Clinical Journal of Gastroenterology最新文献_第3页

A case of an alpha-fetoprotein-producing intrahepatic cholangiocarcinoma. 产生甲胎蛋白的肝内胆管癌1例。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-10 DOI: 10.1007/s12328-025-02127-w

Takahiro Fukuda, Takashi Onoe, Naoki Tanimine, Akihisa Saito, Rie Yamamoto, Tatsunori Hashimoto, Sho Tazuma, Takeshi Sudo, Kazuya Kuraoka, Hirotaka Tashiro

{"title":"A case of an alpha-fetoprotein-producing intrahepatic cholangiocarcinoma.","authors":"Takahiro Fukuda, Takashi Onoe, Naoki Tanimine, Akihisa Saito, Rie Yamamoto, Tatsunori Hashimoto, Sho Tazuma, Takeshi Sudo, Kazuya Kuraoka, Hirotaka Tashiro","doi":"10.1007/s12328-025-02127-w","DOIUrl":"https://doi.org/10.1007/s12328-025-02127-w","url":null,"abstract":"Alpha-fetoprotein is a well-known marker of hepatocellular carcinoma. Alpha-fetoprotein-producing intrahepatic cholangiocarcinoma is rare. This report detailed our experience with such a case and reviewed the relevant literature. A 71-year-old man underwent dynamic computed tomography, which revealed a 40-mm hepatic mass in S6 with early arterial phase enhancement and delayed phase washout. Analysis of tumor markers revealed elevated alpha-fetoprotein levels. Positron emission tomography-computed tomography indicated a maximum standardized uptake value of 3.70. Presuming hepatocellular carcinoma, we performed a laparoscopic subsegmentectomy of S6. However, immunohistochemical examination revealed that the tumor was cytokeratin 7- and cytokeratin 19-positive, whereas the Hepatocytes and glypican-3 were negative, with some cells expressing alpha-fetoprotein, leading to a final diagnosis of alpha-fetoprotein-producing intrahepatic cholangiocarcinoma. After surgery, the patient was followed up without postoperative adjuvant chemotherapy at his request. Six months later, the patient's alpha-fetoprotein level increased again, and computed tomography revealed multiple intrahepatic and lung metastases. Chemotherapy was subsequently initiated. Six courses were administered; however, the disease gradually worsened, and the patient died 13 months after surgery. Differentiating between hepatocellular carcinoma and intrahepatic cholangiocarcinoma is crucial because of divergent postoperative treatments. Although rare, alpha-fetoprotein-producing intrahepatic cholangiocarcinoma should be considered in liver tumors, even with isolated alpha-fetoprotein elevation.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronic intestinal pseudo-obstruction complicated with sand-like enterolithiasis: case report. 慢性假性肠梗阻合并沙样肠内结石1例。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-09 DOI: 10.1007/s12328-025-02123-0

Yoshikazu Miura, Shin-Ichiro Hagiwara, Keinosuke Hizuka, Ryutaro Saura, Ayaha Hata, Takatoshi Maeyama, Yuri Etani

{"title":"Chronic intestinal pseudo-obstruction complicated with sand-like enterolithiasis: case report.","authors":"Yoshikazu Miura, Shin-Ichiro Hagiwara, Keinosuke Hizuka, Ryutaro Saura, Ayaha Hata, Takatoshi Maeyama, Yuri Etani","doi":"10.1007/s12328-025-02123-0","DOIUrl":"https://doi.org/10.1007/s12328-025-02123-0","url":null,"abstract":"Enterolithiasis is typically associated with gastrointestinal tract stasis. Here, we report on a rare case of chronic intestinal pseudo-obstruction with sand-like enterolithiasis in an 18-year-old Japanese female admitted to our hospital with high fever and abdominal pain. Despite initiating antibiotic treatment, the fever persisted. A contrast-enhanced computed tomography revealed colonic enlargement and a large amount of residue with a high-density area in the ascending colon. A colonoscopy revealed sand-like enteroliths in the ascending colon, which were drained using a colonoscope. The patient's symptoms improved significantly after the drainage and antibiotic therapy. The granules were white-brown in color and smaller than 300 μm in size. Infrared spectroscopy indicated similar peaks for crystals and hydroxypropyl cellulose which is an additive used in certain medications. We hypothesized that hydroxypropyl cellulose contributed to the formation of sand-like enteroliths in cases of severe intestinal dysmotility. Intestinal failure may cause enterolithiasis due to an unharmful additive and require careful follow-up.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unprecedented case of rapid-onset autoimmune hepatitis triggered by COVID-19 mRNA vaccination, complicated by concurrent severe hemophagocytic lymphohistiocytosis and acute liver failure in a previously healthy adult: a multidisciplinary approach and review of therapeutic interventions. 前所未有的由COVID-19 mRNA疫苗接种引发的快速发作自身免疫性肝炎病例，并发严重的噬血细胞淋巴组织细胞增多症和急性肝衰竭：多学科方法和治疗干预措施的回顾

