This report presents a case of a left hepatectomy and a caudate lobectomy combined resection of the ventral segment of the
right anterior sector for hilar cholangiocarcinoma using percutaneous transhepatic portal vein embolization (PVE). The patient
was a 44-year-old man admitted to a local hospital with obstructive jaundice. He was diagnosed to have hilar cholangiocarcinoma
and was referred to the hospital for further treatment. Cholangiography revealed stenosis of the left hepatic duct and the
hilar bile ducts. The dorsal branch of the right anterior sector joined the right posterior branch and the tumor did not invade
to the confluence of these branches. Arteriography and portography reconstructed by multidetector-raw computed tomography
revealed the ventral branches of the right anterior sector, which separately diverged from the other right anterior branches.
It was therefore necessary to perform a left hepatectomy and caudate lobectomy combined resection of the ventral segment of
the right anterior sector to completely remove the tumor. Portal vein embolization was thus performed on the left portal vein
and the ventral branches of the right anterior sector. Intraoperatively, when the hepatic artery was temporally clamped, the
demarcation between the ventral segment and the dorsal segment of the right anterior sector could be clearly visualized. The
planned surgery was performed safely. This case demonstrates that the utilization of PVE is useful for a difficult and intricate
hepatectomy, which requires an accurate identification of a hepatic subsegment.
Key words Portal vein embolization - Cholangiocarcinoma - Ventral segment of right anterior sector