Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery: An algorithmic approach

Table 1 Characteristics of patients with injury of aberrant bile ducts

No	Sex	Age	Initial operation	Biliary variant injury1	Treatment	Outcome
1	F	51	Left lateral sectionectomy (Hydatid cyst)	RPSD (type D)	Resection of segment IV and biliary-enteric (B-E) anastomosis	Uneventful
2	F	76	Left Hepatectomy (CHD carcinoma)	RPSD (type C)	Denied liver resection	Died
3	M	65	Left hepatectomy (Liver carcinoma)	RASD (type D)	Conservative (external drainage)	Resolved after 2 mo
4	M	71	Left hepatectomy (Liver carcinoma)	RASD (type D)	Conservative (external drainage)	Resolved after 4 mo
5	M	51	Right extended lobectomy (cholangiocarcinoma)	Segment’s I duct (type E)	Resection of segment I	Uneventful
6	F	49	Resection of segment V (Hydatid cyst)	RPSD (type E)	Liver resection (VI, VII)	Uneventful
7	F	36	Laparoscopic cholecystectomy	RPSD (type F)	1. B-E anastomosis failed	Died
					2. Liver resection (VI, VII)

¹Types of biliary variants[17]: Type A: Right hepatic duct (RHD) joins the left hepatic duct (LHD); Type B: Triple confluence of right posterior sectorial duct (RPSD) and right anterior sectorial duct (RASD) and LHD; Type C: RASD or the RPSD joins the common bile duct (CBD); Type D: RASD or RPSD joins separately the LHD; Type E: Absence of confluence; sectorial ducts join separately at the common hepatic duct (CHD); Type F: RPSD joins the cystic duct.