Journal of

Case Reports and Images in Surgery

 
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Case Report
 
Management of an injured accessory hepatic duct during laparoscopic cholecystectomy: The importance of operative cholangiography
Hayden Andrew Snow1, Aqiq Tulip Chowdhury1, Hai Thanh Bui2
1MBBS, Surgical Registrar, Department of General Surgery, Western Health, Footscray, Victoria, Australia.
2MBBS FRACS, Upper GI Surgeon, Department of General Surgery, Western Health, Footscray, Victoria, Australia.

Article ID: 100001Z12HS2015
doi:10.5348/Z12-2015-1-CR-1

Address correspondence to:
Hayden Andrew Snow
Western Health, Gordon St
Footscray, Victoria 3011
Australia
Phone: +61 408844227

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How to cite this article:
Snow HA, Chowdhury AT, Bui HT. Management of an injured accessory hepatic duct during laparoscopic cholecystectomy: The importance of operative cholangiography. J Case Rep Images Surg 2015;1:1–4.


Abstract
Introduction: We present a case of intra-operative bile duct injury during laparoscopic cholecystectomy. Commonly, this complication would require conversion to an open procedure for repair or biliary-enteric reconstruction. We also review the definitions and implications of extra-hepatic bile duct anomalies.
Case Report: A 30-year-old female undergoing laparoscopic cholecystectomy sustained an intraoperative bile duct injury, suspicious for the right posterior sectoral duct. However, with the employment of operative cholangiography via the injured duct, it was then able to be identified as accessory, rather than aberrant. The duct could then be ligated and divided, and the procedure could be completed laparoscopically without complication.
Conclusion: This case serves as an example of the utility of operative cholangiography, especially when encountering unexpected extrahepatic biliary anatomy. Operative cholangiography allowed safe division of an anomalous hepatic duct and completion of the procedure laparoscopically.

Keywords: Bile Ducts, Extrahepatic cholangiography cholecystectomy, Laparoscopic


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Author Contributions
Hayden Andrew Snow – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Aqiq Tulip Chowdhury – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Hai Thanh Bui – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Hayden Andrew Snow et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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