Biomedical subjects

H Amano

Publications and source records attributed to H Amano.

323 records · Page 18Linked to original sources

PubMedDate not supplied

Simple determination of tin in biological materials by atomic absorption spectrometry with a graphite furnace.

A simple and rapid determination of tin in biological materials (blood, brain, liver, kidney, etc,) by atomic absorption spectrometry (AAS) with a graphite furnace is described. Suppression of interferences by direct addition of ascorbic acid in wet-ashed biological materials was investigated for the determination of tin. This method involves no extraction with organic solvent for removal of the interferences, and therefore it is neither time consuming nor error prone, and is suitable for large sample sizes and small sample volumes. The limit of detection of this method is 0.002 microgram/mL, equivalent to a limit of detection in the materials of 0.02 microgram/g. The calibration graph is linear up to 1 microgram/mL of tin.

Animals↗

PubMedDate not supplied

Efferent neurotransmitters and intracellular Ca2+ concentrations in inner hair cells of guinea pig.

To elucidate efferent inhibitory mechanisms of the cochlear inner hair cells (IHCs), the effects of candidate efferent neurotransmitters on intracellular Ca2+ concentrations ([Ca2+]i) in the isolated IHCs of guinea pig were determined using the Ca2+ sensitive dye fura-2 and digital imaging microscopy. In the presence of 1 mM acetylcholine (ACh), there was a gradual and reversible increase in [Ca2+]i. In the presence of 10 microM ATP, there was a rapid and marked rise in [Ca2+]i. Thus, both ACh and ATP seem to be efferent neurotransmitters in IHCs of guinea pig. The ATP-induced elevation of [Ca2+]i in IHCs was suppressed when ACh was concomitantly applied; therefore, ACh may act as an antagonist of ATP-induced Ca2+ entry. With the independent addition of 10 microM calcitonin gene-related peptide and 10 microM enkephalin, there were no significant increases in [Ca2+]i. These neuropeptides are putative candidates for the efferent neuromodulators in IHCs of the guinea pig.

Acetylcholine↗

PubMedDate not supplied

Enzyme-linked immunosorbent assay for the differential diagnosis of pulmonary tuberculosis and pulmonary diseases due to Mycobacterium avium-intracellulare complex.

We studied the usefulness of antibody estimation by the enzyme-linked immunosorbent assay (ELISA) technique in the differential diagnosis of pulmonary mycobacterial diseases. Sera from patients with active pulmonary diseases caused by Mycobacterium tuberculosis (n = 42) or Mycobacterium avium-intracellulare complex (MAI) (n = 26) and from healthy controls (n = 75) were assayed for IgG and IgA antibody titers to antigen of M. tuberculosis and MAI. The IgG and IgA antibody titers to M. tuberculosis antigen were significantly higher in patients with mycobacterial diseases than in healthy controls, however, there was no significant difference between patients with pulmonary tuberculosis and those with pulmonary diseases due to M. avium-intracellulare complex (MAID). The IgG and IgA antibody titers to MAI antigen in MAID patients were significantly higher than in healthy controls and in patients with pulmonary tuberculosis. ELISA for IgG antibody against M. tuberculosis antigen had a sensitivity of 54.8% and a specificity of 73.1% in the differential diagnosis of pulmonary tuberculosis. The estimation of the IgA antibody against MAI antigen using ELISA is more useful for the differential diagnosis of MAID because of its sensitivity (69.2%) and specificity (90.5%).

Adult↗

PubMedDate not supplied

Calcium distribution and mobilization during depolarization in single cochlear hair cells. Imaging microscopy and fura-2.

Intracellular distribution of cytoplasm-free Ca2+ concentrations ((Ca2+)i) and dynamic changes during stimulation of viable hair cells were studied using digital imaging microscopy and the Ca2(+)-sensitive dye fura-2. (Ca2+)i was visualized on pseudo-colour images and three-dimensional computer graphics. In the resting state, the intra-cellular distribution of (Ca2+)i in both the outer and inner hair cells was heterogeneous, and the amount of (Ca2+)i in most of the peripheral cytoplasm just beneath the plasma membrane was greater than that throughout the entire cytoplasm. Cell depolarization, induced by elevated K+, led to an increase in (Ca2+)i in the outer hair cells. The increase in (Ca2+)i was not observed under conditions of depolarization in Ca2(+)-free medium. These observations are interpreted to mean that the increase in (Ca2+)i is induced by depolarization with the result that there is an influx of extracellular Ca2+ into the cytoplasm. When Mn2+ was applied during depolarization, a fluorescence quenching occurred. By such means the site of Ca2+ channels was elucidated.

