Surgical Anatomy of the Hepatobiliary System

The gall bladder is intimately related to the liver, hepatoduodenal ligament containing the common bile duct, proper hepatic artery and main portal vein, duodenum—pancreas and colon resulting in early and frequent involvement of these structures in gall bladder cancer. Gall bladder straddles segments IV and V of the liver, parts of which are always removed during radical resection for gall bladder cancer. Lymphatic spread occurs to cystic, pericholedochal, and pancreato-duodenal lymph nodes; celiac, superior mesenteric, and aorto-caval are distant lymph nodes.