Kaneko shiori12/15/2023 Here's how it will go, Today a lot of you will recieve a Happy Smile. Saitama-ken umare no 27-sai, Kaneko Shiori desu. To iu wake de, kyou mo takusan no HAPISUMAIRU wo otodoke shimasu. 7.2.2 AKB48 Group Rinji Soukai "Shirokuro tsukeyou janai ka!".7.2.1 1!2!3!4! YOROSHIKU! Shoubu wa Kore Kara da!.Pancreaticoduodenectomy (PD) is rarely performed for pancreatic cancer with hepatic arterial invasion owing to its poor prognosis and high surgical risks. Although there has been a recent increase in the reports of PD combined with hepatic arterial resection due to improvements in disease prognosis and operative safety, PD with major arterial resection and reconstruction is still considered a challenging treatment.Ī 61-year-old man with back pain was diagnosed with pancreatic head and body cancer. Although distant metastasis was not confirmed, the tumor had extensively invaded the hepatic artery therefore, we diagnosed the patient with locally advanced unresectable pancreatic cancer. #Shiori kaneko plus#Īfter gemcitabine plus nab-paclitaxel (GnP) therapy, the tumor considerably decreased in size from 35 to 20 mm. Magnetic resonance imaging revealed a gap between the tumor and the hepatic artery. Tumor marker levels returned to their normal range, and we decided to perform conversion surgery. In this case, an artery of liver segment 2 (A2) had branched from the left gastric artery therefore, we decided to preserve A2 and perform PD combined with hepatic arterial resection without reconstruction. After four cycles of GnP therapy, we performed hepatic arterial embolization to prevent postoperative ischemic complications prior to surgery. Immediately after embolization, collateral arterial blood flow to the liver was observed. Operation was performed 19 days after embolization. Although there was a temporary increase in liver enzyme levels and an ischemic region was found near the surface of segment 8 of the liver after surgery, no liver abscess developed. The postoperative course was uneventful, and S-1 was administered for a year as adjuvant chemotherapy. The patient is currently alive without any ischemic liver events and cholangitis and has not experienced recurrence in the past 4 years since the surgery. In PD for pancreatic cancer with hepatic arterial invasion, if a part of the hepatic artery is aberrant and can be preserved, combined resection of the common and proper hepatic artery without reconstruction might be feasible for both curability and safety.Īberrant hepatic artery Chemotherapy Conversion surgery Embolization Hepatic arterial resection Pancreatic cancer Pancreaticoduodenectomy.īickenbach KA, Gonen M, Tang LH, O'Reilly E, Goodman K, Brennan MF, et al. Downstaging in pancreatic cancer: a matched analysis of patients resected following systemic treatment of initially locally unresectable disease. doi: 10.1245/s1043-7.Īsano T, Hirano S, Nakamura T, Okamura K, Tsuchikawa T, Noji T, et al. Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment. Gemenetzis G, Groot VP, Blair AB, Laheru DA, Zheng L, Narang AK, et al. Survival in locally advanced pancreatic cancer after neoadjuvant therapy and surgical resection. Arterial en bloc resection for pancreatic carcinoma. Okusaka T, Nakamura M, Yoshida M, Kitano M, Uesaka K, Ito Y, et al. Clinical practice guidelines for pancreatic cancer 2019 from the Japan Pancreas Society: a synopsis. VotingStation is continuous popularity voting system including communication BBS, started to promote world peace among the different people around the world. What are important concepts in VotingStation?Ī. Fairness and Peace are an absolute must in VotingStation. So, double voting and hurtful comments are strictly forbidden. How can I vote for my favorite star? Does it cost anything?Ī. Anyone who has twitter, facebook or google account can vote after logging in with one of those accounts. What kind of information do I have to provide through social login?Ī. VotingStation accepts just only your screen name, profile image URL, and unique service number. We never preserve your E-mail address or any kind of personal information from your SNS account. Will I possibly recieve any spams coused by logging in to VotingStation?Ī. That's completely impossible because we don't accept your E-mail address. And also we never post anything by ourselves to your twitter, facebook or google+ account. VotingStation does function on most of modern browsers.
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