Session Category List
Special Program
- 01-01.
- The Success of Female Hepato-Biliary-Pancreatic Surgeons in a Gender-Neutral Society
In a gender-neutral society, female hepato-biliary-pancreatic (HBP) surgeons are expected to play an increasingly active role in the future. The field of HBP surgery has had fewer female physicians compared to other specialties. However, in recent years, the number of highly skilled female specialists has increased, and further progress is anticipated. HBP surgery requires many long hours of surgery and an extended training period. In this session, successful female HBP surgeons from various institutions who have achieved a work-life balance, along with leaders of institutions that effectively implement gender-neutral organizational management, will give presentations and discuss future challenges and their solutions.
- 01-02.
- Unforgettable Cases
The pathogenesis of diseases treated in HBP surgery is often complex, making it challenging to determine a treatment plan. Furthermore, highly complex and invasive surgeries are often performed, and patients may struggle to overcome postoperative complications. Patients may also experience unpredictable progress long after surgery. With this background, HBP surgeons have encountered cases that have followed rare courses and have learned a great deal from each one. In this session, each speaker will present an “unforgettable” case they have experienced, discuss the meaning of the case together, and share their valuable experience.
- 01-03.
- Improving Short-Term Outcomes after HBP Surgery Through Medical Safety
HBP surgery involves many highly invasive and complex procedures that require thorough preparation, meticulous surgical techniques and advanced clinical judgment. However, variances can still occur. To continue providing high-quality treatment under these circumstances, it is essential to respect basic medical safety concepts, such as governance, transparency and accountability. In addition, non-technical skills to facilitate team-based care, as well as holding M&M (morbidity and mortality) conferences with multi-disciplinary members who can contribute to improving the quality of care, are recommended. This session will cover various institutions’ medical safety systems including procedures to introduce minimally invasive, highly advanced surgeries that are now widely performed, as well as the establishment of educational systems for young HBP surgeons. We aim to explore the impact of these medical safety systems on the outcomes of HBP surgery and identify ways to further advance sound HBP surgery.
- 01-04.
- Present and Future of HBP Surgery from the Next Generation’s Perspective
The environment surrounding young surgeons, who will lead the next generation, which is the theme of this meeting, is changing significantly. While HBP surgery requires advanced techniques, the training of young HBP surgeons has been in a period of transition due to the advancements in laparoscopic and robot-assisted surgery, as well as the implementation of workstyle reform for doctors. In this session, speakers will present the current training of young HBP surgeons who will lead the next generation at their institutions, as well as the current efforts to enhance their daily workstyle. They will then discuss actions to ensure a bright future for HBP surgery in Japan.
Symposium
- 02-01.
- Significance of Hepatic Resection in Multidisciplinary Treatment for hepatocellular carcinoma (HCC)
Remarkable progress has been made in drug therapy for liver cancer, with the introduction of molecular targeted drugs and immune checkpoint inhibitors. This has led to the proposal of a resectability classification. The potential for resection is expanding to include borderline resectable HCC, highlighting the urgent need for the development of new treatment strategies. We aim to discuss the indications for hepatectomy, postoperative complications and long-term outcomes at various institutions, based on the resectability classification in multidisciplinary treatment for advanced HCC, including chemotherapy and radiation therapy.
- 02-02.
- Multidisciplinary Treatment Strategies to Prevent Early Postoperative Recurrence in Advanced Pancreatic Cancer
The effectiveness of conversion surgery for patients with unresectable pancreatic cancer (UR-LA, UR-M) who responded to chemotherapy or chemoradiotherapy has been reported. However, the timing of conversion surgery, case selection, and the optimal duration and regimen of postoperative treatment have not been determined. In this session, outcomes of multidisciplinary treatments for advanced pancreatic cancer at each institution will be presented, and optimal strategies to prevent early postoperative recurrence will be discussed.
- 02-03.
