臨床グループは、上部消化管、下部消化管、消化器腫瘍、肝臓、胆膵、消化器内視鏡と6つの班に分かれて外来・病棟業務、臨床研究に取り組んでいます。いずれの臨床グループにも経験豊富な専門医が多数そろっており、症例も多岐にわたります。病棟業務は専門スタッフ、卒後5-7年目消化器内科医師、後期および初期研修医、医学生で屋根瓦のチームをつくり患者さんの診療にあたっています。
胆・膵班
特徴
膵・胆道疾患の診療は、肝胆膵クラスターとして各診療科(消化器内科、消化器外科、放射線診断科、病理診断部、腫瘍センター、内視鏡センター)と共同で行っています。 合同カンファレンスも定期的に開催され、そのため単独の診療科ではあまり経験されないような希少疾患からCommon Diseaseまで、幅広い疾患を対象としていることが特徴です。 ERCPやEUSを用いた内視鏡的検査・治療手技も数多く経験することができます。
対象疾患
腫瘍性疾患
膵癌、嚢胞性腫瘍(IPMN、MCN、SPN、SCNなど)、胆嚢癌、胆管癌、胆管細胞癌、十二指腸乳頭部腫瘍など
良性疾患
胆石、総胆管結石、胆嚢炎・胆管炎、慢性膵炎、急性膵炎、自己免疫性膵炎、原発性硬化性胆管炎など
胆膵班の教育
当科では消化器内科に帰室後に専門分野の配属を決定します。稀な疾患や難易度の高い内視鏡治療、緊急内視鏡時の対応まで幅広く学ぶことができます。
経験のある上級医の手技を見学し十分なトレーニングを積みながら、段階的に胆膵内視鏡や超音波内視鏡検査、処置などの技術を身に付けます。丁寧な指導を心がけており、研修者の技術に合わせて内視鏡の指導をおこなっています。
基礎研究
基礎研究については、時代の先端を担う魅力的なテーマに取り組んでいます。胆膵班の大学院生を選択された先生は胆膵疾患に関わる疾患を対象として、消化器内科基礎研究グループに所属して研究に邁進しています。
基礎研究の中心は慶應義塾大学医学部坂口記念オルガノイド医学研究室HPにおいて膵再生、膵腫瘍の個別化医療の基礎研究をおこなっています。
臨床研究
また、胆膵班は臨床研究に最も力を入れています。臨床研究をメインとした臨床系大学院(4年間)に入学していただき、基礎的な疫学・統計学の勉強から開始します。 関連病院との豊富なネットワークを活かした多施設共同研究も可能であり、研究の基盤は整っています。 消化器内科医としての臨床経験、胆膵内視鏡のスキルアップを図りながら、同時に一生応用することが可能な臨床研究の力を身に着けたい先生はぜひ入学を検討してください。 最近の業績は以下に示します。
研究業績
1.
|
IgG4-related disease in the Japanese population: a genome-wide association study
Chikashi Terao,
Prof Masao Ota,
Takeshi Iwasaki,
Masahiro Shiokawa,
Shuji Kawaguchi,
Katsutoshi Kuriyama,
Takahisa Kawaguchi,
Yuzo Kodama,
Izumi Yamaguchi,
Kazushige Uchida,
Koichiro Higasa,
Motohisa Yamamoto,
Prof Kensuke Kubota,
Shujiro Yazumi,
Kenji Hirano,
Prof Yasufumi Masaki,
Hiroyuki Maguchi,
Tomoki Origuchi,
Prof Shoko Matsui,
Takahiro Nakazawa,
Hideyuki Shiomi,
Terumi Kamisawa,
Osamu Hasebe,
Eisuke Iwasaki,
Prof Kazuo Inui,
et al.
. The Lancet Rheumatology, 1,E14-22 2020
|
2.
|
The Horibe GI bleeding prediction score: a simple
score for triage decision-making in patients with
suspected upper GI bleeding.
