Infraportal bile duct of the caudate lobe: a troublesome anatomic variation in right-sided hepatectomy for perihilar cholangiocarcinoma.

摘要: Objective We present our experiences with infraportal bile duct of the caudate lobe (B1) and discuss surgical implications this rare variation. Summary background data Although various authors have investigated biliary anatomy at hepatic hilum, an B1 (joining caudally to transverse portion left portal vein) has not been reported. Methods Between January 1981 December 2005, 334 patients underwent hepatectomy combined lobectomy for perihilar cholangiocarcinoma. Four them (1.2%) had were clinicoanatomically. Results All B1l, draining Spiegel's lobe; no B1r (draining paracaval portion) or B1c ducts process) found. The B1l joined common duct. Three right trisectionectomy lobectomy; one, in whom preoperative diagnosis was possible, vein resection reconstruction performed before resect en bloc without division B1. For other 2 patients, divided preserve vein, then resected bloc. fourth patient cut end showed cancer by frozen section, so ligated lobe. Conclusion Infraportal can cause difficulties performing right-sided harvesting side liver transplantation. Hepatobiliary transplant surgeons should carefully evaluate keeping variation mind.