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石田 潤大学院医学系研究科 医科学専攻助教
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■ 論文- BACKGROUND: Portomesenteric vein (PMV) resection is performed for pancreatic ductal adenocarcinoma with venous invasion. However, positive transection margins may lead to local recurrence. This study aimed to evaluate whether routine intraoperative frozen section analysis (FSA) reduces positive PMV transection margins. METHODS: This retrospective study reviewed patients who underwent pancreatectomy with PMV resection at Kobe University Hospital from 2010 to 2020. Routine FSA of the PMV transection margin was introduced in 2017. Clinicopathological factors and the incidence of positive PMV transection margins were compared between patients who underwent FSA (PMV frozen [+]) and those who did not (PMV frozen [-]). Cox regression was used to assess the prognostic effect of margin status. RESULTS: A total of 115 patients were included (57 in the PMV frozen [+] group and 58 in the PMV frozen [-] group). The rate of positive PMV transection margins was significantly lower in the PMV frozen (+) group than in the PMV frozen (-) group (1.8% vs 17.2%, respectively; P =.003). Multivariate logistic regression analysis demonstrated that intraoperative FSA of the PMV transection margin was an independent factor associated with a reduced risk of positive PMV transection margins on final pathological diagnosis (odds ratio, 13.7 [95% CI, 1.61-116.7]; P =.017). However, the positive PMV transection margin was not associated with overall survival (hazard ratio, 0.96 [95% CI, 0.31-2.50; P =.937). CONCLUSION: Routine FSA of the PMV transection margin markedly reduces positive PMV transection margins after pancreatectomy. However, the prognostic effect of a positive PMV transection margin remains unclear. Larger prospective studies are needed to determine its prognostic relevance.2026年06月, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 30(6) (6), 102410 - 102410, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Technetium-99m-diethylenetriamine-penta-acetic acid-galactosyl human serum albumin (99mTc-GSA) scintigraphy is a useful method for assessing liver function and its heterogeneity. We evaluated its predictive usefulness for post-hepatectomy liver failure (PHLF) in liver resection for biliary tract cancer. METHODS: Between 2013 and 2024, 95 patients underwent major hepatectomy with bile duct resection for biliary tract cancer and had preoperative 99mTc-GSA scintigraphy. The GSA-K value was defined using established reduction formulas of indocyanine green plasma clearance rate (ICG-K) values based on LHL15 value (99mTc-GSA uptake ratio of the liver to the liver plus heart at 15 min) from 99mTc-GSA scintigraphy. Functional remnant liver volume (f-RLV) ratio was estimated by dividing scintillation counts of the future remnant liver by total counts of the whole liver. We compared volumetric (ICG-Krem: ICG-K x RLV ratio) and functional (GSA-Krem: GSA-K x f-RLV ratio) assessment methods of the future remnant liver for predicting PHLF. RESULTS: PHLF was observed in 34 patients (35.8%) and a receiver operating characteristic curve revealed cut-off values for predicting PHLF of 0.088 for ICG-Krem and 0.086 for GSA-Krem. Positive predictive values for PHLF were 53.2% (ICG-Krem) and 87.6% (GSA-Krem). In patients with portal vein embolization (PVE), GSA-Krem showed 89.1% of positive predictive value for PHLF, and ICG-Krem was very low (53.3%). The multivariate analysis identified GSA-Krem as one of independent predictors of PHLF. CONCLUSIONS: GSA-Krem derived from 99mTc-GSA scintigraphy is a valuable predictor of PHLF.2026年05月, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 52(8) (8), 111914 - 111914, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Laparoscopic liver resection is technically demanding for hepatocellular carcinoma (HCC) ≥10 cm in the right liver. In open liver resection, the anterior approach is established for large right-lobe tumors because it avoids parenchymal compression during mobilization.1, 2 However, its laparoscopic use remains limited,3 particularly in right posterior sectionectomy (RPS). This study describes the technique and perioperative outcomes of laparoscopic RPS using the anterior approach for huge HCCs. METHODS: Among 799 minimally invasive liver resections performed between 2011 and 2025, four men (median age 72.5 years, range 60-84) with huge tumors (median diameter 11.5 cm, range 10-12) underwent laparoscopic (extended) RPS with an anterior approach. As the tumor bulk caused firm adhesion to the diaphragm and retroperitoneum, the right lobe was left in situ. Parenchymal transection was initiated caudally and progressed cranially along the right inferior vena cava. The specimen was detached only after the transection. Patients were placed in the left hemilateral decubitus position with French lithotomy, and clamp-crushing was used for transection. RESULTS: Two standard and two extended RPSs were completed. The median operative time was 524 minutes (range 418-603), and blood loss was 80 mL (range 10-550); no transfusions were required. The median weight was 753.5 g (range 450-934). No Clavien-Dindo ≥IIIa complications occurred. The median postoperative stay was 11 days (range 9-16). All margins were negative. CONCLUSIONS: Laparoscopic anterior-approach RPS is feasible and safe for huge right posterior HCCs, enabling secure transection without mobilization and yielding favorable short-term outcomes.2026年05月, Annals of surgical oncology, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Relationship between timing of initiating adjuvant chemotherapy (AC) and clinical outcomes after surgery for pancreatic cancer remains controversial. METHODS: In this ancillary analysis of the JASPAC 01 trial, 187 patients were classified according to the interval between surgery and chemotherapy initiation to Early (< 6 weeks, n = 45), Standard (6-8 weeks, n = 70), and Delayed (> 8 weeks, n = 72). Overall survival (OS) and relapse-free survival (RFS) were analyzed. RESULTS: Baseline characteristics were comparable among three groups. The Standard group showed significantly longer OS than the Early group (median, 66 vs. 37 months; HR 0.61, 95% CI 0.38-0.99; p = 0.041), and relatively longer OS compared with the Delayed group (median, 45 months; HR 0.68, 95% CI 0.44-1.05; p = 0.077). RFS was longer in the Standard group (median, 46 months) compared with the Early group (20 months; HR 0.61, 95% CI 0.38-0.99; p = 0.040) and the Delayed group (20 months; HR 0.59, 95% CI 0.39-0.89; p = 0.011). Multivariate analysis identified operative procedure, R1 resection, lymph node metastasis, and nonstandard initiation (< 6 or > 8 weeks) as independent adverse prognostic factors. CONCLUSIONS: Initiation of S-1 AC at 6-8 weeks after pancreatectomy was associated with favorable survival outcomes.2026年04月, Journal of hepato-biliary-pancreatic sciences, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: The classification of oncological resectability for hepatocellular carcinoma (HCC) has been established, requiring validation of treatment outcomes for hepatectomy and systemic chemotherapy. METHODS: The study evaluated treatment outcomes in 978 patients who underwent hepatectomy and 222 patients with HCC who received first-line systemic chemotherapy (atezolizumab plus bevacizumab, lenvatinib, or durvalumab plus tremelimumab). RESULTS: Among three factors defining patients with borderline resectable 1 (BR1) and 2 (BR2), macrovascular invasion factor was associated with significantly worse prognosis in a hepatectomy group (BR1: 34.2 vs. 63.4 months, p = 0.04; BR2: 14.4 vs. 20.9 months, p = 0.004). In contrast, in the systemic chemotherapy group, none of the three factors affected prognosis in either BR1 or BR2 patients. In BR2 patients undergoing hepatectomy, those with a single risk factor had significantly better outcomes than those with 2-3 factors (20.1 vs. 12.6 months, p < 0.001). Similarly, in the entire systemic chemotherapy cohort, patients with a single risk factor had better outcomes than those with 2-3 (22.6 vs. 11.9 months, p = 0.001). However, among chemotherapy responders (per modified Response Evaluation Criteria in Solid Tumors), prognosis did not significantly differ between those with one factor and those with 2-3 factors (25.4 vs. 24.5 months, p = 0.502). CONCLUSION: Macrovascular invasion significantly impacted prognosis in patients undergoing hepatectomy, for both BR1 and BR2, whereas any of the tumor factors did not affect the prognosis of patients receiving systemic chemotherapy. Tumor burden correlated with prognosis in the entire cohort but not in chemotherapy responders, suggesting effective treatment may overcome poor prognostic indicators.2026年04月, World journal of surgery, 50(4) (4), 1049 - 1058, 英語, 国際誌研究論文（学術雑誌）
- 2026年04月, Surgery today, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND/AIM: The prognostic impact of the timing of adjuvant chemotherapy initiation in patients with resected pancreatic cancer is unclear. Therefore, this study aimed to investigate whether delayed initiation of S-1 adjuvant chemotherapy affects the survival of patients with resectable pancreatic cancer. PATIENTS AND METHODS: Patients who received S-1 adjuvant chemotherapy after undergoing R0/R1 resection were grouped according to whether adjuvant chemotherapy was initiated <60 (n=36) or ≥60 days (n=27) after surgery. Correlations between the time to chemotherapy initiation, clinicopathological factors, and survival were analyzed. RESULTS: The median and mean times to chemotherapy initiation were 58 and 61 days, respectively. The delayed group had worse 2-year overall (57% vs. 80%, p=0.032) and recurrence-free survival (35% vs. 54%, p=0.044) rates than the early group. These results were similar in patients who completed S-1 adjuvant chemotherapy. In multivariate analysis, delayed initiation of chemotherapy, R1 resection, and tumor size (≥40 mm) were independent prognostic factors for poor overall survival. The delayed group had more patients with severe postoperative complications (Clavien-Dindo grade ≥III) (30% vs. 8%, p=0.028) and delayed recovery of serum albumin levels (postoperative days 7, 14, and 30: p=0.040, 0.004, and 0.003, respectively) than the early group. CONCLUSION: Delayed initiation of S-1 adjuvant chemotherapy had an adverse impact on survival and was correlated with severe postoperative complications and delayed recovery of postoperative nutritional status.2026年02月, Anticancer research, 46(2) (2), 987 - 999, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Resection of pancreatic ductal adenocarcinoma (PDAC) after prior esophagectomy for esophageal cancer is technically demanding and its oncologic value is unclear. We evaluated the peri-operative safety and long-term survival after pancreatectomy for PDAC in this setting. METHODS: All patients undergoing pancreatectomy for PDAC at Kobe University Hospital (2017-2024) were reviewed. Outcomes in patients with previous esophagectomy for esophageal cancer were compared with those in patients undergoing contemporaneous resectable PDAC without such history. Primary endpoints were postoperative morbidity/mortality and overall survival. RESULTS: Of 415 pancreatectomies, nine (2.2%) had a history of esophagectomy for esophageal cancer (pancreaticoduodenectomy five; distal pancreatectomy four). Preservation of the gastrointestinal-conduit vessels was achieved in seven patients; two required right gastroepiploic artery and vein reconstruction. Major morbidity occurred in one patient (11.1%); there was no 90-day mortality and no conduit-related complication. However, only three patients (33.3%) received adjuvant chemotherapy. Median overall survival was significantly shorter in post-esophagectomy patients (n = 9) than in controls (n = 249) (8.4 vs. 41.7 months, p = 0.001). Survival after pancreaticoduodenectomy was especially poor (7.4 vs. 47.2 months, p < 0.001), whereas outcomes after distal pancreatectomy did not differ (16.4 vs. 38.9 months, p = 0.781). CONCLUSIONS: Pancreatectomy after esophagectomy can be performed safely, even with minimally invasive techniques, yet long-term survival remains dismal, particularly after pancreaticoduodenectomy. Careful patient selection with specific attention to the feasibility of delivering perioperative chemotherapy may be required to improve outcomes in this highly selected cohort.2026年02月, Annals of surgical oncology, 33(2) (2), 918 - 924, 英語, 国際誌研究論文（学術雑誌）
- 2025年11月, Annals of surgical oncology, 英語, 国際誌研究論文（学術雑誌）
- AIM: Regarding the resectability of pancreatic adenocarcinoma (PDAC), not only anatomical factors but also biological and conditional factors have come to be considered. This study examined the impact of the Global Leadership Initiative on Malnutrition (GLIM) criteria on prognosis after resection of anatomically resectable PDAC. METHODS: The medical records of consecutive patients who underwent resection for resectable PDAC between January 1, 2014, and December 31, 2022, were retrospectively reviewed. Patients were classified as normal, moderately, or severely malnourished according to the GLIM criteria. RESULTS: In total, 194 patients were included in the analysis. According to the GLIM criteria, 61 (31.4%), 49 (25.2%), and 84 (42.3%) patients were normal, moderately, and severely malnourished, respectively. Patients with malnutrition had shorter overall, recurrence-free, and disease-specific survival (OS, RFS, and DSS) than normal patients (OS, normal vs. moderate, p = 0.015; normal vs. severe, p < 0.001; RFS, normal vs. moderate p = 0.012, normal vs. severe, p < 0.001; DSS, normal vs. moderate, p = 0.023; normal vs. severe, p < 0.001). In multivariate analysis regarding OS using all factors, moderate or severe malnutrition according to the GLIM criteria (p = 0.007), performance status (p = 0.086), preoperative diabetes (p = 0.017), tumor diameter ≥ 3 cm (p = 0.002), lymph node metastasis (p < 0.001), and postoperative adjuvant therapy (p = 0.027) were independent prognostic factors. In multivariate analysis using preoperative factors, malnutrition according to the GLIM criteria remained a significant prognostic factor (p = 0.003). CONCLUSION: The GLIM criteria are effective prognostic predictors in patients with resectable PDAC undergoing upfront surgery. Preoperative nutritional assessment using these criteria may contribute to determining treatment plans for resectable PDAC.2025年11月, Annals of gastroenterological surgery, 9(6) (6), 1351 - 1361, 英語, 国内誌研究論文（学術雑誌）
