Rational Resection of the Right Dorsal Liver for Hepatic Hilar Bile Duct Carcinoma.

Location of the ventral margin of the paracaval portion of the caudate lobe of the human liver with special reference to the configuration of hepatic portal vein branches

“…Finally, our "dorsolateral paracaval branch" (dlP in Fig. 1) is almost identical to the original definition (Ishiyama et al, 1997(Ishiyama et al, , 1999. We define it as a branch arising from the posterior sectorial trunk (a common stem of PV6 and PV7) or the proximal 10 mm of the PV7 stem.…”

“…Although the morphology of the border area around the caudate lobe has been extensively investigated (Kumon, 1985;Kamiya et al, 1994;Ishiyama et al, 1997;Kogure et al, 2000;Onishi et al, 2000), in the present study, we found several portal branches with an unusual appearance that were difficult to identify. Ishiyama et al (1999) and Ishiyama and Yamauchi (2000) attempted to define patterns of the portal blood supply to the border areas.…”

“…We often observed numerous short branches, Ͻ1.0 mm in width and Ͻ20 mm in length, that originated from the hepatic portal vein, the hilar bifurcation, the umbilical portion of the left portal vein, and, some- 1 (3.6) 5 (6.6) PV4sup 2 (4.2) 0 (0) 2 (2.6) - -------------------------------------------------------------------------------------------------------------------- f Narrower definitions were adopted in the present study for the dorsolateral paracaval branch and PV8c as compared to their original ones (Ishiyama et al, 1997(Ishiyama et al, , 1999Kumon, 1985). g This intermediate branch originated at the wedged position between the origins of the anterior and posterior sectorial trunks.…”

Configuration of the right portion of the caudate lobe with special reference to identification of its right margin

“…Since the left portal trunk frequently gives off branches to the left S1 as well as the right S9, Couinaud proposes that the CL does not belong either to the left or right surgical lobe, but it is an independent entity, which he calls the dorsal sector. In contrast, based on similar descriptions of the ramification of the portal vein, several researchers (Kumon, 1985;Kogure, 1990Kogure, , 1992Ishiyama et al, 1997) conclude that the right side of the CL, particularly the paracaval portion, is a peripheral area of the left surgical lobe. Therefore, they believe that S9 cannot logically be regarded as a "segment" but is merely a "portion."…”

“…Couinaud (1994) reported that the right portion of the CL neighbors S8 as well as S7. It is widely accepted that the CL lies adjacent to the terminal portion of the right hepatic vein (Couinaud, 1994;Gadzijev and Ravnik, 1996;Ishiyama et al, 1997). The right hepatic vein passes between S7 and S8 in the upper half of the right lobe, even if thick tributaries running in different directions are present (Elias and Petty, 1952;Goldsmith and Woodburne, 1957;Hardy, 1972;Masselot and Leborgne, 1978;Gupta and Gupta, 1979;Bismuth, 1982;van Leeuwen et al, 1994;Hata et al, 1999a).…”