Journal of hepato-biliary-pancreatic surgery最新文献_第10页

Distended glands or overreplacement of ampullary mucosa at the papilla of Vater. 扁桃腺扩张或壶腹粘膜在水乳头处过度置换。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2004-01-01 DOI: 10.1007/s00534-004-0901-z

Koichi Suda, Masahiko Ootaka, Shigetaka Yamasaki, Hiroshi Sonoue, Kenro Matsubara, Masaru Takase, Bunsei Nobukawa, Fujihiko Suzuki

{"title":"Distended glands or overreplacement of ampullary mucosa at the papilla of Vater.","authors":"Koichi Suda, Masahiko Ootaka, Shigetaka Yamasaki, Hiroshi Sonoue, Kenro Matsubara, Masaru Takase, Bunsei Nobukawa, Fujihiko Suzuki","doi":"10.1007/s00534-004-0901-z","DOIUrl":"https://doi.org/10.1007/s00534-004-0901-z","url":null,"abstract":"Background/purpose: The role of the ampullary mucosa, especially its distended glands at the papilla of Vater, has not been fully explored.Methods: Twenty-nine pancreatoduodenectomized specimens from pancreatobiliary diseases and 44 autopsied cases, as controls, were studied histopathologically and immunohistochemically.Results: In 12 out of the 29 pancreatoduodenectomized cases the ampullary mucosa was in contact with the duodenal mucosa just at the outlet of the ampulla. In the remaining 17 cases, the ampullary mucosa overgrew beyond the ostium, replacing a portion of the surrounding duodenal mucosa, termed \"distended glands,\" which measured an average of 1532 microm in length. The muscularis mucosae of the duodenum and the Oddi's sphincter muscle merged in an \"end-to-end, sharp-angled\" manner at the ostium in the former, whereas this occurred in an \"end-to-side, less sharp, rather right-angled\" manner in the latter. Immunohistochemically, the distended glands in some cases showed negative/weakly positive staining for anti-carbohydrate antigen (CA) 19-9 and a high proliferation index evaluated using Ki67. In the autopsied materials, distended glands were found in 24 out of the 44 cases.Conclusions: Distended glands of the ampullary mucosa were frequently found and only grew on the Oddi's sphincter muscle extension. They may represent not only malignant change but also an adaptive phenomenon for bile and pancreatic juice flow.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"11 4","pages":"260-5"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00534-004-0901-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24684001","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: 4

Configurational anatomy of the pancreas: its surgical relevance from ontogenetic and comparative-anatomical viewpoints. 胰腺的形态解剖学:从个体发生和比较解剖学的角度看其手术相关性。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01

Hideo Hagai

{"title":"Configurational anatomy of the pancreas: its surgical relevance from ontogenetic and comparative-anatomical viewpoints.","authors":"Hideo Hagai","doi":"","DOIUrl":"","url":null,"abstract":"The structure of the adult human pancreas retains develop-mental traits in ontogenesis and comparative anatomy, under-standing of which greatly contributes to pancreatic surgical anatomy. The pyramidal process called the \"auricle\" or \"ear\"at the inferior margin of the neck suggests the vestige of the ontogenetic twist at the neck, resulting from bursal bulging with rotation of the pancreatic body and tail. This anatomical consideration serves to avoid inadvertent bleeding or pancreatic fistula during dissection of the right gastroepiploic arteryand vein at their roots. Recognition of embryonic rotation of the gastrointestinal tract eases detachment of the pancreati-coduodenal and jejunal vessels at their origins, enabling \"reversed Kocherization\" and complete resection of the mesoduodenum and upper mesojejunum. Embryological knowledge of vascular arcades of the pancreatic head serves as a guide for limited resection of the pancreas. The anterior inferior pancreaticoduodenal artery often runs behind, not in front of, the lower portion (\"mentum\" or \"chin\") of the pancreatic head, but still on the anterior leaflet of the embryonic mesoduodenum. The attachment of the adult pancreatic head to the duodenum occurs only at the major papilla of Vater and at the region around the minor papilla, which seems to be rational from ontogenetical and comparative-anatomical aspects. Knowledge of the pancreatic attachment helps when performing duodenum-preserving pancreatectomy and pancreas-sparing duodenectomy. The \"lingula\" or \"small tongue\", a pancreatic portion overlapping the common bile duct on the posterior aspect of the pancreas, is a key structure in resection of the extrahepatic bile duct.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"10 1","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22530479","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

Techniques for difficult cases of laparoscopic cholecystectomy. 腹腔镜胆囊切除术疑难病例的处理技术。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s00534-002-0825-4

