Radiological anatomy of the medial segmental bile duct of the liver assessed by CT cholangiography.
OBJECTIVE
To analyze drainage areas and points of confluence of the medial segmental bile ducts of the liver, 72 patients with obstructive jaundice underwent computed tomography cholangiography.


METHODS
We divided the medial segmental ducts into the following three subsegmental branches: B4a was defined as the inferior branch, B4b as the superior branch, and B4c as the dorsal branch.


RESULTS
In 62 (86%) of the 72 patients, each B4a and B4b branches joined to form a single medial segmental duct, which joined the left hepatic duct in 25 patients (35%), the confluence of the lateral inferior (B3) and superior (B2) branches in 18 patients (25%), B3 in 15 patients (20%), the confluence of the right and left hepatic ducts in 4 patients (6%). In addition, these medial segmental ducts primarily entered the left hepatic duct in the final half of its length or more distant portion from the hepatic hilum in 43 (77%) of the 62 patients.


CONCLUSIONS
Thus, in most cases the inferior area of the medial segment should be preserved when right-sided resection of the liver is indicated for hilar bile duct cancer.
Cho
Akihiro
A
Department of Academic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba 260-0856, Japan. cho@insei.m.chiba-u.ac.jp
Ryu
Munemasa
M
Kinoshita
Taira
T
Kawano
Noriaki
N
Konishi
Masaru
M
Miyazawa
Yukimasa
Y
Okazumi
Shinichi
S
Ochiai
Takenori
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D002758:Cholangiography; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology; D004067:Digestive System Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036542:Tomography, Spiral Computed