone position to achieve inguinal decompression of the hernia (CT hernia study). [Methods] Fifty-four adult patients with inguinal hernia underwent laparoscopic hernia repair by tr...

[Background/Objective] We assessed trends in serum nutritional status markers and body mass index (BMI) to evaluate the long-term nutritional status in patients with pylorus-preserving pancreatoduodenectomy (PPPD). [Methods] From 240 patients who underwent PD from January 2005 to October 2014, we selected 45 patients who underwent PPPD and had surv...

Objective: Dysphagia occurring after surgery to treat thoracic esophageal cancer is commonly believed to be caused by recurrent laryngeal nerve (RLN) paralysis and injury to the muscles involved in swallowing due to manipulation during cervical lymph node dissection. However, we previously performed studies in our department and reported that RLN p...

Background and study aims Biliary plastic stents are generally substituted for gallbladder stents in endoscopic transpapillary gallbladder stenting (EGBS), there is no sufficient evidence about what type of plastic stent is suitable. We examined outcomes of EGBS using standard biliary stents and a novel stent for acute cholecystitis and evaluated t...

Swallowing difficulty is among the major complications that can occur after surgery for thoracic esophageal cancer. Recurrent laryngeal nerve paralysis (RLNP) has been considered the most significant cause of a postoperative swallowing difficulty, but association between the two has not been adequately explained. We investigated the relation betwee...

A 77-year-old woman presented with the chief complaint of large amounts of hematochezia. Contrast-enhanced computed tomography (CT) revealed extravasation of contrast medium from the diverticula in the sigmoid colon; therefore, upon diagnosis of sigmoid colonic diverticular hemorrhage, she was immediately admitted to our hospital. Emergency colonos...

Background: Survival benefit of liver resection for noncolorectal liver metastases (NCRLM) remains to be defined. Methods: This multicenter, retrospective cohort analysis included consecutive patients with NCRLM whose primary tumor and all metastases were treated with curative intent between 2000 and 2013. The primary endpoint was 5-year overall...

Purpose To improve diagnostic accuracy in cases of a suspected inguinal hernia, we perform a “CT hernia study,” with the patient lying prone to allow decompression of the structures in the inguinal region. Methods We reviewed the records of 914 patients with a suspected inguinal hernia who underwent prone non-contrast lower abdominal CT with two r...

Background/aims: Endoscopic sphincterotomy (EST) is often performed before fully covered self-expandable metal stent (FCSEMS) placement in order to prevent pancreatitis. However, it is not clear whether EST prevents pancreatitis or affects other adverse events (AEs). This study is conducted to evaluate the necessity of EST before FCSEMS placement...

Background: A new device with metallic wires for scrape cytology was developed. Aims: To compare the diagnostic performance of scrape cytology and conventional cytology during endoscopic retrograde cholangiopancreatography for biliary strictures. Methods: A total of 420 cases with biliary stricture underwent transpapillary bile cytology. Among...

The case was a male in his 40s who was referred to our institution for further examination and treatment of abdominal pain. He was diagnosed with acute appendicitis by CT examination and underwent laparoscopic appendectomy. Histopathological examination revealed Goblet cell carcinoid (GCC) of the appendix and the appendiceal stump was positive with...

Objective: Recurrent laryngeal nerve (RLN) paralysis was previously believed to be a major cause of dysphagia after esophageal cancer surgery. However, reports from recent years have indicated that dysphagia may be caused by decreased laryngeal elevation due to cervical lymph-node dissection (LND). For this reason, we studied whether a relation exi...

We encountered a case of pancreatic acinar cell carcinoma (ACC), which is a somewhat rare clinical entity. The patient was a 78-year-old woman who had been examined elsewhere for persistent upper abdominal pain that had begun a few months earlier. The examination revealed a neoplastic lesion in the head and tail of the pancreas. Contrast-enhanced a...

Objectives Laparoscopic surgery is widely used for treatment of colorectal cancer. However, due to the restricted operating space in patients with rectal cancer, the degree of surgical difficulty is greater than that in patients with colon cancer. For assistance in planning the surgery, we have calculated the pelvic volume, rectal volume, and tumor...