- Atezolizumab plus bevacizumab (AteBev) is used as a first-line treatment for advanced hepatocellular carcinoma (HCC). Combining AteBev with sequential local treatment holds potential; however, optimal timing, modality and continuation of systemic chemotherapy remain undetermined. In the present study, a retrospective analysis of 123 patients with HCC treated with AteBev at two institutions was performed. Patients with no apparent residual lesions after sequential local treatment or AteBev treatment alone were followed up without any systemic chemotherapy ('drug-free' cohort). Outcomes focused on the impact of achieving 'drug-free' status, with timing assessed based on tumor size and α-fetoprotein levels. The results revealed that serum α-fetoprotein levels and tumor shrinkage plateaued at ~3 and 6 months post-AteBev treatment, respectively. Patients achieving 'drug-free' status demonstrated prolonged median survival (P<0.001) and progression-free survival (P<0.001), comparable with patients with 'clinical complete response' or 'drug-off' statuses. Moreover, particle radiotherapy was the most common local treatment modality. In conclusion, achieving a 'drug-free' status was associated with favorable prognoses. Optimal timing for sequential local treatment is suggested as 3-6 months after AteBev initiation, with multidisciplinary strategies to achieve 'drug-free' status offering a promising option for the treatment of advanced HCC.2025年10月, Oncology letters, 30(4) (4), 466 - 466, 英語, 国際誌研究論文（学術雑誌）
- ABSTRACT Background Pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) with arterial abutment is a complex, high‐risk surgery. We aimed to investigate the clinicopathological features, risk factors, and learning curve for local recurrence after pancreatectomy for PDAC with arterial abutment. Methods Sixty consecutive patients who underwent pancreatectomy for borderline resectable and locally advanced PDAC with arterial abutment at Kobe University Hospital between 2010 and 2020 were enrolled in this retrospective study. Logistic regression analysis was performed to investigate the risk factors for local recurrence. The local recurrence rate was examined for every 10 cases over time. Results Eighteen (30.0%) patients developed local recurrence; 12 (20.0%) developed local‐only recurrence, and six (10.0%) developed local and other recurrences. The median survival time after surgery was similar between patients with local‐only (n = 12) and other recurrences (n = 31) (18.9 vs. 17.3 months, p = 0.650). The local recurrence rate was significantly lower during the late period than during the early period (13.3% vs. 46.7%, respectively). In the multivariate analyses, the operative period (odds ratio, 7.01; 95% CI: 1.09–45.2; p = 0.041) was the independent factor associated with local recurrence. The local recurrence rate in the first 10 patients was 70%, but it gradually decreased to 10% in the last 10 patients. Conclusions Local recurrence has a significant impact on survival, as do other recurrences after pancreatectomy for PDAC with arterial abutment. A learning curve may exist for the local recurrence rate, suggesting that it should be performed by experienced surgical teams at high‐volume centers.Wiley, 2025年09月, Annals of Gastroenterological Surgery研究論文（学術雑誌）
- PURPOSE: The prognosis of patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) in the first-order or main trunk/contralateral branches (Vp3/4) is poor. The present study aimed to clarify the real-world data of atezolizumab plus bevacizumab treatment (Ate/bev) for HCC patients with Vp3/4 PVTT. METHODS: The subjects of this study were 22 consecutive HCC patients with Vp3/4 PVTT, who were treated with Ate/bev. Survival rates and radiological responses were evaluated based on the modified albumin-bilirubin (mALBI) grade [mALBI 1 + 2a (1/2a) versus 2b + 3 (2b/3)] using the modified Response Evaluation Criteria in Solid Tumors. RESULTS: The median survival time of the 22 patients was 15.0 months, with 1- and 2-year survival rates of 62.7% and 49.3%, respectively. The objective response (OR) rates of patients with mALBI 1/2a and 2b/3 were 91.7% (11/12) and 10.0% (1/10), respectively, with a significant difference (p < 0.001). The 2-year survival rates of patients with mALBI 1/2a and 2b/3 were 78.6% and 20.0%, respectively, with a significant difference (p = 0.0041). CONCLUSION: Ate/bev was effective for treating HCC patients with Vp3/4 PVTT. OR rate and MST were favorable, particularly for patients with preserved liver function (mALBI 1/2a), suggesting its great potential for the treatment of HCC in patients with Vp3/4 PVTT.2025年07月, Surgery today, 55(7) (7), 900 - 908, 英語, 国内誌研究論文（学術雑誌）
- Portal annular pancreas (PAP) is an uncommon anomaly in which the pancreatic parenchyma surrounds the portal or superior mesenteric vein. An adequate operative approach is necessary to prevent clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy for PAP. We herein report a case of robotic pancreaticoduodenectomy for PAP. In PAP, dissection of the retroportal parenchyma is the most important aspect of surgery. Adequate retraction of the portal system using vessel loops allows for a safe dissection and transection of the retroportal parenchyma. The robotic approach has some advantages for dissecting the retroportal parenchyma. The magnified three-dimensional view helps the surgeon distinguish the nerve plexus from the pancreatic parenchyma. The caudal view allows for direct dissection of the retroportal parenchyma from the superior mesenteric artery. Dissection can easily be performed using articulated forceps. Owing to these advantages, robotic pancreaticoduodenectomy can be safely performed for PAP.2025年07月, Surgery today, 55(7) (7), 1004 - 1007, 英語, 国内誌研究論文（学術雑誌）
- INTRODUCTION: Oncological resectability criteria for hepatocellular carcinoma have been defined (resectable [R]/borderline resectable 1 [BR1]/borderline resectable 2 [BR2]); however, their validation is necessary. METHODS: A total of 1,469 patients who underwent hepatectomy and 525 patients who received systemic chemotherapy, including lenvatinib, atezolizumab plus bevacizumab, and durvalumab plus tremelimumab, as first-line treatment were analyzed. RESULTS: In the BR1 group, the median survival times (MSTs) of patients who underwent hepatectomy and systemic chemotherapy were 52.7 and 34.6 months, respectively, without a significant difference (p = 0.075). In the propensity score matching (PSM) analysis of the BR1 group, the MSTs of hepatectomy and systemic chemotherapy were 42.4 and 35.1 months, respectively, without a significant difference (p = 0.772). Hepatitis virus infection, modified albumin-bilirubin (mALBI) grade 2b + 3, and the presence of extrahepatic metastasis were identified as poor prognostic factors for hepatectomy, whereas mALBI grade 2b + 3 was the only poor prognostic factor for systemic chemotherapy. In the BR2 group, the MSTs of hepatectomy and systemic chemotherapy were 20.1 and 19.5 months, respectively, with significantly better survival for hepatectomy than for systemic chemotherapy (p = 0.017). In the PSM analysis of the BR2 group, the MSTs of hepatectomy and systemic chemotherapy were 20.1 and 21.0 months, respectively, without a significant difference (p = 0.375). Serum alpha-fetoprotein levels≥100, intrahepatic tumor number ≥6, and the presence of extrahepatic metastasis were identified as poor prognostic factors for hepatectomy, whereas female, serum alpha-fetoprotein levels ≥100, mALBI grade 2b + 3, intrahepatic maximal tumor size >5 cm, and the presence of extrahepatic metastasis were identified as poor prognostic factors for systemic chemotherapy. CONCLUSION: In the PSM analysis, no significant differences were observed between the BR1 and BR2 groups for hepatectomy and systemic chemotherapy. The intrahepatic tumor number for hepatectomy and the intrahepatic maximal tumor size for systemic chemotherapy are significant risk factors for BR2 patients, highlighting the characteristics of each treatment and the potential for selecting the optimal modality.2025年06月, Liver cancer, 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: The Global Leadership Initiative on Malnutrition (GLIM) criteria, proposed in 2018, provide universal diagnostic standards for malnutrition, a known risk factor for postoperative complications in patients with various cancers. However, its impact on surgery for biliary tract cancer (BTC) remains unclear. This study evaluates the relationship between GLIM-defined malnutrition and postoperative complications after resection for BTC. METHODS: The subjects of this retrospective study were patients who underwent pancreaticoduodenectomy or major hepatectomy with extrahepatic bile duct resection for BTC between January, 2013 and December, 2021. The comprehensive complication index (CCI), an indicator of postoperative complications, was calculated based on the total number and severity of postoperative complications. RESULTS: GLIM-defined malnutrition was diagnosed in143 (71.1%) of the total 201 patients. The median CCI was significantly higher in the GLIM-defined malnutrition group than in the non-malnutrition group (37.2 vs. 28.3; P < 0.001). Multivariate logistic regression analysis revealed that GLIM-defined malnutrition (odds ratio 2.87 [95% confidence interval 1.38-5.96], P = 0.005) and intraoperative blood loss > 1,000 mL (odds ratio 3.77 [95% confidence interval 1.06-13.47], P = 0.041) were independent predictors of high morbidity (CCI ≥ 37.1). CONCLUSION: Preoperative GLIM-defined malnutrition was closely associated with increased postoperative complications in patients who underwent resection for BTC.2025年05月, Surgery today, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Partial pancreatectomies for intraductal papillary mucinous neoplasms (IPMN) often leave a dilated main pancreatic duct (MPD). However, its impact on the development of remnant pancreatic lesions is unknown. METHODS: Medical records of consecutive patients who underwent partial pancreatectomy for noninvasive or microinvasive IPMN with dilated MPD on preoperative imaging between April 2007 and March 2023 at two tertiary referral centers in Japan were retrospectively reviewed. A dilated remnant MPD (DRM) was defined as an MPD diameter of the expected remnant pancreas of ≥5 mm. The clinically significant remnant pancreatic lesion (CSRPL) was defined as a remnant pancreatic lesion which requires intervention. RESULTS: A total of 172 patients (106 males and 66 females) were analyzed. Preoperatively, 132 patients (76.7 %) had mixed-type IPMN and 40 (23.1 %) had main duct IPMN. Among them, 16 patients (9.3 %) had CSRPL at 1569 days (median; range, 120-5503 days) after the initial surgery. In the preoperative imaging analysis, 104 patients (60.5 %) had DRM. The univariate analysis revealed that high-grade or micro-invasive pathology (p = 0.013) was significantly associated with CSRPL, whereas DRM was inversely associated with CSRPL (p = 0.021). The multivariate analysis revealed that the trends of DRM (p = 0.002) and high-grade/micro-invasive pathology (p = 0.003) remained significant. CONCLUSIONS: Leaving a dilated MPD did not increase but instead inversely associated with the incidence of CSRPL after IPMN resection. It was suggested that preserving the pancreas, including the dilated MPD, is oncologically safe if the lesion of interest can be resected.2025年05月, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 25(3) (3), 440 - 449, 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: We aimed to investigate the differences in surgical difficulty between laparoscopic partial liver resections of segments 7 and 8. METHODS: We analyzed 173 patients who underwent partial liver resections of segments 7 or 8 between 2010 and 2022 at two institutions. We investigated differences in the surgical outcomes of each procedure using propensity score matching. We compared these outcomes with those of open partial liver resections for segments 7 and 8 to determine whether the differences were unique to the laparoscopic approach. RESULTS: Thirty and 54 patients underwent laparoscopic partial liver resections of segments 7 and 8. In the matched cohort (22 in each group), the operation time was significantly longer (377 vs. 278 min, P = 0.020) and the proportion of postoperative complications significantly higher in segment 7 (27% vs. 0%, P = 0.008). Forty-one and 48 patients underwent open partial liver resections of segments 7 and 8, respectively. There were no significant differences in the surgical outcomes between the segments in the matched cohort (20 in each group). CONCLUSIONS: Laparoscopic partial liver resections of segment 7 may be more challenging than that of segment 8. This difference in difficulty was not observed in open partial liver resections.2025年04月, Surgery today, 英語, 国内誌研究論文（学術雑誌）
