These anomalies, noted with increasing frequency, include the hepatocystic duct where the common hepatic or right hepatic duct
inserts into the gallbladder, choledochal cysts, stenosis and choledochocoele.
In this system, type I anatomy is associated with atresia at the level of the common bile duct (approximately 12% of cases); in type II, atresia is at the level of the hepatic duct
In this particular case jaundice was due to involvement of the hepatic confluence with destruction of the right hepatic duct
The height of the injury is usually referenced by using the Bismuth scale, which gauges an injury based on its location in relationship to the confluence of the right and left hepatic duct
Findings from the common bile duct, the common hepatic duct
, and the main hepatic ducts
(including intrahepatic branches) were normal.
Malignant biliary obstruction is usually secondary to pancreatic adenocarcinoma or is due to cholangiocarcinoma of the common bile, or common hepatic duct
(including the bifurcation, collectively called hilar), or the intrahepatic bile ducts (peripheral).
To the Editor: In 1980, we reported a case of paraganglioma of the hepatic duct
in a 37-year-old man.
A short cystic duct, a low origin of the cystic duct, or a cystic duct that runs parallel to the common hepatic duct
may predispose to the syndrome, he said.
We reported this case to emphasise that, though most tumours arising at the hepatic duct
convergence are malignant, benign lesions are also encountered.
Adenocarcinoma of the hepatic duct
at its bifurcation within the porta hepatis: an unusual tumor with distinctive clinical and pathological features.
However, if the recipient common hepatic duct
is diseased, too short, or otherwise inadequate for anastomosis, a choledochojejunostomy or hepaticojejunostomy with a Roux-en-Y limb is constructed.
A choledochoscopy performed during the surgery found a left hepatic duct
stone and a final diagnosis of cholelithiasis and Mirizzi syndrome was made.
Another interesting aspect of this case is the presence of a chronically distended gallbladder (gallbladder hydrops), associated with extrinsic compression of the common hepatic duct
by an impacted stone in the infundibulum (Mirizzi syndrome type I) (8).
Non-functioning argyrophilic tumor (APUDoma) of the hepatic duct
Magnetic resonance i maging (MRI) of the abdomen with cholangiographic reconstruction showed an isolated stricture in the common hepatic duct
close to the junction of the right and left hepatic ducts