Relationship between left biliary duct system and left portal vein: evaluation with three-dimensional portocholangiography.

Abstract

To investigate the relationship between the left biliary duct system and the left portal vein by using in vivo analysis of the human liver with three-dimensional portocholangiography. Twenty-seven patients underwent helical computed tomography during both arterial portography and cholangiography. Three-dimensional portocholangiograms were reconstructed to evaluate the relationship between the left biliary duct system and the left portal vein, in particular the umbilical portion. In 16 (59%) patients, segment II and III ducts united just above the umbilical portion or laterally to it, and the segment IV duct joined medially to the umbilical portion. In eight (30%) patients, segment III and IV ducts united medially to the umbilical portion and the segment II duct joined at a point close to the hepatic hilum. In three (11%) patients, three ducts from segments II-IV united at a position immediately medial to the umbilical portion. Three types of left bile duct anatomy were seen in relation to the left portal vein.