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高齢膵疾患患者に対する緩和医療 为老年胰腺疾病患者提供姑息治疗。
Suizo Pub Date : 2024-02-29 DOI: 10.2958/suizo.39.48
Satofumi Shimoyama
{"title":"高齢膵疾患患者に対する緩和医療","authors":"Satofumi Shimoyama","doi":"10.2958/suizo.39.48","DOIUrl":"https://doi.org/10.2958/suizo.39.48","url":null,"abstract":"","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"14 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140414901","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
超高齢社会における急性膵炎診療 超高龄社会的急性胰腺炎治疗。
Suizo Pub Date : 2024-02-29 DOI: 10.2958/suizo.39.12
E. Iwasaki
{"title":"超高齢社会における急性膵炎診療","authors":"E. Iwasaki","doi":"10.2958/suizo.39.12","DOIUrl":"https://doi.org/10.2958/suizo.39.12","url":null,"abstract":"","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140411127","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
European Pancreas Club―日本膵臓学会合同シンポジウム報告 European Pancreas Club -日本胰脏学会联合研讨会报告
Suizo Pub Date : 2023-10-31 DOI: 10.2958/suizo.38.301
淳 正宗
{"title":"European Pancreas Club―日本膵臓学会合同シンポジウム報告","authors":"淳 正宗","doi":"10.2958/suizo.38.301","DOIUrl":"https://doi.org/10.2958/suizo.38.301","url":null,"abstract":"","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"93 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135979080","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
Questionnaire survey for early detection of pancreatic cancer 胰腺癌早期发现的问卷调查
Suizo Pub Date : 2023-10-31 DOI: 10.2958/suizo.38.318
Yoshiaki KAWAGUCHI, Yohei KAWASHIMA, Itaru ENDO, Masanao OKA, Akira OKAZAWA, Yasushi OGIWARA, Ichiro KAWANA, Takazumi KIMURA, Yukiko SANDOU, Kazuo TARAO, Kazuki NAGAI, Shin MAEDA
{"title":"Questionnaire survey for early detection of pancreatic cancer","authors":"Yoshiaki KAWAGUCHI, Yohei KAWASHIMA, Itaru ENDO, Masanao OKA, Akira OKAZAWA, Yasushi OGIWARA, Ichiro KAWANA, Takazumi KIMURA, Yukiko SANDOU, Kazuo TARAO, Kazuki NAGAI, Shin MAEDA","doi":"10.2958/suizo.38.318","DOIUrl":"https://doi.org/10.2958/suizo.38.318","url":null,"abstract":"【背景】1cm以下の早期膵癌を見つけるためには腹部超音波検査（AUS）における膵癌間接所見とリスクファクターから一般診療医が拾い上げることが重要である．","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135979081","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
急性膵炎を契機に発見された膵管癒合不全を伴う腹側膵回転異常の1例 以急性胰腺炎为契机发现的胰管愈合不全伴随腹侧胰旋转异常1例
Suizo Pub Date : 2023-10-31 DOI: 10.2958/suizo.38.348
