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Biomedical subjects

K Suruga

Publications and source records attributed to K Suruga.

At least 55 records · Page 3Linked to original sources
PubMed1982

Reoperation in the treatment of biliary atresia.

Rehepatic-portoenterostomy and curettage were performed as reoperative procedures for treatment of biliary atresia. In cases of rehepatic-portoenterostomy, microsurgical technique is an important factor in order to obtain satisfactory operative results. The indication for rehepatic-portoenterostomy, the age of the patient, the size of the intrahepatic bile ducts at the porta hepatis area, the degree of liver fibrosis and liver cell change are closely related to the prognosis of rehepatic-portoenterostomy cases. Since 1977, all seven cases who underwent rehepatic-portoenterostomy showed bile excretion and at present, 3 out of 7 have no jaundice. Curettage is an effective treatment for cessation of bile flow in cases which underwent hepatic portoenterostomy and showed bile excretion for a certain period postoperatively. The timing of curettage is closely related to the results of the curettage. In 9 out of 17 cases which received curettage, we were able to obtain fairly good bile flow and at present, 4 out of 9 show no jaundice.

Bile↗
PubMed1981

Experimental model of infantile obstructive cholangiopathy using 1,4-phenylenediisothiocyanate.

Inflammatory processes on the hepato-biliary system may play an important role in the pathogenesis of infantile obstructive cholangiopathy (including biliary atresia, neonatal hepatitis and bile duct dilatation). A model of the disease was produced in rats using 1,4-phenylenediisothiocyanate (P.D.T.) P.D.T. was given to five groups of rats of different developmental stages from the fetal stage. Changes in the hepato-biliary system due to P.D.T. were compared histo-pathologically in 97 rats. Three groups of rats given P.D.T. after birth showed characteristic dilatation of the extrahepatic bile ducts with inflammation. One group of rats given P.D.T. during the fetal period showed thickening and fibrosis of the wall of the extrahepatic bile ducts without dilatation. The last group of rats given P.D.T. during the fetal period and again at thirty days postnatally showed stenosis or almost atresia of the ductal lumen due to severe fibrosis and thickening of the extrahepatic bile ducts. This experimental model suggests that the difference in developmental stages of the pathogenic processes may play an important role in the production of different pathogenic features of infantile obstructive cholangiopathy.

Animals↗
PubMed1981

Treatment of biliary atresia: a study of our operative results.

The operative results in 87 biliary atresia cases were investigated from the aspect of the histologic findings in the liver and the remnant of the extrahepatic bile ducts, and the details of the operative procedures. The degree of liver fibrosis, the liver cell changes, and the type of extrahepatic bile ducts are closely related to our operative results. Our operative results have been improving since 1977 due to the advancement of microsurgical techniques and a new type of operative procedure for prevention of ascending cholangitis. Twenty-five of 29 cases (86.2%) surgically corrected are alive, showing bile excretion, and are in a satisfactory general condition.

Bile Ducts↗
PubMed1981

"The choledocho-pancreatic long common channel disorders" in relation to the etiology of congenital biliary dilatation and other biliary tract disease.

The amylase level of bile and various cholangiograms was studied in 36 cases of congenital biliary dilatation. (C.B.D.) The amylase level above 10000 U/L was considered to suggest the existence of choledocho-pancreatic long common channel formation. Radiologically, the dilatation of intrahepatic bile duct was seen in 9 out of 19 (47%) Type I cases and in all (100%) Type II cases. The cystic dilatation of intrahepatic bile duct was seen in all Type I cases which have cystic choledochal dilatation. On the other hand, fusiform dilatation was seen in all Type II cases with fusiform choledochal dilatation. End to side Choledocho-pancreatic anastomosis was performed to produce an experimental model of human choledocho-pancreatic long common channel disorders, thus leading to the dilatation of the common bile duct as well as the reflux of pancreatic juice into the bile duct. The reflux of Pancreatic juice and congenital stricture due to the choledocho-pancreatic long common channel formation were considered to be the important causative factors in the etiology of C.B.D.. Furthermore, pathology of the choledocho-pancreatic long common channel disorders was found to be important in relation to the etiology of both C.B.D. and other lesions of the biliary tract and pancreas.

