POST-CHOLECYSTECTOMY RIGHT POSTERIOR SECTORAL BILE DUCT INJURY -- A SINGLE INSTITUTION SERIES.

Dr P. J. Halder, Dr Swapnil Sharma

Abstract


Injuries to sectoral bile ducts are less common than their major bile duct counterparts and present diagnostic and therapeutic challenges because of
their rarity. Records of 17 patients (5 men and 12 women) with right posterior sectoral bile duct injuries managed in a single institution from year
2000 to 2020 were analysed. Seven patients were managed non - operatively, and 9 patients underwent denitive surgery with a sectoral bile duct
Roux – en – Y hepaticojejunostomy. Follow up ranged between 1 to 11 years. One patient had minor post-operative leak; 2 patients had anastomotic
narrowing managed by percutaneous balloon dilatation. Persistence of bile leak despite a “normal” biliary anatomy on Endoscopic Retrograde
Cholangiography ± Magnetic Resonance Cholangio Pancreatography should lead to a suspicion of a right sectoral bile duct injury. Awareness of
the condition, Magnetic Resonance Cholangio Pancreatography ± Percutaneous Transhepatic Cholangiography, and expert interpretation of the
ndings of imaging, are the keys to diagnosis of a Right Posterior Sectoral Bile Duct Injury.


Keywords


Right sectoral biliary injury, posterior sectoral bile duct injury, sectoral duct injuries, biliary leak.

Full Text:

PDF

References


Mangieri, C. W., Hendren, B. P., Strode, M. A., Bandera, B. C., & Faler, B. J. (2019). Bile duct injuries (BDI) in the advanced laparoscopic cholecystectomy era. Surgical endoscopy, 33, 724-730.

de’Angelis, N., Catena, F., Memeo, R., Coccolini, F., Martínez-Pérez, A., Romeo, O. M., ... & Sommacale, D. (2021). 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy. World journal of emergency surgery, 16(1), 30.

Alexander, H. C., Bartlett, A. S., Wells, C. I., Hannam, J. A., Moore, M. R., Poole, G. H., & Merry, A. F. (2018). Reporting of complications after laparoscopic cholecystectomy: a systematic review. HPB, 20(9), 786-794.

Kapoor, V. K., & BjörnTörnqvist. (2020). Epidemiology of bile duct injury. In Post-cholecystectomy Bile Duct Injury (pp. 11-19). Singapore: Springer Singapore.

Michael Brunt, L., Deziel, D. J., Telem, D. A., Strasberg, S. M., Aggarwal, R., Asbun, H., ... & Stefanidis, D. (2020). Safe cholecystectomy multi-society practice guideline and state-of-the-art consensus conference on prevention of bile duct injury during cholecystectomy. Surgical endoscopy, 34, 2827-2855.

Lillemoe, K. D., Petrofski, J. A., Choti, M. A., Venbrux, A. C., & Cameron, J. L. (2000). Isolated right segmental hepatic duct injury: a diagnostic and therapeutic challenge. Journal of Gastrointestinal Surgery, 4(2), 168-177.

GW, J. (1986). Iatrogenic bile duct stricture: An avoidable surgical hazard? Br J Surg, 73, 245-247.

Choi, J. W., Kim, T. K., Kim, K. W., Kim, A. Y., Kim, P. N., Ha, H. K., & Lee, M. G. (2003). Anatomic variation in intrahepatic bile ducts: an analysis of intraoperative cholangiograms in 300 consecutive donors for living donor liver transplantation. Korean journal of radiology, 4(2), 85.

Wojcicki, M., Patkowski, W., Chmurowicz, T., Bialek, A., Wiechowska-Kozlowska, A., Stankiewicz, R., ... & Krawczyk, M. (2013). Isolated right posterior bile duct injury following cholecystectomy: report of two cases. World journal of gastroenterology: WJG, 19(36), 6118.

Mariolis-Sapsakos, T., Kalles, V., Papatheodorou, K., Goutas, N., Papapanagiotou, I., Flessas, I., ... & Sgantzos, M. N. (2012). Anatomic variations of the right hepatic duct: results and surgical implications from a cadaveric study. Anatomy research international, 2012.

Düşünceli, E., Erden, A., & Erden, I. (2004). Anatomic variations of the bile ducts: MRCP findings. Tanisal ve girisimsel radyoloji: Tibbi Goruntuleme ve Girisimsel Radyoloji Dernegi yayin organi, 10(4), 296-303.

Strasberg, S. M., Hertl, M., & Soper, N. J. (1995). An analysis of the problem of biliary injury during laparoscopic cholecystectomy. Journal of the American College of Surgeons, 180(1), 101-125.

Babel, N., Sakpal, S. V., Paragi, P., Wellen, J., Feldman, S., & Chamberlain, R. S. (2009). Iatrogenic bile duct injury associated with anomalies of the right hepatic sectoral ducts: a misunderstood and underappreciated problem. HPB surgery, 2009.

Li, J., Frilling, A., Nadalin, S., Radunz, S., Treckmann, J., Lang, H., ... & Broelsch, C. E. (2010). Surgical management of segmental and sectoral bile duct injury after laparoscopic cholecystectomy: a challenging situation. Journal of Gastrointestinal Surgery, 14(2), 344-351.

Mazer, L. M., Tapper, E. B., & Sarmiento, J. M. (2011). Non-operative management of right posterior sectoral duct injury following laparoscopic cholecystectomy. Journal of Gastrointestinal Surgery, 15(7), 1237-1242.

Perera, M. T. P. R., Monaco, A., Silva, M. A., Bramhall, S. R., Mayer, A. D., Buckels, J. A. C., & Mirza, D. F. (2011). Laparoscopic posterior sectoral bile duct injury: the emerging role of nonoperative management with improved long-term results after delayed diagnosis. Surgical endoscopy, 25, 2684-2691.

Colovic, R. B. (2009). Isolated segmental, sectoral and right hepatic bile duct injuries. World Journal of Gastroenterology: WJG, 15(12), 1415.

Gupta, V., & Chandra, A. (2011). Conservative management of isolated sectoral duct injury with bile leak (type C injury): important and essential initial step in the management, not an option. Journal of Gastrointestinal Surgery, 15(11), 2124-2124.


Refbacks

  • There are currently no refbacks.