Carcinosarcoma of the liver.

Herein we present a 73-year-old man with primary carcinosarcoma of the liver, a rare malignant tumor of the liver. The case was followed up due to HBV-related liver cirrhosis. Regular check-up by ultrasound demonstrated a hyperechoic tumor in the left lobe of the liver, and he was referred and admitted to our hospital.

Hepatic steatosis as a possible risk factor for the development of hepatocellular carcinoma after eradication of hepatitis C virus with antiviral therapy in patients with chronic hepatitis C.

Aim: To elucidate risk factors contributing to the development of hepatocellular carcinoma (HCC) among patients with sustained viral response (SVR) after interferon (IFN) treatment and to examine whether HCV-RNA still remained in the liver of SVR patients who developed HCC.

Methods: Two-hundred and sixty-six patients, who achieved SVR, were enrolled in this study. We retrospectively reviewed clinical, viral and histological features of the patients, and examined whether the development of HCC depends on several clinical variables using Kaplan-Meier Method.

Proposal of a new and simple staging system of colorectal liver metastasis.

Aim: To create a new, simple and useful staging system for colorectal liver metastasis analogous to the Tumor Node Metastasis classification system of International Union Against Cancer.

Methods: A retrospective review was undertaken of 81 consecutive patients who underwent partial hepatectomy for colorectal liver metastases (group 1). Clinical and pathological features of both primary and metastatic liver cancers were entered into a multivariate analysis to determine independent variables helpful in accurately predicting long-term prognosis after hepatectomy.

Proposal of criteria to select candidates with colorectal liver metastases for hepatic resection: comparison of our scoring system to the positive number of risk factors.

Aim: To select accurately good candidates of hepatic resection for colorectal liver metastasis.

Methods: Thirteen clinicopathological features, which were recognized only before or during surgery, were selected retrospectively in 81 consecutive patients in one hospital (Group I). These features were entered into a multivariate analysis to determine independent and significant variables affecting long-term prognosis after hepatectomy.

[Trend in the management of pancreatic adenocarcinoma--Japan vs. US and Europe].

Pancreatic adenocarcinoma remains to have poor prognosis. Most of all patients have locally advanced disease with or without distant disease when diagnosed. Current rationale for the treatment of pancreatic adenocarcinoma in the US and European countries consists of the following formula: (1) accurate staging by improved imaging.

The lethal toxicity of pancreatic ascites fluid in severe acute necrotizing pancreatitis.

Background/aims: The pathogenesis and the molecular mechanisms of the development and progression of the acute pancreatitis (AP) are not clearly understood. Ascites fluid is known to be important in the clinical progression of AP. We present the lethal toxicity of human pancreatic ascites fluid for experimental pancreatitis, with the therapeutic course of severe necrotizing AP.

Evaluation of CT during arterial portography for preoperative diagnosis of intrahepatic cholangiocarcinoma.

Background/aims: To evaluate computed tomography during arterial portography for preoperative evaluation in patients with intrahepatic cholangiocarcinoma.

Methodology: Computed tomography during arterial portography was performed in 11 intrahepatic cholangiocarcinoma patients undergoing hepatectomy. Segmental perfusion defect, sensitivity of the main tumor, and sensitivity of intrahepatic metastasis on computed tomography during arterial portography were retrospectively evaluated.

MPR-hCT imaging of the pancreatic fluid pathway to Grey-Turner's and Cullen's sign in acute pancreatitis.

Subcutaneous manifestations (Grey Turner's sign and Cullen's sign) of severe acute pancreatitis (SAP) are often discussed but rarely observed in a daily clinic setting. This paper will demonstrate the anatomic pathways followed by the extravasated pancreatic enzymes and how their effects lead to these ecchymoses by multiplanar reformation (MPR) images obtained by helical computed tomography (hCT). A 34-year-old female was admitted with SAP.

Exceptional ultra-late recurrence of papilla Vater carcinoma after pancreaticoduodenectomy: two cases at 17 and 25 years.

Curative resection does not always equate with long-term survival. Cancer of the papilla Vater can remain clinically quiescent for decades prior to regional or distant recurrence. Nevertheless, late and ultra-late recurrence (respectively 10 and 15 years after initial treatment) are exceptional events.

A scoring system for the assessment of the risk of mortality after partial hepatectomy in patients with chronic liver dysfunction.

Background/purpose: The aim of this study is to evaluate a new scoring system, called the chronic liver dysfunction (CLD) score, for prediction of the surgical risk of partial hepatectomy in patients with chronic liver damage. Morbidity and mortality rates after gastroenterological surgery are high in patients with hepatic cirrhosis. Accordingly, it is very important to assess the surgical risk in such patients before surgery.

Successful treatment of ruptured hepatocellular carcinoma with intraperitoneal injection of OK-432.

We report a 51-year-old man with a ruptured hepatocellular carcinoma (HCC). He was admitted to the hospital with abdominal pain and distension. Imaging studies revealed massive ascites, liver cirrhosis, and a 3-cm tumor at the inferior edge of the medial segment of the liver, with adhesions to the greater omentum.

Percutaneous transhepatic papillary balloon dilation as a therapeutic option for choledocholithiasis.

Background: For choledocholithiasis, endoscopic therapy, including endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation (EPBD), is now standard. However, the procedure of endoscopic therapy is very complicated and sometimes incomplete for reasons of anatomical anomalies. Therefore, we started performing percutaneous transhepatic papillary balloon dilations (PTPBD) instead of endoscopic therapy for choledocholithiasis 1 year ago for some selected patients.

A new scoring system to classify patients with colorectal liver metastases: proposal of criteria to select candidates for hepatic resection.

Background: Although many studies have reported the beneficial effects of hepatic resection for colorectal liver metastases on survival rates, it is still difficult to preoperatively select good candidates for hepatectomy.

Methods: Fifteen clinicopathological features, which were recognized only before or during surgery, were selected retrospectively in 81 consecutive patients in one hospital (Group I). These features were entered into a multivariate analysis to determine independent and significant variables affecting long-term prognosis after hepatectomy.

Diffuse intrahepatic bile duct dilation caused by a very small hepatic cyst.

A 72-year-old woman presented to our hospital with diffuse dilation of the intrahepatic bile ducts. Imaging studies revealed a solitary hepatic cyst, 3 cm in diameter, in segment 4 of Couinaud's category of the liver, riding on the hilar hepatic duct. Deroofing of the hepatic cyst was performed, and the dilation of the intrahepatic bile ducts was attenuated.

[Duodenum-preserving total pancreatic head resection and pancreatic head resection with segmental duodenostomy].

A duodenum-preserving pancreatic head resection (DPPHR) was first reported by Beger et al. in 1980. However, its application has been limited to chronic pancreatitis because of it is a subtotal pancreatic head resection.

Effect of superparamagnetic iron oxide-enhanced MRI of the liver with hepatocellular carcinoma and hyperplastic nodule.

Purpose: To evaluate the possibility of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) of the liver in predicting the histologic grade of hepatocellular carcinoma (HCC) and differentiating HCC from benign hyperplastic nodule (HPN).

Materials And Methods: Thirty patients with 31 histologically proved HCC and HPN underwent MRI (1.5 Tesla).