亀井 敬子(カメイ ケイコ)
医学科 | 講師 |
Last Updated :2024/10/16
■教員コメント
コメント
肝胆膵外科、特に膵疾患について。良性から悪性まで。
■研究者基本情報
J-Global ID
現在の研究分野(キーワード)
肝胆膵外科、特に膵疾患について。良性から悪性まで。
■経歴
■研究活動情報
論文
- Chihoko Nobori; Ippei Matsumoto; Masaya Nakano; Katsuya Ami; Yuta Yoshida; Dongha Lee; Takaaki Murase; Keiko Kamei; Atsushi Takebe; Takuya Nakai; Yoshifumi TakeyamaSurgery today 2024年09月PURPOSE: To clarify the prevalence, risk factors, and clinical implications associated with zinc deficiency in patients undergoing pancreatic surgery. METHODS: The serum zinc levels were measured in 329 patients post-pancreatic surgery between January and April 2021. The postoperative serum zinc levels and clinicopathological variables were retrospectively analyzed. RESULTS: The median serum zinc level was 73 µg/dL (33-218). Zinc deficiency (zinc level < 60 µg/dL) was observed in 52 patients (16%). A total of 329 patients were classified into zinc-deficient (n = 52) and non-deficient (zinc ≥ 60 µg/dL, n = 277) groups. A univariate analysis revealed significant differences in sex, postoperative body mass index, serum albumin, total cholesterol, creatinine, aspartate aminotransferase (AST), HbA1c levels, diabetes, surgical procedures, and operative blood loss. According to a multivariate analysis, male sex [odds ratio (OR) 3.70; 95% confidence interval (CI) 1.67-8.20; p = 0.001], postoperative serum albumin levels < 3.9 g/dL (OR 6.39; 95% CI 3.30-12.37; p < 0.001), postoperative serum AST ≥ 51 U/L (OR, 4.6; 95% CI 0.07-0.29; p < 0.001), and total pancreatectomy (OR 3.68; 95% CI 1.37-9.85; p = 0.009) were found to be independent predictors of zinc deficiency after pancreatic surgery. CONCLUSIONS: Zinc deficiency frequently occurs in patients undergoing pancreatic surgery. Lower postoperative zinc levels could be linked to sex, the serum albumin and AST levels, and surgery type.
- 外科的ネクロゼクトミーを施行した重症急性膵炎の2例山田 淳史; 登 千穂子; 吉田 雄太; 李 東河; 村瀬 貴昭; 亀井 敬子; 武部 敦志; 中居 卓也; 山崎 友裕; 大本 俊介; 三長 孝輔; 竹中 完; 松本 逸平日本消化器病学会近畿支部例会プログラム・抄録集 120回 107 - 107 日本消化器病学会-近畿支部 2024年01月
- Shuzo Imamura; Fumimaru Niwano; Naru Babaya; Yoshihisa Hiromine; Ippei Matsumoto; Keiko Kamei; Yuta Yoshida; Yasunori Taketomo; Sawa Yoshida; Yoshifumi Takeyama; Shinsuke Noso; Norikazu Maeda; Hiroshi IkegamiThe Journal of Clinical Endocrinology & Metabolism 109 3 619 - 630 2023年10月Abstract Context Glucose tolerance worsens after distal pancreatectomy (DP); however, the long-term incidence and factors affecting interindividual variation in this worsening are unclear. Objective To investigate the changes in diabetes-related traits before and after DP and to clarify the incidence of diabetes and its predictors. Methods Among 493 registered patients, 117 underwent DP. Among these, 56 patients without diabetes before surgery were included in the study. Glucose and endocrine function were prospectively assessed using a 75-g oral glucose tolerance test preoperatively, 1 month after DP, and every 6 months thereafter for up to 36 months. Pancreatic volumetry was performed using multidetector row computed tomography before and after surgery. Results Insulin secretion decreased and blood glucose levels worsened after DP. Residual pancreatic volume was significantly associated with the reserve capacity of insulin secretion but not with blood glucose levels or the development of diabetes. Among 56 patients, 33 developed diabetes mellitus. The cumulative incidence of diabetes at 36 months after DP was 74.1%. Multivariate Cox regression analysis showed that impaired glucose tolerance as a preoperative factor as well as a decreased insulinogenic index and impaired glucose tolerance at 1 month postoperatively were identified as risk factors for diabetes following DP. Conclusion Impaired glucose tolerance and reduced early-phase insulin response to glucose are involved in the development of new-onset diabetes after DP; the latter is an additional factor in the development of diabetes and becomes apparent when pancreatic beta cell mass is reduced after DP.
- Akiko Todaka; Mitsuhito Sasaki; Hideki Ueno; Takuma Goto; Gou Murohisa; Nobumasa Mizuno; Masato Ozaka; Satoshi Kobayashi; Kazuhiro Uesugi; Noritoshi Kobayashi; Hideyuki Hayashi; Kentaro Sudo; Naohiro Okano; Yosuke Horita; Keiko Kamei; Shoko Nanami; Narikazu BokuAnticancer research 43 9 4115 - 4123 2023年09月BACKGROUND/AIM: FOLFIRINOX (FFX) is a standard treatment for patients with advanced pancreatic cancer. However, it often causes serious hematological adverse events. This study aimed to identify the risk factors for febrile neutropenia (FN) and grade 4 (G4) neutropenia during treatment with FFX in the real world. PATIENTS AND METHODS: We analyzed data obtained from a nationwide multicenter observational study (JASPAC 06) that included 399 patients with unresectable or recurrent pancreatic cancer who received FFX at 27 institutions in Japan. RESULTS: Nadir neutrophil counts occurred from day 8 to day 22 of cycle 1, and granulocyte colony-stimulating factor was administered to over a quarter of the patients in the first cycle. Of 399 patients, FN and G4 neutropenia occurred in 51 (13%) and 108 (27%) patients, respectively. Most FN (83%) and G4 neutropenia (75%) occurred in the first or second cycles. Multivariate logistic regression analyses showed that total bilirubin (TB) > the upper limit of normal range (ULN) and no dose modification from the original regimen were significantly associated with FN, and that TB > ULN, no dose modification from the original regimen, low platelet count (<15×104/μl), and recurrent disease after pancreatectomy were independent risk factors for G4 neutropenia. CONCLUSION: No dose modification from the original regimen and TB > ULN were risk factors for FN and G4 neutropenia.
- 急性膵炎の致命率改善への集学的治療 地域連携モデル構築による重症急性膵炎死亡率低減への取り組み竹中 完; 大本 俊介; 高島 耕太; 田中 秀和; 福永 朋洋; 吉田 晃浩; 山崎 友祐; 三長 孝輔; 鎌田 研; 亀井 敬子; 松本 逸平; 竹山 宜典; 工藤 正俊膵臓 38 3 A169 - A169 (一社)日本膵臓学会 2023年07月
- 地域連携システムを用いた南大阪地区早期膵癌発見・診断プロジェクト吉田 晃浩; 竹中 完; 高島 耕太; 田中 秀和; 福永 朋洋; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 亀井 敬子; 松本 逸平; 竹山 宜典; 工藤 正俊膵臓 38 3 A370 - A370 (一社)日本膵臓学会 2023年07月
- 急性膵炎の致命率改善への集学的治療 地域連携モデル構築による重症急性膵炎死亡率低減への取り組み竹中 完; 大本 俊介; 高島 耕太; 田中 秀和; 福永 朋洋; 吉田 晃浩; 山崎 友祐; 三長 孝輔; 鎌田 研; 亀井 敬子; 松本 逸平; 竹山 宜典; 工藤 正俊膵臓 38 3 A169 - A169 (一社)日本膵臓学会 2023年07月
- 地域連携システムを用いた南大阪地区早期膵癌発見・診断プロジェクト吉田 晃浩; 竹中 完; 高島 耕太; 田中 秀和; 福永 朋洋; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 亀井 敬子; 松本 逸平; 竹山 宜典; 工藤 正俊膵臓 38 3 A370 - A370 (一社)日本膵臓学会 2023年07月
- Shumpei Satoi; Yutaka Kimura; Rie Shimizu; Masataka Matsumoto; Kohei Kawaguchi; Yuta Yoshida; Takaaki Murase; Keiko Kamei; Ippei Matsumoto; Takuya Nakai; Yoshifumi TakeyamaSurgery today 2023年04月PURPOSE: Although reports suggest that the pancreatic volume decreases after gastrectomy for gastric cancer, the relationship between the pancreatic volume and secretory function after gastrectomy remains unclear. In this study, we examined the relationship between the pancreatic volume and exocrine and endocrine functions after total gastrectomy. METHODS: The pancreatic volumes of 18 distal gastrectomy and 15 total gastrectomy patients were retrospectively measured using computed tomography volumetry up to 5 years postoperatively. Ten low anterior resection patients were selected as controls. In addition, the pancreatic volume and exocrine function evaluated by fecal elastase and the insulin secretory function evaluated by glucagon tolerance testing were prospectively examined before and one year after surgery in nine cases of total gastrectomy. RESULTS: After low anterior resection, the pancreatic volume did not change, but after distal and total gastrectomy, the pancreatic volume decreased continuously until the fifth year. After total gastrectomy, fecal elastase decreased significantly from 865.8 μg/g to 603.2 μg/g in the first year (p = 0.0316), and the insulin secretion capacity also decreased significantly from 3.83 ng/mL to 2.26 ng/mL (p = 0.0019). CONCLUSIONS: The pancreatic volume decreases continuously after gastrectomy for gastric cancer, and the pancreatic exocrine and endocrine functions decrease along with pancreatic atrophy after total gastrectomy.
- Fumimaru Niwano; Naru Babaya; Yoshihisa Hiromine; Ippei Matsumoto; Keiko Kamei; Yasunori Taketomo; Sawa Yoshida; Yoshifumi Takeyama; Shinsuke Noso; Hiroshi IkegamiThe Journal of Clinical Endocrinology & Metabolism 107 12 3362 - 3369 2022年09月Abstract Context The glucose tolerance of patients changes considerably from before to after pancreaticoduodenectomy wherein approximately half of the pancreas is resected. Purpose The aim of this prospective study was to investigate the incidence of and risk factors for diabetes after pancreaticoduodenectomy. Methods This study is a part of an ongoing prospective study, the Kindai Prospective Study on Metabolism and Endocrinology after Pancreatectomy (KIP-MEP) study. Of the 457 patients enrolled to date, 96 patients without diabetes who underwent pancreaticoduodenectomy were investigated in this study. Preoperatively, 1-month post-pancreaticoduodenectomy, and every 6 months thereafter, the glucose metabolism and endocrine function were evaluated using the 75-g oral glucose tolerance test. Various other metabolic, endocrine, and exocrine indices were also examined over a period of up to 36 months. Results Of the 96 patients analyzed in this study, 33 were newly diagnosed with diabetes. The cumulative diabetes incidence at 36 months following pancreaticoduodenectomy was 53.8%. The preoperative insulinogenic index and ΔC-peptide in the glucagon stimulation test were significantly lower in the progressors than in the non-progressors to diabetes. Multivariate Cox regression analysis demonstrated that the insulinogenic index was the only significant risk factor for new-onset diabetes. Conclusions The majority of patients developed new-onset diabetes after pancreaticoduodenectomy, and a low value of the insulinogenic index was suggested to be a risk factor for diabetes. Preoperative assessment for the prediction of the onset of diabetes serves as useful information for patients and is important for postoperative glycemic control and diabetes management in patients who require pancreaticoduodenectomy.
- Hironobu Suto; Keiko Kamei; Hiroyuki Kato; Takeyuki Misawa; Michiaki Unno; Hiroyuki Nitta; Sohei Satoi; Yasunari Kawabata; Masayuki Ohtsuka; Toshiki Rikiyama; Takeshi Sudo; Ippei Matsumoto; Tomohiro Hirao; Keiichi Okano; Yasuyuki Suzuki; Naohiro Sata; Shuji Isaji; Masanori Sugiyama; Yoshifumi TakeyamaSurgery 172 3 962 - 967 2022年09月BACKGROUND: The number of total pancreatectomy cases have increased worldwide, expanding the need for new insulin products and high-titer pancrelipases. However, the current data that is focused on hypoglycemic events after a total pancreatectomy from large nationwide series are still lacking. This study is aimed to assess the risk factors associated with hypoglycemic events after a total pancreatectomy. METHODS: Data were prospectively collected from 216 consecutive patients who underwent total pancreatectomies between August 2015 and December 2017 from 68 Japanese centers. Of the 216 patients, 166 with a follow-up period of 1 year were analyzed. The risk factors for hypoglycemic events at 6 and 12 months (postoperative months 6 and 12) were investigated based on the results of a nationwide multicenter prospective study. RESULTS: Of the 166 patients, 57 (34%) and 70 (42%) experienced moderate or severe hypoglycemic events or hypoglycemia unawareness on a monthly basis at postoperative months 6 and 12, respectively. Multivariate analysis revealed that body weight loss after surgery ≥0.3 kg and total cholesterol level ≤136 mg/dL at postoperative month 6, and glycated hemoglobin level ≤8.9% and rapid-acting insulin use at postoperative month 12 were independent risk factors for hypoglycemic events after a total pancreatectomy. There were different independent risk factors depending on the postoperative period. CONCLUSION: Patients with body weight loss after surgery, low total cholesterol level, strict glycemic control, and using rapid-acting insulin should be aware of the occurrence of hypoglycemic events after their total pancreatectomy. In order to prevent hypoglycemic events after a total pancreatectomy, we need to consider optimal nutritional and glycemic control according to the postoperative period.
