Arteriovenous fistula （AVF） involving the inferior mesenteric vessels is rare, and the affected patients usually present with abdominal pain, mass, or features of established portal hypertension. Colonic ischemia is...Arteriovenous fistula （AVF） involving the inferior mesenteric vessels is rare, and the affected patients usually present with abdominal pain, mass, or features of established portal hypertension. Colonic ischemia is a less common and more serious manifestation of AVE We report a case of ischemic colitis secondary to inferior mesentedc AVF in a patient who underwent a previous liver transplantation, subsequently developed portal vein stenosis, and then presented with acute lower gastrointestinal bleeding. He underwent percutaneous transhepatic placement of a portal vein stent and left colectomy.展开更多
The ideal surgery for pancreatic head cancer is isolated pancreatoduodenectomy(PD);that is,en bloc resection using a non-touch isolation technique.We have been developing isolated PD for pancreatic cancer since 1981,w...The ideal surgery for pancreatic head cancer is isolated pancreatoduodenectomy(PD);that is,en bloc resection using a non-touch isolation technique.We have been developing isolated PD for pancreatic cancer since 1981,when we developed an antithrombogenic bypass catheter for the portal vein.In this operation,the first and most important step is the use of a mesenteric approach instead of Kocher’s maneuver.The mesenteric approach allows dissection from the non-cancer infiltrating side and determination of cancer-free surgical margins and resectability,followed by systemic lymphadenectomy around the superior mesenteric artery.This approach enables early ligation of the inferior pancreatoduodenal artery and mesopancreas excision.The mesopancreas is the second portion of the pancreatic head nerve plexus.Isolated PD is the ideal surgery for pancreatic head cancer from both surgical and oncological viewpoints.In patients with resectable pancreatic head cancer,isolated PD using the mesenteric approach is suspected to have a higher survival rate than conventional PD using Kocher’s maneuver.The precise surgical techniques of the mesenteric approach are herein described.展开更多
基金A grant from the National R & D Program for Cancer Control,Ministry of Health & Welfare,Republic of Korea, No.0620220-1
文摘Arteriovenous fistula （AVF） involving the inferior mesenteric vessels is rare, and the affected patients usually present with abdominal pain, mass, or features of established portal hypertension. Colonic ischemia is a less common and more serious manifestation of AVE We report a case of ischemic colitis secondary to inferior mesentedc AVF in a patient who underwent a previous liver transplantation, subsequently developed portal vein stenosis, and then presented with acute lower gastrointestinal bleeding. He underwent percutaneous transhepatic placement of a portal vein stent and left colectomy.
文摘The ideal surgery for pancreatic head cancer is isolated pancreatoduodenectomy(PD);that is,en bloc resection using a non-touch isolation technique.We have been developing isolated PD for pancreatic cancer since 1981,when we developed an antithrombogenic bypass catheter for the portal vein.In this operation,the first and most important step is the use of a mesenteric approach instead of Kocher’s maneuver.The mesenteric approach allows dissection from the non-cancer infiltrating side and determination of cancer-free surgical margins and resectability,followed by systemic lymphadenectomy around the superior mesenteric artery.This approach enables early ligation of the inferior pancreatoduodenal artery and mesopancreas excision.The mesopancreas is the second portion of the pancreatic head nerve plexus.Isolated PD is the ideal surgery for pancreatic head cancer from both surgical and oncological viewpoints.In patients with resectable pancreatic head cancer,isolated PD using the mesenteric approach is suspected to have a higher survival rate than conventional PD using Kocher’s maneuver.The precise surgical techniques of the mesenteric approach are herein described.
