Isolated segmental, sectoral and right hepatic bile duct injuries

Figure 1 Cystic duct. A: near a segmental bile duct; B: very close to the sectoral bile duct.

Figure 2 Cystic duct. A: Cystic duct joining the segmental; B: Sectoral hepatic ducts that could be misinterpreted as cystic ducts; C: Right hepatic ducts that could be misinterpreted as cystic ducts.

Figure 3 Cystic duct joins the convergence of the sectoral (A) and hepatic ducts (B).

Figure 4 Cholangiography. A: An operative cholangiography with missing ducts within segments V and VIII; B: Cholangiography of the injured anterior sectoral duct; C: A schematic of the biliary anatomy before the injury took place (the anterior sectoral duct was misinterpreted as a cystic duct); D: Following hepatico-jejunostomy.

Figure 5 Demonstrates a case with an external biliary fistula that required Roux-en-Y repair. A: Fistulography showing the right hepatic duct; B: ERCP showing the rest of the biliary tree; C: A schematic of the biliary anatomy before the injury took place (the right hepatic duct was misinterpreted as a cystic duct); D: Following hepatico-jejunostomy.

Figure 6 A biliary fistula that resolved spontaneously. A: Fistulography showing the ducts within segment V; B: ERCP showing the rest of the biliary tree; C: The entire biliary tree if the injury hadn’t take place; D: A schematic of the biliary anatomy prior to injury.