- Tatsuya Ioka; Masashi Kanai; Shogo Kobayashi; Daisuke Sakai; Hidetoshi Eguchi; Hideo Baba; Satoru Seo; Akinobu Taketomi; Tadatoshi Takayama; Hiroki Yamaue; Masahiro Takahashi; Masayuki Sho; Keiko Kamei; Jiro Fujimoto; Masanori Toyoda; Junzo Shimizu; Takuma Goto; Yoshitaro Shindo; Kenichi Yoshimura; Etsuro Hatano; Hiroaki NaganoJournal of hepato-biliary-pancreatic sciences 30 1 102 - 110 2022年07月BACKGROUND: Gemcitabine/cisplatin (GC) combination therapy has been the standard palliative chemotherapy for patients with advanced biliary tract cancer (BTC). No randomized clinical trials could demonstrate the survival benefit over GC during the past decade. In our previous phase II trial, adding S-1 to GC (GCS) showed promising efficacy and we aimed to determine whether GCS could improve overall survival compared with GC for patients with advanced BTC. PATIENTS AND METHODS: We performed a mulitcenter, randomized phase III trial across 39 centers. Enrolled patients were randomly allocated (1:1) to either the GCS or GC arm. GCS regimen comprised gemcitabine (1,000 mg/m2 ) and cisplatin (25 mg/m2 ) infusion on day 1 and 80 mg/m2 of S-1 on days 1-7 every 2 weeks. The primary endpoint was overall survival (OS) and the secondary endpoints were progression-free survival (PFS), response rate (RR), and adverse events (AEs). This study is registered with Clinical trial identification: NCT02182778. RESULTS: Between July 2014 and February 2016, 246 patients were enrolled. The median OS and 1-year OS rate were 13.5 months and 59.4% in the GCS arm and 12.6 months and 53.7% in the GC arm, respectively (hazard ratio [HR] 0.79, 90% confidential interval [CI] 0.628-0.996; p = 0.046 [stratified log-rank test]). Median PFS was 7.4 months in the GCS arm and 5.5 months in the GC arm (HR 0.75, 95% CI 0.577-0.970; p = 0.015). RR was 41.5% in the GCS arm and 15.0% in the GC arm. Grade 3 or worse AEs did not show significant differences between the two arms. CONCLUSIONS: GCS is the first regimen which demonstrated the survival benefits as well as higher RR over GC in a randomized phase III trial and could be the new first-line standard chemotherapy for advanced BTC. To exploit the advantage of its high RR, GCS is now tested in the neoadjuvant setting in a randomized phase III trial for potentially resectable BTC.
- Ippei Matsumoto; Keiko Kamei; Kohei Kawaguchi; Yuta Yoshida; Masataka Matsumoto; Dongha Lee; Takaaki Murase; Shumpei Satoi; Atsushi Takebe; Yoshifumi TakeyamaAnnals of gastroenterological surgery 6 3 412 - 419 2022年05月Aim: Pancreaticodigestive tract anastomotic stricture is a long-term complication of pancreticoduodenectomy (PD). However, optimal treatment has not yet been defined. We conducted longitudinal pancreaticojejunostomy (LPJ) in symptomatic patients with anastomotic stricture after PD. This study aimed to evaluate the efficacy of this procedure. Methods: Pancreticoduodenectomy was performed in 605 patients at our institution between January 2005 and April 2020. Of these, 15 patients (2.5%) developed symptomatic pancreaticodigestive tract anastomotic stricture after PD. Three patients were referred to our institution owing to recurrent pancreatitis with anastomotic stricture after PD. LPJ was indicated for these 18 patients, and they were enrolled in this study. Results: The median time from the initial operation to LPJ was 2.0 y. Preoperative clinical presentations included obstructive pancreatitis in 10 patients, a rapid deterioration of glucose tolerance in nine, and severe steatorrhea in two. Surgical morbidity ≥grade III defined by the Clavien-Dindo classification was not observed. After LPJ, preoperative symptoms improved in 16 patients (89%) during a median follow-up of 39 mo. Nine of the 10 patients with obstructive pancreatitis achieved complete pain relief. All nine patients with a rapid deterioration of glucose tolerance showed improved endocrine function. Daily insulin requirement was significantly decreased after LPJ (11.6 ± 3.3 vs 3.4 ± 4.3 units, P = .0239). Four of the seven patients who required insulin injections were free of insulin after LPJ. Conclusion: LPJ is a safe and effective surgical procedure for symptomatic patients with stricture of the pancreaticodigestive tract anastomosis after PD.
- Daisuke Hashimoto; Sohei Satoi; Hideki Ishikawa; Yasuhiro Kodera; Keiko Kamei; Satoshi Hirano; Tsutomu Fujii; Kenichiro Uemura; Akihiko Tsuchida; Suguru Yamada; Tomohisa Yamamoto; Kiichi Hirota; Mitsugu SekimotoTrials 23 1 135 - 135 2022年02月BACKGROUND: The prognosis of pancreatic ductal adenocarcinoma remains very poor. One possible reason for the short survival of patients with this disease is malnutrition, which can be present at the initial diagnosis, and continue after pancreatectomy. Then, it is important to improve nutritional status and to decrease adverse events during neoadjuvant and adjuvant chemotherapy. Active hexose correlated compound (AHCC) is a standardized extract of cultured Lentinula edodes mycelia, and is considered a potent biological response modifier in the treatment of cancer. To evaluate the survival impact of AHCC on the patients with pancreatic ductal adenocarcinoma, we plan to perform this trial. METHODS: This is a prospective multicenter phase II trial in patients with resectable/borderline resectable pancreatic ductal adenocarcinoma to investigate the efficacy of AHCC regarding survival. Patients will begin taking AHCC or placebo on the first day of neoadjuvant therapy. AHCC or placebo will be continued until 2 years after surgery. The primary endpoint will be 2-year disease-free survival. The secondary endpoints are the completion rate, dose intensity, and adverse event profile of preoperative chemotherapy; response rate to preoperative chemotherapy; rate of decrease in tumor marker (carbohydrate antigen 19-9, carcinoembryonic antigen) concentrations during preoperative chemotherapy; entry rate, completion rate, dose intensity, and adverse event profile of adjuvant chemotherapy; safety of the protocol therapy (adverse effect of AHCC); 2-year overall survival rate; and nutrition score before and after preoperative chemotherapy, and before and after adjuvant chemotherapy. We will enroll 230 patients, and the study involves eight leading Japanese institutions that are all high-volume centers in pancreatic surgery. DISCUSSION: AHCC is expected to function as a supportive food in patients with pancreatic ductal adenocarcinoma, to reduce the proportion of severe adverse events related to neoadjuvant chemotherapy, and to increase the completion proportion of multimodal treatments, resulting in improved survival. TRIAL REGISTRATION: The trial protocol has been registered in the protocol registration system at the Japan Registry of Clinical Trials (Trial ID: jRCTs051200029 ). At the time of the submission of this paper (October 2020), the protocol version is 2.0. The completion date is estimated to be November 2024.
- 動脈結紮術を施行した未破裂第一空腸動脈瘤の1例山田 淳史; 松本 逸平; 松本 正孝; 吉田 雄太; 登 千穂子; 川口 晃平; 李 東河; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典日本臨床外科学会雑誌 82 増刊 S863 - S863 日本臨床外科学会 2021年10月
- 弓状靱帯狭窄症による前上膵十二指腸動脈瘤コイル塞栓後に生じた十二指腸狭窄に対する1手術例松本 正孝; 松本 逸平; 吉田 雄太; 山田 淳史; 登 千穂子; 川口 晃平; 李 東河; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典日本臨床外科学会雑誌 82 増刊 S1208 - S1208 日本臨床外科学会 2021年10月
- Ken-Ichi Okada; Manabu Kawai; Seiko Hirono; Masayuki Sho; Masaji Tani; Ippei Matsumoto; Suguru Yamada; Ryosuke Amano; Hirochika Toyama; Yo-Ichi Yamashita; Takeshi Gocho; Kazuto Shibuya; Minako Nagai; Hiromitsu Maehira; Keiko Kamei; Go Ohira; Yoshihiro Shirai; Hideki Takami; Nana Kimura; Takumi Fukumoto; Hideo Baba; Yasuhiro Kodera; Akimasa Nakao; Toshio Shimokawa; Masahiro Katsuda; Hiroki YamaueTrials 22 1 633 - 633 2021年09月BACKGROUND: Radical antegrade modular pancreatosplenectomy (RAMPS) is an isolation procedure in pancreatosplenectomy for pancreatic body/tail cancer. Connective tissues around the bifurcation of the celiac axis are dissected, followed by median-to-left retroperitoneal dissection. This procedure has the potential to isolate blood and lymphatic flow to the area of the pancreatic body/tail and the spleen to be excised. This is achieved by division of the inflow artery, transection of the pancreas, and then division of the outflow vein in the early phases of surgery. In cases of pancreatic ductal adenocarcinoma (PDAC), the procedure has been shown to decrease intraoperative blood loss and increase R0 resection rate by complete clearance of the lymph nodes. This trial investigates whether the isolation procedure can prolong the survival of patients with pancreatic ductal adenocarcinoma who undergo distal pancreatosplenectomy (DPS) compared with those that undergo the conventional approach. METHODS/DESIGN: Patients with PDAC scheduled to undergo DPS are randomized before surgery to undergo either a conventional procedure (arm A) or to undergo the isolation procedure (arm B). In arm A, the pancreatic body, tail, and spleen are mobilized, followed by removal of the regional lymph nodes. The splenic vein is transected at the end of the procedure. The timing of division of the splenic artery (SA) is not restricted. In arm B, regional lymph nodes are dissected, then we transect the root of the SA, the pancreas, then the splenic vein. At the end of the procedure, the pancreatic body/tail and spleen are mobilized and removed. In total, 100 patients from multiple Japanese high-volume centers will be randomized. The primary endpoint is 2-year recurrence-free survival by intention-to-treat analysis. Secondary endpoints include intraoperative blood loss, R0 resection rate, and overall survival. DISCUSSION: If this trial shows that the isolation procedures can improve survival with a similar R0 rate and with a similar number of lymph node dissections to the conventional procedure, the isolation procedure is expected to become a standard procedure during DPS for PDAC. Conversely, if there were no significant differences in endpoints between the groups, it would demonstrate justification of either procedure from surgical and oncological points of view. TRIAL REGISTRATION: UMIN Clinical Trials Registry UMIN000041381 . Registered on 10 August 2020. ClinicalTrials.gov NCT04600063 . Registered on 22 October 2020.
- 松本 逸平; 三長 孝輔; 村瀬 貴昭; 宮田 剛; 川口 晃平; 亀井 敬子; 水野 修吾; 糸井 隆夫; 大原 弘隆; 正宗 淳; 阪上 順一; 佐田 尚宏; 竹中 完; 北野 雅之; 乾 和郎; 竹山 宜典膵臓 36 3 A123 - A123 (一社)日本膵臓学会 2021年08月
- 局所進行切除不能膵癌に対するConversion surgeryのタイミング〜内科と外科の連携〜 当院における局所進行切除不能膵癌に対するconversion surgeryの短期・長期成績の検討吉田 雄太; 松本 逸平; 川口 晃平; 松本 正孝; 李 東河; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 鎌田 研; 山雄 健太郎; 竹中 完; 竹山 宜典膵臓 36 3 A146 - A146 (一社)日本膵臓学会 2021年08月
- 慢性膵炎による難治性疼痛に対する内科的インターベンション治療と外科治療の比較解析松本 逸平; 三長 孝輔; 村瀬 貴昭; 宮田 剛; 川口 晃平; 亀井 敬子; 水野 修吾; 糸井 隆夫; 大原 弘隆; 正宗 淳; 阪上 順一; 佐田 尚宏; 竹中 完; 北野 雅之; 乾 和郎; 竹山 宜典膵臓 36 3 A123 - A123 (一社)日本膵臓学会 2021年08月
- Ippei Matsumoto; Keiko Kamei; Shumpei Satoi; Takaaki Murase; Masataka Matsumoto; Kohei Kawaguchi; Yuta Yoshida; Lee Dongha; Atsushi Takebe; Takuya Nakai; Yoshifumi TakeyamaSurgery today 52 2 260 - 267 2021年07月PURPOSE: Postoperative pancreatic fistula (POPF) remains the most clinically relevant complication of laparoscopic distal pancreatectomy (LDP). The present study evaluated the efficacy of the "slow firing method" using a reinforced triple-row stapler (Covidien, Tokyo, Japan) during LDP. METHODS: This retrospective single-center study included 73 consecutive patients who underwent LDP using the slow firing method. A black cartridge was used in all patients. The primary endpoint was the rate of clinically relevant POPF (CR-POPF) after LDP. Secondary endpoints included perioperative outcomes and factors associated with CR-POPF as well as the correlation between the transection time and thickness of the pancreas. RESULTS: Four patients (5.5%) developed CR-POPF (grade B). Overall morbidity rates, defined as grade ≥ II and ≥ III according to the Clavien-Dindo classification, were 21 and 11%, respectively. The median postoperative hospital stay was 10 days. Preoperative diabetes (13.6 vs. 0.2%, P = 0.044) and thickness of the pancreas ≥ 15 mm (13.8% vs. 0%, P = 0.006) were identified as independent risk factors for CR-POPF. The median transection time was 16 (8-29) min. CONCLUSION: The slow firing method using a reinforced triple-row stapler for pancreatic transection is simple, safe, and effective for preventing CR-POPF after LDP.
- 膵切除術前後における内分泌・代謝動態の前向き観察研究(KIP-MEP study) 膵頭十二指腸切除と膵体尾部切除の相違庭野 史丸; 馬場谷 成; 廣峰 義久; 松本 逸平; 亀井 敬子; 武友 保憲; 川畑 由美子; 竹山 宜典; 能宗 伸輔; 池上 博司糖尿病 64 Suppl.1 I - 4 (一社)日本糖尿病学会 2021年05月
- Fumimaru Niwano; Naru Babaya; Yoshihisa Hiromine; Ippei Matsumoto; Keiko Kamei; Shinsuke Noso; Yasunori Taketomo; Yoshifumi Takeyama; Yumiko Kawabata; Hiroshi IkegamiThe Journal of clinical endocrinology and metabolism 106 5 e2203-e2214 2021年04月CONTEXT: The rate of glucose metabolism changes drastically after partial pancreatectomy. OBJECTIVE: This work aims to analyze changes in patients' glucose metabolism and endocrine and exocrine function before and after partial pancreatectomy relative to different resection types (Kindai Prospective Study on Metabolism and Endocrinology after Pancreatectomy: KIP-MEP study). METHODS: A series of 278 consecutive patients with scheduled pancreatectomy were enrolled into our prospective study. Of them, 109 individuals without diabetes, who underwent partial pancreatectomy, were investigated. Data were compared between patients with pancreaticoduodenectomy (PD, n = 73) and those with distal pancreatectomy (DP, n = 36). RESULTS: Blood glucose levels during the 75-g oral glucose tolerance test (75gOGTT) significantly decreased after pancreatectomy in the PD group (area under the curve [AUC] -9.3%, P < .01), and significantly increased in the DP population (AUC + 16.8%, P < .01). Insulin secretion rate during the 75gOGTT and glucagon stimulation test significantly decreased after pancreatectomy both in the PD and DP groups (P < .001). Both groups showed similar homeostasis model assessment of insulin resistance (HOMA-IR) values after pancreatectomy. Decrease in exocrine function quality after pancreatectomy was more marked in association with PD than DP (P < .01). Multiple regression analysis indicated that resection type and preoperative HOMA-IR independently influenced glucose tolerance-related postoperative outcomes. CONCLUSIONS: Blood glucose levels after the OGTT differed markedly between PD and DP populations. The observed differences between PD and DP suggest the importance of individualization in the management of metabolism and nutrition after partial pancreatectomy.
