Yoshihiro Sakamoto

..In the absence of extrahepatic recurrence, surgical resection of liver metastasis from breast cancer can offer an acceptable prognosis and should not be avoided in selected patients...

..Optical surgical management of infrahilar/suprapancreatic cholangiocarcinoma remains controversial...

..The aim of this study was to determine the clinical significance of extrahepatic bile duct (EHBD) resection during surgery for advanced gallbladder cancer...

..Major hepatectomy for perihilar cholangiocarcinoma has considerable risk of hepatic insufficiency even with preoperative portal vein embolization (PVE). Postoperative bilirubinemia is a great concern for hepatic surgeons...

..Surgical indication for stage IV colorectal cancer patients with bilobar hepatic metastases may be controversial...

..Although the resectional margin is known to be a predictive factor, the prognostic significance of a positive ductal margin and other radial margin has never been evaluated independently...

..The clinical significance of resectional surgery with reconstruction of the right hepatic artery for biliary malignancy remains unclear...

..The prognosis of patients with liver metastasis from gastric cancer (LMGC) is dismal. The purpose of this study was to review our recent outcomes of hepatectomy for LMGC and to determine the suitable candidates for surgery...

..We aimed to investigate preoperative findings that are useful to distinguish intraductal papillary-mucinous neoplasm (IPMN) subtypes...

..The purpose of this study was to clarify the clinicopathologic characteristics and surgical outcomes of patients with the mass-forming (MF) plus periductal infiltrating (PI) type of intrahepatic cholangiocellular carcinoma (ICC)...

..These results need to be confirmed and validated in another data set or future prospective trial according to the scoring scheme we outline...

..To analyze the short-term surgical outcome of hepatobiliary resections for perihilar cholangiocarcinoma in the last 5 years...

..Unnecessary surgical intervention was avoided by an early and accurate diagnosis and effective antifungal therapy. The bile culture was the key to the definitive diagnosis in this case...

..The clinical impact of the surgical margin status in macroscopic curative hepatectomy for intrahepatic cholangiocarcinoma (ICC) has not yet been fully investigated...

..The therapeutic value of the procedure during hepatectomy has, however, not been evaluated...

..Clinically hepatobiliary resection is indicated for both hilar bile duct cancer (BDC) and intrahepatic cholangiocarcinoma involving the hepatic hilus (CCC). The aim of this study was to compare the long-term outcome of BDC and CCC...

..Intrahepatic cholangiocellular carcinoma (ICC) presenting intraductal growth (IG) has distinct clinicopathological features with a favorable prognosis. The mass-forming (MF) plus IG type of ICC has not been previously investigated...

..Because liver resection is still the only treatment that offers a cure, surgery for multiple metastases may be justified as long as the operation is safe and technically feasible...

..The surgical approach is recommended for selected patients with cHCC-CC...

..In addition, selections of the most effective treatments for patients with recurrent HCC still remain controversial...

..The aim of this study was to determine the long-term post-resection outcomes for cirrhotic patients with early-stage hepatocellular carcinoma (HCC)...

..Precise assessment of retroperitoneal invasion is clinically important to allow the achievement of negative margin resections...

..The object of this study was to investigate the predictive factors for survival, including preoperative and postoperative serum CA 19-9 levels in patients with pancreatic cancer...

..In conclusion, CapG was identified as a novel candidate biomarker to predict response to gemcitabine treatment and survival in cholangiocarcinoma...

..In patients with advanced cholangiocarcinoma involving the inferior vena cava (IVC), an extended hepatobiliary resection with combined resection and reconstruction of the IVC is often prerequisite to obtain a clear resection margin...

..The aim of this study was to characterize changes in surgical outcomes following major HBR for HCCa at a single center over a 25-year period...

..A curative hepatectomy is the mainstay of effective treatment for small hepatocellular carcinoma (HCC), but the treatment of large HCC remains challenging...

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..Surgical resections for invasive ductal adenocarcinoma of the pancreas can provide the only chance of cure, although the 5-year survivors are not always equated with cure...

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..Autologous venous grafts made from the bilateral gonadal veins (BGVs) have never been utilized or discussed...

..The objective of this study is to reveal the risk factors for POPF defined by the international study group after pancreaticoduodenectomy in a Japanese high-volume center...

..However, in patients with 4 or more colorectal lymph node metastases, biological selection by neoadjuvant chemotherapy may be more suitable...

..When positive nodes are confirmed by frozen section, early recurrence and poor survival are inevitable, even after radical operation including extended lymphadenectomy...

..The clinical implications of combined portal vein resections are controversial...

..Recent advances in diagnostic modalities have made it possible to detect small pancreatic ductal carcinoma and to increase the number of resected cases. However, the postoperative prognosis remains dismal...

..An aggressive surgical approach will be a rational treatment of choice for recurrent disease when metachronous multicentric tumor development in the bile duct is suspected and curative resection can be safely performed...

..A thrombectomy remains the only therapeutic option that offer a chance of complete tumor removal avoiding acute portal vein obstruction. However, the efficacy of tumor thrombectomy in addition to hepatectomy has not been well evaluated...

..The incidence of positive resectional margin was 25%. With biliary decompression and preoperative portal embolization techniques, left hepatic trisegmentectomy was a safe and curative resectional option for hilar cholangiocarcinoma...

..Even if HCC tumor thrombus is recognized in the major branches of bile duct, extensive and curative surgical treatment should be recommended when hepatic functional reserve is satisfactory without intrahepatic metastases...

