Research: Kurume UniversityKurume University · Department of SurgeryJapan · Kurume
Article: Evaluation of magnifying endoscopy using narrow band imaging using ex vivo bile duct (with video).Yusuke Ishida, Yoshinobu Okabe, Ryohei Kaji, Makiko Yasumoto, Yu Sasaki, Tomoyuki Ushijima, Gen Sugiyama, Yuhei Kitasato, Hiroyuki Horiuchi, Hisafumi Kinoshita, Osamu Tsuruta, Michio Sata[show abstract] [hide abstract]
ABSTRACT: Detailed endoscopic findings of the bile duct mucosa, even of the non-neoplastic mucosa, have not yet been established. The aim of the present study was to compare a currently used video cholangioscope (CCS) with a magnifying endoscope (ME) that is commonly used for the gastrointestinal tract, for visualization of the bile duct mucosa. Ten freshly resected common bile ducts were used in this study. We observed the non-neoplastic bile duct mucosa with CCS and ME, and carried out both conventional white light imaging and narrow band imaging. After histological diagnosis, the 10 specimens were classified into three categories according to the degree of histological inflammation: normal to mild, moderate, and severe. Then, we examined the relationship between the magnifying endoscopic findings and the histopathological findings. In eight of the 10 cases, the visualization obtained with CCS was inferior to that obtained by ME. Five specimens were classified as normal to mild inflammation, and many oval-shaped, depressed areas and a fine, regular network of the microvessels were observed by ME on the mucosal surfaces of these specimens. The remaining specimens were classified as moderate or severe inflammation, and the aforementioned findings could not be clearly visualized. CCS does not allow visualization of the bile duct mucosa with high sensitivity. Oval-shaped depressed areas and a fine, regular network of microvessels are characteristic endoscopic features of non-neoplastic bile duct mucosa without inflammation.Digestive Endoscopy 05/2013; 25(3):322-8. · 1.19 Impact Factor
Article: [Endoscopic retrograde biliary drainage for the liver metastases from colorectal cancer and obstructive jaundice].Yuhei Kitasato, Yusuke Ishida, Yoshinobu Okabe, Osamu Tsuruta, Munehiro Yoshitomi, Gen Akasu, Kazuhiro Mikagi, Yousuke Oka, Yuichirou Maruyama, Ryuichi Kawahara, Hisamune Sakai, Hiroto Ishikawa, Toru Hisaka, Masafumi Yasunaga, Hiroyuki Horiuchi, Yoshito Akagi, Koji Okuda, Hisafumi Kinoshita, Kazuo Shirouzu, Hiroyuki Tanaka[show abstract] [hide abstract]
ABSTRACT: The success of biliary drainage in patients with liver metastases from colorectal cancer and obstructive jaundice influences its prognosis greatly. In this study, we report a retrospective evaluation of endoscopic retrograde biliary drainage in patients with liver metastases from colorectal cancer and obstructive jaundice. Materials and methods: From April 2004 to December 2011, 9 patients with liver metastases from colorectal cancer and obstructive jaundice who underwent endoscopic biliary drainage were evaluated retrospectively. Results: The mean serum levels of total bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase improved significantly after biliary drainage. The median survival time after biliary drainage was 133 days. Only 4 cases were able to resume chemotherapy after biliary drainage, and their prognosis was significantly better than patients who were not able to resume chemotherapy(p=0.014). Discussion: Endoscopic biliary drainage in patients with liver metastases from colorectal cancer and obstructive jaundice was effective, led to the resumption of chemotherapy, and improved prognosis. However, sufficient consideration of the patient's prognosis and performance status is required in order to perform biliary drainage.Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):1860-2.
