Evolving Role of Endoscopic Retrograde Cholangiopancreatography in Management of Extrahepatic Hepatic Ductal Injuries due to Blunt Trauma: Diagnostic and Treatment Algorithms

Table 1

Collected summary of all reported cases of extrahepatic hepatic ductal injuries from 1925 to present.

Date, Author, (Ref.) (chronological)	Age (y.)	Gender	Mechanism of injury	Nature of ductal injury	Treatment	ERCP
1925, Cope [44]	10	M	MVC	Confluence of R & LHD	Cholecystostomy drains	N
1929, Long [45]	40	M	Crushed between autos	Confluence of R & LHD	Cholecystostomy drains	N
1938, Lewis [27]	49	M	MV versus PED	Confluence of R & LHD	Drainage. Followed by re-drainage	N
1953, Walker [46]	2	M	Run over by a tractor	Confluence of R & LHD	R-en-Y repair over stents	N
1955, Baty [47]	25	M	MVC	LHD laceration	Common duct T-tube	N
1955, Schaer [48]	50	M	Struck by a bull	RHD lacerated anteriorly (0.5 cm)	CBD stent, drains	N
1956, Foman [49]	34	M	MVC	R & LHD near the confluence	Cholecystostomy, drain	N
1961, Nikishin [50]	3	M	Run over by an auto	RHD laceration	Drains	N
1964, Hartman [51]	2	F	MV versus PED	Confluence of R & LHD	Cholecystostomy with drainage	N
	6	M	MVC	(1) Bile duct leak at unknown site (2) LHD transection	Drains, primary repair over catheters, common duct tube, cholecystostomy, feeding jejunostomy	N
1967, Noone [52]	8	M	Bicyclist falling onto handle bars	(1) Lacerated R liver lobe (2) R & LHD disruption	Primary anastomosis over catheters, cholecystostomy, drains	N
1967, Sewell [53]	14	F	MVC	LHD avulsion	LHD ligation, T tube	N
1968, Maier [26]	37	M	MCC	RHD laceration (lateral)	Repair over T tube	N
1969, Haynes [54]	N/A	N/A	Blunt abdominal trauma	(1) R hepatic lobe laceration (2) LHD laceration	Drains, Primary ductal repair	N
1969, Estrada [55]	26	M	MVC	LHD laceration, posterior	Repair over T-tube	N
1972, Zollinger [32]	21	F	MVC	R & LHD laceration	Repair over catheters, drain	N
	48	M	MVC	LHD avulsion	Drains, RHD anastomoses to R-en-Y, stent, T-tube	N
1974, Williams [56]	3	M	MV versus PED	LHD avulsion	End-to end anastomosis	N
1980, McFadden [28]	31	M	MVC	Combined R & LHD	Hepaticojejunostomy	N
1985, Jones [21]	37	M	MCC	Confluence of R & LHD	R & L hepaticojejunostomy	N
1985, Michelassi [2]	9	M	Patient denied any trauma	LHD partially severed	Suture repair. Drains. T-tube	N
1987, Salam [19]	17	F	MVC	RHD laceration	Suture repair	N
1991, Dawson [3]	17	M	Crushed by a log	LHD avulsion, 3 cm tear across the junction of CHD and RHD	Suture repair of RHD & CHD, R-en-Y hepaticojejunostomy	N
1991, Monk [34]	14	M	Bicycle crash	LHD disruption (noncircumferential)	Vein patch cholangioplasty with stent & drainage	N
1992, Muin [24]	45	M	Hit by falling tree branch	Confluence of R & LHD (superiorly)	R-en-Y hepaticojejunostomy	N
1993, Hills [30]	18	F	MVC	LHD injury	Percutaneous stent	N
	15	F	MVC	LHD injury	Cholecystectomy, omental plug	N
	16	M	MCC	LHD injury	Partial liver resection	N
1993, Moulton [10]	5	F	MV versus PED	LHD tear	Stent placed via ERCP	Y
1994, Brenneman [57]	36	M	MCC	LHD injury	Repair over T-tube	N
1995, Gerndt [8]	20	M	MVC	L & RHD injury	Primary repair. Drains.	Y
	19	M	MVC	LHD transection	Drains, R-en-Y hepaticojejunostomy	N
	21	M	MVC	(1) L & RHD injury near bifurcation (2) Transected lateral LHD	ERCP with stenting of R ductal system	Y
1995, Baer et al. [58]	31	M	Fell 10 meters	LHD injury	Drains	N
1995, Poli [9]	12	F	Kicked by a horse	Confluence of R & LHD, CHD tear	Nasobiliary and percutaneous drains	Y
1996, Eid [4]	21	M	Crushed by a container	ERCP, LHD tear	Stenting via ERCP	Y
1996, Hayakawa et al. [59]	21	M	MCC	LHD transection	Primary repair over stent	N
1996, Sharma [5]	35	M	Fall from a height	RHD bile leak	Endoscopic papillotomy	Y
1997, Sakamoto [17]	23	M	Fall from ladder	Confluence of R & LHD	Drains at laparotomy	N
	22	M	MV versus PED	LHD laceration	Stent at laparotomy	N
1999, Arkovitz [6]	7	M	MV versus PED	(1) Complete avulsion of LHD (2) Attenuated RHD	Stenting, Drainage, L and R hepaticojejunostomies	Y
1999, Simstein [60]	21	M	Pinned under automobile	(1) Injury at R & LHD confluence (2) RHD disruption	Intraoperative placement of drains	Y
1999, Bin Yahib et al. [14]	3	M	MV versus PED	Torn R & LHD	Primary repair of R & LHD, R-en-Y hepaticojejunostomy	Y
2000, Sanders [7]	11	M	All terrain vehicle accident	LHD injury	Cholecystostomy tube, Jackson-Pratt™ drains	Y
2001, D'Amours [61]	34	M	Fall 9 meters	R & LHD injury	ERCP. Sphincterotomy and stenting	Y
	41	M	MVC	LHD injury	Drains, ERCP with sphincterotomy and double pigtail stent	Y
2001, Nuzzo [29]	42	F	MVC	(1) LHD transection (2) LHD stricture	LHD end-to-end anastomosis. ERCP stenting and serial dilations of LHD stricture	Y
2001, Rodriguez-Montes [25]	N/A	N/A	N/A	RHD laceration	T-tube, RHD R-en-Y choledochojejunostomy	N
	N/A	M	N/A	(1) LHD transection (2) RHD stricture (delayed finding)	Primary repair of LHD transection. Endoscopic stenting od RHD.	Y
2002, Sharpe [11]	11	M	Sledding accident	Transected LHD	Percutaneous drainage of subhepatic space and transampullary stent	Y
2003, Nathan [16]	17	M	MVC	Confluence of R & LHD	Intraoperative placement of drains. ERCP with stent placement	Y
2006, Almaramhi [43]	6	F	MVC	RHD	ERCP with stent placement and percutaneous drainage	Y
	6	M	MVC	RHD	ERCP with stent placement and percutaneous drainage	Y
Current case	26	M	MCC	(1) Confluence of R & LHD (2) LHD injury	External drainage, ERCP with sphincterotomy and CBD stenting	Y

Abbreviations: N/A = Data Not Available; ERCP = Endoscopic retrograde cholangiopancreatography; CHD = Common hepatic duct; LHD = Left hepatic Duct; RHD = Right hepatic duct; R & LHD = Right and Left Hepatic Ducts; R = Right; L = Left; R-en-Y = Roux-en-Y; MVC = Motor vehicle crash; MV versus PED = Motor vehicle versus pedestrian.