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Left hepatic trisectionectomy for perihilar cholangiocarcinoma with a right-sided round ligament:A case report

World Journal of Gastrointestinal Surgery 2020年第2期12卷 68-76页

作者： Tomoyuki Ishida Satoshi Nara Keiichi Akahoshi Takeshi Takamoto Yoji Kishi Minoru Esaki Nobuyoshi Hiraoka Kazuaki Shimada Department of Hepatobiliary and Pancreatic Surgery National CancerCenter HospitalTokyo 104-0045Japan Department of Pathology and Clinical Laboratories National Cancer Center HospitalTokyo 104-0045Japan

BACKGround A right-sided round ligament(RSRL)is a rare,congenital anomaly of the intrahepatic portal vein,with a reported frequency of 0.2%-1.2%.For patients with perihilar cholangiocarcinoma associated with an RSRL,an accurate understanding of the vascular and biliary anatomy is *** SUMMARY We report a 70-year-old male with perihilar cholangiocarcinoma associated with an *** percutaneous transhepatic embolization of the left and anterior portal branches,we conducted a left trisectionectomy of the liver with extrahepatic bile duct resection and *** postoperative course was uneventful,and R0 resection was *** the liver volume of each section was compared between 7 patients with an RSRL and 20 patients with normal portal vein anatomy,the posterior section in RSRL patients was significantly larger than that in patients with normal portal vein anatomy(median:457 mL vs 306 mL,P=0.031).In patients with perihilar cholangiocarcinoma associated with an RSRL,left trisectionectomy has several surgical advantages:(1)The posterior branch of the portal vein often ramifies independently,and the division of the portal vein is easily conducted;(2)A relatively large amount of remnant liver can be retained;and(3)The anatomy of the posterior branch of the Glissonian pedicle is similar to that in patients with normal *** In patients with an RSRL and perihilar cholangiocarcinoma that does not involve the posterior section,left trisectionectomy may be a favorable choice.

关键词： right-sided round ligament Left-sided gallbladder Perihilar cholangiocarcinoma Case report

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