Preoperative detection and handling of aberrant right posterior sectoral hepatic duct during laparoscopic cholecystectomy.
J Hepatobiliary Pancreat Sci
; 22(7): 558-62, 2015 Jul.
Article
en En
| MEDLINE
| ID: mdl-25882210
ABSTRACT
BACKGROUND:
An aberrant right posterior sectoral hepatic duct (PHD) draining into extrahepatic bile duct, gallbladder or cystic duct directly is a common and critical anomaly during cholecystectomy. This study aimed to investigate the frequency of aberrant PHD and describe why PHD is critical.METHODS:
In 753 consecutive patients who underwent laparoscopic cholecystectomy (LC) using our standardized procedure over 9 years, we reinvestigated whether an aberrant PHD was present using preoperative images. A PHD joining the common bile duct through the cranial side of the hilar plate was defined as the supraportal type, and one passing through the caudal side of the right portal vein was defined as the infraportal type.RESULTS:
Fifty-one (6.8%) patients had aberrant PHD. All of them had the infraportal type, and the cystic duct drained into aberrant PHD in 10 (1.3%) and aberrant PHD drained into the cystic duct in six (0.8%). These 16 most dangerous anomalies were diagnosed before surgery. In all patients with aberrant PHD, LC was completed without any complications.CONCLUSIONS:
It seems possible to identify most aberrant PHD by attention to the infraportal-type PHD, and injury to them can be avoided by exposing a critical view using an appropriate procedure.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Colecistectomía Laparoscópica
/
Conducto Hepático Común
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Hepatobiliary Pancreat Sci
Año:
2015
Tipo del documento:
Article
País de afiliación:
Japón