he right posterior sectoral bile duct (RPSD) draining segments 6 and
7 of the liver commonly unite with the anterior sectoral duct to form
the right hepatic duct, which in turn is joined by the left hepatic duct
at the liver hilum to form the common hepatic duct.
1
In the literature,
anomalous drainage of the right posterior sectoral bile duct into the cystic
duct, the gallbladder neck or the common hepatic duct is reported in around
2%-9% of patients.
1,2
Aberrant biliary anatomy and poor visualization of the
operative field are the most common risk factors for iatrogenic RPSD in-
juries.
In this case report, we reviewed literature for the management strate-
gies of patients who had RPSD injury: wait and watch by nonoperative ap-
proach (percutaneous drainage and/or endoscopic stenting) or consider
operative treatment.
CASE REPORT
A 43 year old female patient referred to our hospital with dispepsy and ab-
dominal pain. In physical examination only Murphy sign was positive. Her
complete blood count, renal and hepatic function tests were in normal
ranges. Abdominal ultrasonography was performed and multiple milimet-
ric gall stones were found in gall bladder. After empiric antimicrobial ther-
apy, analgesia and IV fluids, laparoscopic cholecystectomy was performed.
Turkiye Klinikleri J Case Rep. 2019;27(1):13-6
13
Laparoscopic Right Posterior Sectoral Bile
Duct Injury Recognized Postoperatively:
How to Manage it?
ABSTRACT The right posterior sectoral bile duct (RPSD) draining segments 6 and 7 of the liver
commonly unite with the anterior sectoral duct to form the right hepatic duct, which in turn is
joined by the left hepatic duct at the liver hilum to form the common hepatic duct. Aberrant bil-
iary anatomy and poor visualization of the operative field are the most common risk factors for in-
juries. Management of the patient is easier if the injury is diagnosed during the operation; but when
it is diagnosed postoperatively, the management planning is more complicated. In this case report,
a female patient diagnosed as right posterior sectoral duct injury one month after the laparoscopic
cholecystectomy was reported while reviewing the literature for current strategies of diagnosis and
management.
Keywords: Right posterior sectoral bile duct; Strasberg C injury; diagnosis; treatment
Sevim TURANLI
a
,
Emine KURT
a
,
Yavuz PİRHAN
b
a
Department of General Surgery,
Ankara Oncology Training and
Research Hospital,
Ankara, TURKEY
b
Department of General Surgery,
Amasya University
Sabuncuoğlu Şerefeddin Training and
Research Hospital,
Amasya, TURKEY
Received: 15.06.2018
Received in revised form: 13.09.2018
Accepted: 13.09.2018
Available online: 05.03.2019
Correspondence:
Sevim TURANLI
Ankara Oncology Training and
Research Hospital,
Department of General Surgery,
Ankara, TURKEY
turanlisevim@hotmail.com
Copyright © 2019 by Türkiye Klinikleri
OLGU SUNUMU
DOI: 10.5336/caserep.2018-61848