Transition of serum cytokines following pancreaticoduodenectomy: A subsidiary study of JAPAN‑PD

Maeda, Hiromichi; Okada, Ken-ichi; Fujii, Tsutomu; Oba, Mari S.; Kawai, Manabu; Hirono, Seiko; Kodera, Yasuhiro; Sho, Masayuki; Akahori, Toshikazu; Shimizu, Yasuhiro; Ambo, Yoshiyasu; Kondo, Naru; Murakami, Yoshiaki; Ohuchida, Jiro; Eguchi, Hidetoshi; Nagano, Hiroaki; Sakamoto, Junichi; Yamaue, Hiroki

doi:10.3892/ol.2018.9422

Cited by 3 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have previously summarized the clinical variables of these patients. 12 The tumor characteristics, operation variables, and patient characteristics were similar between the two groups. However, the mean age of the patients was slightly higher in the TJ-100 group than that of the Placebo group (64.9±8.0 vs 65.1±11.4, p=0.004, t -test).…”

Section: Resultsmentioning

confidence: 79%

See 1 more Smart Citation

<p>No Significant Effect of Daikenchuto (TJ-100) on Peritoneal IL-9 and IFN-γ Levels After Pancreaticoduodenectomy</p>

Maeda

Okada

Fujii

et al. 2020

CEG

Self Cite

View full text Add to dashboard Cite

Aim and Background TJ-100 is a traditional Japanese medicine that affects inflammation and gastrointestinal motility, and is used as a preventive and treatment for paralytic ileus. This study aims at determining the effect of TJ-100 on the peritoneal levels of IFN-γ/IL-9, cytokines related to ileus, after pancreaticoduodenectomy (PD) in a clinical setting. Methods This was a subsidiary study of the clinical trial investigating the effect of TJ-100 on postoperative bowel function. Ascites was collected from 180 patients using an abdominal drainage tube on postoperative day 1 and 3 after PD (POD 1 or POD 3) and used to measure 27 cytokines. We performed univariate and multivariate analyses using several perioperative variables and administration of TJ-100/placebo to determine the effect of TJ-100 on the levels of IFN-γ and IL-9. Results Peritoneal levels of IL-9 and IFN-γ decreased between POD 1 and 3 (Wilcoxon signed-rank test p<0.001). Multivariate analysis was performed after univariate analysis to select the variables and patients with a body mass index of ≥22 kg/m 2 , older age, use of epidural anesthesia, and longer surgery correlated with the levels of IL-9 and IFN-γ. However, we could not detect a correlation between the use of TJ-100 and cytokine levels in ascites either on POD 1 or 3. Conclusion TJ-100 did not affect peritoneal IL-9 and IFN-γ levels after PD. This was in accordance with published clinical findings showing no improvement in bowel function after PD and TJ-100 treatment.

show abstract

Section: Resultsmentioning

confidence: 79%

“… 11 Nevertheless, TJ-100 regulated the serum levels of interleukin (IL)‑4, IL‑9, IL‑10, PDGF-BB, and TNF-α in patients without severe inflammation. 12 This suggests that TJ-100 exerts its effects under specific conditions that should be further studied in the future.…”

Section: Introductionmentioning

confidence: 99%

<p>No Significant Effect of Daikenchuto (TJ-100) on Peritoneal IL-9 and IFN-γ Levels After Pancreaticoduodenectomy</p>

Maeda

Okada

Fujii

et al. 2020

CEG

Self Cite

View full text Add to dashboard Cite

show abstract

“…It can thus be speculated that proteases in pancreatic juice are likely to be activated into active forms under a high serum CRP environment. PD is known as one of the representative surgical procedures that often bring about highly inflammatory stress without infection 30 . Intra‐abdominal infection and markedly elevated CRP (which is suggestive of a highly inflammatory status) can affect each other and may form a vicious cycle to worsen the other.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding study limitation (c), elevation of CRP may be suppressed by markedly exaggerated stress, which has been reported to induce an anti‐inflammatory response 30 . A recent study that demonstrated a benefit of perioperative steroid use in patients undergoing PD showed that the use of steroid significantly reduced the highest value of CRP in the early postoperative period 31 .…”

Section: Discussionmentioning

confidence: 99%

Prophylactic drain management after pancreaticoduodenectomy without focusing on the drain fluid amylase level: A prospective validation study regarding criteria for early drain removal that do not include the drain fluid amylase level