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Clinical Journal of Gastroenterology Pub Date : 2025-04-08 DOI: 10.1007/s12328-025-02109-y

Zeyad Khalil, Mohamed Fouly, Paulo Helito

引用次数: 0

Erosive Meckel's diverticulum causing concurrent intraluminal and intraperitoneal hemorrhage: first case report in infancy and review of literature. 糜烂性梅克尔憩室并发腔内和腹腔出血：婴儿一例报告及文献复习。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-08 DOI: 10.1007/s12328-025-02125-y

Mohammed Elifranji, Muhammed E A Ahmed, Sheena Heffernan, John O'Neill, John Gillick

{"title":"Erosive Meckel's diverticulum causing concurrent intraluminal and intraperitoneal hemorrhage: first case report in infancy and review of literature.","authors":"Mohammed Elifranji, Muhammed E A Ahmed, Sheena Heffernan, John O'Neill, John Gillick","doi":"10.1007/s12328-025-02125-y","DOIUrl":"https://doi.org/10.1007/s12328-025-02125-y","url":null,"abstract":"Background: Meckel's diverticulum (MD) is a congenital anomaly which is often asymptomatic. However, complications, including gastrointestinal hemorrhage and obstruction, can arise and primarily in young children. While gastrointestinal bleeding is relatively common, intraperitoneal bleeding from MD is exceedingly rare, particularly in infancy.Case presentation: We report a rare case of a 9-month-old male who presented with symptoms of bronchiolitis but subsequently developed acute per rectum (PR) bleeding; initially passing dark blood-stained stools followed by fresh blood. Hemodynamic instability and severe anemia necessitated urgent fluid resuscitation and blood transfusion. Imaging revealed a dilated, inflamed segment of small bowel with adjacent fluid, raising the possibility of a complicated MD. Laparoscopic exploration confirmed intra-abdominal bleeding from a perforated MD eroding into an adjacent mesenteric vessel. Surgical intervention included resection of the MD and end-to-end anastomosis. Histological analysis revealed a perforated MD which contained ectopic gastric mucosa and eroded adjacent vascular mesentery.Conclusion: This is the first reported case of concurrent gastrointestinal and intraperitoneal bleeding from MD in an infant. The unique presentation underscores the importance of considering MD in cases of unexplained GI bleeding in infants, even when intraperitoneal hemorrhage is present. This case adds to the limited pediatric literature on MD-associated intraperitoneal bleeding and emphasizes prompt surgical management in achieving favorable outcomes.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multicystic biliary hamartoma with long-term gradual enlargement treated by laparoscopic partial hepatectomy. 腹腔镜肝部分切除术治疗长期逐渐扩大的多囊胆道错构瘤。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-05 DOI: 10.1007/s12328-025-02124-z

Satoshi Nishiwada, Tetsuya Tanaka, Yuki Kirihataya, Takeshi Takei, Tomomi Sadamitsu, Masato Takano, Masayoshi Sawai, Atsushi Yoshimura

