研究業績

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肝胆膵外科

当教室における研究

肝胆膵外科臨床においては切除が困難といわれている肝門部胆管癌をはじめとする胆道癌、膵癌、原発性および転移性肝癌などの外科治療を研究対象に、治療成績向上のための新しい手技、治療法の開発、確立のための臨床・基礎研究を行っており、国内外に多数発表しています。

また、当教室では生体肝移植術も積極的に施行しており、その外科手術の研究および基礎的研究も行っています。

臨床研究

  1. 肝門部胆管癌に対する術式の工夫と、拡大手術・縮小手術
  2. 高度進行転移性肝癌に対する術前化学療法に関する研究
  3. 黄疸肝における肝切除時の生体反応と術後合併症に関する研究
  4. 膵・胆道癌に対する術前および術後化学療法の有用性に関する研究
  5. 肝膵切除時における免疫栄養療法の有用性に関する研究
  6. 進行肝胆膵癌に対する術前化学療法の有用性に関する研究
  7. 門脈・下大静脈腫瘍栓を有する進行肝細胞癌に対する積極的外科切除の治療成績
  8. 進行膵癌に対する動・門脈合併切除再建の手術成績
  9. 生体肝移植における自家静脈グラフトを用いた肝静脈再建の工夫
  10. 良性胆道狭窄や難治性胆汁瘻に対する胆道IVRによる治療の確立

基礎的研究

  1. 肝胆膵悪性腫瘍の病理学的および分子生物学的検討
  2. 粘液産生胆道腫瘍の病態の解析
  3. 癌細胞と周囲間質細胞の相互作用
  4. 癌幹細胞の意義、役割の研究
  5. 癌進展と炎症反応の関連に関する研究
  6. 生体肝移植における過小グラフト克服に関する研究
  7. 肝阻血再灌流障害の機序に関する検討
  8. 肝胆膵悪性腫瘍における浸潤・転移の分子生物学的機構の解明
  9. プロテオミクスを用いた肝胆膵悪性腫瘍に対する早期診断・個別化治療の開発
  10. 肝切除後の肝再生の分子生物学的機序の解明

Publication(過去5年間でFirst authorが当教室からの英文論文)

