Abstract
Two cases of intrahepatic gallstones with stenosis of the common hepatic duct caused by overriding of the right hepatic artery are described. The probable diagnosis of the compression of the bile duct by the artery was obtained by superimposing a direct cholangiogram on an angiogram. The final diagnosis was made at operation. The first patient was successfully treated by resection of the compressed common hepatic duct with Roux-en-Y hepaticojejunostomy anterior to the right hepatic artery. In the second patient, lateral segmentectomy and cholangiojejunostomy were performed.
Résumé
Deux cas de calculs biliaires intrahépatiques coexistant avec une sténose du canal hépatique commun, secondaire à la compression exercée sur le canal biliaire par la branche droite de l'artère hépatique, sont rapportés. Le diagnostic de probabilité en faveur de la compression du canal hépatique commun par la branche droite de l'artère hépatique fut envisagé en superposant cholangiographies et angiographies. Le diagnostic de certitude fut porté lors de l'intervention. La première malade fut opérée avec succès en réséquant le segment biliaire comprimé et en établissant une hépatico-jéjunostomie en avant de la branche artérielle à l'origine de la compression. Chez la deuxième malade, on a pratiqué une résection hépatique segmentaire latérale et une cholangio-jéjunostomie.
Resumen
Se describen dos casos de cálculos biliares intrahepáticos con estenosis del canal hepático común producida por compresión por la arteria hepática derecha. La posibilidad del diagnóstico de compresión del canal biliar por la arteria fue planteada al sobreponer un colangiograma directo sobre un angiograma, y el diagnóstico definitivo fue establecido durante la operación. La primera paciente fue tratada con éxito mediante resección del canal hepático común comprimido y hepaticoyeyunostomía en Y de Roux anterior a la arteria hepática derecha. En la segunda paciente se realizó una segmentectomía lateral con colangioyeyunostomía.
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Tsuchiya, R., Eto, T., Harada, N. et al. Compression of the common hepatic duct by the right hepatic artery in intrahepatic gallstones. World J. Surg. 8, 321–326 (1984). https://doi.org/10.1007/BF01655064
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DOI: https://doi.org/10.1007/BF01655064