Prinz R A, Howell H S, Pickleman J R
Am J Surg. 1976 Jun;131(6):755-7. doi: 10.1016/0002-9610(76)90195-1.
A patient with an anomalous insertion of the right hepatic duct into the cystic duct was noted during cholecystectomy and confirmed by operative cholangiography. This case and related anomalies of the bile ducts are of sufficient importance that, because of the technical difficulties and dangers incidental to their presence, no surgeon who operates on the gallbladder and bile ducts can afford to be unaware of their existence. Adequate exposure, careful dissection, and accurate knowledge of the regional anatomy plus a realization of the frequency and multiplicity of abnormalities of the extrahepatic biliary tree are requisites for safe biliary tract surgery. In addition, carefully performed operative cholangiography can be an indispensable aid in the clarification of anatomic variations. In case of recognized operative injury to the extrahepatic biliary tree, primary repair or biliary-intestinal anastomosis can usually be carried out with good results.
在胆囊切除术中发现一名患者右肝管异常插入胆囊管，并经术中胆管造影证实。该病例及相关胆管异常具有足够的重要性，由于其存在会带来技术困难和危险，任何进行胆囊和胆管手术的外科医生都不能忽视它们的存在。充分暴露、仔细解剖、对局部解剖结构的准确了解以及认识到肝外胆管树异常的频率和多样性是安全胆道手术的必要条件。此外，仔细进行的术中胆管造影在明确解剖变异方面可能是不可或缺的辅助手段。如果认识到肝外胆管树存在手术损伤，通常可以进行一期修复或胆肠吻合，效果良好。
