研究者業績
基本情報
- 所属
- 藤田医科大学 ばんたね病院 医学部 医学科 消化器外科 講師
- 学位
- 博士(藤田保健衛生大学)
- J-GLOBAL ID
- 201501002607087520
- researchmap会員ID
- 7000012879
研究分野
1論文
292-
Fujita medical journal 10(3) 69-74 2024年8月OBJECTIVE: This study was performed to demonstrate the clinical application of duodenum-preserving pancreatic head resection (DPPHR) as a surgical treatment for pancreatic neuroendocrine tumors (PNETs) in terms of both curability and maintenance of postoperative quality of life. METHODS: Seven patients diagnosed with PNETs underwent DPPHR from January 2011 to December 2021 at our institution. We investigated the clinical relevance of DPPHR based on the patients' clinicopathological findings. RESULTS: The median operative time was 492 min, and the median blood loss was 302 g. Postoperative complications were evaluated according to the Clavien-Dindo classification, and postoperative intra-abdominal bleeding was observed in one patient. Pathological examination revealed a World Health Organization classification of G1 in six patients and G2 in one patient. Microvascular invasion was observed in two patients (29%); however, no patients developed lymph node metastasis or recurrence during the follow-up period. A daughter lesion was observed near the primary tumor in one patient. All patients achieved curative resection, and no tumor specimens showed positive margins. CONCLUSIONS: DPPHR facilitates anatomical resection of the pancreatic head in patients with PNETs as well as detailed pathological evaluation of the resected specimen. Therefore, this surgical procedure is an acceptable alternative to pancreaticoduodenectomy or enucleation for patients with PNETs.
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胆膵の病態生理 40(1) 65-69 2024年6月症例は68歳男で、19年前に膵体部IPMNに対して膵中央切除+膵管-膵管吻合(Martin手術)を施行された。今回、心窩部痛を主訴に受診し、CTで膵管吻合部から尾側に乏血性腫瘤を認め、残膵癌が疑われた。諸検査の結果から、膵管吻合部に発生したDe novo膵癌が強く疑われたため、残膵切除術を行うこととした。膵切離を行い迅速病理に提出したところ腺癌陽性と診断されたため術式を膵全摘に変更し、術後経過は良好であった。
MISC
185-
HEPATO-GASTROENTEROLOGY 59(117) 1498-1500 2012年7月Background/Aims: Pancreatic body cancer often involves the common hepatic artery and/or the celiac axis, and is regarded as an unresectable disease. Hepatic blood flow must be monitored while performing distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for managing the progression of pancreatic body cancer. We first confirmed a safe level of blood flow by monitoring hepatic venous oxygen saturation (ShvO(2)) to prevent hepatic ischemia caused by occlusion of the common hepatic artery. However, this method is technically difficult and a long period of time is required to insert the catheter. Thus, we monitored hepatic arterial flow by using a transonic flowmeter in the hepatic artery during operation. Methodology: Between April 1992 and January 2011, 14 patients underwent DP-CAR. In 6 of these 14 patients we measured ShvO(2). In 2 of the 14 patients, a transonic flowmeter was used for determining the hepatic arterial flow during operation. Results: There were no complications during this operation. Operation time when the blood flow was monitored using a transonic flowmeter was less than that when ShvO(2) was measured. Conclusions: Monitoring the transonic flowmeter hepatic artery is a useful and quick method for real-time evaluation of hepatic circulation during operation.
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日本外科学会雑誌 113(2) 2012年3月5日
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HEPATO-GASTROENTEROLOGY 57(97) 162-164 2010年1月The current literature contains little information about laparoscopic surgery for pancreatic disease. We performed spleen-preserving distal pancreatectomy on 7 cases during the period from 2005 to 2008 at our university hospital, including 2 laparoscopic operations. Case 2: A 54-year-old woman was found to have a hypoechoic 4x4 cm lesion in the tail of the pancreas, adjacent to and impinging on the spleen. On careful assessment we suspected a mucoid cystic tumor (MCT), and performed a laparoscopic spleen-preserving distal pancreatectomy. Blood loss was 380 g, and operating time was 310min. Case 1: A 27-year-old woman was found to have a hypoechoic 2x2 cm mass on ultrasound examination of the body of the pancreas. We performed laparoscopic spleen-preserving distal pancreatectomy for solid pseudopapillary tumour (SPT) of the pancreas. Blood loss was minimal, and operating time was 182 min. The other 5 cases were operated upon using the open method. All were female, with an average age of 54.8 years. The average blood loss was 387g. Operating time was 321 min. Laparoscopic pancreatic surgery is generally thought to be difficult owing to the need for lymph node resection, and because nerve plexus invasion occurs with malignant tumors such as pancreatic cancer. The present case series was reported to demonstrate the techniques that have evolved the safety of the operation and its future potential related to the minimally invasive nature of the surgery.
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JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 22 A248-A248 2007年10月