Iatrogenic bile duct injury associated with anomalies of the right hepatic sectoral ducts: a misunderstood and underappreciated problem.
Although laparoscopic cholecystectomy (LC) has been widely accepted as the standard of care, it continues to have a higher complication rate than open cholecystectomy. Bile duct injury with LC has often been attributed to surgical inexperience, but it is also clear that aberrant bile ducts are present in a significant number of patients who sustain biliary injuries during these procedures. We present three cases of right sectoral hepatic duct injuries which occurred during LC and provide a discussion of the conditions which are likely to lead to these injuries, as part of a strategy to prevent them.
Babel
Nitin
N
Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ 07039, USA.
Sakpal
Sujit V
SV
Paragi
Prakash
P
Wellen
Jason
J
Feldman
Stephen
S
Chamberlain
Ronald S
RS
D000368:Aged; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D007813:Laparotomy / Q000379:methods; D008875:Middle Aged; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment