RESUMEN
A 71-year-old man presented with the chief complaint of fecal occult blood. Based on imaging studies, the patient was diagnosed advanced rectal cancer. He received laparoscopic low anterior resection. Three months after the rectal cancer operation, upper gastrointestinal endoscopy revealed gastric cancer. The patient had a diagnosis of synchronous cancer of the rectum and stomach, and received laparoscopic distal gastrectomy. Two years after the rectal cancer operation, liver metastasis(S4)was detected and resected. Three years after the rectal cancer operation, esophageal cancer and laryngeal cancer were detected synchronously and chemoradiotherapy was performed. Five years after the rectal cancer operation, small intestinal cancer with infiltration of descending colon and esophagus cancer were detected synchronously. Small intestinal resection and Hartmann procedure were performed for small intestinal cancer. ESD was performed for esophageal cancer. Six years after the rectal cancer operation, FDG-PET showed the peritracheal lymph node metastasis, lumbar spine metastasis and local recurrence in the pelvis. Currently, systemic chemotherapy is undergoing. We report a rare case of synchronous- metachronous cancer of the rectum, stomach, pharynx, esophagus and small intestine.
Asunto(s)
Faringe , Neoplasias del Recto , Anciano , Esófago/patología , Humanos , Intestino Delgado/patología , Masculino , Pelvis/patología , Faringe/patología , Neoplasias del Recto/patología , Neoplasias del Recto/cirugía , Estómago/patologíaRESUMEN
A 76-year-old woman presented to the hospital with the colon prolapsing through the anus. The enhanced abdominal computed tomography(CT)showed intussusception of the sigmoid colon due to sigmoid colon cancer. It was difficult to reduce the intussusception, and we did not recognize the ileus and ischemic change of the colon. Therefore, we performed an elective surgery. Hartmann's procedure and lymph node dissection were performed 8 days after the hospitalization. The postoperative course was uneventful. We report a case of sigmoid colon cancer with intussusception prolapsing through the anus.
Asunto(s)
Obstrucción Intestinal , Intususcepción , Neoplasias del Colon Sigmoide , Femenino , Humanos , Anciano , Neoplasias del Colon Sigmoide/complicaciones , Neoplasias del Colon Sigmoide/cirugía , Neoplasias del Colon Sigmoide/patología , Intususcepción/etiología , Intususcepción/cirugía , Canal Anal/patología , Colon Sigmoide/patologíaRESUMEN
OBJECTIVES: This study aimed to investigate the validity of laparoscopic gastric cancer surgery in elderly patients. METHODS: A total of 202 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2007 and December 2016 were divided into an elderly group (age ≥75 years, n = 36) and a control group (age < 75 years, n = 166). The patients' clinicopathological data were reviewed. RESULTS: The overall morbidity rate was relatively higher in the elderly group (16.7 vs. 11.4%, p = 0.389), whereas the incidence of serious complications ≥grade III according to the Clavien-Dindo classification did not increase significantly in the elderly group (8.3 vs. 7.8%, p = 0.920). Univariate and multivariate analyses revealed that age ≥75 years was not a significant predictive factor of postoperative morbidity (p = 0.568). There was no significant difference in the 5-year overall survival rate of patients with pathological stage I gastric cancer between the groups (97.1 vs. 96.1%, p = 0.704; hazard ratio, 0.669; 95% confidence interval, 0.036-3.692). CONCLUSIONS: Laparoscopic gastrectomy has an acceptable morbidity rate in elderly patients, and the long-term outcome of patients with stage I gastric cancer was similar to that of the control group.
Asunto(s)
Gastrectomía/estadística & datos numéricos , Neoplasias Gástricas/cirugía , Factores de Edad , Anciano , Femenino , Gastrectomía/efectos adversos , Humanos , Japón/epidemiología , Masculino , Morbilidad , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patologíaRESUMEN
A 54-year-old man presented with melena and was conservatively monitored for duodenitis. He developed epigastric pain, and dynamic computed tomography revealed abnormal blood flow in the pancreatic head. The endoscopic retrograde cholangiography revealed that the common bile and pancreatic ducts were simultaneously enhanced, thereby indicating the perforation of an arteriovenous malformation into both ducts. Despite medical treatment, the epigastric pain rapidly worsened and therefore, pancreatoduodenectomy was performed. The present report suggests that if the patient's general condition permits, surgical resection should be actively considered for the treatment of symptomatic pancreatic arteriovenous malformation.
