CBD injury during cholecystectomy

Question

Asked for Male, 34 Years

Confluence of the right anterior and posterior sectoral ducts and left hepatic duct could not be visualised on the MRCP images. Immediately distal to the site of the expected confluence, there is a small fluid collection noted alongside the expected common hepatic duct. The tip of the pigtail catheter lies in the vicinity of this collection. There is suspicion of breech in continuity of the common hepatic duct at this site. Showing few linear hyperdensities at this site.

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Dr. Kumar Parth Gastroenterologist 21 yrs exp Bangalore · Accepted Answer

Dr. Kumar Parth

Gastroenterologist 21 yrs exp Bangalore

This is type 4 CBD injury. Management should be to drain the collection with appropriate antibiotics as per sensitivity, maintaining good hydration and A DEFINITIVE REPAIR AFTER 4-6 WEEKS ( BYPASSING / CONNECTING BOTH BILE DUCT ( INTRAHEPATIC) TO SMALL BOWEL ( HEPATICO- JEJUNOSTOMY)

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