CT of hepatoduodenal ligament

In determining the operability, especially of super-radical approach to malignancies of biliary tract, it is very important to confirm the direct infiltration or metastasis to the lymphnodes in the hepatoduodenal ligament. To date, the information about hepatoduodnal ligament obtained by conventional means such as angiography, cholangiography, etc, has been limited. In the present study, we performed some analysis on CT findings of hepatoduodenal ligament produced by malignant tumors of the biliary tract. Forty-two biliary tract malignancies (24 cases of bile duct cancer, 18 cases of gallbladder cancer) showed tumor shadows in the region of hepatoduodenal ligament and/or bile duct dilatation on CT : Ten bile duct (41,7%) and 5 gallbladder primary (27.8%). Of 19 cases with bile duct cancer in hepatoduodenal ligament, 10 (52.6%) had the tumor shadows. In one case, the shadow within the ligament was suggestive of primary tumor. Of these 10 cases, only one was resectable by surgery. With gallbladder cancer, the shadows were the cancer infiltration and/or lymphnode metastasis. All cases bile duct cancer and 11 cases gallbladder cancer (61.1%) showed dilatations of bile duct in various degrees. As a preoperative examination, CT was thought to be the most useful in confirming the cancer infiltration and/or lymphnode metastasis in the hepatoduodenal ligament. (author)