Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report

Abstract Background Anatomic variants of the biliary tree present challenges to surgical management during laparoscopic cholecystectomy and affect perioperative outcomes. An aberrant right hepatic duct connecting into the cystic duct is a practically important variation because of the susceptibility...

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Main Authors: Keisuke Oyama, Shin Nakahira, Hisataka Ogawa, Kazuya Kato, Makoto Hasegawa, Takayuki To, Ryosuke Maki, Hoshi Himura, Hidemi Nishi, Nobuyoshi Ohhara, Jota Mikami, Yoichi Makari, Ken Nakata, Masaki Tsujie, Junya Fujita
Format: Article
Language:English
Published: Japan Surgical Society 2019-05-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-019-0632-7
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author Keisuke Oyama
Shin Nakahira
Hisataka Ogawa
Kazuya Kato
Makoto Hasegawa
Takayuki To
Ryosuke Maki
Hoshi Himura
Hidemi Nishi
Nobuyoshi Ohhara
Jota Mikami
Yoichi Makari
Ken Nakata
Masaki Tsujie
Junya Fujita
author_facet Keisuke Oyama
Shin Nakahira
Hisataka Ogawa
Kazuya Kato
Makoto Hasegawa
Takayuki To
Ryosuke Maki
Hoshi Himura
Hidemi Nishi
Nobuyoshi Ohhara
Jota Mikami
Yoichi Makari
Ken Nakata
Masaki Tsujie
Junya Fujita
author_sort Keisuke Oyama
collection DOAJ
description Abstract Background Anatomic variants of the biliary tree present challenges to surgical management during laparoscopic cholecystectomy and affect perioperative outcomes. An aberrant right hepatic duct connecting into the cystic duct is a practically important variation because of the susceptibility to serious postoperative refractory bile leakage. We report a successful case of laparoscopic cholecystectomy in the aberrant right hepatic duct of a patient diagnosed with chronic cystitis. Case presentation A 49-year-old man was referred to our department for treatment of chronic cholecystitis. Magnetic resonance cholangiopancreatography indicated that the cystic duct branched from the common bile duct and an aberrant bile duct connected to the cystic duct. Intraoperative cholangiography revealed that the bile duct was not confluent to the major right branch of the intrahepatic bile duct and drained a narrow area. Preoperative magnetic resonance cholangiopancreatography had diagnostic value. Furthermore, intraoperative cholangiography with the Critical View of Safety method was paramount to achieving safe cholecystectomy based on confirmation of the biliary anatomy and the drainage area of the aberrant right hepatic duct. Conclusion We encountered a rare but clinically significant case of laparoscopic cholecystectomy. This case suggests that precise understanding of the anatomy and drainage area of the aberrant right hepatic duct preoperatively and intraoperatively can lead to safe cholecystectomy.
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spelling doaj-art-e988ac6c4dae4483b5e8c800572a5a3b2025-08-20T02:50:59ZengJapan Surgical SocietySurgical Case Reports2198-77932019-05-01511410.1186/s40792-019-0632-7Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case reportKeisuke Oyama0Shin Nakahira1Hisataka Ogawa2Kazuya Kato3Makoto Hasegawa4Takayuki To5Ryosuke Maki6Hoshi Himura7Hidemi Nishi8Nobuyoshi Ohhara9Jota Mikami10Yoichi Makari11Ken Nakata12Masaki Tsujie13Junya Fujita14Department of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterDepartment of Surgery, Sakai City Medical CenterAbstract Background Anatomic variants of the biliary tree present challenges to surgical management during laparoscopic cholecystectomy and affect perioperative outcomes. An aberrant right hepatic duct connecting into the cystic duct is a practically important variation because of the susceptibility to serious postoperative refractory bile leakage. We report a successful case of laparoscopic cholecystectomy in the aberrant right hepatic duct of a patient diagnosed with chronic cystitis. Case presentation A 49-year-old man was referred to our department for treatment of chronic cholecystitis. Magnetic resonance cholangiopancreatography indicated that the cystic duct branched from the common bile duct and an aberrant bile duct connected to the cystic duct. Intraoperative cholangiography revealed that the bile duct was not confluent to the major right branch of the intrahepatic bile duct and drained a narrow area. Preoperative magnetic resonance cholangiopancreatography had diagnostic value. Furthermore, intraoperative cholangiography with the Critical View of Safety method was paramount to achieving safe cholecystectomy based on confirmation of the biliary anatomy and the drainage area of the aberrant right hepatic duct. Conclusion We encountered a rare but clinically significant case of laparoscopic cholecystectomy. This case suggests that precise understanding of the anatomy and drainage area of the aberrant right hepatic duct preoperatively and intraoperatively can lead to safe cholecystectomy.http://link.springer.com/article/10.1186/s40792-019-0632-7Aberrant right hepatic ductLaparoscopic cholecystectomy
spellingShingle Keisuke Oyama
Shin Nakahira
Hisataka Ogawa
Kazuya Kato
Makoto Hasegawa
Takayuki To
Ryosuke Maki
Hoshi Himura
Hidemi Nishi
Nobuyoshi Ohhara
Jota Mikami
Yoichi Makari
Ken Nakata
Masaki Tsujie
Junya Fujita
Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report
Surgical Case Reports
Aberrant right hepatic duct
Laparoscopic cholecystectomy
title Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report
title_full Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report
title_fullStr Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report
title_full_unstemmed Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report
title_short Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report
title_sort successful management of aberrant right hepatic duct during laparoscopic cholecystectomy a rare case report
topic Aberrant right hepatic duct
Laparoscopic cholecystectomy
url http://link.springer.com/article/10.1186/s40792-019-0632-7
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