Horibe M, Iwasaki E, Bazerbachi F, Kaneko T,
Matsuzaki J, Minami K, Masaoka T, Hosoe N, Ogura Y,
Namiki S, Hosoda Y, Ogata H, Chan AT, Kanai
T.Gastrointest Endosc. 2020 Mar
30:S0016-5107(20)34124-9. doi:
10.1016/j.gie.2020.03.3846. Online ahead of
print.PMID: 32240682 |
3.
|
Etiology and mortality in severe acute
pancreatitis: A multicenter study in Japan.
Yasuda H, Horibe M, Sanui M, Sasaki M, Suzuki N,
Sawano H, Goto T, Ikeura T, Takeda T, Oda T, Ogura
Y, Miyazaki D, Kitamura K, Chiba N, Ozaki T,
Yamashita T, Koinuma T, Oshima T, Yamamoto T,
Hirota M, Sato M, Miyamoto K, Mine T, Misumi T,
Takeda Y, Iwasaki E, Kanai T, Mayumi
T.Pancreatology. 2020 Apr;20(3):307-317. doi:
10.1016/j.pan.2020.03.001. Epub 2020 Mar 6.PMID:
32198057 |
4.
|
Efficacy and safety of immediate oral intake in
patients with mild acute pancreatitis: A randomized
controlled trial.
Horibe M, Iwasaki E, Nakagawa A, Matsuzaki J,
Minami K, Machida Y, Tamagawa H, Takimoto Y, Ueda
M, Katayama T, Kawasaki S, Matsushita M, Seino T,
Fukuhara S, Kanai T.Nutrition. 2020 Jan
15;74:110724. doi: 10.1016/j.nut.2020.110724.
Online ahead of print.PMID: 32200266
|
5.
|
A long (7 cm) prophylactic pancreatic stent
decreases incidence of post-endoscopic papillectomy
pancreatitis: a retrospective study.
Minami K, Iwasaki E, Kawasaki S, Fukuhara S, Seino
T, Katayama T, Takimoto Y, Tamagawa H, Machida Y,
Horibe M, Kitago M, Ogata H, Kanai T.Endosc Int
Open. 2019 Dec;7(12):E1663-E1670. doi:
10.1055/a-1010-5581. Epub 2019 Nov 25.PMID:
31788550Free PMC article.
|
6.
|
Continuous regional arterial infusion versus
intravenous administration of the protease
inhibitor nafamostat mesilate for predicted severe
acute pancreatitis: a multicenter, randomized,
open-label, phase 2 trial.
Hirota M, Shimosegawa T, Kitamura K, Takeda K,
Takeyama Y, Mayumi T, Ito T, Takenaka M, Iwasaki E,
Sawano H, Ishida E, Miura S, Masamune A, Nakai Y,
Mitoro A, Maguchi H, Kimura K, Sanuki T, Ito T,
Haradome H, Kozaka K, Gabata T, Kataoka K, Hirota
M, Isaji S, Nakamura R, Yamagiwa K, Kayaba C, Ikeda
K.J Gastroenterol. 2020 Mar;55(3):342-352. doi:
10.1007/s00535-019-01644-z. Epub 2019 Nov 22.PMID:
31758329Free PMC article.
|
7.
|
Transient hypotension during endoscopic resection
of gangliocytic paraganglioma with ampullary
involvement.
Katayama T, Iwasaki E, Minami K, Fukuhara S, Kanai
T.VideoGIE. 2019 Oct 25;5(1):26-28. doi:
10.1016/j.vgie.2019.09.007. eCollection 2020
Jan.PMID: 31922078Free PMC article.No abstract
available.
|
8.
|
Impact of electrical pulse cut mode during
endoscopic papillectomy: Pilot randomized clinical
trial.
Iwasaki E, Minami K, Itoi T, Yamamoto K, Tsuji S,
Sofuni A, Tsuchiya T, Tanaka R, Tonozuka R, Machida
Y, Takimoto Y, Tamagawa H, Katayama T, Kawasaki S,
Seino T, Horibe M, Fukuhara S, Kitago M, Ogata H,
Kanai T.Dig Endosc. 2020 Jan;32(1):127-135. doi:
10.1111/den.13468. Epub 2019 Oct 3.PMID: 31222794
|
9.
|
Management of perforation related to endoscopic
submucosal dissection for superficial duodenal
epithelial tumors.
