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Preoperative evaluation of the safety zone of hepatectomy for the patients with hepatobiliary discases accompanying with liver cirrhosis or jaundice.

Research Project

Project/Area Number 06671301
Research Category

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

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionWakayama Medical School

Principal Investigator

ISHIMOTO Kiwao  Wakayama Medical School, Second Department associate professor, 医学部, 助教授 (40176227)

Co-Investigator(Kenkyū-buntansha) OHNISHI Hironobu  Wakayama Medical School, Second Department assistant staff, 医学部, 助手 (40264882)
UCHIYAMA Kazuhisa  Wakayama Medical School, Second Department assistant professor, 医学部, 講師 (80232867)
TANIMURA Hiroshi  Wakayama Medical School, Second Department professor, 医学部, 教授 (10026990)
Project Period (FY) 1995 – 1996
Project Status Completed (Fiscal Year 1995)
Budget Amount *help
¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1995: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1994: ¥1,200,000 (Direct Cost: ¥1,200,000)
KeywordsBile acid tolerance test / Functional resurve of the liver / liver cirrhosis / 肝汁酸負荷試験
Research Abstract

The significance of oral ursodeoxycholic acid (UDCA) tolerance test and liver volume prediction with CT-scan using a new computer soft system was investigated in 60 patients in order to estimate preoperatively the safety zone of hepatectomy for patients with hepatobiliary diseases accompanying with liver cirrhosis or jaundice.
The area under the curve of total bile acid levels (T・AUC) in UDCA tolerance test was significantly correlated with the ICG retention rate (ICG R15) (correlation coefficient : 0.83), and was more useful in 4 patients than ICG R15.
Preoperative CT-scan prediction of the liver volume was performed in 17 patients, and was showed to correlate closely with the weight of resected liver volume.
In 60 patients, the prediction of resected liver volume calculated preoperatively and other liver function tests of these patients were compared to postoperative prognosis, including 4 patients who died of hepatic failure after hepatectomy. Postoperative prognosis (Y) of these Patients was computed by the following multiple regression equation. :
Y=3.48X+1.61DELTAUDCA120-0.12T・AUC+1.68R15-31.0
proportion 0.58 (p<0.01) ; the Y-score was represented as 100 (died of hepatic failure) or 0 (discharged) point ; X : normal liver volume=resected liver volume-the vulume of the tumor ; R15 (%) : retention rate of ICG ; T・AUC (mumol・h/l) ; DELTAUDCA120 (mumol/l) : the UDCA levels increased from 0 min to 120 min after loading
From these results, it was showed that the patients with more than 25 points could be predicted to fall into hepatic failure after hepatectomy.
Conclusion. UDCA tolerance test and liver volume prediction with CT-scan using a new computer soft system are very useful to estimate preoperative functional reserve of the liver.

Report

(3 results)
  • 1995 Annual Research Report   Final Research Report Summary
  • 1994 Annual Research Report
  • Research Products

    (31 results)

All Other

All Publications (31 results)

