S-1/cisplatin therapy had been administered as first-line therapy and paclitaxel/ramucirumab treatment because the second-line treatment. Nonetheless, considering that the patient developed a peritoneal dissemination and her lymph node metastasis increased despite these regimens, nivolumab had been introduced as a 3rd- line treatment. The CT scan disclosed that after the 5 courses of nivolumab, both the peritoneal dissemination and metastatic lymph nodes shrunk; after 12 programs of nivolumab, the peritoneal dissemination virtually vanished. Although nivolumab, an anti-programmed mobile death-1(PD-1)antibody, has got the possibility resulting in immune-related unpleasant events not seen with main-stream chemotherapy, in our case, these events failed to take place in addition to antitumor results were preserved for a somewhat long period without a decrease within the overall performance status(PS). We experienced an instance of peritoneal metastasis from gastric cancer with a decent response to nivolumab. Herein, this case is reported with some literature review.An 84-year-old man on hemodialysis ended up being labeled our division for an advanced gastric cancer with pyloric stenosis. Pre-operative CT showed thickening of this stomach wall surface at the main lesion and local lymph node metastasis, while no clear peritoneal metastasis ended up being found. Nevertheless, we found peritoneal disseminations through the operation, so gastrojejunal bypass was done. After the procedure, he hoped chemotherapy despite danger factors such as renal failure and later years. We launched a lower life expectancy dosage of weekly nab-paclitaxel to him. After 3 courses, CT revealed the primary lesion had diminished in dimensions, and after 6 courses, serum CA19-9 level reduced to 61.8 U/mL from 2,343 U/mL during the earlier treatment. No severe unpleasant events had been seen throughout the chemotherapy. Nevertheless, after 8 courses, the cyst markers had been gradually re-increased, and CT revealed the main tumor re-increased after 9 courses. Therefore, he got irinotecan alone because the second-line. He’s nevertheless live 12 months and 8 months after diagnosis of gastric cancer. Its generally speaking stated that the possibility of cancer tumors chemotherapy for dialysis clients plus the senior is high. Nonetheless, we claim that it may be safely carried out by examining the appropriate medication and dose. Weekly nab-paclitaxel regimen might be one of several encouraging alternatives for these customers.Laparoscopic pancreaticoduodenectomy(LPD)is less invasive and provides better aesthetic results than open pancreaticoduodenectomy( OPD). LPD without vascular excision and lymph node dissection has been covered by insurance coverage since 2016 in Japan. On the other hand, additional little bowel volvulus is an unusual condition caused after abdominal operation. A 77-year-old girl underwent a laparoscopic pancreaticoduodenectomy with pancreatic disease of pT2N0M0, pStageⅠB. She suffered from epigastric discomfort after meal. The abdominal CT revealed counterclockwise rotation associated with the SMV on SMA about 540 level. Gastrointestinal endoscopy revealed no irregular conclusions in May 2017. Her stomach discomfort was disappeared in July 2017. But the pain had been recurred in May 2019. The stomach CT disclosed mesenteric edema and counterclockwise rotation about 810 degree. Her stomach pain was disappeared once more in February 2020. The counterclockwise rotation was decreased about 540 degree. Between May 2012 and February 2020, 50 patients underwent LPD at Kansai Rosai Hospital. 111 clients whom obtained OPD between 2010 and February 2015 had been included for contrast. No significant variations had been noted between your LPD and OPD groups pertaining to patient age(67.9 vs 70.3), gender(M/F 31/19 vs 70/41). The intraoperative blood loss was lower(106 g vs 1,064 g, p less then 0.0001)and the operation time ended up being much longer (624 vs 535 min, p less then 0.0001)in the LPD team compared to OPD team. Little bowel volvulus over 270 level had been 7/43 vs 5/106(p=0.0338), and over 360 degree ended up being 6/44 vs 1/110(p=0.0014), respectively. Tiny bowel volvulus after pancreaticoduodenectomy was frequently noticed in the laparoscopic group.A 53-year-old male had a history of gastrectomy of this pyloric part for gastric cancer tumors and Billroth Ⅰ reconstruction done two decades ago. The patient selleck products went to the intestinal interior medical division of our hospital with stomach pain as the chief issue. Pancreatic cancer was identified as having the help of an abdominal CT, and he ended up being regarded our department. The preoperative condition phase had been cT3, N0, M0, Stage ⅡA. Since it was over twenty years because the previous surgery plus the preoperative CT showed cardiac limbs associated with left substandard phrenic artery, we inferred that the rest of the tummy can be preserved. The circulation was confirmed by the intraoperative ICG fluorescence strategy, and we then performed pancreatotomy associated with pancreatic end, protecting the belly and a splenectomy. The pathologic results had been unpleasant ductal carcinoma, pT3, N1a, M0, Stage ⅡB, and R0. S-1 ended up being Medical sciences administered orally as postoperative adjunctive chemotherapy. The postoperative program was favorable without recurrence for just two years. In the event a pancreatotomy associated with pancreatic end is performed for disease regarding the pancreatic human body after gastrectomy associated with the pyloric side Knee infection , it was considered that the intraoperative ICG fluorescence technique had been helpful to confirm the the flow of blood associated with the recurring stomach.A man inside the 60s with upper stomach discomfort was referred to our hospital.