Fukuhara S, Kato M, Iwasaki E, Sasaki M, Tsutsumi
K, Kiguchi Y, Akimoto T, Takatori Y, Nakayama A,
Maehata T, Minami K, Ogata H, Kanai T, Yahagi
N.Gastrointest Endosc. 2020 May;91(5):1129-1137.
doi: 10.1016/j.gie.2019.09.024. Epub 2019 Sep
26.PMID: 31563595
|
10.
|
The Effect of an Invasive Strategy for Treating
Pancreatic Necrosis on Mortality: a Retrospective
Multicenter Cohort Study.
Minami K, Horibe M, Sanui M, Sasaki M, Iwasaki E,
Sawano H, Goto T, Ikeura T, Takeda T, Oda T, Yasuda
H, Ogura Y, Miyazaki D, Kitamura K, Chiba N, Ozaki
T, Yamashita T, Koinuma T, Oshima T, Yamamoto T,
Hirota M, Tokuhira N, Azumi Y, Nagata K, Takeda K,
Furuya T, Lefor AK, Mayumi T, Kanai T.J
Gastrointest Surg. 2019 Aug 19. doi:
10.1007/s11605-019-04333-7. Online ahead of
print.PMID: 31428962
|
11.
|
Electric Endocut and Autocut Resection for
Endoscopic Papillectomy: A Systematic Review.
Minami K, Iwasaki E, Fukuhara S, Horibe M, Seino T,
Kawasaki S, Katayama T, Takimoto Y, Tamagawa H,
Machida Y, Kanai T, Itoi T.Intern Med. 2019 Oct
1;58(19):2767-2772. doi:
10.2169/internalmedicine.2720-
|
12.
|
Large Volume Fluid Resuscitation for Severe Acute
Pancreatitis is Associated With Reduced Mortality:
A Multicenter Retrospective Study.
Yamashita T, Horibe M, Sanui M, Sasaki M, Sawano H,
Goto T, Ikeura T, Hamada T, Oda T, Yasuda H, Ogura
Y, Miyazaki D, Hirose K, Kitamura K, Chiba N, Ozaki
T, Koinuma T, Oshima T, Yamamoto T, Hirota M,
Masuda Y, Tokuhira N, Kobayashi M, Saito S, Izai J,
Lefor AK, Iwasaki E, Kanai T, Mayumi T.J Clin
Gastroenterol. 2019 May/Jun;53(5):385-391. doi:
10.1097/MCG.0000000000001046.PMID: 29688917
|
13.
|
Impact of Antimicrobial Prophylaxis for Severe
Acute Pancreatitis on the Development of Invasive
Candidiasis: A Large Retrospective Multicenter
Cohort Study.
Horibe M, Sanui M, Sasaki M, Honda H, Ogura Y,
Namiki S, Sawano H, Goto T, Ikeura T, Takeda T, Oda
T, Yasuda H, Miyazaki D, Hirose K, Kitamura K,
Chiba N, Ozaki T, Yamashita T, Koinuma T, Oshima T,
Yamamoto T, Hirota M, Yamamoto S, Oe K, Ito T,
Masuda Y, Saito N, Iwasaki E, Kanai T, Mayumi
T.Pancreas. 2019 Apr;48(4):537-543. doi:
10.1097/MPA.0000000000001269.PMID: 30946245Clinical
Trial.
|
14.
|
Novel mainstream capnometer system is safe and
feasible even under CO2 insufflation
during ERCP-related procedure: a pilot study.
Takimoto Y, Iwasaki E, Masaoka T, Fukuhara S,
Kawasaki S, Seino T, Katayama T, Minami K, Tamagawa
H, Machida Y, Ogata H, Kanai T.BMJ Open
Gastroenterol. 2019 Feb 28;6(1):e000266. doi:
10.1136/bmjgast-2018-000266. eCollection 2019.PMID:
30899539Free PMC article.
|
15.
|
Risk Factors for Pancreatic Stone Formation in Type
1 Autoimmune Pancreatitis: A Long-term Japanese
Multicenter Analysis of 624 Patients.
