[A case of polysplenia syndrome with annular pancreas and agenesis of the dorsal pancreas].

A 69-year-old woman had a history of acute pancreatitis. On abdominal computed tomography, the pancreatic body and tail could not be visualized, and the pancreatic head encircled the descending part of the duodenum. On endoscopic retrograde cholangiopancreatography, we could not find the minor papilla. The major papilla was located on the lateral wall of the descending part of the duodenum. The pancreatic duct was short, and the common bile duct was on the lateral side of the duodenum near the hepatic hilum. We diagnosed polysplenia syndrome with annular pancreas and agenesis of the dorsal pancreas. The syndrome includes several congenital anomalies, but there is very little information currently available about this particular syndrome. We report our patient's case and review the pertinent literature.

Efficacy and safety of cisplatin versus miriplatin in transcatheter arterial chemoembolization and transarterial infusion chemotherapy for hepatocellular carcinoma: A randomized controlled trial.

AIM: Transcatheter arterial chemoembolization (TACE) and transarterial infusion chemotherapy (TAI) are the main therapeutic strategies for treatment of advanced hepatocellular carcinoma (HCC). We conducted a randomized controlled trial to compare the efficacy and safety of cisplatin and miriplatin in TACE and TAI. METHODS: Patients with HCC of indication for TACE or TAI were randomly assigned to receive either cisplatin or miriplatin (49 patients per group) between April 2010 and May 2013. The primary end-point was the therapeutic effect (TE) 3 months after initial treatment, and the secondary end-point was overall survival. RESULTS: TE could be evaluated in 26 patients of the cisplatin group and 20 patients of the miriplatin group. In the cisplatin group, 11 (42.3%) and 15 (57.7%) patients were classified as showing TE3 + 4 and TE1 + 2, respectively, while in the miriplatin group, each number was nine (45.0%) and 11 (55.0%) (P = 0.8551). Furthermore, no significant difference in overall survival was found between two groups for all patients (P = 0.905) or those treated only with TAI (10 in the cisplatin group and eight in the miriplatin group; P = 0.695). TE3 + 4 group showed better overall survival than TE1 + 2 group (P = 0.0263). Grade 4 or higher adverse event did not occur in either group. Creatinine levels in the cisplatin group rose 3 days after TACE or TAI (P = 0.0397). CONCLUSION: Cisplatin and miriplatin had equal efficacy for TACE and TAI, but cisplatin should be avoided for patients with renal dysfunction or inadequate hydration. Good TE improved overall survival.