- Tomohiro Yamazaki; Mamoru Takenaka; Shunsuke Omoto; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Atsushi Nakai; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Yoriaki Komeda; Tomohiro Watanabe; Naoshi Nishida; Keiko Kamei; Ippei Matsumoto; Yoshifumi Takeyama; Takaaki Chikugo; Yasutaka Chiba; Masatoshi KudoJournal of clinical medicine 10 9 2021年04月This study aimed to investigate whether the incorporation of contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) into the international consensus guidelines (ICG) for the management of intraductal papillary mucinous neoplasm (IPMN) could improve its malignancy diagnostic value. In this single-center retrospective study, 109 patients diagnosed with IPMN who underwent preoperative CH-EUS between March 2010 and December 2018 were enrolled. We analyzed each malignancy diagnostic value (sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV)) by replacing fundamental B-mode EUS with CH-EUS as the recommended test for patients with worrisome features (WF) (the CH-EUS incorporation ICG) and comparing the results to those obtained using the 2017 ICG. The malignancy diagnostic values as per the 2017 ICG were 78.9%, 42.3%, 60.0%, and 64.7% for Se, Sp, PPV, and NPV, respectively. The CH-EUS incorporation ICG plan improved the malignancy diagnostic values (Se 78.9%/Sp, 53.8%/PPV, 65.2%/NPV 70.0%). CH-EUS may be useful in determining the appropriate treatment strategies for IPMN.
- Ippei Matsumoto; Keiko Kamei; Shumpei Satoi; Takaaki Murase; Masataka Matsumoto; Kohei Kawaguchi; Yuta Yoshida; Dongha Lee; Atsushi Takebe; Takuya Nakai; Yoshifumi TakeyamaSurgery today 51 1 70 - 78 2021年01月PURPOSE: The purpose of this study was to determine the factors influencing conversion from laparoscopic distal pancreatectomy (LDP) to open surgery, and the effect of such conversion on the outcome. METHODS: This retrospective single-center study included 70 consecutive patients undergoing LDP. The primary endpoint was the rate of conversion to open surgery during LDP. The secondary endpoints were determining the reasons for conversion to open surgery, with detailed analyses of these cases and a comparison of the surgical outcome with and without conversion. RESULTS: Seven patients (10%) required conversion to open surgery during LDP. Pancreatic ductal adenocarcinoma (PDAC) was identified as a risk factor for conversion (p = 0.010). The reasons for conversion included technical difficulty (two bleeding, one severe adhesion) and pancreatic stump-related issues (two margin-positive, two stapling failures). Although the overall morbidity rate (29 vs. 11%, p = 0.48) and the rate of clinically relevant postoperative pancreatic fistula (14 vs. 5%, p = 0.82) were no different for the patients with or without open conversion, the postoperative hospital stay was significantly longer in the former (median 15 vs. 10 days, p = 0.03). CONCLUSIONS: Careful preoperative assessment is required when planning LDP for PDAC. Although conversion to open surgery does not result in failure of LDP, efforts to reduce the duration of postoperative hospital stay and the occurrence of complications are desirable to improve the outcome of LDP.
- Soichiro Morinaga; Morihito Takita; Atsuko Yoshizawa; Keiko Kamei; Shoji Nakamori; Shin Ishihara; Hidekazu Kuramochi; Yukihiro Yokoyama; Takashi Uchiyama; Gou Murohisa; Marina Ishigaki; Akiko Todaka; Akira FukutomiPancreas 49 10 1372 - 1377 2020年11月
- 胆管癌切除後の異時性胆管癌に対する2切除例の報告村瀬 貴昭; 武部 敦志; 吉田 雄太; 川口 晃平; 松本 正孝; 李 東河; 亀井 敬子; 里井 俊平; 松本 逸平; 中居 卓也; 木村 雅友; 竹山 宜典日本臨床外科学会雑誌 81 増刊 543 - 543 日本臨床外科学会 2020年10月
- Keiko Kamei; Tadashi Ohnishi; Ken Nakata; Katsuki Danno; Atsushi Ohkawa; Yasuhiro Miyake; Satoshi Okazaki; Mutsumi Fukunaga; Akihiro Toyokawa; Tetsuhiro Hamada; Junichi Shindoh; Akiyoshi KanazawaAsia-Pacific journal of clinical oncology 16 5 e257-e262 2020年10月INTRODUCTION: Oxaliplatin-induced peripheral neuropathy (OIPN) is a common adverse events that can limit a patient's quality of life during/after chemotherapy. However, no appropriate methods have been established yet for monitoring the risk of progression of OIPN. METHODS: A simple assessment tool using gem clips, the CLIP test, was established and its performance in predicting the risk of progression to ≥grade 2 peripheral sensory neuropathy (CTCAE ver. 4.0) was investigated in patients receiving chemotherapy with oxaliplatin. RESULTS: Among 101 patients included in this study, 71 patients developed CTCAE ≥grade 1 peripheral neuropathy (grade 1, n = 67; grade 2, n = 4) at a median of 63 (range, 14-259) days after the start of treatment. Of the 67 patients with grade 1 peripheral neuropathy, 17 showed progression to ≥grade 2 neuropathy after a median interval of 84 (range, 21-246) days. Of these patients, 27 showed a positive result of the CLIP test at a median of 91 (range, 14-224) days, excluding one patient who already showed a positive result of the test at the baseline. Therefore, the risk ratio for the development of CTCAE ≥grade 2 peripheral neuropathy was 8.3 in the patients who showed a positive result on the CLIP test. Multivariate analysis confirmed that a positive results on the CLIP test was significantly correlated with the risk of future development of CTCAE ≥grade 2 peripheral neuropathy (odds ratio, 9.37; P = 0.002). CONCLUSION: A positive result on the CLIP test predict is predictive of the risk of progression of OIPN during chemotherapy with oxaliplatin.
- Noritoshi Kobayashi; Katsuhiro Omae; Yosuke Horita; Hideki Ueno; Nobumasa Mizuno; Kazuhiro Uesugi; Kentaro Sudo; Masato Ozaka; Hideyuki Hayashi; Naohiro Okano; Keiko Kamei; Atsushi Yamaguchi; Satoshi Kobayashi; Shuhei Suzuki; Shin Ishihara; Takashi Uchiyama; Akiko Todaka; Akira FukutomiPancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 20 7 1519 - 1525 2020年10月BACKGROUND: Data on FOLFIRINOX as a second-line chemotherapy for advanced pancreatic cancer are limited. In the JASPAC06 study-a nationwide, multicenter, observational study-FOLFIRINOX for patients with unresectable or recurrent pancreatic cancer as any line of treatment showed favorable efficacy and safety in Japanese clinical practice. METHODS: We performed exploratory analyses of patients with unresectable or recurrent pancreatic cancer who received FOLFIRINOX as the second-line chemotherapy in Japanese clinical settings. RESULTS: Of the 399 evaluable patients, 44 were eligible for inclusion in the analysis. The patients' characteristics were as follows: median age, 62 years; men, 26 (59%); Eastern Cooperative Oncology Group-Performance status 0/1, 30 (68%)/14 (32%); disease status, recurrent/local/metastatic: 4 (9%)/8 (18%)/32 (73%). The initial dose was reduced in 28 (64%) patients. The median time to treatment failure and number of cycles were 4.5 (range, 0.2-19.1) months and 6 cycles (range, 1-13 or more), respectively. The major grade 3/4 adverse events were neutropenia in 29 (66%), leucopenia in 17 (39%), anorexia in 7 (16%), febrile neutropenia in 5 (11%), and anemia in 5 (11%) patients. The median overall survival, progression-free survival, and 1-year survival rates were 10.3 (95% confidence interval [CI], 7.2-13.3), 4.1 (95% CI, 2.6-5.5) months, and 30%, respectively. CONCLUSION: Our findings suggest that FOLFIRINOX as a second-line chemotherapy for advanced pancreatic cancer was effective in patients with a good performance status. It displayed toxicity similar to that observed with its use as a first-line treatment.
- Yuta Yoshida; Ippei Matsumoto; Tomonori Tanaka; Kentaro Yamao; Akihiro Hayashi; Keiko Kamei; Shumpei Satoi; Atsushi Takebe; Takuya Nakai; Mamoru Takenaka; Yoshifumi TakeyamaSurgical case reports 6 1 222 - 222 2020年09月BACKGROUND: Pancreatic pleural effusion and ascites are defined as fluid accumulation in the thoracic and abdominal cavity, respectively, due to direct leakage of the pancreatic juice. They usually occur in patients with acute or chronic pancreatitis but are rarely associated with pancreatic neoplasm. We present here an extremely rare case of pancreatic neuroendocrine tumor with stenosis of the main pancreatic duct, leading to pancreatic pleural effusion. CASE PRESENTATION: A 51-year-old man complained of dyspnea. Left-sided pleural effusion was detected on the chest X-ray. Pleural puncture was performed, and the pleural fluid indicated a high amylase content (36,854 IU/L). Hence, the patient was diagnosed with pancreatic pleural effusion. Although no tumor was detected, the computed tomography (CT) scan showed a pseudocyst and dilation of the main pancreatic duct in the pancreatic tail. Magnetic resonance cholangiopancreatography showed a fistula from the pseudocyst into the left thoracic cavity. Endoscopic retrograde pancreatic drainage was attempted; however, it failed due to stenosis in the main pancreatic duct in the pancreatic body. Endoscopic ultrasound revealed a hypoechoic mass measuring 15 × 15 mm in the pancreatic body that was not enhanced in the late phase of contrast perfusion and was thus suspected to be an invasive ductal carcinoma. The patient underwent distal pancreatectomy with splenectomy and the postoperative course was uneventful. Histopathological examination confirmed a neuroendocrine tumor of the pancreas (NET G2). The main pancreatic duct was compressed by the tumor. Increased pressure on the distal pancreatic duct by the tumor might have caused formation of the pseudocyst and pleural effusion. To the best of our knowledge, this is the first case report of pancreatic pleural effusion associated with a neuroendocrine tumor. CONCLUSIONS: Differential diagnosis of a pancreatic neoplasm should be considered, especially when a patient without a history of pancreatitis presents with pleural effusion.
- Ippei Matsumoto; Keiko Kamei; Takaaki Murase; Yuta Yoshida; Kohei Kawaguchi; Masataka Matsumoto; Shumpei Satoi; Atsushi Takebe; Takuya Nakai; Yoshifumi TakeyamaJournal of hepato-biliary-pancreatic sciences 27 9 632 - 639 2020年09月BACKGROUND/PURPOSE: To determine the short- and long-term results of surgical treatments for chronic pancreatitis (CP) at a high-volume center in Japan. METHODS: The records of 151 consecutive patients undergoing surgery for CP were retrospectively reviewed. Selection of surgical procedures used had been according to the Japanese Clinical Practice Guidelines for CP 2015. Long-term (≥1 year) follow-up was performed in 100 patients (median of 37 months). RESULTS: Surgical drainage procedures were performed in 107 patients (Frey operation in 81, longitudinal pancreaticojejunostomy in 26), pancreatic resection in 37 (subtotal stomach-preserving pancreaticoduodenectomy in 11, distal pancreatectomy in 26), and other procedures in six. The rates of postoperative mortality and morbidity were 1% and 26%, respectively. The rates of complete and partial pain relief were 62% and 37%. The frequency of occurrence of severe morbidity was significantly higher after pancreatic resection than in patients receiving drainage procedures (13% vs 2%, P = .019). The rate of new-onset diabetes was also significantly higher after resection than drainage (60% vs 25%, P = .017). CONCLUSIONS: Surgical treatment for painful chronic pancreatitis can be safe and effective. An optimal procedure should guarantee pain relief and preserve a maximum of pancreatic function.