Adolescent↗
PubMed1980

A clinicopathologic study of choledochal cyst.

Choledochal cyst is quite common in Japan. The etiology of this lesion is not clear, and there remain problems in its treatment as well. Radiologic investigation of the distal common bile and pancreatic ducts was performed by operative cholangiography and endoscopic retrograde cholangiopancreatography. Anomalies at the junction of these ducts were found in all of the patients. Localilzed cystic dilatation of the extra-hepatic bile ducts without intrahepatic bile duct dilatation was produced experimentally by ligation of the distal choledochus in infant rats. Concerning the etiology, we agree with Babbitt's hypothesis that weakness of the choledochal wall is produced by reflux of pancreatic juice via an anomalous choledochopancreatic junction. We think that the stenosis associated with this anomaly is the critical factor. From our follow-up study of 30 cases, we find excision of the cyst to be the most important part of treatment. Choledochal cysts presenting under 6 months of age had clinical symptoms and pathology similar to biliary atresia.

Age Factors↗
PubMed1980

A histopathologic study of the region of the ampulla of Vater in congenital biliary atresia.

A histopathologic investigation of the duodenal wall and adjacent tissues in the vicinity of the papilla of Vater was performed in 37 autopsied cases of congenital biliary atresia which were treated in the Department of Pediatric Surgery of the Juntendo University Hospital during the past 11 years. A high incidence of the association of a congentially abnormal junction of the common bile duct and pancreatic duct, that is, a long common channel and a poorly developed sphincter musculature, were found in congenital biliary atresia. This suggests the possibility that reflux of pancreatic juice into the biliary system, followed by nonsuppurative chronic inflammation of bile ducts, may ultimately lead to the obstructive cholangiopathy seen in biliary atresia.

Ampulla of Vater↗
PubMed1979

Abnormal choledocho-pancreatico ductal junction related to the etiology of infantile obstructive jaundice diseases.

According to our current radiologic, histopathologic, and experimental studies, the congenital stenosis associated with anomalous choledocho-pancreatico ductal junction is considered to be the most important etiologic factor in congenital biliary dilatation. Furthermore, the possibility of pancreatic juice reflux into the biliary tract due to the abnormal choledocho-pancreatico ductal junction, which could lead to obstructive cholangiopathy, was suggested in relation to the pathogenesis of congenital biliary atresia.

Animals↗
PubMed1977

A histopathological study of the remnant of extrahepatic bile duct in so-called uncorrectable biliary atresia.

Histopathological study of the remnant of extrahepatic bile ducts in 40 cases of so-called uncorrectable biliary atresia, upon which we operated the last three years, has been performed. The histological findings of the remnant were classified into three types. Only two cases were found to have type 1a ducts in the porta hepatis area, from which we can expect better prognosis postoperatively. We also found that as the patients become older, the size of the duct in the remnant becomes smaller and the hepatic fibrosis becomes more remarkable. Therefore the operation should be performed in the infant with this lesion as young as possible. As for the evaluation of operative results of hepatic portoenterostomy for this lesion, a proper evaluation can be made only in those cases in which a microscopic examination of the remnant of extrahepatic bile duct at the porta hepatis area has been adequately performed. Concerning the pathogenesis of biliary atresia, we presume that congenital abnormalities of bile ducts are a basic factor, and additional nonspecific inflammation and bile stasis complete its pathological condition.

Age Factors↗
PubMed1976

Treatment of biliary atresia: microsurgery for hepatic portoenterostomy.

Microsurgery was used for hepatic portoenterostomy as the treatment of biliary atresia in 46 patients whom we treated since 1972. The microscope had a higher power (eight or ten times) magnification. As for the results of the operative procedure with the microscope, of 46 patients, 32 (70 percent) showed satisfactory bile flow postoperatively.

Common Bile Duct↗
PubMed1975

Bone changes in congenital biliary atresia. Radiologic observation of 8 cases.

In reviewing 38 cases of biliary atresia, 8 cases were detected to have osseous abnormalities. We found definite generalized demineralization of bones in 3 cases, metaphyseal abnormalities in 5 cases, and fractures in 4 cases. Marked demineralization of bones was seen in cases in which the clinical course was more than 1 year. No good correlation was observed between osseous changes and severity of liver dysfunction.

Bile Ducts↗