Shuhei Ikeda

Closure of the Distal Pancreatic Stump with a Seromuscular Flap

We describe herein our new method for transecting the pancreas and closing its stump in distal pancreatectomy, devised to decrease the risk of pancreatic fistula formation. With this technique, the pancreas is transected in such a way that a convex stump is left, whereby the pancreatic secretions from the parenchyma near the pancreatic stump are fully drained into the main pancreatic duct. A pedicled seromuscular flap of the stomach or jejunum is then used to cover the cut surface of the pancreas. This new technique provides tight closure of the pancreatic stump after distal pancreatectomy.

The inclusion of an omental flap in pancreatoduodenectomy

A technique for reducing the morbidity and mortality of pancreatoduodenectomy by using an omental flap to protect the anastomoses and splanchnic vessels exposed during dissection is described herein.

Combination gastric seromuscular patch and omental pedicle flap for bronchial fistula

We report the successful closure of a recurrent bronchial fistula using a combination gastric seromuscular patch and omental pedicle flap. This new method provided an immediate airtight closure of the bronchial fistula. This technique appears superior to closure by omentum alone.

Pedicled jejunal seromuscular flap for bronchocutaneous fistula

We report the successful closure of a complicated bronchocutaneous fistula using a pedicled jejunal flap. The fistula, secondary to tuberculosis and irradiation, previously had been closed with a latissimus dorsi musculocutaneous flap. This initial repair failed. The recurrent fistulas were closed again using a jejunal seromuscular flap, and the chest wall defect was reconstructed with a rectus abdominis musculocutaneous flap.

Case Report: Hepatic adenoma with bone marrow metaplasia in a patient with glycogen storage disease type 1a

A 34 year old man with glycogen storage disease type 1a had two hepatic tumours since 18 years of age. They had continued to grow until he was 24 years old, but showed no further growth since then. He underwent a right hepatic trisegmentectomy with caudate lobectomy under veno‐venous bypass. The tumour in the posterior segment showed nodule‐within‐nodule appearance. Histologically, the inner adenoma with dysplasia, bone marrow metaplasia and lymphocytic infiltration was separated by a fibrous band from the outer adenoma of usual histology.

Hepatocellular carcinoma invading the duodenum: combined resection of the lateral duodenum and repair with a pedicled gastric flap

A 57-year-old man presented with gastrointestinal bleeding from duodenal invasion by hepatocellular carcinoma. He underwent an extended right hepatic lobectomy with resection of the lateral duodenum.