An Unusual Case of a Rare Anatomic Variation of Billary Ductation during Cholecystomy
Published: 2023-11-17
Page: 581-585
Issue: 2023 - Volume 6 [Issue 2]
Ouhammou Y. *
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
Condé A. Y.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
DJogbe M.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
Kaba I.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
El Allami Y.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
Bakounda C.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
El Absi M.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
ElMahjoub E.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
El Ounani M.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
Amraoui M.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
El Alami E. H.
Visceral Surgical Emergency Department de l’hôpital Ibn Sina de Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Injuries to the biliary tract are a major problem in biliary surgery.
The lack of knowledge of the anatomical variations of the biliary tract is the main reason for this in biliary surgery. These are similar to the injuries to the bile ducts that occur during cholecystectomy.
(1) The incidence of these conditions has risen significantly as a result of the development of new surgical techniques.
Laparoscopic surgery has become the "gold standard" in the treatment of gallstones. This is due to surgeons' experience with open cholecystectomy.
We present the case of a patient undergoing surgery for cholelithiasis. Intraoperative cholangiography revealed a posterior paramedian duct.
Systematic intraoperative cholangiography candetect anatomical variations in the bile ducts, thus avoiding life-threatening trauma to the bile ducts.
Keywords: Bile ducts, anatomical variations, intraoperative cholangiography, cholangio, IRM
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References
Fletcher DR, Hobbs MS, Tan P, et al. Complications of cholecystectomy: Risks of the laparoscopic approach and protective effects of operative cholangiography: a population-based study. Ann Surg. 1999;229:449-457.
Metcalf AM, Ephgrave KS, Dean TR, Paher JW. Preoperative screening with ultrasonography for laparoscopic cholecystectomy: An alternative to routine intraoperative cholangiography. Surgery. 1992;112:813-817.
Echchikhi M, et al. Mise au point sur les variantes anatomiques des voies biliaires extra-hépatiques en cholangio-pancréato-IRM et leurs risques de complicationsFocus on anatomical variants of the extrahepatic bile ducts in cholangio-pancreato-MRI and risks of complications. 2021;4(5):307-316.
Heloury Y, Leborgne J, Rogez JM, Robert R, Lehur PA, Pannier M, et al. Radiological anatomy of the bile ducts based on intraoperative investigation in 250 cases. Anat Clin. 1985;7:93-102.
Taourel P, Bret PM, Reinhold C, Barkun AN, Atri M. Anatomic variants of the biliary tree: Diagnosis with MR cholangiopancreatography. Radiology. 1996;199:521-7.
Tsutsumi S, Hosouchi Y, Shimura T, Asao T, Kojima T, Takenoshita S, et al. Double cystic duct detected by endoscopic retrograde cholangiopancreatography and confirmed by intraoperative cholangiography in laparoscopic cholecystectomy: A case report. Hepatogastroenterology. 2000;47:1266- 8.
Couinaud C. Liver: Anatomical and surgicalstudies Paris, Masson; 1957.
Bismuth H, Mutricy J. Biliary tract anomalies. EMC Tech Chir 40-905Puente SG, Bannura GC. Radiological anatomy of the biliary tract: Variation and congenital abnormalities. World J Surg. 1992,1983;85 :1160-1165
Paineau J, Hamy A, Guguenheim J. Plaies iatrogenes de la voie biliaire outside of hepatic surgery: Monographs of the French Surgical Association, Report presented at the 113th French Surgery Congress, Paris; 5-7 October 2011.
Slaoui Meryem. Trauma to the main biliary tract. Fes thesis; 042/08, 2008.
Neuhaus P, Schmidt SC, Hintze RE. Classification and treatment of bile duct lesions after laparoscopic cholecystectomy. Endoscopic and surgical Chirurg. 2000;71:166-73.
Csendes A, Navarrete C, Burdiles P, Yarmuch J. treatment of common bile duct injuries during laparoscopic cholecystectomy. Endoscopic and surgical management. World J Surg. 2001;25: 1346-51.
Stewart L. et al. Right hepatic artery injury associated with laparoscopic bile duct injury: incidence, mechanism, and consequences » Gastrointest J Surg. 2004;8(5):523-30; discussion 530-1. 48. Lau WY, Lai EC. Classification of iatrogenic bile duct injury. Hepatobiliary Pancreat Dis Int, 2007;6(5):459-63.
Schol FP, Go PM, Gouma DJ. Risk factors for bile duct injury in laparoscopic cholecystectomy: analysis of 49 cases. Br J Surg. 1994;82:565-6.
Siewert JR. Ungeheuer A, Feussner H. Bile duct lesions in laparoscopic cholecystectomy. Chirurg. 1996;67:467.
Bektas H, Schrem H, Winny M, Klempnauer J. « Surgical treatment and outcome of iatrogenic bile duct lesions after cholecystectomy and the impact of different clinical classification systems » Br J Surg. 2007;94(9):1119-27.
McMahon AJ. Bile duct injury and bile leakage in laparoscopic cholecystectomy, Br J Surg. 1995;82(3):307-13.