Gál Adrián Róbert, Kalmár-Nagy Károly, Fincsur András, Horváth Örs Péter, Vereczkei András
Sebészeti Klinika, Pécsi Tudományegyetem 7624 Pécs, Ifjúság útja 13.
Pathológiai Intézet, Pécsi Tudományegyetem Pécs.
Magy Seb. 2018 Mar;71(1):12-15. doi: 10.1556/1046.71.2018.1.2.
The authors present a case of a 67-year-old male patient, who previously had been diagnosed with a malignant liver tumor localized in segment II. He underwent bisegmentectomy (II and III) and partial IV segmentectomy. After the primary surgery jaundice developed, the level of bilirubin increased and after several imaging modalities reoperation was indicated. During the surgery a rare bile duct anatomy variant was found. The right hepatic duct joined the left duct in the parenchyma of the left lobe, and was ligated at the resection. As the liver hilum was not explored, the absence of the right duct was not discovered. Reconstruction of the biliary system was accomplished by a Roux-en-Y loop.
作者报告了一例67岁男性患者的病例,该患者此前被诊断为位于肝段II的恶性肝肿瘤。他接受了双段切除术(II和III段)及IV段部分切除术。初次手术后出现黄疸,胆红素水平升高,经多种影像学检查后提示需再次手术。手术过程中发现了一种罕见的胆管解剖变异。右肝管在左叶实质内与左肝管汇合,并在切除时被结扎。由于未探查肝门,右肝管缺如未被发现。通过Roux-en-Y袢完成了胆道系统重建。