Relationship between right portal and biliary systems based on reclassification of the liver

Cho, Akihiro; Asano, Takehide; Yamamoto, Hiroshi; Nagata, Matsuo; Takiguchi, Nobuhiro; Kainuma, Osamu; Soda, Hiroaki; Mori, Mikito; Narumoto, Souichi; Okazumi, Shinichi; Makino, Harufumi; Ochiai, Takenori; Ryu, Munemasa

doi:10.1016/j.amjsurg.2006.10.007

« Previous Next »The American Journal of Surgery
Volume 193, Issue 1 , Pages 1-4, January 2007

Relationship between right portal and biliary systems based on reclassification of the liver

Akihiro Cho, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
- Corresponding author. Tel.: +81-43-264-5431; fax: +81-43-262-8680.
Takehide Asano, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Hiroshi Yamamoto, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Matsuo Nagata, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Nobuhiro Takiguchi, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Osamu Kainuma, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Hiroaki Soda, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Mikito Mori, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Souichi Narumoto, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan
Shinichi Okazumi, M.D.
- Department of Academic Surgery, Graduate School of Medicine, Chiba University, Chuouku, Chiba, Japan
Harufumi Makino, M.D.
- Research Center for Medical Engineering, Chiba University, Chuouku, Chiba, Japan
Takenori Ochiai, M.D., Ph.D., F.A.C.S.
- Department of Academic Surgery, Graduate School of Medicine, Chiba University, Chuouku, Chiba, Japan
Munemasa Ryu, M.D.
- Department of Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba 260-8717, Japan

Received 9 January 2006; received in revised form 23 April 2006

Abstract

Background

Although the anatomy of the right portal and biliary systems and their interrelationships must be understood to safely and satisfactorily perform left-sided resection of hilar cholangiocarcinoma or right-lobe living donor liver transplantation, the anatomies of the right portal and biliary systems are extremely difficult to understand.

Methods

A total of 60 patients with normal liver underwent computed tomography during both portography and cholangiography to evaluate relationships between the right biliary and portal systems based on reclassification of the liver to divide the right liver into 3 segments.

Results

All ventral and posterior ducts constantly join medially to the anterior portal trunk. In contrast, some dorsal ducts join the ventral duct medially and others join the posterior duct lateral to the anterior trunk.

Conclusions

Reclassification of the liver to divide the right liver into 3 segments facilitates an understanding of relationships between the right portal and biliary systems.

Keywords: Hilar cholangiocarcinoma, Living donor liver transplantation, Reclassification of the liver, 3D portocholangiography