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1. Risk factors associated with hypoglycemic events after total pancreatectomy: A nationwide multicenter prospective study in Japan

Author

Hironobu Suto, Keiko Kamei, Hiroyuki Kato, Takeyuki Misawa, Michiaki Unno, Hiroyuki Nitta, Sohei Satoi, Yasunari Kawabata, Masayuki Ohtsuka, Toshiki Rikiyama, Takeshi Sudo, Ippei Matsumoto, Tomohiro Hirao, Keiichi Okano, Yasuyuki Suzuki, Naohiro Sata, Shuji Isaji, Masanori Sugiyama, and Yoshifumi Takeyama

Subjects
Blood Glucose, Glycated Hemoglobin, Cholesterol, Pancreatectomy, Japan, Risk Factors, Insulin, Short-Acting, Weight Loss, Humans, Hypoglycemic Agents, Insulin, Surgery, Prospective Studies
Abstract

The number of total pancreatectomy cases have increased worldwide, expanding the need for new insulin products and high-titer pancrelipases. However, the current data that is focused on hypoglycemic events after a total pancreatectomy from large nationwide series are still lacking. This study is aimed to assess the risk factors associated with hypoglycemic events after a total pancreatectomy.Data were prospectively collected from 216 consecutive patients who underwent total pancreatectomies between August 2015 and December 2017 from 68 Japanese centers. Of the 216 patients, 166 with a follow-up period of 1 year were analyzed. The risk factors for hypoglycemic events at 6 and 12 months (postoperative months 6 and 12) were investigated based on the results of a nationwide multicenter prospective study.Of the 166 patients, 57 (34%) and 70 (42%) experienced moderate or severe hypoglycemic events or hypoglycemia unawareness on a monthly basis at postoperative months 6 and 12, respectively. Multivariate analysis revealed that body weight loss after surgery ≥0.3 kg and total cholesterol level ≤136 mg/dL at postoperative month 6, and glycated hemoglobin level ≤8.9% and rapid-acting insulin use at postoperative month 12 were independent risk factors for hypoglycemic events after a total pancreatectomy. There were different independent risk factors depending on the postoperative period.Patients with body weight loss after surgery, low total cholesterol level, strict glycemic control, and using rapid-acting insulin should be aware of the occurrence of hypoglycemic events after their total pancreatectomy. In order to prevent hypoglycemic events after a total pancreatectomy, we need to consider optimal nutritional and glycemic control according to the postoperative period.

Published
2022
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2. Hemosuccus pancreaticus successful treatment by double balloon-assisted coil embolization for active bleeding from the main trunk of the superior mesenteric artery

Author

Hajime Kitagaki, Takeshi Yoshizako, Yukihisa Tamaki, Yasunari Kawabata, Yoshikazu Takinami, Rika Yoshida, Mitsunari Maruyama, Keiko Fukushi, Megumi Nakamura, Shinji Ando, and Tomonori Nakamura

Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine, medicine.medical_specialty, lcsh:R895-920, 030230 surgery, Balloon, 030218 nuclear medicine & medical imaging, Pseudoaneurysm, 03 medical and health sciences, 0302 clinical medicine, Superior mesenteric artery, medicine.artery, Hemosuccus pancreaticus, Interventional Radiology, Medicine, Radiology, Nuclear Medicine and imaging, Coil embolization, business.industry, SMA, medicine.disease, Trunk, Short segment, Radiology, business
Abstract

We report a case of a 63-year-old man with hemosuccus pancreaticus due to large pseudoaneurysm originating from the main trunk of the superior mesenteric artery (SMA). The patient was treated successfully with the double balloon-assisted coil embolization technique combined with proximal and distal balloon inflation in the short segment of the SMA. This technique preserved the pancreaticoduodenal arterial arcade and the supply to the distal part of the SMA by embolizing SMA in a short segment. Keywords: Hemosuccus pancreaticus, Pseudoaneurysm, Superior mesenteric artery

Published
2018
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3. Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

Author

Yama Issa, Hjalmar C. van Santvoort, Paul Fockens, Marc G. Besselink, Thomas L. Bollen, Marco J. Bruno, Marja A. Boermeester, Frank G. Moody, Claude Bertrand, Colin Johnson, Aude van Lander, Ross Carter, John B. Conneely, Frederik Berrevoet, Donzília Sousa Silva, Zong-Fang Li, Philippe Lévy, Kofi Oppong, Timothy B. Gardner, C. Mel Wilcox, Jeremy French, Michael Steer, Edward L. Bradley, Peter Layer, Bertrand Napoleon, Jorge Antonio Mosquera, D.J. Gouma, Roland Andersson, Antonio Manzelli, J.M. Klaase, Massimo Falconi, Enrique de-Madaria, Riccardo Casadei, Giuseppe Malleo, Raffaele Pezzilli, Ewa Malecka-Panas, Matthias Lohr, Julia Mayerle, Erik A.J. Rauws, Martin L. Freeman, Affirul Chairil Ariffin, Bhavin Vasavada, Paul Bo-San Lai, Jose Luis Beristain-Hernandez, Álvarez Juan, Haralds Plaudis, Dionisios Vrochides, Vincenzo Neri, Vimalraj Velayutham, Aleksey Andrianov, Joan Figueras, Kjetil Soreide, Aliaksei Shcherba, Mahir Gachabayov, Roger G. Keith, Georgios Tsoulfas, Michael Anthony Fink, Stefano Crippa, Mehrdad Nikfarjam, Dibyajyoti Bora, Rajendra Desai, Marcello Donati, Jan Jin Bong, Emma Martínez Moneo, Gareth Morris-Stiff, Ahmet Coker, Alexandre Prado de Resende, Suryabhan Sakhahari Bhalerao, Sadiq S. Sikora, Dezső Kelemen, László Czakó, Hariharan Ramesh, Oleg Rummo, Aliaksei Fedaruk, Alexey Hlinnik, Madhusudhan Chinthakindi, Traian Dumitrascu, Vyacheslav Egorov, Vincent Bettschart, Michele Molinari, E. Aldana D. Guillermo, Susan L. Orloff, Daniel Vasilev Kostov, Laurent Sulpice, Brett Knowles, Yasutoshi Kimura, Gabriele Marangoni, Rajeev Joshi, Tibor Gyökeres, null Bedin, V. Vladimir, Arpad Ivanecz, Adelmo Antonucci, Jones A.O. Omoshoro-Jones, Richard Nakache, Marco Del Chiaro, Marianne Johnstone, Tomoaki Saito, Gianpaolo Balzano, Serge Chooklin, Piero Boraschi, Walter Park, Pedro Nuno Valente Reis Pereira, Nico Pagano, Pavlos Lykoudis, Lars Ivo Partecke, Aliaksandr Siatkouski, Rosa Jorba Martín, Yasunari Kawabata, Luís Carvalho Lourenço, Carlos Marra-Lopez, Jun Kyu Lee, Nils Habbe, Robert C. Verdonk, Yliya Rabotyagova, Rupjyoti Talukdar, Luca Frulloni, Shamil Galeev, Zoltán Berger, Takeo Yasuda, Thilo Hackert, Ziyovuddin Saatov, Dimitri Aristotle Raptis, Jaume Boadas, Francesco Vitali, Livia Archibugi, Miroslav Ryska, Balazs Tihanyi, Vikesh K. Singh, Atsushi Masamune, Paul Yeaton, Kerrington D. Smith, Shrey Modi, Laura Cosen-Binker, Savio George Barreto, Eugenio Morandi, Sergio Valeri, Cintia Yoko Morioka, Luis