腹腔鏡下胆囊摘出術中に副肝管を損傷した1例

A case of aberrant bile duct which was jnjured during laparoscopic cholecystectomy

◆要旨：腹腔鏡下胆囊摘出術の際に，術前MRCP検査で同定できなかった副肝管を切離してしまった1例を経験したので報告する．患者は65歳，男性．胆石症の診断で腹腔鏡下胆囊摘出術を施行したが，胆囊管と誤認して，総胆管から副肝管（右後上区域枝）が胆囊管と共通管となって分岐する副肝管（Ⅴ型）を切離したことが判明した．ただちに副肝管と右後上区域枝の端々吻合を行った．本例のように腹腔鏡下胆囊摘出術施行の際には常に副肝管の存在を念頭に置き，Calot三角の剝離（critical view）を十分に得て慎重な手術操作を行うこと，損傷に気がついた場合は修復できる手技を備えておく必要もある．

　We report a case of a 65-year-old man who had an aberrant bile duct which was injured during laparosocopic cholecystectomy（LC）. The presence of this anomaly was not detected preoperatively by MRCP. The important thing to avoid this kind of complication is that we should always keep anatomy like this in mind. The condition of this patient after operation was unevenful due to successful anastomosis of the cut aberrant bile duct during operation.