Right hepatic lobectomy and subsegmental resection of the left caudate lobe for gallbladder carcinoma involving the hepatic hilus: Preservation of the ventral portion of the left caudate lobe |
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Authors: | Hideo Yamamoto Naokazu Hayakawa Shun-ichiro Komatsu Masato Nagino and Yuji Nimura |
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Institution: | (1) Department of Surgery, Tohkai Hospital, 1-1-1 Chiyodabashi, Chikusa-ku, Nagoya 464, Japan, JP;(2) First Department of Surgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466, Japan, JP |
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Abstract: | A case of gallbladder carcinoma in a 75-year-old woman with familial hyperbilirubinemia and preoperative hepatic dysfunction
is presented. Tube cholangiography through a percutaneous transhepatic biliary drainage (PTBD) catheter demonstrated a stricture
and the hepatic confluence without filling of the gallbladder and showed two bile duct branches arising from the left caudate
lobe. Cholangiography also disclosed that the left dorsal branch, which joined the right hepatic bile duct, was involved with
tumor, while the left ventral branch, which joined the left hepatic duct, was not. Extended right hepatic lobectomy with resection
of the dorsal portion of the left caudate lobe, preserving the ventral portion of the left caudate lobe, was performed. Postoperative
cholangiography showed that the ventral branch of the left caudate lobe bile duct was preserved. Precise preoperative anatomic
diagnosis of the biliary system in patients with hepatobiliary cancer allows successful subsegmental resection of the caudate
lobe.
Received for publication on July 23, 1997; accepted on Oct. 6, 1997 |
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Keywords: | : gallbladder carcinoma caudate lobe subsegmental resection |
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