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右肝管异常连接至胆囊管:磁共振胰胆管造影的应用价值

Anomalous connection of the right hepatic duct into the cystic duct: utility of magnetic resonance cholangiopancreatography.

作者信息

Yamamoto Satoshi, Sakuma Atsushi, Rokkaku Kyu, Nemoto Takehiko, Kubota Keiichi

机构信息

Second Department of Surgery, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.

出版信息

Hepatogastroenterology. 2003 May-Jun;50(51):643-4.

Abstract

A 41-year-old female was admitted to our hospital for treatment of uterus carcinoma. Abdominal ultrasound showed gallbladder stones. Although magnetic resonance cholangiopancreatography revealed the right intrahepatic bile ducts, left hepatic duct and the common bile duct, the confluence of the right and left hepatic ducts was not visualized. At surgery, intra-operative cholangiography showed a biliary anomaly of the right hepatic duct entering the cystic duct. Subsequently cholecystectomy was accomplished without any injury to the bile duct. Our case may be the eighth such case of this rare biliary anomaly. When magnetic resonance cholangiopancreatography does not show the confluence of the right and left hepatic ducts, biliary anomaly of the right hepatic duct should be suspected and careful dissection should be performed from the Hartman's pouch, followed by intraoperative cholangiography, in order to avoid unnecessary injury to the bile duct.

摘要

一名41岁女性因子宫癌入院治疗。腹部超声显示胆囊结石。尽管磁共振胰胆管造影显示了右肝内胆管、左肝管和胆总管,但左右肝管汇合处未显影。手术中,术中胆管造影显示右肝管进入胆囊管的胆管异常。随后成功实施了胆囊切除术,未对胆管造成任何损伤。我们的病例可能是这种罕见胆管异常的第八例。当磁共振胰胆管造影未显示左右肝管汇合处时,应怀疑右肝管胆管异常,应从哈特曼袋开始仔细解剖,随后进行术中胆管造影,以避免对胆管造成不必要的损伤。

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