Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Aug 7, 2010; 16(29): 3723-3726
Published online Aug 7, 2010. doi: 10.3748/wjg.v16.i29.3723
Right anterior segmental hepatic duct emptying directly into the cystic duct in a living donor
Yasunao Ishiguro, Masanobu Hyodo, Takehito Fujiwara, Yasunaru Sakuma, Nobuyuki Hojo, Koichi Mizuta, Hideo Kawarasaki, Alan T Lefor, Yoshikazu Yasuda
Yasunao Ishiguro, Masanobu Hyodo, Takehito Fujiwara, Yasunaru Sakuma, Nobuyuki Hojo, Koichi Mizuta, Hideo Kawarasaki, Alan T Lefor, Yoshikazu Yasuda, Department of Surgery, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, Tochigi 329-0498, Japan
Author contributions: Ishiguro Y and Yasuda Y contributed equally to this work; Hyodo M, Fujiwara T, Sakuma Y, Hojo N, Mizuta K, Kawarasaki H and Yasuda Y performed perioperative management of this case; Ishiguro Y, Lefor AT and Yasuda Y wrote the paper.
Correspondence to: Yasunao Ishiguro, MD, Department of Surgery, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, Tochigi 329-0498, Japan. ynao-i@mub.biglobe.ne.jp
Telephone: +81-285-587371 Fax: +81-285-443234
Received: January 11, 2010
Revised: February 18, 2010
Accepted: February 25, 2010
Published online: August 7, 2010
Abstract

A 35-year-old mother was scheduled to be the living donor for liver transplantation to her second son, who suffered from biliary atresia complicated with biliary cirrhosis at the age of 2 years. The operative plan was to recover the left lateral segment of the mother’s liver for living donor transplantation. With the use of cholangiography at the time of surgery, we found the right anterior segmental duct (RASD) emptying directly into the cystic duct, and the catheter passed into the RASD. After repairing the incision in the cystic duct, transplantation was successfully performed. Her postoperative course was uneventful. Biliary anatomical variations were frequently encountered, however, this variation has very rarely been reported. If the RASD was divided, the repair would be very difficult because the duct will not dilate sufficiently in an otherwise healthy donor. Meticulous preoperative evaluation of the living donor’s biliary anatomy, especially using magnetic resonance cholangiography and careful intraoperative techniques, is important to prevent bile duct injury and avoid the risk to the healthy donor.

Keywords: Bile duct injury, Cystohepatic duct, Intraoperative cholangiography, Living liver transplantation, Bile duct injury, Magnetic resonance cholangiography