Laparoscopic cholecystectomy for cholecystitis with biliary tract anomaly, joining the cystic duct and aberrant hepatic duct Sumika TAKAHASHI 1 , Yasuhiro TAKANO 1 , Yuta TAKANO 1 , Hironori KANNO 1 , Toshiaki MORIKAWA 1 , Nobuyoshi HANYU 1 1Department of Surgery, General Tokyo Hospital Keyword: 腹腔鏡下胆囊摘出術 , 胆管走行異常 , 副肝管 pp.293-297
Published Date 2019/7/15
DOI https://doi.org/10.11477/mf.4426200713
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 A 58-year-old man presented with epigastric discomfort, and was diagnosed as having gallstone cholecystitis. Conservative treatment with antibiotics was started and the surgery was planned after 2 months. Preoperative MRCP revealed the cystic duct draining into an aberrant right posterior hepatic duct. We performed laparoscopic cholecystectomy (Lap-C) and were able to separate the cystic duct after exposing the inner layer of the gallbladder subserosa (SS-I) and confirming the aberrant right posterior hepatic duct. Between April 2014 and April 2018, we have performed Lap-C in 77 patients. The cystic duct draining into the right posterior hepatic duct, as in this case, is unusual, and we need to carefully expose the SS-I so as to avoid mistaking between the hepatic duct and cystic duct. Especially in cases with severe inflammation, preoperative imaging examination is useful to avoid biliary tract injury.

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