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Article ; Online: Single-Incision Laparoscopic Pancreatoduodenectomy (Whipple Procedure) - a Pioneer Technical Report.

Chuang, Shu-Hung / Chuang, Shih-Chang / Kuo, Kung-Kai

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

2022 Volume 26, Issue 11, Page(s) 2402–2408

MeSH term(s)	Humans ; Pancreaticoduodenectomy/methods ; Laparoscopy/methods ; Pancreatic Neoplasms/surgery ; Surgical Wound/surgery
Language	English
Publishing date	2022-08-01
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/s11605-022-05348-3
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Article: Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review.

Chiu, Bo-Ya / Chuang, Shu-Hung / Chuang, Shih-Chang / Kuo, Kung-Kai

World journal of clinical cases

2022 Volume 11, Issue 9, Page(s) 1939–1950

Abstract: Situs inversus (SI) is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs. Since the 1990s, more than one hundred SI patients have been reported to have successfully undergone laparoscopic ... ...

Abstract	Situs inversus (SI) is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs. Since the 1990s, more than one hundred SI patients have been reported to have successfully undergone laparoscopic cholecystectomy. In these cases, the major problem is to overcome is the left-right condition for right-handed surgeons. Laparoscopic common bile duct exploration (LCBDE), an alternative to treat patients with bile duct stones, has shown equivalent efficacy and is less likely to cause pancreatitis than endoscopic retrograde cholangiopancreatography. Recent updated meta-analyses revealed that a shorter postoperative hospital stay, fewer procedural interventions, cost-effectiveness, a higher stone clearance rate, and fewer perioperative complications are additional advantages of LCBDE. However, the technique is technically demanding, even for skilled laparoscopic surgeons. Conducting LCBDE in patients with difficult situations, such as SI, is more complex than usual. We herein review published SI patients with choledocholithiasis treated by LCBDE, including our own experience, and this paper focuses on the technical aspects.
Language	English
Publishing date	2022-12-22
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2307-8960
ISSN	2307-8960
DOI	10.12998/wjcc.v11.i9.1939
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Article ; Online: Optimal Post-Operative Nalbuphine Dose Regimen: A Randomized Controlled Trial in Patients with Laparoscopic Cholecystectomy.

Chen, Guan-Yu / Kuo, Kung-Kai / Chuang, Shih-Chang / Tseng, Kuang-Yi / Wang, Shen-Nien / Chang, Wen-Tsan / Cheng, Kuang-I

Medicina (Kaunas, Lithuania)

2024 Volume 60, Issue 2

Abstract: ... ...

Abstract	Background
MeSH term(s)	Humans ; Nalbuphine/adverse effects ; Analgesics, Opioid/adverse effects ; Cholecystectomy, Laparoscopic/adverse effects ; Pain, Postoperative/drug therapy ; Analgesia
Chemical Substances	Nalbuphine (L2T84IQI2K) ; Analgesics, Opioid
Language	English
Publishing date	2024-01-23
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina60020195
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Article ; Online: A rare case of primary adenosquamous carcinoma of the liver with gallbladder metastasis.

Wu, Po-Hsuan / Su, Yue-Chiu / Kuo, Kung-Kai

The Kaohsiung journal of medical sciences

2020 Volume 36, Issue 7, Page(s) 561–562

MeSH term(s)	Aged ; Biomarkers, Tumor/genetics ; Biomarkers, Tumor/metabolism ; Carcinoma, Adenosquamous/genetics ; Carcinoma, Adenosquamous/metabolism ; Carcinoma, Adenosquamous/secondary ; Carcinoma, Adenosquamous/surgery ; Gallbladder/metabolism ; Gallbladder/pathology ; Gallbladder/surgery ; Gallbladder Neoplasms/genetics ; Gallbladder Neoplasms/metabolism ; Gallbladder Neoplasms/secondary ; Gallbladder Neoplasms/surgery ; Humans ; Immunohistochemistry ; Keratin-19/genetics ; Keratin-19/metabolism ; Keratin-7/genetics ; Keratin-7/metabolism ; Liver/metabolism ; Liver/pathology ; Liver/surgery ; Liver Neoplasms/genetics ; Liver Neoplasms/metabolism ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Male ; Membrane Proteins/genetics ; Membrane Proteins/metabolism ; Tomography, X-Ray Computed
Chemical Substances	Biomarkers, Tumor ; CKAP4 protein, human ; KRT19 protein, human ; Keratin-19 ; Keratin-7 ; Membrane Proteins
Language	English
Publishing date	2020-05-24
Publishing country	China (Republic : 1949- )
Document type	Case Reports ; Letter
ZDB-ID	639302-0
ISSN	2410-8650 ; 0257-5655
ISSN (online)	2410-8650
ISSN	0257-5655
DOI	10.1002/kjm2.12227
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Article ; Online: Extremely rare case of retroperitoneal "ancient" schwannoma with significant cystic change embedded in the psoas muscle.