Atsushi Ota, Nobuyasu Kano, Hiroshi Kusanagi, Shigetoshi Yamada, Arty Garg

{"title":"Techniques for difficult cases of laparoscopic cholecystectomy.","authors":"Atsushi Ota, Nobuyasu Kano, Hiroshi Kusanagi, Shigetoshi Yamada, Arty Garg","doi":"10.1007/s00534-002-0825-4","DOIUrl":"https://doi.org/10.1007/s00534-002-0825-4","url":null,"abstract":"Our basic techniques for the management of difficult cases of laparoscopic cholecystectomy (LC) are presented in this article. If access to Calot's triangle cannot be gained safely, dissection should be started at the fundus or body of the gallbladder (GB), rather than the neck (fundus-first method). In cases with a short and wide cystic duct, a transfixing suture should be applied for ligation instead of clipping. EndoGIA is useful for ligating and transecting this case to avoid a subsequent stricture caused by normal method of ligation. Intraoperative cholangiography should be performed near the neck of the GB in cases in which orientation is lost during dissection. More dissection should be performed in the direction of the junction of the bile ducts after orientation is regained. In cases with GB filled with stones accompanied by severe fibrosis, part of the GB is incised to remove the stones and expose the lumen of the GB. Confluence stones can be removed by placing an incision on the GB side of the junction of the duct. The incised part is closed with suture. A cystic tube (C-tube) is placed in the common bile duct through the cystic duct for decompression. In more difficult cases in which dissection cannot be started safely at any location, the body and the fundus of the GB are excised, and a drain is placed at the neck of the GB. Dissection can be carried out from the main surgeon's or the assistant's side depending on the situation, and cooperation between the two surgeons is mandatory to achieve safe LC in difficult cases. When performing the LC, one must have a low threshold for converting to open surgery if injuries cannot be managed safely.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"10 2","pages":"172-5"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00534-002-0825-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40820329","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: 23

Suppression of proliferative cholangitis in a rat model by local delivery of paclitaxel. 局部给药紫杉醇对大鼠增生性胆管炎的抑制作用。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s00534-002-0804-9

Seon-Mee Park, Jae-Woon Choi, Seung-Taik Kim, Myung-Chan Cho, Ryo Hyen Sung, Lee-Chan Jang, Jin-Woo Park, Sum Ping Lee, Yong-Hyun Park

{"title":"Suppression of proliferative cholangitis in a rat model by local delivery of paclitaxel.","authors":"Seon-Mee Park, Jae-Woon Choi, Seung-Taik Kim, Myung-Chan Cho, Ryo Hyen Sung, Lee-Chan Jang, Jin-Woo Park, Sum Ping Lee, Yong-Hyun Park","doi":"10.1007/s00534-002-0804-9","DOIUrl":"https://doi.org/10.1007/s00534-002-0804-9","url":null,"abstract":"Background: Proliferative cholangitis (PC) leads to biliary stricture, which is the main cause of hepatolithiasis, recurrent cholangitis, and biliary cirrhosis. The aim of this study was to determine whether local delivery of paclitaxel, which inhibits cell proliferation by overstabilization of microtubules, prevents PC in a rat model.Methods: PC was induced by introducing a fine nylon thread into the bile duct in a rat. Paclitaxel (100 microl of 10, 100, and 1000 micromol/l) or solvent vehicle was administered into the bile duct for 15 min. One week after treatment, histopathologic examination and 5-bromodeoxyuridine (BrdU) labeling of the bile duct were performed.Results: In comparison with the control, the mean thickness of the bile duct was reduced by 29% in the 1000 micromol/l paclitaxel-treated group (2.61 +/- 0.31 microm vs 3.67 +/- 0.25 micro m, P << 0.05). The luminal area increased ( P << 0.0001) and the grade of epithelial-glandular proliferation was decreased ( P << 0.01) as the dose of paclitaxel increased. Ductal fibrosis and inflammatory cell infiltration were similar in both groups. The BrdU labeling index was significantly lower in the paclitaxel-treated group ( P << 0.05).Conclusions: Local delivery of paclitaxel suppressed PC in a rat model by the inhibition of epithelial-glandular proliferation and may offer an effective therapeutic option for biliary stricture.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"10 2","pages":"176-82"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00534-002-0804-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40820330","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: 15

Intraductal papillary mucinous tumors and mucinous cystic tumors of the pancreas: imaging. 胰腺导管内乳头状粘液瘤和粘液囊性肿瘤:影像学。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s00534-002-0740-8