Asunto(s)
Malformaciones Arteriovenosas , Bilis , Páncreas/anomalías , Pancreaticoduodenectomía , Conducto Colédoco/patología , Humanos , Masculino , Persona de Mediana Edad , Conductos Pancreáticos/patologíaRESUMEN
BACKGROUND: Elderly patients have a high risk of adverse outcomes after surgery. Therefore, it is essential to determine the predictive factors for postoperative morbidity in elderly patients undergoing gastric cancer surgery. METHODS: A total of 544 patients who underwent elective gastrectomy for gastric cancer at Yodogawa Christian Hospital between January 2007 and December 2015 were divided into the elderly group (age ≥70 years, n=282) and a control group (age <70 years, n=262). Clinicopathological data from all patients were reviewed. RESULTS: The overall morbidity rates were 24.8% in the elderly group and 13.4% in the control group, indicating a significant difference (P<0.001). The incidence rates of anastomotic leakage (4.6% vs. 1.5%, P=0.039) and cardiovascular complications (2.5% vs. 0%, P=0.01) were significantly higher in the elderly group. A multivariate analysis revealed that a blood loss of ≥320 mL was an independent predictive factor of overall morbidity (P=0.004). A blood loss of ≥219 mL (P=0.025) and American Society of Anesthesiologists (ASA) physical status of 3/4 (P=0.006) were associated with anastomotic leakage and postoperative cardiovascular complications, respectively. CONCLUSIONS: The overall morbidity rate was significantly higher among elderly patients and an intraoperative blood loss of ≥320 mL was a significant predictive factor. In particular, anastomotic leakage and cardiovascular complications were seen with greater frequency among those with a higher blood loss volume and ASA physical status, respectively.
RESUMEN
The present study involved 6 patients who had urgent surgery for acute cholecystitis(AC)complicated with gallbladder cancer(GBC)in our hospital from January 2014 to December 2016. We analyzed the clinical outcome of early surgery for AC complicated with GBC. According to Tokyo Guidelines 2013, the AC severity was classified as Mild 1 case, Moderate 5 cases. Only one patient was diagnosed with GBC before the operation for AC. The others were during or after the laparoscopic cholecystectomy. Histopathologically, all patients had Stage II disease or greater. Two patients had adjunctive radical operation with the wedge resection of the gallbladder bed, lymphadenectomy and bile duct resection, and they survived without recurrence for 28 months and 12 months, respectively. Of the 3 patients without any additional surgery, 2 patients died in several months after the operation. In consideration of the concurrence of GBC, early surgery for AC must be decided carefully.
Asunto(s)
Colecistitis Aguda/etiología , Colecistitis Aguda/cirugía , Neoplasias de la Vesícula Biliar/complicaciones , Anciano , Anciano de 80 o más Años , Colecistectomía , Intervención Médica Temprana , Femenino , Neoplasias de la Vesícula Biliar/diagnóstico , Neoplasias de la Vesícula Biliar/cirugía , Humanos , Masculino , Persona de Mediana Edad , Estadificación de NeoplasiasRESUMEN
We report a case of pathologicallycomplete response in ruptured hepatocellular carcinoma(HCC)treated with transcatheter arterial embolization(TAE). A 56-year-old man presented to our hospital with a hepatic tumor. Enhanced computed tomography(CT)revealed a tumor 65mm in diameter at S7/8 of the liver and the presence of abdominal fluid collection around the tumor. We diagnosed rupture of HCC and selective TAE was subsequentlyperformed. After TAE, the elevated PIVKA- / â ¡ tumor marker level(1,008mAU/mL)decreased to the normal level. Three weeks after TAE, we performed right hepatectomy. The resected specimen revealed that the tumor consisted of necrotic tissue. Viable tumor cells were absent in this tumor. The pathological diagnosis was therefore HCC in which complete response was obtained with TAE.
