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Biliary decompression in hilar obstruction. Round ligament approach.
Archives of Surgery (Chicago, Ill. : 1960)
|April 1, 1979
Summary
This study presents a novel surgical approach for biliary decompression in patients with obstructed hepatic hilus. The technique accesses the left hepatic duct, bypassing difficult anatomy for effective treatment.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
- Surgical Anatomy
Background:
- Biliary obstruction poses challenges when hepatic hilus access is compromised by tumors or scar tissue.
- Standard surgical approaches may be unfeasible in complex cases.
Purpose of the Study:
- To describe an alternative method for biliary decompression in challenging cases of biliary obstruction.
- To detail the anatomical landmarks and surgical steps for accessing the left hepatic duct.
Main Methods:
- Surgical access to the left hepatic duct via the left intersegmental plane.
- Identification of the left hepatic duct superior to the left portal vein.
- Division of the round ligament and liver parenchyma in an avascular plane.
Main Results:
- Successful exposure of the left hepatic duct is achievable using this approach.
- Biliary decompression can be performed via tube drainage or Roux-en-Y hepaticojejunostomy.
Conclusions:
- This technique offers a viable alternative for biliary decompression when the hepatic hilus is inaccessible.
- It provides a crucial option for managing complex biliary obstruction cases.