F. Lara, Yoshifumi Takeyama, Frank G. Gress, Young-Dong Yu, Ezio Gaia, Sorin Traian Barbu, Ali Tüzün İnce, Akkraporn Deeprasertvit, Yu-Ting Chang, Stephen Olusola Abiola, Sabite Kacar, Peter Muscarella, Henri Braat, Samuel Han, Ali A. Aghdassi, Jean-Louis Frossard, Jill P. Smith, M.P. Schwartz, H.M. van Dullemen, N.G. Venneman, B.W.M. Spanier, Sjoerd Kuiken, Erwin van Geenen, Greg Beilman, Georgios Papachristou, Oscar Chapa Azuela, P. van der Schaar, Nevin Oruc, Marie-Paule Anten, William H. Nealon, Jesús García-Cano, Manol Jovani, Ziad Melki, Mustafa Mohammed Ahmed Ibrahim, M.U. Awajdarip, Mohammad Azam, K.G. Sabu, Igor Ermolaev, Shiran Shetty, Belei Oana, Juris Pokrotnieks, Malgorzata Lazuchiewicz-Kot, Riadh Bouali, Marek Winiarski, Marcus Schmitt, Mihai Rimbas, Alexander Meining, Bories Erwan, Peter N. Meier, Rainer Schoefl, Ahmed Youssef Altonbary, Igor Marsteller, Ingo Wallstabe, Skerdi Prifti, Arnaud Lemmers, M. Horvath, Ajay Kumar, Joseph J. Palermo, Issa, Y., van Santvoort, H. C., Fockens, P., Besselink, M. G., Bollen, T. L., Bruno, M. J., Boermeester, M. A., Moody, F. G., Bertrand, C., Johnson, C., van Lander, A., Carter, R., Conneely, J. B., Berrevoet, F., Sousa Silva, D., Li, Z. -F., Levy, P., Oppong, K., Gardner, T. B., Wilcox, C. M., French, J., Steer, M., Bradley, E. L., Layer, P., Napoleon, B., Mosquera, J. A., Gouma, D. J., Andersson, R., Manzelli, A., Klaase, J. M., Falconi, M., de-Madaria, E., Casadei, R., Malleo, G., Pezzilli, R., Malecka-Panas, E., Lohr, M., Mayerle, J., Rauws, E. A. J., Freeman, M. L., Ariffin, A. C., Vasavada, B., Lai, P. B. -S., Beristain-Hernandez, J. L., Juan, A., Plaudis, H., Vrochides, D., Neri, V., Velayutham, V., Andrianov, A., Figueras, J., Soreide, K., Shcherba, A., Gachabayov, M., Keith, R. G., Tsoulfas, G., Fink, M. A., Crippa, S., Nikfarjam, M., Bora, D., Desai, R., Donati, M., Bong, J. J., Martinez Moneo, E., Morris-Stiff, G., Coker, A., de Resende, A. P., Bhalerao, S. S., Sikora, S. S., Kelemen, D., Czako, L., Ramesh, H., Rummo, O., Fedaruk, A., Hlinnik, A., Chinthakindi, M., Dumitrascu, T., Egorov, V., Bettschart, V., Molinari, M., Guillermo, E. A. D., Orloff, S. L., Kostov, D. V., Sulpice, L., Knowles, B., Kimura, Y., Marangoni, G., Joshi, R., Gyokeres, T., Bedin, Vladimir, V., Ivanecz, A., Antonucci, A., Omoshoro-Jones, J. A. O., Nakache, R., Del