Hidehito SUMIYA, Akinobu KOIWAI, Morihisa HIROTA, Atsuko TAKASU, Kennichi SATOH
{"title":"急性膵炎を契機に発見された膵管癒合不全を伴う腹側膵回転異常の1例","authors":"Hidehito SUMIYA, Akinobu KOIWAI, Morihisa HIROTA, Atsuko TAKASU, Kennichi SATOH","doi":"10.2958/suizo.38.348","DOIUrl":"https://doi.org/10.2958/suizo.38.348","url":null,"abstract":"症例は69歳，男性．心窩部痛の精査目的で施行した造影CT検査で，背側膵に限局した膵炎，背側膵管の軽度拡張，膵鉤部の欠損，腸回転異常の所見を認めた．MRCPでは膵管癒合不全を認め，膵管癒合不全に伴う軽症の背側膵炎と診断した．超音波内視鏡検査により腹側・背側膵管の評価を行ったところ，腹側膵管が背側膵管よりも頭側に位置し，膵鉤部が欠損している所見を認め，腹側膵回転異常と診断した．これは，膵の発生過程において，腸管の回転異常によって腹側膵原基の回転に異常が生じ，膵頭上部の位置で背側膵原基に癒合したことに由来すると考えた．背側膵管の拡張は保存的加療で改善し，副乳頭経由の背側膵管に対するドレナージ術は要さずに膵炎は軽快した．腹側膵回転異常と膵管癒合不全の合併例の報告はなく，腹側膵管の評価を行うことで腹側膵の位置異常を示すことができた1例と考え報告する．","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"180 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135979083","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
Giant pancreatic serous cystic neoplasm requiring percutaneous variceal embolization due to repeated bleeding from gastric varices after unsuccessful endoscopic treatment: 巨大胰腺浆液性囊性肿瘤，内镜治疗失败后胃静脉曲张反复出血，需要经皮静脉曲张栓塞术;
Suizo Pub Date : 2023-10-31 DOI: 10.2958/suizo.38.337
Shoichiro YONEYAMA, Ryo KODAMA, Taro NAKAJIMA, Masayuki IDA, Yukiko YOKOTA, Hisanobu SAEGUSA, Hiroyasu USHIMARU
{"title":"Giant pancreatic serous cystic neoplasm requiring percutaneous variceal embolization due to repeated bleeding from gastric varices after unsuccessful endoscopic treatment:","authors":"Shoichiro YONEYAMA, Ryo KODAMA, Taro NAKAJIMA, Masayuki IDA, Yukiko YOKOTA, Hisanobu SAEGUSA, Hiroyasu USHIMARU","doi":"10.2958/suizo.38.337","DOIUrl":"https://doi.org/10.2958/suizo.38.337","url":null,"abstract":"症例は60代男性．14年前より腹部腫瘤を自覚していたが，症状がないため医療機関を受診しなかった．検診で腹部腫瘤を指摘され当院を受診した．画像検査で上腹部に26cm大の巨大な腫瘍を認めた．腫瘍は嚢胞成分と充実成分が混在しており，mixed typeの膵漿液性嚢胞腫瘍（SCN）が疑われた．総肝動脈が腫瘍内を走行していること，腫瘍周囲の静脈瘤が発達していることから手術適応外と判断し経過観察の方針となった．しかし6年後に胃静脈瘤からの出血を繰り返すようになり，内視鏡的止血術では効果不十分であった．経皮的腫瘍生検によりSCNと確定診断をした後，胃静脈瘤に対し血管内治療を行った．胃静脈瘤は豊富な腫瘍血流による求肝性であり，超音波ガイド下に左胃静脈を穿刺し胃静脈瘤へn-ブチルシアノアクリレートを注入し塞栓した．治療により胃静脈瘤は改善した．本症例は手術適応外の巨大なSCNに経皮的静脈瘤塞栓術を要した初の症例報告である．","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"157 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135979084","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
MEN1に合併し，粘液性嚢胞腫瘍（MCN）との鑑別困難な大型の嚢胞様形態を伴った多発性膵神経内分泌腫瘍の1例 MEN1合并多发性胰神经内分泌肿瘤1例，伴有与黏液性囊性肿瘤(MCN)难以鉴别的大型囊样形态
