ABSTRACT
The duct of segment III of the liver has been used as a conduit to the jejunum in cases of hilar biliary obstruction. Twenty five fresh livers were studied. The bile duct-common hepatic or common bile-, the hepatic artery and the portal vein were injected with latex and dissected to display the anatomy of the round ligament approach to segment III duct. The round ligament approach was attempted in six patients operated upon for hilar biliary stricture. In ten specimens [40%], the duct of segment III passed from its sheath and followed the left side of the left portal branch posterosuperiorly in the fissure for ligamentum teres till the origin of the sheath of segment II where it changed its direction to the right to run above and behind the left portal branch in the porta hepatis [the pattern of the curved duct]. In 9 specimens [36%], the duct of segment III passed from its sheath directly to the right in front of the left portal branch just proximal to its junction with the round ligament on its way to the left end of the porta hepatis [the pattern of straight duct]. In 6 specimens [24%], segment III was drained by two ducts [the pattern of double duct]. In the six cases operated upon, the duct could not be reached in a cirrhotic patient, three patients had straight ducts which were easily exposed, one patient had the curved duct pattern which was exposed with great difficulty, and in one patient a hepatotomy was done to reach the duct