Zhao PJ, Ma Y, Yang JW. Laparoscopic cholecystectomy with communicating accessory hepatic duct injury and management: A case report. World J Gastrointest Surg 2024; 16(12): 3870-3874 [DOI: 10.4240/wjgs.v16.i12.3870]
Corresponding Author of This Article
Peng-Ju Zhao, Associate Chief Physician, Department of General Surgery II, The First Affiliated Hospital of Dali University, No. 32 Jiashibo Avenue, Dali 67100, Yunnan Province, China. hardzhpj@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3870-3874 Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3870
Laparoscopic cholecystectomy with communicating accessory hepatic duct injury and management: A case report
Peng-Ju Zhao, Yan Ma, Ji-Wu Yang
Peng-Ju Zhao, Ji-Wu Yang, Department of General Surgery II, The First Affiliated Hospital of Dali University, Dali 671000, Yunnan Province, China
Yan Ma, Department of Rehabilitation Medicine, The First Affiliated Hospital of Dali University, Dali 671000, Yunnan Province, China
Author contributions: Zhao PJ participated in the surgical procedure and collected data; Ma Y supported postoperative management and rehabilitation; Yang JW supervised the surgery and managed the clinical aspects; Zhao PJ, Ma Y, and Yang JW wrote the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng-Ju Zhao, Associate Chief Physician, Department of General Surgery II, The First Affiliated Hospital of Dali University, No. 32 Jiashibo Avenue, Dali 67100, Yunnan Province, China. hardzhpj@163.com
Received: August 21, 2024 Revised: October 17, 2024 Accepted: October 23, 2024 Published online: December 27, 2024 Processing time: 99 Days and 4.2 Hours
Abstract
BACKGROUND
Laparoscopic cholecystectomy is considered the gold standard for the treatment of patients with gallstones. However, bile duct injury is one of the most serious complications of this surgery, with an incidence rate of 0.3%-0.7%. Variations in anatomical structures are one of the main reasons for such injuries.
CASE SUMMARY
We report a 26-year-old male patient who presented with repeated upper abdominal pain for 1 year. Ultrasound examination and blood tests indicated gallstones accompanied by chronic cholecystitis. The patient underwent laparoscopic cholecystectomy. During the surgery, a communicating bile duct connecting the gallbladder neck and the right hepatic duct was discovered and injured. Meticulous dissection identified it as a communicating accessory hepatic duct, which was then definitively ligated. Postoperatively, the patient recovered well, magnetic resonance imaging and magnetic resonance cholangiopancreatography showed no intrahepatic or extrahepatic bile duct strictures. The pathology report showed chronic cholecystitis with gallstones.
CONCLUSION
Carefully manage communicating accessory bile ducts in cholecystectomy using cholangiography or meticulous separation, followed by ligation is effective.
Core Tip: This case report highlights the significance of recognizing and managing accessory hepatic duct injuries during laparoscopic cholecystectomy. Utilizing intraoperative cholangiography or indocyanine green fluorescence cholangiography can help identify biliary anomalies, while expert evaluation by a hepatobiliary surgeon is crucial. For confirmed communicating accessory hepatic ducts, total cholecystectomy with duct ligation offers an effective solution to prevent further complications.
