Caudal left hepatic duct in relation to the umbilical portion of the portal vein.
OBJECTIVE
Intrahepatic ducts from the left lateral segment of the liver are generally considered to run from the cranial to the umbilical portion of the left portal vein. This understanding often limits surgical exploration of the left hepatic ducts during both curative and palliative surgical procedures. The prevalence of ducts from the lateral segment running caudally to the umbilical portion was studied retrospectively on computed tomography (CT) films, and its clinical implications were evaluated.


METHODS
One hundred and sixty-six DIC (drip infusion cholangiography) CT and 30 post-PTCD (percutaneous transhepatic cholangio-drainage) CT films taken during 4 consecutive years were reviewed giving special consideration to whether the ducts from the left lateral segment of the liver run caudal to the umbilical portion of the left portal vein.


RESULTS
Corresponding variation was found in 3.6% of the DIC-CT examinations and in 3.3% of the CT examination after PTCD, respectively.


CONCLUSIONS
The incidence of caudal left hepatic ducts with respect to the umbilical portion of the left portal vein was higher than expected from clinical experience. These results emphasize that more careful planning is necessary prior to hepatobiliary surgery.
Kitamura
H
H
Department of Surgery, NTT Nagano Hospital, Japan. h-kitamura@surg101.shinshuu.ac.jp
Mori
T
T
Arai
M
M
Tsukada
K
K
Numata
M
M
Kawasaki
S
S
D001662:Biliary Tract Surgical Procedures; D002758:Cholangiography; D006500:Hepatic Duct, Common / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D010166:Palliative Care; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed