To organize the current status and understanding of liver resection in the treatment of hepatocellular carcinoma, a questionnaire survey was conducted. The Kyushu Liver Surgery Study Group was sponsoring 15 institutions including hepatologists and liver surgeons. Regarding the excision borderline, hepatologists felt limited by numbers and Vps, while surgeons felt limited by Vvs. In the case of BCLC-B, hepatologists had few choices for resection even if the treatment succeeded. Surgeons chose treatment for the conversion surgery attempt in the case of portal vein proximity, but hepatologists chose resection as a result after successful treatment. For the conversion attempt, most hepatologists hoped to use drug therapy or local treatment. It has become clear that hepatologists and surgeons must further change their mindset to perform hepatic resection and local or systemic therapy in the treatment of hepatocellular cancer.

Due to a low level of consciousness, a 73-year-old man was brought to the emergency department. Blood analysis demonstrated hypoglycemia. A 50% glucose infusion restored consciousness. Computed tomography scans revealed massive ascites, hydrothorax, liver atrophy, and multiple pancreatic cysts. After 12 days, his general condition deteriorated and he died. The results of the postmortem examination indicated liver atrophy and pancreatic cancer. Autopsy histopathology revealed lipofuscin accumulation in the cytoplasm of the liver and diagnosed brown liver atrophy.

The patient was a 31-year-old man who had undergone the Fontan Procedure for a single right ventricle at 3 years. A liver mass in segment 3 grew in size (23 mm in diameter) and alpha-fetoprotein concentration, raising the possibility of Fontan procedure-related liver cancer (FRLC). Laparoscopic partial liver resection was performed. Laparoscopic surgery is generally thought to be harmful for Fontan circulation patents with high central venous pressure (CVP). Several studies have recommended managing fluid administration to maintain low CVP, stopping positive end expiratory pressure, and decreasing airway pressure to avoid these situations. In the case of uncontrollable CVP despite several measures, a laparotomy may be recommended. Therefore, some indications of laparoscopic hepatectomy for FRLC should be necessary. We should collect data on FRLC patients by creating a large-scale, nationwide database.

A retrospective study was conducted to determine the efficacy of a diet and exercise hospitalization program for fatty liver. During six days, a diet of 25 to 30 kcal/kg multiplied by ideal body weight (BW) was followed by aerobic and resistance exercise (exercise intensity of 4 to 5 METs daily). The changes in liver function (AST, ALT, and γGTP), glycolipid metabolism (HbA1c and triglyceride), ferritin, and BW were assessed based on whether or not the patient was hospitalized (86 cases) (17 cases). Except for BW, the parameters improved significantly at 6 months after hospitalization when compared to baseline. However, these did not improve in no hospitalization. At 6 months after hospitalization, a diet and exercise program improved liver function and glycolipid metabolism.