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Analysis of right-sided ligamentum teres: The novel anatomical findings and classification.

Authors:
Fumihiro Terasaki Yusuke Yamamoto Teiichi Sugiura Yukiyasu Okamura Takaaki Ito Ryo Ashida Katsuhisa Ohgi Takeshi Aramaki Katsuhiko Uesaka

J Hepatobiliary Pancreat Sci 2021 Feb 17;28(2):221-230. Epub 2020 Nov 17.

Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.

Background: The true anatomy of right-sided ligamentum teres (RSLT) has not been fully explained for a century. This study aimed to clarify the exact anatomy of RSLT.

Methods: The computed tomography data of 17 651 surgical patients were observed and 76 patients with RSLT, were classified into the bilateral ligamentum teres (LT) group (type A) and three RSLT groups, (B) bifurcation type, (C) trifurcation type, and (D) independent posterior branch type.

Results: Type A had double LT that connected to both the right and left sides of the umbilical portion (UP). Types B-D had a P3 + 4 rather than a left UP. Type D was anatomically different from types A-C. Upon comparing types A-C and type D, type D had a significantly smaller volume of segments 3 + 4 (P < .001), and the UP was more often on the left side. The position of the gallbladder fundus in type D was more commonly observed on the right side of the LT compared with that observed in the other types (P = .007).

Conclusions: The change in the volume of segments 3 + 4 and the extent of the RSLT shift create a false perception that the gallbladder changes the position.

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http://dx.doi.org/10.1002/jhbp.856DOI Listing
February 2021

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1Department of Orthopedic Surgery, Lower Extremities, Schulthess Clinic, Zurich, Switzerland.

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