Abstract
Hepatobiliary resection with caudate lobectomy has been conducted in the surgical treatment of bile duct carcinoma of the hepatic hilus. However, insufficient attention has been paid to the anatomy of the right portion of the caudate lobe, and techniques to visualize the portal branches of the right caudate lobe (P1r) have not been reported. Contrast medium was injected into the dorso-caudal branches of the middle hepatic vein (MHV) and images were obtained by digital subtraction venography. Retrograde portography of the P1r was achieved in 64 (84%) out of 76 cases. The mean number of visualized branches was 2.1 (137 out of 64) and the P1r coursed beyond the trunk of the MHV in 36 (56%) out of the 64 cases. Contrast medium flowed into the right portal vein from 59 P1r branches in 32 cases and into the left portal vein in 20 cases. No complications were encountered. Retrograde portograms of the P1r may provide valuable information not previously available to surgeons operating on the caudate lobe.
Similar content being viewed by others
References
Barlett D, Fong Y, Blumgart LH (1996) Complete resection of the caudate lobe of the liver: technique and results. Br J Surg 83: 1076–1081
Cho A, Okazumi S, Takayama W, Takeda A, Iwasaki K, Sasagawa S (2000) Anatomy of the right anterosuperior area (segment 8) of the liver: evaluation with helical CT during arterial portography. Radiology 214: 491–495
Couinaud C (1989) Surgical anatomy of the liver revisited. C. Couinaud, Paris
Couinaud C (1994) The paracaval segments of the liver. J Hepatobiliary Pancreat Surg 2: 145–151
Gray H (1985) The liver. In: Clemente CD (ed) Gray’s anatomy. 30th American edn. Williams & Wilkins, Baltimore, pp 1489–1502
Healey JE, Schroy PC (1953) Anatomy of the biliary ducts within the human liver. Arch Surg 66: 599–516
Iwasaki Y, Okamura T, Ozaki A, Todoroki T, Takase Y, Ohara K (1986) Surgical treatment of carcinoma of the confluence of the major hepatic ducts. Surg Gynecol Obstet 162: 457–464
Kamiya J, Nimura Y, Hayakawa N, Hasegawa H, Kondo S, Shionoya S (1986) Clinical significance of selective middle hepatic venography. J Jpn Surg Soc 87: 1559–1563
Kamiya J, Nimura Y, Hayakawa N, Kondo S, Nagino M, Kanai M (1995) Preoperative cholangiography of the caudate lobe: surgical anatomy and staging for biliary carcinoma. J Hepatobiliary Pancreat Surg 1: 385–389
Kitagawa S, Murakami G, Hata F, Hirata K (2000) Configuration of the right portion of the caudate lobe with special reference to identification of its right margin. Clin Anat 13: 321–340
Kogure K, Kuwano H, Fufimaki N, Makuuchi M (2000) Relation among portal segmentation, proper hepatic vein, and external notch of the caudate lobe in the human liver. Ann Surg 231: 223–228
Kumon M (1985) Anatomy of the caudate lobe with special reference to the portal vein and bile duct. Kanzo 55: 1193–1199
Mizumoto R, Kawarada Y, Suzuki H (1986) Surgical treatment of hilar carcinoma of the bile duct. Surg Gynecol Obstet 162: 193–158
Nagino M, Nimura Y, Kamiya J, Kondo S, Kanai M, Miyachi M (1995) Preoperative management of hilar cholangiocarcinoma. J Hepatobiliary Pancreat Surg 2: 215–223
Nimura Y (1994) Hepatectomy for proximal bile duct cancer. In: Surgical diseases of the biliary tract and pancreas. Multidisciplinary management. Mosby, St Louis, pp 251–261
Nimura Y, Hayakawa N, Kamiya J, Kondo S, Shionoya S (1990) Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus. World J Surg 14: 535–544
Nimura Y, Hayakawa N, Kamiya J, Kondo S, Nagino M, Kanai M (1995) Hilar cholangiocarcinoma. Surgical anatomy and curative resection. J Hepatobiliary Pancreat Surg 2: 239–248
Takayasu K, Moriyama N, Muramatsu Y, Goto H, Yamada T (1985) Intrahepatic portal vein branches by percutaneous transhepatic portography. Radiology 154: 31–36
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kamiya, J., Nagino, M. & Nimura, Y. Retrograde portography of the right caudate lobe via the middle hepatic vein. Surg Radiol Anat 26, 24–27 (2004). https://doi.org/10.1007/s00276-003-0181-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-003-0181-3