title: Major hepatectomy using the glissonean approach in cases of right umbilical portion.
abstract: Right umbilical portion (RUP) is a rare congenital anomaly associated with anomalous ramifications of the hepatic vessels and biliary system. As such, major hepatectomy requires a careful approach. We describe the usefulness of the Glissonean approach in two patients with vessel anomalies, such as RUP. The first patient underwent a right anterior sectionectomy for intrahepatic cholangiocarcinoma. We encircled several Glissonean pedicles that entered the right anterior section along the right side of the RUP. We temporarily clamped each pedicle, confirmed the demarcation area, and finally cut them. The operation was performed safely and was successful. The second patient underwent a left trisectionectomy for perihilar cholangiocarcinoma. We secured the right posterior Glissonean pedicle. The vessels in the pedicle were preserved, and the other vessels and contents were resected. Identifying the vessels for preservation facilitated the safe lymphadenectomy and dissection of the vessels to be resected. We successfully performed the operation.
authors.affiliation: Yusuke Ome, Kazuyuki Kawamoto, Tae Bum Park, Tadashi Ito, Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ome
authors.affiliation: Yusuke Ome, Kazuyuki Kawamoto, Tae Bum Park, Tadashi Ito, Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kawamoto
authors.affiliation: Yusuke Ome, Kazuyuki Kawamoto, Tae Bum Park, Tadashi Ito, Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Tae Bum
authors.initials: TB
authors.lastname: Park
authors.affiliation: Yusuke Ome, Kazuyuki Kawamoto, Tae Bum Park, Tadashi Ito, Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ito
keywords: Cholangiocarcinoma; Glissonean approach; Glissonean pedicle; Hepatocellular carcinoma; Left trisectionectomy; Right anterior sectionectomy; Right umbilical portion