臨床論文
  1. Miyazaki M, Shimizu H, Ohtsuka M, Yoshidome H, Kato A, Yoshitomi H, Furukawa K, Kimura F. Hepatic S4a + S5 and bile duct resection for gallbladder carcinoma. J Hepatobiliary Pancreat Sci. 2012;19:225-229.
  2. Shimizu H, Kimura F, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, Nozawa S, Furukawa K, Mitsuhashi N, Takeuchi D, Takayashiki T, Suda K, Miyazaki M. Intrahepatic cholangiojejunostomy (Longmire procedure) for recurrent bilioenteric anastomotic stricture with hepatolithiasis. Hepatogastroenterology. 2012;59:1023-1025.
  3. Hosokawa I, Kato A, Shimizu H, Furukawa K, Miyazaki M. Percutaneous transhepatic metallic stent insertion for malignant afferent loop obstruction following pancreaticoduodenectomy: a case report. J Med Case Rep. 2012;6:198. doi: 10.1186/1752-1947-6-198.
  4. Kato A, Shimizu H, Ohtsuka M, Yoshidome H, Yoshitomi H, Furukawa K, Takeuchi D, Takayashiki T, Kimura F, Miyazaki M. Surgical resection after downsizing chemotherapy for initially unresectable locally advanced biliary tract cancer: a retrospective single-center study. Ann Surg Oncol. 2013;20:318-324.
  5. Hosokawa I, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, Furukawa K, Takayashiki T, Kuboki S, Okamura D, Suzuki D, Nakajima M, Miyazaki M. Left hepatic trisectionectomy for hepatolithiasis with occluded left and right anterior branches of the portal vein: report of a case. Surg Today. 2014;44:1556-1560.
  6. Hosokawa I, Yoshitomi H, Shimizu H, Takayashiki T, Miyazaki M. Usefulness of pure laparoscopic hepatectomy for hepatocellular carcinoma in a severely cirrhotic patient. Case Rep Gastroenterol. 2013;7:308-313.
  7. Shimizu Y, Otani T, Matsumoto J, Takanishi K, Minami T, Tsunoda H, Miyazaki M. Cystic duct with no visible signal on magnetic resonance cholangiography is associated with laparoscopic difficulties: an analysis of 695 cases. Surg Today. 2014;44:1490-1495.
  8. Miyazaki M, Yoshitomi H, Shimizu H, Ohtsuka M, Yoshidome H, Furukawa K, Takayasiki T, Kuboki S, Okamura D, Suzuki D, Nakajima M. Repeat pancreatectomy for pancreatic ductal cancer recurrence in the remnant pancreas after initial pancreatectomy: is it worthwhile? Surgery. 2014;155:58-66.
  9. Hosokawa I, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, Miyazaki M. Surgical strategy for hilar cholangiocarcinoma of the left-side predominance: current role of left trisectionectomy. Ann Surg. 2014;259:1178-1185.
  10. Hosokawa I, Shimizu H, Ohtsuka M, Kato A, Yoshitomi H, Furukawa K, Takayashiki T, Ishihara T, Yokosuka O, Miyazaki M. Preoperative diagnosis and surgical management for solid pseudopapillary neoplasm of the pancreas. J Hepatobiliary Pancreat Sci. 2014;21:573-578.
  11. Aida T, Furukawa K, Suzuki D, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, Miyazaki M. Preoperative immunonutrition decreases postoperative complications by modulating prostaglandin E2 production and T-cell differentiation in patients undergoing pancreatoduodenectomy. Surgery. 2014;155:124-133.
  12. Ohtsuka M, Shimizu H, Kato A, Yoshitomi H, Furukawa K, Tsuyuguchi T, Sakai Y, Yokosuka O, Miyazaki M. Intraductal papillary neoplasms of the bile duct. Int J Hepatol. 2014;2014:459091. Review.
  13. Yoshitomi H, Kato A, Shimizu H, Ohtsuka M, Furukawa K, Takayashiki T, Kuboki S, Takano S, Okamura D, Suzuki D, Sakai N, Kagawa S, Miyazaki M. Tips and tricks of surgical technique for pancreatic cancer: portal vein resection and reconstruction (with videos). J Hepatobiliary Pancreat Sci. 2014;21:E69-74.
  14. Shimizu H, Hosokawa I, Ohtsuka M, Kato A, Yoshitomi H, Miyazaki M. Clinical significance of anatomical variant of the left hepatic artery for perihilar cholangiocarcinoma applied to right-sided hepatectomy. World J Surg. 2014;38:3210-3214.
  15. Yoshidome H, Shimizu H, Ohtsuka M, Yoshitomi H, Kato A, Furukawa K, Miyazaki M. Pancreaticoduodenetomy combined with hepatic artery resection following preoperative hepatic arterial embolization. J Hepatobiliary Pancreat Sci. 2014;21:850-855.
  16. Kato A, Shimizu H, Ohtsuka M, Yoshitomi H, Furukawa K, Takayashiki T, Nakadai E, Kishimoto T, Nakatani Y, Yoshidome H, Miyazaki M. Downsizing Chemotherapy for Initially Unresectable Locally Advanced Biliary Tract Cancer Patients Treated with Gemcitabine Plus Cisplatin Combination Therapy Followed by Radical Surgery. Ann Surg Oncol. 2015;22 Suppl 3:1093-1099.
  17. Kuboki S, Shimizu H, Ohtsuka M, Kato A, Yoshitomi H, Furukawa K, Takayashiki T, Takano S, Okamura D, Suzuki D, Sakai N, Kagawa S, Miyazaki M. Incidence, risk factors, and management options for portal vein thrombosis after hepatectomy: a 14-year, single-center experience. Am J Surg. 2015;210:878-85.e2.