Asunto(s)
Carcinoma Hepatocelular , Embolización Terapéutica , Neoplasias Hepáticas , Carcinoma Hepatocelular/terapia , Hepatectomía , Humanos , Neoplasias Hepáticas/terapia , Masculino , Persona de Mediana Edad , Rotura EspontáneaRESUMEN
OBJECTIVES: This study aimed to investigate the validity of gastric cancer surgery in elderly patients. METHODS: A total of 544 patients who underwent elective gastrectomy for gastric cancer were divided into an elderly group (age ≥75 years, n = 171) and a control group (age <75 years, n = 373). The clinicopathological data of the patients were reviewed. RESULTS: The overall morbidity rate (26.3 vs. 16.1%, p = 0.005) and the incidence rate of anastomotic leakage (6.4 vs. 1.6%, p = 0.003) were significantly higher in the elderly group. The proportion of patients who had severe complications (≥grade IIIa) was relatively higher in the elderly group (10.5 vs. 5.7%); however, the difference was not significant (p = 0.074). A stage-matched survival analysis revealed no significant differences between the groups (stage I: p = 0.978; stage II: p = 0.964; stage III: p = 0.199). For the pathological stages II and III, the overall survival of the patients in the elderly group who received adjuvant chemotherapy for >3 months was significantly better than that of the patients who received it for ≤3 months or did not receive it (p = 0.023). CONCLUSIONS: An aggressive treatment strategy should be adopted in selected elderly patients with gastric cancer.
Asunto(s)
Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/cirugía , Anciano , Quimioterapia Adyuvante/métodos , Femenino , Gastrectomía/métodos , Humanos , Masculino , Estadificación de Neoplasias/métodos , Neoplasias Gástricas/patología , Neoplasias Gástricas/terapia , Análisis de SupervivenciaRESUMEN
BACKGROUND: The Glasgow prognostic score (GPS) has been reported as a sensitive prognostic marker for gastric cancer. This study aimed to investigate whether the GPS is equally applicable to patients with early-stage and advanced-stage gastric cancers. METHODS: Patients (n = 544) who underwent elective gastrectomy for gastric cancer between 2007 and 2015 were retrospectively studied. GPSs of 2, 1, and 0 were allocated to patients with both an elevated C-reactive protein level (> 1.0 mg/dL) and hypoalbuminemia (< 3.5 mg/dL), patients with only one of these abnormalities, and patients with neither abnormality, respectively. The prognostic factors relevant to patients with early-stage (pStage I, n = 304) and advanced-stage (pStage II, III, and IV, n = 240) gastric cancer were analyzed through univariate and multivariate analyses. RESULTS: In the early-stage group, only the serum carbohydrate antigen (CA) 19-9 level (P = 0.037) was a significant prognostic factor in the multivariate analysis; the GPS was not significant (P = 0.095). In the advanced-stage group, an American Society of Anesthesiologists physical status of 3 or 4 (P = 0.032), elevated carcinoembryonic antigen (CEA) (P = 0.043) and CA19-9 (P = 0.045) levels, a GPS 1 - 2 (P = 0.017), and type 4 tumor (P = 0.020) correlated significantly with worse overall survival. CONCLUSIONS: GPS is a simple and useful prognostic score for patients with advanced-stage, but is not applicable to early-stage patients.
RESUMEN
A 69-year-old man with left upper abdominal pain visited our hospital. Abdominal CT revealed a hypovascular mass(66× 57mm)in the pancreatic tail. MRI revealed hemorrhage and cysts in the caudal lesion of the tumor. The tumor involved the posterior wallof the stomach. Based on a diagnosis of pancreatic tailcancer with gastric posterior wallinvasion, distalpancreatectomy and partialgastrectomy were performed. Histopathologicalexamination indicated 2 adjacent tumors through a capsule in the pancreas tail. These tumors were diagnosed as synchronous invasive ductal carcinomas of the pancreas, which were anaplastic and papillary carcinomas. We report a rare case of synchronous multi-centric invasive ductalcarcinomas of the pancreas.
