研究者詳細 - 長谷川　康

長谷川　康（ハセガワ　ヤスシ）

Hasegawa, Yasushi

写真a

所属（所属キャンパス）: 医学部外科学教室（一般・消化器）（信濃町）

職名: 専任講師

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Safety and efficacy of pancreaticogastrostomy for hepatopancreatoduodenectomy compared to pancreaticojejunostomy for perihilar cholangiocarcinoma

Nakano Y., Abe Y., Udagawa D., Kitago M., Hasegawa Y., Hori S., Tanaka M., Uemura S., Odaira M., Mihara K., Nishiyama R., Chiba N., Hayatsu S., Kawachi S., Kitagawa Y.

World Journal of Surgical Oncology 23 （ 1 ） 2025年12月

　概要を見る

Background: Hepatopancreatoduodenectomy (HPD) is one of the most challenging surgeries for perihilar cholangiocarcinoma. Postoperative pancreatic fistula (POPF) is a critical and fatal complication. The safety and efficacy of pancreaticogastrostomy (PG) for HPD compared to pancreaticojejunostomy (PJ) remain unclear. In this study, we aimed to investigate and compare the short-term outcomes of PG and PJ for HPD in terms of the POPF rate. Methods: Two groups of patients (PG group vs. PJ group) were retrospectively compared between January 2013 and January 2024. The reconstruction method was changed from PJ to PG in March 2021. Results: A total of 50 patients were enrolled in this study. The PG and PJ groups comprised 15 (30.0%) and 35 (70.0%) patients, respectively. In the PJ group, three (8.6%) patients died after surgery because of clinically relevant POPF (CR-POPF), intraabdominal bleeding, and post-hepatectomy liver failure. The operative time was longer in the PG group (909 min vs. 706 min, P = 0.020); however, the CR-POPF rate was lower in the PG group than in the PJ group (0 [0%] vs. 19 [54.3%], P < 0.001). Moreover, the number of patients who developed massive postoperative ascites (≥ 1,500 mL/day) was lower in the PG group than in the PJ group (3 [20.0%] vs. 16 [45.7%] patients, P = 0.028). Conclusions: Changing the method of pancreatic reconstruction for HPD from PJ to PG improved the short-term outcomes of patients at our institution. PG reconstruction is safe and effective for HPD as it reduces the incidence of CR-POPF.
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Laparoscopic cholecystectomy with synchronous navigation of ICG fluorescence and Yellow Enhance mode

Sonoda K., Abe Y., Kitago M., Yagi H., Hasegawa Y., Hori S., Tanaka M., Nakano Y., Kojima H., Kitagawa Y.

Asian Journal of Surgery 48 （ 7 ） 4186 - 4187 2025年07月

ISSN 10159584

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Technique: Laparoscopic cholecystectomy (LC), widely performed for gallbladder (GB) diseases poses risks of severe complications. To minimize these risks, Tokyo Guidelines 2018 advocated for “safe steps in LC for acute cholecystitis (AC)” including “maintaining the plane of dissection on the GB surface throughout LC”. Moreover, the dissection along the inner layer of the subserosa (SS-inner) of GB helps surgeons avoid bile duct or vascular injury. This step occasionally becomes challenging when distinguishing the GB surface from adjacent fat. ICG, injected into biliary tract, illuminates in green under Infra-red (IR) mode and facilitates the identification of biliary tract. Otherwise, Yellow Enhance (YE) mode developed by Olympus Corporation, which highlights yellow-colored tissues by converting orange-yellow tissues to a clearer yellow, improves the contrast between anatomical structures. Results: In a case of AC following percutaneous transhepatic gallbladder drainage (PTGBD), we applied both ICG fluorescence and YE mode. The ICG injected from PTGBD illuminated the GB surface in green, while YE mode highlighted the fatty tissue in a clearer yellow, facilitating the distinction between these two tissues and the accurate dissection along the SS-inner. An additional advantage of injecting ICG from PTGBD, or from the cannulation tube intraoperatively inserted to GB, over intravenous administration is that the GB surface can be illuminated in cases of GB stone incarceration. Conclusion: The combination of ICG fluorescence and YE mode encourages surgeons to identify the boundary between the GB surface and the surrounding fatty tissues, which assists the accurate dissection along the SS-inner.
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Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation

Uemura S., Hasegawa Y., Obara H., Kitago M., Yagi H., Abe Y., Hori S., Tanaka M., Nakano Y., Kitagawa Y.

