RIGHT POSTERIOR SECTORAL DUCT INJURY - HEPATICOJEJUNOSTOMY
DR YOGESH BANG, SURGICAL GASTROENTEROLOGY, MIDAS MULTISPECIALITY HOSPITAL, NAGPUR
CASE REPORT –
Young female underwent Laparoscopic cholecystectomy for biliary colic. Postoperative day 3 patient had bilious drain. She was discharged with bilious drain on POD -5. Patient was referred to us one month later with drain output of 150ml per day. Patient did not have fever, jaundice.
On evaluation MRCP showed stricture in Right hepatic duct with dilatation of Intrahepatic right ductal system. ERCP stenting was done and cholangiogram showed suspected leak in right peripheral duct. Stent did not decrease the leak. Tubogram was done and it revealed isolated right posterior sectoral duct injury with leak from that (Strassberg type C injury)
Surgery – Right subcostal incision was given. Adhesiolysis was done and drain was traced till the site of leak and right posterior duct was identified. RPSD had extrahepatic course. It was opened along its extrahepatic course and wide roux-en-y hepaticojejunostomy was made.
Post operative recovery was uneventful. CBD stent was removed 2 months later.
Key words – Biliary Fistula, Hepatico-jejunostomy
