title: Three-dimensional imaging identified the accessory bile duct in a patient with cholangiocarcinoma.
abstract: The development of diagnostic imaging technology, such as multidetector computed tomography (MDCT) and magnetic resonance cholangiopancreatography (MRCP), has made it possible to obtain detailed images of the bile duct. Recent reports have indicated that a 3-dimensional (3D) reconstructed imaging system would be useful for understanding the liver anatomy before surgery. We have investigated a novel method that fuses MDCT and MRCP images. This novel system easily made it possible to detect the anatomical relationship between the vessels and bile duct in the portal hepatis. In this report, we describe a very rare case of extrahepatic cholangiocarcinoma associated with an accessory bile duct from the caudate lobe connecting with the intrapancreatic bile duct. We were unable to preoperatively detect this accessory bile duct using MDCT and MRCP. However, prior to the second operation, we were able to clearly visualise the injured accessory bile duct using our novel 3D imaging modality. In this report, we suggest that this imaging technique can be considered a novel and useful modality for understanding the anatomy of the portal hepatis, including the hilar bile duct.
authors.affiliation: Ryoichi Miyamoto, Yukio Oshiro, Shinji Hashimoto, Keisuke Kohno, Kiyoshi Fukunaga, Tatsuya Oda, Nobuhiro Ohkohchi, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Miyamoto
authors.affiliation: Ryoichi Miyamoto, Yukio Oshiro, Shinji Hashimoto, Keisuke Kohno, Kiyoshi Fukunaga, Tatsuya Oda, Nobuhiro Ohkohchi, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Oshiro
authors.affiliation: Ryoichi Miyamoto, Yukio Oshiro, Shinji Hashimoto, Keisuke Kohno, Kiyoshi Fukunaga, Tatsuya Oda, Nobuhiro Ohkohchi, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Hashimoto
authors.affiliation: Ryoichi Miyamoto, Yukio Oshiro, Shinji Hashimoto, Keisuke Kohno, Kiyoshi Fukunaga, Tatsuya Oda, Nobuhiro Ohkohchi, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kohno
authors.affiliation: Ryoichi Miyamoto, Yukio Oshiro, Shinji Hashimoto, Keisuke Kohno, Kiyoshi Fukunaga, Tatsuya Oda, Nobuhiro Ohkohchi, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Fukunaga
authors.affiliation: Ryoichi Miyamoto, Yukio Oshiro, Shinji Hashimoto, Keisuke Kohno, Kiyoshi Fukunaga, Tatsuya Oda, Nobuhiro Ohkohchi, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Oda
authors.affiliation: Ryoichi Miyamoto, Yukio Oshiro, Shinji Hashimoto, Keisuke Kohno, Kiyoshi Fukunaga, Tatsuya Oda, Nobuhiro Ohkohchi, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohkohchi
mesh_terms: D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D049448:Cholangiopancreatography, Magnetic Resonance; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: 3-dimensional imaging; Accessory bile duct; Caudate lobe bile duct; Cholangiocarcinoma; Hepatobiliary and pancreatic surgery