- 松本 正孝; 松本 逸平; 吉田 雄太; 山雄 健太郎; 川口 晃平; 村瀬 貴昭; 大本 俊介; 亀井 敬子; 里井 俊平; 竹中 完; 武部 敦志; 中居 卓也; 竹山 宜典膵臓 35 3 A337 - A337 (一社)日本膵臓学会 2020年07月
- 膵全摘術の現状と展望 膵全摘患者のQOL調査 多施設共同前向き研究結果亀井 敬子; 松本 逸平; 加藤 宏之; 須藤 広誠; 三澤 健之; 海野 倫明; 新田 浩幸; 里井 壯平; 川畑 康成; 大塚 将之; 力山 敏樹; 首藤 毅; 岡野 圭一; 鈴木 康之; 佐田 尚宏; 伊佐地 秀司; 杉山 政則; 竹山 宜典膵臓 35 3 A115 - A115 (一社)日本膵臓学会 2020年07月
- 加藤 宏之; 亀井 敬子; 須藤 広誠; 三澤 健之; 海野 倫明; 新田 浩幸; 里井 壯平; 川畑 康成; 大塚 将之; 力山 敏樹; 首藤 毅; 松本 逸平; 岡野 圭一; 鈴木 康之; 佐田 尚宏; 伊佐地 秀司; 杉山 政則; 竹山 宜典膵臓 35 3 A117 - A117 (一社)日本膵臓学会 2020年07月
- 膵全摘術の現状と展望 膵全摘術後の糖尿病コントロールと栄養指標の変化について須藤 広誠; 亀井 敬子; 加藤 宏之; 三澤 健之; 海野 倫明; 新田 浩幸; 里井 壯平; 川畑 康成; 大塚 将之; 力山 敏樹; 首藤 毅; 松本 逸平; 岡野 圭一; 鈴木 康之; 佐田 尚宏; 伊佐地 秀司; 杉山 政則; 竹山 宜典膵臓 35 3 A118 - A118 (一社)日本膵臓学会 2020年07月
- 膵全摘術の現状と展望 膵全摘患者のQOL調査 多施設共同前向き研究結果亀井 敬子; 松本 逸平; 加藤 宏之; 須藤 広誠; 三澤 健之; 海野 倫明; 新田 浩幸; 里井 壯平; 川畑 康成; 大塚 将之; 力山 敏樹; 首藤 毅; 岡野 圭一; 鈴木 康之; 佐田 尚宏; 伊佐地 秀司; 杉山 政則; 竹山 宜典膵臓 35 3 A115 - A115 (一社)日本膵臓学会 2020年07月
- 膵全摘術の現状と展望 膵全摘後の脂肪肝発生頻度とそのリスク解析 膵全摘患者に対する前向き実態調査の結果から加藤 宏之; 亀井 敬子; 須藤 広誠; 三澤 健之; 海野 倫明; 新田 浩幸; 里井 壯平; 川畑 康成; 大塚 将之; 力山 敏樹; 首藤 毅; 松本 逸平; 岡野 圭一; 鈴木 康之; 佐田 尚宏; 伊佐地 秀司; 杉山 政則; 竹山 宜典膵臓 35 3 A117 - A117 (一社)日本膵臓学会 2020年07月
- 膵全摘術の現状と展望 膵全摘術後の糖尿病コントロールと栄養指標の変化について須藤 広誠; 亀井 敬子; 加藤 宏之; 三澤 健之; 海野 倫明; 新田 浩幸; 里井 壯平; 川畑 康成; 大塚 将之; 力山 敏樹; 首藤 毅; 松本 逸平; 岡野 圭一; 鈴木 康之; 佐田 尚宏; 伊佐地 秀司; 杉山 政則; 竹山 宜典膵臓 35 3 A118 - A118 (一社)日本膵臓学会 2020年07月
- Iwasaki Toshimitsu; Matsumoto Masataka; Satoi Shumpei; Yoshida Yuta; Kawaguchi Kohei; Kamei Keiko; Takebe Atsushi; Matsumoto Ippei; Nakai Takuya; Takeyama Yoshifumi TakeyamaInternational Journal of Surgery Research and Practice 7 2 2020年04月 [査読有り]
- Keiko Kamei; Junichi Shindoh; Yoshitaka Kiya; Ippei Matsumoto; Masaji Hashimoto; Yoshifumi TakeyamaClinical journal of gastroenterology 13 2 240 - 246 2020年04月A 53-year-old woman who was diagnosed as having advanced gallbladder cancer (T3N1M1, Stage IVB) showed a dramatic response to chemotherapy using gemcitabine + cisplatin and surgery with curative intent was attempted. Histopathological examination revealed residual tumor limited to the perimuscular connective tissue of the gallbladder (T2bN0M0, Stage IIB) and a mixture of poorly differentiated adenocarcinoma and neuroendocrine carcinoma (NEC) components was confirmed. At 6 months after the surgery, a small peritoneal nodule was detected and chemotherapy was resumed with gemcitabine, cisplatin, and S-1. However, the recurrent lesion showed no response at all and gradually formed a mass with the liver and kidney. Considering the difficulty of intensive chemotherapy and the relatively indolent progression of the disease at 15 months after the recurrence was first detected, repeat resection was performed. Histopathology of the resected lesions revealed only a NEC components. Although surgical intervention may be effective in selected cases, given that the NEC component is often associated with progression and recurrence of the disease, the chemotherapy regimen would need to include drugs for the NEC component in cases where the histopathological diagnosis of MANEC has been established.
- Masataka Matsumoto; Keiko Kamei; Takaaki Chikugo; Ippei Matsumoto; Kohei Kawaguchi; Yoshifumi TakeyamaPancreas 49 4 503 - 508 2020年04月OBJECTIVES: Early death in severe acute pancreatitis (SAP) is caused by pancreatic necrosis and multiple-organ failure due to microcirculation disorder. The aim of this study was to prove that recombinant human-soluble thrombomodulin (rTM) has therapeutic effects on SAP by preventing pancreatic necrosis and organ failure. METHODS: Male Wister rats were used. Cerulein was administered intraperitoneally 4 times every 1 hour, and lipopolysaccharide was administered intraperitoneally 3 hours after. One hour after administration of lipopolysaccharide, rTM was injected intravenously. Rats were observed for 24 hours after starting the experiment, and the survival rate was evaluated. All surviving rats were killed, and the blood sample, liver, and pancreas were excised. Serum amylase, aspartate aminotransferase, alanine aminotransferase, and high mobility group box 1 were measured, and the liver and pancreas were examined histologically. For the evaluation of microcirculation, von Willebrand factor staining was performed. RESULTS: Serum amylase, aspartate aminotransferase, and alanine aminotransferase were significantly decreased. The survival rate was significantly improved to 100%. Moreover, serum high mobility group box 1 was decreased. Liver injury and pancreatic necrosis became less severe, and microcirculation was preserved histologically. CONCLUSIONS: Early administration of rTM prevents organ failure by maintenance of microcirculation and improves prognoses of SAP.
- Masataka Matsumoto; Ippei Matsumoto; Keiko Kamei; Yuta Yoshida; Kohei Kawaguchi; Takaaki Murase; Shumpei Satoi; Atsushi Takebe; Takuya Nakai; Yoshifumi TakeyamaGan to kagaku ryoho. Cancer & chemotherapy 47 1 108 - 110 2020年01月A 62 year-old female presenting with shortness of breath and severe anemia(Hb level 4.4 g/dL)was diagnosed with tumor bleeding and duodenal cancer by gastrointestinal endoscopy.Computed tomography scan revealed multiple liver metastases.After admission, the Hb level dropped from 9.1 g/dL to 5.1 g/dL in one night, and emergency pancreaticoduodenectomy( PD)was performed to control the bleeding.The postoperative course was uneventful, and the patient was discharged on postoperative day(POD)16.Systemic chemotherapy was initiated 1 month after surgery, but the patient died from the disease 13 months after surgery.Emergency PD could be a treatment option in patients with uncontrolled tumor bleeding and fatal conditions.
- Yuta Yoshida; Ippei Matsumoto; Masataka Matsumoto; Kohei Kawaguchi; Takaaki Murase; Keiko Kamei; Shumpei Satoi; Atsushi Takebe; Takuya Nakai; Yoshifumi TakeyamaJournal of hepato-biliary-pancreatic sciences 26 11 510 - 516 2019年11月BACKGROUND: Postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) remains the most common surgical complication. We have developed a novel stump closure technique after DP using transpancreatic mattress suture with Vicryl mesh (TMV) and reported our initial findings. The purpose of this study is to evaluate the efficacy of TMV compared to the conventional handsewn stump closure technique (CHS). METHODS: This retrospective single-center study included 165 consecutive patients who underwent open DP from January 2010 to May 2018. Of these, 71 patients underwent DP using TMV after September 2014 and 94 patients underwent DP with CHS. The surgical outcomes were compared between the two groups. RESULTS: Clinically relevant POPF rate in the TMV group was significantly lower than that in the CHS group (5.6% vs. 17.2%, P = 0.027). Morbidity rate was higher in the CHS group than that in the TMV group (16.9% vs. 27.7%, P = 0.104). In the multivariate analysis, absence of additional organ resection (OR 3.57; 95% CI 1.18-10.43; P = 0.025) and TMV (OR 0.24; 95% CI 0.07-0.73; P = 0.010) were identified as independent preventing factors for clinically relevant POPF. CONCLUSION: TMV can be an effective stump closure technique for preventing POPF after DP.
- Shogo Kobayashi; Hiroaki Nagano; Akira Tomokuni; Kunihito Gotoh; Daisuke Sakai; Etsuro Hatano; Satoru Seo; Hiroaki Terajima; Yoichiro Uchida; Tetsuo Ajiki; Hironaga Satake; Keiko Kamei; Taiji Tohyama; Tetsuro Hirose; Iwao Ikai; Satoshi Morita; Tatsuya IokaAnnals of surgery 270 2 230 - 237 2019年08月OBJECTIVE: To evaluate each arm independently and compare adjuvant gemcitabine (GEM) and S-1 chemotherapy after major hepatectomy (hemihepatectomy or trisectionectomy) for biliary tract cancer (BTC). BACKGROUND: Standardized adjuvant therapy is not performed after major hepatectomy for BTC, and we determined the recommended dose in the former study (KHBO1003). METHODS: We performed a multicenter, randomized phase II study. The primary measure was 1-year recurrence-free survival (RFS); the secondary measures were other RFS, overall survival (OS), and others. The following 6-month adjuvant chemotherapy was administered within 12 weeks of R0/1: GEM (1000 mg/m) every 2 weeks; or S-1 (80 mg/m/d) for 28 days every 6 weeks. Thirty-five patients were assigned to each arm (alpha error, 10%; beta error, 20%). RESULTS: No patients were excluded for the per-protocol analysis. There were no statistically significant differences in the patient characteristics of the 2 arms. The 1-year RFS and 1-year OS rates of the GEM arm were 51.4% and 80.0%, respectively, whereas those of the S-1 group were 62.9% and 97.1%. The comparison of the 2 arms revealed that 2-year RFS rate, 1 and 2-year OS rates, and OS curve of the S-1 arm were superior to GEM. With regard to OS, the hazard ratio of the S-1 group was 0.477 (90% confidence interval 0.245-0.927). CONCLUSION: The comparison of the survival of the 2 groups revealed that adjuvant S-1 therapy may be superior to adjuvant GEM therapy after major hepatectomy for BTC.
- Ippei Matsumoto; Keiko Kamei; Shumpei Satoi; Takaaki Murase; Masataka Matsumoto; Kohei Kawaguchi; Yuta Yoshida; Toshimitsu Iwasaki; Atsushi Takebe; Takuya Nakai; Yoshifumi TakeyamaSurgery today 49 5 394 - 400 2019年05月PURPOSE: The purpose of the study was to compare the outcomes of laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) for benign and low-grade malignant lesions to determine the safety and efficacy of LDP. METHODS: This retrospective comparative study included 67 consecutive patients who underwent LDP (n = 32) and ODP (n = 35) for benign or low-grade malignant lesions of the pancreas from January 2012 to March 2017. Thirty-five patients who were eligible for LDP in the ODP group were carefully selected. The clinical outcomes were compared in an intention-to-treat analysis. RESULTS: LDP was associated with significantly less operative blood loss (182 ± 232 vs. 505 ± 376 ml, P < 0.001) but a longer operation time (327 ± 89 vs. 173 ± 48 min, P < 0.001), than ODP. There were no significant differences between the 2 groups in the overall morbidity rates defined by Clavien-Dindo classification ≥ grade II (13% vs. 11%), clinically relevant postoperative pancreatic fistula rates (6% vs. 9%), and lengths of postoperative hospital stay (11 vs. 11 days). CONCLUSION: The study showed that LDP was safe and feasible. LDP should be considered as the first-line treatment for benign and low-grade malignant lesions in the left side of the pancreas.
- Ippei Matsumoto; Keiko Kamei; Katsuhiro Omae; Shuhei Suzuki; Hidehiko Matsuoka; Nobumasa Mizuno; Masato Ozaka; Hideki Ueno; Satoshi Kobayashi; Kazuhiro Uesugi; Marina Kobayashi; Akiko Todaka; Akira FukutomiPancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 19 2 296 - 301 2019年03月BACKGROUND: FOLFIRINOX (oxaliplatin, irinotecan, 5-fluorouracil, leucovorin) treatment significantly improved overall survival in the recent phase III study and became a standard therapy for metastatic pancreatic cancer. However, treatment for locally advanced pancreatic cancer is still controversial. We conducted subset analyses from a nation-wide multicenter observational study in Japan to evaluate the tolerability and efficacy of FOLFIRINOX in patients with locally advanced pancreatic cancer and to investigate independent prognostic factors with pre-treatment variables. METHODS: The study included 66 patients with unresectable locally advanced pancreatic cancer from 27 institutions in Japan who received FOLFIRINOX as first-line treatment between December 20, 2013 and December 19, 2014 and surveyed until December 2015. RESULTS: The median age was 63 with the Eastern Cooperative Oncology Group performance status of 0 or 1. Major Grade 3 or 4 adverse events included neutropenia (64%), leukopenia (33%), febrile neutropenia (15%), and diarrhea (15%). Severe adverse event occurred in 14 patients (11%) without fatal event. The median overall survival and progression-free survival times were 18.5 and 7.6 months, respectively. The objective response rate 15.2% and the disease control rate was 81.9%. A high modified Glasgow prognostic score (mGPS, ≥1) (95%CI 1.96-12.5) and female (95%CI 0.20-0.97) were identified as independent poor prognostic factors. CONCLUSIONS: First-line FOLFIRINOX treatment for locally advanced pancreatic cancer seems to be effective with acceptable toxicities. A high mGPS may be associated with poor survival in patients with locally advanced pancreatic cancer who receive FOLFIRINOX. This study was registered at the UMIN Clinical Trials Registry (UMIN000014658).
- Hiromichi Shirasu; Akiko Todaka; Katsuhiro Omae; Hirofumi Fujii; Nobumasa Mizuno; Masato Ozaka; Hideki Ueno; Satoshi Kobayashi; Kazuhiro Uesugi; Noritoshi Kobayashi; Hideyuki Hayashi; Kentaro Sudo; Naohiro Okano; Yosuke Horita; Keiko Kamei; Seigo Yukisawa; Marina Kobayashi; Akira FukutomiCancer science 110 2 707 - 716 2019年02月Studies have indicated an association between UDP-glucuronosyltransferase-1A1 (UGT1A1) genetic polymorphisms and irinotecan-induced toxicity. We undertook this study to investigate the association between UGT1A1 genetic polymorphisms and toxicity in patients treated with the FOLFIRINOX (comprising oxaliplatin, irinotecan, fluorouracil, and leucovorin) chemotherapy regimen in the JASPAC 06 study. Patients screened for UGT1A1*6 and UGT1A1*28, and treated with either the original FOLFIRINOX (oxaliplatin 85 mg/m2 , irinotecan 180 mg/m2 , leucovorin 200 mg/m2 , bolus 5-fluorouracil [5-FU] 400 mg/m2 , and continuous 5-FU 2400 mg/m2 ) or a modified FOLFIRINOX (oxaliplatin 85 mg/m2 , irinotecan 150 mg/m2 , leucovorin 200 mg/m2 , and continuous 5-FU 2400 mg/m2 ) as first-line chemotherapy were included. Of 199 patients eligible for this analysis, 79 patients were treated with the original FOLFIRINOX regimen and 120 patients were treated with the modified FOLFIRINOX regimen. In the original FOLFIRINOX group, 54 were UGT1A1 WT, and 25 were UGT1A1 heterozygous type (-/*6, 12 patients; -/*28, 13 patients). In the modified FOLFIRINOX group, 64 were UGT1A1 WT and 56 were UGT1A1 heterozygous type (-/*6, 33 patients; -/*28, 23 patients). In the original FOLFIRINOX group, the incidence of diarrhea was significantly higher among patients with UGT1A1 heterozygous type than among those with UGT1A1 WT and the incidence of leukopenia and diarrhea was significantly higher among patients with UGT1A1 -/*6 than among those with UGT1A1 -/*28. Patients with UGT1A1 heterozygous type, especially those with UGT1A1 -/*6, tended to show a higher incidence rate of severe adverse events, but this was not statistically significant. However, for patients who received the modified FOLFIRINOX, there was no difference in the frequency of adverse events due to UGT1A1 status. In conclusion, patients with heterozygous UGT1A1 polymorphisms treated with the original FOLFIRINOX regimen experienced severe toxicity more frequently than patients with WT UGT1A1.