Ito T, Kawa S, Matsumoto A, Kubota K, Kamisawa T,
Okazaki K, Hirano K, Hirooka Y, Uchida K, Masuda A,
Ohara H, Shimizu K, Arakura N, Masamune A, Kanno A,
Sakagami J, Itoi T, Ito T, Ueki T, Nishino T, Inui
K, Mizuno N, Yoshida H, Sugiyama M, Iwasaki E,
Irisawa A, Shimosegawa T, Chiba T.Pancreas. 2019
Jan;48(1):49-54. doi:
10.1097/MPA.0000000000001210.PMID: 30540679Clinical
Trial.
|
16.
|
Successful EUS-guided antegrade stenting for
malignant severe biliary obstruction combined with
a newly developed plastic stent.
Minami K, Iwasaki E, Itoi T, Fukuhara S, Horibe M,
Seino T, Kawasaki S, Katayama T, Takimoto Y,
Tamagawa H, Machida Y, Hamamoto Y, Ogata H, Kanai
T.Endosc Int Open. 2018 Nov;6(11):E1336-E1339. doi:
10.1055/a-0719-4861. Epub 2018 Nov 7.PMID:
30410954Free PMC article.
|
17.
|
IgG4-related mastopathy: A case report and
literature review.
Yokoe T, Hayashida T, Kikuchi M, Watanuki R,
Nakashoji A, Maeda H, Toyota T, Seki T, Takahashi
M, Iwasaki E, Mikami S, Kameyama K, Kitagawa Y.Clin
Case Rep. 2018 Jun 22;6(8):1549-1553. doi:
10.1002/ccr3.1657. eCollection 2018 Aug.PMID:
30147902Free PMC article.
|
18.
|
Absence of high-risk stigmata predicts good
prognosis even in severely anemic patients with
suspected acute upper gastrointestinal bleeding.
Horibe M, Ogura Y, Matsuzaki J, Kaneko T, Yokota T,
Okawa O, Nakatani Y, Iwasaki E, Nishizawa T, Hosoe
N, Masaoka T, Yahagi N, Namiki S, Kanai T.United
European Gastroenterol J. 2018 Jun;6(5):684-690.
doi: 10.1177/2050640618764161. Epub 2018 Apr
10.PMID: 30083330Free PMC article.
|
19.
|
Clinical course of type 1 autoimmune pancreatitis
patients without steroid treatment: a Japanese
multicenter study of 97 patients.
Kubota K, Kamisawa T, Hirano K, Hirooka Y, Uchida
K, Ikeura T, Shiomi H, Ohara H, Shimizu K, Arakura
N, Kanno A, Sakagami J, Itoi T, Ito T, Ueki T,
Nishino T, Inui K, Mizuno N, Yoshida H, Sugiyama M,
Iwasaki E, Irisawa A, Okazaki K, Kawa S,
Shimosegawa T, Takeyama Y, Chiba T.J Hepatobiliary
Pancreat Sci. 2018 Apr;25(4):223-230. doi:
10.1002/jhbp.541. Epub 2018 Mar 23.PMID:
29430861Clinical Trial.
|
20.
|
Human Pancreatic Tumor Organoids Reveal Loss of
Stem Cell Niche Factor Dependence during Disease
Progression.
Seino T, Kawasaki S, Shimokawa M, Tamagawa H,
Toshimitsu K, Fujii M, Ohta Y, Matano M, Nanki K,
Kawasaki K, Takahashi S, Sugimoto S, Iwasaki E,
Takagi J, Itoi T, Kitago M, Kitagawa Y, Kanai T,
Sato T.Cell Stem Cell. 2018 Mar 1;22(3):454-467.e6.
doi: 10.1016/j.stem.2017.12.009. Epub 2018 Jan
11.PMID: 29337182
|
21.
|
Successful EUS-guided nondilated pancreatic duct
stent placement in patient with refractory
pancreatic fistula after pancreaticoduodenectomy.