- Perioperative Strategies to Improve Safety in Hepatic Resection for Biliary Tract Cancer
Results from a benchmark study have shown that the short-term postoperative outcomes for hepatic resection for biliary tract cancer in Japan are positive compared to those in other countries. However, it remains a high-risk procedure with a high postoperative mortality rate among highly advanced HBP surgery. In this session, the surgical indications and selection of surgical procedures for hepatic resection for biliary tract cancer at each institution, as well as efforts to facilitate perioperative management before, during, and after surgery, to improve short-term outcomes will be presented. Strategies for improving safety will then be discussed. We look forward to discussions from various perspectives, including surgical indications, liver failure management and infection control.
- 02-04.
- Short- and Long-Term Outcomes and Strategies for Highly-advanced HBP Surgery in Elderly Patients
Japan was the first country in the world to become a super-aged society. However, aging is also progressing worldwide, particularly in Asia, where the number of elderly people is increasing significantly as the rate of aging rises. In this global context, it is important to disseminate evidence from Japan, where many highly-advanced HBP surgeries on elderly patients are being performed. In recent years, attention has been focused on conditions specific to elderly patients, such as frailty and sarcopenia. In this session, indications and short-term as well as long-term outcomes at each institution for high-advanced HBP surgery on elderly patients will be presented. We hope to discuss strategies and indications that take into account postoperative ADL and QOL.
Panel Discussion
- 03-01.
- Thinking about Sustainable HBP Surgery with Young Surgeons (Beyond Work Style Reform)
The era of work style reform has begun. What changes have occurred in the working environment, surgical training, education of young surgeons, and research activities for HBP surgeons? What benefits have been gained from capping working hours and overtime, ensuring paid leave is taken, and re-allocating tasks, and what challenges have emerged? Maintaining physical and mental well-being while accepting diverse work styles is not easy, especially when pursuing professionalism as an HBP surgeon. What can be done now to help HBP surgeons work more effectively and extend their careers, while also encouraging more young doctors to aspire to become HBP surgeons? We would like to discuss these topics with young HBP surgeons who will lead the future.
- 03-02.
- Roadmap for Training HBP Surgeons in the Era of Minimally Invasive Surgery
Laparoscopic surgery has become more common for both hepatic and pancreatic resections, while robot-assisted surgery is now covered under national health insurance for major surgical procedures, ushering in an era of minimally invasive surgery in the field of HBP surgery. On the other hand, open surgery remains the standard procedure for extended surgeries, such as conversion surgery and combined vascular resection. We must therefore promote further training of HBP surgeons. We look forward to presentations on each institution’s efforts in the education of operating surgeons, as well as initiatives for obtaining highly skilled specialists and technical certification, with the aim of shortening the training period. We would like to discuss the ideal education system for this purpose.
- 03-03.
- New Developments in Pancreatic Cancer Treatment Based on the 8th Edition of the General Rules for the Study of Pancreatic Cancer
In the 8th edition of the General Rules for the Study of Pancreatic Cancer has been newly published, positive peritoneal washing cytology (CY+) is classified as distant metastasis (M1). For lymph nodes, regional lymph nodes corresponding to the tumor location are defined. Additionally, the long-established classification of lymph node dissection levels, such as D1 and D2, has been removed. Numerous issues, including treatment strategies for CY+ pancreatic cancer and the significance of staging laparoscopy, remain to be addressed. Regarding lymph nodes, the extent of dissection depending on the tumor’s location will need to be discussed. In this session, treatment strategies and outcomes from each institution will be presented, and the optimal treatment strategy based on the revised 8th edition of the General Rules for the Study of Pancreatic Cancer will be discussed.
- 03-04.
- Developing Multidisciplinary Treatment Strategies for Biliary Tract Cancer by Introducing New Drug Therapies
Surgical resection is the only treatment option that can potentially cure biliary tract cancer. However, its after surgery is not satisfactory. Multidisciplinary treatment using recent new drugs, including immune checkpoint inhibitors, is promising for improving the prognosis. While multidisciplinary treatments based on resectability classifications are being developed for pancreatic and liver cancers, no such treatment has been established for biliary tract cancer. We will discuss challenges specific to biliary tract cancer, such as the assessment of drug therapy efficacy and the diagnosis of lymph node metastasis, to advance the discussion on multidisciplinary treatment of this cancer.
- 03-05.
- Developing Extended Hepatectomy Strategies Aiming at Liver Regeneration
－PVE, HVE, Two-Stage, ALPPS－
－PVE, HVE, Two-Stage, ALPPS－
In major hepatectomy, portal vein embolization (PVE) has been performed to increase further growth of future liver remnant and prevent postoperative liver failure. With the introduction of two-stage hepatectomy and ALPPS procedure, indications were expected to dramatically expand. However, only a limited number of institutions actively perform ALPPS procedure in Japan. In recent years, combining PVE with hepatic vein embolization (HVE) has been reported to further enhance the growth of the future liver remnant. Given the need to reconsider extended hepatectomy strategies aiming at liver regeneration, the latest criteria and strategies for hepatectomy of each institution will be presented.
Workshop
- 04-01.
- Importance of Nutritional Index and Nutritional Support in Highly-advanced HBP Surgeries
Perioperative nutritional assessment is an important topic as it affects short- and long-term outcomes after HBP surgery. Although various nutritional indexes are used to evaluate malnutrition and different nutritional supports have been trialed to improve the outcomes, developing a truly effective strategy to enhance both short- and long-term postoperative outcomes remains challenging. Therefore, in this session, we invite presentations from various perspectives on the importance of nutritional indexes and nutritional support. We will discuss how to differentiate between different nutritional indexes and how to implement fast-acting, versatile nutritional support.
- 04-02.
- Biliary Reconstruction Techniques to Prevent Biliary Complications
Biliary reconstruction can be performed using various approaches, including open, laparoscopic, and robot-assisted techniques. The chosen method should be tailored to the specific case. This includes cases of dilated bile duct due to biliary obstruction, normal bile duct with thin walls, or the need for reconstruction in multiple bile ducts. As complications associated with biliary reconstruction, bile leaks can be a short-term problem, while biliary jejunostomy stricture and cholangitis can be long-term issues. The strategies of each institution to reduce these complications during biliary reconstruction will be presented.
- 04-03.
- Latest Techniques and Ideas for the Prevention of Pancreatic Fistula in Pancreatic Resection
Pancreatic fistula is the most critical complication associated with pancreatectomy, potentially leading to severe outcomes. Presentations will cover the techniques and ideas employed at various institutions for pancreatic resection and pancreatico-enteric anastomosis in pancreaticoduodenectomy or pancreatic resection in distal pancreatectomy, including short-term outcomes. The discussion will then focus on the optimal methods for preventing pancreatic fistula.
- 04-04.
- A New Definition of Resectable Pancreatic Cancer to Improve Prognosis
Preoperative therapy with gemcitabine hydrochloride plus S-1 (GS) is the standard treatment for anatomically resectable pancreatic cancer in Japan. However, the outcomes remain unsatisfactory. Among anatomically resectable pancreatic cancers, cases with poor biological markers, such as serum CA19-9 levels and SUVmax on PET-CT, have shown a poor prognosis. These cases have been proposed as biologically borderline resectable pancreatic cancer, but the details require further discussion. In this session, we will explore a new definition of resectable pancreatic cancer and treatment strategies based on that definition, aiming to improve prognosis.
- 04-05.
- Reconsidering Appropriate Resection Limits for Perihilar Cholangiocarcinoma
High volume centers in Japan have developed and established surgical techniques and perioperative management strategies to ensure cure and safety, leading the world in the field of resection for perihilar cholangiocarcinoma. Nevertheless, a report from the JSHBPS Safety Management Committee indicates that the postoperative mortality rate for major hepatectomy with bile duct resection and reconstruction has not improved in Japan. We look forward to presentations that will contribute to the standardization of curative and safe resection limits for perihilar cholangiocarcinoma, which can be shared across all institutions. The aim is to reduce mortality while ensuring a cure.