Animals↗

PubMedDate not supplied

Community-acquired pneumonia in Ugandan adults: short-term parenteral ampicillin therapy for bacterial pneumonia.

A hospital-based prospective study of 99 patients with community-acquired pneumonia (CAP) was carried out in Kampala, Uganda. We evaluated microbiological etiologies, clinical features and effectiveness of short-term parenteral ampicillin followed by oral amoxicillin for these patients in relation to HIV-status. We demonstrated a very high prevalence (75%) of HIV-1 infection. No significant difference was observed with respect to age, gender, prior antibiotic usage, symptoms, laboratory data or bacterial etiology between HIV-1-infected and HIV-uninfected CAP patients. Most strains of Streptococcus pneumoniae (n = 19) and Haemophilus influenzae (n = 8) isolated from HIV-1-infected patients were penicillin-resistant (95%) and beta-lactamase producing (75%) strains, respectively. A high percentage of good clinical response was found in both HIV-1-infected (81%) and HIV-uninfected (86%) among 39 patients with CAP due to a defined bacterial pathogen. These data support the use of short-term parenteral ampicillin for patients with bacterial CAP irrespective of HIV-status.

Administration, Oral↗

PubMedDate not supplied

Combination of preoperative embolization of the right portal vein and hepatic artery prior to major hepatectomy in high-risk patients: a preliminary report.

BACKGROUND/AIMS: Preoperative transhepatic portal vein embolization may not always be sufficient to achieve the desired changes in contralateral hepatic volume and function. The beneficial role of additional transcatheter arterial embolization performed after inadequate response to preoperative transhepatic portal vein embolization is described. METHODOLOGY: Four patients underwent both preoperative transhepatic portal vein embolization and transcatheter arterial embolization, and 6 control patients underwent preoperative transhepatic portal vein embolization only. Changes in right liver lobe volume fraction, residual left lobe volume fraction, and prediction score (low-risk, < 45; borderline, 45-55; high-risk > 55); were evaluated. RESULTS: 1) The change in right liver lobe volume after both preoperative transhepatic portal vein embolization and transcatheter arterial embolization (volume after/before) was 0.75 times that of the original level whereas after preoperative transhepatic portal vein embolization, they were only 0.81 times that of the original level. 2) The change in residual left liver volume after both preoperative transhepatic portal vein embolization and transcatheter arterial embolization (volume after/before) was 1.40 times that of the original level whereas after preoperative transhepatic portal vein embolization they were only 1.30 times than the original level. The changes in left liver volume after preoperative transhepatic portal vein embolization/transcatheter arterial embolization was more favorable than those after preoperative transhepatic portal vein embolization only. 3) The change in prediction score after both preoperative transhepatic portal vein embolization and transcatheter arterial embolization (after/before) was 0.81 times that of the original level. All prediction score in high-risk patients recovered to the borderline or safety zone. Change after preoperative transhepatic portal vein embolization only (before/after) was 0.87 times that of the original level. 4) All 4 patients who underwent both preoperative transhepatic portal vein embolization and transcatheter arterial embolization received right hepatic lobectomy successfully and returned to their normal life style. CONCLUSIONS: Preoperative occlusion of right hepatic inflow vessels increased the volume and function of the contralateral lobe where high-risk patients recovered to the borderline zone for major hepatic resection.

Aged↗

PubMedDate not supplied

Release of [3H]- and endogenous GABA from slices of the rat medulla oblongata: modification by 3-mercaptopropionic acid, nipecotic acid and diaminobutyric acid.

Slices of the rat medulla oblongata were superfused and electrically stimulated. The amount of [3H]- and endogenous GABA was determined. There was a stimulus-evoked release of [3H]- and endogenous GABA, which was Ca2+-dependent and tetrodotoxin-sensitive. 3-Mercaptopropionic acid (3-MP) reduced the release of endogenous GABA, whereas the release of [3H]-GABA was not affected by this agent. Nipecotic acid enhanced the spontaneous and stimulus-evoked release of both [3H]- and endogenous GABA. 3-MP, nipecotic acid and diaminobutyric acid modified the stimulus-evoked release of endogenous GABA from slices containing the rostral ventrolateral medulla, the caudal ventrolateral medulla or the nucleus tractus solitarii, regions responsible for blood pressure regulation. These results suggest that 3-MP inhibits the stimulus-evoked release of GABA without affecting its release process, whereas nipecotic acid enhances the release via its uptake inhibition action.

3-Mercaptopropionic Acid↗

PubMedDate not supplied

Antitumor activity and immunological properties of marine algal polysaccharides, especially fucoidan, prepared from Sargassum thunbergii of Phaeophyceae.

Marine algal polysaccharide, GIV-A from Sargassum thunbergii markedly inhibited the growth of Ehrlich ascites carcinoma at the dose of 20 mg/kg per day X10 with no sign of toxicity in mice. GIV-A is suggested to be a hexouronic acid containing L-fucan sulfate, fucoidan by the analyses of physicochemical properties and IR- and NMR-spectra. The results of carbon clearance activity with fucoidan demonstrated that it is acting as a so-called activator of the reticuloendothelial system. Fucoidan enhanced the phagocytosis and chemiluminescence of macrophages. By the immunofluorescent method, binding of the third component of complement (C3) cleavage product to macrophages and the proportion of C3 positive cells were increased. In crossed immunoelectrophoresis, human serum C3 was converted by fucoidan and appeared as the 3rd peak (converted C3). The height of the 3rd peak was directly proportional to the doses of fucoidan. The residual CH50 units of human serum decreased dose-dependently. These results suggest that the antitumor activity of fucoidan is related to the enhancement of immune responses. The present results indicate that fucoidan may open new perspectives in cancer chemotherapy.

Animals↗

PubMedDate not supplied

Necrotizing pancreatitis and gizzard erosion associated with adenovirus infection in chickens.

Cases of focal necrotic pancreatitis and gizzard erosion in chickens are reported. Intranuclear inclusion bodies were seen in necrotic pancreatic acinar cells and necrotic epithelial cells of the gizzard, and electron microscopy demonstrated virus particles in affected gizzard epithelium. Adenovirus antigens were detected immunohistochemically in these intranuclear inclusion bodies. These findings suggest that the necrotizing pancreatitis and gizzard erosion were associated with adenovirus infection.

Adenoviridae Infections↗

PubMedDate not supplied

Immunological analysis of inhibition of lung metastases by fucoidan (GIV-A) prepared from brown seaweed Sargassum thunbergii.

The antimetastatic effect of GIV-A (fucoidan) and/or 5-FU was examined in an experimental model of lung metastases induced by Lewis lung carcinoma in mice. Injection of GIV-A i.p. after removal of the implanted primary tumor inhibited the development of lung metastases. Combination treatment with GIV-A and 5-FU inhibited significantly the lung metastases. The number of peritoneal macrophages, total cells and macrophages in the lung increased in mice treated with GIV-A. Binding of the third component of complement (C3) cleavage products (C3b) to the C3 receptor on peritoneal macrophages after i.v. injection of GIV-A was enhanced, as shown by the fluorescent antibody technique. Lung metastases were inhibited by i.v. injection of peritoneal macrophages activated with GIV-A. GIV-A depressed aniline hydroxylase and aminopyrine demethylase activities of the hepatic microsomal drug-metabolizing system in tumor-bearing mice. Moreover, the concentration of 5-FU in the tissues (lung, liver, kidney, spleen and blood) was increased significantly by coadministration of GIV-A. The picryl chloride-induced delayed type hypersensitivity (PC-DTH) response in mice was depressed after the implantation of tumor and treatment with 5-FU. GIV-A restored the suppression of PC-DTH by 5-FU, but did not increase the PC-DTH of normal mice. GIV-A not only enhanced the degree of spleen cell-mediated sheep red blood cell (SRBC) hemolysis (quantitative hemolysis of SRBC), the indexes of the spleen and thymus and the number of spleen cells, but also restored the suppressive effect of 5-FU. In the group receiving GIV-A, the percentages of splenic Thy1.2-, L3T4- and asialo GM1-positive cells were significantly increased as compared with the tumor-bearing mice treated with saline. Furthermore, the L3T4+/Lyt2+ ratio showed a tendency to increase, and the Lyt2+/Thy1.2+ ratio was decreased. These results suggest that the antitumor effect of GIV-A may be correlated with the changing pattern of the Thy1.2-, L3T4- and asialo GM1-positive cells, C3 activation, macrophage activation and depression of the hepatic microsomal drug-metabolizing system. These findings raise the possibility that GIV-A may have clinical value in the prevention of cancer metastasis.

Animals↗

PubMedDate not supplied

Simultaneous hepatic resection with pancreato-duodenectomy for metastatic pancreatic head carcinoma: does it improve survival?

BACKGROUND/AIMS: To determine whether aggressive surgery, consisting of a simultaneous pancreatic and partial hepatic resection, for patients with an invasive metastatic ductal adenocarcinoma of the pancreatic head improves the postoperative outcome. MATERIALS AND METHODS: A total of 109 patients with adenocarcinoma of the pancreatic head were divided into two groups. Group 1 consisted of 33 patients with liver metastasis and Group 2 consisted of 76 patients without liver metastasis. Group 1 was further subdivided into 11 patients(Group 1-A) to aggressive surgery, consisting of pancreatoduodenectomy and partial liver resection, and 22 patients to palliative bypass surgery(group 1-B). Group 2 was subdivided into 37 patients to pancreatoduodenectomy(group 2-A), and 39 patients to bypass surgery(group 2-B). RESULTS: No significant statistical differences were seen in the outcomes between Group 1-A (median survival period: 6 months) and Group 1-B (median survival period: 4 months). Further, all Group 1-A patients died from multiple recurrent liver metastasis within a year. In addition, the outcomes of Group 1-A were significantly poorer than that of 2-A patients(median survival period: 24 months). CONCLUSION: Patients who underwent an aggressive simultaneous resection of primary and metastatic hepatic lesion did not exhibit any improvement. However, it is anticipated that these findings will provide insights into developing an effective adjuvant therapy to impede or destroy macroscopic/occult liver metastasis.

Adenocarcinoma↗

PubMedDate not supplied

Results of a pylorus-preserving pancreatoduodenectomy for pancreatic cancer: a comparison with results of the Whipple procedure.

BACKGROUND/AIMS: A pylorous-preserving pancreatoduodenectomy (PPPD) was performed in patients with an invasive ductal adenocarcinoma of the pancreatic head, but with no direct invasion to the duodenal bulb or pyloric ring and no perigastric lymph node metastasis. This study compares the results achieved by the Whipple procedure in patients with invasive ductal adenocarcinoma of the pancreatic head. METHODOLOGY: Over the past 14 years, we have treated 109 patients with an invasive ductal adenocarcinoma of the head of the pancreas, this number excluding low-grade malignancies such as intraductal papillary mucinous carcinoma or cystadenocarcinoma. The postoperative survival rate, level of postoperative social activity and changes in body weight were studied in 48 resected patients and compared with the results of those who underwent the Whipple procedure. RESULTS: In the resected patients, the 3-year survival rate was 20.8%, and the 5-year survival rate was 16.7%. All patients who underwent the bypass operation, however, had a survival rate of less than 2 years, hence the prognosis for resected patients was better (p < 0.01). Among the resected patients, the postoperative survival rate was better in those who underwent a curative resection than in those who underwent a non-curative resection (p < 0.01). No difference was observed in the postoperative survival rate of PPPD vs Whipple procedure patients. The level of postoperative resumption of social activity and changes in body weight were significantly better after the PPPD than after the Whipple operation. CONCLUSIONS: For patients with cancer of the pancreatic head, but with no direct invasion of the duodenal bulb or pyloric ring and no perigastric lymph node metastasis, a PPPD proved more effective than the Whipple operation. Further, as the prognosis was also better after curative resection, an extended lymphadenectomy in conjunction with the PPPD was also considered necessary to ensure a cancer-free state following resection.

Adenocarcinoma↗

PubMedDate not supplied

The effects of omeprazole, a proton pump inhibitor, on early gastric stagnation after a pylorus-preserving pancreaticoduodenectomy: results of a randomized study.

