MRCP IDENTIFICATION OF ECTOPIC RIGHT POSTERIOR SECTORAL DUCT (HUANG TYPE A5): AN ANATOMICAL PITFALL IN LAPAROSCOPIC CHOLECYSTECTOMY
Main Article Content
Abstract
Background: Anatomical variations of the intrahepatic biliary system occur in approximately 20-45% of the population, increasing the risk of injury during cholecystectomy. Ectopic drainage of the right posterior hepatic duct (RPHD) into the cystic duct, classified as Huang type A5, is rare but carries important clinical significance and may be overlooked preoperatively.
Objective: To describe MRCP features of Huang type A5, emphasizing diagnostic pitfalls and its value in surgical planning.
Methods: Descriptive pictorial review analyzing 3 representative cases with confirmed Huang type A5 on MRCP at Tam Anh General Hospital, Ho Chi Minh City. Detailed assessment included insertion site, ductal diameter, angle of confluence, indirect findings, and 3D reconstructions.
Results: MRCP provides noninvasive, high-resolution visualization of the entire biliary tree. 3D reconstructions enhance spatial understanding and directly assist surgical planning. Common pitfalls include misinterpretation as the right hepatic duct or inaccurate confluence assessment due to overlapping structures.
Conclusion: Ectopic RPHD drainage (Huang type A5) is a potentially hazardous anatomical pitfall in laparoscopic cholecystectomy. Comprehensive recognition of imaging features and diagnostic pitfalls, along with effective multidisciplinary collaboration, is essential to prevent iatrogenic bile duct injury. Standardization of MRCP reporting, integration of 3D reconstruction techniques, and multidisciplinary collaboration may further improve early detection and optimize treatment strategies.
Keywords
Bile duct variation, Right posterior hepatic duct, Bile duct injury
Article Details
References
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