A Case of Left Sided Gallbladder and Anomalous Branching of the Intrahepatic Portal Vein in which a Biliary Cystadenoma of the Liver was Resected

Shigekazu Takemura, Osamu Yamasaki, Kwan Choon Lee, Akihumi Mori, Kazuo Ikeda, Hiroaki Kinoshita*, Kazuhiro Hirohashi*

Department of Surgery, Osaka City Momoyama Municipal Hospital
*Second Department of Surgery, Osaka City University Medical School

A 55-year-old man with biliary cystadenoma of the liver with left-sided gallbladder is reported. He was admitted to our hospital because of right hypochondralgia. Ultrasonography revealed an anechoic mass of the liver, left-sided gall bladder, and anomalous branching of the intrahepatic portal vein. Percutaneous transhepatic portography did not show the left umbilical portion, and the right anterior branch looked like an umbilical portion. The round ligament arose anomalously from the right anterior branch. During exploration of the abdomen, this mass was excised with attention to the anomalous branching of the portal vein. The pathological diagnosis was benign biliary cystadenoma of the liver. Anomalous branching of the portal vein with left-side gallbladder has been reported in 10 patients, 7 of whom had other anomalies; 6 patients lacked the left umbilical portion but had a so-called right umbilical portion. In liver surgery for patients with left-sided gallbladder, identification of the cystic duct and the branching of the hepatic duct and the portal vein is important.

Key words
left-sided gallbladder, anomalous branching of the intrahepatic portal vein, biliary cystadenoma of the liver

Reprint requests
Shigekazu Takemura Second Department of Surgery, Osaka City University Medical School
1-5-7 Asahimachi, Abenoku, Osaka, 545 JAPAN

Accepted
June 8, 1994

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