BACKGROUND/AIMS: To determine the effects of Omeprazole, a proton pump inhibitor (PPI), on gastric stasis following a pylorus-preserving pancreatico-duodenectomy (PPPD) by means of a randomized trial of PPPD patients. METHODOLOGY: Forty-two PPPD patients were randomly divided into two groups: Group 1 (n=24) received a PPI through a jejunal tube after PPPD, whereas Group 2 (n=18), serving as controls, received a saline solution through a jejunal tube and no medication after a PPPD. The daily volume and total acidity of the gastric juice, aspirated via nasogastric tube, were measured each day for 7 days following PPPD. RESULTS: In Group 1 the mean daily aspirated volume of gastric juice was 160.2 ml, and the mean maximum volume was 222.8 ml on the first postoperative day. In Group 2, six patients were withdrawn from this study for therapy on the third or fourth postoperative day due to gastric bleeding and/or a large amount of excreted gastric juice (in excess of 2,000 ml). The mean daily aspirated volume of gastric juice in the remaining Group 2 patients was 787.4 ml, and the mean maximum volume was 1,039 ml on the third postoperative day. Gastric secretion was significantly lower in Group 1 (p<0.05). Further, the total acidity of the gastric juice was significantly lower in Group 1 than in Group 2 for each of the 7 postoperative days (p<0.05). CONCLUSIONS: These results indicate that postoperative administration of a PPI significantly suppresses the volume and acidity of the gastric juice after PPPD.

Aged↗

PubMedDate not supplied

An introduction to mucin-producing tumors of the pancreas: why they deserve more attention.

BACKGROUND/AIMS: Mucin-producing tumors of the pancreas are clinically characterized by dilatation of the major pancreatic duct due to pooled mucin, and by dilatation of the orifice of the duodenal papilla. The concept of mucin-producing tumors of the pancreas was proposed in 1982, but has undergone revision since then. METHODOLOGY: The present paper reviews the history, classification, and description of mucin-producing tumors of the pancreas. Problems relating to this type of tumor are also discussed. RESULTS: The clinical concept of mucin-producing tumors of the pancreas has affected studies of the pancreatic diseases in many areas. First, when recognition of pancreatic cancer with a relatively good prognosis commenced, this concept led to awareness of the necessity for a detailed examination of the pancreatic duct epitheliums in cases of suspected pancreatic carcinoma. Second, the concept made it easier to diagnose carcinoma in situ. Third, new classifications of cystic lesions of the pancreas were initiated. Fourth, a molecular biological view of the onset of pancreatic cancer was developed. Pathologically, this type of tumor is characterized by papillary growth of the epitheliums within the pancreatic duct, and it has been regarded as having a good prognosis. The term mucin-producing tumors of the pancreas now includes: intraductal papillary tumors which are non-invasive carcinomas or carcinoma in situ; duct-ectatic tumors, or mucinous cystic tumors; and, invasive carcinomas, derived from the former types. CONCLUSIONS: The definition of "mucin-producing tumor of the pancreas" has been undergoing revision. In the past, it has referred to pancreatic tumors with a good prognosis. It is now time to consider a more detailed classification.

Adenocarcinoma, Mucinous↗

PubMedDate not supplied

Surgery for mucin-producing pancreatic tumor.

BACKGROUND/AIMS: There is a diversity of mucin-producing tumors of the pancreas, including benign adenoma, malignant intraductal papillary carcinoma and invasive papillary carcinoma. However, there has been little discussion of appropriate techniques for surgically treating these tumors. METHODOLOGY: From August 1981 to December 1997, surgery was performed on 24 patients with mucin-producing pancreatic tumors (18 cases were malignant and 6 were benign). The surgical techniques which were used, the results of surgery, and the post-operative course of the patients are discussed. RESULTS: Surgical resection was possible in 23 patients and included: 4 cases of total pancreatectomy; 1 case of pancreaticoduodenectomy (Whipple's procedure); 1 case of Whipple's procedure with a transverse colectomy; 13 cases of pylorus-preserving pancreaticoduodenectomy (PPPD); 2 cases of duodenum-preserving pancreatic head resection (DPPHR); 1 case of resection of the posterior segment of the pancreas (posterior segmentectomy); and, 1 case of resection of the medial segment of the pancreas (medial segmentectomy). Surgical resection was also used for 17 (94.4%) of the 18 patients with malignant tumor. There were no fatalities during or immediately following surgery. One patient developed transient duodenal stenosis after DPPHR. The 5-year survival rate after surgical resection was 68.4% for the 17 patients with malignant tumor. Mucus leaked from the pancreatic duct into the operating field of 1 patient during pancreatectomy. This patient died 7 months after surgery from a tumor metastasis of the thoracic mediastinal lymph nodes and peritoneal seeding. This episode illustrates the high risk associated with leakage of pancreatic duct mucus into the operating field. The longest surviving patient, 13 years and 11 months after total pancreatectomy, has good health and shows no signs of recurrence. CONCLUSIONS: The prognosis for surgically resectable mucin-producing pancreatic tumors is better than that for invasive pancreatic duct carcinoma. When treating mucin-producing pancreatic tumors surgically, techniques which allow preservation of pancreatic and gastroenteric functions should be selected when possible. These techniques include PPPD, DPPHR and pancreatic segmentectomy. A total pancreatectomy should only be selected in cases where cancer has invaded the entire pancreas (especially when cancer has invaded the duct within the pancreatic head, through the tail). It may also be used when residual cancer cells have been detected by intra-operative pathological examination at the distal stump of the pancreas. During surgery with any technique, leakage of pancreatic duct mucus into the operating field must be avoided.

