Bipartite liver: an incidental rare anomaly of the liver

Bipartite liver is a rare congenital anomaly without phylogenetic significance, which needs to be known for the potential risk of torsion or internal gastrointestinal herniation and also in the pre-operative planning of liver surgery, being potentially associated to complex surgical dissection of the hepatic hilum.

A 77-year-old woman presented with recurrent episodes of right upper-quadrant abdominal pain and weight loss. During the diagnostic workup a computed tomographic scan showed a cholangiocarcinoma of segment six and gallstones, in the context of a bipartite liver where otherwise normal right and left lobes were distinctly divided from each other by a bridge of tissue (Figure 1).

Figure 1 Abdominal CT-scan axial views demonstrating the right lobe and left lobe of liver connected by a bridge of tissue (A,B); abdominal CT-scan coronal view demonstrating the portal vein trifurcation with the sketch of the portal branch for hypoplastic segment IV (arrow), the RPV and LPV (C); intraoperative views of the bipartite liver with the right lobe and left lobe connected by a bridge of tissue (D). R, right liver lobe; G, gallbladder; L, left liver lobe; S, spleen; B, bridge connecting liver lobes; RPV, right portal vein; LPV, left portal vein.

A robot-assisted hepatic segmentectomy and cholecystectomy with the use of indocyanine-green cholangiography and intraoperative ultrasound were performed.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was a standard submission to the journal. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-22-128/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.