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HCCの肝内小転移巣につき,肝動脈内炭酸ガス注入による術中Angio-echography(以下アンジオエコーと略す)の診断能について検討した.対象症例はHCCに対する肝切除症例の内,切除標本にて10mm以下の肝内転移巣の存在の有無が明確となっている23例である.小転移巣を持っていた症例は9例で16病巣であった.アンジオエコー画像はPositive enhance, Negative enhance, Non enhanceの3型に分けられるが,これら16結節の内13結節がPositive enhanceに,3結節はNegative enbanceとして結節の存在が確認され,顕出率は100%である.これらの内5結節は通常のエコーでは顕出されず,本法により初めて発見され,最小のものは4mmであった.また標本で肝内転移巣が無かったものは14症例であるが,これらは全てAngio-echoではNon enhanceであった.

In cases of massive bleeding from post-bulbar duodenal ulcer, pancreatoduodenectomy has sometimes been done to resect the bleeding portion. However, since this operation is performed at emergency, it is desirable to reduce its risk. We have devised a simplified operative procedure, pancreas-saving duodenectomy. In this operation, the feeding vessels of the duodenum are transected on the line of pancreato-duodenal fixation. There is no need to resect any part of the pancreas. We have experienced two cases of this operation with satisfactory results. In the first case, the duodanal papilla remained as a 3×3cm patch, and anastmosis to the jejunum was designed for reconstruction. In the second case, the duodenal papilla was also resected, and the pancreatic duce and bile duct, which were directly opened at the head of the pancreas, were anastomed to the jejunum.

Primary lymphoma of the liver is an extremely rare entity; only eight cases have been reported in the literature. We treated a 34-year-old man with primary hepatic lymphoma by right hepatic lobectomy, including right hemicolectomy the nephrectomy. The histological diagnosis was a small cell diffuse histiocytic lymphoma. Details of this case plus that of others in the literature are described in this report.