title: Hepatectomy for metastatic liver tumors complicated with right umbilical portion.
abstract: We report the case of a 76-year-old man, presenting with a right umbilical portion (RUP), with two liver metastases of rectal cancer, 2cm and 1 cm tumors in the caudate lobe and anterior segment, respectively. The portal first branch ran to the right posterior segment and the remaining formed a left trunk, thereafter forming RUP. The tumor in the caudate was close to the right posterior segment's Glissonean pedicle. On 3-dimensional CT analysis under tubography via an endoscopic naso-biliary tube, the anatomical patterns of the arteries and bile ducts were complicated. On laparotomy, the gallbladder was located to the left of the round ligament. Right posterior segmentectomy plus partial caudate resection and partial hepatectomy of the anterior segment was performed after skeletonization of the biliovascular structures at the hepatic hilum. Precise examination of the biliovascular structures is needed to safely perform hepatectomy in patients complicated with RUP.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan. saka1119@hama-med.ac.jp
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Shohachi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Morita
authors.forename: Kosuke
authors.initials: K
authors.lastname: Oishi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Inaba
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Baba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D000368:Aged; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D012004:Rectal Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014472:Umbilicus / Q000473:pathology*