- AIM: Evidence regarding the reliability of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for assessing histological proliferation and WHO grading of small (≤20 mm) pancreatic neuroendocrine tumors (PanNETs) is limited. METHODS: In this multicenter retrospective study, we analyzed data from 122 patients with small PanNETs who underwent EUS-TA followed by surgical resection between 2006 and 2022. We compared the histopathological proliferation assessment and WHO grading between preoperative EUS-TA and surgical definitive specimens. RESULTS: Among the 122 patients with small PanNETs (80% with surgical definitive WHO grade G1 and 20% with G2), EUS-TA histology identified neuroendocrine tumors in 101 (83%) patients and provided WHO grading in 85 (70%) patients. Histopathological WHO grading for EUS-TA was concordant with surgical definitive grading in 86% (73/85) of cases, overstaged in 4% (3/85), and understaged in 11% (9/85). Moderate, severe, and fatal adverse events associated with EUS-TA, as classified by the lexicon, were not reported in this cohort. CONCLUSION: EUS-TA is a reliable method for assessing histopathological proliferation and WHO grading of small PanNETs. However, grading discordance may occur, and a risk-benefit evaluation on a per-patient basis is recommended.2025年03月, Annals of gastroenterological surgery, 9(2) (2), 339 - 346, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND/AIM: Biliary tract cancers (BTCs) have poor prognoses, with limited curative options beyond surgical resection. Adjuvant S-1 chemotherapy has shown survival benefits in Japanese patients undergoing resection for BTC. However, prognostic factors influencing survival in these patients remain uncertain. In this study, we aimed to investigate the efficacy of preoperative nutritional status using the Global Leadership Initiative on Malnutrition (GLIM) criteria as a prognostic factor in patients receiving adjuvant S-1 chemotherapy for BTC. PATIENTS AND METHODS: In this retrospective study, excluding intrahepatic cholangiocarcinoma, we evaluated 58 patients who underwent curative surgery for BTC at Kobe University from 2013 to 2022, followed by adjuvant S-1 chemotherapy. Nutritional status was classified by GLIM criteria into normal/moderate and severe malnutrition groups. Overall (OS) and recurrence-free (RFS) survival were analyzed using Kaplan-Meier and Cox proportional hazards models. RESULTS: Of the 58 patients, 3.4% had no malnutrition, 72.5% had moderate malnutrition, and 24.1% had severe malnutrition. Patients with severe malnutrition had significantly worse 5-year OS (24.7% vs. 52.5%, p=0.0014) and RFS (34.3% vs. 52.0%, p=0.0066). Severe malnutrition was an independent prognostic factor for poorer OS (hazard ratio=3.40, 95% confidence interval=1.46-7.94; p=0.0047) and RFS (hazard ratio=2.48, 95% confidence interval=1.07-5.76; p=0.035). No significant difference in S-1 completion rates was observed. CONCLUSION: Severe malnutrition, as defined by GLIM criteria, is a poor prognostic factor in patients with BTCs undergoing adjuvant S-1 chemotherapy.2025年, Cancer diagnosis & prognosis, 5(5) (5), 557 - 565, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND/AIM: Atezolizumab plus bevacizumab (AteBev) is widely used as a first-line treatment for advanced hepatocellular carcinoma (HCC). However, evidence regarding the optimal drug sequence following AteBev treatment is limited. This study aimed to compare the treatment outcomes between tyrosine kinase inhibitors (TKIs) and durvalumab plus tremelimumab (DurTre) following AteBev treatment. PATIENTS AND METHODS: Overall, 134 consecutive patients who received AteBev for advanced HCC were enrolled in this study. Treatment outcomes were retrospectively compared between TKIs (AteBev→TKI group) and DurTre (AteBev→DurTre group). RESULTS: The AteBev→TKI and Ate→DurTre groups included 46 and 7 patients, respectively. The AteBev→TKI group had significantly longer median progression-free survival after second-line treatment (3.6 vs. 0.94 months, p<0.001). The disease control rate was significantly higher in the AteBev→TKI group (p=0.020). The serum alpha-fetoprotein levels significantly decreased at one month in the AteBev→TKI group (0.909 vs. 1.435, p=0.035), whereas the albumin-bilirubin score significantly decreased at one month in the AteBev→TKI group (0.875 vs. 0.952, p=0.017). Each group reported no new unmanageable adverse events. CONCLUSION: TKIs may be a more optimal drug sequence than DurTre after AteBev treatment from an oncological perspective. TKIs following AteBev treatment require careful monitoring for deteriorating liver function.2025年01月, Anticancer research, 45(1) (1), 251 - 260, 英語, 国際誌研究論文（学術雑誌）
- INTRODUCTION: Portal vein (PV) and splenic vein (SV) stenosis are known complications of pancreatoduodenectomy (PD) and often lead to portal hypertension. PV stenosis extending to the SV confluence can result in sinistral portal hypertension (SPH), characterized by gastrointestinal varices and splenomegaly in the presence of normal liver function. There is no standardized treatment strategy for SPH following PD. CASE PRESENTATION: A 42-year-old female underwent robot-assisted PD for a pancreatic neuroendocrine tumor without immediate PV complications. Postoperatively, the patient experienced fluid retention; however, this did not pose a problem, and no therapeutic intervention was necessary. Two months later, imaging revealed PV stenosis and SV obstruction. Eleven months after surgery, the patient presented with melena, and imaging confirmed the presence of gastroesophageal varices with severe PV stenosis and complete SV obstruction. Endoscopic variceal ligation was performed, and the hemodynamic status of the portal system was assessed using computed tomography during arterial portography (CTAP). CTAP showed communication between the superior mesenteric vein and the SV via the middle colic vein. Therefore, we decided to perform PV stenting. The stent was successfully placed, resulting in a significant improvement in the esophageal varices. The patient was discharged on postoperative day 4, receiving anticoagulant therapy, with no further complications. CONCLUSIONS: This case demonstrates the efficacy of PV stenting after careful hemodynamic assessment in a patient who developed SPH due to PV stenosis and SV obstruction following PD.2025年, Surgical case reports, 11(1) (1), 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Around 5-10 % of pancreatic cancer patients are non-expressors of carbohydrate antigen 19-9 (CA 19-9), which has an unknown impact on the aggressiveness and prognosis of pancreatic adenocarcinoma (PDAC). This study aimed to evaluate the characteristics and the prognosis of PDAC patients who do not express CA 19-9. METHODS: Patients with PDAC diagnosed between 2010 and 2018 were identified in the National Cancer Database. Clinical characteristics were compared according to CA 19-9 levels stratified in four different groups: non-expressors (≤1.0 U/mL), normal range (1.1-37.0 U/mL), mildly elevated (37.1-97.9 U/mL), and CA 19-9 ≥98.0 U/mL. The characteristics were analyzed in the whole cohort and overall survival (OS) was evaluated in a subgroup of upfront resected patients who had cT1-3 tumors without distant metastases. RESULTS: In total, 88,749 patients were included, of which 4.5 % were CA 19-9 non-expressors. The non-expressors had a higher risk of having distant metastasis at diagnosis, compared to patients with normal-range or mildly elevated CA 19-9 levels. In resected patients (n = 4008), CA 19-9 non-expressors had shorted median OS compared to patients with normal-range CA 19-9 levels (29.3 vs 34.4 months, p = 0.024). This OS association remained in a multivariable Cox regression model (adjusted HR 1.22, 95 % CI 1.04-1.44). CONCLUSIONS: CA 19-9 non-expression is associated with distant metastatic disease at diagnosis and with death in resected non-metastatic patients compared to normal-range CA 19-9 levels. This clinically relevant subgroup requires alternative biomarkers, and may need consideration of more extensive preoperative staging and intensive perioperative systemic therapy.2024年12月, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 24(8) (8), 1340 - 1347, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Systemic inflammation and altered metabolism are essential hallmarks of cancer. We hypothesized that the rapid turnover protein transthyretin (TTR) (half-life: 2-3 days), compared with the conventional marker albumin (21 days), better reflects the inflammatory/metabolic dynamics of pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy (NAT) and is a useful prognostic marker. METHODS: Serum TTR and albumin levels were measured in 104 consecutive post-NAT PDAC patients before curative resection. The associations of preoperative TTR and albumin levels with overall survival (OS) after pancreatectomy were retrospectively analyzed. RESULTS: The mean (SD) TTR and albumin levels were 21.6 (6.4) mg/dL (normal range: ≥22.0 mg/dL) and 3.9 (0.55) g/dL. A low (<22.0 mg/dL) post-NAT TTR level was associated with an advanced tumor stage and higher CEA and CRP levels. Patients with low TTR levels showed significantly worse OS compared with normal levels (3-year OS 39 % vs. 54 %, P = 0.037), although albumin levels did not. We modified prognostic biomarkers of systemic inflammation/metabolism, such as GPS, PNI, and CONUT scores, using the serum TTR instead of albumin level and successfully showed that modified scores were better associated with OS compared with original scores using serum albumin level. CONCLUSIONS: Our data suggest that the TTR level is a promising prognostic biomarker for PDAC patients after NAT.2024年09月, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 24(6) (6), 917 - 924, 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear. METHODS: We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023. RESULTS: Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences. CONCLUSION: The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss. THE TRIAL REGISTRATION NUMBER: B230165 (approved at December 26, 2023).2024年08月, Langenbeck's archives of surgery, 409(1) (1), 243 - 243, 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: The impact of postoperative bile leak on the prognosis of patients with hepatocellular carcinoma who underwent liver resection is controversial. This study aimed to investigate the prognostic impact of bile leak for patients with hepatocellular carcinoma who underwent liver resection. METHODS: Patients with hepatocellular carcinoma who underwent liver resection between 2009 and 2019 at Kobe University Hospital and Hyogo Cancer Center were included. After propensity score matching between the bile leak and no bile leak groups, differences in 5-year recurrence-free and overall survival rates were evaluated using the Kaplan-Meier method. RESULTS: A total of 781 patients, including 43 with postoperative bile leak, were analyzed. In the matched cohort, 40 patients were included in each group. The 5-year recurrence-free survival rates after liver resection were 35% and 32% for the bile leak and no bile leak groups, respectively (P = 0.857). The 5-year overall survival rates were 44% and 54% for the bile leak and no bile leak groups, respectively (P = 0.216). CONCLUSION: Overall, bile leak may not have a profound negative impact on the prognosis of patients with hepatocellular carcinoma who have undergone liver resection.2024年07月, Langenbeck's archives of surgery, 409(1) (1), 233 - 233, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Drainage fluid amylase (DFA) is useful for predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after distal pancreatectomy (DP). However, difference in optimal cutoff value of DFA for predicting CR-POPF between open DP (ODP) and laparoscopic DP (LDP) has not been investigated. This study aimed to identify the optimal cutoff values of DFA for predicting CR-POPF after ODP and LDP. METHODS: Data for 294 patients (ODP, n = 127; LDP, n = 167) undergoing DP at Kobe University Hospital between 2010 and 2021 were reviewed. Propensity score matching was performed to minimize treatment selection bias. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff values of DFA for predicting CR-POPF for ODP and LDP. Logistic regression analysis for CR-POPF was performed to investigate the diagnostic value of DFA on postoperative day (POD) three with identified cutoff value. RESULTS: In the matched cohort, CR-POPF rates were 24.7% and 7.9% after ODP and LDP, respectively. DFA on POD one was significantly lower after ODP than after LDP (2263 U/L vs 4243 U/L, p < 0.001), while the difference was not significant on POD three (543 U/L vs 1221 U/L, p = 0.171). ROC analysis revealed that the optimal cutoff value of DFA on POD one and three for predicting CR-POPF were different between ODP and LDP (ODP, 3697 U/L on POD one, 1114 U/L on POD three; LDP, 10564 U/L on POD one, 6020 U/L on POD three). Multivariate analysis showed that DFA on POD three with identified cutoff value was the independent predictor for CR-POPF both for ODP and LDP. CONCLUSIONS: DFA on POD three is an independent predictor for CR-POPF after both ODP and LDP. However, the optimal cutoff value for it is significantly higher after LDP than after ODP. Optimal threshold of DFA for drain removal may be different between ODP and LDP.2024年05月, Surgical endoscopy, 38(5) (5), 2699 - 2708, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND/AIM: This study aimed to evaluate the utility of the albumin-bilirubin grade for predicting the prognosis after repeat liver resection for patients with recurrent hepatocellular carcinoma. PATIENTS AND METHODS: Ninety patients with intrahepatic recurrent hepatocellular carcinoma who underwent repeat liver resection at our institution between 2005 and 2019 were retrospectively analyzed. Cox proportional-hazards regression models evaluated independent preoperative prognostic factors, including the albumin-bilirubin grade. Prognosis differences between patients with albumin-bilirubin grades 1 and 2 were analyzed using the Kaplan-Meier method. RESULTS: Cox proportional-hazards regression analysis revealed that albumin-bilirubin grade 2 (p=0.003) and early recurrence within one year from the initial surgery (p=0.001) were independently associated with poor recurrence-free survival, and albumin-bilirubin grade 2 (p=0.020) was independently associated with poor overall survival. The five-year recurrence-free (31% and 17%, respectively) and overall (86% and 60%, respectively) survival rates after repeat liver resection for patients with albumin-bilirubin grades 1 and 2 were significantly different between groups (both p=0.003). CONCLUSION: The albumin-bilirubin grade is useful for preoperatively predicting favorable survival rates after repeat liver resection for patients with recurrent hepatocellular carcinoma. Patients with an albumin-bilirubin grade 1 are better candidates for surgical treatment of recurrent hepatocellular carcinoma.2024年05月, Anticancer research, 44(5) (5), 2031 - 2038, 英語, 国際誌研究論文（学術雑誌）
- AIM: The IMbrave150 trial revealed that atezolizumab plus bevacizumab (AtezoBv) showed a higher objective response rate (ORR) in patients with advanced hepatocellular carcinoma (HCC). Although conversion therapy after AtezoBv has been recently reported, markers predictive of its efficacy, particularly radiological imaging markers, have not yet been identified. The present study focused on tumor morphological appearance on radiological imaging and evaluated whether it could be associated with AtezoBv efficacy. METHODS: Ninety-five intrahepatic lesions in 74 patients who were given AtezoBv for advanced HCC were recruited for evaluation. The lesions were divided into two groups, simple nodular (SN group) and non-simple nodular (non-SN group), based on the gross morphology on pretreatment imaging, and retrospectively evaluated for treatment response and other relevant clinical outcomes. RESULTS: Assessing the size of individual tumors after treatment, waterfall plots showed that tumor shrinkage in the non-SN group including 56 lesions was higher than that in the SN group comprising 39 lesions. The ORR was significantly higher in the non-SN group (39.3% vs. 15.4%, p = 0.012). Additionally, the median time to nodular progression was longer in the non-SN group (21.0 months vs. 8.1 months, p = 0.119) compared to the SN group. Six patients with non-SN lesions underwent sequential local therapy. CONCLUSIONS: Atezolizumab plus bevacizumab may show increased therapeutic efficacy in patients with tumors with a higher potential for aggressive oncological behavior, such as non-SN lesions. Treatment strategies focusing on conversion therapy may be crucial in patients with non-SN lesions.2024年02月, Hepatology research : the official journal of the Japan Society of Hepatology, 英語, 国際誌研究論文（学術雑誌）