Livers 5 （ 2 ） 2025年06月

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Background: De novo malignancies (DNMs) after liver transplantation (LT) are a major cause of long-term mortality. However, no definitive screening protocol has been established due to their diversity. This study aimed to evaluate DNM diagnosis methods, screening protocols, and prognoses. Methods: This retrospective study included 231 adult LT recipients from April 1997 to March 2021. Disease-specific survival (DSS) was analyzed to assess the impact of screening on prognosis. Most recipients underwent serum tests every three months, annual gastrointestinal endoscopy, and chest-abdominal CT as part of routine surveillance. Results: Twenty-five DNMs were diagnosed in 22 patients, with median age of 61 years (range, 23–72), of whom 13 (59.1%) were female. The duration from transplantation to DNM diagnosis of DNM was 88 months (range, 4–195). DNM was diagnosed as follows: seven patients (31.8%) through screening (screening group) and 15 patients (68.2%) by other means (non-screening group). Curative treatment was achieved in all of the patients diagnosed by screening, whereas it was possible in only 60.0% of patients diagnosed by other means (p = 0.026). DSS in the screening group was significantly longer than that in the non-screening group (p = 0.024). Conclusions: While screening was associated with earlier-stage diagnosis and improved outcomes in some patients, the overall efficacy of the protocol requires further validation in larger studies.
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A case of hepatic epithelioid hemangioendothelioma with features resembling those of acute-onset autoimmune hepatitis that was undiagnosed before liver transplantation

Usui S., Chu P.S., Hirano M., Hasegawa Y., Ueno A., Nomura R., Obara H., Kitagawa Y., Kanai T., Nakamoto N.

Clinical Journal of Gastroenterology 18 （ 3 ） 514 - 519 2025年06月

ISSN 18657257

　概要を見る

Hepatic epithelioid hemangioendothelioma (HEHE), which is extremely rare, is considered to have a malignant grade between that of hepatic hemangioma and that of hepatic hemangiosarcoma; however, some cases progress so quickly that they present with portal hypertension. We report the case of a woman with findings similar to those of acute-onset autoimmune hepatitis (AIH) that was not diagnosed before liver transplantation. The patient presented with jaundice and ascites. A hematological examination revealed negative tumor markers, high IgG levels, and negative hepatitis virus markers. Computed tomography findings of the liver showed map-like signs characteristic of acute-onset AIH. Despite some response, immunosuppressive drugs such as prednisolone, cyclosporine, and mycophenolate mofetil did not improve liver failure, and she underwent liver transplantation after 200 days of treatment. The explanted liver exhibited white areas that extended in a map-like manner and were occupied by fibrous stroma. Tumors with WWTR1-CAMTA1 gene fusion were recognized and diagnosed as HEHE. Although a histological examination is essential, a percutaneous liver biopsy could not be performed preoperatively because of the presence of ascites. Furthermore, the rarity of the disease, similarity of imaging findings with non-neoplastic patterns, and serological findings made it difficult to differentiate this case from acute-onset autoimmune hepatitis.
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Chronological changes in etiology, pathological and imaging findings in primary liver cancer from 2001 to 2020

Tsuzaki J., Ueno A., Masugi Y., Tamura M., Yamazaki S., Matsuda K., Kurebayashi Y., Sakai H., Yokoyama Y., Abe Y., Hayashi K., Hasegawa Y., Yagi H., Kitago M., Jinzaki M., Sakamoto M.

