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Article ; Online: Short- and long-term outcomes of laparoscopic liver resection for non-alcoholic fatty liver disease-associated hepatocellular carcinoma: a retrospective cohort study.

Watanabe, Yukihiro / Aikawa, Masayasu / Oshima, Yuhei / Kato, Tomotaka / Takase, Kenichiro / Watanabe, Yuichiro / Okada, Katsuya / Okamoto, Kojun / Koyama, Isamu

HPB : the official journal of the International Hepato Pancreato Biliary Association

2023 Volume 25, Issue 12, Page(s) 1573–1586

Abstract: Background: We compared the recurrence-free survival (RFS), overall survival (OS), and safety of laparoscopic liver resection (LLR) between non-alcoholic fatty liver disease (NAFLD) and non-NAFLD hepatocellular carcinoma (HCC) patients.: Methods: ... ...

Abstract	Background: We compared the recurrence-free survival (RFS), overall survival (OS), and safety of laparoscopic liver resection (LLR) between non-alcoholic fatty liver disease (NAFLD) and non-NAFLD hepatocellular carcinoma (HCC) patients. Methods: Patients with HCC (n = 349) were divided into four groups based on the HCC etiology (NAFLD [n = 71], hepatitis B [n = 27], hepatitis C [n = 187], alcohol/autoimmune hepatitis [AIH] [n = 64]). RFS and OS were assessed by multivariate analysis after adjustment for clinicopathological variables. A subgroup analysis was performed based on the presence (n = 248) or absence (n = 101) of cirrhosis. Results: Compared with the NAFLD group, the hazard ratios (95% confidence intervals) for RFS in the hepatitis B, hepatitis C, and alcohol/AIH groups were 0.49 (0.22-1.09), 0.90 (0.54-1.48), and 1.08 (0.60-1.94), respectively. For OS, the values were 0.28 (0.09-0.84), 0.52 (0.28-0.95), and 0.59 (0.27-1.30), respectively. With cirrhosis, NAFLD was associated with worse OS than hepatitis C (P = 0.010). Without cirrhosis, NAFLD had significantly more complications (P = 0.034), but comparable survival than others. Discussion: Patients with NAFLD-HCC have some disadvantages after LLR. In patients with cirrhosis, LLR is safe, but survival is poor. In patients without cirrhosis, the complication risk is high.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular ; Non-alcoholic Fatty Liver Disease/surgery ; Liver Neoplasms ; Retrospective Studies ; Liver Cirrhosis/surgery ; Hepatitis C/complications ; Hepatitis B/complications ; Laparoscopy/adverse effects
Language	English
Publishing date	2023-09-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2023.09.002
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Zs.A 6326: Show issues

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Article ; Online: Development of an artificial portal vein using bioabsorbable polymers.

Takashima, Junpei / Miyazawa, Mitsuo / Aikawa, Masayasu / Suga, Hirotaka / Fujimoto, Daisuke / Miura, Fumihiko / Taniguchi, Keizo / Matsutani, Noriyuki / Kobayashi, Hirotoshi

Surgery today

2022 Volume 53, Issue 2, Page(s) 261–268

Abstract: Purpose: During surgical resection of malignant tumors in the hepatobiliary pancreatic region, portal vein resection and reconstruction may be needed. However, there is no alternative to the portal vein. We therefore developed an artificial portal vein ... ...

Abstract	Purpose: During surgical resection of malignant tumors in the hepatobiliary pancreatic region, portal vein resection and reconstruction may be needed. However, there is no alternative to the portal vein. We therefore developed an artificial portal vein that could be used in the abdominal cavity. Methods: In the experiments, hybrid pigs (n = 8) were included. An artificial portal vein was created using a bioabsorbable polymer sheet (BAPS). Subsequently, the portal vein's anterior wall was excised into an elliptical shape. A BAPS in the form of a patch was implanted at the same site. At 2 weeks (n = 3) and 3 months (n = 5) after the implantation, the BAPS implantation site was resected and evaluated macroscopically and histopathologically. Results: Immediately after the implantation, blood leakage was not detected. Two weeks after implantation, the BAPS remained, and endothelial cells were observed. Thrombus formation was not observed. Three months after implantation, the BAPS had been completely absorbed and was indistinguishable from the surrounding portal vein. Stenosis and aneurysms were not observed. Conclusions: BAPS can replace a defective portal vein from the early stage of implantation to BAPS absorption. These results suggest that it can be an alternative material to the portal vein in surgical reconstruction.
MeSH term(s)	Animals ; Swine ; Portal Vein/surgery ; Portal Vein/pathology ; Absorbable Implants ; Polymers ; Endothelial Cells ; Pancreas
Chemical Substances	Polymers
Language	English
Publishing date	2022-07-17
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-022-02555-y
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Zs.B 1077: Show issues

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Article ; Online: Influence of Child-Pugh B7 and B8/9 cirrhosis on laparoscopic liver resection for hepatocellular carcinoma: a retrospective cohort study.

Watanabe, Yukihiro / Aikawa, Masayasu / Kato, Tomotaka / Takase, Kenichiro / Watanabe, Yuichiro / Okada, Katsuya / Okamoto, Kojun / Koyama, Isamu

Surgical endoscopy

2022 Volume 37, Issue 2, Page(s) 1316–1333

Abstract: Background: Laparoscopic liver resection for hepatocellular carcinoma (HCC) in patients with Child-Pugh A cirrhosis has been shown to be beneficial. However, less is known regarding the outcomes of such treatment in patients with Child-Pugh B cirrhosis. ...

Abstract	Background: Laparoscopic liver resection for hepatocellular carcinoma (HCC) in patients with Child-Pugh A cirrhosis has been shown to be beneficial. However, less is known regarding the outcomes of such treatment in patients with Child-Pugh B cirrhosis. We conducted a retrospective study to evaluate the outcomes of laparoscopic liver resection for HCC in patients with Child-Pugh B cirrhosis, focusing on surgical risks, recurrence, and survival. Methods: 357 patients with HCC who underwent laparoscopic liver resection from 2007 to 2021 were identified from our single-institute database. The patients were divided into three groups by their Child-Pugh score: the Child-Pugh A (n = 280), Child-Pugh B7 (n = 42), and Child-Pugh B8/9 groups (n = 35). Multivariable Cox regression models for recurrence-free survival (RFS) and overall survival (OS) were constructed with adjustment for preoperative and postoperative clinicopathological factors. Results: The Child-Pugh B8/9 group had a significantly higher complication rate, but the complication rates were comparable between the Child-Pugh B7 and Child-Pugh A groups (Child-Pugh A vs. B7 vs. B8/9: 8.2% vs. 9.6% vs. 26%, respectively; P = 0.010). Compared with the Child-Pugh A group, the risk-adjusted hazard ratios (95% confidence intervals) in the Child-Pugh B7 and B8/9 groups for RFS were 1.39 (0.77-2.50) and 3.15 (1.87-5.31), respectively, and those for OS were 0.60 (0.21-1.73) and 1.80 (0.86-3.74), respectively. There were no significant differences in major morbidities (Clavien-Dindo grade > II) (P = 0.117) or the proportion of retreatment after HCC recurrence (P = 0.367) among the three groups. Conclusion: Among patients with HCC, those with Child-Pugh A and B7 cirrhosis can be good candidates for laparoscopic liver resection in terms of complications and recurrence. Despite poor postoperative outcomes in patients with Child-Pugh B8/9 cirrhosis, laparoscopic liver resection is less likely to interfere with retreatment and can be performed as part of multidisciplinary treatment.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular/surgery ; Retrospective Studies ; Liver Neoplasms/surgery ; Liver Cirrhosis/complications ; Hepatectomy ; Laparoscopy ; Treatment Outcome
Language	English
Publishing date	2022-10-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09677-x
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Zs.A 2214: Show issues

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Article ; Online: Outcomes of Arterial Embolization vs Covered Stents for Delayed Massive Hemorrhage After Pancreatic or Biliary Surgery.

Watanabe, Yukihiro / Nakazawa, Ken / Takase, Kenichiro / Watanabe, Yuichiro / Okada, Katsuya / Aikawa, Masayasu / Okamoto, Kojun / Koyama, Isamu

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2022 Volume 26, Issue 6, Page(s) 1187–1197

Abstract: Background: Covered stent placement (CSP) is gaining popularity for the management of delayed massive hemorrhage (DMH) after pancreatic or biliary surgery. However, early studies have produced conflicting results regarding the potential advantages of ... ...

Abstract	Background: Covered stent placement (CSP) is gaining popularity for the management of delayed massive hemorrhage (DMH) after pancreatic or biliary surgery. However, early studies have produced conflicting results regarding the potential advantages of the procedure. We aimed to compare the short- and medium-term outcomes of arterial embolization (AE) and CSP for DMH. Methods: We analyzed data for patients who underwent AE or CSP as an endovascular treatment (EVT) for DMH from the common hepatic artery (CHA) and its distal arteries between January 2009 and December 2019. We evaluated the major hepatic complications, in-hospital mortality, and 1-year mortality associated with the procedures, according to age, sex, reintervention, arterial variant, interval between surgery and EVT, and portal vein stenosis. Results: All hemorrhages were treated using AE (n = 50) or CSP (n = 20). CSP was associated with no in-hospital mortality (32% vs. 0%, p = 0.003), and lower incidences of major hepatic complications (44% vs. 10%, p = 0.011) and 1-year mortality (54% vs. 25%, p = 0.035) compared with AE, respectively. There was no significant difference in technical success and reintervention rates. Compared with AE, the risk-adjusted odds ratios for CSP (95% confidence intervals) for major hepatic complications and 1-year mortality were 0.06 (0.01-0.39) and 0.19 (0.05-0.71), respectively. Conclusions: CSP is superior to AE regarding major hepatic complications and in-hospital- and 1-year mortality in patients with DMH from hepatic arteries.
MeSH term(s)	Humans ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/methods ; Postoperative Hemorrhage/surgery ; Postoperative Hemorrhage/therapy ; Retrospective Studies ; Stents/adverse effects ; Treatment Outcome
Language	English
Publishing date	2022-01-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-022-05259-3
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Zs.A 5207: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 354: Show issues

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Article ; Online: Pitfalls and promises of bile duct alternatives: A narrative review.

Miyazawa, Mitsuo / Aikawa, Masayasu / Takashima, Junpei / Kobayashi, Hirotoshi / Ohnishi, Shunsuke / Ikada, Yoshito

World journal of gastroenterology

2020 Volume 28, Issue 39, Page(s) 5707–5722

Abstract: Biliodigestive anastomosis between the extrahepatic bile duct and the intestine for bile duct disease is a gastrointestinal reconstruction that abolishes duodenal papilla function and frequently causes retrograde cholangitis. This chronic inflammation ... ...

Abstract	Biliodigestive anastomosis between the extrahepatic bile duct and the intestine for bile duct disease is a gastrointestinal reconstruction that abolishes duodenal papilla function and frequently causes retrograde cholangitis. This chronic inflammation can cause liver dysfunction, liver abscess, and even bile duct cancer. Although research has been conducted for over 100 years to directly repair bile duct defects with alternatives, no bile duct substitute (BDS) has been developed. This narrative review confirms our understanding of why bile duct alternatives have not been developed and explains the clinical applicability of BDSs in the near future. We searched the PubMed electronic database to identify studies conducted to develop BDSs until December 2021 and identified studies in English. Two independent reviewers reviewed studies on large animals with 8 or more cases. Four types of BDSs prevail: Autologous tissue, non-bioabsorbable material, bioabsorbable material, and others (decellularized tissue, 3D-printed structures,
MeSH term(s)	Animals ; Bile Ducts/surgery ; Bile Ducts, Extrahepatic/surgery ; Bile Duct Diseases ; Cholangitis ; Anastomosis, Surgical ; Constriction, Pathologic
Language	English
Publishing date	2020-09-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v28.i39.5707
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Zs.A 6039: Show issues

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Article ; Online: Portal vein aneurysm with complete spontaneous regression after 10 years using conservative treatment.

Watanabe, Yukihiro / Takase, Kenichiro / Okada, Katsuya / Aikawa, Masayasu / Okamoto, Kojun / Koyama, Isamu

Clinical journal of gastroenterology

2020 Volume 13, Issue 5, Page(s) 940–945

Abstract: Portal vein aneurysms are rare vascular findings for which there are no optimal treatment guidelines. The scarce knowledge about their etiology, natural history, and management mean that there are limited treatment options. Here, we describe the case of ... ...

Abstract	Portal vein aneurysms are rare vascular findings for which there are no optimal treatment guidelines. The scarce knowledge about their etiology, natural history, and management mean that there are limited treatment options. Here, we describe the case of a 69-year-old woman who presented with a 35-mm hypoechoic area in the hilar region of the liver that was accidentally detected by ultrasonography. Color Doppler ultrasonography demonstrated a mass with internal flow contiguous with portal vein, which was confirmed to be a portal vein aneurysm by computed tomography. Given that she experienced no symptoms of impending rupture or thrombosed aneurysms, we adopted a conservative treatment. Follow-up imaging demonstrated slow progression of the aneurysm diameter, from 35 to 43 mm at 3 years, and to 48 mm at 6 years; subsequent imaging after 6 years did not show any change in the diameter from 48 mm. However, the portal vein aneurysm completely regressed with no complications at a follow-up of over 10 years. This case suggests that long-term observation with periodic imaging may be an acceptable therapeutic option for asymptomatic portal vein aneurysms that show no short-term improvement. This case report contributes to a better understanding of how to treat this rare disease.
MeSH term(s)	Aged ; Aneurysm/diagnostic imaging ; Aneurysm/therapy ; Conservative Treatment ; Female ; Humans ; Liver ; Portal Vein/diagnostic imaging ; Ultrasonography
Language	English
Publishing date	2020-05-24
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	2429411-1
ISSN	1865-7265 ; 1865-7257
ISSN (online)	1865-7265
ISSN	1865-7257
DOI	10.1007/s12328-020-01131-6
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Article ; Online: Is prophylactic lateral lymph node dissection needed for lower rectal cancer? A single-center retrospective study.

Kondo, Hiroka / Yamaguchi, Shigeki / Hirano, Yasumitsu / Aikawa, Masayasu / Sato, Hiroshi / Okamoto, Kojun / Sakuramoto, Shinichi / Koyama, Isamu

BMC surgery

2021 Volume 21, Issue 1, Page(s) 261

Abstract: Background: The effectiveness of prophylactic lateral lymph node dissection (LLND) in treating patients with lower rectal cancer remains controversial and has not been clearly established. Therefore, we aimed to retrospectively analyze the survival ... ...

Abstract	Background: The effectiveness of prophylactic lateral lymph node dissection (LLND) in treating patients with lower rectal cancer remains controversial and has not been clearly established. Therefore, we aimed to retrospectively analyze the survival impact of prophylactic LLND in patients with lower rectal cancer. Methods: Data of 301 patients with lower rectal cancer (tumor's lower edge on the anal side of the peritoneal reflexion) with clinical T3 disease and negative preoperative lateral lymph node metastasis, who underwent radical resection (R0) at our hospital between April 2007 and March 2017, were included in this study. Patients who received preoperative chemotherapy or radiotherapy were excluded. The relapse-free survival (RFS) and overall survival (OS) rates were compared between the dissection (prophylactic LLND, n = 37) and non-dissection (no prophylactic LLND, n = 264) groups. Results: Significantly fewer men and younger patients were noted in the dissection group than in the non-dissection group. Post-surgery 3- and 5-year RFS rates were 69.6% and 66.8% in the dissection group and 75.1% and 72.5% in the non-dissection group, respectively (5-year post-surgery RFS, p = 0.58). In the dissection and non-dissection groups, the 5-year OS rates were 86.5% and 79.7%, respectively (p = 0.29), and the 5-year cancer-specific survival rates were 88.9% and 86.0%, respectively (p = 0.29), with no significant differences. Lateral lymph node recurrence was observed in one (2.7%) and 10 patients (3.8%) in the dissection and non-dissection groups, respectively, and there was no significant difference between the groups. Conclusions: In this study, the effectiveness of prophylactic LLND was limited in patients with > T3 lower rectal cancer with no evidence of preoperative lymph node metastasis. Prophylactic LLND may not be necessary if there is no preoperative lymph node metastasis, even if the invasion depth is T3 or higher.
MeSH term(s)	Dissection ; Humans ; Lymph Node Excision ; Lymph Nodes/pathology ; Male ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/prevention & control ; Neoplasm Staging ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Retrospective Studies
Language	English
Publishing date	2021-05-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-021-01263-7
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Article ; Online: Lymphoid hyperplasia with a polyp form of the gallbladder macroscopically mimicking carcinoma.

Watanabe, Yuichiro / Aikawa, Masayasu / Takase, Kenichiro / Watanabe, Yukihiro / Okada, Katsuya / Okamoto, Kojun / Fujita, Akashi / Ryozawa, Shomei / Hirano, Yasumitsu / Sato, Hiroshi / Sakuramoto, Shinichi / Koyama, Isamu / Izu, Asami / Kawasaki, Tomonori

Clinical journal of gastroenterology

2022 Volume 15, Issue 2, Page(s) 500–504

Abstract: Lymphoid hyperplasia is a type of tumor-like hyperplasia of lymphoid tissue. There have been few reports on lymphoid hyperplasia of the gallbladder. Here, we report a case of lymphoid hyperplasia with a polyp form of the gallbladder macroscopically ... ...

