POST-CHOLECYSTECTOMY RIGHT POSTERIOR SECTORAL BILE DUCT INJURY--A SINGLE INSTITUTION SERIES.

Abstract

Injuries to sectoral bile ducts are less common than their major bile duct counterparts and present diagnostic and therapeutic challenges because of their rarity. Records of 17 patients (5 men and 12 women) with right posterior sectoral bile duct injuries managed in a single institution from year 2000 to 2020 were analysed. Seven patients were managed non - operatively, and 9 patients underwent denitive surgery with a sectoral bile duct Roux – en – Y hepaticojejunostomy. Follow up ranged between 1 to 11 years. One patient had minor post-operative leak; 2 patients had anastomotic narrowing managed by percutaneous balloon dilatation. Persistence of bile leak despite a “normal” biliary anatomy on Endoscopic Retrograde Cholangiography ± Magnetic Resonance Cholangio Pancreatography should lead to a suspicion of a right sectoral bile duct injury. Awareness of the condition, Magnetic Resonance Cholangio Pancreatography ± Percutaneous Transhepatic Cholangiography, and expert interpretation of the ndings of imaging, are the keys to diagnosis of a Right Posterior Sectoral Bile Duct Injury.