Isolated Right Segmental Hepatic Duct Injury Following Laparoscopic Cholecystectomy

Abstract

Successful management of IRSHDI after LC requires adequate identification of the lesion, and multidisciplinary treatment is necessary. Half of the patients can be treated successfully by nonsurgical procedures.

Laparoscopic posterior sectoral bile duct injury: the emerging role of nonoperative management with improved long-term results after delayed diagnosis

“…Interestingly, the majority of these data advocate surgical intervention. A large proportion of the patients with RPSD injury had eventually experienced late complications in the form of biliary strictures and cholangitic abscesses necessitating further intervention including hepatic resection [10,13,14,19,20]. To the author's knowledge, this report describes the first series promoting the evolving role of nonoperative management for RPSD injury.…”

“…Perini et al [14] reported the second largest series to date. In this series of 12 patients, 8 underwent various surgical reconstruction techniques.…”

“…However, diagnostic and therapeutic uncertainties exist for patients presenting with RPSD injury several days or weeks after LC. A higher incidence of complications, reaching 33-37%, mainly in the form of biliary stricture requiring further radiologic or surgical intervention, have been reported [13,14] when late operative interventions have been attempted for patients with a delayed diagnosis of RPSD injury.…”

Percutaneous Transhepatic Biliary Drainage in the Management of Post-surgical Biliary Leaks

“…Injuries of the common duct usually require the placement of only one drain, whereas hilar injuries with high-grade strictures of the left and right hepatic ducts or loss of continuity in the ducts require bilateral drain placement [12,13]. Transection or ligation of an aberrant right hepatic duct requires targeted drain placement in the affected segments of the biliary tree [12][13][14].…”

Freehand diffuse optical spectroscopy imaging for intraoperative identification of major venous and arterial vessels underlying peritoneal fat: an in vivo demonstration in a pig model

“…The concern of iatrogenic injury in MIS becomes even greater for obese patients because the large layer of peritoneal fat further challenges intraoperative definition of the internal anatomy that is already inherently difficult for MIS. 4 Currently, surgeons operating minimal-invasively do not have an easy-touse, real-time device to aid in intraoperative identification of important anatomic structures that underlie native tissue planes 5 or secondary scar tissues 6 that must be carefully dissected in a stepwise layer-by-layer fashion to avoid injury to these structures. Techniques with a goal of detecting arterial vessels using standalone laparoscopic probes have been a topic of investigation for many years.…”