1. Isolated aberrant right cysticohepatic duct injury during laparoscopic cholecystectomy: Evaluation and treatment challenges of a severe postoperative complication associated with an extremely rare anatomical variant
- Author
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Dimitrios Kapetanos, Panagiotis Tzitzis, Sofia Papaioannou, Stamatia Dimou, Elena Moschou, K. Vasiliadis, Eleni Lazaridou, Christos Papavasiliou, and Albion Totsi
- Subjects
medicine.medical_specialty ,Bile duct ,business.industry ,Right sectoral bile duct ,Hepaticojejunostomy ,Postoperative complication ,Case Report ,Surgery ,Biliary anatomy ,Laparoscopic cholecystectomy ,Variability in bile duct branching pattern ,medicine.anatomical_structure ,Rare case ,Right posterior ,medicine ,Cystic duct ,General Materials Science ,Rule rather than the exception ,business ,Bile duct injury ,Left Hepatic Duct - Abstract
A typical bile duct branching patterns represent one of the major causes of bile duct injury (BDI) during laparoscopic cholecystectomy (LC). The most common classified variations of bile duct branching, involve the right posterior sectoral duct (RPSD) and its joining with the right anterior or left hepatic duct. Variant bile duct anatomy can rarely be extremely complex and unclassified. This report describes an extremely rare case of an isolated injury to an aberrant right hepatic duct formed by the joining of ducts from segments V, VII, and VIII draining into the cystic duct (cysticohepatic duct) during LC, associated with an inferior RPSD opening to left hepatic duct. Detailed evaluation of both endoscopic and magnetic cholangiograms established the diagnosis. Bile duct injury was subsequently managed surgically by a demanding Roux-en-Y hepaticojejunostomy. This extremely rare case aims to serve as a useful reminder of the consistent inconsistency of biliary anatomy, alerting surgeons to beware of variant bile duct branching patterns during open or LC that constitute a dreadful pitfall for severe and life-threatening bile duct injuries.
- Published
- 2020
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