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Volume 32, Issue 9
Displaying 1-21 of 21 articles from this issue
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Masashi Kodama1999 Volume 32 Issue 9 Pages 2197-2207
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSIn this paper, views of the 21-century are described based on research and clinical experience to cancer of the esophagus. The following problems were presented from a clinical point of view, ; (1) Clarify the significance and effects to prognosis of cervical lymph node dissection is a future problem, (2) The combined neoadjuvant chemotherapy of CDDP/PEP/VDS with pre and postoperative use was not effective to the advanced esophageal cancer. Low dose of CDDP/5FU combined chemotherapy showed a high remission rate. Hereafter, prospective randomized control study should be scheduled for this combined chemotherapy, (3) For the m3 and sm1 superficial cancer, it should be clarified whether EMR or operation should be selected. From a research point of view, cyclin D1 was perceived to as the factor that controls a cell cycle, and also uPA and PAI-2 was researched as factors that is related to tumor infiltration and metastasis. As the results, both cyclin D1 and uPA/PAI-2 system were related to the prognosis and may be the important factors that prescribe the malignant potential of esophageal cancer. Furthermore research of comparative genomic hybridization (CGH) has been carried out to screening the gene abnormality. To try developing a new therapy, we have been conducting a basic research with regard to vaccine therapy using cancer specific antigen, to antisense therapy, and to gene introduction therapy that induces apoptosis.View full abstractDownload PDF (191K) -
Chikara Kunisaki, Masazumi Takahashi, Yoshihiro Moriwaki, Hirotoshi Ak ...1999 Volume 32 Issue 9 Pages 2208-2213
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSTo clarify the risk factors of postoperative respiratory complications for patients with esophageal cancer, nutritional status and immunity were assessed in 26 patients with thoracic esophageal cancer undergoing curative resection with right side trans-thoracotomy and laparotomy. Postoperative respiratory complications were observed in five patients (19.2%). In univariate analysis, the proportion of fat measured by indirect calorimetry significantly increased and that of carbohydrate and protein significantly decreased in complicated patietns. FEV1.0/m2 significantly decreased in complicated patietns. In logistic regression analysis, retinol binding protein, the proportion of fat in indirect calorimetry, α1-antitrypsin, duration of surgery were selected as the independent risk factor for postoperative respiratory complication. These results suggest that patients who move into fat catabolism, or starvation status, and patients with reduced retinol binding protein and α1-antitrypsin activity have a higher postoperative morbidity rate. To prevent postoperative respiratory complications, we need appropriate nutritional support to improve nutritional immunomodulation and reduction of duration of operation.View full abstractDownload PDF (56K) -
Hideaki Yamanami, Tsuneaki Fujiya, Kiyoaki Ouchi1999 Volume 32 Issue 9 Pages 2214-2218
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSVarious clinicopathological factors influencing lymph node metastasis at the splenic hilum (No.10) and along the splenic artery (No.11) were studied retrospectively in 130 advanced gastric cancer patients who underwent total gastrectomy with distal pancreatectomy and splenectomy. Significant factors affecting incidences of No.10 lymph node metastasis were tumor location, macroscopic appearance, histologic appearance, sex and peritoneal metastasis. Logistic regression analysis revealed that location, macroscopic appearance of tumors, sex and peritoneal metastasis were valuable factors affecting No.10 lymph node metastatis. Except for peritoneal metastasis, no factors significantly influenced No.11 lymph node metastasis. In conclusion, total gastrectomy with distal pancreatectomy and splenectomy is indicated for patients who develop tumors with macroscopically positive infiltration to the serosa that:(1) locate in the greater curvature or anterior wall of the stomach, (2) show macroscopically type 1 or 4, or (3) female. On the other hand, patients who have other kinds of tumors can be treated with pancreas-preserving total gastrectomy.View full abstractDownload PDF (39K) -
