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At least 19 recordsLinked to original sources
PubMed2000

Laparoscopic cholecystectomy in a patient with a duplicated cystic duct.

Cystic duct duplication with a single gallbladder is one of the most uncommon abnormalities of the biliary tract, with fewer than 15 instances published. The authors describe a 49-year-old patient undergoing a laparoscopic cholecystectomy in whom a second cystic duct was found, initially misdiagnosed as the biliary tract. The cholecystectomy was performed successfully with the aid of intraoperative cholangiography. It is the first time a duplicated cystic duct has been treated successfully using a laparoscopic approach.

Cholecystectomy, Laparoscopic↗
PubMed1999

Anomalous insertion of the right hepatic duct into the cystic duct: report of a case diagnosed before laparoscopic cholecystectomy.

Although an aberrant hepatic duct entering the cystic duct is not especially rare, the main right hepatic duct entering the cystic duct is extremely rare, with only six cases reported thus far. All of the reported patients underwent open cholecystectomy, during which one patient received a bile duct injury. The anomaly was unsuspected preoperatively in all of these cases. We report an additional patient with this anomaly, the first such case diagnosed before laparoscopic cholecystectomy using direct cholangiography. Cholangiography may be mandatory whenever biliary anomalies are suspected during laparoscopic cholecystectomy. As the right hepatic duct entering the cystic duct can lead to ductal injury, this anomaly should be kept in mind when performing laparoscopic cholecystectomy.

Adult↗
PubMed1987

Interposition of the gallbladder--or the absent common hepatic duct and cystic duct.

Interposition of the gallbladder is a rare anomaly, but its diagnosis is important since it represents a surgically correctable cause of jaundice. The patients present with jaundice, abdominal pain and sometimes an enlarged gallbladder. Radiological diagnosis may be difficult since the condition may be mistaken for a choledochal cyst, hydrops of the gallbladder or Caroli's disease. The ultrasound, cholangiogram and surgical findings of dilated intrahepatic ducts adjacent to a normal or enlarged gallbladder with no dilatation of the common bile duct are presented in two children with this condition.

Child, Preschool↗
PubMed1988

Exploration of the common bile duct through the cystic duct.

Formal exploration of the common bile duct through choledochotomy is a standard surgical technique; however, the prevalence of postoperative morbidity and mortality from intraoperative extraction of stones and debris of the common duct remains significant. From 1982 to present, we performed 25 explorations of the common bile duct entirely through the cystic duct in patients in whom duct size was large enough to permit passage of instrumentation greater than 6.5 millimeters in diameter. All instrumentation, including biliary Fogarty balloon-tipped catheterization and fiberoptic choledochoscopy, was used through the cystic duct without difficulty. No complications of bile leakage or stricture formation were encountered, and all patients are doing well at five and one-half years after surgical treatment without known retained stones. The early community hospital experience of this report supports the view that exploration of the common bile duct through a suitably sized cystic duct is a safe, efficient and effective alternative to choledochotomy for exposure of the common bile duct.

Adult↗
PubMed1990

[Obstruction of the common bile duct by a cystic duct cyst in the recipient after liver transplantation].

Four cases of tension mucocele of the cystic duct of the graft after orthotopic liver transplantation have been described in the English literature. We report the case of a mucocele of the recipient's cystic duct occurring in a patient who underwent liver transplantation for sclerosing cholangitis secondary to histiocytosis X. At variance with the 4 previously reported cases, this complication could be related to progression of the initial disease in the recipient's cystic duct. To avoid such a biliary complication in patients undergoing a liver transplantation for sclerosing cholangitis, resection of the extra-hepatic duct must be as large as possible and choledochojejunostomy seems to be the best procedure for biliary reconstruction.

Adolescent↗
PubMed2001

Right hepatic duct emptying into the cystic duct: report of a case.

