Bile duct injury in an anatomical variant of the posterior right hepatic duct draining in the cystic duct: case report

Authors

  • José Adrián Yamamoto-Moreno Department of Gastrointestinal Surgery, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, México http://orcid.org/0000-0002-2468-5943
  • Ricardo Gómez-Fernández Department of Gastrointestinal Surgery, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, México
  • Alejandro Steven Iturbide-Aguirre Department of Gastrointestinal Surgery, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, México
  • Jessica Hernández-Sánchez Department of Gastrointestinal Surgery, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, México
  • Gainsborough Gonzalo Cutipa-Flores Department of General Surgery, Hospital General Regional “Dr. Carlos MacGregor Sánchez-Navarro”, Instituto Mexicano del Seguro Social, Mexico City, México

DOI:

https://doi.org/10.18203/2320-6012.ijrms20221996

Keywords:

Strasberg classification, MRCP imaging, Surgical case reports, Biliary tree variants, Post cholecystectomy BDI

Abstract

During laparoscopic cholecystectomy, several factors increase the likelihood of bile duct injury (BDI). The most common cause of BDI during laparoscopic cholecystectomy is an inappropriate identification of the critical view of safety associated with acute and chronic inflammation, obesity, haemorrhage, and anatomical variants. Of all anatomic variants of the biliary tree, Blumgart type F has been reported as the least common, but allegedly it carries the biggest risk of BDI. We present the case of a 45-year-old woman with acute cholecystitis subjected to laparoscopic cholecystectomy with Strasberg type C injury in association with a Blumgart F variation confirmed by magnetic resonance cholangiopancreatography. The anatomical variant was identified during the surgical procedure but the BDI was diagnosed postoperatively. Intraoperative identification and treatment of the injury confers a better prognosis to the patient. Management of a BDI on a Blumgart F variant can be challenging and must be targeted to the individual case. Safety measures to prevent such injuries must be promoted by institutions.

References

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Published

2022-07-27

How to Cite

Yamamoto-Moreno, J. A., Gómez-Fernández, R., Iturbide-Aguirre, A. S., Hernández-Sánchez, J., & Cutipa-Flores, G. G. (2022). Bile duct injury in an anatomical variant of the posterior right hepatic duct draining in the cystic duct: case report. International Journal of Research in Medical Sciences, 10(8), 1782–1785. https://doi.org/10.18203/2320-6012.ijrms20221996

Issue

Section

Case Reports