Safe introduction of laparoscopic partial liver resection (LPLR) requires the selection of appropriate cases not exceeding the surgeon's skills as well as standardization of surgical procedures. After introduction at our institution, 60 LPLR procedures were performed between April 2010 and May 2016. To identify indices for case selection, short-term perioperative parameters were analyzed, including operative time, blood loss, postoperative complications, and postoperative hospital stay. Operative time was significantly shorter in the last 30 cases compared with the first 30 cases (182.5 min vs. 253 min; p＝0.023) and in 16 cases involving the left lobe (S2-4) compared with 44 cases involving the right lobe (S1, S5-8; 148.5 min vs. 246 min; p＝0.004). Blood loss was significantly less (0 mL vs. 50 mL; p＝0.028) and operative time was significantly shorter (185 min vs. 250 min; p＝0.048) in 27 cases with tumor diameter ＜2.5 cm compared with 33 cases with tumor diameter ≥ 2.5 cm. Operative time tended to be longer in 9 cases of multiple-site resection compared with 51 cases of single-site resection (207 min vs. 260 min; p＝0.085). BMI, pathology, and hepatitis virus status showed no significant difference in perioperative short-term results. For the introduction of LPLR, it may be preferable to select cases located in the left lobe with a tumor diameter ＜2.5 cm and to accumulate a certain amount of experience in similar cases first.

Objective：The movement of an elderly person involving stepping over a bathtub makes them prone to falls and requires caution. Gait analysis suggested that the risk of falling increases with time spent in supporting both legs. A similar relationship was expected for side-straddling motion. This study aims to analyze differences in the side-straddling movements between THA patients who did not fully recover their functional balance, mobility, or walking ability from the viewpoint of the ratio of time spent supporting both legs.Methods：Eleven patients with hip osteoarthritis underwent initial unilateral THA via a posterior approach. Using a portable three-dimensional motion analyzer, we calculated the percentages of time spent supporting both legs while entering the bathtub, and exiting the bathtub with a handrail and examined the factors associated with percent of the time spent supporting both legs.Results：The percentage of time spent supporting both legs when exiting the bathtub was significantly lesser when exiting using the nonoperative than the operated side. A negative correlation was found between the percentages of time spent supporting both legs. while exiting the bathtub, and the percentage of handrail load values.Conclusion：The risk of falling may be reduced by using the nonoperative leg as the leading leg when exiting a bathtub. Use of handrails contributes to a reduction in fall risk.

Objective: IgG4-related sclerosing cholecystitis is generally associated with IgG4-related sclerosing cholangitis and presents with diffuse, circumferential thickening of the gallbladder wall. We report a rare case of localized IgG4-related sclerosing cholecystitis without IgG4-related sclerosing cholangitis, which was difficult to differentiate from gallbladder cancer preoperatively.Patient: A 56-year-old man with suspected IgG4-related disease or gallbladder cancer was admitted to our ward. The serum IgG4 level was elevated at 721 mg/dL. Computed tomography (CT) demonstrated focal wall thickening of the gallbladder fundus. Drip infusion cholecystocholangiography with CT revealed no dilation, stenosis, or border irregularity of the bile duct.Results: For diagnostic and treatment purposes, cholecystectomy with wedge resection of the gallbladder bed was performed. The pathological diagnosis was IgG4-related sclerosing cholecystitis.Conclusion: It is difficult to differentiate IgG4-related sclerosing cholecystitis from gallbladder cancer in cases involving localized thickening of the gallbladder wall. In similar cases, surgical resection with cancer in mind might be performed based on present clinical knowledge.