Minami K, Iwasaki E, Itoi T, Hibi T, Kanai
T.VideoGIE. 2017 Oct 12;2(11):315-316. doi:
10.1016/j.vgie.2017.07.012. eCollection 2017
Nov.PMID: 30027134Free PMC article.No abstract
available.
|
22.
|
The Prognosis of Severe Acute Pancreatitis Varies
According to the Segment Presenting With Low
Enhanced Pancreatic Parenchyma on Early
Contrast-Enhanced Computed Tomography: A
Multicenter Cohort Study.
Kitamura K, Horibe M, Sanui M, Sasaki M, Yamamiya
A, Ishii Y, Yoshida H, Sawano H, Goto T, Ikeura T,
Hamada T, Oda T, Yasuda H, Ogura Y, Miyazaki D,
Hirose K, Chiba N, Ozaki T, Yamashita T, Koinuma T,
Oshima T, Yamamoto T, Hirota M, Azumi Y, Nagata K,
Saito N, Sato M, Miyamoto K, Iwasaki E, Kanai T,
Mayumi T.Pancreas. 2017 Aug;46(7):867-873. doi:
10.1097/MPA.0000000000000851.PMID: 28697125Clinical
Trial.
|
23.
|
Continuous Regional Arterial Infusion of Protease
Inhibitors Has No Efficacy in the Treatment of
Severe Acute Pancreatitis: A Retrospective
Multicenter Cohort Study.
Horibe M, Sasaki M, Sanui M, Sugiyama D, Iwasaki E,
Yamagishi Y, Sawano H, Goto T, Ikeura T, Hamada T,
Oda T, Yasuda H, Shinomiya W, Miyazaki D, Hirose K,
Kitamura K, Chiba N, Ozaki T, Yamashita T, Koinuma
T, Oshima T, Yamamoto T, Hirota M, Moriya T, Shirai
K, Mayumi T, Kanai T.Pancreas. 2017
Apr;46(4):510-517. doi:
10.1097/MPA.0000000000000775.PMID: 27977624Free PMC
article.Clinical Trial.
|
24.
|
Plasmapheresis therapy has no triglyceride-lowering
effect in patients with hypertriglyceridemic
pancreatitis.
Miyamoto K, Horibe M, Sanui M, Sasaki M, Sugiyama
D, Kato S, Yamashita T, Goto T, Iwasaki E, Shirai
K, Oe K, Sawano H, Oda T, Yasuda H, Ogura Y, Hirose
K, Kitamura K, Chiba N, Ozaki T, Oshima T, Yamamoto
T, Nagata K, Mine T, Saito K, Sekino M, Furuya T,
Matsuda N, Hayakawa M, Kanai T, Mayumi T.Intensive
Care Med. 2017 Jun;43(6):949-951. doi:
10.1007/s00134-017-4722-3. Epub 2017 Feb 23.PMID:
28233051Clinical Trial.No abstract available.
|
25.
|
Low-dose maintenance steroid treatment could reduce
the relapse rate in patients with type 1 autoimmune
pancreatitis: a long-term Japanese multicenter
analysis of 510 patients.
Kubota K, Kamisawa T, Okazaki K, Kawa S, Hirano K,
Hirooka Y, Uchida K, Shiomi H, Ohara H, Shimizu K,
Arakura N, Kanno A, Sakagami J, Itoi T, Ito T, Ueki
T, Nishino T, Inui K, Mizuno N, Yoshida H, Sugiyama
M, Iwasaki E, Irisawa A, Shimosegawa T, Takeyama Y,
Chiba T.J Gastroenterol. 2017 Aug;52(8):955-964.
doi: 10.1007/s00535-016-1302-1. Epub 2017 Jan
6.PMID: 28062947Clinical Trial.
|
26.
|
The First Case Report of Acute Cholangitis and
Bacteremia Due to Neisseria subflava.
