There is no positive therapeutic effect besides providing surgical margins in hepatectomy and EBDR in the surgical treatment of pT2 GBC whereas lymph node dissection is most effective procedure for improving survival. Provided that the negative surgical margins are secured, a hepatectomy and an EBDR can therefore be withheld in the surgical treatment for the pT2 GBC.

We defined the subsegmental divisions and the ramification patterns of the portal vein in the right and caudate lobes using 25 human liver casts. The ramifications of the portal vein and the subdivisions of the liver were classified based on the major portal veins with the largest diameter and those having a diameter of not less than two thirds of the largest vein in each subsegment. The following results were obtained. (l)The portal trunk showed three ramification patterns and the basic pattern was bifurcation (80%). (2) The anterior portal vein first ramified into several anterior-inferior portal veins (P₅) and ran toward the superior direction to bifurcate into 2 major portal veins in the anterior-superior subsegment (Sg). (3)There were three types of ramification patterns of the portal veins in S₈: bifurcation (84%), trifurcation and one-pedicle type. (4)There were also three branching types of the largest vein (P₅-max) in P5: ramification from the anterior portal vein, Pg-anterior vein supplying the anterior region of S₈ and Pg-posterior vein supplying the posterior region of S₈. (5)The posterior portal vein showed two ramification patterns of the bifurcation (36%) and nonbifurcation type. (6) The major portal veins in the caudate subsegment ramified at various sites such as the portal trunk, left, right and/or other portal veins.

We report a rare case of an epidermoid cyst in an accessory spleen at the pancreatic tail. Only 12 cases have been reported. Among the different diagnostic modalities, magnetic resonance imaging was most useful for the differential diagnosis. Precise imaging of the cyst wall and its comparison with the surrounding organs are essential.

Two patients with adenofibromyomatous hyperplasia located at the distal end of the extrahepatic bile duct are reported herein. The chief symptom in both patients was upper abdominal pain and the lesions found involved the proliferation of submucosal mucous glands and fibrous elements. Further progress in imaging diagnostic techniques would increase the frequency with which such lesions are discovered. But, even now, if mural irregularities and shadow defects are found in the extrahepatic bile duct, particularly in the distal end of the common bile duct, the possibility of a benign lesion such as adenofibromyomatous hyperplasia should be taken into consideration when making a diagnosis.

No abstract