Suizo Pub Date : 2023-10-31 DOI: 10.2958/suizo.38.328
Yasuharu OHTA, Masaru AKIYAMA, Chika YODOKAWA, Hiroko NAKABAYASHI, Akihiko TAGUCHI, Yoshitaro SHINDO, Shogo AMANO, Shigeyuki SUENAGA, Yuki KAWATANI, Atsunori OGA, Yoshinobu HOSHI, Hiroshi ITO, Taro TAKAMI, Hiroaki NAGANO
{"title":"MEN1に合併し，粘液性嚢胞腫瘍（MCN）との鑑別困難な大型の嚢胞様形態を伴った多発性膵神経内分泌腫瘍の1例","authors":"Yasuharu OHTA, Masaru AKIYAMA, Chika YODOKAWA, Hiroko NAKABAYASHI, Akihiko TAGUCHI, Yoshitaro SHINDO, Shogo AMANO, Shigeyuki SUENAGA, Yuki KAWATANI, Atsunori OGA, Yoshinobu HOSHI, Hiroshi ITO, Taro TAKAMI, Hiroaki NAGANO","doi":"10.2958/suizo.38.328","DOIUrl":"https://doi.org/10.2958/suizo.38.328","url":null,"abstract":"35歳，女性．9歳時にプロラクチン産生下垂体腺腫の摘出術が施行された．成人成長ホルモン分泌不全症に対する補充療法開始4ヶ月後の腹部CTで，膵尾部に径50mm大の嚢胞性病変を偶発的に認めた．高ガストリン，高グルカゴン血症に加えてintact PTHも軽度高値であり，ソマトスタチン受容体シンチグラフィーでも同部位に集積が認められた．pNETが疑われるも，嚢胞性病変が主体であるためEUS-FNAによる確定診断が困難であり，超音波内視鏡でのcyst in cystの所見から，術前診断は粘液性嚢胞腫瘍とされ，腹腔鏡下膵体尾部腫瘍切除術が施行された．嚢胞の壁肥厚部や辺縁以外にもガストリン産生腫瘍が認められ，MEN1に伴うpNETと確定診断した．嚢胞を伴う膵腫瘍の鑑別診断は難しく，より多角的な視点からの検討が求められる．pNETの術後補助療法のエビデンスの構築のためにも症例の集積が望まれる．","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135979078","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
Epithelial cellular arrangement in rat pancreatic tissue 大鼠胰腺组织上皮细胞排列
Suizo Pub Date : 2023-10-31 DOI: 10.2958/suizo.38.303
Nobuo ASHIZAWA
{"title":"Epithelial cellular arrangement in rat pancreatic tissue","authors":"Nobuo ASHIZAWA","doi":"10.2958/suizo.38.303","DOIUrl":"https://doi.org/10.2958/suizo.38.303","url":null,"abstract":"ラット膵組織連続切片を光学顕微鏡と透過電子顕微鏡で観察し，膵上皮細胞の配列について検討した．介在部導管細胞列に1個から数個の大型の腺房細胞が分泌細管とともに内腔に達するまで差し込まれていて，それに連結する腺房細胞群は介在部導管基底面に向かい基底膜を介さずに接着し，介在部導管腔へと繋がる分泌細管を接着面に形成しながら導管周囲をとり囲んでいた．ほとんどのランゲルハンス島（ラ氏島）周囲基底膜は複数箇所で欠損し，そこでは腺房細胞または介在部導管細胞がラ氏島外側面に接着して接着面に分泌細管または介在部導管腔を形成していた．以上から，発生の過程で未熟な膵導管末梢部に内分泌細胞，続いて腺房細胞が分化・出現し，それぞれ外側に向かって増生するが，隣接する内分泌細胞群同士は融合してラ氏島を形成し，その後に腺房細胞が導管とラ氏島の外側面に向かって分泌細管を形成しながら基底膜を介さずに接着して増生すると推察された．","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135979079","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
術前に診断しえた膵頭部神経鞘腫に対して腹腔鏡下核出術を施行した1例 对术前确诊的胰头部神经鞘瘤实施腹腔镜下出核手术1例
Suizo Pub Date : 2023-08-31 DOI: 10.2958/suizo.38.279
Toshiya ABE, Kohei NAKATA, Keiichi SHIGEMATSU, So NAKAMURA, Noboru IDENO, Naoki IKENAGA, Nao FUJIMORI, Shinichiro RYU, Yuki SHIMADA, Yoshinao ODA, Masafumi NAKAMURA