Uwamino Y, Sugita K, Iwasaki E, Fujiwara H,
Nishimura T, Hasegawa N, Iwata S.Intern Med.
2017;56(2):221-223. doi:
10.2169/internalmedicine.56.
|
27.
|
Metal stent for refractory post-ES bleeding: Is
this the ultimate treatment modality?
Iwasaki E, Itoi T, Kanai T.Endosc Int Open. 2016
Dec;4(12):E1265-E1266. doi: 10.1055/s-0042-117633.
Epub 2016 Nov 24.PMID: 27995187
|
28.
|
Validation of the efficacy of the prognostic factor
score in the Japanese severity criteria for severe
acute pancreatitis: A large multicenter study.
Ikeura T, Horibe M, Sanui M, Sasaki M, Kuwagata Y,
Nishi K, Kariya S, Sawano H, Goto T, Hamada T, Oda
T, Yasuda H, Ogura Y, Miyazaki D, Hirose K,
Kitamura K, Chiba N, Ozaki T, Yamashita T, Koinuma
T, Oshima T, Yamamoto T, Hirota M, Yamamoto S, Oe
K, Ito T, Iwasaki E, Kanai T, Okazaki K, Mayumi
T.United European Gastroenterol J. 2017
Apr;5(3):389-397. doi: 10.1177/2050640616670566.
Epub 2016 Sep 27.PMID: 28507751
|
29.
|
A simple scoring system to assess the need for an
endoscopic intervention in suspected upper
gastrointestinal bleeding: A prospective cohort
study.
Horibe M, Kaneko T, Yokogawa N, Yokota T, Okawa O,
Nakatani Y, Ogura Y, Matsuzaki J, Iwasaki E, Hosoe
N, Masaoka T, Inadomi JM, Suzuki H, Kanai T, Namiki
S.Dig Liver Dis. 2016 Oct;48(10):1180-6. doi:
10.1016/j.dld.2016.07.009. Epub 2016 Jul 18.PMID:
27507771
|
30.
|
Profile of acotiamide in the treatment of
functional dyspepsia.
Ueda M, Iwasaki E, Suzuki H.Clin Exp Gastroenterol.
2016 Apr 6;9:83-8. doi: 10.2147/CEG.S72172.
eCollection 2016.PMID: 27103837
|
31.
|
Successful Pancreatic Duct Stent Placement for
Recurrent Pancreatitis in a Patient with
Polysplenia with Agenesis of the Dorsal Pancreas
and Peutz-Jeghers Syndrome.
Kawasaki S, Itoi T, Iwasaki E, Hosoe N, Ogata H,
Kanai T.Intern Med. 2016;55(13):1743-6. doi:
10.2169/internalmedicine.55.6128. Epub 2016 Jul 1.
PMID: 27374675
|
32.
|
Timing of oral refeeding in acute pancreatitis: A
systematic review and meta-analysis.
Horibe M, Nishizawa T, Suzuki H, Minami K, Yahagi
N, Iwasaki E, Kanai T.United European Gastroenterol
J. 2016 Dec;4(6):725-732. doi:
10.1177/2050640615612368. Epub 2015 Oct 13.PMID:
28408989
|
33.
|
Safety and efficacy of ultra-tapered mechanical
dilator for EUS-guided hepaticogastrostomy and
pancreatic duct drainage compared with
electrocautery dilator (with video).
Honjo M, Itoi T, Tsuchiya T, Tanaka R, Tonozuka R,
Mukai S, Sofuni A, Nagakawa Y, Iwasaki E, Kanai
T.Endosc Ultrasound. 2018 Nov-Dec;7(6):376-382.
doi: 10.4103/eus.eus_2_18.PMID: 29882518
|
34.
|
Insights and updates on endoscopic papillectomy.
Yamamoto K, Iwasaki E, Itoi T.Expert Rev
Gastroenterol Hepatol. 2020 May 7. doi:
10.1080/17474124.2020.1766965. Online ahead of
print.PMID: 32380873 |