Chiaro, M., Johnstone, M., Saito, T., Balzano, G., Chooklin, S., Boraschi, P., Park, W., Pereira, P. N. V. R., Pagano, N., Lykoudis, P., Partecke, L. I., Siatkouski, A., Martin, R. J., Kawabata, Y., Lourenco, L. C., Marra-Lopez, C., Lee, J. K., Habbe, N., Verdonk, R. C., Rabotyagova, Y., Talukdar, R., Frulloni, L., Galeev, S., Berger, Z., Yasuda, T., Hackert, T., Saatov, Z., Raptis, D. A., Boadas, J., Vitali, F., Archibugi, L., Ryska, M., Tihanyi, B., Singh, V. K., Masamune, A., Yeaton, P., Smith, K. D., Modi, S., Cosen-Binker, L., Barreto, S. G., Morandi, E., Valeri, S., Morioka, C. Y., Lara, L. F., Takeyama, Y., Gress, F. G., Yu, Y. -D., Gaia, E., Barbu, S. T., Ince, A. T., Deeprasertvit, A., Chang, Y. -T., Abiola, S. O., Kacar, S., Muscarella, P., Braat, H., Han, S., Aghdassi, A. A., Frossard, J. -L., Smith, J. P., Schwartz, M. P., van Dullemen, H. M., Venneman, N. G., Spanier, B. W. M., Kuiken, S., van Geenen, E., Beilman, G., Papachristou, G., Chapa Azuela, O., van der Schaar, P., Oruc, N., Anten, M. -P., Nealon, W. H., Garcia-Cano, J., Jovani, M., Melki, Z., Ibrahim, M. M. A., Awajdarip, M. U., Azam, M., Sabu, K. G., Ermolaev, I., Shetty, S., Oana, B., Pokrotnieks, J., Lazuchiewicz-Kot, M., Bouali, R., Winiarski, M., Schmitt, M., Rimbas, M., Meining, A., Erwan, B., Meier, P. N., Schoefl, R., Altonbary, A. Y., Marsteller, I., Wallstabe, I., Prifti, S., Lemmers, A., Horvath, M., Kumar, A., Palermo, J. J., Surgery, Amsterdam institute for Infection and Immunity, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Cancer Center Amsterdam, APH - Methodology, AII - Infectious diseases, Issa, Yama, van Santvoort, Hjalmar C., Fockens, Paul, Besselink, Marc G., Bollen, Thomas L., Bruno, Marco J., Boermeester, Marja A., Moody, Frank G., Bertrand, Claude, Johnson, Colin, van Lander, Aude, Carter, Ro, Conneely, John B., Berrevoet, Frederik, Sousa Silva, Donzã­lia, Zong-Fang, Li, Lã©vy, Philippe, Oppong, Kofi, Gardner, Timothy B., Wilcox, C. Mel, French, Jeremy, Steer, Michael, Bradley, Edward L., Layer, Peter, Napoleon, Bertrand, Mosquera, Jorge Antonio, Andersson, Roland, Manzelli, Antonio, Falconi, Massimo, de-Madaria, Enrique, Casadei, Riccardo, Malleo, Giuseppe, Pezzilli, Raffaele, Malecka-Panas, Ewa, Lohr, Matthia, Mayerle, Julia, Rauws, Erik A. J., Freeman, Martin L., Ariffin, Affirul Chairil, Vasavada, Bhavin, Lai, Paul Bo-San, Beristain-Hernandez, Jose Lui, Juan, à lvarez, Plaudis, Harald, Vrochides, Dionisio, Neri, Vincenzo, Velayutham, Vimalraj, Andrianov, Aleksey, Figueras, Joan, Soreide, Kjetil, Shcherba, Aliaksei, Gachabayov, Mahir, Keith, Roger G., Tsoulfas, Georgio, Fink, Michael