Wang, Che-Yuan / Yin, Hsin-Ling / Lee, King-Teh / Kuo, Kung-Kai

The Kaohsiung journal of medical sciences

2021 Volume 37, Issue 7, Page(s) 632–633

MeSH term(s)	Aging ; Female ; Humans ; Middle Aged ; Neurilemmoma/diagnosis ; Neurilemmoma/surgery ; Neurilemmoma/therapy ; Peripheral Nervous System Neoplasms/diagnosis ; Peripheral Nervous System Neoplasms/surgery ; Peripheral Nervous System Neoplasms/therapy ; Psoas Muscles/physiopathology ; Psoas Muscles/surgery ; Radiography, Abdominal ; Retroperitoneal Space
Language	English
Publishing date	2021-02-20
Publishing country	China (Republic : 1949- )
Document type	Case Reports ; Letter
ZDB-ID	639302-0
ISSN	2410-8650 ; 0257-5655
ISSN (online)	2410-8650
ISSN	0257-5655
DOI	10.1002/kjm2.12366
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Article ; Online: Comparison of laparoscopic common bile duct exploration plus cholecystectomy and endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy for elderly patients with common bile duct stones and gallbladder stones.

Wu, Po-Hsuan / Yu, Min-Wei / Chuang, Shih-Chang / Wang, Shen-Nien / Kuo, Kung-Kai / Chang, Wen-Tsan / Chuang, Shu-Hung / Su, Wen-Lung / Huang, Jian-Wei / Chen, Ling-An

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

2024

Abstract: Background: Common bile duct (CBD) stones commonly occur in cholecystectomy cases. The management options include laparoscopic CBD exploration (LCBDE) or endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC). ...

Abstract	Background: Common bile duct (CBD) stones commonly occur in cholecystectomy cases. The management options include laparoscopic CBD exploration (LCBDE) or endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC). Although ERCP is fully developed, it has complications, and LCBDE is a proven alternative. This study aimed to evaluate the safety and efficacy of these treatments in elderly individuals aged ≥70 years. Methods: A retrospective study between January 2015 and July 2022 included 160 elderly patients (aged ≥70 years) diagnosed with cholelithiasis and choledocholithiasis. The patients were divided into 1-stage (LCBDE [n = 80]) or 2-stage (ERCP followed by LC [n = 80]) treatment groups. Data collected encompassed comorbidities, symptoms, bile duct clearance, postoperative complications, and long-term outcomes for systematic analysis. Results: This study analyzed 160 patients treated for CBD stones, comparing 1-stage and 2-stage groups. The 1-stage group had more female patients than the 2-stage group (57.5% vs 37.5%, respectively). The 1-stage group had a mean age of 80.55 ± 7.00 years, which was higher than the mean age in the 2-stage group. American Society of Anesthesiologists classification, Charlson Comorbidity Index, and laboratory findings were similar. Pancreatitis and cholangitis occurred after ERCP in the 2-stage group. Stone clearance rates (92.35% [1-stage group] vs 95.00% [2-stage group]) and biliary leakage incidence (7.5% [1-stage group] vs 3.0% [2-stage group]) were similar, as were postoperative complications and long-term recurrence rates (13.0% [1-stage group] vs 12.5% [2-stage group]). Conclusion: Our research indicates that both the combination of LCBDE and LC and the sequence of ERCP followed by LC are equally efficient and secure when treating CBD stones in elderly patients. Consequently, the 1-stage procedure may be considered the preferred treatment approach for this demographic.
Language	English
Publishing date	2024-03-01
Publishing country	Netherlands
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	10.1016/j.gassur.2024.02.026
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Article ; Online: Oncological and surgical result of hepatoma after robot surgery.

Wang, Wen-Hsiuan / Kuo, Kung-Kai / Wang, Shen-Nien / Lee, King-Teh

Surgical endoscopy

2018 Volume 32, Issue 9, Page(s) 3918–3924

Abstract: Background: Most liver resections are currently performed using an open approach. Robotic hepatectomy has been suggested as a safe and effective approach for hepatocellular carcinoma; however, studies regarding oncological and surgical outcomes are ... ...

Abstract	Background: Most liver resections are currently performed using an open approach. Robotic hepatectomy has been suggested as a safe and effective approach for hepatocellular carcinoma; however, studies regarding oncological and surgical outcomes are still limited. Accordingly, we performed this study to compare the surgical and oncological outcomes between robotic and open approaches. Methods: Between June, 2013 and July, 2016, a total of 63 HCC patients undergoing robotic hepatectomy, and 177 patients undergoing open hepatectomy were included in this study to assess the surgical and oncological outcomes after hepatectomy. The data of demographic, clinical features, hepatitis profile, tumor characters, TNM stage, surgical type, pathological outcomes, and postoperative results were collected prospectively and analyzed retrospectively. Results: The demographic and clinical features of patients with HCC in both groups were statistically comparable. The robotic group had longer operative times (296 ± 84 vs. 182 ± 51 min, p = 0.032). The postoperative complications rate was slightly lower in the robotic group (11.1 vs. 15.3%, p = 0.418). The rate of Ro resection was similar in both groups (93.7 vs. 96%, p = 0.56). The length of hospital stay was significantly shorter in the robotic group (6.21 ± 2.06 vs. 8.18 ± 6.99 days, p = 0.001). The overall recurrence rate of HCC was lower in the robotic group (27 vs. 37.3%, p = 0.140). The 1, 2, 3 year disease-free survival rates were 72.5, 64.3, and 61.6%, respectively, for the open group, while they were 77.8, 71.9, and 71.9%, respectively, for the robotic group, (p = 0.325). The 1, 2, 3 year overall survival rates were 95.4, 92.3, and 92.3%, respectively, for the open group, while they were 100, 97.7, and 97.7%, respectively, for the robotic group (p = 0.137). Conclusion: Robotic surgery is a safe and feasible procedure for liver resection in selected patients. The oncological and surgical outcomes of robotic hepatectomy were comparable to open surgery. The robotic hepatectomy carried significantly shorter length of hospital stay.
MeSH term(s)	Aged ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/surgery ; Disease-Free Survival ; Female ; Hepatectomy/methods ; Humans ; Length of Stay/statistics & numerical data ; Liver Neoplasms/mortality ; Liver Neoplasms/surgery ; Male ; Neoplasm Recurrence, Local ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Robotic Surgical Procedures
Language	English
Publishing date	2018-02-27
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/s00464-018-6131-2
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Article ; Online: The association between oral health status and the clinical outcome of cirrhotic patients on the waiting list for liver transplantation.

Wu, Ju-Hui / Lee, Chen-Yi / Chang, Wen-Tsan / Wu, Po-Hsuan / Chen, Lin-Ann / Huang, Jian-Wei / Su, Wen-Lung / Kuo, Kung-Kai

The Kaohsiung journal of medical sciences

2021 Volume 37, Issue 10, Page(s) 910–917

Abstract: Liver transplantation (LT) candidates often present with poor oral hygiene, which could potentially lead to systemic infections and sepsis owing to their cirrhotic state. In this study, we investigated the oral health status of LT candidates and propose ... ...

