Diagnosis and surgical treatment of aberrant right posterior hepatic bile duct injury: a report of 28 patients / 中华肝胆外科杂志

ABSTRACT

Objective To review our experience in the diagnosis and surgical management of aberrant right posterior hepatic bile duct injury.Methods Twenty eight patients with aberrant right posterior hepatic bile duct injury treated at the First Affiliated Hospital of Xinjiang Medical University between January 2002 to December 2011 were studied retrospectively.According to the injury type and the time of diagnosis,these patients were divided into three groups.The first group comprised of 10 patients in whom the injury was recognized and repaired at the time of the original surgery.The second group consisted of 10 patients in whom the injured aberrant right posterior hepatic bile duct was diagnosed and treated after operation.The third group comprised of 8 patients who developed an external bile fistula after the aberrant right posterior hepatic bile duct injury.The short and long term complications after surgical repair in the three groups were compared.Results In the first group,1 patient developed an intra-abdominal fluid collection.There was no bile stricture patients in first group.In the second group,1 patient developed bile fistula,2 patients intra-abdominal fluid collections,1 patient wound infection,and 1 patient bile duct stricture.In the third group,2 patients developed bile fistula,1 patient intestinal obstruction,2 patients wound infection,1 patient intra-abdominal hemorrhage,2 patients bile duct stricture and 1 patient an incisional hernia on follow-up.Conclusions Finding and repairing an aberrant right posterior hepatic bile duct injury at the original operation is the best treatment.According to the type and time of diagnosis,different surgical repair methods can be used for the aberrant right posterior hepatic bile duct injury.