- Toshimitsu Iwasaki; Yoshifumi Takeyama; Yuta Yoshida; Kohei Kawaguchi; Masataka Matsumoto; Takaaki Murase; Keiko Kamei; Atsushi Takebe; Ippei Matsumoto; Takuya NakaiInternational journal of surgery case reports 61 115 - 118 2019年INTRODUCTION: Aberrant subvesical bile ducts are rare structural anomaly located in the peri-hepatic gallbladder fossa. This duct poses the risk for intraoperative bile duct injury resulting in clinically relevant bile leakage. PRESENTATION OF CASE: Aberrant subvesical bile duct was detected by preoperative magnetic resonance cholangiopancreatography in a 52-year old woman with gallbladder polypoid tumor harboring the risk to be gallbladder cancer. During open cholecystectomy with full thickness dissection, the aberrant duct was identified by intraoperative fluorescent cholangiography (IFC), and dissected safely. DISCUSSION: Aberrant subvesical bile ducts are mostly found unexpectedly as intra and/or postoperative bile leakage, and remain an important cause of bile duct injuries after laparoscopic cholecystectomy. IFC, which offers real-time imaging of biliary anatomy, has a potential to overcome these problems. CONCLUSION: We performed cholecystectomy by using IFC to identify the aberrant subvesical bile duct. To the best of our knowledge, this is the first report showing the fluorescence image of an aberrant subvesical bile duct in a state of nature.
- 胆道癌術後の大量肝切除状態におけるGEMまたはS-1療法の第I/II相試験(KHBO1003/1208)小林 省吾; 永野 浩昭; 波多野 悦朗; 瀬尾 智; 寺嶋 宏明; 味木 徹夫; 佐竹 悠良; 亀井 敬子; 藤山 泰二; 廣瀬 哲朗; 猪飼 伊和夫; 竹村 茂一; 柳本 泰明; 森田 智視; 井岡 達也日本癌治療学会学術集会抄録集 56回 O36 - 4 2018年10月
- Akiko Todaka; Nobumasa Mizuno; Masato Ozaka; Hideki Ueno; Satoshi Kobayashi; Kazuhiro Uesugi; Noritoshi Kobayashi; Hideyuki Hayashi; Kentaro Sudo; Naohiro Okano; Yosuke Horita; Keiko Kamei; Seigo Yukisawa; Shoji Nakamori; Yutaka Yachi; Toshiyuki Henmi; Marina Kobayashi; Narikazu Boku; Keita Mori; Akira FukutomiPancreas 47 5 631 - 636 2018年05月
- 幕谷 悠介; 松本 逸平; 大本 俊介; 筑後 孝章; 川口 晃平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 中居 卓也; 竹中 完; 工藤 正俊; 竹山 宜典日本消化器外科学会雑誌 51 2 114 - 121 (一社)日本消化器外科学会 2018年02月膵・胆管合流異常に合併した共通管内乳頭状腫瘍の1例を報告する.症例は75歳の男性で,6ヵ月間に2度の急性膵炎を発症し保存的加療で軽快した.急性膵炎の原因精査および加療目的で当院へ紹介となった.ERCPでは膵・胆管合流異常を認め,共通管内に7mmの結節様陰影欠損像を認めた.上部内視鏡検査では乳頭部からの粘液排出は認めず,超音波内視鏡検査では共通管内に乳頭状の腫瘍が描出された.造影CTでは膵頭部に拡張した共通管と内部に増強効果を持つ8mmの腫瘤を認めた.尾側の主膵管の拡張は認めなかった.膵・胆管合流異常に合併した共通管内乳頭状腫瘍と診断し,亜全胃温存膵頭十二指腸切除術を施行した.病理肉眼所見では共通管内に発育する有茎性の乳頭状腫瘍で,組織像は管状構造増生を主体とする腺腫であった.免疫組織学的染色ではMUC1,MUC2陰性,MUC5AC陽性で胃型腺腫と最終診断した.(著者抄録)
- Keiko Kamei; Ippei Matsumoto; Yusuke Makutani; Kohei Kawaguchi; Masataka Matsumoto; Takaaki Murase; Shumpei Satoi; Takuya Nakai; Ken Kamata; Hajime Imai; Takaaki Chikugo; Yoshifumi TakeyamaGan to kagaku ryoho. Cancer & chemotherapy 44 12 1191 - 1193 2017年11月We present a case ofa 67-year-old woman with Stage IV pancreatic head cancer with invasion to the superior mesenteric vein and artery, and distant lymph node metastases. The patient received S-1 mono-chemotherapy. After 2 courses of chemotherapy, the tumor marker was decreased to the normal levels, and the tumor size was dramatically reduced with undetectable lymph node metastases on CT. As the disease status was maintained following chemotherapy, the patient underwent subtotal stomach preserving pancreaticoduodenectomy, 8 months after initiation of the chemotherapy. Histopathologically, no cancer cells were found in the main tumor and dissected lymph nodes. Final diagnosis was made with pathological complete response. The patient was alive without recurrence for 10 months after surgery.
- Ippei Matsumoto; Keiko Kamei; Shumpei Satoi; Takuya Nakai; Yoshifumi TakeyamaINTERNATIONAL SURGERY 101 11-12 550 - 553 2016年11月 [査読有り]
Portal annular pancreas (PAP) is an asymptomatic congenital pancreatic anomaly in which the uncinate process of the pancreas extends and fuses to the dorsal surface of the body of the pancreas by surrounding the portal vein and or the superior mesenteric vein. During pancreaticoduonectomy (PD), the presence of PAP significantly increased risk for postoperative pancreatic fistula (POPF) because specific management of 2 pancreatic resection planes with 1 or 2 pancreatic ducts is required for pancreatico-intestinal reconstruction. To reduce the risk of POPF, a shift of the resection plain to the left for 1 anastomosis is recommended. We report a case of PAP that was successfully performed PD with pancreaticogastrostomy (PG). PG was conducted with invagination of the 2 resected pancreatic planes together into the stomach to minimize resected volume of the pancreas. A 78-year-old male patient with PAP underwent PD due to a duodenal adenocarcinoma. Intraoperatively, the uncinate process extended extensively behind the portal vein and fused with the dorsal surface of the pancreatic body above the splenic vein. For pancreatico-intestinal reconstruction, PG was performed with invagination of the 2 resected pancreatic planes together into the stomach. The postoperative course was uneventful, and he was discharged on postoperative day 12. Endocrine and exocrine function of the pancreas were maintained well at 10 months after surgery. PG is one of the useful choices for patients with PAP to prevent POPF while maintaining the pancreatic endocrine and exocrine function after PD. - Ippei Matsumoto; Yoshifumi Takeyama; Keiko Kamei; Shumpei Satoi; Yasuyuki Nakata; Hajime Ishikawa; Takaaki Murase; Masataka Matsumoto; Takuya NakaiJournal of the American College of Surgeons 223 2 e1-5 2016年08月
- 膵仮性嚢胞内出血を繰り返す血友病B併存患者に対し、安全に脾合併尾側膵切除と周術期管理を施行し得た1例村瀬 貴昭; 石川 原; 松本 正孝; 中多 靖幸; 亀井 敬子; 里井 俊平; 松本 逸平; 中居 卓也; 法里 慧; 井上 宏昭; 中尾 慎一; 竹山 宜典日本肝胆膵外科学会・学術集会プログラム・抄録集 28回 555 - 555 (一社)日本肝胆膵外科学会 2016年06月
- 松本逸平; 亀井敬子; 松本正孝; 村瀬貴昭; 中多靖幸; 里井俊平; 石川原; 廣峰義久; 庭野史丸; 川畑由美子; 中居卓也; 池上博司; 竹山宜典胆膵の病態生理 32 1 39 - 42 2016年06月
- Tatsuya Ioka; Masashi Kanai; Shogo Kobayashi; Daisuke Sakai; Amane Kitasato; Hiroki Yamaue; Hideyuki Hayashi; Naoko Chayahara; Masahiro Takahashi; Takatsugu Yamada; Etsuro Hatano; Takuma Goto; Jiro Fujimoto; Masahiro Murakami; Keiko Kamei; Kenichi YoshimuraJOURNAL OF CLINICAL ONCOLOGY 33 15 2015年05月 [査読有り]
- 当院における8年間の周術期肺塞栓症予防の取り組み保田 知生; 梶川 竜治; 柳生 行伸; 塩川 泰啓; 牛嶋 北斗; 松本 正孝; 中多 靖幸; 加藤 寛章; 岩間 密; 亀井 敬子; 石川 原; 上田 和毅; 中居 卓也; 竹山 宜典; 奥野 清隆日本血管外科学会雑誌 23 2 309 - 309 (NPO)日本血管外科学会 2014年04月 [査読有り]
- 当院における周術期肺塞栓症予防の取り組みと今後の対策保田 知生; 梶川 竜治; 柳生 行伸; 塩川 泰啓; 牛嶋 北斗; 松本 正孝; 中多 靖幸; 加藤 寛章; 岩間 密; 亀井 敬子; 石川 原; 上田 和毅; 中居 卓也; 竹山 宜典; 安田 卓志; 光富 徹哉; 奥野 清隆日本血栓止血学会誌 25 2 327 - 327 (一社)日本血栓止血学会 2014年04月 [査読有り]
- 研修医からの質問Q&A XP療法により発熱性好中球減少症のために入院した胃がん症例。この後の治療方針は?竹田 治彦; 亀井 敬子臨床腫瘍プラクティス 9 4 447 - 447 (株)ヴァンメディカル 2013年11月
- 大学病院における周術期肺血栓塞栓症のリスクマネジメント保田 知生; 岩間 密; 武本 智樹; 村瀬 貴昭; 松本 正孝; 加藤 寛章; 中多 靖幸; 亀井 敬子; 石川 原; 杉浦 史哲; 中居 卓也; 安田 卓司; 光冨 徹哉; 竹山 宜典; 奥野 清隆日本臨床外科学会雑誌 74 増刊 308 - 308 日本臨床外科学会 2013年10月
- 【新人から使える!56術式の看護のツボがわかる!保存版 超早わかり手術看護のササッと先読みポイント】(第1章)ササッとわかる解剖図イラスト 消化器外科今本 治彦; 上田 和毅; 安田 篤; 亀井 敬子オペナーシング 2013秋季増刊 8 - 10 (株)メディカ出版 2013年09月 [査読有り]
- Keiko Kamei; Takeo Yasuda; Shumpei Satoi; Hajime Ishikawa; Hiroki Sakamoto; Masayuki Kitano; Takaaki Chikugo; Takuya Nakai; Yoshifumi TakeyamaClinical journal of gastroenterology 6 2 156 - 9 2013年04月Cystic lesions of the pancreas are sometimes difficult to diagnose. We report a case of a gastric duplication cyst (GDC) of the pancreas in an adult. A 45-year-old woman was admitted to our department for the investigation of anemia. Abdominal ultrasonography revealed a large cystic lesion, measuring about 40 × 70 mm with calcification in the tail of the pancreas. Contrast-enhanced computed tomography of the abdomen revealed a non-enhanced cystic lesion with non-enhanced wall. Endoscopic retrograde pancreatography revealed a mild extended main pancreatic duct and an aberrant pancreatic duct, but there was no communication with the cyst. We could not deny the malignancy, so distal pancreatectomy was performed. The pathological examination revealed that the inner wall of the cyst consisted of columnar epithelium and smooth muscle layer. Immunohistochemical analysis revealed the columnar epithelium to be immunopositive for cytokeratin 7 (CK7) and immunonegative for cytokeratin 20 (CK20) and the glands to be immunonegative for CK 7 and immunopositive for CK 20. Therefore, a diagnosis of GDC of the pancreas was made. On imaging, a GDC usually mimics a pancreatic pseudocyst or a cystic neoplasm of the pancreas. Therefore, even though it is rare, a GDC should be considered in the differential diagnosis of cystic tumors of the pancreas.
- Takeo Yasuda; Keiko Kamei; Mariko Araki; Yasuyuki Nakata; Hajime Ishikawa; Mitsuo Yamazaki; Hiroki Sakamoto; Masayuki Kitano; Takuya Nakai; Yoshifumi TakeyamaCase reports in gastroenterology 7 2 322 - 6 2013年A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy) was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl) was found to exist in the extraperitoneal space (over the peritoneum), but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.
- Keiko Kamei; Takeo Yasuda; Takuya Nakai; Yoshifumi TakeyamaCase reports in gastroenterology 7 3 433 - 7 2013年We report a rare case of adenocarcinoma of the duodenum arising from Brunner's gland. A 70-year-old man with a history of hypertension was referred to us with the complaint of abdominal discomfort. Upper gastrointestinal endoscopy revealed an irregular elevated mucosa and a submucosal tumor with delle in the duodenal bulb. Biopsy specimens revealed adenocarcinoma (the former) and hyperplasia (the latter). We could not agree with the patient about performing pancreaticoduodenectomy, so under the diagnosis of primary duodenal carcinoma, we performed resection of the bulbus and the antrum. Pathological examination showed that one of the tumors was consistent with normal Brunner's glands, Brunner's gland hyperplasia and adenocarcinoma arising from Brunner's glands. The patient's postoperative course was good, but 15 months after, he developed lymph node recurrence at the site of the pancreas head. Under the diagnosis of lymph node metastasis of duodenal cancer, we performed pancreaticoduodenectomy this time. Pathological examination confirmed our preoperative diagnosis. The patient remained well after the surgery for 2 years.