- OBJECTIVE: The objective of this study was to assess the association of survival with neoadjuvant chemotherapy (NAC) in resectable pancreatic adenocarcinoma (PDAC). BACKGROUND: The early control of potential micrometastases and patient selection using NAC has been advocated for patients with PDAC. However, the role of NAC for resectable PDAC remains unclear. METHODS: Patients with clinical T1 and T2 PDAC were identified in the National Cancer Database from 2010 to 2017. Kaplan-Meier estimates, and Cox regression models were used to compare survival. To address immortal time bias, landmark analysis was performed. Interactions between preoperative factors and NAC were investigated in subgroup analyses. A propensity score analysis was performed to compare survival between multiagent NAC and upfront surgery. RESULTS: In total, 4041 patients were treated with upfront surgery and 1,175 patients were treated with NAC (79.4% multiagent NAC, 20.6% single-agent NAC). Using a landmark time of 6 months after diagnosis, patients treated with multiagent NAC had longer median overall survival compared with upfront surgery and single-agent NAC. (35.8 vs 27.1 vs 27.4 mo). Multiagent NAC was associated with lower mortality rates compared with upfront surgery (adjusted hazard ratio, 0.77; 95% CI, 0.70-0.85), whereas single-agent NAC was not. The association of survival with multiagent NAC were consistent in analyses using the matched data sets. Interaction analysis revealed that the association between multiagent NAC and a lower mortality rate did not significantly differ across age, facility type, tumor location, CA 19-9 levels, and clinical T/N stages. CONCLUSIONS: The findings suggest that multiagent NAC followed by resection is associated with improved survival compared with upfront surgery.2024年02月, Annals of surgery, 279(2) (2), 331 - 339, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of hepatectomy. The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding. Therefore, we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy. AIM: To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy. METHODS: The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed. Patients were divided into two groups according to whether or not they developed VTE after hepatectomy, as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities. Clinicopathological factors, including demographic data and perioperative D-dimer values, were compared between the two groups. Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value. Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors. RESULTS: In total, 234 patients who underwent hepatectomy were, of whom (5.6%) were diagnosed with VTE following hepatectomy. A comparison between the two groups showed significant differences in operative time (529 vs 403 min, P = 0.0274) and blood loss (530 vs 138 mL, P = 0.0067). The D-dimer levels on postoperative days (POD) 1, 3, 5, 7 were significantly higher in the VTE group than in the non-VTE group. In the multivariate analysis, intraoperative blood loss of > 275 mL [odds ratio (OR) = 5.32, 95% confidence interval (CI): 1.05-27.0, P = 0.044] and plasma D-dimer levels on POD 5 ≥ 21 μg/mL (OR = 10.1, 95%CI: 2.04-50.1, P = 0.0046) were independent risk factors for VTE after hepatectomy. CONCLUSION: Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.2024年01月, World journal of clinical cases, 12(2) (2), 276 - 284, 英語, 国際誌研究論文（学術雑誌）
- Transarterial chemoembolization (TACE) is performed for pancreatic neuroendocrine tumor (PanNEN) liver metastases; however, the safety and efficacy of TACE procedures, especially for patients who have undergone previous pancreatic surgery, have not been established. We reviewed 48 TACE procedures (1-6 procedures/patient) performed on 11 patients with PanNEN liver metastases, including 16 TACE procedures (4-6 procedures/patient) for 3 patients with a history of biliary-enteric anastomosis. The overall tumor objective response rate was 94%. The incidence of Clavien‒Dindo grade ≥ 2 complications was 1/16 (6%) and 1/32 (3%), and the median time to untreatable progression was 31 (14-41) and 27 (2-60) months among patients with and without a history of biliary-enteric anastomosis, respectively. Although validation is needed in future studies, our experiences have shown that TACE treatment is a viable treatment option for PanNEN liver metastases, even after biliary-enteric anastomosis with experienced teams and careful patient follow-up.2023年12月, Surgery today, 53(12) (12), 1396 - 1400, 英語, 国内誌研究論文（学術雑誌）
- [A Case of Ampullary Carcinoma with Celiac Axis Stenosis That Underwent Pancreaticoduodenectomy and Arterial Reconstruction].A 72-year-old male patient presented with obstructive jaundice and was diagnosed with ampullary carcinoma. Contrast- enhanced computed tomography(CT)showed stenosis of the common hepatic artery and dilatation of the pancreaticoduodenal arcade(PDA)due to celiac axis stenosis(CAS)at the origin, suggesting that hepatic artery blood flow was supplied from the superior mesenteric artery via the PDA. Since calcification of the arterial wall was observed at the origin of the celiac artery(CA), the cause of the CAS was diagnosed as atherosclerotic. An intraoperative gastroduodenal artery(GDA) clamp test showed no obvious decrease in hepatic arterial blood flow. However, because of concerns about the postoperative patency of the CA, an inferior pancreaticoduodenal artery-GDA bypass using the left great saphenous vein and subtotal stomach-preserving pancreaticoduodenectomy were performed. The postoperative course was uneventful. When pancreaticoduodenectomy is performed in patients with atherosclerotic CAS, this arterial reconstruction method can be considered as an option.2023年12月, Gan to kagaku ryoho. Cancer & chemotherapy, 50(13) (13), 1534 - 1536, 日本語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Postoperative cholangitis is a common complication of pancreaticoduodenectomy. Frequent cholangitis impairs patients' quality of life after pancreaticoduodenectomy. However, the risk factors for recurrence of cholangitis remain unclear. Hence, this retrospective study aimed to identify risk factors for recurrence of cholangitis after pancreaticoduodenectomy. METHODS: The medical records of patients who underwent pancreaticoduodenectomy between 2015 and 2019 in our institution were retrospectively reviewed. At least two episodes of cholangitis a year after pancreaticoduodenectomy were defined as 'recurrence of cholangitis' in the present study. Univariate and multivariate analyses were performed. RESULTS: The recurrence of cholangitis occurred in 40 of 207 patients (19.3%). Multivariate analysis revealed that internal stent (external, RR: 2.16, P = 0.026; none, RR: 4.76, P = 0.011), firm pancreas (RR: 2.61, P = 0.021), constipation (RR: 3.49, P = 0.008), and postoperative total bilirubin>1.7 mg/dL (RR: 2.94, P = 0.006) were risk factors of recurrence of cholangitis. Among patients with internal stents (n = 54), those with remnant stents beyond 5 months had more frequent recurrence of cholangitis (≥5 months, 75%; <5 months, 30%). CONCLUSIONS: Internal stents, firm pancreas, constipation, and postoperative high bilirubin levels are risk factors for cholangitis recurrence after pancreaticoduodenectomy. In addition, the long-term implantation of internal stents may trigger cholangitis recurrence.2023年10月, World journal of surgery, 47(10) (10), 2499 - 2506, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Long-term outcomes and prognostic factors of proton radiotherapy for locally advanced pancreatic cancer (LAPC) in the body and tail are still unknown. The aim of this study was to determine the prognostic factors after proton radiotherapy in a large group of patients with LAPC in the body and tail. METHODS: The medical records of 200 patients with LAPC in the body and tail who underwent proton radiotherapy between February 2009 and January 2021 at the Hyogo Ion Beam Medical Center were retrospectively reviewed to identify prognostic factors that contribute to long-term survival. RESULTS: The overall survival rate at 1- and 2-year after PT was 69.6% and 35.4% with a median overall survival of 18.4 months. The 1- and 2-year local progression-free, and progression-free survival rates were 84.3% and 68.0%, and 44.3% and 19.4%, respectively. In multivariate analysis, superior mesenteric artery (SMA) invasion (SMA only invasion vs. celiac artery only invasion; P = 0.049: SMA and celiac artery invasion vs. celiac artery only invasion; P = 0.017), carbohydrate antigen 19-9 (CA 19-9) level ≥ 231.9 U/mL (P = 0.001), anterior peripancreatic invasion (P = 0.006), and incomplete scheduled concurrent chemotherapy (P = 0.009) were statistically significant prognostic factors for overall survival. There was no significant difference in local progression-free survival; however, distant metastasis-free survival was statistically worse in patients with prognostic factors than in those without. CONCLUSIONS: Proton radiotherapy for LAPC in the body and tail may be a valuable multidisciplinary treatment option. Patients with SMA invasion, higher pre-proton radiotherapy serum CA 19-9 level, anterior peripancreatic invasion, or incomplete scheduled concurrent chemotherapy had worse overall survival because of worse distant metastasis-free survival, suggesting that distant metastases have a significant impact on overall survival in such patients. TRIAL REGISTRATION: Retrospectively registered.2023年08月, Radiation oncology (London, England), 18(1) (1), 131 - 131, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Less intra-abdominal adhesions are expected following laparoscopic surgery. Although an initial laparoscopic approach for primary liver tumors may have advantages in patients who require repeat hepatectomies for recurrent liver tumors, this has not been sufficiently investigated. METHODS: Patients who underwent repeat hepatectomies for recurrent liver tumors at our hospital between 2010 and 2022 were retrospectively analyzed. Of 127 patients, 76 underwent laparoscopic repeat hepatectomy (LRH), of whom 34 patients initially underwent laparoscopic hepatectomy (L-LRH) and 42, open hepatectomy (O-LRH). Fifty-one patients underwent open hepatectomy as both the initial and second operation (O-ORH). We analyzed surgical outcomes between L-LRH and O-LRH groups and between L-LRH and O-ORH groups using propensity-matching analysis for each pattern. RESULTS: Twenty-one patients each were included in L-LRH and O-LRH propensity-matched cohorts. The L-LRH group had a lower rate of postoperative complications than the O-LRH group (0 vs 19%, P = 0.036). When we compared surgical outcomes between L-LRH and O-ORH groups in another matched cohort with 18 patients in each group, in addition to the lower rate of postoperative complications, the L-LRH group had additional favorable surgical outcomes including shorter operation time and lower blood loss volume than the O-ORH group (291 vs 368 min, P = 0.037 and 10 vs 485 mL, P < 0.0001). CONCLUSIONS: An initial laparoscopic approach would be favorable for patients undergoing repeat hepatectomies, as it leads to lower risk of postoperative complications. Compared with O-ORH, the advantage of the laparoscopic approach may be enhanced when it is repeatedly adopted.2023年08月, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 27(8) (8), 1621 - 1631, 英語, 国際誌研究論文（学術雑誌）
- IMPORTANCE: The total number of patients with pancreatic ductal adenocarcinoma (PDAC) who receive neoadjuvant chemotherapy (NAC) is increasing. However, the added role of adjuvant chemotherapy (AC) in these patients remains unknown. OBJECTIVE: To evaluate the association of AC with overall survival (OS) in patients with PDAC who received multiagent NAC followed by curative-intent surgery. DESIGN, SETTING, AND PARTICIPANTS: This retrospective, matched-cohort study used data from the National Cancer Database and included patients with PDAC diagnosed between 2010 and 2018. The study included patients at least 18 years of age who received multiagent NAC followed by surgical resection and had available records of the pathological findings. Patients were excluded if they had clinical or pathological stage IV disease or died within 90 days of their operation. EXPOSURES: All included patients received NAC and underwent resection for primary PDAC. Some patients received adjuvant chemotherapy. MAIN OUTCOMES AND MEASURES: The main outcome was the OS of patients who received AC (AC group) vs those who did not (non-AC group). Interactions between pathological findings and AC were investigated in separate multivariable Cox regression models. RESULTS: In total, 1132 patients (mean [SD] age, 63.5 [9.4] years; 577 [50.1%] male; 970 [85.7%] White) were included, 640 patients in the non-AC group and 492 patients in the AC group. After being matched by propensity score according to demographic and pathological characteristics, 444 patients remained in each group. The multivariable Cox regression model adjusted for all covariates revealed an association between AC and improved survival (hazard ratio, 0.71; 95% CI, 0.59-0.85; P < .001). Subgroup interaction analysis revealed that AC was significantly associated with better OS (26.6 vs 21.2 months; P = .002), but the benefit varied by age, pathological T category, and tumor differentiation. Of note, AC was associated with better survival in patients with any pathological N category and positive margin status. CONCLUSIONS AND RELEVANCE: In this cohort study, AC following multiagent NAC and resection in patients with PDAC was associated with significant survival benefit compared with that in patients who did not receive AC. These findings suggest that patients with aggressive tumors may benefit from AC to achieve prolonged survival, even after multiagent NAC and curative-intent resection.2023年03月, JAMA oncology, 9(3) (3), 316 - 323, 英語, 国際誌研究論文（学術雑誌）
