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.