An 89-year-old woman with rectal prolapse underwent laparoscopic ventral rectopexy. Five ports were used : a 12-mm umbilical camera port, and four 5-mm upper and lower abdominal right and left ports. She started to complain of nausea and vomiting on the 3rd postoperative day, was diagnosed with paralytic ileus, and her oral intake was restricted. U...

This report documents simultaneous laparoscopic resection of a small bowel gastrointestinal stromal tumor (GIST) and transverse colon cancer that were diagnosed preoperatively and concomitantly. The patient was an 88-year-old man who was referred to us when computed tomography (CT) performed as follow-up for prostate cancer revealed what appeared t...

Vasoactive intestinal peptide (VIP) is a modulator of inflammatory responses. VIP receptors are expressed in several tumor types, such as colorectal carcinoma. The study described herein was conducted to confirm the presence of VIP and its receptors (VPAC1 and VPAC2) in surgically resected hepatocellular carcinoma (HCC) tissues and in HCC cell line...

An 80-year-old female rheumatoid arthritis patient with oral administration of methotrexate visited our institution due to a large amount of vaginal discharge which started 4 days prior to hospitalization. Dehydration, elevated inflammatory response, and anemia were found in the blood test. She was hospitalized because of ileal uterine fistula from...

Background: Billroth I reconstruction is a means of anastomosis that is widely performed after surgical resection for distal gastric cancer. Interest has grown in totally laparoscopic gastrectomy, and several methods for totally laparoscopic performance of Billroth I reconstruction have been reported. However, the methods are cumbersome, and posto...

Hepatitis B virus (HBV) infection is a major cause of hepatocellular carcinoma (HCC). Nucleos(t)ide analogue (NA) therapy effectively reduces the incidence of HCC, but it does not completely prevent the disease. Here, we show that dysregulation of microRNAs (miRNAs) is involved in post-NA HCC development. We divided chronic hepatitis B (CHB) patien...

Oxaliplatin, a chemotherapeutic agent for colorectal cancer, has been associated with pathological evidence of sinusoidal endothelial injury in the liver. However, esophagogastric varices are a poorly recognized outcome of oxaliplatin-based chemotherapy. We report a 78-year-old man, whose past history of colon cancer was resection and treatment wit...

A 55-year-old man underwent distal gastrectomy and D2 lymph node dissection for type 2 gastric cancer of the antrum. One year later, CEA elevation was discovered, and contrast-enhanced abdominal computed tomography(CT)revealed a 40 mm mass in the liver(S8), which was judged to be a metastatic recurrence of the gastric cancer.S -1 plus CDDP was admi...

Background/purpose: Enhanced recovery after surgery (ERAS) protocols are beneficial for pancreatoduodenectomy (PD). Our aim was to evaluate risk factors associated with ERAS protocol failure after PD. Methods: Clinical variables of 187 patients managed using ERAS protocols between April 2011 and April 2017, including non-early recovery (non-ER)...

Cytochrome P450 (CYP) enzymes contribute to the first-pass metabolism of orally administered drugs in both the liver and human small intestine, thus influencing their bioavailability. Although the CYPs profile in the small intestine of Caucasians was reported previously, that of the Japanese population has not. We investigated CYP(1A2, 2C9, 2C19, 2...

Gastrointestinal perforation by fish bone is most frequently seen in Japan, and surgical intervention is often required in cases of lower gastrointestinal perforation. Here we report a case of sigmoidal colon perforation by a fish bone in which the fish bone was endoscopically removed. The case was an 85-year-old female. She had myasthenia gravis a...

Background/aims: We describe a new reconstruction method of duodenojejunal anastomosis, the "vertical array reconstruction" (VAR) technique, following pylorus-preserving pancreatoduodenectomy (PPPD). Methods: The VAR technique aligns the stomach, duodenum, and jejunal loop vertically along the body's longitudinal axis. It was performed in 120 co...

A 62-year-old woman was referred to our department by our hospital's Department of Gastroenterology because a cyst in the right lobe of the liver that had measured 10.2 × 10.5 cm when it was identified on computed tomography (CT) three years earlier had since grown to 30.0 × 20.1 cm. CT also showed severe displacement of the inferior vena cava (IVC...

