title: Right anterior segmental hepatic duct emptying directly into the cystic duct in a living donor.
abstract: A 35-year-old mother was scheduled to be the living donor for liver transplantation to her second son, who suffered from biliary atresia complicated with biliary cirrhosis at the age of 2 years. The operative plan was to recover the left lateral segment of the mother's liver for living donor transplantation. With the use of cholangiography at the time of surgery, we found the right anterior segmental duct (RASD) emptying directly into the cystic duct, and the catheter passed into the RASD. After repairing the incision in the cystic duct, transplantation was successfully performed. Her postoperative course was uneventful. Biliary anatomical variations were frequently encountered, however, this variation has very rarely been reported. If the RASD was divided, the repair would be very difficult because the duct will not dilate sufficiently in an otherwise healthy donor. Meticulous preoperative evaluation of the living donor's biliary anatomy, especially using magnetic resonance cholangiography and careful intraoperative techniques, is important to prevent bile duct injury and avoid the risk to the healthy donor.
authors.affiliation: Department of Surgery, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, Tochigi, Japan. ynao-i@mub.biglobe.ne.jp.
authors.forename: Yasunao
authors.initials: Y
authors.lastname: Ishiguro
authors.forename: Masanobu
authors.initials: M
authors.lastname: Hyodo
authors.forename: Takehito
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Yasunaru
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hojo
authors.forename: Koichi
authors.initials: K
authors.lastname: Mizuta
authors.forename: Hideo
authors.initials: H
authors.lastname: Kawarasaki
authors.forename: Alan T
authors.initials: AT
authors.lastname: Lefor
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003549:Cystic Duct / Q000033:anatomy & histology* / Q000601:surgery; D005260:Female; D006500:Hepatic Duct, Common / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male