St Michael's Hospital, Dun Laoghaire, Dublin, Ireland.
St Vincent's University Hospital, Elm Park, Dublin, Ireland.
Ann R Coll Surg Engl. 2021 Sep;103(8):e241-e243. doi: 10.1308/rcsann.2020.7044.
Aberrant insertion of the right posterior sectoral duct is a particularly hazardous variation of biliary anatomy which makes it prone to injury during laparoscopic cholecystectomy. Such injuries are challenging to manage, as multiple therapeutic options are available with no clear consensus in the literature for an optimal approach. Options include conservative management, intraoperative ligation of the injured duct, Roux-en-Y reconstruction and segmental liver resection. Most cases in the literature advocate for nonoperative management or hepaticojejunostomy. We present an unusual case of aberrant right posterior sectoral duct injury in which neither of these approaches was viable, necessitating a bi-segmental liver resection.
右后叶段胆管异常汇入是一种特别危险的胆管解剖变异，使得其在腹腔镜胆囊切除术中容易受到损伤。这些损伤难以处理，因为有多种治疗选择，但文献中没有明确共识哪种方法是最佳的。选择包括保守治疗、术中结扎受损胆管、Roux-en-Y 重建和肝段切除术。文献中的大多数病例主张非手术治疗或胆肠吻合术。我们报告了一例罕见的右后叶段胆管损伤病例，这两种方法都不可行，需要进行双肝段切除术。
