Greetings
At the Department of Gastroenterological Surgery II, advanced surgical care is provided to treat diseases of particularly the stomach, esophagus, biliary tract and pancreas among the digestive organs.We specifically often perform extended radical surgery (resection that extends as widely as possible to achieve a cure) for highly advanced cancer, and endoscopic surgery (performed using a camera passed through a small hole) for esophageal cancer, stomach cancer and some other diseases of the biliary tract and pancreas. We have already started robotic surgery for stomach cancer. Recently We have also performed laparoscopic sleeve resection of the stomach as metabolic surgery for patients with severe obesity and diabetes mellitus.
Outline
Characteristics of our department
In the esophageal and gastric surgery field, surgeons certified by the Japan Society for Endoscopic Surgery perform minimally invasive, safe and radical endoscopic surgery. Surgical treatment for esophageal cancer involves thoracoscopic esophagectomy, which is performed in all cases, including salvage surgery after chemoradiotherapy. For stomach cancer, laparoscopic surgery is performed in almost all cases excluding highly advanced cancer.Our hospital is one of Japan’s foremost medical facilities in the biliary tract and pancreas field, and highly complicated surgery of highly advanced cancer is performed. We apply independently developed operative procedures and our advanced skills to actively perform surgery even for bile duct cancer and progressive pancreatic cancer, which used to be considered unresectable, and patients who have already undergone chemotherapy and radiation therapy.
Treatment policy
Concerning the surgical procedures we perform, we place emphasis on minimizing the impact on patients’ postoperative quality of life (QOL) without adversely affecting safety and curability (complete resection of lesion).To this end, accurate preoperative diagnosis is performed in cooperation with Internal Medicine, Radiology, Pathology and other clinical departments to maximize the effectiveness of endoscopic surgery (performed with the use of a camera).
Even in highly invasive surgery (with a high physical burden), we ensure safety and achieve early postoperative recovery and social reintegration in collaboration with many other clinical departments.
Area of medical care
The major target diseases are as follows:Biliary tact/pancreas diseases
- Intrahepatic bile duct cancer (cholangiocarcinoma)
- Bile duct cancer, gallbladder cancer, duodenum papilla cancer
- Pancreatic cancer, other pancreatic tumors
- Malfusion of the pancreaticobiliary duct, pancreatic injury
- Cholelithiasis (intrahepatic calculosis)
- Gastroenteropancreatic neuroendocrine tumor (GEP-NET)
Gastrointestinal diseases
- Esophageal cancer, other esophageal diseases
- Stomach cancer, GIST (mesenchymal tumor), other stomach diseases
- Duodenal cancer
Others
Severe obesity with diabetes mellitusConsultation days/hours
- General outpatient clinic
Tuesdays and Thursdays: from 9:30 a.m. (only mornings for first-visit patients)
Esophageal and gastric diseases clinic: Monday through Friday, 9:30 a.m. – noon (only first-visit patients) - Surgery
Mondays, Wednesdays and Fridays
Special time is made for surgery of patients seen at the emergency department of our hospital as needed.
Major tests and equipment
Tests and procedures
Abdominal ultrasonography, reserve liver function tests, cholangiography, bile duct endoscopy, pancreatic function test, biliary drainage, gastrointestinal series, bronchoscopy, X-rays, etc.Equipment
Ultrasonic diagnostic equipment, endoscopic diagnostic equipment, blood gas analyzer, blood sodium/potassium measuring equipment, patient monitoring equipment, artificial respiratorMedical care results
Diverse surgical procedures are performed on a daily basis. Common surgical procedures performed at our department are as follows:- Surgery of biliary tract cancers (bile duct cancer, gallbladder cancer, intrahepatic bile duct cancer)
Hepatectomy with combined vascular resection is widely performed with favorable outcomes in many cases. - Pancreatectomy after chemotherapy for pancreatic cancer
Surgery is performed in cases in whom chemotherapy (radiation therapy) over a long period of time has been successful enough to allow resection, which had been regarded impossible at the time of diagnosis. - Distal pancreatectomy with en-bloc celiac axis resection
Resection with combined vascular resection is performed in cases of pancreatic body cancer that used to be unresectable. - Duodenum/biliary tract-conserving pancreas head resection
Minimal pancreatectomy is performed for benign/low malignant potential pancreatic head tumors. - Endoscope-assisted esophagectomy
Surgery for esophageal cancer using endoscopes in the chest and the abdomen - Laparoscopic gastrectomy
Gastrectomy with a minimal surgical wound using an endoscope for gastric cancer - Laparoscopic sleeve gastrectomy (LSG) as bariatric surgery
