Aberrant Right Hepatic Duct Draining into the Cystic Duct: Clinical Outcomes and Management
Background. Aberrant right hepatic duct (ARHD) draining into cystic duct (CD) is relatively rare but clinically important because of its susceptibility to injuries during cholecystectomy. These injuries are often-times missed or diagnosed late and as a result can develop serious complications. Metho...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2011-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2011/458915 |
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| Summary: | Background. Aberrant right hepatic duct (ARHD) draining into
cystic duct (CD) is relatively rare but clinically important
because of its susceptibility to injuries during cholecystectomy.
These injuries are often-times missed or diagnosed late and as a
result can develop serious complications. Methods. Four
consecutive patients diagnosed with ARHD draining into CD were
identified for inclusion. Results. The mean age of patients was
42.5 years. The diagnosis in one of the patient was incidental
during a routine endoscopic retrograde cholangiopancreatography
(ERCP). Other three patients were diagnosed post-cholecystectomy-
one presented with suspected intra-operative biliary injury, one
with persistent bile leak and another with recurrent cholangitis.
Inadequate filling of the segment of liver on ERCP with dilation
of intrahepatic ducts in the corresponding segment on imaging was
present in two patients with complete obstruction of ARHD which
was managed surgically. In another patient, the partially
obstructed ARHD was managed by endoscopic therapy. Conclusion.
ARHD draining into the CD can have varied clinical manifestations.
In appropriate clinical settings, it should be suspected in
patients with persistence of bile leak early after
cholecystectomy, segmental dilation of intrahepatic-bile ducts on
imaging and paucity of intrahepatic filling in a segment of liver
on ERCP. |
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| ISSN: | 1687-6121 1687-630X |