Abstract	Liver transplantation (LT) candidates often present with poor oral hygiene, which could potentially lead to systemic infections and sepsis owing to their cirrhotic state. In this study, we investigated the oral health status of LT candidates and propose guidance for the detection and treatment of encountered oral lesions among these patients. The decayed, missing, and filled teeth (DMFT) index was determined through oral examination. The presence of dental calculus was detected using panoramic radiography and defined by the radiopaque dental calculus (RDC). From January 2011 to August 2018, 56 LT candidates were enrolled with a median follow-up of 39 months. The overall mean numbers of decayed, missing, and filled teeth among these patients were 2.7 ± 2.8, 10.9 ± 8.3, and 5.4 ± 4.5, respectively. Eighteen patients (32.1%) had RDC. The 5-year survival rates of all 56 patients was 57.7%, while that of those who either received LT (23 patients) or not were 82.1% and 39.8%, respectively. A Cox regression model revealed better overall survival of patients after LT (adjusted hazard ratio [aHR] = 0.067, p = 0.001), worse survival among patients with RDC (aHR = 3.468, p = 0.010), at Child-Pugh stages B and C (aHR for stage B = 11.889, p = 0.028; aHR for stage C = 19.257, p = 0.013) compared to patients at Child-Pugh stage A, and those with a model for end-stage liver disease (MELD) score ≥25 (aHR = 13.721, p = 0.018). This study demonstrates that RDC was associated with worse prognosis in LT candidates. We therefore recommend that interprofessional collaboration should be a routine preoperative procedure for the evaluation of oral hygiene among LT candidates.
MeSH term(s)	Female ; Humans ; Liver Cirrhosis/surgery ; Liver Transplantation ; Male ; Middle Aged ; Oral Health ; Treatment Outcome ; Waiting Lists
Language	English
Publishing date	2021-07-19
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ZDB-ID	639302-0
ISSN	2410-8650 ; 0257-5655
ISSN (online)	2410-8650
ISSN	0257-5655
DOI	10.1002/kjm2.12406
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Article ; Online: Heterogeneity of Phase II Enzyme Ligands on Controlling the Progression of Human Gastric Cancer Organoids as Stem Cell Therapy Model.

Wu, Deng-Chyang / Ku, Chia-Chen / Pan, Jia-Bin / Wuputra, Kenly / Yang, Ya-Han / Liu, Chung-Jung / Liu, Yi-Chang / Kato, Kohsuke / Saito, Shigeo / Lin, Ying-Chu / Chong, Inn-Wen / Hsiao, Michael / Hu, Huang-Ming / Kuo, Chao-Hung / Kuo, Kung-Kai / Lin, Chang-Shen / Yokoyama, Kazunari K

International journal of molecular sciences

2023 Volume 24, Issue 21

Abstract: Gastric cancer (GC) organoids are frequently used to examine cell proliferation and death as well as cancer development. Invasion/migration assay, xenotransplantation, and reactive oxygen species (ROS) production were used to examine the effects of ... ...

Abstract	Gastric cancer (GC) organoids are frequently used to examine cell proliferation and death as well as cancer development. Invasion/migration assay, xenotransplantation, and reactive oxygen species (ROS) production were used to examine the effects of antioxidant drugs, including perillaldehyde (PEA), cinnamaldehyde (CA), and sulforaphane (SFN), on GC. PEA and CA repressed the proliferation of human GC organoids, whereas SFN enhanced it. Caspase 3 activities were also repressed on treatment with PEA and CA. Furthermore, the tumor formation and invasive activities were repressed on treatment with PEA and CA, whereas they were enhanced on treatment with SFN. These results in three-dimensional (3D)-GC organoids showed the different cancer development of phase II enzyme ligands in 2D-GC cells. ROS production and the expression of TP53, nuclear factor erythroid 2-related factor (NRF2), and Jun dimerization protein 2 were also downregulated on treatment with PEA and CA, but not SFN. NRF2 knockdown reversed the effects of these antioxidant drugs on the invasive activities of the 3D-GC organoids. Moreover, ROS production was also inhibited by treatment with PEA and CA, but not SFN. Thus, NRF2 plays a key role in the differential effects of these antioxidant drugs on cancer progression in 3D-GC organoids. PEA and CA can potentially be new antitumorigenic therapeutics for GC.
MeSH term(s)	Humans ; Antioxidants/pharmacology ; Apoptosis ; Cell- and Tissue-Based Therapy ; Isothiocyanates/pharmacology ; Isothiocyanates/metabolism ; NF-E2-Related Factor 2/metabolism ; Organoids/metabolism ; Oxidative Stress ; Reactive Oxygen Species/metabolism ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/metabolism ; Sulfoxides/pharmacology
Chemical Substances	Antioxidants ; Isothiocyanates ; NF-E2-Related Factor 2 ; Reactive Oxygen Species ; sulforaphane (GA49J4310U) ; Sulfoxides
Language	English
Publishing date	2023-11-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms242115911
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Article: Jdp2 is a spatiotemporal transcriptional activator of the AhR via the Nrf2 gene battery.