- 04-06.
- What is the Optimal Treatment Strategy for Intrahepatic Cholangiocarcinoma?
The curative treatment for intrahepatic cholangiocarcinoma is surgical resection, but the risk of postoperative recurrence is high, particularly in cases with positive lymph node metastasis, and the prognosis is poor. There is no consensus on the significance of prophylactic lymph node dissection or the indications for preoperative chemotherapy. On the other hand, some unresectable or recurrent cases have shown long-term survival with immune checkpoint inhibitors and molecular targeted drugs. This workshop aims to discuss treatment strategies at each institution, such as preoperative diagnosis of intrahepatic cholangiocarcinoma, the significance of preoperative and postoperative chemotherapy, and the selection of surgical procedures, including lymph node dissection.
- 04-07.
- Impact of Genomic Medicine on Hepato-Biliary-Pancreatic Cancer
More than five years have passed since cancer genomic profiling testing became covered under national health insurance. In addition to immune checkpoint inhibitors in MSI-high and TMB-high cases, the effectiveness of treatments targeting BRCA gene mutations in pancreatic cancer and FGFR2 fusion gene mutations in biliary tract cancer has been reported. However, challenges remain, including low positive rates, high testing costs, limited testing periods and turnaround times. We will broadly discuss past clinical trials in genomic medicine and future prospects.
- 04-08.
- Developing Multidisciplinary Treatment Strategies for Colorectal Liver Metastasis
The prognosis of colorectal liver metastasis varies depending on the number of tumors, tumor size, and metastasis to other organs. It is important to develop a multidisciplinary treatment strategy (an effective combination of chemotherapy and hepatic resection) tailored to each patient’s condition to extend overall survival. Additionally, the presence or absence of certain gene mutations has been reported as an important prognostic factor following the resection of liver metastases. The treatment strategies of various institutions for colorectal liver metastases will be presented. We look forward to discussions aimed at developing the optimal multidisciplinary treatment strategy.
- 04-09.
- Donor-related Problems in Living Donor Liver Transplantation
The selection of the donor and determination of graft size are crucial in living donor liver transplantation, as they significantly influence the recipient’s prognosis post-transplantation. Managing so-called marginal donors and preventing complications after donor hepatectomy are significantproblems. Laparoscopic donor hepatectomy is now being performed, and there is an increasing demand for safer and less invasive surgical procedures. We look forward to discussions regarding the short- and long-term outcomes of donor hepatectomy, as well as the current status of the introduction of minimally invasive donor hepatectomy at each institution.
- 04-10.
- Latest Translational Research in the Field of HBP Surgery
Surgical treatment outcomes for intractable HBP diseases are often unsatisfactory. In this context, basic research is crucial for dramatically improving treatment outcomes. As surgeons, we have access to patients’ detailed clinical information and specimens, allowing us to easily identify challenges in the clinical setting and conduct basic research. This workshop will showcase the results from the latest basic and translational research from various institutions aimed at clinical applications. We will discuss the anticipated impact of these findings and the challenges that need to be addressed for successful clinical applications.
- 04-11.
- Long-Term Outcomes for Total Pancreatectomy
The number of cases of total pancreatectomy for extensive pancreatic IPMN and remnant pancreatic cancer is increasing. The advent of insulin analogues and high-potency pancreatin has enabled the management of blood sugar and nutrition following total pancreatectomy, which was previously challenging. However, long-term problems remain after total pancreatectomy, such as fatty liver, impaired digestion and malnutrition. In this session, the long-term prognosis and late complications of total pancreatectomy at each institution will be reported, and the challenges and management of these issues will be discussed.
- 04-12.
- New Liver Function Index and Corresponding Hepatic Resection Strategy
In hepatectomy, preoperative assessment of liver function is crucial for preventing complications such as postoperative liver failure. Historically, the ICG test and serum bilirubin levels have contributed to positive outcomes of hepatic resection in Japan. In recent years, methods to evaluate liver functional reserve using blood tests including ALBI grade, ALICE score, and M2BPGi, as well as imaging techniques such as GSA scintigraphy and EOB-MRI, have been reported. We look forward to presentations on appropriate liver function assessments to select a curative and safe hepatic resection for patients with liver injury, including initiatives and treatment outcomes at various institutions, along with new liver function assessments.
- 04-13.
- Discussion on Optimal SSI Management in HBP Surgery
Data from a report of the Japan Nosocomial Infections Surveillance, Ministry of Health, Labour and Welfare, indicate a high incidence of surgical site infection (SSI) in HBP surgery, with rates of 22.7% for pancreaticoduodenectomy and 14.0% for other HBP surgeries. Effective SSI management during the perioperative period is important, as SSIs related to pancreatic fistula and bile leaks impact postoperative outcomes. We look forward to discussions on the current status of SSIs and perioperative management, including antibiotic selection and drainage management, at each institution.
- 04-14.
- The Current Status and Future of Expanding Indications for Liver Transplantation
In recent years, the number of deceased donor has increased, and transplant programs for perihilar cholangiocarcinoma and colorectal liver metastases have been launched in Japan. The expansion of current indications for liver transplantation, such as the introduction of transplant oncology and simultaneous multiple organ transplantation, could lead to new strategies for disease control. In this session, outcomes and current challenges at each institution will be presented, and discussions will focus on further improving outcomes and expanding indications.
Video Symposium
- 05-01.
- Standardization of Robot-assisted Pancreaticoduodenectomy and Its Advantages
Robot-assisted pancreaticoduodenectomy has become increasingly common since it became covered under national health insurance in April 2020. Various institutions have reported their specific approaches to resection and standardized lymph node dissection techniques. In this session, each institution will introduce their innovative robot-assisted pancreaticoduodenectomy methods and discuss the advantages by comparing outcomes with those of open and laparoscopic surgeries.
- 05-02.
- Standardization of Robot-assisted Partial Hepatectomy
Since robot-assisted surgery for hepatic resection became covered under national health insurance in 2022, an increasing number of institutions have adopted it for partial liver resections. While some advantages over laparoscopic hepatic resection have been reported, the question remains: is it possible to standardize hepatectomy for all liver segments, particularly the challenging posterior-superior segments? The efforts of various institutions in addressing this question will be presented.
- 05-03.
- New Trends in Simulation and Navigation in HBP Surgery
With advancements in AI technology and the advent of the digital transformation era, navigation and AI technologies are progressing in the field of HBP surgery. Evidence of ICG fluorescence navigation has been reported in several organs. Given this background, which simulation or navigation technology is expected to be truly effective? We look forward to presentations on the novelty and usefulness of these techniques, including those considered new trends.
Video Workshop
- 06-01.
- Trouble shooting During Minimally Invasive HBP Surgery
HBP surgery is challenging, and as minimally invasive surgeries become more common, safer techniques are required. However, when issues such as bleeding from large blood vessels and biliary injury occur, a decision on whether to proceed to laparotomy and responses specific to laparoscopy are required. The primary goal of surgery is to prevent problems before they occur; however, corrective actions are crucial when issues do arise. Valuable experiences of recovery actions carried out at various institutions will be shared through video.
- 06-02.
- Vascular reconstruction in Liver Transplantation
In liver transplant recipient surgery, the patency rate of reconstructed blood vessels is very important. There are various options for vascular grafts and reconstruction methods in living donor liver transplantation. Innovative vascular reconstruction techniques in liver transplantation based on the recipient’s hemodynamics will be presented through video.