Fujio Makita, Norikazu Kamoshita, Mitsunobu Kobayashi, Yoshinao Mitsug ...1999 Volume 32 Issue 9 Pages 2219-2223
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe analyzed the predisposing factors for extrahepatic metastases following hepatic resection for hepatocellular carcinoma (HCC), and also analized the treatment for the metastases, results with included surgical resection. Extrahepatic metastases occured in eight out of 48 resected HCCs, and these were all initially diagnosed as poorly differentiated HCC. There were no significant predisposing factors such as tumor size, presence of vascular invasion, curativity of the resection or adequacy of the resected margins. Extrahepatic metastases also occurred in patients without intrahepatic recurrence following curative resections. The mean interval from surgery to the occurrence of metastases was 15. 4 months. Metastatic sites included the abdominal lymph nodes (3), the lungs (2), the adrenal gland (2) and the omentum (1). Four extrahepatic metastases were resected including the lymph nodes (2), the adrenal gland (1) and the omentum (1). Median survival of patients who could undergo resection of extrahepatic metastases was significantly longer compared to patients who could not (544 vs 116 days, respectively). In conclusion, surgical resection of extrahepatic metastases is the treatment of choice when (1) they are solitary, (2) there is no recurrence in the remnant liver, or (3) if the metastasis in the remnant liver can be well controlled.View full abstractDownload PDF (39K) -
Masahiro Katada, Yasuyuki Sugiyama, Katsuyuki Kunieda, Shigetoyo Saji1999 Volume 32 Issue 9 Pages 2224-2230
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe expression of mutant p53, bcl-2 and the apoptotic index (AI) was investigated by immunohistochemical stain in a total of 174 colorectal tubular adenomas obtained from endoscopic polypectomy. The following results were obtained. The positive expression of bcl-2 was significantly higher in tubular adenoma with moderate atypia in comparison with mild atypia, while it slightly decreased in early cancer. The positive expression of mutant p53 increased in proportion to the degree of atypia of the adenoma and was highest in early cancer. AI value was significantly lower in tubular adenoma with mild stypia, moderate atypia, severe atypia, early cancer than in normal tissues. The both positive expression of both p53 and bcl-2 were significantly higher in tubular adenomas more than 6 mm in size and in the shape of I sp and I p.
1) From the above results, it is suggested that bcl-2 and mutant p53 probably play an important role in the early and late stages of the adenoma-carcinoma sequence. 2) Moreover, tubular adenomas with more than moderate atypia, of more than 6 mm and pedunculated, should have a high malignant potential.View full abstractDownload PDF (61K) -
Toru Tezuka, Mamoru Suzuki, Yuji Inoue, Katsutoshi Yoshida, Ken Takasa ...1999 Volume 32 Issue 9 Pages 2231-2237
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESS150 patients with colorectal cancer not infiltrating serous membrane (outer membrane) were devided into two groups of patients on the basis of tumor-occupying rates in the most distant positive lymphnodes; 77 patients (mild type) who had tumor-occupying rate of less than 50% and 73 patients (massive type) of 50% or more. Statistical significance between the two groups was seen in the rate of poorly differentiated adenocarcinoma and mucinous carcinoma, the number of metastatic lymphnode (3.4 nodes vs 2.0), and the maximal diameter of metastatic lymphnode (9.2mm vs 5.7). Postoperative recurrence of the lymphnodes occurred in 2 of the 77 patients with mild types (2.6%) and in 17 of the 73 with massive types (23.3%). Lymphonde recurrence free cumulative five-year survival rate was statistically higher in mild type than in massive type (97.3% vs 73.4%), and statistical significance was also seen in the patients with n1 (+)(96.6% and 76.5%) and n2 (+)(100% and 64.3%). Those data show that tumor-occupying rates in most distant postive lymphnodes can predict postoperative lymphnode recurrence.View full abstractDownload PDF (83K) -
Shunroh Ohtsukasa, Misao Yoshida, Tomoko Hanashi, Toshimi Mizobuchi, H ...1999 Volume 32 Issue 9 Pages 2238-2242
