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      KCI등재후보 SCOPUS

      Isolated aberrant right cysticohepatic duct injury during laparoscopic cholecystectomy: Evaluation and treatment challenges of a severe postoperative complication associated with an extremely rare anatomical variant

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      https://www.riss.kr/link?id=A106905958

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      다국어 초록 (Multilingual Abstract)

      A typical bile duct branching patterns represent one of the major causes of bile duct injury (BDI) during laparoscopic cholecystectomy (LC). The most common classified variations of bile duct branching, involve the right posterior sectoral duct (RPSD)...

      A typical bile duct branching patterns represent one of the major causes of bile duct injury (BDI) during laparoscopic cholecystectomy (LC). The most common classified variations of bile duct branching, involve the right posterior sectoral duct (RPSD) and its joining with the right anterior or left hepatic duct. Variant bile duct anatomy can rarely be extremely complex and unclassified. This report describes an extremely rare case of an isolated injury to an aberrant right hepatic duct formed by the joining of ducts from segments V, VII, and VIII draining into the cystic duct (cysticohepatic duct) during LC, associated with an inferior RPSD opening to left hepatic duct. Detailed evaluation of both endoscopic and magnetic cholangiograms established the diagnosis. Bile duct injury was subsequently managed surgically by a demanding Roux-en-Y hepaticojejunostomy. This extremely rare case aims to serve as a useful reminder of the consistent inconsistency of biliary anatomy, alerting surgeons to beware of variant bile duct branching patterns during open or LC that constitute a dreadful pitfall for severe and life-threatening bile duct injuries.

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      목차 (Table of Contents)

      • INTRODUCTION
      • CASE
      • DISCUSSION
      • REFERENCES
      • INTRODUCTION
      • CASE
      • DISCUSSION
      • REFERENCES
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      참고문헌 (Reference)

      1 Kullman E, "Value of routine intraoperative cholangiography in detecting aberrant bile ducts and bile duct injuries during laparoscopic cholecystectomy" 83 : 171-175, 1996

      2 Champetier J, "The cystohepatic ducts : surgical implications" 13 : 203-211, 1991

      3 Turner MA, "The cystic duct : normal anatomy and disease processes" 21 : 3-22, 2001

      4 Li J, "Surgical management of segmental and sectoral bile duct injury after laparoscopic cholecystectomy : a challenging situation" 14 : 344-351, 2010

      5 Ohkubo M, "Surgical anatomy of the bile ducts at the hepatic hilum as applied to living donor liver transplantation" 239 : 82-86, 2004

      6 Strasberg SM, "Rationale and use of the critical view of safety in laparoscopic cholecystectomy" 211 : 132-138, 2010

      7 Bujanda L, "MRCP in the diagnosis of iatrogenic bile duct injury" 16 : 475-478, 2003

      8 Meyers WC, "Low insertion of hepatic segmental duct VII-VIII is an important cause of major biliary injury or misdiagnosis" 171 : 187-191, 1996

      9 Perera MT, "Laparoscopic posterior sectoral bile duct injury : the emerging role of nonoperative management with improved long-term results after delayed diagnosis" 25 : 2684-2691, 2011

      10 Perini RF, "Isolated right segmental hepatic duct injury following laparoscopic cholecystectomy" 28 : 185-195, 2005

      1 Kullman E, "Value of routine intraoperative cholangiography in detecting aberrant bile ducts and bile duct injuries during laparoscopic cholecystectomy" 83 : 171-175, 1996

      2 Champetier J, "The cystohepatic ducts : surgical implications" 13 : 203-211, 1991

      3 Turner MA, "The cystic duct : normal anatomy and disease processes" 21 : 3-22, 2001

      4 Li J, "Surgical management of segmental and sectoral bile duct injury after laparoscopic cholecystectomy : a challenging situation" 14 : 344-351, 2010

      5 Ohkubo M, "Surgical anatomy of the bile ducts at the hepatic hilum as applied to living donor liver transplantation" 239 : 82-86, 2004

      6 Strasberg SM, "Rationale and use of the critical view of safety in laparoscopic cholecystectomy" 211 : 132-138, 2010

      7 Bujanda L, "MRCP in the diagnosis of iatrogenic bile duct injury" 16 : 475-478, 2003

      8 Meyers WC, "Low insertion of hepatic segmental duct VII-VIII is an important cause of major biliary injury or misdiagnosis" 171 : 187-191, 1996

      9 Perera MT, "Laparoscopic posterior sectoral bile duct injury : the emerging role of nonoperative management with improved long-term results after delayed diagnosis" 25 : 2684-2691, 2011

      10 Perini RF, "Isolated right segmental hepatic duct injury following laparoscopic cholecystectomy" 28 : 185-195, 2005

      11 Lillemoe KD, "Isolated right segmental hepatic duct injury : a diagnostic and therapeutic challenge" 4 : 168-177, 2000

      12 Kaffes AJ, "Impact of endoscopic intervention in 100 patients with suspected postcholecystectomy bile leak" 61 : 269-275, 2005

      13 LeBedis CA, "Iatrogenic, blunt, and penetrating trauma to the biliary tract" 42 : 28-45, 2017

      14 Schipper IB, "Diagnosis of right hepatic duct injury after cholecystectomy : the use of cholangiography through percutaneous drainage catheters" 44 : 350-354, 1996

      15 Palmucci S, "Contrast-enhanced magnetic resonance cholangiography : practical tips and clinical indications for biliary disease management" 2017 : 2403012-, 2017

      16 Sarawagi R, "Common and uncommon anatomical variants of intrahepatic bile ducts in magnetic resonance cholangiopancreatography and its clinical implication" 81 : 250-255, 2016

      17 Lyu SY, "Common and rare variants of the biliary tree : magnetic resonance cholangiographic findings and clinical implications" 37 : 59-67, 2012

      18 Bismuth H, "Biliary strictures : classification based on the principles of surgical treatment" 25 : 1241-1244, 2001

      19 Wright KD, "Bile duct injury during laparoscopic cholecystectomy without operative cholangiography" 85 : 191-194, 1998

      20 Martin RF, "Bile duct injuries. Spectrum, mechanisms of injury, and their prevention" 74 : 781-803, 1994

      21 Mangieri CW, "Bile duct injuries(BDI)in the advanced laparoscopic cholecystectomy era" 33 : 724-730, 2019

      22 Karakas HM, "Bile duct anatomy of the Anatolian Caucasian population : Huang classification revisited" 30 : 539-545, 2008

      23 Mariolis-Sapsakos T, "Anatomic variations of the right hepatic duct : results and surgical implications from a cadaveric study" 2012 : 838179-, 2012

      24 최진우, "Anatomic Variation in Intrahepatic Bile Ducts: an Analysis of Intraoperative Cholangiograms in 300 Consecutive Donors for Living Donor Liver Transplantation" 대한영상의학회 4 (4): 3-90, 2003

      25 Strasberg SM, "An analysis of the problem of biliary injury during laparoscopic cholecystectomy" 180 : 101-125, 1995

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