A Case of Hilar Cholangiocarcinoma with Right-sided Ligamentum Teres Hepatis

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  • SHINDOH Junichi
    Hepatobiliary-pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital
  • FUKUI Yudai
    Hepatobiliary-pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital
  • HASHIMOTO Masaji
    Hepatobiliary-pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital

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Other Title
  • 右側肝円索を伴う肝門部胆管癌の1例
  • 症例 右側肝円索を伴う肝門部胆管癌の1例
  • ショウレイ ミギガワ カンエンサク オ トモナウ カンモンブタンカン ガン ノ 1レイ

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Abstract

An 81-year-old man presenting intrahepatic bile duct dilatation on ultrasound was referred to our department with a diagnosis of hilar cholangiocarcinoma originated from the right hepatic duct. Preoperative radiographic assessments suggested no remarkable anomalies in the intrahepatic vascular structures. The patient was considered to be a candidate for surgical resection because his estimated percentage remnant liver volume was 47%, however, he was found to have anomalous right-sided ligamentum teres hepatis at laparotomy. The bile duct for the region just right side of the umbilical fissure had been involved by the tumor and needed to be resected. However, due to decreased hepatic functional reserve, extended resection was considered to be risky for this patient. Therefore, hepatic parenchyma of the corresponding area was preserved with patient blood flow sacrificing the biliary drainage. R0 resection was achieved and there was no clinical evidence of postoperative hepatic insufficiency or bile leak.

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