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 48-year-old man who unsuccessfully underwent an endoscopic mucosal resection for a mucosal esophageal cancer in the upper one-third of the thoracic esophagus, was treated with external and intraluminal radiation therapy. Nine months later, a giant tracheoesophageal fistula was revealed. To prevent pneumonia, a covered expandable metal stent was inserted into the esophagus. His general condition subsequently improved and preoperative evaluation of the lesion was done. An operation to remove the metal stent, to close the esophageal stumps and to cover the distal stump with an omental pedicle flap was carried out and included gastric pull-up and retrosternal esophagogastric anastomosis. Tracheoesophageal fistula is a lifethreatening complication of esophageal irradiation. In this case, a covered expandable metal stent was used to close the tracheoesophageal fistula and to prevent pneumonia. The covered expandable metal stent also allowed us to evaluate the lesion and to determine the correct treatment.View full abstractDownload PDF (101K) -
Tatsuyuki Seshimo, Masao Ito, Kazunobu Monden, Tomoo Mizukami1999 Volume 32 Issue 9 Pages 2243-2247
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 78-year-old woman was admitted to our hospital because of upper abdominal symptoms including nausea and anorexia. A chest X-ray film showed an air-fluid level in the mediastinum. An upper gastrointestinal series demonstrated a sliding hiatal hernia with gastric volvulus in an organoaxial form and a filling defect of the antrum. The patient was diagnosed as having Borrmann 2 carcinoma of the antrum by the endoscopic examination. A laparotomy revealed that the entire stomach was dislocated toward the mediastinum. Subsequent distal gastrectomy and repair of the esophageal hiatus were performed. Herein we report the first case of advanced gastric cancer within a sliding hiatal hernia associated with organoaxial gastric volvulus in Japan.View full abstractDownload PDF (89K) -
Takashi Hojo, Seiichiro Ishii, Nozomu Shirasugi, Yuko Kitagawa, Kouich ...1999 Volume 32 Issue 9 Pages 2248-2252
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA Case of Gastric Cancer with Intramural Metastasis to the Esophagus is reported. A 50-year-old male patient had gastric upset, nausea, and high frequency of vomiting since September 1993. He was diagnosed to our department by a doctor in his neighborhood in December of the same year. The endoscopic examination demonstrated a tumor of Borrmann type 2 on the lesser curvatur of the angle to the antrum in the stomach and a small elevation (approximately 2 cm in diameter) in the esophagus of the lower chest. The esophageal lesion was negative for Lugol solution staining. Although these lesions were separated from each other, histologically both were differentiated adenocarcinoma. Palliative distal gastrectomy and Billroth II were performed as of peritonel dissemination was demonstrated by perioperative cytology. The oral wedge of the stomach was free from cancer cells in histologically. Complete response was obtained for metastasis by adjuvant chemotherapy (CDDP+UFT). However, he died from brain metastasis 7 months after the operation. The gastric cancer with intramural metastasis to the esophagus is very rare, and only 10 cases including our experience have been reported so far. Sine prognosis is very bad, adjuvant chemotherapy with palliative operation should be considered in these patients.View full abstractDownload PDF (141K) -
Tomoki Tokugawa, Yoshitaka Yamamura, Akihito Torii, Yasuhiro Shimizu, ...1999 Volume 32 Issue 9 Pages 2253-2257
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe sign of Leser-Trélat which belongs to paraneoplastic dermatoses is defined as sudden appearance and rapid increase in size and number of seborrheic keratoses. Two cases of cancer of the gastrointestinal tract with the sign of Leser-Trélat are reported. Case 1: A 73-year-old man visited the Department of Dermatology at our hospital because of rapid proliferation of seborrheic keratosis with itching on his neck. A diagnosis of the sign of Leser-Trélat was made, followed by probing for any malignant tumor of the viscera, which disclosed a IIc lesion on the posterior wall of the gastric upper body. Proximal gastrectomy was performed. The histological findings were classified as moderately differentiated tubular adenocarcinoma stage I according to the Japanese Classification of Gastric Carcinoma by the Japanese Research Society for Gastric Cancer. Case 2: A 72-year-old man visited the Department of Gastroenterological Medicine at our hospital because of anorexia and narrow stools. At the same time he developed the