PDF(Pubmed)
Abstract：
A boy with congenital hydronephrosis underwent ultrasonography every month for follow-up. At 4 months of age, ultrasonography incidentally revealed congenital biliary dilatation (5-cm type Ia). We performed laparoscopic extrahepatic bile duct resection and hepaticojejunostomy. After dissecting the dilated common bile duct (CBD), we found that the arcading-like shaped right hepatic artery (RHA) coursed in front of the CBD. Additionally, a tiny duct was identified below the main hepatic duct. At first, we thought it was a lymphatic vessel and dissected it from the main hepatic duct. However, bile flow out was recognized after dissecting the tiny duct. Finally, we confirmed it as an aberrant bile duct from the caudate region. We anastomosed the bile duct from the caudate region and main hepatic duct in a double-barrel fashion and performed hepaticojejunostomy below the RHA. The postoperative course was uneventful. Ultrasonography showed no intrahepatic ductal dilatation including the caudate lobe.
摘要：
一名患有先天性肾积水的男孩每月接受超声检查以进行随访。在4个月大的时候，超声检查偶然发现先天性胆道扩张（5厘米Ia型）。我们进行了腹腔镜肝外胆管切除术和肝空肠吻合术。解剖扩张的胆总管（CBD）后，我们发现弧形形状的右肝动脉（RHA）在CBD前面。此外,在主肝管下方发现了一个微小的导管。起初,我们认为这是淋巴管，并将其从肝主导管中解剖出来。然而,解剖小导管后发现胆汁流出。最后,我们证实它是来自尾状区的异常胆管。我们以双管方式从尾状区和主肝导管吻合胆管，并在RHA下方进行了肝空肠吻合术。术后病程顺利。超声检查显示没有肝内导管扩张，包括尾状叶。
