title: Vascular architecture in anomalous right-sided ligamentum teres: three-dimensional analyses in 35 patients.
abstract: BACKGROUND
  Right-sided ligamentum teres (RSLT) is a congenital anomaly that is sometimes encountered during hepatobiliary surgeries. However, a valid protocol for describing the segmental anatomy of livers with RSLT has not been established, and confusions or anatomic misunderstandings have been a major problem.
  
  
  METHODS
  The vascular architecture and morphological characteristics were investigated in 35 livers with RSLT using three-dimensional (3D) simulations.
  
  
  RESULTS
  Couinaud's four sectors and three hepatic veins were clearly distinguished in the liver with RSLT using 3D simulations. The ligamentum teres was connected with the right paramedian portal pedicle, and the long axis of the cystic fossa was always observed on the left of the ligamentum teres in all 35 livers. However, when the main portal scissura was visualized using 3D simulation, the gallbladder was always located on the border of either side of the hemilivers, and the malposition of the gallbladder was not confirmed.
  
  
  CONCLUSIONS
  Although the right-sided components of the livers are well developed as a result of the right-dominant distribution of the feeding vessels in livers with RSLT, the basic segmental structure defined by the four sectors and the three hepatic veins are as well preserved as those in the typical liver anatomy.
authors.affiliation: Hepato-biliary-pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan. kokudo-2su@h.u-tokyo.ac.jp
authors.forename: Junichi
authors.initials: J
authors.lastname: Shindoh
authors.forename: Masaaki
authors.initials: M
authors.lastname: Akahane
authors.forename: Shoichi
authors.initials: S
authors.lastname: Satou
authors.forename: Taku
authors.initials: T
authors.lastname: Aoki
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Beck
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006503:Hepatic Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional; D008022:Ligaments / Q000002:abnormalities* / Q000098:blood supply / Q000000981:diagnostic imaging; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014471:Umbilical Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging