Biomedical subjects

K Takada

Publications and source records attributed to K Takada.

1,046 records · Page 59Linked to original sources

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

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.

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