Journal of hepato-biliary-pancreatic sciences
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J Hepatobiliary Pancreat Sci · Jul 2012
Adjuvant chemotherapy with gemcitabine and S-1 after surgical resection for advanced biliary carcinoma: outcomes and prognostic factors.
The aims of this study were to evaluate long-term outcomes and to determine prognostic factors for survival in patients with resected biliary carcinoma who received adjuvant gemcitabine plus S-1 chemotherapy. ⋯ Adjuvant gemcitabine plus S-1 chemotherapy may be a promising strategy for patients with resected biliary carcinoma, and nodal status and surgical margin status may be predictors of survival with this treatment strategy.
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J Hepatobiliary Pancreat Sci · May 2012
Comparative StudyCompliance with and effects of preoperative immunonutrition in patients undergoing pancreaticoduodenectomy.
This study was conducted to ascertain the feasibility and effectiveness of preoperative enteral immunonutrition using an immune-enhanced formula (Impact) in patients undergoing pancreaticoduodenectomy. ⋯ The preoperative oral ingestion of Impact was well tolerated and appeared to be effective for preventing incisional wound infection and reducing the response to surgical stress in patients undergoing a pancreaticoduodenectomy.
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J Hepatobiliary Pancreat Sci · Mar 2012
Randomized Controlled Trial Comparative StudyIschemic preconditioning prior to intermittent Pringle maneuver in liver resections.
Continuous inflow vascular occlusion during liver resections causes less severe ischemia and reperfusion injury (IRI) if it is preceded by ischemic preconditioning (IP) or if intermittent inflow occlusion is used during the resection. No previous clinical trial has studied the effects of adding IP to intermittent inflow occlusion. ⋯ IP before intermittent vascular occlusion does not reduce the serum parameters used to assess IRI. IP seems to improve aerobic glucose metabolism, as the levels of glucose, pyruvate, and lactate locally in the liver were reduced, compared to controls, in patients having >3 segments resected. μD may be used to monitor metabolism locally.
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J Hepatobiliary Pancreat Sci · Mar 2012
Pancreatic dissection in the procedure of pancreaticoduodenectomy (with videos).
The procedure of pancreaticoduodenectomy consists of three parts: resection, lymph node dissection, and reconstruction. A transection of the pancreas is commonly performed after a maneuver of the pancreatic head, exposing of the portal vein or lymph node dissection, and it should be confirmed as a safe method for pancreatic transection for decreasing the incidence of pancreatic fistula. However, there are only a few clinical trials with high levels of evidence for pancreatic surgery. In this report, we discuss the following issues: dissection of peripancreatic tissue, exposing the portal vein, pancreatic transection, dissection of the right hemicircle of the peri-superior mesenteric artery including plexus and lymph nodes, and dissection of the pancreatic parenchyma.
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J Hepatobiliary Pancreat Sci · Jan 2012
Multicenter Study Comparative StudyA nomogram predicting disease-free survival in patients with colorectal liver metastases treated with hepatic resection: multicenter data collection as a Project Study for Hepatic Surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery.
The aim of this study was to create a nomogram to predict the disease-free survival of patients with colorectal liver metastases treated with hepatic resection. ⋯ This nomogram can easily calculate the median and yearly disease-free survival rates from only 6 preoperative variables. This is a very useful tool to determine the likelihood of early recurrence and the necessity for perioperative chemotherapy in patients with colorectal liver metastases after hepatic resection.