Asunto(s)
Adenocarcinoma Mucinoso , Carcinoma Ductal Pancreático , Neoplasias Primarias Múltiples/cirugía , Neoplasias Pancreáticas/patología , Dolor Abdominal/etiología , Adenocarcinoma Mucinoso/complicaciones , Adenocarcinoma Mucinoso/cirugía , Anciano , Carcinoma Ductal Pancreático/complicaciones , Carcinoma Ductal Pancreático/cirugía , Humanos , Masculino , Invasividad Neoplásica , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/cirugíaRESUMEN
A 79-year-old man was admitted to our hospital because of a positive fecal occult blood test. Gastrointestinal endoscopy revealed a tumor in the duodenal bulb. Histologically, biopsy specimens indicated adenocarcinoma. The patient underwent distal gastrectomy. Histopathological examination showed a neuroendocrine carcinoma with an adenocarcinoma. According to the 2010WHO Classification of Tumours of the Digestive System, this case was diagnosed as mixed adenoneuroendocrine carcinoma(MANEC). There was no metastatic lesion in the resected lymph node. The patient has been followed up for 2 years without evidence of recurrence. We report a rare case of MANEC in the duodenum.
Asunto(s)
Adenocarcinoma/cirugía , Carcinoma Neuroendocrino/cirugía , Neoplasias Duodenales/patología , Neoplasias Duodenales/cirugía , Anciano , Gastrectomía , Humanos , Masculino , Resultado del TratamientoRESUMEN
A 63-year-old man was admitted to our hospital with a cough. Based on imaging studies, the patient was diagnosed with locally advanced descending colon cancer with extensive infiltration into peripheral organs by extramural progression. There was no distant metastasis. Therefore, he received left hemicolectomy with splenectomy, partial gastrectomy, and partial diaphragm resection. Histopathological examination showed a mucinous adenocarcinoma, pT4b, pN1, cM0, fStage III A. We report a rare case of extramural progression colon cancer with invasion of various organs and review 12 previous case reports.
Asunto(s)
Colon Descendente/patología , Neoplasias del Colon/patología , Colectomía , Colon Descendente/cirugía , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/cirugía , Progresión de la Enfermedad , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Invasividad NeoplásicaRESUMEN
Low-grade appendiceal mucinous neoplasm(LAMN)is a rare disease. In consideration of consistency with the 2010WHO Classification, LAMNwas classified in the Japanese Classification of Colorectal Carcinoma 8th edition. The present study involved 14 patients with LAMNover a 5-year period. The preoperative diagnosis was made as mucocele of the appendix in 9 cases. Operative interventions included ileocecal resection in 6 cases(laparoscopic; 3 cases)and appendectomy in 8 cases (laparoscopic; 6 cases). Histopathologically, there was no LNpositive case. While adjuvant therapies were not administered in all cases, all patients remain alive without recurrence. The treatment strategy for LAMNhas not been established. Therefore, an adequate surgical method with careful postoperative surveillance should be considered.
Asunto(s)
Adenocarcinoma Mucinoso/diagnóstico , Neoplasias del Apéndice/diagnóstico , Adenocarcinoma Mucinoso/complicaciones , Adenocarcinoma Mucinoso/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Apendicectomía , Neoplasias del Apéndice/complicaciones , Neoplasias del Apéndice/patología , Neoplasias del Apéndice/cirugía , Apendicitis/etiología , Apendicitis/cirugía , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Clasificación del Tumor , Resultado del TratamientoRESUMEN
BACKGROUND/AIMS: To investigate graft viability assessment before transplantation using 31P-Nuclear Magnetic Resonance (NMR) spectroscopy combining a two-layer old storage method (TLM). METHODOLOGY: Rat pancreases were divided into three groups and respectively subjected to 0 (group 1), and 30 minutes (group 2) of warm ischemia (WI) before procurement. Pancreases were digested and pancreatic digest tissues were preserved for 3 h using TLM. 31P-NMR spectroscopy was used to measure ATP levels of digest tissue. After TLM, the ratio of beta-adenosine triphosphate to phosphate monoester (betaATP/PME) obtained by 31P-NMR spectroscopy was evaluated. Isolated islets were assessed for yield and in vivo function separately using nude mice. RESULTS: The betaATP/PME ratios were 0.11 +/- 0.04, and 0.03 +/- 0.01 in groups 1 and 2, respectively (P < 0.05). Islet yields (IEQ/pancreas) were significantly less in group 3 (P < 0.05) and the cure rate after transplantation of 200 islets to athymic nude mice were 100% (7/7), and 0% (0/7) in groups 1 and 2, respectively. We regard groups 1 as viable group and group 2 as non-viable group. The viable groups and the non-viable group were clearly distinguished by betaATP/PME ratios. CONCLUSION: 31P-NMR spectroscopy combining TLM provided an objective and rapid means to assess severity of islet graft damage prior to transplantation in the rat model.