[Objective] We performed a prospective comparative study of early postoperative pain in adult patients with inguinal hernia treated by the transabdominal preperitoneal approach (TAPP) or the anterior approach (AA). [Patients and Methods] The participants comprised 89 adult patients with inguinal hernia operated on from August 2015 to March 2017. Th...

Contralateral inguinal hernias that occur after inguinal hernia repair may include so-called subclinical inguinal hernias (SIH). These latent hernias are not accompanied by symptoms such as swelling. However, few studies have investigated the prevalence and incidence of SIH using imaging. This paper documents a study of SIH incidence detected on he...

Background Esophagogastric anastomosis performed after esophagectomy is technically complex and often the source of postoperative complications. The best technique for this anastomosis remains a matter of debate. We describe a new all-stapled side-to-side anastomosis, which we refer to as triple-stapled quadrilateral anastomosis (TRIQ), that can be...

In recent years, narrowing of the root of the celiac artery has drawn attention as a cause of pancreaticoduodenal artery aneurysm. The median arcuate ligament (MAL) is formed by connecting the left crus of the diaphragm and the right crus anterior to the vertebral body, and vascular compression at this level can alter the hemodynamics of the celiac...

We report 2 cases of two-stage pancreatoduodenectomy for injuries to the pancreatic head, in which the pancreatojejunostomy was performed first. Case #1 was caused by a traffic accident and case #2 by a blow to the abdomen. Both injuries to the pancreatic head were classified as American Association for the Surgery of Trauma Organ Injury Score grad...

The patient was a 40-year-old man who had visited his previous doctor with the complaints of black stools and dizziness. Blood tests showed severe anemia, and upper gastrointestinal bleeding was suspected. He had undergone contrast CT and had been diagnosed with small bowel bleeding ; he was then referred to our hospital. When admitted to our hospi...

Objective: Pancreatic fistula (PF) occurs often after pancreatoduodenectomy (PD) and can lead to further, serious complications. To clarify important predictors of early post-PD PF, we compared clinical variables between patients in whom no or low-grade PF (no fistula or PF-A) developed and patients in whom PF-B or PF-C developed. Patients and Meth...

A 51-year-old man was referred to our hospital because of a stomachache and vomiting. Contrast-enhanced abdominal computed tomographic imaging revealed intestinal intussusception, a low-absorption tumorous lesion, and a spirally revolving small intestine. We diagnosed the patient as having a small bowel volvulus and intestinal intussusception cause...

The diagnosis of hepatocellular carcinoma (HCC) in the early stages is important for successful clinical management. Laminin (Ln)-γ2 expression has been reported in various types of malignant carcinomas. We recently developed a highly sensitive method to measure serum monomeric Ln-γ2 levels using a fully automated chemiluminescent immunoassay (CLIA...

The most common initial strategy for treatment of severe liver trauma is damage control in which hemostasis is achieved by perihepatic gauze packing and/or vascular embolization. However, we encounter patients in whom this strategy alone is not adequate. We have applied the principles of Glissonean pedicle transection, a technique that was original...

Leriche syndrome is a chronic abdominal aortic occlusive disease. We encountered a case of gastric cancer with Leriche syndrome, therefore we consider the case in light of the available literature. A 73-year-old man had been followed for Leriche syndrome. Due to development of anemia, he underwent upper gastrointestinal endoscopy for evaluation of...

Purpose: We investigated safety-related outcomes of HBP surgeries performed after establishment of the Japanese Society of Hepato-Biliary-Pancreatic Surgery board certification system for expert surgeons. Methods: We analyzed post-HBP surgery mortality data obtained from annual safety reports provided by board-certified training institutions bet...

Adenosquamous carcinoma(ASqC) and undifferentiated carcinoma(UC) of the pancreas are rare, and thus we do not clearly know their biological characteristics. We therefore conducted a clinicopathological study of 17 patients with ASqC or UC to investigate their clinical features, imaging findings, histopathological findings of resected specimens, and...

In this study, we report two cases of appendiceal diverticulitis with perforation. Case 1 was a 50-year-old man who visited our hospital because of epigastralgia and pyrexia. He had rebound tenderness in the right lower abdominal quadrant, as well as an increased inflammatory response observed upon biological examination. Computed tomography reveal...