sign of Leser-Trélat. Biochemical examination rerealed occult blood in the stool so we referred him for lower intestinal endoscopy and radiographic examinations. By these examinations type 2 cancer was found in the rectosigmoid region. A low anterior resection was performed. The histological findings were classified as moderately differentiated adenocarcinoma stage IIIa according to the Japanese Classification of Colorectal Carcinoma by the Japanese Society for Cancer of the Colon and Rectum. The sign of Leser-Trélat is frequently associated with adenocarcinoma of the gastrointestinal tract and appears to be clinically significant.View full abstractDownload PDF (130K) -
Review of the Japanese LiteratureYasuo Tsuchiya, Yoshihiko Sano, Toshio Nakamura, Yasuhiko Umehara, Tad ...1999 Volume 32 Issue 9 Pages 2258-2262
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 63-year-old man was admitted to our hospital with right hypochondralgia. Ultrasonography and computed tomography revealed a tumor in a dilated intrahepatic bile duct. Endoscopic retrograde cholangiography also showed an elevated tumor in the right and common hepatic ducts. It was noted on cholangiography that a filling defect by the tumor intermittently appeared and disappeared. Angiography demonstrated a hypervascular lesion in the right lobe of the liver. Hepatocellular carcinoma invading the biliary tract was diagnosed. Because of tumor extension into the right hepatic duct noted at laparotomy, right lobectomy was performed. The tumor was histologically hepatocellular carcinoma which was invading the bile duct. In the literature, the prognosis of patients who undergo hepatectomies was better than that of patients treated palliatively. Hepatocellular carcinoma invading the biliary tract seldom has capsular formation and is invasive, hence adequate hepatic resection is essential to good prognosis regardless of the tumor size.View full abstractDownload PDF (120K) -
Katsushi Yoshida, Yoshichika Okamoto, Takehito Katoh, Haruhiko Chigira ...1999 Volume 32 Issue 9 Pages 2263-2267
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 40-year-old female complained of right upper quadrant pain. Clinical images revealed that the patient had congenital biliary dilatation (CBD) of Alonso-Lej's type I. Arterial portography showed cavernous transformation of the portal vein (CTPV). On March 1, 1995, resection of the dilatated bile duct and gallabladder with hepaticojejunostomy was performed. Because of difficulty in managing the bleeding from collateral portal veins, operative time was over 10 hours and operative blood loss was 5, 615g. There was no significant change in the portal pressure before (15 cmH2O) and after (16 cmH2O) bile duct resection. Postoperative portograms disclosed that the cavernous transformation with hepatopetal collateral pathways was preserved. The patient is doing well 3 years and 10 months after operation. CBD with CTPV is a rare condition. Only three other cases are reported in the Japanese literature, and this is the first report of a patient undergoing resection of the bile duct. Operative indication and optimal procedure for this condition must be decided prudently. It should be noted that resection of the bile duct for CBD with CTPV is a high-risk operation for a benign disease, and may damage the portal collaterals that are essential for healthy hepatic function.View full abstractDownload PDF (108K) -
Tatsuto Ashizawa, Keiichi Kitamura, Akihiko Murano, Tetsuo Sumi, Shiny ...1999 Volume 32 Issue 9 Pages 2268-2272
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 55-year old woman presented complaining of back pain. A tumor was detected in the body of the pancreas by ultrasonography and CT scan. Preoperative ERP and angiographic findings were suggestive of pancreatic cancer. Distal pancreatectomy was performed and the body of the pancreas was found to be filled with an oval expanding whitish tumor. The histological feature was a giant cell carcinoma (pleomorphic type) at the pancreas. The characteristic clinical features of 36 cases (including this case) in Japanese literatures were similar to that of common pancreatic duct carcinoma. The mean age was 63.4 years. Abdominal and back pain were the most common chief symptoms, and the tumors occupied the head (15 cases) or the body to tail (17 cases) of the pancreas respectively. Of the 36 cases, 23 could be diagnosed by imaging diagnosis, while 15 out of 22 cases showed hypo echoic findings on ultrasonography, and 19 out of 25 cases showed low density findings on CT scan. Stenosis (9 cases) and occlusion (5 cases) of the main pancreatic duct could be seen by ERP. However, no difference in findings by imaging modalities between giant cell carcinoma and common duct carcinoma of the pancreas were found. Twenty five (including this case) out of 33 cases died within 12 months after establishing a diagnosis.View full abstractDownload PDF (160K) -