- Keiko Kamei; Takeo Yasuda; Takashi Ueda; Fu Qiang; Yoshifumi Takeyama; Hitoshi ShiozakiJournal of hepato-biliary-pancreatic sciences 17 3 305 - 12 2010年05月BACKGROUND/PURPOSE: Triggering receptor expressed on myeloid cells-1 (TREM-1) is a regulator of immunity and an amplifier of inflammatory signaling. The aim was to clarify the role of TREM-1 in the pathophysiology of experimental severe acute pancreatitis (SAP). METHODS: SAP was induced by retrograde injection of 3 and 20% sodium deoxycholate (DCA) into the biliopancreatic ducts in rats (DCA pancreatitis). Soluble TREM-1 levels in serum, ascitic fluid, pancreas, liver and kidney were determined with an established available enzyme-linked immunosorbent assay (ELISA) kit. To clarify the source of soluble TREM-1 in serum and ascitic fluid, peritoneal macrophage depletion was done. Moreover, the effect of blockade of TREM-1 pathway was examined using LP17 (a synthetic TREM-1 inhibitor). RESULTS: Soluble TREM-1 levels in serum and ascitic fluid were higher in SAP. Membrane-bound TREM-1 protein was increased in pancreas, liver and kidney in SAP. Peritoneal macrophage depletion resulted in the reduction of soluble TREM-1 levels in serum and ascitic fluid. Pretreatment with LP17 improved the hepatic and renal dysfunction (serum aspartate aminotransferase and blood urea nitrogen levels) in SAP. CONCLUSIONS: TREM-1 may act as an important mediator for inflammation and organ injury in SAP. TREM-1 may be a potential therapeutic target for the development of SAP and associated organ dysfunction.
- 保田 知生; 廣畑 健; 竹山 宜典; 北口 博士; 新崎 亘; 亀井 敬子; 里井 俊平; 安田 武生; 上田 和毅; 石川 原; 石丸 英三郎; 土師 誠二; 中居 卓也; 大柳 治正; 塩崎 均日本外科学会雑誌 110 臨増2 737 - 737 (一社)日本外科学会 2009年02月 [査読有り]
- Keiko Kamei; Takeo Yasuda; Wataru Shinzaki; Shumpei Satoi; Takashi Ueda; Yoshifumi TakeyamaDigestive surgery 26 1 25 - 6 2009年
- Takashi Ueda; Yoshifumi Takeyama; Takeo Yasuda; Keiko Kamei; Shumpei Satoi; Hidehiro Sawa; Makoto Shinzeki; Yonson Ku; Yoshikazu Kuroda; Harumasa OhyanagiJournal of gastroenterology 44 5 453 - 9 2009年BACKGROUND: The Japanese severity score (JSS) for acute pancreatitis was revised in 2008. As special therapies for severe acute pancreatitis (SAP), continuous regional arterial infusion of protease inhibitor and antibiotics (CRAI) and enteral nutrition (EN) are now utilized in Japan. We investigated the usefulness of the new JSS and the indications for CRAI and EN based on the new JSS. METHODS: We assessed the new JSS in 138 patients with SAP according to the previous Japanese criteria. Usefulness of the new JSS for the prediction of mortality rates was compared with conventional scoring systems by receiver-operator characteristic curve analysis. We analyzed the relationship between the new JSS and prognosis in patients with and without CRAI and EN, respectively. RESULTS: Forty-five patients (33%) were assessed as having mild acute pancreatitis, and 93 patients (67%) were assessed as having SAP. Their mortality rates were 7 and 40%, respectively. The area under the curve for the prediction of mortality rates with the new JSS was 0.822 and was the highest among conventional scoring systems. In patients with new JSS >or= 6, the mortality rate was lower in patients with CRAI than in patients without CRAI (P = 0.129). In patients with new JSS >or= 4, the mortality rate was lower in patients with EN than in patients without EN (P = 0.016). CONCLUSIONS: The new JSS is useful and easier to use for the prediction of prognosis compared to the conventional scoring systems. EN was effective in reducing the mortality rate in patients with a new JSS >or= 4.
- Takeo Yasuda; Takashi Ueda; Keiko Kamei; Wataru Shinzaki; Hidehiro Sawa; Makoto Shinzeki; Yonson Ku; Yoshifumi TakeyamaJournal of gastroenterology 44 10 1071 - 9 2009年BACKGROUND: In acute pancreatitis (AP), disorders of the coagulation-fibrinolysis system are closely related to the severity of the AP and to organ dysfunctions. We previously reported that plasma tissue factor (TF) levels were elevated in patients with AP, particularly in cases of alcoholic AP with pancreatic necrosis. Tissue factor pathway inhibitor (TFPI) is a key regulator of the extrinsic coagulation pathway, but plasma TFPI levels in AP have not yet been determined. METHODS: Plasma TFPI concentrations were measured by enzyme-linked immunosorbent assay in 44 patients with AP on admission. The relationships between AP severity, pancreatic necrosis, organ dysfunction, infection, and prognosis were analyzed. RESULTS: Plasma TFPI levels were increased in AP patients compared with healthy volunteers. Plasma TFPI levels in severe AP were greater than those in mild AP. Plasma TFPI levels significantly correlated with Ranson score, APACHE II score, and Japanese severity score. Plasma TFPI levels in patients with pancreatic necrosis were greater than those in patients without pancreatic necrosis. Plasma TFPI levels in patients with organ dysfunction were greater than those in patients without organ dysfunction. In patients with pancreatic necrosis, the TF/TFPI ratios in non-survivors were lower than those in survivors. Moreover, the mortality rates in patients with TF/TFPI ratios > or = 2.0 were lower than those in patients with TF/TFPI ratios < 2.0. CONCLUSIONS: Plasma TFPI levels were significantly increased in patients with AP, and the elevation was markedly related to the severity, pancreatic necrosis and organ dysfunctions. The imbalance of TF and TFPI may influence the disease state and thereby the prognosis in AP.
- Keiko Kamei; Yoshifumi Takeyama; Takeo Yasuda; Masanori Kawasaki; Takashi Ueda; Harumasa Ohyanagi; Hitoshi ShiozakiSurgery today 39 12 1083 - 5 2009年Mild acute pancreatitis (AP) is rarely complicated by infection, and the value of prophylactic antibiotics is questionable. We report a case of mild AP complicated by infection, which developed within 1 week after the onset. A 66-year-old woman was referred to our hospital where a diagnosis of mild AP was made, based on laboratory data and computed tomography (CT) findings. She was managed conservatively with fluid resuscitation, intravenous antibiotics, and protease inhibitor. Her general condition improved initially, but a high fever redeveloped on hospital day 3. On hospital day 7, a repeat CT scan showed a peripancreatic fluid collection with gas, indicating peripancreatic abscess. A drainage operation was performed, and the organism cultured from the abscess was Escherichia coli. Her postoperative course was uneventful. We report this case to stress that infection may develop even in mild AP, and even in the early phase.
- Takeo Yasuda; Yoshifumi Takeyama; Takashi Ueda; Makoto Shinzeki; Hidehiro Sawa; Nakajima Takahiro; Keiko Kamei; Yonson Ku; Yoshikazu Kuroda; Harumasa OhyanagiCritical care medicine 36 7 2048 - 53 2008年07月OBJECTIVE: To determine the contribution of triggering receptor expressed on myeloid cells (TREM)-1 in acute pancreatitis (AP). DESIGN: Prospective study. SETTING: General intensive care unit at Kobe University Hospital. PATIENTS: Forty-eight patients with AP and seven patients as control. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We measured serum concentrations of soluble TREM-1 (sTREM-1) at the time of admission by enzyme-linked immunoadsorbent assay. Serum sTREM-1 levels increased significantly in AP (63 +/- 11 pg/mL) and correlated with Ranson score (R = .628, p < .001) and Acute Physiology and Chronic Health Evaluation II score (R = .504, p < .001). Serum TREM-1 levels were higher in patients with early organ dysfunction (which occurred within 7 days after onset) than those without early organ dysfunction (101 +/- 19 vs. 25 +/- 4 pg/mL, p < .001). Incidences of early organ dysfunction in patients whose serum sTREM-1 levels were < or = 40 and > 40 pg/mL were 17% and 83%, respectively (p < .001). The usefulness of serum sTREM-1 in detecting early organ dysfunction was superior to that of C-reactive protein, interleukin-6, interleukin-8, Ranson score, and Acute Physiology and Chronic Health Evaluation II score. Serum sTREM-1 levels decreased with resolution of early organ dysfunction. CONCLUSIONS: Serum sTREM-1 levels were significantly increased and correlated with disease severity and early organ dysfunction in patients with AP. Serum sTREM-1 level may be a useful marker for early organ dysfunction in AP.