Asunto(s)
Supervivencia de Injerto/fisiología , Trasplante de Islotes Pancreáticos/métodos , Islotes Pancreáticos/fisiología , Adenosina Trifosfato/metabolismo , Análisis de Varianza , Animales , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/terapia , Espectroscopía de Resonancia Magnética/métodos , Masculino , Ratones Endogámicos BALB C , Ratones Desnudos , Páncreas/fisiología , Isótopos de Fósforo , Valor Predictivo de las Pruebas , Ratas , Ratas Endogámicas Lew , Conservación de Tejido/métodosRESUMEN
A 64-year-old woman presented to our hospital with subcutaneous tumors in the right thoracic region. After undergoing a thorough medical evaluation, she was diagnosed with multiple skin metastases arising from cancer of the descending colon. Surgical resection of the primary lesion was performed and FOLFIRI (5-fluorouracil, levofolinate calcium, irinotecan) and cetuximab chemotherapy for the metastases was initiated. The patient subsequently entered remission and did not experience any major side effects. This case report details an effective therapy for colon cancer with multiple skin metastases and presents a discussion of the expression profiles of epidermal growth factor receptor in both the primary and metastatic lesions.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Colon/tratamiento farmacológico , Neoplasias del Colon/patología , Neoplasias Cutáneas/secundario , Anticuerpos Monoclonales Humanizados/administración & dosificación , Antineoplásicos/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Camptotecina/administración & dosificación , Camptotecina/análogos & derivados , Cetuximab , Resultado Fatal , Femenino , Fluorouracilo/administración & dosificación , Humanos , Leucovorina/administración & dosificación , Persona de Mediana EdadRESUMEN
PURPOSE: The aim of this study was to compare the efficacy between the use of transnasal and transanal tube decompression and self-expanding metallic stents (SEMS) as a bridge to surgery for obstructive colorectal cancer. MATERIALS: Of a total of 42 patients with obstructive colorectal cancer, 29 were managed with transnasal or transanal tubes and 13 were managed by SEMS. RESULTS: The management duration to surgery in the stent group was longer than that in the tube group (18 vs 11 days; p<.05). More patients in the stent group could be discharged and take food or liquid normally. There was no difference in overall complications including anastomotic leakage, surgical side effects, or primary anastomosis. Perforation occurred in 2 patients in the tube group, while stent migration occurred in 1 patient in the stent group. There was no difference in complications between 2 groups. CONCLUSIONS: SEMS as a bridge to surgery for obstructive colorectal cancer could improve patients' quality of life during the preoperative period. Evaluations of the complications during decompression are needed for both methods.
Asunto(s)
Neoplasias Colorrectales/complicaciones , Descompresión Quirúrgica , Obstrucción Intestinal/cirugía , Stents , Anciano , Femenino , Humanos , Obstrucción Intestinal/etiología , Masculino , Complicaciones Posoperatorias , Calidad de Vida , Resultado del TratamientoRESUMEN
A total of 37 patients were surgically treated for a colorectal perforation between May 2006 and December 2013. The patients were divided into 2 groups: those with perforation due to colorectal cancer(colorectal cancer group, n=12) and those with perforation due to benign colorectal disease(non-colorectal cancer group, n=25). We examined the influence that onset near the perforation had on colorectal cancer clinical outcome. There was no significant difference in patient backgrounds between the two groups. In the colorectal cancer group, curative resections were performed in eight of the cases (67%), while there were 7 cases (58%) of regional lymph node dissection and all patients received a stoma without bowel anastomosis. In the colorectal cancer group, 1 patient (8%) died of a pulmonary embolism after surgery, whereas 2 patients (8.3%) in the non-colorectal cancer group died of sepsis after surgery. Nine of those patients (75%) received adjuvant chemotherapy. Four patients survived without recurrence. Prompt judgment of the disease severity and selection of optical surgical procedures including tumor resection and regional lymph node dissection is important for colorectal cancer perforation, and an adjuvant setting for the purpose of the long-term survival is necessary.