Kyuran Ann Choe

引用次数: 7

Recent topics in mucinous cystic tumor and intraductal papillary mucinous tumor of the pancreas. 胰腺粘液囊性肿瘤和导管内乳头状粘液瘤的最新研究课题。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s00534-002-0815-6

Masanori Sugiyama, Yutaka Atomi

引用次数: 20

Predeposit self-transfusion (PDS) in a hepatobiliopancreatic surgery (HBPS) unit: preliminary data. 肝胆胰外科(HBPS)单位的存款前自体输血(PDS):初步数据。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s00534-002-0829-0

Alejandro Serrablo, JosE Antonio Garcia-Erce, Rodolfo Serrablo, Elena Gonzalvo, JesUs MarIa Esarte

{"title":"Predeposit self-transfusion (PDS) in a hepatobiliopancreatic surgery (HBPS) unit: preliminary data.","authors":"Alejandro Serrablo, JosE Antonio Garcia-Erce, Rodolfo Serrablo, Elena Gonzalvo, JesUs MarIa Esarte","doi":"10.1007/s00534-002-0829-0","DOIUrl":"https://doi.org/10.1007/s00534-002-0829-0","url":null,"abstract":"Hepatobiliary pancreatic surgery (HBPS) has high morbility and mortality and frequently requires blood transfusion. Allogeneic transfusion may cause adverse sequelae. Predeposit self-transfusiOn (PDS) minimizes allogeneic blood transfusion and avoids most adverse reactions. We present the preliminary data of our PDS experience (with recombinant human erythropoieting, r-HuEPO) in HBPS during the first year. We studied our first-year HBPS-PDS program by a retrospective review of the case histories and transfusion records in our Blood Bank. Sex, weight, underlying disease, packed red cell units (PRCUs) requested, drawn, and transfused, and hospital and ICU stays were analyzed. Nine patients were admitted in the PDS program. Of desired blood units, 83% was obtained, successfully in 77.8% of patients, and 63.2% were transfused with autologous blood transfusion. Only three patients needed allogeneic blood (33.3%). All complications occurred in patients who received allogeneic units. Also, we found stays were three times longer in those patients. PDS could be a valid and safe alternative for patients undergoing elective HBPS because it decreases allogeneic blood requirements, reduces overall complications, and also reduces hospital and ICU stays.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"10 2","pages":"183-6"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00534-002-0829-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40820331","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: 1

Preoperative chemoradiation in resectable pancreatic cancer. 可切除胰腺癌的术前放化疗。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s10534-002-0736-5

Nicole M Chandler, Jonathan J Canete, Keith E Stuart, Mark P Callery

{"title":"Preoperative chemoradiation in resectable pancreatic cancer.","authors":"Nicole M Chandler, Jonathan J Canete, Keith E Stuart, Mark P Callery","doi":"10.1007/s10534-002-0736-5","DOIUrl":"https://doi.org/10.1007/s10534-002-0736-5","url":null,"abstract":"Despite advancements in the field of surgical oncology, the diagnosis of pancreatic cancer still carries a grave and dismal prognosis. Surgery alone for adenocarcinoma of the pancreatic head or uncinate process has a median survival time of 12 months. These grim statistics have led many to study the effects of combined multimodality therapy in the fight against pancreatic cancer. The long recovery time associated with pancreaticoduodenectomy has resulted in as many as 25% of patients unable to proceed with planned adjuvant therapy. For these reasons preoperative or neoadjuvantc hemoradiation therapy (CRT) has been evaluated. Pre-operative CRT ensures that all eligible patients receive the benefits of multimodality therapy, and patients who manifest metastatic disease on restaging evaluations are spared the morbidity of an unnecessary laparotomy. Multimodality therapy appears to lengthen the survival duration in patients with pancreatic cancer. It also affords a selection advantage, in that patients with aggressive disease biology with advanced metastatic disease following CRT are spared the morbidity of surgery. Conversely, a limited subset of patients may even be downstaged, allowing for a potentially curative resection. In this article we review the current status of neoadjuvant chemoradiation in adenocarcinoma of the pancreas. We discuss its rationale in light of the reported strengths and weaknesses of postoperative adjuvant CRT.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"10 1","pages":"61-6"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10534-002-0736-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22530481","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: 23

IHPBA in Tokyo, 2002: surgical treatment of IPMT vs MCT: a Japanese experience. 2002年东京IHPBA: IPMT与MCT的手术治疗:日本的经验。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s00534-002-0799-2