{"title":"Multicystic biliary hamartoma with long-term gradual enlargement treated by laparoscopic partial hepatectomy.","authors":"Satoshi Nishiwada, Tetsuya Tanaka, Yuki Kirihataya, Takeshi Takei, Tomomi Sadamitsu, Masato Takano, Masayoshi Sawai, Atsushi Yoshimura","doi":"10.1007/s12328-025-02124-z","DOIUrl":"https://doi.org/10.1007/s12328-025-02124-z","url":null,"abstract":"Multicystic biliary hamartoma (MCBH) is an extremely rare liver tumor characterized by a well-circumscribed, multicystic honeycomb appearance on imaging. Herein, we report a case of long-term gradually enlarging MCBH that underwent laparoscopic hepatectomy. A 69-year-old man presented with mildly elevated carcinoembryonic antigen levels and underwent computed tomography (CT) 11 and 5 years ago, at which time the physicians did not note any particular abnormal findings. The current contrast CT for screening demonstrated a cystic lesion in segment 2 of the liver. A retrospective review of CT images showed that the cystic lesion had gradually increased over time. The patients successfully underwent laparoscopic partial hepatectomy and recovered without any complications. The surgically resected specimen grossly presented an aggregated nodule of small cysts. Pathological findings showed multiple cysts of various sizes covered with cuboidal cells without dysplasia resembling bile duct epithelium, with lumens containing a stone component consisting of brown bile. Around the cyst, there was vascular fibrous tissue, smooth muscle bundles, normal hepatocytes, and chronic inflammation. Based on these findings, we finally diagnosed MCBH. Although MCBH is histologically classified as a benign tumor, physicians may have to pay careful attention to the potential for enlargement in actual clinics.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A large non-inverted true diverticulum resembling a submucosal tumor of the ascending colon: a report of a rare case. 一个巨大的非倒置的真憩室，类似于升结肠粘膜下肿瘤：一个罕见病例的报告。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-04 DOI: 10.1007/s12328-025-02120-3

Masahiro Maeda, Hiromichi Maeda, Kazune Fujisawa, Takayoshi Yamada, Hinako Maruoka, Ken Okamoto, Tsutomu Namikawa, Hideyuki Miyachi, Michiya Kobayashi, Satoru Seo

{"title":"A large non-inverted true diverticulum resembling a submucosal tumor of the ascending colon: a report of a rare case.","authors":"Masahiro Maeda, Hiromichi Maeda, Kazune Fujisawa, Takayoshi Yamada, Hinako Maruoka, Ken Okamoto, Tsutomu Namikawa, Hideyuki Miyachi, Michiya Kobayashi, Satoru Seo","doi":"10.1007/s12328-025-02120-3","DOIUrl":"https://doi.org/10.1007/s12328-025-02120-3","url":null,"abstract":"A 57-year-old woman presented with a chief complaint of right lower abdominal pain. Abdominal radiography and plain abdominal computed tomography revealed a mass with extensive calcification. A colonoscopy demonstrated a 20-mm-sized mass lesion protruding into the intestinal lumen from the ileocecal valve's lower lip. The mass was covered with normal mucosa without erosions. Endoscopic ultrasonography indicated that the tumor originated from or beneath the proper muscle layer. To treat the pain, eliminate the obstruction risk, and obtain a definitive diagnosis, the patient chose surgical resection. Laparoscopic-assisted ileocecal resection was performed under the diagnosis of a submucosal ascending colon tumor. Macroscopically, the tumor showed no gross epithelial abnormalities. However, it was filled with fecal material and had an orifice of approximately 3 mm on the proximal side of the tumor. Histopathologically, the cyst wall consisted of an entire colonic structure, and continuity was noted between the cystic lesion's wall and the ascending colon's wall, leading to a diagnosis of diverticular expansion due to fecal matter. No malignancies were detected. A diverticulum can collect feces and protrude into the colonic lumen, resembling colonic submucosal tumors with calcification. Although rare, this condition should be included in the differential diagnosis of colon tumors.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare case of a malignant hepatic perivascular epithelioid cell tumor (PEComa) with aggressive progression following the relapse of renal pecoma despite everolimus therapy. 一例罕见的恶性肝血管周围上皮样细胞瘤（PEComa），在肾PEComa复发后，尽管依维莫司治疗仍有侵袭性进展。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-01 Epub Date: 2025-01-07 DOI: 10.1007/s12328-024-02085-9

Ayaka Kitagawa, Akira Nishio, Hayato Hikita, Taigo Kato, Akira Doi, Katsuhiko Sato, Shinichiro Tahara, Yasushi Kimura, Yusuke Ono, Tetsuo Takehara

