ARTERIAL RECONSTRUCTION OF THE POSTERIOR SEGMENT AFTER CENTRAL BISEGMENTECTOMY AND CAUDATE LOBECTOMY

A 71 year old woman was admitted with jaundice and found to have a tum or originating from the cystic and common, hepatic ducts, which infilt rated the origins of the right bile duct and duct of Spiegel. The tumo r was also shown to encase the right hepatic artery. A central bisegme ntectomy with concurrent caudate lobectomy was performed using the rig ht gastroepiploic artery for reconstruction of the posterior segmental branch of the right hepatic artery. Celiac angiography conducted 3 we eks postoperatively confirmed the patency of the hepatic segmental art erial anastomosis. The patient had an uneventful recovery with no evid ence of fiver failure, and was discharged home thirty-two days. Tumors infiltrating the right hepatic artery, which have traditionally been treated with extensive liver resection, can be managed with hepatic se gmentectomy and reconstruction of the segmental hepatic artery.