..The aim of the present study was to investigate the clinicopathologic difference between invasive IPMN and a common type of invasive ductal carcinoma of the pancreas...

..However, ductal occlusion has not proved satisfactory for preventing pancreatic fistulas in pancreaticoduodenectomy (PD)...

..This is the first successfully resected case of HCC associated with BBF...

..The clinical impact of the distal pancreatectomy with en-bloc celiac axis resection for locally advanced pancreatic body cancer remains unclear...

..Colorectal liver metastases with hepatic vein (HV) involvement may require combined resection of the liver and HV. However, the short- and long-term outcomes of such a procedure remain unclear...

..The objective of this study is to investigate the clinicopathologic factors and survival of patients who underwent hepatectomy for solitary HCC originating in the caudate lobe...

..These findings suggest that a significant proportion of ACC shows IPG, which is potentially linked to less aggressive clinicopathologic characteristics...

..This is the first detailed report of solid pseudopapillary tumor arising outside the pancreas complicated by repetitive liver metastases and peritoneal carcinomatosis, suggesting the existence of a more lethal subgroup of tumors...

..CONCLUSION: Surgical resection for liver metastases of gastric cancer may be beneficial for patients with a solitary metastasis, whether it is synchronous or metachronous...

..Precise preoperative staging for gallbladder carcinoma is difficult, despite recent advances in hepatobiliary imaging. However, the most accurate preoperative staging may be possible by integrating preoperative key data...

..CONCLUSION Low HCV viral load predicts better long-term surgical outcomes in patients with HCC regardless of the serologic eradication of HCV...

..We investigated the impact of marginal resection on recurrence-free survival after a resection of a solitary hepatocellular carcinoma...

..Postoperative pancreatic fistula (POPF) remains a leading cause of morbidity after pancreaticoduodenectomy (PD). In the present study we sought to establish a preoperative scoring system with which to predict this complication...

..Neural invasion is a distinct route for the spread of pancreatic carcinoma. However, the clinicopathologic significance of neural invasion, with particular reference to intrapancreatic nerve invasion, remains to be elucidated...

..The aim of this study was to reveal the utility of alimentary reconstruction using staplers during pancreaticoduodenectomy (PD), focusing on the occurrence of delayed gastric emptying...

..MPD dilatation is a crucial sign and clue enabling the early detection of tiny pancreatic tumors...

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..In conclusion, this is the first report on the reconstruction of MHV tributaries using a single autologous Y-shaped portal vein graft during a hepatectomy. This method produces no complications related to the harvesting of the graft...

..There is intense clinical interest to determine whether a wide surgical margin is required to improve postoperative recurrence after locoregional therapy for small hepatocellular carcinomas (HCCs)...

..Simultaneous resection of multiple tumors and closure of the portosystemic shunt are strongly recommended in a patient with LCA associated with IHPSS...

..Adequate surgical procedure for gastrointestinal stromal tumors (GISTs) arising in the second portion of the duodenum remains controversial...

..We evaluated the results of Japanese patients to determine the prognostic factors and the feasibility of our aggressive surgical approach...

..Factors predicting survival were not evaluated fully in patients with invasive pancreatic carcinoma of the body and tail who had undergone distal pancreatectomy with extended lymphadenectomy...

..This study attempts to elucidate a part of the genetic predisposition to the sporadic invasive ductal adenocarcinoma of the pancreas focusing on the genes implicated in the gene-environment interactions in carcinogenesis...

..Surgical cure seems to be difficult due to the high frequency of repeat metastasis to various sites. Therefore, adjuvant therapy must be required in the treatment of metastatic GIST...

..Surgeons should not be persistent in trying to achieve a negative surgical margin when the intraoperative frozen section diagnosis is R1 (is), and can choose a safe surgical procedure to avoid postoperative complications...

..However, the role of this procedure remains controversial. We investigate outcomes using this method in 14 patients...

..In conclusion, the baseline HABR appears to be continuously activated in patients with LC; this phenomenon probably results in the impairment of the acute HABR...

..Further study is necessary to determine the significant advantages and disadvantages of using PPG or TrG...

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..There have been few reports on the minimum surgical margins (SMs) required for successful liver resection in patients with colorectal metastases. This minimum requirement may be narrower than the previously recommended margin of 10 mm...

..The patient survived, despite the expected poor prognosis on admission. CONCLUSIONS: GCAP is recommended as a potential therapeutic option for severe alcoholic hepatitis...

..We did not need to perform total vascular exclusion or portovenous shunting during the liver transection. This simple and safe method can increase the surgical indications for previously unresectable tumors...

..The major disadvantage may be a slower transection speed. A prospective randomized trial is needed to clarify the clinical benefits of liver resections performed using this novel technique...

..RESULTS: No patient developed venous thrombosis of the graft or edema of the lower leg. CONCLUSIONS: The newly customized vein graft was safe and useful for the reconstruction of the major hepatic or portal veins...

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..We report a case of surface calcification on an implanted silicone IOL. The purpose of our study was to examine the clinical and ultrastructural findings associated with the late surface calcification of a silicone IOL...

..The goal of the present study was to evaluate the efficacy of the novel LigaSure Vessel Sealing System (Valleylab, Boulder, CO) when used for liver resection...

..Pancreatoduodenectomy is not always necessary in the treatment of a duodenal GIST. This duodenectomy procedure can serve as a less extensive resection for a duodenal GIST located in the third portion of the duodenum...