Gonta Okumura, Hideaki Kaneko, Toshiya Maeda, Ricca Fukuda, Yukari Yab ...1999 Volume 32 Issue 9 Pages 2273-2277
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 41-year-old man at the age of 25 years, underwent gastrectomy of the pylorus for gastric ulcer. The patient consulted our hospital for sudden-onset of intense abdominal pain, nausea and vomiting at night. During initial consultation, biochemical blood test revealed no abnormalities other than an increase in the leukocyte count. However, abdominal radiography disclosed an ilues. Furthermore, abdominal computed tomography (CT) demonstrated intussusception. Irritative peritoneal symptoms develped, and the patient was emergently admitted to our hospital, and surgery was immediately performed. During laparotomy, a moderate volume of bloody ascites was observed. Roux-en-Y reconstruction had been performed following gastrectomy of the pylorus. Intussusception of the jejunum, anal to the Y anastomotic site, was detected. The involved area measured approximatery 13 cm, and manual reduction was difficult, however partial resection of the small intestine was performed. No abnormal findings were found on the intestinal mucosa, such as polyp that might have formed the end of the intussusception. Adult intussusception at the Y anastomotic site following gastrectomy, as observed in the present case, is extremely rare. We report this patient with reference to the literature.View full abstractDownload PDF (72K) -
Kimihiko Funahashi, Tatsuya Chida, Toshimichi Maeda, Natsuki Tokura, T ...1999 Volume 32 Issue 9 Pages 2278-2282
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 58-year-old man was admitted to our hospital because of melena. He had undergone total cystectomy and ureterosigmoidostomy for bladder tumor 11 years before. We surmised the presence of a malignant tumor because of barium enema and colonofiberscopic findings, that showed a fungous tumor around the ureterosigmoidostomy. We, therefore, performed a sigmoidectomy and ureterostomy. Histological findings showed the tumor was a hyperplastic polyp without malignant cells. We report a rare case of hyperplastic polyp at the ureterosigmoid anastomosis occuring 11 years after total cystectomy and review the literature including our case.View full abstractDownload PDF (77K) -
Tsuyoshi Igami, Hiroshi Hasegawa, Seiji Ogiso, Masaya Shiomi, Masato M ...1999 Volume 32 Issue 9 Pages 2283-2286
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSAsynchronous Liver Metastasis from Rectal Carcinoid Tumor 12mm in Diameter: A case report A 53-year-old man was diagnosed with a rectal carcinoid tumor at Rs because of fecal occult blood.
We performed transsacral resection of the rectal tumor. The rectal carcinoid measured 12×10mm and tumor invasion was limited to the submucosal layer. About 3 years later, we diagnosed liver metastasis from the rectal carcinoid tumor, and performed lateral segment rescection of the liver. The liver tumor measured 35×30mm, the histological finding of the tumor was rectal carcinoid-like tumor. In the Japanese literature, only 6 cases of liver metastasis from rectal carcinoid tumor, smaller than 20mm and limited to the submucosal layer have been reported. To our Knowledge, this is the first case to be reported in Japan of liver metastasis after resection of rectal carcinoid tumor.View full abstractDownload PDF (96K) -
Toshiyuki Natsume, Shinichi Okazumi, Wataru Takayama, Akihiko Takeda, ...1999 Volume 32 Issue 9 Pages 2287-2291
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe patient was a 61-year old man. Polypectomies and transanal resection were perfomed for rectal carcinoid. After 9 years, US and CT revealed a SOL of 10cm in the S5 segment and a SOL of 5cm in the S7 segment of the right lobe of the liver. Right hepatectomy was performed under the diagnosis of liver metastasis of rectal carcinoid or cystadenocarcinoma of the liver. The resected specimens showed liver metastasis of rectal carcinoid. However US and CT performed 6 months after operation revealed a SOL of 2cm in the S2 segment of the liver and another SOL of 5cm in the S4 segment. The serum 5HIAA level was increased and the diagnosis of recurrent liver metastasis was made. Enucleations were performed. The tumor in the S2 segment was determined as liver metastasis of rectal carcinoid, but the S4 tumor was biloma. After undergoing two hepatectomies, the patient is alive and disease free 2 years and 3 months after operation.View full abstractDownload PDF (139K) -
