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J Minim Access Surg. 2019 Oct 1. doi: 10.4103/jmas.JMAS_285_18. [Epub ahead of print]

Single-incision laparoscopic cholecystectomy with the right accessory hepatic duct diagnosed preoperatively: A case report.

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1
Department of Surgery, Himeji Medical Center, Himeji, Hyogo, Japan.

Abstract

Accessory hepatic duct or gallbladder duplication is considered to be a risk factor for bile duct injuries and open conversion during laparoscopic cholecystectomy (LC). A 32-year-old woman with epigastric pain was referred to our department. Gallstone disease in the gallbladder was diagnosed by ultrasonography and magnetic resonance cholangiopancreatography. The involvement of an accessory hepatic duct was suspected during endoscopic retrograde cholangiography. Drip infusion cholangiography with computed tomography showed that the cystic duct merged with the accessory right hepatic duct. Single-incision LC (SILC) was successfully performed without bile duct injury. The operative time and intraoperative blood loss were 145 min and 1 mL, respectively. The patient was discharged 3 days' postoperatively, without complications. The involvement of the accessory right hepatic duct is a rare anomaly and is considered to be a risk factor for bile duct injuries. However, obtaining pre-operative images enabled us to perform SILC successfully.

KEYWORDS:

Accessory hepatic duct; drip infusion cholangiography with computed tomography; laparoscopic cholecystectomy; single-incision

PMID:
31571670
DOI:
10.4103/jmas.JMAS_285_18
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