{"_buckets": {"deposit": "63823eb0-ef14-4452-8493-70bf1e3182c6"}, "_deposit": {"id": "10038", "owners": [], "pid": {"revision_id": 0, "type": "depid", "value": "10038"}, "status": "published"}, "_oai": {"id": "oai:niigata-u.repo.nii.ac.jp:00010038", "sets": ["456", "956"]}, "item_7_alternative_title_1": {"attribute_name": "その他のタイトル", "attribute_value_mlt": [{"subitem_alternative_title": "Clinical Significance of Williamson\u0027s Bypass Operation for Irresectable Carcinoma of the Pancreatic Head"}]}, "item_7_biblio_info_6": {"attribute_name": "書誌情報", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "2011-04", "bibliographicIssueDateType": "Issued"}, "bibliographicIssueNumber": "4", "bibliographicPageEnd": "211", "bibliographicPageStart": "207", "bibliographicVolumeNumber": "125", "bibliographic_titles": [{"bibliographic_title": "新潟医学会雑誌"}, {"bibliographic_title": "新潟医学会雑誌", "bibliographic_titleLang": "en"}]}]}, "item_7_description_4": {"attribute_name": "抄録", "attribute_value_mlt": [{"subitem_description": "切除不能膵頭部癌は予後不良であり, 癌の進行に伴い出現する閉塞性黄疸や十二指腸閉塞に起因する症状を取り除くことが治療の要点となることが多い. 今回, 切除不能膵頭部癌に対してバイパス術を実施し, 良好な quality of life を維持しつつ化学療法を継続できた1例を経験したので報告する. 症例は63歳, 女性. 心窩部不快感にて発症し, 精査にて十二指腸水平部及び上腸間膜動脈への直接浸潤を伴う切除不能膵頭部癌と診断された. 開腹にて上腸間膜動脈への浸潤を組織学的に確認し, Williamsonらの報告に準じて, 吊り上げ空腸を用いて結腸前経路で胃空腸吻合術, 胆管空腸吻合術, 空腸空腸吻合術の順にバイパス術を実施した. 術後はgemcitabineを中心とした化学療法が奏効し, 1年11か月の生存期間が得られた. また, 閉塞性黄疸や消化管の通過障害は, 終末期まで認められなかった. 切除不能膵頭部癌に対するWilliamsonらの提唱するバイパス術は, 終末期まで良好な quality of life を維持しつつ化学療法を継続するための有用な術式であることが示唆された. 本症例のような遠隔転移を認めない比較的予後の期待できる症例は, バイパス術の良い適応であると考えられる.", "subitem_description_type": "Abstract"}]}, "item_7_full_name_3": {"attribute_name": "著者別名", "attribute_value_mlt": [{"nameIdentifiers": [{"nameIdentifier": "69169", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Maruyama, Tomohiro"}]}, {"nameIdentifiers": [{"nameIdentifier": "69170", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Sakata, Jun"}]}, {"nameIdentifiers": 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"nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "佐々木, 正貴"}], "nameIdentifiers": [{"nameIdentifier": "69168", "nameIdentifierScheme": "WEKO"}]}]}, "item_files": {"attribute_name": "ファイル情報", "attribute_type": "file", "attribute_value_mlt": [{"accessrole": "open_date", "date": [{"dateType": "Available", "dateValue": "2019-08-06"}], "displaytype": "detail", "download_preview_message": "", "file_order": 0, "filename": "125(4)_207-211.pdf", "filesize": [{"value": "1.1 MB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensetype": "license_free", "mimetype": "application/pdf", "size": 1100000.0, "url": {"label": "125(4)_207-211.pdf", "url": "https://niigata-u.repo.nii.ac.jp/record/10038/files/125(4)_207-211.pdf"}, "version_id": "134c506f-6b26-4bbd-ac3b-0ff19c92dff0"}]}, "item_keyword": {"attribute_name": "キーワード", "attribute_value_mlt": [{"subitem_subject": "膵癌", "subitem_subject_scheme": "Other"}, {"subitem_subject": "切除不能", "subitem_subject_scheme": "Other"}, {"subitem_subject": "バイパス術", "subitem_subject_scheme": "Other"}, {"subitem_subject": "姑息手術", "subitem_subject_scheme": "Other"}]}, "item_language": {"attribute_name": "言語", "attribute_value_mlt": [{"subitem_language": "jpn"}]}, "item_resource_type": {"attribute_name": "資源タイプ", "attribute_value_mlt": [{"resourcetype": "departmental bulletin paper", "resourceuri": "http://purl.org/coar/resource_type/c_6501"}]}, "item_title": "Williamsonバイパス術が有効であった切除不能膵頭部癌の1例", "item_titles": {"attribute_name": "タイトル", "attribute_value_mlt": [{"subitem_title": "Williamsonバイパス術が有効であった切除不能膵頭部癌の1例"}, {"subitem_title": "Williamsonバイパス術が有効であった切除不能膵頭部癌の1例", "subitem_title_language": "en"}]}, "item_type_id": "7", "owner": "1", "path": ["456", "956"], "permalink_uri": "http://hdl.handle.net/10191/29081", "pubdate": {"attribute_name": "公開日", "attribute_value": "2014-07-29"}, "publish_date": "2014-07-29", "publish_status": "0", "recid": "10038", "relation": {}, 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