BACKGROUND: Anomalous insertion of the right hepatic duct into the cystic duct is a rare anatomic variation. At this writing, only nine cases have been reported in the literature. In the patients presenting with this anomaly, the surgeon may accidentally transect the right hepatic duct during cholecystectomy. METHODS: We encountered a case of anomalous insertion of the right hepatic duct into the cystic duct, which was clearly demonstrated in the intraoperative cholangiography during laparoscopic cholecystectomy. RESULTS: As the half-cut point of the cystic duct happened to be on the gallbladder side of the cystic duct, cholecystectomy was accomplished laparoscopically. CONCLUSIONS: In anomalous insertion of the right hepatic duct into the cystic duct, hepatic duct transection could happen. Preoperative precise evaluation of the biliary duct, awareness of potential biliary variations, and identification of all anatomic structures before ligation and division were essential to prevent bile duct injury.

Aged↗
PubMed1987

Cystic malformations of the cystic duct.

While cystic malformations of the main biliary tract are wellknown and classified, it is exceptional to find cystic malformations of the accessory biliary tract (cystic duct). An adolescent aged 15 years and an adult of 49 years were operated for cysts of the cystic duct revealed by associated lesions, a cyst of the common bile-duct and gallbladder stones respectively. Ultrasonography showed cystic lesions which opacification during intravenous cholangiography and endoscopic retrograde cholangiography (EPRC) proved to be related to the cystic duct. The radiography outline of the biliary pathways so obtained served as a guide to the operative procedure, consisting of excision of the accessory biliary tract in both cases combined with resection of the common bile-duct cyst in one case. The radiologic, anatomic and histologic findings distinguished the lesions encountered from other malformations of the accessory biliary tract and confirmed their derivation from the cystic duct.

Adolescent↗
PubMedDate not supplied

Anomalous connection of the right hepatic duct into the cystic duct: utility of magnetic resonance cholangiopancreatography.

A 41-year-old female was admitted to our hospital for treatment of uterus carcinoma. Abdominal ultrasound showed gallbladder stones. Although magnetic resonance cholangiopancreatography revealed the right intrahepatic bile ducts, left hepatic duct and the common bile duct, the confluence of the right and left hepatic ducts was not visualized. At surgery, intra-operative cholangiography showed a biliary anomaly of the right hepatic duct entering the cystic duct. Subsequently cholecystectomy was accomplished without any injury to the bile duct. Our case may be the eighth such case of this rare biliary anomaly. When magnetic resonance cholangiopancreatography does not show the confluence of the right and left hepatic ducts, biliary anomaly of the right hepatic duct should be suspected and careful dissection should be performed from the Hartman's pouch, followed by intraoperative cholangiography, in order to avoid unnecessary injury to the bile duct.

Adult↗
PubMed2003

Three-dimensional identification of the cystic infundibulum-cystic duct junction: a technique for identification of the cystic duct in laparoscopic cholecystectomy.

OBJECTIVE: The main cause of bile duct injury (BDI) at laparoscopic cholecystectomy is misidentification of the common bile duct as the cystic duct (CD). The aim of this article is to introduce a modified technique, i.e., three-dimensional identification of the cystic infundibulum (CI)-CD junction, to prevent misidentification-induced BDI during laparoscopic cholecystectomy. METHODS: The CI was extensively dissected to expose its anterior, interior-superior and inferior-dorsal aspects. With the CI nearly circularly dissected out, the CI and the appearance-indicated CI-CD junction might be three-dimensionally identified and the reality of the CI-CD junction as well as the reality of the CD could be precisely judged. RESULTS: Overall 10 BDIs were documented in this group. Since BDI occurred in 8 of 4382 patients receiving laparoscopic cholecystectomy, the technique for prevention of misidentification-induced BDI was established. Among the late batch of 7618 patients, only two BDIs were noted. CONCLUSIONS: Three-dimensional identification of the CI-CD junction is a reliable, feasible and relatively low experience-dependent technique to prevent most of misidentification-induced BDI.

Adolescent↗