【Abstract】ObjectiveTo investigate the anatomic feature and special clinical manifestations of variant right intrahepatic bile duct draining into left hepatic bile duct near the umbilical portion.
MethodsVariant right intrahepatic bile ducts joining into left hepatic bile ducts near the umbilical portions were identified through cholangiograms in 52 patients, who were included in this study. Their history, clinical process and operations were reviewed.
ResultsThere were total 38 cases of intrahepatic gallstone in this group. High incidence of intrahepatic calculi was found in variant right intrahepatic bile ducts (23/38 cases, 60.52%) and left hepatic ducts (33/38 cases, 86.84%). Most of these cases were accompanied with dilatation and stricture of bile ducts in these area. The gallstones in the variant right intrahepatic bile ducts were not detected in 8 cases (8/23) and the rate of residual gallstone was as high as 86.95%(20/23). Injury of variant right intrahepatic bile duct took place when left hepatectomy was performed in one case.
ConclusionGallstone is very likely to be formed in the variant right intrahepatic bile duct due to derangement of bile hydrokinetics and compression of blood vessel. Special attention should be paid to the diagnosis and operation of this abnormity.
Citation:
CHEN Xiaoli,XU Nan,LU Lingjun,RAN Ruitu.. Variant Right Intrahepatic Bile Duct Joining to Left Bile Hepatic Duct Near Umbilical Portion: Its Anatomic Feature and Clinical Significance. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(4): 431-433下转436. doi:
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- 2. Elias H, Petty D. Gross anatomy of the blood vessels and ducts within the human liver [J]. Am J Anat, 1952; 90(1)∶59.
- 3. Blumgart LH, Fong Y. Surgery of the liver and biliary tract 〔Third Edition Health Science Asia,Elsevier Science〕 (影印版) [M]. 北京: 人民卫生出版社, 2002∶3~34.
- 4. Cheng YF, Huang TL, Chen CL, et al. Anatomic dissociation between the intrahepatic bile duct and portal vein: risk factors for left hepatectomy [J]. World J Surg, 1997; 21(3)∶297.
- 5. Nimura K. Progress in clinical and biological research Vol.152: Intrahepatic calculi [M]. Inc New York: Alam R Liss, 1981∶156-159.
- 6. 黄志强, 顾倬云, 张晓卫, 等. 我国肝内胆管结石外科治疗的现况——全国4 197例手术病例的分析 [J]. 中华外科杂志, 1988; 26(9)∶513.
- 7. 诸建初. 人体胆管优化问题初探 [J]. 生物医学工程杂志, 1986; 3(1)∶29.
- 8. 黄志强. 高位右肝管狭窄的外科治疗问题 [J]. 中华外科杂志, 1985; 23(9)∶517.
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