Yamagata University Hospital

Department

Surgery I

Introduction of the First Department of Surgery (Department of Gastroenterological, General, Breast and Thyroid Surgery)

We specialize in various surgical treatments for digestive organs, such as esophagus, stomach, small intestine, large intestine, liver, bile, and pancreas, and breast and thyroid glands.

The digestive organs, such as esophagus, stomach, small intestine, large intestine, liver, biliary, and pancreas, and breast and thyroid glands are treated at the Departments of Gastroenterology and General Surgery (first Department of Surgery), Yamagata University Hospital. Although all doctors have their specialized fields, they can examine the whole body to provide the best medical care in the field of surgery anytime.

Professors, associate professors, and all medical staff members participate in conferences held every morning for more than an hour at 8 o'clock to examine treatment policies in serious and preoperative and postoperative patients. In the conferences, they actively exchange their opinions beyond the boundaries of their specialized fields to determine the best treatment policies. Students also participate in the conferences to learn the importance of preoperative/postoperative management, as well as operations, in the field of surgery. The conferences have significantly reduced postoperative complications and facilitated treatments for complications. As a result, no surgical death has been reported for the past 20 years in more than 800 cases, including complicated surgeries, in the fields of hepatobiliary pancreatic surgery. We are proud of world-class medical examination and research achievements.

Specifically

  1. Pancreaticoduodenectomy combined with preoperative chemoradiotherapy for pancreatic cancer;
  2. Laparoscopic spleen-preserving distal pancreatectomy for benign pancreatic tumors (e.g., pancreatic ductal papillary mucinous tumor);
  3. Expanded hepatectomy combined with preoperative portal vein embolization for hepatoduodenal cholangiocarcinoma and gall bladder cancer;
  4. Laparoscopic cholecystectomy (single-hole method) for cholecystolithiasis;
  5. Multidisciplinary treatments (e.g., chemoradiotherapy) for nonresected cases of liver, biliary tract, and pancreatic cancers;
  6. Function-preserving surgeries, such as complete laparoscopic surgery (distal, proximal, and complete gastrectomy) and laparoscopy-assisted pylorus-preserving gastrectomy, for early gastric cancer;
  7. Multidisciplinary treatment for advanced gastric cancer (preoperative/postoperative chemotherapy and routine/expanded surgery);
  8. Laparoscopic (laparo-endoscopic) surgery for gastric submucosal tumors;
  9. Preoperative chemotherapy and thoracoscopic surgery for esophageal cancer and salvage surgery after chemoradiotherapy;
  10. Laparoscopic surgery for esophageal hiatal hernia and reflux esophagitis;
  11. Laparoscope-assisted colectomy and rectal resection for (early/progressive) colorectal cancer;
  12. Laparoscope-assisted colorectomy for ulcerative colitis and surgery for Crohn's disease;
  13. Breast-conserving surgery and multidisciplinary treatments (e.g., hormone chemotherapy) for breast cancer;
  14. Surgery for thyroid and parathyroid diseases;
  15. Laparoscopic appendectomy;
  16. Radical surgery for hernia; and
  17. Emergency surgery for abdominal diseases.

* In our department, almost all diseases related to the gastrointestinal tract and mammary/thyroid glands can be diagnosed and treated.

Main achievements of our clinical research

Theme: Perioperative outcomes of gastroenterological surgery based on the National Clinical Database (NCD) in Japan.
Abstract: In Japan, data before, during, and after surgical treatments have been entered since 2011. The mortality during hospitalization in 8,575 cases of pancreaticoduodenectomy was 2.8%. 13 risk factors (e.g., BMI 25, white blood cell count >11,000, and COPD) were revealed by multivariate analysis. In addition, esophageal cancer, gastrectomy, distal gastrectomy, right colectomy, rectal resection, and surgical treatment of pervasive peritonitis have been analyzed using the NCD.
Publication: Kimura W, Miyata H, Gotoh M, Hirai I, Kenjo A, Kitagawa Y, Shimada M, Baba H, Tomita N, Nakagoe T, Sugihara K, Mori M.A. pancreaticoduodenectomy risk model derived from 8575 cases from a national single-race population (Japanese) using a web-based data entry system: the 30-day and in-hospital mortality rates for pancreaticoduodenectomy. Ann Surg. 2014 Apr;259(4):773-80.

Theme: Diagnosis and treatment of intraductal papillary mucinous neoplasms (IPMNs) - Creation of international guidelines
Abstract: IPMN progresses from benign adenoma to invasive carcinoma. The international guidelines (second edition) of IPMNs was created and published. In the Department of Surgery I, more than 100 IPMNs have been resected. We reported the significance of tumor + pancreatic duct volumes in the preoperative MRI diagnoses of IPMNs and subclassification by MUC staining.
Publication: Tanaka M1, Fernández-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, Kimura W, Levy P, Pitman MB, Schmidt CM, Shimizu M, Wolfgang CL, Yamaguchi K, Yamao K; International Association of Pancreatology.International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012 May-Jun;12(3):183-97.

Theme: Serous cystic neoplasms
Abstract: Serous cystic neoplasms (SCNs) are benign pancreatic cystic tumors with unknown natural history. At the meeting of the Cyst Study Group of the Japan Pancreas Society, Wataru Kimura, the group leader, examined 172 cases of SCNs. Of these cases, two malignant cases with liver metastasis were reported. An article on a collaborative study on 2,622 SCNs with world's leading institutions was accepted by famous medical journal GUT.
Publication: Kimura W, Moriya T, Hirai I, Hanada K, Abe H, Yanagisawa A, Fukushima N, Ohike N, Shimizu M, Hatori T, Fujita N, Maguchi H, Shimizu Y, Yamao K, Sasaki T, Naito Y, Tanno S, Tobita K, Tanaka M.Multicenter study of serous cystic neoplasm of the Japan pancreas society. Pancreas. 2012 Apr;41(3):380-7.　Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). Gut. 2016 Feb;65(2):305-12.

Introduction of the First Department of Surgery (Department of Gastroenterological, General, Breast and Thyroid Surgery)