Background Pancreas transplantation (PT) is a radical treatment for diabetes mellitus (DM). Although the results of PT have been improving, surgical complications remain. Few reports have focused on complications associated with pancreatic fluid (CAPF) after PT. We aimed to investigate the risk factors and predictors for CAPF after PT. Methods Sixty‐nine patients, who underwent deceased‐donor PT for type 1 DM at our institution from August 2001 to May 2020, were retrospectively studied. We identified CAPF from those with Clavien‐Dindo Classification ≥grade III and assessed risk factors by univariate and multivariate analyses using logistic regression. Results Twenty‐one (30.4%) patients had complications with Clavien‐Dindo Classification ≥grade III. Eleven (16.0%) patients were diagnosed with CAPF. Median serum pancreatic amylase (P‐AMY) levels with CAPF on postoperative day (POD)1 and POD2 were significantly higher than those without CAPF (P = .019 and P = .027, respectively). In multivariable analysis, serum P‐AMY levels on POD1 were an independent predictive factor for CAPF (odds ratio 1.83, 95% confidence interval 1.07‐3.14, P = .008). Conclusions Complications associated with pancreatic fluid after PT is associated with high serum P‐AMY in the early postoperative period. Serum pancreatic enzymes in the first few postoperative days after PT may be a significant predictive factor for CAPF.
A 73-year-old man underwent colonoscopy for an examination of anemia, which revealed a type 2 lesion on the anterior wall of rectum Ra-Rb. It was diagnosed as adenocarcinoma on biopsy. He had no history of parasitic disease, although he had lived in an area where Schistosoma japonicum used to be epidemic. Preoperative examination revealed no evidence of schistosomiasis, and laparoscopic-assisted abdominal perineal rectal amputation was performed. The pathological diagnosis was T3N0M0 Stage Ⅱ. However, Schistosoma japonicum eggs were found in the submucosa of the surrounding normal area. Schistosoma japonicum is a parasitic disease caused by Oncomelania hupensis nosophora with dermatitis, gastrointestinal symptoms, and cirrhosis in severe cases. Thanks to the eradication of Oncomelania hupensis nosophora, there have been no cases of infection in Japan since 1978. However, there have been several case reports in which Schistosoma japonicum eggs were found in pathological specimens of colorectal cancers since then. In the present case, Schistosoma japonicum eggs happened to be found in a resected rectal cancer specimen. We report the case, with a review of the literature.
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