- Solid organ transplantation (SOT) recipients are known to carry an increased risk of malignancy because of long-term immunosuppression. However, the progression of intraductal papillary mucinous neoplasm of the pancreas (IPMN) in this population remains unclear. We performed a systematic review by searching PubMed, Embase, Scopus, and Google Scholar. All studies containing IPMNs in solid organ transplantation recipients were screened. We included 11 studies in our final analysis, totaling 274 patients with IPMNs of the 8213 SOT recipients. The prevalence from 8 studies was 4.7% (95% CI 2.4%-7.7%) in a random-effects model with median study periods of 24 to 220 months. The median rate for all progressions from 10 studies was 20% (range, 0%-88%) within 13 to 41 months of the median follow-up time. By utilizing the results of 3 case-control studies, the relative risk from a random-effects model for progression (worrisome features and high-risk stigmata) of IPMNs was 0.39 (95% CI 0.12-1.31). No adenocarcinoma derived from IPMN was reported in the included studies. Overall, this study indicates that the progression of pretransplant IPMN does not increase drastically compared with the general nontransplant population. However, considering the limited literature, further studies are required for confirmation.2023年03月, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 23(3) (3), 429 - 436, 英語, 国際誌研究論文（学術雑誌）
- IMPORTANCE: The number of patients with small nonfunctional pancreatic neuroendocrine tumors (NF-PanNETs) is increasing. However, the role of surgery for small NF-PanNETs remains unclear. OBJECTIVE: To evaluate the association between surgical resection for NF-PanNETs measuring 2 cm or smaller and survival. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the National Cancer Database and included patients with NF-pancreatic neuroendocrine neoplasms who were diagnosed between January 1, 2004, and December 31, 2017. Patients with small NF-PanNETs were divided into 2 groups: group 1a (tumor size, ≤1 cm) and group 1b (tumor size, 1.1-2.0 cm). Patients without information on tumor size, overall survival, and surgical resection were excluded. Data analysis was performed in June 2022. EXPOSURES: Patients with vs without surgical resection. MAIN OUTCOMES AND MEASURES: The primary outcome was overall survival of patients in group 1a or group 1b who underwent surgical resection compared with those who did not, which was evaluated using Kaplan-Meier estimates and multivariable Cox proportional hazards regression models. Interactions between preoperative factors and surgical resection were analyzed with a multivariable Cox proportional hazards regression model. RESULTS: Of the 10 504 patients with localized NF-PanNETs identified, 4641 were analyzed. These patients had a mean (SD) age of 60.5 (12.7) years and included 2338 males (50.4%). The median (IQR) follow-up time was 47.1 (28.2-71.6) months. In total, 1278 patients were in group 1a and 3363 patients were in group 1b. The surgical resection rates were 82.0% in group 1a and 87.0% in group 1b. After adjustment for preoperative factors, surgical resection was associated with longer survival for patients in group 1b (hazard ratio [HR], 0.58; 95% CI, 0.42-0.80; P < .001) but not for patients in group 1a (HR, 0.68; 95% CI, 0.41-1.11; P = .12). In group 1b, interaction analysis found that age of 64 years or younger, absence of comorbidities, treatment at academic institutions, and distal pancreatic tumors were factors associated with increased survival after surgical resection. CONCLUSIONS AND RELEVANCE: Findings of this study support an association between surgical resection and increased survival in select patients with NF-PanNETs measuring 1.1 to 2.0 cm who were younger than 65 years, had no comorbidities, received treatment at academic institutions, and had tumors of the distal pancreas. Future investigations of surgical resection for small NF-PanNETs that include the Ki-67 index are warranted to validate these findings.2023年03月, JAMA network open, 6(3) (3), e234096, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has a high recurrence rate even after curative resection. Lung recurrence may have better outcomes than other recurrences. However, its detailed clinicopathological features are unclear. We investigated the clinicopathological features and risk factors for lung recurrence after pancreatectomy for PDAC. METHODS: The study included 161 patients with potentially and borderline resectable PDAC who had undergone R0 or R1 pancreatectomy between January 2008 and December 2016. We retrospectively examined the prognosis and predictors for lung recurrence after curative resection. RESULTS: Seventeen patients (10.6%) had isolated lung recurrence. The median overall and recurrence-free survivals were 38.0 and 16.1 months, respectively. In multivariate analysis, para-aortic lymph node (PALN) metastasis (p = 0.006) and female sex (p = 0.027) were independent factors for lung recurrence. CONCLUSION: Lung recurrence had a better prognosis than other recurrences. PALN metastasis and female sex are independent risk factors for lung recurrence after curative resection for PDAC.2023年01月, Asian journal of surgery, 46(1) (1), 207 - 212, 英語, 国際誌研究論文（学術雑誌）
- Stapling is the standard method for pancreatic transection during laparoscopic distal pancreatectomy. Although most surgeons use a 60 mm cartridge stapler, space limitations created by laparoscopic surgery make the instrument difficult to handle, especially during pancreatic transection at the neck. Therefore, we currently use a 45 mm cartridge stapler for laparoscopic pancreatic transection at the neck. Between October 2019 and December 2020, we performed pancreatic transection using a 45 mm cartridge stapler in 27 patients. Fifteen patients experienced biochemical leakage, but no patients developed clinically relevant pancreatic fistula. The compactness of the 45 mm cartridge has several benefits: (1) less space is required for flexing, opening, and closing the device; (2) it enables easy insertion of the lower jaw behind the pancreas, even if the dissected space behind the pancreas is narrow; (3) less obstruction of the surgeons' view prevents accidental injury to the surrounding tissues and vessels. These benefits may enable safe pancreatic transection.2023年01月, Surgery today, 53(1) (1), 153 - 157, 英語, 国内誌研究論文（学術雑誌）
- 2023年01月, Surgery today, 53(1) (1), 158 - 158, 英語, 国内誌
- BACKGROUND/AIM: Atezolizumab plus bevacizumab therapy is the new standard treatment option for advanced hepatocellular carcinoma (HCC). The clinical details and sequential course after atezolizumab plus bevacizumab therapy remain to be determined. PATIENTS AND METHODS: Thirty-four consecutive patients who received atezolizumab plus bevacizumab therapy were evaluated. Their clinical outcomes were assessed according to liver function classified by modified albumin-bilirubin (ALBI) grade 1 and 2a (1/2a) versus 2b and treatment line (first-line versus second- or later-line). Furthermore, the treatment sequence after atezolizumab plus bevacizumab therapy was also assessed. RESULTS: The objective response and disease control rates were 15.6% and 93.8%, respectively. The median proportions of ALBI scores at 1, 2, and 3 months relative to the baseline scores were 0.94, 0.97, and 0.93, respectively. The median proportions of α-fetoprotein (AFP) scores at 1, 2, and 3 months relative to the baseline scores were 0.98, 1.12, and 1.83, respectively. There were no significant differences in the changes in the proportions of AFP and ALBI scores according to both liver function and treatment line. Twelve patients were administered lenvatinib treatment after the failure of atezolizumab plus bevacizumab therapy. The proportions of AFP and ALBI scores at 1 month relative to the baseline scores were 0.55 and 0.81, respectively. CONCLUSION: Atezolizumab plus bevacizumab therapy can be effective for advanced HCC irrespective of the patients' liver function and treatment line. Lenvatinib administration after atezolizumab plus bevacizumab therapy can be effective, although special attention should be paid to the deterioration of liver function.2022年03月, Anticancer research, 42(3) (3), 1403 - 1412, 英語, 国際誌研究論文（学術雑誌）
- [Laparoscopic Distal Pancreatectomy for Pancreatic Metastasis of Undifferentiated Pleomorphic Sarcoma-A Case Report].Undifferentiated pleomorphic sarcoma(UPS)is a non-epithelial malignant tumor with a high rate of recurrence and metastasis. The frequent metastasis site is lung, lymph node, liver and bone. Pancreatic metastasis is rare. 71-year-old woman whose course after right foot UPS resection had been followed up at our hospital. But multiple bone and muscle metastasis occurred 1 year after operation. She had resection or radiation for the recurrence. 3 years after the first operation, PET-CT and EUS-FNA revealed pancreatic tail metastasis. The tumor grew up in 6 months, so we performed laparoscopic distal pancreatectomy. The patient recovered uneventfully and was discharged on post-operative day 14. Currently 5 years and 6 months have passed since the first surgery and she is alive. Function-preserving and minimally invasive surgery for UPS pancreatic metastasis is considered to be essential.2022年01月, Gan to kagaku ryoho. Cancer & chemotherapy, 49(1) (1), 80 - 82, 日本語, 国内誌研究論文（学術雑誌）
- OBJECTIVE: This study aimed to determine whether retrocolic alimentary tract reconstruction is noninferior to antecolic reconstruction in terms of DGE incidence after pancreatoduodenectomy (PD) and investigated patients' postoperative nutritional status. SUMMARY OF BACKGROUND DATA: The influence of the route of alimentary tract reconstruction on DGE after PD is controversial. METHODS: Patients from 9 participating institutions scheduled for PD were randomly allocated to the retrocolic or antecolic reconstruction groups. The primary outcome was incidence of DGE, defined according to the 2007 version of the International Study Group for Pancreatic Surgery definition. Noninferiority would be indicated if the incidence of DGE in the retrocolic group did not exceed that in the antecolic group by a margin of 10%. Patients' postoperative nutrition data were compared as secondary outcomes. RESULTS: Total, 109 and 103 patients were allocated to the retrocolic and antecolic reconstruction group, respectively (n = 212). Baseline characteristics were similar between both groups. DGE occurred in 17 (15.6%) and 13 (12.6%) patients in the retrocolic and antecolic group, respectively (risk difference; 2.97%, 95% confidence interval; -6.3% to 12.6%, which exceeded the specified margin of 10%). There were no differences in the incidence of other postoperative complications and in the duration of hospitalization. Postoperative nutritional indices were similar between both groups. CONCLUSIONS: This trial could not demonstrate the noninferiority of retrocolic to antecolic alimentary tract reconstruction in terms of DGE incidence. The alimentary tract should not be reconstructed via the retrocolic route after PD, to prevent DGE.2021年12月, Annals of surgery, 274(6) (6), 935 - 944, 英語, 国際誌研究論文（学術雑誌）
- A 68-year-old man who had undergone distal gastrectomy for gastric cancer 3 years previously, presented to our hospital for examination of dilatation of the main pancreatic duct on follow-up computed tomography and magnetic resonance cholangiopancreatography. After examination, he was diagnosed with early-stage pancreatic cancer and distal pancreatectomy (DP) was planned. With informed consent, we performed indocyanine green (ICG) fluorography during DP and digital subtraction angiography (DSA) of vessels supplying the remnant stomach immediately before and after DP. On ICG fluorography, the remnant stomach gradually became fluoresced starting at the area of the lesser curvature, and the fluorescence eventually intensified over the entire area of the remnant stomach to the same brightness as that of the liver and duodenum. On DSA following DP, the terminal branches of the left inferior phrenic artery (LIPA) were distributed to more than half of the area of the remnant stomach, centering around the proximal area. It is useful to confirm blood flows to the remnant stomach by ICG fluorography using a near-infrared imaging camera during DP. We found that the LIPA played an important role in maintaining the blood supply to the remnant stomach in the absence of the left gastric artery and splenic artery.2021年12月, Clinical journal of gastroenterology, 14(6) (6), 1749 - 1755, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Effects of pancreatectomy on glucose tolerance have not been clarified, and evidence regarding the difference in postoperative glucose tolerance between pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) is lacking. STUDY DESIGN: This prospective, single-center observational study analyzed 40 patients undergoing PD and 29 patients undergoing DP (Clinical trial registry number UMIN000008122). Glucose tolerance, including insulin secretion (Δ C-peptide immunoreactivity, ΔCPR) and insulin resistance (homeostasis model assessment of insulin resistance, HOMA-IR) were assessed before and 1 month after pancreatectomy using the oral glucose tolerance test (OGTT) and glucagon stimulation test. We assessed long-term hemoglobin A1c (HbA1c) levels in patients, with a follow-up time of 3 years. RESULTS: Percentages of patients diagnosed with abnormal OGTT decreased after PD (from 12 [30%] to 7 [17.5%] of 40 patients, p = 0.096); however, they increased after DP (from 4 [13.8%] to 8 [27.6%] of 29 patients, p = 0.103), although the changes were not statistically significant. ΔCPR decreased after both PD (from 3.2 to 1.0 ng/mL, p < 0.001) and DP (from 3.3 to 1.8 ng/mL, p < 0.001). HOMA-IR decreased after PD (from 1.10 to 0.68, p < 0.001), but did not change after DP (1.10 and 1.07, p = 0.42). Median HbA1c level was higher after DP than after PD for up to 3 years, but the differences were not statistically significant. CONCLUSIONS: In comparisons of pre- and 1 month post-pancreatectomy data, glucose tolerance showed improvement after PD, whereas it worsened after DP. Insulin secretion decreased after both PD and DP. Insulin resistance improved after PD, but did not change after DP. Further studies are warranted to clarify mechanisms of improved insulin resistance after PD.2021年12月, Journal of the American College of Surgeons, 233(6) (6), 753 - 762, 英語, 国際誌研究論文（学術雑誌）
- [A Patient with Ascending Jejunal Mesentery Metastasis of Pancreatic Cancer after a Subtotal Stomach-Preserving Pancreaticoduodenectomy].A 73-year-old woman underwent a subtotal stomach-preserving pancreaticoduodenectomy, wedge resection of the portal vein, and partial resection of the transverse colon for pancreatic cancer at the age of 71. After 18 months, a computed tomography image showed an 8 mm tumor in the ascending jejunal mesentery. Six months later, the tumor grew to 20 mm and had an increased FDG uptake. The tumor was diagnosed as metastasis of pancreatic cancer to the ascending jejunal mesentery. Since no metastasis was found in the other organs, resection was performed. The pathological results showed adenocarcinoma with proximal lymph node metastasis. The patient was diagnosed with ascending jejunal mesentery metastasis of pancreatic cancer. The patient has remained healthy without recurrent disease 1 year 6 months after the resection. Ascending jejunal mesentery metastasis of pancreatic cancer is a type of distant metastasis. In the absence of metastasis to other organs, it is tolerable and radical resection is possible.2021年12月, Gan to kagaku ryoho. Cancer & chemotherapy, 48(13) (13), 2008 - 2010, 日本語, 国内誌研究論文（学術雑誌）
