Abstract
A 53-year-old man underwent percutaneous transhepatic biliary drainage involving the rightanterior, posterior and left lateral hepatic ducts because of obstructive jaundice due to a cholangiocellular carcinoma at the hepatic hilus. From the findings of ultrasonography and CT, a mass was located at the hepatic hilus, and the right anterior and medial segmental portal branches originating from the right unbilical portion (RUP). Transarterial portography confirmed this anomaly and the left lateral segmental portal vein coursed solely to the left. The medial segmental arteries ramified from the anterior hepatic artery and middle hepatic artery. The medial segmental hepatic ducts also had two ramifications similar to those of the artery. Left hepatectomy with the caudate lobectomy was performed with preservation of the RUP. Separate hepatico-jejunostomies were constructed on the right anterior and posterior segmental bile ducts. We discuss the intrahepatic biliary confluent with the ramification of intrahepatic vessel regarding to association of the RUP and cholangiocellular carcinoma at the hepatic hilus.
