Avoidance of injury to the left hepatic duct during parenchymal dissection for hepatic trisegmentectomy.
A simplified and safe technique is described herein for the dissection of the feedback structures to the medial segment of the left lobe, while preserving the integrity of the remaining left hepatic bile duct during the dissection for right hepatic trisegmentectomy. This is accomplished by passing a biliary probe into the main left hepatic duct from the stump of the right hepatic duct. Use of this technique during the performance of a hepatic trisegmentectomy expedites the hepatic dissection and decreases the potential for intraoperative injuries of the remaining bile duct to the lateral segment of the left lobe of the liver. In addition, irrigation of the left hepatic bile duct through the open right duct stump may demonstrate leakages of bile that may be repaired, leading to a decreased over-all morbidity in the subsequent postoperative period.
Brower
S T
ST
Department of Surgery, Mount Sinai Medical Center, New York, New York 10029.
Miller
C
C
McElhinney
A J
AJ
D001649:Bile Duct Diseases / Q000517:prevention & control; D001653:Bile Ducts, Intrahepatic / Q000293:injuries*; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008113:Liver Neoplasms / Q000601:surgery*