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Experomental and clinical studies to increase curability and safety of surgery for hilar cholangiocarcinoma

Research Project

Project/Area Number 04404050
Research Category

Grant-in-Aid for General Scientific Research (A)

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionNagoya University

Principal Investigator

NIMURA Yuji  Nagoya University School of Medicine Professor, 医学部, 教授 (80126888)

Co-Investigator(Kenkyū-buntansha) KANAI Michio  Nagoya University School of Medicine Associate Professor, 医学部, 助手 (50242871)
MIYACHI Masahiko  Nagoya University School of Medicine Associate Professor, 医学部, 助手 (80242874)
NAGINO Masato  Nagoya University School of Medicine Associate Professor, 医学部, 助手 (20237564)
KONDO Satoshi  Nagoya University School of Medicine Associate Professor, 医学部, 講師 (30215454)
KAMIYA Junichi  Nagoya University School of Medicine Associate Professor, 医学部, 講師 (70194975)
Project Period (FY) 1992 – 1994
Project Status Completed (Fiscal Year 1994)
Budget Amount *help
¥19,500,000 (Direct Cost: ¥19,500,000)
Fiscal Year 1994: ¥4,000,000 (Direct Cost: ¥4,000,000)
Fiscal Year 1993: ¥6,000,000 (Direct Cost: ¥6,000,000)
Fiscal Year 1992: ¥9,500,000 (Direct Cost: ¥9,500,000)
KeywordsHilar cholangiocarcinoma / Obstructive Jaundice / Hepatectomy / Liver failure / Portal vein embolization / Biliary drainage / Cholangitis / Caudate lobe / 肝再生能 / 胆道ドレナージ / xanthine oxidase / 肝虚血 / histo chemistry / 虚血再潅流障害 / xanthine oxiclase / histochemistry / free radicals
Research Abstract

*Clinical Research*
(1) Preoperative accurate diagnosis of cancer extent was achievable using cholangiography throgh biliary drainage catheter, percutaneous transhepatic cholangioscopy, selective angiography, pcrcutaneous transhepatic portography and hepatic venography. This, in turn led to rational surgical prcoedures. (2) Perineural lnvasion proved to have a profound impact on survival of the patients with bile duct carcinoma, indicating that thorough skeletonization resection is essential for curative intent. (3) We developed a new approach of percutaneous transhepatic portal vein cmbolization, the ipsilateral approach, which made it possible to embolize the right or left trisegment portal vein. Portal vein cmbolization had the potential to increase safety of and to extend indication of major hepatectomy for hilar cholangiocarcinoma. (4) Technique of multiple selective biliary for hilar cholangiocarcinoma was well established by the direct anterior approach under fluoroscopic control … More . This aggressive drainage was essential for preventing and/or treating segmental cholangitis in patients with malignant biliary obstruction at the hepatic confluence.
*Experimental Research*
The following resukts were demonstrated experimentally using rats or mioe. (1) External bilisry drainage, unlike internal drainage, does not suppress regcenration of cholestatic liver after partial hepatectomy. (2) Biliary infection, especially associated with obstructive jaundice, injures hepatic mitochondrial function markedly. Biliary drainage is definitely effective in improving the impaierd function. (3) Under a condition of selective biliary obstruction, hepatic mitochondrial function is decreased also in the non-cholestatic lobe, as well as the cholestatic lobc. This implies that biliary drainage of the entire biliary system is beneficial. (4) An application of lipid emulsion to total parenteral nutrition is useful for hepatic regeneration after partial hepatectomy. (5) Portal branch ligation induces hepatocyte proliferation in the non-ligated lobe in a way similar to partial hepatectomy, from the viewpoint of changes in DNA polymerases and mitochondrial gene expression. (6) Portal branch ligation induces hepatocyte proliferation in the non-ligated lobe, irrespective of obstructive jaundice. (7) An increment in IL-10 production in the liver is involved in the protective effect of dibutyryl cAMP on inflammatory liver injury. Less