Taniguchi

Matsuyama

Yabushita

et al. 2020

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

Background/Purpose: Early drain removal (EDR) based on drain fluid amylase level (DFA) after pancreaticoduodenectomy excluded 15%-40% patients from EDR because of inappropriate DFA. Methods: Of 198 pancreatoduodenectomy cases, we used the first 105 cases as an exploration cohort to construct the optimal criteria for EDR on postoperative day (POD)4 that were applied to the subsequent 93 cases used as the validation cohort. After that, we examined another 142 patients to further assess the efficacy of the new EDR criteria. Results: Of the four independent predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) ([1] soft pancreas, [2] positive drain fluid culture on POD1, and [3] serum C-reactive protein [CRP] ≥13 mg/dL on POD4) in the exploration cohort, EDR was applied to cases in the validation cohort meeting the [2] and/or [3], enabling 96% (89/93) applicability of EDR. Outcomes were improved in the validation cohort compared to the exploration cohort; CR-POPF: 8.6% vs 25.7%, P = .005; Dindo-Clavien grade ≥ 3 complications: 23.7% vs 41.9%, P = .007; and median hospital stay (day): 21 vs 27, P = .005. The subsequent 142 patients showed 92% (131/142) applicability of EDR and 5.6% (8/142) incidence of CR-POPF. Conclusions: Our new criteria for EDR, without DFA, enabled ≥ 90% applicability of EDR and reduced CR-POPF. K E Y W O R D S clinical outcomes, criteria, early drain removal, pancreaticoduodenectomy, postoperative pancreatic fistula | 951 TANIGUCHI eT Al. How to cite this article: TaniguchiK, Matsuyama R, Yabushita Y, et al. Prophylactic drain management after pancreaticoduodenectomy without focusing on the drain fluid amylase level: A prospective validation study regarding criteria for early drain removal that do not include the drain fluid amylase level.

show abstract

“…Accordingly, a meta‐analysis of DKT was conducted. As shown in Table 2, previous studies by RCTs and meta‐analysis on DKT have been reported [17, 20–60]. These studies are categorized according to the underlying disease and the targeted condition, and the main ones are described below.…”

Section: Clinical Applications and Clinical Trialsmentioning

confidence: 99%

A review of frequently used Kampo prescriptions part 1. Daikenchuto

Namiki

Hoshino

Egashira

et al. 2022

Traditional & Kampo Medicine

View full text Add to dashboard Cite

Background The original formula name for daikenchuto (DKT) was written in ‘Jin Gui Yao Lue (Kinkiyōryaku in Japanese)’. DKT as used in Japan consists of four types of crude drug. Key findings Although there are few examples of its use in Chinese classical records, it has begun to be used extensively in modern Japan for intestinal obstruction after laparotomy. Furthermore, to prove its usefulness, many clinical trials on DKT for intestinal obstruction have been conducted since the 1990s. Although the efficacy of DKT in preventing or improving intestinal obstruction was controversial, a meta‐analysis of nine studies reported in recent years showed that DKT significantly reduced the incidence of intestinal obstruction after gastrointestinal cancer surgery, suggesting its effectiveness. Related knowledge of irritable bowel syndrome has also been accumulated through case reports. DKT has been shown to be involved in the promotion of gastrointestinal motility, inhibition of excessive gastrointestinal motility, secretion of gastrointestinal hormones, and improvement of gastrointestinal blood flow, and to have anti‐inflammatory effects. In addition to drug rash, serious adverse events include hepatic dysfunction and interstitial pneumonia, but there have been relatively few reports. Conclusion DKT has been used in many cases in Japan, but it is often used without considering the ‘pattern (shō)’. Since it was originally formulated for the treatment of chills (hie), it would be more effective if its target (pattern) were taken into consideration. Overall, DKT is a safe prescription with a wide range of applications.

show abstract

Transition of serum cytokines following pancreaticoduodenectomy: A subsidiary study of JAPAN‑PD

Cited by 3 publications

References 26 publications

<p>No Significant Effect of Daikenchuto (TJ-100) on Peritoneal IL-9 and IFN-γ Levels After Pancreaticoduodenectomy</p>

<p>No Significant Effect of Daikenchuto (TJ-100) on Peritoneal IL-9 and IFN-γ Levels After Pancreaticoduodenectomy</p>

Prophylactic drain management after pancreaticoduodenectomy without focusing on the drain fluid amylase level: A prospective validation study regarding criteria for early drain removal that do not include the drain fluid amylase level

A review of frequently used Kampo prescriptions part 1. Daikenchuto

Contact Info

Product

Resources

About