Article: Metastatic pulmonary adenocarcinoma 13 years after curative resection for pancreatic cancer: report of a case and review of Japanese literature.Yuhei Kitasato, Masamichi Nakayama, Gen Akasu, Munehiro Yoshitomi, Kazuhiro Mikagi, Yuichiro Maruyama, Ryuichi Kawahara, Hiroto Ishikawa, Toru Hisaka, Masafumi Yasunaga, Hiroyuki Horiuchi, Naoyuki Saito, Shinzo Takamori, Yoshinobu Okabe, Masayoshi Kage, Hisafumi Kinoshita, Hiroyuki Tanaka[show abstract] [hide abstract]
ABSTRACT: For the majority of patients, ductal adenocarcinoma of the pancreas remains a lethal disease. Currently, surgical extirpation for localized disease offers the only chance for long-term survival. We report a patient who underwent successful resection of isolated lung metastasis occurring 13 years after pancreatic cancer resection. A 59-year-old woman underwent distal pancreatectomy for pancreatic cancer 13 years previously, followed by adjuvant chemotherapy, and was followed-up at the outpatient clinic of a local hospital. From around June 2010, she noticed bloody sputum, so she visited a local hospital. Since her chest X-ray and CT revealed a 1.5 cm mass shadow in the segment 10 of her right lung and she was referred to the Respiratory Disease Center of our hospital. As a result of through examinations, she was strongly suspected of having lung metastasis of pancreatic cancer, and underwent partial pneumonectomy. Postoperative histopathological examination of the resected specimen was consistent with lung metastasis of pancreatic cancer. She is still alive and currently receives third line of chemotherapy. Patients who have achieved long-term survival after pancreatic cancer resection and can tolerate surgery may benefit from resection of a lung metastasis of pancreatic cancer in terms of survival, if it controls the metastasis.JOP: Journal of the pancreas 01/2012; 13(3):296-300.
Yusuke Kawashima, Hiroyuki Horiuchi, Masanori Akashi, Hidefumi Nogita, Yuhei Kitasato, Gen Akasu, Kazuhiro Mikagi, Ryuichi Kawahara, Hiroto Ishikawa, Toru Hisaka, Hisafumi Kinoshita, Kazuo Shirouzu[show abstract] [hide abstract]
ABSTRACT: BACKGROUND: Prognosis of pancreas cancer is extremely poor. For unresectable pancreas cancer, there has not been an effective method of treating. In our institution, the mean survival time was 13 . 6 months for a chemoradiotherapy case that used gemcitabine (GEM), but was 7.3 months for a non-treatment case in locally advanced and metastatic pancreas cancer. This time, we experienced a good case for unresectable pancreas cancer treated with chemoradiotherapy using GEM/S-1 that clearly exhibited a decrease in tumor size by tumor marker.Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2155-7.
Article: [A case of peritoneal recurrence of invasive carcinoma derived from IPMN after distal pancreatectomy].Yuhei Kitasato, Masafumi Yasunaga, Masamichi Nakayama, Gen Akasu, Munehiro Yoshitomi, Kazuhiro Mikagi, Ryuichi Kawahara, Hiroto Ishikawa, Toru Hisaka, Hiroyuki Horiuchi, Hisafumi Kinoshita, Yoshinobu Okabe[show abstract] [hide abstract]
ABSTRACT: The patient was a 62-year-old man who underwent distal pancreatectomy and partial resection of transverse colon with diagnosis of cystic tumor of pancreas tail in July 2006. In histology, the tumor was an invasive carcinoma derived from intraductal tumor. So, Chemotherapy using gemcitabine (GEM) was administered. Eleven months after the operation, abdominal contrast-enhanced CT showed a cystic tumor in the subdiaphragm and CEA increased to 15 .2 ng/mL. Combination chemotherapy using GEM and S-1 was administered under the diagnosis of peritoneal recurrence. CEA decreased to a normal level, but 19 months after the operation, CA19-9 increased to 187 .7 U/mL. Then, radiotherapy (a total of 40 Gy) was performed. Twenty two months after the radiotherapy, though chemotherapy using S-1 was continued, CA19-9 re- increased to 134 .2 U/mL. Abdominal contrast-enhanced CT and PET detected no other recurrent lesion. A tumor resection was performed in January 2010. In immunostaining MUC1(+), MUC2(-), MUC5AC(+), MUC6(+) and mucus expression forms as well as with previous specimen, and was diagnosed as recurrence of the invasive carcinoma derived from intraductal tumor.Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2161-4.