Background: Oxaliplatin is a key drug in the chemotherapy for colorectal cancer, while adverse events by oxaliplatin, such as the sinusoidal injury, may affect the outcome of patients. Recently, splenic volume assessment has been reported to be useful to predict the sinusoidal injury development. The effect of chemotherapy with oxaliplatin are to be clarified in patients following liver resection despite that resection of liver metastasis was shown to improve the outcome of patients with colorectal cancer. Methods: Subjects were 51 patients with colorectal cancer receiving resection of liver metastasis including 29 patients who were given chemotherapy with oxaliplatin following liver resection and 22 patients who were given chemotherapy without oxaliplatin. Splenic volumes were measured after liver resection, at the end of chemotherapy and 1 year later. Results: Among 29 patients receiving chemotherapy with oxaliplatin, splenic volumes were increased in 21 patients (72.4%) at the end of chemotherapy compared to those after liver resection, and the medium volume in 29 patients was 149.6 ml after liver resection and 195.7 ml at the end of chemotherapy (p < 0.001). Enlargement of splenic volumes were also seen 1 year later in 15 of 21 patients (71.4%), and the medium volume in 29 patients was 194.0 ml, which was larger than that after liver resection (p =.005). In contrast, such changes in splenic volumes were absent in patients receiving chemotherapy without oxaliplatin. Conclusion: Considering the change in splenic volumes, the sinusoidal injury might occur in about 70% of patients receiving oxaliplatin following liver resection, and was also seen in about 70% of these patients even 1 year later.

Possibility to identify feeding vessels of esophageal varices based on endoscopic findings of varices was evaluated. Subjects were 124 patients receiving EIS with EO or EISL monotherapy, and the frequency of each feeding vessel was evaluated depending on location of esophageal varices on clockwise direction. The lest gastric vain was identified as a feeding vessel of varices located in all clockwise directions of the esophagus, while was seen especially frequent in patients with varices located from the anterior to left walls of the esophagus. In contrast, the posterior gastric vain was identified as a feeding vessel especially in patients with varices located on the left wall of the esophagus. Consequently, he feeding vessels were the left gastric vein in 111 patients (90%), the posterior gastric vein in 9 patients (7%), and the left gastric vein plus posterior gastric vein in 4 patients (3%), suggesting that the main feeding vessel of esophageal varices was the left gastric vein followed by the posterior gastric vein. These data suggest that possible feeding vessels may be estimated based on the clockwise direction of esophageal varices. Our observation may contribute to establish therapeutic strategy for esophageal varices, since feeding vessels in which EO is injected during the EIS procedure can be identified based on endoscopic findings of esophageal varices.