Objective To discuss the treatment and prevention of bile duct complications after living donor liver transplantation. Methods The clinical data of 84 cases of living donor liver trans-plantation including 56 adult recipients and 28 pediatric recipients were analyzed. Amongst the 84 pa-tients, 66 had benign end-stage liver diseases and 18 hepatocellular carcinoma. Duct-to-duct biliary re-construction was performed in 50 cases. One recipient received an end-to-end and end-to-side anasto-mosis of hepatic duct of donor and hepatic duct and common bile duct of recipient and another under-went end-to-end anastomosis of hepatic duct of donor and hepatic duct and cystic duct of recipient while the other 32 cases hepaticojejunostomy. 4Fr or 6Fr stent was routinely inserted into bile duct af-ter biliary reconstruction and elicited from the anterior wall of common bile duct or lateral wall of jeju-nal caecum of recipient in all the 84 cases. Results Twenty-four cases had biliary complications and the incidence was 28.5 %. The incidence of biliary leakage was significantly different between duct-to-duct reconstruction and hepaticojejunostomy (8.3% νs 16.7%, P＜0.05). The incidence of biliary stricture was markedly different between duct-to-duct reconstruction and hepaticojejunostomy (50% νs 16.7%, P＜0.05). The biliary complication was remarkably different between single hepatic duct and multiple hepatic duct (20.8% νs 79.2, P＜0.05). Four cases of biliary leakage were cured with con-servative treatment and the other 4 need reoperation. Four cases of biliary stricture were cured by way of endoscopic dilation and nose-biliary drainage, 2 cases turned to be better. Six cases were cured by conversion of hepaticojejunostomy and 4 turned to be better by way of percutaneous transhepatic biliar-y dilation and drainage. The recipients didn't die of biliary complications. Conclusion It is necessary to decrease the biliary complications after living donor liver transplantation, to be satisfactory blood supply and anastomotic technigue and select appropriato biliary reconstruction.

In recent years, depression has become diverse, particularly in the younger population. In the field of medical education, it is assumed that a number of educators often experience difficulties in attending to their learners with depression. In this review article, information which contributes to the promotion of mental health for medical residents is provided, considering the knowledge of recent depression in the younger population, including its diversity together with the characteristics of the "generation educated with latitude".

The dawn of Japan’s super-aged society is accompanied by various problems, including increased social security expenditures and greater nursing care burden as well as reduced labor force. Targeting 2025, when Japan’s baby-boomer generation will be aged ≥75 years, the government’s Ministry of Health, Labour and Welfare is promoting the establishment of local comprehensive support and service provision systems (Comprehensive Community Care Systems). Although such comprehensive community care systems will require medical professionals to provide treatment through collaborative interprofessional cooperation with colleagues in other fields, effective cooperation has currently not been established because of a lack of understanding regarding the roles and functions of other occupations. Considering that the promotion of interprofessional-based collaborative learning prior to university graduation will be important for resolving this problem, we organized a workshop for medical students based in Ehime Prefecture and evaluated its usefulness based on questionnaire surveys administered before and after the workshop. Consequently, it was ascertained that pharmacy, medical, and nursing students had a heightened awareness of “the importance of interprofessional collaboration” after the workshop as against before the workshop. Students’ degree of comprehension of the nature of the work in each category increased significantly. These results demonstrate the importance and effectiveness of students familiarizing themselves with the learning and work content of other fields by working with colleagues in different medical fields as observed in this workshop. They also expect that student-led study groups will contribute to promote the comprehensive community care systems.