Abstract：
A 15-year-old girl with recurrent upper abdominal pain was diagnosed with congenital biliary dilatation. Abdominal enhanced computed tomography (CT) showed the anterior segmental branch of the right hepatic artery (RHA) running across the ventral aspect of the dilated common hepatic duct (CHD). Laparoscopic extrahepatic dilated biliary duct excision and Roux-en-Y hepaticojejunostomy were planned. Intraoperatively, the dilated CHD was observed to bifurcate into the ventral and dorsal ducts, between which the anterior segmental branch of the RHA crossed through the CHD. The CHD rejoined on the distal side as one duct. We transected the CHD just above the cystic duct. The patency of the ventral and dorsal sides of the bifurcated CHD was confirmed. Laparoscopic hepaticojejunostomy was performed at the distal side of the rejoined CHD, without sacrificing the anterior segmental branch of the RHA. There was no postoperative blood flow impairment in the right hepatic lobe or anastomotic stenosis.
摘要：
一名15岁的上腹痛反复发作的女孩被诊断为先天性胆道扩张。腹部增强计算机断层扫描（CT）显示右肝动脉（RHA）的前节支穿过扩张的总肝管（CHD）的腹侧。计划腹腔镜肝外扩张胆管切除术和Roux-en-Y肝空肠吻合术。术中,观察到扩张的CHD分叉到腹侧和背侧导管，RHA的前节支穿过CHD。CHD在远端侧重新连接为一个导管。我们在胆囊管上方切开了冠心病。确定了分叉CHD的腹侧和背侧的通畅性。腹腔镜肝空肠吻合术在合并的冠心病远端进行，而不牺牲RHA的前节段分支。右肝叶或吻合口狭窄没有术后血流受损。
