Common XXXX following laparoscopic cholecystectomy in the setting of sinistroposition of the galladder and biliary confluence: a case report.

@entity1 @entity1087 @entity1157 @entity2963 @entity10584 @entity395
INTRODUCTION: A @entity1157 occurred to a 64-year-old female with highly aberrant bile ducts due to sinistroposition. Methods of potential injury avoidance are discussed. MATERIALS AND METHODS: A @entity1 underwent elective laparoscopic cholecystectomy for symptomatic @entity2963 . A @entity10584 was diagnosed intraoperatively. Three days later, the @entity1 presented with @entity1087 and rising liver function tests. The @entity1 was referred to our institution for suspected @entity1157 . Endoscopic retrograde cholangiopancreatography showed complete occlusion of the common bile duct. A percutaneous transhepatic tube was placed in the bile ducts for decompression. During later operative exploration, a left-sided common hepatic duct was discovered. Review of preoperative imaging confirmed that the right hepatic duct crossed superior to the umbilical portion of the left portal vein and that segment 4 ducts drained into the right anterior sectional bile duct. CONCLUSION: This case describes an @entity395 associated with an injury to the common bile duct during laparoscopic cholecystectomy. Knowledge of the complex and unusual alterations in biliary anatomy, which may accompany sinistroposition of the gallbladder, should aid in avoidance of such injuries in the future.
