Abstract
A 67-year-old woman was referred to our hospital with jaundice and elevation of serum hepatic enzymes. Abdominal ultrasound, enhanced CT, and ERCP revealed stricture of the bile duct at the hepatic hilum with wall thickening between the common bile duct and the gallbladder neck. Simultaneously, the patient was radiologically diagnosed to have the right-sided round ligament as well as anomalous intrahepatic portal venous branching. The patient underwent left hepatectomy, cholecystectomy, extrahepatic bile duct resection, and lymphadenectomy (D2). Intraoperative US showed independent branching of the posterior branch of the portal vein. Postoperatively, the histopathological examination revealed stage IVa gallbladder carcinoma with curability B. Concomitant gallbladder carcinoma and right-sided round ligament is rare, and only one case has been reported in Japan. Careful preoperative surgical simulation and precise interpretation of complex hepatic hilar anatomy structure are important because the patients with right-sided round ligament often accompany anomaly of the intrahepatic portal venous branching.