Wataru Kimura

{"title":"IHPBA in Tokyo, 2002: surgical treatment of IPMT vs MCT: a Japanese experience.","authors":"Wataru Kimura","doi":"10.1007/s00534-002-0799-2","DOIUrl":"https://doi.org/10.1007/s00534-002-0799-2","url":null,"abstract":"The differences and similarities between intraductal papillary mucinous tumor (IPMT) and mucinous cystadenoma or carcinoma (mucinous cystic tumor; MCT) of the pancreas have been noted. The similarities include: (1). both tumors originate from pancreatic duct cells, (2). massive mucin production is found in both tumors, and (3). papillary projection is a common histological characteristic. However, there are also many differences. IPMT is most frequently found in men in their sixties, and originates in the head of the pancreas, with 62% (123/199) of tumors reported to be found in the head of the pancreas. This tumor sometimes spreads throughout the entire pancreas. The tumor itself basically is of the dilated pancreatic duct type, and the prognosis is generally good. In contrast, MCT frequently develops in women in their forties. This tumor is usually large, round, and almost totally encapsulated by fibrous tissue, with no communication with the pancreatic duct. The tumor histologically has an ovarian-like stroma. It most often develops in the body or tail of the pancreas. Invasion is often present and the operative prognosis is not good. IPMT resembles the shape of a bunch of grapes and MCT resembles that of an orange. From the differences between these two types of tumors, they are classified into different categories. With regard to therapeutic strategies for MCT, the tumor should be resected with lymph node dissection immediately when it is detected. In contrast, some patients with branch-type IPMT can be followed without surgical procedures. Because IPMT shows good prognosis and little tendency for infiltration, some kinds of organ-preserving procedures would be possible for some patients with this tumor. Such organ-preserving procedures are: duodenum-preserving pancreas head resection, spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein, and so on.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"10 2","pages":"156-62"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00534-002-0799-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40820326","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: 38

Surgical treatment of intraductal papillary-mucinous tumor (IPMT) of the pancreas: operative indications based on surgico-pathologic study focusing on invasive carcinoma derived from IPMT. 胰腺导管内乳头状粘液瘤(IPMT)的手术治疗:基于IPMT引起的浸润性癌的外科病理研究的手术指征。

Journal of hepato-biliary-pancreatic surgery Pub Date : 2003-01-01 DOI: 10.1007/s00534-002-0746-2

Makoto Seki, Akio Yanagisawa, Hirotoshi Ohta, Yasuro Ninomiya, Yoshihiro Sakamoto, Junji Yamamoto, Toshiharu Yamaguchi, Eiji Ninomiya, Koichi Takano, Akiko Aruga, Keiko Yamada, Keiko Sasaki, Yo Kato

{"title":"Surgical treatment of intraductal papillary-mucinous tumor (IPMT) of the pancreas: operative indications based on surgico-pathologic study focusing on invasive carcinoma derived from IPMT.","authors":"Makoto Seki, Akio Yanagisawa, Hirotoshi Ohta, Yasuro Ninomiya, Yoshihiro Sakamoto, Junji Yamamoto, Toshiharu Yamaguchi, Eiji Ninomiya, Koichi Takano, Akiko Aruga, Keiko Yamada, Keiko Sasaki, Yo Kato","doi":"10.1007/s00534-002-0746-2","DOIUrl":"https://doi.org/10.1007/s00534-002-0746-2","url":null,"abstract":"Background/purpose: Between 1979 and 2000, 51 patients with intraductal papillary-mucinous tumor (IPMT) of the pancreas underwent surgical resection.Methods: The patients were reviewed to disclose the surgical pathology of invasive carcinoma derived from IPMT and to determine the surgical indications for IPMT on the basis of the pathologic findings.Results: The incidence of invasive carcinoma derived from IPMT according to the localization of the tumor was as follows: 4/9 (44%) in the main pancreatic duct (MPD type), 4/9 (44%) showing ductal spread from the MPD to branch ducts (mixed type), and 2/33 (6%) in the 2 branch duct (branch type). The maximal size of the intraductal spread of invasive carcinomas (8 of 18 cases in the MPD and mixed type together and 2 of 33 cases in the branch type) was as follows: 6/8 (75%) in the MPD and mixed type were over 6 cm in size, and the 2-branch-type invasive carcinomas were within the 3-cm size range.Conclusions: We concluded that for both invasive and noninvasive IPMTs, surgical resection was necessary for any MPD or mixed-type IPMTs, and that surgical resection was appropriate for branch-type lesions larger than or equal to 3 cm in diameter, or for lesions smaller than 3 cm showing rapid growth on clinical images.","PeriodicalId":15992,"journal":{"name":"Journal of hepato-biliary-pancreatic surgery","volume":"10 2","pages":"147-55"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00534-002-0746-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40820325","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: 25