- Takeo Kosaka; Hideko Imaizumi; Keiko Kamei; Kazuo Usami; Yasuharu Nakano; Keiichi Ueno; Shigeki TakashimaGan to kagaku ryoho. Cancer & chemotherapy 31 11 1737 - 9 2004年10月We performed radio-frequency ablation (RFA) therapy combined with intra-arterial chemotherapy for a 71-year old female gastric cancer patient with liver metastasis. She underwent total gastrectomy due to advanced gastric cancer in July of 1996. Because CT scans revealed multiple liver tumors with her, she also underwent intra-arterial chemotherapy comprising of 5-fluorouracil, cis-platinum and Leucovorin. Although her liver tumors decreased in size and number, after 9 months, we had to remove the catheter because of hepatic artery obstruction. Immediately after the removal, 5 hepatic metastases appeared, which were 3.5 cm in maximum diameter. After RFA therapy, CT scans revealed homogenously attenuated lesions. Liver biopsy demonstrated a complete coagulation necrosis. She is currently alive going into 19 months after liver metastasis and 7 months after RFA.
- 下血で発見された直腸MPカルチノイドの一例亀井 敬子; 原田英也; 吉谷新一郎; 中野泰治; 高島茂樹北陸外科学会誌 22 1 87 - 89 2003年10月
MISC
- 尾側膵切除術における新しい縫合糸を用いたバイクリルメッシュ、膵貫通マットレス法の有効性の検討 Transpancreatic mattress double suture(TPMD suture)の有効性について吉田 雄太; 松本 逸平; 川口 晃平; 松本 正孝; 李 東河; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本外科学会定期学術集会抄録集 121回 PS -1 2021年04月
- 腹腔鏡下膵頭十二指腸切除術の安全な導入と手術手技松本 逸平; 吉田 雄太; 川口 晃平; 松本 正孝; 李 東河; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本外科学会定期学術集会抄録集 121回 PS -8 2021年04月
- 肝内胆管拡張を伴う進行肝内胆管癌に対する肝左葉切除術武部 敦志; 吉田 雄太; 川口 晃平; 松本 正孝; 李 東河; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 松本 逸平; 中居 卓也; 竹山 宜典 日本外科学会定期学術集会抄録集 121回 PS -3 2021年04月
- 当院における切除可能膵癌に対する術前治療症例の検討李 東河; 松本 逸平; 亀井 敬子; 川口 晃平; 吉田 雄太; 松本 正孝; 村瀬 貴昭; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本外科学会定期学術集会抄録集 121回 PS -8 2021年04月
- 外科医としての重症急性膵炎研究と化学療法への取り組み亀井 敬子 日本消化器病学会雑誌 118 (臨増総会) A23 -A23 2021年03月
- 慢性膵炎を巡る諸問題:早期慢性膵炎から外科治療まで 局所合併症を伴う慢性膵炎に対するFrey手術の安全性と有効性松本 逸平; 亀井 敬子; 竹山 宜典 日本消化器病学会雑誌 118 (臨増総会) A124 -A124 2021年03月
- 松本逸平; 三長孝輔; 村瀬貴昭; 宮田剛; 川口晃平; 亀井敬子; 水野修吾; 糸井隆夫; 大原弘隆; 正宗淳; 阪上順一; 佐田尚宏; 竹中完; 北野雅之; 乾和郎; 竹山宜典 膵臓(Web) 36 (3) 2021年
- 吉田雄太; 松本逸平; 川口晃平; 松本正孝; 李東河; 村瀬貴昭; 亀井敬子; 里井俊平; 武部敦志; 中居卓也; 鎌田研; 山雄健太郎; 竹中完; 竹山宜典 膵臓(Web) 36 (3) 2021年
- 膵体尾部切除後膵液瘻低減を可能としたバイクリルメッシュと新規マットレス縫合糸による新しい膵断端処理法亀井 敬子; 松本 逸平; 吉田 雄太; 川口 晃平; 村瀬 貴昭; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本消化器外科学会総会 75回 P300 -3 2020年12月
- 膵臓 悪性亀井 敬子; 松本 逸平; 川口 晃平; 吉田 雄太; 村瀬 貴昭; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 53 (Suppl.2) 317 -317 2020年11月
- 膵臓 悪性松本 逸平; 吉田 雄太; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 53 (Suppl.2) 319 -319 2020年11月
- 膵臓 良性村瀬 貴昭; 松本 逸平; 吉田 雄太; 川口 晃平; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 筑後 孝章; 竹山 宜典 日本消化器外科学会雑誌 53 (Suppl.2) 324 -324 2020年11月
- 松本逸平; 松本正孝; 村瀬貴昭; 亀井敬子; 里井俊平; 武部敦志; 中居卓也; 三長孝輔; 竹中完; 竹山宜典 肝胆膵 80 (2) 2020年
- 松本正孝; 松本逸平; 吉田雄太; 山雄健太郎; 川口晃平; 村瀬貴昭; 大本俊介; 亀井敬子; 里井俊平; 竹中完; 武部敦志; 中居卓也; 竹山宜典 膵臓(Web) 35 (3) 2020年
- 膵全摘術後の栄養障害とその対策松本 逸平; 吉田 雄太; 川口 晃平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 武部 敦志; 庭野 史丸; 廣峰 義久; 馬場谷 成; 中居 卓也; 池上 博司; 竹山 宜典 外科と代謝・栄養 54 (5) 126 -126 2020年
- バイクリルメッシュと貫通マットレス縫合による新しい尾側膵切除後膵断端処理法の有用性松本 逸平; 吉田 雄太; 川口 晃平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 52 (Suppl.2) 130 -130 2019年11月
- 【膵癌における内視鏡診断・治療の最前線】術後膵液瘻に対する内視鏡的ドレナージの現状竹中 完; 中井 敦史; 吉川 智恵; 石川 嶺; 岡本 彩那; 山崎 友裕; 大本 俊輔; 三長 孝輔; 鎌田 研; 山雄 健太郎; 亀井 敬子; 松本 逸平; 竹山 宜典; 工藤 正俊 胆と膵 40 (9) 807 -814 2019年09月
- 膵全摘術の治療成績松本 逸平; 吉田 雄太; 川口 晃平; 松本 正孝; 村瀬 貴昭; 岩崎 寿光; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 51 (Suppl.2) 376 -376 2018年11月
- 胆道癌術後の大量肝切除状態におけるGEMまたはS-1療法の第I/II相試験(KHBO1003/1208)小林 省吾; 永野 浩昭; 波多野 悦朗; 瀬尾 智; 寺嶋 宏明; 味木 徹夫; 佐竹 悠良; 亀井 敬子; 藤山 泰二; 廣瀬 哲朗; 猪飼 伊和夫; 竹村 茂一; 柳本 泰明; 森田 智視; 井岡 達也 日本癌治療学会学術集会抄録集 56回 O36 -4 2018年10月
- 松本逸平; 吉田雄太; 川口晃平; 松本正孝; 村瀬貴昭; 亀井敬子; 里井俊平; 中居卓也; 庭野史丸; 廣峰義久; 竹山宜典 胆と膵 39 (5) 475 -479 2018年05月
- 幕谷 悠介; 松本 逸平; 大本 俊介; 筑後 孝章; 川口 晃平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 中居 卓也; 竹中 完; 工藤 正俊; 竹山 宜典 日本消化器外科学会雑誌 51 (2) 114 -121 2018年02月
- 幕谷悠介; 松本逸平; 大本俊介; 筑後孝章; 川口晃平; 松本正孝; 村瀬貴昭; 亀井敬子; 里井俊平; 中居卓也; 竹中完; 工藤正俊; 竹山宜典 日本消化器外科学会雑誌(Web) 51 (2) 2018年
- 亀井 敬子; 松本 逸平; 幕谷 悠介; 川口 晃平; 松本 正孝; 村瀬 貴昭; 里井 俊平; 中居 卓也; 鎌田 研; 今井 元; 筑後 孝章; 竹山 宜典 癌と化学療法 44 (12) 1191 -1193 2017年11月
- S-1単独療法が奏効し組織学的完全奏効が得られた切除不能膵癌の1例亀井 敬子; 松本 逸平; 幕谷 悠介; 川口 晃平; 松本 正孝; 村瀬 貴昭; 里井 俊平; 中居 卓也; 鎌田 研; 今井 元; 筑後 孝章; 竹山 宜典 癌と化学療法 44 (12) 1191 -1193 2017年11月
- 「それぞれの癌」難治性癌に対する治療戦略 肝・胆・膵 局所進行切除不能膵癌に対するFOLFIRINOX療法の治療成績と治療前予後因子の検討松本 逸平; 亀井 敬子; 大前 勝弘; 鈴木 修平; 松岡 英彦; 水野 伸匡; 尾阪 将人; 上野 秀樹; 小林 智; 上杉 和寛; 細川 貴史; 逸見 利幸; 小林 真里奈; 戸高 明子; 福冨 晃 日本癌治療学会学術集会抄録集 55回 WS11 -6 2017年10月
- 膵疾患における腹腔鏡手術は有用か? 膵良性・低悪性度腫瘍に対する腹腔鏡下尾側膵切除術の有用性に関する検討松本 逸平; 亀井 敬子; 竹山 宜典 日本消化器外科学会雑誌 50 (Suppl.2) 158 -158 2017年10月
- 大腸癌肝転移おけるNAC後肝切除症例のTNIを用いた臨床病理学的予後解析による術後化学療法の指針中居 卓也; 川口 晃平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 松本 逸平; 竹山 宜典 日本消化器外科学会雑誌 50 (Suppl.2) 272 -272 2017年10月
- フライ手術後に一過性可逆性脳症を発症した慢性膵炎急性増悪症例里井 俊平; 川口 晃平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 松本 逸平; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 50 (Suppl.2) 422 -422 2017年10月
- XELOX療法施行患者のQOL及び副作用に対するシイタケ菌糸体の効果(LEM-OX study)亀井 敬子; 所 忠男; 大東 弘治; 上田 和毅; 川村 純一郎; 肥田 仁一; 石丸 英三郎; 塚本 義貴; 奥野 清隆 日本癌治療学会学術集会抄録集 55回 O15 -4 2017年10月
- Ippei Matsumoto; Takaaki Murase; Keiko Kamei; Kohei Kawaguchi; Masataka Matsumoto; Shumpei Satoi; Takuya Nakai; Yoshifumi Takeyama GASTROENTEROLOGY 152 (5) S1270 -S1270 2017年04月
- 肥満若年男性から発生した肝細胞腺腫が悪性転化した1例幕谷 悠介; 川口 晃平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 松本 逸平; 中居 卓也; 竹山 宜典 日本外科学会定期学術集会抄録集 117回 RS -4 2017年04月
- 亀井 敬子; 松本 逸平; 川口 晃平; 松本 正孝; 村瀬 貴昭; 里井 俊平; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 50 (9) 713 -720 2017年
- 膵胆管合流異常症に合併した胆管内乳頭状腫瘍の1例幕谷 悠介; 松本 逸平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 中居 卓也; 竹山 宜典 日本臨床外科学会雑誌 77 (増刊) 680 -680 2016年10月
- 超音波内視鏡下穿刺吸引法が術前診断,術式選択に有用であった腹腔鏡下尾側膵切除術を施行した膵solid-pseudopapillary neoplasmの1例亀井 敬子; 松本 逸平; 村瀬 貴昭; 石川 原; 中居 卓也; 竹山 宜典 日本内視鏡外科学会雑誌 21 (3) 307 -313 2016年05月
- 池上博司; 川畑由美子; 廣峰義久; 伊藤鉄英; 亀井敬子; 松本逸平; 竹山宜典 厚生労働科学研究費補助金 難治性疾患等政策研究事業(難治性疾患政策研究事業)「難治性膵疾患に関する調査研究」平成27年度 総括・分担研究報告書 140 -142 2016年03月
- Masato Ozaka; Akiko Todaka; Keita Mori; Narikazu Boku; Nobumasa Mizuno; Hideki Ueno; Satoshi Kobayashi; Kazuhiro Uesugi; Noritoshi Kobayashi; Hideyuki Hayashi; Kentaro Sudo; Naohiro Okano; Yosuke Horita; Keiko Kamei; Seigo Yukisawa; Shoji Nakamori; Yutaka Yachi; Toshiyuki Henmi; Marina Kobayashi; Akira Fukutomi JOURNAL OF CLINICAL ONCOLOGY 34 (4) 2016年02月
- 川村 純一郎; 上田 和毅; 杉浦 史哲; 大東 弘治; 吉岡 康多; 所 忠男; 肥田 仁一; 亀井 敬子; 牛嶋 北斗; 今本 治彦; 奥野 清隆 消化器外科 39 (2) 181 -188 2016年02月
- 膵液瘻低減を目指したバイクリルメッシュとマットレス縫合を用いた新しい尾側膵切除後膵断端処理法(第1報)松本 逸平; 村瀬 貴昭; 亀井 敬子; 中多 靖幸; 里井 俊平; 石川 原; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 48 (Suppl.2) 239 -239 2015年10月
- 準緊急手術を行った難治性膵性腹水の3例亀井 敬子; 松本 逸平; 村瀬 貴昭; 中多 靖幸; 里井 俊平; 石川 原; 中居 卓也; 竹山 宜典 日本消化器外科学会雑誌 48 (Suppl.2) 273 -273 2015年10月
- 【1術式15分でわかる!イラスト・写真でかんたん理解!術前に予習できる消化器外科の解剖・手術はや調べファイル】 手術編 腹腔鏡下胆嚢摘出術亀井 敬子; 松本 逸平; 竹山 宜典 オペナーシング 30 (8) 823 -826 2015年08月
- 池上博司; 伊藤鉄英; 廣峰義久; 川畑由美子; 亀井敬子; 松本逸平; 竹山宜典 厚生労働科学研究費補助金 難治性疾患等政策研究事業(難治性疾患政策研究事業) 「難治性膵疾患に関する調査研究」 平成26年度総括・分担研究報告書 102 -103 2015年03月
- 杉浦史哲; 助川寧; 亀井敬子; 吉藤竹仁; 川村純一郎; 上田和毅; 所忠男; 肥田仁一; 奥野清隆 日本臨床腫瘍学会学術集会(CD-ROM) 13th 2015年
- 荒木麻利子; 松本正孝; 中多靖幸; 亀井敬子; 石川原; 中居卓也; 村上卓道; 竹山宜典 近畿大学医学雑誌 39 (3-4) 125 -132 2014年12月
- 進行・再発大腸癌に対するHLA-A24拘束性ペプチドワクチン療法第I/II相試験杉浦 史哲; 井上 啓介; 小北 晃弘; 吉岡 康多; 亀井 敬子; 大東 弘治; 上田 和毅; 吉藤 竹仁; 所 忠男; 肥田 仁一; 奥野 清隆 日本癌治療学会誌 49 (3) 1221 -1221 2014年06月
- 松本 正孝; 中居 卓也; 小北 晃弘; 中多 靖幸; 亀井 敬子; 石川 原; 竹山 宜典; 奥野 清隆 日本外科学会雑誌 115 (2) 413 -413 2014年03月
- 亀井 敬子; 竹山 宜典 膵臓 29 (2) 189 -195 2014年
- StageIV大腸癌治療におけるがんペプチドワクチン療法杉浦 史哲; 井上 啓介; 小北 晃弘; 吉岡 康多; 亀井 敬子; 大東 弘治; 吉藤 竹仁; 上田 和毅; 所 忠男; 肥田 仁一; 奥野 清隆 日本大腸肛門病学会雑誌 66 (9) 820 -820 2013年09月