Report

(4 results)
  • 1994 Annual Research Report   Final Research Report Summary
  • 1993 Annual Research Report
  • 1992 Annual Research Report
  • Research Products

    (41 results)

All Other

All Publications (41 results)

  • [Publications] Bhuiya MMR,Nimura Y,et al.: "Clinicopathological studies on perineural invasion of bile duct carcinoma" Annals of Surgery. 215. 344-349 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Suzuki H,Nimura Y,et al.: "Internal biliary drainage,unlike external drainage,does not suppress the generation cholestatic rat liver after partial hepatectomy" Hepatology. 20. 1318-1322 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nagino M,Nimura Y,et al.: "Changes in hepatic lobe volume in biliary tract cancer patients after right portal vein embolization" Hepatology. 21. 434-439 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Arai T,Nimura Y,et al.: "IL-10 is involved in the protective effect of dibutyryl cyclic adenosine monophosphate on endotoxin-induced inflammatory liver injury" Journal of Immunology. 155. 5743-5749 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Shimizu Y,Nimura Y,et al.: "Elevated mitochondrial gene expression during rat liver regeneration after portal vein ligation" Hepatology. 22. 1222-1229 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Uesaka K,Nimura Y,et al.: "Changes in hepatic lobar function after right portal vein embolization : An appraisal by biliary indocyanine green excretion" Annals of Surgery. 223. 77-83 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nimura Y.: "Hepatectomy for proximal bile duct cancer. In : Braash JW.et al.eds.Surgical diseases of the biliary tract and pancreas." Mosby,St.Louis, 725 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nimura Y,et al.: "Hilar cholangiocarcinoma. In : Serio G,et al.eds.Hepatobiliary and pancreatic tumors." Graffham Press,Verona, 158 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Bhuiya MMR,Nimura Y,et al: "Clinicopathologic studies on perineural invasion of bile duct carcinoma." Ann Surg. 215. 344-349 (1992)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nimura Y: "Staging of biliary carcinoma : Cholangiography and cholangioscopy" Endoscopy. 25. 76-80 (1993)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Kin T.Nimura T,et al: "Doppler analysis of hepatic blood flow predicts liver dysfunction after major hepatectomy" World J Surg. 18. 143-149 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Suzuki H.Nimura Y,et al: "Internal biliary drainage, unlike external drainage, does not suppress the regeneration of cholestatic rat liver after partial hepatectomy." Hepatology. 20. 1318-1322 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Kato S,Nimura Y,et al: "Hepatic recovery after biliary drainage in experimental obstructive jaundice complicated by biliary infection." Hepato-Gastroenterology. 41. 217-221 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nagino M,Nimura Y,et al: "Changes in hepatic lobe volume in biliary tract cancer patients after right portal vein embolization." Hepatology. 21. 434-439 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Arai T,Nimura Y,et al: "IL-10 is involved in the protective effect of dibutyryl cyclic adenosine monophsphate on endotoxin-induced inflammatory liver injury." J Immunol. 155. 5743-5749 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Ikuta K,Nimura Y,et al: "Effect of lipid emulsion for total parenteral nutrition on regeneration of the liver after partial hepatectomy in rats." Nutrition. 11. 365-370 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Shimizu Y,Nimura Y,et al: "Elevated mitochondrial gene expression during rat liver regeneration after portal" Hepatology. 22. 1222-1229 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nagion M,Nimura Y,et al: "Disseminated intravascular coagulation after liver resection : Retrospective study in patients with biliary tract carcuioma." Surgery. 117. 581-585 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nimura Y,et al: "Technique of inserting multiple biliary drains and management." Hepato-Gastroenterology. 42. 323-331 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Uesaka K.Nimura Y,et al: "Changes in hepatic lobar function after right portal vein embolization : An appraisal by biliary indocyanine green excretion." Anm Surg. 223. 77-83 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Mizuno S,Nimura Y,et al: "Portal branch occlusion induces cell proliferation of rat liver irrespective of obstructive jaundice." J Surg Res. 60. 249-257 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nagion M,Nimura Y,et al: "Selective percutaneous transhepatic embolization of the portal vein : The ipsilateral approach" Radiology. 200. 559-563 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Kanai M.Nimura Y et al: "Preoperative intrahepatic segmental cholangitis in patients with advanced carcinoma involving the hepatic hilus." Surgery. 119. 498-504 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nimura Y,et al: "Hepatectomy for hilar bile duct cancer" Asian J Surg. 19. 94-100 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Nagino M: "Percutaneous transhepatic ciliary drainage in patients with malignant biliary obstruction of the hepatic confluence" Hepato-Gastroenterologv. 39. 296-300 (1992)