{"title":"術前に診断しえた膵頭部神経鞘腫に対して腹腔鏡下核出術を施行した1例","authors":"Toshiya ABE, Kohei NAKATA, Keiichi SHIGEMATSU, So NAKAMURA, Noboru IDENO, Naoki IKENAGA, Nao FUJIMORI, Shinichiro RYU, Yuki SHIMADA, Yoshinao ODA, Masafumi NAKAMURA","doi":"10.2958/suizo.38.279","DOIUrl":"https://doi.org/10.2958/suizo.38.279","url":null,"abstract":"症例は48歳，女性，腹痛を主訴に近医を受診し，腹部超音波検査で膵頭部腫瘤を指摘され，精査加療目的に当院を紹介され受診した．造影CTで膵頭部に15mm大の遅延性に増強される充実性腫瘤を認め，MRIのT2強調画像で高信号を示し，EUSでは膵頭部に境界明瞭な15mm大の低エコー腫瘤を認め，画像上は神経内分泌腫瘍や充実性偽乳頭状腫瘍が鑑別診断に挙げられた．EUS-FNBによる生検で束状に増殖した紡錘形細胞を認め，免疫染色でS-100蛋白陽性であることから膵神経鞘腫と診断した．経過観察も検討されたが，核出術での摘出が可能，かつ，症状消失が期待されたため，切除を選択し，腹腔鏡下膵腫瘍核出術を施行した．術後合併症を認めず第12病日に退院となった．最終病理診断も膵神経鞘腫の診断であった．術後に腹痛は消失し，術後1年経過し，再発を認めていない．","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136035666","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
Endoscopic ultrasonography-guided transluminal drainage (EUS-TD) and direct endoscopic necrosectomy (DEN) for typical late complications associated with acute pancreatitis 超声内镜引导下腔内引流(EUS-TD)和直接内镜下坏死切除术(DEN)治疗急性胰腺炎的典型晚期并发症
Suizo Pub Date : 2023-08-31 DOI: 10.2958/suizo.38.217
Akira YAMAMIYA, Atsushi IRISAWA, Yoko ABE, Kazunori NAGASHIMA, Takahito MINAGUCHI, Ken KASHIMA, Yasuhito KUNOGI, Fumi SAKUMA, Koh FUKUSHI
{"title":"Endoscopic ultrasonography-guided transluminal drainage (EUS-TD) and direct endoscopic necrosectomy (DEN) for typical late complications associated with acute pancreatitis","authors":"Akira YAMAMIYA, Atsushi IRISAWA, Yoko ABE, Kazunori NAGASHIMA, Takahito MINAGUCHI, Ken KASHIMA, Yasuhito KUNOGI, Fumi SAKUMA, Koh FUKUSHI","doi":"10.2958/suizo.38.217","DOIUrl":"https://doi.org/10.2958/suizo.38.217","url":null,"abstract":"膵周囲液体貯留（PFC）は急性膵炎に伴う代表的な晩期合併症であり，治療の第一選択は保存的治療であるが，感染や消化管通過障害を併発した場合にはドレナージの適応となる．近年の機器や手技の進歩により，超音波内視鏡（EUS）下にPFCを穿刺しドレナージを行う方法が普及し，良好な治療成績が報告されている．しかし，壊死物質を多く含むwalled-off necrosis（WON）に対してはEUS下ドレナージ単独では治療に難渋することも多く，内視鏡的ネクロセクトミーを段階的に追加する，内視鏡的step-up approach法が主流となっている．現在，さらなる良好なドレナージ効果を目指し専用の金属ステントも開発され，この分野の技術的進歩は著しい．このような背景から治療困難であったPFCに対しても内視鏡治療のみで完治が望めるようになってきた．しかし，時に治療に伴い致命的な偶発症が起きる可能性があり，適応の判断と手技，起こりうる偶発症とその対処法を熟知することが重要である．","PeriodicalId":471545,"journal":{"name":"Suizo","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136035661","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
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