Adenocarcinoma, Mucinous↗

PubMedDate not supplied

Prospective randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C for non-resectable pancreatic and biliary carcinoma: multicenter randomized trial.

BACKGROUND/AIMS: The efficacy of combination chemotherapy, which consists of fluorouracil, doxorubicin and mitomycin, was compared with that of palliative surgery-only in patients (control) having non-resectable pancreatic and biliary carcinomas in a multicenter randomized trial. METHODOLOGY: The patients were assigned to combination chemotherapy consisting of concomitant 5-fluorouracil 200 mg/m2, doxorubicin 15 mg/m2, and mitomycin 5 mg/m2 by intravenous administration. This combination chemotherapy was given concurrently as the initial dose within 1 week after palliative operation, and this regimen was repeated for at least 2 whole courses at 4-week intervals before the next course of therapy. Forty-two cases of this combination chemotherapy group and 41 of the control group were completely eligible for analysis. RESULTS: Regarding the overall 50% inhibition of tumor progression and that of gallbladder carcinoma, there were significantly better outcomes in the modified FAM therapy group. In this group, tumor reduction was achieved in 1 complete response (CR) and 2 partial response (PR) patients. With respect to the overall and differentiated survival times according to the tumor sites and the clinical efficacy, there was no difference between the groups. The most frequent adverse reactions were gastrointestinal manifestations such as anorexia, nausea, vomiting, and diarrhea; also noted was alopecia. CONCLUSIONS: Since this combination chemotherapy inhibited the tumor progression for significantly longer duration and, to a lesser extent, reduced the tumor size in non-resectable gallbladder carcinomas compared to a non-administrated chemotherapy group, this study will function as the basis for pursuing a more effective chemotherapy.

Adult↗

PubMedDate not supplied

Pancreatic duct patency after pancreaticogastrostomy: long-term follow-up study.

BACKGROUND/AIMS: To clarify whether the pancreatic duct remains patent during long-term follow-up of patients after pancreaticogastrostomy. In a previous study of pancreaticogastrostomy with post-operative follow up for 3 years after surgery, we found that the orifice of the pancreatic duct was difficult to detect in some patients because of swelling of the gastric mucosa. Previous studies have not examined pancreatic duct patency during long-term follow-up. METHODOLOGY: Between July 1985 and August 1989, 20 patients underwent a pylorus-preserving pancreaticoduodenectomy with reconstruction by pancreaticogastrostomy. Five of these patients were followed up post-operatively for more than 9 years to determine the patency of the pancreatic duct. All pancreatic anastomoses were performed by the telescopic method. RESULTS: All 5 patients were female, with a mean age of 65.4 years (range: 54-75). Median post-operative follow-up was 10.8 years (range: 9-12). The indications for surgery were carcinoma of the ampulla of Vater in 4 patients and chronic pancreatitis in 1 patient. Pancreatic duct patency was confirmed in 4 patients by gastroscopy and pancreatography. However, the anastomotic orifice could not be detected in the remaining patient because of complete coverage by the gastric mucosa. In this patient, pancreatic exocrine and endocrine function deteriorated with dilation of the distal pancreatic duct. The patient underwent a second operation involving dissociation of the pancreatico-gastric anastomosis and resection of about 1 cm of the fibrous, proximal portion of the pancreas. Reconstruction was performed with a Roux-en-Y pancreaticojejunostomy and a mucosa-to-mucosa anastomosis. CONCLUSIONS: Although pancreaticogastrostomy has been applied as a safe and straightforward method for reconstruction after pancreaticoduodenectomy, anastomotic stenosis is a potential late complication of this approach.

Aged↗