  18. Tanaka K, Kishimoto T, Ohtsuka M, Nakatani Y, Miyazaki M. Importance of NAB2-STAT6 Fusion in the Diagnosis of Pancreatic Solitary Fibrous Tumor with Hamartoma-Like Features: A Case Report and Review of the Literature. Case Rep Pathol. 2015;2015:149606. doi: 10.1155/2015/149606.
  19. Shimizu H, Kato A, Takayashiki T, Kuboki S, Ohtsuka M, Yoshitomi H, Furukawa K, Miyazaki M. Peripheral portal vein-oriented non-dilated bile duct puncture for percutaneous transhepatic biliary drainage. World J Gastroenterol. 2015;21:12628-12634.
  20. Miyazaki M, Ohtsuka M, Miyakawa S, Nagino M, Yamamoto M, Kokudo N, Sano K, Endo I, Unno M, Chijiiwa K, Horiguchi A, Kinoshita H, Oka M, Kubota K, Sugiyama M, Uemoto S, Shimada M, Suzuki Y, Inui K, Tazuma S, Furuse J, Yanagisawa A, Nakanuma Y, Kijima H, Takada T. Classification of biliary tract cancers established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery: 3(rd) English edition. J Hepatobiliary Pancreat Sci. 2015;22:181-196.
  21. Ohtsuka M, Miyakawa S, et al. Revision concepts and distinctive points of new Japanese classification for biliary tract cancers in comparison wih the 7th edition of the UICC/AJCC staging system. J Hepatobiliary Pncreat Sci. 2015;22:197-201.
  22. Miyazaki M, Yoshitomi H, Miyakawa S, Uesaka K, Unno M, Endo I, Ota T, Ohtsuka M, Kinoshita H, Shimada K, Shimizu H, Tabata M, Chijiiwa K, Nagino M, Hirano S, Wakai T, Wada K, Isayama H, Okusaka T, Tsuyuguchi T, Fujita N, Furuse J, Yamao K, Murakami K, Yamazaki H, Kijima H, Nakanuma Y, Yoshida M, Takayashiki T, Takada T. Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition. J Hepatobiliary Pancreat Sci. 2015;22:249-273.
  23. Yoshitomi H, Miyakawa S, Nagino M, Takada T, Miyazaki M. Updated clinical practice guidelines for the management of biliary tract cancers: revision concepts and major revised points. J Hepatobiliary Pancreat Sci. 2015;22:274-278.
  24. Uno H, Furukawa K, et al. Immunonutrition suppresses acute inflammatory responses through modulation of resolvin E1 in patients undergoing major hepatobiliary resection. Surgery 2016;160:228-236.
  25. Watanabe Y, Kuboki S, Hiroaki Shimizu, Masayuki Ohtsuka, Hideyuki Yoshitomi, Katsunori Furukawa, Masaru Miyazaki. A New Proposal of Criteria For the Future Remnant Liver Volume in Older Patients Undergoing Major Hepatectomy For Biliary Tract Cancer. Ann Surg 2016 (in press)
  26. Ohtsuka M and Miyazaki M. Long-term survival after resection of periampullary cancer The Pancreas, third edition. Beger HG, Warshow AI, Hruban R, Buchler MW, Lerch MM, Neoptolemos JP, Shimosegawa T, Whitcomb DC eds. Wiley-Blackwell 2017 (in press)
基礎論文
  1. Okaya T, Nakagawa K, Kimura F, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, Ito H, Miyazaki M. The alterations in hepatic microcirculation and Kupffer cell activity after biliary drainage in jaundiced mice. J Hepatobiliary Pancreat Sci. 2012;19:397-404.
  2. Sakai N, Yoshidome H, Shida T, Kimura F, Shimizu H, Ohtsuka M, Takeuchi D, Sakakibara M, Miyazaki M. CXCR4/CXCL12 expression profile is associated with tumor microenvironment and clinical outcome of liver metastases of colorectal cancer. Clin Exp Metastasis. 2012;29:101-110.
  3. Miura S, Mitsuhashi N, Shimizu H, Kimura F, Yoshidome H, Otsuka M, Kato A, Shida T, Okamura D, Miyazaki M. Fibroblast growth factor 19 expression correlates with tumor progression and poorer prognosis of hepatocellular carcinoma. BMC Cancer. 2012;12:56. doi: 10.1186/1471-2407-12-56.
  4. Kagawa S, Takano S, Yoshitomi H, Kimura F, Satoh M, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Furukawa K, Matsushita K, Nomura F, Miyazaki M. Akt/mTOR signaling pathway is crucial for gemcitabine resistance induced by Annexin II in pancreatic cancer cells. J Surg Res. 2012;178:758-767.
  5. Yoichi T, Takayashiki T, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, Furukawa K, Kuboki S, Okamura D, Suzuki D, Nakajima M, Miyazaki M. Protective effects of simultaneous splenectomy on small-for-size liver graft injury in rat liver transplantation. Transpl Int. 2014;27:106-113.
  6. Hayashi T, Ohtsuka M, Okamura D, Seki N, Kimura F, Shimizu H, Yoshidome H, Kato A, Yoshitomi H, Furukawa K, Miyazaki M. Cytoskeleton-associated protein 2 is a potential predictive marker for risk of early and extensive recurrence of hepatocellular carcinoma after operative resection. Surgery. 2014;155:114-123.
  7. Shinoda K, Kuboki S, Shimizu H, Ohtsuka M, Kato A, Yoshitomi H, Furukawa K, Miyazaki M. Pin1 facilitates NF-κB activation and promotes tumour progression in human hepatocellular carcinoma. Br J Cancer. 2015;113:1323-1331.
  8. Akiyama T, Shida T, et al. Expression of Sex Determining Region Y-Box 2 and Pancreatic and Duodenal Homeobox 1 in Pancreatic Neuroendocrine Tumors. Pancreas. 2016;45:522-527.
  9. Nishida T, Yoshitomi H, et al. Low Stromal Area and High Stromal Microvessel Density Predict Poor Prognosis in Pancreatic Cancer. Pancreas. 2016;45:593-600.