  • [Publications] 石本喜和男: "大腸癌肝転移の早期診断と肝切除・肝動脈癌化学療法の意義" 日本消化器病学会雑誌. 91. 1883 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 石本喜和男: "大腸癌術後肝転移の早期診断と治療方針" 日本臨床外科医学会雑誌. 55. 301 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 石本喜和男: "閉塞性黄疸に対する血中・胆汁中3β‐OH胆汁酸の減黄効果指標としての意義" 日本消化器外科学会雑誌. 27. 1658 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 石本喜和男: "閉塞性黄疸における3β‐OH胆汁酸の変動からみた減黄効果の判定法" 日本外科学会雑誌. 臨増. 249 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 石本喜和男: "硬変肝の胆汁酸負荷試験による切除量決定" 日本消化器外科学会雑誌. 28. 437 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 石本喜和男: "高速液体クロマトグラフィーによる胆石中長鎖脂肪酸測定" 医学のあゆみ. 173. 935-936 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 谷村弘: "胆石症、戸田剛太郎、大原毅編「消化器病学」第4版" 医学書院東京, 21(576-595) (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 内山和久: "総胆管結石の治療法の選択、胆管結石症の治療法の変遷" 自然科学者、東京「胆道疾患研究の進歩」, 5(161-165) (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Ishimoto K,Tanimura H,Murakami K,Ohnishi H,Yamade N: "Preoperative staging by endoscopic ultrasonography on indication of intrapelvic lymphadenectomy for rectal cancer" Collegium Internationale Chirurugiae Digestivae, Monduzzi Editore.Italy. 551-555 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Tanimura H,Taniguchi K.Nakai T,Yamoto H,Kasano Y,Fukiage S,Hayashido M,Tanaka H: "Hepatectomy under in situ cold perfusion with fructose-1.6-diphosphate solution" J Hep Bil Panc Surg. 1. 481 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Uchiyama K,Tanimura H,Ishimoto K,Murakami K,Nakai T,Yamasami S: "Extracorporeal Shock Wave Lithotripsy (ESWL) for Biliary Stones A Nationwide Survey in Japan" Arch Jpn Chir. 63. 199-207 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Ohnishi H,Tanimura H,Ishimoto K: "Clinical significance of bile acid tolerance test for preoperative estimation of functional reserve of liver in hepatic resection" Collegium Internationale Chirurgiae Digestivae, Monduzzi Editore.Italy. 407-410 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Nakai T,Tanimura H,Hirabayashi N: "Effects of intrahepatic arterial infusion of prostaglandin E1 on hepatic hemodynamics and oxygen metabolism" Collegium Internationale Chirurgiae Digestivae, Monduzzi Editore.Italy. 393-397 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Uchiyama K,Tanimura H,Ishimoto K,Go Sekito: "Extracorporeal shock wave lithotripsy for treatment of hepatolithiasis" Journal of Biliary Tract & Pancreas, Japan. 475-481 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Tanimura H,Uchiyama K,Ishimoto K,Go Sekito: "Epidemiology of Hepatolithiasis" Journal of Biliary Tract & Pancreas, Japan. 401-408 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] Uchiyama K,Tanimura H,Ishimoto K,Murakami K,Nakai T,Yamasali S: "A national survey of extracorporeal shock wave lithotripsy (ESWL) for cholelithiasis in Japan" Journal of Biliary Tract & Pancreas, Japan. 571-576 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] 石本喜和男: "閉塞性黄疸における3β-OH胆汁酸の変動からみた減黄効果の判定法" 日本外科学会雑誌. 臨増. 249 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 石本喜和男: "胆石中エステル型高級脂肪酸のHPLC測定の意義" 日本外科学会雑誌. 臨増. 120 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 石本喜和男: "硬変肝の胆汁酸負荷試験による切除量決定" 日本消化器外科学会雑誌. 28. 437 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 石本喜和男: "高速液体クロマトグラフィーによる胆石中長鎖脂肪酸測定" 日本消化器外科学会雑誌. 28. 1139 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 石本喜和男: "高速液体クロマトグラフィーによる胆石中長鎖脂肪酸測定" 医学のあゆみ. 173. 935-936 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 内山和久: "全国統計からみた肝内結石症の胆汁中検出菌について" 日本外科感染症研究. 7. 121-125 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 谷村弘: "胆石症.戸田剛太郎,大原毅編「消化器病学」第4版" 医学書院 東京, 21(576〜595) (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 内山和久: "総胆管結石の治療法の選択,胆管結石症の治療法の変遷" 自然科学者東京「胆道疾患研究の進歩」, 5(161〜165) (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 石本喜和男: "大腸癌肝転移の早期診断と肝切除・肝動脈癌化学療法の意義" 日本消化器病学会雑誌. 91. 1883 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 石本喜和男: "大腸癌術後肝転移の早期診断と治療方針" 日本臨床外科医学会雑誌. 55. 301 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 石本喜和男: "大腸癌再発における血清CEA,CAI9-9血測定による部位診断と再切除" 日本癌治療学会誌. 29. 1440 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 石本喜和男: "閉塞性黄疸に対する血中・胆汁3β-OH胆汁酸の減黄効果指標と12の意義" 日本消化器外科学会雑誌. 27. 1658 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 石本喜和男: "3β-OH胆汁酸のHPLC測定法の臨床的意義" 日本消化器病学会雑誌. 91. 1795 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] K.Ishimoto: "A new determination method of 3β-hydroxylated bile acid by high pertomance liguid chromatography in obstructive Jaubdice" world congresses of gostroenterlogy. 10th. 2599 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 谷村弘: "「特集」肝内結石症の治療、肝内結石症に対する胆管空腸端側の吻合術" 外科治療. 70. 293-301 (1994)

    • Related Report
      1994 Annual Research Report

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Published: 1994-04-01   Modified: 2016-04-21  

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