Anthony, Crippa, Stefano, Nikfarjam, Mehrdad, Bora, Dibyajyoti, Desai, Rajendra, Donati, Marcello, Bong, Jan Jin, Martínez Moneo, Emma, Morris-Stiff, Gareth, Coker, Ahmet, de Resende, Alexandre Prado, Bhalerao, Suryabhan Sakhahari, Sikora, Sadiq S., Kelemen, Dezså, Czakã³, Lã¡szlã³, Ramesh, Hariharan, Rummo, Oleg, Fedaruk, Aliaksei, Hlinnik, Alexey, Chinthakindi, Madhusudhan, Dumitrascu, Traian, Egorov, Vyacheslav, Bettschart, Vincent, Molinari, Michele, Guillermo, E. Aldana D., Orloff, Susan L., Kostov, Daniel Vasilev, Sulpice, Laurent, Knowles, Brett, Kimura, Yasutoshi, Marangoni, Gabriele, Joshi, Rajeev, Gyã¶keres, Tibor, Bedin, Null, Ivanecz, Arpad, Antonucci, Adelmo, Omoshoro-Jones, Jones A. O., Nakache, Richard, Del Chiaro, Marco, Johnstone, Marianne, Saito, Tomoaki, Balzano, Gianpaolo, Chooklin, Serge, Boraschi, Piero, Park, Walter, Pereira, Pedro Nuno Valente Rei, Pagano, Nico, Lykoudis, Pavlo, Partecke, Lars Ivo, Siatkouski, Aliaksandr, Martã­n, Rosa Jorba, Kawabata, Yasunari, Lourenã§o, Luís Carvalho, Marra-Lopez, Carlo, Lee, Jun Kyu, Habbe, Nil, Verdonk, Robert C., Rabotyagova, Yliya, Talukdar, Rupjyoti, Frulloni, Luca, Galeev, Shamil, Berger, Zoltã¡n, Yasuda, Takeo, Hackert, Thilo, Saatov, Ziyovuddin, Raptis, Dimitri Aristotle, Boadas, Jaume, Vitali, Francesco, Archibugi, Livia, Ryska, Miroslav, Tihanyi, Balaz, Singh, Vikesh K., Masamune, Atsushi, Yeaton, Paul, Smith, Kerrington D., Modi, Shrey, Cosen-Binker, Laura, Barreto, Savio George, Morandi, Eugenio, Valeri, Sergio, Morioka, Cintia Yoko, Lara, Luis F., Takeyama, Yoshifumi, Gress, Frank G., Young-Dong, Yu, Gaia, Ezio, Barbu, Sorin Traian, Ä°nce, Ali Tüzün, Deeprasertvit, Akkraporn, Chang, Yu-Ting, Abiola, Stephen Olusola, Kacar, Sabite, Muscarella, Peter, Braat, Henri, Han, Samuel, Aghdassi, Ali A., Frossard, Jean-Loui, Smith, Jill P., Kuiken, Sjoerd, van Geenen, Erwin, Beilman, Greg, Papachristou, Georgio, Chapa Azuela, Oscar, Oruc, Nevin, Anten, Marie-Paule, Nealon, William H., García-Cano, Jesãº, Jovani, Manol, Melki, Ziad, Ibrahim, Mustafa Mohammed Ahmed, Azam, Mohammad, Ermolaev, Igor, Shetty, Shiran, Oana, Belei, Pokrotnieks, Juri, Lazuchiewicz-Kot, Malgorzata, Bouali, Riadh, Winiarski, Marek, Schmitt, Marcu, Rimbas, Mihai, Meining, Alexander, Erwan, Borie, Meier, Peter N., Schoefl, Rainer, Altonbary, Ahmed Youssef, Marsteller, Igor, Wallstabe, Ingo, Prifti, Skerdi, Lemmers, Arnaud, Kumar, Ajay, Palermo, Joseph J., and Gastroenterology & Hepatology

