title: Safe bile duct division in right lateral sector graft.
abstract: OBJECTIVE
  Right lateral sector (RLS, segments VI and VII according to Couinaud's nomenclature for liver segmentation) graft was introduced as an alternative liver graft. The authors report their surgical techniques for bile duct division in RLS graft harvest.
  
  
  METHODS
  Between January 2000 and December 2001, 11 donors provided their RLS. Intraoperative cholangiography was performed and the anatomy of the upper biliary confluence was confirmed. When the right lateral duct entered the common bile duct (caudal right lateral duct), the duct was divided at its root in situ. In other situations, the right portal branch was first dissected and taped. With the right portal branch pulled cranially, the right lateral duct was dissected from surrounding connective tissues and divided as long as possible.
  
  
  RESULTS
  Cholangiography revealed various right lateral duct anatomies, such as entering the right duct (n=6), the left and right bifurcation (n=2), the common bile duct (n=2) and the left duct (n=1). The postoperative course was uneventful in all donors. All of the patients survived the operation.
  
  
  CONCLUSIONS
  Careful attention should be paid to bile duct division in donor hepatectomy. The present technique can ensure a safe harvest of RLS graft with a long right lateral duct.
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine University of Tokyo, Tokyo, Japan. yasusuga-tky@umin.ac.jp
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Matsui
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Noritomi
authors.forename: Junichi
authors.initials: J
authors.lastname: Kaneko
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D001652:Bile Ducts / Q000033:anatomy & histology / Q000601:surgery*; D002675:Child, Preschool; D004210:Dissection / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D020858:Tissue and Organ Harvesting / Q000379:methods*