[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Patients undergoing surgery for hepato‐biliary‐pancreatic cancers and liver transplantation （LT） are often associated with not only primary sarcopenia due to aging, but also secondary sarcopenia caused by malnutrition, liver failure, and surgery. However, the impact of sarcopenia and body composition, including muscle quality and visceral obesity, on outcomes after these surgeries was unclear until several years ago. Therefore, we investigated the significance of sarcopenia and body composition in patients undergoing surgery for hepato‐biliary‐pancreatic cancers and LT. In my opinion, accurate evaluation and sufficient intervention are essential for perioperative rehabilitation and nutritional therapy. Therefore, tailor‐made rather than uniform intervention is highly recommended. For example, based on our study, we revised our criteria for LT considering body composition and started aggressive intervention, including perioperative nutrition therapy and rehabilitation, for patients undergoing LT at Kyoto University. As a result, the 1‐year overall survival rate markedly improved to 99％. Furthermore, we achieved early discharge from the hospital after pancreaticoduodenectomy at St. Luke’s International Hospital. In this review, we introduce our efforts and innovations focusing on the significance of body composition in hepato‐biliary‐pancreatic cancers and LT.

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Studies on intestinal microbiota and the development of probiotics started only 100 to 150 years ago. Recently, a new method to analyze the intestinal microbiota using molecular biology techniques was developed and many novel findings have been reported.
We started applying a newly designed synbiotic therapy from 1997 for patients who required neonatal surgery. Controlling the intestinal microbiota by probiotics in neonates and infants is highly effective for maintaining the intestinal luminal environment and for promoting patient growth.
Fecal microbiota transplantation and combinations of several bacteria have been reported to effectively restore disorder of the intestinal microbiota.
Bifidobacterium, which becomes dominant in early infancy, plays important roles in establishing homeostasis of the intestinal luminal environment, and the complex community of different types of Bifidobacteria may be useful as a probiotic for neonates and infants who require surgery.

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