Asunto(s)
Neoplasias Colorrectales/cirugía , Perforación Intestinal/cirugía , Anciano , Neoplasias Colorrectales/complicaciones , Neoplasias Colorrectales/patología , Femenino , Humanos , Perforación Intestinal/etiología , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Estadificación de Neoplasias , Resultado del TratamientoRESUMEN
A 57-year-old man with abdominal discomfort visited our hospital. Abdominal computed tomography (CT) revealed no tumorous lesions. Endoscopic retrograde cholangiography (ERC) revealed a tumorous lesion in the middle bile duct. Peroral cholangioscopy-assisted biopsy was performed, and the lesion was diagnosed as a papillary adenocarcinoma. Extra bile duct resection and regional lymph node dissection were performed; however, residual carcinoma in situ was detected at the ductal margins by intraoperative frozen section analysis. Therefore, external radiation therapy at a dose 50.4 Gy/28 Fr was administered after the operation. No complication due to radiotherapy occurred. The patient remains alive and recurrence -free for more than 7 years after the operation. We report the long-term disease-free survival of a patient with extrahepatic cholangiocarcinoma who was treated with external radiation therapy for positive ductal margins after surgical resection.
Asunto(s)
Adenocarcinoma Papilar/radioterapia , Neoplasias de los Conductos Biliares/radioterapia , Conductos Biliares Extrahepáticos/patología , Conductos Biliares Intrahepáticos/patología , Colangiocarcinoma/radioterapia , Adenocarcinoma Papilar/cirugía , Neoplasias de los Conductos Biliares/cirugía , Conductos Biliares Extrahepáticos/cirugía , Conductos Biliares Intrahepáticos/cirugía , Colangiocarcinoma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Radioterapia Adyuvante , Factores de Tiempo , Resultado del TratamientoRESUMEN
In islet transplantation, insufficient yield is a major obstacle to one-donor/one-recipient transplant. Collagenase, which is injected via a pancreatic duct to separate islets from acini, can so easily distribute into the islet core that it may result in disruption of islets. The purpose of this study was to evaluate the superiority of reduced pressure-controlled collagenase injection (RPCI) at 80 mmHg on islet isolation to injection at 180 mmHg by examining in vivo transplant experiments besides the yield and the glucose stimulation test in a rat model. Lewis rat pancreases were distended with collagenase solution at 80 mmHg pressure as the RPCI group (group 1) and at 180 mmHg (group 2), followed by isolation. The yield in group 1 (1100 +/- 160 islets with 2750 +/- 530 IEQ) was significantly higher than that in group 2 (900 +/- 130 islets with 1570 +/- 350 IEQ, p < 0.01) due to the significant difference of the number of islets sized >150 microm in diameter, although the purity was not significantly different between the two groups. Stimulation indices in the glucose stimulation tests were 2.88 +/- 1.12 in group 1 and 1.93 +/- 0.62 in group 2 (p < 0.05). The cure rate by transplantation of 100 islets to diabetic nude mice in group 1 (8/10) was significantly higher than that in group 2 (3/10, p < 0.05). In a syngenic transplant model of 90% of islets isolated from one donor, the cure rates were 100% and 67% in groups I and 2, respectively (NS). The area under the curve on the graph of IPGTT on postoperative day 28 in group I was significantly smaller than that in group 2 (p < 0.05). In conclusion, our data show that RPCI at 80 mmHg could contribute to consistently high islet yield and in vivo function in a rat model. It was suggested that the current human protocol should be reviewed from this viewpoint.