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安全な広範肝切除を目的とした門脈枝塞栓術の基礎的および臨床的研究

Research Project

Project/Area Number 09671298
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Digestive surgery
Research InstitutionNagoya University

Principal Investigator

NAGINO Masato  Nagoya University School of Medicine, Assosiate Professor, 医学部, 講師 (20237564)

Co-Investigator(Kenkyū-buntansha) SANO Tsuyoshi  Nagoya University School of Medicine, Assosiate Professor, 医学部, 助手 (60303632)
MIYACHI Katsuhiko  Nagoya University School of Medicine, Assosiate Professor, 医学部, 助手 (20283434)
MIYACHI Masahiko  Aichi medical University, Assistant Professor, 講師 (80242874)
KAMIYA Junichi  Nagoya University School of Medicine, Assosiate Professor, 医学部, 講師 (70194975)
NIMURA Yuji  Nagoya University School of Medicine, Professor, 医学部, 教授 (80126888)
金井 道夫  名古屋大学, 医学部, 助手 (50242871)
Project Period (FY) 1997 – 1998
Project Status Completed (Fiscal Year 1998)
Budget Amount *help
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 1998: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 1997: ¥1,600,000 (Direct Cost: ¥1,600,000)
KeywordsPercutaneous transhepatic protal vein embolization / Trisegment portal vein embolization / Ipsilateral approach / Portal plus arterial embolization / Portal blood flow velocity / Doppler ultrasound / Liver regeneration / Apoptosis / 肝門部胆肝癌 / 胆嚢癌 / 肝切除術 / 術後肝不全
Research Abstract

[Clinical Study] 1) We have developed trisegment portal vein embolization in preparation for right or left hepatic trisegmentectomy. In right trisegment embolization, the left medial, right anterior, and right posterior segments were embolized ; in left trisegment embolization, the left lateral, left medial, and right anterior segments were involved. Trisegment enibolization has made hepatic trisegmentectomy safe. 2) Portal plus arterial embolization (dual embolization) was devised, in order to expand the indication of extensive liver resection for patients with poor functional reserve. This new intervention can produce sizable hypertrophy in the non-embolized hepatic segments. 3) Portal blood flow velocity after embolization was estimated using Doppler ultrasound. This study clearly has demonstrated that the hypertrophy rate of non-embolized hepatic segments after embolization is predictable from the extent of the increase in portal blood flow velocity. 4) With Angio-CT, we have found an immediate increase in the hepatic artery blood flow in the embolized hepatic segments after portal vein embolization.
[Experimental Study] 1) We have investigated the mechanism of hypertrophy in the non-embolized hepatic segments after portal vein embolization, using portal branch ligated rat model.. From the view point of polymerase activity and mitochondrial function, portal vein embolization induces hepatocyte proliferation in the non-embolized hepatic segments in a way similar to partial hepatectomy. 2) We have also studied the mechanism of atrophy in the embolized hepatic segments after portal vein embolization, using portal branch ligated rat model.. This atrophy results from, not necrosis, apoptosis of hepatocyte. In addition, we have elucidated that nuclear sphingomyelin breakdown with an accumulation of ceramide and/or sphingosine in nuclei may induce the apoptosis of hepatocyte in vivo.

Report

(3 results)
  • 1998 Annual Research Report   Final Research Report Summary
  • 1997 Annual Research Report
  • Research Products

    (24 results)

All Other

All Publications (24 results)

  • [Publications] Tsugane K: "A possible role of nuclear ceramide and sphingosine in hepatocyte apoptosis in rat liver" Journal of Hepatology. in press. (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nagino M: "Immediate increase in arterial blood flow in embolized hepatic segments after portal vein embolization" American Journal of Roentgenology. 171. 1037-1039 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Goto Y: "Doppler estimation of portal blood flow after percutaneous transhepatic portal vein embolization" Annals of Surgery. 228. 209-213 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Hamahata N: "APACH III,unlike APACHE II,predicts posthepatectomy mortality in patients with biliary tract carcinoma" Critical Care Medicine. 26. 1671-1676 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nagino M: "Preperative transhepatic portal vein embolization for impaired residual hepatic function in patients with obstructive jaundice" Journal of Hepato-Biliary-Pancreatic Surgery. 4. 373-376 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nagino M: "Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection: The ipsilateral approach" Radiology. 200. 559-563 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Tsugane K: "A possible role of nuclear ceramide and sphingosine in hepatocyte apoptosis in rat liver" Journal of Hepatology. (in press). (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nagino M: "Immediate increase in arterial blood flow in embolized hepatic segments after portal vein embolization" American Journal of Roentgenology. 171. 1037-1039 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Goto Y: "Doppler estimation of portal blood flow after percutaneous transhepatic portal vein embolization" Annals of Surgery.228. 209-213 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Hamahata N: "APACH III,unlike APACHE II,predicts posthepatectomy mortality in patients with biliary tract carcinoma" Critical Care Medicine. 26. 1671-1676 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nagino M: "Preoperative transhepatic portal vein embolization for impaired residual hepatic function in patients with obstructive jaundice" Journal of Hepato-Biliary-Pancreatic Surgery. 4. 373-376 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nagino M: "Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection : The ipsilateral approach" Radiology. 200. 559-563 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Tsugane K: "A possible role of nuclear ceramide and sphingosine in hepatocyte apoptosis in rat liver" Journal of Hepatology. in press. (1999)

    • Related Report
      1998 Annual Research Report
  • [Publications] Nagino M: "Immediate increase in arterial blood flow in embolized hepatic segments after portal vein embolization" American Journal of Roentgenology. 171. 1037-1039 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Goto Y: "Doppler estimation of portal blood flow after percutaneous transhepatic portal vein embolization" Annals of Surgery. 228. 209-213 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Hamahata N: "APACH III,unlike APACHE II,predicts posthepatectomy mortality in patients with biliary tract carcinoma" Critical Care Medicine. 26. 1671-1676 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Nagino M: "Preoperative transhepatic portal vein embolization for impaired residual hepatic function in patients with obstructive jaundice" Journal of Hepato-Biliary-Pancreatic Surgery. 4. 373-376 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] Nagino M: "Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection : The ipsilateral approach" Radiology. 200. 559-563 (1996)

    • Related Report
      1998 Annual Research Report
  • [Publications] Nagano M, et al.: "Preoperative transhepatic portal vein embolization for impaired residual hepatic function in patients with obstructive jaundice." Journal of Hepto-Biliary-Pancreatic Surgery. 4. 373-376 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Takeuchi E,Nagino M, et al.: "Human hepatocyte growth factor in bile." Hepatology. 26. 1092-1099 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Goto Y,Nagino M, et al.: "Doppler estimation of portal blood flow after percutaneous transhepatic portal vein embolization." Annals of Surgery. (in press).

    • Related Report
      1997 Annual Research Report
  • [Publications] Nagino M, et al.: "Segmental liver resection for hilar cholangiocarcinoma." Hepato-Gastroenterology. (in press).

    • Related Report
      1997 Annual Research Report
  • [Publications] Hamahata N,Nagino M, et al.: "APACHE III,unlike APACHE II,predicts posthepatectomy mortality in patients with biliary tract carcinoma." Critical Care Medicine. (in press).

    • Related Report
      1997 Annual Research Report
  • [Publications] Nagino M, et al.: "Immediate increase in arterial blood flow in emblized hepatic segments after portal vein embolization." American Journal of Roentgenology. (in press).

    • Related Report
      1997 Annual Research Report

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Published: 1997-04-01   Modified: 2016-04-21  

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