{"title":"A rare case of a malignant hepatic perivascular epithelioid cell tumor (PEComa) with aggressive progression following the relapse of renal pecoma despite everolimus therapy.","authors":"Ayaka Kitagawa, Akira Nishio, Hayato Hikita, Taigo Kato, Akira Doi, Katsuhiko Sato, Shinichiro Tahara, Yasushi Kimura, Yusuke Ono, Tetsuo Takehara","doi":"10.1007/s12328-024-02085-9","DOIUrl":"10.1007/s12328-024-02085-9","url":null,"abstract":"A 55-year-old man with tuberous sclerosis complex (TSC) was diagnosed with left renal angiomyolipoma (AML), a group of perivascular epithelioid cell tumors called PEComas. He had received the mTOR inhibitor everolimus, which resulted in a complete response. However, a left renal mass relapsed in two years, followed by the occurrence of a hepatic mass five months later. Renal biopsy yielded no diagnosis because of massive necrosis in the tumor cells of the left kidney; however, pathological evaluation of the hepatic mass revealed a PEComa with pleomorphic cells. Even with continuous everolimus therapy, hepatic PEComa progressed aggressively and occupied the entire liver within a year from the first detection. An autopsy revealed pleomorphic cells with nuclear atypia spreading in the liver, kidney, and lung, which were not present in the renal AML sample prior to the initiation of everolimus therapy. This finding raises the possibility of a malignant transformation of the PEComa under the mTOR inhibitor therapy. While PEComas often present with benign characteristics, there are rare instances where the tumor exhibits malignant behavior. This highlights the importance of careful monitoring and long-term follow-up to ensure early detection and effective management of potential malignancies.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"343-351"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pathological complete response after chemotherapy in initially unresectable distal cholangiocarcinoma. 最初不可切除的远端胆管癌化疗后病理完全缓解。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-01 Epub Date: 2024-12-28 DOI: 10.1007/s12328-024-02084-w

Toshihiro Nakayama, Hiroshi Nakano, Reika Matsushita, Tomoaki Hayakawa, Shimpei Takagi, Yuya Tanaka, Takahiro Ozaki, Tsunehisa Matsushita, Yasuhiro Sumi, Masayuki Takagi

{"title":"Pathological complete response after chemotherapy in initially unresectable distal cholangiocarcinoma.","authors":"Toshihiro Nakayama, Hiroshi Nakano, Reika Matsushita, Tomoaki Hayakawa, Shimpei Takagi, Yuya Tanaka, Takahiro Ozaki, Tsunehisa Matsushita, Yasuhiro Sumi, Masayuki Takagi","doi":"10.1007/s12328-024-02084-w","DOIUrl":"10.1007/s12328-024-02084-w","url":null,"abstract":"Surgical resection is the only curative treatment for cholangiocarcinoma, but it is often diagnosed at advanced stages, making surgical resection infeasible. Recently, the concept of conversion surgery has expanded the indications for surgical treatment, thanks to advancements in both perioperative management and chemotherapy. However, it remains unclear which patients benefit most from this treatment strategy. We present a case of initially unresectable cholangiocarcinoma in which a pathologic complete response was achieved following chemotherapy. A man in his seventies presented with jaundice and was referred to our hospital. Abdominal computed tomography revealed dilation of the intrahepatic bile ducts and thickening of the common bile duct, suggestive of distal cholangiocarcinoma. The tumor was initially unresectable due to metastatic para-aortic lymph nodes, and chemotherapy with gemcitabine and cisplatin was initiated. After six courses of chemotherapy, the lymph nodes showed a partial response, and tumor markers returned to normal levels. However, further chemotherapy was intolerable due to thrombocytopenia. Our cancer board then decided to perform a pancreaticoduodenectomy. Pathologic examination of the resected specimen showed complete disappearance of the primary tumor, but viable cancer cells were found in the resected lymph nodes. Seven months post-surgery, recurrence in the para-aortic nodes was detected through imaging and elevated tumor markers. Despite this, the patient remains alive 16 months post-surgery with normal tumor marker levels, following additional chemotherapy. Pathologic complete response of the primary tumor is rarely observed in patients with initially unresectable distal cholangiocarcinoma, and a multidisciplinary approach, including conversion surgery, may be effective in such cases.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"357-362"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of deep endometriosis with cyst formation as a differential diagnosis of rectal duplication cyst in the presacral space. 深子宫内膜异位症伴囊肿形成对骶前间隙直肠重复囊肿的鉴别诊断1例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2025-04-01 Epub Date: 2025-02-12 DOI: 10.1007/s12328-025-02100-7

Masato Nakano, Yoshifumi Shimada, Hikaru Ozeki, Akio Matsumoto, Mae Nakano, Shuhei Kondo, Ryosuke Goto, Nozomi Yachida, Kosuke Yoshihara, Toshifumi Wakai

