Kaoru Miyakawa

Ten-year long-term results after non-surgical management of hepatolithiasis, including cases with choledochoenterostomy.

Long‐term follow‐up of non‐surgical procedures for the management of hepatolithiasis has been reported, but risk factors for mortality have not been properly evaluated.

LONG-TERM OUTCOME OF ENDOSCOPIC PAPILLOTOMY FOR CHOLEDOCHOLITHIASIS WITH CHOLECYSTOLITHIASIS

Aim:  To assess long‐term outcome of endoscopic papillotomy alone without subsequent cholecystectomy in patients with choledocholithiasis and cholecystolithiasis.

Diagnostic value of magnetic resonance cholangiopancreatography for clinically suspicious spontaneous passage of bile duct stones.

Background and Aim:  We investigated the usefulness of magnetic resonance cholangiopancreatography (MRCP) and the need for endoscopic retrograde cholangiopancreatography (ERCP) in patients with clinically suspicious spontaneous passage of bile duct stones.

Overexpressed cyclo‐oxygenase‐2 in the background liver is associated with the clinical course of hepatitis C virus‐related cirrhosis patients after curative surgery for hepatocellular carcinoma

Background:  The probable role of cyclo‐oxygenase‐2 (COX‐2) in the development of hepatocellular carcinoma (HCC) in patients with chronic liver diseases has been accepted to be relevant. The purpose of the present study was to determine whether overexpressed COX‐2 in the background liver affects the clinical course of hepatitis C virus (HCV)‐related cirrhosis patients after curative surgery for HCC.

Long‐term prognosis of patients with endoscopically treated postoperative bile duct stricture and bile duct stricture due to chronic pancreatitis

Aim:  To compare the outcome of endoscopic therapy for postoperative benign bile duct stricture and benign bile duct stricture due to chronic pancreatitis, including long‐term prognosis.

Abstract 394: Close association between subsided inflammation and the development of histologically less malignant HCC in HCV-associated LC

Aim: We recently demonstrated that severe inflammation in the background cirrhotic tissue correlate with the development of histologically more malignant hepatocellular carcinoma (Edmondson III HCC) in HCV-associated liver cirrhosis (LC), and that histology activity index (HAI) was the only one significant contributor to the development of Edmondson III (Ed III) HCC in small nodular HCC. There is a possibility, in the contrary of this phenomenon, that subsided inflammation correlates with the development of histologically less malignant HCC (Ed I type HCC) and that long-term subsided inflammation correlates with the development of large Ed I HCC. We examined the possibility. Methods: Curative hepatic resection for HCC with LC was performed in 264 patients during the past 10 years in Kanagawa Cancer Center hospital. Of 264 patients 197 patients were anti-HCV-positive or HCV-RNA positive. Out of the 197 patients, 32 patients whose HCC revealed only one small HCC nodule (≤ 3 cm) were selected for this study. Furthermore, the cases whose HCC nodules were large (> 3 cm), but consisted of predominantly Ed I component, were also examined. For the evaluation of inflammation in the background LC, modified Knodell9s histology activity index (HAI) was used. (for the evaluation of pure inflammation, items of fibrosis was omitted); piece meal necrosis (1-4), intra lobular cellular degeneration and focal necrosis (1-4), portal cellular inflammation (1-4), were estimated by two well experienced pathologist. In each case, the HAI score was estimated in five field and average HAI score was calculated. All the sections of resected HCC tissue was examined pathologically in all patients for determining the grade of malignancy according to Edmondson Steiner9s classification; Ed I (well differentiated), Ed II (moderately diff.), Ed III (poorly diff.). Results: The average HAI score in 7 Ed I HCC patients was as low as 3.61 ± 0.70 (mean ± SD), and was significantly lower than that in 17 Ed III HCC patients (5.21 ± 1.15, P Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 394. doi:1538-7445.AM2012-394

Abstract 2712: Inflammation in the background cirrhotic tissue might accelerate the promotion in the HCC development from HCV-associated cirrhosis

Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL Aim: Hamada et al. succeeded in converting ER-1, a weakly tumorigenic cloned cell line of a rat mammary carcinoma, into a highly tumorigenic and metastatic cell line by interaction with host cell reactive to a foreign body (plastic plates). They attributed these phenomenon to the cytokines such as LL-6 derived from host reactive inflammatory cells crowded around the foreign body. It is possible that the same mechanism is involved in the development of human HCC, and that inflammation in the background cirrhotic tissue might accelerate the process of promotion. Methods: Curative hepatic resection for HCC with LC was performed in 223 patients during the past 8 years in Kanagawa Cancer Center hospital. Of 223 patients 182 patients were anti-HCV-positive or HCV-RNA positive without habitual alcohol intake. Out of 182 patients, 32 patents whose HCC revealed only one small HCC nodule of less than 3 centimeter in diameter were selected for this study. For the evaluation of inflammation in the background LC, modified Knodells histology activity index (HAI) was used. (for the evaluation of pure inflammation, items of fibrosis was omitted); piece meal necrosis (1-4), intra lobular cellular degeneration and focal necrosis (1-4), portal cellular inflammation (1-4), were estimated by two well experienced pathologist. In each case, the HAI score was estimated in five field and average HAI score was calculated. All the sections of resected HCC tissue was examined pathologically in all patients for determining the grade of malignancy according to Edmondson Steiners classification; Ed I (well differentiated), Ed II (moderately diff.), Ed III (poorly diff.) Results: The average HAI score in the non-cancerous cirrhotic portion in HCC patients with Ed III was 5.50 ± 0.98 (mean ± SD), and was significantly larger than that in HCC patients without Ed III (4.18 ± 0.70, p < 0.001). Furthermore, the occurence rate of HCC containing Ed III component in the HCC patients whose HAI score was more than 5.0 was as high as 88.9% (16 out of 18), and was highly significant as compared with those in HCC patients whose HAI score was less than 5.0% (3 out of 14, 21.4%, p < 0.005).Conclusions: It is suggested that inflammation in the surrounding non-cancerous cirrhotic tissue would accelerate the process of promotion in the HCC development. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2712. doi:10.1158/1538-7445.AM2011-2712

The successful use of peroral cholangioscopy for the diagnosis and treatment of the biliary tract lesions and giant bile duct stones in a 76-year-old man.

We encountered a case in whom peroral cholangioscopy was useful for the diagnosis and treatment of irregular biliary tract mucosa and giant bile duct stones. Peroral cholangioscopy seems to improve the diagnosis of biliary tract diseases and allow internal treatment. The proper diagnosis of biliary tract diseases may be further confirmed by the concomitant use of narrow band imaging and this endoscopic technology.