- [A Case of Pancreatic Cancer with Gastric Wall Recurrence after Laparoscopic Distal Pancreatectomy Due to Needle Tract Seeding following EUS-FNA].A woman in her 80s was diagnosed with pancreatic tail cancer by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). We performed laparoscopic distal pancreatectomy followed by adjuvant chemotherapy with S-1 for 6 months. One year after surgery, contrast-enhanced computed tomography revealed a 15 mm mass in the posterior wall of the gastric body. EUS showed a hypoechoic mass in the muscular layer in the gastric wall, which was diagnosed as adenocarcinoma by FNA. We diagnosed gastric wall recurrence due to needle tract seeding(NTS)following EUS-FNA and performed partial gastrectomy. Histopathological diagnosis was gastric wall recurrence of pancreatic cancer. Since NTS following EUS-FNA can be proven only by the presence of gastric wall recurrence after surgery for pancreatic body or tail cancer, the actual risk of NTS including peritoneal dissemination is not clear and may have been underestimated. In case of resectable pancreatic body or tail cancer, indication for EUS-FNA should be carefully considered.2021年12月, Gan to kagaku ryoho. Cancer & chemotherapy, 48(13) (13), 2011 - 2013, 日本語, 国内誌研究論文（学術雑誌）
- Highlight Venous tumor thrombus can occur in association with pancreatic neuroendocrine neoplasm. Ishida and colleagues report their experience with a patient in whom a solitary recurrent tumor developed in the portal vein after pancreaticoduodenectomy for pancreatic neuroendocrine neoplasm. They performed portal vein resection and reconstruction using a left external iliac vein graft.2021年08月, Journal of hepato-biliary-pancreatic sciences, 28(8) (8), e36-e37, 英語, 国内誌研究論文（学術雑誌）
- Indication of Surgical Hepatectomy for the Patients of Hepatocellular Carcinoma with Inferior Vena Cava Tumor Thrombosis.The prognosis of hepatocellular carcinoma (HCC) presenting with inferior vena cava tumor thrombus (IVCTT) is extremely poor. The aim of this study was to reveal the postoperative course and to identify patients who have survived surgical hepatectomy among HCC patients with IVCTT. Between January 2006 and December 2018, 643 patients underwent surgical hepatectomy for HCC at Kobe University Hospital. Among them, 20 patients were categorized as Vv3 according to the Japanese staging system. We retrospectively collected detailed data on these patients. The statistical, clinical, and pathological data were recorded prospectively and analyzed retrospectively. The median survival time was 9.8 months. Among all patients, 11 (55%) achieved R0 resection, and only two survivors were from this group. The number of tumors (solitary vs. multiple; p=0.050) and pathological Vp (pVp0 vs. other; p=0.009) were identified as risk factors for overall survival in the univariate analysis. In the multivariate analysis, pathological Vp (pVp0 vs. other; p=0.037) was identified as a significant prognostic factor for survival. Pathological Vp affected overall survival among IVCTT patients; the median survival time was 53.7 months with pVp0, 10.2 months with pVp1, and 8.8 months with pVp2-4 (p=0.035). For patients with IVCTT, surgical hepatectomy should be indicated only for those who do not have portal vein invasion and could achieve R0 resection.2021年06月, The Kobe journal of medical sciences, 67(1) (1), E10-E17, 英語, 国内誌研究論文（学術雑誌）
- The bifid pancreas is a rare anatomical variation of the pancreatic duct in which double main pancreatic ducts in the body and tail of the pancreas join at the pancreas head and drain through the major papilla. When pancreaticoduodenectomies are carried out on bifid pancreases, close attention must be paid to the reconstruction because of the possibility that there may be two pancreatic ducts that need to be reconstructed. We present a case of pancreaticoduodenectomy for the bifid pancreas and a novel technique named the 'two-in-one' method for double pancreatic duct to jejunum anastomosis. Using the two-in-one method, we anastomosed one jejunal hole to a double pancreatic duct. Pancreatic texture was normal and postoperative volumes of pancreatic juice from the two external pancreatic duct stents were 250 mL and 100 mL/day, respectively. Postoperative recovery went well although the patient needed a slightly longer hospital stay as a result of surgical site infection. This novel anastomotic technique was as simple to carry out as a normal pancreaticojejunostomy and may be useful for reconstruction of the bifid pancreas.2020年03月, Annals of gastroenterological surgery, 4(2) (2), 175 - 179, 英語, 国内誌研究論文（学術雑誌）
- [A Patient with Multiple Pancreatic Metastases Undergoing Total Pancreatectomy 18 Years after Renal Cell Carcinoma Resection].A 71-year-old woman underwent right nephrectomy for the treatment of clear cell renal cell carcinoma at the age of 53. After 15 years, surgical removal of a solitary tumor was performed in the right adrenal gland and thyroid gland; both were diagnosed as metastases of renal cell carcinoma. Eighteen years after the initial resection, computed tomography(CT) showed multiple hypervascular tumors spreading across the entire area of the pancreas. She was referred to our hospital, and endoscopic ultrasound-guided fine needle aspiration biopsy(EUS-FNA)revealed that they were metastases from the renal cell carcinoma. Total pancreatectomy and splenectomy were performed, and the patient remains alive and well with no evidence of recurrent disease 7 months after the pancreatectomy. Furthermore, her blood glucose level is well controlled with insulin therapy.2018年12月, Gan to kagaku ryoho. Cancer & chemotherapy, 45(13) (13), 2214 - 2216, 日本語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Perioperative management for patients receiving long-term anticoagulant (AC) and antiplatelet (AP) therapy is a great concern for surgeons. This single-center retrospective study evaluated the risks of hemorrhage and thromboembolism after hepato-biliary-pancreatic (HBP) surgery in such patients. METHODS: Between 2009 and 2014, 886 patients underwent HBP surgery. Patients were categorized into the AC (n = 39), AP (n = 77), or control (n = 770) group according to the administration of antithrombotic drugs. Perioperative management of AC and AP therapies followed the guidelines of the Japanese Circulation Society. The incidences of hemorrhage and thromboembolism were compared among groups. We used 1:1 propensity score matching and compared the incidences between the matched pairs. RESULTS: There were 0, 1 (1.3%), and 26 (3.4%) hemorrhagic complications in the AC, AP, and control groups, respectively (p = 0.16). There were 0, 1 (1.3%), and 6 (0.8%) thromboembolic complications in the AC, AP, and control groups, respectively (p = 0.66). There was no significant difference in hemorrhagic and thromboembolic complications between the propensity-matched pairs. CONCLUSION: The incidences of hemorrhage and thromboembolism after HBP surgery in patients receiving long-term AC and AP therapies are within acceptable ranges.2017年, Digestive surgery, 34(2) (2), 114 - 124, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本移植学会, 2016年09月, 移植, 51(総会臨時) (総会臨時), 419 - 419, 日本語十二指腸グラフトが起因した縫合不全の2例
- PURPOSE: The therapeutic strategy for borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) has remained unestablished because the preoperative prognostic factors have not been determined. METHODS: One hundred eighty-four consecutive PDAC patients who underwent upfront surgery with a curative resection between January 2000 and June 2013 at Kobe University Hospital were retrospectively studied. The PDAC patients were stratified into resectable (R)-PDAC (n = 147) and BR-PDAC patients (n = 37). We evaluated the independent prognostic significance of the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) in the BR-PDAC patients. RESULTS: BR-PDAC patient survival was significantly worse than R-PDAC patient survival (median survival time: 22.1 months vs. 24.3 months; 5-year survival rate 6 vs. 21 %; P = 0.042). The median survival in BR-PDAC patients with a preoperative NLR of >3 (n = 12) was 10.2 months, while that in patients with preoperative NLR of ≤3 (n = 25) was 24.9 months (P = 0.002). Moreover, the median survival in BR-PDAC patients with a preoperative PLR of >225 (n = 8) was 10.2 months, while that in patients with a preoperative PLR of ≤225 (n = 29) was 24.7 months (P = 0.003). Preoperative NLR >3 (HR = 2.980, 95 % CI 1.251-6.920; P = 0.015) and PLR >225 (HR = 3.050, 95 % CI 1.169-7.468; P = 0.024) were independent prognostic factors in BR-PDAC patients. CONCLUSIONS: Higher preoperative NLR and PLR can be independent predictive risk factors in BR-PDAC patients following curative resection.2016年05月, Surgery today, 46(5) (5), 583 - 92, 英語, 国内誌研究論文（学術雑誌）
- (一社)日本外科学会, 2016年04月, 日本外科学会定期学術集会抄録集, 116回, PS - 1, 日本語局所進行膵癌に対する粒子線治療を用いた治療戦略
- OBJECTIVES: The aim of this study was to determine the incidence rate and clinical features of second primary pancreatic ductal carcinoma (SPPDC) in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma (PDC). METHODS: Data of patients undergoing R0 resection for PDC at a single high-volume center were reviewed. SPPDC was defined as a tumor in the remnant pancreas after R0 resection for PDC, and SPPDC met at least one of the following conditions: 1) the time interval between initial pancreatectomy and development of a new tumor was 3 years or more; 2) the new tumor was not located in contact with the pancreatic stump. We investigated the clinical features and treatment outcomes of patients with SPPDC. RESULTS: This study included 130 patients who underwent surgical resection for PDC between 2005 and 2014. Six (4.6%) patients developed SPPDC. The cumulative 3- and 5-year incidence rates were 3.1% and 17.7%, respectively. Four patients underwent remnant pancreatectomy for SPPDC. They were diagnosed with the disease in stage IIA or higher and developed recurrence within 6 months after remnant pancreatectomy. One patient received carbon ion radiotherapy and survived 45 months. One patient refused treatment and died 19 months after the diagnosis of SPPDC. CONCLUSIONS: The incidence rate of SPPDC is not negligible, and the cumulative 5-year incidence rate of SPPDC is markedly high. Post-operative surveillance of the remnant pancreas is critical for the early detection of SPPDC, even in long-term survivors after PDC resection.2016年, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 16(4) (4), 615 - 20, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内視鏡外科学会, 2015年12月, 日本内視鏡外科学会雑誌, 20(7) (7), SY27 - 7, 日本語腹腔鏡下膵切除術 安全な術式の定型化を目指して 腹腔鏡下尾側膵切除術の安全な術式の定型化
- BACKGROUND: Adjuvant chemotherapy (AC) is recommended as a standard treatment after curative resection in patients with pancreatic adenocarcinoma (PA). Although patients who failed to complete AC had significantly worse survival compared with those who completed AC for cancers in various organs, the effects of complete AC on survival in patients with PA have not been investigated. The purpose of this study was to clarify the impact of complete AC on PA patient survival and to identify independent risk factors for incomplete AC. METHODS: Medical records of 236 consecutive PA patients who planned to undergo surgical resection with curative intent between January 2000 and September 2012 at Kobe University Hospital were retrospectively reviewed. Of these, the complete AC (n = 75) and the incomplete AC (n = 30) groups due to adverse events were compared. RESULTS: Patient survival was significantly better in the complete AC group than in the incomplete AC group (median survival time 48.9 vs. 17.9 months; 5-year survival rate 42.7 vs. 17.1 %; p < 0.0001). Preoperative white blood cell count and postoperative serum albumin level were identified as independent risk factors for incomplete AC. By receiver operating characteristic curve analysis, the cutoff value of postoperative serum albumin level was 3.1 mg/dL. CONCLUSIONS: PA patients who completed AC had significantly better survival than those who failed to complete AC. Postoperative serum albumin level is a marker for failure to complete AC. Further prospective studies are needed to determine whether perioperative nutritional intervention could increase AC completion rate and improve prognosis in PA patients.2015年07月, Annals of surgical oncology, 22(7) (7), 2408 - 15, 英語, 国際誌研究論文（学術雑誌）
- [A case of adjuvant surgery for a patient with initially unresectable locally advanced pancreatic cancer (LAPC) with a favorable response to S-1 chemotherapy].A 67-year-old man was admitted to our hospital with a complaint of epigastric discomfort. A 29-mm hypovascular tumor was detected in the head of the pancreas by abdominal computed tomography imaging. As the superior mesenteric artery (SMA) was also involved, we diagnosed the tumor as unresectable pancreatic cancer. With S-1 chemotherapy, a radiological partial response was seen. After 4 courses of chemotherapy, a subtotal-stomach-preserving-pancreatoduodenectomy with dissection of the nerve plexus surrounding the SMA was performed. Although the tissue surrounding the SMA was hard, invasion of the SMA was not detected. Microscopic investigation revealed a few moderately differentiated adenocarcinoma cells in the fibrous tissue and the nerve fibers of pancreas. No cancer cells were found at the edges of the surgical specimen. The patient underwent R0 resection and a pathological evaluation showed Grade III tumor according to the Evans classification. After surgery, S-1 was interrupted because of diarrhea and local recurrence appeared 4 months postoperatively. For improving the prognosis of patients with pancreatic cancers, surgical intervention is often performed in patients with initially unresectable pancreatic cancers who have "long-term" favorable responses to chemotherapy or chemoradiotherapy. However, because of the possibility of relatively good prognosis with nonsurgical treatment for such patients and also the demerits of surgical stress, it is important to carefully consider the adjuvant surgery option.2014年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 41(12) (12), 2178 - 80, 日本語, 国内誌研究論文（学術雑誌）