Subjects
Endoscopic ultrasound, medicine.medical_treatment, Islets of Langerhans Transplantation, Practice Patterns, Diagnosis, treatment, chronic pancreatitis, survey, Bioinformatics, 0302 clinical medicine, Risk Factors, Lithotripsy, Diagnosis, 03.02. Klinikai orvostan, Endoscopy, Digestive System, Chronic, Practice Patterns, Physicians', Tomography, Digestive System Surgical Procedures, treatment, medicine.diagnostic_test, Gastroenterology, Magnetic Resonance Imaging, X-Ray Computed, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Predictive value of tests, Pancreatectomy, 030211 gastroenterology & hepatology, Autologous, medicine.medical_specialty, Clinical Decision-Making, Transplantation, Autologous, Decision Support Techniques, chronic pancreatitis, 03 medical and health sciences, Predictive Value of Tests, Pancreatitis, Chronic, medicine, Humans, survey, Pancreatic duct, Transplantation, Physicians', Hepatology, business.industry, General surgery, Gastroenterologists, Endoscopy, Magnetic resonance imaging, medicine.disease, Pancreatitis, Health Care Surveys, Tomography, X-Ray Computed, business, Digestive System
Abstract

Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Buchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.

Published
2017
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4. Appraisal of a total meso-pancreatoduodenum excision with pancreaticoduodenectomy for pancreatic head carcinoma

Author

Yasunari Kawabata, Seiji Yano, Yoshitsugu Tajima, Hiroyuki Monma, Tsuneo Tanaka, and Takeshi Nishi

Subjects
Male, medicine.medical_specialty, Surgical margin, medicine.medical_treatment, Pancreaticoduodenectomy, Mesenteric Artery, Superior, medicine.artery, Carcinoma, Humans, Medicine, Lymph node, Aged, Neoplasm Staging, Aged, 80 and over, business.industry, Angiography, Inferior pancreaticoduodenal artery, Jejunal arteries, General Medicine, Middle Aged, medicine.disease, Survival Analysis, Surgery, Pancreatic Neoplasms, Treatment Outcome, medicine.anatomical_structure, Oncology, Lymphatic Metastasis, Resection margin, Lymph Node Excision, Female, Lymphadenectomy, Lymph Nodes, Radiology, Tomography, X-Ray Computed, business
Abstract

Background The most significant prognostic factors for pancreatic head carcinoma (PHC) with pancreaticoduodenectomy (PD) are the resection margin and lymph node status. The curative surgical margin (R0) and complete clearance of regional lymph nodes contribute to the improvement of survival. To reduce microscopic residual tumor resection (R1) and achieve a complete lymphadenectomy around the superior mesenteric artery (SMA) when performing a PD for PHC, we propose a new concept of a total excision of the “meso-pancreatoduodenum.” which consists of a cluster of the soft connective tissue along the inferior pancreaticoduodenal artery and the first jejunal artery. Methods A total of 39 consecutive patients underwent a PD for PHC between May 2006 and August 2011 at Shimane University Hospital. Twenty-five patients received a standard PD (sPD), while 14 cases underwent a total meso-pancreatoduodenum excision (tMPDe) with PD. Results The tMPDe procedure was performed safely without any intraoperative complications. The total number of lymph nodes dissected was 18 (median, range: 5–40) in the sPD and 26 (median, range: 13–50) in the tMPDe ( p = 0.027). R0 resection was accomplished in 60% and 93% of patients with the sPD and tMPDe, respectively, resulting in a significant decrease in the R1 rate in the tMPDe (7%) compared to that in the sPD (40%) ( p = 0.019). No loco-regional recurrence was found around the SMA in the tMPDe patients. Conclusion Our surgical technique, tMPDe, is safe and more radical when performing a PD and should be adopted when performing pancreatic surgery as a pathological cure for pancreatic head carcinoma.

Published
2012
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5. Preliminary study on the efficacy of conversion surgery following intensive chemotherapy for initially unresectable pancreatic cancer

Author

Takeshi Nishi, Yasunari Kawabata, Takashi Kishi, Yoshitsugu Tajima, and Hikota Hayashi

Subjects
Unresectable Pancreatic Cancer, medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, General surgery, Gastroenterology, medicine, Intensive chemotherapy, business, Surgery
Published
2017
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7. Efficacy of adjuvant chemoratiation therapy on survival in patients with curative resected pancreatic cancer

Author

Yasunari Kawabata, Hikota Hayashi, Takeshi Nishi, Takashi Kishi, and Yoshitsugu Tajima

Subjects
Oncology, medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Gastroenterology, medicine.disease, Internal medicine, Pancreatic cancer, medicine, In patient, business, Adjuvant
Published
2017
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9. Chemotherapy for unresectable/recurrent pancreatic cancer: A retrospective, single-center study

Author

Tatsuya Miyake, Kousaku Kawashima, Yasumasa Tada, Fumiyoshi Ikejiri, Nobuhiko Fukuba, Ichiro Moriyama, Yoshikazu Kinoshita, Akihiko Oka, Shuichi Sato, Satoshi Kumanomidou, Naoki Oshima, Shunji Ishihara, Takafumi Yuki, Yasunari Kawabata, Junji Suzumiya, Hiroshi Tobita, Hikota Hayashi, Koshi Kawakami, Ritsuro Suzuki, Hiroki Sonoyama, Yoshitsugu Tajima, Masaya Inoue, and Norihisa Ishimura

Subjects
Oncology, medicine.medical_specialty, Chemotherapy, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Internal medicine, Gastroenterology, medicine, Recurrent pancreatic cancer, Single Center, business
Published
2015
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10. Septic shock related to antibiotic-induced endotoxin release after major surgery for hepatobiliary and pancreatic malignancies

Author

Hikota Hayashi, Takahito Taniura, Yoshitsugu Tajima, Kazunori Mizutani, and Yasunari Kawabata

