Biomedical subjects

T Motohara

Publications and source records attributed to T Motohara.

40 records · Page 3Linked to original sources

PubMedDate not supplied

Solitary hepatocellular carcinoma fed by the cystic artery: limitation of transcatheter arterial embolization.

PURPOSE: To clarify the limitations of transcatheter treatment for hepatocellular carcinoma (HCC) with parasitic feeders from the cystic artery. METHODS: Three male patients had a solitary HCC (average diameter 3 cm) fed by the cystic artery among 221 patients with HCC from 1994 to 1997. One tumor was nourished entirely from the cystic artery arising from the medial branch of the left hepatic artery, and two tumors were fed partially by the cystic arteries arising from the anterior inferior branch of the right hepatic artery. We analyzed the indications for transcatheter treatment for these three patients. RESULTS: We chose not to embolize the cystic artery for fear of necrosis of the gallbladder. Although embolization of the anterior branch of the right hepatic artery was performed in one patient with a tumor fed partially by the cystic artery, only half the tumor was embolized. Two patients underwent hepatic resection, and one received percutaneous ethanol injection therapy. At follow-up of 28-40 months (average 33 months) all patients are alive. CONCLUSION: Feeding by the cystic artery represents a limitation of TAE for HCC.

Adult↗

PubMedDate not supplied

Interventional radiologic treatment for idiopathic portal hypertension.

PURPOSE: To evaluate the usefulness of interventional radiological treatment for idiopathic portal hypertension. METHODS: Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of whom had refused surgery and one of whom had undergone surgery. Three patients with gastroesophageal varices (GEV) were treated by partial splenic embolization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one patient with GEV by percutaneous transhepatic obliteration (PTO). Midterm results were analyzed in terms of the effect on esophageal and/or gastric varices. RESULTS: In one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight reduction of the EV was obtained with one application of PSE combined with endoscopic variceal ligation therapy. PTO for GV in one patient resulted in good control of the varices. All patients have survived for 16-42 months since the first interventional treatment, and varices are well controlled. CONCLUSION: Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery.

Adult↗

PubMedDate not supplied

Two cases of esophageal cancer with portal hypertension: esophagectomy with venous shunt procedure.

We performed venous shunt procedure in the reconstruction of the esophagus after esophagectomy using the gastric tube in two cases of esophageal cancer with portal hypertension due to liver cirrhosis. In both cases, the short-term postoperative course was uneventful, without congestion in the gastric tube. In Case 1 where the short gastric vein had been used as the shunt vein, the long-term postoperative course was also uneventful, without hepatic encephalopathy or hemorrhage from deterioration of the varices of the gastric tube. However, in Case 2 where the left gastroepiploic vein had been used, hepatic encephalopathy developed due to excessive shunt flow. These results suggested that appropriate shunt flow could be expected by using short gastric vein.

Esophageal Neoplasms↗

PubMedDate not supplied

Duodenum-preserving resection of the head of the pancreas--modified procedures and long-term results-.

BACKGROUND/AIMS: Relief of chronic pancreatitis can be accomplished surgically or with medication. Surgical treatment of pancreatitis should preserve the endocrine and exocrine function of the pancreas. This paper details the results of our modified procedure for resecting the head of the pancreas. The advantage of this procedure is small resection, preservation of endocrine and exocrine function, complete relief of pain by the pancreatic duct drainage and maintenance of function of the duodenum and bile duct. PATIENTS AND METHODS: Duodenum-preserving resection of the pancreatic head with denervation of the body and tail of the pancreas was performed in 41 patients with severe chronic pancreatitis. RESULTS: Mortality after a median follow-up period of 36 months was 2.4%. Complete relief or alleviation of pain were found in 92% of patients and any other patients of recurrent pain due to postoperative pancreatitis was not found. Eighty-seven percent of patients had maintained more than preoperative body weight. Postoperative glucose tolerance was unchanged in 88% of patients. After long-term follow-up postoperative exocrine function had been maintained at preoperative condition. CONCLUSIONS: Our procedure can maintain endocrine and exocrine function of the pancreas, relieve pain well and prevent pain due to recurrent pancreatitis.

Adult↗