- 06-03.
- Prevention of Biliary Injury during Laparoscopic Cholecystectomy
Laparoscopic cholecystectomy is a routine surgical procedure that generally has a low incidence of intraoperative biliary injury. However, when such injuries occur, they can often lead to significant complications. The risk is particularly high in cases with severe inflammatory reactions or anomalies in bile duct branching. In recent years, intraoperative ICG fluorescence imaging has been shown to be effective in preventing biliary injuries. Strategies employed by various institutions to prevent intraoperative biliary injury will be presented and discussed with reference to actual cases.
- 06-04.
- Implementation and Innovation of Highly Advanced Minimally Invasive (Laparoscopy, Robot-assisted) Hepatectomy
In minimally invasive hepatectomy, highly advanced laparoscopic procedures are becoming more common in many institutions, and an increasing number of institutions are introducing these procedures for robot-assisted surgery. Given the favorable evidence compared to open hepatectomy, there is no doubt that minimally invasive hepatectomy will become more widespread for highly advanced surgical procedures in the future. Tips and tricks for introducing highly advanced laparoscopic and robotic surgical procedures will be presented to share strategies aimed at their safe, widespread use.
- 06-05.
- What Is the Optimal Surgical Procedure for Gallbladder Cancer in the Era of Minimally Invasive Surgery?
Indications for laparoscopic and robot-assisted surgeries are rapidly expanding in the field of HBP surgery. In gallbladder cancer, laparoscopic surgeries for malignant tumors became covered under national health insurance in Japan in 2022. However, determining preoperatively whether a gallbladder lesion is benign or malignant often proves challenging. Careful consideration is frequently required regarding the presence or absence of lymph node metastasis and bile duct invasion. Maintaining a balance between minimal invasiveness and curative potential is an important challenge. Videos of minimally invasive surgery for gallbladder cancer will be presented, followed by a broad discussion on selecting the optimal surgical procedures and treatment strategies, including technical tricks and special considerations.
English Training Session
A native English speaker who proofreads English medical papers in Japan will teach you the basics of English presentations. After presenting a case report or case series in English, participants will receive feedback from the tutor on their English expressions, presentation style and overall structure. The session will provide ample time for advice, serving as a training opportunity for junior doctors to improve their presentation skills in English. Eligibility: Under 40 years old; residents are also welcome.
Student & Resident
We invite all residents and students interested in hepatobiliary and pancreatic surgery to enthusiastically apply.
Requested Oral
- 08-01.
- Ideas for Improving Short-Term Outcomes in Pancreas Transplantation
- 08-02.
- Treatment Strategies for Pancreatic Neuroendocrine Tumors
- 08-03.
- Indications for IPMN Resection
- 08-04.
- Treatment Strategies for Common Bile Duct Stones
- 08-05.
- Optimal Devices for Hepatic Resection
- 08-06.
- Standardization of Robot-Assisted Distal Pancreatectomy for Pancreatic Cancer
- 08-07.
- Innovations in Robot-Assisted/Laparoscopic Common Bile Duct Dilation Surgery
- 08-08.
- Innovations and Standardization of Minimally Invasive Donor Surgery for Liver Transplant
- 08-09.
- Ensuring Surgical Outcomes While Training HBP Surgeons
- 08-10.
- Significance of Resection for Oligometastatic HBP Cancers
- 08-11.
- Distinguishing Robot-Assisted Surgery from Laparoscopic Surgery in the HBP Field
Free Paper（Poster）
| Diseas | Areas |
|---|---|
| 01. Liver (benign) | 01. Diagnosis |
| 02. Liver (malignant) | 02. Surgery |
| 03. Pancreas (benign) | 03. Endoscopic surgery |
| 04. Pancreas (malignant) | 04. Postoperative complications |
| 05. Biliary tract (benign) | 05. Treatment |
| 06. Biliary tract (malignant) | 06. Other |
| 07. Other |
