c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Biliary Pitfalls: 16

A D V E R T I S E M E N T

   

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The deep branch must be clearly identified as arterial, and terminating on the gallbladder. Because it is deeper in the hilum, such a structure may be a small common duct or a right hepatic duct rather that a deep branch of the cystic artery. Since the cystic duct has usually been divided at this point, cholangiogram is no longer an option. Needle puncture of the structure in question may help differentiate arterial from biliary structure. If the structure is greater than 1mm in size, a high index of suspicion is called for.   

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Biliary Pitfalls: 17

A D V E R T I S E M E N T

   

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Only when identification is certain should the deep branch be divided.     

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This page was last modified on 8/11/2009.