Subjects
medicine.medical_specialty, Chemotherapy, Combination therapy, Hepatology, business.industry, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Gastroenterology, Immunotherapy, medicine.disease, Surgery, Regimen, Pancreatic cancer, medicine, Adjuvant therapy, business, Adverse effect, Adjuvant
Abstract

s / Pancreatology 15 (2015) S1eS141 S84 pancreatic cancer; however, ourprevious results showed thatGEMimproved the recurrence-free but not overall survival. Therefore, we have developed a combination adjuvant regimen using GEM and gd T lymphocytes. Aims: The aim of the study is to evaluate a combination adjuvant regimen using GEM and gd T lymphocytes. Patients & methods: The inclusion criteria was (1) pancreatic cancer patients receiving R0 or R1 resections, (2) PS 0-1, (3) maintained hepatic, renal, and bone-marrow function. After resections, patients’ peripheral blood mononuclear cells (PBMCs) were stimulated with zoledronate, and harvested gd T cells were given intravenously every 2 weeks for 12 times. The percentages of the accumulated gd Tcells were counted in each patient during the immunotherapy. The primary endpoints were safety of the therapy and recurrence-free survival. Results: During the study period, 28 patients received the combination chemo-immunotherapy (Group A), 37 patients received chemotherapy only (Group B), and 26 patients had no adjuvant therapy (Group C). The combination therapy was abandoned in 5 patients (4 for recurrence). No severe adverse event was observed. The recurrence-free survivals were similar in the three groups; however, significantly better outcomes were observed among patients in whom gd T cells were accumulated during the immunotherapy (> 20% of the PBMCs). Conclusion: Immunotherapy using gd T cells may have additional effect to the adjuvant GEMmonotherapy, and could be an option in patients with maintained immunological functions after resections of pancreatic cancer.

Published
2015
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12. 328. Prognostic value of excision repair cross-complementing gene-1, dihydropyrimidine dehydrogenase, and human equilibrative nucleotide transporter-1 expression in patients with ampullary carcinoma

Author

Yoshitsugu Tajima, Hikota Hayashi, and Yasunari Kawabata

Subjects
chemistry.chemical_classification, Ampullary carcinoma, business.industry, Transporter, General Medicine, Oncology, chemistry, Cancer research, Dihydropyrimidine dehydrogenase, Medicine, Surgery, In patient, Nucleotide, business, Gene, Excision repair cross-complementing
Published
2014
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13. Surgical outcome of pancreaticoduodenectomy with a total meso-pancreatoduodenum excision for pancreatic head cancer

Author

Yasunari Kawabata, Akihiko Kidani, Takeshi Nishi, and Yoshitsugu Tajima

Subjects
medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, General surgery, medicine.medical_treatment, Gastroenterology, Infarction, Gastric varices, medicine.disease, Pancreaticoduodenectomy, Pancreatic fistula, Internal medicine, medicine, Platelet, business, Pancreatic head cancer
Abstract

s / Pancreatology 14 (2014) S1eS129 S113 min (168-512)/316 min (238-376), 443 gr (5-3250)/96 gr (9-210), and 16 days (8-29)/16 days (5-24), respectively. There was no grade B or C pancreatic fistula in both procedures. The postoperative maximum platelet counts in WT/SVP were 36.3/10.9 104/ml. Five patients (28%) with splenic partial infarction and 2 patients (11%) with gastric varices in WT were observed without any treatments. In SVP, There were no complications in the splenic circulation. No local recurrences were seen in both procedures. Conclusion: Two procedures of LSPDP for benign and low-grade malignant tumors are safe and effective.

Published
2014
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17. S1783 New Classification of Cytokeratin 20 (CK20) and Apomucin 1 (MUC1) Expression in Ampullary Carcinoma:Its Relationship with Tumor Progression and Prognosis

Author

Touko Inao, Tsuneo Tanaka, Seiji Yano, Takashi Nishisaka, Yasunari Kawabata, and Takeshi Nishi

Subjects
Oncology, Cytokeratin, medicine.medical_specialty, Ampullary carcinoma, Hepatology, business.industry, Tumor progression, Internal medicine, Gastroenterology, Cancer research, Medicine, business, MUC1
Published
2008
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