Japanese Journal of Clinical Oncology 55 （ 4 ） 362 - 371 2025年04月

ISSN 03682811

　概要を見る

Purpose: To achieve a historical perspective, the chronological changes in primary liver cancer over a 20-year period were investigated at a single institution, focusing on shifts in etiology and the impact on imaging and pathological findings using The Liver Imaging Reporting and Data System. Materials and methods: A retrospective study of surgically resected primary liver cancer in 680 patients from 2001 to 2020 resulted in 434 patients with 482 nodules being analyzed. Dynamic contrast-enhanced computed tomography imaging and the Liver Imaging Reporting and Data System 2018 classification were employed. Two pathologists and two radiologists independently evaluated specimens and images. Results: This study highlighted a significant decline in cases of viral hepatitis and cirrhosis in primary liver cancer patients but an increase in intrahepatic cholangiocarcinoma and scirrhous hepatocellular carcinoma. Notably, there was a rise in non-viral hepatitis cases, potentially pointing toward an increase in steatohepatitic hepatocellular carcinoma cases in the future. Intrahepatic cholangiocarcinoma, scirrhous hepatocellular carcinoma and steatohepatitic hepatocellular carcinoma tumors exhibited slightly different distributions in the Liver Imaging Reporting and Data System classification compared with ordinary hepatocellular carcinoma, which may reflect the presence of fibrosis and lipid in tumor parenchyma. Conclusions: Consistent with past reports, this study demonstrated the emergence of primary liver cancer against a backdrop of non-viral and non-cirrhotic liver. Liver Imaging Reporting and Data System has been consistently useful in diagnosing primary liver cancer; however, among the histological subtypes of hepatocellular carcinoma, an increase is anticipated in scirrhous hepatocellular carcinoma and steatohepatitic hepatocellular carcinoma, which may present imaging findings different from those of ordinary hepatocellular carcinoma. This development may necessitate a reevaluation of the current approach for diagnosing and treating hepatocellular carcinoma based solely on imaging.
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Corrigendum to ‘A novel scoring system to predict short-term mortality after living donor liver transplantation for acute liver failure’ [American Journal of Transplantation 24 (2024): 1857–1867, (S1600613524002880), (10.1016/j.ajt.2024.04.016)]

Shimata K., Yoon Y.I., Hibi T., Morinaga J., Narayanan A.K., Toshima T., Ito T., Akamatsu N., Kotera Y., Hong S.K., Hasegawa Y., Umeda Y., Reddy M.S., Ong A.D.L., Sivaprasadan S., Varghese J., Sugawara Y., Chen C.L., Nakayama N., Mochida S., Tanaka A., Suh K.S., Ikegami T., Lee K.W., Lee S.G.

American Journal of Transplantation 24 （ 11 ） 2139 - 2140 2024年11月

ISSN 16006135

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The authors regret that the original corrected proofs contained incomplete authorship and funding information. Authors Nobuaki Nakayama, Satoshi Mochida, and Atsushi Tanaka were inadvertently missed from the author list and have now been added. The Authors have also made correction to Section 2.1. Study design and Table 4, as well as the Acknowledgments and Funding sections of the article. The online article has been updated accordingly. The authors would like to apologise for any inconvenience caused.
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Early Dynamics of MELD Scores Predict Corticosteroid Responsiveness to Severe Acute-Onset Autoimmune Hepatitis

Noguchi F., Chu P.s., Yoshida A., Taniki N., Morikawa R., Hasegawa Y., Yamataka K., Hoshi H., Kasuga R., Tabuchi T., Ebinuma H., Shinoda M., Obara H., Kitagawa Y., Kanai T., Nakamoto N.

Clinical Gastroenterology and Hepatology （Clinical Gastroenterology and Hepatology） 20 （ 11 ） 2641 - 2643.e3 2022年11月

ISSN 15423565
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