{"created":"2023-07-27T07:00:38.205591+00:00","id":60636,"links":{},"metadata":{"_buckets":{"deposit":"98959243-ac8d-4bf4-956c-91400fd754df"},"_deposit":{"created_by":18,"id":"60636","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"60636"},"status":"published"},"_oai":{"id":"oai:kanazawa-u.repo.nii.ac.jp:00060636","sets":["2812:2813:2839"]},"author_link":["31980"],"item_9_biblio_info_8":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"1999-03-08","bibliographicIssueDateType":"Issued"},"bibliographicPageStart":"3p.","bibliographicVolumeNumber":"1992 – 1994","bibliographic_titles":[{"bibliographic_title":"平成6(1994)年度 科学研究費補助金 一般研究(C) 研究成果報告書概要"},{"bibliographic_title":"1994 Fiscal Year Final Research Report Summary","bibliographic_titleLang":"en"}]}]},"item_9_creator_33":{"attribute_name":"著者別表示","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{}],"nameIdentifiers":[{},{}]}]},"item_9_description_21":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"肝門部胆管癌および肝門部浸潤を有する進行胆襄癌に対する拡大肝門部切除術式を考案し、その臨床応用に向けての基礎的研究を行うことを目的とした。本術式は肝十二指腸間膜の全切除すなわち門脈、肝動脈、胆管の全切除と再建、肝門部肝の広範囲切除から構成されるが、切除再建手技の開発、習熟と術後に高率に発生する肝障害対策が大きな問題となる。初年度(平成4年度)には術後肝不全対策として部分的門脈動脈血化法の有用性について検討した。すなわち門脈大腿動脈間のウロキナーゼコーティングカテーテルを用いたチューブバイパス法を行ってその有用性を2週にわたり追跡し、肝門部の完全郭清を伴う肝動脈血流遮断に際して極めて有効であることを立証した。次年度(平成5年度)には肝門部郭清の構成要素である肝門部リンパ管及び神経の切離郭清が肝に及ぼす影響について4週にわたり検討した。その結果、肝内リンパ管の長期にわたる拡張と胆道系酵素の上昇、肝組織ENERGY CHARGEの低下が証明された。これらの結果は門脈及び肝動脈血流量の低下と密接に関係しており、肝門部肝切除に際してはより重篤な肝障害の発生に帰結する可能性が示唆された。最終年度(平成6年度)では肝門部肝切除に部分的門脈動脈血化法を加えたモデル作成を行うべく、門脈肝動脈シャント、小腸静脈小腸動脈シャントを作成し、それらにおける肝血流量、肝酸素受容動態、肝機能、肝組織ENERGY CHARGE、肝の組織学的変化について術後4週にわたり観察した。その結果、門脈肝動脈シャントでは門脈圧上昇に起因した肝機能障害を惹起するのに対し、小腸静脈小腸動脈シャントでは門脈圧上昇はみられず、肝動脈の遮断に対しても有効な酸素供給が維持され、肝機能もほぼ正常に保たれた。肝動脈の肝内分枝での再建は現在不安定な手技であり、門脈を介して肝血流の酸素化を図ることは術後肝障害を防止する上で有用であると結論した。","subitem_description_type":"Abstract"},{"subitem_description":"The purpose of this experimental study was the application to the clinical treatment for the patients with hepatic hilar carcinoma or advanced gallbladder cancer. Total hepatoduodenal ligamentectomy and extended resection of hepatic hilar region could bring the improvement of the curability. This procedure included the resection of the hepatic artery and the portal vein. However the incidence of postoperative hepatic failure was very high. In 1992, for preventing these postoperative hepatic failure, we designed the use of partial arterialization of the portal vein on the dearterialized in dog. We performed to examine the effect of the partial arterialization of the portal vein using a urokinase immobilized catheter. The catheter was used for 7 days after the operation to prevent hepatic failure caused by hepatoduodenal ligamentectomy. In 1993, we examined the influence of the ligation of the hepatic hilar lymph system and the resection of the hepatic hilar nerve. As the results, we proved the intrahepatic lymphangioectasis for a long time, the elevation of the serum biliary enzymes and the lowering of energy charge in liver. In 1994, we compared two experimental groups with intracorporial partial artetialization by portoarterial shunting for 14 days after operation. One group was the shunt between the portal vein and the hepatic artery. Another group was the shunt between the ileal vein and the ileal artery. Both groups were performed hepatic hilar dissetion and the ligation of the hepatic artery. In conclusion, the group of the shunt between the ileal vein and artery was better than the group of the shunt between the portal vein and the hepatic artery from the view point of the survival rate and the postoperative hepatic function. We concluded the partial arterialization of the portal vein in dearterialized liver was very useful methods for the prevention of postoperative hepatic failure and the shunt between the ileal vein and artery for the method of artetialization was better than the other methods.","subitem_description_type":"Abstract"}]},"item_9_description_22":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"研究課題/領域番号:04670769, 研究期間(年度):1992 – 1994","subitem_description_type":"Other"},{"subitem_description":"出典：研究課題「拡大肝門部全切除術式開発のための基礎的研究」課題番号04670769\n（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） \n（https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-04670769/046707691994kenkyu_seika_hokoku_gaiyo/）を加工して作成","subitem_description_type":"Other"}]},"item_9_description_5":{"attribute_name":"提供者所属","attribute_value_mlt":[{"subitem_description":"金沢大学医学部","subitem_description_type":"Other"}]},"item_9_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.24517/00066883","subitem_identifier_reg_type":"JaLC"}]},"item_9_relation_28":{"attribute_name":"関連URI","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"https://kaken.nii.ac.jp/search/?qm=30184948"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://kaken.nii.ac.jp/search/?qm=30184948","subitem_relation_type_select":"URI"}},{"subitem_relation_name":[{"subitem_relation_name_text":"https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-04670769/"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-04670769/","subitem_relation_type_select":"URI"}},{"subitem_relation_name":[{"subitem_relation_name_text":"https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-04670769/046707691994kenkyu_seika_hokoku_gaiyo/https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-04670769/046707691994kenkyu_seika_hokoku_gaiyo/"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-04670769/046707691994kenkyu_seika_hokoku_gaiyo/","subitem_relation_type_select":"URI"}}]},"item_9_version_type_25":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_ab4af688f83e57aa","subitem_version_type":"AM"}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-07-25"}],"displaytype":"detail","filename":"ME-PR-UENO-K-kaken 1999-3p.pdf","filesize":[{"value":"97.8 kB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"ME-PR-UENO-K-kaken 1999-3p.pdf","url":"https://kanazawa-u.repo.nii.ac.jp/record/60636/files/ME-PR-UENO-K-kaken 1999-3p.pdf"},"version_id":"8df71d3d-0344-473f-a0e3-223f3c947590"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"research report","resourceuri":"http://purl.org/coar/resource_type/c_18ws"}]},"item_title":"拡大肝門部全切除術式開発のための基礎的研究","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"拡大肝門部全切除術式開発のための基礎的研究"},{"subitem_title":"Experimental study of extended resection of hepatic hilar region for the patient with hepatic hilar carcinoma","subitem_title_language":"en"}]},"item_type_id":"9","owner":"18","path":["2839"],"pubdate":{"attribute_name":"公開日","attribute_value":"2022-07-25"},"publish_date":"2022-07-25","publish_status":"0","recid":"60636","relation_version_is_last":true,"title":["拡大肝門部全切除術式開発のための基礎的研究"],"weko_creator_id":"18","weko_shared_id":-1},"updated":"2023-07-27T12:36:09.587216+00:00"}