Portoenterostomy as a Salvage Procedure for Unexpected Injury of Aberrant Hepatic Duct During Hepatectomy for Hepatoblastoma: A Case Report

Abstract

An aberrant hepatic duct (AHD) is extremely rare in children, and preoperative diagnosis is often difficult. AHD injury during hepatobiliary surgery could lead to bile leakage or cholangitis postoperatively, resulting in prolonged hospitalization and low QOL. Repair of AHD injury would be difficult owing to the small caliber and weakness of AHD. In this paper, we report a case of AHD injury that was reconstructed by portoenterostomy. A 6-year-old boy underwent left hepatectomy for PRETEXT II hepatoblastoma. A preoperative imaging study showed no bile duct anomaly. AHD branching from the B5 region connected to the cystic duct, and AHD injury occurred during cystectomy. We reconstructed the AHD by portoenterostomy without an anastomotic stent as a salvage procedure. The patient showed no intrahepatic dilatation 6 months after the surgery. If hepaticoenterostomy is not feasible, portoenterostomy is an alternative option as a salvage procedure for unexpected biliary injury during hepatobiliary surgery for children.