[A case of unresectable advanced pancreatic tail cancer successfully treated with gemcitabine hydrochloride].

We report a case of a 76-year-old female with unresectable advanced pancreatic tail cancer in whom systemic chemotherapy using gemcitabine hydrochloride was effective. The patient came to our hospital with a complaint of upper abdominal discomfort and was diagnosed as an advanced pancreatic tail cancer with severe vessel invasion. A curative operation was thought to be impossible, so gemcitabine hydrochloride was administered (800 mg/m2/week x 3/4 weeks).

Proposal for a reclassification of liver based anatomy on portal ramifications.

Background: Portal branching patterns that differ from those previously described are occasionally encountered during liver surgery.

Methods: A total of 60 patients with normal intrahepatic venous anatomy underwent helical computed tomography during arterial portography (CTAP). Next, 3 dimensional portograms were reconstructed to verify the locations of the portal veins.

Limited resection based on reclassification of segment 8 of the liver.

Liver vein patterns which differ from those previously described are occasionally encountered during surgery. Therefore, we reclassified the anterosuperior segment (S8) into S8v (ventral area) and S8d (dorsal area), and the right paramedian sector into the ventral segment (S8v+S5) and the dorsal segment (S8d) based on portal and hepatic vein patterns. Using this new classification, we performed three types of limited resection of S8 in six patients with neither major nor minor procedural complications including biliary leaks, and no blood transfusion.

Relation between hepatic and portal veins in the right paramedian sector: proposal for anatomical reclassification of the liver.

Although a right liver graft without a middle hepatic vein resulted in potential venous congestion in the right paramedian sector, the details of the hepatic venous distribution in the right paramedian sector have not been established. In this study, the ramification patterns of the hepatic veins draining the right anterosuperior segment (S8) and the relation between the hepatic and portal veins were assessed using multislice computed tomography in 44 patients without lesions in the liver. All 52 drainage veins of the ventral area of S8 joined the middle hepatic vein, and all 48 drainage veins of the dorsal area joined the right hepatic vein.

Hepatocellular carcinoma with unusual metastasis to the esophagus.

We describe a rare case of esophageal metastasis from hepatocellular carcinoma. Esophagoscopy showed an oozing semipedunculated polypoid mass. Endoscopic ultrasound showed a mosaic pattern, and angiography and computed tomography showed tumor staining similar to that of the primary tumor in the liver.

[Treatment of colorectal cancer--hepatic metastases].

The aim of this study was to evaluate the effect of the local therapy for colorectal liver metastases on overall survival. Seventy-two patients who had resected liver metastases from colorectal cancer during the period from 1982 to 2001 were evaluated for survival. There was no significant difference in overall survival by either surgical method for colorectal liver metastases or postoperative arterial infusion chemotherapy.