|ikegami Toru||Last modified date：2019.08.08|
Lecturer / Graduate school of medical science / Liver Surgery / Kyushu University Hospital
|ikegami Toru||Last modified date：2019.08.08|
|1.||Ikegami T, Yoshizumi T, Uchiyama H, Harimoto N, Harada N, Itoh S, Motomura T, Nagatsu A, Soejima Y, Maehara Y:, The ways to perform successful living donor liver transplantation using left lobe grafts in adults., The 2017 joint international congress of ILTS, ELITA & LICAGE, 2017.05.|
|2.||29. Ikegami T, Yoshizumi T, Soejima Y, Maehara Y, Left lobe with caudate lobe LDLT graft procurement by the (open) upper midline incision, International living donor liver transplantation study group 2017, 2017.10.|
|3.||Ikegami T, Yoshizumi T, Soejima Y, Maehara Y., Intraoperative decision-making for Inflow modulation and available options, 8th Annual Congress of the Korean Association of HBP Surgery, 2018.03.|
|4.||ikegami Toru, Living Related Transplant: State of the Field
, American Collage of Surgeons Clinical Congress2016, 2016.10, LDLT is a potent treatment strategy for HCCs, under the revised Kyushu criteria, especially for JIS 2-4 patients.
Possible surgical resection is the only way to have long-term survival for those with recurrent HCC after LDLT.
|5.||ikegami Toru, How to Divide Bile Duct in LDLT Donor - Japanese (Kyushu) Style -, ILTS 22nd annual international congress May 4-7, 2016, 2016.04, 1. Objective pre- and intra-operative imaging studies
to divide the bile duct at the most appropriate line.
Reasonable Glissonean approach followed by
the subtraction method to preserve bile duct blood flow.
|6.||ikegami Toru, Left lobe LDLT is a choice in adult-to-adult LDLT
, ILTS 22nd annual international congress, 2016.04, LL donation keeps larger volume in donors than RL donation, preventing donor hepatic failure.
There are many technical points to have acceptable outcomes in adult-to-adult LL- LDLT.
Even in adult-to-adult LDLT, LL graft should be the choice if expected GV/SLV>35%, donor age <48 y and MELD score <19.
|7.||ikegami Toru, Surgical techniques in left lobe LDLT in adults
, Expert Meeting in Liver 2016, 2016.03, Left lobe graft procurement under midline incision is a feasible technique with several technical pitfalls.
The accumulation of experience and technical developments including wide veno-caval anastomosis and splenectomy have improved the outcomes of left lobe LDLT.
|8.||Toru Ikegami, Various Types of Donor Resection in Japan, The Liver Week 2015, 2015.09.|
|9.||Toru Ikegami, Optimal volumetric assessment of liver volume
, LDLT Study Group 2015, 2015.11.
|10.||ikegami Toru, Left Liver How It Works, 7th International Conference: Living Donor Abdominal Organ Transplantation State of the Art.|
|11.||池上 徹, Strategies and techniques in successful left lobe living donor liver transplantation in adults, 2014.04, (Introduction) The aim of this study was to evaluate the impact of progressive refinements in left-lobe living donor liver transplantation (LDLT).
(Methods) The consecutive 411 LDLT cases in adults were reviewed.
(Results) Among the 411 cases, the number of left lobe, right lobe and posterior segment grafts were 255 (62.0%), 149 (36.3%), and 7 (1.7%) and the cumulative 5-year graft survival rate of 80.3%, 81.7% and 57.1%, respectively. The left lobe donors had significantly decreased peak total bilirubin (2.1 mg/dl vs. 2.9 mg/dl, p<0.01) than right lobe donors. Next, the left lobe LDLTs (n=255) were divided into two groups, including Era-I (the former 127 cases) and Era-II (the latter 128 cases). During the Era-I, surgical strategies for left lobe LDLT were developed and established; full left lobe procurement including caudate lobe, graft venoplasty and veno-caval anastomosis, splenectomy and shunt ligation. Graft volume did not affect the incidence of graft function or survival. Era-II had decreased portal venous pressure at closure (16.0 mmHg vs. 19.1 mmHg, p<0.01), increased portal venous flow/ graft volume (301 ml/min/100g vs.391 ml/min/100g, p<0.01) and improved graft survival rate (1-year: 90.6% vs. 81.8%. p<0.01) despite the smaller graft volume/standard liver volume ratio (36.2 % vs. 41.2 %, p<0.01) compared with Era-I.
(Conclusions) The outcomes of left lobe LDLT were improved by accumulated experiences and technical developments including surgical normalization of portal hemodynamics.
|12.||ikegami Toru, Strategies for successful left-lobe living donor liver transplantation in adults, American Collage of Surgeons 99th Annual Clinical Congress .|
|13.||ikegami Toru, PRIMAY GRAFT DYSFUNCTION IN LIVING DONOR LIVER TRANSPLANTATION, 2013 European Society of Organ Transplantation (September 08- 13, Vienna, Austria).|
|14.||池上 徹, 吉住 朋晴, Minimal hilar dissection prevents biliary anastomotic stricture after living donor liver transplantation, 2012.09, Introduction: We introduced a new technique, called minimal hilar dissection (MinHD) technique in living donor liver transplantation (LDLT) to keep vascular networks around the recipient’s bile duct. The aim of this study is to investigate whether the MinHD technique could prevent BAS after LDLT with duct-to-duct biliary reconstruction.
Methods: An analysis of 214 adult-to-adult LDLT grafts (left lobe, n=135; right lobe, n=76; posterior segment, n=3) with duct-to-duct biliary reconstruction was performed.
Results: There were 46 cases with BAS. The incidence of BAS was 32.1% in the conventional technique group (n=84) and 14.6% in the MinHD technique group (n=130, p=0.003). Multivariate regression analysis regarding BAS was carried out and detected hepatic artery flow < 50 ml/min (p=0.002), not using the MinHD technique (p=0.011), biliary anastomotic leakage (BAL, p=0.027) and ductoplasty (p=0.039) for the significant risk factors for BAS. The incidence BAL was 11.9% in the conventional technique group and 0.7% in the MinHD technique group (p=0.002). No other factors showed an impact on the occurrence of BAL. The treatments for BAS were performed by endoscopic or percutaneous procedures. The cumulative completion rate of the treatment after developing BAS was 45.1% and 78.6% at 1- and 3-year, respectively. The median period for treating BAS was 10.8 months.
Conclusion: The MinHD technique is a rational surgical method and it has the potential for preventing BAS and BAL after duct-to duct biliary reconstruction in LDLT. .