Complete biliary obstruction without jaundice due to an anatomic variation
Bülent Ödemiş1, Aydın Şeref Köksal, Serkan Torun
1Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey. koksalas@yahoo.com.
Insights
Aberrant bile ducts can complicate laparoscopic cholecystectomy, leading to bile duct injury. This case highlights how an intact aberrant duct can mask injury, delaying diagnosis and jaundice development.
Area of Science:
- Hepatobiliary surgery
- Surgical anatomy
- Minimally invasive procedures
Background:
- Aberrant right posterior hepatic ducts occur in 4.8-8.4% of individuals.
- These anatomical variations are a known risk factor for bile duct injury during laparoscopic cholecystectomy.
- Bile duct injury can lead to significant patient morbidity.
Abstract:
An aberrant right posterior hepatic duct is present in 4.8-8.4% of the population. It is one of the causes of bile duct injury during laparascopic cholecystectomy. Herein we present a patient with complete transection of the common hepatic duct during laparascopic cholecystectomy (Stewart-Way class 3). Interestingly, the patient had an intact aberrant right posterior duct draining into the common hepatic duct distal to the obstruction site that prevented early diagnosis of the biliary injury because of drainage of the liver sufficient to prevent the development of jaundice.
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