- 進行・再発大腸癌治療におけるがんペプチドワクチン療法杉浦 史哲; 井上 啓介; 助川 寧; 小北 晃弘; 吉岡 康多; 亀井 敬子; 大東 弘治; 上田 和毅; 吉藤 竹仁; 所 忠男; 肥田 仁一; 奥野 清隆 日本癌治療学会誌 48 (3) 1919 -1919 2013年09月
- 研修医からの質問Q&A 十二指腸乳頭部がん再発と原発性非小細胞肺癌の重複癌症例に対する治療の進め方は?川上 尚人; 亀井 敬子 臨床腫瘍プラクティス 9 (3) 338 -339 2013年08月
- XELOX療法導入時のoxaliplatinに起因する血管痛に対するトラマドール鎮痛効果の検討亀井 敬子; 酒井 健一; 船井 貞往; 大和 宗久; 田中 晃 日本消化器外科学会総会 68回 P -8 2013年07月
- 船井貞往; 亀井敬子 日本肝胆膵外科学会・学術集会プログラム・抄録集 25th 525 -525 2013年06月
- 久保田 倫代; 安田 武生; 武 強; 荒木 麻利子; 中多 靖幸; 亀井 敬子; 山崎 満夫; 石川 原; 坤居 卓也; 竹山 宜典 膵臓 = The Journal of Japan Pancreas Society 28 (2) 185 -190 2013年04月
- 北野義徳; 船井貞往; 亀井敬子; 田中晃 癌の臨床 58 (6) 443 -447 2012年12月
- Kamei Keiko; Yasuda Takeo; Nakata Yasuyuki; Yamazaki Mitsuo; Ishikawa Hajime; Nakai Takuya; Takeyama Yoshifumi ACTA MEDICA = The Kinki University Medical Association 37 (2) 95 -97 2012年12月
- 亀井敬子; 酒井健一; 船井貞往; 大和宗久; 田中晃 日本癌治療学会学術集会(CD-ROM) 50th (3) ROMBUNNO.PS2-242 -2346 2012年10月
- 特発性大網出血の一例亀井 敬子; 北野 義徳; 船井 貞往; 田中 晃 日本腹部救急医学会雑誌 32 (2) 540 -540 2012年02月
- 西川智子; 西村町子; 熊木彩乃; 北野義徳; 船井貞往; 亀井敬子; 田中晃 静脈経腸栄養 27 (1) 284 -284 2012年01月
- 北野義徳; 亀井敬子; 船井貞往; 田中晃 日本消化管学会総会学術集会プログラム・抄録集 8th 293 2012年
- 女性外科医が外科医として活躍し続けるためのシステム構築に向けて 女性外科医師をいかに育てていくべきか 医局長の立場から石丸 英三郎; 武本 昌子; 久保田 倫代; 磯野 小百合; 亀井 敬子; 杉浦 史哲; 大東 弘治; 上田 和毅; 所 忠男; 肥田 仁一; 竹山 宜典; 奥野 清隆; 塩崎 均 日本臨床外科学会雑誌 72 (増刊) 361 -361 2011年10月
- 亀井 敬子; 安田 武生; 山崎 満夫; 石川 原; 中居 卓也; 竹山 宜典 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 72 (7) 1848 -1852 2011年07月
- 大腸癌肝転移再肝切除後の難治性胆汁瘻に対する瘻孔空腸吻合術後に合併した胆管気管支瘻の1例船井 貞往; 北野 義徳; 田中 晃; 亀井 敬子; 重岡 宏典; 大和 宗久 日本消化器外科学会総会 66回 864 -864 2011年07月
- 今本 治彦; 安田 篤; 亀井 敬子 オペナーシング 25 (8) 中付1 -9 2010年08月
- 安田 武生; 上田 隆; 亀井 敬子 消化器内科 50 (4) 350 -354 2010年04月
- 土師 誠二; 中多 靖幸; 山崎 満夫; 亀井 敬子; 安田 武生; 石川 原; 中居 卓也; 竹山 宜典 日本外科学会雑誌 111 (2) 151 -151 2010年03月
- 安田 武生; 上田 隆; 亀井 敬子; 新崎 亘; 石川 原; 土師 誠二; 中居 卓也; 塩崎 均; 大柳 治正; 竹山 宜典 日本消化器外科学会雑誌 42 (7) 1266 -1266 2009年07月
- 里井 俊平; 竹山 宜典; 中居 卓也; 土師 誠二; 保田 知生; 石川 原; 安田 武生; 新崎 亘; 亀井 敬子; 大柳 治正 膵臓 = The Journal of Japan Pancreas Society 23 (4) 481 -485 2008年08月
- 亀井 敬子; 竹山 宜典; 安田 武生; 北口 博士; 新崎 亘; 里井 俊平; 大柳 治正; 塩崎 均 日本消化器外科学会雑誌 41 (7) 1523 -1523 2008年07月
- 白石 治; 亀井 敬子; 石川 原; 中居 卓也; 竹山 宜典; 塩崎 均; 大柳 治正 日本外科系連合学会誌 33 (2) 213 -217 2008年04月
- 里井 俊平; 竹山 宜典; 中居 卓也; 土師 誠二; 保田 知生; 石川 原; 白石 治; 亀井 敬子; 大柳 冶正 日本外科学会雑誌 108 (2) 356 -356 2007年03月
- 上田 和毅; 亀井 敬子; 松崎 智彦; 吉藤 竹仁; 服部 高史; 石丸 英三郎; 肥田 仁一; 奥崎 清隆; 塩崎 均 日本消化器外科学会雑誌 39 (7) 1260 -1260 2006年07月
- S状結腸癌術後卵巣転移によりpseudo-Meigs症候群をきたした3例亀井 敬子; 上田 和毅; 服部 高史; 松崎 智彦; 吉藤 竹仁; 石丸 英三郎; 肥田 仁一; 奥野 清隆; 塩崎 均 日本外科系連合学会誌 31 (3) 608 -608 2006年06月
- 今野 元博; 今本 治彦; 塩崎 均; 新崎 亘; 亀井 敬子; 稲山 正人; 彭 秀峰; 川西 賢秀; 新海 政幸; 平井 紀彦; 重岡 宏典; 橋本 直樹; 大柳 治正 日本外科学会雑誌 107 (2) 268 -268 2006年03月
- 食道癌に対する二期分割手術に関する検討重岡 宏典; 今本 治彦; 今野 元博; 平井 紀彦; 川西 賢秀; 新海 政幸; 彭 英峰; 稲山 正人; 亀井 敬子; 橋本 直樹; 塩崎 均 日本臨床外科学会雑誌 66 (増刊) 379 -379 2005年10月
- 胃原発絨毛癌の一例亀井 敬子; 新崎 亘; 稲山 正人; 彭 英峰; 川西 賢秀; 平井 紀彦; 新海 政幸; 今野 元博; 重岡 宏典; 今本 治彦; 橋本 直樹; 塩崎 均 日本臨床外科学会雑誌 66 (増刊) 660 -660 2005年10月
- 小開胸併用胸腔鏡補助下食道癌手術術後の侵襲を軽減するための工夫.各種薬剤を用いた集学的治療の効果今野 元博; 今本 治彦; 塩崎 均; 亀井 敬子; 新崎 亘; 稲山 正人; 彭 英峰; 川西 賢秀; 新海 政幸; 平井 紀彦; 重岡 宏典; 橋本 直樹; 大柳 治正 日本臨床外科学会雑誌 66 (増刊) 619 -619 2005年10月
- 超高齢者の癌治療 超高齢者胃癌に対する腹腔鏡下胃切除術の有用性の検討今本 治彦; 新海 政幸; 川西 賢秀; 彭 英峰; 亀井 敬子; 新崎 亘; 稲山 正人; 平井 紀彦; 今野 元博; 重岡 宏典; 上田 和毅; 橋本 直樹; 塩崎 均 日本癌治療学会誌 40 (2) 200 -200 2005年09月
講演・口頭発表等
- 吉田 左和; 伊藤 裕進; 馬場谷 成; 能宗 伸輔; 廣峰 義久; 村瀬 貴昭; 亀井 敬子; 竹山 宜典; 川畑 由美子; 池上 博司第24回日本老年医学会近畿地方会 2013年11月 京都市 第24回日本老年医学会近畿地方会
- 船井 貞往; 亀井 敬子第25回日本肝胆膵外科学会・学術集会 2013年06月 宇都宮 第25回日本肝胆膵外科学会・学術集会
肝切除後の胆汁瘻は,胆道との交通の有無で治療法が異なり,病態に応じた対処が必要となる.胆汁瘻のなかでも,胆道非交通型の胆汁瘻(離断型胆汁瘻)は難治性となることが多い.69歳の男性で,転移性肝癌に対する肝切除後,離断型胆汁瘻に十二指腸瘻孔を合併したが,内瘻化により治癒した症例を経験し,報告した. - 1年以上の下痢,下血で受診した腸重積合併1型S状結腸がんの1例 [通常講演]河野 匡志; 丸山 康典; 松本 望; 高場 雄久; 奥村 直己; 冨田 崇文; 梅原 康湖; 谷池 聡子; 森村 正嗣; 米田 円; 山田 哲; 辻 直子; 亀井 敬子; 田中 晃; 落合 健; 前倉 俊治; 南 康範; 工藤 正俊日本消化器病学会近畿支部大97会例会 2012年09月 京都市 日本消化器病学会近畿支部大97会例会
- 成人腸重積で発症した盲腸癌の1例. Freshman Session「消化管」 [通常講演]谷浦 允厚; 安達 融; 河野 匡志; 松本 望; 高場 雄久; 奥村 直己; 山本 典雄; 冨田 崇文; 梅原 康湖; 森村 正嗣; 米田 円; 山田 哲; 辻 直子; 亀井 敬子; 北野 義徳; 田中 晃; 落合 健; 前倉 俊治; 南 康範; 工藤 正俊日本消化器病学会近畿支部第96回例会 2012年01月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第96回例会
- EUS-guided broad plexus-neurolysis over the superior mesenteric artery using a 25 gauge needle. [通常講演]坂本 洋城; 北野 雅之; 小牧 孝充; 今井 元; 鎌田 研; 竹山 宜典; 中居 卓也; 安田 武生; 亀井 敬子; 工藤 正俊Joint Meeting of the International Association of Pancreatology and the Japan Pancreas Society 2010 2010年07月 Fukuoka, Japan Joint Meeting of the International Association of Pancreatology and the Japan Pancreas Society 2010
- 肝細胞癌外科治療における術中造影エコーの意義. [通常講演]土師 誠二; 山崎 満夫; 北口 博士; 中多 靖幸; 亀井 敬子; 安田 武生; 石川 原; 中居 卓也; 竹山 宜典; 畑中 絹世; 工藤 正俊第12回関西肝癌局所療法研究会 2010年03月 阪急電鉄本社ビル, 大阪 第12回関西肝癌局所療法研究会
- 皮膚壊死を来たした葉状腫瘍の一例 [通常講演]中山 剛之; 北口 博士; 亀井 敬子; 小川 稔; 村田 賢; 湯川 真生; 井上 雅智第14回日本乳癌学会学術総会 2006年07月 石川県金沢 第14回日本乳癌学会学術総会
- stage II大腸癌における化学療法の有用性と予後について [通常講演]上田 和毅; 亀井 敬子; 松﨑 智彦; 吉藤 竹仁; 石丸 英三郎; 肥田 仁一; 奥野 清隆; 塩﨑 均第61回日本消化器外科学会総会 2006年07月 横浜 第61回日本消化器外科学会総会
stage II 大腸癌術後の患者に対し術後化学療法を行った群と行っていない群の予後を含めた比較検討を行い発表を行った. - 当院における外傷性肝損傷例の検討 [通常講演]村田 賢; 湯川 真生; 亀井 敬子; 北口 博士; 中山 剛之; 小川 稔; 芋縄 啓史; 阿部 泰志; 長谷川 博一; 岡嶋 馨; 井上 雅智第31回日本外科系連合学術集会 2006年06月 石川県金沢 第31回日本外科系連合学術集会
外傷性肝損傷のⅢb型が手術適応で迅速な対応が救命率の向上につながる - 肝胆膵外傷症例の検討 [通常講演]村田 賢; 湯川 真生; 亀井 敬子; 北口 博士; 中山 剛之; 小川 稔; 芋縄 啓史; 阿部 泰志; 長谷川 博一; 岡嶋 馨; 井上 雅智第18回日本肝胆膵外科関連会議・東京 2006年05月 東京 第18回日本肝胆膵外科関連会議・東京
- D2リンパ節郭清を伴った胃全摘後にpaclitaxelを腹腔内投与した後の薬物動態に関する検討 [通常講演]今野 元博; 今本 治彦; 塩﨑 均; 新﨑 亘; 亀井 敬子; 清川敦子; 稲山正人; 彭 英峰; 川西 賢秀; 新海 政幸; 平井 紀彦; 重岡 宏典; 橋本 直樹; 大柳 治正第106回日本外科学会定期学術集会 2006年03月 東京 第106回日本外科学会定期学術集会
D2リンパ節郭清を伴った胃全摘後にpaclitaxelを腹腔内投与した後の薬物動態に関する検討につき報告した - 腹膜播種陽性胃癌症例に対するpaclitaxel腹腔内投与と逐次S1+weekly paclitaxel併用療法(薬物動態の結果を含む中間報告) [通常講演]今野 元博; 今本 治彦; 塩﨑 均; 稲山正人; 亀井 敬子; 彭 英峰; 川西 賢秀; 新海 政幸; 平井 紀彦; 橋本 直樹; 大柳 治正第4回日本臨床腫瘍学会 2006年03月 大阪 第4回日本臨床腫瘍学会
腹膜播種陽性胃癌症例に対するpaclitaxel腹腔内投与と逐次S1+weekly paclitaxel併用療法につき薬物動態の結果を含む中間報告をした - 小開胸併用胸腔鏡補助下食道癌手術術後の侵襲を軽減するための工夫 各種薬剤を用いた集学的治療の効果 [通常講演]今野 元博; 今本 治彦; 塩﨑 均; 亀井 敬子; 新﨑 亘; 稲山正人; 彭 英峰; 川西 賢秀; 新海 政幸; 平井 紀彦; 重岡 宏典; 橋本 直樹; 大柳 治正第67回日本臨床外科学会総会 2005年11月 東京 第67回日本臨床外科学会総会
小開胸併用胸腔鏡補助下食道癌手術術後の侵襲を軽減するための工夫について報告した - 食道癌に対する二期分割手術に関する検討 [通常講演]重岡 宏典; 今本 治彦; 今野 元博; 平井 紀彦; 川西 賢秀; 新海 政幸; 彭 英峰; 稲山正人; 亀井 敬子; 橋本 直樹; 塩? 均第67回日本臨床外科学会総会 2005年11月 東京 第67回日本臨床外科学会総会
近年,食道癌に対する化学放射線療法の増加に伴いSalvage Surgeryの頻度が増加してきた。教室では化学放射線治療後のSalvage Surgeryや高度の呼吸機能障害合併例では,皮下経路で胃管を挙上し,吻合は行わず食道瘻を増設し,2~3週間し全身状態が整った後に局所麻酔で二期的に食道胃管吻合を行っている。 教室で行っている二期分割手術及び大胸筋皮弁による難治性瘻孔に対する手術のビデオを供覧する。 【手術】胸部操作は通常の手術と同様に右第5肋間後方小切開で胸腔鏡補助下に行い,体位変換し仰臥位とした後に基本的にはHALSを用いて胸腔鏡補助下に大彎側の細径胃管を作成し,皮下経路で頸部に挙上する。頸部では食道を長めに温存し,後壁のみ胃管と吻合し創部を閉鎖した後,食道皮膚瘻を作成する。また,二期再建時に吻合部の圧迫を避けるため前頚筋は切離している。創部と全身状態が安定した2~3週間後に局所麻酔科に食道胃管吻合を手縫いで行っている。縫合 - 超高齢者胃癌に対する腹腔鏡下胃切除術の有用性の検討 [通常講演]今本 治彦; 新海 政幸; 川西 賢秀; 彭 英峰; 亀井 敬子; 新﨑 亘; 平井 紀彦; 今野 元博; 重岡 宏典; 上田 和毅; 橋本 直樹; 塩﨑 均第43回日本癌治療学会総会 2005年10月 名古屋 第43回日本癌治療学会総会
- 腎癌の術後経過中に膵転移を来たした一例 [通常講演]亀井 敬子; 林圭; 今泉英子; 横井美樹; 長谷川泰介; 斉藤人志; 高島茂樹第94回 北陸肝胆膵勉強会年度末大会 2004年12月 金沢 第94回 北陸肝胆膵勉強会年度末大会
- 検診を契機に診断された膵尾部solid cystic tumorの一例 [通常講演]亀井 敬子; 秋田千里; 長谷川泰介; 斉藤人志; 高島茂樹第257回 北陸外科学会 2004年10月 内灘 第257回 北陸外科学会
- 腎癌膵転移の一例 [通常講演]亀井 敬子; 黒田雅利; 中野泰治; 斉藤人志; 小坂健夫; 高島茂樹第256回 北陸外科学会 2004年02月 金沢 第256回 北陸外科学会
- 下血で発見された直腸MPカルチノイドの一例 [通常講演]亀井 敬子; 原田英也; 吉谷新一郎; 中野泰治; 高島茂樹第255回 北陸外科学会 2003年09月 福井 第255回 北陸外科学会
共同研究・競争的資金等の研究課題
- 日本学術振興会:科学研究費助成事業研究期間 : 2018年04月 -2023年03月代表者 : 松本 逸平; 亀井 敬子; 竹山 宜典膵全摘術は膵機能の廃絶を招くため、インスリン注射を必要とする糖尿病と膵酵素欠損により膵外分泌機能不全を呈し、QOL低下を著しく招く術式として理解されてきた。近年の周術期管理の向上により、改善傾向にあるとされるも膵全摘術前術後における長期の前向きQOL調査や栄養指標、膵性糖尿病についての前向き研究による報告はない。本研究は膵全摘予定患者を対象として、術前および術後1年後におけるQOL評価、血糖コントロール状況、脂肪肝発生頻度を明らかにすることを目的とした全国多施設共同前向き研究である。全国71施設以上より286例症例が登録された。集計したデータを用いて、膵全摘患者のQOL調査(近畿大学)、膵全摘後の脂肪肝発生頻度とリスク解析(三重大学)、膵全摘の栄養指標と糖尿病コントロールについての解析(香川大学)の3つの研究を行った。 SF36によるQOL評価では「心の健康」は術前より改善を認めたがその他6項目では増悪していた。膵癌の有無、術前糖尿病の有無では術後QOLに差を認めなかった (論文作成中)。 術後脂肪肝の発生頻度は19.6%と比較的低く、女性、高BMI、術後下痢が術後脂肪肝発生の危険因子であった(J Hepatobiliary Pancreat Sci Online ahead of print, 2021)。 術後血糖コントロールは術後3ヶ月で概ね安定し、HbA1c値は7.0%~8.0%の高値で推移する。栄養指標は術後1ヶ月で最も低下し、3ヶ月で改善以降はほぼ横ばいで推移する。一期的膵全摘術と残膵全摘術の術後推移はほぼ同等であった(Br J Surg 108: e237-e-238, 2021)。 以上の結果により、膵全摘術予定患者への情報提供、膵全摘術術後のより質の高い周術期管理法が可能となる。また、本研究で得られた結果をさらに改善することが、新たな課題として抽出された。