{"title":"A case of deep endometriosis with cyst formation as a differential diagnosis of rectal duplication cyst in the presacral space.","authors":"Masato Nakano, Yoshifumi Shimada, Hikaru Ozeki, Akio Matsumoto, Mae Nakano, Shuhei Kondo, Ryosuke Goto, Nozomi Yachida, Kosuke Yoshihara, Toshifumi Wakai","doi":"10.1007/s12328-025-02100-7","DOIUrl":"10.1007/s12328-025-02100-7","url":null,"abstract":"Cysts occurring in the presacral space may become malignant and therefore require surgical removal. A wide variety of cystic lesions can occur in the presacral space, such as tailgut cysts, dermoid cysts, and duplication cysts. However, deep endometriosis with cyst formation in the presacral space is extremely rare. Here, we report a case of deep endometriosis that presented characteristic imaging and pathological findings and required a differential diagnosis of rectal duplication cyst. A 49-year-old female was referred with a chief complaint of lower abdominal pain. Magnetic resonance imaging (MRI) revealed a cystic lesion with a three-layered wall structure on the right side of the rectum, suggesting a rectal duplication cyst. The lesion had a maximum diameter of 8 cm and extended from the lower end of the second sacral vertebra to the levator ani muscle. The cystic lesion was removed laparoscopically, and intraoperative findings revealed no communication between the cystic lesion and the rectum. We found that the wall of the deep endometriosis with cyst formation had a histopathological three-layered structure and considered that the layered structure closely resembled the intestinal wall on MRI. Deep endometriosis should be recognized as a differential diagnosis of cystic lesions in the presacral space.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"330-336"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful staged surgery for advanced esophageal cancer after conversion pancreatoduodenectomy with pancreaticogastrostomy. 晚期食管癌转胰十二指肠切除术合并胰胃造口术后的成功分阶段手术。

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Clinical Journal of Gastroenterology Pub Date : 2025-04-01 Epub Date: 2025-01-14 DOI: 10.1007/s12328-025-02093-3

Yuta Sato, Yoshihiro Tanaka, Yuji Hatanaka, Takeshi Horaguchi, Masahiro Fukada, Itaru Yasufuku, Ryuichi Asai, Jesse Yu Tajima, Katsutoshi Murase, Nobuhisa Matsuhashi

{"title":"Successful staged surgery for advanced esophageal cancer after conversion pancreatoduodenectomy with pancreaticogastrostomy.","authors":"Yuta Sato, Yoshihiro Tanaka, Yuji Hatanaka, Takeshi Horaguchi, Masahiro Fukada, Itaru Yasufuku, Ryuichi Asai, Jesse Yu Tajima, Katsutoshi Murase, Nobuhisa Matsuhashi","doi":"10.1007/s12328-025-02093-3","DOIUrl":"10.1007/s12328-025-02093-3","url":null,"abstract":"Background: Complex surgery during initial cancer treatment can limit surgical options when planning management of a secondary malignancy. Subtotal esophagectomy and pancreatoduodenectomy are the most invasive and difficult procedures in gastroenterological surgery. Surgical cases in which subtotal esophagectomy was performed after pancreatoduodenectomy with pancreaticogastrostomy are extremely rare and challenging procedures due to the resulting complicated anatomical changes.Case presentation: A 60-year-old man with a history of conversion pancreatoduodenectomy with pancreaticogastrostomy for advanced pancreatic head cancer was diagnosed as having advanced thoracic esophageal squamous cell carcinoma. After neoadjuvant chemotherapy, we chose a two-staged surgery with thoracoscopic subtotal esophagectomy. Following percutaneous endoscopic gastrostomy, we performed subtotal esophagectomy, systematic lymph-node dissection, and esophagostomy as the first-stage operation. Fifty-six days later, we performed gastrointestinal reconstruction with pedicle jejunum and microvascular anastomosis by the percutaneous route as the second-stage operation. Postoperatively, the patient was relieved without major complications, and the tumors were amenable to curative pathologic resection.Conclusions: The greatest advantages of staged surgery are to reduce surgical invasiveness and to circumvent the lower rate of curability. Our procedure reported here may be recommended as an option for staged resection and reconstruction in patients with advanced esophageal cancer after pancreatoduodenectomy with pancreaticogastrostomy.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"249-257"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0