Terumitsu Sawai, Takashi Tsuji, Atsushi Nanashima, Masaaki Jibiki, Hir ...1999 Volume 32 Issue 9 Pages 2292-2295
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 49-year-old man who had undergone cholecystectomy for cholecystolithiasis visited our hospital for lower abdominal pain and diarrhea. A colonoscopy revealed a protruded lesion with a double elevation, measuring 5 mm in diameter in the upper rectum, 10 cm from the anal verge. Under the diagnosis of tubular adenoma, the lesion was removed by endoscopic polypectomy. Histological findings showed moderately differentiated adenocarcinoma invasion to the submucosa (sm), and was markedly suggestive of submucosal vertical margin involvement. Four weeks after the polypectomy, low anterior resection with dissection of group 1 and group 2 lymph nodes were performed. Although there was no residual carcinoma, metastases were found in three of the 16 dissected nodes. The present case illustrates that minute protruded colorectal carcinomas can have SM invasion, and that the double elevation is useful in diagnosing the massive SM invasion of these lesions.View full abstractDownload PDF (84K) -
Akiko Murayama, Naokazu Hayakawa, Hideo Yamamoto, Atsuhiko Maki, Yasuj ...1999 Volume 32 Issue 9 Pages 2296-2300
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe present a case of primary malignant melanoma in the anorectal area in a 67-year-old man, who presented with a three-month history of anal bleeding and prolapsed tumor. Colonoscopic examination disclosed a blackish blue tumor just on the dentate line, and the biopsy specimen revealed malignant melanoma. Abdominoperineal resection of the rectum with regional lymph node dissection (D3) was carried out. The resected specimen showed a 27×35×15mm blackish protruding tumor with dark pigmentation and a blackish gray spot in the surrounding mucosa. Microscopical features were as follows: mp, ly0, v0, ow (-), aw (-), n0, stage 1. Adjuvant chemotherapy was not performed. He has been well for 14 months after operation without any evidence of tumor recurrence. Although the treatment of choice for malignant melanoma is controversial because of the extremely poor prognosis, only radical excision was effective in this case. Histological findings, which revealed that melanoma cells existed in a gray spot separate from the main protruding lesion, suggest that careful observation of the surrounding mucosa and adequate surgical treatment with enough margin are important.View full abstractDownload PDF (133K) -
Yutaka Ozeki, Ken-ichiro Tateyama, Yasuhiro Sumi, Takuya Yamada, Kimi ...1999 Volume 32 Issue 9 Pages 2301-2305
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 62-year-old woman was admitted to our hospital because of a liver tumor after undergoing resection for rectal cancer. CT showed a tumor 5 cm in diameter in the right lobe of the liver and an unusual vessel arising from the hepatic hilus into the liver. Under a diagnosis of liver metastasis from rectal cancer, a celiotomy was performed. Intraoperative ultrasonography revealed that the portal branch of the medial segment (P4) independently bifurcated from the portal trunk, and that an unusual branch (P8*) arose from the hepatic hilus along the right side of the middle hepatic vein into the liver. The portal branch of the lateral segment did not connect with P4, but with P8*.A right hepatic lobectomy with a preservation of the P8* was performed. Microscopically, the portal vein showed a thin venous wall and numerous branches. Retrospective study of computed tomography, the portal trunk showed prepancreatic retroduodenal type which indicated some relation to an anomalous branching of the portal vein. At a hepatectomy with an anomalous portal branching, a careful observation is essential before and during an operation.View full abstractDownload PDF (143K) -
[in Japanese], [in Japanese]1999 Volume 32 Issue 9 Pages 2306-2308
Published: 1999
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSDownload PDF (21K)
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