    • Related Report
      1994 Annual Research Report
  • [Publications] Kanai M: "Mitochondrial dysfunction in the non-obstructed lobe of rat liver after selective biliary obstruction" Hepato-Gastroenterology. 39. 385-391 (1992)

    • Related Report
      1994 Annual Research Report
  • [Publications] Nagino M: "Logistic regression and discriminant analyses of hepatic failure after liver resection" World Journal of Surgery. 17. 250-255 (1993)

    • Related Report
      1994 Annual Research Report
  • [Publications] Bhuiya MMR: "Carcinoma of the hepatic hilus with superficial spreading to the intrahepatic segmental bile ducts:report of a case" Journal of Hepato-Biliary-Pancreatic Surgery. 1. 22-26 (1993)

    • Related Report
      1994 Annual Research Report
  • [Publications] Nagino M: "Percutaneous transhepatic portal embolization using newly devised catheters:Preliminary report" World Journal of Surgery. 17. 520-524 (1993)

    • Related Report
      1994 Annual Research Report
  • [Publications] Bhuiya MMR: "Clinicopathologic factors influencing survival of patients with bile duct carcinoma:Multivariate statistical analysis" World Journal of Surgery. 17. 653-657 (1993)

    • Related Report
      1994 Annual Research Report
  • [Publications] Kin Y: "Doppler analysis of hepatic blood flow predicts liver dysfunction after major hepatectomy" World Journal of Surgery. 18. 143-149 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Yuasa N: "Angiographic changes in the hepatic artery after skeletonization resection for biliary tract cancer" Gastrointestinal Endoscopy. 40. 92-93 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Kamiya J: "Preoperative cholangiography of the caudate lobe:Surgical anatomy and staging for biliary carcinoma" Journal of Hepato-Biliary-Pancreatic Surgery. 1. 385-389 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] I.Nagano: "Hepatic mitochondrial changes in experimental obstructive jaundice complicated by biliary infection" Hepatogastroenterology. 41. 432-437 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] S.Kato: "Hepatic recovery after biliary drainage in experimental obstructive joundice complicated by biliary infection" Hepatogastroenterology. 41. 217-221 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Iyomasa,S.: "Successful management of prcopcrative cholangins by pcrcutancous transcpatic biliary drainage:Casc report of advanced gallbladdcr carcinoma with scvcre chotangitis" J.Hep.Bil.Pancr. 4. 424-428 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Nagino M: "Changes in hepatic lobe volume in biliary tract cancer patients after right portal vein embolization" Hepatology. 21. 434-439 (1995)

    • Related Report
      1994 Annual Research Report
  • [Publications] Nagino M: "Disseminated intravascular coagulation after liver resection:Retrospective study in patients with biliary tract carcinoma" Sugery. (in press).

    • Related Report
      1994 Annual Research Report
  • [Publications] Nagino M: "Right or left trisegment portal vein embolization before hepatic trisegmentectomy for hilar bile duct carcinoma" Surgery. (in press).

    • Related Report
      1994 Annual Research Report
  • [Publications] Nagino M: "Preoperative managemant of hilar cholangiocarcinoma" Journal of Hepato-Biliary-Pancreatic Surgery. (in press).

    • Related Report
      1994 Annual Research Report
  • [Publications] Nagino M: "Changes in hepatic lobar function after right portal vein embolization" Annals of Surgery. (in press).

    • Related Report
      1994 Annual Research Report

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Published: 1992-04-01   Modified: 2016-04-21  

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