- [Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy].Here, we report a case of Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy. A 69-year old man underwent pancreatoduodenectomy for pancreatic cancer in 2006 in which the splenic vein was ligated near the portal vein and then divided. The patient suffered repeated episodes of anemia between 2010 and 2013. However, we could not identify the bleeding site at that time. In 2011, local recurrence was detected. Disease progression occurred despite chemotherapy treatment, which was then discontinued. The left-sided portal hypertension gradually progressed, and the collateral vessels became dilated. In 2014, he was examined in our department for gastrointestinal bleeding. An upper gastrointestinal endoscopy revealed bleeding from gastric varices. Gastrointestinal bleeding ceased after endoscopic injection sclerotherapy ( EIS) was performed; however, the bleeding recurred. Balloon retrograde transvenous occlusion (BRTO) could not be performed because blood flow was not detected within the gastro-renal shunt. An emergency surgery was performed. Surgical splenectomy and devascularization (Hassab's operation) were performed. After surgery, the gastric body varices and gastrointestinal anastomosis disappeared and the bleeding did not occur. He is currently receiving outpatient treatment.2014年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 41(12) (12), 2214 - 6, 日本語, 国内誌研究論文（学術雑誌）
- Short- and long-term results of modified Frey's procedure in patients with chronic pancreatitis: a retrospective Japanese single-center study.BACKGROUND: The study aim was to determine the short- and long-term results of surgical drainage procedure for chronic pancreatitis at a single center in Japan. METHODS: The records of 28 consecutive patients were retrospectively reviewed. All patients underwent surgery at Kobe University Hospital between June 1999 and April 2013. Long-term follow-up was performed in all patients for a median period of 77 months. RESULTS: The 26 men (93%) and 2 women (7%) had a mean age of 47 years. The etiology of pancreatitis was chronic alcohol abuse in 24 patients (86%). The major indication for surgery was persistent symptoms (97%). Modified Frey's procedure in 21 patients, lateral pancreaticojejunostomy (LPJ) in 6 patients, LPJ and distal pancreatectomy in one patient, were performed. There was no postoperative mortality. Postoperative morbidity occurred in 6 patients (21%). The percentage of pain-free patients after surgery was 97%, and further acute exacerbation was prevented in 97%. Two patients (6%) required subsequent surgery for infectious pancreatic cyst and intraabdominal abscess. Of the patients that completed follow-up, 13 (46%) had diabetes mellitus, including 5 patients (19%) with new-onset diabetes, and 6 patients (19%) developed pancreatic exocrine insufficiency. CONCLUSIONS: Modified Frey's procedure is safe, feasible, and effective to manage chronic pancreatitis. The technique prevents further exacerbations and maintains appropriate pancreatic endocrine and exocrine function.2014年08月, The Kobe journal of medical sciences, 60(2) (2), E30-6, 英語, 国内誌研究論文（学術雑誌）
- (一社)日本消化器外科学会, 2014年07月, 日本消化器外科学会総会, 69回, RS - 3, 日本語膵癌術後長期無再発生存例の検討
- (一社)日本肝胆膵外科学会, 2014年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 26回, 442 - 442, 日本語膵頭十二指腸切除と尾側膵切除の術後耐糖能の比較検討
- (一社)日本肝胆膵外科学会, 2014年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 26回, 535 - 535, 日本語黄色肉芽腫性胆嚢炎切除後に遺残胆嚢癌を発症した1例
- (一社)日本癌治療学会, 2014年06月, 日本癌治療学会誌, 49(3) (3), 1077 - 1077, 日本語膵癌術前予後予測因子としてのFDG-PETの有用性
- (一社)日本腹部救急医学会, 2014年02月, 日本腹部救急医学会雑誌, 34(2) (2), 512 - 512, 日本語膵中央切除術後膵腸縫合不全に対し緊急手術を施行した1例
- [A case of metachronous pancreatic cancer that developed 4 years after initial pancreatectomy].A 55-year-old woman underwent subtotal stomach-preserving pancreaticoduodenectomy for pancreatic ductal adenocarcinoma( PDAC) in July 2008. The final diagnosis was Stage I PDAC according to the Union for International Cancer Control( UICC) TNM classification. After the operation, adjuvant chemotherapy with gemcitabine was administered for 6 months. The tumor marker level increased at 49 months after the operation, and 18-fluoro-deoxyglucose (FDG)-positron emission tomography( PET) showed FDG accumulation in the remnant pancreas. A hypovascular tumor was revealed in the remnant pancreas on computed tomography( CT). As PDAC was diagnosed without distant metastasis, completion pancreatectomy was performed. Histopathological investigation revealed PDAC with invasion into the muscularis propria of the anastomosed jejunum and splenic plexus. The final diagnosis was T3N0M0 UICC Stage IIA metachronous PDAC. The postoperative course was uneventful. However, multiple liver metastases and local recurrence were detected on CT 2 months after resection, and the patient died 3 months after resection. Most reported cases of metachronous PDACs were diagnosed at an advanced stage despite regular follow-ups after the initial resection. Further investigation is needed to determine the adequate surveillance time and novel therapeutic strategies.2013年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 40(12) (12), 1893 - 6, 日本語, 国内誌研究論文（学術雑誌）
- 日本臨床外科学会, 2013年10月, 日本臨床外科学会雑誌, 74(増刊) (増刊), 366 - 366, 日本語再発癌の治療戦略(肝・胆・膵) 残膵癌に対する治療戦略研究論文（その他学術会議資料等）
- (一社)日本消化器外科学会, 2013年07月, 日本消化器外科学会総会, 68回, P - 1, 日本語腎癌膵転移に対して二度の膵切除を行った一例 当科における腎癌膵転移症例の検討
- [A case with multiple liver metastases from rectal cancer responding completely to FOLFOX for a long duration without exacerbation of peripheral neuropathy].A 61-year-old man had undergone five courses of modified FOLFOX6(mFOLFOX6)chemotherapy with calcium-magnesium(Ca/Mg)infusion for a rectal cancer with multiple liver metastases from October 2008. After this treatment, the primary rectal tumor and metastatic tumors were considered as a partial response(PR), and lower anterior resection was carried out in February 2009. After the operation, mFOLFOX6 chemotherapy with bevacizumab was started in March 2009. After 15 courses of chemotherapy, the patient received 7. 5 g of gosha-jinki-gan(TJ-107)daily from August 2009, and the drug compliance was 69%. From the 18th course of chemotherapy in October 2009, glutathione(GSH)was given at a dose of 200 mg before each oxaliplatin administration. From the 35th course of chemotherapy in November 2010, the patient received 1. 5 g of powdered processed aconite root(TJ-3027)daily. TJ-3027 administration was escalated to 4. 5 g daily, and drug compliance was 73%. Grade 4 neutropenia was observed in December 2010, and we reduced oxaliplatin to 65 mg/m(2) from the 37th course. Fifty chemotherapy courses were administered until October 2011. The patient received a total 3, 970 mg/m(2) of oxaliplatin, however, the neurotoxicity level of the patient remained at grade 2. Ca/Mg infusion and TJ-107 administration have been reported not to reduce the activity of FOLFOX individually, and severe side effects are rare. So one must consider the combination treatment of Ca/Mg and TJ-107 for prevention of oxaliplatin-related neurotoxicity.2013年02月, Gan to kagaku ryoho. Cancer & chemotherapy, 40(2) (2), 255 - 8, 日本語, 国内誌研究論文（学術雑誌）
- 2012年11月, Surgery, 152(5) (5), 934 - 5, 英語, 国際誌研究論文（学術雑誌）
- 日本臨床外科学会, 2015年10月, 日本臨床外科学会雑誌, 76(増刊) (増刊), 417 - 417, 日本語内視鏡外科手術の現状と将来(肝、胆、膵) 膵内視鏡外科の現状と将来 腹腔鏡下尾側膵切除術における当科の経験
- (株)癌と化学療法社, 2014年11月, 癌と化学療法, 41(12) (12), 2178 - 2180, 日本語S-1が著効しR0切除し得た局所進行切除不能膵癌の1例
- 日本臨床外科学会, 2014年10月, 日本臨床外科学会雑誌, 75(増刊) (増刊), 849 - 849, 日本語腹腔鏡下膵体尾部切除術施行後に肺血栓塞栓症を発症した一例
- (一社)日本内視鏡外科学会, 2014年10月, 日本内視鏡外科学会雑誌, 19(7) (7), 461 - 461, 日本語腹腔鏡下尾側膵切除術 導入から術式の定型化・技術認定医取得まで
- (一社)日本内視鏡外科学会, 2014年10月, 日本内視鏡外科学会雑誌, 19(7) (7), 595 - 595, 日本語膵内視鏡外科の安全性と効率化 腹腔鏡下尾側膵切除術における当科の経験
- (一社)日本移植学会, 2014年08月, 日本移植学会総会プログラム抄録集, 50回, 459 - 459, 日本語膵腎同時移植後グラフト十二指腸穿孔を生じた1例
- 日本膵臓学会, 2014年06月, 膵臓, 29(3) (3), 580 - 580, 日本語Stage 0/I膵癌切除症例の検討
- 日本膵臓学会, 2014年06月, 膵臓, 29(3) (3), 592 - 592, 日本語切離部位に着目した腹腔鏡下尾側膵切除術の要点
- (一社)日本肝胆膵外科学会, 2014年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 26回, 508 - 508, 日本語術前診断が困難であった膵頭部IPMCの1例
- (一社)日本肝胆膵外科学会, 2014年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 26回, 511 - 511, 日本語術前FDG-PETにおける浸潤性膵管癌原発巣SUV値と予後に関する検討
- (一社)日本肝胆膵外科学会, 2014年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 26回, 519 - 519, 日本語幽門輪温存膵頭十二指腸切除術と亜全胃温存膵頭十二指腸切除術の短期・長期成績の前向き比較検討
- (一社)日本肝胆膵外科学会, 2014年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 26回, 528 - 528, 日本語術前診断が困難であった膵内副脾Epidermoid cystの1例
- (一社)日本肝胆膵外科学会, 2014年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 26回, 711 - 711, 日本語経皮的冠動脈形成術(PCI)後症例における肝胆膵外科手術
- (一社)日本癌治療学会, 2014年06月, 日本癌治療学会誌, 49(3) (3), 2092 - 2092, 日本語膵癌に対する膵頭十二指腸切除術後左側門脈圧亢進症に対しHassab手術を施行した1例
- 日本膵臓学会, 2014年04月, 膵臓, 29(2) (2), 247 - 252, 日本語
- (一社)日本外科学会, 2014年03月, 日本外科学会雑誌, 115(臨増2) (臨増2), 509 - 509, 日本語膵切除術における周術期管理
- (一社)日本外科学会, 2014年03月, 日本外科学会雑誌, 115(臨増2) (臨増2), 514 - 514, 日本語膵神経内分泌腫瘍(PNET)の転移に関わる因子の検討
- (一社)日本外科学会, 2014年03月, 日本外科学会雑誌, 115(臨増2) (臨増2), 758 - 758, 日本語良低悪性度腫瘍に対する腹腔鏡下膵体尾部切除術
- (一社)日本外科学会, 2014年03月, 日本外科学会雑誌, 115(臨増2) (臨増2), 759 - 759, 日本語膵腫瘍核出術における内視鏡下膵管ステントの適応
- (一財)日本消化器病学会, 2014年03月, 日本消化器病学会雑誌, 111(臨増総会) (臨増総会), A267 - A267, 日本語膵癌術後補助化学療法の完遂予測因子の検討
- (一社)日本内視鏡外科学会, 2013年11月, 日本内視鏡外科学会雑誌, 18(7号) (7号), 769 - 769, 日本語腹腔鏡下尾側膵切除術におけるシリコンディスクを用いた胃・肝圧排法会議報告等
- (株)癌と化学療法社, 2013年11月, 癌と化学療法, 40(12) (12), 1893 - 1896, 日本語
- 日本臨床外科学会, 2013年10月, 日本臨床外科学会雑誌, 74(増刊) (増刊), 1031 - 1031, 日本語主膵管との交通を認め術前診断が困難であった膵粘液性嚢胞腫瘍(MCN)の1切除例会議報告等
- 日本臨床外科学会, 2013年10月, 日本臨床外科学会雑誌, 74(増刊) (増刊), 354 - 354, 日本語吻合、再建の手術手技(膵臓) 膵頭十二指腸切除術における安全、確実な膵空腸再建手術手技会議報告等
- (一社)日本癌治療学会, 2013年09月, 日本癌治療学会誌, 48(3) (3), 1524 - 1524, 日本語膵癌切除後早期再発の危険因子
- (一社)日本肝胆膵外科学会, 2013年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集25回, 25回, 308 - 308, 日本語膵頭十二指腸切除術における安全、確実な膵空腸吻合手術手技[査読有り]会議報告等
- (一社)日本肝胆膵外科学会, 2013年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集25回, 25回, 262 - 262, 日本語胆道癌に対する治療戦略 大動脈周囲リンパ節陽性胆道癌の切除成績[査読有り]会議報告等
- (一社)日本肝胆膵外科学会, 2013年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集25回, 25回, 302 - 302, 日本語膵移植の工夫[査読有り]会議報告等
- (一社)日本外科学会, 2013年03月, 日本外科学会雑誌, 114(臨増2) (臨増2), 830 - 830, 日本語[査読有り]会議報告等
- (一財)日本消化器病学会, 2013年02月, 日本消化器病学会雑誌, 110(臨増総会) (臨増総会), A216 - A216, 日本語IPMN切除例における浸潤・リンパ節転移予測因子の検討[査読有り]会議報告等
- 第56回日本膵臓学会大会, 2025年07月, 日本語, 国内会議切除可能膵癌の予後に対する GLIM 基準の影響シンポジウム・ワークショップパネル（公募）
- 第56回日本膵臓学会大会, 2025年07月, 日本語, 国内会議80 歳以上の Resectable，Borderline resectable 膵癌患者の治療成績についてシンポジウム・ワークショップパネル（公募）
- 第56回日本膵臓学会大会, 2025年07月, 日本語, 国内会議2cm 以下の小膵神経内分泌腫瘍に対する EUS 下生検の有用性シンポジウム・ワークショップパネル（公募）
- 第80回日本消化器外科学会, 2025年07月, 日本語, 国内会議当科における吸収性スペーサー留置術 75 例の検討口頭発表（一般）
- 第80回日本消化器外科学会, 2025年07月, 日本語, 国内会議主膵管拡張を伴う非浸潤・微小浸潤 IPMN 術後残膵再発に対する予定残膵主膵管拡張の影響口頭発表（一般）
- 第80回日本消化器外科学会, 2025年07月, 日本語, 国内会議高齢者に対する膵全摘，残膵全摘の短期・長期成績について口頭発表（一般）
- 第80回日本消化器外科学会, 2025年07月, 日本語, 国内会議膵頭十二指腸切除術後の新規発症脂肪肝患者における lipoprotein 解析口頭発表（一般）
- 第80回日本消化器外科学会, 2025年07月, 日本語, 国内会議ロボット支援膵切除における新機種導入の経験口頭発表（一般）
- 第80回日本消化器外科学会, 2025年07月, 日本語, 国内会議複数機種ロボット支援手術の運用と教育:肝胆膵外科における da Vinci と hinotori の導入事例口頭発表（一般）
- The 15th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE2025), 2025年07月, 英語, 国内会議Impact of Initial Hepatectomy With Hilar Manipulation on Short-Term Outcomes of Repeat Hepatectomy for Recurrent Liver Cancerポスター発表
- The 15th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE2025), 2025年07月, 英語, 国内会議Laparoscopic right posterior sectionectomy using the anterior approach for huge hepatocellular carcinomaポスター発表
- The 15th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE2025), 2025年07月, 英語, 国内会議Impact of Post-Hepatectomy Liver Failure on Long-Term Liver Function and Prognosis in Patients with Hepatocellular Carcinomaポスター発表
- 第61回日本肝癌研究会, 2025年07月, 日本語, 国内会議肝細胞癌患者に対するレンバチニブ併用シスプラチン肝動注療法＋On demand 部分的塞栓の有効性に関する検討口頭発表（一般）
- 第61回日本肝癌研究会, 2025年07月, 日本語, 国内会議肝門部操作を伴う肝切除後の再肝切除に関する検討口頭発表（一般）
- 第61回日本肝癌研究会, 2025年07月, 日本語, 国内会議当院における低侵襲肝切除の実際―ICG 蛍光法と複数機種ロボット支援の最適活用―シンポジウム・ワークショップパネル（公募）
- The 12th Summer Seminar in Okinawa 2025, 2025年06月, 日本語, 国内会議ロボ肝が進む時代にこそ光るラパ肝口頭発表（一般）
- 第32回日本肝がん分子標的治療研究会, 2025年06月, 日本語, 国内会議Vp4 巨大肝細胞癌に対して経鼻経管栄養下に Durvalumab ＋ Tremelimumab 併用療法を施行し conversion 肝切除を達成した 1 例ポスター発表
- 第37回日本肝胆膵外科学会学術集会, 2025年06月, 英語, 国内会議Aretrospective study on the accuracy of preoperative diagnosis of pancreatic carcinoma in situポスター発表
- 第37回日本肝胆膵外科学会学術集会, 2025年06月, 英語, 国内会議Technical tips and postoperative management for prevention of postoperative pancreatic fistula after minimally invasive distal pancreatectomyポスター発表
- 第37回日本肝胆膵外科学会学術集会, 2025年06月, 英語, 国内会議Identifying the Best Nutritional Prognostic Marker for Survival in Pancreatic Ductal Adenocarcinoma Patientsポスター発表
- 第37回日本肝胆膵外科学会学術集会, 2025年06月, 英語, 国内会議A case of laparoscopic distal pancreatectomy with misdissection of the portal vein and reconstruction with artificial vascular graftポスター発表
- 第197回兵庫県外科医会学術集会, 2025年05月, 日本語, 国内会議Frey術後の腹腔内遺残膵石が腹腔内腫瘍を形成した1例口頭発表（一般）
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議当科における吸収性スペーサー留置術 66 例の検討ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議肝腫瘍のサイズが術後肝再生に与える影響ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議胆道癌術後 S-1 術後補助化学療法施行例における GLIM 基準の予後因子としての有用性に関する検討ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議PNI による術前栄養評価と肝細胞癌に対する肝切除の Textbook outcome および長期成績との関連性の検討ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議高度門脈腫瘍栓合併肝細胞癌に対する肝切除術の意義ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議胆道癌におけるアシアロシンチグラフィーを用いた術後肝不全予測ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議重症例に対する肝移植のサステナビリティポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議当科における腫瘍学的切除可能性分類定義に基づいた肝切除・薬物療法成績の検討ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議当科における大腸癌肝転移における治療戦略と術前化学療法の有用性ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議当科における進行膵癌に対する Conversion Surgery の成績と課題ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議肝細胞癌に対する肝右葉切除後の術後肝不全発症予測における肝予備能/線維化指標の有用性の比較ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議肝門部領域胆管癌に対して門脈塞栓術後切除術を施行した症例の術後肝不全の検討ポスター発表
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議非浸潤・微小浸潤 IPMN 切除後残膵再発に対する予定残膵の主膵管拡張の意義口頭発表（一般）
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議肥満症例における右横隔膜下領域の肝切除に対する腹腔鏡アプローチの有用性口頭発表（一般）
- 第125回日本外科学会定期学術集会, 2025年04月, 日本語, 国内会議門脈合併切除を伴う膵癌切除術中の門脈/上腸間膜静脈断端の術中迅速診断の意義シンポジウム・ワークショップパネル（公募）
- 第52回日本膵・膵島移植学会学術集会, 2025年03月, 日本語, 国内会議当科における新規膵島実験室立ち上げの取り組み口頭発表（一般）
- 第208回近畿外科学会, 2025年03月, 日本語, 国内会議膵原発癌肉腫の 1 切除例口頭発表（一般）
- 第208回近畿外科学会, 2025年03月, 日本語, 国内会議Vp4 巨大肝細胞癌に対して経鼻経管栄養下に Durvalumab ＋ Tremelimumab 併用療法 を施行し conversion 肝切除が可能となった 1 例口頭発表（一般）
- 第208回近畿外科学会, 2025年03月, 日本語, 国内会議戸谷 IV-A 型先天性胆道拡張症に対するロボット支援下手術導入の経験口頭発表（一般）
- 日本消化器病学会近畿支部第122回例会, 2025年02月, 日本語, 国内会議Frey術後の腹腔内遺残膵石が腹腔内腫瘍を形成した1例口頭発表（一般）
