Hepatectomy for gallbladder-cancer with unclassified anomaly of right-sided ligamentum teres: A case report and review of the literature

Figure 1 Contrast-enhanced computed tomography, cytological examination of bile, and endoscopic retrograde cholangiography. A, B and C: The highly atrophied gallbladder (yellow arrow) had tumor-like localized wall thickness enhanced by contrast medium; D: The cul-de-sac of the right-sided umbilical portion is shown; E: The gallbladder (yellow arrow) is located on the left-sided liver bed. Direct infiltration of the tumor into the right hepatic artery (red arrow) is not evident; F: Cytological examination of bile obtained from endoscopic retrograde gallbladder drainage demonstrated atypical cells with a high nucleo-cytoplasmic ratio, strongly suggesting adenocarcinoma; G: Endoscopic retrograde cholangiography shows severe stenosis of the right hepatic duct (yellow arrowhead); H and I: The gallbladder tumor (yellow arrow) directly spreads to the nearby right hepatic duct where an endoscopic nasobiliary tube was placed.