Matsumoto Takatsugu, Aoki Taku, Iso Yukihiro, Tago Kazuma, Shimoda Mitsugi, Kubota Keiichi
J Gastrointest Surg. 2016 Feb;20(2):470-2. doi: 10.1007/s11605-015-2992-z.
Right-sided round ligament (RSRL) is a rare congenital anomaly that is strongly associated with a number of intrahepatic vascular anomalies. Here, we report a 77-year-old male case of hepatolithiasis associated with RSRL for which resection was performed using right hemi-hepatectomy (RHH). Intraoperative ultrasonography revealed that the portal branch of segment 4 ramified from the right anterior portal branch, and the patient was diagnosed as having RSRL. To decide the resection line, the portal branch of segment 4 was punctured and stained with indigo carmine under ultrasonographic guidance, clearly demonstrating the demarcation line between the right and left hemiliver. RHH was then carried out successfully without injuring the portal branch of segment 4.
右侧圆韧带（RSRL）是一种罕见的先天性异常，与多种肝内血管异常密切相关。在此，我们报告一例77岁男性肝内胆管结石合并RSRL的病例，该病例采用右半肝切除术（RHH）进行了切除。术中超声检查显示，第4段门静脉分支起源于右前门静脉分支，患者被诊断为RSRL。为确定切除线，在超声引导下对第4段门静脉分支进行穿刺并用靛胭脂染色，清晰显示了左右半肝之间的分界线。随后成功实施了RHH，未损伤第4段门静脉分支。