- 第31回日本肝がん分子標的治療研究会, 2025年01月, 日本語, 国内会議Vp3/4門脈腫瘍栓合併肝細胞癌に対するアテゾリズマブ・ベバシズマブ併用療法の治療成績口頭発表（一般）
- APA/JPS/CAP/IAP 2024, 2024年12月, 英語, 国際会議Impact of a dilated MPD in the expected remnant pancreas on recurrence after resection of non-/micro-invasive IPMN口頭発表（一般）
- APA/JPS/CAP/IAP 2024, 2024年12月, 英語, 国際会議Comprehensive analysis of altered lipid and amino acid metabolism in patients undergoing pancreatoduodenectomy口頭発表（一般）
- 第37回日本内視鏡外科学会総会（JSES2024）, 2024年12月, 日本語, 国内会議胆嚢摘出既往のある再肝切除症例における腹腔鏡アプローチの有用性に関する検討口頭発表（一般）
- 第37回日本内視鏡外科学会総会（JSES2024）, 2024年12月, 日本語, 国内会議Fontan循環における腹腔鏡下肝切除術の経験口頭発表（一般）
- 第37回日本内視鏡外科学会総会（JSES2024）, 2024年12月, 日本語, 国内会議3Dシミュレーション画像は真のリアルタイムナビゲーションになっているか？シンポジウム・ワークショップパネル（公募）
- 第37回日本内視鏡外科学会総会（JSES2024）, 2024年12月, 日本語, 国内会議膵癌に対する腹腔鏡下膵体尾部切除術の短期・長期成績に関する検討シンポジウム・ワークショップパネル（公募）
- 第37回日本内視鏡外科学会総会（JSES2024）, 2024年12月, 日本語, 国内会議40歳肝胆膵外科医の腹腔鏡下膵切除の実際シンポジウム・ワークショップパネル（公募）
- 第37回日本内視鏡外科学会総会（JSES2024）, 2024年12月, 日本語, 国内会議ロボット支援下膵切除導入の経験とフィードバックシンポジウム・ワークショップパネル（公募）
- 第11回神戸肝胆膵外科ビデオクリニック, 2024年11月, 日本語, 国内会議内視鏡技術認定医提出ビデオ口頭発表（一般）
- 日本放射線腫瘍学会第37回学術大会, 2024年11月, 日本語, 国内会議局所進行膵がんに対する定位放射線治療計画上の体内吸収性スペーサー留置の有用性予測口頭発表（一般）
- 日本放射線腫瘍学会第37回学術大会, 2024年11月, 日本語, 国内会議膵癌に対するSpace Making SBRTの意思決定のためのGTV最低線量の予測ポスター発表
- 第86回日本臨床外科学会総会, 2024年11月, 日本語, 国内会議腹腔鏡下肝切除技術認定取得への道シンポジウム・ワークショップパネル（公募）
- 第66回日本消化器病学会大会（JDDW2024）, 2024年10月, 日本語, 国内会議Postoperative complications assessed by the comprehensive complication index (CCI) are associated with early recurrence after curative resection for biliary tract cancerポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議吸収性スペーサー併用粒子線治療後に局所再発した後腹膜平滑筋肉腫に対して2回目の吸収性スペーサー留置術および粒子線治療を行った1例ポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議左側門脈圧亢進症に対する門脈ステントの有用性についてポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議胆道癌術後S-1術後補助療法施行例におけるGLIM基準の予後因子としての有用性に関する検討ポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議胆道癌に対するS-1術後補助化学療法と術後早期再発との関連ポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議膵頭十二指腸切除術後の血中必須脂肪酸の推移およびPD後NAFLDとの関係ポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議膵癌術後再発病変に対する外科的切除は予後延長に寄与するのかポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議主要脈管近接腫瘍に対する腹腔鏡下Parenchymal-sparing hepatectomyポスター発表
- 第22回日本消化器外科学会（JDDW2024）, 2024年10月, 日本語, 国内会議肝細胞癌症例における肝切除術後胆汁漏の予後への影響についての検討ポスター発表
- 第6回関西肝胆膵内視鏡手術研究会, 2024年09月, 日本語, 国内会議【膵臓】演題②神戸大学口頭発表（一般）
- 第47回日本膵・胆管合流異常研究会, 2024年09月, 日本語, 国内会議膵・胆管合流異常に合併した2型 IPNB に相当する胆嚢内乳頭状腫瘍の1例口頭発表（一般）
- International Congress of Endoscopic & Laparoscopic Surgeons of Asia（ELSA2024）, 2024年08月, 英語, 国内会議Optimal cutoff values of drain amylase for predicting pancreatic fistula are different between open and laparoscopic distal pancreatectomyポスター発表
- 第55回日本膵臓学会大会, 2024年07月, 日本語, 国内会議局所進行切除不能膵癌に対するスペーサー留置術後の陽子線治療の成績と展望口頭発表（一般）
- 第55回日本膵臓学会大会, 2024年07月, 日本語, 国内会議膵癌に対する膵切除術における膵断端の癌遺残に関する検討シンポジウム・ワークショップパネル（公募）
- 第55回日本膵臓学会大会, 2024年07月, 日本語, 国内会議膵頭十二指腸切除術後の脂質アミノ酸代謝の変化の解明シンポジウム・ワークショップパネル（公募）
- The 14th Asia-Pacific Primary Liver Cancer Expert Meeting 2024 (APPLE), 2024年07月, 英語, 国内会議Textbook outcomes in initial liver resection for hepatocellular carcinoma: a study with malnutrition grade by the GLIM criteria.ポスター発表
- 第79回日本消化器外科学会総会, 2024年07月, 日本語, 国内会議80 歳以上の高齢膵癌患者に対する膵頭十二指腸切除術の短期成績と長期成績について口頭発表（一般）
- 第79回日本消化器外科学会総会, 2024年07月, 日本語, 国内会議消化器外科医夫婦がキャリア形成を続けるためにした工夫口頭発表（一般）
- 第79回日本消化器外科学会総会, 2024年07月, 日本語, 国内会議膵頭十二指腸切除術後の脂肪肝発症とその生理学的機序解明の試み口頭発表（一般）
- 第79回日本消化器外科学会総会, 2024年07月, 日本語, 国内会議局所進行膵癌に対する動脈剥離手技と動脈・門脈再建手技口頭発表（一般）
- 第60回日本肝癌研究会, 2024年07月, 日本語, 国内会議肝細胞癌における肝切除術後胆汁漏関連因子の予後への影響に関する検討口頭発表（一般）
- 第36回日本肝胆膵外科学会・学術集会, 2024年06月, 英語, 国内会議Our Surgical Techniques for Pancreatic Cancer with Arterial Contact口頭発表（一般）
- 第36回日本肝胆膵外科学会・学術集会, 2024年06月, 英語, 国内会議Nightmare for a 16-year-old man who presented with undiagnosed severe diabetes-induced NOMI and required a total pancreatectomy and massive enterectomy口頭発表（一般）
- 第36回日本肝胆膵外科学会・学術集会, 2024年06月, 英語, 国内会議Short- and long-term outcomes after pancreatectomy for pancreatic cancer in octogenarianシンポジウム・ワークショップパネル（公募）
- 第46回日本癌局所療法研究会, 2024年06月, 日本語, 国内会議腹腔鏡下膵頭十二指腸切除術で R0 手術となった胆管原発神経内分泌癌の1切除例口頭発表（一般）
- The 32nd international Congress of the European Association（EAES2024）, 2024年06月, 英語, 国内会議Laparoscopic SM0 liver resection for hepatocellular carcinoma adjacent to the hepatic hilumポスター発表
- 第110回日本消化器病学会総会, 2024年05月, 日本語, 国内会議大腸癌肝転移におけるRAS遺伝子情報と肝転移巣局在の関連性口頭発表（一般）
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議当科における吸収性スペーサー留置術 45 例の検討ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議胆道癌術後 S-1 術後補助療法施行例における GLIM 基準の予後因子としての有用性に関する検討ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議胆道癌における再発時期と再発様式についての検討ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議肝切除における術中超音波胆道造影法を併用したリークテストの有用性ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議外科医が長く働き続けられるための当院での取り組みポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議肝門部胆管癌における術後肝不全・難治性腹水ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議大腸癌肝転移における切除後再発リスク分類と集学的治療戦略ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議肝細胞癌に対する肝右葉切除後における術後肝不全発症の危険因子の検討ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議肥満症例での肝 S7 切除における腹腔鏡下アプローチのメリットについてポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議高齢遠位胆管癌患者に対する高難度手術成績の検討ポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議進行胆道癌に対する Conversion surgeryポスター発表
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議胆道癌に対する膵頭十二指腸切除術における GLIM 基準低栄養が術後合併症へ与える影響の検討口頭発表（一般）
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議膵頭十二指腸切除術後外分泌不全に対する治療バイオマーカーの探索口頭発表（一般）
- 第124回日本外科学会定期学術集会, 2024年04月, 日本語, 国内会議開腹および腹腔鏡下膵体尾部切除のドレーンアミラーゼ値による適切なドレーン管理の検討口頭発表（一般）
- 日本ERAS®学会第2回学術集会, 2024年04月, 日本語, 国内会議ERAS プロトコルの術前経口補水に分枝鎖アミノ酸飲料は有用か？シンポジウム・ワークショップパネル（公募）
- The 33rd Annual Meeting the Asian Pacific Association for the Study of the Liver (APASL2024), 2024年03月, 英語, 国内会議The Efficacy of Total Tumor Volume in Patients with Colorectal Liver Metastases口頭発表（一般）
- 第10回神戸肝胆膵外科ビデオクリニック, 2024年03月, 日本語, 国内会議講演口頭発表（一般）
- 第51回近畿肝臓外科研究会, 2024年02月, 日本語, 国内会議主要脈管近接腫瘍に対する腹腔鏡下肝切除口頭発表（一般）
- 日本消化器病学会近畿支部第120回例会, 2024年01月, 日本語, 国内会議胆道再建既往の肝切除症例における術後感染性合併症口頭発表（一般）
- 日本消化器病学会近畿支部第120回例会, 2024年01月, 日本語, 国内会議GLIM基準低栄養は胆道癌に対する膵頭十二指腸切除術後合併症リスクを増加させる口頭発表（一般）
- 日本消化器病学会近畿支部第120回例会, 2024年01月, 日本語, 国内会議門脈輪状膵症例に対するロボット支援下膵頭十二指腸切除術の1例シンポジウム・ワークショップパネル（公募）
- 第36回日本内視鏡外科学会総会, 2023年12月, 日本語, 国内会議肝門部に近接する肝細胞癌に対する腹腔鏡下肝部分切除術口頭発表（一般）
- 第36回日本内視鏡外科学会総会, 2023年12月, 日本語, 国内会議当科における肝 S1 病変に対する腹腔鏡手術の有効性と安全性の検討口頭発表（一般）
- 第36回日本内視鏡外科学会総会, 2023年12月, 日本語, 国内会議肝臓外科におけるロボット支援化手術導入への悩み口頭発表（一般）
- 第36回日本内視鏡外科学会総会, 2023年12月, 日本語, 国内会議ロボット支援下手術の拡大視野で得られた門脈輪状膵症例におけるSMA神経叢に関する知見シンポジウム・ワークショップパネル（公募）
- 第85回日本臨床外科学会総会, 2023年11月, 日本語, 国内会議吸収性スペーサー留置術35例の検討口頭発表（一般）
- 第15回膵臓内視鏡外科研究会, 2023年11月, 日本語, 国内会議ロボット支援下膵手術における剥離・切離法の試行錯誤口頭発表（一般）
- 第15回膵臓内視鏡外科研究会, 2023年11月, 日本語, 国内会議ロボット支援下膵頭十二指腸切除を行った門脈輪状膵の１例口頭発表（一般）
- 第65回日本消化器病学会大会（JDDW2023), 2023年11月, 日本語, 国内会議胆道癌における再発時期と再発形式の検討ポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議肝外胆管癌における術前骨格筋量減少の術後早期再発への影響ポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議吸収性スペーサー留置術33例の検討ポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議局所進行切除不能膵癌に対するスペーサー留置術後の陽子線治療の有用性についてポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議肝門部胆管癌術後の術後胆汁漏の検討ポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議肝切除術後の門脈血栓症に対するエドキサバンの治療成績ポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議膵癌術後再発に対する治療戦略の現状と展望ポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議初回肝切除への腹腔鏡アプローチ適応による再肝切除時のメリットについてポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議当院における術後胆管狭窄症例に対する対応と検討ポスター発表
- 第21回日本消化器外科学会大会（JDDW2023）, 2023年11月, 日本語, 国内会議R0切除率向上を目指した門脈合併膵切除術－門脈/上腸間膜静脈断端の迅速診断の有用性についてシンポジウム・ワークショップパネル（公募）
- IASGO-CME Advanced Post-Graduate Course in Kobe 2023, 2023年11月, 英語, 国内会議Association between tumor morphology and efficacy of atezolizumab plus bevacizumab for advanced hepatocellular carcinomaポスター発表
- 7th Kansai-Yeungnam HBP Surgeons Meeting, 2023年10月, 英語, 国内会議Proton radiotherapy as a treatment strategy to increase survival in locally advanced pancreatic cancer in the body and tail: a retrospective studyポスター発表
- 7th Kansai-Yeungnam HBP Surgeons Meeting, 2023年10月, 英語, 国内会議Risk Factors for Recurrence of Cholangitis After Pancreaticoduodenectomy and Comparison of Stents in Hepaticojejunostomyポスター発表
- 第59回日本移植学会総会, 2023年09月, 日本語, 国内会議脳死肝移植・肝グラフト採取術手技習得における Cadaver Surgical Training の有用性口頭発表（一般）
- 第59回日本胆道学会学術集会, 2023年09月, 日本語, 国内会議IPMNに併存した十二指腸乳頭部上皮内癌の1例ポスター発表
- 4th World Congress of International Laparoscopic liver Society（ILLS2023）, 2023年09月, 英語, 国内会議A comparative study of laparo-scopic liver resection for the segment 8 dorsal and ventral area口頭発表（一般）
- 45th ESPEN Congress, 2023年09月, 英語, 国内会議Impact of malnutrition diagnosed by the GLIM criteria on postoperative complications after pancreaticoduodenectomy for biliary tract cancerポスター発表
- 45th ESPEN Congress, 2023年09月, 英語, 国内会議Impact of malnutrition diagnosed by the GLIM criteria on outcome of elderly patients with hepatocellular carcinoma after liver resectionポスター発表
- 第46回日本膵・胆管合流異常研究会, 2023年09月, 日本語, 国内会議膵・胆管合流異常に発生した膵管内乳頭粘液性腺癌の1切除例口頭発表（一般）
- 第54回日本膵臓学会大会, 2023年07月, 日本語, 国内会議当院における膵神経内分泌腫瘍のバイオマーカー探索の試みシンポジウム・ワークショップパネル（公募）
- 第54回日本膵臓学会大会, 2023年07月, 日本語, 国内会議高齢者に対する膵全摘, 残膵全摘の短期・長期成績についてシンポジウム・ワークショップパネル（公募）
- 第54回日本膵臓学会大会, 2023年07月, 日本語, 国内会議Solid - pseudopapillary neoplasm（SPN）に対する至適術式シンポジウム・ワークショップパネル（公募）
- 第78回日本消化器外科学会総会, 2023年07月, 日本語, 国内会議切除可能膵癌に対する術前化学療法症例の成績と問題点口頭発表（一般）
- 第78回日本消化器外科学会総会, 2023年07月, 日本語, 国内会議腹腔鏡下膵頭十二指腸切除の導入と定型化への工夫口頭発表（一般）
- 第78回日本消化器外科学会総会, 2023年07月, 日本語, 国内会議膵体尾部癌における膵切離位置，総肝動脈周囲リンパ節郭清についての検討口頭発表（一般）
- 第35回日本肝胆膵外科学会学術集会, 2023年06月, 英語, 国内会議A study for infectious complication of hepatectomies in patients with preexisting bilioenteric anastomosisポスター発表
- 第35回日本肝胆膵外科学会学術集会, 2023年06月, 英語, 国内会議Successful biliary drainage using hybrid EUS-BD for stricture of choledochojejunostomyポスター発表
- 第35回日本肝胆膵外科学会学術集会, 2023年06月, 英語, 国内会議Intended destination for a board certified surgeon under 45口頭発表（一般）
- 第35回日本肝胆膵外科学会学術集会, 2023年06月, 英語, 国内会議Prognostic significance of malnutrition diagnosed by the GLIM criteria for resected extrahepatic cholangiocarcinoma: A single-center retrospective study口頭発表（一般）
- 第35回日本肝胆膵外科学会学術集会, 2023年06月, 英語, 国内会議Improvement in stapler pancreatic transection to reduce pancreatic fistula after laparoscopic distal pancreatectomy: twelve-year experience at a single high-volume center口頭発表（一般）
- 第35回日本肝胆膵外科学会学術集会, 2023年06月, 英語, 国内会議Anterior approach for open right hepatectomy for huge hepatocellular carcinomaシンポジウム・ワークショップパネル（公募）
- 第35回日本肝胆膵外科学会学術集会, 2023年06月, 英語, 国内会議Our surgical technique of vascular dissection and resection for locally advanced pancreatic cancerシンポジウム・ワークショップパネル（公募）
- 第45回日本癌局所療法研究会, 2023年06月, 日本語, 国内会議腹腔動脈狭窄を伴う十二指腸乳頭部癌に対し膵頭十二指腸切除術を施行した１例口頭発表（一般）
- 第41回日本肝移植学会学術集会, 2023年06月, 日本語, 国内会議脳死肝移植に初めて参加した経験から得られた移植医療に対する抱負口頭発表（一般）
- 第41回日本肝移植学会学術集会, 2023年06月, 日本語, 国内会議当科における MELD スコア制導入後の脳死肝移植希望登録患者に関する検討シンポジウム・ワークショップパネル（公募）
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議当科における吸収性スペーサー留置術22例の臨床経過ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議術前化学療法後に切除を施行したBR-A膵癌，UR-LA膵癌における早期再発risk因子の検討ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議胆道癌における術後静脈血栓症と血漿Dダイマーの関連性の検討ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議術前NLR値と胆嚢癌の予後との関連ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議肝細胞癌切除症例におけるGLIM基準と予後の関連ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議十二指腸乳頭部癌におけるC-reactive protein to albumin ratio（CAR）の予後への影響ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議右肝葉切除を施行した肝門部領域胆管癌の再考；左側からの切除の可能性ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議治療成績から見た大腸癌肝転移における切除可能性分類と治療戦略ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議肝門部領域胆管癌に対する術前門脈塞栓術施行例の検討ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議ロボット支援下膵体尾部切除導入期に直面する技術的問題点ポスター発表
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議Under 40外科医が専門医取得の次に目指すもの口頭発表（一般）
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議初回再発形式からみる表在性肝細胞癌に対する非系統的切除術の妥当性に関する検討シンポジウム・ワークショップパネル（公募）
- 第123回日本外科学会定期学術集会, 2023年04月, 日本語, 国内会議膵癌患者における術前低栄養の評価とその臨床的役割シンポジウム・ワークショップパネル（公募）
- 第109回日本消化器病学会総会, 2023年04月, 日本語, 国内会議食道胃静脈瘤に対するHassab手術が術後肝機能に与える影響についての検討口頭発表（一般）
- 第109回日本消化器病学会総会, 2023年04月, 日本語, 国内会議術前骨格筋量減少が肝外胆管癌切除後の長期予後に与える影響に関する観察研究口頭発表（一般）
- 第109回日本消化器病学会総会, 2023年04月, 日本語, 国内会議肝胆膵領域におけるAIを用いた手術支援技術の現状と展望口頭発表（一般）
- 第59回日本腹部救急医学会総会, 2023年03月, 日本語, 国内会議膵尾側温存の意義シンポジウム・ワークショップパネル（公募）
- 第39回近畿肝移植検討会, 2022年12月, 日本語, 国内会議脳死肝移植登録待機中管理に難渋した一例口頭発表（一般）
- 第35回日本内視鏡外科学会総会, 2022年12月, 日本語, 国内会議ロボット支援膵切除時代における技術認定制度の役割と問題点シンポジウム・ワークショップパネル（公募）
- 第14回膵臓内視鏡外科研究会, 2022年11月, 日本語, 国内会議ロボット支援下膵体尾部切除導入期に直面する諸問題シンポジウム・ワークショップパネル（公募）
- 第14回膵臓内視鏡外科研究会, 2022年11月, 日本語, 国内会議門脈輪状膵を併存した症例に対する腹腔鏡下膵切除術の経験口頭発表（一般）
- 第14回膵臓内視鏡外科研究会, 2022年11月, 日本語, 国内会議腹腔鏡下膵体尾部切除術の膵頚部切離における 45mm カートリッジの有用性シンポジウム・ワークショップパネル（公募）
- 第20回消化器外科学会大会（JDDW2022）, 2022年10月, 日本語, 国内会議食道癌術後の膵癌に対する膵切除6例の検討ポスター発表
- 第20回消化器外科学会大会（JDDW2022）, 2022年10月, 日本語, 国内会議腹腔鏡下膵体尾部切除における45mmカートリッジを用いた膵切離ポスター発表
- 第77回日本消化器外科学会総会, 2022年07月, 日本語, 国内会議膵全摘，残膵全摘後の残胃関連合併症について口頭発表（一般）
- 第122回日本外科学会定期学術集会, 2022年04月, 日本語, 国内会議膵切除後血漿 D-dimer の推移と術後静脈血栓症診断における意義口頭発表（一般）
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2026年04月01日 - 2029年03月31日膵外分泌機能不全に伴う術後脂肪肝の分子病態と予後不良メカニズムの解明
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2023年04月01日 - 2026年03月31日膵及び十二指腸切除後のアミノ酸代謝の変化の解析と新規栄養療法の開発本研究では、膵切除前後におけるアミノ酸プロファイルの変化の解析、膵切除後脂肪肝と栄養障害およびアミノ酸代謝の変化の関係の解析、これらの知見をもとにした膵切除における新たな栄養療法開発を目的としている。解析対象として術前および術後３ヶ月の血液サンプルを収集する必要があるが、目標サンプル数150例に対し、現在約70例のサンプル収集が終了している。そのうち40例程度では、質量分析計にてアミノ酸を網羅的に解析しており、データを収集している。データ数が少ないため今のところ詳細な結果は出ていないが、膵切除における周術期の栄養状態について解析し、術前術後の低栄養、特にプレアルブミンの低下が短期のみならず長期成績や予後にも悪影響を及ぼすことを明らかにし、JDDW2023ワークショップにて報告した。今後約１年で150例のサンプル収集が終了しする予定で、並行してアミノ酸解析を進める予定である。また、現在膵切除後の脂肪肝について臨床例の解析を進めている。膵切除後のおよそ３０％程度に脂肪肝の発生を認めており、現在脂肪肝と膵切除後栄養障害、必須脂肪酸代謝の変化について解析を進めている。その結果、膵切除後の脂肪肝発生には低栄養状態、特に必須アミノ酸の低下の関連が示唆されるデータを得ており、引き続き臨床データを収集し、脂肪肝発生と栄養障害、特に脂質代謝とアミノ酸代謝の関係を解析する予定である。新たな栄養療法の開発についてはまだ十分な根拠がなく、今後栄養やアミノ酸代謝の解析をもとに開発を進めていく予定である。
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2023年04月01日 - 2026年03月31日新規血管新生促進剤を応用した「バイオ人工膵島」移植の確立
- 日本学術振興会, 科学研究費助成事業, 若手研究(B), 神戸大学, 2015年04月01日 - 2016年03月31日間葉系幹細胞のメモリーB細胞、長寿命型抗体産生細胞に対する制御効果の解析(1) マウス由来間葉系幹細胞の単離とその細胞学的特徴の解析 論文などで公開されている、骨髄細胞(BMCs)から接着細胞のみを培養継代し間葉系幹細胞(MSCs)を分離する手法では安定したMSCsを採取することは困難であった。我々は、フローサイトメトリーを用いC57BL/6マウスのBMCsからPI(-)CD45(-)Ter119(-) gated Sca-1(+)PDGFR-α(+)細胞をsortingし、この細胞群だけを培養継代することにより比較的均一なMSCsが分離されることを明らかにした。抗体を用いた表面マーカーの解析ではc-kit, Sca-1, CD34, CD45, CD11b, H-2Kb, I-Ab, CD86がいずれも陰性、CD29, CD44が陽性であることを確認した。分化誘導実験では、この細胞群が骨細胞、脂肪細胞、軟骨細胞いずれにも分化することを確認した。リンパ球混合試験では、リンパ球単独培養群と比較し、MSCs混合培養群では有意にリンパ球の増殖が抑制されることを確認した。これらの結果は文献で報告されているMSCsの細胞学的特徴と一致していた。 ついで、上記手法により分離培養されたMSCsが、in vitroで成熟B 細胞の末梢分化ならびに機能を抑制するかを追試した (Asari et al. Exp Hematol 2009)。Transwell system を用いてC57BL/6マウス由来成熟B 細胞をLipopolysaccharide 刺激下でMSCs と供培養し、B細胞単独培養群と比較した場合、供培養群で有意にB 細胞の形質細胞分化ならびにIgM抗体産生が抑制されることを示した。