Wuputra, Kenly / Tsai, Ming-Ho / Kato, Kohsuke / Ku, Chia-Chen / Pan, Jia-Bin / Yang, Ya-Han / Saito, Shigeo / Wu, Chun-Chieh / Lin, Ying-Chu / Cheng, Kuang-Hung / Kuo, Kung-Kai / Noguchi, Michiya / Nakamura, Yukio / Yoshioka, Tohru / Wu, Deng-Chyang / Lin, Chang-Shen / Yokoyama, Kazunari K

Inflammation and regeneration

2023 Volume 43, Issue 1, Page(s) 42

Abstract: Background: Crosstalk between the aryl hydrocarbon receptor (AhR) and nuclear factor (erythroid-derived 2)-like 2 (Nrf2) signaling is called the "AhR-Nrf2 gene battery", which works synergistically in detoxification to support cell survival. Nrf2- ... ...

Abstract	Background: Crosstalk between the aryl hydrocarbon receptor (AhR) and nuclear factor (erythroid-derived 2)-like 2 (Nrf2) signaling is called the "AhR-Nrf2 gene battery", which works synergistically in detoxification to support cell survival. Nrf2-dependent phase II gene promoters are controlled by coordinated recruitment of the AhR to adjacent dioxin responsive element (DRE) and Nrf2 recruitment to the antioxidative response element (ARE). The molecular interaction between AhR and Nrf2 members, and the regulation of each target, including phase I and II gene complexes, and their mediators are poorly understood. Methods: Knockdown and forced expression of AhR-Nrf2 battery members were used to examine the molecular interactions between the AhR-Nrf2 axis and AhR promoter activation. Sequential immunoprecipitation, chromatin immunoprecipitation, and histology were used to identify each protein complex recruited to their respective cis-elements in the AhR promoter. Actin fiber distribution, cell spreading, and invasion were examined to identify functional differences in the AhR-Jdp2 axis between wild-type and Jdp2 knockout cells. The possible tumorigenic role of Jdp2 in the AhR-Nrf2 axis was examined in mutant Kras-Trp53-driven pancreatic tumors. Results: Crosstalk between AhR and Nrf2 was evident at the transcriptional level. The AhR promoter was activated by phase I ligands such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) through the AhR-Jdp2-Nrf2 axis in a time- and spatial transcription-dependent manner. Jdp2 was a bifunctional activator of DRE- and ARE-mediated transcription in response to TCDD. After TCDD exposure, Jdp2 activated the AhR promoter at the DRE and then moved to the ARE where it activated the promoter to increase reactive oxygen species (ROS)-mediated functions such as cell spreading and invasion in normal cells, and cancer regression in mutant Kras-Trp53-driven pancreatic tumor cells. Conclusions: Jdp2 plays a critical role in AhR promoter activation through the AhR-Jdp2-Nrf2 axis in a spatiotemporal manner. The AhR functions to maintain ROS balance and cell spreading, invasion, and cancer regression in a mouse model of mutant Kras-Trp53 pancreatic cancer. These findings provide new insights into the roles of Jdp2 in the homeostatic regulation of oxidative stress and in the antioxidation response in detoxification, inflammation, and cancer progression.
Language	English
Publishing date	2023-08-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2051471-2
ISSN	1880-9693 ; 0389-4290
ISSN	1880-9693 ; 0389-4290
DOI	10.1186/s41232-023-00290-6
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