Abstract	Lymphoid hyperplasia is a type of tumor-like hyperplasia of lymphoid tissue. There have been few reports on lymphoid hyperplasia of the gallbladder. Here, we report a case of lymphoid hyperplasia with a polyp form of the gallbladder macroscopically mimicking carcinoma. Liver dysfunction was diagnosed in a 75-year-old woman who presented with a gallbladder mass measuring 20 mm during an annual health checkup. Antibody tests for infectious diseases were positive for anti-HBs and anti-HBc antibodies. Accordingly, a laparoscopic cholecystectomy was performed. Macroscopically, the mass was a papillary/sessile tumor (29 × 25 mm) located in the fundus of the gallbladder. Histologically, the tumor was accompanied by an erosion on a portion of the surface layer, while the remaining epithelium showed regenerative changes and mild hyperplasia. No atypia was observed in the constituent epithelium. Hyperplasia of the polarized lymphoid follicles was observed in the interstitium, and tingible body macrophages were scattered in the germinal center. Immuno-histologically, the germinal center showed CD20 positivity, weak CD10 positivity, Bcl-2 negativity, and a high Ki-67 index (MIB-1). These findings suggested that the proliferating lymphoid follicles were reactive rather than neoplastic. Therefore, we diagnosed the patient with lymphoid hyperplasia of the gallbladder and chronic cholecystitis.
MeSH term(s)	Aged ; Carcinoma/pathology ; Diagnosis, Differential ; Female ; Gallbladder ; Gallbladder Diseases/diagnosis ; Gallbladder Neoplasms/diagnosis ; Gallbladder Neoplasms/pathology ; Humans ; Hyperplasia/pathology
Language	English
Publishing date	2022-01-29
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	2429411-1
ISSN	1865-7265 ; 1865-7257
ISSN (online)	1865-7265
ISSN	1865-7257
DOI	10.1007/s12328-021-01580-7
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Article: [

Yamane, Tomohiko / Aikawa, Masayasu / Yasuda, Masanori / Fukushima, Kenji / Seto, Akira / Okamoto, Koujun / Koyama, Isamu / Kuji, Ichiei

EJNMMI research

2019 Volume 9, Issue 1, Page(s) 39

Abstract: Background: While [: Methods: Patients with pancreatic cancer who had been initially planned for surgery received [: Results: We analyzed 25 patients with pancreatic adenocarcinoma (11 women and 14 men, median age, 73 years; range, 58-81 years), ... ...

Abstract	Background: While [ Methods: Patients with pancreatic cancer who had been initially planned for surgery received [ Results: We analyzed 25 patients with pancreatic adenocarcinoma (11 women and 14 men, median age, 73 years; range, 58-81 years), and observed for 39-1101 days (median, 369 days). Nine cases (36.0%) were identified as visually positive of pancreatic cancer on [ Conclusions: [
Language	English
Publishing date	2019-05-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2619892-7
ISSN	2191-219X
ISSN	2191-219X
DOI	10.1186/s13550-019-0507-8
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Article ; Online: Pancreatic Hamartoma Difficult to Diagnose Preoperatively.

Noguchi, Tatsuya / Ryozawa, Shomei / Mizuide, Masafumi / Tanisaka, Yuki / Fujita, Akashi / Ogawa, Tomoya / Suzuki, Masahiro / Katsuda, Hiromune / Nagata, Koji / Kawasaki, Tomonori / Aikawa, Masayasu / Okamoto, Kojun

Internal medicine (Tokyo, Japan)

2021 Volume 60, Issue 13, Page(s) 2055–2059

Abstract: Abdominal ultrasonography in a 70-year-old woman showed a hypoechoic mass, 14 mm in diameter, in the pancreatic body. Computed tomography showed a mass with contrast effect in the pancreatic body. Test results for endocrine factors or tumor markers were ... ...

Abstract	Abdominal ultrasonography in a 70-year-old woman showed a hypoechoic mass, 14 mm in diameter, in the pancreatic body. Computed tomography showed a mass with contrast effect in the pancreatic body. Test results for endocrine factors or tumor markers were normal. The initial consideration was nonfunctional pancreatic neuroendocrine tumor. Over 8 years of monitoring, the tumor diameter increased to 18 mm, until pancreatic tumor enucleation was performed. The postoperative diagnosis was pancreatic hamartoma, a rare type of benign pancreatic tumor. The preoperative diagnosis of pancreatic hamartoma is difficult, but consideration must be given to the possibility of hamartoma when encountering pancreatic tumors.
MeSH term(s)	Aged ; Female ; Hamartoma/diagnostic imaging ; Hamartoma/surgery ; Humans ; Pancreas/diagnostic imaging ; Pancreas/surgery ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/surgery ; Tomography, X-Ray Computed ; Ultrasonography
Language	English
Publishing date	2021-02-01
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	32371-8
ISSN	1349-7235 ; 0021-5120 ; 0918-2918
ISSN (online)	1349-7235
ISSN	0021-5120 ; 0918-2918
DOI	10.2169/internalmedicine.5982-20
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