Distributing pattern of the bile duct of the caudate lobe on computed tomography with drip infusion cholangiography and its surgical significance.
OBJECTIVE
It is important to recognize the distribution of the bile ducts in the caudate lobe of the liver for the hepato-biliary surgery. To map the spatial relationship between the bile ducts and the liver parenchyma under physiological conditions, we performed an anatomical analysis of them using computed tomography combined with drip infusion cholangiography (DIC-CT).


METHODS
We identified the bile ducts in the caudate lobe, which was divided into the Spiegel lobe, paracaval portion, and caudate process, with DIC-CT. We then investigated their number and confluence pattern in 132 patients without any abnormality in the hilar bile ducts.


RESULTS
The mean number of the bile ducts in the caudate lobe was 2.68 per liver. In the Spiegel lobe, the branches drained into the left hepatic duct system in about 83%. The confluence of the paracaval branch was the left hepatic duct, right hepatic duct, and posterior segmental branch, all with the same frequency of approximately 30%. Almost all of the caudate process branches (92.4%) drained into the posterior segmental branch.


CONCLUSIONS
DIC-CT is a useful method for the anatomical analysis of the intrahepatic bile ducts under physiological conditions, and we obtained novel and important findings for surgery.
Takamatsu
Susumu
S
Department of Surgery, Kasukabe Shuwa Hospital, Kasukabe, Saitama, Japan. takamatsu.srg1@med.tmd.ac.jp
Goseki
Narihide
N
Nakajima
Kazumi
K
Teramoto
Kenichi
K
Iwai
Takehisa
T
Arii
Shigeki
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging* / Q000473:pathology; D002758:Cholangiography / Q000379:methods*; D041761:Cholecystolithiasis / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D042882:Gallstones / Q000473:pathology; D006801:Humans; D007262:Infusions, Intravenous; D007458:Iodipamide / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; C012386:meglumine iotroxinate; D007458:Iodipamide