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- Title
Left hepatic trisectionectomy for hepatolithiasis with occluded left and right anterior branches of the portal vein: report of a case.
- Authors
Hosokawa, Isamu; Shimizu, Hiroaki; Yoshidome, Hiroyuki; Ohtsuka, Masayuki; Kato, Atsushi; Yoshitomi, Hideyuki; Furukawa, Katsunori; Takayashiki, Tsukasa; Kuboki, Satoshi; Okamura, Daiki; Suzuki, Daisuke; Nakajima, Masayuki; Miyazaki, Masaru
- Abstract
A 64-year-old male was admitted to a local hospital with epigastric pain. Diagnostic imaging revealed hepatolithiasis in the atrophic left lobe. However, endoscopic intervention was impossible because of the presence of many large stones. He was referred to our hospital for surgical treatment. Enhanced multidetector-row computed tomography revealed that the right posterior portal vein (PV) was branched from the portal trunk as a first-order branch, and the bile duct of segment 3 ran caudally to the umbilical portion of the left PV. Furthermore, the umbilical portion of the left PV, which was located between the dilated bile ducts of segment 2 and segment 3, and also the right anterior PV, was occluded with thrombus. Based on these findings, he underwent left hepatic trisectionectomy. Although the indications for left hepatic trisectionectomy for hepatolithiasis are limited, it is therefore extremely important to determine the most appropriate surgical procedure based on the anatomy and findings of hepatic hilus in individual cases.
- Subjects
PORTAL vein; GALLSTONE treatment; BILE duct diseases; HEPATECTOMY; UMBILICAL veins; COMPUTED tomography; THERAPEUTICS
- Publication
Surgery Today, 2014, Vol 44, Issue 8, p1556
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-013-0598-1